Obstetric Management of Postpartum Haemorrhage

2013 ◽  
pp. 181-188
Author(s):  
Millicent Nwandison ◽  
Susan Bewley
Keyword(s):  
Postpartum Haemorrhage ◽  
Obstetric Management

Discrepancy Analysis between Clinical Versus Ultrasound Estimated Fetal Weight and Actual Birth Weight at 3rd Trimester

2019 ◽  
Vol 11 (1) ◽  
pp. 32-38
Author(s):  
Naznin Rashid Shewly ◽  
Menoka Ferdous ◽  
Hasina Begum ◽  
Shahadat Hossain Khan ◽  
Sheema Rani Debee ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Fetal Weight ◽  
P Value ◽  
Weight Estimation ◽  
Third Trimester ◽  
Mortality And Morbidity ◽  
Fetal Weight Estimation ◽  
Obstetric Management ◽  
Estimated Fetal Weight

Background: In obstetric management fetal weight estimation is an important consideration when planning the mode of delivery in our day to day practice. In Bangladesh low birth weight is a major public health problem & incidence is 38% - 58%. Neonatal mortality and morbidity also yet high. So accurate antenatal estimation of fetal weight is a good way to detect macrosomia or small for date baby. Thus to improve the pregnancy outcome and neonatal outcome decreasing various chance of neonatal mortality and morbidity antenatal fetal weight prediction is an invaluable parameter in some situation where to identify the at risk pregnancy for low birth weight become necessary. Reliable method for prenatal estimation of fetal weight two modalities have got popularity - Clinical estimation and another one is ultrasonic estimation. This study was designed to determine the accuracy of clinical versus ultrasound estimated fetal weight detecting the discrepancy with actual birth weight at third trimester. So that we can verify more reliable and accurate method. Objectives: To find out more accurate and reliable modality of fetal weight estimation in antenatal period during obstetric management planning. To compare clinical versus ultrasound estimated fetal weight & to determine discrepancy of both variable with actual birth weight. Method: This prospective, cross sectional analytical study was carried out in Dhaka Medical College Hospital from January 2006 to December 2006. By purposive sampling 100 pregnant women fulfilling inclusion criteria were included in my study in third trimester (29wks-40wks). In clinical weight estimation procedure SFH (Symphysio Fundal Height) was measured in centimeter. On pervaginal finding whether vertex below or above the ischial spine was determined. By Johnson’s formula fetal weight in grams was estimated. Then by ultrasound scan different biometric measurements were taken and finally by Hadlock’s formula fetal weight was estimated. Eventually actual birth weight was taken after birth by Globe Brand weighing machine. Accuracy of both modalities were compared and which one was more reliable predictor was determined by statistical analysis. Results: After data collection were analyzed by computer based software (SPSS). There was gradual and positive relationship between symphysiofundal height and estimated birth weight. Discrepancy between clinical and actual birth weight at third trimester was statistically significant – Paired Student’s ‘t’ test was done where p value was <0.001. Whereas discrepancy between sonographically estimated fetal weight with actual birth weight was not statistically significant (by paired ‘t’ test where p value was >0.05). That implies discrepancy between ultrasound estimated fetal weight and actual birth weight was significantly less than that of clinically estimated fetal weight. 14% clinically and 46% sonographically estimated fetal weight were observed within £ 5% of actual birth weight. 31% clinical and 42% sonographically estimates observed within 6% to 10% of actual birth weight and 55% clinical and 12% sonographically estimate were >10% of actual birth weight. That is about 88% sonographical versus 45% clinical estimates were within 10% of actual birth weight. Conclusion: There is no doubt about importance of fetal weight in many obstetric situations. Clinical decisions at times depends on fetal weight. Whether to use oxytocin, to use forceps or vacuum for delivery or extend of trial or ended by Caesarian section immediately or no scope of trial to be largely depend on fetal size and weight. So more accurate modality for antenatal fetal weight estimation has paramount importance. In my study sonographically estimated weight have more accuracy than that of clinical estimate in predicting actual birth weight. Sonographically estimated fetal weight is more reliable, accurate and reproducible rather than other modality. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 32-38

scholarly journals A novel solution for finding postpartum haemorrhage using fuzzy neural techniques

2021 ◽  
Author(s):  
V. D. Ambeth Kumar ◽  
S. Sharmila ◽  
Abhishek Kumar ◽  
A. K. Bashir ◽  
Mamoon Rashid ◽  
...  
Keyword(s):  
Postpartum Haemorrhage ◽  
Fuzzy Neural

scholarly journals Reduction in massive postpartum haemorrhage and red blood cell transfusion during a national quality improvement project, Obstetric Bleeding Strategy for Wales, OBS Cymru: an observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah F. Bell ◽  
Rachel E. Collis ◽  
Philip Pallmann ◽  
Christopher Bailey ◽  
Kathryn James ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Quality Improvement ◽  
Blood Loss ◽  
Postpartum Haemorrhage ◽  
Red Cells ◽  
National Database ◽  
Care Bundle ◽  
Red Cell ◽  
National Quality ◽  
Red Cell Transfusion

Abstract Background Postpartum haemorrhage (PPH) is a major cause of maternal morbidity and mortality and its incidence is increasing in many countries despite management guidelines. A national quality improvement programme called the Obstetric Bleeding Strategy for Wales (OBS Cymru) was introduced in all obstetric units in Wales. The aim was to reduce moderate PPH (1000 mL) progressing to massive PPH (> 2500 mL) and the need for red cell transfusion. Methods A PPH care bundle was introduced into all 12 obstetric units in Wales included all women giving birth in 2017 and 2018 (n = 61,094). The care bundle prompted: universal risk assessment, quantitative measurement of blood loss after all deliveries (as opposed to visual estimation), structured escalation to senior clinicians and point-of-care viscoelastometric-guided early fibrinogen replacement. Data were submitted by each obstetric unit to a national database. Outcome measures were incidence of massive PPH (> 2500 mL) and red cell transfusion. Analysis was performed using linear regression of the all Wales monthly data. Results Uptake of the intervention was good: quantitative blood loss measurement and risk assessment increased to 98.1 and 64.5% of all PPH > 1000 mL, whilst ROTEM use for PPH > 1500 mL increased to 68.2%. Massive PPH decreased by 1.10 (95% CI 0.28 to 1.92) per 1000 maternities per year (P = 0.011). Fewer women progressed from moderate to massive PPH in the last 6 months, 74/1490 (5.0%), than in the first 6 months, 97/1386 (7.0%), (P = 0.021). Units of red cells transfused decreased by 7.4 (95% CI 1.6 to 13.2) per 1000 maternities per year (P = 0.015). Red cells were transfused to 350/15204 (2.3%) and 268/15150 (1.8%) (P = 0.001) in the first and last 6 months, respectively. There was no increase in the number of women with lowest haemoglobin below 80 g/L during this time period. Infusions of fresh frozen plasma fell and there was no increase in the number of women with haemostatic impairment. Conclusions The OBS Cymru care bundle was feasible to implement and associated with progressive, clinically significant improvements in outcomes for PPH across Wales. It is applicable across obstetric units of widely varying size, complexity and staff mixes.

O.1 Coagulation factor levels during severe postpartum haemorrhage

2021 ◽  
Vol 46 ◽  
pp. 102989
Author(s):  
J.F.M. Pereira ◽  
P.V. Jenkins ◽  
R. Collis ◽  
L. De Lloyd ◽  
P. Collins
Keyword(s):  
Postpartum Haemorrhage ◽  
Coagulation Factor

scholarly journals Subinvolution of the placental site as the cause of hysterectomy in young woman

2021 ◽  
Vol 14 (2) ◽  
pp. e238945
Author(s):  
Olga Triantafyllidou ◽  
Stavroula Kastora ◽  
Irini Messini ◽  
Dimitrios Kalampokis
Keyword(s):  
Young Woman ◽  
Young Women ◽  
Postpartum Haemorrhage ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Retained Products Of Conception ◽  
Products Of Conception ◽  
Fertility Sparing ◽  
Placental Site ◽  
Retained Products

Subinvolution of placental sites (SPSs) is a rare but severe cause of secondary postpartum haemorrhage (PPH). SPS is characterised by the abnormal persistence of large, dilated, superficially modified spiral arteries in the absence of retained products of conception. It is an important cause of morbidity and mortality of young women. In this study, we present a case of secondary PPH in a young woman after uncomplicated caesarean delivery who was deemed clinically unstable, and finally, underwent emergent total abdominal hysterectomy. We reviewed the literature with an emphasis on the pathophysiology of this situation. Treatment of patients with SPS includes conservative medical therapy, hysterectomy and fertility-sparing percutaneous embolotherapy.

scholarly journals Large concealed paravaginal haematoma: A case report of an occult postpartum haemorrhage

2021 ◽  
pp. e00311
Author(s):  
Stobie William ◽  
Krishnan Danendran
Keyword(s):  
Case Report ◽  
Postpartum Haemorrhage

scholarly journals Effectiveness of uterine tamponade devices for refractory postpartum haemorrhage after vaginal birth: a systematic review

2021 ◽  
Author(s):  
Veronica Pingray ◽  
Mariana Widmer ◽  
Agustin Ciapponi ◽  
G Justus Hofmeyr ◽  
Catherine Deneux ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postpartum Haemorrhage ◽  
Vaginal Birth
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