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Postpartum hemorrhage

Igor Govorov, Signe Löfgren, Roza Chaireti, Margareta Holmström, Katarina Bremme, Miriam Mints
INTRODUCTION: von Willebrand disease (VWD) is a hereditary bleeding disorder, caused by a deficiency in the levels and/or function of von Willebrand factor (VWF). Women with VWD appear to be at increased risk of experiencing postpartum hemorrhage (PPH), though the levels of VWF increase during pregnancy. There is limited knowledge of how PPH is associated with the subtype of VWD, plasma levels of other coagulations factors than VWF and given hemostatic treatment. AIMS: The aims were to investigate the incidence of PPH in women with VWD and to analyse the correlation between PPH and: (1) type of VWD, (2) laboratory monitoring of VWF and FVIII and (3) hemostatic drug treatment...
2016: PloS One
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
Kathryn J Sharma, Tania F Esakoff, Alyson Guillet, Richard M Burwick, Aaron B Caughey
OBJECTIVE: To determine whether adverse outcomes were more common in late preterm pregnancies complicated by preeclampsia and growth restriction compared to those affected by preeclampsia alone. METHODS: This was a retrospective cohort study of 8,927 singleton pregnancies with preeclampsia. Pregnancies with small for gestational age (SGA) neonates (birthweight <10(th) percentile) were compared to those appropriate for gestational age (AGA) neonates. Maternal outcomes included cesarean delivery (CD) rate, CD for fetal heart rate (FHR) abnormalities, abruption, postpartum hemorrhage (PPH), maternal transfusion, acute renal failure, and peripartum cardiomyopathy...
October 19, 2016: Journal of Maternal-fetal & Neonatal Medicine
T Mu, Y Wang, G L Liu, J L Wang
OBJECTIVE: To evaluate the seven existing vaginal birth after cesarean (VBAC) screening tools and to identify additional factors that may predict VBAC or failed trial of labor in China. METHODS: In the study, 53 patients with 1 previous cesarean delivery who then delivered between January 1, 2007 and Novenber 31, 2014 were recruited. The average age of the patients was (32.1±3.5) years,the average gestational age was (38.0±2.3) weeks. There was no significant difference of the successful group and the failed group in the maternal/neonatal mortality and morbidity, also in the incidence of the postpartum hemorrhage and the postpartum infection...
October 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Maria Tølbøll Glavind, Axel Forman, Linn Håkonsen Arendt, Karsten Nielsen, Tine Brink Henriksen
OBJECTIVE: To study the association between endometriosis and risk of pre-eclampsia, cesarean section, postpartum hemorrhage, preterm birth, and small for gestational age (SGA), in a large Danish birth cohort, while taking fertility treatment into account. DESIGN: Population-based study. SETTING: Not applicable. PATIENT(S): A total population of 82,793 singleton pregnancies from the Aarhus Birth Cohort (1989 through 2013); 1,213 women had a diagnosis of endometriosis, affecting 1,719 pregnancies...
October 12, 2016: Fertility and Sterility
Lynn M Yee, Grecio Sandoval, Jennifer Bailit, Uma M Reddy, Ronald J Wapner, Michael W Varner, Steve N Caritis, Mona Prasad, Alan T N Tita, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
OBJECTIVE: To describe factors associated with delayed pushing and evaluate the relationship between delayed pushing and perinatal outcomes in nulliparous women with singleton term gestations. METHODS: This was a secondary analysis of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Assessment of Perinatal Excellence cohort of 115,502 women and their neonates born in 25 U.S. hospitals from 2008 to 2011. Nulliparous women with singleton, cephalic, nonanomalous term births who achieved 10-cm cervical dilation were included...
October 6, 2016: Obstetrics and Gynecology
Rebecca Feldman Hamm, Eileen Y Wang, Jamie A Bastek, Sindhu K Srinivas
Background Obstetrical hemorrhage is a leading cause of morbidity and mortality, yet is inconsistently defined. In 2014, the American Congress of Obstetricians and Gynecologists (ACOG) reVITALize program redefined postpartum hemorrhage (PPH) as greater than 1,000 mL blood loss regardless of the mode of delivery (MOD). Objective We sought to assess the reVITALize definition's validity by understanding whether the definition of PPH should, as proposed by ACOG, be one value regardless of MOD. Study Design This is a retrospective study of all women who delivered at the hospital of the University of Pennsylvania from October 15, 2013 through December 15, 2013...
October 12, 2016: American Journal of Perinatology
Maciej Sobkowski, Zbigniew Celewicz, Jarosław Kalinka, Krzysztof Szymanowski, Marcin Serafin, Katarzyna Śmieja, Anna Grzymała-Figura, Kinga Pacocha, Izabela Pieniążek, Jacek Walczak, Agnieszka Żyła, Adam Bierut
OBJECTIVES: The aim of this study was to compare the costs of using carbetocin in the prevention of uterine atony following delivery of the infant by Cesarean section (C-section) under epidural or spinal anesthesia with standard methods of prevention (SMP). MATERIAL AND METHODS: This retrospective multicenter study was based on data from three medical centers. A questionnaire was developed to gather patient records on consumption and costs of resources related to C-section, prevention of uterine atony and postpartum hemorrhage (PPH) treatment...
2016: Ginekologia Polska
Cheryl K Roth, Lindsey J Syed
von Willebrand disease is the most prevalent inherited bleeding disorder, affecting up to 1.3% of the population. It is caused by a defect or deficiency of the von Willebrand factor. Women with the condition may not be aware of their condition at the time of childbirth, but they are at high risk of postpartum hemorrhage even days after birth. In this article we briefly review the condition and specific considerations for the antepartum, intrapartum, and postpartum phases. It is important for nurses who care for women during childbirth to have a keen understanding of this condition...
October 2016: Nursing for Women's Health
Hanqing Pang, Jun Wang, Yuping Tang, Huiqin Xu, Liang Wu, Yi Jin, Zhenhua Zhu, Sheng Guo, Xuqin Shi, Shengliang Huang, Dazheng Sun, Jin-Ao Duan
Xin-Sheng-Hua granule, a representative formula for postpartum hemorrhage, has been used clinically to treat postpartum diseases. Its main bioactive components comprise aromatic acids, phthalides, alkaloids, flavonoids, and gingerols among others. To investigate the changes in main bioactive constituents in its seven single herbs before and after compatibility, a rapid, simple, and sensitive method was developed for comparative analysis of 27 main bioactive components by using ultrahigh-performance liquid chromatography with triple quadrupole electrospray tandem mass spectrometry for the first time...
October 6, 2016: Journal of Separation Science
Loïc Sentilhes, Benjamin Merlot, Hugo Madar, François Sztark, Stéphanie Brun, Catherine Deneux-Tharaux
Postpartum hemorrhage (PPH) is one of the leading causes of maternal death and severe maternal morbidity worldwide and strategies to prevent and treat PPH vary among international authorities. Areas covered: This review seeks to provide a global overview of PPH (incidence, causes, risk factors), prevention (active management of the third stage of labor and prohemostatic agents), treatment (first, second and third-line measures to control PPH), by also underlining recommendations elaborated by international authorities and using algorithms...
October 5, 2016: Expert Review of Hematology
Andra H James, Chad Grotegut, Homa Ahmadzia, Cathleen Peterson-Layne, Evelyn Lockhart
The purpose of this article is to review the use of blood products and hemostatic agents in the management of coagulopathy at the time of postpartum hemorrhage. Blood product administration strategies are broadly reviewed, including the role of the blood bank, the role of massive transfusion protocols, the role of laboratory monitoring, and the role of anesthesia management. Aspects of patient blood management are discussed. The concept refers to an evidence-based, comprehensive, multidisciplinary approach to optimizing the care of patients who might need transfusion and includes measures to avoid or minimize transfusion such as preoperative anemia management, cell salvage, and the use of hemostatic medication to reduce bleeding...
October 3, 2016: Seminars in Thrombosis and Hemostasis
Joanna Davies, Rezan Kadir
Management of factor XI (FXI) deficiency in pregnancy is complicated by lack of correlation between FXI level and bleeding risk. Clinicians should be vigilant about the potential for prolonged or excessive bleeding following miscarriage or termination of pregnancy, or postpartum hemorrhage (PPH). A multidisciplinary approach along with an individual care plan is recommended to prevent bleeding complications. Assessment of bleeding history, FXI level, and global tests of hemostasis can aid management decisions regarding hemostatic prophylaxis...
October 3, 2016: Seminars in Thrombosis and Hemostasis
Mahmoud H Ibrahim, Asmaa N Moustafa, Ahmed A Fadil Saedii, Ebtesam E Hassan
OBJECTIVE: To determine the adverse pregnancy outcomes associated with maternal prepregnancy overweight and obesity and we measure cord blood erythropoietin and NRBC count as indices of hypoxia and predictors of neonatal outcome. STUDY DESIGN: This prospective cohort study was done in Minia University Hospital, carried out from May 2015 to April 2016.270 full term neonates born to mothers of various body mass indices were included .Excluded were neonates with major factors known to be associated with a potential increase in fetal erythropoiesis...
October 3, 2016: Journal of Maternal-fetal & Neonatal Medicine
Raphael Câmara, Marcelo Burlá, José Ferrari, Lana Lima, Joffre Amim, Antonio Braga, Jorge Rezende
Cesarean section by maternal request is the one performed on a pregnant woman without medical indication and without contraindication to vaginal delivery. There is great controversy over requested cesarean section. Potential risks include complications in subsequent pregnancies, such as uterine rupture, placenta previa and accreta. Potential benefits of requested cesareans include a lower risk of postpartum hemorrhage in the first cesarean and fewer surgical complications compared with vaginal delivery. Cesarean section by request should never be performed before 39 weeks...
July 2016: Revista do Colégio Brasileiro de Cirurgiões
Raffaella Niola, Francesco Giurazza, Aleksandra Torbica, Emiliano Schena, Mattia Silvestre, Franco Maglione
Postpartum hemorrhages occur in 5 % of all deliveries. Open surgery and endovascular embolization techniques are the options commonly applied to face this life-threatening scenario. A cost analysis has been performed to compare the standard embolization endovascular approach, performed postpartum in emergency settlement, with a novel proposed preventive embolization approach, and performed in election in selected high-risk patients before the delivery. Two groups have been compared: 46 patients (non-preventive group) and 67 patients (preventive group)...
September 24, 2016: La Radiologia Medica
Jeevan Prasanga Marasinghe
No abstract text is available yet for this article.
October 2016: Obstetrics and Gynecology
Loïc Sentilhes, Stéphanie Brun, Hugo Madar, Benjamin Merlot
No abstract text is available yet for this article.
October 2016: Obstetrics and Gynecology
Sevan A Vahanian, Anthony M Vintzileos
PURPOSE OF REVIEW: Placental implantation abnormalities (PIAs) comprise a large group of disorders associated with significant maternal, fetal, and neonatal morbidity. RECENT FINDINGS: Risk factors include prior uterine surgery/myometrial scarring and the presence of placenta previa with or without prior cesarean delivery. Newly identified risk factors include previous prelabor cesarean delivery and previous postpartum hemorrhage. PIAs contribute substantially to preterm birth with prematurity rates ranging from 38 to 82%...
September 21, 2016: Current Opinion in Obstetrics & Gynecology
Hsin-Hsin Cheng, Leo Leung-Chit Tsang, Te-Yao Hsu, Chia-Te Kung, Chia-Yu Ou, Ching-Di Chang, Ching-Chang Tsai, Yu-Fan Cheng, Fu-Tsai Kung
BACKGROUND/PURPOSE: To assess the risk factors for intractable and controllable postpartum hemorrhage (PPH) and to evaluate the safety, efficacy, and outcome of transcatheter arterial embolization (TAE). METHODS: An emergency PPH rescue system including the 24-hour-available TAE was established in 2004. TAE with gelatine sponge particles placed on bilateral uterine or internal iliac arteries served as the first-line treatment for intractable PPH. Delivery methods, parity, causes of bleeding, clinical vital signs, coagulopathy, success rate, resumption of menstruation, and subsequent pregnancy outcome after TAE were recorded...
September 19, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
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