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https://www.readbyqxmd.com/read/29153848/-maternal-death-by-stroke-results-from-the-french-enquiry-into-maternal-deaths-2010-2012
#1
H Cohen, M Rossignol
Stroke is a rare event during pregnancy (10/100,000) and can be ischemic (24%), hemorrhagic (74%) or both (2%). Pregnancy probably increases the risk even if it is discussed for arteriovenous malformation (AVM), aneurismal subarachnoid hemorrhage (SAH) and cavernomas. Between 2010 and 2012, 31 maternal deaths were associated with stroke. In 22 cases, stroke was the direct cause of death giving a maternal mortality ratio of 0,9/100,000 witch is not different from the former report (2007-2009). There were 2 cerebral thrombophlebitis, 2 ischemic strokes and 18 hemorrhagic strokes (4 SAH, 2 AVM)...
November 15, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29153617/management-of-a-cornual-ectopic-pregnancy
#2
C Prenaud, S Scherier, B Malgras
Cornual pregnancy is rare. Treatment involves expulsion of the pregnancy and hemostasis of the cornus if required by hemorrhagic rupture. Two techniques are proposed to achieve hemostasis of the uterine cornus, cornuotomy with suture, or corneal resection with salpingectomy, generally laparoscopically.
November 16, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29153056/association-of-retroplacental-blood-with-basal-plate-myofibers
#3
Rachel Wyand, Stewart F Cramer, Assaf Oshri, Debra S Heller
Objectives Diagnosed clinical abruption showing blood clot should be signed out in the pathology report as retroplacental hemorrhage with or without parenchymal indentation, and submitted clot separate from the placenta should be weighed. In our experience, some cases sent as clinical abruptions have been cases of morbid adherence. This study was undertaken to evaluate the association of retroplacental blood with basal plate myofibers (BPMF). Methods One hundred fifty-six placentas reviewed by a board-certified pediatric pathologist at a community hospital were evaluated for significant retroplacental blood...
January 1, 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/29150237/-maternal-deaths-due-to-amniotic-fluid-embolism-results-from-the-french-confidential-enquiry-into-maternal-deaths-2010-2012
#4
E Morau, A Proust, J-C Ducloy
Amniotic fluid embolism (AFE) is an unpredictable, dreadful complication of pregnancy or childbirth. EA typically includes in the same lapse of time respiratory, haemodynamic, neurological and hemorrhagic symptoms (from early and severe coagulopathy). Immediate supportive treatment by a multidisciplinary team is the cornerstone of the management. Between 2010 an 2012 in France, 24 deaths were related to AFE giving a maternal mortality ratio of 1/100,000 live births (CI 95% 0.6-1.4). AFE ranks as the second leading cause of direct maternal death...
November 14, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29147816/development-of-pseudoaneurysm-in-cesarean-section-scar-pregnancy-a-case-report-and-literature-review
#5
Shunki Kiyokawa, Tatsuyuki Chiyoda, Kazunori Ueno, Keiko Saotome, Seon-Hye Kim, Sakura Nakada
Cesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy. It is becoming more common, but it can lead to uterine rupture and severe hemorrhage. Here, we report a case of a 37-year-old woman with CSP complicated with pseudoaneurysm. The pseudoaneurysm emerged following focal injection of methotrexate (MTX) and potassium chloride with systemic MTX treatment. Due to a risk of sudden bleeding, uterine artery embolization (UAE) was recommended, but the patient hoped to avoid this if possible. Because the serum human chorionic gonadotropin level and the gestational sac were still persistent, dilation and curettage were performed with interventional radiologists on standby...
November 16, 2017: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/29147590/paroxysmal-nocturnal-hemoglobinuria-in-pregnancy-a-dilemma-in-treatment-and-thromboprophylaxis
#6
Arpan Patel, Athira Unnikrishnan, Martina Murphy, Robert Egerman, Sarah Wheeler, Ashley Richards, John Wingard
Paroxysmal nocturnal hemoglobinuria (PNH) is a hematologic disorder characterized by an acquired somatic mutation in the phosphatidylinositol glycan class A gene which leads to a higher risk for increased venous and arterial thrombosis. Current treatment for PNH includes eculizumab. Pregnant patients who have PNH have higher risk for thrombosis and hemorrhage with both pregnancy and their underlying PNH. Treatment frequently poses conundrum. The safety and efficacy of eculizumab during pregnancy and breast feeding have not been extensively studied and contraception has been recommended due to potential for teratogenicity...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/29145299/prophylactic-temporary-abdominal-aorta-balloon-occlusion-in-women-with-placenta-previa-accretism-during-late-gestation
#7
Zhongyuan Qiu, Jifen Hu, Jianbo Wu, Lihong Chen
BACKGROUND: To evaluate the clinical efficacy of prophylactic temporary balloon occlusion of the abdominal aorta in patients with placenta previa accretism during cesarean section. METHODS: Twenty-three consecutive patients, prenatally confirmed with placenta previa accretism were retrospectively analyzed in our center from August 2012 to October 2014. All 23 subjects underwent cesarean section with prophylactic balloon occlusion of the abdominal aorta. RESULTS: All of the 23 subjects experienced singleton pregnancies leading to the birth of live infants...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29143329/matsubara-takahashi-cervix-holding-technique-for-massive-postpartum-hemorrhage-in-patients-with-placenta-previa-with-or-without-placenta-accreta-spectrum-disorders
#8
Hironori Takahashi, Akihide Ohkuchi, Rie Usui, Hirotada Suzuki, Yosuke Baba, Shigeki Matsubara
OBJECTIVE: To determine the efficacy and safety of the Matsubara-Takahashi cervix-holding technique (MT-holding) for achieving hemostasis for postpartum hemorrhage (PPH). METHODS: The present retrospective observational study included data from deliveries that occurred between January 1, 2004, and December 31, 2014, at the Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Japan. Deliveries were included where patients experienced blood loss greater than 2500 mL and MT-holding was used...
November 16, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29143222/quantitative-analysis-of-the-level-of-readability-of-online-emergency-radiology-based-patient-education-resources
#9
David R Hansberry, Michael D'Angelo, Michael D White, Arpan V Prabhu, Mougnyan Cox, Nitin Agarwal, Sandeep Deshmukh
PURPOSE: The vast amount of information found on the internet, combined with its accessibility, makes it a widely utilized resource for Americans to find information pertaining to medical information. The field of radiology is no exception. In this paper, we assess the readability level of websites pertaining specifically to emergency radiology. METHODS: Using Google, 23 terms were searched, and the top 10 results were recorded. Each link was evaluated for its readability level using a set of ten reputable readability scales...
November 15, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/29137553/relationship-between-pregnancy-complications-and-psychiatric-disorders-a-population-based-study-with-a-matched-control-group
#10
Christina D Kang-Yi, Sara L Kornfield, C Neill Epperson, David S Mandell
OBJECTIVES: This study sought to identify whether pregnancy complications differ between women with and without a psychiatric disorder diagnosis prior to pregnancy. METHODS: Women who gave birth between 2007 and 2009 in Pennsylvania and were enrolled in Medicaid from one year prior to their pregnancy until their delivery were included (N=9,930); those with psychiatric disorders were compared with a matched control group (N=4,965 for each). Logistic regression analysis estimated the odds of having a pregnancy complication among those with a psychiatric diagnosis prior to pregnancy, adjusting for demographic characteristics and chronic general medical conditions...
November 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29137047/massive-neonatal-intracranial-hemorrhage-caused-by-bromadiolone-a-case-report
#11
Mingsheng Ma, Mengqi Zhang, Xiaoyan Tang, Zhenghong Li
RATIONALE: Bromadiolone, often called a super-warfarin, is a potent rodenticide with long half-life. Skin and mucosal bleeding is the most common clinical manifestations of its intoxication. Bromadiolone intoxications in adults and children have been reported, but this phenomenon is rarely seen in fetuses. This paper presents a case of neonate with massive intracranial hemorrhage mediated by bromadiolone intoxication, highlighting that the bromadiolone is potentially lethal to the fetus...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136018/adverse-obstetric-outcomes-in-pregnant-women-with-uterine-fibroids-in-china-a-multicenter-survey-involving-112-403-deliveries
#12
Rong Zhao, Xin Wang, Liying Zou, Guanghui Li, Yi Chen, Changdong Li, Weiyuan Zhang
OBJECTIVE: To estimate the association between uterine fibroids and adverse obstetric outcomes. METHODS: This was a retrospective cross-sectional study of 112,403 deliveries from 14 provinces and 39 different hospitals in 2011 in mainland China. We compared pregnancy outcomes in women with and without uterine fibroids who underwent detailed second trimester obstetric ultrasonography during 18 to 22 weeks. Obstetric outcomes include cesarean delivery, breech presentation, preterm delivery, placenta previa, placental abruption, premature rupture of membranes and neonatal birthweight...
2017: PloS One
https://www.readbyqxmd.com/read/29135527/venovenous-extracorporeal-membrane-oxygenation-to-prolong-pregnancy-a-case-report
#13
Omar Alyamani, Michael A Mazzeffi, Shobana Bharadwaj, Jessica H Galey, Ruofan Yao, Nirav G Shah, Andrew M Malinow
We report a gravida in fulminant acute respiratory distress syndrome, mechanically ventilated at 27 weeks estimated gestational age, who further deteriorated into severe combined hypercarbic, hypoxemic respiratory failure. At 30 weeks estimated gestational age, she was placed on venovenous extracorporeal membrane oxygenation (ECMO) because of refractory respiratory failure. Her physical status improved without fetal deterioration. She was managed expectantly in an effort to allow continued fetal maturation...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29130675/-severe-adverse-pregnancy-outcomes-in-placenta-previa-and-prior-cesarean-delivery
#14
Mi Zhou, Meng Chen, Li Zhang, Guo-Lin He, Lei He, Qiang Wei, Tao Li, Xing-Hui Liu
OBJECTIVE: To investigate the severe adverse pregnancy outcomes in pregnancies with placenta previa and prior cesarean delivery and its risk factors. METHODS: This retrospective casecontrol study reviewed all pregnancies with placenta previa and prior cesarean delivery delivered by repeat cesarean section in our institution between January 2005 and June 2015,and investigated the incidence of severe adverse pregnancy outcome. A composite of severe adverse pregnancy outcomes (including transfusion of 10 units or more red blood cells,maternal ICU admission,unanticipated injuries,repeat operation,hysterectomy,and maternal death) and other maternal and neonatal outcomes were described...
September 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/29122557/-maternal-deaths-due-to-anesthesia-complications-results-from-the-french-confidential-enquiry-into-maternal-deaths-2010-2012
#15
D Chassard
Over the period 2010-2012, maternal mortality linked to anesthesia accounted for 2% of maternal deaths, with no significant change since 2007-2009. Of the 7 maternal deaths analyzed by the expert committee, anesthetic complications were in 5 cases the main cause of death: 4 attributed to direct causes related to anesthetic procedures during childbirth and 1 to indirect cause in connection with an ENT complication during pregnancy. The anesthetic causes of maternal mortality were for the 2010-2012 period: cardiac arrest under spinal anesthesia during caesarean section, local anesthetic intoxication with unsuccessful resuscitation after cardiac arrest without intralipid administration, acute respiratory distress syndrome in the postpartum period after pulmonary aspiration during caesarean section, cardiac arrest during caesarean section under general anesthesia in a context of non-Hodgkin lymphoma with mediastinal syndrome, unsuccessful endotracheal intubation in a context of cellulitis of the oral cavity floor...
November 6, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29121548/point-of-care-viscoelastic-testing-improves-the-outcome-of-pregnancies-complicated-by-severe-postpartum-hemorrhage
#16
Denis Snegovskikh, Dmitri Souza, Zachary Walton, Feng Dai, Rachel Rachler, Angelique Garay, Victoria V Snegovskikh, Ferne R Braveman, Errol R Norwitz
No abstract text is available yet for this article.
November 6, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29119477/pregnancy-related-deaths-florida-1999-2012-opportunities-to-improve-maternal-outcomes
#17
Leticia E Hernandez, William M Sappenfield, Karen Harris, Deborah Burch, Washington C Hill, Cheryl L Clark, Isaac Delke
Objectives To examine pregnancy-related deaths (PRDs) in Florida, to identify quality improvement (QI) opportunities, and to recommend strategies aimed at reducing maternal mortality. Methods The Florida Pregnancy-Associated Mortality Review (PAMR) Committee reviewed PRDs occurring between 1999 and 2012. The PAMR Committee determined causes of PRDs, identified contributing factors, and generated recommendations for prevention and quality improvement. Information from the PAMR data registry, and live births from Florida vital statistic data were used to calculate pregnancy-related mortality ratios (PRMR) and PRD univariate risk ratios (RR) with 95% confidence intervals (CI)...
November 8, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29114262/in-depth-analysis-of-the-leading-causes-of-maternal-mortality-due-to-cesarean-section-in-iran
#18
Nasrin Changizi, Golnaz Rezaeizadeh, Leila Janani, Mamak Shariat, Abbas Habibelahi
Objective: Despite the declining trend of maternal mortality (MMR) in Iran between 1990 and 2013, direct causes are still the major reasons for maternal death. One of these direct causes is complications of cesarean section (CS). Since the rate of CS in Iran is quite high (47.9%) and the trend continues to rise, there is an alarming threat of the possibility of increasing MMR in the country as a result of cesarean section complications, especially in repeated cases. In this study, we attempted to determine the indications of CS in reported maternal mortality, with special attention to risk factors predisposing to CS and/or to maternal mortality...
March 2017: Journal of Family & Reproductive Health
https://www.readbyqxmd.com/read/29112665/long-term-risk-of-a-seizure-disorder-after-eclampsia
#19
Kara A Nerenberg, Alison L Park, Simone N Vigod, Gustavo Saposnik, Howard Berger, Michelle A Hladunewich, Shital Gandhi, Candice K Silversides, Joel G Ray
OBJECTIVE: To evaluate the incidence rate and relative risk of a seizure disorder after eclampsia. METHODS: We evaluated 1,565,733 births in a retrospective data linkage cohort study in Ontario, Canada, from April 1, 2002, to March 31, 2014. We included females aged 15-50 years and excluded patients with epilepsy, conditions predisposing to seizure, and those who died within 30 days of the delivery discharge date. The exposure was defined as a hypertensive disorder of pregnancy, namely 1) eclampsia, 2) preeclampsia, or 3) gestational hypertension...
November 3, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29110976/emergency-medicine-myths-ectopic-pregnancy-evaluation-%C3%A2-risk%C3%A2-factors-and-presentation
#20
Jennifer J Robertson, Brit Long, Alex Koyfman
BACKGROUND: Ectopic pregnancy (EP) is an important cause of morbidity and mortality in females of reproductive age. Proper diagnosis and treatment are critical, as complications such as rupture, hemorrhagic shock, and even death can occur. OBJECTIVE: EP is a condition emergency physicians are trained to detect, yet there are multiple myths concerning its evaluation and diagnosis. This article reviews several of these myths in order to improve emergency department (ED) evaluation and diagnosis...
October 27, 2017: Journal of Emergency Medicine
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