scholarly journals Prevalence and risk factors of severe postpartum hemorrhage: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chen-ning Liu ◽  
Fu-bing Yu ◽  
Yun-zhe Xu ◽  
Jin-sheng Li ◽  
Zhi-hong Guan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Postpartum Hemorrhage ◽  
Maternal Age ◽  
Placenta Previa ◽  
Previous Cesarean Section ◽  
Estimated Blood Loss ◽  
History Of ◽  
Prolonged Labor ◽  
Previous Cesarean

Abstract Background Although maternal deaths are rare in developed regions, the morbidity associated with severe postpartum hemorrhage (SPPH) remains a major problem. To determine the prevalence and risk factors of SPPH, we analyzed data of women who gave birth in Guangzhou Medical Centre for Critical Pregnant Women, which received a large quantity of critically ill obstetric patients who were transferred from other hospitals in Southern China. Methods In this study, we conducted a retrospective case-control study to determine the prevalence and risk factors for SPPH among a cohort of women who gave birth after 28 weeks of gestation between January 2015 and August 2019. SPPH was defined as an estimated blood loss ≥1000 mL and total blood transfusion≥4 units. Logistic regression analysis was used to identify independent risk factors for SPPH. Results SPPH was observed in 532 mothers (1.56%) among the total population of 34,178 mothers. Placenta-related problems (55.83%) were the major identified causes of SPPH, while uterine atony without associated retention of placental tissues accounted for 38.91%. The risk factors for SPPH were maternal age < 18 years (adjusted OR [aOR] = 11.52, 95% CI: 1.51–87.62), previous cesarean section (aOR = 2.57, 95% CI: 1.90–3.47), history of postpartum hemorrhage (aOR = 4.94, 95% CI: 2.63–9.29), conception through in vitro fertilization (aOR = 1.78, 95% CI: 1.31–2.43), pre-delivery anemia (aOR = 2.37, 95% CI: 1.88–3.00), stillbirth (aOR = 2.61, 95% CI: 1.02–6.69), prolonged labor (aOR = 5.24, 95% CI: 3.10–8.86), placenta previa (aOR = 9.75, 95% CI: 7.45–12.75), placenta abruption (aOR = 3.85, 95% CI: 1.91–7.76), placenta accrete spectrum (aOR = 8.00, 95% CI: 6.20–10.33), and macrosomia (aOR = 2.30, 95% CI: 1.38–3.83). Conclusion Maternal age < 18 years, previous cesarean section, history of PPH, conception through IVF, pre-delivery anemia, stillbirth, prolonged labor, placenta previa, placental abruption, PAS, and macrosomia were risk factors for SPPH. Extra vigilance during the antenatal and peripartum periods is needed to identify women who have risk factors and enable early intervention to prevent SPPH.

scholarly journals Outcome of Pregnancy with History of Previous Cesarean Section

2017 ◽  
Vol 9 (4) ◽  
pp. 308-311
Author(s):  
Reena J DSouza ◽  
Bandeppa H Narayani ◽  
Smitha B Rao
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Cesarean Section ◽  
Perinatal Death ◽  
Placenta Previa ◽  
Birth Asphyxia ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
History Of ◽  
Previous Cesarean

ABSTRACT In modern obstetric practice, pregnancy with history of previous cesarean section is quite common. A cesarean section poses some documented risks to the mother's health in subsequent pregnancies like placenta previa or accreta and uterine scar rupture. It is also associated with increased likelihood of preterm delivery, low birth weight, and perinatal death. Repeat cesarean section is technically difficult and there is chance of injury to surrounding structures. The retrospective study was done in Yenepoya Medical College Hospital during the period of January 2014 to January 2015 to find out the maternal antepartum and intrapartum complications as well as perinatal outcome in patients with a history of cesarean section. A total number of 143 pregnant patients with history of one or more cesarean section who underwent repeat cesarean sections were included. Previous classical cesarean, extreme prematurity, and those who opted for vaginal birth after cesarean (VBAC) were excluded. Mean age of the study population was 27.4 years. Here, 72.12 and 20.98% cases had history of previous one and two cesarean sections respectively. Important antepartum complications were placenta previa (3.50%), scar tenderness (8.39%), gestational diabetes mellitus (GDM; 4.90%), pregnancy-induced hypertension (PIH; 6.99%), etc. There were extensive peritoneal and bladder adhesions in 13.99 and 16.78% cases respectively, causing much preoperative difficulties and in one case urinary bladder was injured during operation. Postoperative period was uneventful in 72.72% cases. In this study, 20.28% neonates developed some complications like prematurity, low birth weight, birth asphyxia, and neonatal jaundice. Here the rate of perinatal mortality was 1.4%. How to cite this article DSouza RJ, Narayani BH, Rao SB. Outcome of Pregnancy with History of Previous Cesarean Section. J South Asian Feder Obst Gynae 2017;9(4):308-311.

scholarly journals Risk Factors and Pregnancy Outcome in Women With a History of Cesarean Section Complicated by Placenta Accreta

2020 ◽  
Author(s):  
Yingyu Liang ◽  
lizi Zhang ◽  
Shilei Bi ◽  
Jingsi Chen ◽  
Shanshan Zeng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Cesarean Sections ◽  
Han Ethnicity ◽  
Parity Number ◽  
History Of ◽  
Independent Risk Factors ◽  
Previous Cesarean

Abstract Objective: To explore the risk factors and pregnancy outcomes in women with a history of cesarean section complicated by placenta accreta.Methods: This retrospective study included clinical data from singleton mothers with a history of cesarean section in 11 public tertiary hospitals in 7 provinces of China between January 2017 and December 2017. According to the intraoperative findings or the pathologic diagnosis after delivery, the study population was divided into placenta accreta (PA) and non-PA groups. We compared the pregnancy outcomes between the 2 groups, used multivariate logistic regression to analyze the risk factors for placental accreta, and used receiver operating characteristic curves to evaluate the value of the risk factors.Results: For this study we included 11,074 pregnant women with a history of cesarean section; and of these, 869 cases were in the PA group and 10,205 cases were in the non-PA group. Compared with the non-PA group, the probability of postpartum hemorrhage, severe postpartum hemorrhage, diffuse intravascular coagulation, puerperal infection, intraoperative bladder injury, hysterectomy, and blood transfusion was significantly increased in the placenta accreta group (P<0.05)). At the same time, the rate of neonatal low-birth weight, the probability of neonatal comorbidities, and the rate of neonatal intensive care unit admission also increased significantly (P<0.05). Weight, parity, number of miscarriages, number of previous cesarean sections, history of premature rupture of membrane, previous cesarean-section transverse incisions, history of placenta previa, and the combination of prenatal hemorrhage and placenta previa were all independent risk factors for placenta accreta; while non-Han ethnicity was an independent protective factor for placenta accreta (P<0.05). The area under the ROC curve (AUC) was 0.93 (95% CI=0.92-0.94); and the specificity, sensitivity, and accuracy rate were 0.87, 0.93, and 0.93, respectively.Conclusions: There was an increased risk of adverse outcomes in pregnancies complicated by placenta accreta in women with a history of cesarean section, and this required close clinical attention. Weight before pregnancy, parity, number of miscarriages, number of previous cesarean sections, Han ethnicity, history of premature rupture of membranes, past transverse incisions in cesarean sections, a history of placenta previa, prenatal hemorrhage, and placenta previa were independent risk factors for pregnancies complicated with placenta accreta in women with a history of cesarean section. These independent risk factors showed a high value in predicting the risk for placental accreta in pregnancies of women with a history of cesarean section.

scholarly journals Pregnancy complicated by previous cesarean section: a retrospective study

2018 ◽  
Vol 7 (11) ◽  
pp. 4470
Author(s):  
Poornima M.
Keyword(s):  
Retrospective Study ◽  
Cesarean Section ◽  
Medical Records ◽  
Neonatal Outcome ◽  
Perinatal Morbidity ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Exclusion Criteria ◽  
History Of ◽  
Previous Cesarean

Background: Previous Cesarean section (CS) is one of the important causes of CS in subsequent pregnancies. Moreover, repeated cesarean sections increase maternal as well as perinatal morbidity and mortality. We conducted this study to find out outcome of pregnancies in women who had a history of previous CS.Methods: This was a retrospective study of patients of previous caesarean section for either maternal or fetal indications. The duration of study was 3 years. Total 215 patients were included in this study on the basis of a predefined inclusion and exclusion criteria. The indications, maternal and neonatal outcome were studied from medical records of the patients. Statistical analysis was done using SSPE 22.0 software.Results: Out of 215 studied cases majority of the patients belonged to age group of 21-30 years (75.35%) and were 2nd gravida (61.86%). 164 (76.28%) patients attended ANC OPD at least for 3 times during pregnancy. 73 (33.95%) patients had Hb of less than 10 gms while blood transfusion was required to be given in 11 (5.12%) patients. cesarean section was required in 172 (80%) patients out of which 166 (77.21%) patients had undergone emergency LSCS while in 6 (2.79%) patients elective LSCS was done. Scar tenderness was the most common indication for repeat cesarean section. There was no maternal mortality in any patients while there was 1 still birth and 1 neonatal death.Conclusions: Previous cesarean section is one of the important causes of CS in subsequent pregnancies hence decision of doing CS, especially primigravida, must be taken in accordance with strict guidelines and the practice of “cesarean section on demand” should be discouraged.

scholarly journals Clinical Experience Over 15 Years with the B-Lynch Compression Suture Technique in the Management of Postpartum Hemorrhage

2021 ◽  
Vol 43 (09) ◽  
pp. 655-661
Author(s):  
Gilberto Nagahama ◽  
Henri Augusto Korkes ◽  
Nelson Sass
Keyword(s):  
Cesarean Section ◽  
Clinical Experience ◽  
Postpartum Hemorrhage ◽  
Surgical Site Infections ◽  
Suture Technique ◽  
Study Patient ◽  
Success Rates ◽  
Previous Cesarean Section ◽  
Cross Sectional ◽  
Previous Cesarean

Abstract Objective To describe the clinical experience with the B-Lynch technique in the management of postpartum hemorrhage as well as the factors related to the indication of the technique and to present the success rates of the application of the B-Lynch technique. Methods Observational, retrospective, cross-sectional, and analytical study. Patient data was obtained through the study of medical records. The study population comprised of patients who underwent hemostatic suture using the B-Lynch technique, including 104 patients within the period from January 1, 2005, to December 31, 2019. Results Of the total of 104 patients, 82.7% did not present any complications. Blood transfusion and intensive care unit admission were the most prevalent complications, with 13.5% and 15.4%, respectively. Only 1% of the patients had puerperal and surgical site infections. The factors most related to the application of the technique were the presence of previous cesarean section (30.8%), use of oxytocin (16.3%), and preeclampsia (11.6%). Puerperal hysterectomy was performed in 4.8% of the patients due to failure of the method. Conclusion The clinical experience with the B-Lynch technique was satisfactory since it presented few complications, with excellent results in hemorrhagic control. Previous cesarean section, the use of oxytocin, and preeclampsia stood out as factors related to the indication of the application of the technique, and the success rate in controlling postpartum hemorrhage was 95.2%.

scholarly journals Placenta Previa Accreta and Previous Cesarean Section

2018 ◽  
Vol 131 (12) ◽  
pp. 1504-1505
Author(s):  
Shigeki Matsubara ◽  
Hironori Takahashi
Keyword(s):  
Cesarean Section ◽  
Placenta Previa ◽  
Previous Cesarean Section ◽  
Previous Cesarean
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