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embolism postpartum

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https://www.readbyqxmd.com/read/27891406/amniotic-fluid-embolism-with-isolated-coagulopathy-a-report-of-two-cases
#1
Chi-Yuan Liao, Fuh-Jinn Luo
Amniotic Fluid Embolism (AFE) is a catastrophic complication of pregnancy with high mortality rate. The most common clinical presentation is an abrupt onset of cardiopulmonary collapse. Here, we present an uncommon variant involving isolated disseminated intravascular coagulation that developed without antecedent cardiopulmonary disturbances. Both patients developed symptoms soon after delivery. Blood test was sent at 14 minutes postpartum for the second patient due to suspected amniotic fluid embolism. Fetal components were observed in the uterine veins of the lower uterine segments in both cases...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27890467/use-of-hyperbaric-oxygen-therapy-and-pegylated-carboxyhemoglobin-bovine-in-a-jehovah-s-witness-with-life-threatening-anemia-following-postpartum-hemorrhage
#2
K Thenuwara, J Thomas, M Ibsen, U Ituk, K Choi, E Nickel, M J Goodheart
We present a case of a Jehovah's Witness patient who refused blood products, with the exception of albumin and clotting factors, and underwent cesarean section under spinal anesthesia complicated by postpartum hemorrhage. She was fluid resuscitated and treated with multiple uterotonics and internal iliac artery embolization. Because of agitation she required emergency tracheal intubation. Her hemoglobin concentration dropped from a preoperative value of 12mg/dL to 3mg/dL on postoperative day one. She was acidotic, requiring vasopressors for hemodynamic stability and remained ventilated and sedated...
October 24, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27880841/association-between-maternal-mortality-and-cesarean-section-turkey-experience
#3
Cihangir Uzuncakmak, Hasene Ozcam
BACKGROUND: To investigate the cesarean Section (C/S) rates and maternal mortality (MM) causes and its relation between 2002 and 2013. METHODS: Data were gathered from Turkish Ministry of Health and Istanbul Health Administration. The Annual Clinical Reports for 2002-2013 were reviewed and analyzed: C/Ss and maternal deaths in women who gave birth ≥20 weeks between January 1, 2002, and December 31, 2013, in any hospital in Turkey and Istanbul. RESULTS: The major causes of MM were hemorrhage (20%), hypertensive disorders (18...
2016: PloS One
https://www.readbyqxmd.com/read/27843682/large-spontaneous-spinal-subdural-epidural-hematoma-after-epidural-anesthesia-for-caesarean-section-conservative-management-with-excellent-outcome
#4
Ioannis D Siasios, Kunal Vakharia, Kevin J Gibbons, Vassilios G Dimopoulos
BACKGROUND: Iatrogenic or spontaneous spinal hematomas are rarely seen and present with multiple symptoms that can be difficult to localize. Most spontaneous spinal hematomas are multifactorial, and the pathophysiology is varied. Here, we present a case of a scattered, multicomponent, combined subdural and epidural spinal hematoma that was managed conservatively. CASE DESCRIPTION: A 38-year-old woman came to the emergency department (ED) complaining of severe neck and back pain...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27824773/prevalence-indications-risk-indicators-and-outcomes-of-emergency-peripartum-hysterectomy-worldwide-a-systematic-review-and-meta-analysis
#5
Thomas van den Akker, Carolien Brobbel, Olaf M Dekkers, Kitty W M Bloemenkamp
OBJECTIVE: To compare prevalence, indications, risk indicators, and outcomes of emergency peripartum hysterectomy across income settings. DATA SOURCES: PubMed, MEDLINE, EMBASE, ClinicalTrials.gov, and Cochrane Library databases up to March 30, 2015. METHODS OF STUDY SELECTION: Studies including emergency peripartum hysterectomies performed within 6 weeks postpartum. Not eligible were comments, case reports, elective hysterectomies for associated gynecologic conditions, studies with fewer than 10 inclusions, and those reporting only percentages published in languages other than English or before 1980...
December 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27823918/the-association-between-intrauterine-balloon-tamponade-duration-and-postpartum-hemorrhage-outcomes
#6
Brett D Einerson, Moeun Son, Patrick Schneider, Ian Fields, Emily S Miller
BACKGROUND: Intrauterine balloon tamponade is an effective treatment for postpartum hemorrhage when first-line treatments fail. The optimal duration of intrauterine balloon tamponade for management of postpartum hemorrhage is unclear. OBJECTIVE: The objective of the study was to determine whether intrauterine balloon tamponade removal >12 hours of duration is associated with postpartum hemorrhage-related clinical outcomes. STUDY DESIGN: This was a retrospective cohort study of women with postpartum hemorrhage from 2007 through 2014 who underwent intrauterine balloon tamponade...
November 4, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27812783/transcatheter-arterial-embolization-for-primary-postpartum-hemorrhage-predictive-factors-of-need-for-embolic-material-conversion-of-gelatin-sponge-particles-to-n-butyl-cyanoacrylate
#7
Yukichi Tanahashi, Satoshi Goshima, Hiroshi Kondo, Tomohiro Ando, Yoshifumi Noda, Hiroshi Kawada, Nobuyuki Kawai, Junichi Kotoku, Shigeru Furui, Masayuki Matsuo
PURPOSE: To identify predictive factors for embolic material conversion to N-butyl cyanoacrylate (NBCA) for the treatment of primary postpartum hemorrhage (PPH) after failed transcatheter arterial embolization (TAE) using gelatin sponge (GS). MATERIALS AND METHODS: Institutional review board approval was obtained. We retrospectively studied 62 consecutive women with primary PPH who underwent TAE between January 2006 and March 2015. Five of them were excluded for the following: cardiopulmonary arrest at arrival (n = 1), uterine inversion (n = 1), and hysterectomy after TAE (n = 3)...
November 3, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27805263/efficacy-of-transfusion-with-fresh-frozen-plasma-red-blood-cell-concentrate-ratio-of-1-or-more-for-amniotic-fluid-embolism-with-coagulopathy-a-case-control-study
#8
Hiroaki Tanaka, Shinji Katsuragi, Kazuhiro Osato, Junichi Hasegawa, Masahiko Nakata, Takeshi Murakoshi, Jun Yoshimatsu, Akihiko Sekizawa, Naohiro Kanayama, Isamu Ishiwata, Tomoaki Ikeda
BACKGROUND: The Japan Association of Obstetricians and Gynecologists (JAOG) recommends transfusion with a fresh-frozen plasma (FFP):red blood cell (RBC) ratio of 1 or more in postpartum hemorrhage. However, no global consensus exists concerning this, and little is known regarding the impact of FFP:RBC ratio on maternal mortality. This study evaluates the efficacy of transfusion with FFP:RBC ratio of 1 or more for amniotic fluid embolism (AFE) with coagulopathy. STUDY DESIGN AND METHODS: The Maternal Death Exploratory Committee, established by the JAOG, conducted this retrospective nationwide case-control study in Japan...
November 2, 2016: Transfusion
https://www.readbyqxmd.com/read/27788743/-multiposition-spiral-suture-of-the-lower-uterine-segment-a-new-technique-to-control-the-intraoperative-bleeding-of-pernicious-placenta-previa
#9
H Y Liu, X G Lin, J L Wu, F Y Qiao, D R Deng, W J Zeng
Objective: To explore the efficacy and safety of multiposition spiral suture of the lower uterine segment, a new technique to control the intraoperative bleeding of pernicious placenta previa(PPP). Methods: From May 2014 to May 2015, 38 patients were diagnosed PPP in Tongji Hospital and cesarean sections were performed. After removing the placenta, multiposition spiral suture was used when massive bleeding occurred, and bilateral descending branches of uterine artery ligation was conducted when necessary. Results: 18 of the 38 PPP patients(47%,18/38)were diagnosed placenta accreta...
October 25, 2016: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/27764878/environmental-and-genetic-risk-factors-associated-with-venous-thromboembolism
#10
Marta Crous-Bou, Laura B Harrington, Christopher Kabrhel
Venous thromboembolism (VTE) includes deep vein thrombosis and pulmonary embolism, and a combination of environmental and genetic risk factors contributes to VTE risk. Within environmental risk factors, some are provoking (e.g., cancer, surgery, trauma or fracture, immobilization, pregnancy and the postpartum period, long-distance travel, hospitalization, catheterization, and acute infection) and others are nonprovoking (e.g., age, sex, race/ethnicity, body mass index and obesity, oral contraceptive or hormone therapy use, corticosteroid use, statin use, diet, physical activity, sedentary time, and air pollution)...
November 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27755062/amniotic-fluid-embolism
#11
Courtney Stanley Sundin, Lauren Bradham Mazac
Amniotic fluid embolism (AFE) is a rare but serious and potentially deadly complication of pregnancy that is unpreventable and unpredictable. Most AFE events occur during labor; however, approximately one third happen during the immediate postpartum period. Presentation is abrupt and thought to be an abnormal response to fetal materials entering maternal circulation through the placental insertion site. Care providers must recognize the signs and symptoms of AFE and react quickly to treat potential complications...
January 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/27665305/predelivery-uterine-arteries-embolization-in-patients-with-placental-implant-anomalies-a-cost-effective-procedure
#12
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
https://www.readbyqxmd.com/read/27659552/transcatheter-arterial-embolization-as-first-line-rescue-in-intractable-primary-postpartum-hemorrhage-assessment-outcome-and-subsequent-fertility
#13
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
https://www.readbyqxmd.com/read/27646587/a-case-of-idiopathic-severe-acute-pancreatitis-following-cesarean-section-delivery
#14
Jung Kim, Jin Ho Choi, Bang Sup Shin, Joon Yeul Nam, Eun Ae Kang, Joo Seong Kim, Jin Hyeok Hwang, Jaihwan Kim
Acute pancreatitis rarely occurs in the postpartum period. Furthermore, there are very few reports of it after cesarean section delivery. A 35-year-old woman presented with dyspnea and abdominal distension on the third day after cesarean section delivery. Under a suspicion of acute pancreatitis, she was initially managed with conservative treatment. However, she developed intra-abdominal fluid collections and gastric bleeding, which were managed with percutaneous drainage, endoscopic hemostasis, and angiographic embolization...
September 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/27612214/outcomes-of-pelvic-arterial-embolization-in-the-management-of-postpartum-haemorrhage-a-case-series-study-and-systematic-review
#15
F J Ruiz Labarta, M P Pintado Recarte, A Alvarez Luque, L Joigneau Prieto, L Perez Martín, M Gonzalez Leyte, F Palacio Abizanda, F Morillas Ramirez, A Perez Corral, L Ortiz Quintana, J De Leon-Luis
BACKGROUND: Postpartum haemorrhage (PPH) is an unpredictable obstetric emergency that requires a multidisciplinary approach. Pelvic arterial embolization (PAE) is considered as a second-line treatment, although the published results have not been reviewed systematically since 2007. OBJECTIVES: To evaluate success and complication rates of PAE to treat PPH in the study hospital between 2009 and 2015, and to perform a systematic review of the literature on the reported efficacy and safety of PAE for the management of PPH...
August 4, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27591063/cryptogenic-postpartum-stroke
#16
Dániel Bereczki, Norbert Szegedi, Zoltán Szakács, István Gubucz, Zsolt May
An estimated 25-40% of ischemic strokes are classified as cryptogenic, which means the cause of the cerebral infarction remains unidentified. One of the potential pathomechanisms - especially among young patients with no cardiovascular risk factors - is paradoxical embolism through a patent foramen ovale. Pregnancy, cesarean delivery and the postpartum period are associated with an increased risk of cerebrovascular events. Factors that may contribute to ischemic strokes during gestation and puerperium include classic cardiovascular risk factors, changes in hemostaseology/hemodynamics, and pregnancy-specific disorders such as pre-eclampsia, eclampsia, postpartum cerebral angiopathy or peripartum cardiomyopathy...
2016: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/27589544/use-of-uterine-artery-embolization-to%C3%A2-prevent-peripartum-hemorrhage-of-placental-abruption-with-fetal-demise-severe-dic
#17
E Latif, S Adam, B Rungruang, A Al-Hendy, M P Diamond, E Rotem, J Cannell, P C Browne
Uterine artery embolization (UAE) is typically not indicated in the pre-operative management of pregnancies with a live fetus, because risk of fetal death from reduced uteroplacental blood flow. However, pre-operative UAE in pregnancies with a fetal demise poses no fetal risk, and may offer maternal benefits. Patients with placental abruption resulting in fetal demise are at high-risk for developing disseminated intravascular coagulation (DIC), which could have devastating complications such as peri-operative hemorrhage and death...
September 16, 2016: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/27552986/incidence-of-immediate-postpartum-hemorrhages-in-french-maternity-units-a-prospective-observational-study-hera-study
#18
Françoise Vendittelli, Chloé Barasinski, Bruno Pereira, Didier Lémery
BACKGROUND: Most estimates of postpartum hemorrhage (PPH) are calculated from studies that use administrative or medical birth databases, and only a few from prospective observational studies. Our principal objective was to estimate the incidence of PPH according to their severity (mild or severe) in vaginal deliveries (>500 mL, ≥1000 mL) and cesareans (>1000 mL and ≥1500 mL). The secondary objectives were to describe the incidence of PPH according to maternity unit characteristics, causes, and types of PPH management...
2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27523914/ectopic-adrenocortical-carcinoma-located-in-the-ovary
#19
Farida Chentli, Nadia Terki, Said Azzoug
AIM: Ovarian corticosteroid-producing tumors are exquisitely rare. Our aim was to describe the first case observed in our practice. CASE HISTORY: A 34-year-old female was referred for Cushing's syndrome (CS) occurring in the postpartum period. Clinical examination showed severe CS with diabetes mellitus, hypertension, and a large mass in the right lower abdomen. Biochemistry demonstrated corticotropin (ACTH)-independent CS (cortisol=1900ng/mL (n=50-250), ACTH<10pg/mL (n=20-46)) with estradiol and testosterone overproduction...
October 2016: European Journal of Endocrinology
https://www.readbyqxmd.com/read/27512467/acute-respiratory-failure-in-pregnancy
#20
REVIEW
Stephen E Lapinsky
Respiratory failure affects up to 0.2% of pregnancies, more commonly in the postpartum period. Altered maternal respiratory physiology affects the assessment and management of these patients. Respiratory failure may result from pregnancy-specific conditions such as preeclampsia, amniotic fluid embolism or peripartum cardiomyopathy. Pregnancy may increase the risk or severity of other conditions, including thromboembolism, asthma, viral pneumonitis, and gastric acid aspiration. Management during pregnancy is similar to the nonpregnant patient...
September 2015: Obstetric Medicine
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