scholarly journals Patient Characteristics and feto-maternal Outcomes Among Cases Of Placenta Previa and Accidental Hemorrhage

2021 ◽  
Vol 25 (3) ◽  
pp. 2-15
Author(s):  
Laila Ezzat , Mohamed Salah
Keyword(s):  
Placenta Previa ◽  
Patient Characteristics ◽  
Maternal Outcomes

scholarly journals Perinatal and maternal outcome after vitrification of blastocysts: a Nordic study in singletons from the CoNARTaS group

2019 ◽  
Author(s):  
Erica Ginström Ernstad ◽  
Anne Lærke Spangmose ◽  
Signe Opdahl ◽  
Anna-Karina Aaris Henningsen ◽  
Liv Bente Romundstad ◽  
...  
Keyword(s):  
Gestational Age ◽  
Lower Risk ◽  
Placenta Previa ◽  
Collaborative Study ◽  
Blastocyst Transfer ◽  
Fertility Treatment ◽  
Maternal Outcomes ◽  
Cleavage Stage ◽  
Significant Difference ◽  
Per Se

Abstract STUDY QUESTION Is transfer of vitrified blastocysts associated with higher perinatal and maternal risks compared with slow-frozen cleavage stage embryos and fresh blastocysts? SUMMARY ANSWER Transfer of vitrified blastocysts is associated with a higher risk of preterm birth (PTB) when compared with slow-frozen cleavage stage embryos and with a higher risk of a large baby, hypertensive disorders in pregnancy (HDPs) and postpartum hemorrhage (PPH) but a lower risk of placenta previa when compared with fresh blastocysts. WHAT IS KNOWN ALREADY Transfer of frozen-thawed embryos (FETs) plays a central role in modern fertility treatment, limiting the risk of ovarian hyperstimulation syndrome and multiple pregnancies. Following FET, several studies report a lower risk of PTB, low birth weight (LBW) and small for gestational age (SGA) yet a higher risk of fetal macrosomia and large for gestational age (LGA) compared with fresh embryos. In recent years, the introduction of new freezing techniques has increased treatment success. The slow-freeze technique combined with cleavage stage transfer has been replaced by vitrification and blastocyst transfer. Only few studies have compared perinatal and maternal outcomes after vitrification and slow-freeze and mainly in cleavage stage embryos, with most studies indicating similar outcomes in the two groups. Studies on perinatal and maternal outcomes following vitrified blastocysts are limited. STUDY DESIGN, SIZE, DURATION This registry-based cohort study includes singletons born after frozen-thawed and fresh transfers following the introduction of vitrification in Sweden and Denmark, in 2002 and 2009, respectively. The study includes 3650 children born after transfer of vitrified blastocysts, 8123 children born after transfer of slow-frozen cleavage stage embryos and 4469 children born after transfer of fresh blastocysts during 2002–2015. Perinatal and maternal outcomes in singletons born after vitrified blastocyst transfer were compared with singletons born after slow-frozen cleavage stage transfer and singletons born after fresh blastocyst transfer. Main outcomes included PTB, LBW, macrosomia, HDP and placenta previa. PARTICIPANTS/MATERIALS, SETTING, METHODS Data were obtained from the CoNARTaS (Committee of Nordic ART and Safety) group. Based on national registries in Sweden, Finland, Denmark and Norway, the CoNARTaS cohort includes all children born after ART treatment in public and private clinics 1984–2015. Outcomes were assessed with logistic multivariable regression analysis, adjusting for the country and year of birth, maternal age, body mass index, parity, smoking, parental educational level, fertilisation method (IVF/ICSI), single embryo transfer, number of gestational sacs and the child’s sex. MAIN RESULTS AND THE ROLE OF CHANCE A higher risk of PTB (<37 weeks) was noted in the vitrified blastocyst group compared with the slow-frozen cleavage stage group (adjusted odds ratio, aOR [95% CI], 1.33 [1.09–1.62]). No significant differences were observed for LBW (<2500 g), SGA, macrosomia (≥4500 g) and LGA when comparing the vitrified blastocyst with the slow-frozen cleavage stage group. For maternal outcomes, no significant difference was seen in the risk of HDP, placenta previa, placental abruption and PPH in the vitrified blastocyst versus the slow frozen cleavage stage group, although the precision was limited. When comparing vitrified and fresh blastocysts, we found higher risks of macrosomia (≥4500 g) aOR 1.77 [1.35–2.31] and LGA aOR 1.48 [1.18–1.84]. Further, the risks of HDP aOR 1.47 [1.19–1.81] and PPH aOR 1.68 [1.39–2.03] were higher in singletons born after vitrified compared with fresh blastocyst transfer while the risks of SGA aOR 0.58 [0.44–0.78] and placenta previa aOR 0.35 [0.25–0.48] were lower. LIMITATIONS, REASONS FOR CAUTION Since vitrification was introduced simultaneously with blastocyst transfer in Sweden and Denmark, it was not possible to explore the effect of vitrification per se in this study. WIDER IMPLICATIONS OF THE FINDINGS The results from the change of strategy to vitrification of blastocysts are reassuring, indicating that the freezing technique per se has no major influence on the perinatal and maternal outcomes. The higher risk of PTB may be related to the extended embryo culture rather than vitrification. STUDY FUNDING/COMPETING INTEREST(S) The study is part of the ReproUnion Collaborative study, co-financed by the European Union, Interreg V ÖKS. The study was also financed by grants from the Swedish state under the agreement between the Swedish government and the county councils, the ALF agreement (LUA/ALF 70940), Hjalmar Svensson Research Foundation and NordForsk (project 71 450). There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER ISRCTN11780826.

Maternal Outcomes in Women with Major Degree Placenta Previa: An Observational Cohort Study

2020 ◽  
Vol 17 ◽  
Author(s):  
Safinaz Reda Mahmoud Abdelwhab ◽  
Ali El-Shabrawy Ali ◽  
Mostafa Abdo Ahmed ◽  
Basem Mohamed Hamed
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Placenta Previa ◽  
Observational Cohort Study ◽  
Maternal Outcomes ◽  
Significant Difference ◽  
Before And After ◽  
Screening Protocol ◽  
Observational Cohort ◽  
Study Participants

Objective:: We aimed to evaluate the maternal outcomes among pregnant women with major degree placenta previa. Methods:: We conducted an observational cohort study on 80 pregnant women diagnosed with major placenta previa (grades III and IV where the placenta partially or completely cover the internal cervical os) after 20 weeks of pregnancy, within the period from January 2019 to June 2019. The diagnosis of placenta previa was made by ultrasound and confirmed at the time of delivery. The study participants were divided into three groups based on the placental location (Anterior, Central, and Posterior). All analyses were conducted using IBM SPSS software package version 20.0. Results:: Eighty pregnant women, with a mean age of 32.3 (5.01) years and a mean gestational age of 36.2 (2.03) weeks, were included in our study. Of them, 56.30% had a previous abortion, and previous Cs delivery was reported in 75%. Most of the placenta previa cases were central (52.5%), with a completely covered internal cervical os (70%). Thirty-nine patients (48.8%) had placenta accreta. Blood transfusion, postpartum hemorrhage, and anemia were noted with a percentage of 75%, 32.5%, and 32.5%, respectively. Around 28.8% of the included patients had a hysterectomy. Before and after delivery, nine patients (21.4%) and 15 patients (35.7%) of the placenta previa centralis group had anemia, respectively. Moreover, there was no statistically significant difference between the three studies groups in terms of anemia before and after delivery (P= 0.41 and P= 0.78. respectively). Placenta previa centralis showed a higher incidence of CS hysterectomy (45.2%) while wound infection was higher in anterior placenta previa (18.2%). Conclusion:: As a predictor of possible obstetric adverse events, placenta previa should be considered. A combination of proper clinical assessment and timely delivery to reduce the associated complications should be considered as well as developing a prenatal screening protocol.

Maternal Outcomes of Hysterectomy and Conservative Surgery in Placenta Accreta

2020 ◽  
Vol 16 (3) ◽  
pp. 201-205
Author(s):  
Muara Panusunan Lubis ◽  
Muhammad Rizki Yaznil ◽  
Melvin N.G. Barus ◽  
Edwin Martin Asroel ◽  
Michelle Faustine
Keyword(s):  
Placenta Accreta ◽  
Placenta Previa ◽  
Multidisciplinary Care ◽  
Conservative Surgery ◽  
Emerging Disease ◽  
Bladder Injury ◽  
Maternal Outcomes ◽  
Mortality And Morbidity ◽  
Estimated Blood Loss ◽  
Duration Of Surgery

Background: Abnormal invasive placentation or placenta accreta spectrum (PAS) has been an emerging disease in developing countries where cesarean sections are routinely performed. Here we report our own data to contribute to the variety of techniques for reducing morbidity and mortality in placenta accreta cases across the world. Objective: This study aims to analyze maternal outcomes, associated risk factors, and our surgery technique in placenta accreta patients treated at Haji Adam Malik Hospital, Indonesia. Methods: We conducted a retrospective study in a tertiary hospital in North Sumatra, with a total of 70 patients suspected to have placenta accreta between January 2017 and June 2019. We compared age, gestational age, previous cesarean section, history of antepartum bleeding, placenta accreta index score, and intraoperative data, including the type of anesthesia, estimated blood loss, the need for transfusion, duration of surgery, complication, and management of the patient. Results: From 70 suspected cases of placenta accreta, 52 (74.2%) patients were diagnosed with placenta accreta and 18 (25.7%) were diagnosed with placenta previa (non-accreta) during surgery. Of the 52 placenta accreta patients, hysterectomy was performed in 42 and the other 10 were treated with conservative surgical procedures. Morbidities such as bladder injury (5.8%; 3/42) and iliac vein injury (4.8%; 2/42) were reported during hysterectomy. There were two (4.8%) mortalities reported. Conclusion: PAS is an emerging disease with high mortality and morbidity rates, which requires comprehensive management including referral to a multidisciplinary care team for diagnosis and management.

scholarly journals Severe preeclampsia leads to higher prevalence of mortality and morbidity affecting maternal outcomes in single tertiary hospital

2020 ◽  
Vol 28 (3) ◽  
pp. 99
Author(s):  
Khonsa’ Tsabitah ◽  
Budi Wicaksono ◽  
Samsriyaningsih Handayani
Keyword(s):  
Placenta Previa ◽  
Kidney Injury ◽  
Tertiary Hospital ◽  
Severe Preeclampsia ◽  
Sectio Caesarea ◽  
Maternal Outcomes ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Maternal Characteristics ◽  
Cross Sectional Design

Objective: The purpose of this study was to determine the maternal outcomes of severe preeclampsia at RSUD Dr. Soetomo Surabaya in January 2013-December 2014.Materials and Methods: This research was a descriptive study with cross-sectional design to observe maternal characteristics and maternal outcomesof severe preeclampsia. Data were retrieved from medical records of severe preeclampsia patients admitted to Obstetric Ward of Dr Soetomo Hospital, from January 2013 to December 2014. This study used total sampling for collecting its data. These data were proccessed descriptively and presented in graphic, tables, and short description.Results: From January 2013 to December 2014 there were 386 (44.2%) cases of severe preeclampsia that were included in this study from a total of 874 cases available. The maternal outcomes of severe preeclampsia consisted of 42 cases (10.9%) of HELLP syndrome, 36 cases (9.3%) of pulmonary edema, 225 cases (58.3%) of sectio caesarea, 7 cases(1.8%) of antepartum bleeding with 5 cases (1.3%) of placenta previa and 2 cases (0.5%) of solutio placenta, 2 cases (0.5%) of postpartum bleeding, 8 cases (2.1%) of eclampsia, 31 cases (8%) of impending eclampsia, 5 cases (1.3%) of acute kidney injury, and 2 cases (0.5%) of maternal death.Conclusion: In conclusion, this study shows that severe pre-eclampsia patients have high prevalence of mortality and morbidities that affects maternal outcomes. It also reccommends that all patients with severe preeclampsia need to receive intensive maternal and fetal care. It is necessary to do careful complication examination, prevention of seizures using magnesium sulfate, and continous fetal and maternal monitoring.

scholarly journals Inflammatory Bowel Disease in Pregnancy: Patient Characteristics and Adverse Maternal Outcomes

2022 ◽  
Vol 226 (1) ◽  
pp. S383
Author(s):  
Sarina R. Chaiken ◽  
Afsoon Ghafari-Saravi ◽  
Claire H. Packer ◽  
Bharti Garg ◽  
Aaron B. Caughey
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Patient Characteristics ◽  
Maternal Outcomes ◽  
Inflammatory Bowel ◽  
In Pregnancy

scholarly journals Association of early neonatal-maternal outcomes with timing of elective caesarean section at term gestation

2021 ◽  
Vol 10 (6) ◽  
pp. 2403
Author(s):  
Priyanka Rohilla ◽  
Poonam Goel ◽  
Suksham Jain
Keyword(s):  
Caesarean Section ◽  
Respiratory Distress ◽  
Placenta Previa ◽  
Elective Caesarean Section ◽  
Full Term ◽  
Respiratory Morbidity ◽  
Optimal Time ◽  
Bladder Injury ◽  
Maternal Outcomes ◽  
Early Term

Background: The decision for optimal time for elective caesarean section (ECS) should be taken considering the minimum risk to the newborn as well as to the mother. This prospective observational study aimed to investigate the effect of gestation of ECS, on neonatal and maternal outcomes.Methods: All the pregnant term mothers admitted to our hospital for ECS and fulfilling the inclusion criteria were enrolled and divided into 2 groups, early term and full term. Patients having high-risk factors like intrauterine growth restriction, amniotic fluid disorders, multiple pregnancies, placenta previa, abruption placenta and medical co-morbidities were excluded. Early neonatal and maternal outcomes were compared between the 2 groups.Results: 244 mothers were eligible for ECS, 183 (75%) women underwent ECS in the early term and 61 (25%) at full term as per the decision of obstetricians of various units. The incidence of neonatal respiratory morbidity (NRM) was 2 percent in our study. Out of 244 newborns, 4 developed NRM in the form of delayed adaption in 3 and respiratory distress in 1. The incidence of respiratory distress was comparable in both groups. The incidence of NNJ, MSL and sepsis was higher in the early term but it was not significant statistically. Maternal outcomes like postpartum haemorrhage, the need for blood transfusion, bladder injury, thin scar, adhesions poorly formed LUS were observed in the early term but the difference was not significant.Conclusions: More research needs to be done for optimization of timing of ECS.

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