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postpartum hemorrhage and curettage

Hyun Jung Lee, Young Jai Lee, Eun Hee Ahn, Hyeon Chul Kim, Sang Hee Jung, Sung Woon Chang, Ji Yeon Lee
Objective: To identify factors associated with massive postpartum bleeding in pregnancies complicated by incomplete placenta previa located on the posterior uterine wall. Methods: A retrospective case-control study was performed. We identified 210 healthy singleton pregnancies with incomplete placenta previa located on the posterior uterine wall, who underwent elective or emergency cesarean section after 24 weeks of gestation between January 2006 and April 2016...
November 2017: Obstetrics & Gynecology Science
Yuko Iraha, Masahiro Okada, Masafumi Toguchi, Kimei Azama, Keiko Mekaru, Tadatsugu Kinjo, Wataru Kudaka, Yoichi Aoki, Hajime Aoyama, Akiko Matsuzaki, Sadayuki Murayama
Secondary postpartum hemorrhage (PPH) and postabortion hemorrhage are rare complications. Retained products of conception (RPOC) is among the most common causes of both secondary PPH and postabortion hemorrhage. Other less common causes of secondary PPH are uterine vascular abnormalities such as arteriovenous malformations and pseudoaneurysms. These are usually related to a history of a procedure such as dilation and curettage or cesarean delivery. Subinvolution of the placental site is an idiopathic cause of secondary PPH; this condition may be underrecognized and therefore could have a higher incidence than currently reported...
January 2018: Japanese Journal of Radiology
Ning Zhang, Wei-Hua Lou, Xue-Bin Zhang, Jian-Hua Lin, Wen Di
Postpartum hemorrhage (PPH), a leading cause of maternal mortality, can occur within 24 h of delivery (primary PPH), or during the period from 24 h after delivery to Week 6 of puerperium (secondary PPH). It requires health professionals to be alert to the symptoms to ensure prompt diagnosis and treatment, especially in the case of rupture of a uterine artery pseudoaneurysm (UAP) due to its life-threatening consequence (Baba et al., 2014). Most of the published case reports or case serials describe UAP as a possible cause of delayed PPH after traumatic procedures during delivery or pregnancy termination, including cesarean section (CS), manual removal of the placenta, or dilation and curettage (D&C) (Wald, 2003)...
May 2017: Journal of Zhejiang University. Science. B
Ran Cui, Junli Lu, Zhenyu Zhang, Huimin Bai
OBJECTIVE: To evaluate the feasibility of conservative management for patients with morbidly adherent placenta (MAP) accidentally encountered after term vaginal delivery. METHODS: Medical records of patients with MAP who were accidentally encountered after term vaginal delivery and treated in our hospital from January 2009 to December 2015 were retrospectively reviewed. RESULTS: A total of 8 eligible patients were included in this analysis...
2017: Gynecologic and Obstetric Investigation
Ítalo Morais, Andréa Lemos, Leila Katz, Lorena Fernandes Rosendo de Melo, Mariano Maia Maciel, Melania Maria Ramos de Amorim
Introduction Systematic reviews that evaluate the perineal cryotherapy to reduce pain in the vaginal postpartum are inconclusive. Purpose To evaluate clinical effectiveness of cryotherapy in the management of humanized postpartum perineal pain and vaginal edema. Methods A double-bind randomized controlled clinical trial (UTN number: U1111-1131-8433) was conducted in a hospital in Northeastern, Brazil. Women were included following humanized childbirth. All had vaginal deliveries of a single, full-term pregnancy with cephalic presentation...
July 2016: Revista Brasileira de Ginecologia e Obstetrícia
Hsiu-Huei Peng, Zooi-Ping Ng, Yun-Hsin Tang, Angelica Anne A Chua, Kuan-Gen Huang
OBJECTIVE: Term pregnancy with choriocarcinoma is a rare condition that can be a serious health threat to both the mother and the fetus. We present a rare case of term pregnancy with choriocarcinoma presenting as severe fetal anemia and postpartum hemorrhage. CASE REPORT: A 34-year-old woman, gravida 3 para 2, was admitted for profuse vaginal bleeding 2 weeks after cesarean delivery of a full-term anemic baby. Transvaginal sonography revealed a 4.7-cm×10.6-cm heterogenous lesion in the endometrial cavity...
June 2016: Taiwanese Journal of Obstetrics & Gynecology
T Weissbach, E Haikin-Herzberger, K Bacci-Hugger, G Shechter-Maor, M Fejgin, T Biron-Shental
OBJECTIVES: Approximately 1% of term deliveries are complicated by retained products of conception. Untreated, this condition may cause bleeding, infection and intrauterine adhesions. This study assessed whether performing routine bedside uterine ultrasound immediately after manual removal of the placenta reduced the occurrence of undiagnosed, retained products of conception and its associated complications. STUDY DESIGN: A retrospective study was conducted using the records of patients who delivered and underwent manual removal of placenta at a single obstetrics center over a 6-year period...
September 2015: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Cathrine Ebbing, Torvid Kiserud, Synnøve L Johnsen, Susanne Albrechtsen, Svein Rasmussen
OBJECTIVE: To assess whether anomalous cord insertion is associated with risk of complications in the third stage of labor. DESIGN: A population-based study. SETTING: Norwegian Medical Birth Register. POPULATION: All singleton births (gestational age >16 weeks and <45 weeks) during the period 1999-2011 (n = 738,443 singletons). Deliveries by cesarean were excluded, leaving 628,680 vaginal singleton deliveries for the analyses...
August 2015: Acta Obstetricia et Gynecologica Scandinavica
Signe Egenberg, Pål Øian, Lars Edvin Bru, Michael Sautter, Gunn Kristoffersen, Torbjørn Moe Eggebø
OBJECTIVE: To investigate whether inter-professional simulation training influenced the rate of red blood cell (RBC) transfusions after birth. DESIGN: Two cohorts were compared retrospectively using a pre-post design. SETTING: Norwegian university hospital with 4800 deliveries annually. POPULATION: Women with estimated blood loss >500 mL within 24 h after birth in 2009 and 2011. METHODS: In 2010, all maternity staff attended a 6-h, scenario-based training on emergency obstetrics including postpartum hemorrhage, using a birthing simulator...
March 2015: Acta Obstetricia et Gynecologica Scandinavica
Ana María Castillo-Cañadas, Carolina Serrano-Diana, Esther López-Del Cerro, María Teresa Gómez-García, Gaspar González De Merlo
Acquired hemophilia A is a truly exceptional hemorrhagic diathesis, that consists of the emergence of polyclonal autoantibodies (inhibitor) IgG-type (subclasses 1 and 4, in most cases) against the coagulant function of the circulating factor VIII, which acts in the domains C2, A2 and A3 of the molecule, thus interfering their interaction with the factor IXa, the phospholipids and the Von Willebrand factor. Its morbidity and mortality are high, but nevertheless its low incidence (1-1.5 cases per million population per year) is the most frequent autoimmune disorder...
October 2014: Ginecología y Obstetricia de México
C Y Akladios, N Sananes, A Gaudineau, E Boudier, B Langer
OBJECTIVES: To define secondary postpartum hemorrhage (HSPP), to discuss its main etiologies and suggest a proposal for its management. MATERIALS AND METHODS: Bibliographic research by crossing keywords: secondary postpartum hemorrhage, delayed postpartum hemorrhage, postpartum bleeding, placental remnant, placental and hysteroscopy. RESULTS: The HSPP (0.5 and 2%) is defined as bleeding occurring between 24hours and 6weeks after birth and requiring therapeutic action whatsoever (professional consensus)...
December 2014: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Gayoung Yang, Daeun Lee, Sara Lee, Kyungah Jeong
There is no current consensus on the best treatment modality for cesarean scar pregnancy (CSP) with favorable reproductive and pregnancy outcome. We treated 3 cases of symptomatic CSP with fetal cardiac activity. The first case underwent laparoscopic repair at 6 weeks' gestational age of unruptured CSP. The second patient underwent laparoscopic repair due to massive vaginal bleeding after suction curettage. Both patients conceived naturally 6 months later and underwent repeated cesarean section at term. These were successful live births although the second patient was treated with uterine artery embolization for postpartum hemorrhage...
2014: Gynecologic and Obstetric Investigation
Katherine M Scolari Childress, Mary B Holloran-Schwartz, Heather Wuebker, Jeffrey Gavard, Robert Blaskiewicz
OBJECTIVE: To evaluate the length of the third stage of labor in second trimester pregnancies, to determine the rate of complications such as hemorrhage or infection, and to determine the ideal timing for delivery of the placenta in these pregnancies. STUDY DESIGN: A review of 121 consecutive vaginal deliveries between 16 and 27 gestational weeks was performed. Length of the third stage of labor was determined, as well as the composite endpoint of need for manual or instrumented removal of the placenta, or development of chorioamnionitis or endometritis...
July 2014: Journal of Reproductive Medicine
Mireily Rivera-Rosado, Iehsus S Flores-Pérez, Keimari Méndez, Juana I Rivera-Viñas
UNLABELLED: The aim of this research was to study the relationship of abnormal placentation and cesarean hysterectomy risk factors at the University District Hospital. METHOD: A retrospective study was conducted using 60 medical records of patients in the University District Hospital from 2001 to 2008 with a diagnosis of abnormal placentation. Descriptive statistics and chi square for associations were used for statistical analysis. RESULTS: The mean age in our population was 29 years and mean BMI was 29...
2014: Boletín de la Asociación Médica de Puerto Rico
Yosuke Baba, Shigeki Matsubara, Tomoyuki Kuwata, Akihide Ohkuchi, Rie Usui, Miyuki Saruyama, Manabu Nakata, Mitsuaki Suzuki
PURPOSE: Uterine artery pseudoaneurysm (UAP) is considered a rare disorder after traumatic delivery or traumatic pregnancy termination such as cesarean section or dilatation and curettage, initially manifesting as genital hemorrhage. Our clinical impression contradicts these three assumptions; after traumatic delivery/termination, hemorrhage, and its rarity. Thus, we attempted to clarify these three issues. METHODS: We retrospectively analyzed 22 UAP cases treated at our institute over a 6-year period...
September 2014: Archives of Gynecology and Obstetrics
S S Kulkarni, W H L Teoh, A T H Sia, S Nair
We report an exceptional case of secondary postpartum hemorrhage (PPH) twenty days after cesarean delivery, resulting from a ruptured uterine artery pseudoaneurysm (UAP). The diagnosis was initially confounded by a septic shock necessitating inotropic support in the intensive care unit. Intense vaginal bleeding occurred eleven days after uterine curettage. Doppler ultrasound showed an anechoic focus in the inferior part of the uterus with turbulent flow. Bilateral internal iliac artery angiograms revealed a left uterine artery pseudoaneurysm that was successfully embolized...
2013: Acta Anaesthesiologica Belgica
Daniela Marchetti, Valerio Vellone, Ollga Dhimitri, Ezio Fulcheri
OBJECTIVE: This study reviews the surgical pathology reports of post-partum hemorrhages to support clinicians in malpractice litigation and, potentially, to enhance pregnancy-related diagnoses. STUDY DESIGN: This work is a retrospective study of surgical pathology reports of term pregnancies between January 2000 and January 2012 selected from the Surgical Pathology database of the I.R.C.C.S Azienda Ospedaliera Universitaria San Martino-IST (Istituto Nazionale per la Ricerca sul Cancro, Genoa)...
April 2014: Medicine, Science, and the Law
Mei-Chu Wu, Yao-Peng Hsu, Ho-Hsiung Lin, Sheng-Mou Hsiao
BACKGROUND: Symptomatic uterine diverticula are rare and, to our knowledge, have never been reported as a cause of postpartum hemorrhage. CASE: A 35-year-old woman presented with severe vaginal bleeding on the 47th day after a cesarean section. She had received endometrial curettage due to postpartum hemorrhage a few days earlier in another local hospital. Transvaginal ultrasound revealed a thickened heteroechoic endometrium and an isolated isthmic heteroechoic cystic lesion...
July 2013: Journal of Reproductive Medicine
Fatma Devran Bildircin, Emel Kurtoglu, Arif Kokcu, Yuksel Işik, Murat Ozkarci, Serkan Kuruoglu
OBJECTIVE: The aim of this study was to compare perinatal outcomes between adolescent and adult pregnancies. MATERIAL AND METHODS: In 527 adolescent and 1334 adult pregnant women who delivered at Ondokuz Mayis University Obstetrics and Gynecology Department between 2006 and 2013, perinatal outcomes were retrospectively compared in terms of including spontaneous abortion, induced abortion rate, dilatation and curettage (D&C), pregnancy-induced hypertension, premature prelabor and prelabor rupture of membranes, polihydramnios, oligohydramnios, maternal anemia, delivery modes and also neonatal outcomes including 5th minute Apgar score and fetal birth weight...
May 2014: Journal of Maternal-fetal & Neonatal Medicine
Pinar Ozcan Cenksoy, Cem Ficicioglu, Mert Yesiladali, Ozge Kizilkale
Intrauterine adhesions (IUAs) frequently occur as a result of trauma to the basal layer of endometrium following pregnancy-related curettage such as incomplete abortion (33,3%), postpartum hemorrhage (37,5%), and elective abortion (8,3%). Hysterotomy, myomectomy, Cesarean section, hysteroscopic procedures, such as resection of submucosal leiomyomata or uterine septae, and endometrial ablation are less common etiologic factors resulting in IUA formation. Patients with Asherman's syndrome usually present with menstrual disturbances, infertility, or recurrent pregnancy loss...
2013: Case Reports in Obstetrics and Gynecology
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