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uterine atonic

Shinya Matsuzaki, Masayuki Endo, Yutaka Ueda, Kazuya Mimura, Aiko Kakigano, Tomomi Egawa-Takata, Keiichi Kumasawa, Kiyoshi Yoshino, Tadashi Kimura
BACKGROUND: Sheehan's syndrome occurs because of severe postpartum hemorrhage causing ischemic pituitary necrosis. Sheehan's syndrome is a well-known condition that is generally diagnosed several years postpartum. However, acute Sheehan's syndrome is rare, and clinicians have little exposure to it. It can be life-threatening. There have been no reviews of acute Sheehan's syndrome and no reports of successful pregnancies after acute Sheehan's syndrome. We present such a case, and to understand this rare condition, we have reviewed and discussed the literature pertaining to it...
June 14, 2017: BMC Pregnancy and Childbirth
Abd Elaziz A El Refaeey, Hosam Abdelfattah, Alaa Mosbah, Anas M Gamal, Emad Fayla, Waleed Refaie, Abdelhady Zaied, Rafik I Barakat, Amal K Seleem, Mohammed Maher
BACKGROUND: Postpartum hemorrhage is the leading cause of maternal death, uterine atony accounts for 75-90% of primary postpartum hemorrhage. The efficacy of the Uterine compression suture in the treatment of atonic postpartum hemorrhage is time-tested and can be said to be almost established.The aim of this study was to assess the role of the Mansoura-VV uterine compression suture as an early intervention in the management of primary atonic postpartum hemorrhage. METHODS: This prospective observational study included 108 women with primary atonic PPH over a period of 44 months...
May 31, 2017: BMC Pregnancy and Childbirth
Ariela L Marshall, Urshila Durani, Adam Bartley, Clinton E Hagen, Aneel Ashrani, Carl Rose, Ronald S Go, Rajiv K Pruthi
BACKGROUND: Postpartum hemorrhage is a major cause of maternal morbidity and mortality, but the association between postpartum hemorrhage and hospital length of stay has not been rigorously investigated. OBJECTIVE: We explored the impact of postpartum hemorrhage on hospital length of stay and inpatient mortality, as these outcomes have both clinical and economic significance. STUDY DESIGN: We performed a retrospective analysis using data from the National Inpatient Sample database during the 2012 through 2013 time period...
May 11, 2017: American Journal of Obstetrics and Gynecology
Atef M Darwish, Mohamed M Abdallah, Omar M Shaaban, Mohammed K Ali, Mohamed Khalaf, Ali Mohamed A Sabra
OBJECTIVE: To assess the efficacy and safety of condom-loaded Foley's catheter versus Bakri Balloon in the management of primary atonic post partum hemorrhage (PPH) secondary to vaginal delivery. STUDY DESIGN: This study was single blinded randomized controlled trial conducted at Assiut Woman's Health Hospital, Egypt in the period between October 2014 and December 2015. It Comprised 66 women with primary atonic PPH following vaginal delivery. Eligible participants were randomly assigned to Bakri balloon (group A) or condom-loaded Foley's catheter (group B)...
March 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
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
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