scholarly journals Post Partum Etraperitoneal Pelvic Hematoma: A Rare Complication after Vaginal Delivery

2021 ◽  
Vol 09 (12) ◽  
Author(s):  
Dr Kamini Randhawa ◽  
2013 ◽  
pp. 49-54
Author(s):  
Roberto Boni ◽  
Pier G. Rabitti

Introduction: De Quervain’s subacute thyroiditis is a self-limiting granulomatous inflammatory disorder, which is thought to be virally induced in genetically predisposed individuals. It is characterized by thyroid pain and thyrotoxicosis, as well as by systemic symptoms like fever, hepatic cytolysis, and an elevated erythrocyte sedimentation rate. It is often mistaken for an upper respiratory tract infection. Materials and methods: The authors review recent advances in the understanding of the pathogenesis and pathophysiology of De Quervain’s subacute thyroiditis; risk factors for complications, with emphasis on relapses and end-stage hypothyroidism; differential diagnosis and the exclusion of other subtypes of thyroiditis; and current treatment options. Four cases of De Quervain’s thyroiditis are then analyzed and compared with cases in the literature. Discussion: In three of the patients, onset occurred in June and was probably related to a small, seasonal epidemic cluster. These cases were quite different from the fourth one, which occurred in October, suggesting that two distinct viruses might be involved. One of the patients presented a very rare complication, vocal-cord paralysis, which responded well to glucocorticoid therapy. Another presented with an even rarer post-partum form of painful thyroiditis.


Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1885
Author(s):  
Guglielmo Stabile ◽  
Francesco Cracco ◽  
Davide De Santo ◽  
Giulia Zinicola ◽  
Federico Romano ◽  
...  

Objective: To identify the possible causes of spontaneous bladder rupture after normal vaginal delivery and to propose a diagnostic and therapeutic algorithm. Material and Methods: MEDLINE (PubMed), Web of Science and Scopus databases were searched up to August 2020. Manuscripts considered were published from 1990 and only English articles were included. The research strategy adopted included the following terms: (bladder rupture) AND (spontaneous) AND (delivery). 103 studies were identified. Duplicates were found through an independent manual screening. Subsequently, two authors independently screened the full text of articles and excluded those not pertinent to the topic. Discrepancies were resolved by consensus. Finally, thirteen studies were included. Results: PRISMA guidelines were followed. For each study, fetal weight, catheterization during labor, parity, maternal age, occurrence time, previous abdominal or pelvic surgery, symptoms complained of, diagnostic methods, and treatment were considered. Median age was 26.0 (range 20–34 years); median presentation time was 3.0 days after delivery (range 1–20 days); and median newborn weight was 3227.0 g (range 2685–3600 g). Catheterization during labor was reported only in four of the thirteen cases (30.8%) identified. The symptoms most frequently complained of were abdominal pain and distension, fever, oliguria, haematuria and vomiting. Instrumental diagnosis was performed using X-rays in five cases and computerized tomography in six cases. Ultrasound was chosen in five cases as a first diagnostic tool. In two cases, cystography was performed. Treatment was always laparotomic repair of the visceral defect. Conclusion: Abdominal pain, increased creatinine and other signs of kidney failure on blood tests should lead to suspicion of this complication. Cystourethrography is regarded as a procedure of choice, but a first ultrasound approach is recommended. The main factor for the therapeutic choice is the intraperitoneal or extraperitoneal rupture of the bladder. Classical management for intraperitoneal rupture of the bladder is surgical repair and urinary rest.


Author(s):  
Shabnam Ara ◽  
Cimona Lyn Saldanha ◽  
Insha Khan

Background: Anemia is the most common hematological abnormality detected during the pregnancy and forms a major problem in affecting the females especially in the developing countries.Methods: All pregnant females with clinical evidence of anemia without any other co-morbidity attending the antenatal clinic were included in the study. Patients were studied in terms of the age, parity, inter-pregnancy spacing, type of pregnancy, post-partum outcome along with the biochemical tests like peripheral blood picture, hemoglobin estimation, and serum ferritin levels.Results: Total no. of patients was 500, age ≤20 years were 60 and ≥35 years were 107, mild anemia (10-10.9 gm%) 160, moderate anemia (7-10 gm%) 250, severe anemia (<7 gm%) 90. Normal vaginal delivery with medio-lateral episiotomy was done in 385 patients, normal vaginal delivery without medio-lateral episiotomy in 35 while lower-segment caesarean section in 80 patients. Pre-term delivery was done in 95 patients, post-term delivery in 20. 90 babies delivered were low-birth weight (<2500 gm), antepartum hemorrhage was seen in 10 patients while 20 patients had Post-partum hemorrhage.Conclusions: The present study concludes that anemia is still rampant in the society especially in pregnant women. The main cause of anemia-in-pregnancy is still the iron deficiency anemia. The peripheral blood picture, hemoglobin estimation, and serum ferritin levels form the basic pillars in the evaluation of the etiology and type of anemia. The multiple government sponsored facilities are to be made available to each pregnant female and that requires community, government as well as healthcare professional’s participation.


Author(s):  
Mridu Sinha ◽  
Shashi Bala Arya ◽  
Shashi Saxena ◽  
Nitant Sood

Background: Induction of labour is an iatrogenic deliberate attempt to terminate the pregnancy in order to achieve vaginal delivery in cases of valid indication. It should be carefully supervised as it is a challenge to the clinician, mother and the fetus. Aim of this study was to find out common indications for IOL in a tertiary care teaching centre and its feto-maternal outcome.Methods: An institutional based retrospective observational study was conducted to describe the prevalence of labour induction and factors associated with its outcome, during the time-period of one year from January 2018 to December 2018, at SRMS IMS, Bareilly. Logistic regression analysis was employed to assess the relative effect of determinants and statistical tests were used to see the associations.Results: Most of the patients were primigravidas of younger age-group. Idiopathic oligohydramnios and postdatism were the commonest indications for induction of labour and Misoprost was the commonest drug used for it. Though majority had vaginal delivery, as the method was changed to combined method it was significantly associated with increased likelihood of LSCS. Similarly there was increased association with maternal cervico-vaginal tear / lacerations as the method was changed to combined type. However there were no association between post-partum hemorrhage, meconium stained liquor or fetal distress.Conclusions: Common indications for induction of labour were oligohydramnios and postdatism. Misoprost can be safely used for induction of labour without any increased risk for LSCS or any fetal / neonatal risks.


Author(s):  
Bratati Moitra ◽  
Bulllu Priya Oraon

Background: Postpartum haemorrhage is one of the common causes of maternal death worldwide. Whenever the amount of blood loss from or into genital tract is 500 ml or more after delivery of baby or any amount of bleeding that makes patients haemodynamically unstable is post-partum haemorrhage.Methods: In this study amount of blood loss after spontaneous vaginal delivery was measured in 100 cases by calibrated blood drape. Patients having high risk criteria for PPH were excluded.Results: In this study 55% patients were from 20-30 years age group. 82% cases were nontribal. 94% belonged to lower middle class. 67% patients were primigravida. 89% patients had atonic PPH and 11% had traumatic PPH. 85% patients had mild PPH. 60% of atonic PPH was managed by oxytocin only. 10% required oxytocin + Methergin, 6% required oxytocin + Methergin + Misoprostol. 6% required Oxytocin + Methergin + Misoprostol + Carboprost. In this study surgical intervention was required in 18% cases. Blood transfusion was required in 74% cases. 75% cases were from non-tribal ethnicity.Conclusions: PPH is a life-threatening condition. If it can be diagnosed early and managed properly then many maternal lives can be saved. In this study there was no maternal death.


Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1779
Author(s):  
Marta Selma-Royo ◽  
Izaskun García-Mantrana ◽  
Marta Calatayud ◽  
Anna Parra-Llorca ◽  
Cecilia Martínez-Costa ◽  
...  

The importance of the maternal microbiota in terms of the initial bacterial seeding has previously been highlighted; however, little is currently known about the perinatal factors that could affect it. The aim of this study was to evaluate the effects of various delivery-related factors on the intestinal microbiome at delivery time and on post-partum weight retention. Data were collected from mothers (n = 167) during the first four months post-partum. A subset of 100 mothers were selected for the determination of the salivary cortisol concentration and microbiome composition at birth by 16S rRNA gene sequencing. The maternal microbiota was classified into two distinct clusters with significant differences in microbial composition and diversity. Maternal microbiota was also significantly influenced by the mode of delivery. Moreover, the salivary cortisol concentration was associated with some maternal microbiota genera and it was significantly higher in the vaginal delivery group (p = 0.003). The vaginal delivery group exhibited lower post-partum weight retention than the C-section (CS) mothers at four months post-partum (p < 0.001). These results support the hypothesis that the mode of delivery as well as the codominant hormonal changes could influence the maternal microbiota and possibly impact maternal weight recovery during the post-partum period.


2017 ◽  
Vol 71 (2) ◽  
pp. 143-145
Author(s):  
Ivo Kjaev ◽  
Jana Kjaeva Nivicka ◽  
Sasha Kjaeva ◽  
Dafina Karadjova ◽  
Irena Aleksioska ◽  
...  

Abstract Introduction. Preeclampsia presents a medical condition in pregnancy that is manifested with increased blood pressure and protein urine. Ocular involvement is rare. Retinal detachment in preeclampsia is a rare complication; it only occurs in 1-2% of severe preeclampsia but in 10% of those with eclamptic seizures. Case report. A pregnant patient G1P0 visited the outpatient clinic of the University Clinic for Ophthalmology complaining on visual disturbances. The chief complaint was blurred vision and headaches. She was in 31 week of gestation and complained that she had increased blood pressure over the last month. After initial assessment she was suspected of central serous retinal ablation (CSCR). Ocular ultrasound and posterior segment OCT (optical coherence tomography) confirmed the diagnosis. Treatment and outcome. Obstetric examination confirmed high blood (TA180/130) pressure with dipstick urine showing(+++). Unfortunately, the ultrasound showed an eutrophic pregnancy in 31 g.w. with fetus mortus inutero. The patient was administered to the intensive care unit. She had an ophthalmologic check-upat 2 weeks and one month post-partum that showed regression and visual acuity was getting better. The final check-up after 6 months revealed that retina was in place with no subretinal substantial fluid and no macular edema. Conclusion. Serous retinal detachment is a rare complication of preeclampsia. In most case it resolves spontaneously few weeks post delivery.


2016 ◽  
Vol 295 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Liran Hiersch ◽  
Riki Bergel-Bson ◽  
Dorit Asher ◽  
Amir Aviram ◽  
Rinat Gabby-Benziv ◽  
...  

2009 ◽  
Vol 35 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Kampan Nirmala ◽  
Ani Amelia Zainuddin ◽  
Nur Azurah Abdul Ghani ◽  
Syed Zulkifli ◽  
Mohd Abdul Jamil

Author(s):  
Gayatri Devi Sivasambu ◽  
Sujani B. Kempaiah ◽  
Urvashi Thukral

Background: Operative vaginal delivery is a timely intervention to cut short second stage labor when imminent delivery is in the interests of mother, fetus, or both. It reduces second stage cesarean section morbidity and uterine scar and its influence on future obstetric career. The possible structural neonatal adverse outcomes due to operative vaginal delivery are well quantified. However, its effects on maternal outcome need to be understood better. In this paper, we study the effect of operative vaginal delivery on maternal post-partum hemorrhage (PPH) and the associated risk factors.Methods: It was a retrospective study carried out for the period July 2016 to July 2020 at Ramaiah Medical College, Bengaluru. Total number of vaginal deliveries in this period were 6318. Out of these, 1020 patients underwent assisted vaginal delivery using vacuum/ forceps/ sequential use of instrument. Blood loss greater than 500 ml is considered PPH for the purpose of this study. 15% of the study population was noted to have PPH. We employ a multivariate logistic regression to identify statistically significant risk factors for PPH in women undergoing operative vaginal delivery.Results: The logistic regression model identifies multiparity, maternal age, neonatal birth weight more than 3.5 kg, application of forceps in women with hypertensive disorders, III-degree tear, cervical tear to significantly increase the risk of PPH in our study population.Conclusions: Certain factors seem to increase the risk of PPH in operative vaginal delivery. The risks and benefits must be weighed properly before use of instruments.


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