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https://www.readbyqxmd.com/read/29324461/efficacy-of-treatment-immune-thrombocytopenic-purpura-in-pregnancy-with-corticosteroids-and-intravenous-immunoglobulin-a-prospective-follow-up-of-suggested-practice
#1
Gisela Wegnelius, Katarina Bremme, Pelle G Lindqvist
: The current study is performed to assess a routine for treatment of immune thrombocytopenic purpura in pregnancy. A prospective programme for monitoring and treatment with intravenous immunoglobulin or cortisone in pregnancies with immune thrombocytopenic purpura was suggested to all delivery units in Sweden. Treatment should be avoided if platelet counts were more than 20 × 10/l during pregnancy with no bleeding complications and with a target of 100 × 10/l at delivery. Descriptive statistics and logistic regression analysis were used...
January 10, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29306890/intrapartum-and-neonatal-mortality-among-low-risk-women-in-midwife-led-versus-obstetrician-led-care-in-the-amsterdam-region-of-the-netherlands-a-propensity-score-matched-study
#2
Melanie M J Wiegerinck, Birgit Y van der Goes, Anita C J Ravelli, Joris A M van der Post, Fayette C D Buist, Pieter Tamminga, Ben W Mol
OBJECTIVE: To compare intrapartum and neonatal mortality in low-risk term women starting labour in midwife-led versus obstetrician-led care. STUDY DESIGN: We performed a propensity score matched study using data from our national perinatal register, completed with data from medical files. We studied women without major risk factors with singleton pregnancies who gave birth at term between 2005 and 2008 in the Amsterdam region of the Netherlands. Major risk factors comprised non-vertex position of the fetus, previous Caesarean birth, hypertension, (gestational) diabetes mellitus, post-term pregnancy (≥42 weeks), prolonged rupture of membranes (>24 hours), vaginal bleeding in the second half of pregnancy or induced labour...
January 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29295710/knowledge-of-danger-signs-during-pregnancy-and-subsequent-healthcare-seeking-actions-among-women-in-urban-tanzania-a-cross-sectional-study
#3
Beatrice Mwilike, Gorrette Nalwadda, Mike Kagawa, Khadija Malima, Lilian Mselle, Shigeko Horiuchi
BACKGROUND: Tanzania is among the countries with a high maternal mortality ratio. However, it remains unclear how information and education on danger signs of pregnancy translate into appropriate actions when a woman recognizes danger signs. This study aimed to determine women's knowledge of obstetric danger signs during pregnancy and their subsequent healthcare seeking actions. METHODS: The study design was a health facility-based cross-sectional study. Quantitative data were collected through interviewer-administered questionnaires...
January 3, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29287294/outcomes-of-medically-indicated-preterm-births-differ-by-indication
#4
Michelle J Wang, Spencer G Kuper, Robin Steele, Rachel A Sievert, Alan T Tita, Lorie M Harper
OBJECTIVE:  We aim to examine whether outcomes of preterm birth (PTB) are further modified by the indication for delivery. STUDY DESIGN:  We performed a retrospective cohort study of all singletons delivered at 23 to 34 weeks from 2011 to 2014. Women were classified by their primary indication for delivery: maternal (preeclampsia) or fetal/obstetric (growth restriction, nonreassuring fetal status, and vaginal bleeding). The primary neonatal outcome was a composite of neonatal death, cord pH <7 or base excess < - 12, 5-minute Apgar ≤3, C-reactive protein during resuscitation, culture-proven sepsis, intraventricular hemorrhage, and necrotizing enterocolitis...
December 29, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/29284899/myometrium-invasion-tumour-size-and-lymphovascular-invasion-as-a-prognostic-factor-in-dissemination-of-pelvic-lymphatics-at-endometrial-carcinoma
#5
Nenad Lucic, Dragica Draganovic, Sanja Sibincic, Vesna Ecim-Zlojutro, Snjezana Milicevic
Objective: The aim of this work is to show the importance of the depth of myometrium invasion, tumour size and lymphovascular invasion as prognostic factors in dissemination of lymphatic nodes at endometrial carcinoma (CE). Materials and methods: In the period from 2010 to 2015 at the University Clinic for Gynecology and Obstetrics in Banja Luka, 221 endometrial cancer surgeries were done (laparatomy 184-83%, laparascopy 37-16,74%). Patients who had uterus bleeding in peri/postmenopause or those whose endometrium thickness was bigger than 5 mm which was established by ultrasound, or those who had in their cavum uteri pathological (PH) diagnosis, underwent fractional curettage (FC) or hysteroscopy in order to obtain pathohistological endometrium diagnosis...
October 2017: Medical Archives
https://www.readbyqxmd.com/read/29241928/uses-of-floseal%C3%A2-in-obstetric-hemorrhage-case-series-and-literature-review
#6
Jacqueline Pui-Wah Chung, Tak-Yeung Leung
OBJECTIVE: FloSeal© has been shown to be an alternative and effective method of hemostasis. The current study examines the various uses of FloSeal© in obstetric hemorrhage and gives an overview of the literature. CASE REPORTS: In this retrospective case review, a total of 11 cases with obstetric hemorrhage were reviewed throughout a period of one year. All but one case was successful in using FloSeal© in arresting the bleeding with hysterectomy avoided. FloSeal© can be considered when bleeding occurs locally at the placental bed, bladder base, adhesiolysis site, vaginal tears or at suture holes...
December 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29241907/a-systematic-review-of-massive-transfusion-protocol-in-obstetrics
#7
REVIEW
Hiroaki Tanaka, Shigetaka Matsunaga, Tomoyuki Yamashita, Toshiyuki Okutomi, Atsushi Sakurai, Akihiko Sekizawa, Junichi Hasegawa, Katsuo Terui, Yasutaka Miyake, Jun Murotsuki, Tomoaki Ikeda
Post-partum obstetric haemorrhage is a leading cause of mortality among Japanese women, generally treated with haemostatic measures followed by supplementary transfusion. Commonly used in the setting of severe trauma, massive transfusion protocols (MTPs), preparations of red blood cell concentrate (RBC) and fresh frozen plasma (FFP) with additional supplements, have proved effective in decreasing patient mortality following major obstetric bleeding events. Although promising, the optimal configuration of RBC and FFP utilized for obstetric bleeding needs to be verified...
December 2017: Taiwanese Journal of Obstetrics & Gynecology
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
#8
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
#9
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/29222250/iron-deficiency-in-gynecology-and-obstetrics-clinical-implications-and-management
#10
REVIEW
Christian Breymann, Michael Auerbach
Iron deficiency is the commonest cause of anemia during pregnancy; however, its prevalence is highly determined by nutritional and socioeconomic status. Oral iron is the frontline therapy, but is often poorly tolerated. Awareness of the available intravenous formulations is essential for management. Before delivery, risk factors such as multiparity and heavy uterine bleeding increase the prevalence of iron deficiency and should be motivation for early diagnosis and treatment. Neonates born with iron deficiency have a statistically significant increment in both cognitive and behavioral abnormalities that persist after repletion, highlighting the need for heightened awareness of the diagnosis...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29217972/clinical-aspects-and-antenatal-diagnosis-of-invasive-placenta-a-review-of-ten-years-experience-of-a-multi-profile-hospital-in-lithuania
#11
Jelena Volochovič, Diana Ramašauskaitė, Ramunė Šimkevičiūtė
Background: Invasive placenta is a rare obstetrical pathology that is life-threatening to mother and child. It is important to diagnose this pathology as early as possible and to plan further optimal care of patients in order to minimize life-threatening complications. The aim of this study was to analyze the frequency of cases of invasive placenta, the peculiarities of their clinical manifestation in women who gave birth from 2006 to 2015, to evaluate diagnostic and treatment options of this pathology, and to review their changes when the level of services provided by the institution changes...
2017: Acta Medica Lituanica
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
#12
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/29181210/bilateral-tubal-pregnancy-without-known-risk-factor
#13
Hyacinthe Zamané, Barnabé Yameogo, Paul Dantola Kain, François Gueswendé Xavier Kaboré, Yobi Alexis Sawadogo, Sibraogo Kiemtoré, Sidbewenné Yacinthe Kaboré, Blandine Bonané Thiéba
Spontaneous bilateral ectopic gestation is very rare. The authors report a case diagnosed and taken care of at Yalgado Ouedraogo Teaching Hospital, Ouagadougou. It was a 30-year-old patient with no known pathological history. She had presented at the obstetric emergencies with a state of hypovolemic shock by haemoperitoneum with digestive disorders, pelvic pain, vaginal bleeding, and a mention of delayed menstruation. The ultrasound coupled with the urinary immunological pregnancy test confirmed the diagnosis of ruptured ectopic pregnancy and a bilateral form was suspected...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29176380/congenital-hypofibrinogenemia-in-pregnancy-a-report-of-11-cases
#14
He Cai, Meiying Liang, Jingjing Yang, Xiaohui Zhang
: To investigate the obstetrical outcomes and plasma concentrations of fibrinogen (FIB) in patients with congenital hypofibrinogenemia in pregnancy, 11 cases with hypofibrinogenemia in pregnancy were analyzed retrospectively. The demographic database, bleeding tendency, plasma levels of FIB throughout pregnancy, peripartum management, as well as, maternal and neonatal outcomes were assessed. FIB levels in our patients remained relatively stable throughout the pregnancy. The mean FIB levels during the three trimesters of pregnancy were 75...
November 23, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29166183/the-development-of-an-interactive-health-education-model-based-on-the-djuwita-application-for-adolescent-girls
#15
Sri Djuwitaningsih, Setyowati
Alarming incidents of maternal deaths in Indonesia are due to three major causes: bleeding, sepsis, and hypertension, in addition to other non-obstetric causes and unsafe abortions. Adolescent girls contributed to maternal mortality based on early marriage, unwanted pregnancy, and childbirth. Prevention efforts have been taken through government programs and non-governmental organizations, but in practice those were considered ineffective. Thus, a preventative effort in the form of health education should be made, preferably embedded in a popular mobile application that most teenagers would be apt to use...
2017: Comprehensive Child and Adolescent Nursing
https://www.readbyqxmd.com/read/29153952/surveillance-of-the-safety-and-efficacy-of-recombinant-human-soluble-thrombomodulin-in-patients-with-obstetrical-disseminated-intravascular-coagulation
#16
Takao Kobayashi, Masahiro Kajiki, Katsuhito Nihashi, Goichi Honda
BACKGROUND: Recombinant human soluble thrombomodulin (TM-α) has been shown to be useful in the treatment of disseminated intravascular coagulation (DIC) in a heparin-controlled study, and has been available for clinical use in Japan since 2008. However, use of TM-α for obstetrical DIC has not yet been established, so efficacy and safety were analyzed in 117 obstetrical DIC patients identified from post-marketing surveillance. MATERIALS AND METHODS: From June 2010 to March 2012, the cases of 117 patients with obstetrical DIC treated with TM-α were registered...
November 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29145815/illness-recognition-and-care-seeking-for-maternal-complications-of-pregnancy-and-birth-in-rural-amhara-and-oromia-regional-states-of-ethiopia
#17
Lynn Sibley, Yared Amare
BACKGROUND: Ethiopia has made steady progress in improving maternal health over the decade, yet mortality remains high. The Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) was a 3.5-year project aimed at developing a community-oriented model to improve maternal and newborn survival in rural Ethiopia. Two years after the project ended, we carried out a case study to explore illness recognition and care seeking for complications of pregnancy and childbirth in the project area...
November 16, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29141365/-effect-of-short-acting-combined-oral-contraceptives-on-bleeding-after-induced-abortion
#18
X F Wang, M Zhong, J Liu
Objective: To explore the effect of short-acting combined oral contraceptives on vaginal bleeding after induced abortion. Methods: A total of 726 patients, who had took induced abortion from July 2016 to September 2016 in obstetrics and gynecology outpatient department of Nanfang Hospital, Southern Medical University, were included and divided into the observation group and the control group according to whether they took short-acting combined oral contraceptives after induced abortion, with 312 cases, 414 cases respectively...
November 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29139277/tailor-management-to-the-patient-with-fibroids
#19
Marie O'Sullivan, Caroline Overton
Fibroids are benign, hormone-dependent tumours of uterine smooth muscle and connective tissue. They are commonly asymptomatic, but can cause symptoms such as heavy menstrual bleeding and pelvic pressure symptoms. Between 20 to 30% of women with heavy menstrual bleeding have fibroids. Fibroids are most prevalent in women aged 30-50 years and there may be a genetic predisposition. They are more common in black women than white women. Other risk factors include obesity and nulliparity. Asymptomatic women should only be referred if their uterus is palpable abdominally, if fibroids distort the uterine cavity or the uterus is larger than 12 cm in length...
March 2017: Practitioner
https://www.readbyqxmd.com/read/29129501/-maternal-deaths-due-to-haemorrhage-results-from-the-french%C3%A2-confidential-enquiry-into-maternal-deaths-2010-2012
#20
E Morau, J C Ducloy, S Le Roux, P Weber
Haemorrhage is the first cause of maternal mortality and morbidity in France and a quality of care marker. Haemorrhage rate in France is around 5 to 10% of deliveries. PPH is defined as a post-partum blood loss≥500mL whatever the delivery route and sometime blood can be concealed inside the pelvis. Between 2010 and 2012 in France, 29 deaths were related to haemorrhage giving a maternal mortality ratio of 1,2/100,000 live births (CI 95% 0,8-1,7). Haemorrhage cases decreased from last triennium (2007-2009) especially for uterine atony cases (12/29) but remains the first leading cause of direct maternal death...
November 9, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
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