post-partum haemorrhage

BACKGROUND: Routine health facility data provides the opportunity to monitor progress in quality and uptake of health care continuously. Our study aimed to assess the reliability and usefulness of emergency obstetric care data including temporal and regional variations over the past five years in Tanzania Mainland. METHODS: Data were compiled from the routine monthly district reports compiled as part of the health management information systems for 2016-2020. Key indicators for maternal and neonatal care coverage, emergency obstetric and neonatal complications, and interventions indicators were computed...

A pregnant woman with rheumatic heart disease always runs the risk of developing both thromboembolic and hemorrhagic symptoms, necessitating careful monitoring of her anticoagulation treatments both throughout pregnancy and after delivery. Postpartum haemorrhage, a hemorrhagic manifestation, can be challenging to control and presents a significant challenge when it comes to beginning anticoagulation after delivery. Thus, pregnancy in these patients is an extremely risky endeavour. Given that these women take anticoagulants, managing these women with artificial heart valves throughout pregnancy can be difficult...

BACKGROUND: The increasing utilisation of in vitro fertilisation (IVF) has prompted significant interest in determining the optimal endometrial environment to increase pregnancy rates and minimise the obstetric complications associated with various embryo transfer strategies. AIMS: To determine which cycle is associated with increased obstetric complications: fresh embryo transfer (FreshET), natural thaw (NatThawET) or artificial thaw (ArtThawET). Outcomes of interest included: hypertensive disorders of pregnancy (HDP), gestational diabetes (GD), pre-term birth (PTB), post-partum haemorrhage (PPH) and large for gestational age (LGA)...

OBJECTIVES: To compare pregnancy complications in pregnancies with and without pre-gestational diabetes mellitus (DM) managed in a multidisciplinary high-risk diabetes antenatal clinic. METHODS: This screening cohort study was undertaken at a large maternity unit in the United Kingdom between January 2010 and December 2022. We included singleton pregnancies that booked at our unit at 11-13 weeks' gestation. Univariate and multivariate logistic regression analysis was carried out to determine risks of complications in pregnancies with type 1 and type 2 DM after adjusting for maternal and pregnancy characteristics...

BACKGROUND: Kidney diseases requiring haemodialysis are becoming an emerging public health problem. This study aimed to determine the burden, socio-demographic and other risk factors associated with haemodialysis in Northwest Nigeria. METHODOLOGY: The study was a retrospective multicentre review of secondary data from the dialysis centres of public hospitals in northwestern Nigeria. Risk factors for renal failure were examined in 1329 patients who were enrolled for haemodialysis between 2019 and 2022 in the four public dialysis centres in Kano and Jigawa state...

A new approach to treating post-partum haemorrhage is having a substantial impact on maternal deaths. Tatum Anderson reports.

OBJECTIVES: The Shock Index (SI) is used in emergency medicine to assess the severity of active bleeding and in the postpartum context for postpartum haemorrhage (PPH). We investigated the diagnostic value of haemodynamic parameters (SI, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP)) in predicting subsequent use of uterotonic sulprostone treatment. METHODS: This was a retrospective study including parturients with PPH ≥ 500mL between January 2017 and December 2018...

INTRODUCTION AND IMPORTANCE: Idiopathic spontaneous intraperitoneal haemorrhage is a rare and life-threatening condition that results from non-traumatic visceral artery rupture in the latter half of pregnancy and within the postpartum period [1-3]. CASE PRESENTATION: A 32 -year-old woman presented to emergency department, 14 weeks post-partum, with sharp left sided abdominal pain, nausea, and vomiting. Initial computed tomography (CT) was suggestive of non-specific colitis from transverse to descending colon of unclear cause...

A 20-year-old, primi gravid, south Asian woman, was referred from secondary care to Aga Khan University Hospital for further management of primary post-partum haemorrhage after a normal vaginal delivery, on July 12, 2021. She was otherwise healthy, with no known comorbidity. She tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during her admission, on account of universal Covid-19 testing policy. Initially, conservative measures were instituted to control bleeding, including bilateral internal iliac artery ligation, concluding with hysterectomy to stop the haemorrhage...

BACKGROUND: In the last few decades, the life expectancy of patients with transfusion-dependent thalassaemia (TDT) and sickle cell disease (SCD) has improved significantly, in part because of improved iron chelation. Fertility challenges and pregnancy complications have historically limited reproductive options in this group; however, improved multi-disciplinary care has made infertility a chronic disease complication requiring attention. Despite this, there are very few reports and no Australian data describing fertility and pregnancy outcomes in this population...

Background Cesarean section (CS) involves the delivery of the fetus through incisions in the abdomen or uterine walls which is an alternative to vaginal delivery. In the majority of women, second-stage CS is performed without even attempting assisted vaginal delivery. This leads to difficulty for obstetricians for whether to perform an immediate CS or attempt a difficult vaginal birth as the effective method of delivery as CS are linked with higher morbidities which further increase when a CS is performed in the second stage...

BACKGROUND: Lower rates of successful trial of labor after cesarean (TOLAC) in association with fetal macrosomia were previously reported. This study aimed to compare TOLAC to elective caesarean delivery (CD) in women with estimated fetal weight large for gestational age (eLGA) and a prior CD. Primary outcome was to analyse the mode of delivery in case of TOLAC. Secondary outcome was to compare maternal and foetal morbidity. METHODS: We conducted a retrospective, descriptive, multicentric, cohort study in five maternity units between January and December 2020...

PURPOSE: To investigate the impact on future reproductive potential of systemic methotrexate (MTX) administration, uterine artery embolization (UAE) and expectant management as treatments of caesarean scar pregnancy (CSP) and to assess their efficacy and safety. BASIC PROCEDURES: We retrospectively analyzed patients with a diagnosis of CSP treated in a five years' period (2014-2018). Hospitalization, hCG normalization, menstrual cycle recovery, ultrasound restitutio ad integrum times, reproductive desire accomplishment after the resolution of the picture, and outcomes of subsequent pregnancies were considered...

INTRODUCTION: Postpartum haemorrhage is the most life-threatening complication during pregnancy and atonic postpartum haemorrhage being the commonest one, often poses difficulties in management. B-Lynch suture with a high success rate has emerged as a life-saving measure in uncontrolled atonic postpartum haemorrhage refractory to uterotonics. The objective of this study was to find out the prevalence of B-Lynch suture management among patients with post-partum haemorrhage in a tertiary care centre...

BACKGROUND: Post-partum haemorrhage occurs in over 10% of all births and is the leading cause of maternal mortality, accounting for 25% of all maternal deaths worldwide. Active management of the third stage of labor is the most important intervention for reducing maternal morbidity and mortality by preventing postpartum hemorrhage. Previously, documented primary studies had been great discrepancy, inconsistent results, and there is a lack of comprehensive study. Hence, this systematic review and meta-analysis were intended to assess the prevalence and associated factors of the practice of active management of the third stage of labour among obstetric care providers in Ethiopia...

This study was aimed at exploring the causes of relaparotomy following caesarean section. The surgical procedures performed during relaparotomy were also discussed. This was a prospective study conducted in the Department of Obstetrics and Gynaecology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from November 2020 to May 2021. MMCH is the largest referral Hospital in Mymensingh. During this study period 48 puerpera needed relaparotomy after caesarean section within 6 weeks of caesarean section...

INTRODUCTION: Haemoglobin variants and preeclampsia (PE) are associated with adverse fatal events of which oxidative stress may be an underlying factor. Oxidative stress (OS) among preeclamptic women with haemoglobin variants has been well established. It is, however, unclear whether haemoglobin variants induce OS to aggravate the risk of adverse foeto-maternal outcomes in pregnant women with preeclampsia. We measured the levels of OS biomarkers and determined the association between haemoglobin variants, and adverse foeto-maternal outcomes among pregnant women with PE...

A 27-year-old female presented at 13 weeks' gestation with epigastric pain and anemia requiring blood and iron transfusions but no family history of gastrointestinal malignancy. Upper endoscopy revealed a giant circumferential polyp and associated hyperplastic-appearing polyps in the proximal stomach. Biopsies revealed hyperplasia with lamina propria eosinophils. She was supported with intermittent transfusions until labor was induced at 34 weeks' gestation. Total gastrectomy was performed at seven weeks post-partum...

BACKGROUND: There is conflicting evidence regarding the safety of Kielland's rotational forceps delivery (KRFD) in comparison with other modes of delivery for the management of persistent fetal malposition in the second stage of labour. OBJECTIVES: To derive estimates of risks of maternal and neonatal complications following KRFD, compared with rotational ventouse delivery (RVD), non-rotational forceps delivery (NRFD) or a second-stage caesarean section (CS), from a systematic review and meta-analysis of the literature...

BACKGROUND: Observational studies relating maternal 25-hydroxyvitamin D status to timing and mode of delivery have reported inconsistent results. We assessed the effect of antenatal cholecalciferol supplementation on the incidence of preterm birth, delivery mode and post-partum haemorrhage (PPH). METHODS: MAVIDOS was a randomized, double-blind, placebo-controlled trial of 1000 IU/day cholecalciferol from 14 weeks' gestation until delivery. Gestational age, mode of delivery [categorized as spontaneous vaginal delivery (SVD), instrumental (including forceps and vacuum extraction) or Caesarean section] and PPH (>500 ml estimated blood loss) were determined from medical records...