scholarly journals Advanced Abdominal Pregnancy (AAP) after 20 Weeks of Gestation in Japan: A Retrospective Review

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Tatsuji Hoshino ◽  
Tatsuo Mori ◽  
Yu Fujii ◽  
Shinya Yoshioka
Keyword(s):  
Birth Weight ◽  
Live Birth ◽  
Placenta Previa ◽  
Breech Presentation ◽  
Developed Countries ◽  
Current Medical ◽  
Careful Examination ◽  
Abdominal Pregnancy ◽  
Medical Environment ◽  
Advanced Abdominal Pregnancy

Background. An advanced abdominal pregnancy (AAP) rarely continues to a live birth, but sometimes, a live birth may occur. In developed countries, women with AAP who have not been diagnosed preoperatively are expected to be diagnosed quickly, and the pregnant woman and the fetus will be saved. After careful examination of the past cases, we sought to derive what is the best diagnosis and treatment choice in the current medical environment. Materials and Methods. We retrospectively studied AAP cases in Japan. We examined diagnosis of AAP before fetal delivery and placental treatment at the time of delivery. AAP was well documented in 10 cases. We contacted the AAP authors, who reported 10 AAP cases in Japan, directly to confirm any unclear points. Results. Two cases were diagnosed with AAP before laparotomy, one was diagnosed after IUFD, and seven were diagnosed at the time of laparotomy. The two most recent cases were diagnosed with AAP preoperatively by ultrasound and MRI. Six cases were described for preoperative diagnosis. There were two cases of placenta previa, one of a bicornuate uterus, one of breech presentation, one of a combination of uterine cervical fibroids and placenta previa, and one of a combination of presentation and placental abnormality with uterine fibroids. In five cases, the placenta was removed at the time of laparotomy. Simultaneous removal of the placenta during laparotomy could not be performed because of intra-amniotic infection with a macerated fetus in an IUFD case. Among eight cases, excluding 20-week and 21-week gestation with no expectation of viable newborns, there were one male and seven female fetuses. The birth weight ranged from 1765 to 3520 g, with a median birth weight of 2241 g. Combined malformations were described in six of the seven live births. Clubfoot, torticollis, joint contracture, and bone deformity were transient because intrauterine compression quickly improved. Conclusion. In recent cases, AAP has been diagnosed by MRI and ultrasound. MRI should be performed if abdominal pregnancy is suspected. Postoperative infections may occur if the placenta is not removed at the time of delivery. We recommend placental resection with the help of an anesthesiologist, a gynecologist, a urologist, and a surgeon in the current medical environment.

Foley catheter tourniquet for uncontrollable extra-uterine placental hemorrhage: description of a novel surgical technique.

2021 ◽  
Author(s):  
G.J. Hofmeyr ◽  
Busiwe D. Majeke ◽  
Mercy-Nkuba Nassali
Keyword(s):  
Surgical Technique ◽  
Placenta Previa ◽  
Foley Catheter ◽  
Good Condition ◽  
Breech Presentation ◽  
Distal Portion ◽  
Abdominal Pregnancy ◽  
Acute Hemorrhage ◽  
Life Saving ◽  
Foley’S Catheter

Abstract Introduction Hemorrhage from a partially or fully detached placenta with an advanced abdominal pregnancy can be profuse and catastrophic. The general approach to placenta management is removal of “all or nothing’’. In the event of acute hemorrhage, every attempt to achieve hemostasis quickly is critical. The Foley catheter has shown utility when used to control placental hemorrhage or as a temporary tourniquet applied around structures surrounding the implantation site to aid placental removal with minimal hemorrhage. We report use of the technique on four occasions with good surgical outcomes. Case Presentation We report a case of a 33 year-old primigravida admitted at term with an ultrasound diagnosis of breech presentation and placenta previa grade four. Her pre-operative clinical assessment however, raised suspicion of an abdominal pregnancy. At laparotomy, a live female infant was delivered from the extra-uterine gestation sac, weighing 3640g and with an Apgar score of 7 and 6 at one and 5 minutes respectively. Following delivery, there was profuse bleeding from the partially detached distal portion of the placenta that derived rich blood supply from the poorly accessible posterior pelvic wall. We applied a novel, simple and effective surgical technique for minimizing blood loss from the partially detached placenta using a Foley’s catheter tourniquet that was applied between the detached and still attached parts of the placenta. The tourniquet was left in situ and removed at laparotomy 4 days later. The placenta was not removed. The mother and baby did well postoperatively and were discharged after 10 and 21 days respectively in good condition. The surgical technique was similarly used in 3 additional cases with good clinical outcomes. Discussion Use of a Foley catheter as an intraoperative tourniquet has become accepted as a useful technique in obstetric and gynecological surgery. We describe a simple life saving technique of applying a Foley tourniquet across a partially detached placenta following an advanced extra-uterine pregnancy to control acute hemorrhage. Conclusion We recommend that surgeons keep in mind the option of intraoperative tourniquets when faced with uncontrollable bleeding as a short-term or medium-term temporizing measure.

scholarly journals Undiagnosed advanced abdominal pregnancy: a case report

2021 ◽  
Vol 7 (12) ◽  
pp. 590
Author(s):  
Ekundayo O. Ayegbusi ◽  
Oluwatoyin O. Fadare ◽  
Akintunde O. Fehintola ◽  
Akinyosoye D. Ajiboye ◽  
Akaninyene E. Ubom
Keyword(s):  
Breech Presentation ◽  
Fetal Outcome ◽  
Morbidity And Mortality ◽  
Abdominal Pregnancy ◽  
Emergency Cesarean ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Advanced Abdominal Pregnancy ◽  
Live Fetus ◽  
High Index Of Suspicion

<p class="abstract">Abdominal pregnancy is a rare form of extra-uterine gestation in which implantation occurs in the peritoneal cavity, unlike this case it rarely reaches advanced gestation and viability of fetal outcome are not commonly documented. Abdominal pregnancy accounts for about 1-2% of ectopic gestation. It is associated with poor fetal outcome and great morbidity and mortality due to heamorrhage especially in a low resource setting. We present an undiagnosed advanced case of abdominal pregnancy of a 30 yr old unbooked G2P1+0 (1A) with early ultrasound estimation of 37 weeks and 6 days. She presented with (abdominal) labour pains and ultrasound diagnosis of breech presentation, suspicion of a bicornuate uterus and intrauterine growth restriction. She was planned for emergency cesarean delivery on this basis but found advanced abdominal pregnancy, and subsequently on delivery had good maternal and fetal outcome. Abdominal pregnancy with live fetus is extremely rare, and requires a high index of suspicion, to avoid high risk of maternal morbidity and mortality and it is also imperative for all healthcare givers to localized pregnancy whenever they get in contact with a woman who has recently missed her period.</p>

Hubungan Antara Anemia dan Kebiasaan Merokok pada Ibu Hamil dengan Kejadian BBLR di Rumah Sakit Umum Pusat Dr. Mohammad Hoesin Palembang Tahun 2016

2018 ◽  
Vol 1 (2) ◽  
pp. 89-94
Author(s):  
Intan Sari
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
General Hospital ◽  
Smoking Habit ◽  
Complete Information ◽  
Developed Countries ◽  
Statistical Test ◽  
Survey Method ◽  
Bivariate Analysis ◽  
Cross Sectional

Low Birth Weight (LBW) is an infant born with a birth weight of less than 2500 grams regardless of gestation. Birth weight is the weight of the baby weighed in 1 hour after birth. (Depkes RI, 2009). Based on WHO and UNICEF data, in 2013 about 222 million babies were born in the world, of which 16% were born with low birth weight. The percentage of LBW in developing countries is 16.5% twice that of developed countries (7%) (Scholar Unand, 2014). The purpose of this study was to determine whether there is a relationship between anemia and Smoking Habit in Pregnant Women with LBW occurrence in General Hospital Dr. Mohammad Hoesin Palembang Year 2016. This research use analytical survey method with cross sectional approach. The population in this study were all mothers who gave birth monthly in Midwifery Installation of Dr. General Hospital Mohammad Hoesin Palembang in 2016 as many as 315 respondents. The sample of this research is some of mothers who give birth enough month in Midwifery Installation of Dr. General Hospital Mohammad Hoesin Palembang Year 2016 as many as 315 respondents. ". From the results of bivariate analysis of anemic respondents with the occurrence of LBW obtained statistical test X2 count = 23.22 which means there is a significant relationship between anemia with the incidence of BBLR. Respondents smoking with the occurrence of LBWR obtained statistical test X2 count = 41.20 which means there is a relationship Meaningful between smoking and LBW incidence. From the results of this study is expected that this research can be a reference material and is a complete information and useful for the development of knowledge about LBW.

MR Imaging in Advanced Abdominal Pregnancy

1995 ◽  
Vol 36 (2) ◽  
pp. 193-195 ◽  
Author(s):  
A. Wagner ◽  
A. -J. Burchardt
Keyword(s):  
Mr Imaging ◽  
Abdominal Pregnancy ◽  
Advanced Abdominal Pregnancy

scholarly journals Frequency, risk factors and materno-foetal outcomes among cases of Placenta previa at a tertiary care hospital: a two year study

2019 ◽  
Vol 8 (6) ◽  
pp. 2240
Author(s):  
Pamulaparthi Bindu Reddy ◽  
Gurram Swetha Reddy
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care Hospital ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Previous History ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Early Date

Background: Placenta previa refers to the presence of placental tissue that extends over the internal cervical os.  Placenta previa is linked to maternal hypovolemia, anaemia, and long hospital stay and with prematurity, low birth weight, low APGAR score in newborn. So it is very important to identify the condition at an early date to warn the condition thereby reducing the maternal and foetal morbidity and mortality. The present study was aimed to estimate the prevalence of PP, its associated predisposing risk factors and maternal morbidity, mortality and the perinatal outcome.Methods: A prospective observational study for two years was conducted at a tertiary care hospital. Pregnant mothers with >28 weeks of age with H/o ante partum haemorrhage were screened for placenta previa, confirmed by ultra sonography and included in the study. Clinical history, obstetric examination was done and followed up till the delivery. Maternal and foetal outcomes were recorded. Data analyzed by using SPSS version 20.Results: 1.4% incidence of PP was noted, mean age of group was 29.17±1.6 years. Age group of 21-30 years, multiparity Gravida 2-4, previous history of caesarean section and less number of ante natal checkups were significant risk factors and LSCS was most common outcome. Prematurity, low birth weight and APGAR <7 score for 1 minute was common foetal outcomes.Conclusions: Our study strongly suggests foetal surveillance programmes in cases of placenta previa. Measures should be made to bring awareness about PP, in urban slums and to increase medical checkups regularly. Making USG mandatory during every ANC and referral of cases of PP to tertiary care centres would definitely reduce the chances of morbidity and mortality.

The effects of the day of trophectoderm biopsy and blastocyst grade on the clinical and neonatal outcomes of preimplantation genetic testing–frozen embryo transfer cycles

Zygote ◽  
2021 ◽  
pp. 1-6
Author(s):  
Linjun Chen ◽  
Zhenyu Diao ◽  
Jie Wang ◽  
Zhipeng Xu ◽  
Ningyuan Zhang ◽  
...  
Keyword(s):  
Birth Weight ◽  
Genetic Testing ◽  
Embryo Transfer ◽  
Live Birth ◽  
Frozen Embryo Transfer ◽  
Neonatal Outcomes ◽  
Miscarriage Rate ◽  
Birth Rates ◽  
Preimplantation Genetic Testing ◽  
Live Birth Rates

Summary This study analyzed the effects of the day of trophectoderm (TE) biopsy and blastocyst grade on clinical and neonatal outcomes. The results showed that the implantation and live birth rates of day 5 (D5) TE biopsy were significantly higher compared with those of D6 TE biopsy. The miscarriage rate of the former was lower than that of the latter, but there was no statistically significant difference. Higher quality blastocysts can achieve better implantation and live birth rates. Among good quality blastocysts, the implantation and live birth rates of D5 and D6 TE biopsy were not significantly different. Among fair quality and poor quality blastocysts, the implantation and live birth rates of D5 TE biopsy were significantly higher compared with those of D6 TE biopsy. Neither blastocyst grade nor the day of TE biopsy significantly affected the miscarriage rate. Neonatal outcomes, including newborn sex, gestational age, preterm birth, birth weight and low birth weight in the D5 and D6 TE biopsies were not significantly different. Both blastocyst grade and the day of TE biopsy must be considered at the same time when performing preimplantation genetic testing–frozen embryo transfer.

scholarly journals Consequences of antepartum hemorrhage and its maternal and perinatal outcome

2019 ◽  
Vol 8 (4) ◽  
pp. 1480
Author(s):  
Himang Jharaik ◽  
Bishan Dhiman ◽  
S. K. Verma ◽  
Aditi Sharma
Keyword(s):  
Perinatal Outcome ◽  
Placenta Previa ◽  
Developed Countries ◽  
Perinatal Morbidity ◽  
Antepartum Haemorrhage ◽  
High Risk Factors ◽  
Fetal Complications ◽  
Life Threatening ◽  
One Year ◽  
Life Threatening Event

Background: Antepartum haemorrhage, a life-threatening event, is defined as bleeding per vaginum occurring after the fetus has reached the period of viability, considered to be 20 weeks in developed countries and 28 weeks in countries with low resource settings. We evaluated the consequences of antepartum haemorrhage, their maternal and perinatal outcome so as to outline the proper management of patient in order to improve both maternal and perinatal morbidity and mortality.Methods: This one-year prospective study totaled 133 cases of APH fulfilling the inclusion criteria were studied. Data was recorded on the MS excel sheet for further analysis and processing.Results: Total 6693 deliveries were conducted out of which 133 presented as APH and incidence of APH was found out to be 1.98%. Placenta previa was most common. APH was commonly associated with multigravida and most cases were in age group of 26-30 years. Most of the PP and abruption cases were admitted at 34-37 weeks and 31-33 weeks respectively. High risk factors included previous LSCS and D and C, hypertension, multiple pregnancies and malpresentations. Most of the patients underwent preterm LSCS. Most fetal complications were due to prematurity. 58.6% patients were transfused blood. Overall perinatal mortality was 20.1% and maternal mortality was zero.Conclusions: Early diagnoses, timely referrals and transfusion facilities along with trained team of doctors with well-equipped ICU facility goes a long way in avoiding APH related maternak and fetal complications.

scholarly journals Current obesity was associated with hypertension in children born very low birth weight

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Chompoonut Limratchapong ◽  
Pracha Nuntnarumit ◽  
Wischuri Paksi ◽  
Kwanchai Pirojsakul
Keyword(s):  
Blood Pressure ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Blood Pressure Monitoring ◽  
Developed Countries ◽  
Masked Hypertension ◽  
Normal Birth ◽  
The Developed Countries ◽  
Hypertension In Children

Abstract Objectives Previous studies from the developed countries showed that children born very low birth weight have a higher risk of hypertension compared with that of the normal birth weight controls. However, studies regarding the prevalence of hypertension in such children from the developing countries are scarce. This study aimed to identify the perinatal and postnatal factors associated with hypertension in children born very low birth weight. Results Forty-six children aged ≥ 6 years from the VLBW cohort of Ramathibodi Hospital, Bangkok, Thailand underwent the ambulatory blood pressure monitoring. The prevalence of hypertension was 15.2% (7/46). The hypertension group had a significant higher BMI z-score at 3 years of age (0.90 ± 1.44 vs − 0.45 ± 1.47, p = 0.045) and a greater proportion of current obesity (42% vs 2.5%, p < 0.01) compared to those in the normotensive group. Multivariate analysis revealed that current obesity was associated with hypertension (OR 34.77, 95%CI 1.814–666.5). Among 36 children with normal office blood pressure, four children (11.1%) had high blood pressure uncovered by ABPM, called “masked hypertension”. Office systolic blood pressure at the 85th percentile was the greatest predictor for masked hypertension with a sensitivity of 75% and a specificity of 81.2%.

GROWTH AND DEVELOPMENT OF THE CHILD

PEDIATRICS ◽  
1979 ◽  
Vol 64 (5) ◽  
pp. 591-591
Author(s):  
Keyword(s):  
Birth Weight ◽  
Adult Life ◽  
Developed Countries ◽  
Infant Mortality Rate ◽  
Physical Growth ◽  
Rural Populations ◽  
Vicious Cycle ◽  
Catch Up ◽  
The Individual ◽  
Dramatic Consequence

Deaths of infants and of their mothers may be the most dramatic consequence of ill health, but there are other serious consequences which affect the child and, indeed, may follow it throughout adult life. The damage done by infections and associated malnutrition to a young child in its formative years is manifested in retarded physical growth and mental development, which it may never be able to catch up on, thus impairing the potential for a full and active adult life. Poverty, ignorance, and ill health thus create a vicious cycle spanning from one generation to the next, and from which the individual has little chance of escape. A striking expression of this generation link is the frequency of "low birth weight" (LBW) babies, ie, babies weighing less than 2500 gm at birth. It is now known that this frequency is closely determined by the same adverse maternal and environmental factors which determine the nutritional status of the mother. It has also been observed in developed countries that the frequency is higher among mothers who smoke during pregnancy. About 21 million LBW (small for date) babies are born each year, the greatest majority of them in developing countries. The observed incidence rate ranges from about 4% in the most developed countries to over 30% in some poor rural populations. It is also known that LBW is the single most important factor determining the survival chances of the child. The infant mortality rate is about 20 times greater for all LBW babies than for other babies, and the lower the birth weight the lower is the survival chance.

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