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post-partum haemorrhage

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https://www.readbyqxmd.com/read/29318575/post-partum-haemorrhage-and-tranexamic-acid-a-global-issue
#1
REVIEW
Stephen P Hibbs, Ian Roberts, Haleema Shakur-Still, Beverley J Hunt
Post-partum haemorrhage (PPH) remains the major cause of maternal death worldwide, with the overwhelming majority of bleeding deaths occurring in low income countries. These bleeding deaths occur due to a complex network of biological and socioeconomic factors, including changes to haemostasis and fibrinolysis during pregnancy. Tranexamic acid (TxA) has been shown to reduce death in bleeding trauma patients safely and is effective in reducing bleeding in surgical patients, however its role in PPH has been less well established...
January 9, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29258541/intravenous-iron-vs-blood-for-acute-post-partum-anaemia-iibappa-a-prospective-randomised-trial
#2
Seng Chua, Sarika Gupta, Jennifer Curnow, Beata Gidaszewski, Marjan Khajehei, Hayley Diplock
BACKGROUND: Acute post-partum anaemia can be associated with significant morbidity including a predisposition for postnatal depression. Lack of clear practice guidelines means a number of women are treated with multiple blood transfusions. Intravenous iron has the potential to limit the need for multiple blood transfusions but its role in the post-partum setting is unclear. METHODS/DESIGN: IIBAPPA is a multi-centre randomised non-inferiority trial. Women with a primary post-partum haemorrhage (PPH) >1000 mL and resultant haemoglobin (Hb) 5...
December 19, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29241907/a-systematic-review-of-massive-transfusion-protocol-in-obstetrics
#3
REVIEW
Hiroaki Tanaka, Shigetaka Matsunaga, Tomoyuki Yamashita, Toshiyuki Okutomi, Atsushi Sakurai, Akihiko Sekizawa, Junichi Hasegawa, Katsuo Terui, Yasutaka Miyake, Jun Murotsuki, Tomoaki Ikeda
Post-partum obstetric haemorrhage is a leading cause of mortality among Japanese women, generally treated with haemostatic measures followed by supplementary transfusion. Commonly used in the setting of severe trauma, massive transfusion protocols (MTPs), preparations of red blood cell concentrate (RBC) and fresh frozen plasma (FFP) with additional supplements, have proved effective in decreasing patient mortality following major obstetric bleeding events. Although promising, the optimal configuration of RBC and FFP utilized for obstetric bleeding needs to be verified...
December 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29240754/maternal-death-review-and-outcomes-an-assessment-in-lagos-state-nigeria
#4
Friday Okonofua, Donald Imosemi, Brian Igboin, Adegboyega Adeyemi, Chioma Chibuko, Adewale Idowu, Wilson Imongan
The objective of the study was to investigate the results of Maternal and Perinatal Death Surveillance and Response (MPDSR) conducted in three referral hospitals in Lagos State, Nigeria over a two-year period and to report the outcomes and the lessons learned. MPDRS panels were constituted in the three hospitals, and beginning from January 2015, we conducted monthly MPDSR in the three hospitals using a nationally approved protocol. Data on births and deaths and causes of deaths as identified by the MPDSR panels were collated in the hospitals...
2017: PloS One
https://www.readbyqxmd.com/read/29207784/emergency-peripartum-hysterectomy-a-14-year-experience-at-a-tertiary-care-centre-in-india
#5
S Tahmina, Mary Daniel, Preetha Gunasegaran
Introduction: Emergency Peripartum Hysterectomy (EPH), although relatively infrequent in present day obstetrics, is a life-saving procedure in the event of a massive postpartum haemorrhage. Aim: To assess incidence, risk factors, indications and complications of peripartum hysterectomies at a tertiary care teaching hospital in India. Materials and Methods: A retrospective study was conducted at 650-bedded tertiary care medical teaching hospital in Southern India...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29187935/-haemorrhagic-stroke-of-the-brainstem-secondary-to-postpartum-eclampsia-about-a-case-and-literature-review
#6
REVIEW
Khadija Ennaqui, Assia Makayssi, Houssine Boufettal, Naima Samouh
Strokes are rare but severe accidents during pregnancy and post-partum period. They are responsible for high mortality and morbidity rates. Pre-eclampsia, eclampsia, and strokes are significantly related. Endothelial dysfunction, alteration of brain self-regulation and severe hypertension are, probably, the cause of many strokes in pregnant women and during postpartum period. We report a case of hemorrhagic stroke of the brainstem in a nonmonitored 21-year old patient at 38 weeks pregnant admitted with severe preeclampsia complicated by eclampsia and then by haemorrhagic stroke of the brainstem on the second post-operative day after cesarean section performed due to suspicion of retroplacental haematoma arisen since her admission...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29187254/acute-disseminated-melioidosis-giving-rise-to-pneumonia-and-renal-abscesses-complicated-with-thrombotic-thrombocytopenic-purpura-in-a-post-partum-woman-a-case-report
#7
Piyumi Sachindra Alwis Wijewickrama, Rohini Weerakoon
BACKGROUND: Melioidosis is an established endemic infection in Sri Lanka, caused by Burkholderia pseudomallei, a gram negative bacterium distributed in saprophytes in soil and surface water. Main mode of transmission is via percutaneous inoculation. Pneumonia is the most common presentation in acute disease. CASE PRESENTATION: We report a 33 year old previously healthy Sinhalese female with an occupational exposure to surface water in paddy fields, who was on postpartum day 6 following an uncomplicated pregnancy and delivery via an elective caesarian section...
November 29, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29129501/-maternal-deaths-due-to-haemorrhage-results-from-the-french%C3%A2-confidential-enquiry-into-maternal-deaths-2010-2012
#8
E Morau, J C Ducloy, S Le Roux, P Weber
Haemorrhage is the first cause of maternal mortality and morbidity in France and a quality of care marker. Haemorrhage rate in France is around 5 to 10% of deliveries. PPH is defined as a post-partum blood loss≥500mL whatever the delivery route and sometime blood can be concealed inside the pelvis. Between 2010 and 2012 in France, 29 deaths were related to haemorrhage giving a maternal mortality ratio of 1,2/100,000 live births (CI 95% 0,8-1,7). Haemorrhage cases decreased from last triennium (2007-2009) especially for uterine atony cases (12/29) but remains the first leading cause of direct maternal death...
November 9, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29126600/effect-of-treatment-delay-on-the-effectiveness-and-safety-of-antifibrinolytics-in-acute-severe-haemorrhage-a-meta-analysis-of-individual-patient-level-data-from-40%C3%A2-138-bleeding-patients
#9
Angèle Gayet-Ageron, David Prieto-Merino, Katharine Ker, Haleema Shakur, François-Xavier Ageron, Ian Roberts
BACKGROUND: Antifibrinolytics reduce death from bleeding in trauma and post-partum haemorrhage. We examined the effect of treatment delay on the effectiveness of antifibrinolytics. METHODS: We did an individual patient-level data meta-analysis of randomised trials done with more than 1000 patients that assessed antifibrinolytics in acute severe bleeding. We identified trials done between Jan 1, 1946, and April 7, 2017, from MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, PubMed, Popline, and the WHO International Clinical Trials Registry Platform...
November 7, 2017: Lancet
https://www.readbyqxmd.com/read/29110753/a-multicentre-randomised-controlled-trial-of-position-during-the-late-stages-of-labour-in-nulliparous-women-with-an-epidural-clinical-effectiveness-and-an-economic-evaluation-bumpes
#10
Debra Bick, Annette Briley, Peter Brocklehurst, Pollyanna Hardy, Edmund Juszczak, Lynn Lynch, Christine MacArthur, Phillip Moore, Mary Nolan, Oliver Rivero-Arias, Julia Sanders, Andrew Shennan, Matt Wilson
BACKGROUND: Epidural analgesia leads to increased risk of instrumental vaginal delivery (IVD). There is debate about whether or not posture in second-stage labour influences the incidence of spontaneous vaginal birth (SVB). OBJECTIVES: In nulliparous women with epidural analgesia, does a policy of adopting an 'upright position' throughout second-stage labour increase the incidence of SVB compared with a policy of adopting a 'lying-down' position? DESIGN: Two-arm randomised controlled trial...
November 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29100880/updated-who-recommendation-on-intravenous-tranexamic-acid-for-the-treatment-of-post-partum-haemorrhage
#11
Joshua P Vogel, Olufemi T Oladapo, Therese Dowswell, A Metin Gülmezoglu
No abstract text is available yet for this article.
January 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29016591/caesarean-section-during-second-stage-of-labor-in-a-tertiary-centre
#12
Padma Gurung, Sameer Malla, Sushma Lama, Anagha Malla, Alka Singh
BACKGROUND: There is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. Within this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlight the feto-maternal outcome of caesarean section in second stage of labour. METHODS: This was a retrospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between April 1, 2013 and March 30, 2017 at Patan Academy of Health Sciences...
September 8, 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28970677/red-cell-alloimmunization-in-repeatedly-transfused-patients
#13
Dimel K Bhuva, Jitendra H Vachhani
INTRODUCTION: Repeated blood transfusions can result in the production of alloantibodies against one or more red cell antigens, which complicates subsequent transfusions. Aims: The study was done to find incidence of various red cell alloantibodies; to determine the type of alloantibody; to identify the factors such as frequency of transfusion, splenectomy status, donor ethnicity and gender and their association with the development of antibody in repeatedly transfused patients. MATERIALS AND METHODS: This study was carried out in Dept...
July 2017: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/28969322/viscoelastometric-testing-fibrinogen-and-transfusion-during-post-partum-haemorrhage
#14
J G van der Bom
No abstract text is available yet for this article.
September 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28898688/improving-non-technical-skills-teamwork-in-post-partum-haemorrhage-a-grouped-randomised-trial
#15
Pippa M Letchworth, Shane P Duffy, Dan Phillips
OBJECTIVE: To determine the effect of a decision support technology on teamwork and associated non-technical (NTS) and technical skills when teams manage post-partum haemorrhage (PPH) in the simulated environment. METHODS: Multidisciplinary (MDT) maternity teams were taught how to manage post partum haemorrhage. They were randomised to the intervention: using a decision support mobile digital platform or a control group. Each team managed a post-partum simulation, which was recorded and reviewed by assessors...
October 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28892994/life-threatening-severe-hypernatraemic-dehydration-in-neonates-a-report-of-two-cases
#16
Priyaja Paramasivam, Sujay Kumar Earan, Arulkumaran Arunagirinadhan, Shilpa Kantamneni
Hypernatraemic dehydration in neonates may lead to potentially lethal consequences like cerebral oedema, intracranial haemorrhage, hydrocephalus and gangrene. In the light of increase in the infants presenting with hypernatraemic dehydration, there is a definitive need to heighten the awareness and have a high degree of suspicion in diagnosis for this potentially lethal condition. We report two neonates of severe hypernatraemia with dehydration highlighting its diagnosis and management. Treatment of hypernatraemic dehydration involves correction of electrolyte imbalance by careful restoration of fluids and ensuring appropriate intake of calories...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28886702/safety-and-effectiveness-of-oral-misoprostol-for-induction-of-labour-in-a-resource-limited-setting-a-dose-escalation-study
#17
Marilyn Morris, John W Bolnga, Ovoi Verave, Jimmy Aipit, Allanie Rero, Moses Laman
BACKGROUND: Oral misoprostol as an induction of labour (IOL) agent is rapidly gaining popularity in resource-limited settings because it is cheap, stable at ambient temperatures, and logistically easier to administer compared to dinoprostone and oxytocin. We aim to investigate the safety and effectiveness of a regimen of oral misoprostol in Papua New Guinean women undergoing IOL. METHODS: As part of a prospective dose escalation study conducted at Modilon Hospital in Papua New Guinea, women with a singleton pregnancy in cephalic presentation and an unfavourable cervix who gave written informed consent were administered oral misoprostol, commencing at 25mcg once every 2 h for 4 doses and increased to 50mcg once every 2 h for 8 doses within 24 h...
September 8, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28816629/a-cascade-model-of-mentorship-for-frontline-health-workers-in-rural-health-facilities-in-eastern-uganda-processes-achievements-and-lessons
#18
Judith Ajeani, Richard Mangwi Ayiasi, Moses Tetui, Elizabeth Ekirapa-Kiracho, Gertrude Namazzi, Ronald Muhumuza Kananura, Suzanne Namusoke Kiwanuka, Jolly Beyeza-Kashesya
BACKGROUND: There is increasing demand for trainers to shift from traditional didactic training to innovative approaches that are more results-oriented. Mentorship is one such approach that could bridge the clinical knowledge gap among health workers. OBJECTIVES: This paper describes the experiences of an attempt to improve health-worker performance in maternal and newborn health in three rural districts through a mentoring process using the cascade model. The paper further highlights achievements and lessons learnt during implementation of the cascade model...
August 2017: Global Health Action
https://www.readbyqxmd.com/read/28811777/acute-renal-morbidities-with-obstetrical-emergencies-an-important-women-health-issue
#19
Meharun-Nissa Khaskheli, Shahla Baloch, Aneela Sheeba, Sarmad Baloch, Fahad Khan, Mohammad Rafique Ansari
OBJECTIVE: To observe the impact of acute renal morbidities with obstetrical emergencies on maternal health. METHODS: In this study pregnant women between 28-40 weeks gestational period and delivered women in their puerperal period up to 42 days after delivery having acute renal problems associated with obstetrical emergencies were included. Pregnant and delivered women with obstetrical emergencies and associated other morbidities were excluded. These women were registered on the predesigned proforma after taking written informed consent and taking approval from institutional ethic research committee...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28637428/quality-of-care-provided-in-two-scottish-rural-community-maternity-units-a-retrospective-case-review
#20
Sara Denham, Tracy Humphrey, Ruth Taylor
BACKGROUND: Women in Scotland with uncomplicated pregnancies are encouraged by professional bodies and national guidelines to access community based models of midwife-led care for their labour and birth. The evidence base for these guidelines relates to comparisons of predominantly urban birth settings in England. There appears to be little evidence available about the quality of the care during the antenatal, birth and post birth periods available for women within the Scottish Community Maternity Unit (CMU) model...
June 21, 2017: BMC Pregnancy and Childbirth
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