scholarly journals Calculated blood loss overestimates diagnosis of postpartum hemorrhage in patients with hypertensive disorders of pregnancy

2022 ◽  
Vol 226 (1) ◽  
pp. S329
Author(s):  
Gabriela Dellapiana ◽  
Savannah Gonzales ◽  
Richard M. Burwick
Keyword(s):  
Blood Loss ◽  
Postpartum Hemorrhage ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders

scholarly journals Association between Receipt of Intrapartum Magnesium Sulfate and Postpartum Hemorrhage

2021 ◽  
Vol 11 (01) ◽  
pp. e21-e25
Author(s):  
Emily M.S. Miller ◽  
Allie Sakowicz ◽  
Elise Leger ◽  
Elizabeth Lange ◽  
Lynn M. Yee
Keyword(s):  
Blood Loss ◽  
Magnesium Sulfate ◽  
Postpartum Hemorrhage ◽  
Blood Cells ◽  
Uterine Atony ◽  
Hypertensive Disorders Of Pregnancy ◽  
Packed Red Blood Cells ◽  
Hypertensive Disorders ◽  
Estimated Blood Loss ◽  
Secondary Outcomes

Abstract Objective The aim of the study is to investigate the association between intrapartum administration of magnesium sulfate in women with hypertensive disorders of pregnancy and postpartum hemorrhage. Study Design This was a retrospective cohort study of women diagnosed with a hypertensive disorder of pregnancy who delivered singleton gestations >32 weeks at a single, large volume tertiary care center between January 2006 and February 2015. Women who received intrapartum magnesium sulfate for seizure prophylaxis were compared with women who did not receive intrapartum magnesium sulfate. The primary outcome was frequency of postpartum hemorrhage. Secondary outcomes included estimated blood loss, uterine atony, and transfusion of packed red blood cells. Bivariable analyses were used to compare the frequencies of each outcome. Multivariable logistic regression models examined the independent associations of magnesium sulfate with outcomes. Results Of 2,970 women who met inclusion criteria, 1,072 (36%) received intrapartum magnesium sulfate. Women who received magnesium sulfate were more likely to be nulliparous, publicly insured, of minority race or ethnicity, earlier gestational age at delivery, and undergo labor induction. The frequency of postpartum hemorrhage was significantly higher among women who received magnesium sulfate compared with those who did not (12.4 vs. 9.3%, p = 0.008), which persisted after controlling for potential confounders. Of secondary outcomes, there was no difference in estimated blood loss between women who did and did not receive magnesium sulfate (250 mL [interquartile range 250–750] vs. 250 mL [interquartile range 250–750], p = 0.446). However, compared with women who did not receive magnesium sulfate, women who received magnesium sulfate had a greater frequency of uterine atony (8.9 vs 4.9%, p < 0.001) and transfusion of packed red blood cells (2.0 vs. 0.8%, p = 0.008). These differences persisted after controlling for potential confounders. Conclusion Intrapartum magnesium sulfate administration to women with hypertensive disorders of pregnancy is associated with increased odds of postpartum hemorrhage, uterine atony, and red blood cell transfusion.

scholarly journals Evaluation of Pregnancy Outcomes in Women with Hypertension Disorders of Pregnancy

2021 ◽  
Vol 15 (10) ◽  
pp. 3420-3422
Author(s):  
Kalsoom Essa Bhattani ◽  
Shumaila Khawaja Khail ◽  
Kashif Ali Samin ◽  
Zubaida Khanum Wazir ◽  
Mobashara Ghulam Muhammad ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Pregnant Women ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Postpartum Hemorrhage ◽  
Health Centre ◽  
Mode Of Delivery ◽  
Hypertensive Disorders Of Pregnancy ◽  
Maternal Complications ◽  
Hypertensive Disorders

Background and Aim: Globally, hypertension disorder is the most common disorder in pregnancy. It complicates 6–10% of pregnancies with a major contribution to the worldwide maternal mortality rate. The aim of the current study was to evaluate the pregnancy outcomes in women with Hypertension disorders. Materials and Methods: This cross-sectional study was carried out on women with hypertension disorders enrolled in the department of Gynecology, Mardan Women Hospital, Sheikh Maltoon Town, Mardan and Family Health Centre, Peshawar from March 2021 to August 2021. Demographic details such as age, gestational age, parity, intrapartum, early postpartum complications such as perinatal outcomes and mode of delivery, and antepartum were recorded from each individual. Chi-square test was used for comparing the composite adverse outcomes such as preterm birth, postpartum hemorrhage, abrupt placenta, and mortality rate. SPSS version 20 was used for data analysis. Results: Of the total 2357 pregnant women, about 146 (6.2%) women had hypertensive disorders of pregnancy. The mean age of 146 pregnant women was 29.45±4.67 years with an age range from 17 to 43 years. About 37 (25.3%) women had no perinatal and maternal complications. Out of 109 pregnant women, the prevalence of eclampsia, preeclampsia, and pregnancy-induced hypertension were 8 (7.3%), 44 (40.4%), and 57 (52.3%) respectively. Based on gestational age, preterm (24-36 weeks) and term (>37 weeks) were 35 (32.1%) and 74 (67.9%) respectively. Other maternal complications were Abruption Placentae, Postpartum hemorrhage (PPH), Renal Failure., Pulmonary Edema, Disseminated intravascular coagulation (DIC), and Maternal Death. Conclusion: Our study found hypertension disorders as a significant medical disorder in pregnant women. However, neonatal outcomes and pregnancy outcomes were significantly smooth in more than 50% of pregnant women. Keywords: Hypertensive disorders of pregnancy, Pre-eclampsia, Eclampsia.

Microalbuminuria and the Hypertensive Disorders of Pregnancy

2010 ◽  
Vol 6 (1) ◽  
pp. 8-19
Author(s):  
Anne-Marie Cote ◽  
Peter Dadelszen ◽  
Jean-Marie Moutquin ◽  
Jean-Luc Ardilouze ◽  
Laura Magee
Keyword(s):  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders

scholarly journals Assessment the role of tranexamic acid in prevention of postpartum hemorrhage

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Nevein Gerges Fahmy ◽  
Fahmy Saad Latif Eskandar ◽  
Walid Albasuony Mohammed Ahmed Khalil ◽  
Mohammed Ibrahim Ibrahim Sobhy ◽  
Amin Mohammed Al Ansary Amin
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Postoperative Bleeding ◽  
Control Group ◽  
Study Group ◽  
Mortality And Morbidity ◽  
Lower Segment Cesarean Section ◽  
Prophylactic Use

Abstract Background Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity worldwide. It is believed that hemostatic imbalance secondary to release of tissue plasminogen activator (tPA) and subsequent hyperfibrinolysis plays a major role in PPH pathogenesis. Antifibrinolytic drugs such as tranexamic acid (TXA) are widely used in hemorrhagic conditions associated with hyperfibrinolysis. TXA reduced maternal death due to PPH and its use as a part of PPH treatment is recommended, and in recent years, a number of trials have investigated the efficacy of prophylactic use of TXA in reducing the incidence and the severity of PPH. The study is aiming to assess the efficacy of tranexamic acid in reducing blood loss throughout and after the lower segment cesarean section and reducing the risk of postpartum hemorrhage. Results The amount of blood loss was significantly lower in the study group than the control group (416.12±89.95 and 688.68±134.77 respectively). Also the 24-h postoperative hemoglobin was significantly higher in the study group (11.66±0.79 mg/dl) compared to the control group (10.53±1.07mg/dl), and the 24-h postoperative hematocrit value was significantly higher in the study group (34.99±2.40) compared to control (31.62±3.22). Conclusion Prophylactic administration of tranexamic acid reduces intraoperative and postoperative bleeding in cesarean section and the incidence of postpartum hemorrhage.

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