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Priyanka Jha, Spencer Behr, Tara Morgan, Erin Washburn, Jennifer Lucero, Lee-May Chen, Liina Poder
Placental abruption is an important cause of feto-maternal hemorrhage, with significant impact on both fetal and maternal mortality. In most cases, it presents with abdominal pain and vaginal bleeding. However, vaginal bleeding may be absent with concealed intra-amniotic hemorrhage, as in cases with placenta previa, hence confounding this diagnosis. In such cases, imaging studies may be obtained to evaluate for abdominal pain in pregnancy; hence, radiologists should be aware of the ultrasound and magnetic resonance (MR) imaging appearance of intra-amniotic hemorrhage...
June 17, 2018: Emergency Radiology
Gali Garmi, Shabtai Romano, Hadas Rubin, Eyal Rom, Sivan Zuarez-Easton, Raed Salim
OBJECTIVE: To examine the occurrence of intra-abdominal adhesions (IAA) among women with placenta accreta (PA). STUDY DESIGN: Case control study conducted at a single teaching hospital on data from January 2004 to December 2016. The cases included women who underwent a cesarean hysterectomy due to PA and had a pathological confirmation of accretion. The controls were matched for delivery date and number of cesarean deliveries (CDs) at a ratio of 1:4. IAA were categorized as "none", "filmy", or "dense"...
June 5, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Shigeki Matsubara, Hironori Takahashi
No abstract text is available yet for this article.
June 12, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Kui Li, Yu Zou, Jin Sun, Hong Wen
OBJECTIVES: To evaluate the efficacy of prophylactic balloon occlusion (PBO), and to compare haemostatic effects and perioperative outcomes of PBO of the internal iliac arteries (IIA), common iliac arteries (CIA) and infrarenal abdominal aorta (IAA) in patients with placenta accreta. METHODS: One hundred and ninety-nine patients with placenta accreta were retrospectively reviewed. One hundred and twelve cases who underwent PBO were allocated into PBO group, and 87 cases without endovascular intervention were classified as the control group...
June 5, 2018: European Radiology
Kui Zeng, Wei Huang, Chao Yu, Rurong Wang
Intraoperative cell salvage (IOCS) for high-risk obstetric hemorrhage is now endorsed by a number of obstetric organizations. Most previous studies have focused on the safety of IOCS from case series and small controlled studies. Here, we describe the effect of IOCS on rates of allogeneic blood transfusion (ABT) under different degrees of bleeding during cesarean section in women with placenta accreta, which has seldom been reported in the literature.We conducted a retrospective analysis on the introduction of routine application of IOCS for the management of hemorrhage during cesarean section in women with placenta accreta...
June 2018: Medicine (Baltimore)
Qiaozhen Peng, Weishe Zhang, Yuelan Liu
To explore the clinical value of stage operation to patients with placenta accreta after previous caesarean section (CS).Nineteen women with medium and late pregnancies diagnosed with placenta accreta after previous CS were enrolled in this retrospective study and all underwent stage operation. Postpartum hemorrhage volume, red blood cells (RBC) transfusion, uterus retention rate, postpartum complications, and menstrual recovery were analyzed to evaluate the value of stage operation in patients with placenta accreta...
June 2018: Medicine (Baltimore)
Asma Tariq, Maria O'Rourke, Steven J Carstens, Vicken Y Totten
We describe an unusual ruptured ectopic pregnancy. The unique features of the case include abdominal pain without vaginal bleeding; cervical implantation and a placenta accreta; and the late presentation at 16 weeks of gestation without prior symptoms. Both the initial point-of-care ultrasound and the formal ultrasound were interpreted as showing an intrauterine pregnancy. The clinical presentation was misleading; the correct diagnosis was made by magnetic resonance imaging. We show the ultrasonic images. We discuss cervical ectopic pregnancies, their diagnosis and management...
May 2018: Clinical practice and cases in emergency medicine
Sumaya Huque, Ian Roberts, Bukola Fawole, Rizwana Chaudhri, Sabaratnam Arulkumaran, Haleema Shakur-Still
BACKGROUND: Peripartum hysterectomy can cause significant morbidity and mortality. Most studies of peripartum hysterectomy are from high income countries. This cohort study examined risk factors for peripartum hysterectomy using data from Africa, Asia, Europe and the Americas. METHODS: We used data from the World Maternal Antifibrinolytic (WOMAN) trial carried out in 193 hospitals in 21 countries. Peripartum hysterectomy was defined as hysterectomy within 6 weeks of delivery as a complication of postpartum haemorrhage...
May 29, 2018: BMC Pregnancy and Childbirth
Giuseppe Cali, Francesco Forlani, Ilan Timor-Trisch, Josè Palacios-Jaraquemada, Francesca Foti, Gabriella Minneci, MariaElena Flacco, Lamberto Manzoli, Alessandra Familiari, Giorgio Pagani, Giovanni Scambia, Francesco D'Antonio
INTRODUCTION: The aim of this study was to assess the diagnostic accuracy of ultrasound in detecting the depth of abnormally invasive placenta in women at risk. MATERIAL AND METHODS: Prospective longitudinal study including women with placenta previa and at least one prior caesarean delivery or uterine surgery. Depth of abnormally invasive placenta was defined as the degree of trophoblastic invasion through the myometrium and assessed on histopathological analysis...
May 25, 2018: Acta Obstetricia et Gynecologica Scandinavica
Yunchang Liu, Wendy Wenyi Zhang, Min He, Chunmei Gong, Bin Xie, Xiangxia Wen, Dandan Li, Lian Zhang
OBJECTIVE: To retrospectively analyze the adverse effects of high-intensity focused ultrasound (HIFU) in management of benign uterine diseases. MATERIALS AND METHODS: From 2011 to 2017, 27,053 patients with benign uterine diseases were treated with HIFU in 19 centers in China. Among them, 17,402 patients had uterine fibroids, 8434 had adenomyosis, 876 had caesarean scar pregnancies, and 341 had placenta accreta. RESULTS: The median age, height, weight, BMI of the patients was 42 years, 158 mm, 56 kg, 22...
May 24, 2018: International Journal of Hyperthermia
Matheus Roque, Marcello Valle, Marcos Sampaio, Selmo Geber
OBJECTIVE: To evaluate if there are differences in the risks of obstetric outcomes in IVF/ICSI singleton pregnancies when compared fresh to frozen-thawed embryo transfers (FET). METHODS: This was a systematic review and meta-analysis evaluating the obstetric outcomes in singleton pregnancies after FET and fresh embryo transfer. The outcomes included in this study were pregnancy-induced hypertension (PIH), pre-eclampsia, placenta previa, and placenta accreta. RESULTS: The search yielded 654 papers, 6 of which met the inclusion criteria and reported on obstetric outcomes...
May 21, 2018: JBRA Assisted Reproduction
Ferdinando Antonio Gulino, F Di Guardo, E Zambrotta, L M Di Gregorio, Andrea Miranda, Stella Capriglione, M A Palumbo
PURPOSE: We studied the efficacy of using pre-cesarean delivery (CD) temporary occlusion of internal iliac arteries with balloon catheters in case of placenta previa-accreta in terms of maternal and neonatal outcomes and to test accuracy of ultrasound (US) and magnetic resonance imaging (MRI) for prenatal diagnosis. METHODS: From March 2014 to January 2018, women with an US and/or MRI diagnosis of placenta previa-accreta and a planned delivery were enrolled and divided into two groups: balloon catheterization group (women treated with preoperative catheters and CD) and control group (women candidates to elective CD)...
May 18, 2018: Archives of Gynecology and Obstetrics
Patrick J Nicholson, Owen O'Connor, John Buckley, Liam D Spence, Richard A Greene, David J Tuite
PURPOSE: To report on outcomes following the use of prophylactic internal iliac artery occlusion balloons in patients with abnormal placental implantation. METHODS: A retrospective analysis was undertaken of patients with abnormal placental implantation who underwent prophylactic iliac balloon placement prior to delivery in a University Maternity Hospital. Various clinical and technical factors were analysed, including technical success of balloon placement, blood loss and number of blood units transfused, duration of surgery, length of stay, hysterectomy rates, complications related to the balloon insertion, foetal pH and infant Apgar scores...
May 18, 2018: Cardiovascular and Interventional Radiology
M Anthony Cometa, Scott M Wasilko, Adam L Wendling
Uterine and placental pathology can be a major cause of morbidity and mortality in the parturient and infant. When presenting alone, placental abruption, uterine rupture, or placenta accreta can result in significant peripartum hemorrhage, requiring aggressive surgical and anesthetic management; however, the presence of multiple concurrent uterine and placental pathologies can result in significant morbidity and mortality. We present the anesthetic management of a parturient who underwent an urgent cesarean delivery for non-reassuring fetal tracing in the setting of chronic hypertension, preterm premature rupture of membranes, and chorioamnionitis who was subsequently found to have placental abruption, uterine rupture, and placenta accreta...
April 2018: Romanian Journal of Anaesthesia and Intensive Care
Y Zhao, J W Zhu, D Wu, Q H Wang, S S Lu, X X Liu, L Zou
Objective: To explore the efficacy and safety of uterine lower posterior wall breakwater-like suture technique in controlling the intraoperative bleeding of placenta previa. Methods: From June 2016 to June 2017, 47 patients were diagnosed placenta previa in Union Hospital, Tongji Medical College of Huazhong University of Science and Technology. Posterior wall breakwater-like suture technique was used preferentially, as for cases with poor myometrium layer, lower anterior wall stitch suture was used at the same time...
April 25, 2018: Zhonghua Fu Chan Ke za Zhi
Laiz Laura Godoy, Ulysses S Torres, Giuseppe D'Ippolito
No abstract text is available yet for this article.
March 2018: Radiologia Brasileira
Louis Marcellin, Pierre Delorme, Marie Pierre Bonnet, Gilles Grange, Gilles Kayem, Vassilis Tsatsaris, François Goffinet
BACKGROUND: Abnormally invasive placentation is the leading cause of obstetric hysterectomy and can cause poor to disastrous maternal outcomes. Most previous studies of peripartum management and maternal morbidity have included variable proportions of severe and less severe cases. OBJECTIVE: The aim of this study was to compare maternal morbidity from placenta percreta and accreta. STUDY DESIGN: This retrospective study at a referral center in Paris includes all women with abnormally invasive placentation from 2003 to 2017...
May 4, 2018: American Journal of Obstetrics and Gynecology
I V Barinova, N I Kondrikov, I N Voloshchuk, M A Chechneva, N A Shchukina, V A Petrukhin
OBJECTIVE: to investigate the structural and pathogenetic features of pathological placental attachment in the scar after cesarean section. MATERIAL AND METHODS: The investigators explored 12 uteri; 11 of which were removed with placentas at 9 to 38 weeks' gestation (one in the first trimester, three at 18-22 weeks, two at 32-35 weeks, and five at 37-38 weeks); one uterus was removed after an artificial abortion at 12 weeks' gestation in the scar, as well as the scars excised in the first trimester in non-developing (n=4) and progressive (n=2) pregnancies...
2018: Arkhiv Patologii
Robert M Silver, D Ware Branch
New England Journal of Medicine, Volume 378, Issue 16, Page 1529-1536, April 2018.
April 19, 2018: New England Journal of Medicine
Bhagya Sannananja, Anna Ellermeier, Daniel S Hippe, Thomas C Winter, Stella K Kang, Susanna I Lee, Mark R Kilgore, Manjiri K Dighe
PURPOSE: The aim of this study was to evaluate the utility of added DWI sequences as an adjunct to traditional MR imaging in the evaluation of abnormal placentation in patients with suspicion for placenta accreta spectrum abnormality or morbidly adherent placenta (MAP). MATERIALS AND METHODS: The study was approved by local ethics committee. The subjects included pregnant women with prenatal MRI performed between July 2013 to July 2015. All imaging was performed on a Philips 1...
April 17, 2018: Abdominal Radiology
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