scholarly journals Uterine Rupture with Evisceration of Intestines through the Vagina during Labour

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Ubong Akpan ◽  
Chinyere Akpanika ◽  
Victor Nwagbara ◽  
Udeme Asibong ◽  
Saturday Etuk
Keyword(s):  
Risk Factors ◽  
Perinatal Mortality ◽  
Uterine Rupture ◽  
Factors Associated ◽  
Obstetric Emergency ◽  
Modes Of Presentation ◽  
Grand Multiparity ◽  
Life Threatening ◽  
Small Intestines ◽  
Scarred Uterus

Uterine rupture is a life threatening obstetric emergency and is associated with high maternal and perinatal mortality. There are some risk factors associated with uterine rupture which may include: prolonged obstructed labour, previous scarred uterus, grand-multiparity, macrosomic baby, abnormal lie, instrumental delivery, induction of labour, oxytocin stimulation and excessive uterine manipulation. Its modes of presentation have been widely reported. Here, we present a case with an unusual mode of presentation where about two-third of the small intestines protruded through the vagina following some manipulations by an unskilled birth attendant. This highlights the fact that when uterine rupture is suspected, the cord-like structure protruding per vaginum may not always be umbilical cord.

scholarly journals Uterine Rupture - Risk Factors and Pregnancy Outcome in Bundelkhand Region

2021 ◽  
Vol 10 (27) ◽  
pp. 1961-1965
Author(s):  
Sheela Jain
Keyword(s):  
Risk Factors ◽  
Uterine Rupture ◽  
Fetal Mortality ◽  
Mortality And Morbidity ◽  
Factors Associated ◽  
Uterine Surgery ◽  
Grand Multiparity ◽  
Uterine Scar ◽  
Congenital Uterine Anomaly ◽  
Inter Pregnancy Interval

BACKGROUND Uterine rupture is defined as the tearing of the muscular wall of the uterus during pregnancy or labour.1 Often it occurs from the tearing of previous caesarean scar during labour.2 The other known risk factors for uterine rupture include, maternal age, height, body mass index (BMI), education, birth weight, gestational age, induction of labour, instrumental vaginal delivery, interpregnancy interval, congenital uterine anomaly, grand multiparity, previous uterine surgery, fetal macrosomia, fetal malposition, obstructed labour, uterine instrumentation, attempted forceps delivery, external version, and uterine trauma. 2-6This study was done to find out the prevailing risk factors associated with this grave condition in Bundelkhand region, so that mortality and morbidity associated with it could be prevented. METHODS We have studied 37 cases of uterine rupture, operated in our institution from Jan. 2018 to Oct. 2019. During this period a total of 2986 Caesarean sections (CS) were performed. Of these 37 cases, 5 were Nullipara (13.51 %), 16 primipara (31.25 %) and 16 were grand multipara (31.25 %). 24 cases (64.86 %) had previous uterine scar while 13 (35.13 %) had no scar. RESULTS In our study major risk factors for uterine rupture were found to be previous scars (64.68 %). Obstructive labour (23.07 %), malpresentation (7.69 %), grand multiparity (38.46 %) and prolong labour (30.76 %), were responsible for rupture in unscarred uterus. In all cases we first tried to repair the tear and only 9 (24.32 %) needed hysterectomy. In our study 28 patients (75.67 %) required only repair whereas 24.32 % cases needed hysterectomy. Maternal death was just 1 case (2.7 %) and (51.35 %) babies survived. CONCLUSIONS Majority of uterine rupture cases were found in women who had previous CS. So, first CS should be performed after very careful understanding of its indications. 2.7 % maternal mortality and 51.35 % delivery of live birth babies in our study proves that early detection and proper managing of the case can reduce maternal and fetal mortality in uterine rupture cases. KEY WORDS Uterine Rupture, Previous Scar, Inter-Pregnancy Interval

scholarly journals Red blood cell alloimmunization in sickle cell disease: pathophysiology, risk factors, and transfusion management

Blood ◽  
2012 ◽  
Vol 120 (3) ◽  
pp. 528-537 ◽  
Author(s):  
Karina Yazdanbakhsh ◽  
Russell E. Ware ◽  
France Noizat-Pirenne
Keyword(s):  
Risk Factors ◽  
Sickle Cell Disease ◽  
Blood Cell ◽  
Sickle Cell ◽  
Red Blood Cell ◽  
Cell Disease ◽  
Factors Associated ◽  
Life Threatening ◽  
Red Blood Cell Transfusions ◽  
Transfusion Reactions

Abstract Red blood cell transfusions have reduced morbidity and mortality for patients with sickle cell disease. Transfusions can lead to erythrocyte alloimmunization, however, with serious complications for the patient including life-threatening delayed hemolytic transfusion reactions and difficulty in finding compatible units, which can cause transfusion delays. In this review, we discuss the risk factors associated with alloimmunization with emphasis on possible mechanisms that can trigger delayed hemolytic transfusion reactions in sickle cell disease, and we describe the challenges in transfusion management of these patients, including opportunities and emerging approaches for minimizing this life-threatening complication.

scholarly journals Episiotomy practices in France: epidemiology and risk factors in non-operative vaginal deliveries

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Clesse Christophe ◽  
Cottenet Jonathan ◽  
Lighezzolo-Alnot Joelle ◽  
Goueslard Karine ◽  
Scheffler Michele ◽  
...  
Keyword(s):  
Risk Factors ◽  
Breech Presentation ◽  
Population Based ◽  
Protective Effects ◽  
Factors Associated ◽  
Nulliparous Women ◽  
Vaginal Deliveries ◽  
Multiparous Women ◽  
Scarred Uterus ◽  
Hospital Teams

AbstractEpisiotomy use has decreased due to the lack of evidence on its protective effects from maternal obstetric anal sphincter injuries. Indications for episiotomy vary considerably and there are a great variety of factors associated with its use. The aim of this article is to describe the episiotomy rate in France between 2013 and 2017 and the factors associated with its use in non-operative vaginal deliveries. In this retrospective population-based cohort study, we included vaginal deliveries performed in French hospitals (N = 584) and for which parity was coded. The variable of interest was the rate of episiotomy, particularly for non-operative vaginal deliveries. Trends in the episiotomy rates were studied using the Cochran-Armitage test. Hierarchical logistic regression was used to identify variables associated with episiotomy according to maternal age and parity. Between 2013 and 2017, French episiotomy rates fell from 21.6 to 14.3% for all vaginal deliveries (p < 0.01), and from 15.5 to 9.3% (p < 0.01) for all non-operative vaginal deliveries. Among non-operative vaginal deliveries, epidural analgesia, non-reassuring fetal heart rate, meconium in the amniotic fluid, shoulder dystocia, and newborn weight (≥ 4,000 g) were risk factors for episiotomy, both for nulliparous and multiparous women. On the contrary, prematurity reduced the risk of its use. For nulliparous women, breech presentation was also a risk factor for episiotomy, and for multiparous women, scarred uterus and multiple pregnancies were risk factors. In France, despite a reduction in episiotomy use over the last few years, the factors associated with episiotomy have not changed and are similar to the literature. This suggests that the decrease in episiotomies in France is an overall tendency which is probably related to improved care strategies that have been relayed by hospital teams and perinatal networks.

scholarly journals 851 Risk Factors Associated with Life Threatening Infections in Children with Febrile Neutropenia a Data Mining Approach

2012 ◽  
Vol 97 (Suppl 2) ◽  
pp. A245-A245
Author(s):  
Z. Badiei ◽  
M. Alami ◽  
M. Khalesi ◽  
H. Farhangi ◽  
A. Banihashem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Data Mining ◽  
Febrile Neutropenia ◽  
Factors Associated ◽  
Data Mining Approach ◽  
Life Threatening

scholarly journals Uterine Rupture at a Site Distant From Old Scar: An Unusual Presentation

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Poonam Shakya ◽  
Sonam Jindal ◽  
Avir Sarkar ◽  
Ankita Yadav ◽  
Jagadish Chandra Sharma
Keyword(s):  
Uterine Rupture ◽  
Index Case ◽  
Neonatal Morbidity ◽  
Fetal Demise ◽  
Area Index ◽  
Surgical Incision ◽  
Caesarean Scar ◽  
Life Threatening ◽  
Scarred Uterus ◽  
A Site

Uterine rupture is a rare life threatening emergency with severe obstetric consequences. Most ruptures occur in a scarred uterus at the site of previous transmyometrial surgical incision. However, rupture on site distant from previous scar is a very rare entity. It is associated with major maternal and neonatal morbidity than rupture at a scarred area. Index case describes a scenario where uterine rupture occurred at the fundal region, far away from previous caesarean scar site leading to fetal demise. Till now, only a very few cases with uterine rupture away from the site of previous caesarean scar have been reported. Keywords: uterine rupture, unscarred uterus, acute abdomen, hemoperitoneum

scholarly journals Angioedema Secondary to tPA Use in Acute Ischemic Stroke Patient with Hypertension: A Case Report

2021 ◽  
Vol 2 (5) ◽  
pp. 159-162
Author(s):  
Chris Kim ◽  
Andrea Hladik
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Case Report ◽  
Acute Ischemic Stroke ◽  
Ace Inhibitor ◽  
Sudden Onset ◽  
Acute Ischemic Stroke Patient ◽  
Factors Associated ◽  
Tissue Plasminogen ◽  
Life Threatening

Introduction: A well-documented complication of administering tissue plasminogen activator (tPA) in stroke patients is acute intracranial bleeding. A lesser known but still significant complication is angioedema secondary to tPA administration, which can develop in certain individuals with risk factors such as angiotensin converting enzyme (ACE) inhibitor use and location of the stroke. Knowing the potential for this life-threatening complication and being prepared for its proper management is vital for emergency physicians. Case Report: We report a 53-year-old Black female who presented to the emergency department with sudden onset of slurred speech and a facial droop. She was found to have an acute ischemic stroke and tPA was administered. She subsequently developed angioedema. Retrospectively, the patient was found to have risk factors that are thought to predispose patients to tPA-induced angioedema. Conclusion: Risk factors associated with angioedema secondary to tPA administration have been documented in patients taking ACE inhibitors, as well as patients who develop strokes in the frontal lobe. While many cases may be mild, some patients may develop life-threatening angioedema. Although this complication does not necessarily contraindicate tPA use, it is prudent for the emergency physician to be vigilant for its development, prepared for its treatment, and to be diligent in assessing the need for control of the patient’s airway.

Risk Factors Associated with Life-threatening Rickettsial Infections

2008 ◽  
Vol 78 (6) ◽  
pp. 973-978 ◽  
Author(s):  
Nelson Lee ◽  
Owen Tak Yin Tsang ◽  
Grace Lui ◽  
Sik To Lai ◽  
Bonnie Wong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Factors Associated ◽  
Rickettsial Infections ◽  
Life Threatening

Risk Factors Associated With Life-threatening Infections in Children With Febrile Neutropenia

2011 ◽  
Vol 33 (1) ◽  
pp. e9-e12 ◽  
Author(s):  
Zahra Badiei ◽  
Maryam Khalesi ◽  
Mohammad Hasan Alami ◽  
Hamid Reza Kianifar ◽  
Abdollah Banihashem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Febrile Neutropenia ◽  
Factors Associated ◽  
Life Threatening

Laryngospasm

2017 ◽  
Author(s):  
Cory M. Furse ◽  
Matthew D. McEvoy
Keyword(s):  
Risk Factors ◽  
Cardiac Arrest ◽  
Perioperative Care ◽  
Motor Innervation ◽  
Patient Assessment ◽  
Safe Patient Care ◽  
Factors Associated ◽  
Prompt Treatment ◽  
Life Threatening ◽  
Type Of Surgery

Laryngospasm is one of the most vexing problems in anesthesia and perioperative care. The onset of which carries the risk of oxygen desaturation, bradycardia, aspiration, and cardiac arrest. In this chapter, the mechanisms involved in producing laryngospasm are covered in detail, and an anatomical review of both sensory and motor innervation is included. Risk factors associated with the development of laryngospasm, including those specific to the patient, the type of surgery, and/or the anesthesia techniques are discussed. Proper patient assessment and prompt treatment for this life-threatening emergency are essential skills needed for safe patient care in the peri-operative arena.

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