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Post partum hemorrhage

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https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#1
C McDonald, J Laurie, S Janssens, C Zazulak, P Kotze, K Shekar
Mortality during pregnancy in a well-resourced setting is rare, but acute pulmonary embolism is one of the leading causes. We present the successful use of extracorporeal cardiopulmonary resuscitation (eCPR) in a 22-year old woman who experienced cardiopulmonary collapse following urgent caesarean section in the setting of a sub-massive pulmonary embolus. Resources and personnel to perform eCPR were not available at the maternity hospital and were recruited from an adjacent pediatric hospital. Initial care used low blood flow extracorporeal membrane oxygenation (ECMO) with pediatric ECMO circuitry, which was optimized when the team from a nearby adult cardiac hospital arrived...
January 9, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28182668/cross-sectional-study-of-mode-of-delivery-and-maternal-and-perinatal-outcomes-in-mainland-china
#2
Lei Hou, Susan Hellerstein, Allison Vitonis, Liying Zou, Yan Ruan, Xin Wang, Weiyuan Zhang
BACKGROUND: Cesarean delivery (CD) rates have risen globally with nearly 50% of the non-indicated CDs worldwide in China and Brazil. In China's One Child Policy era (1979-2015) most deliveries were women having their only child. Family size is a major determinant of the safety of medically non-indicated CD or CD on maternal request. The goal of this study is to document CD rates, indications, and analyze the relative safety of non-indicated CD compared to SVD and intrapartum CD. METHODS: Univariate and multivariate logistic regression analyses of the association between mode of delivery and short-term maternal and perinatal outcomes were performed on a cross-section of all deliveries at 39 hospitals in 14 provinces of China in 2011, presented as adjusted odds ratio (aOR), 99% confidence intervals (CI)...
2017: PloS One
https://www.readbyqxmd.com/read/28050068/blood-transfusion-practices-among-delivery-cases-a-retrospective-study-of-two-years
#3
S K Kathpalia, Jaya Chawla, A K Harith, Priyanka Gupta, Anupam Anveshi
BACKGROUND: Many women die while going through childbirth; hemorrhage being common cause for maternal mortality. Many maternal deaths can be saved by building up hemoglobin antenatally and timely blood transfusion. The transfusion may result in many complications hence the blood transfusion practices should be streamlined and adhered to and reviewed periodically. This retrospective study was undertaken at one of the tertiary care hospital to find out the blood demand and utilization practices among the delivery cases and suggest measures if any to improve the existing practices...
December 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28012808/post-partum-hemorrhage-complicated-by-reverse-takotsubo-cardiogenic-shock-a-novel-therapeutic-approach
#4
John Papanikolaou, Demosthenes Makris, Vasiliki Tsolaki, Konstantinos Spathoulas, Epaminondas Zakynthinos
Takotsubo Cardiomyopathy (TTC) is a type of transient, yet severe left ventricular systolic dysfunction, rarely complicating extreme emotional stress ("primary" TTC) or critical medical/surgical illness ("secondary" TTC forms). Although usually reversible, TTC may result in cardiogenic shock with dismal prognosis. "Secondary" TTC forms are particularly in danger for this complication, bearing significantly worse short and long-term prognosis. Herein, we report a rare case of a life-threatening "secondary" TTC in a patient with post-cesarean section severe hemorrhage, and we point out that early co-administration of esmolol and levosimendan might be an effective and safe therapeutic approach in "reversing" TTC-induced cardiogenic shock, especially when invasive therapeutic strategies are practically unfeasible...
December 19, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27991742/novel-approach-to-uterine-artery-pseudoaneurysm-embolization-for-delayed-post-partum-hemorrhage
#5
Ross Parker, Marc Wuerdeman, Matthew Grant, Charles Kitley
Uterine artery pseudoaneurysms (UAP) are a rare cause of post-partum hemorrhage. Conservative management is discouraged due to the risk of spontaneous hemorrhage. Intra-arterial embolization is highly successful (>90%) and offers definitive treatment. We present the case of a 27-year-old woman with significant delayed post-partum hemorrhage after cesarean section who was found to have a UAP on imaging. Her tortuous vascular anatomy and spasmodic aneurysmal neck presented technical challenges to embolization with traditional material, such as gel foam and coils...
December 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27987348/conservative-management-of-post-partum-hemorrhage-secondary-to-placenta-previa-accreta-with-hypogastric-artery-ligation-and-endo-uterine-hemostatic-suture
#6
Melekoglu Rauf, Celik Ebru, Eraslan Sevil, Buyukkurt Selim
AIM: The aim of this study was to investigate maternal and neonatal outcomes of conservative management of post-partum hemorrhage due to placenta previa-accreta using hypogastric artery ligation and endo-uterine hemostatic suture to lower uterine segment. METHODS: The records of 38 patients who were managed conservatively with hypogastric artery ligation and endo-uterine hemostatic suture to control post-partum hemorrhage secondary to placenta previa-accreta between April 2014 and January 2016, were reviewed retrospectively...
December 17, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27987342/comparison-between-two-management-protocols-for-postpartum-hemorrhage-during-cesarean-section-in-placenta-previa-balloon-protocol-versus-non-balloon-protocol
#7
Mohammad Ahmed Maher, Ahmed Abdelaziz
AIM: This study was conducted to compare two management protocols for post-partum hemorrhage (PPH) during cesarean section (CS) in placenta previa (PP), Bakri balloon protocol versus non-balloon protocol. Secondary analysis among balloon treated cases was also performed to identify predictors of success, failure or complications, if any. METHODS: A prospective cohort study was conducted in two hospitals in Saudi Arabia, including cases that developed PPH during CS for PP...
December 17, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27987297/misdiagnosis-of-obstetrical-cases-and-the-clinical-and-cost-consequences-to-patients-a-cross-sectional-study-of-urban-providers-in-the-philippines
#8
Riti Shimkhada, Orville Solon, Diana Tamondong-Lachica, John W Peabody
BACKGROUND: Misdiagnosis may be a significant and under-recognized quality of care problem. In birthing facilities located in anurban Philippine setting, we investigated the diagnostic accuracy for three obstetric conditions: cephalopelvic disproportion (CPD), post-partum hemorrhage (PPH), and pre-eclampsia. DESIGN: Identical simulated cases were used to measure diagnostic accuracy for every provider (n=103). We linked misdiagnosis - identified by the simulated cases - to obstetrical complications of the patients at the participating facilities...
2016: Global Health Action
https://www.readbyqxmd.com/read/27785900/can-coagulopathy-in-post-partum-hemorrhage-predict-maternal-morbidity
#9
Kyung Joon Oh, Joon-Seok Hong, Jina Youm, Soo-Hyun Cho, Eun Young Jung
AIM: The purpose of this study was to evaluate the clinical implications of coagulopathy in women with post-partum hemorrhage (PPH). METHODS: This retrospective cohort study included 262 consecutive women referred for management of PPH at a single tertiary hospital between 2009 and 2012. We reviewed medical records, including vital signs at arrival, laboratory values (hemoglobin, prothrombin time international normalized ratio [PT-INR], platelet, fibrinogen), and total amount of transfused blood product...
November 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27775757/risk-of-pregnancy-associated-stroke-across-age-groups-in-new-york-state
#10
Eliza C Miller, Hajere J Gatollari, Gloria Too, Amelia K Boehme, Lisa Leffert, Mitchell S V Elkind, Joshua Z Willey
Importance: Older age is associated with increased risk of pregnancy-associated stroke (PAS). Data are limited on age-specific incidence ratios of PAS compared with stroke risk in nonpregnant women. Objectives: To assess the risk of stroke by age group in pregnant and postpartum women compared with their nonpregnant contemporaries and to compare risk factors across age groups in the exposed (pregnant/postpartum) and unexposed (nonpregnant) populations. Design, Setting, and Participants: International Classification of Diseases, Ninth Revision, billing codes from the calendar year 2003-2012 New York State Department of Health inpatient database and population data were used to identify all women aged 12 to 55 years with cerebrovascular events, including transient ischemic attack, ischemic and hemorrhagic stroke, cerebral venous thrombosis, and nonspecified PAS...
December 1, 2016: JAMA Neurology
https://www.readbyqxmd.com/read/27765939/inadvertent-methylergonovine-administration-to-a-neonate
#11
Bryan M Corbett, Charles O'Connell, Mallory A Boutin, Nabil I Fatayerji, Charles W Sauer
BACKGROUND Methylergonovine is an ergot alkaloid used to treat post-partum hemorrhage secondary to uterine atony. Mistaking methylergonovine for vitamin K with accidental administration to the neonate is a rare iatrogenic illness occurring almost exclusively in the delivery room setting. Complications of ergot alkaloids in neonates include respiratory depression, seizures, and death. CASE REPORT A term infant was inadvertently given 0.1 mg of methylergonovine intramuscularly in the right thigh. The error was only noted when the vial of medication was scanned, after administration, identifying it as methylergonovine rather than vitamin K...
October 21, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27718301/embolization-of-the-inferior-mesenteric-artery-for-post-partum-hemorrhage-with-a-vaginal-laceration-a-case-with-unusual-collateral-supply
#12
Cho Hee Kim, Gyeong Sik Jeon, Shin Jae Lee, Suk Ho Kang
A 36-year-old primipara woman was referred to the interventional department for management of severe primary post-partum hemorrhage with a vaginal laceration after a normal vaginal delivery. Angiography revealed that the superior rectal branch of the inferior mesenteric artery was one of the origins of persistent vaginal bleeding following embolization of both uterine arteries. The patient was successfully treated by selective embolization without other complications. Our case report highlights that the inferior mesenteric artery should be considered as an unusual extrauterine source for post-partum hemorrhage...
December 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27683268/risk-factors-for-post-partum-hemorrhage-following-vacuum-assisted-vaginal-delivery
#13
Liran Hiersch, Riki Bergel-Bson, Dorit Asher, Amir Aviram, Rinat Gabby-Benziv, Yariv Yogev, Eran Ashwal
OBJECTIVE: To identify risk factors for post-partum hemorrhage (PPH) following vacuum assisted vaginal delivery (VAVD). STUDY DESIGN: A retrospective study of all women with singleton pregnancies who underwent VAVD in a tertiary hospital (2012-2014). PPH was defined as any of the following: ≥500 ml estimated blood loss, hemoglobin drop ≥3 g/dl (difference between pre- and post-VAVD hemoglobin levels) or the need for blood products transfusion. Characteristics of women with PPH following VAVD were compared to those of women with no PPH following VAVD...
September 29, 2016: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/27624996/pregnancy-is-possible-on-long-term-home-parenteral-nutrition-in-patients-with-chronic-intestinal-failure-results-of-a-long-term-retrospective-observational-study
#14
Lore Billiauws, Laura Armengol Debeir, Florian Poullenot, Cécile Chambrier, Nicolas Cury, Pierre-François Ceccaldi, Emilie Latour Beaudet, Olivier Corcos, Evelyne Marinier, Olivier Goulet, Eric Lerebours, Francisca Joly
BACKGROUND & AIMS: Home parenteral nutrition (HPN) improves survival and quality of life in patients with chronic intestinal failure (IF). Few cases of pregnancy on HPN have been published. The aim of this study was to report pregnancy cases on long-term HPN in benign IF. METHODS: This retrospective study included all pregnant patients on HPN from 4 HPN referral centers. Data on demographics, ongoing pathology, HPN type, maternal and newborn complications were collected...
August 23, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27567564/drug-delivery-to-the-human-and-mouse-uterus-using-immunoliposomes-targeted-to-the-oxytocin-receptor
#15
Jonathan W Paul, Susan Hua, Marina Ilicic, Jorge M Tolosa, Trent Butler, Sarah Robertson, Roger Smith
BACKGROUND: The ability to provide safe and effective pharmacotherapy during obstetric complications, such as preterm labor or postpartum hemorrhage, is hampered by the systemic toxicity of therapeutic agents leading to adverse side effects in the mother and fetus. Development of novel strategies to target tocolytic and uterotonic agents specifically to uterine myocytes would improve therapeutic efficacy while minimizing the risk of side effects. Ligand-targeted liposomes have emerged as a reliable and versatile platform for targeted drug delivery to specific cell types, tissues or organs...
August 24, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27549985/maternal-anemia-effects-during-pregnancy-on-males-and-females-fetuses-are-there-any-differences
#16
Cinzia Orlandini, Michela Torricelli, Nicoletta Spirito, Lucia Alaimo, Mariarosaria Di Tommaso, Filiberto Maria Severi, Antonio Ragusa, Felice Petraglia
OBJECTIVE: Sideropenic anemia is a common pregnancy disorder. The relationship between anemia and adverse pregnancy outcome are contradictory and it is related to the severity of the hemoglobin deficit. The aim of the study was to evaluate the relationship between maternal mild anemia at third trimester of pregnancy, fetal birth weight and fetal gender. STUDY DESIGN: A retrospective study including 1131 single physiological term pregnancies was conducted. According to maternal Hb levels during the third trimester, pregnant women enrolled, were divided in 2 groups: Group A (n = 156) with Hb≤11 g/dl and Group B (n = 975) with Hb≥11,1 g/dl...
August 22, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27476248/-active-management-of-postpartum-hemorrhage-and-bakri-balloon-placement-in-primiparous-and-multiparous
#17
D Cruz-Cruz, H Peña-Dehesa, A Cérbulo-Vázquez, M Guzmán-López
OBJECTIVE: To evaluate the usefulness of active management of the third stage of labor plus Bakri balloon in primiparous and multiparous. patients with postpartum hemorrhage. MATERIAL AND MET HOD: A retrospective, cross-sectional analytical study in the Hospital of Women, from 1st January 2013 to 31st December 2014. We use uterotonics and after persistence of postpartum hemorrhage also considered Bakri balloon placement, and further transfusion management were evaluated. Analysis descriptive and inferential statistics were performed (Mann-Whitney U and linear regression) and the relationship between inter- and intra-group variables analyzed, a significance level of p <0...
May 2016: Ginecología y Obstetricia de México
https://www.readbyqxmd.com/read/27426696/pregnancy-and-perinatal-outcomes-according-to-surgery-to-conception-interval-and-gestational-weight-gain-in-women-with-previous-gastric-bypass
#18
Louise Laage Stentebjerg, Lise Lotte Torvin Andersen, Kristina Renault, René Klinkby Støving, Dorte Møller Jensen
OBJECTIVE: To compare perinatal and pregnancy outcomes including adherence to the Institute of Medicine's (IOM) recommendations for gestational weight gain (GWG) in pregnant women with conception <18 months (early group) compared to ≥18 months following gastric bypass (late group). METHODS: Retrospective cohort study comprising 71 women with gastric bypass and a singleton pregnancy presenting at Odense University Hospital, November 2007-October 2013. Data were extracted from medical records and laboratory systems...
July 17, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27405776/a-primer-on-pituitary-injury-for-the-obstetrician-gynecologist-simmonds-disease-sheehan-s-syndrome-traumatic-injury-dahan-s-syndrome-pituitary-apoplexy-and-lymphocytic-hypophysitis
#19
Michael H Dahan, SeangLin Tan
The pituitary gland plays a critical role in reproduction. In response to the hypothalamus the anterior pituitary secretes prolactin, thyroid stimulating hormone (TSH), Adreno corticotropic hormone (ACTH), follicle stimulating hormone (FSH), luteinizing hormone (LH) and growth hormone. Dysregulation in these hormones often lead to reproductive failure. Multiple mechanisms of pituitary injury exist. Simmond's disease is atrophy or destruction of the anterior lobe of the pituitary gland resulting in hypopitiutaryism...
July 13, 2016: Minerva Ginecologica
https://www.readbyqxmd.com/read/27328504/late-gestational-liver-dysfunction-and-its-impact-on-pregnancy-outcomes
#20
D X Zhou, X Y Bian, X Y Cheng, P Xu, Y F Zhang, J X Zhong, H Y Qian, S Huang
OBJECTIVE: The aim of this study was to investigate the impacts of late gestational liver dysfunction and its impact on pregnancy outcomes. MATERIALS AND METHODS: The patients hospitalized for liver dysfunction in their late pregnancy between 2010-2012 were set as the observation group, and the pregnant women with normal liver function at the same period were randomly selected and set as the control group. The impacts towards the pregnancy outcomes were compared between these two groups and the impacts of different-degree transaminase increasing towards the pregnancy outcome were analyzed...
2016: Clinical and Experimental Obstetrics & Gynecology
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