scholarly journals The new clinical application of bilateral-contralateral cervix clamp in postpartum hemorrhage: a retrospective cohort study

2020 ◽  
Author(s):  
QianWen Zhang ◽  
Tao Li ◽  
Yu Xu ◽  
Yayi Hu
Keyword(s):  
Cohort Study ◽  
Informed Consent ◽  
Blood Transfusion ◽  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Retrospective Cohort ◽  
Caesarean Delivery ◽  
Control Group ◽  
Efficacy And Safety ◽  
Complementary Treatment

Abstract Background: To assess the efficacy and safety of bilateral-contralateral cervix clamp firstly applied in postpartum hemorrhage caused by uterine tony of lower segment.Methods: Totally 47 pregnant women with postpartum hemorrhage secondary to lower uterine segment atony in vaginal delivery or after caesarean delivery were included from March 1, 2020 to May 31, 2020. According to patient’s informed consent, 22 women accepted cervical clamp to treat and 25 only used uterotonics in control group.Then hemostatic efficacy and safety of bilateral-contralateral cervix clamp were assessed by retrospective analysis.Results: It was found that mean blood loss in clamp group was much less during vaginal delivery (656.2±72.79g vs 811.8±86.07g, p=0.001) or after caesarean delivery (42.8±6.60g vs 126.3±86.97g, p=0.007), and incidence of uterotonic repeated usage (81.8% vs 36%, 18.2 % vs 64%, p=0.001) or side effect (18.2% vs 48.0%, p=0.031) appeared less than control group, but there was no statistical differences on hospital stay(4.1±1.57days vs 3.8±1.61days, p=0.535), hemoglobin(119±4.10g vs 121.4±4.19g, p=0.058)，blood transfusion(9.1% vs 12%,p=0.746), surgical procedures(4.5% vs 4.0%, p=0.93), also no clamp complications occurred.Conclusions: The bilateral-contralateral cervix clamp was effective and safe, this new technique could be a complementary treatment for postpartum hemorrhage.

scholarly journals The new clinical application of bilateral-contralateral cervix clamp in postpartum hemorrhage: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qianwen Zhang ◽  
Tao Li ◽  
Yu Xu ◽  
Yayi Hu
Keyword(s):  
Cohort Study ◽  
Informed Consent ◽  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Retrospective Cohort ◽  
Caesarean Delivery ◽  
Control Group ◽  
Efficacy And Safety ◽  
Lower Segment ◽  
Complementary Treatment

Abstract Background To assess the efficacy and safety of bilateral-contralateral cervix clamp firstly applied in postpartum hemorrhage caused by uterine tony of lower segment. Methods Totally 47 pregnant women with postpartum hemorrhage secondary to lower uterine segment atony in vaginal delivery or after caesarean delivery were included from March 1, 2020 to May 31, 2020. According to patient’s informed consent, 22 women accepted cervical clamp to treat and 25 only used uterotonics in control group. Then hemostatic efficacy and safety of bilateral-contralateral cervix clamp were assessed by retrospective analysis. Results It was found that mean blood loss in clamp group was much less during vaginal delivery (656.2±72.79 g vs 811.8±86.07 g, p = 0.001) or after caesarean delivery (42.8±6.60 g vs 126.3±86.97 g, p = 0.007), and incidence of uterotonic repeated usage (81.8% vs 36, 18.2% vs 64%, p = 0.001) or side effect (18.2% vs 48.0%, p = 0.031) appeared less than control group, but there was no statistical differences on hospital stay (4.1±1.57 days vs 3.8±1.61 days, p = 0.535), hemoglobin (119±4.10 g vs 121.4±4.19 g, p = 0.058), blood transfusion (9.1% vs 12%,p = 0.746), surgical procedures (4.5% vs 4.0%, p = 0.93), also no clamp complications occurred. Conclusions The bilateral-contralateral cervix clamp was effective and safe, this new technique could be a complementary treatment for postpartum hemorrhage.

scholarly journals Evaluation of the risk of umbilical cord prolapse in the second twin during vaginal delivery: a retrospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046616
Author(s):  
Rokuhiro Asahina ◽  
Hiroyuki Tsuda ◽  
Yuki Nishiko ◽  
Kazuya Fuma ◽  
Momoko Kuribayashi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Vaginal Delivery ◽  
Umbilical Cord ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Caesarean Delivery ◽  
Cord Prolapse ◽  
Umbilical Cord Insertion ◽  
Umbilical Cord Prolapse ◽  
Second Twin

ObjectiveThis study aimed to evaluate the success rate of vaginal delivery, the reasons for unplanned caesarean delivery, the rate of umbilical cord prolapse and the risk of umbilical cord prolapse in twin deliveries.DesignRetrospective cohort study.SettingSingle institution.ParticipantsThis study included 455 women pregnant with twins (307 dichorionic and 148 monochorionic) who attempted vaginal delivery from January 2009 to August 2018. The following criteria were considered for vaginal delivery: diamniotic twins, cephalic presentation of the first twin, no history of uterine scar, no other indications for caesarean delivery, no major structural abnormality in either twin and no fetal aneuploidy.ResultsThe rate of vaginal delivery of both twins was 89.5% (407 of 455), caesarean delivery of both twins was 7.7% (35 of 455) and caesarean delivery of only the second twin was 2.9% (13 of 455). The major reasons for unplanned caesarean delivery were arrest of labour and non-reassuring fetal heart rate pattern. The rate of umbilical cord prolapse in the second twin was 1.8% (8 of 455). Multivariate analysis revealed that abnormal umbilical cord insertion in the second twin (velamentous or marginal) was the only significant factor for umbilical cord prolapse in the second twin (OR, 5.05, 95% CI 1.139 to 22.472, p=0.033).ConclusionsAbnormal umbilical cord insertion in the second twin (velamentous or marginal) was a significant factor for umbilical cord prolapse during delivery. Antenatal assessment of the second twin’s umbilical cord insertion using ultrasonography would be beneficial.

Timing and Safety of Postpartum Enoxparin.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4110-4110
Author(s):  
Rachel A. Freedman ◽  
Jeffrey Zwicker ◽  
Kenneth Alan Bauer
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Postpartum Period ◽  
Retrospective Cohort ◽  
Low Molecular Weight Heparin ◽  
Control Group ◽  
Low Molecular Weight ◽  
Cesarean Sections ◽  
Vaginal Deliveries

Abstract The appropriate time to restart anticoagulation in the postpartum period is not known. Both the American College of Obstetrics and Gynecology as well as American College of Chest Physicians (ACCP) have issued guidelines regarding the use of anticoagulants during pregnancy but neither have generated recommendations regarding the timing of the first dose of low-molecular-weight heparin (LMWH) in the postpartum period. The incidence of postpartum hemorrhage was assessed in a retrospective cohort study of 95 women treated with enoxaparin and compared with 303 consecutive deliveries where anticoagulation was not administered. The rate of severe postpartum hemorrhage did not differ significantly for women treated with peripartum enoxaparin versus a control group of women undergoing vaginal delivery (3.6% versus 1.4%, P=0.72) or cesarean section (5.1% versus 3.4%, P=0.98). There were no severe postpartum hemorrhages following the re-initiation of enoxaparin postpartum. In 75% of vaginal deliveries and 49% of cesarean sections, enoxaparin was restarted within 24 hours. Two incisional hematomas were observed in the group of women who received enoxaparin within 24 hours following cesarean section. We conclude that severe postpartum hemorrhage is an infrequent complication following the administration of enoxaparin postpartum. In support of current clinical practice, enoxaparin can be safely administered 0 to 24 hours following vaginal delivery and 12 to 36 hours following cesarean section.

Personalized Preoperative Education Reduces Perioperative Anxiety in Old Men with Benign Prostatic Hyperplasia: A Retrospective Cohort Study

Gerontology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Lihong Li ◽  
Shasha Li ◽  
Yating Sun ◽  
Shaoxia Zhang ◽  
Xue Zhang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Benign Prostatic Hyperplasia ◽  
Informed Consent ◽  
Psychological Health ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Prostatic Hyperplasia ◽  
Control Group ◽  
Preoperative Education ◽  
Old Patients

<b><i>Introduction:</i></b> Psychological health is important to old patients with benign prostatic hyperplasia (BPH) after prostatic surgery. In this retrospective cohort study, we evaluated the effect of personalized preoperative education in the reduction of perioperative anxiety in old BPH patients after prostatic surgery. <b><i>Methods:</i></b> Senior patients (≥65 years) admitted with a diagnosis of BPH and scheduled for initial transurethral resection of the prostate from January 1, 2017 to November 30, 2019 were retrieved. Patients in the preoperatively educated group completed the Chinese version of generalized anxiety disorder 7-item scale (GAD-7) form to evaluate their anxiety level at admission and 14 days clinical visits after individual preoperative education. Patients in the control group completed GAD-7 forms but did not receive personalized preoperative education. Patients in both groups discussed their disease with physicians during clinic visits and after admission, and were given an informed consent about their treatment plans. <b><i>Results:</i></b> Seven hundred and twenty-four patients were retrieved, including 312 patients who received preoperative education and 412 patients who did not. There were significantly lower postoperative GAD-7 score and fewer moderate to severe postoperative anxiety patients in the preoperatively educated group (<i>p</i> &#x3c; 0.01). Patients with education above secondary education level had less perioperative anxiety. <b><i>Conclusion:</i></b> Personalized education incorporated with shared valuable physiological and psychological experience and expectations dealing with BPH, in comparison to traditional uniformed patient education and informed consent before surgery, may reduce perioperative anxiety more efficiently in BPH patients. A higher educational level helps patients reduce perioperative anxiety before and after their personalized preoperative education.

scholarly journals Effects of a New Patient Safety-Driven Oxytocin Dosing Protocol on Postpartum Hemorrhage

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
David S. McKenna ◽  
Kari Rudinsky ◽  
Jiri Sonek
Keyword(s):  
Patient Safety ◽  
Cohort Study ◽  
Standard Deviation ◽  
Blood Transfusion ◽  
Retrospective Cohort Study ◽  
Postpartum Hemorrhage ◽  
Retrospective Cohort ◽  
Blood Transfusions ◽  
Time Frames ◽  
Best Fit

Objective.To determine if there was an increase in postpartum (PP) hemorrhage after decreasing the PP oxytocin dose from 40 to 30 units.Study Design.Retrospective cohort study comparing 8 months before to 8 months after the change. PP day 1 hemoglobin was subtracted from admission hemoglobin. Mean change was compared by Student’st-test. The best fit polynomial was analyzed for trends between the two time frames. Women who received blood transfusions were excluded.Results.73/3564 (2.0%) women received blood transfusions in the pre group and 64/3295 (1.9%) women in the post group,P=0.8. Mean hemoglobin change ± standard deviation was1.53±0.03 g/dL for pre versus1.52±0.05 g/dL for post,P=0.68. 1003/3114 (32.2%) in the pre group had a hemoglobin decrease of ≥2 g/dL compared to 918/2895 (31.7%) in the post group,P=0.7. 261/3114 (8.4%) in the pre group had a hemoglobin decrease of ≥3 g/dL compared to 252/2895 (8.7%),P=0.7. There were no significant trends between the two time frames.Conclusion.The change in the dose of PP oxytocin did not result in an increase in postpartum hemorrhage or an increase in the need for blood transfusion.

scholarly journals Effect of cryoprecipitate transfusion therapy in patients with postpartum hemorrhage: a retrospective cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ryo Kamidani ◽  
Takahito Miyake ◽  
Hideshi Okada ◽  
Genki Yoshimura ◽  
Keigo Kusuzawa ◽  
...  
Keyword(s):  
Cohort Study ◽  
Fluid Balance ◽  
Retrospective Cohort Study ◽  
Postpartum Hemorrhage ◽  
Retrospective Cohort ◽  
Active Bleeding ◽  
University Hospital ◽  
Control Group ◽  
Initial Examination ◽  
Transfusion Therapy

AbstractTo evaluate the effect of cryoprecipitate (CRYO) transfusion in women referred for postpartum hemorrhage (PPH). This retrospective cohort study included patients with primary PPH referred to Gifu University Hospital between April 2013 and March 2020. We analyzed the effect of CRYO transfusion on fluid balance 24 h after the initial examination using a multivariable linear regression model adjusted for several confounding variables. To evaluate whether outcomes were modified by active bleeding, an interaction term of CRYO*active bleeding was incorporated into the multivariable model. We identified 157 women: 38 in the CRYO group (cases) and 119 in the control group. Fluid balance in the aforementioned period tended to decrease in the CRYO group compared with that in the control group (coefficient − 398.91; 95% CI − 1298.08 to + 500.26; p = 0.382). Active bleeding on contrast-enhanced computed tomography affected the relationship between CRYO transfusion and fluid balance (p = 0.016). Other outcomes, except for the overall transfusion requirement, were not significantly different; however, the interaction effect of active bleeding was significant (p = 0.016). CRYO transfusion may decrease the fluid balance in the first 24 h in PPH patients, especially in those without active bleeding.

scholarly journals A prospective cohort study of shock index as a reliable marker to predict the patient’s need for blood transfusion due to postpartum hemorrhage

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Süleyman Cemil Oğlak ◽  
Mehmet Obut ◽  
Ali Emre Tahaoğlu ◽  
Neslihan Uğur Demirel ◽  
Bekir Kahveci ◽  
...  
Keyword(s):  
Cohort Study ◽  
Blood Transfusion ◽  
Vaginal Delivery ◽  
Prospective Cohort Study ◽  
Postpartum Hemorrhage ◽  
Prospective Cohort ◽  
Shock Index ◽  
Record System ◽  
Tertiary Center ◽  
Reliable Marker

Objective: This study was aimed to compare the shock index (SI) values between patients who required blood transfusion due to postpartum hemorrhage (PPH) and patients who received no blood transfusion. Methods: We conducted this cross-sectional study at a tertiary center between January 2019 and June 2019. A total of 2534 patients who underwent vaginal delivery were included in this study. We measured SI values upon admission, 30 minutes, 1-hour, and 2-hours after delivery. We identified women who required blood transfusion as the study group. Control patients who delivered in the same period and received no blood transfusion were identified in the medical record system and randomly selected. Age, parity, BMI, and SI values at each one prepartum and three postpartum periods of the groups were analyzed. Results: A total of 2534 patients were included in the study. A varying amount of blood transfusion was performed in 54 patients (2.13%). When we compared with patients who did not receive blood transfusion after delivery, patients who received any amount of blood transfusion after vaginal delivery had significantly higher SI values 30 minutes after delivery (0.99±0.20, and 085±0.11, p=0.0001), at 1-hour (1.00±0.18, and 0.85±0.11, p=0.0001), and 2-hours (1.09±0.16, and 0.87±0.11, p=0.0001). Conclusion: SI value could be a reliable and consistent marker to predict the requirement for any amount of blood transfusion due to PPH. doi: https://doi.org/10.12669/pjms.37.3.3444 How to cite this:Oglak SC, Obut M, Tahaoglu AE, Demirel NU, Kahveci B, Bagli I. A prospective cohort study of shock index as a reliable marker to predict the patient’s need for blood transfusion due to postpartum hemorrhage. Pak J Med Sci. 2021;37(3):---------.  doi: https://doi.org/10.12669/pjms.37.3.3444 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Psychological Traits and Behavioural Influences in Patients with Dystonia—An Observational Cohort Study in a Romanian Neurology Department

Life ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 612
Author(s):  
Eugenia Irene Davidescu ◽  
Irina Odajiu ◽  
Delia Tulbă ◽  
Iulia Mitrea ◽  
Camelia Cucu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Informed Consent ◽  
Personality Traits ◽  
Patient Group ◽  
Observational Cohort Study ◽  
Control Group ◽  
Inclusion Criteria ◽  
Control Subjects ◽  
Observational Cohort ◽  
Idiopathic Dystonia

(1) Background: Emerging evidence indicates that non-motor symptoms significantly influence the quality of life in dystonic patients. Therefore, it is essential to evaluate their psychological characteristics and personality traits. (2) Methods: Subjects with idiopathic dystonia and a matched control group were enrolled in this prospective observational cohort study. Inclusion criteria for patient group included idiopathic dystonia diagnosis, evolution exceeding 1 year, and signed informed consent. Inclusion criteria for the control group included lack of neurological comorbidities and signed informed consent. All subjects completed the DECAS Personality Inventory along with an additional form of demographic factors. Data (including descriptive statistics and univariate and multivariate analysis) were analyzed with SPSS. (3) Results: In total, 95 participants were included, of which 57 were in the patient group. Females prevailed (80%), and the mean age was 54.64 ± 12.8 years. The most frequent clinical features of dystonia were focal distribution (71.9%) and progressive disease course (94.73%). The patients underwent regular treatment with botulinum toxin (85.95%). In addition, patients with dystonia obtained significantly higher openness scores than controls, even after adjusting for possible confounders (p = 0.006). Personality traits were also different between the two groups, with patients more often being fantasists (p = 0.007), experimenters (p = 0.022), sophists (p = 0.040), seldom acceptors (p = 0.022), and pragmatics (p = 0.022) than control subjects. (4) Conclusion: Dystonic patients tend to have different personality profiles compared to control subjects, which should be taken into consideration by the treating neurologist.

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