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uterine atonic

Denis J Crankshaw, David A Crosby, John J Morrison
KIR7.1, an inwardly rectifying K(+) channel, plays a critical role in regulating uterine excitability during pregnancy and has been suggested as a potential new target for the treatment of conditions arising from dysfunctional uterine contractility, for example, atonic postpartum hemorrhage. The aim of this study was to investigate the effects of the selective KIR7.1 blocker, VU590, on both spontaneous and agonist-stimulated contractions of human pregnant myometrium in vitro. At a concentration of 20 µmol/L, VU590 significantly increased the mean contractile force and the frequency of spontaneous contractions ( P < 0...
January 1, 2017: Reproductive Sciences
M Vijayasree
Background Postpartum Haemorrhage causes significant maternal mortality and morbidity all over the world. Active management of the third stage of labour with oxytocics is come into practice. If postpartum haemorrhage is anticipated conservative surgical procedures like B-lynch suture is being applied. Objective To evaluate the effect of elective B-Lynch suture in preventing atonic postpartum haemorrhage during emergency caesarian section with high risk factors for atonicity. Method Forty antenatal women undergoing emergency caesarean section with risk factors for atony of the uterus were selected in our study...
January 2016: Kathmandu University Medical Journal (KUMJ)
Mohamed Kandeel, Zakaria Sanad, Hamed Ellakwa, Alaa El Halaby, Mohamed Rezk, Ibrahim Saif
OBJECTIVE: To evaluate uterine balloon tamponade using a condom catheter for the management of early postpartum hemorrhage (PPH). METHODS: In a prospective observational study at Menoufia University Hospital, Shebin Elkom, Egypt, women with early PPH were enrolled between May 2011 and September 2012. Uterine balloon tamponade with a condom catheter was applied in women who were unresponsive to uterotonics and bimanual compression; patients with successful catheter placement were included in analyses...
December 2016: International Journal of Gynaecology and Obstetrics
M El-Sokkary, K Wahba, Y El-Shahawy
BACKGROUND: To assess the effectiveness of the new modified technique in order to control bleeding in women presenting with atonic, flabby uterus compared to the most commonly described technique of classic B-Lynch suture. METHOD: This study included 160 women of uncontrolled atonic postpartum hemorrhage delivered by cesarean section at Ain Shams University Maternity Hospital between January 2013 and October 2015. Participants were randomly assigned following simple randomization procedures (computerized random numbers) and divided into two groups...
August 27, 2016: BMC Pregnancy and Childbirth
John J Morrison, David A Crosby, Denis J Crankshaw
Uterine atony is a major cause of postpartum haemorrhage and maternal mortality. However, the comparative pharmacology of agents used to treat this condition is poorly understood. This study evaluates, using human pregnant myometrium in vitro, a range of contractile parameters for agents used in the clinical treatment of atonic postpartum haemorrhage. The effects of oxytocin, carbetocin, ergometrine, carboprost, syntometrine and misoprostol were investigated in 146 myometrial strips from 19 donors. The potency and maximal response values were obtained, and compared, using both maximal amplitude and mean contractile force as indices of contraction...
October 15, 2016: European Journal of Pharmacology
A Nishikawa, S Matsuzaki, K Mimura, T Kanagawa, T Kimura
PURPOSE: The influence of the B-Lynch suture technique on subsequent fertility and pregnancy outcomes is not clear. In the present report, the authors describe the case of a very short interpregnancy interval following the successful placement of a B-lynch suture and discuss the associated problems. MATERIALS AND METHODS: A 33-year-old-woman underwent cesarean section after undergoing artificial induction of labor and subsequent atonic postpartum hemorrhage. Placement of a B-Lynch brace suture successfully stopped the bleeding and preserved the uterus...
2016: Clinical and Experimental Obstetrics & Gynecology
Guang-Tai Li, Guang-Rui Li, Hong-Mei Xu, Bao-Ping Wu, Xiao-Nian Wang
OBJECTIVE: To observe the efficacy and safety of a uterine folding hemostatic technique in controlling atonic postpartum hemorrhage (PPH) during cesarean delivery. METHODS: Thirty-nine women with severe postpartum bleeding from uterine inertia, which did not react to conventional initial management protocols, underwent a uterine folding hemostasis. The procedure was to fold the uterine fundus onto the anterior wall of the corpus uterus using an absorbable suture that thread tautly through the inner myometrial layer of the uterus 1-3 cm below the fundus (not entered into uterine cavity) and 1-2 cm above and below the CS incision (entered into uterine cavity 2-4 cm medal to bilateral border of the uterus)...
October 2016: Archives of Gynecology and Obstetrics
Jaya Chawla, D Arora, Mohini Paul, Sangita N Ajmani
OBJECTIVES: We sought to determine the frequency, demographic characteristics, indications, and feto-maternal outcomes associated with emergency peripartum hysterectomy in an easily accessible urban center. METHODS: We conducted a retrospective, observational, and analytical study over a period of eight years, from August 2006 to July 2014. A total of 56 cases of emergency obstetric hysterectomy (EOH) were studied in the Department of Obstetrics and Gynecology, Kasturba Hospital, New Delhi...
May 2015: Oman Medical Journal
E Schneck, V Mann, C Körner, A Jost, J Thul, J B Engel, M F Müller
Adults suffering from congenital heart diseases (CHD) represent a challenge to anesthesiologists because of the diverse pathologies, complex pathophysiology and special treatment strategies. Due to improved therapeutic options for CHD, patient quality of life and life expectancy is increasing, leaving them as a growing population including pregnant patients with CHD. This article presents the main principles of the pathophysiology and anesthesiological management of pregnant patients living with a Fontan circulation based on a case report, which was complicated by an aortic coarctation and atonic uterine hemorrhage...
July 2015: Der Anaesthesist
Sharda Brata Ghosh, Y M Mala
Objective. The most commonly described technique of modified B-Lynch suture may not be suitable for all the patients presenting with flabby, atonic uterus. Study Design. A retrospective analysis of twelve patients with uncontrolled postpartum haemorrhage, who underwent this procedure from March 2007 to September 2012, was conducted. In this novel technique, sutures are passed in the lower uterine segment and are tightened alternately to control uterine bleeding. Results. Average duration of the procedure was 4 minutes (range 2-7 minutes)...
2015: Obstetrics and Gynecology International
K S Joseph, Odile Sheehy, Azar Mehrabadi, Marcelo L Urquia, Jennifer A Hutcheon, Michael Kramer, Anick Bérard
BACKGROUND: Rates of postpartum haemorrhage and atonic postpartum haemorrhage have increased in several high-income countries. We carried out a study to examine if drug use in pregnancy, or drug and other interactions, explained this increase in postpartum haemorrhage. METHODS: The linked administrative and hospital databases of the Québec Pregnancy Cohort were used to define a cohort of pregnant women in Québec, Canada, from 1998 to 2009 (n = 138,704). Case-control studies on any postpartum haemorrhage and atonic postpartum haemorrhage were carried out within this population, with up to five controls randomly selected for each case after matching on index date and hospital of delivery (incidence density sampling)...
May 2015: Paediatric and Perinatal Epidemiology
Maija Jakobsson, Anna-Maija Tapper, Lotte Berdiin Colmorn, Pelle G Lindqvist, Kari Klungsøyr, Lone Krebs, Per E Børdahl, Karin Gottvall, Karin Källén, Ragnheiður I Bjarnadóttir, Jens Langhoff-Roos, Mika Gissler
OBJECTIVE: To assess the prevalence and risk factors of emergency peripartum hysterectomy. DESIGN: Nordic collaborative study. POPULATION: 605 362 deliveries across the five Nordic countries. METHODS: We collected data prospectively from patients undergoing emergency peripartum hysterectomy within 7 days of delivery from medical birth registers and hospital discharge registers. Control populations consisted of all other women delivering on the same units during the same time period...
July 2015: Acta Obstetricia et Gynecologica Scandinavica
Guang Tai Li, Xiao Fan Li, Ji Li, Ya Jing Liu, Hong Mei Xu
BACKGROUND/AIMS: Postpartum hemorrhage (PPH) is a life-threatening condition with a worldwide occurrence. The purpose of this study is to evaluate the efficacy and safety of a reflexed compression suture in controlling severe atonic PPH with placenta accreta. METHODS: Eleven women with severe PPH due to uterine inertia or placenta accreta were administered the reflexed compression suture. The procedure was to reflex the fundus onto the anterior wall of the uterus for compressing hemostasis and to form a 'belt-like' binding suture to reinforce the effectiveness of pressing the myometrium...
2015: Gynecologic and Obstetric Investigation
Guang Tai Li, Xiao Fan Li, Ya Jing Liu, Wei Li, Hong Mei Xu
OBJECTIVE: To evaluate the efficacy and safety of a symbol "&" compression suture technique in controlling severe atonic postpartum hemorrhage with placenta previa accreta during cesarean delivery. METHODS: Nine women with heavy postpartum bleeding from uterine inertia and placenta previa percret, which did not react to conventional initial management protocols, were underwent the suture in the shape of symbol "&" in China Meitan General Hospital. The suture procedure was to staple the anterior and posterior walls (of the lower uterine segment as well as corpus uterus) together using number 1 chromic catgut, with a cross at about 2 cm above the upper boundary of lower uterine segment...
February 2015: Archives of Gynecology and Obstetrics
Ghazala Mahmud, Kiran Javaid, Nasira Tasnim, Arfa Tabassum, Kausar Tasneem Bangash
OBJECTIVE: To compare the safety and efficacy of 10 units of intravenous syntocinon alone with 10 units intravenous syntocinon and 0.25 mg intramuscular ergometrine in the prevention of atonic uterine haemorrhage during caesarean section. METHOD: The quasi-experimental study was conducted at the Maternal and Child Health Centre, Unit I, Pakistan Institute of Medical Sciences, Islamabad, from November 1, 2010 to February 28, 2011. All women undergoing caesarean section were included in the study...
August 2014: JPMA. the Journal of the Pakistan Medical Association
Akie Takebayashi, Fuminori Kimura, Akiyoshi Yamanaka, Akimasa Takahashi, Shunichiro Tsuji, Tetsuo Ono, Shoji Kaku, Nobuyuki Kita, Kentaro Takahashi, Hidetoshi Okabe, Takashi Murakami
Every year, 14 million cases of obstetric hemorrhage occur worldwide, causing 127,000 maternal deaths. About 75% of postpartum hemorrhage cases are due to atonic uterus, which is loss of uterine muscular tone or strength for contraction of the uterus after delivery. The prediction of atonic uterus is therefore important for the prevention of postpartum maternal death. However, prediction of occurrence of atonic uterus is difficult before delivery, because the precise pathophysiological mechanism to trigger this condition remains unclear...
2014: Tohoku Journal of Experimental Medicine
Brian T Bateman, Lawrence C Tsen, Jun Liu, Alexander J Butwick, Krista F Huybrechts
BACKGROUND: The incidence of postpartum hemorrhage due to uterine atony has increased significantly in the United States during the past decade. For patients with refractory uterine atony after oxytocin administration, second-line uterotonics including methylergonovine maleate, carboprost, and misoprostol are recommended. In this study, we describe hospital-level patterns of second-line uterotonic use in a large, nationwide sample of admissions for childbirth in the United States. METHODS: The Premier Research Database was used to define a cohort of 2,180,916 patients hospitalized for delivery at 1 of 367 hospitals from 2007 to 2011...
December 2014: Anesthesia and Analgesia
Anne Saxton, Kathleen Fahy, Carolyn Hastie
BACKGROUND: The importance of optimising maternal/baby psychophysiology has been integrated into contemporary midwifery theories but not in the detail required to really understand the underpinning biological basis. METHOD: The functioning of the autonomic nervous system, as it relates to the uterus is reviewed. The physiology of myometrial cell contraction and relaxation is outlined. The main focus is on the factors that affect the availability and uptake of oxytocin and adrenaline/noradrenaline in the myometrial cells...
December 2014: Women and Birth: Journal of the Australian College of Midwives
Jasmina Begum, P Pallave, Seetesh Ghose
Postpartum haemorrhage is a leading cause of global maternal mortality and morbidity, accounting for 25-30% of all maternal deaths, and 75-90% of these casualties result from uterine atony. Uterine compressive sutures are a well established measure for control of haemorrhage following atonic postpartum haemorrhage, when medical and nonmedical interventions fail. Here, we are reporting a case of secondary infertility in a 24-year-old lady who had undergone an elective caesarean section for central placenta previa in her first pregnancy...
April 2014: Journal of Clinical and Diagnostic Research: JCDR
Ihab Serag Allam, Ihab Adel Gomaa, Hisham Mohamed Fathi, Ghada Fathi Mahmoud Sukkar
PURPOSE: To estimate the incidence of emergency peripartum hysterectomy over 6 years in Ain-shams University Maternity Hospital. METHODS: Detailed chart review of all cases of emergency peripartum hysterectomy, 2003-2008, including previous obstetric history, details of the index pregnancy, indications for emergency peripartum hysterectomy, outcome of the hysterectomy and infant morbidity. RESULTS: The overall rate of emergency peripartum hysterectomy was 149 of 66,306 or 2...
November 2014: Archives of Gynecology and Obstetrics
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