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Obstetrics complications

Qiaozhen Peng, Weishe Zhang
RATIONALE: Placenta accreta is the main cause of severe obstetric postpartum hemorrhage (PPH) and hysterectomy. Several hemostatic techniques have been performed in patients with placenta accreta to prevent PPH and reserve fertility. Abdominal aorta and pelvic arteries balloon occlusion are the only techniques which could be performed before cesarean section (CS) in patients who want to keep the fetus and reserve fertility. However, abdominal aorta and pelvic arteries balloon occlusion might lead to severe complications such as formation and rupture of pseudoaneurysm, angiorrhexis, etc...
March 2018: Medicine (Baltimore)
Grace Lim, Francesca L Facco, Naveen Nathan, Jonathan H Waters, Cynthia A Wong, Holger K Eltzschig
Obstetric anesthesia has evolved over the course of its history to encompass comprehensive aspects of maternal care, ranging from cesarean delivery anesthesia and labor analgesia to maternal resuscitation and patient safety. Anesthesiologists are concerned with maternal and neonatal outcomes, and with preventing and managing complications that may present during childbirth. The current review will focus on recent advances in obstetric anesthesia, including labor anesthesia and analgesia, cesarean delivery anesthesia and analgesia, the effects of maternal anesthesia on breastfeeding and fever, and maternal safety...
March 21, 2018: Anesthesiology
Lijie Zhao, Guojing Jiang, Xingfang Tian, Xiaoqin Zhang, Ting Zhu, Beibei Chen, Yongxiang Wang, Qingliang Ma
The aim of this study is to estimate the timing impact on levothyroxine replacement among pregnant women with subclinical hypothyroidism (SCH). Ninety-eight pregnant women diagnosed as SCH in the first trimester were randomly divided into three groups: Group A, instantly initiated levothyroxine after diagnosis; Group B, administrated treatment in the second trimester, and Group C, received no prescription. Incidence of pregnancy complications and pregnancy outcomes were compared among three groups and subgroup analysis were performed stratified with TPO status in Group B...
March 21, 2018: Gynecological Endocrinology
Marie-Therese I Valovska, Vernon M Pais
Urolithiasis is the most common nonobstetric complication in the gravid patient. The experience can provoke undue stress for the mother, fetus, and management team. The physiologic changes of pregnancy render the physical exam and imaging studies less reliable than in the typical patient. Diagnosis is further complicated by the need for careful selection of imaging modality in order to maximize diagnostic utility and minimize obstetric risk to the mother and ionizing radiation exposure to the fetus. Ultrasound remains the first-line diagnostic imaging modality in this group, but other options are available if results are inconclusive...
April 2018: Therapeutic Advances in Urology
Pedro A A Monteleone, Pedro F M Peregrino, Edmund C Baracat, Paulo C Serafini
INTRODUCTION: Assisted reproductive technologies (ARTs) are associated with potential risks, mainly related to multiple pregnancies, which are around 20% to 25%. Iatrogenic multiple pregnancies due to ovarian stimulation with multiples embryos transferred can be avoided by the elective single-embryo transfer (eSET), a growing practice worldwide. Adequately applied eSET, which impact on the incidence of complications without compromising treatment success, is still a challenge. The aim of this study was to compare the cumulative success rates of elective transfer of 2 embryos when transferred one by one (eSET), versus the success rates of elective double-embryo transfer (DET) in a single procedure, in a good prognosis population...
January 1, 2018: Reproductive Sciences
Andrea Ciavattini, Giovanni Delli Carpini, Lorenzo Moriconi, Nicolò Clemente, Nina Montik, Rosa De Vincenzo, Anna Del Fabro, Monica Buttignol, Caterina Ricci, Francesca Moro, Francesco Sopracordevole
OBJECTIVES: To evaluate cervical regeneration at 6 months following excisional treatment for high-grade cervical intraepithelial neoplasia (CIN), and to investigate the effect of cone dimensions, age of patients and technique of excision on the efficacy of the regeneration process. DESIGN: Prospective observational multicentric study. SETTING: Three tertiary care and research centres. PARTICIPANTS: Among the 197 eligible women of childbearing age, older than 25 years of age, undergoing for the first time a loop electrosurgical excision procedure or carbon dioxide laser cervical excision for a high-grade CIN at the colposcopy-directed cervical punch biopsy, and with a final diagnosis of high-grade CIN, 165 completed the 6-month follow-up and were included in the analysis...
March 19, 2018: BMJ Open
Omotayo Bernard, Roger C Gibson, Affette McCaw-Binns, Jody Reece, Charlene Coore-Desai, Sydonnie Shakespeare-Pellington, Maureen Samms-Vaughan
BACKGROUND: Antenatal depression is associated with adverse maternal and infant well-being. However, compared to postpartum depression, it has been less frequently explored globally or in Jamaica. This study aimed to determine the prevalence of, and factors associated with, antenatal depressive symptoms among Jamaican women in order to inform policy and build interventions that could improve their management and reduce their negative consequences. METHODS: This secondary analysis of data from the second Jamaican Birth Cohort Study (JA-Kids Birth Cohort) included 3,517 women enrolled during pregnancy...
2018: PloS One
Yu-Ching Lin, Meei-Ling Gau, Ghi-Hwei Kao, Hung-Chang Lee
BACKGROUND: The physical positions that are adopted by women during childbirth significantly impact their childbirth outcomes and experiences. Literature studies have associated using a squatting position with reduced childbirth pain and increased comfort and pushing efficiency. However, the major disadvantage of the squatting position is that women may lack the muscular fitness and stamina necessary to sustain this position for a long period. PURPOSE: The aim of this study was to compare the pushing experiences and birth outcomes of three different pushing positions during the second stage of labor...
March 16, 2018: Journal of Nursing Research: JNR
Melih Velipasaoglu, Metin Sentürk, Reyhan Ayaz, Barbaros Atesli, H Mete Tanir
This study aimed to elucidate the diagnostic process, the associated anomalies and the perinatal outcomes of right aortic arch (RAA) in a group of low-risk patients. The obstetric imaging database and digital patient files were reviewed between January 2015 and June 2016. There were 12 RAA cases detected prenatally. Seven foetuses had an aberrant left subclavian artery and one foetus had mirror image branching. The prevalence of RAA was 1.8 in 1000. Invasive prenatal diagnosis was offered to patients and seven tests were performed...
March 19, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Gülşah İlhan, Hüseyin Gültekin, Ayça Kubat, Ayse Filiz Gokmen Karasu, Emre Sinan Güngör, Galip Ali Zebitay, Fatma Ferda Verit Atmaca
The aim of the study was to assess the standard foetal biometric measurements and foetal liver volume (FLV) in pregnancies complicated by gestational diabetes mellitus (GDM) at the time of GDM screening and to compare the results with foetuses in normal pregnancies. Ninety-seven pregnant women with normal singleton uncomplicated pregnancies between 24 and 28 weeks of gestation were allocated into GDM (+) (n: 33) and GDM (-) (n: 64) groups based on their 75 g oral glucose tolerance test results. Foetal biometric measurements and FLV measurements of the groups were compared...
March 19, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Balázs Dezsényi, László Sárközi, László Kaiser, Klára Tárkányi, Radka Nikolova, Zorán Belics
Enterobiasis is an easily recognizable and treatable disease with higher incidence among children. Based on these facts, its clinical importance is usually underestimated. This infection also occurs during adulthood and without treatment, it can cause severe complications in some rare cases. Unnoticed subclinical infection in women can lead to infertility and even to life-threatening conditions. It is also emphasized in this paper that the treatment of identified enterobiasis during pregnancy needs caution...
March 19, 2018: Acta Microbiologica et Immunologica Hungarica
Richard Godin, Geneviève Roy, James Douketis
Women who are receiving an oral anticoagulant appear to be at higher risk of developing bleeding-related adverse events than men. Physiological bleeding related to the ovulatory cycle poses an ongoing risk for bleeding complications during anticoagulant therapy. Abnormal uterine bleeding and hemorrhagic ovarian cysts are risks specific to women of reproductive age who are treated with anticoagulants. The use of combined oral contraceptives can help minimize such adverse events and would also mitigate the risks of obstetrical complications related to thrombosis and anticoagulation, in addition to avoiding fetal exposure to potentially teratogenic anticoagulants...
March 8, 2018: Thrombosis Research
Cathy Liu, Jade Lodge, Christopher Flatley, Alexander Gooi, Cameron Ward, Karen Eagleson, Sailesh Kumar
OBJECTIVE: To determine obstetric, intrapartum and perinatal outcomes for pregnancies with isolated fetal congenital heart defects (CHD). METHODS: This was a retrospective cohort study of women that delivered an infant with an isolated major CHD between January 2010 and April 2017 at a major Australian perinatal centre. The study cohort was compared with a cohort of women with infants without CHD. Cardiac abnormalities were broadly subdivided into the following five categories using the International Classification of Diseases Tenth Revision (ICD-10) as a guide - transposition of the great arteries (TGA), septal defects, right heart lesions (RHL), left heart lesions (LHL) and "other"...
March 16, 2018: Journal of Maternal-fetal & Neonatal Medicine
Erum Saleem Khan, Reeta Chander Parkash
Fibroid in pregnancy is common in clinical obstetric practice.There are conflicting reports in the literature on many so-called fibroid complications in pregnancy, and there are inadequate data on the optimum management strategy. We present a case of a pregnancy with large fibroid which was uneventful till delivery but ended in immediate postpartum complication of fibroid degenerating and prolapsing into vagina dealt with myomectomy at day 30 postnatal. Initially managed conservatively with intrauterine balloon tamponade and anaemia correction and discharged home...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Carolina Fux-Otta, Manuel Maliqueo, Bárbara Echiburú, Otilio Rosato, Nicolás Crisosto, Gabriel S Iraci, Marta Fiol de Cuneo, Paula Szafryk de Mereshian, Teresa Sir-Petermann
Pregnancy complications and obstetric outcomes were compared in 80 Chilean (PPCOSCh ) and 70 Argentinian (PPCOSAr ) pregnant women. Reference groups of Chilean and Argentinian normal pregnant women from the same antenatal care units were also compared. PPCOSCh showed a higher prevalence of gestational diabetes mellitus (GDM) (OR, 2.28, 95% CI: 1.08-4.77, p = .030) and a lower prevalence of pregnancy-induced hypertension (PIH) (OR, 0.20, 95% CI: 0.07-0.54, p = .001) compared to PPCOSAr . In the normal pregnant groups, the prevalence of PIH was lower in Chilean women compared to Argentinian women (OR, 0...
March 14, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Bharti Kalra, Meenu Choudhary, Meenakshi Thakral, Sanjay Kalra
Background: Hypothyroidism is common in pregnancy. No study has determined the prevalence of hypothyroidism in term pregnancies in India. Aim: This study aims to determine the prevalence and correlates of hypothyroidism in women who delivered at a center in Karnal, Haryana, North India. Results: Indoor records of all women who had delivered at this centre from April 2016 to March 2017 were reviewed. The prevalence of hypothyroidism was 12...
January 2018: Indian Journal of Endocrinology and Metabolism
Solina Tith, Garinder Bining, Laurent Bollag
Background : Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by "The American College of Obstetrics and Gynecology" as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists' unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia...
2018: F1000Research
Sudip Kundu, Hatun Karakas, Hermann Hertel, Peter Hillemanns, Ismini Staboulidou, Cordula Schippert, Philipp Soergel
INTRODUCTION: For the last two decades, obesity rates have been increasing in both developed and developing countries, with the number of obese women roughly doubling during this period (Stevens et al. in Popul Health Metr 10(1):33, 2012). Obesity represents one of the biggest epidemics of the 21st century. The aim of this retrospective study is to characterise the outcomes of gynaecologic surgeries in cases of extremely obese women with a body mass index (BMI) over 40 kg/m2 . METHODS: This study is a retrospective case control study in a single-centre setting...
March 10, 2018: Archives of Gynecology and Obstetrics
Ali Khatibi, Anne-Marie Nybo Andersen, Mika Gissler, Nils-Halvdan Morken, Bo Jacobsson
OBJECTIVES: Childbearing at extremely advanced maternal age is a globally increasing trend, but only a few studies have described the outcomes of these pregnancies. The aim of this study was to describe the occurrence of childbearing at age 50 and up in the Nordic countries, as well as to examine the frequency of adverse obstetric and neonatal outcomes. STUDY DESIGN: A descriptive population-based study was designed. Data from 1991 to 2013 were collected from the Medical Birth Registries in Denmark, Finland, Norway and Sweden...
March 3, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Lucía Paniagua-González, Cristian Jiménez-Morigosa, Elena Lendoiro, Marta Concheiro, Angelines Cruz, Manuel López-Rivadulla, Ana de Castro
Tobacco exposure during pregnancy is associated with obstetric and fetal complications. We developed and validated an LC-MS/MS method to determine nicotine, cotinine and hydroxycotinine (OH-cotinine) in placenta (PL) and umbilical cord (UC). Specimens were homogenized in water, followed by solid phase extraction. Chromatographic separation was performed using an Atlantis® HILIC Silica column. Detection was accomplished in electrospray in positive mode. Method validation included: linearity (5 to 1000 ng/g), accuracy (86...
March 10, 2018: Drug Testing and Analysis
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