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Dilek Uysal, Hakan Cokmez, Cetin Aydin, Tolga Ciftpinar
Postpartum haemorrhage is the most important cause of maternal morbidity and mortality, especially when all conservative measures, including syntometrine oxytocin and Bakri balloons have failed to accomplish haemostasis and expeditious surgical procedures, such as uterine artery ligation and emergency peripartum hysterectomy (EPH) are required. This retrospective study analysed 31 cases of EPH performed between January 2007 and January 2016 in the Department of Gynecology and Obstetrics of Izmir Ataturk Teaching and Research Hospital...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Giuseppe Cali, Francesco Forlani, Francesca Foti, Gabriella Minneci, Lamberto Manzoli, Maria Elena Flacco, Danilo Buca, Marco Liberati, Giovanni Scambia, Francesco D'Antonio
OBJECTIVES: To ascertain the diagnostic accuracy of ultrasound in detecting AIP during the first trimester (11-14 weeks of gestation) of pregnancy in women at risk of these conditions. METHODS: Retrospective analysis on prospectively collected data on women at risk for AIP based upon the presence of at least one prior CS and/or uterine surgery and placenta previa who had an ultrasound assessment for AIP since the 11-14 weeks scan. The ultrasound signs explored in the present study were: loss of clear zone, placental lacunae, bladder wall interruption, uterovescical hypervascularity...
March 13, 2018: Ultrasound in Obstetrics & Gynecology
Xiao-Ming Shi, Yan Wang, Yan Zhang, Yuan Wei, Lian Chen, Yang-Yu Zhao
Background: Cesarean section (CS) is an independent risk factor for placenta accreta. Some researchers think that the timing of primary cesarean delivery is associated with placenta accreta in subsequent pregnancies. The aim of this study was to investigate the risk of placenta accreta following primary CS without labor, also called primary elective CS, in a pregnancy complicated with placenta previa. Methods: A retrospective, single-center, case-control study was conducted at Peking University Third Hospital...
March 20, 2018: Chinese Medical Journal
Eun Jung Jung, Hwa Jin Cho, Jung Mi Byun, Dae Hoon Jeong, Kyung Bok Lee, Moon Su Sung, Ki Tae Kim, Young Nam Kim
INTRODUCTION: Placenta previa is a condition in which the placenta implants in the poorly vascularized lower uterine segment, which may result in inadequate uteroplacental perfusion, in turn, adversely affect the neonatal outcome. Abnormal placentation may also lead to severe postpartum hemorrhage as placenta separation proceeds. We aimed to evaluate the differences in placental histopathology and perinatal outcomes in pregnancies complicated with placenta previa and controls. METHOD: We undertook a retrospective case-control study of 93 pregnancies with placenta previa and 81 controls between 2011 and 2017...
March 2018: Placenta
John C Markley, Michaela K Farber, Nicola C Perlman, Daniela A Carusi
BACKGROUND: General anesthesia (GA) is often selected for cesarean deliveries (CD) with placenta previa and suspected morbidly adherent placenta (MAP) due to increased risk of hemorrhage and hysterectomy. We reviewed maternal outcomes and risk factors for conversion to GA in a cohort of patients undergoing CD and hysterectomy under neuraxial anesthesia (NA). METHODS: We performed a single-center, retrospective cohort study of parturients undergoing nonemergent CD for placenta previa with suspected MAP from 1997 to 2015...
February 23, 2018: Anesthesia and Analgesia
Christina M Duzyj, Irina A Buhimschi, Christine A Laky, Genevieve Cozzini, Guomao Zhao, Mark Wehrum, Catalin S Buhimschi
OBJECTIVE: Placenta accreta is clinically associated with maternal uterine scar. Our objective was to investigate the biochemical contribution of maternal scarring to hyperinvasive trophoblast. We hypothesized that trophoblast over-invasion in placenta accreta is associated with aberrant invasion-site signaling of growth and angiogenic factors known to be involved in wound healing and promotion of cell invasion through the epithelial to mesenchymal cellular program. DESIGN: Cross-sectional series...
February 22, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
Sonia DaSilva-Arnold, Stacy Zamudio, Abdulla Al-Khan, Jesus Alvarez-Perez, Ciaran Mannion, Christopher Koenig, Davlyn Luke, Anisha Perez, Margaret Petroff, Manuel Alvarez, Nicholas P Illsley
Differentiation of first trimester human placental cytotrophoblast from an anchorage-dependent epithelial phenotype into the mesenchymal-like invasive extravillous trophoblast is crucial in the development of the maternal-fetal interface. We showed previously that differentiation of first trimester cytotrophoblast to extravillous trophoblast involves an epithelial-mesenchymal transition (EMT). Here we compare the epithelial-mesenchymal characteristics of cytotrophoblast (CTB) and extravillous trophoblast (EVT) derived from normal third trimester placenta or placenta previa versus abnormally invasive placenta (AIP)...
February 9, 2018: Biology of Reproduction
Michiko Yamashita, Keiichi Kumasawa, Hitomi Nakamura, Tadashi Kimura
INTRODUCTION: Placenta previa is an abnormality in which the placenta covers the internal uterine os, and it can cause serious morbidity and mortality in both mother and fetus due to catastrophic hemorrhage. Some pregnant women recover from placenta previa due to a phenomenon called "migration." However, the mechanism of "migration" of the placenta has not been elucidated. METHODS: Human placentas were collected from patients with placenta previa and those with no abnormal placentation (control)...
January 30, 2018: Biochemical and Biophysical Research Communications
Jennifer K Durst, Methodius G Tuuli, Lorene A Temming, Owen Hamilton, Jeffrey M Dicke
OBJECTIVES: To identify the incidence and resolution rates of a low-lying placenta or placenta previa and to assess the optimal time to perform follow-up ultrasonography (US) to assess for resolution. METHODS: We conducted a retrospective cohort study of women with a diagnosis of a low-lying placenta or placenta previa at routine anatomic screening. Follow-up US examinations were reviewed to estimate the proportion of women who had resolution. A Kaplan-Meier survival curve was generated to estimate the median time to resolution...
February 5, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
D M Wei, Z Z Zhang, Z Wang, P Li, J F Wang, Y J Liu, J T Zhang, Y H Shi
Objective: To compare the difference in risks of obstetric complications of singleton pregnancy between women with hyperandrogenic polycystic ovary syndrome (PCOS) and women with normoandrogenic PCOS. Methods: Prospective cohort study. This study was a secondary analysis of data collected during a multicenter randomized controlled clinical trial. Women who got clinical singleton pregnancy were grouped according to whether they were diagnosed with hyperandrogenism at baseline. There were 118 women with hyperandrogenism and 366 women without hyperandrogenism...
January 25, 2018: Zhonghua Fu Chan Ke za Zhi
Kazuki Saito, Maki Fukami, Mami Miyado, Ichiro Ono, Keijiro Sumori
Case: A 39-year-old woman presented with a genital hemorrhage at 5 weeks of gestation after an artificial cycle double frozen-thawed embryo transfer. She was diagnosed with a cervical heterotopic pregnancy. Although hormone supplementation was discontinued to terminate the pregnancy at 5 weeks of gestation, the intrauterine and cervical gestational sacs continued to develop. Outcome: The cervical gestational sac was surgically removed and the intrauterine pregnancy continued uneventfully, except for vasa previa...
January 2018: Reproductive Medicine and Biology
Mahsa Nordqvist, Bo Jacobsson, Anne-Lise Brantsæter, Ronny Myhre, Staffan Nilsson, Verena Sengpiel
OBJECTIVES: To investigate whether the timing of probiotic milk intake before, during early or late pregnancy influences associations with preeclampsia and preterm delivery. DESIGN: Population based prospective cohort study. SETTING: Norway, between 1999 and 2008. PARTICIPANTS: 70 149 singleton pregnancies resulting in live-born babies from the Norwegian Mother and Child Cohort Study (no chronic disease, answered questionnaires, no placenta previa/cerclage/serious malformation of fetus, first enrolment pregnancy)...
January 23, 2018: BMJ Open
Oonagh E Keag, Jane E Norman, Sarah J Stock
BACKGROUND: Cesarean birth rates continue to rise worldwide with recent (2016) reported rates of 24.5% in Western Europe, 32% in North America, and 41% in South America. The objective of this systematic review is to describe the long-term risks and benefits of cesarean delivery for mother, baby, and subsequent pregnancies. The primary maternal outcome was pelvic floor dysfunction, the primary baby outcome was asthma, and the primary subsequent pregnancy outcome was perinatal death. METHODS AND FINDINGS: Medline, Embase, Cochrane, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were systematically searched for published studies in human subjects (last search 25 May 2017), supplemented by manual searches...
January 2018: PLoS Medicine
Yaakov Melcer, Eric Jauniaux, Shlomit Maymon, Anna Tsviban, Marina Pekar-Zlotin, Moshe Betser, Ron Maymon
BACKGROUND: Placenta accreta spectrum (PAS) and vasa previa (VP) are congenital disorders of placentation associated with high morbidity and mortality for both mothers and newborns when undiagnosed before delivery. Prenatal diagnosis of these conditions is essential to allow multidisciplinary management and thus improve perinatal outcomes. OBJECTIVES: To compare perinatal outcome in women with PAS or VP before and after implementation of targeted scanning protocols...
January 15, 2018: American Journal of Obstetrics and Gynecology
Xian-Ying Cheng, Li Cheng, Wen-Juan Li, Ling-Hua Qian, Yong-Qin Zhang
OBJECTIVE: To determine whether surgical treatment of cesarean scar diverticulum (CSD) reduced adverse outcomes during the subsequent pregnancy. METHODS: A retrospective observational study was conducted using the medical records of pregnant women with CSD who attended a single hospital in Hangzhou, China, between January 1, 2014, and December 31, 2016. Baseline characteristics and pregnancy outcomes were compared between the surgery group and the no surgery group...
January 17, 2018: International Journal of Gynaecology and Obstetrics
Harissou Adamou, Ibrahim Amadou Magagi, Souleymane Oumarou Garba, Oumarou Habou
BACKGROUND: Acute intestinal obstruction during pregnancy is a rare digestive surgical emergency with significant maternal and fetal mortality. Diagnosis is difficult, often delaying the management. Here, we report an exceptional association of mechanical acute intestinal obstruction due to compression by previa uterine leiomyoma, and a ruptured ectopic pregnancy. CASE PRESENTATION: This is the case report of a 43-year-old primiparous black woman from a rural area, who was admitted to the surgical emergency department for acute intestinal obstruction...
January 16, 2018: Journal of Medical Case Reports
Tingting Sha, Xunqiang Yin, Wenwei Cheng, Isaac Yaw Massey
OBJECTIVE: To provide an updated comparison of pregnancy-related complications and adverse perinatal outcomes of pregnancies conceived after frozen embryo transfer (FET) versus fresh embryo transfer (fresh ET). DESIGN: Meta-analysis. SETTING: University. PATIENT(S): Pregnancies resulting from FET versus fresh ET. INTERVENTIONS(S): Pubmed, Embase, Cochrane Library, Google Scholar, and Chinese databases, including the China National Knowledge Infrastructure Database, Wanfang, and Chinese Scientific Journals Full-Text Database were searched by two independent reviewers from January 1980 to September 2017...
January 11, 2018: Fertility and Sterility
Heather J Baldwin, Jillian A Patterson, Tanya A Nippita, Siranda Torvaldsen, Ibinabo Ibiebele, Judy M Simpson, Jane B Ford
OBJECTIVE: To evaluate the association between prior invasive gynecologic procedures and the risk of subsequent abnormally invasive placenta (ie, placenta accreta, increta, and percreta). METHODS: We conducted a population-based data linkage study including all primiparous women who delivered in New South Wales, Australia, between 2003 and 2012. Data were obtained from linked birth and hospital admissions with a minimum lookback period of 2 years. Prior procedures invasive of the uterus were considered including gynecologic laparoscopy with instrumentation of the uterus; hysteroscopy, including operative hysteroscopy; curettage, including suction curettage and surgical termination; and endometrial ablation...
February 2018: Obstetrics and Gynecology
Fatimat M Akinlusi, Kabiru A Rabiu, Idayat A Durojaiye, Adeniyi A Adewunmi, Tawaqualit A Ottun, Yusuf A Oshodi
BACKGROUND: Caesarean delivery carries a risk of major intra-operative blood loss and its performance is often delayed by non-availability of blood and blood products. Unnecessary cross-matching and reservation of blood lead to apparent scarcity in centres with limited supply. This study set out to identify the risk factors for blood transfusion in women who underwent caesarean delivery at a tertiary obstetric unit with a view to ensuring efficient blood utilization. METHODS: A prospective cohort analysis of 906 women who had caesarean deliveries at the Lagos State University Teaching Hospital, Nigeria between January and December, 2011...
January 10, 2018: BMC Pregnancy and Childbirth
Yoshihisa Ono, Yoshihiko Murayama, Sumiko Era, Shigetaka Matsunaga, Tomonori Nagai, Hisato Osada, Yasushi Takai, Kazunori Baba, Satoru Takeda, Hiroyuki Seki
AIMS: We investigated whether common iliac artery balloon occlusion (CIABO) was effective for decreasing blood loss during cesarean hysterectomy (CH) in patients with placenta previa with accreta and was safe for mothers and fetuses. METHODS: Of the 67 patients who underwent CH for placenta previa with accreta at our facility from 1985 to 2014, 57 patients were eligible for the study. The amount of intraoperative bleeding during CH was compared between three groups: surgery without blood flow occlusion (13 patients), internal iliac artery ligation (15 patients) and CIABO (29 patients)...
January 3, 2018: Journal of Obstetrics and Gynaecology Research
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