HEMORRAGIA PÓS-PARTO

2018 ◽  
Vol 5 (3) ◽  
pp. 59-64
Author(s):  
Pollyana de Cássia Macedo ◽  
Hanna Helena Lopes
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Literature Review ◽  
Postpartum Haemorrhage ◽  
Active Management ◽  
Therapeutic Management ◽  
Maternal Deaths ◽  
Mortality And Morbidity ◽  
The Third ◽  
Maternal Mortality And Morbidity

RESUMO Introdução: A hemorragia pós-parto é a principal causa de morbimortalidade materna no mundo, sendo responsável por cerca de 25% do óbitos maternos mundiais, tratando-se, pois, de uma condição potencialmente grave e importante para a saúde pública. Métodos: Foi realizada uma revisão de literatura no banco de dados MEDLINE, PUBMED e SCIELO, selecionando artigos que tratavam principalmente do manejo, da prevenção e dos fatores de risco relacionados à hemorragia pós-parto. Resultados: O conhecimento dos fatores de risco, bem como o manejo ativo no terceiro período, com o uso de uterotônicos, clampeamento do cordão em tempo oportuno e tração controlada do cordão, são eficazes na redução da hemorragia pós-parto. A identificação de sinais e sintomas da hemorragia deve ser precoce para iniciar o manejo terapêutico, o qual divide-se em manutenção da estabilidade hemodinâmica e tratamento específico segundo a etiologia. Inicialmente é preferido o tratamento clínico, com fármacos e manobras, e em caso de falha terapêutica, o tratamento cirúrgico deve ser indicado e realizado o quanto antes. Conclusão: A redução da morbimortalidade por hemorragia pós-parto baseia-se em três pilares de atendimento: assistência pré-natal e durante o trabalho de parto de qualidade, manejo ativo no terceiro período e manejo terapêutico rápido e eficaz.   Palavras-chave: Hemorragia pós-parto; Prevenção; Fatores de risco; Manejo terapêutico; Trabalho de parto; Terceiro período. ABSTRACT Introduction: Postpartum haemorrhage is the main cause of maternal mortality and morbidity worldwide, and its being responsible for nearly 25% of maternal deaths. Methods: The research was conducted through a literature review of MEDLINE, PUBMED and SCIELO database, and the articles were selected that discussed mainly about management, prophylaxis and risk factors related to postpartum haemorrhage. Results: The risk factors knowledge, as well as the active management in the Third Period, with uterotonics use, opportunal cord clampeament and controled cord traction are effective in reduce postpartum haemorrhage. The identification of the signs and symptons of haemorrhage is essential to iniciate the therapeutic management, which is divided in haemodynamic establizitation maintanace and especif treatment, directed towards the etiology. Inicially the clinical treatment is preferred, with the use of drugs and techiniques, and if therapeutic failure, surgical treatment must be indicated and early managed. Conclusion: Postpartum haemorrhage morbimortality reduction is based in three attendance pilars: antenatal, intrapartum and postpartum qualified assistance, active management of the third period and fast and effective therapeutic managem. Keywords: Postpartum haemorrhage; Prevention; Risk factors; Therapeutic management; Delivery; Third period.

scholarly journals Active Management of the Third Stage of Labour: A Brief Review and Update

2020 ◽  
Vol 33 (2) ◽  
pp. 149-156
Author(s):  
Nahid Sultana ◽  
Ferdousi Begum ◽  
Shahana Shermin
Keyword(s):  
Blood Loss ◽  
Postpartum Haemorrhage ◽  
Active Management ◽  
Evidence Based ◽  
Mortality And Morbidity ◽  
The Third ◽  
Third Stage ◽  
Maternal Mortality And Morbidity ◽  
And Training ◽  
Uterine Fundus

Blood loss due to postpartum haemorrhage (PPH) and its complications constitute one ofthe major causes of maternal mortality and morbidity. Active management of third stage oflabour (AMTSL) plays an immense role in preventing maternal death due PPH. But till dateobstetricians all over the world and the concerned international bodies could not reach to asingle agreement about its universal use. This approach is practiced widely in many centresand there are some specific guidelines regarding its practical use. AMTSL as a prophylacticintervention and is composed of a package of three components or steps: 1) administrationof a uterotonic, preferably oxytocin, immediately after birth of the baby; 2) controlled cordtraction (CCT) to deliver the placenta; and 3) massage of the uterine fundus after the placentais delivered. In 2012, the results of a large WHO-directed, multi-centred clinical trial showedthat the most important AMTSL component was the administration of an uterotonic, theother two steps contributes relatively less in blood loss. But WHO recommends to continueall three steps of AMTSL for management and training of third stage of labour. This article isa brief review of the recent guidelines and evidence based practice of active management ofthe third stage of labour. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 149-156

scholarly journals Causes and management of secondary postpartum haemorrhage in a tertiary medical college hospital in Bangladesh

2017 ◽  
Vol 6 (7) ◽  
pp. 2694
Author(s):  
Kamrun Nessa ◽  
Sumia Bari ◽  
Sanjida Khan ◽  
Ferdowsi Sultana ◽  
Tania Akbar
Keyword(s):  
Maternal Morbidity ◽  
Postpartum Haemorrhage ◽  
Mode Of Delivery ◽  
Wound Dehiscence ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Maternal Mortality And Morbidity ◽  
Postnatal Women ◽  
Low Incidence

Background: Globally postpartum haemorrhage remains a leading cause of maternal death. It affects only 1-2% of postnatal women. This low incidence of secondary PPH and linkage to maternal morbidity rather than mortality was the reason for the little attention among obstetricians, but it is recently gaining importance and interest with the increase morbidity and mortality related to secondary PPH.Methods: A retrospective study was conducted on the diagnosed patients of secondary PPH admitted in Enam Medical College and Hospital, Dhaka, Bangladesh, from January 2015 to December 2016. Among 33 cases of secondary PPH age of the patients, parity, mode of delivery, causes and management were noted from medical records. All data was analyzed by SPSS16.Results: Among 33 patients 14 (42.4%) were primi and 19 (57.6%) were multipara, age between 18 to 38 years, majority admitted 2nd and 3rd week after delivery. Among 33 patients 12% delivered vaginally at home and 30% vaginally at hospital and 58% undergone LUCS. We found 34% retained bits of placenta, 27% uterine wound dehiscence, 24% retained clots and 15% endometritis as causes. Less than 3 units blood needed in 22 (66.7%) patients and 11 (33.3%) needed more than 3 units. About 6 (18%) patients were treated conservatively, MVA were needed in 18 (55%) patients, repair of wound in 4 (12%) and TAH was in 5 (15%).Conclusions: Secondary PPH is increasing may result in significant maternal morbidity as well as mortality. More study needed to identify the risk factors and causes to reduce maternal mortality and morbidity.

scholarly journals The long-term effects of modifiable and unmodifiable risk factors of stroke

2020 ◽  
Vol 7 (11) ◽  
pp. 4626
Author(s):  
Khaled M. Hassan ◽  
Asala M. Wafa ◽  
Manea S. Alosaimi ◽  
Kawthar A. Bokari ◽  
Mosab A. Alsobhi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Saudi Arabia ◽  
Arabian Peninsula ◽  
Modifiable Risk Factors ◽  
Long Term Effects ◽  
Kingdom Of Saudi Arabia ◽  
Mortality And Morbidity ◽  
The Third ◽  
The World

Stroke is a major cerebrovascular disease causes high mortality and morbidity in people around the world. Stroke is the third leading cause of death and the leading cause of adult disability. The largest country in the middle East, the Kingdom of Saudi Arabia (KSA), has been occupying approximately four-fifths of the Arabian Peninsula supporting a population of more than 28 million. Stroke is getting to be a quickly expanding issue and is the leading cause of illness and deaths in Saudi Arabia. It is clear that researches and studies regarding the incidence, prevalence and their sociodemographic properties of stroke is still incomplete due to lack of present studies being conducted in these specified areas. This article aims to discuss the aspect of stroke in Saudi Arabia beside the effects of modifiable and the non-modifiable risk factors from the literature published. 

scholarly journals What Really Causes Necrotising Enterocolitis?

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Thomas Peter Fox ◽  
Charles Godavitarne
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Literature Review ◽  
Medical Knowledge ◽  
Necrotising Enterocolitis ◽  
Gastrointestinal Disorders ◽  
Mortality And Morbidity ◽  
Abdominal Emergency ◽  
Comprehensive Literature Review ◽  
Single Well

Background. One of the most serious gastrointestinal disorders occurring in neonates is necrotising enterocolitis (NEC). It is recognised as the most common intra-abdominal emergency and is the leading cause of short bowel syndrome. With extremely high mortality and morbidity, this enigmatic disease remains a challenge for neonatologists around the world as its definite aetiology has yet to be determined. As current medical knowledge stands, there is no single well-defined cause of NEC. Instead, there are nearly 20 risk factors that are proposed to increase the likelihood of developing NEC. Aims and Objectives. The aim of this project was to conduct a comprehensive literature review around the 20 or so well-documented and less well-documented risk factors for necrotising enterocolitis. Materials and Methods. Searches of the Medline, Embase, and Science direct databases were conducted using the words “necrotising enterocolitis + the risk factor in question” for example, “necrotising enterocolitis + dehydration.” Search results were ordered by relevance with bias given to more recent publications. Conclusion. This literature review has demonstrated the complexity of necrotising enterocolitis and emphasised the likely multifactorial aetiology. Further research is needed to investigate the extent to which each risk factor is implicated in necrotising enterocolitis.

Active management of the third stageof labor for the prevention of postpartum haemorrhage

2014 ◽  
Vol 63 (2) ◽  
pp. 22-27
Author(s):  
Natalya Vladimirovna Artymuk ◽  
Mariya Nikolayevna Surina ◽  
Tatyana Yuryevna Marochko ◽  
Natalya Borisovna Kolesnikova
Keyword(s):  
Blood Loss ◽  
Maternal Morbidity ◽  
Postpartum Haemorrhage ◽  
Active Management ◽  
Controlled Study ◽  
The Third ◽  
Randomized Controlled ◽  
Obstetric Haemorrhage ◽  
Maternal Morbidity And Mortality ◽  
Perinatal Center

Obstetric haemorrhage remains a main cause of maternal morbidity and mortality. A hospital-based, individually randomized controlled study was proposed. 1095 women delivering vaginally in Kemerovo Perinatal Center were examined. Absence of controlled cord tractions hasn’t significant effect on amount of blood loss in the III stage, and frequency of PPH, in usage of additional uterotonics, postpartum hemoglobin levels, frequency of manual removal of placenta.

scholarly journals RISK FACTOR OF ECTOPIC PREGNANCY BY USING LITERATURE REVIEW METHOD

2021 ◽  
Vol 5 (3) ◽  
pp. 277
Author(s):  
Winda Fatma Sari ◽  
Adityawarman Adityawarman ◽  
Budiono Budiono
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Risk Factor ◽  
Literature Review ◽  
Ectopic Pregnancy ◽  
Exclusion Criteria ◽  
Mortality And Morbidity ◽  
Pregnancy History ◽  
Major Predictor ◽  
History Of

Background: Ectopic pregnancy is a pregnancy outside the uterus, embryo could attached to thefallopian tube, ovary cervix or cervix. Around 85-90% incidence of ectopic pregnancy is found inmultigravid women. According to data from the Health Office, maternal mortality in 2017 tendsto increase in the last two years. Not only it is a major predictor of mortality and morbidity inpregnant women, but individuals with a history of ectopic pregnancy have a greater risk. Thepurpose of this research was to determine the risk factors that cause ectopic pregnancy by usingliterature studies review. Method:This study used a systematic review of articles that publishedbetween 2013-2020 in the Science Direct, Scopus and Google Scholar. 10 articles that meet theinclusion and exclusion criteria, included as a sample for further review. The results regarding torisk factors that caused ectopic pregnancy in each article were systematically synthesized. Results:Risk factors found to be significantly associated with the incidence of ectopic pregnancy in thearticle were age (2), infertility (2), IUD (3), PID (3), Ectopic Pregnancy History (5), Progestine Pills (2), History of Abortion (1), Smoking (3). Conclusions: age, infertility, IUD, PID, history of ectopic pregnancy, progestine pill, History of abortion, and smoking were risk factors that hadsignificant relationship with the incidence of ectopic pregnancy.

scholarly journals Revisión de sepsis obstétrica [Obstetrics sepsis review article]

2021 ◽  
Vol 40 (03) ◽  
Author(s):  
Yamilka Yoani Yard Foster ◽  
Jose Daniel Correoso Guevara ◽  
Jenia Melissa Nuñez Ortega
Keyword(s):  
Patient Outcomes ◽  
Population Group ◽  
Signs And Symptoms ◽  
Diagnosis And Treatment ◽  
Maternal Deaths ◽  
Mortality And Morbidity ◽  
Maternal Mortality And Morbidity ◽  
Proper Diagnosis ◽  
The Moment ◽  
Specific Diagnostic Test

<p>La sepsis es una de las principales causas de mortalidad y morbilidad materna a nivel mundial, con una incidencia de 240-300 casos por cada 100 000 habitantes. La clave en el manejo de esta patología está en la identificación temprana de los signos y síntomas sugestivos de sepsis. Este concepto ha variado de manera significativa durante la última década con la creación de nuevas herramientas, que han permitido la captación oportuna de una mayor proporción de pacientes, además de estrategias terapéuticas con lo que se ha logrado mejorar el resultado de los pacientes; sin embargo, hasta el momento no hay una prueba diagnóstica específica. A pesar de todos los avances ocurridos en el diagnóstico y tratamiento de la sepsis en el paciente adulto, no existe un concepto definido para “Sepsis obstétrica” o Sepsis en el embarazo, dado que las pacientes en estado de gravidez representan un grupo poblacional con consideraciones específicas propias del embarazo, que se deben tomar en cuenta para realizar un diagnóstico y tratamiento oportuno.</p><p> </p><p>ABSTRACT</p><p>Sepsis is one of the main causes of maternal mortality and morbidity worldwide, representing 8.3% of maternal deaths in Latin America. The key in the management of this pathology is in the early identification of the signs and symptoms suggestive of sepsis. This concept has changed significantly in the last decade with the creation of new tools, which have allowed the timely recruitment of a greater proportion of patients, in addition to therapeutic strategies, thereby improving patient outcomes; however until the moment there is no specific diagnostic test. Despite all the advances that have occurred in the diagnosis and treatment of sepsis in the adult patient, there is no defined concept for “Obstetric Sepsis” or Sepsis in pregnancy, since pregnant patients represent a population group with diagnosis specific to pregnancy, which must be taken into account to make a proper diagnosis and treatment.<br /><br /></p>

scholarly journals Abruptio placenta: a retrospective study on maternal and perinatal outcome

2017 ◽  
Vol 6 (10) ◽  
pp. 4389
Author(s):  
Subha Sivagami Sengodan ◽  
Mohana Dhanapal
Keyword(s):  
Retrospective Study ◽  
Fetal Outcome ◽  
Age Group ◽  
Third Trimester ◽  
College Hospital ◽  
Maternal Deaths ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Maternal Mortality And Morbidity ◽  
Abruptio Placenta

Background: Abruptio placenta is separation of a normally situated placenta after 20 weeks of gestation and prior to the birth of the fetus. It is an important cause of antepartum haemorrhage and presents as an acute abdomen in the third trimester of pregnancy. Obstetrical haemorrhage is one of the triad (Haemorrhage hypertension and infection) of causes of maternal deaths in both developed and underdeveloped countries.Methods: This is a retrospective study of Abruptio Placenta cases carried out between January 2015 and December 2015 at Government Mohan Kumaramangalam Medical College Hospital, Salem and about its perinatal and maternal outcome.Results: Incidence of Abruptio placenta is 0.5%. It is most common in the women of age group 26-30yrs. 67% of cases were associated with severe pre-eclampsia. Live births were 69.8% while stillbirths were 30.2%. PPH occurred in 19.6% of cases. DIC accounts for 16.7% of the complication.Conclusions: Abruptio placenta is associated with poor maternal and fetal outcome. Hence early diagnosis and prompt resuscitative measures would prevent both perinatal and maternal mortality and morbidity.

scholarly journals Hasűri terhesség élő újszülöttel

2017 ◽  
Vol 158 (13) ◽  
pp. 508-511
Author(s):  
Tamás Koltai ◽  
György Bacskó
Keyword(s):  
Abdominal Pregnancy ◽  
Mortality And Morbidity ◽  
The Third ◽  
Abdominal Bleeding ◽  
Literature Overview ◽  
Advanced Abdominal Pregnancy ◽  
High Incidence ◽  
Maternal Mortality And Morbidity ◽  
Fetal Malformations ◽  
Very High

Abstract: Advanced abdominal pregnancy is extremely rare. Symptoms are often nonspecific, and the diagnosis is frequently missed. Maternal mortality and morbidity are also very high especially if the condition is not diagnosed and managed properly. In abdominal pregnancy there is a high incidence of fetal malformations. We are presenting a case of a 38 year old primigravida with an undiagnosed advanced abdominal pregnancy carried beyond 36 weeks of gestation. We delivered a 2090 g baby from the abdomen. A relaparotomy was necessary on the third postoperative day because of abdominal bleeding. At the time of discharge both mother and baby were doing well. The publication also provides a literature overview, including definition, epidemiology, diagnosis and therapy. Orv. Hetil., 2017, 158(13), 508–511.

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