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Postpartum hemorrhage

Charlotte Holm, Lars L Thomsen, Jens Langhoff-Roos
BACKGROUND AND OBJECTIVES: To explore if intravenous iron isomaltoside (Monofer® ) leads to a better relief of fatigue than current treatment practice with oral iron in women suffering from severe fatigue after postpartum hemorrhage. MATERIALS AND METHODS: This is a subanalysis of a single-center, open-label, randomized controlled trial conducted in women suffering from postpartum hemorrhage. Participants were randomized 1:1 to 1200 mg iron isomaltoside or current treatment practice with oral iron...
March 20, 2018: Journal of Maternal-fetal & Neonatal Medicine
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
Rajesh Kumari, Venus Dalal, Garima Kachhawa, Ipshita Sahoo, Rajesh Khadgawat, Reeta Mahey, Vidushi Kulshrestha, Perumal Vanamail, J B Sharma, Neerja Bhatla, Alka Kriplani
Background: Gestational diabetes mellitus (GDM) is defined as a carbohydrate intolerance first diagnosed in pregnancy and may be associated with adverse maternal and perinatal outcome. Aim: The aim of the study was to determine the maternal and perinatal outcome in GDM during pregnancy. Materials and Methods: It is a retrospective analysis of women diagnosed with GDM who got antenatal care and delivered in our hospital in previous 5 years...
January 2018: Indian Journal of Endocrinology and Metabolism
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
Dogukan Yildirim, Sefik Eser Ozyurek
OBJECTIVE: Postpartum hemorrhage is still the most significant cause of maternal mortality and morbidity worldwide. Our aim was to evaluate the effect of timing of oxytocin administration on postpartum hemorrhage incidence in parturients with low-risk for postpartum hemorrhage. STUDY DESIGN: A randomized controlled trial was completed on 343 women at a level-three care hospital. In group 1, 10 IU of oxytocin was injected intramuscularly within the first minute following the delivery of the fetus...
March 9, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Abigail R Koch, Pamela T Roesch, Caitlin E Garland, Stacie E Geller
CONTEXT: Severe maternal morbidity (SMM) rates in the United States more than doubled between 1998 and 2010. Advanced maternal age and chronic comorbidities do not completely explain the increase in SMM or how to effectively address it. The Centers for Disease Control and Prevention and American College of Obstetricians and Gynecologists have called for facility-level multidisciplinary review of SMM for potential preventability and have issued implementation guidelines. IMPLEMENTATION: Within Illinois, SMM was identified as any intensive or critical care unit admission and/or 4 or more units of packed red blood cells transfused at any time from conception through 42 days postpartum...
March 7, 2018: Journal of Public Health Management and Practice: JPHMP
Huijing Zhang, Ruochong Dou, Huixia Yang, Xianlan Zhao, Dunjin Chen, Yilin Ding, Hongjuan Ding, Shihong Cui, Weishe Zhang, Hong Xin, Weirong Gu, Yali Hu, Guifeng Ding, Hongbo Qi, Ling Fan, Yuyan Ma, Junli Lu, Yue Yang, Li Lin, Xiucui Luo, Xiaohong Zhang, Shangrong Fan
OBJECTIVE: The objective of this study is to identify the maternal and neonatal outcomes in women with placenta increta or placenta percreta in China. MATERIALS AND METHODS: We retrospectively analyzed 2219 cases from 20 tertiary care centers in China between January 2011 and December 2015. All cases were diagnosed of placenta increta or placenta percreta, based on either intraoperative findings or histopathological findings. RESULTS: The incidence of placenta increta and placenta percreta progressively increased from 0...
March 7, 2018: Journal of Maternal-fetal & Neonatal Medicine
Molly R Altman, Karen Colorafi, Kenn B Daratha
BACKGROUND:  Hospital electronic health record (EHR) data are increasingly being called upon for research purposes, yet only recently has it been tested to examine its reliability. Studies that have examined reliability of EHR data for research purposes have varied widely in methods used and field of inquiry, with little reporting of the reliability of perinatal and obstetric variables in the current literature. OBJECTIVE:  To assess the reliability of data extracted from a commercially available inpatient EHR as compared with manually abstracted data for common attributes used in obstetrical research...
January 2018: Applied Clinical Informatics
Natascha de Lange, Pim Schol, Marcus Lancé, Mallory Woiski, Josje Langenveld, Robbert Rijnders, Luc Smits, Martine Wassen, Yvonne Henskens, Hubertina Scheepers
BACKGROUND: Postpartum hemorrhage (PPH) is associated with maternal morbidity and mortality and has an increasing incidence in high-resource countries, despite dissemination of guidelines, introduction of skills training, and correction for risk factors. Current guidelines advise the administration, as fluid resuscitation, of almost twice the amount of blood lost. This advice is not evidence-based and could potentially harm patients. METHODS: All women attending the outpatient clinic who are eligible will be informed of the study; oral and written informed consent will be obtained...
March 6, 2018: Trials
Víctor Lago Leal, Loida Pamplona Bueno, Lucía Cabanillas Vilaplana, Estefanía Nicolás Montero, Mónica Martín Blanco, Cristina Fernández Romero, Sara El Bakkali, Tamara Pradillo Aramendi, Lara Sobrino Lorenzano, Paula Castellano Esparza, Esther Ballesteros Benito, Nieves Rayo Navarro, Pablo Del Barrio Fernández, Vanesa Ocaña Martínez, Luis Martínez Cortés
OBJECTIVE: To assess the short and medium-term effects of milking maneuver (MM) compared with early cord clamping for infants born before 37 weeks of pregnancy. MATERIAL AND METHODS: 138 infants between 24+0 and 36+6 weeks of gestation were allocated to MM or early cord clamping. Primary outcomes were the requirement of red blood cell transfusions or phototherapy. RESULTS: Initial hemoglobin was significantly higher in the MM group by 1.675 g/dL (p < 0...
March 5, 2018: Fetal Diagnosis and Therapy
Haiya Yan, Ling-Qun Hu, Yun Wu, Qihui Fan, Cynthia A Wong, Robert J McCarthy
BACKGROUND: Autologous transfusion of intraoperative cell salvage blood may be a potential method to decrease the need for allogeneic packed red blood cell transfusions after cesarean delivery, although there are limited data on the benefits of this method. This study evaluated the implementation of targeted intraoperative cell salvage during cesarean delivery in women at increased risk for hemorrhage at the Women's and Children's Hospital in Ningbo, China. METHODS: All women who underwent cesarean delivery >28 weeks of gestation were included in the study...
March 1, 2018: Anesthesia and Analgesia
Gabriele Saccone, Claudia Caissutti, Andrea Ciardulli, Vincenzo Berghella
BACKGROUND: Cesarean delivery could be complicated by postpartum hemorrhage (PPH), the first cause of maternal death. OBJECTIVES: To evaluate the efficacy of uterine massage in preventing postpartum hemorrhage at cesarean delivery. DATA SOURCES: Electronic databases from their inception until October 2017. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS: We included all RCTs comparing uterine massage alone or as part of the active management of labor before or after delivery of the placenta, or both, with non-massage in the setting of cesarean delivery...
February 23, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Anne-Sophie Ducloy-Bouthors, Emmanuelle Jeanpierre, Imen Saidi, Anne-Sophie Baptiste, Elodie Simon, Damien Lannoy, Alain Duhamel, Delphine Allorge, Sophie Susen, Benjamin Hennart
BACKGROUND: Evidence increases that a high or a standard dose of tranexamic acid (TA) reduces postpartum bleeding. The TRACES pharmacobiological substudy aims to establish a therapeutic strategy in hemorrhagic (H) Cesarean section (CS) with respect to the intensity of fibrinolysis by using innovative assays. METHOD/DESIGN: The TRACES trial is a multicenter, randomized, double-blind, placebo-controlled, TA dose-ranging study that measures simultaneously plasmatic and uterine and urine TA concentrations and the plasmin peak inhibition tested by a simultaneous thrombin plasmin generation assay described by Van Geffen (novel hemostasis assay [NHA])...
March 1, 2018: Trials
Anne-Sophie Bouthors, Benjamin Hennart, Emmanuelle Jeanpierre, Anne-Sophie Baptiste, Imen Saidi, Elodie Simon, Damien Lannoy, Alain Duhamel, Delphine Allorge, Sophie Susen
BACKGROUND: Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide. Tranexamic acid (TA), an antifibrinolytic drug, reduces bleeding and transfusion need in major surgery and trauma. In ongoing PPH following vaginal delivery, a high dose of TA decreases PPH volume and duration, as well as maternal morbidity, while early fibrinolysis is inhibited. In a large international trial, a TA single dose reduced mortality due to bleeding but not the hysterectomy rate. TA therapeutic dosages vary from 2...
March 1, 2018: Trials
Maria Lúcia Moleiro, Luís Guedes-Martins, Alexandrina Mendes, Cláudia Marques, Jorge Braga
Nowadays, postpartum hemorrhage is the major cause of maternal mortality and morbidity worldwide. Uterine atony is its main cause; thus, prophylactic measures, as well as medical and surgical fast approaches, have been developed to manage it. The uterine compression sutures are a possible treatment that preserves the uterus and, consequently, the fertility potential. Bearing that in mind, we report two cases of postpartum hemorrhage after caesarean section, successfully treated with a new modification of Pereira suture - longitudinal and transverse uterine sutures were applied after no response was registered to the first-line therapies...
February 2018: Revista Brasileira de Ginecologia e Obstetrícia
Eun Jung Jung, Hwa Jin Cho, Jung Mi Byun, Dae Hoon Jeong, Kyung Bok Lee, Moon Su Sung, Ki Tae Kim, Young Nam Kim
INTRODUCTION: Placenta previa is a condition in which the placenta implants in the poorly vascularized lower uterine segment, which may result in inadequate uteroplacental perfusion, in turn, adversely affect the neonatal outcome. Abnormal placentation may also lead to severe postpartum hemorrhage as placenta separation proceeds. We aimed to evaluate the differences in placental histopathology and perinatal outcomes in pregnancies complicated with placenta previa and controls. METHOD: We undertook a retrospective case-control study of 93 pregnancies with placenta previa and 81 controls between 2011 and 2017...
March 2018: Placenta
Lise Brogaard, Lone Hvidman, Kim Hinshaw, Ole Kierkegaard, Tanja Manser, Peter Musaeus, Julie Arafeh, Kay I Daniels, Amy E Judy, Niels Uldbjerg
INTRODUCTION: This study aimed to develop a valid and reliable TeamOBS-PPH tool for assessing clinical performance in the management of postpartum hemorrhage (PPH). The tool was evaluated using video-recordings of teams managing PPH in both real-life and simulated settings. MATERIAL AND METHODS: A Delphi panel consisting of 12 obstetricians from the UK, Norway, Sweden, Iceland, and Denmark achieved consensus on a) the elements to include in the assessment tool, b) the weighting of each element, and c) the final tool...
February 27, 2018: Acta Obstetricia et Gynecologica Scandinavica
Saeed Baradwan, Dina Shafi, Amira Baradwan, Muhammad Salman Bashir, Dania Al-Jaroudi
Background: Hysteroscopic adhesiolysis anatomically restores the uterine cavity in cases of Asherman's syndrome (AS); however, the extent of endometrial fibrosis could determine the pregnancy outcome. Objectives: To determine whether endometrial thickness could influence pregnancy outcome of hysteroscopic adhesiolysis in women with a history of AS. Subjects and methods: This was a retrospective cohort study that included 41 women who attended Women's Specialized Hospital, King Fahad Medical City from December 2008 to December 2015, presented with a history of infertility or recurrent pregnancy loss, and were diagnosed with intrauterine adhesions and treated by hysteroscopic adhesiolysis...
2018: International Journal of Women's Health
Aivara Urbutė, Marija Paulionytė, Domicelė Jonauskaitė, Eglė Machtejevienė, Rūta J Nadišauskienė, Žilvinas Dambrauskas, Paulius Dobožinskas, Mindaugas Kliučinskas
BACKGROUND AND OBJECTIVES: There are only few training programs in obstetric emergencies currently in use and only some of them were evaluated with an adequate sample of participants. Therefore, we present the evaluation of the novel Standardized Trainings in Obstetrical Emergencies (STrObE), conducted in Lithuania. The aim of this study was to analyze whether participants' self-reported knowledge and confidence increased after the trainings, and whether the impact of the trainings was long-lasting...
February 8, 2018: Medicina
Novera G Chughtai, Raheela Mohsin Rizvi
The management of puerperal hematomas after normal delivery has always been challenging for obstetricians. Vulvar, vulvovaginal, or paravaginal hematomas are common. On the other hand, retroperitoneal hematomas are uncommon and can be life-threatening. The diagnosis of vascular injury is rarely made preoperatively as atonic or traumatic postpartum hemorrhage (PPH), uterine rupture and amniotic fluid embolism are more common differential diagnoses. Injury to internal pudendal and uterine vessels is extremely rare in cases of vaginal delivery and, therefore, the literature on this topic is very scarce...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
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