Comparison of perinatal outcomes and placental histology between IVF and unassisted pregnancies complicated by placenta-previa

Aims: This study was performed to review the places, indications, maternal-perinatal outcomes requiring emergency air transfer to a tertiary level referral center.Methods: A hospital based descriptive study of one year duration, conducted in Tribhuvan University Teaching Hospital (TUTH), over a period of twelve months. All the women who were air transferred for pregnancy complications were enrolled.Results: There were total 19 airlifted obstetric emergencies to TUTH over one year period: majority (68%) from hilly areas and others (32%) from mountain region. Out of them, referred cases were 11 [district hospital (5), healthpost (4); Primary Health Center (PHC) (2)]; and rest were from home (8). Two cases were abortion related; septic abortion (1) and incomplete abortion (1). There were three antepartum cases: pregnancy with meningoencephalitis (1), eclampsia (1) and bleeding placenta previa (1); maximum, eleven intrapartum cases, obstructed labor (6),labor dystocia (3), breech in labor (1) and undelivered second twin (1). Rest three were postpartum cases, one each of eclampsia, puerperal sepsis and retained placenta. Maternal morbidities were one each case of uterine rupture, acute kidney injury, retained placenta with PPH and vesicovaginal fistula that developed in the case of shoulder dystocia. Maternal mortality occurred in 2 cases, first women with antepartum eclampsia who had intracerebral bleed and second was a case of pregnancy with meningoencephalitis who later developed brain death. Regarding perinatal outcome 12/14 (86%) had live birth and 2/14 (14%) had IUFD upon arrival.Conclusion: Air lift on personal expenditure, despite economic constraints has proven beneficial in our country’s context with difficult geographical terrain and inadequate health services, whereas anticipation of any critical condition right in the beginning and timely transfer however could have been more advantageous.

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Risks and challenges in multiple pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20214666 ◽

2021 ◽

Vol 10 (12) ◽

pp. 4578

Author(s):

Aditi Agarwal ◽

Arti Sharma ◽

Neeta Bansal ◽

Neha Panwar ◽

Shweta Singh ◽

...

Keyword(s):

Placenta Previa ◽

Multiple Pregnancy ◽

Perinatal Outcomes ◽

Obstetric Care ◽

Elevated Risk ◽

Multiple Pregnancies ◽

Triplet Pregnancy ◽

Mother And Child ◽

Fetal Complications ◽

Fetal Malformations

Because of breakthroughs in reproductive medicine, multiple pregnancies have become more common in the industrialized world. As a result, obstetric care for women with multiple pregnancies and neonatal care for the same has become more demanding. Multifetal pregnancies are linked to an elevated risk for both the mother and child. There is increased incidence of obstetric complications such as spontaneous abortion, hypertensive disorders, placenta previa, and fetal malformations. Perinatal outcome is also affected which is attributable to increased incidence of fetal complications like prematurity, congenital malformations, growth discordance and cord accidents. We are presenting 2 cases, one of MCMA twin pregnancy with fetal congenital anomaly and another of a triplet pregnancy and their perinatal outcomes.

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Perinatal outcomes in pregnant patients presenting with antepartum hemorrhage: Our experiences at a teaching hospital in Central Punjab.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.10.3152 ◽

2019 ◽

Vol 26 (10) ◽

pp. 1645-1650

Author(s):

Rabia Mushtaq ◽

Afroza Abbas ◽

Waqas Ahmed

Keyword(s):

Mortality Rate ◽

Perinatal Mortality ◽

Low Birthweight ◽

Placenta Previa ◽

Mode Of Delivery ◽

Perinatal Outcomes ◽

Cross Sectional Study ◽

Adverse Outcomes ◽

Cross Sectional ◽

Perinatal Mortality Rate

Objectives: Antepartum Hemorrhage is bleeding from or into the genital tract from the period of viability of fetus (28 weeks) till the end of second stage of labor. Antepartum hemorrhage is associated with a very high perinatal mortality rate. We present our experience of perinatal outcomes in cases of antepartum hemorrhage with the aim of highlighting the cause of antepartum hemorrhage and the adverse outcomes. Study Design: Descriptive Cross sectional study. Setting: Department of Gynecology & Obstetrics, Sargodha Medical College, Sargodha. Period: Jan 2018 to Jun 2018. Material and Methods: Ninety six pregnant patients between ages of 15-45 years diagnosed as cases of antepartum hemorrhage were enrolled. Patients with coagulation disorders, twin pregnancies, abnormal lie or presentation, previous scar and any known congenital anomaly. Cause of antepartum hemorrhage and mode of delivery was recorded. Perinatal outcomes were determined in terms of frequencies of perinatal mortality, stillbirth and low birthweight babies. Results: The etiology of antepartum hemorrhage in our setup was placenta previa (43.75%); placental abruption (37.5%); Toxemia (10.41%) and unclassified causes in 8.33% patients. The perinatal mortality rate was 43.75% in our study. The overall frequency of low birthweight babies and stillbirth was 62.5% and 27.08% respectively. Conclusion: Antepartum hemorrhage is a major cause of perinatal mortality in our country. A prompt diagnosis of the cause followed by early cesarean section can help reduce the overall mortality.

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Association between isolated hypothyroxinaemia in early pregnancy and perinatal outcomes

Endocrine Connections ◽

10.1530/ec-19-0088 ◽

2019 ◽

Vol 8 (4) ◽

pp. 435-441 ◽

Cited By ~ 2

Author(s):

Xiujuan Su ◽

Yan Zhao ◽

Zhijuan Cao ◽

Yingying Yang ◽

Tony Duan ◽

...

Keyword(s):

Pregnancy Complications ◽

Placenta Previa ◽

Perinatal Outcomes ◽

Thyroid Stimulating Hormone ◽

Neonatal Outcomes ◽

Human Beings ◽

Hypertensive Disorders Of Pregnancy ◽

Singleton Pregnancy ◽

Hypertensive Disorders ◽

Increased Risk

Background The effect of isolated maternal hypothyroxinaemia (IMH) on pregnancy complications and neonatal outcomes in human beings is still controversial. Methods This was a retrospective cohort study based on the electronic medical register system. The records of women with a singleton pregnancy who sought antenatal examination between January 2014 and December 2015 at Shanghai First Maternity and Infant Hospital were extracted from the electronic medical records system. Thyroid-stimulating hormone (TSH), free thyroxine (fT4) and anti-thyroperoxidase autoantibody (TPO-Ab) was measured before 20 gestational weeks, and a multiple logistic regression model was used to estimate the odds ratios of pregnancy complications and neonatal outcomes between euthyroid women and those with isolated hypothyroxinaemia. Results A total of 8173 women were included in this study, of whom 342 (4.18%) were diagnosed with IMH. Regression analysis showed that IMH diagnosed in the second trimester (13–20 weeks) was associated with an increased risk of hypertensive disorders of pregnancy (OR = 2.66, 95% CI: 1.38–5.10) and placenta abruption (OR = 3.64, 95% CI: 1.07–12.41), but not with preterm delivery (OR = 1.09, 95% CI: 0.50–2.40), small or large gestational age of infant (OR = 0.91, 95% CI: 0.39–2.12; OR = 1.16, 95% CI: 0.72–1.86), macrosomia (OR = 1.71, 95% CI: 0.95–3.07), gestational diabetes mellitus (OR = 1.36, 95% CI: 0.86–2.15) and placenta previa (OR = 1.62, 95% CI: 0.39–7.37). Conclusion IMH could be a risk factor for hypertensive disorders of pregnancy.

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Characteristics and outcomes of pregnant women with placenta accreta spectrum in Italy: A prospective population-based cohort study

PLoS ONE ◽

10.1371/journal.pone.0252654 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0252654

Author(s):

Sara Ornaghi ◽

Alice Maraschini ◽

Serena Donati ◽

Keyword(s):

Blood Transfusion ◽

Cesarean Section ◽

Placenta Accreta ◽

Placenta Previa ◽

Geographical Area ◽

Perinatal Outcomes ◽

Population Based ◽

Source Population ◽

Italian Regions ◽

Placenta Accreta Spectrum

Introduction Placenta accreta spectrum (PAS) is a rare but potentially life-threatening event due to massive hemorrhage. Placenta previa and previous cesarean section are major risk factors for PAS. Italy holds one of the highest rates of primary and repeated cesarean section in Europe; nonetheless, there is a paucity of high-quality Italian data on PAS. The aim of this paper was to estimate the prevalence of PAS in Italy and to evaluate its associated factors, ante- and intra-partum management, and perinatal outcomes. Also, since severe morbidity and mortality in Italy show a North-South gradient, we assessed and compared perinatal outcomes of women with PAS according to the geographical area of delivery. Material and methods This was a prospective population-based study using the Italian Obstetric Surveillance System (ItOSS) and including all women aged 15–50 years with a diagnosis of PAS between September 2014 and August 2016. Six Italian regions were involved in the study project, covering 49% of the national births. Cases were prospectively reported by a trained clinician for each participating maternity unit by electronic data collection forms. The background population comprised all women who delivered in the participating regions during the study period. Results A cohort of 384 women with PAS was identified from a source population of 458 995 maternities for a prevalence of 0.84/1000 (95% CI, 0.75–0.92). Antenatal suspicion was present in 50% of patients, who showed reduced rates of blood transfusion compared to unsuspected patients (65.6% versus 79.7%, P = 0.003). Analyses by geographical area showed higher rates of both concomitant placenta previa and prior CS (62.1% vs 28.7%, P<0.0001) and antenatal suspicion (61.7% vs 28.7%, P<0.0001) in women in Southern compared to Northern Italy. Also, these women had lower rates of hemorrhage ≥2000 mL (29.6% vs 51.2%, P<0.0001), blood transfusion (64.5% vs 87.5%, P = 0.001), and severe maternal morbidity (5.0% vs 11.1%, P = 0.036). Delivery in a referral center for PAS occurred in 71.9% of these patients. Conclusions Antenatal suspicion of PAS is associated with improved maternal outcomes, also among high-risk women with both placenta previa and prior CS, likely because of their referral to specialized centers for PAS management.

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Risk factors and perinatal outcomes for persistent placenta previa in nulliparous women

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2021.11.563 ◽

2022 ◽

Vol 226 (1) ◽

pp. S335-S336

Author(s):

Rebecca J. Post ◽

Jenny Chang ◽

Argyrios Ziogas ◽

Adam Crosland ◽

Bob M. Silver ◽

...

Keyword(s):

Risk Factors ◽

Placenta Previa ◽

Perinatal Outcomes ◽

Nulliparous Women

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PLACENTA PREVIA IN IVF AND UNASSISTED PREGNANCIES – PERINATAL OUTCOMES AND PLACENTAL HISTOLOGY

Fertility and Sterility ◽

10.1016/j.fertnstert.2021.07.405 ◽

2021 ◽

Vol 116 (3) ◽

pp. e146

Author(s):

Elad Barber ◽

Hadas Ganer Herman ◽

Michal Kovo Prof ◽

Daniel Tairy ◽

Letizia Schreiber ◽

...

Keyword(s):

Placenta Previa ◽

Perinatal Outcomes

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Effect of inter-pregnancy interval on maternal and fetal outcome

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v15i1.29343 ◽

2020 ◽

Vol 15 (1) ◽

pp. 58-61

Author(s):

Pravin Shrestha ◽

Vibha Mahato ◽

Smita Karmacharya

Keyword(s):

Placenta Previa ◽

Perinatal Outcomes ◽

Fetal Outcome ◽

Cross Sectional Study ◽

Chronic Hypertension ◽

Maternal Complications ◽

Cross Sectional ◽

Increased Risk ◽

The Impact ◽

Inter Pregnancy Interval

Aims: To explore the impact of inter-pregnancy interval on maternal and fetal health Methods: Descriptive cross sectional study conducted at Department of Obstetrics and Gynaecology, Manipal Teaching hospital, Pokhara, Nepal. Inter-pregnancy interval (IPI) was calculated as the time elapsed between the woman’s last delivery and the date of last menstrual period for the present second or higher order birth. Intervals were taken in weeks and then converted to months. IPI were categorized as <18months, 18-23, 24-59, >59 months. Results: Among the 550 pregnancies studied, the majority (57%) of them had an IPI of more than 59 months. Long IPI of >59 months had increased risk of maternal complications like preeclampsia (12.4%), postdate pregnancy (10.8%), PROM (4.4%), oligohydramnios (3.8%), placenta previa (2.5%), gestational diabetes mellitus (2.2%), chronic hypertension (1.5%), abruptio placenta (0.3%), IUFD (0.6%) and overt DM (0.3%). Increased preterm birth was seen in IPI <18 months (25%). Short IPI had also increased risk of IUGR (8.3%) and anaemia. Adverse maternal outcome was least when IPI was between 18-23 months. Conclusions: IPI shorter than 18 months and longer than 59 months were associated with increased risk of adverse maternal and perinatal outcomes. Keywords: fetal, inter-pregnancy, interval

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