hemorragic obstetrics

Between 2016 and 2018, twenty maternal deaths were associated with a stroke. The 20 deaths whose main cause was stroke represent 7.4% of all maternal deaths, i.e. a maternal mortality ratio (MMR) of 0.9 per 100,000 live births(95% CI 0, 6-1,3). Among the 20 stroke deaths, it was hemorrhagic in 17 cases (85%), ischemic in 2 cases, and due to thrombophlebitis in 1 case. Stroke occurred during pregnancy in 8 women (40%) - one case before 12 weeks, 3 cases between 28 and 32 weeks, and 4 cases between 34 and 40 weeks; in 3 cases the stroke occurred intrapartum, and for the other 9 cases (45%) the stroke occurred postpartum between Day 1 and Day 15...

Cesarean sections (CS) have become increasingly common in both developed and developing countries, raising legitimate concerns regarding their appropriateness. Since improvement of obstetric care at the hospital level needs quantitative evidence, using routinely collected health data we contrasted the performance of the 11 maternity centres (coded with an alphabetic letter A to L) of an Italian region, Friuli Venezia Giulia (FVG), during 2005-15, after removing the effect of several factors associated with different delivery modes (DM): spontaneous vaginal delivery (SVD), instrumental vaginal delivery (IVD), overall CS (OCS) and urgent/emergency CS (UCS)...

OBJECTIVE: To describe management of a spontaneus rupture of renal angiomyolipoma after cesarean section. DESIGN: Case report. SETTING: Department of Gynaecology and Obstetrics, Hospital Šternbek; Department of Obstetrics and Gynaecology, Palacky University and University Hospital, Olomouc. CASE REPORT: 29-year-old patient underwent acute cesarean section at 35 weeks of gestation for pPROM, placenta praevia marginalis, suspicion of placenta accreta by ultrasound and MRI and transverse position of the fetus...

OBJECTIVE: Introduction: Maternal mortality has always been the main problem in obstetrics worldwide. According to WHO, obstetric hemorrhage is one of the three major causes leading to mortality in 27% of all maternal losses. In Russia, hypotonic hemorrage is the leading cause of maternal mortality, whereas in the developing countries it is usually connected with traumas. However, today modern medicine rejects these ways as ineffective and time-wasting. Instead, doctors use other methods, such as compression hemostatic sutures, controlled balloon tamponade and modern uterotonic drugs...

Women who are carriers for hemophilia are usually considered as safe carriers. However, they can present hemorragic symptoms associated with low factor VIII or IX levels. During pregancy, factor VIII increases whereas factor IX does not. The peripartum period is at risk of increased bleeding in these women. Here are presented reports of clinical data concerning two hemophilia carriers with low factor VIII or IX (30-40%) during the peripartum period. They received remifentanil and ketamine for labor pain management because of contraindication of epidural and spinal analgesia...

INTRODUCTION: Known since over than seventy years, von willebrand disaese is the most common herediary bleeding disorder. This condition was first described by Pr. Willebrand in 1926 in a family with (positive) history of excesive bleeding tendency. Von Willebrand desease is characterized by a lifelong tendency toward easy spontaneous mucosal or post operative bleeding. In females, excessive or prolonged menorrhagia could be a sign of von willebrand desease; symptoms that are often misunderstood to be gynecologic rather than hematologic problem...

OBJECTIVE: To observe analgesic effect of scalp acupuncture on labor. METHODS: Seventy primiparae with term pregnancy and monocyesis were randomly divided into scalp acupuncture group treated by acupuncture at the Shengzhi area of scalp, and control group by no treatment. Pain grades before and after scalp acupuncture were evaluated with the pain 4-grade rating criteria stipulated by WHO, and the active stage and the second birth process, the Apgar scores of new-born and postpartum hemorrage amount were compared between the two groups...

The study of the long-term outcome of extremely premature babies is specially difficult because data in the literature is very heterogeneous. Recruitment (inborn, outborn), type of obstetrical management, and criteria and means used for interrupting curative treatment have varied greatly. We present the outcome of 204 infants born before 28 weeks of gestation between 1992 and 1997. The minimal follow up is 6 years. 82 infants (40.2%) died during the neonatal period. Significantly associated with neonatal death were absence of prenatal steroid course, male gender, elevated lactic acid at birth, and occurrence of pulmonary complications...

Severe head injuries in infants have specific circumstances such as obstetrical injury, battered infant, shaken infant. Pediatric scales must be used for neurological evaluation, the Bicêtre scale being a sensitive index of clinical course. Transfontanellar ultrasound can be useful as first line tool of evaluation of brain injury, but computerized tomography scan is necessary to correctly assess the brain lesions and the presence of hematoma. Hemorragic lesions can rapidly lead to hypovolemic state which must be prevented, or treated without delay...