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embolism postpartum

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https://www.readbyqxmd.com/read/29318985/a-randomised-controlled-trial-and-economic-evaluation-of-intraoperative-cell-salvage-during-caesarean-section-in-women-at-risk-of-haemorrhage-the-salvo-cell-salvage-in-obstetrics-trial
#1
Khalid S Khan, Philip Moore, Matthew Wilson, Richard Hooper, Shubha Allard, Ian Wrench, Tracy Roberts, Carol McLoughlin, Lee Beresford, James Geoghegan, Jane Daniels, Sue Catling, Vicki A Clark, Paul Ayuk, Stephen Robson, Fang Gao-Smith, Matthew Hogg, Louise Jackson, Doris Lanz, Julie Dodds
BACKGROUND: Caesarean section is associated with blood loss and maternal morbidity. Excessive blood loss requires transfusion of donor (allogeneic) blood, which is a finite resource. Cell salvage returns blood lost during surgery to the mother. It may avoid the need for donor blood transfusion, but reliable evidence of its effects is lacking. OBJECTIVES: To determine if routine use of cell salvage during caesarean section in mothers at risk of haemorrhage reduces the rates of blood transfusion and postpartum maternal morbidity, and is cost-effective, in comparison with standard practice without routine salvage use...
January 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29305367/embolic-stroke-in-a-postpartum-patient-with-fontan-physiology
#2
Katherine VanHise, Linda Li, Emily Smith, Niamh Condon
In cardiac physiology, single ventricle typically refers to the presence of a dominant systemic ventricle along with a hypoplastic ventricle. The Fontan operation is used to repair the single ventricle by directing deoxygenated systemic venous flow to the pulmonary arterial circulation. Normal pregnancy physiology, particularly increased intravascular volume, increased heart rate, increased cardiac output, hypercoagulability and decreased systemic vascular resistance, can exacerbate cardiac disease in patients with Fontan circulation, leading to pregnancy complications...
January 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29245268/posterior-reversible-encephalopathy-syndrome-after-postpartum-hemorrhage-and-uterine-artery-embolization-a-case-report
#3
Fangfang Shi, Liwei Shen, Yonghui Shi, Lei Shi, Xiaoli Yang, Zhi Jin, Wenpeng Liu, Danhong Wu
RATIONALE: Posterior reversible encephalopathy syndrome (PRES) is characterized by clinical and radiological features, including headache, disturbed consciousness, seizures, and cortical blindness associated with findings indicating posterior leukoencephalopathy on imaging studies. Ours is the first case of PRES developing after postpartum hemorrhage and uterine artery embolization. PATIENT CONCERNS: An 18-year-old patient had postpartum hemorrhage after a normal delivery...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29238971/postauthorization-safety-study-of-clottafact%C3%A2-a-triply-secured-fibrinogen-concentrate-in-acquired-fibrinogen-deficiency-a-prospective-observational-study
#4
C Négrier, A-S Ducloy-Bouthors, V Piriou, E De Maistre, N Stieltjes, A Borel-Derlon, P Colson, J Picard, T Lambert, S Claeyssens, S Boileau, A Bertrand, M-H André, F Fourrier, Y Ozier, P Sié, Y Gruel, Z Tellier
BACKGROUND AND OBJECTIVES: A postauthorization safety study was performed between 2009 and 2012 to describe the use of Clottafact® in acquired fibrinogen deficiency in real-life medical practice in France. MATERIALS AND METHODS: One hundred and fifty patients were planned for 28 days of prospective follow-up after infusion. The analysis of this observational study was descriptive and performed according to the type of treatment (curative or preventive) and the origin of the bleed...
December 13, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/29224660/postpartum-hemorrhage
#5
Janice Newsome, Jonathan G Martin, Zachary Bercu, Jay Shah, Haris Shekhani, Gail Peters
Interventional radiologists are often called for emergent control of abnormal uterine bleeding. Bleeding, even heavy bleeding as a result of uterine fibroids is not a common emergent procedure; instead, pregnancy and pregnancy related conditions, trauma and malignancy associated with bleeding can be the source of many interventional radiology on call events or procedures. Postpartum hemorrhage (PPH) is the most common cause, and is defined as blood loss of 500mL after vaginal delivery or 1000mL after cesarean section...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29215522/intrauterine-balloon-tamponade-for-severe-postpartum-hemorrhage
#6
Mathilde Revert, Patrick Rozenberg, Jonathan Cottenet, Catherine Quantin
OBJECTIVE: To compare the rates of invasive procedures (surgical or vascular) for hemorrhage control between a perinatal network that routinely used intrauterine balloon tamponade and another perinatal network that did not in postpartum hemorrhage management. METHODS: This population-based retrospective cohort study included all women (72,529) delivering between 2011 and 2012 in the 19 maternity units in two French perinatal networks: a pilot (in which balloon tamponade was used) and a control network...
December 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29207784/emergency-peripartum-hysterectomy-a-14-year-experience-at-a-tertiary-care-centre-in-india
#7
S Tahmina, Mary Daniel, Preetha Gunasegaran
Introduction: Emergency Peripartum Hysterectomy (EPH), although relatively infrequent in present day obstetrics, is a life-saving procedure in the event of a massive postpartum haemorrhage. Aim: To assess incidence, risk factors, indications and complications of peripartum hysterectomies at a tertiary care teaching hospital in India. Materials and Methods: A retrospective study was conducted at 650-bedded tertiary care medical teaching hospital in Southern India...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29187254/acute-disseminated-melioidosis-giving-rise-to-pneumonia-and-renal-abscesses-complicated-with-thrombotic-thrombocytopenic-purpura-in-a-post-partum-woman-a-case-report
#8
Piyumi Sachindra Alwis Wijewickrama, Rohini Weerakoon
BACKGROUND: Melioidosis is an established endemic infection in Sri Lanka, caused by Burkholderia pseudomallei, a gram negative bacterium distributed in saprophytes in soil and surface water. Main mode of transmission is via percutaneous inoculation. Pneumonia is the most common presentation in acute disease. CASE PRESENTATION: We report a 33 year old previously healthy Sinhalese female with an occupational exposure to surface water in paddy fields, who was on postpartum day 6 following an uncomplicated pregnancy and delivery via an elective caesarian section...
November 29, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29184859/risk-factors-for-massive-postpartum-bleeding-in-pregnancies-in-which-incomplete-placenta-previa-are-located-on-the-posterior-uterine-wall
#9
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
https://www.readbyqxmd.com/read/29170316/19%C3%A2-accuracy-of-biomarkers-for-venous-thromboembolism-in-pregnancy-the-diagnosis-of-pulmonary-embolism-in-pregnancy-dipep-biomarker-study
#10
Steve Goodacre, Beverley Hunt, Kiran Parmar, Neil Shephard, Kimberley Horspool
OBJECTIVE: To estimate the accuracy of biomarkers for venous thromboembolism (VTE) in pregnant and postpartum women with suspected pulmonary embolism (PE). DESIGN: Observational cohort study augmented with additional cases with VTE. SETTING: Emergency departments and maternity units at eleven prospectively recruiting sites. PARTICIPANTS: Pregnant or postpartum women presenting with suspected PE or diagnosed DVT. INTERVENTIONS: Research nurses/midwives collected a blood sample from women with suspected PE or diagnosed DVT and data relating to diagnostic imaging, treatment and adverse outcomes...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170307/10%C3%A2-decision-analysis-modelling-of-diagnostic-strategies-for-suspected-pulmonary-embolism-in-pregnancy-the-dipep-economic-evaluation
#11
Daniel Pollard, Steve Goodacre, Matthew Stevenson, Gordon Fuller
BACKGROUND: Using diagnostic imaging for suspected pulmonary embolism (PE) in pregnancy involves weighing the benefits, harms and costs of different approaches to selecting women for imaging. OBJECTIVES: To estimate the effectiveness of diagnostic strategies for PE in pregnancy and postpartum, in terms of adverse outcomes from venous thromboembolism, bleeding and radiation exposure, and cost effectiveness, measured as the incremental cost per quality-adjusted life year (QALY)...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29169973/-maternal-death-by-venous-thromboembolic-disease
#12
M Rossignol, E Morau, M Dreyfus
Pregnancy and postpartum are very high-risk periods for venous thromboembolism events (TEE), which seems to extend far beyond the classical 6-8 weeks after childbirth. Pulmonary embolism (PE) is one of the 3 main causes of direct maternal death in western countries. Between 2010 an 2012 in France, 24 deaths were related to PE giving a maternal mortality ratio of 1/100,000, which is not different from the former report (2007-2009). PE is responsible of 9% of maternal deaths, in equal position with postpartum hemorrhage and amniotic fluid embolism...
November 20, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29166810/anesthetic-management-of-amniotic-fluid-embolism-a-multi-center-retrospective-cohort-study
#13
Shiri Skolnik, Alexander Ioscovich, Leonid A Eidelman, Atara Davis, Anat Shmueli, Amir Aviram, Sharon Orbach-Zinger
INTRODUCTION: Amniotic fluid embolism (AFE) is a rare and potentially lethal obstetric complication, commonly occurring during labor, delivery, or immediately postpartum. There is a paucity of data regarding incidence, risk factors, and clinical management. Our primary objective in this study was to evaluate clinical presentation of AFE and delineate anesthesia management of these cases. METHODS: This 10 years retrospective multi-center cohort study was performed in five tertiary university-affiliated medical centers, between the years 2005 and 2015...
November 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29107951/the-effect-of-tranexamic-acid-on-blood-loss-and-maternal-outcome-in-the-treatment-of-persistent-postpartum-hemorrhage-a-nationwide-retrospective-cohort-study
#14
Ada Gillissen, Dacia D C A Henriquez, Thomas van den Akker, Camila Caram-Deelder, Merlijn Wind, Joost J Zwart, Jos van Roosmalen, Jeroen Eikenboom, Kitty W M Bloemenkamp, Johanna G van der Bom
BACKGROUND: Recent results show a protective effect of tranexamic acid on death due to bleeding in patients with postpartum hemorrhage in low- and middle-resource countries. We quantify the association between early administration of tranexamic acid compared to late or no administration and severe acute maternal morbidity and blood loss among women suffering from persistent severe postpartum hemorrhage in a high-income country. METHODS AND FINDINGS: We performed a nationwide retrospective cohort study in 61 hospitals in the Netherlands...
2017: PloS One
https://www.readbyqxmd.com/read/29106356/cell-salvage-for-postpartum-haemorrhage-during-vaginal-delivery-a-case-series
#15
Grace Lim, Eleni Kotsis, Jamie M Zorn, Patricia L Dalby, Catherine J Ralph, Jonathan H Waters
BACKGROUND: The safety and effectiveness of cell salvage for vaginal delivery is unknown. This case series aimed to assess the utility and adverse events related to the use of cell salvage for maternal haemorrhage during vaginal delivery. MATERIALS AND METHODS: A cohort study design was chosen, focused on postpartum haemorrhages that occurred after vaginal delivery for which cell salvage equipment was requested to be set up in the labour and delivery room outside of a sterile operating room environment...
September 29, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/29065701/postpartum-hemorrhage-from-non-uterine-arteries-clinical-importance-of-their-detection-and-the-results-of-selective-embolization
#16
Jeong-Eun Kim, Young Ho So, Byoung Jae Kim, Sun Min Kim, Young Ho Choi, Chang Kyu Sung
Background Identification of the source of postpartum hemorrhage (PPH) is important for embolization because PPH frequently originates from non-uterine arteries. Purpose To evaluate the clinical importance of identifying the non-uterine arteries causing the PPH and the results of their selective embolization. Material and Methods This retrospective study enrolled 59 patients who underwent embolization for PPH from June 2009 to July 2016. Angiographic findings and medical records were reviewed to determine whether non-uterine arteries contributed to PPH...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/29056469/intrauterine-bakri-balloon-and-vaginal-tamponade-combined-with-abdominal-compression-for-the-management-of-postpartum-hemorrhage
#17
Yuna Guo, Renyi Hua, Shoufang Bian, Xianjing Xie, Jue Ma, Yanqin Cai, Suren R Sooranna, Weiwei Cheng
OBJECTIVE: This study sought to investigate the effect of Bakri balloon use and vaginal tamponade combined with abdominal compression for the management of postpartum hemorrhage (PPH). METHODS: This retrospective study reviewed cases of PPH in the International Peace Maternal and Child Health Hospital of China Welfare Institution in Shanghai, China from January 1, 2010 to December 31, 2015. A single use of the intrauterine Bakri balloon was applied in some cases, and additional vaginal tamponade combined with abdominal compression (double compression) was applied in other cases...
October 19, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28992892/obstetric-risk-factors-for-depression-during-the-postpartum-period-in-south-korea-a-nationwide-study
#18
HyunChul Youn, Suji Lee, Sung Won Han, Log Young Kim, Tae-Seon Lee, Min-Jeong Oh, Hyun-Ghang Jeong, Geum Joon Cho
OBJECTIVE: Postpartum depression is related to many adverse effects in both mothers and their children; therefore, proper screening and early interventions are needed. This study aims to identify the risk factors of postpartum depression. Our primary focus is on obstetric risk factors. METHODS: This study is a cross-sectional study which we extracted the data of women who gave birth between January 1st, 2010 and December 31st, 2012 from the Health Insurance Review and Assessment service (HIRA) database...
November 2017: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/28989925/genital-tract-cavernous-hemangioma-as-a-rare-cause-of-postpartum-hemorrhage
#19
Bo Ram Yu, Ga Eul Lee, Dong Hyu Cho, Young Ju Jeong, Jeong Heon Lee
Cavernous hemangiomas rarely involve the female genital tract. It is difficult to identify vascular malformations when these lesions are concealed in the vagina or deep vulva area. We present a rare case of vaginal cavernous hemangioma in a 30-year-old primiparous woman with an early severe postpartum hemorrhage (PPH) and delayed continuous bleeding from the episiotomy site. She was treated successfully with transarterial embolization of the left vaginal artery. To our knowledge, this is the first reported case of PPH caused by rupture of a vaginal hemangioma during vaginal delivery in English literature...
September 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28971803/perioperative-risk-factors-for-postpartum-pulmonary-embolism-in-taiwanese-cesarean-section-women
#20
Hao-Chin Wang, Pei-Shan Tsai, Kuang-Yao Li, Yen-Chun Fan, Chun-Jen Huang
OBJECTIVE: To explore the perioperative risk factors for predicting postpartum pulmonary embolism (PE) in Taiwanese women with Cesarean section (CS) delivery. METHODS: Data from Taiwan Longitudinal Health Insurance Database were analyzed. All CS women (2002-2007) in Taiwan, according to Diagnosis-Related Group codes, were included. Women having postpartum PE were identified by the diagnosis codes of PE from the medical records within 40 days after CS. Risk factors were analyzed using multivariate logistic regression...
June 2017: Asian Journal of Anesthesiology
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