scholarly journals Study of uterine artery embolization: a newer modality in secondary PPH

2018 ◽  
Vol 7 (2) ◽  
pp. 452
Author(s):  
Sweta Agrawal ◽  
Ratnamala Thakur ◽  
Shikha Sonker
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Blood Product ◽  
Tertiary Care ◽  
Clinical Effectiveness ◽  
Care Hospital ◽  
Obstetric Hemorrhage ◽  
Artery Embolization ◽  
Mortality And Morbidity ◽  
Maternal Mortality And Morbidity

Background: Postpartum hemorrhage remains a major cause of both maternal mortality and morbidity worldwide. This study reflects the clinical outcomes including clinical effectiveness, and safety of uterine artery embolization (UAE) for the treatment of obstetrical uterine hemorrhage at a tertiary-care hospital, in terms of secondary PPH.Methods: The data were collected as a retrospective study from SAMC and PGI obstetric and gynecology department 12 women with secondary pph were included in the study.Results: With the use of uterine artery embolization 12 women were successfully treated amongst them maximum patients were in 26-35 yrs of age and mean age of women were 32.4yrs and gravidity of patients presenting with pph is 3 or more.Conclusions: Selective UAE is a safe and effective method to control obstetric hemorrhage. Blood product requirements after UAE were low, and the surgical risks and absolute loss of fertility associated with hysterectomy were avoided.

IMPACT OF GOVERNMENT SCHEMES ON MATERNAL HEALTH: AN OBSERVATIONAL STUDY IN A TERTIARY CARE HOSPITAL IN NORTH INDIA

2021 ◽  
pp. 63-65
Author(s):  
Neena Gupta ◽  
Uruj Jahan ◽  
Subhashini Singh
Keyword(s):  
Maternal Health ◽  
Observational Study ◽  
Maternal Mortality ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
North India ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Maternal Mortality And Morbidity

BACKGROUND: Maternal health is an important aspect for the development of any country in terms of increasing equity and reducing poverty. For reduction of maternal mortality and morbidity Government of India launched National health mission (NHM). Some of the major initiatives under NHM are– ASHA (Accredited Social Health Activist), JSY/JSSK (Janani Suraksha Yojana / Janani Shishu Suraksha Karyakaram), National mobile medical units, National ambulance services. METHODS: A retrospective observational study was performed in department of Obstetrics and Gynaecology, G.S.V.M Medical College, Kanpur, Uttar Pradesh which is a low performing state, during the period of 2018 to 2019. A total of 5134 obstetric patients including 1032 low general condition patients were included over duration of 20 months since January 2018 to august 2019. This observational study collected information regarding number of deliveries in different years in this tertiary care hospital, effect on availability of health facilities and antenatal care to the antenatal women after introduction of JSY, ASHA and ambulance services. CONCLUSIONS: After JSY there is major difference in OPD admission and institutional delivery rate. Ambulance services had major contributory role in reducing maternal mortality and morbidity. There is need to improve performance of ASHA by proper supervision and monitoring.

scholarly journals Rising trend in cesarean sections: a retrospective study at tertiary care hospital in Jammu

2021 ◽  
Vol 10 (5) ◽  
pp. 1958
Author(s):  
Shazia Zargar ◽  
Nikita Gandotra
Keyword(s):  
Retrospective Study ◽  
Health Care Providers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Care Hospital ◽  
Care Providers ◽  
Cesarean Sections ◽  
Mortality And Morbidity ◽  
Maternal Mortality And Morbidity

Background: The uncontrolled wave of cesarean rates has increased globally which has resulted in a significant amount of maternal mortality and morbidity. The present study aims to evaluate the trend in cesarean section rates in Jammu, India. Methods: The present retrospective study was carried out at the department of Obstetrics and Gynecology, SMGS Hospital, Jammu, India. We collected data based on total number of deliveries and cesarean sections performed at the hospital during (March2015-Feb2020) along with indications for CS.Results: The percentage of cesarean sections has increased drastically from 39.4% during (2015-16) to 49.9% in (2019-20). The study shows that the most common indication for CS is post CS followed by NPOL, Fetal distress, breech, APH, CPD, PIH and others.Conclusions: There is a growing concern among public and health care providers regarding the escalating and uncontrolled trend of cesarean sections which needs to be curtailed within optimal limits recommended by WHO. 

scholarly journals Gossypiboma: A case study of medical error in obstetrician Tertiary Care Hospital.

2020 ◽  
Vol 27 (05) ◽  
pp. 1085-1088
Author(s):  
Ikram Ali ◽  
Muhammad Kashif ◽  
Muhammad Owais Aziz ◽  
Haider Darain
Keyword(s):  
Reporting System ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Multiple Factors ◽  
Initial Surgery ◽  
Maternal Mortality And Morbidity ◽  
Before And After

Pakistan is striving hard to achieve millennial developmental goals by considering multiple factors. However, maternal mortality and morbidity due to medical errors remain unnoticed and undocumented due to lack of reporting system. This case report is based on a multigravida, who presented with severe abdominal pain and tenderness. She was on multiple medications after five months of three consecutive surgeries including initial surgery for uterine rupture during labor. On examination, a mass was noticed in the umbilical region. A foreign body was suspected on ultrasound and diagnosed as gossypiboma after surgery. It is usually misdiagnosed and needs attention especially considering differential diagnosis in post-operative patients. Such errors might be avoided by properly counting number of gauze pieces before and after an intervention, and usage of radio opaque gauze pieces.

scholarly journals Repeated broad ligament hematomas managed by uterine artery embolization: time to execute

2019 ◽  
Vol 8 (8) ◽  
pp. 3417
Author(s):  
Subrat Panda ◽  
Nalini Sharma ◽  
Pranjal Phukan
Keyword(s):  
Complication Rate ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Effective Interaction ◽  
Broad Ligament ◽  
Arterial Embolization ◽  
Clinical Effectiveness ◽  
Artery Embolization ◽  
Uterine Arteries ◽  
Obstetric Haemorrhage

Selective arterial embolization (SAE) of the uterine arteries is an alternative to surgery when medical management fails in cases of intractable posrtpartum haemorrhage. It is highly efficacious with low complication rate. Here we report a case of repeated broad ligament haematoma managed by selective uterine artery embolization. Present case 28year old P4L4 was referred from a district hospital as post LSCS case with broad ligament haematoma. Patients general condition was very poor at the time of admission. She underwent laparotomy twice and finally uterine artery embolization for repeated broad ligament haematoma and responded. Massive obstetric haemorrhage remains a significant cause of maternal morbidity and mortality. The threshold for uterine artery embolization (UAE) in women with obstetric haemorrhage should be low, as it is coupled with a high clinical effectiveness rate, low complication rate and preservation of fertility. However, it requires an infrastructure, multidisciplinary approach, as well as speedy and effective interaction between various specialties.

scholarly journals A study on diagnosis and management of arteriovenous malformation of uterus

2020 ◽  
Vol 9 (7) ◽  
pp. 2878
Author(s):  
Nidhi B. Patel ◽  
Sapana R. Shah ◽  
Purvi M. Parikh ◽  
Tanmay J. Chudasama
Keyword(s):  
Arteriovenous Malformation ◽  
Diagnostic Criteria ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Clinical Status ◽  
Tertiary Care ◽  
Clinical Feature ◽  
Colour Doppler ◽  
Artery Embolization ◽  
History Of

Background: Arteriovenous malformation is abnormal connection between an organ’s arterial and venous circulation. In acquired AVM, history of uterine procedure seems inevitable. Their clinical feature is usually vaginal bleeding. It is diagnosed by 2-D ultrasonography combined with colour doppler. Most of the time they resolve spontaneously; however, if left untreated, uterine artery embolization or hysterectomy comes in hand. The purpose of this study was to evaluate the role of TVUS and colour doppler in the diagnosis and follow-up of treated cases of uterine AVM. This study also aims to evaluate different modalities to manage uterine AVM.Methods: This was a retrospective study done at tertiary care centre from January 2018 to December 2019 to assess the presentation, treatment, and clinical pictures of patients with uterine AVM that were diagnosed with TVUS. Authors reviewed both (1) clinical data (2) ultrasound data of patients. The diagnostic criteria were “subjective” with a rich vascular network in the myometrium with the use of colour Doppler images and “objective” with a high PSV of 20 cm/sec in the vascular web.Results: Thirteen patients met the diagnostic criteria mentioned above. Out of that 100% presented with on and off bleeding per vaginum. Recent and remote history of uterine procedures were in found in 84.6% (n=11) of cases. UAE was done in 53.8% (n=7) cases. Thirty-three (33%) (n=5) cases spontaneously resolved when closely monitored with serial imaging and serum beta- HCG levels. Hysterectomy was needed in 7.4% (n=1) of patients of AVM.Conclusions: Uterine AVM occurred after unsuccessful pregnancies or uterine procedures. Triage of patients for expectant treatment, hormonal treatment vs intervention with uterine artery embolization based on their clinical status, which was supplemented by objective measurements of blood velocity measurement in the AVM, appears to be a good predictor of outcome.

scholarly journals Uterine artery embolization for the treatment of symptomatic myomas in Brazilian women

2003 ◽  
Vol 121 (5) ◽  
pp. 185-190 ◽  
Author(s):  
Maurício Sena-Martins ◽  
Cecilia Maria Roteli-Martins ◽  
Valdir Tadini ◽  
Gustavo Antonio de Souza ◽  
Nestor Kisilevzky ◽  
...  
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Benign Tumors ◽  
Artery Embolization ◽  
Menstrual Flow ◽  
Gynecological Examination ◽  
The Mean ◽  
Uterine Volume

CONTEXT: Uterine myomas are benign tumors that mostly occur in women of reproductive age at a frequency ranging from 20 to 25%. The symptoms are increased menstrual flow, pain and compressive signs. New treatments have been proposed and uterine artery embolization is one of them. OBJECTIVE: To evaluate the effects of treatment by embolization of the uterine artery, in women with symptomatic myomas. Uterine and dominant myoma volumes and the major symptoms were evaluated before treatment and 12 weeks later. TYPE OF STUDY: Open clinical trial. SETTING: A tertiary-care women's hospital. PARTICIPANTS: The study was conducted on 32 women with symptomatic single or multiple myomas of the uterine body, seen at the outpatient unit from May 2000 to September 2001. MAIN MEASUREMENTS: The patients were submitted to gynecological examination and abdominal and endovaginal pelvic ultrasonography, and the examinations were repeated 12 weeks after the first procedure. Uterine artery embolization using PVA (polyvinyl alcohol) particles of 355-700 µ was performed by catheterization of the right femoral artery in 30 women and by bilateral catheterization in two. RESULTS: Before embolization, the mean uterine volume of the 32 women was 455 cm³ and the mean volume of the dominant myoma was 150 cm³. Twelve weeks after embolization, the mean uterine volume was 256 cm³ and the mean volume of the dominant myoma was 91 cm³, with p < 0.01 in both cases. Twelve weeks after the treatment, all the women answered a questionnaire, which showed that 71% had improvement in menstrual regularity, 90% decreased menstrual volume and 81% shortened menstrual duration. The most frequent immediate post-procedure symptoms, established as complications, were pain (100%) and fatigue (34%). One woman had myoma degeneration and was submitted to myomectomy. CONCLUSION: The significant reduction in uterine and dominant myoma volume confirms the validity of the treatment of symptomatic myomas by the technique of uterine artery embolization in Brazilian women. There was significant reduction in menstrual flow and duration, as well as better cycle regularity in the women studied. The few adverse effects observed in the sample studied mainly involved pain immediately after embolization.

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