scholarly journals Emergency obstetric hysterectomy: a lifesaving procedure

2018 ◽  
Vol 7 (5) ◽  
pp. 1876
Author(s):  
Usha Doddamani ◽  
Nirmala Rampure ◽  
Sanyogita Kulkarni ◽  
Shoba Patil ◽  
Neelavati Tambre
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Antenatal Care ◽  
Placenta Previa ◽  
Reproductive Capacity ◽  
Fetal Mortality ◽  
Early Referral ◽  
High Risk Factors ◽  
Scarred Uterus ◽  
Placenta Accrete

Background: Emergency Obstetric Hysterectomy (EOH) is removal of uterus following vaginal delivery, Emergency LSCS or within the puerperium period. Because of increasing caesarean deliveries, the number of scarred uterus is increasing exposing the gravid women to increasing morbidity from uterine rupture, placenta accrete and placenta previa thus increasing the incidence of Emergency obstetric hysterectomy. The aim was to determine the incidence, demographic details, high risk factors and fetomaternal outcome of patients who underwent EOH.Methods: This was a retrospective study where data was collected from the record sheets of patients who underwent Emergency Obstetric Hysterectomy from January 2016 to December 2017 in the department of OBG, GIMS Gulbarga. Maternal age, parity, socioeconomic status, antenatal care, high risk factors and fetomaternal outcome were analysed.Results: During the study period there were 17,820 deliveries out of which 20 cases underwent EOH giving an incidence of 0.12%. Most of patients were uneducated, unbooked, low SES and of rural background and were multiparous. Main cause for EOH were rupture uterus, PPH and morbidly adherent placenta. There were 2 cases of maternal mortality and fetal mortality was 65%.Conclusions: Though EOH is a lifesaving procedure it curtails the reproductive capacity of the women. Proper antenatal care, early referral, timely decision and skill of surgeon in performing this procedure is important.

scholarly journals Role of Abdominal Aortic Balloon Placement in Planned Conservative Management of Placenta Previa With Placenta Increta or Percreta

2021 ◽  
Vol 8 ◽  
Author(s):  
Ruihui Lu ◽  
Ran Chu ◽  
Qiannan Wang ◽  
Yintao Xu ◽  
Ying Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Propensity Score ◽  
Blood Loss ◽  
Conservative Management ◽  
Placenta Previa ◽  
Intraoperative Blood Loss ◽  
Placenta Increta ◽  
High Risk Factors

Background: We investigated the role of balloon placement in the abdominal aorta (BPAA) in planned conservative management of placenta previa with placenta increta or percreta and the effects of BPAA on perinatal adverse maternal events.Methods: This retrospective case-control study included women with placenta previa (increta or percreta), who underwent pregnancy termination at the Qilu Hospital of Shandong University between January 2016 and June 2019. Patients were categorized into the BPAA and non-BPAA groups based on the BPAA placement before delivery. The Chi-square and non-parametric rank-sum tests were used for the intergroup comparison of patient characteristics. The propensity score matching algorithm was used to minimize the intergroup differences in clinical characteristics. Logistic regression analysis was used to identify the factors associated with a high risk of adverse pregnancy outcomes. The area under the receiver operating characteristic curve [area under the curve (AUC)] was used to evaluate the classification of the selected high-risk factors.Results: The study included 260 patients, and 104 patients were identified after propensity score matching. In the post-matched cohort, intraoperative blood loss was significantly lower in the BPAA than in the non-BPAA group (median 1,000 vs. 2,250 ml, P < 0.001). Intraoperative B-Lynch suture was performed in fewer patients in the BPAA (15.4 vs. 34.6%, P = 0.024) than in the non-BPAA group. The packed red blood cell (PRBC) transfusion rate was lower in the BPAA group (median 4 vs. 8 units, P < 0.001). Overall, 46 (45.1%) patients developed adverse maternal events; however, the rate of adverse maternal events was lower in the BPAA group (19.6 vs. 80.4%, P < 0.001). No ligation of the ascending branch of the uterine artery (P = 0.034), no BPAA (P < 0.001), intraplacental vascular lacunae (P = 0.046), and cervical hypervascularity (P = 0.001) were associated with a high risk of adverse perinatal maternal events. The AUC of the high-risk factors was 0.89 in the post-matched and 0.76 in the pre-matched cohorts.Conclusion: Planned conservative management using BPAA significantly minimized the intraoperative blood loss, the need for a B-Lynch suture, and PRBC transfusion in patients with severe placenta accreta spectrum and placenta previa.

scholarly journals Emergency Obstetric Hysterectomies at a Tertiary Referral Shri Vasantrao Naik Government Medical College and Hospital of Tribal of Yavatmal District (Maharashtra): Retrospective Critical Analysis (6 Years Study)

2015 ◽  
Vol 7 (2) ◽  
pp. 55-60
Author(s):  
Archana D Rathod ◽  
Sandhya P Pajai
Keyword(s):  
High Risk ◽  
Antenatal Care ◽  
Critical Analysis ◽  
Fetal Mortality ◽  
Government Medical College ◽  
Tertiary Referral ◽  
Mortality And Morbidity ◽  
Tertiary Referral Center ◽  
Medical College ◽  
High Risk Factors

ABSTRACT Objective To evaluate the demographic profile, high-risk factors, fetomaternal outcome, causes and incidence of emergency peripartum hysterectomies at tertiary referral center Government Medical College and Hospital at Yavatmal. Study design Retrospective analysis. Methodology Review of 14 case records of patient who undergone emergency peripartum hysterectomies during the year January 2007 to December 2012. Results During the study period, there were 39,612 deliveries, out of which 14 patients had undergone emergency peripartum hysterectomy (EPH), having an incidence of 0.35/1000 births. There was 1 (7.14%) maternal death and 5 (35.71%) perinatal deaths. The commonest indications noted were atonic PPH 7 (50%), morbidly adherent placenta 5 (35.71%) and rupture uterus 2 (14.28%). Five (35.71%) of these patients had not received antenatal care prior to their hospitalization. Lack of antenatal care and health education indeed a preventable factor that needs to be addressed to reduce maternal and fetal mortality and morbidity. Identification of high-risk patients, institutional deliveries by expert of risk group and early referral from peripheral health infrastructures are utmost importance in avoiding EPH and reduce maternal and fetal morbidity and mortality. Emergency obstetric hysterectomy still remains as life saving procedure which every obstetrician must be familiar with it. How to cite this article Rathod AD, Pajai SP. Emergency Obstetric Hysterectomies at a Tertiary Referral Shri Vasantrao Naik Government Medical College and Hospital of Tribal of Yavatmal District (Maharashtra): Retrospective Critical Analysis (6 Years Study). J South Asian Feder Obst Gynae 2015;7(2): 55-60.

Association between maternal high-risk factors and anemia among women in Ethiopia

Nutrition ◽  
2021 ◽  
pp. 111404
Author(s):  
Noha Fadl ◽  
Gillian H Ice ◽  
Zelalem T Haile
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
High Risk Factors

Quantification of risk of recurrence associated with high risk factors in Stage II colon cancer: A retrospective study from a tertiary cancer institute in India

2021 ◽  
Vol 5 (1) ◽  
pp. 25
Author(s):  
LinuAbraham Jacob ◽  
Lalatendu Moharana ◽  
Lokanatha Dasappa ◽  
MC Suresh Babu ◽  
KN Lokesh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Colon Cancer ◽  
Retrospective Study ◽  
High Risk ◽  
Stage Ii ◽  
Risk Of Recurrence ◽  
High Risk Factors ◽  
Stage Ii Colon Cancer

Abstract 18634: Favorable Cardiovascular Health and the Compression of Morbidity: Findings From the Chicago Heart Detection Project in Industry Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Norrina B Allen ◽  
Lihui Zhao ◽  
Lei Liu ◽  
Martha Daviglus ◽  
Kiang Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Healthcare Costs ◽  
Cardiovascular Health ◽  
Heart Association ◽  
Baseline Risk ◽  
Compression Of Morbidity ◽  
High Risk Factors ◽  
Morbidity Score

Introduction: We sought to determine the association of CV health at younger ages with the proportion of life lived free of morbidity, the cumulative burden of morbidity, and average healthcare costs at older ages. Methods: The Chicago Heart Association (CHA) study is a longitudinal cohort of employed men and women aged 18-59 years at baseline exam in 1967-1973. Baseline risk factor levels included blood pressure, cholesterol, diabetes, BMI and smoking. Individuals were classified into one of four strata: favorable levels of all factors, 0 factors high but 1+ elevated, 1 high, and ≥2 high risk factors. Linked CMS/NDI data from 1984-2010 were used to determine morbidity in older age providing up to 40 years of follow-up. We included participants who were age 65+ between 1984 and 2010 and enrolled in Medicare FFS. All-cause morbidity was defined using the Gagne score. A CV morbidity score was defined as the sum of 4 CVDs including CHD (includes MI), PVD, cerebrovascular disease and CHF. Results: We included 25,390 participants (43% female, 90% White, mean age 44 at baseline); 6% had favorable levels, 19% had 1+ risk factors at elevated levels, 40% had 1 high risk factor and 35% had 2+ high risk factors. As compared to those with 2+ high risk factors, favorable CV health had lower levels of all-cause and CV morbidity from age 65-90 years, and a lower cumulative morbidity burden (p<0.001) translating to lower average annual healthcare costs ($15,905 vs $20,791 per year, p<0.001). Favorable CV health postponed the onset of all-cause morbidity by 4.5 years, the onset of CV morbidity by almost 7 years and extended life by almost 4 years resulting in a compression of morbidity on both the absolute and relative scale (see figure). Conclusion: Individuals in favorable CV health live a longer, healthier life and a greater proportion of life free of morbidity. These findings provide support for prevention efforts aimed at preserving cardiovascular health and reducing the burden of disease in older ages.

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