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post-partum hemorrhage

Eliza C Miller, Hajere J Gatollari, Gloria Too, Amelia K Boehme, Lisa Leffert, Mitchell S V Elkind, Joshua Z Willey
Importance: Older age is associated with increased risk of pregnancy-associated stroke (PAS). Data are limited on age-specific incidence ratios of PAS compared with stroke risk in nonpregnant women. Objectives: To assess the risk of stroke by age group in pregnant and postpartum women compared with their nonpregnant contemporaries and to compare risk factors across age groups in the exposed (pregnant/postpartum) and unexposed (nonpregnant) populations. Design, Setting, and Participants: International Classification of Diseases, Ninth Revision, billing codes from the calendar year 2003-2012 New York State Department of Health inpatient database and population data were used to identify all women aged 12 to 55 years with cerebrovascular events, including transient ischemic attack, ischemic and hemorrhagic stroke, cerebral venous thrombosis, and nonspecified PAS...
October 24, 2016: JAMA Neurology
Bryan M Corbett, Charles O'Connell, Mallory A Boutin, Nabil I Fatayerji, Charles W Sauer
BACKGROUND Methylergonovine is an ergot alkaloid used to treat post-partum hemorrhage secondary to uterine atony. Mistaking methylergonovine for vitamin K with accidental administration to the neonate is a rare iatrogenic illness occurring almost exclusively in the delivery room setting. Complications of ergot alkaloids in neonates include respiratory depression, seizures, and death. CASE REPORT A term infant was inadvertently given 0.1 mg of methylergonovine intramuscularly in the right thigh. The error was only noted when the vial of medication was scanned, after administration, identifying it as methylergonovine rather than vitamin K...
October 21, 2016: American Journal of Case Reports
Cho Hee Kim, Gyeong Sik Jeon, Shin Jae Lee, Suk Ho Kang
A 36-year-old primipara woman was referred to the interventional department for management of severe primary post-partum hemorrhage with a vaginal laceration after a normal vaginal delivery. Angiography revealed that the superior rectal branch of the inferior mesenteric artery was one of the origins of persistent vaginal bleeding following embolization of both uterine arteries. The patient was successfully treated by selective embolization without other complications. Our case report highlights that the inferior mesenteric artery should be considered as an unusual extrauterine source for post-partum hemorrhage...
October 8, 2016: Journal of Obstetrics and Gynaecology Research
Liran Hiersch, Riki Bergel-Bson, Dorit Asher, Amir Aviram, Rinat Gabby-Benziv, Yariv Yogev, Eran Ashwal
OBJECTIVE: To identify risk factors for post-partum hemorrhage (PPH) following vacuum assisted vaginal delivery (VAVD). STUDY DESIGN: A retrospective study of all women with singleton pregnancies who underwent VAVD in a tertiary hospital (2012-2014). PPH was defined as any of the following: ≥500 ml estimated blood loss, hemoglobin drop ≥3 g/dl (difference between pre- and post-VAVD hemoglobin levels) or the need for blood products transfusion. Characteristics of women with PPH following VAVD were compared to those of women with no PPH following VAVD...
September 29, 2016: Archives of Gynecology and Obstetrics
Lore Billiauws, Laura Armengol Debeir, Florian Poullenot, Cécile Chambrier, Nicolas Cury, Pierre-François Ceccaldi, Emilie Latour Beaudet, Olivier Corcos, Evelyne Marinier, Olivier Goulet, Eric Lerebours, Francisca Joly
BACKGROUND & AIMS: Home parenteral nutrition (HPN) improves survival and quality of life in patients with chronic intestinal failure (IF). Few cases of pregnancy on HPN have been published. The aim of this study was to report pregnancy cases on long-term HPN in benign IF. METHODS: This retrospective study included all pregnant patients on HPN from 4 HPN referral centers. Data on demographics, ongoing pathology, HPN type, maternal and newborn complications were collected...
August 23, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Jonathan W Paul, Susan Hua, Marina Ilicic, Jorge M Tolosa, Trent Butler, Sarah Robertson, Roger Smith
BACKGROUND: The ability to provide safe and effective pharmacotherapy during obstetric complications, such as preterm labor or postpartum hemorrhage, is hampered by the systemic toxicity of therapeutic agents leading to adverse side effects in the mother and fetus. Development of novel strategies to target tocolytic and uterotonic agents specifically to uterine myocytes would improve therapeutic efficacy while minimizing the risk of side effects. Ligand-targeted liposomes have emerged as a reliable and versatile platform for targeted drug delivery to specific cell types, tissues or organs...
August 24, 2016: American Journal of Obstetrics and Gynecology
Cinzia Orlandini, Michela Torricelli, Nicoletta Spirito, Lucia Alaimo, Mariarosaria Di Tommaso, Filiberto Maria Severi, Antonio Ragusa, Felice Petraglia
OBJECTIVE: Sideropenic anemia is a common pregnancy disorder. The relationship between anemia and adverse pregnancy outcome are contradictory and it is related to the severity of the hemoglobin deficit. The aim of the study was to evaluate the relationship between maternal mild anemia at third trimester of pregnancy, fetal birth weight and fetal gender. STUDY DESIGN: A retrospective study including 1131 single physiological term pregnancies was conducted. According to maternal Hb levels during the third trimester, pregnant women enrolled, were divided in 2 groups: Group A (n = 156) with Hb≤11 g/dl and Group B (n = 975) with Hb≥11,1 g/dl...
August 22, 2016: Journal of Maternal-fetal & Neonatal Medicine
D Cruz-Cruz, H Peña-Dehesa, A Cérbulo-Vázquez, M Guzmán-López
OBJECTIVE: To evaluate the usefulness of active management of the third stage of labor plus Bakri balloon in primiparous and multiparous. patients with postpartum hemorrhage. MATERIAL AND MET HOD: A retrospective, cross-sectional analytical study in the Hospital of Women, from 1st January 2013 to 31st December 2014. We use uterotonics and after persistence of postpartum hemorrhage also considered Bakri balloon placement, and further transfusion management were evaluated. Analysis descriptive and inferential statistics were performed (Mann-Whitney U and linear regression) and the relationship between inter- and intra-group variables analyzed, a significance level of p <0...
May 2016: Ginecología y Obstetricia de México
Louise Laage Stentebjerg, Lise Lotte Torvin Andersen, Kristina Renault, René Klinkby Støving, Dorte Møller Jensen
OBJECTIVE: To compare perinatal and pregnancy outcomes including adherence to the Institute of Medicine's (IOM) recommendations for gestational weight gain (GWG) in pregnant women with conception <18 months (early group) compared to ≥18 months following gastric bypass (late group). METHODS: Retrospective cohort study comprising 71 women with gastric bypass and a singleton pregnancy presenting at Odense University Hospital, November 2007-October 2013. Data were extracted from medical records and laboratory systems...
July 17, 2016: Journal of Maternal-fetal & Neonatal Medicine
Michael H Dahan, SeangLin Tan
The pituitary gland plays a critical role in reproduction. In response to the hypothalamus the anterior pituitary secretes prolactin, thyroid stimulating hormone (TSH), Adreno corticotropic hormone (ACTH), follicle stimulating hormone (FSH), luteinizing hormone (LH) and growth hormone. Dysregulation in these hormones often lead to reproductive failure. Multiple mechanisms of pituitary injury exist. Simmond's disease is atrophy or destruction of the anterior lobe of the pituitary gland resulting in hypopitiutaryism...
July 13, 2016: Minerva Ginecologica
D X Zhou, X Y Bian, X Y Cheng, P Xu, Y F Zhang, J X Zhong, H Y Qian, S Huang
OBJECTIVE: The aim of this study was to investigate the impacts of late gestational liver dysfunction and its impact on pregnancy outcomes. MATERIALS AND METHODS: The patients hospitalized for liver dysfunction in their late pregnancy between 2010-2012 were set as the observation group, and the pregnant women with normal liver function at the same period were randomly selected and set as the control group. The impacts towards the pregnancy outcomes were compared between these two groups and the impacts of different-degree transaminase increasing towards the pregnancy outcome were analyzed...
2016: Clinical and Experimental Obstetrics & Gynecology
Wenjing Cheng, Qiushi Wang, Zhenyu Zhang
AIM: Post-partum hemorrhage (PPH) is a common complication of cesarean sections (CS) and affects maternal and newborn health. We used a new method to control bleeding and compared its efficacy with conventional methods. METHODS: Eighty-six women who experienced PPH with volume of bleeding over 1000 mL in CS between January 2008 and January 2012 were chosen as samples. Thirty-three underwent the new method in which normal saline ice blocks are placed in the uterus, and 53 underwent the conventional method...
June 9, 2016: Journal of Obstetrics and Gynaecology Research
Ahmed Mohamed Shaker El-Sayed Azzaz, María Angeles Martínez-Maestre, Rafael Torrejón-Cardoso
AIM: The frequency of antenatal care visits during pregnancy was examined to determine their effect on maternal and fetal outcomes in patients with pre-eclampsia. METHODS: This study included 150 pregnant women with pre-eclampsia who attended the Outpatient Clinic of the Obstetrics and Gynecology Department, Ismailia General Hospital. The women were interviewed and their antenatal care visits recorded. Blood pressure control, cardiotocography, ultrasonographic and Doppler evaluations and the administration of methyldopa were recorded...
September 2016: Journal of Obstetrics and Gynaecology Research
Yuko Nakamura, Shigeru Aoki, Shigeo Takebayashi, Fumiki Hirahara
Although pregnancy after transarterial embolization (TAE) has occasionally been reported, gelatin sponge was used as the embolic agent in most of these cases. Reports on the effect of TAE with permanent embolic agents such as N-butyl cyanoacrylate or coil on subsequent pregnancies are rare. We describe placenta accreta associated with difficult hemostasis in two patients who became pregnant after TAE with permanent embolic agents. In pregnancy after TAE with permanent embolic agents, placenta accreta occurs frequently and well-developed collateral vessels are highly likely, resulting in difficult hemostasis...
September 2016: Journal of Obstetrics and Gynaecology Research
Mikolaj Milewski, Adrian Goodey, Dinah Lee, Eric Rimmer, Robert Saklatvala, Shuzo Koyama, Mic Iwashima, Shunji Haruta
PURPOSE: To probe the suitability of a dry-powder oxytocin formulation containing a carrier (μco™; SNBL, Ltd.) for intranasal (IN) administration to treat post-partum hemorrhage in the developing world. Specifically, to investigate (1) whether IN administration can achieve rapid systemic absorption in cynomolgus monkeys, and (2) whether the formulation exhibits sufficient physical and chemical stability. This study was conducted to support Merck for Mothers, Merck's 10-year global initiative to end preventable maternal deaths...
August 2016: Pharmaceutical Research
F Daney de Marcillac, L Lecointre, A Guillaume, N Sananes, G Fritz, B Viville, E Boudier, I Nisand, A Gaudineau, B Langer, C Y Akladios
BACKGROUND: High risk of morbidly adherent placenta increased during past years. Their management is controversial. Cesarean hysterectomy, considered the gold standard treatment by American Society, is associated with high risk of maternal morbimortality. Conservative management has been sought to reduce maternal morbidity associated with caesarean hysterectomy while maintaining fertility. It consists of leaving the placenta in place but long-term monitoring. Our main objective was to determine advantage/disadvantage of conservative management on patient with an antenatal diagnosis of placenta accreta, increta or percreta...
April 23, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Liangcheng Wang, Shigetaka Matsunaga, Yukiko Mikami, Yasushi Takai, Katsuo Terui, Hiroyuki Seki
AIM: Placental abruption is a severe obstetric complication of pregnancy that can cause disseminated intravascular coagulation and progress to massive post-partum hemorrhage. Coagulation disorder due to extreme consumption of fibrinogen is considered the main pathogenesis of disseminated intravascular coagulation in patients with placental abruption. The present study sought to determine if the pre-delivery fibrinogen level could predict adverse maternal or neonatal outcomes in patients with placental abruption...
July 2016: Journal of Obstetrics and Gynaecology Research
Lior Drukker, Naama Srebnik, Deborah Elstein, Lorinne Levitt, Arnon Samueloff, Rivka Farkash, Sorina Grisaru-Granovsky, Hen Y Sela
UNLABELLED: Whether intra- and early post-partum hemorrhage is influenced by ABO blood groups remains unknown. Therefore, we compared women with O to non-O blood groups with regard to maternal post-partum hemorrhage and transfusion need. This retrospective study was conducted in a single tertiary center between 2005 and 2014. For the purpose of the study, parturients were categorized as O and non-O blood groups. Data included all deliveries but excluded patients with missing blood grouping or hemoglobin values, and/or stillbirth...
October 2016: Journal of Thrombosis and Thrombolysis
Esther Cathyln Atukunda, Godfrey Rwambuka Mugyenyi, Celestino Obua, Elly Bronney Atuhumuza, Nicholas Musinguzi, Yarine Fajardo Tornes, Amon Ganaafa Agaba, Mark Jacob Siedner
BACKGROUND: Accurate estimation of blood loss is central to prompt diagnosis and management of post-partum hemorrhage (PPH), which remains a leading cause of maternal mortality in low-resource countries. In such settings, blood loss is often estimated visually and subjectively by attending health workers, due to inconsistent availability of laboratory infrastructure. We evaluated the diagnostic accuracy of weighed blood loss (WBL) versus changes in peri-partum hemoglobin to detect PPH...
2016: PloS One
Keely Jordan, Elizabeth Butrick, Gavin Yamey, Suellen Miller
BACKGROUND: Obstetric hemorrhage (OH), which includes hemorrhage from multiple etiologies during pregnancy, childbirth, or postpartum, is the leading cause of maternal mortality and accounts for one-quarter of global maternal deaths. The Non-pneumatic Anti-Shock Garment (NASG) is a first-aid device for obstetric hemorrhage that can be applied for post-partum/post miscarriage and for ectopic pregnancies to buy time for a woman to reach a health care facility for definitive treatment. Despite successful field trials, and endorsement by safe motherhood organizations and the World Health Organization (WHO), scale-up has been slow in some countries...
2016: PloS One
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