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Shock in Obstetrics

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https://www.readbyqxmd.com/read/29733839/placenta-percreta-is-associated-with-more-frequent-severe-maternal-morbidity-than-placenta-accreta
#1
Louis Marcellin, Pierre Delorme, Marie Pierre Bonnet, Gilles Grange, Gilles Kayem, Vassilis Tsatsaris, François Goffinet
BACKGROUND: Abnormally invasive placentation is the leading cause of obstetric hysterectomy and can cause poor to disastrous maternal outcomes. Most previous studies of peripartum management and maternal morbidity have included variable proportions of severe and less severe cases. OBJECTIVE: The aim of this study was to compare maternal morbidity from placenta percreta and accreta. STUDY DESIGN: This retrospective study at a referral center in Paris includes all women with abnormally invasive placentation from 2003 to 2017...
May 4, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29693946/a-case-of-sudden-shock-during-caesarean-section-in-whi-ch-amniotic-fluid-embolism-is-suspected
#2
Hiroo Shimono, Satoko Haraguchi, Yuko Minoda, Mari Beppu, Naomi Shinmura, Yuki Suzuki, Mikiko Higashi, Yuichi Kanmura
We report a case of sudden shock during caesarean section under combined spinal epidural anesthesia. The patient was a 29-year-old woman. During the operation vital signs had been almost stable until a female-baby was born. But after the delivery of the placenta, the patient developed an episode of coughing and dyspnea followed by unconsciousness and bradycardia. She was given adrenaline and intubated, appearing ventricular fibrillation on a EKG. Cardiopulmonary resuscitation was immediately started and sinus rhythm returned...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29681937/sheehan-s-syndrome-revisited-underlying-autoimmunity-or-hypoperfusion
#3
José Gerardo González-González, Omar David Borjas-Almaguer, Alejandro Salcido-Montenegro, René Rodríguez-Guajardo, Anasofia Elizondo-Plazas, Roberto Montes-de-Oca-Luna, René Rodríguez-Gutiérrez
Sheehan's syndrome remains a frequent obstetric complication with an uncertain pathophysiology. We aimed to assess the incidence of hypopituitarism (≥2 hormonal axis impairment) within the first six postchildbirth months and to determine the existence of anti-pituitary antibodies. From 2015 to 2017, adult pregnant women, who developed moderate to severe postpartum hemorrhage (PPH), were consecutively included in the study. Pituitary function was assessed 4 and 24 weeks after PPH. At the end of the study, anti-pituitary antibodies were assessed...
2018: International Journal of Endocrinology
https://www.readbyqxmd.com/read/29630130/inhibitive-effects-of-microrna-34a-on-protecting-against-ischemia-reperfusion-injury-of-vital-organs-in-hemorrhagic-shock-pregnant-mice
#4
L-B Qin, Z-Y Li, H Li, X-Q Fan, H-G Liu, X-M Dong, W-Y Jia
OBJECTIVE: Hemorrhagic shock is a common vital condition in obstetrics, and major treatment consists of bleeding control and liquid resuscitation. MicroRNA (miR) has been found to regulate multiple diseases. However, its expression profile in hemorrhagic shock or effects on the ischemia-reperfusion injury in pregnant mice has not been reported yet. PATIENTS AND METHODS: This study generated rat hemorrhagic shock pregnant model, on which real-time quantitative PCR was used to measure miR-34a expressions...
March 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29587875/evaluation-of-a-novel-device-for-the-management-of-high-blood-pressure-and-shock-in-pregnancy-in-low-resource-settings-study-protocol-for-a-stepped-wedge-cluster-randomised-controlled-trial-cradle-3-trial
#5
Hannah L Nathan, Kate Duhig, Nicola Vousden, Elodie Lawley, Paul T Seed, Jane Sandall, Mrutyunjaya B Bellad, Adrian C Brown, Lucy C Chappell, Shivaprasad S Goudar, Muchabayiwa F Gidiri, Andrew H Shennan
BACKGROUND: Obstetric haemorrhage, sepsis and pregnancy hypertension account for more than 50% of maternal deaths worldwide. Early detection and effective management of these conditions relies on vital signs. The Microlife® CRADLE Vital Sign Alert (VSA) is an easy-to-use, accurate device that measures blood pressure and pulse. It incorporates a traffic-light early warning system that alerts all levels of healthcare provider to the need for escalation of care in women with obstetric haemorrhage, sepsis or pregnancy hypertension, thereby aiding early recognition of haemodynamic instability and preventing maternal mortality and morbidity...
March 27, 2018: Trials
https://www.readbyqxmd.com/read/29562027/epidemiological-profile-of-maternal-mortality
#6
Ana Claudia Sierra Martins, Lélia Souza Silva
OBJECTIVE: To know the epidemiological profile of maternal mortality in Juiz de Fora, a city in the state of Minas Gerais. Data collection was carried out from April to December 2016. METHOD: Summary of a confidential investigation of maternal mortality on deaths occurred from January 1st, 2005 to December 31, 2015. RESULTS: Eighty-five deaths of women residing in Juiz de Fora were identified and analyzed. The age group was between 20 and 36 years...
2018: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/29527717/outcomes-following-balloon-mitral-valvuloplasty-in-pregnant-females-with-mitral-stenosis-and-significant-sub-valve-disease-with-severe-decompensated-heart-failure
#7
Ajith Ananthakrishna Pillai, Chandramohan Ramasamy, Saranya Gousy V, Harichandrakumar Kottyath
BACKGROUND: Mitral stenosis may present with decompensated heart failure during pregnancy. Many patients do have advanced sub valve disease and present late with decompensated state. The outcomes of balloon mitral valvuloplasty (BMV) in such advanced sub valve disease with severe heart failure in pregnancy has not been specifically studied till now. METHODS: A descriptive study looking at the immediate and long-term outcomes of pregnant patients with MS who presented with severe heart failure and sub valve disease who had undergone BMV...
March 11, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29520693/alteration-of-heat-shock-protein-20-expression-in-preeclamptic-patients-and-its-effect-in-vascular-and-coagulation-function
#8
Fanfan Li, Mengzhou He, Meitao Yang, Yao Fan, Yun Chen, Xi Xia, Yin Xie, Dongrui Deng
Preeclampsia (PE) is a pregnancy-specific, multi-system disorder and the leading cause of maternal and perinatal morbidity and mortality in obstetrics worldwide. Excessive vasoconstriction and dysregulated coagulation function are closely associated with PE. Heat shock protein 20 (HSP20) is ubiquitously expressed under normal physiological conditions and has important roles in vascular dilatation and suppression of platelet aggregation. However, the role of HSP20 in the pathogenesis of PE remains unclear. In this study, we collected chorionic plate resistance arteries (CPAs) and serum from 118 healthy pregnant women and 80 women with PE and detected the levels of HSP20 and its phosphorylated form...
March 9, 2018: Frontiers of Medicine
https://www.readbyqxmd.com/read/29510266/what-about-sentinel-lymph-node-biopsy-for-early-breast-cancer-during-pregnancy
#9
V Balaya, H Bonsang-Kitzis, C Ngo, M Delomenie, M Gosset, M Mimouni, C Nos, P M David, A S Bats, F Lecuru
Pregnancy-associated breast cancer is rare, but this clinical situation arises in 1/10,000-1/3000 pregnancies. In patients presenting an early-stage breast tumor devoid of clinically pathological lymph node, sentinel lymph node (SLN) biopsy has not yet been validated as a routine procedure for pregnant women due to the lack of data in the literature. The blue dye injection is not recommended because of 2% theoretical risk of anaphylactic shock. Several studies have shown that Tc99m injection at conventional dose between 12...
May 2018: Journal of Gynecology Obstetrics and Human Reproduction
https://www.readbyqxmd.com/read/29482706/a-rare-case-rupture-of-internal-pudendal-and-uterine-artery-in-a-vaginal-delivery
#10
Novera G Chughtai, Raheela Mohsin Rizvi
The management of puerperal hematomas after normal delivery has always been challenging for obstetricians. Vulvar, vulvovaginal, or paravaginal hematomas are common. On the other hand, retroperitoneal hematomas are uncommon and can be life-threatening. The diagnosis of vascular injury is rarely made preoperatively as atonic or traumatic postpartum hemorrhage (PPH), uterine rupture and amniotic fluid embolism are more common differential diagnoses. Injury to internal pudendal and uterine vessels is extremely rare in cases of vaginal delivery and, therefore, the literature on this topic is very scarce...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29439891/resuscitative-endovascular-balloon-occlusion-of-the-aorta-using-a-low-profile-device-is-easy-and-safe-for-emergency-physicians-in-cases-of-life-threatening-hemorrhage
#11
Takahiro Shoji, Takehiko Tarui, Takashi Igarashi, Yuki Mochida, Hiroyuki Morinaga, Yasuhiko Miyakuni, Yoshitaka Inoue, Yasuhiko Kaita, Hiroshi Miyauchi, Yoshihiro Yamaguchi
BACKGROUND: Bleeding from hemorrhagic shock can be immediately controlled by blocking the proximal part of the hemorrhagic point using either resuscitative thoracotomy for aortic cross-clamping or insertion of a large-caliber (10-14Fr) resuscitative endovascular balloon occlusion of the aorta (REBOA) device via the femoral artery. However, such methods are very invasive and have various complications. With recent progress in endovascular treatment, a low-profile REBOA device (7Fr) has been developed...
April 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29344403/maternal-morbidity-and-mortality-associated-with-retroperitoneal-haematomas-in-pregnancy
#12
Junaid Rafi, Haroona Khalil
Retroperitoneal haematomas in obstetrics are uncommon. The causes and pathogenesis of retroperitoneal haematomas lack clarity and the aim of this review is to recognise retroperitoneal haematomas as a separate entity from commonly seen vaginal and pelvic haematomas. It is time to raise awareness among obstetricians to recognise retroperitoneal haematomas as an important cause of maternal morbidity and mortality which requires high clinical suspicion and multidisciplinary input. As retroperitoneal haematomas are rare but can cause serious threat to maternal wellbeing, resources should be directed towards their management...
January 2018: JRSM Open
https://www.readbyqxmd.com/read/29329527/emotional-and-cognitive-experiences-during-the-time-of-diagnosis-and-decision-making-following-a-prenatal-diagnosis-a-qualitative-study-of-males-presented-with-congenital-heart-defect-in-the-fetus-carried-by-their-pregnant-partner
#13
Tommy Carlsson, Elisabet Mattsson
BACKGROUND: Expectant fathers consider the second-trimester obstetric ultrasound examination as an important step towards parenthood, but are ill prepared for a detection of a fetal anomaly. Inductive research is scarce concerning their experiences and needs for support. Consequently, the aim of this study was to explore the emotional and cognitive experiences, during the time of diagnosis and decision-making, among males presented with congenital heart defect in the fetus carried by their pregnant partner...
January 12, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29319760/acute-kidney-injury-in-critically-ill-obstetric-patients-a-cross-sectional-study-in-an-intensive-care-unit-in-northeast-brazil
#14
Geraldo Bezerra da Silva Junior, Suzanne Vieira Saintrain, Gabriel de Castro Castelo, Vanessa Ribeiro de Vasconcelos, Juliana Gomes Ramalho de Oliveira, Amanda Maria Timbó Rocha, Adolfo Gomes Vasconcelos Júnior, Maria Vieira de Lima Saintrain, Elizabeth De Francesco Daher
INTRODUCTION: Acute kidney injury (AKI) is a complication still poorly studied in the setting of obstetric patients, which is associated with increased mortality. Objective: The aim of this study was to investigate the frequency and risk factors of AKI among critically ill obstetric patients. METHODS: A cross-sectional study was conducted with all patients admitted to an intensive care unit (ICU) due to obstetric complications, in Fortaleza, Brazil, in the period between January 2012 and December 2014...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29306854/successful-management-of-a-24-year-old-pregnant-woman-with-necrotising-fasciitis-of-the-forearm
#15
Sam Nahas, Anne McKirdy, Arjuna Imbuldeniya
A 24-year-old woman who was 24 weeks pregnant presented to the emergency department with septic shock and an elbow wound that had become infected. She sustained an injury to the tip of the right elbow on a light switch 4 days prior. In the space of 1 day, she developed a necrotising soft tissue infection, which was rapidly spread to the forearm with florid sepsis. Her initial serum C reactive protein was 392 mg/L, and white cell count was 32×109 /L. The patient was treated promptly with aggressive surgical debridement and broad-spectrum antibiotics...
January 6, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29286937/hemoperitoneum-in-peripartum-a-case-series
#16
A Lemaire, M Bonnin, B Storme, A Fournet-Fayard, G Rosano, L Vernis, S Cayot, M Accocebery, P Dechelotte, L Boyer, D Gallot, E Futier, J M Constantin, J E Bazin
Hemorrhages are the first cause of perinatal deaths in French women. Thirteen percent of these deaths are not linked to obstetrical problems but rather to hemoperitoneum. These incidents are under-diagnosed and as a result, treatment is delayed and fetal and maternal mortality increases. We report three cases of patients, all White female in their last trimester of a non-problematic pregnancy presenting with hemoperitoneum and resulting in different outcomes. The analysis of published materials and of our cases leads us to infer that a diagnosis of hemoperitoneum must be considered in pregnant women when abdominal pain, symptoms of shock and a decrease in hemoglobin are associated...
2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/29259389/retracted-induction-of-heat-shock-protein-expression-in-cervical-epithelial-cells-by-human-semen
#17
Infectious Diseases In Obstetrics And Gynecology
[This retracts the article DOI: 10.1155/S1064744999000046.].
2017: Infectious Diseases in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29224660/postpartum-hemorrhage
#18
REVIEW
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/29188070/the-first-case-report-of-septic-abortion-resulting-from-%C3%AE-lactamase-negative-ampicillin-resistant-non-typeable-haemophilus-influenzae-infection
#19
Hiroaki Baba, Risako Kakuta, Hasumi Tomita, Minako Miyazoe, Masatoshi Saito, Chihiro Oe, Noriomi Ishibashi, Misa Sogi, Kengo Oshima, Tetsuji Aoyagi, Yoshiaki Gu, Makiko Yoshida, Koichi Tokuda, Shiro Endo, Hisakazu Yano, Mitsuo Kaku
Introduction. This is the first case report of septic abortion due to β-lactamase-negative ampicillin-resistant (BLNAR) non-typeable Haemophilus influenzae infection. In Japan, BLNAR H. influenzae is widespread and has become a clinical concern, especially in paediatrics and otolaryngology, but H. influenzae has not been previously recognized as a causative agent of obstetric or gynaecological infection. Case presentation. A 31-year-old pregnant woman presented at 17 weeks and 6 days of gestation with a high fever; she was admitted with a diagnosis of threatened premature delivery...
October 2017: JMM Case Reports
https://www.readbyqxmd.com/read/29181210/bilateral-tubal-pregnancy-without-known-risk-factor
#20
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
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