Preoperative moderate thrombocytopenia is not associated with increased blood loss for low-risk cesarean section: a retrospective cohort study

Abstract Background/Objective To estimate the effectiveness of uterine massage UM in reducing blood loss before delivery of placenta in CS. Methods This was a retrospective cohort study of 1393 women who delivered with CS. Patients who underwent UM (671women) were compared with those who underwent controlled cord traction (722 women). According to risk assessment of PPH, 2 groups were both divided to low risk group and high risk group. Outcomes included blood loss amount within 2 h after delivery, incidence of PPH and intractable PPH. Results Blood loss amount within 2 h was lower in UM group than CCT group(516.6±196.5 ml compared with 674.1±272.2 ml, P<0.01). The incidence of PPH and intractable PPH didn’t differ significantly between the 2 groups (6.7% compared with 9.1%, P=0.09 and 3.9% compared with 5.3%, P=0.22,respectively).In high risk group, the amount of blood loss within 2 h and the incidence of PPH were both lower in UM group (n=382) than CCT group (n=407) (576.8±228.1 ml compared with 854.9±346.1 ml, P<0.01 and 7.1% compared with 11.3%,P=0.04 ,respectively). The incidence of intractable PPH didn’t differ significantly between the 2 groups (4.7% compared with 6.9%,P=0.19). In low risk group, the 3 outcomes didn’t differ significantly between the 2 groups(n=289 vs. 315) (428.5±172.6 ml compared with 447.9±180.5 ml; 6.2% compared with 6.3%; 2.8% compared with 3.2%; P=0.56, 0.95 and 0.77,respectively). Conclusion In high risk patients of PPH, UM before delivery of placenta contributed to reduce blood loss in CS.

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Faculty Opinions recommendation of Long-term analgesic use after low-risk surgery: a retrospective cohort study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.14054961.15521063 ◽

2012 ◽

Author(s):

Marc De Kock ◽

Patrice Forget

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Low Risk ◽

Analgesic Use

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Comparison of adverse perinatal outcomes between Asians and Caucasians: a population-based retrospective cohort study in Ontario

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03467-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Na Zeng ◽

Erica Erwin ◽

Wendy Wen ◽

Daniel J. Corsi ◽

Shi Wu Wen ◽

...

Keyword(s):

Cohort Study ◽

Birth Weight ◽

Preterm Birth ◽

Cesarean Section ◽

Gestational Age ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Perinatal Outcomes ◽

Population Based ◽

Adverse Perinatal Outcomes

Abstract Background Racial disparities in adverse perinatal outcomes have been studied in other countries, but little has been done for the Canadian population. In this study, we sought to examine the disparities in adverse perinatal outcomes between Asians and Caucasians in Ontario, Canada. Methods We conducted a population-based retrospective cohort study that included all Asian and Caucasian women who attended a prenatal screening and resulted in a singleton birth in an Ontario hospital (April 1st, 2015-March 31st, 2017). Generalized estimating equation models were used to estimate the independent adjusted relative risks and adjusted risk difference of adverse perinatal outcomes for Asians compared with Caucasians. Results Among 237,293 eligible women, 31% were Asian and 69% were Caucasian. Asians were at an increased risk of gestational diabetes mellitus, placental previa, early preterm birth (< 32 weeks), preterm birth, emergency cesarean section, 3rd and 4th degree perineal tears, low birth weight (< 2500 g, < 1500 g), small-for-gestational-age (<10th percentile, <3rd percentile), neonatal intensive care unit admission, and hyperbilirubinemia requiring treatment, but had lower risks of preeclampsia, macrosomia (birth weight > 4000 g), large-for-gestational-age neonates, 5-min Apgar score < 7, and arterial cord pH ≤7.1, as compared with Caucasians. No difference in risk of elective cesarean section was observed between Asians and Caucasians. Conclusion There are significant differences in several adverse perinatal outcomes between Asians and Caucasians. These differences should be taken into consideration for clinical practices due to the large Asian population in Canada.

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Myomectomy during cesarean section: A retrospective cohort study

Journal of Gynecology Obstetrics and Human Reproduction ◽

10.1016/j.jogoh.2020.101900 ◽

2020 ◽

Vol 49 (10) ◽

pp. 101900

Author(s):

Waleed El-refaie ◽

Mohamed Hassan ◽

Mohamed Sayed Abdelhafez

Keyword(s):

Cohort Study ◽

Cesarean Section ◽

Retrospective Cohort Study ◽

Retrospective Cohort

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A comparison of spinal and epidural anesthesia for cesarean section following epidural labor analgesia: A retrospective cohort study

Acta Anaesthesiologica Taiwanica ◽

10.1016/j.aat.2015.01.003 ◽

2015 ◽

Vol 53 (1) ◽

pp. 7-11 ◽

Cited By ~ 12

Author(s):

Chia-Hsiang Huang ◽

Yi-Jer Hsieh ◽

Ko-Hsin Wei ◽

Wei-Zen Sun ◽

Shao-Lun Tsao

Keyword(s):

Cohort Study ◽

Cesarean Section ◽

Epidural Anesthesia ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Labor Analgesia

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Does implementation of the PECARN rules for minor head trauma improve patient-centered outcomes in a lower resource emergency department: a retrospective cohort study

BMC Pediatrics ◽

10.1186/s12887-020-02328-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Rasha D. Sawaya ◽

Cynthia Wakil ◽

Adonis Wazir ◽

Sami Shayya ◽

Iskandar Berbari ◽

...

Keyword(s):

Emergency Department ◽

Cohort Study ◽

High Risk ◽

Head Trauma ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Pediatric Emergency ◽

Low Risk ◽

Minor Head Trauma ◽

Scan Rate

Abstract Background Managing children with minor head trauma remains challenging for physicians who evaluate for the need for computed tomography (CT) imaging for clinically important traumatic brain injury (ciTBI) identification. The Pediatric Emergency Care Applied Research Network (PECARN) prediction rules were adopted in our pediatric emergency department (PED) in December 2013 to identify children at low risk for ciTBI. This study aimed to evaluate this implementation’s impact on CT rates and clinical outcomes. Methods Retrospective cohort study on pediatric patients with head trauma presenting to the PED of the American University of Beirut Medical Center in Lebanon. Participants were divided into pre- (December 2012 to December 2013) and post-PECARN (January 2014 to December 2016) groups. Patients were further divided into < 2 and ≥ 2 years and stratified into groups of low, intermediate and high risk for ciTBI. Bivariate analysis was conducted to determine differences between both groups. Results We included 1362 children of which 425 (31.2%) presented pre- and 937 (68.8%) presented post-PECARN rules implementation with 1090 (80.0%) of low, 214 (15.7%) of intermediate and 58 (4.3%) of high risk for ciTBI. CTs were ordered on 92 (21.6%) pre- versus 174 (18.6%) patients post-PECARN (p = 0.18). Among patients < 2 years, CT rates significantly decreased from 25.2% (34/135) to 16.5% (51/309) post-PECARN (p = 0.03), and dropped in all risk groups but only significantly for low risk patients from 20.7% (24/116) to 11.4% (30/264) (p = 0.02). There was no significant decrease in CT rates in patients ≥2 years (20% pre (58/290) vs 19.6% post (123/628), p = 0.88). There was no increase in bounce back numbers, nor in admission rates or positive CT findings among bounce backs. Conclusions PECARN rules implementation did not significantly change the overall CT scan rate but reduced the CT scan rate in patients aged < 2 years at low risk of ciTBI. The implementation did not increase the number of missed ciTBI.

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