scholarly journals Placental Mesenchymal Dysplasia Associated with Placenta Previa and Preterm Labor

Perinatology ◽  
2020 ◽  
Vol 31 (2) ◽  
pp. 90
Author(s):  
Soo Jung Kim ◽  
Ha Young Yun ◽  
Soon-Sup Shim ◽  
Hye-Sim Kang ◽  
Chang Lim Hyun
Keyword(s):  
Preterm Labor ◽  
Placenta Previa ◽  
Placental Mesenchymal Dysplasia

Association between Number of Prior Cesareans and Early Preterm Delivery in Women with Abnormal Placentation

2020 ◽  
Author(s):  
Ayamo Oben ◽  
Elizabeth B. Ausbeck ◽  
Melissa N. Gazi ◽  
Akila Subramaniam ◽  
Lorie M. Harper ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Preterm Labor ◽  
Placenta Previa ◽  
Secondary Analysis ◽  
Blood Products ◽  
Primary Analysis ◽  
Logistic Regression Models ◽  
Placenta Accreta Spectrum ◽  
Nicu Admission ◽  
Early Preterm Birth

Objective Delivery timing at 34 to 36 weeks is nationally recommended for pregnancies complicated by placenta accreta spectrum (PAS). However, it has recently been suggested that those with ≥2 prior cesarean deliveries (CD) and PAS should be delivered earlier than 34 weeks because of a higher risk of unscheduled delivery and complications. We sought to evaluate whether the number of prior CD in women with PAS is associated with early preterm delivery (PTD) (<34 weeks). We also evaluated the same relationship in women with placenta previa alone (without PAS). Study Design This is a secondary analysis of a multicenter and observational study that included women with prior CD (maternal–fetal medicine unit cesarean registry). Women with a diagnosis of PAS (regardless of placenta previa) were included for our primary analysis, and women with known placenta previa (without a component of PAS) were independently analyzed in a second analysis. Two groups of patients from the registry were studied: patients with PAS (regardless of placenta previa) and patients with placenta previa without PAS. The exposure of interest was the number of prior CD: ≥2 CD compared with <2 CD. The primary outcome was PTD <34 weeks. Secondary outcomes included preterm labor requiring hospitalization or tocolysis, transfusion of blood products, composites of maternal and neonatal morbidities, and NICU admission. Outcomes by prior CD number groups were compared in both cohorts. Backward selection was used to identify parsimonious logistic regression models. Results There were 194 women with PAS, 97 (50%) of whom had <2 prior CD and 97 (50%) of whom had ≥2 prior CD. The rate of PTD <34 weeks in women with ≥2 prior CD compared with <2 in the setting of PAS was 23.7 versus 29.9%, p = 0.27; preterm labor requiring hospitalization was 24.7 versus 13.5%; p = 0.05. The rates of plasma transfusion were increased with ≥2 prior CD (29.9 vs. 17.5%, p = 0.04), but there were no differences in transfusion of other products or in composite maternal or neonatal morbidities. After multivariable adjustments, having ≥2 CDs was not associated with PTD <34 weeks in women with PAS (adjusted odds ratio (aOR): 0.73, 95% confidence interval [CI]: 0.39–13.8) despite an association with preterm labor requiring hospitalization (aOR: 2.69; 95% CI: 1.15–6.32). In our second analysis, there were 687 women with placenta previa, 633 (92%) with <2 prior CD, and 54 (8%) with ≥2 prior CD. The rate of PTD <34 weeks with ≥2 CD in the setting of placenta previa was not significantly increased (27.8 vs. 22.1%, aOR: 1.49; 95% CI: 0.77–2.90, p = 0.08); the maternal composite outcome (aOR: 4.85; 95% CI: 2.43–9.67) and transfusion of blood products (aOR: 6.41; 95% CI: 2.30–17.82) were noted to be higher in the group with ≥2 prior CD. Conclusion Women with PAS who have had ≥2 prior CD as compared with women with <2 prior CD did not appear to have a higher risk of complications leading to delivery prior to 34 weeks. As such, considering the associated morbidity with early preterm birth, we would not recommend scheduled delivery prior to 34 weeks in this population. Key Points

Pregnancy and childbirth in patients with endometriosis

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (1) ◽  
pp. 6-11
Author(s):  
Natalia V. Artymuk ◽  
Ekaterina N. Vaulina ◽  
Olga A. Zotova
Keyword(s):  
Preterm Labor ◽  
Assisted Reproductive Technologies ◽  
Placenta Previa ◽  
Reproductive Technologies ◽  
Perinatal Complications ◽  
Pregnancy And Childbirth ◽  
Increased Risk ◽  
Fertility Problems ◽  
Severity Of The Disease ◽  
Risk Of Preeclampsia

Aim. To review the current publication highlighting the features of pregnancy and childbirth outcomes in patients with endometriosis. Materials and methods. The analysis of 45 foreign and domestic publications on this topic has been carried out. Results. Patients with endometriosis have fertility problems, and when pregnancy occurs, it was characterized by a higher risk of preeclampsia, placenta previa, gestational diabetes, miscarriage and preterm labor, as well as delivery by caesarean section. Newborns in women with endometriosis have an increased risk of prematurity and small for gestational age. Probably, in addition to the presence of endometriosis, the risk of obstetric and neonatal complications is influenced by the localization and severity of the disease, as well as the use of assisted reproductive technologies. Conclusion. The results obtained indicate that patients with endometriosis have a high risk of perinatal complications and require additional antenatal monitoring and care.

scholarly journals Classical Cesarean Section

2020 ◽  
Vol 06 (S 02) ◽  
pp. S98-S103
Author(s):  
Amano Kan
Keyword(s):  
Cesarean Section ◽  
Uterine Rupture ◽  
Preterm Labor ◽  
Placenta Previa ◽  
Subsequent Pregnancy ◽  
Lower Uterine Segment ◽  
Transverse Incision ◽  
Dense Adhesion ◽  
Trial Of Labor ◽  
Vertical Incision

AbstractCesarean section is the most common surgery in obstetrics. Several techniques are proposed according to the indication and the degree of urgency. Usually laparotomy followed by hysterotomy with a low transverse incision is preferable. However, in cases in which it is difficult to access the lower uterine segment, such as that in preterm labor, dense adhesion, placenta previa/accrete a vertical hysterotomy (classical cesarean section) may be needed. Although a smooth and gentle delivery of the fetus is possible through the vertical incision, uterine closure is technically difficult. To decrease the risks of hemorrhage and adhesion, a speedy and skillful technique is mandatory. The most serious risk of vertical incision in the contractile corpus is uterine rupture in the subsequent pregnancy. Therefore, cases of prior classical cesarean section are contraindicated for trial of labor after cesarean section.

scholarly journals Determinants of placenta previa: a case-control study

2017 ◽  
Vol 4 (06) ◽  
pp. 1411
Author(s):  
Fatemeh Shobeiri ◽  
Ensiyeh Jenabi ◽  
Manoochehr Karami ◽  
Simin Karimi
Keyword(s):  
Risk Factors ◽  
Preterm Labor ◽  
Maternal Age ◽  
Case Control Study ◽  
Placenta Previa ◽  
Significant Risk ◽  
Uterine Cavity ◽  
Case Control ◽  
Cesarean Sections ◽  
Control Study

Background: The risk factors of placenta previa differ around the world. This study evaluated risk factors of pregnancies complicated with placenta previa during a 5-year period in a referral center in Hamadan, Iran. Methods: This case control study was conducted in Hamadan city (Hamadan Province of Iran) from April 2013 to March 2017. The cases were women whose deliveries were complicated by placenta previa and the controls were those who delivered without placenta previa. We recruited 130 cases and 130 controls. Multivariate unconditional logistic regression analysis was conducted, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: The OR of placenta previa was 4.08 (95% CI= 1.44, 11.58) by maternal age, 4.08 (95% CI =1.44, 11.58) by preterm labor, and 6.64 (95% CI =1.09, 40.45) by prior operations of the uterine cavity, compared to normal deliveries and after adjusting for other variables. Multiparity, prior spontaneous abortions, and prior cesarean sections were not statistically significant risk factors for placenta previa, when adjusted for other variables.  Conclusion: Our study suggests that high maternal age and prior operations of the uterine cavity are risk factors for placenta previa.

scholarly journals Effect of types of placenta previa on maternal and neonatal outcomes: A 10-year retrospective cohort study

2021 ◽  
Author(s):  
Shilei Bi ◽  
Lizi Zhang ◽  
Zhijian Wang ◽  
Jingsi Chen ◽  
Jingman Tang ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Labor ◽  
Placenta Previa ◽  
Multivariate Logistic Regression Analysis ◽  
Neonatal Outcomes ◽  
Classification Method ◽  
Different Types ◽  
Maternal And Neonatal Outcomes

Abstract Purpose: Through this study, we aimed to evaluate the effects of different types of placenta previa (PP) on maternal and neonatal outcomes.Methods: This study was conducted in The Third Affiliated Hospital of Guangzhou Medical University and Tongji Hospital between January 2009 and 2019. PP was traditionally classified into four types, namely low-lying placenta, marginal, partial, and complete PP. Previous studies have classified PP into two types, namely low-lying placenta and PP. Based on our clinical experience, we proposed the classification of PP into three types, for the first time, which included low-lying placenta, “marpartial” (marginal and partial) PP, and complete PP. Multivariate logistic regression analysis was performed to determine the effects of different types of PP on maternal and neonatal outcomes.Results: In total, 4490 singleton pregnancies were complicated with PP. In the four-classification method, compared with women with low-lying placenta, women with complete PP had a risk of placenta accrete spectrum disorders, postpartum hemorrhage (PPH), hemorrhagic shock, severe PPH, blood transfusion, hysterectomy, puerperal infection, preterm labor, NICU admission, and low birth weight. There was no difference in maternal and neonatal outcomes between marginal and partial PP, except for increased chances of preterm labor and low birth weight in partial PP. In the two-classification method, PP was the risk factor for most of the adverse maternal and neonatal outcomes, compared with low-lying placenta.Conclusion: Complete PP and low-lying placenta were associated with the highest and lowest risks of adverse pregnancy outcomes, respectively, whereas clinically similar outcomes were observed between marginal and partial PP. The three-classification of PP may be practical from the clinical perspective.

scholarly journals OBSTETRIC RISKS IN PREGNANT WOMEN ATTENDED AT THE GYNECOLOGICAL OBSTETRIC UNIVERSITY HOSPITAL OF GUAYAQUIL

2020 ◽  
Vol 8 (3) ◽  
pp. 238-244
Author(s):  
Vicky Narea Morales ◽  
Jorge Daher Nader ◽  
Katherine Rodríguez ◽  
Gabriel Jiménez ◽  
Cinthya Baño
Keyword(s):  
Pregnant Women ◽  
Preterm Labor ◽  
Ad Hoc ◽  
Gestational Hypertension ◽  
Placenta Previa ◽  
Research Work ◽  
University Hospital ◽  
Premature Rupture Of Membranes ◽  
Exclusion Criteria ◽  
Collection Form

The word risks is derived from the Greek word riscare, that is to say, they dare, the concept of risks is associated with several possibilities and a predisposing risk factor in pregnancy which seems to identify the degrees of vulnerability during the periods of pregnancy , childbirth, puerperium, the present research work aimed to determine the main obstetric risks in pregnant women of the Hospital Gineco Obstétrico Universitario de Guayaquil, Guayas - Ecuador from January - June 2019. The study design is non-experimental, prospective, in the methodology from the investigation, the data collection form was used, an ad hoc form was prepared. The sample was made up of 407 nulliparous and multiparous pregnant women, who met the inclusion and exclusion criteria. The following results were obtained: preeclampsia with 36%, diabetes 29%, gestational hypertension 20%, preterm labor 6%, premature rupture of membranes 3% and the placenta praevia 1%. In conclusion, the obstetric risks observed in the present study, the highest percentage is preeclampsia with 36% and the lowest percentage placenta previa with 1%.

A pregnant woman with an operated bladder extrophy and a pregnancy complicated by placenta previa and preterm labor

2018 ◽  
Vol 7 (2) ◽  
Author(s):  
Atakan Tanacan ◽  
Fatih Aktoz ◽  
Erdem Fadiloglu ◽  
Canan Unal ◽  
Mehmet Sinan Beksac
Keyword(s):  
Preterm Labor ◽  
Methylenetetrahydrofolate Reductase ◽  
Placenta Previa ◽  
Bladder Exstrophy ◽  
Plasminogen Activator Inhibitor ◽  
Male Infant ◽  
Plasminogen Activator Inhibitor 1 ◽  
Working Together ◽  
Activator Inhibitor

Abstract Background Bladder exstrophy (BE) is a complex congenital anomaly that affects the urinary, reproductive, musculoskeletal and intestinal systems. Highlights This pregnancy case was complicated by BE, methylenetetrahydrofolate reductase (MTHFR) A1298C and plasminogen Activator inhibitör-1 (PAI) 4G/4G homozygous polymorphisms, placenta previa, preterm labor and preterm premature rupture of the membranes. The fetus was evaluated by ultrasonography daily and anhydramnios was detected on the 2nd day of the patient’s hospitalization. A cesarean section (C/S) was performed at 27 weeks and 6 days of gestation and a 1330 g male infant was delivered. Conclusions Adult female patients with BE can have successful pregnancy outcomes if they receive appropriate antenatal care. However, the follow-up of these patients must be carried out at experienced tertiary reference centers with a multidisciplinary approach. This difficult process must be managed by obstetricians, neonatologists, urologists and pediatric surgeons working together.

Sudden fetal death with placental mesenchymal dysplasia complicated by placenta previa

2021 ◽  
Author(s):  
Kenji Tanimura ◽  
Yutoku Shi ◽  
Hitomi Imafuku ◽  
Takaaki Nakanishi ◽  
Maki Kanzawa ◽  
...  
Keyword(s):  
Fetal Death ◽  
Placenta Previa ◽  
Placental Mesenchymal Dysplasia
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