A local hemostatic agent for the management of postpartum hemorrhage due to placenta previa and placenta accreta: a cross-sectional study

2013 ◽  
Vol 288 (3) ◽  
pp. 543-549 ◽  
Author(s):  
Diego Portilla ◽  
Cristian Hernández-Giraldo ◽  
Bernardo Moreno ◽  
Fabio Quijano ◽  
Luis R. Hoyos ◽  
...  
Keyword(s):  
Postpartum Hemorrhage ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Cross Sectional Study ◽  
Hemostatic Agent ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals PLACENTA ACCRETA IN PLACENTA PREVIA

2018 ◽  
Vol 21 (05) ◽  
pp. 892-896
Author(s):  
Farzana Majid ◽  
Robina Ali ◽  
Shazia Shaheen
Keyword(s):  
Placenta Accreta ◽  
Placenta Previa ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
History Of ◽  
Scarred Uterus ◽  
Demographic Features ◽  
Previous Cesarean

Objective: To calculate the frequency of placenta accreta in placenta previawith or without scarred uterus and compare clinico demographic features of cases with orwithout placenta accreta. Study Design: Cross sectional study. Place and Duration of Study:Department of Obst & Gynae Allied Hospital, Faisalabad from 1st June 2007 to 31st May 2008.Methodology: 200 patients of placenta previa, 100 with history of previous cesarean sectionand 100 without history of previous C-section fulfilling inclusion criteria were taken. They wereevaluated by history, examination and ultrasound noting placental location and type. Placentaaccreta was diagnosed during delivery. Results: Out of 200 patients, frequency of placentaaccreta was significantly increased with history of previous C-section. It was 20% in patientswith previous C-sections and 6% in patients without previous C-sections. Conclusions: Ourdata suggests that frequency of placenta accreta is greater in patients with previous C-sectionand its frequency increases with increasing number of C-sections especially with anterior andcentral placenta previa.

scholarly journals Peripartum Hysterectomies over a Fifteen-year Period

2021 ◽  
Vol 43 (01) ◽  
pp. 003-008
Author(s):  
Alessandra Dorigon ◽  
Sérgio Hofmeister Martins-Costa ◽  
José Geraldo Lopes Ramos
Keyword(s):  
Placenta Accreta ◽  
Placenta Previa ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Southern Brazil ◽  
Sectional Study ◽  
Porto Alegre ◽  
Cross Sectional ◽  
The Past ◽  
Previous Cesarean

Abstract Objective To determine the indications and outcomes of peripartum hysterectomies performed at Hospital de Clínicas de Porto Alegre (a university hospital in Southern Brazil) during the past 15 years, and to analyze the clinical characteristics of the women submitted to this procedure. Methods A cross-sectional study of 47 peripartum hysterectomies from 2005 to 2019. Results The peripartum hysterectomies performed in our hospital were indicated mainly due to placenta accreta or suspicion thereof (44.7% of the cases), puerperal hemorrhage without placenta accreta (27.7%), and infection (25.5%). Total hysterectomies accounted for 63.8% of the cases, and we found no difference between total versus subtotal hysterectomies in the studied outcomes. Most hysterectomies were performed within 24 hours after delivery, and they were associated with placenta accreta, placenta previa, and older maternal age. Conclusion Most (66.0%) patients were admitted to the intensive care unit (ICU). Those who did not need it were significantly older, and had more placenta accreta, placenta previa, or previous Cesarean delivery.

scholarly journals Emerging Role of Prenatal Magnetic Resonance Imaging in the Diagnosis of Placental Adhesion Disorders and its Relation with Intraoperative Findings- A Cross-sectional Study

2021 ◽  
Author(s):  
Saryu Gupta ◽  
Preetkanwal Sibia ◽  
Sarabhjit Kaur ◽  
Puneet Gambhir
Keyword(s):  
Magnetic Resonance Imaging ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Cross Sectional ◽  
Prenatal Magnetic Resonance Imaging ◽  
Risk Patients

Introduction: Placental Adhesion Disorders (PADs) aka Placenta Accreta Spectrum (PAS) of disorders are a common cause of postpartum haemorrhage, which in turn is an avoidable cause of significant maternal morbidity and mortality. The exponential increase in the prevalence of PADs worldwide primarily ascribed to increasing percentage of caesarean section deliveries therefore contributes significantly to potentially life-threatening obstetrical emergencies. Accurate prenatal diagnosis of PAD is hence fundamental for patient management and prognostication. Imaging plays an indispensable role in the antenatal diagnosis of PAD thereby translating to improved maternal outcomes. Aim: To determine the diagnostic accuracy of prenatal Magnetic Resonance Imaging (MRI) in predicting abnormal invasive placentation and to associate MRI findings with intraoperative findings. Materials and Methods: The present cross-sectional study was conducted between March 2019 to March 2020. Pregnant females with clinically and/or sonographically suspected PAD and having major risk factors of PAD {Lower Segment Caesarean Section (LSCS) in previous and placenta previa in present gestation} were subjected to dedicated placenta protocol MRI examination. The placental morphology, localisation and adhesion suggestive features were evaluated in detail. Descriptive statistical analysis was done for final assessment. Results: A total of 27 study participants, with mean age of 28±2.15 years, showed MRI findings compatible with PAD. Placenta previa complete (66.67%); was the dominant subtype observed in the study. In terms of degree of invasion, placenta accreta in 44.44% (n=12) was predominantly observed on preliminary MRI based assessment. The most reliable MRI features predictive of placental invasion in the present study (seen in 100% cases of PAD) included T2 dark intraplacental bands, heterogenous intraplacental signal intensity, disorganised intraplacental vascularity, myometrial thinning, loss of the uteroplacental interface and maternal neovascularity. In one case, MRI erroneously over-diagnosed increta as percreta. The overall diagnostic performance of these MRI parameters was with sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of 100%, 95%; 87.5% and 100% in those with placenta percreta compared to 94.12%, 100.00%, 100% and 95% for the placenta accreta or increta cases, respectively. Conclusion: MRI has high diagnostic accuracy in detection of PADs among the high-risk patients. Dedicated placenta protocol prenatal MRI should hence be incorporated in diagnostic work- up of all high-risk patients of PAD for reaping benefits of timely management, planning and saving lives.

scholarly journals Peripartum hysterectomy and its risk factors

2019 ◽  
Vol 9 (1) ◽  
pp. 27-31
Author(s):  
Renuka Tamrakar ◽  
Upendra Pandit ◽  
Sabita Shrestha ◽  
Basant Sharma ◽  
Rakshya Joshi
Keyword(s):  
Placenta Accreta ◽  
Length Of Hospital Stay ◽  
Cross Sectional Study ◽  
Morbidity Rate ◽  
Sectional Study ◽  
Cross Sectional ◽  
Peripartum Hysterectomy ◽  
Estimated Blood Loss ◽  
Severe Hemorrhage ◽  
Emergency Peripartum Hysterectomy

Background: Emergency Peripartum Hysterectomy (EPH) is an important lifesaving surgical procedure considered in cases of severe hemorrhage unresponsive to medical and conservative management. The objective is to review incidence, identification, intervention and impact of emergency peripartum hysterectomy. Methods: The retrospective, cross-sectional study designed was to used. EPH data were collected from January 2014 to December 2018.Descriptive statistics was used to analyzed data and presented in tables and charts. Results: Incidence of Emergency Peripartum Hysterectomies was 2.3% out of 252(2.6%) cases of obstetrical emergencies and 0.06% that is 1 in 1600 deliveries. Most common indications for EPH were uterine rupture (33.3%); placenta accreta (33.3%) followed by retained placenta (16.6%) and endometritis with pyometritis (16.6%). Estimated blood loss 1916 ml., timeliness from delivery to hysterectomy was 140 minutes; most common post-operative complication was surgical site infection (33.3%) and length of hospital stay 11.7 days. Maternal morbidity rate was 33.3%. There was no maternal mortality recorded. Conclusions: The timely intervention improves the outcome in Peripar­tum Hysterectomy, which is frequently associated with abnormal placen­tation as a consequence of increasing caesarean deliveries rate.

The current state of active third stage management to prevent postpartum hemorrhage: a cross-sectional study

2013 ◽  
Vol 92 (11) ◽  
pp. 1277-1283 ◽  
Author(s):  
Babette W. Prick ◽  
Amber A. Vos ◽  
Wim C.J. Hop ◽  
Henk A. Bremer ◽  
Eric A.P. Steegers ◽  
...  
Keyword(s):  
Postpartum Hemorrhage ◽  
Cross Sectional Study ◽  
Stage Management ◽  
Sectional Study ◽  
Cross Sectional ◽  
Current State ◽  
Third Stage

scholarly journals Postpartum Hemorrhage in Pregnancy beyond 40 Weeks of Gestation in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (237) ◽  
Author(s):  
Rashmi Bastakoti Gaire ◽  
Suman Raj Tamrakar ◽  
Anjana Singh Dongol
Keyword(s):  
High Risk ◽  
Confidence Interval ◽  
Postpartum Hemorrhage ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
In Pregnancy

Introduction: Postpartum hemorrhage is defined as a blood loss of 500ml or more within 24 hours after birth. It is the leading cause of maternal mortality in low-income countries and the primary cause of nearly one-quarter of all maternal deaths globally. It occurs in up to 18% of total births. Post-dated pregnancy is a high-risk pregnancy with increased maternal morbidity. This study aims to determine the prevalence of postpartum hemorrhage in pregnancy beyond 40 weeks of gestation in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted among pregnant women beyond 40 weeks in Dhulikhel hospital from October 2016 to March 2017. The study was conducted after ethical clearance from the hospital research committee (reference number#128/16). The sample size was calculated and convenient sampling was done. Statistical Package for the Social Sciences is used for analysis. Point estimate at 95% confidence interval was calculated along with frequency and percentage for binary data. Results: Out of 465 ladies enrolled in this study postpartum hemorrhage was seen in 6 (1.29%) (95% Confidence Interval = 0.267-2.31), and the mean age was 24.25+4.8. About 346 (74.4%) had a normal delivery, 104 (22.36%) had cesarean section and 15 (3.22%) had instrumental delivery. Conclusions: Postpartum haemorrhage prevalence is low among the pregnant women beyond 40 weeks compared to the standard study. Postpartum hemorrhage is the common leading cause of maternal mortality. So high-risk cases should be identified and active management should be done to reduce morbidity and mortality.

scholarly journals MAGNETIC RESONANCE EVALUATION OF INVASIVE PLACENTA – OUR EXPERIENCE

2020 ◽  
pp. 1-3
Author(s):  
Prajwaljeet Gour ◽  
Deoyani Sarjare ◽  
Kalyani Wani ◽  
Sandhya Yeshwante
Keyword(s):  
Magnetic Resonance ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Post Partum ◽  
Treatment Options ◽  
Cross Sectional Study ◽  
Treatment Modalities ◽  
Mri Findings ◽  
Cross Sectional ◽  
Obstetric Management

Introduction: Placenta accreta (PA) includes various types of abnormal placentation in which chorionic villi attach directly to or invade he myometrium. There is a rising trend of placenta accreta owing to increased number of primary and repeat Caesarean sections. Accurate and timely identification of affected pregnancies allows optimal obstetric management to reduce maternal morbidity and mortality. The availability of conservative treatment modalities for the management of post partum hemorrhage arising from the same mandates the use of magnetic resonance imaging (MRI) to precisely evaluate the degree of placental invasion so as to further guide the treatment options. Materials and Methods: In two years observational cross sectional study, 18 pregnant females between age group 15-40 years were subjected to MRI pelvis and MRI findings were noted. Result : Placenta accrete vera was the most common type found in our study. Patients with placenta previa and previous Caesarean section were at highest risk. Intraplacental bands, heterogenous placenta, lumpy placental contour were the most commonly observed findings. Conclusion: MRI is very useful for accurate evaluation of placenta accreta particularly when USG findings are ambiguous or when there is a posterior placenta. There is increased incidence of placenta accreta with multiparity, placenta previa and history of previous Caesarean sections.

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