- Management of post abortion complications in Botswana -The need for a standardized approach. [Journal Article]
- PlosPLoS One 2018; 13(2):e0192438
- CONCLUSIONS: There is evidence of delayed patient care and prolonged hospital stay. Metallic curette was the primary method used for uterine evacuation across all the facilities. Pain management and antibiotics use was not standardized. A protocol has to be developed with the aim of standardizing post abortion care.
- Evaluating a magnetic resonance imaging of the third-trimester abdominal pregnancy: What the radiologist needs to know. [Case Reports]
- MMedicine (Baltimore) 2017; 96(48):e8986
- CONCLUSIONS: By using MRI, we can accurately diagnose an abdominal pregnancy. MRI provides more details than ultrasonography, and explains the possible mechanism of abdominal pregnancy. We advocate using MRI to help surgical planning and improve outcome in cases of abdominal pregnancy.
- Fertility outcomes following pelvic embolization in women with acquired uterine arteriovenous malformation. [Journal Article]
- TJTaiwan J Obstet Gynecol 2017; 56(6):831-835
- CONCLUSIONS: UAE is an acceptable method for preserving fertility and treatment in women with symptomatic UAVMs.
- Prophylactic temporary abdominal aorta balloon occlusion in women with placenta previa accretism during late gestation. [Journal Article]
- MMedicine (Baltimore) 2017; 96(46):e8681
- CONCLUSIONS: Prophylactic abdominal aorta balloon occlusion (ABO) was relatively safe in the treatment of patients with placenta previa accretism. This approach could represent a key aspect in a multidisciplinary algorithm in reducing hemorrhage in abnormal placentation.
- Manifestations of Hypoxia in the Second and Third Trimester Placenta. [Review]
- BDBirth Defects Res 2017 Oct 16; 109(17):1345-1357
- The placental pathologies that develop in the context of hypoxic insults to the fetus and placenta are termed maternal vascular malperfusion (MVM). On molecular analysis, these lesions primarily show...
The placental pathologies that develop in the context of hypoxic insults to the fetus and placenta are termed maternal vascular malperfusion (MVM). On molecular analysis, these lesions primarily show evidence of oxidative damage, suggesting that they arise in the context of hypoxia-reperfusion injury. The earliest abnormalities are likely incomplete or absent remodeling of maternal spiral arteries (decidual arteriopathy). These vascular remodeling defects then lead to subsequent damage patterns, including accelerated villous maturation, distal villous hypoplasia, increased syncytial knots, villous infarction, retroplacental hemorrhage, and placental hypoplasia. MVM may occur in a surprisingly wide array of clinical disorders, but the relation between these clinical disorders and placental MVM is complex. It seems likely that these clinical disorders represent final common pathways for multiple etiologies, only some of which result in MVM. Birth Defects Research 109:1345-1357, 2017.© 2017 Wiley Periodicals, Inc.
- Pregnancy and delivery after complete uterine rupture. [Journal Article]
- JGJ Gynecol Obstet Hum Reprod 2018; 47(1):23-28
- CONCLUSIONS: Women with a history of complete uterine rupture can have a subsequent pregnancy with a thoroughly favorable outcome with appropriate care conditions, including prophylactic caesarean section.
- Society for Maternal-Fetal Medicine (SMFM) Consult Series #44: Management of bleeding in the late preterm period. [Practice Guideline]
- AJAm J Obstet Gynecol 2018; 218(1):B2-B8
- Third-trimester bleeding is a common complication arising from a variety of etiologies, some of which may initially present in the late preterm period. Previous management recommendations have not be...
Third-trimester bleeding is a common complication arising from a variety of etiologies, some of which may initially present in the late preterm period. Previous management recommendations have not been specific to this gestational age window, which carries a potentially lower threshold for delivery. The purpose of this document is to provide guidance on management of late preterm (34 0/7-36 6/7 weeks of gestation) vaginal bleeding. The following are Society for Maternal-Fetal Medicine recommendations: (1) we recommend delivery at 36-37 6/7 weeks of gestation for stable women with placenta previa without bleeding or other obstetric complications (GRADE 1B); (2) we do not recommend routine cervical length screening for women with placenta previa in the late preterm period due to a lack of data on an appropriate management strategy (GRADE 2C); (3) we recommend delivery between 34 and 37 weeks of gestation for stable women with placenta accreta (GRADE 1B); (4) we recommend delivery between 34 and 37 weeks of gestation for stable women with vasa previa (GRADE 1B); (5) we recommend that in women with active hemorrhage in the late preterm period, delivery should not be delayed for the purpose of administering antenatal corticosteroids (GRADE 1B); (6) we recommend that fetal lung maturity testing should not be used to guide management in the late preterm period when an indication for delivery is present (GRADE 1B); and (7) we recommend that antenatal corticosteroids should be administered to women who are eligible and are managed expectantly if delivery is likely within 7 days, the gestational age is between 34 0/7 and 36 6/7 weeks of gestation, and antenatal corticosteroids have not previously been administered (GRADE 1A).
- Acupuncture or acupressure for induction of labour. [Review]
- CDCochrane Database Syst Rev 2017 10 17; 10:CD002962
- CONCLUSIONS: Overall, there was no clear benefit from acupuncture or acupressure in reducing caesarean section rate. The quality of the evidence varied between low to high. Few trials reported on neonatal morbidity or maternal mortality outcomes. Acupuncture showed some benefit in improving cervical maturity, however, more well-designed trials are needed. Future trials could include clinically relevant safety outcomes.
- Spontaneous intraperitoneal hemorrhage in the third trimester of pregnancy: Clinical suspicion made the difference. [Case Reports]
- JOJ Obstet Gynaecol Res 2018; 44(1):161-164
- A case of spontaneous hemoperitoneum resulting from ruptured vessels in the uterine-ovarian plexus, in the third trimester of pregnancy is described. This is a rare and challenging obstetric emergenc...
A case of spontaneous hemoperitoneum resulting from ruptured vessels in the uterine-ovarian plexus, in the third trimester of pregnancy is described. This is a rare and challenging obstetric emergency. Acute abdominal pain is the main presenting symptom. Clinical suspicion and rapid intervention consisting of emergency cesarean section with ligation of bleeding vessels resulted in favorable outcomes for both mother and baby. The importance of prompt action in the case of deteriorating vital signs is emphasized to achieve success in their management.
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- Outcome of Pregnancy Related Acute Kidney Injury Observed in a Tertiary Care Hospital. [Journal Article]
- MMMymensingh Med J 2017; 26(3):463-470
- This prospective case control study was carried out in Mymensingh Medical College Hospital (MMCH) from April 2011 to March 2012. The main objective of the study was to determine the short term matern...
This prospective case control study was carried out in Mymensingh Medical College Hospital (MMCH) from April 2011 to March 2012. The main objective of the study was to determine the short term maternal outcome of pregnancy related Acute Kidney Injury and to identify aetiological factors and to observe clinical features of pregnancy related Acute Kidney Injury. Total 60 pregnant women with AKI were included in the study as sample and equal (60) number of pregnant women with normal renal function was taken as control. Mean ages (±SD) of study and control group were observed 31.6±6.9 years and 25.5±4.7 years respectively. It was observed that most patients were from rural area with low income group. Most women were multiparous and presented in third trimester and postpartum period. Majority of the study subjects did not receive antenatal care at any stage of pregnancy. Fifty (86.7%) of the study subjects were oligo-anuric, forty-nine (81.7%) were edematous and fifty one (85%) were anaemic. Twenty-five (41.7%) patients presented with abnormal vaginal bleeding. Sepsis (including septic abortion and puerperal sepsis) was responsible for of Pregnancy Related AKI (PR-AKI) in more than two fifths of cases. Haemorrhage (APH & PPH combined) was the next common cause of Pregnancy Related AKI (PR-AKI). Toxemia of Pregnancy was responsible in one fourth of cases. Dialysis (HD & IPD combined) was required for two fifths of the patients. Rest patients were treated conservatively with antibiotics, blood transfusion, maintenance of fluid and electrolytes balance etc. Maternal outcome of Pregnancy related acute kidney injury was considered for the period of patient's hospital staying. 56.6% patients recovered completely, 15.0% patients recovered partially, 6.7% did not recover at the time of hospital discharge; while 21.7% died. So it can be concluded that, pregnancy related acute kidney injury is a critical condition, associated with worse prognosis.