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post-partum haemorrhage

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https://www.readbyqxmd.com/read/28317421/a-prospective-cohort-study-evaluating-the-cost-effectiveness-of-carbetocin-for-prevention-of-postpartum-haemorrhage-in-caesarean-sections
#1
Yasmin Luni, Aditya Borakati, Arti Matah, Katie Skeats, Padma Eedarapalli
Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Prophylaxis with oxytocic medication is recommended by the WHO to prevent its occurrence. Carbetocin is a newer oxytocic, with potential to lower PPH rates, reduce the total use of oxytocic drugs and lead to financial savings. Meta-analyses have confirmed a reduction in the use of additional oxytocic medication with the use of carbetocin compared to oxytocin. However, there are few studies evaluating the costs of carbetocin prophylaxis...
March 20, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28263044/mri-for-premature-neonatal-brain-injury-a-case-report
#2
Alexander Langham
This case report aims to extend analytical thinking and clinical reasoning of clinicians and radiographers when presented with diagnosing premature neonatal brain injuries (PNBI). The report considers the uses and merit of magnetic resonance imaging (MRI) in the primary assessment of PNBI. The traditional technique of cranial ultrasound as the first modality of choice can have several limitations, which includes a lower temporal resolution in its ability to differentiate grey-white matter distribution patterns, lower spatial resolution in its ability to accurately map white matter fibre tracts and distribution patterns which are critical in white matter injury pathological events...
March 6, 2017: Journal of Medical Radiation Sciences
https://www.readbyqxmd.com/read/28253206/invasive-therapies-for-primary-post-partum-haemorrhage-as-missed-opportunities-for-medical-prevention
#3
Gilles Kayem, Catherine Deneux-Tharaux
PURPOSE OF REVIEW: Examine the available results from population-based studies to test the hypothesis that differences between countries in medical practices for the management of labour, delivery and early bleeding may lead to a differential risk of post-partum haemorrhage (PPH)-related maternal morbidity and in the need for PPH-related invasive therapies. RECENT FINDINGS: International comparison of ratios of maternal mortality due to PPH shows significant differences between developed countries...
April 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28238320/-oxytocin-administration-during-spontaneous-labour-guidelines-for-clinical-practice-guidelines-short-text
#4
C Dupont, M Carayol, C Le Ray, C Barasinski, R Beranger, A Burguet, A Chantry, C Chiesa, B Coulm, A Evrard, C Fischer, L Gaucher, C Guillou, F Leroy, E Phan, A Rousseau, V Tessier, F Vendittelli, C Deneux-Tharaux, D Riethmuller
OBJECTIVES: To define the different stages of spontaneous labour. To determine the indications, modalities of use and the effects of administering synthetic oxytocin. And to describe undesirable maternal and perinatal outcomes associated with the use of synthetic oxytocin. METHOD: A systematic review was carried out by searching Medline database and websites of obstetrics learned societies until March 2016. RESULTS: The 1st stage of labor is divided in a latence phase and an active phase, which switch at 5cm of cervical dilatation...
January 2017: Gynecol Obstet Fertil Senol
https://www.readbyqxmd.com/read/28236342/maternal-cardiac-output-in-early-labour-a-possible-link-with-obstetrics-risks
#5
Herbert Valensise, Grazia Maria Tiralongo, Ilaria Pisani, Daniele Farsetti, Damiano Lo Presti, Giulia Gagliardi, Ripalta Marica Basile, Gian Paolo Novelli, Barbara Vasapollo
OBJECTIVE: to verify if the hemodynamic assessment of "low risk" pregnant women at term can improve the identification of patients with a maternal or foetal-neonatal complication during labour MATERIALS AND METHODS: a prospective observational study was conducted on 77 pregnant women at term with diagnosis of initial labour. We obtained haemodynamic indices using the USCOM(®) system. Patients were followed until the end of labour to check for foetal-neonatal and maternal outcomes. RESULTS: Eleven patients (14...
February 25, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28208947/delayed-uterine-necrosis-rare-cause-of-nonhealing-wound
#6
Aruna Nigam, Neha Gupta, Arifa A Elahi, Zeeba S Jairajpuri, Swaraj Batra
Uterine necrosis is a very rare condition and most of the reported cases occurred after pelvic arterial embolization for post-partum haemorrhage, embolization of fibroid uterus or application of B-Lynch sutures. A case of delayed myometrial necrosis is reported in post-cesarean patient where no embolization or uterine compression sutures have been applied. Patient presented with foul smelling discharge from the gaped abdominal wound following caesarean section. Abdomen was closed after exploration and lavage...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28088109/carbetocin-versus-oxytocin-for-prevention-of-post-partum-haemorrhage-at-caesarean-section-in-the-united-kingdom-an-economic-impact-analysis
#7
Helen A van der Nelson, Tim Draycott, Dimitrios Siassakos, Christopher W H Yau, Anthony J Hatswell
OBJECTIVE: To determine the economic impact of the introduction of carbetocin for the prevention of postpartum haemorrhage (PPH) at caesarean section, compared to oxytocin. STUDY DESIGN: The model is a decision tree conducted from a UK National Health Service perspective. 1500 caesarean sections (both elective and emergency) were modelled over a 12 month period. Efficacy data was taken from a published Cochrane meta-analysis, and costs from NHS Reference costs, the British National Formulary and the NHS electronic Medicines Information Tool...
January 3, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28087186/spontaneous-subdural-haemorrhage-due-to-meningioma-in-the-post-partum-setting
#8
Krishnan Ravindran, Frank Gaillard, Arian Lasocki
An acute presentation of a meningioma with spontaneous haemorrhage is rare, with mechanisms of haemorrhage remaining unclear. Here, we present a case of a meningioma causing spontaneous intra-tumoural and subdural haemorrhage in the post-partum setting, to our knowledge not previously described, with review of pertinent literature.
January 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28065966/implementation-of-warning-tool-to-improve-maternal-newborn-health-outcomes-in-a-developing-country
#9
Sana Sheikh, Rahat Qureshi, Sidrah Nausheen, Rozina Sikandar
OBJECTIVE: To improve health outcomes through the implementation of national early warning sign tool for babies delivered through emergency caesarean section in off-work hours. METHODS: This comparative clinical study was conducted at the Aga Khan Hospital for Women and Children, Karachi, from April to August 2014, and comprised women who had an emergency caesarean section. Maternal and perinatal outcomes were compared of patients in Group A and Group B which represented individuals before and after the implementation of the national early warning score respectively...
January 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27901638/atlantic-dip-insulin-therapy-for-women-with-iadpsg-diagnosed-gestational-diabetes-mellitus-does-it-work
#10
D Bogdanet, A M Egan, C Reddin, O Kgosidialwa, B Kirwan, L Carmody, F P Dunne
INTRODUCTION: Approximately 40% of women with gestational diabetes mellitus (GDM) diagnosed using IADPSG criteria require insulin therapy. OBJECTIVE: To assess if the outcomes for women with GDM treated with insulin are comparable to women with normal glucose tolerance (NGT). MATERIALS AND METHODS: This retrospective cohort study included 752 women with insulin-treated GDM and 2496 women with NGT during pregnancy. Maternal and foetal outcomes were examined...
November 30, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27891407/successful-pregnancy-outcome-in-a-patient-with-solitary-kidney-affected-by-angiomyolipoma-a-rare-case
#11
Vineet Vashistha Mishra, Kavita Mistry, Sakshi Nanda, Sumesh Choudhary, Khushali Gandhi
Renal angiomyolipoma is a rare benign tumour and its occurrence during pregnancy is even rare. It is usually diagnosed incidentally. It can increase in size during pregnancy and can present acutely as rupture with retroperitoneal haemorrhage, mechanism of which is still unclear. We present a case of successful pregnancy outcome in a patient with congenital solitary kidney affected by angiomyolipoma, diagnosed incidentally at 19 years of age. The patient had conceived twice. Her antenatal and post partum period was uneventful both the times...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27819760/reversible-cerebral-vasoconstriction-syndrome-in-association-with-fingolimod-use
#12
Scott Belliston, Jayshree Sundararajan, Nancy Hammond, Kathy Newell, Sharon Lynch
BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS), also known as Call-Fleming syndrome, is characterized by thunderclap headaches, non-aneurysmal segmental cerebral vasoconstriction seen on arteriogram, and spontaneously resolves within 12 weeks. Fingolimod has been reported to cause posterior reversible encephalopathy syndrome (PRES) and one case of RCVS. OBJECTIVE: We report a case of RCVS possibly related to fingolimod use, and compare to cases of adverse outcomes in fingolimod use...
November 23, 2016: International Journal of Neuroscience
https://www.readbyqxmd.com/read/27790522/the-effect-of-oxygen-inhalation-plus-oxytocin-compared-with-oxytocin-only-on-postpartum-haemorrhage-a-randomized-clinical-trial
#13
Zainab Suhrabi, Hamid Taghinejad, Ashraf Direkvand-Moghadam, Malihe Akbari
INTRODUCTION: Post Partum Haemorrhage (PPH) is the leading cause of maternal mortality across the world, mainly in the developing countries. AIM: The present study was conducted with the aim to investigate effect of oxygen inhalation plus oxytocin compared with oxytocin only on PPH. MATERIALS AND METHODS: This study was a clinical trial which was performed in Shahid Mustafa Khomieni Teaching Hospital of Ilam (western Iran) from April 2012 to Nov 2013...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27783611/lactate-in-amniotic-fluid-predictor-of-labor-outcome-in-oxytocin-augmented-primiparas-deliveries
#14
Eva Wiberg-Itzel, Andrea B Pembe, Hans Järnbert-Pettersson, Margareta Norman, Anna-Carin Wihlbäck, Irene Hoesli, Monya Todesco Bernasconi, Elie Azria, Helena Åkerud, Elisabet Darj
BACKGROUND: One of the major complications related to delivery is labor dystocia, or an arrested labor progress. Many dystocic deliveries end vaginally after administration of oxytocin, but a large numbers of women with labor dystocia will undergo a long and unsafe parturition. As a result of the exertion required in labor, the uterus produces lactate. The uterine production of lactate is mirrored by the level of lactate in amniotic fluid (AFL). OBJECTIVES: To evaluate whether the level of AFL, analysed in a sample of amniotic fluid collected vaginally at arrested labor when oxytocin was needed, could predict labor outcome in nulliparous deliveries...
2016: PloS One
https://www.readbyqxmd.com/read/27743977/clinical-management-of-pregnancy-in-the-obese-mother-before-conception-during-pregnancy-and-post-partum
#15
REVIEW
Ronald Ching Wan Ma, Maria Ines Schmidt, Wing Hung Tam, Harold David McIntyre, Patrick M Catalano
The global epidemic of obesity has led to an increasing number of obese women of reproductive age. Obesity is associated with reduced fertility, and pregnancies complicated by maternal obesity are associated with adverse outcomes, including increased risk of gestational diabetes, pre-eclampsia, preterm birth, instrumental and caesarean births, infections, and post-partum haemorrhage. The medical and obstetric management of obese women is focused on identifying, addressing, and preventing some of these associated complications, and is a daunting challenge given the high percentage of patients with obesity and few therapeutic options proven to improve outcomes in this population...
December 2016: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/27743975/preconceptional-and-maternal-obesity-epidemiology-and-health-consequences
#16
REVIEW
Lucilla Poston, Rishi Caleyachetty, Sven Cnattingius, Camila Corvalán, Ricardo Uauy, Sharron Herring, Matthew W Gillman
Obesity in women of reproductive age is increasing in prevelance worldwide. Obesity reduces fertility and increases time taken to conceive, and obesity-related comorbidities (such as type 2 diabetes and chronic hypertension) heighten the risk of adverse outcomes for mother and child if the woman becomes pregnant. Pregnant women who are obese are more likely to have early pregnancy loss, and have increased risk of congenital fetal malformations, delivery of large for gestational age infants, shoulder dystocia, spontaneous and medically indicated premature birth, and stillbirth...
December 2016: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/27691987/claw-disorders-in-dairy-cattle-an-unexpected-association-between-energy-metabolism-and-sole-haemorrhages
#17
Katrin Wilhelm, Jürgen Wilhelm, Manfred Fürll
The present study investigated whether changes of energy metabolism post-partum (pp) are associated with claw health. For this purpose, back-fat-thickness (BFT) was measured and blood samples were taken from 146 cows at four examination times. The serum levels of free fatty acids (FFA), ß-hydroxybutyrate (BHB) and glucose were measured. Furthermore, in the first week postpartum (pp) and at 8 weeks pp, a claw trimming was done and the presence and extent of sole haemorrhages (SH) was recorded. Animals with high BFT at calving and therefore high fat mobilisation and whose FFA and BHB levels in the first week pp exceeded the reference values had fewer pathological changes of the claws than thinner animals whose FFA and BHB levels stayed within reference ranges...
February 2017: Journal of Dairy Research
https://www.readbyqxmd.com/read/27663913/-simulation-benefits-in-obstetrical-emergency-which-proof-level
#18
P Raynal
Simulation in obstetrical emergency is in expansion. The important economic and human cost in simulation needs a real evaluation about enhancement in technical and non-technical skills, maternal and neonatal morbidity and mortality. We present a literature review of the results published on the subject in shoulder dystocia, post-partum haemorrhage, eclampsia and cord prolaps with a selection of publications with high evidence level or positive impact of training on obstetrical emergencies. There are few publications with a positive impact of training on obstetrical emergencies...
October 2016: Gynécologie, Obstétrique & Fertilité
https://www.readbyqxmd.com/read/27651628/role-of-intravenous-tranexamic-acid-on-caesarean-blood-loss-a-prospective-randomised-study
#19
Irene Ray, Ratneshwar Bhattacharya, Somajita Chakraborty, Chiranjib Bagchi, Sima Mukhopadhyay
BACKGROUND: Post-partum haemorrhage (PPH) is a major cause of maternal mortality globally. Tranexamic acid, an anti-fibrinolytic agent, is a novel approach in an attempt to prevent this dreadful complication. This study aims to document the efficacy of intravenous (IV) tranexamic acid in reducing blood loss during and after caesarean section (CS). METHODS: In this prospective randomised placebo-controlled open-label study, 100 mothers scheduled for elective CS were randomly selected and divided into two groups (study and control) of 50 each...
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27631446/-the-new-german-guideline-on-postpartum-haemorrhage-pph-essential-aspects-for-coagulation-and-circulatory-therapy
#20
Heiko Lier, Dietmar Schlembach, Wolfgang Korte, Christian von Heymann, Susanne Steppat, Maritta Kühnert, Holger Maul, Wolfgang Henrich, Werner Rath, Jürgen Wacker, Franz Kainer, Daniel Surbek, Hanns Helmer
Worldwide, post-partum haemorrhage (PHH) remains one of the leading causes for maternal mortality. The German Society of Gynaecology and Obstetrics, the German Midwifes' Society, the German Society of Thrombosis and Haemostasis and the German Society of Anaesthesiology and Intensive Care updated the former guideline. The resulting recommendations are the results of a structured literature search and a formal consensus process and contain all aspects of PPH including diagnosis, causes, risk factors and therapy...
September 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
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