Etiology and therapy of uterine atony. Haselhorst (D. m. Woch. 1926, No. 18)

1926 ◽  
Vol 22 (12) ◽  
pp. 1393-1393
Author(s):  
A. Timofeev
Keyword(s):  
Multiple Pregnancy ◽  
Uterine Atony ◽  
Multiple Gestation ◽  
Endocrine Glands ◽  
Uterine Muscle ◽  
Uterine Malformations ◽  
Uterine Diseases

The author classifies the causes of this anomaly as follows: constitutional anomalies, uterine malformations, uterine diseases, innervation disorders, disorders of a certain group of endocrine glands, and further, causes based on pregnancy, such as uterine muscle distension in multiple pregnancy, in multiple gestation or with a too abundant fetus.

Prematurity, multiple gestation, and abnormal presentation

2016 ◽  
Author(s):  
Oonagh Keag ◽  
E. Sarah Cooper
Keyword(s):  
Preterm Labour ◽  
Multiple Pregnancy ◽  
Breech Presentation ◽  
Neonatal Morbidity ◽  
External Cephalic Version ◽  
Multiple Gestation ◽  
Antenatal Corticosteroids ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Maternal Risks

Preterm labour is a common cause of neonatal morbidity and mortality. This chapter describes the definition, aetiology, diagnosis, and management of preterm labour and delivery with a focus on tocolytic therapy, the use of antenatal corticosteroids, and of magnesium sulphate. Anaesthesia for preterm delivery is discussed. The section on multiple pregnancy details the recommended antenatal careplan for dichorionic and monochorionic twin pregnancies, the fetal and maternal risks and potential complications, and the management of labour and delivery of twins, as well as the anaesthetist’s role in managing these high-risk pregnancies. There are a number of abnormal presentations managed by obstetricians, including abnormal cephalic presentations such as occiputo-posterior positions, breech, transverse, and compound presentations. This chapter focuses specifically on breech presentation, comparing the evidence for vaginal breech delivery versus planned caesarean delivery. It also discusses external cephalic version and vaginal breech delivery itself.

scholarly journals Complications of multiple gestation

2016 ◽  
Vol 10 (2) ◽  
Author(s):  
Razia Ashraf ◽  
Asma Gul ◽  
Rabia Noor ◽  
Saqib Siddique
Keyword(s):  
Preterm Labour ◽  
Multiple Pregnancy ◽  
Multiple Gestation ◽  
Pregnancy Induced Hypertension ◽  
Common Complication ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Induced Hypertension ◽  
Fetal Complications

A Total of selected 50 Patients with Multiple Pregnancy were Studied. The aim of the study was to see the complications of multiple gestation. It was concluded from the results that most common complication is Preterm labour (54%) anemia (38%) Pregnancy induced hypertension (32%) Preterm Premature rupture of membranes (12%) and antepartum haemmorhge in (6%). Fetal Complications were prematurity and low birth weight.

scholarly journals Investigating and modelling risk factors for primary postpartum haemorrhage among childbearing Women in the Northern Province of Rwanda: A Case Control Study

2021 ◽  
Author(s):  
Oliva Bazirete ◽  
Manassé Nzayirambaho ◽  
Aline Umubyeyi ◽  
Innocent Karangwa ◽  
Marilyn Evans
Keyword(s):  
Risk Factors ◽  
Postpartum Haemorrhage ◽  
Fetal Death ◽  
Case Control Study ◽  
Prediction Models ◽  
Multiple Pregnancy ◽  
Case Control ◽  
Uterine Atony ◽  
Antepartum Haemorrhage ◽  
Control Study

Abstract Background: The vast majority of maternal deaths occur in Low- and Middle-Income Countries. Postpartum haemorrhage (PPH) remains a major global burden contributing to high maternal mortality and morbidity rates. Assessment of PPH risk factors should be undertaken during antenatal, intrapartum and postpartum periods for timely prevention of maternal morbidity and mortality associated with PPH. The aim of this study is to investigate and model risk factors for primary PPH in Rwanda. Methods: We conducted an observational case-control study of 430 (108 cases: 322 controls) pregnant women with gestational age of 32 weeks and above who gave birth in five selected health facilities of Rwanda between January and June 2020. Poisson regression, a generalized linear model with a log link and a Poisson distribution was used to estimate the risk ratio of factors associated with PPH. The research protocol was approved by the University of Rwanda, College of Medicine and Health Sciences Institutional Ethics Review Board. Results: The overall prevalence of primary PPH was 25.2%. The following risk factors were identified: antepartum haemorrhage (RR=3.36; 95% CI 1.80- 6.26, P<0.001); intrauterine fetal death (RR=1.93; 95% CI 0.93- 4.03, P<0.077); multiple pregnancy (RR=1.83; 95% CI 1.11- 3.01, P=0.016); haemoglobin level <11 gr/dL (RR=1.51; 95% CI 1.00- 2.30, P=0.050), and premature rupture of membranes (RR=0.58; 95% CI 0.32- 1.05, P<0.077). During the intrapartum and immediate postpartum period, the main causes of primary PPH were: uterine atony (RR=6.70; 95% CI 4.78- 9.38, P<0.001), retained tissues (RR= 4.32; 95% CI 2.87- 6.51, P<0.001); and lacerations of genital organs after birth (RR= 2.14; 95% CI 1.49- 3.09, P<0.001). Coagulopathy was not prevalent in primary PPH. Conclusion: Based on our findings, uterine atony remain the foremost cause of primary PPH. As well as other established risk factors for PPH, antepartum haemorrhage and intra uterine fetal death should be included as risk factors in the development and validation of prediction models for PPH. Large scale studies are needed to investigate further potential PPH risk factors.

Guidelines for the Prevention of Multiple Pregnancy in Treatment by in Vitro Fertilization

1990 ◽  
Vol 39 (3) ◽  
pp. 371-378 ◽  
Author(s):  
F. Leroy ◽  
F. Puissant ◽  
P. Barlow ◽  
G. de Maertelaer
Keyword(s):  
In Vitro Fertilization ◽  
Multiple Pregnancy ◽  
Average Score ◽  
Multiple Gestation ◽  
Reliable Criterion ◽  
Vitro Fertilization ◽  
Stimulation Parameters ◽  
The Mean ◽  
High Age

AbstractWithin the same in vitro fertilization (IVF) program, treatment trials leading to single and multiple ongoing gestation were compared. Rates of cesarean delivery, prematurity and perinatal mortality were found much higher among twin and multiple IVF pregnancies. Our work thus attempts at defining characteristics of proneness to multiple gestation in IVF treatment, in order to try and avoid its occurrence. The mean vitality score of embryos replaced is the most reliable criterion for this purpose, enabling one to replace no more than two embryos when the average score is high. Age of the patient and cause of infertility are almost nondiscriminant in this respect. Ovarian stimulation parameters such as total dosage of gonadotropin treatment and level of estrogenic response, as well as numbers of oocytes and embryos obtained, may serve as secondary criteria for assessing the twinning risk.

scholarly journals Risk factors for uterine atony in two semi-urban hospitals

2020 ◽  
Vol 6 (2) ◽  
pp. 45-49
Author(s):  
Elie Nkwabong ◽  
Celestine Koumwo Mouafo ◽  
Théophile Nana Njamen
Keyword(s):  
Risk Factors ◽  
Past History ◽  
Multiple Pregnancy ◽  
Uterine Atony ◽  
Third Trimester ◽  
Exact Test ◽  
Gestational Age At Delivery ◽  
History Of ◽  
Level Of Significance ◽  
Control Study

Objective: To look for uterine atony (UA) risk factors (RFs). Methods: This case-control study was carried out between 1st February and 31st May 2019. All women with or without UA were recruited. The main variables recorded included gestational age at delivery, past-history of macrosomic baby (≥4000g), third trimester malaria, intrapartum fever, time spent from four cm cervical dilatation to delivery (TFD), birthweight, UA or not. Data were analysed using SPSS 21.0. Fisher’s exact test, t-test and logistic regression were used for comparison. The level of significance was P<0.05. Results: UA was present among 49 women (5.5%). Significant RFs for UA included multiple pregnancy (aOR 7.14, 95%CI 2.01-21.43), delivery before 34 weeks (aOR 5.72, 95%CI 1.24-22.04), TFD ˃10 hours (aOR 5.57, 95%CI 1.34-26.03), macrosomic baby (aOR 3.64, 95%CI 1.37-9.46), recent malaria or preeclampsia (aOR 3.11, 95%CI 1.11-9.79). Conclusion: Measures to manage UA should be made ready when these RFs are present

Routine Cervical Cerclage in Higher Order Multiple Gestation — Does It Prolong the Pregnancy?

Twin Research ◽  
2002 ◽  
Vol 5 (2) ◽  
pp. 67-70 ◽  
Author(s):  
Alexander Strauss ◽  
Ivo M. Heer ◽  
Udo Janßen ◽  
Christian Dannecker ◽  
Peter Hillemanns ◽  
...  
Keyword(s):  
Gestational Age ◽  
Perinatal Outcome ◽  
Positive Impact ◽  
Multiple Pregnancy ◽  
Medical Intervention ◽  
Multiple Gestation ◽  
Perinatal Morbidity ◽  
Cervical Cerclage ◽  
Significant Difference ◽  
Prophylactic Cerclage

AbstractPreterm birth following cervical dilatation is the greatest threat to infants of a multiple pregnancy. Lacking reliable data concerning the effect of prophylactic cerclage, we compared a study group to controls for maternal and perinatal outcome. Sixteen of 94 triplet-, 9 of 18 quadruplet/quintuplet-pregnancies, treated with prophylactic cerclage, were retrospectively compared to those without cervical cerclage respectively. Kruskal-Wallis test and Mann-Whitney-U test were performed as non-parametric one way analysis of variance. For the analysis of frequencies Chi Square test or Fisher’s exact test were performed. Odds ratio with 95% confidence interval was used to compare the need for intravenous tocolysis as well as perinatal morbidity and mortality. Gestational age at delivery was not different from the controls in all studied groups. Birth weight revealed a 200g dominance for the “no cerclage-triplets”, while this significant difference was inverted for quadruplets/quintuplets (1245g vs. 1069g). With respect to gestational age at birth, need for hospitalisation or medical intervention no benefit was achieved. Moreover, perinatal outcome analysed by arterial pH, APGAR-Score and perinatal mortality was not altered by a prophylactic cerclage. Perinatal morbidity for quadruplets and quintuplets was even higher in cerclage pregnancies. Therefore, these retrospective results disclaim a positive impact of cervical cerclage on pregnancy management or perinatal outcome in multifetal pregnancies.

scholarly journals Comparative analysis of monocyesis and multiple gestation course after in vitro fertilization and embriotransfer

2014 ◽  
Vol 18 (2 (70)) ◽  
Author(s):  
L. I. Sehedii ◽  
О. I. Prokopiv
Keyword(s):  
Intrauterine Growth Retardation ◽  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
Multiple Gestation ◽  
Stimulation Protocol ◽  
Vitro Fertilization ◽  
Intrauterine Growth ◽  
Adverse Perinatal Outcomes ◽  
Observation Period

The data of comparative clinical and statistical analysis of gestation process and pregnancy outcome after IVF & ET in the observation period from 2008 through 2012 have been presented. For a set of initial parameters (age structure; cases, duration and infertility factors, the choice of controlled ovarian stimulation protocol) the studied groups did not differ. It has been concluded, that multiple gestation has a aggravating impact on pregnancies achieved in the result of IVF & ET, which was manifested in statistically more frequent, in comparison to monocyesis, cases of late miscarriage threat, intrauterine growth retardation of fetus (fetuses), preterm labour, adverse perinatal outcomes instances, which has been supported by the corresponding findings of the research in both monocyesis and multiple pregnancy groups. A substantial role in aggravating impact on pregnancy also refers to anemia, which statistically more frequently develops in women with a multiple gestation in comparison to those with monocyesis.

Screening for Multiple Pregnancy Determination of Human Chorionic Gonadotropin (hCG), Alpha-Fetoprotein (α-FP) and Human Placental Lactogen (hPL) in Blood During the Second Trimester of Pregnancy

1984 ◽  
Vol 33 (4) ◽  
pp. 571-574 ◽  
Author(s):  
F. Vandekerckhove ◽  
M. Dhont ◽  
M. Thiery ◽  
R. Derom
Keyword(s):  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Multiple Pregnancy ◽  
Placental Lactogen ◽  
Multiple Gestation ◽  
Consecutive Series ◽  
Human Placental Lactogen ◽  
Second Trimester ◽  
Twin Pregnancies

AbstractThe value of single determinations of serum hCG, hPL, and αFP for the detection of multiple pregnancy was investigated in a consecutive series of 992 women between the 14th and 24th week of pregnancy. With the 90th percentile as referent value, all twin pregnancies (n = 10) were detected by the combined results of the three determinations. Considered separately, hPL proved to be the most useful indicator of multiple gestation; the sensitivity of hPL alone was 70% and the predictive value of hPL concentrations above the 90th percentile was 8.1.

Rational management of the third period of labour

1986 ◽  
Vol 67 (1) ◽  
pp. 59-61
Author(s):  
Z. N. Yakubova ◽  
F. A. Miftakhova ◽  
L. F. Shilova ◽  
R. S. Baryshkina ◽  
N. A. Shamova ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Muscle Wasting ◽  
Obstetric Care ◽  
Important Task ◽  
Uterine Atony ◽  
Uterine Contractility ◽  
The Third ◽  
Uterine Muscle ◽  
Single Term ◽  
Rational Management

Reducing maternal mortality from haemorrhage is still the most important task of modern obstetric care. When it comes to the prevention of haemorrhage, a single term 'atonic haemorrhage' is appropriate. The etiology of uterine atony is not well understood, but it is known to be based on disorders of uterine contractility, hormonal imbalances or uterine muscle wasting.

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