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Postpartum hemorrhage

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https://www.readbyqxmd.com/read/28534017/delayed-postpartum-hemoperitoneum-due-to-uterine-artery-pseudoaneurysm-rupture
#1
Kyu-Sang Kyeong, Ji-Yeon Moon, Song-Hwa Chae, Seung Hwa Hong, Minho Kang, Eun-Hwan Jeong
A 30-year-old woman experienced severe abdominal pain 8 days after vaginal delivery. The patient was diagnosed with hemoperitoneum due to rupture of the left uterine artery pseudoaneurysm, which was confirmed via ultrasound with color Doppler and computed tomography scans. This patient was treated with bilateral uterine artery embolization to maintain fertility. A uterine artery pseudoaneurysm that causes delayed postpartum hemorrhage can occur after cesarean section or vaginal delivery. A uterine artery pseudoaneurysm can be fatal, so its detection and diagnosis are critical...
May 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28532287/maternal-body-mass-index-and-oxytocin-exposure-in-nulliparous-women-is-there-an-interaction-associated-with-maternal-and-neonatal-morbidities
#2
Akila Subramaniam, John Owen, Sukhkamal B Campbell, Lorie M Harper, Joseph L Fitzwater, Rodney K Edwards
OBJECTIVE: Increasing body mass index (BMI) and administered doses of oxytocin are related to maternal and neonatal morbidities. We evaluated the effect of oxytocin dosage, BMI, and their interaction on select perinatal outcomes. STUDY DESIGN: We retrospectively studied nulliparas with singletons ≥36 weeks' gestation who received oxytocin and reached the second stage of labor. Oxytocin dosage was defined by the oxytocin product ([maximum oxytocin dose] X [duration of oxytocin infusion]/100 (milliunits))...
May 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28532262/trial-of-vaginal-delivery-for-twins-is-it-safe-a-single-center-experience
#3
Dana Sadeh-Mestechkin, Yair Daykan, Mor Bostan, Ofer Markovitch, Gil Shechter-Maor, Tal Biron-Shental
PURPOSE: This study assessed our hospital protocol of vaginal delivery for twins and evaluated whether trial of vaginal delivery (unless contraindicated) was as safe as elective cesarean. Risk factors leading to failed trial of labor (TOL) were characterized to improve our ability to advise patients and select cases for TOL. METHODS: This retrospective, cohort study included women >32 weeks gestation, with twin A in cephalic presentation and no contraindications for vaginal delivery...
May 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28532255/outpatient-vs-inpatient-management-for-superimposed-preeclampsia-without-severe-features-a-retrospective-multicenter-study
#4
Corina N Schoen, Sindy C Moreno, Gabriele Saccone, Nora M Graham, Lauren C Hand, Giuseppe M Maruotti, Pasquale Martinelli, Vincenzo Berghella, Amanda Roman
PURPOSE: To determine if women with preterm superimposed preeclampsia without severe features can be successfully and safely triaged to outpatient management. MATERIALS AND METHODS: This was a multicenter, retrospective, cohort study of singleton pregnancies with superimposed preeclampsia without severe features diagnosed before 37 weeks managed outpatient versus inpatient at Thomas Jefferson University (Philadelphia, USA) and at University of Naples (Naples, Italy) from January 2008 to July 2015...
May 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28528140/maternal-and-neonatal-outcomes-of-respiratory-failure-during-pregnancy
#5
Chen-Yiu Hung, Han-Chung Hu, Li-Chung Chiu, Chih-Hao Chang, Li-Fu Li, Chung-Chi Huang, Chuan-Chi Kao, Po-Jen Cheng, Kuo-Chin Kao
BACKGROUND: Obstetric patients comprise a limited portion of intensive care unit patients, but they often present with unfamiliar conditions and exhibit the potential for catastrophic deterioration. This study evaluated the maternal and neonatal outcomes of respiratory failure during pregnancy. METHODS: Information on 71 patients at >25 weeks gestation in the ICU with respiratory failure was recorded between 2009 and 2013. The characteristics and outcomes of mothers and fetuses were determined through a retrospective chart review and evaluated using Student's t test, chi-square test, and Fisher's exact test...
May 17, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28526143/uterotonic-medications-oxytocin-methylergonovine-carboprost-misoprostol
#6
REVIEW
Cristianna Vallera, Lynn O Choi, Catherine M Cha, Richard W Hong
Uterine atony is a common cause of primary postpartum hemorrhage, which remains a major cause of pregnancy-related mortality for women worldwide. Oxytocin, methylergonovine, carboprost, and misoprostol are commonly used to restore uterine tone. Oxytocin is the first-line agent. Methylergonovine and carboprost are both highly effective second-line agents with severe potential side effects. Recent studies have called into question the effectiveness of misoprostol as an adjunct to other uterotonic agents, but it remains a useful therapeutic in resource-limited practice environments...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28522320/risks-and-consequences-of-puerperal-uterine-inversion-in-the-united-states-2004-2013
#7
Sarah L Coad, Leanne S Dahlgren, Jennifer A Hutcheon
BACKGROUND: Puerperal uterine inversion is a rare, potentially life-threatening obstetrical emergency. The current literature consists of small case series and a single nationwide study from Europe with only 15 cases. OBJECTIVE: We aimed to define the incidence, temporal trends and outcomes in women with uterine inversion using a nationally representative United States (US) cohort. STUDY DESIGN: We used the Nationwide Inpatient Sample, a 20% sample of US hospital admissions, to identify all deliveries from 2004 to 2013...
May 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28508390/elevated-maternal-placental-protein-13-serum-levels-at-term-of-pregnancy-in-postpartum-major-hemorrhage-1000%C3%A2-mls-a-prospective-cohort-study
#8
Antonio Farina, Dalila Bernabini, Cinzia Zucchini, Paola De Sanctis, Maria Soledad Quezada, Mara Mattioli, Nicola Rizzo
PROBLEM: To compare placental protein 13 (PP13) levels in the serum of women with primary postpartum hemorrhage (PPH) with a control population. METHODS: A prospective cohort study was conducted between May 2014 and May 2016 and included 435 pregnant women at term (38 weeks gestation) without any known risk factor and with normal labor. Multiples of median (MoM) were used to evaluate differences of the PP13 values between cases and controls. PP13 concentrations were adjusted for maternal and neonatal weight...
May 15, 2017: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/28506946/maternal-mortality-due-to-hypertensive-disorders-in-pregnancy-childbirth-and-the-puerperium-between-2012-and-2015-in-turkey-a-nation-based-study
#9
Bekir Keskinkılıç, Yaprak Engin-Üstün, Sema Sanisoğlu, Dilek Şahin Uygur, Hüseyin Levent Keskin, Selma Karaahmetoğlu, Ayşe Özcan, Meral Esen, Afra Alkan, Aysun Kabasakal, İrfan Şencan
OBJECTIVE: To analyze maternal deaths in Turkey due to hypertensive disorders. MATERIAL AND METHODS: In this retrospective study 812 maternal deaths were analyzed. Maternal demographic features, presence of antenatal care, medical and obstetric history, mode of delivery, and use emergency antihypertensive therapy were recorded. The delay model for each case was investigated. RESULTS: Hypertensive disorders accounted for 15.5% (n=126) out of all maternal mortality...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28502758/the-impact-of-postpartum-hemorrhage-on-hospital-length-of-stay-and-inpatient-mortality-a-national-inpatient-sample-nis-based-analysis
#10
Ariela L Marshall, Urshila Durani, Adam Bartley, Clinton E Hagen, Aneel Ashrani, Carl Rose, Ronald S Go, Rajiv K Pruthi
BACKGROUND: Postpartum hemorrhage (PPH) is a major cause of maternal morbidity and mortality, but the association between PPH and hospital length of stay (LOS) has not been rigorously investigated. OBJECTIVE: We explored the impact of PPH on hospital length of stay (LOS) and inpatient mortality, as these outcomes have both clinical and economic significance. STUDY DESIGN: We performed a retrospective analysis using data from the National Inpatient Sample (NIS) database during the 2012-2013 time period...
May 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28501265/an-algorithm-for-the-management-of-coagulopathy-from-postpartum-hemorrhage-using-fibrinogen-concentrate-as-first-line-therapy
#11
S Seto, A Itakura, R Okagaki, M Suzuki, O Ishihara
BACKGROUND: We constructed an algorithm for the management of coagulopathy from massive postpartum hemorrhage. Fibrinogen concentrate was administered preferentially, and the dose of both fibrinogen concentrate and fresh frozen plasma given was determined by the plasma fibrinogen concentration and prothrombin time. The efficacy of the algorithm and the amount of fibrinogen concentrate and fresh frozen plasma transfused were determined. METHODS: The study was conducted in a single teaching perinatal center...
April 1, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28499533/obstetric-emergencies-shoulder-dystocia-and-postpartum-hemorrhage
#12
REVIEW
Joshua D Dahlke, Asha Bhalwal, Suneet P Chauhan
Shoulder dystocia and postpartum hemorrhage represent two of the most common emergencies faced in obstetric clinical practice, both requiring prompt recognition and management to avoid significant morbidity or mortality. Shoulder dystocia is an uncommon, unpredictable, and unpreventable obstetric emergency and can be managed with appropriate intervention. Postpartum hemorrhage occurs more commonly and carries significant risk of maternal morbidity. Institutional protocols and algorithms for the prevention and management of shoulder dystocia and postpartum hemorrhage have become mainstays for clinicians...
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28499381/experience-in-the-use-of-non-pneumatic-anti-shock-garment-nasg-in-the-management-of-postpartum-haemorrhage-with-hypovolemic-shock-in-the-fundaci%C3%A3-n-valle-del-lili-cali-colombia
#13
María Fernanda Escobar, Carlos Eduardo Füchtner, Javier Andrés Carvajal, Albaro José Nieto, Adriana Messa, Sara Sofía Escobar, Angélica María Monroy, Angélica María Forero, José David Casallas, Marcela Granados, Suellen Miller
BACKGROUND: The aim of this case series is to describe the experience of using the non-pneumatic anti-shock garment (NASG) in the management of severe Postpartum hemorrhage (PPH) and shock, and the value of implementing this concept in high-complexity obstetric hospitals. METHODS: Descriptive case series of 77 women that received NASG in the management of PPH with severe hypovolemic shock from June 2014 to December 2015. Vital signs, shock index (SI), the lactic acid value and the base deficit were compared before and after NASG application...
May 12, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28497006/under-pressure-intraluminal-filling-pressures-of-postpartum-hemorrhage-tamponade-balloons
#14
Kathleen M Antony, Diana A Racusin, Michael A Belfort, Gary A Dildy
Objective Uterine tamponade by fluid-filled balloons is now an accepted method of controlling postpartum hemorrhage. Available tamponade balloons vary in design and material, which affects the filling attributes and volume at which they rupture. We aimed to characterize the filling capacity and pressure-volume relationship of various tamponade balloons. Study Design Balloons were filled with water ex vivo. Intraluminal pressure was measured incrementally (every 10 mL for the Foley balloons and every 50 mL for all other balloons)...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28491165/carbon-dioxide-angiography-and-arterial-embolization-could-successfully-control-postpartum-uterine-hemorrhage-for-the-patient-with-hypersensitivity-to-iodine-compound
#15
Sayaka Kawashita, Masanori Kaneuchi, Daisuke Nakayama, Naoki Fuchi, Yuko Murakami, Kiyonori Miura, Hideaki Masuzaki
Transcatheter arterial embolization has become a common management option for intractable postpartum uterine hemorrhage. Iodinated contrast agents are commonly used for embolotherapy but cannot be used in patients with renal dysfunction or iodine allergy. A 37-year-old woman spontaneously delivered a healthy girl but developed severe postpartum uterine hemorrhage, probably due to placenta accrete. Contrast-enhanced computed tomography revealed extravasation of the iodinated contrast agent into the uterine cavity...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28487769/ferric-carboxymaltose-as-treatment-in-women-with-iron-deficiency-anemia
#16
Melvin H Seid, Angelia D Butcher, Ashwin Chatwani
Objective. To evaluate safety and efficacy of intravenous ferric carboxymaltose (FCM) versus standard medical care (SMC) for iron-deficiency anemia (IDA) in postpartum women and women with heavy menstrual bleeding. Study Design. This open-label, multicenter study randomized women with IDA (hemoglobin ≤ 11.0 g/dL) to single doses of FCM (15 mg/kg [maximum 1000 mg]) or SMC (this treatment was determined by the investigator and there may have been no treatment). Safety data (primary outcome) were collected for 30 days...
2017: Anemia
https://www.readbyqxmd.com/read/28486381/intracervical-foley-catheter-with-and-without-oxytocin-for-labor-induction-a-randomized-controlled-trial
#17
Corina N Schoen, Gwendolyn Grant, Vincenzo Berghella, Matthew K Hoffman, Anthony Sciscione
OBJECTIVE: To evaluate whether adding oxytocin to preinduction cervical ripening with a Foley catheter increases the rate of delivery within 24 hours. METHODS: This was a randomized, multicenter, parallel trial of women with a singleton pregnancy at 24 weeks of gestation or greater undergoing labor induction. Women were randomly allocated to an intracervical Foley catheter followed by oxytocin or Foley with concurrent oxytocin infusion. Nulliparous and multiparous women were randomized and analyzed separately based on parallel design...
May 5, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28484667/racial-ethnic-disparities-in-postpartum-hemorrhage-in-native-hawaiians-pacific-islanders-and-asians
#18
Scott A Harvey, Eunjung Lim, Krupa R Gandhi, Jill Miyamura, Kazuma Nakagawa
The objective of this study was to assess racial-ethnic differences in the prevalence of postpartum hemorrhage (PPH) among Native Hawaiians and other Pacific Islanders (NHOPI), Asians, and Whites. We performed a retrospective study on statewide inpatient data for delivery hospitalizations in Hawai'i between January 1995 and December 2013. A total of 243,693 in-hospital delivery discharges (35.0% NHOPI, 44.0% Asian, and 21.0% White) were studied. Among patients with PPH, there were more NHOPI (37.1%) and Asians (47...
May 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28479288/a-randomized-trial-of-foley-bulb-for-labor-induction-in%C3%A2-premature-rupture-of-membranes-in-nulliparas-flip
#19
Jennifer M H Amorosa, Joanne Stone, Stephanie H Factor, Whitney Booker, Meredith Newland, Angela Bianco
BACKGROUND: In premature rupture of membranes (PROM), the risk of chorioamnionitis increases with increasing duration of membrane rupture. Decreasing the time from PROM to delivery is associated with lower rates of maternal infection. The American College of Obstetricians and Gynecologists suggests that all women with PROM who do not have a contraindication to vaginal delivery have their labor induced instead of being managed expectantly. Although the use of oxytocin for labor induction has been demonstrated to decrease the time to delivery compared with expectant management, no studies have evaluated the effectiveness of cervical ripening with a Foley bulb to additionally decrease the time to delivery...
May 4, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28479286/pdbu-induced-pkc-activation-triggers-sustained-contracture-in-human-myometrium-in-vitro
#20
Laurence Massenavette, Wilène Paul, Stéphanie Corriveau, Jean-Charles Pasquier, Éric Rousseau
BACKGROUND: Although physiological transition from rhythmic contractions to uterine retraction postpartum remains a poorly understood process, it has been shown that the latter is essential in the prevention of hemorrhage and its negative consequences. OBJECTIVE: This study aimed to investigate the transition from oscillatory contractions to tonic contracture in human myometrium after delivery; a mechanism purported to facilitate postpartum hemostasis. Protein Kinase C (PKC) plays a key regulatory role in human uterine contractions since it can prevent dephosphorylation of regulatory proteins and sensitize the contractile machinery to low Ca2+...
May 4, 2017: American Journal of Obstetrics and Gynecology
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