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https://www.readbyqxmd.com/read/28325580/perinatal-death-investigations-what-is-current-practice
#1
REVIEW
J W Nijkamp, N J Sebire, K Bouman, F J Korteweg, J J H M Erwich, S J Gordijn
Perinatal death (PD) is a devastating obstetric complication. Determination of cause of death helps in understanding why and how it occurs, and it is an indispensable aid to parents wanting to understand why their baby died and to determine the recurrence risk and management in subsequent pregnancy. Consequently, a perinatal death requires adequate diagnostic investigation. An important first step in the analysis of PD is to identify the case circumstances, including relevant details regarding maternal history, obstetric history and current pregnancy (complications are evaluated and recorded)...
March 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28324223/adverse-neonatal-and-maternal-outcome-following-vacuum-assisted-vaginal-delivery-does-indication-matter
#2
Lina Salman, Amir Aviram, Eyal Krispin, Arnon Wiznitzer, Rony Chen, Rinat Gabbay-Benziv
PURPOSE: To estimate the impact of indication for vacuum-assisted vaginal delivery on neonatal and maternal adverse outcome. METHODS: Retrospective analysis of women carrying singleton-term pregnancies undergoing vacuum-assisted vaginal delivery in a tertiary hospital (2007-2014). Cohort was stratified by indication: non-reassuring fetal heart rate or prolonged second stage. Primary outcome was adverse neonatal outcome and secondary outcome was maternal morbidity...
March 21, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#3
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28322870/painless-bilateral-visual-loss-in-a-33-year-old-woman-with-severe-arterial-hypotension
#4
Olaia Subirà, Silvia Muñoz, Juan José Sánchez, Paloma Puyalto, Andrew G Lee
A 32-year-old woman experienced dizziness and headache for 5 months. She also complained of painless, progressive bilateral visual loss for several weeks. Prior to developing the initial symptoms, she had an uncomplicated pregnancy except for dizziness and systemic hypotension during the first term. Fundus examination disclosed prominent retinal arteries, as well diffuse microaneurysms, widespread intraretinal hemorrhages, and hyperemic optic discs. Brain magnetic resonance imaging revealed multiple supratentorial white matter lesions suggestive of ischemic strokes...
March 16, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28321338/frequency-risk-factors-and-adverse-fetomaternal-outcomes-of-placenta-previa-in-northern-tanzania
#5
Elizabeth Eliet Senkoro, Amasha H Mwanamsangu, Fransisca Seraphin Chuwa, Sia Emmanuel Msuya, Oresta Peter Mnali, Benjamin G Brown, Michael Johnson Mahande
Background and Objective. Placenta previa (PP) is a potential risk factor for obstetric hemorrhage, which is a major cause of fetomaternal morbidity and mortality in developing countries. This study aimed to determine frequency, risk factors, and adverse fetomaternal outcomes of placenta previa in Northern Tanzania. Methodology. A retrospective cohort study was conducted using maternally-linked data from Kilimanjaro Christian Medical Centre birth registry spanning 2000 to 2015. All women who gave birth to singleton infants were studied...
2017: Journal of Pregnancy
https://www.readbyqxmd.com/read/28318214/preterm-labor-prevention-and-management
#6
Kristen Rundell, Bethany Panchal
In the United States, preterm delivery is the leading cause of neonatal morbidity and is the most common reason for hospitalization during pregnancy. The rate of preterm delivery (before 37 weeks' gestation) has been declining since 2007. Clinical diagnosis of preterm labor is made if there are regular contractions and concomitant cervical change. Less than 10% of women with a clinical diagnosis of preterm labor will deliver within seven days of initial presentation. Women with a history of spontaneous preterm delivery are 1...
March 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28304315/using-antifibrinolytics-in-the-peripartum-period-concern-for-a-hypercoagulable-effect
#7
H K Ahmadzia, E L Lockhart, S M Thomas, I J Welsby, M R Hoffman, A H James, A P Murtha, G K Swamy, C A Grotegut
INTRODUCTION: Although antifibrinolytic agents are used to prevent and treat hemorrhage, there are concerns about a potential increased risk for peripartum venous thromboembolism. We sought to determine the impact of tranexamic acid and ɛ-aminocaproic acid on in vitro clotting properties in pregnancy. METHODS: Blood samples was obtained from healthy pregnant, obese, and preeclamptic pregnant women (n = 10 in each group) prior to delivery as well as from healthy non-pregnant controls (n = 10)...
March 16, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28292635/value-of-round-ligament-artery-embolization-in-the-management-of-postpartum-hemorrhage
#8
Grégoire Leleup, Audrey Fohlen, Anthony Dohan, Lara Bryan-Rest, Vincent Le Pennec, Olivier Limot, Olivier Le Dref, Philippe Soyer, Jean-Pierre Pelage
PURPOSE: To evaluate the feasibility and efficacy of embolization of the round ligament arteries in the management of postpartum hemorrhage. MATERIALS AND METHODS: Eleven women (mean age, 31 y) underwent round ligament artery because of persistent or recurrent hemorrhage after initial uterine or internal iliac artery embolization. RESULTS: A total of 16 round ligament arteries were embolized. The round ligament artery arose from the inferior epigastric artery in 11 cases (69%) and directly from the external iliac artery in 5 (31%)...
March 11, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28291126/strategies-to-reduce-blood-product-utilization-in-obstetric-practice
#9
Holger Neb, Kai Zacharowski, Patrick Meybohm
PURPOSE OF REVIEW: Patient blood management (PBM) aims to improve patient outcome and safety by reducing the number of unnecessary RBC transfusions and vitalizing patient-specific anemia reserves. Although PBM is increasingly recognized as best clinical practice in elective surgery, implementation of PBM is restrained in the setting of obstetrics. This review summarizes recent findings to reduce blood product utilization in obstetric practice. RECENT FINDINGS: PBM-related evidence-based benefits should be urgently adopted in the field of obstetric medicine...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28290978/a-30-year-old-female-found-to-have-a-couvelaire-uterus-with-placenta-accreta-during-planned-cesarean-delivery
#10
Omici N Uwagbai, Arthur C Wittich
A case of Couvelaire uterus with placenta accreta found during scheduled repeat low transverse Cesarean section will be discussed within this article. First described in the 1900s, Couvelaire syndrome, also known as uteroplacental apoplexy, is a rare form of nonfatal placenta abruption complication. The case involves a 30-year-old gravida 3 para 2 otherwise healthy female with an uncomplicated pregnancy and two previous cesarean deliveries without complication. She received routine prenatal care. During her pregnancy, she did not experience any symptoms such as vaginal bleeding or abdominal pain...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28286684/prenatal-and-peripartum-management-of-patients-with-hypofibrinogenemia-resulted-in-two-successful-deliveries
#11
Yuko Teraoka, Hiroshi Miyoshi, Kumi Oshima, Satoshi Urabe, Norifumi Tanaka, Yoshiki Kudo
Fibrinogen is an essential agent involved in maintaining pregnancy and coagulation. Since inherited fibrinogen disorders introduce greater risks for conditions such as placental abruption and postpartum hemorrhage, careful prenatal and perinatal management is essential for this patient population. We report two cases of successful deliveries in patients with hypofibrinogenemia. Case 1 is of a 26-year-old (gravida 1, para 1) woman. The patient's fibrinogen level increased spontaneously to higher than 300 mg/dL during pregnancy, without treatment...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28284179/research-on-the-expression-of-integrin-%C3%AE-3-and-leukaemia-inhibitory-factor-in-the-decidua-of-women-with-cesarean-scar-pregnancy
#12
Zhi-Da Qian, Yue Weng, Chun-Fen Wang, Li-Li Huang, Xiao-Ming Zhu
BACKGROUND: Cesarean scar pregnancy (CSP) is a late serious complication of cesarean section. There has been an increase in the incidence of CSP worldwide in recent years. It's a life-threatening condition because of the high risk of uncontrolled hemorrhage and uterine rupture. The mechanism of CSP is still unclear. The endometrial receptivity might be different in the cesarean scar between CSP and normal pregnancies. Endometrial expression of integrin β3 and LIF positively correlates with endometrial receptivity and embryo implantation...
March 11, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28283263/impact-of-oocyte-donation-on%C3%A2-perinatal-outcome-in-twin-pregnancies
#13
Lucie Guilbaud, Pietro Santulli, Eva Studer, Vanessa Gayet, François Goffinet, Camille Le Ray
OBJECTIVE: To compare perinatal outcomes of twin pregnancies after oocyte donation (OD), in vitro fertilization (IVF) with autologous oocyte (AO), and non-IVF conception. DESIGN: Five-year retrospective cohort study. SETTING: Tertiary university medical center. PATIENT(S): All patients with twin pregnancies who gave birth after 24 weeks of gestation. The outcomes of 102 OD twin pregnancies were compared with those of 201 AO and 369 non-IVF twin pregnancies...
March 7, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28279445/a-comprehensive-analysis-of-continuous-epidural-analgesia-s-effect-on-labor-and-neonates-in-maternal-hypertensive-disorder-patients
#14
Bin Han, Mingjun Xu
BACKGROUND: Maternal hypertensive disorder is one of the most common and severe medical complications during pregnancy. Epidural analgesia administration is widely used during labor process. AIM: To evaluate the potential advantage or disadvantage of continuous epidural analgesia's on labor and neonates for maternal hypertensive disorder patients comprehensively. METHODS: We have retrospectively analyzed 232 patients who diagnosed as maternal hypertensive disorder in our hospital since 2015...
January 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/28277324/risk-factors-for-severe-postpartum-hemorrhage-after-cesarean-delivery-case-control-studies
#15
Alexander J Butwick, Bharathi Ramachandran, Priya Hegde, Edward T Riley, Yasser Y El-Sayed, Lorene M Nelson
BACKGROUND: Women who undergo intrapartum caesarean delivery (CD) are at increased risk of postpartum hemorrhage (PPH) compared with those undergoing prelabor CD. To determine whether the presence and strength of the associations between individual risk factors and severe PPH vary among women undergoing prelabor CD or intrapartum CD, stratified analyses are needed according to CD subtype. METHODS: To identify risk factors for severe PPH within 2 distinct CD populations, prelabor CD and intrapartum CD, we performed 2 case-control studies...
March 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28272076/hypopituitarism-presenting-as-congestive-heart-failure
#16
S Giri, P Bansal, S Malik, R Bansal
Sheehan's syndrome (SS) develops as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage and is characterized by various degrees of hypopituitarism. Although the occurrence of SS is now rare, it should still be considered in any woman with a history of peripartum hemorrhage who develops manifestations of pituitary hormone deficiency any time following the event. Appropriate hormone replacement therapy results in marked clinical improvement. We present an unusual case of SS in a young lady who continued to have normal menstruation after the index event, had two spontaneous pregnancies, and was diagnosed only 11 years later when she presented to us with acute heart failure...
March 3, 2017: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/28271663/vascular-complications-following-prophylactic-balloon-occlusion-of-the-internal-iliac-arteries-resolved-by-successful-interventional-thrombolysis-in-a-patient-with-morbidly-adherent-placenta
#17
Ning Zhang, Wei-Hua Lou, Xue-Bin Zhang, Jia-Ning Fu, Yun-Yan Chen, Zhi-Guo Zhuang, Jian-Hua Lin
The increasing incidence of morbidly adherent placenta (MAP) is placing women at a higher risk of life-threatening massive hemorrhage. The involvement of interventional radiology to manage this complex condition by performing prophylactic iliac artery balloon occlusion has been reported recently. However, the effectiveness and safety of this technique have not been fully determined. Here we report the case of a 25-year-old woman with placenta increta with preemptive bilateral internal iliac artery balloons who had external iliac artery thrombosis detected by computed tomography angiography (CTA) 72 h post cesarean section...
2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28270117/antepartum-complications-and-perinatal-mortality-in-rural-bangladesh
#18
Rasheda Khanam, Saifuddin Ahmed, Andreea A Creanga, Nazma Begum, Alain K Koffi, Arif Mahmud, Heather Rosen, Abdullah H Baqui
BACKGROUND: Despite impressive improvements in maternal survival throughout the world, rates of antepartum complications remain high. These conditions also contribute to high rates of perinatal deaths, which include stillbirths and early neonatal deaths, but the extent is not well studied. This study examines patterns of antepartum complications and the risk of perinatal deaths associated with such complications in rural Bangladesh. METHODS: We used data on self-reported antepartum complications during the last pregnancy and corresponding pregnancy outcomes from a household survey (N = 6,285 women) conducted in Sylhet district, Bangladesh in 2006...
March 7, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28267932/hemoglobin-is-a-vital-determinant-of-arterial-oxygen-content-in-hypoxemic-patients-with-pulmonary-arteriovenous-malformations
#19
Abeer Rizvi, Patricia Macedo, Lydia Babawale, Hannah C Tighe, J Michael B Hughes, James E Jackson, Claire L Shovlin
RATIONALE: Arterial partial pressure of oxygen (PaO2), and oxygen saturation (SaO2) are commonly measured in respiratory practice, but arterial oxygen content (CaO2) refers to the volume of oxygen delivered to the tissues per unit blood volume. CaO2 is calculated from SaO2 and the hemoglobin concentration in blood, recognizing that each gram of hemoglobin can transport approximately 1.34mls of oxygen when fully saturated. OBJECTIVES: To prospectively evaluate serial changes in CaO2 in man, incorporating and excluding dynamic changes to oxygenation and hemoglobin parameters that may occur during life...
March 7, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28267444/a-multicenter-prospective-study-of-neonatal-outcomes-at-less-than-32-weeks-associated-with-indications-for-maternal-admission-and-delivery
#20
Thomas J Garite, C Andrew Combs, Kimberly Maurel, Anita Das, Kevin Huls, Richard Porreco, Dale Reisner, George Lu, Melissa Bush, Bruce Morris, April Bleich
BACKGROUND: Counseling for patients with impending premature delivery has been traditionally based primarily on the projected gestational age at delivery. There are limited data regarding how the indications for the preterm birth affect the neonatal outcome and whether this issue should be taken into account in decisions regarding management and patient counseling. OBJECTIVE: We performed a prospective study of pregnancies resulting in premature delivery at less than 32 weeks to determine the influence of both the Indications for Admission and their associated Indications for Delivery on neonatal mortality and complications of prematurity...
March 3, 2017: American Journal of Obstetrics and Gynecology
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