Obstetric Outcomes After Perforation of Uterine Cavity

2021 ◽  
Author(s):  
Polina Schwarzman ◽  
Yael Baumfeld ◽  
Salvatore Andrea Mastrolia ◽  
Shimrit Yaniv-Salem ◽  
Elad Leron ◽  
...  
Keyword(s):  
Uterine Rupture ◽  
Medical Center ◽  
Intrauterine Device ◽  
Uterine Cavity ◽  
Intrauterine Fetal Death ◽  
Obstetric Outcomes ◽  
Uterine Perforation ◽  
Retrospective Case ◽  
Fetal Malformations ◽  
Control Study

Abstract Purpose: We aimed to evaluate the pregnancy characteristics and obstetric outcomes in patients after perforation of uterus.Study design: A retrospective, case control study was conducted and included all patients who were diagnosed with uterine perforation and treated in a tertiary referral medical center between the years 1996 to 2018. Up to two deliveries after perforations were investigated.Results: During the study period, 51 women were diagnosed with uterine perforation during gynecological procedures, including intrauterine device (IUD) insertion. The mean age of patients at the time of diagnosis was 27.9 (±4.7) years. The majority, 76.5% (n=39), experienced perforation during IUD insertion, and 23.5% (n=12) of the patients experienced perforation during surgical procedures. Most of the patients were multiparous or grand multiparous, 45.8. % (n=22) and 39.6% (n=19) respectively. Anteflexed uterus found in 86.4% of patients (n=38). Five patients (9.8%) had pelvic abscesses after the IUD insertion. 50 patients had 71 deliveries subsequent the uterine perforation. One patient had intrauterine fetal death due to fetal malformations. One patient had uterine rupture. No other major obstetric complications were noted.Conclusion: Uterine perforation may impair obstetric outcomes; the possibility of uterine rupture must be considered while managing deliveries of patients post uterine perforation.

scholarly journals Gestational diabetes mellitus and obstetric outcomes in a Ghanaian community

2018 ◽  
Vol 8 (1) ◽  
pp. 204
Author(s):  
Ahmed Tijani Bawah ◽  
Robert Amadu Ngala ◽  
Mohammed Mustapha Seini ◽  
Francis Abeku Ussher ◽  
Huseini Alidu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnancy Outcome ◽  
Obstetric Outcomes ◽  
Retrospective Case ◽  
Family History Of Diabetes ◽  
Maternal Characteristics ◽  
History Of ◽  
Control Study

Background: This study was aimed at evaluating effect of Gestational diabetes mellitus (GDM) and maternal characteristics on pregnancy outcomes. GDM has several risk factors including; advanced maternal age, ethnic background, obesity and family history of diabetes mellitus. These pregnancy complications are associated with fetal morbidity and mortality and may lead to macrosomia and shoulder dystocia. Others are stillbirth, miscarriages, preterm and small for gestational age babies.Methods: This was a retrospective case-control study which compared maternal characteristics and pregnancy outcome among pregnant women with and without GDM. Diagnosis of GDM was done in accordance with the American Diabetes Association (ADA) criteria. Weight and height were determined and Body mass index (BMI) calculated. Pregnancy outcome was determined at the end of pregnancy and information on maternal characteristics obtained using questionnaire and patient folders.Results: Those who developed GDM were significantly older (OR=1.772; 95% CI=1.432-2.192; P<0.0001) and had higher BMI (OR=1.637; 95% CI=1.004-1.289; P=0.044) than those who did not. A significant number of those who developed GDM also had stillbirths (OR= 5.188; 95% CI=1.093-24.613; p=0.038) and cesarean deliveries (OR=14.362; 95% CI=3.661-56.335; p= 0.001).Conclusions: Women who develop GDM are more likely to deliver stillborn or macrosmic babies and may require surgical intervention in order to have normal deliveries.

scholarly journals Maternal mortality related to postpartum hemorrhage: a case-control study at the Befelatanana maternity of Madagascar

2018 ◽  
Vol 8 (1) ◽  
pp. 121
Author(s):  
Rakotozanany Besaina ◽  
Randriamahavonjy Romuald ◽  
Rabearizaka Laingo ◽  
Ratsiatosika Tanjona ◽  
Randriambelomanana J. A.
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Postpartum Hemorrhage ◽  
Case Control Study ◽  
Case Control ◽  
Intrauterine Fetal Death ◽  
Retrospective Case ◽  
Technical Platform ◽  
Control Study ◽  
Global Reduction

Background: Postpartum hemorrhage (PPH) remains the main cause of maternal death throughout the world. present goal was to determine the associated factors to maternal death in postpartum hemorrhage.Methods: This was a retrospective case-control study; carried out within Befelatanana maternity, in Antananarivo, from January 1st, 2013 to December 31st, 2015, on parturients who presented PPH. The cases were represented by the parturients who died despite well-managed care, and the control, by the living parturients.Results: Authors recorded 181 cases of PPH from 20,888 deliveries, with a prevalence of 0.86%; 47 of them died and 134 were alive; the mortality rate by PPH is 25.96%. Factors associated with death were low education (p=0.00 OR:3.2), non-working (p=0.01, OR:2.4), multiparity ( p:2.2 OR:0.01), absence of prenatal care (p:0.01 OR:2.2), cesarean section (p:0.00 OR:5.5); Intrauterine Fetal Death (p= 0.02, OR:2.2); uterine atony (p=0.03, OR 2.1); the state of shock (p=0.00 OR:57.8), sanitary evacuation (p=0.01 OR: 2.4), the need for blood transfusion (p=0.00 OR: 3, 7), use of catecholamines (p=0.00, OR:17.5); delayed management (p=0.01, OR:2.2), hemostasis hysterectomy (p=0.00 OR: 8.67).Conclusions: The decrease of maternal mortality related to PPH requires better monitoring of pregnancy, delivery and postpartum. Speed care management, improvement of technical platform and establishment of a powerful health system are also needed. Thus, the global reduction of poverty is indispensable.

Does Physiologic Breakdown Mask Significant Pathology in Endometrial Biopsies? A Retrospective Case-Control Study

2006 ◽  
Vol 130 (12) ◽  
pp. 1847-1849
Author(s):  
Mark Galan ◽  
Young Bae Kim ◽  
Jonathan L. Hecht
Keyword(s):  
Case Control Study ◽  
Medical Center ◽  
Case Control ◽  
Endometrial Biopsy ◽  
Control Group ◽  
Retrospective Case ◽  
Significant Pathology ◽  
Initial Sampling ◽  
Control Study

Abstract Context.—Adequacy criteria for endometrial biopsy samples do not exist. Objective.—To assess the sensitivity of endometrial sampling for detecting neoplasia in the setting of extensive glandular and stromal breakdown. Design.—Retrospective case-control study. Surgical pathology records between 1996 and 2005 at Beth Israel Deaconess Medical Center (Boston, Mass) were searched for endometrial samples with diagnoses containing the key words “menstrual” or “extensive breakdown.” Hospital records for these women were parsed for demographics, clinical indications, and follow-up with rebiopsy within 6 months. Age cutoffs enriched the population for women at higher risk for carcinoma. A control group, consisting of 2 age-matched control patients for each test patient, was also studied; each control patient had an endometrial sample taken within a 6-month period and was not diagnosed with extensive breakdown, menstrual endometrium, or neoplasia on initial sampling. Results.—Fifty-four cases were identified. The primary biopsy reports had benign descriptive diagnoses (ie, proliferative, secretory, polyp). Follow-up biopsies showed benign pathology in all cases and specific causes of bleeding—including polyp, leiomyoma, or endometritis—in 28 (52%) of 54. In the control group, neoplasia was found in 2 of the 108 follow-up biopsies. Only 5 other controls had specific diagnoses; all were polyps. Conclusions.—Extensive breakdown or menstrual-pattern endometrium may mask other specific benign pathologies but does not commonly mask cancer.

Wandering intrauterine contraceptive device: an unusual case of migration to the sigmoid colon

2021 ◽  
Vol 15 (1) ◽  
pp. 1-6
Author(s):  
Elpida Samara ◽  
Kerry Howe-Bush ◽  
Mark Portet ◽  
David C Howlett
Keyword(s):  
Sigmoid Colon ◽  
Intrauterine Device ◽  
Uterine Cavity ◽  
Major Complication ◽  
Unusual Complication ◽  
Uterine Perforation ◽  
Contraceptive Device ◽  
Pelvic Magnetic Resonance Imaging ◽  
Intrauterine Contraceptive ◽  
And Migration

An intrauterine device is a well-tolerated and widely used contraceptive method. A rare but major complication is perforation of the uterus and migration into the sigmoid colon. In this case report, a 33-year-old woman presented for follow up after placement of a copper-T intrauterine device 4 months previously. A clinical examination found significant tenderness on palpation, and the threads could not be detected. An ultrasound was conducted, which revealed no coil in the uterine cavity. The pelvic x-ray found it in the mid-pelvis and pelvic magnetic resonance imaging confirmed the position of the T-component at the mid-sigmoid colon. The patient underwent a sigmoidoscopy, which confirmed the position in the sigmoid colonic wall. The device was removed with an endoscopy without further complications. Uterine perforation and translocation to the sigmoid colon is an unusual complication of an intrauterine device. Removal of a translocated intrauterine device is recommended in all symptomatic cases.

scholarly journals Epidemiology of Vancomycin-Resistant Enterococcus faecalis: a Case-Case-Control Study

2012 ◽  
Vol 57 (1) ◽  
pp. 49-55 ◽  
Author(s):  
Kayoko Hayakawa ◽  
Dror Marchaim ◽  
Mohan Palla ◽  
Uma Mahesh Gudur ◽  
Harish Pulluru ◽  
...  
Keyword(s):  
Enterococcus Faecalis ◽  
Case Control Study ◽  
Medical Center ◽  
Case Control ◽  
Study Cohort ◽  
Retrospective Case ◽  
Content Type ◽  
Skin Ulcers ◽  
Vancomycin Resistant ◽  
Control Study

ABSTRACTAlthough much is known about vancomycin-resistant (VR)Enterococcus faecium, little is known about the epidemiology of VREnterococcus faecalis. The predilection of VRE. faecalisto transfer the vancomycin resistance determinant toStaphylococcus aureusis much greater than that of VRE. faecium. The epidemiology of VRE. faecalishas important implications regarding the emergence of vancomycin-resistantS. aureus(VRSA); 8 of 13 reported VRSA cases have been from Michigan. A retrospective case-case-control study was conducted at the Detroit Medical Center, located in southeastern Michigan. Unique patients with VRE. faecalisinfection were matched to patients with strains of vancomycin-susceptible (VS)E. faecalisand to uninfected controls at a 1:1:1 ratio. Five hundred thirty-two VRE. faecaliscases were identified and were matched to 532 VSE. faecaliscases and 532 uninfected controls. The overall mean age of the study cohort (n= 1,596) was 63.0 ± 17.4 years, and 747 (46.8%) individuals were male. Independent predictors for the isolation of VRE. faecalis(but not VSE. faecalis) compared to uninfected controls were an age of ≥65 years, nonhome residence, diabetes mellitus, peripheral vascular disease, exposure to cephalosporins and fluoroquinolones in the prior 3 months, and immunosuppressive status. Invasive procedures and/or surgery, chronic skin ulcers, and indwelling devices were risk factors for both VRE. faecalisand VSE. faecalisisolation. Cephalosporin and fluoroquinolone exposures were unique, independent predictors for isolation of VRE. faecalis. A majority of case patients had VRE. faecalispresent at the time of admission. Control of VRE. faecalis, and ultimately VRSA, will likely require regional efforts focusing on infection prevention and antimicrobial stewardship.

scholarly journals Cesarean delivery complicated with peripartum infection increases the risk of uterine rupture during subsequent trial of labour: A retrospective case-control study

2021 ◽  
Author(s):  
Rina Tamir Yaniv ◽  
Sivan Farladansky-Gershnabel ◽  
Hadar Gluska ◽  
Yair Daykan ◽  
Gil Shechter Maor ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Uterine Rupture ◽  
Caesarean Delivery ◽  
Case Control Study ◽  
Case Control ◽  
Control Group ◽  
Vaginal Birth After Cesarean ◽  
Retrospective Case ◽  
Subsequent Trial ◽  
Control Study

Objective: To evaluate the relation between peripartum infection at first caesarean delivery to uterine dehiscence or rupture at the subsequent delivery. Design: Retrospective case-control study from March 2014 to October 2020. Setting: University-affiliated medical centre. Sample: Women with a prior caesarean delivery and proven dehiscence or uterine rupture diagnosed during their subsequent delivery. The control group included women who had a successful vaginal birth after Cesarean section without evidence of dehiscence or uterine rupture. Methods: We compared the rate of peripartum infection during the first Cesarean delivery and other relevant variables, between the two groups. We also analysed the type of infection correlated with uterine rupture or dehiscence. Main Outcome Measures: Rate of peripartum infection. Results: A total of 168 women were included, 71 with uterine rupture or dehiscence and 97 with successful vaginal birth after Cesarean section as the control group. The rate of peripartum infection at the first caesarean delivery was significantly higher in the study group compared to the control group (22.2% vs. 8.2%, p=0.013). Multivariate logistic regression analysis found that peripartum infection remained an independent risk-factor for uterine rupture at the subsequent trial of labour after Cesarean delivery (95% CI, P=0.018). We also found that endometritis had the highest correlation to uterine rupture (9.8% vs. 0%, p=0.02) Conclusion: Peripartum infection in the first caesarean delivery, may be an independent risk-factor for uterine rupture in a subsequent delivery. Compared to other infections, endometritis may pose the greatest risk for uterine rupture or dehiscence.

scholarly journals Risk Factors for Resistance to β-Lactam/β-Lactamase Inhibitors and Ertapenem in Bacteroides Bacteremia

2015 ◽  
Vol 59 (8) ◽  
pp. 5049-5051 ◽  
Author(s):  
Janessa M. Smith ◽  
Edina Avdic ◽  
Pranita D. Tamma ◽  
Long Zhang ◽  
Karen C. Carroll ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Medical Center ◽  
Tertiary Care ◽  
Case Control ◽  
Retrospective Case ◽  
Content Type ◽  
Development Of Resistance ◽  
Tertiary Care Medical Center ◽  
Control Study

ABSTRACTThe objective of this study was to determine risk factors for the development of resistance to β-lactams/β-lactamase inhibitors (βL/βLIs) and ertapenem amongBacteroidesspecies bacteremia. We conducted a retrospective case-control study of 101 adult patients withBacteroidesspecies bacteremia at a 1,051-bed tertiary care medical center. The duration of exposure to βL/βLIs (odds ratio [OR], 1.25; 95% confidence interval [CI], 1.08 to 2.31) was the only independent risk factor for resistance.

scholarly journals Missing IUD Despite Threads at the Cervix

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Andrew L. Atkinson ◽  
Jonathan D. Baum
Keyword(s):  
Intrauterine Device ◽  
Uterine Cavity ◽  
Uterine Perforation ◽  
Pelvic Magnetic Resonance Imaging ◽  
Multiple Imaging ◽  
Gentle Traction ◽  
Diagnostic Hysteroscopy ◽  
Magnetic Resonance Imaging Mri ◽  
And Migration

Today, the intrauterine device (IUD) is by far the most popular form of long term reversible contraception in the world. Side effects from the IUD are minimal and complications are rare. Uterine perforation and migration of the IUD outside the uterine cavity are the most serious complications. Physician visualization and/or the patient feeling retrieval threads at the cervical os are confirmation that the IUD has not been expelled or migrated. We present a case of a perforated, intraperitoneal IUD with threads noted at the cervical os. Office removal was not possible using gentle traction on the threads. Multiple imaging and endoscopic modalities were used to try and locate the IUD including pelvic ultrasound, diagnostic hysteroscopy, cystoscopy, and pelvic magnetic resonance imaging (MRI). The studies gave conflicting results on location of the IUD. Ultimately, the missing IUD was removed via laparoscopy.

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