Maternal mortality after cesarean section in the Netherlands

<div class="WordSection1">Cardiovascular disease in pregnancy is common range from 1% to 3 and contributes to 10-15% of maternal mortality. Valvular heart disease accounts for about 25% of cases of cardiac complications in pregnancy and important cause of maternal mortality, some of which are mitral stenosis and mitral regurgitation. Cesarean delivery remains the preferred choice, as it reduces the hemodynamic changes that can occur in normal delivery and allows for better monitoring and hemodynamic management. Our paper provide in-depth information regarding the pathophysiology of heart valve disease in pregnant women and an appropriate perianesthesia approach to obtain a good prognosis. We report a case of a 26-year-old pregnant woman, with obstetric status G1P0A0, 36 weeks’ gestation, body weight 61 kg accompanied by severe mitral regurgitation and moderate mitral stenosis. This patient was planned to undergo elective cesarean section. The patient's condition in the perioperative examination was: GCS E4V5M6, other vital signs within normal limits, SpO2 98-99% in supine position. Other physical and laboratory examinations were also within normal limits. The goal of anesthesia during surgery in patients with heart valve disease undergoing cesarean section maintain pulmonary capillary pressure to prevent acute pulmonary edema. In this case, regional anesthesia of epidural anesthesia was chosen because it can reduce systemic vascular resistance and provide better post-cesarean section pain. The patient's hemodynamics perianesthesia tended to be stable without any complications such as pulmonary edema. </div>

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Incidence of Eclampsia and Maternal Mortality from Eclampsia in the Netherlands during the Period from 1920 to 1960

Pathobiology ◽

10.1159/000161154 ◽

1961 ◽

Vol 24 (4) ◽

pp. 474-477

Author(s):

J.L. Mastboom

Keyword(s):

The Netherlands ◽

Maternal Mortality

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A multivariate analysis of risk factors influencing the cesarean section rate in two university hospitals in Leiden (the Netherlands) and Bandung (Indonesia)

Medical Journal of Indonesia ◽

10.13181/mji.v7i1.796 ◽

1998 ◽

pp. 38

Author(s):

Firman F. Wirakusumah ◽

R Brand ◽

J Bennebroek Gravenhorst

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

The Netherlands ◽

Cesarean Section ◽

Cesarean Section Rate ◽

University Hospitals ◽

Factors Influencing

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452. Maternal mortality in the Netherlands

Pregnancy Hypertension ◽

10.1016/j.preghy.2018.08.049 ◽

2018 ◽

Vol 13 ◽

pp. S15

Author(s):

Thomas van den Akker

Keyword(s):

The Netherlands ◽

Maternal Mortality

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The Efficacy of Intravenous Tranexamic Acid in Reduction of Blood Loss in Women at High Risk of Postpartum Hemorrhage

QJM ◽

10.1093/qjmed/hcaa056.014 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

K M Diab ◽

R M Mohamed ◽

A G Abdelhay

Keyword(s):

Blood Loss ◽

Cesarean Section ◽

Tranexamic Acid ◽

Maternal Mortality ◽

Vaginal Delivery ◽

Control Group ◽

Study Group ◽

Control Groups ◽

Significant Difference ◽

And Control

Abstract Background Postpartum hemorrhage (PPH) is the leading cause of maternal mortality. All women who carry a pregnancy beyond 20 weeks’ gestation are at risk for PPH and its sequelae. Although maternal mortality rates have declined greatly in the developed world, PPH remains a leading cause of maternal mortality elsewhere. Aim of the Work To assess the efficacy and safety intravenous tranexamic acid in reduction of amount of blood loss in high risk women who deliver by cesarean section or vaginal delivery in postpartum period. Patients and Methods This prospective double blind randomized controlled clinical trial study was conducted on 200 patients planned for LSCS or vaginal delivery at Gestational Age ≥ 34 Weeks at Ain Shams University Maternity Hospital. Recruitment of data begun once the protocol was approved by research and ethical committee of the department of obstetrics and gynecology. Results No significant difference between Study and Control groups as regards age (p = 0.508), no significant difference between Study and Control groups as regards Gestational age (p = 0.447),total blood loss (p < 0.001) was significantly lower in study group than control group, Vaginal pads in the 1st 24 hours post-partum was significantly less soaked in study group than control group (p < 0.001). no significant difference between Study and Control groups as regards Preoperative Hemoglobin, Postoperative Hemoglobin was significantly higher in study group than control group (p < 0.001), Reduction in Hemoglobin was significantly less in study group than control group (p < 0.001), no significant difference between Study and Control groups as regards Preoperative Hematocrite, Postoperative Hematocrit was significantly higher in study group than control group (p < 0.001), Reduction in Hematocrite was significantly less in study group than control group (p < 0.001).Need to iron replacement or blood transfusion was significantly less frequent in study group than control group (p = 0.24). Conclusion The use of tranexamic acid prior to cesarean section or vaginal delivery is effective as a prophylaxis against post-partum hemorrhage as shown by the results of this study. It can significantly reduce blood loss during and after cesarean section or vaginal delivery.

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