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Uterine Rupture

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https://www.readbyqxmd.com/read/28212958/economic-evaluations-comparing-a-trial-of-labor-with-an-elective-repeat-cesarean-delivery-a-systematic-review
#1
REVIEW
Anna Joy Rogers, Nathaniel G Rogers, Meredith L Kilgore, Akila Subramaniam, Lorie M Harper
BACKGROUND: For women who have had a previous low transverse cesarean delivery, the decision to undergo a trial of labor after cesarean (TOLAC) or an elective repeat cesarean delivery (ERCD) has important clinical and economic ramifications. OBJECTIVES: To evaluate the cost-effectiveness of the alternative choices of a TOLAC and an ERCD for women with low-risk, singleton gestation pregnancies. METHODS: We searched EMBASE, MEDLINE, CINAHL, Cochrane Library, EconLit, and the Cost-Effectiveness Analysis Registry with no language, publication, or date restrictions up until October 2015...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28188975/contemporary-analysis-of-maternal-and-neonatal-morbidity-after-uterine-rupture-a-nationwide-population-based-study
#2
Gustavo Vilchez, Jing Dai, Komal Kumar, Moraima Lagos, Robert J Sokol
AIM: Uterine rupture is a rare but feared perinatal event. Despite abundant research and changes to guidelines implemented to reduce this complication, evaluation of whether uterine rupture still engenders significant maternal/neonatal morbidity has not been conducted. We analyzed recent cases of maternal/neonatal morbidity after uterine rupture. METHODS: Deliveries complicated by uterine rupture from 2011 to 2012 in the United States were selected. Comparison cases without uterine rupture were used as controls...
February 11, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28186617/sonographic-evaluation-of-surgical-repair-of-uterine-cesarean-scar-defects
#3
Michal Pomorski, Tomasz Fuchs, Anna Rosner-Tenerowicz, Mariusz Zimmer
BACKGROUND: The aim of the study was to assess the clinical outcomes of surgical repair of uterine cesarean scar defects with sonography (US). METHODS: Seven nonpregnant women with history of cesarean section and a large uterine scar defect were enrolled. The surgical repair was performed by minilaparotomy. The US assessment of the uterine scar was performed using a standardized approach at baseline, then at a first visit 2-3 days following the surgical intervention (V1) and at a follow-up visit 3 months later (V2)...
February 10, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28183709/consequences-of-delivery-at-home-in-a-woman-without-prenatal-care
#4
Nakul Kumar, Lisa Gilbert, Terry Ellis, Sandeep Krishnan
This is a case report of a 39-year-old multigravida woman without allopathic prenatal care who, after three previous caesarean sections, attempted to deliver her fourth child at home with the help of a direct entry midwife. During labour, fetal movement and fetal heart tones became undetectable, at which time the patient was referred by the midwife to the hospital. The patient was diagnosed with uterine rupture, bladder rupture and fetal demise; she was rushed to emergency surgery. The patient's lack of allopathic prenatal care, attempt of vaginal birth after three previous caesarean sections, coupled with her desire for delivery at home, led to her complicated course...
February 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28179200/laparoscopic-management-of-abdomininal-pregnancy
#5
Francesco Cosentino, Cristiano Rossitto, Luigi Carlo Turco, Salvatore Gueli Alletti, Carmine Vascone, Lavinia Di Meglio, Giovanni Scambia, Mario Malzoni
CASE REPORT OBJECTIVE: To show the surgical management in laparoscopy of a particular localization of an extra-uterine pregnancy misunderstood until 12 week of EG complicated by hemoperitoneum and abortion. BACKGROUND: The prevalence of ectopic pregnancy among women who go to an emergency department with first trimester bleeding, pain, or both ranges from 1 to 16 percent [1]. The most common localization of ectopic pregnancy are the Fallopian tubes while abdominal pregnancy represent at least 1 percent of extra-uterine pregnancies...
February 4, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28179198/cesarean-scar-ectopic-pregnancy-laparoscopic-resection-and-total-scar-dehiscence-repair-a-case-report
#6
Sara Mahgoub, Victor Gabriele, Emilie Faller, Bruno Langer, Arnaud Wattiez, Lise Lecointre, Cherif Akladios
STUDY OBJECTIVE: Illustrate laparoscopic technique for resection of cesarean scar ectopic pregnancy, associated with isthmocele repair. DESIGN: Case report SETTING: Tertiary referral centre in Strasbourg, France. The study was approved by the local IRB. BACKGROUND: Cesarean scar pregnancy is a rare form of ectopic pregnancy. The major risk of this type of pregnancy is the early uterine rupture with massive bleeding and maternal life-threatening...
February 4, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28178940/accuracy-of-clinical-fetal-weight-estimation-by-midwives
#7
Assaad Kesrouani, Chady Atallah, Ramzi AbouJaoude, Norma Assaf, Hanaa Khaled, Elie Attieh
BACKGROUND: Clinical fetal weight estimation is a common practice in obstetrics. This study aims to evaluate the accuracy of fetal weight estimation by midwives, and to identify factors that may lead to overestimation or underestimation of fetal weight. METHODS: A cohort prospective study in a Lebanese university hospital, included weight estimation of singleton pregnancies above 35 weeks. Multiple pregnancies, unclear dating, growth retardation, malformations and stillbirths cases are excluded...
February 8, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28178058/risk-factors-for-postcesarean-maternal-infection-in-a-trial-of-extended-spectrum-antibiotic-prophylaxis
#8
Kim A Boggess, Alan Tita, Victoria Jauk, George Saade, Sherri Longo, Erin A S Clark, Sean Esplin, Kristin Cleary, Ronald Wapner, Kelli Letson, Michelle Owens, Sean Blackwell, Carmen Beamon, Jeffrey M Szychowski, William Andrews
OBJECTIVE: To identify maternal clinical risk factors for postcesarean maternal infection in a randomized clinical trial of preincision extended-spectrum antibiotic prophylaxis. METHODS: We conducted a planned secondary analysis of a randomized clinical trial. Patients were 24 weeks of gestation or greater and delivered by cesarean after a minimum of 4 hours of ruptured membranes or labor. All participants received standard preincision prophylaxis and were randomized to receive azithromycin or placebo...
February 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28170398/emergency-obstetric-care-in-a-rural-district-of-burundi-what-are-the-surgical-needs
#9
E De Plecker, R Zachariah, A M V Kumar, M Trelles, S Caluwaerts, W van den Boogaard, J Manirampa, K Tayler-Smith, M Manzi, K Nanan-N'zeth, B Duchenne, B Ndelema, W Etienne, P Alders, R Veerman, R Van den Bergh
OBJECTIVES: In a rural district hospital in Burundi offering Emergency Obstetric care-(EmOC), we assessed the a) characteristics of women at risk of, or with an obstetric complication and their types b) the number and type of obstetric surgical procedures and anaesthesia performed c) human resource cadres who performed surgery and anaesthesia and d) hospital exit outcomes. METHODS: A retrospective analysis of EmOC data (2011 and 2012). RESULTS: A total of 6084 women were referred for EmOC of whom 2534(42%) underwent a major surgical procedure while 1345(22%) required a minor procedure (36% women did not require any surgical procedure)...
2017: PloS One
https://www.readbyqxmd.com/read/28151754/maternal-risks-of-fetal-therapy
#10
Alyaa Al-Refai, Greg Ryan, Tim Van Mieghem
PURPOSE OF REVIEW: Although most fetal disorders can be treated after birth, a few conditions that predictably lead to fetal or neonatal death, or that progress significantly before birth, are ideally treated prenatally. The number of centers offering fetal therapeutic procedures is gradually increasing worldwide. Patients and caregivers should be aware of the potential maternal risks of these interventions. RECENT FINDINGS: For transplacental medical therapy (corticosteroids, antiarrhythmics and immunoglobulins), severe maternal adverse events are rare, when done in expert centers...
February 1, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28133695/rupture-rudimentary-horn-pregnancy-at-31-week
#11
Abdullah A Al Qarni, Nawal Al-Braikan, Moh'd M Al-Hanbali, Abdullah H Alharmaly
Rudimentary horn could be a rare congenital uterine anomalies result from incomplete fusion of the two Müllerian ducts throughout embryo-genesis. Pregnancy in an exceedingly rudimentary horn is rare and typically terminates in rupture throughout the late of first or second trimester of pregnancy. We tend to present a rare case of a gravida within the trimester (31 weeks) presented with complain of abdominal pain, nausea, and vomit for 3 days. On presentation, the patient was pale and irritable. Ultrasound scan showed fetus at (30 weeks) with cardiac activity...
February 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28133615/pregnancy-during-adolescence-and-associated-risks-an-8-year-hospital-based-cohort-study-2007-2014-in-romania-the-country-with-the-highest-rate-of-teenage-pregnancy-in-europe
#12
Demetra-Gabriela Socolov, Magdalena Iorga, Alexandru Carauleanu, Ciprian Ilea, Iolanda Blidaru, Lucian Boiculese, Razvan-Vladimir Socolov
Aim. To determine pregnancy and delivery outcomes among teenagers. Materials and Methods. An 8-year retrospective comparative hospital-based cohort study is analysing singleton pregnancy comorbidities and delivery parameters of a teenage group under the age of 20 compared with a young adult group 20-24 years of age in a university hospital. Results. Teenage is a risk factor for preterm birth <37 weeks (1.21 [1.08-1.35]), foetal growth restriction (1.34 [1.21-1.48]), episiotomy (1.27 [1.21-1.34]), uterine revision (1...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28128916/vaginal-evisceration-related-to-genital-prolapse-in-premenopausal-woman
#13
Lucas Schreiner, Thais Guimarães Santos, Christiana Campani Nygaard, Daniele Sparemberger Oliveira
Vaginal evisceration is a rare problem, usually related to a previous hysterectomy. We report a case of spontaneous rupture of the cul-de-sac in a premenopausal woman under treatment with glucocorticoids to treat Systemic Lupus Erythematosus (SLE), with uterine prolapse that occurred during evacuation. Main findings-Case Report: A 40-year-old woman with SLE, using glucocorticoids, with uterine prolapse grade 4 (POP-Q), awaiting surgery presented at the emergency room with vaginal bleeding after Valsalva during defection...
January 27, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28127487/spontaneous-rupture-of-a-leiomyoma-causing-life-threatening-intra-abdominal-hemorrhage
#14
Melissa Schwartz, Kristin Powell
Background. Uterine fibroids are common benign tumors in women. Clinical manifestations are well known. Acute complications necessitating emergent surgical intervention are rare. Case. We report a case of a 53-year-old woman with a history of uterine fibroids presenting with acute-onset severe abdominal pain. Imaging indicated massive free fluid and a large partially solid uterine mass. Vitals were consistent with hypovolemic shock. Examination revealed a surgical abdomen. She underwent an emergent laparotomy and total hysterectomy...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28118763/spontaneous-uterine-laceration-in-labor-a-type-of-intrapartum-uterine-injury-different-from-the-classical-uterine-rupture
#15
Kenji Hishikawa, Remi Watanabe, Kazuya Onuma, Takeshi Kusaka, Takanori Fukuda, Yutaka Kohata, Hiromi Inoue
Uterine rupture, a complete disruption of uterine wall, is synonymously used of intrapartum uterine corpus injuries. However, uterine laceration, partial and minor myometrial tear, is not well characterized. A 35-year-old Japanese woman with unscarred uterus was delivered of a baby at 38 gestational weeks. Shortly after delivering the placenta, she complained of severe lower abdominal pain with shock vitals. Exploratory laparotomy revealed a partial and shallow myometrial and serosal tear with massive hemoperitoneum...
January 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28115056/the-clinical-outcome-of-cesarean-scar-pregnancies-implanted-on-the-scar-versus-in-the-niche
#16
Andrea Kaelin Agten, Giuseppe Cali, Ana Monteagudo, Johana Oviedo, Joanne Ramos, Ilan Timor-Tritsch
BACKGROUND: The term "cesarean scar pregnancy" (CSP) refers to placental implantation within the scar of a prior cesarean delivery. The rising numbers of cesarean deliveries in the last decades have lead to an increased incidence of CSP. Complications of CSP include: morbidly adherent placenta, uterine rupture, severe hemorrhage, and preterm labor. It is suspected that CSPs implanted within a dehiscent scar ("niche") behave differently compared to those implanted on top of a well healed scar...
January 20, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28110586/prediction-of-maternal-near-miss-in-placenta-previa-a-retrospective-analysis-from-a-tertiary-center-in-ankara-turkey
#17
Bora Coskun, Iltac Akkurt, Rıza Dur, Mehmet O Akkurt, Seval Y Ergani, Ozerk T Turan, Bugra Coskun
AIM: To determine risk factors for severe complications during and after cesarean delivery (CD) in placenta previa (PP). METHODS: We reviewed retrospectively collected data from women with PP who underwent CD during a 6-year study period. We identified the complicated group based on the modified World Health Organization near-miss criteria. Complicated and non-complicated groups were compared considering clinical, laboratory, and sonographic features. RESULTS: Thirty-seven of 256 cases classified as near miss consisting of 14 peripartum hysterectomies, 12 uterine balloon placements, 10 great artery ligations, and 4 B-lynch suture placement procedures without maternal mortality...
January 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28109894/pregnancy-outcomes-following-direct-uterine-fibroid-thermal-ablation-a-review-of-the-literature
#18
REVIEW
Julia Keltz, Mark Levie, Scott Chudnoff
The objective of this review is to describe the reproductive outcomes of women after radiofrequency volumetric thermal ablation (RFVTA) of fibroids or magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU). This is a literature review of the current case reports of reproductive outcomes following direct fibroid thermal ablation at multiple academic and private centers throughout the world. A literature search was performed using PubMed and Medline. All publications that included data of women who underwent radiofrequency fibroid ablation or magnetic resonance-guided high-intensity focused ultrasound of fibroids and subsequently conceived were included...
January 18, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28108735/fertility-sparing-uterine-lesion-resection-for-young-women-with-gestational-trophoblastic-neoplasias-single-institution-experience
#19
Xiaoyu Wang, Junjun Yang, Jie Li, Jun Zhao, Tong Ren, Fengzhi Feng, Xirun Wan, Yang Xiang
PURPOSE: To evaluate the oncological safety and pregnant outcomes of fertility-sparing uterine lesion resection in treating gestational trophoblastic neoplasias. RESULTS: After the treatment of surgery and chemotherapy, all the patients achieved complete remission. With a median follow-up time of 44 months (range, 6-188), 3 patients (3.85%) relapsed within 3-26 months. Multivariate analysis showed that tumor size was the independent risk factor of recurrence and the cutoff value was 4...
January 18, 2017: Oncotarget
https://www.readbyqxmd.com/read/28103463/-uterine-rupture-at-18-weeks-of-pregnancy-in-the-context-of-malformed-uterus
#20
Emídio Vale-Fernandes, Neusa Teixeira, Alexandra Cadilhe, Maria José Rocha
Birth defects of the female genital tract are relatively common and often asymptomatic. Despite the pregnancy outcome can be favorable, adverse obstetric outcomes are described in women with uterine malformations. The authors report the case of an obstetric emergency which enhances the possibility of a very adverse and rare outcome of uterine rupture in a left hemi-cavity of a bicornuate uterus away from the term, at 18 weeks of pregnancy, in a pregnant woman with history of caesarean in the right hemi-cavity and with placenta increta...
October 2016: Acta Médica Portuguesa
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