Intra-operative uterine artery embolization with caesarean delivery in an adjoining operating theatre and catheter lab (OT/CL) complex vs. conventional management in patients with abnormally invasive placenta: a retrospective case control study

Abstract The aim of this study was to test if maternal serum vascular endothelial growth factor (VEGF) or N-terminal pro B-type natriuretic peptide (NT-proBNP) predicts abnormally invasive placenta (AIP) better. Secondary objective was to test whether the serum levels of VEGF and NT-proBNP can predict the degree of invasion. In a multicenter case–control study design, gestational age-matched serum samples from pregnant women with AIP (n = 44) and uncomplicated pregnancies (n = 55) who had been enrolled at Charité – Universitätsmedizin Berlin, Germany and Centre Hospitalier Régional de la Citadelle in Liège, Belgium were analyzed. Maternal blood serum VEGF and NT-proBNP levels were immunoassayed from samples taken immediately before delivery (GA median: 35 weeks). Biomarker levels were compared between AIP and control group. The correlation of biomarker levels with the clinical AIP degree was assessed. The predictive biomarker ability was characterized through a multivariate regression model and receiver operating characteristic curves. Women with AIP had significantly lower maternal serum VEGF levels (AIP mean 285 pg/ml, 95% CI 248–322, vs. control: 391 pg/ml, 95% CI 356–426, p < 0.01) and higher NT-proBNP levels (AIP median 329 pg/ml, IQR 287–385, vs. control 295 pg/ml, IQR 273–356, p = 0.03). Maternal serum VEGF levels were able to predict AIP better (AUC = 0.729, 0.622–0.836, p < 0.001; VEGF + number of previous cesarean deliveries: AUC = 0.915, 0.853–0.977, p < 0.001). Maternal serum VEGF levels correlated inversely with the clinical AIP degree (r = − 0.32, p < 0.01). In short, maternal serum VEGF, more than NT-proBNP, can help in predicting AIP and hints at the degree of invasion.

Download Full-text

541: Outcome of pregnancies after uterine artery embolization (UAE) for post-partum hemorrhage (PPH): a case-control study

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2014.10.587 ◽

2015 ◽

Vol 212 (1) ◽

pp. S270-S271

Author(s):

Sarah Poggi ◽

Alessandro Ghidini ◽

Andrew Yaeger ◽

Arletta Van Breda ◽

Yesmean Wahdan

Keyword(s):

Uterine Artery Embolization ◽

Uterine Artery ◽

Case Control Study ◽

Post Partum ◽

Case Control ◽

Artery Embolization ◽

Post Partum Hemorrhage ◽

Control Study

Download Full-text

Cesarean delivery complicated with peripartum infection increases the risk of uterine rupture during subsequent trial of labour: A retrospective case-control study

10.22541/au.163264948.81936761/v1 ◽

2021 ◽

Author(s):

Rina Tamir Yaniv ◽

Sivan Farladansky-Gershnabel ◽

Hadar Gluska ◽

Yair Daykan ◽

Gil Shechter Maor ◽

...

Keyword(s):

Cesarean Delivery ◽

Uterine Rupture ◽

Caesarean Delivery ◽

Case Control Study ◽

Case Control ◽

Control Group ◽

Vaginal Birth After Cesarean ◽

Retrospective Case ◽

Subsequent Trial ◽

Control Study

Objective: To evaluate the relation between peripartum infection at first caesarean delivery to uterine dehiscence or rupture at the subsequent delivery. Design: Retrospective case-control study from March 2014 to October 2020. Setting: University-affiliated medical centre. Sample: Women with a prior caesarean delivery and proven dehiscence or uterine rupture diagnosed during their subsequent delivery. The control group included women who had a successful vaginal birth after Cesarean section without evidence of dehiscence or uterine rupture. Methods: We compared the rate of peripartum infection during the first Cesarean delivery and other relevant variables, between the two groups. We also analysed the type of infection correlated with uterine rupture or dehiscence. Main Outcome Measures: Rate of peripartum infection. Results: A total of 168 women were included, 71 with uterine rupture or dehiscence and 97 with successful vaginal birth after Cesarean section as the control group. The rate of peripartum infection at the first caesarean delivery was significantly higher in the study group compared to the control group (22.2% vs. 8.2%, p=0.013). Multivariate logistic regression analysis found that peripartum infection remained an independent risk-factor for uterine rupture at the subsequent trial of labour after Cesarean delivery (95% CI, P=0.018). We also found that endometritis had the highest correlation to uterine rupture (9.8% vs. 0%, p=0.02) Conclusion: Peripartum infection in the first caesarean delivery, may be an independent risk-factor for uterine rupture in a subsequent delivery. Compared to other infections, endometritis may pose the greatest risk for uterine rupture or dehiscence.

Download Full-text