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https://www.readbyqxmd.com/read/29669438/standardized-management-protocol-in-severe-postpartum-hemorrhage-a-single-center-study
#1
Giuseppe Colucci, Karin Helsing, Franziska Demarmels Biasiutti, Luigi Raio, Pirmin Schmid, Dimitrios A Tsakiris, Balthasar Eberle, Daniel Surbek, Bernhard Lämmle, Lorenzo Alberio
Severe postpartum hemorrhage (sPPH) is an obstetric emergency that needs prompt and effective therapy to reduce the risk of complications. In this study, women who developed sPPH (study cohort, n = 27) were treated according to a standardized management protocol prescribing sequential administration of uterotonic drugs, crystalloids, tranexamic acid, labile blood products, low-dose fibrinogen, and recombinant activated factor VII (rFVIIa). This group was compared to patients treated with different strategies during 2 preceding periods: an in-house guideline regulating the administration of rFVIIa (historical cohort 1, n = 20) and no specific guideline (historical cohort 2, n = 27)...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29665357/second-trimester-surgical-abortion-practices-in-the-united-states
#2
Katharine O White, Heidi E Jones, Jade Shorter, Wendy V Norman, Edith Guilbert, E Steve Lichtenberg, Maureen Paul
OBJECTIVE: To assess whether second-trimester surgical abortion practices of U.S. providers agree with evidence-based policy guidelines. STUDY DESIGN: We conducted a cross-sectional survey of abortion facilities in the U.S. identified via publicly available resources and professional networks from June through December 2013. RESULTS: Of 703 identified facilities, 383 (54%) participated including 172 clinicians providing second-trimester surgical abortions (D&Es)...
April 14, 2018: Contraception
https://www.readbyqxmd.com/read/29628615/pelvic-artery-embolization-for-treatment-of-postpartum-hemorrhage
#3
REVIEW
Jonathan D Lindquist, Robert L Vogelzang
Postpartum hemorrhage (PPH) is the leading cause of maternal perinatal morbidity and mortality worldwide. Defined as greater than 500 mL blood loss after vaginal delivery, and greater than 1,000 mL blood loss after cesarean delivery, PPH has many causes, including uterine atony, lower genital tract lacerations, coagulopathy, and placental anomalies. Correction of coagulopathy and identification of the cause of bleeding are mainstays of treatment. Medical therapies such as uterotonics, balloon tamponade, pelvic artery embolization, and uterine-sparing surgical options are available...
March 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29628594/an-unusual-case-of-a-parturient-with-uncorrected-pentalogy-of-fallot-presenting-for-elective-cesarean-section-delivery-of-twins
#4
Ying Ci Ho, Sek Koon Boey, Abey Matthew Varughese Mathews, Hooi Geok See, Nian Chih Hwang
We present a 31-year-old primigravida with uncorrected pentalogy of Fallot, pregnant with monochorionic-diamniotic twins, undergoing elective lower segment cesarean section at 36 weeks gestation. Preoperative workup included a transthoracic echocardiogram which revealed a large ventricular septal defect of 1.8 cm with bidirectional shunting, a moderate size atrial septal defect of 1.8 cm with predominant left-to-right shunting, an overriding aorta, moderate right ventricular hypertrophy, and severe pulmonary valve stenosis...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29608125/kinesiologic-tape-for-labor-pain-control-randomized-controlled-trial
#5
Maria Amelia Miquelutti, Carla Silveira, José Guilherme Cecatti
BACKGROUND: Kinesiologic taping has been studied for managing diverse types of dysfunctions and pain, but not for managing pain during labor. OBJECTIVE: This study evaluated the effectiveness and safety of using kinesiologic tape (KT) during labor relative to pain, maternal satisfaction, and obstetric and neonatal outcomes. METHOD: The study was a single-blind randomized controlled trial composed of 60 pregnant women divided into two groups...
April 2, 2018: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/29558231/comparing-success-rates-of-the-hayman-compression-suture-and-the-bakri-balloon-tamponade
#6
Berna Aslan Cetin, Begum Aydogan Mathyk, Alev Atis Aydin, Nadiye Koroglu, Pinar Yalcin Bahat, Ilkbal Temel Yuksel, Elif Goknur Topcu, Ismail Ozdemir
BACKGROUND: Postpartum hemorrhage (PPH) is one of the leading causes of maternal morbidity and mortality around the world. Medical treatments and uterus-sparing interventions including balloon tamponades and compression sutures are the first line options before the decision is made to perform a hysterectomy. Our aim is to compare the success rates of the Hayman compression suture and the Bakri balloon tamponade in patients with PPH. METHODS: We enrolled 82 patients who were diagnosed with uterine atony during their cesarean sections and failed to respond to uterotonic agents...
March 20, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29535559/ebb-%C3%A2-complete-tamponade-system-effective-hemostasis-for-postpartum-hemorrhage
#7
REVIEW
Ross W McQuivey, Jon E Block, Robert A Massaro
As a leading cause of maternal death, postpartum hemorrhage (PPH) remains a worldwide obstetrical problem. However, in most cases, mortality and morbidity can be averted if efforts are immediately undertaken to achieve hemostasis. Uterine balloon tamponade has been shown to provide effective control of PPH and avoid more invasive surgical procedures and even the emergency peripartum hysterectomy. Recent clinical recommendation suggests that balloon tamponade should be considered earlier in the treatment cascade in conjunction with uterotonic agents to ensure hemostasis in the most timely fashion and maximize clinical outcomes...
2018: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/29458216/institution-of-a-comprehensive-postpartum-hemorrhage-bundle-at-a-large-academic-center-does-not-immediately-reduce-maternal-morbidity
#8
Rebecca Feldman Hamm, Eileen Wang, Kathleen O'Rourke, April Romanos, Sindhu K Srinivas
OBJECTIVE: Obstetric hemorrhage is a leading cause of morbidity and mortality. We sought to assess whether institution of a postpartum hemorrhage (PPH) bundle could improve maternal morbidity in our population. STUDY DESIGN: Preintervention data (PRE) was collected on all deliveries at Hospital of the University of Pennsylvania between October 15, 2013 and December 15, 2013. A two-pronged, multidisciplinary educational and procedural intervention related to PPH was instituted from March 2015 to June 2015...
February 19, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29451861/induction-of-labor-in-twin-gestation-can-we-predict-success
#9
Armin S Razavi, Stephen T Chasen, Fiona Chambers, Robin B Kalish
OBJECTIVE: To identify factors associated with a successful induction of labor in twin pregnancies and associated maternal morbidity. STUDY DESIGN: This was a retrospective review of twin pregnancies ≥24 weeks' gestation undergoing labor induction from 2011 to 2016. The primary outcome was a successful induction of labor. The secondary outcome was a composite of maternal morbidity, including ≥1 of the following: estimated blood loss (EBL) >1500 ml, blood transfusion, hysterectomy, intensive care unit (ICU) admission or maternal death...
February 16, 2018: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29409456/task-shifting-in-active-management-of-the-third-stage-of-labor-a-systematic-review
#10
Tessa M Raams, Joyce L Browne, Verena J M M Festen-Schrier, Kerstin Klipstein-Grobusch, Marcus J Rijken
BACKGROUND: Active management of the third stage of labor (AMTSL) describes interventions with the common goal to prevent postpartum hemorrhage (PPH). In low- and middle-income countries, implementation of AMTSL is hampered by shortage of skilled birth attendants and a high percentage of home deliveries. Task shifting of specific AMTSL components to unskilled birth attendants or self-administration could be a strategy to increase access to potentially life-saving interventions. This study was designed to evaluate the effect, acceptance and safety of task shifting of specific aspects of AMTSL to unskilled birth attendants...
February 6, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29360539/discovery-of-leonuri-and-therapeutical-applications-from-bench-to-bedside
#11
REVIEW
Yi Zhun Zhu, Weijun Wu, Qing Zhu, Xinhua Liu
Despite several advances in percutaneous coronary intervention and the discovery of new drugs, the incidence of myocardial infarction and deaths due to cardiovascular diseases (CVD) has not decreased markedly in China. The quality of life is affected seriously, which further results in great social and family burden. Many drugs, from the century-old aspirin to the newly FDA-approved Byvalson, have been proven to be effective in the treatment and prevention of CVD. As clinically reported, those life-saving drugs still have their side effects in regards to the narrow therapeutic indexes influenced by individual genetic variations...
March 8, 2018: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29330113/runt-related-transcription-factor-1-runx1-deficiency-attenuates-inflammation-induced-pro-inflammatory-and-pro-labour-mediators-in-myometrium
#12
Martha Lappas
Identifying new targets that regulate myometrial activation are required to develop effective treatments to stop preterm labor. Inflammation, which can be induced by sterile or infective insults, plays a role in initiating and maintaining uterine contractions. Several high throughput transcription screening studies have identified an upregulation of runt-related transcription factor 1 (RUNX1) mRNA expression in myometrium with labor. The role of RUNX1 in labor, however, is not known. We report increased RUNX1 during late gestation which was further augmented in labor, suggesting that RUNX1 may be involved in the transition of the myometrium from a quiescent into a contractile state in preparation for labor...
January 9, 2018: Molecular and Cellular Endocrinology
https://www.readbyqxmd.com/read/29241383/the-effect-of-prophylactic-oral-tranexamic-acid-plus-buccal-misoprostol-on-blood-loss-after-vaginal-delivery-a-randomized-controlled-trial
#13
Nahla W Shady, Hany F Sallam, Ahmed H Elsayed, Abdelrahman M Abdelkader, Shymaa S Ali, Ahmed Alanwar, Ahmed M Abbas
OBJECTIVE: The objective of this study is to evaluate the effect of prophylactic oral tranexamic acid (TA) plus buccal misoprostol on the amount of blood loss after vaginal delivery in women at low risk for post-partum hemorrhage (PPH). MATERIALS AND METHODS: The study was a randomized open label clinical trial conducted in a tertiary University Hospital between January 2016 and June 2017. We included women who delivered vaginally with a singleton pregnancy. They were randomized into three groups: group I (women received 10 IU oxytocin IV after delivery of the baby), group II (women received 600 µg buccal misoprostol after delivery of the baby), and group III (women received 1000 mg oral TA at the end of the first stage of labor plus 600 µg buccal misoprostol after delivery of the baby)...
December 27, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29223625/development-and-validation-of-a-predictive-model-for-excessive-postpartum-blood-loss-a-retrospective-cohort-study
#14
Ana Rubio-Álvarez, Milagros Molina-Alarcón, Ángel Arias-Arias, Antonio Hernández-Martínez
BACKGROUND: postpartum haemorrhage is one of the leading causes of maternal morbidity and mortality worldwide. Despite the use of uterotonics agents as preventive measure, it remains a challenge to identify those women who are at increased risk of postpartum bleeding. OBJECTIVE: to develop and to validate a predictive model to assess the risk of excessive bleeding in women with vaginal birth. DESIGN: retrospective cohorts study. SETTING: "Mancha-Centro Hospital" (Spain)...
November 26, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29202781/acta2-mutation-and-postpartum-hemorrhage-a-case-report
#15
Kylie Cooper, Stephen Brown
BACKGROUND: ACTA2 encodes smooth muscle specific α-actin, a critical component or the contractile complex of vascular smooth muscle. Mutations in ACTA2 are the most common genetic cause of thoracic aortic aneurysm, and are also the cause of other disorders, including Moyamoya disease, coronary artery disease and stroke as well as Multisystemic Smooth Muscle Dysfunction Syndrome. We note that ACTA2 is also expressed in uterine smooth muscle, and this raises the possibility that women harboring ACTA2 mutations might exhibit uterine smooth muscle dysfunction...
December 4, 2017: BMC Medical Genetics
https://www.readbyqxmd.com/read/29187156/lack-of-controlled-studies-investigating-the-risk-of-postpartum-haemorrhage-in-cesarean-delivery-after-prior-use-of-oxytocin-a-scoping-review
#16
Karin Bischoff, Monika Nothacker, Cornelius Lehane, Britta Lang, Joerg Meerpohl, Christine Schmucker
BACKGROUND: Postpartum haemorrhage (PPH) is a major cause of maternal mortality and morbidity worldwide. Experimental and clinical studies indicate that prolonged oxytocin exposure in the first or second stage of labour may be associated with impaired uterine contractility and an increased risk of atonic PPH. Therefore, particularly labouring women requiring cesarean delivery constitute a subset of patients that may exhibit an unpredictable response to oxytocin. We mapped the evidence for comparative studies investigating the hypothesis whether the risk for PPH is increased in women requiring cesarean section after induction or augmentation of labour...
November 29, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29175179/effects-of-oxytocin-and-pgf2%C3%AE-on-uterine-contractility-in-cows-with-and-without-metritis-an-in-vitro-study
#17
M Heppelmann, J Volland, C Pfarrer, M Kietzmann, W Bäumer, S Merbach, H-A Schoon, O Wellnitz, M Schmicke, M Hoedemaker, H Bollwein
The aim of this study was to investigate the effects of PGF2α and oxytocin in vitro on myometrial contractility in puerperal uteri. Thirteen puerperal uteri were removed and perfused after euthanasia of cows with (n=7) and without metritis (n=6). Measurement of uterine contractility was done using four piezoelectric crystals, which were implanted into the myometrium along the greater curvature of the uterine horn where fetal implantation occurred during the previous pregnancy. After 30min of equilibration, oxytocin (5 IU) or PGF2α (2...
January 2018: Animal Reproduction Science
https://www.readbyqxmd.com/read/29141679/intramuscular-oxytocin-versus-intravenous-oxytocin-to-prevent-postpartum-haemorrhage-at-vaginal-delivery-labor-trial-study-protocol-for-a-randomised-controlled-trial
#18
Nita Adnan, Fiona Boland, Deirdre J Murphy
BACKGROUND: Primary postpartum haemorrhage (PPH) is one of the leading causes of maternal morbidity and mortality worldwide. The most common cause of primary PPH is uterine atony. Atonic PPH rates are increasing in developed countries despite routine active management of the third stage of labour. In less-developed countries, primary PPH remains the leading cause of maternal death. Although the value of routine oxytocics in the third stage of labour has been well established, there is inconsistent practice in the choice of agent and route of administration...
November 15, 2017: Trials
https://www.readbyqxmd.com/read/29132342/a-low-cost-uterine-balloon-tamponade-for-management-of-postpartum-hemorrhage-modeling-the-potential-impact-on-maternal-mortality-and-morbidity-in-sub-saharan-africa
#19
Tara Herrick, Mercy Mvundura, Thomas F Burke, Elizabeth Abu-Haydar
BACKGROUND: Postpartum hemorrhage (PPH) is the leading cause of maternal deaths worldwide. This study sought to quantify the potential health impact (morbidity and mortality reductions) that a low-cost uterine balloon tamponade (UBT) could have on women suffering from uncontrolled PPH due to uterine atony in sub-Saharan Africa. METHODS: The Maternal and Neonatal Directed Assessment of Technology (MANDATE) model was used to estimate maternal deaths, surgeries averted, and cases of severe anemia prevented through UBT use among women with PPH who receive a uterotonic drug but fail this therapy in a health facility...
November 13, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29122802/emergency-obstetric-care-provision-in-southern-ethiopia-a-facility-based-survey
#20
Mitchell Windsma, Tienke Vermeiden, Floris Braat, Andualem Mengistu Tsegaye, Asheber Gaym, Thomas van den Akker, Jelle Stekelenburg
OBJECTIVES: To assess the provision of basic emergency obstetric and newborn care (BEmONC), knowledge of high-risk pregnancies and referral capacity at health centres in Southern Ethiopia. DESIGN: A facility-based survey, using an abbreviated version of the Averting Maternal Death and Disability needs assessment tool for emergency obstetric and newborn care. Modules included infrastructure, staffing, number of deliveries, maternal and perinatal mortality, BEmONC signal functions, referral capacity and knowledge of risk factors in pregnancy...
November 8, 2017: BMJ Open
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