scholarly journals Risk Factors for Postpartum Hemorrhage After Elective Cesarean Delivery for Twin Pregnancy

2021 ◽  
Author(s):  
xiao jie wan ◽  
Wei Zhao ◽  
Li Zhao ◽  
Hong Wen
Keyword(s):  
Risk Factors ◽  
Cesarean Delivery ◽  
Postpartum Hemorrhage ◽  
Twin Pregnancy ◽  
Placenta Previa ◽  
Elective Cesarean Section ◽  
Elective Cesarean Delivery ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Elective Cesarean

Abstract Objective: To identify the high risk factors associated with postpartum hemorrhage (PPH) after selective cesarean delivery of twins. Methods: This retrospective cohort study included all women with twin gestations who choosed an elective cesarean delivery after 28 weeks of gestation at Women's Hospital of Zhejiang University School of m from September 2014 to April 2019. The Women with an intrauterine fetal demise one or both of twins were excluded.A total of 532 wemen were analysed,they were classified as PPH group(n=70) and No PPH group(n=462). Estimated blood loss greater than or equal to 1000 ml was defined as Postpartum hemorrhage(PPH).Univariate and multivariate logistic regression analysis were performed to assess the independent risk factors.Results: Of the 532 twin pregnant women, PPH occurred in 13.2% (n=70). There were statistically signifcant diferences in preeclampsia (P=0.005), premature rupture of membranes(P<0.001), placental adhesion (P<0.001), placenta previa (P<0.001), hemoglobin (Hb)< 100 g/L（P=0.003)）, hematocrit (HCT)< 0.39（P=0.004）.However, the indepedent risk factors for PPH after selective cesarean delivery for twin pregnancy were preeclampsia (OR3.538, p < 0.05), premature rupture of membranes (OR17.9, P < 0.05), placental adhesion (OR5.71, p < 0.05) and placenta previa (OR10, p < 0.05). Conclusions: preeclampsia , premature rupture of membranes , placental adhesion and placenta previa were risk factors for postpartum hemorrhage after elective cesarean section for twin pregnancy. Risk factor identification and prevention should be a priority.

Safety of subarachnoid block for elective cesarean delivery in women with major degree placenta previa

2016 ◽  
Vol 18 (2) ◽  
pp. 68
Author(s):  
BasseyE Edem ◽  
AjenS Anzaku ◽  
StephenD Ngwan ◽  
MichaelE Efu ◽  
AdaJ Opita
Keyword(s):  
Cesarean Delivery ◽  
Placenta Previa ◽  
Elective Cesarean Delivery ◽  
Subarachnoid Block ◽  
Elective Cesarean

scholarly journals Successful Delivery of Twin Pregnancy in Class U3b/C2/V1 Uterus by Bilateral Caesarean Section after Spontaneous Conception

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Yasmine El-Masry ◽  
Ahmed M. E. Ossman ◽  
Mohammed El-Namoury ◽  
Sameh Sarsik
Keyword(s):  
Caesarean Section ◽  
Cesarean Delivery ◽  
Twin Pregnancy ◽  
Mode Of Delivery ◽  
Full Term ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Vaginal Septum ◽  
Spontaneous Conception ◽  
History Of

A case of a 19-year-old female with class U3b/C2/V1 uterus conceived a twin pregnancy with a fetus in each horn after spontaneous conception. She referred to our department with presentation of premature rupture of membranes, with a history of cesarean delivery of a single full term living fetus a year and a half before this delivery. Examination revealed two completely separate uterine horns with a fetus in each horn, two distinct externally rounded cervices, and a single vagina with a short nonobstructing vaginal septum in the upper part of the vagina. And as the appropriate mode of delivery is still unclear, each case should be managed as the condition requires, and in our case urgent bilateral caesarean sections were performed.

Prophylactic Angiotensin II Infusion during Spinal Anesthesia for Elective Cesarean Delivery 

1998 ◽  
Vol 88 (6) ◽  
pp. 1475-1479 ◽  
Author(s):  
Robert D. Vincent ◽  
Carol F. Werhan ◽  
Patricia F. Norman ◽  
Grace H. Shih ◽  
David H. Chestnut ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Angiotensin Ii ◽  
Systolic Blood Pressure ◽  
Spinal Anesthesia ◽  
Cesarean Delivery ◽  
Elective Cesarean Section ◽  
Elective Cesarean Delivery ◽  
Maternal Heart Rate ◽  
Elective Cesarean

Background Angiotensin II may prove useful in treating regional anesthesia-induced hypotension in obstetric patients, because it causes less uterine vasoconstriction than do other vasoconstrictor drugs (such as phenylephrine). This study compared (1) maternal blood pressure and heart rate and (2) fetal status at delivery in parturients given either prophylactic angiotensin II or ephedrine infusion during spinal anesthesia for elective cesarean delivery. Methods Fifty-four women were randomized to receive either angiotensin II or ephedrine infusion intravenously during spinal anesthesia for elective cesarean section delivery. Simultaneous with subarachnoid injection, infusion of angiotensin II (2.5 microg/ml) or ephedrine (5 mg/ml) was initiated at 10 ng x kg(-1) x min(-1) and 50 microg x kg(-1) x min(-1), respectively. The rate of each infusion was adjusted to maintain maternal systolic blood pressure at 90-100% of baseline. Results Cumulative vasopressor doses (mean+/-SD) through 10, 20, and 30 min were 150+/-100, 310+/-180, and 500+/-320 ng/kg in the angiotensin group and 480+/-210, 660+/-390, and 790+/-640 microg/kg in the ephedrine group. Maternal heart rate was significantly higher (P &lt; 0.001) during vasopressor infusion in the ephedrine group than in the angiotensin group. Umbilical arterial and venous blood pH and base excess were all significantly higher (P &lt; 0.05) in the angiotensin group than in the ephedrine group. Conclusions Angiotensin II infusion maintained maternal systolic blood pressure during spinal anesthesia without increasing maternal heart rate or causing fetal acidosis.

A Randomized Controlled Trial of Intact Cord Milking versus Immediate Cord Clamping in Term Infants Born by Elective Cesarean Section

2019 ◽  
Author(s):  
Vincenzo Zanardo ◽  
Pietro Guerrini ◽  
Lorenzo Severino ◽  
Alphonse Simbi ◽  
Matteo Parotto ◽  
...  
Keyword(s):  
Body Weight ◽  
Cord Blood ◽  
Cesarean Delivery ◽  
Controlled Trial ◽  
Elective Cesarean Section ◽  
Safe Procedure ◽  
Elective Cesarean Delivery ◽  
Clinical Trial Registration ◽  
Cord Clamping ◽  
Elective Cesarean

Abstract Objective We evaluated whether intact umbilical cord milking (UCM) is more effective than immediate cord clamping (ICC) in enhancing placental transfusion after elective cesarean delivery. Study Design In a randomized trial, volume of placental transfusion was assessed by Δ hematocrit (Hct) between neonatal cord blood and capillary heel blood at 48 hours of age, corrected for the change in body weight. Results There were no significant differences in cord blood mean Hct values at birth (UCM, 44.5 ± 4.8 vs. ICC, 44.9 ± 4.2%, p = 0.74). Conversely, at 48 hours of age, the UCM group had significantly higher capillary heel Hct values (UCM, 53.7 ± 5.9 vs. ICC, 49.8 ± 4.6%, p < 0.001), supporting a higher placental transfusion volume (Δ Hct, UCM 9.2 ± 5.2 vs. ICC 4.8 ± 4.7, p < 0.001), despite comparable neonatal body weight decrease (UCM, −7.3 vs. ICC, −6.8%, p = 0.77). Conclusion Higher Δ Hct between cord blood at birth and capillary heel blood at 48 hours of age, corrected for the change in body weight, suggests that intact UCM is an efficacious and safe procedure to enhance placental transfusion among neonates born via elective cesarean delivery. Clinical Trial Registration ClinicalTrials.gov, www.clinicaltrials.gov, NCT03668782.

scholarly journals Ethnic disparities in postpartum hemorrhage after cesarean delivery: a retrospective case–control study

2021 ◽  
Author(s):  
Yu Wang ◽  
Hexin Gao ◽  
Tuvshin Bao ◽  
Lijuan Yang ◽  
Guifeng Ding ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Cesarean Delivery ◽  
Ethnic Groups ◽  
Postpartum Hemorrhage ◽  
Placenta Previa ◽  
Multiple Pregnancy ◽  
Ethnic Disparities ◽  
Case Control ◽  
Case Control Studies

Abstract Purpose To explore the relationship of ethnicity and postpartum hemorrhage (PPH) for women who underwent cesarean delivery (CD) and examine the risk factors for PPH in distinct ethnic groups in China. Methods We conducted case–control studies with the maternity data from the 11,778 CD cases, in Xinjiang Uygur Autonomous Region. Initially, multivariable logistic regression was used to estimate the disparity of race-ethnicity on the risk of PPH in ethnic Han, Uygur, Hui and Kazakh. Then, we performed case–control studies within two major ethnic groups, identifying the specific risk factors for PPH. Results Ethnic Uygur were associated with a statistically significant increased odds [adjusted odds ratios (aOR) 2.05; 95% confidence interval (CI) 1.26–3.33] of PPH compared with ethnic Han. For subgroup analyses, in Uygur subgroup, general anesthesia (aOR 7.78; 95% CI 2.31–26.20); placenta previa (aOR 11.18; 95% CI 3.09–40.45); prenatal anemia (aOR 4.84; 95% CI 2.44–9.60); emergency surgery (aOR 4.22; 95% CI 1.95–9.13) were independently associated with PPH. In Han subgroup, general anesthesia (aOR 5.70; 95% CI 1.89–17.26); placenta previa (aOR 20.08; 95% CI 6.35–63.46); multiple pregnancy (aOR 7.21; 95% CI 1.61–32.37); body mass index (aOR 1.19; 95% CI 1.07–1.31) were the risk factors to PPH. Conclusion Uygur have more tendency to PPH compared to Han, and risk factors for PPH in Uygur and Han groups may differ. Knowing these differences may be meaningful when planning interventions and resources for high-risk patients undergoing cesarean delivery, and we need more research aimed at risk factors for PPH.

Perinatal outcome according to the timing of elective cesarean delivery for placenta previa

Placenta ◽  
2016 ◽  
Vol 46 ◽  
pp. 112
Author(s):  
Asako Kanai ◽  
Shuusaku Hayashi ◽  
Masako Kanda ◽  
Kazufumi Haino ◽  
Keisuke Ishii ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Perinatal Outcome ◽  
Placenta Previa ◽  
Elective Cesarean Delivery ◽  
Elective Cesarean

scholarly journals Impact of the new guidelines on the management of premature rupture of membranes for the prevention of late preterm birth: an 11-year retrospective study

2019 ◽  
Vol 47 (3) ◽  
pp. 341-346 ◽  
Author(s):  
Noémie Bouchet ◽  
Arnaud Joal ◽  
Angèle Gayet-Ageron ◽  
Marina Lumbreras Areta ◽  
Begoña Martinez de Tejada
Keyword(s):  
Expectant Management ◽  
Late Preterm ◽  
Elective Cesarean Section ◽  
Evidence Based ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Late Preterm Birth ◽  
Elective Cesarean ◽  
New Guidelines

Abstract Objectives To evaluate the number of late preterm (LPT) births (between 34 0/7 and 36 6/7 weeks) that could have been prevented if expectant management of preterm premature rupture of membranes (PPROM) had been applied according to new recommendations. Methods A retrospective cohort study included all births at one Swiss center between January 1, 2002 and December 31, 2012. Births were categorized using an adapted evidence-based classification. Two scenarios were considered: best scenario (maximum averted cases) and a conservative scenario (minimum averted cases). Results Among 2017 LPT births (5.0% of all deliveries; n=40,609), 1122 (60.6%) women had PPROM. Spontaneous labor occurred in 473 (42.2%) cases and 649 (57.8%) had induction of labor or an elective cesarean section. In the latter group, 44 (6.8%) had evidence-based indications for LPT delivery and 605 (83.2%) had non-evidence-based indications. Depending on the scenario, the rate of avoided LPT cases would have varied between 4.2% (95% confidence interval [CI]: 3.4–5.2) if the conservative scenario was applied, and 30% (95% CI: 28.0–32.0) for the best scenario. Conclusion Adoption of new guidelines for the management of PPROM will prevent a considerable number of LPT births and help decrease the adverse effects and potential disability associated with late preterm infants.

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