scholarly journals Management of refractory atonic post partum hemorrhage by upper segment compression suture

2016 ◽  
Vol 11 (3) ◽  
Author(s):  
Rakhshanda Toheed ◽  
Naela Tarique ◽  
Saqib Siddique
Keyword(s):  
Medical Treatment ◽  
Post Partum ◽  
Medical Institute ◽  
Effective Technique ◽  
Post Partum Hemorrhage ◽  
Uterine Massage ◽  
Compression Suture ◽  
Complex Surgical Procedures ◽  
Normal Menstruation

Aims: The study was undertaken to test the efficacy of Upper Segment Compression Suture(USC Suture) for the control of atonic post partum hemorrhage unresponsive to medical treatment. Study Design: Observational study. Duration:: From March 1998 to March 2003. Setting: Department of Obstetrics & Gynaecology, Lahore General Hospital , Post Graduate Medical Institute, Lahore, Pakistan. Subjects: Fourteen women with atonic PPH refractory to medical treatment. Results:: Fourteen women with severe atonic PPH were managed using uterine massage and utero tonic drugs. Failing these measures, Upper Segment compression suture was used as first line conservative surgical technique. There was no relaparotomy for recurrent PPH. All cases were managed successfully avoiding hysterectomy or other complex surgical procedures. Recovery in all cases was uneventful.Long term follow up was available in four cases. All were having normal menstruation. Two o f them achieved spontaneous pregnancies. Conclusion:: Upper Segment Compression Suture is an effective technique for managing refractory PPH caused by uterine atony.

scholarly journals Comparative Study between Modified Transverse and Hayman Suture Regarding the Efficacy and Purperium Complications in Thi-Qar

2021 ◽  
pp. 22-33
Author(s):  
Aseel Mosa Jabber
Keyword(s):  
Statistical Difference ◽  
Post Partum ◽  
High Rate ◽  
P Value ◽  
Post Partum Hemorrhage ◽  
Significant Statistical Difference ◽  
Surgeon Experience ◽  
Compression Suture ◽  
Uncontrolled Hemorrhage

Background: Main causes of death post-partum is the uncontrolled hemorrhage, that managed by different modalities, whereuterine compression suture had different efficacies as a main interventional tools of sever postpartum hemorrhage. Aim: comparing different sutures types (modified transverse and Hayman suture) regarding their efficacy through its impact and in determining the final outcome and complications of post-partum hemorrhage. Materials and methods: A prospective comparative analytical study including 122 females , who underwent delivery between march 2017and December 2019, all of them followed for , 1 week, 6,weeks 6 months. Were the samples collected from Bent-Al-Huda teaching hospital and Al-Rehman private hospital-Thi-Qar, 2 groups of study; 1st one (52) underwent modified B-lynch suturing (Hyman suturing) while the 2nd group(70) underwent transverse sutures of modified Ouahba suture, written consent had taken from all patients, SPSS version 24 used for analysis. Results: Among 122 delivered women suffer from primary post-partum hemorrhage, 52 (42.63%) were sutured by Hayman suture, and 70 (57.37%)were sutured by transverse suturing,There was significant statistical difference between the types of intervention and blood loss P value <0.05. There was significant statistical difference between the types of intervention and complication development (p value=0.0001). There was no significant independent predictors or determinant for the complication development except the type of intervention. Only follow-up period and complication were truly to be correlated with type of intervention, the other variable were confounders Conclusion: Even though the hemostasis had been achieved in both maneuver with excellent success rate, the transvers suture carrying high rate of persistent pain but the Hayman suture carry higher rate of serious complication such hysterectomy and intestinal obstruction. several factors determine the choosing of the suture type such as site, severity and cause of bleeding and the surgeon experience.

Simpler compression suture for controlling atonic post-partum hemorrhage

2015 ◽  
Vol 41 (6) ◽  
pp. 993-994 ◽  
Author(s):  
Guang-Tai Li ◽  
Xiao-Fan Li ◽  
Guangrui Li
Keyword(s):  
Post Partum ◽  
Post Partum Hemorrhage ◽  
Compression Suture

Surgical versus medical treatment for secondary post-partum hemorrhage

2009 ◽  
Vol 88 (8) ◽  
pp. 909-913 ◽  
Author(s):  
Tomer Feigenberg ◽  
Yael Eitan ◽  
Hen Y. Sela ◽  
Uriel Elchalal ◽  
Assaf Ben-Meir ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Post Partum ◽  
Post Partum Hemorrhage

Ring compression suture for controlling post-partum hemorrhage during cesarean section

2018 ◽  
Vol 44 (8) ◽  
pp. 1424-1430 ◽  
Author(s):  
Guang-Tai Li ◽  
Xiao-Fan Li ◽  
Yun-He Zhang ◽  
Yue Si ◽  
Guang-Rui Li ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Post Partum ◽  
Post Partum Hemorrhage ◽  
Ring Compression ◽  
Compression Suture

Gestational diabetes mellitus: are mothers being followed-up? A retrospective study

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697469
Author(s):  
Rebecca Ward ◽  
Fahmy W Hanna ◽  
Ann Shelley-Hitchen ◽  
Ellen Hodgson ◽  
Adrian Heald ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Median Time ◽  
Post Partum ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Tertiary Referral Centre ◽  
Alternative Approach ◽  
Nice Guidance ◽  
History Of

BackgroundWomen with gestational diabetes (GDM) have an elevated risk of developing type 2 diabetes (T2DM). NICE Guidance recommends women who develop GDM are screened 6 weeks post-partum and annually thereafter.AimTo evaluate conformity to guidance of screening in women with GDM by 6-week post-partum fasting plasma glucose (FPG) and annual FPG and determine time between delivery and development of T2DM.MethodRecords at a tertiary referral centre were used to identify women (n = 54) diagnosed with GDM by antenatal oral glucose tolerance test between July 1999 and January 2007. Data from laboratory records were used to collect investigations of glycaemic status during the follow-up period (median follow-up 12.4 years, range 9.5–17.1 years).ResultsOf 252 women, 102 (40.2%) did not have a FPG at 6 weeks (+/−2 weeks). Of these, median time to first test was 1.2 years (range 0.04–10.8 years), with only 43.1% followed-up within 1 year. In those who had a 6-week FPG, 17 (11.3%) women had no further tests. A total of 84 (33% of those with gestational diabetes in the index pregnancy) women were diagnosed with T2DM; median time from delivery to diagnosis was 5.2 years (range 0.35–15.95). We found the only significant factor for a follow-up test at 1-year post-partum was the use of insulin.ConclusionOur data suggest an alternative approach is needed for monitoring women with a history of GDM. This needs to be appropriate for a generally healthy group in which traditional screening mechanisms may not be adequate or sufficient.

scholarly journals Client satisfaction with existing postnatal care and associated factors: A study among mothers in Awi Zone, Amhara region, Ethiopia

2020 ◽  
Vol 16 ◽  
pp. 174550652097601
Author(s):  
Daniel Adane ◽  
Biresaw Wassihun
Keyword(s):  
Antenatal Care ◽  
Health Care Providers ◽  
Postnatal Care ◽  
Associated Factors ◽  
Client Satisfaction ◽  
Post Partum ◽  
Care Providers ◽  
Amhara Region ◽  
Awi Zone

Background: The majority of maternal and neonatal adverse events take place during the postnatal period. However, it is the most neglected period for the provision of quality care. Objective: The aim of this study among mothers in the Awi Zone, Amhara region, Ethiopia, was to assess client satisfaction with existing postnatal care and associated factors. Methods: An institution-based cross-sectional study was conducted in Awi Zone hospitals from 1 to 30 April 2018. A total of 422 post-partum mothers were selected by systematic sampling. The data were collected using a pre-tested structured questionnaire via a face-to-face interview. Data entry and analysis were completed using EpiData version 3.1 and SPSS version 22, respectively. The data were summarized with frequency and cross-tabulation. Both binary and multiple logistic regressions were used to identify predictor variables using odds ratios and 95% confidence intervals. Result: The prevalence of postnatal care satisfaction was 63%. Being from urban area (AOR = 2.1, 95% CI = (1.11–3.99)), having a history of antenatal care follow up (AOR = 1.62, 95% CI = (1.23–1.64)), spontaneous vaginal birth (AOR = 3.14, 95% CI = (1.77–3.28)), and those who did not face any complications during birth (AOR = 2.90, 95% CI = (1.47–1.69)) were some of the factors associated with client satisfaction. Conclusion: According to the results of this study, the majority of mothers were satisfied with post-partum care services. The study findings indicate that maternal satisfaction on post-partum care is mainly affected by residency, antenatal care follow up, mode of delivery, and complications during birth. Therefore, health care providers and other concerned bodies should give special attention to those mothers who are from rural areas, who face complications during birth or who have instrumental-assisted or cesarean section birth. Also, every pregnant mother should be supported to have at least four regular antenatal care visits.

scholarly journals SAT0267 ROLE OF AGGRESSIVE IMMUNOSUPPRESSION ON SUBGLOTTIC STENOSIS IN GRANULOMATOSIS WITH POLYANGIITIS: RETROSPECTIVE ANALYSIS OF A MONOCENTRIC COHORT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1076.1-1077
Author(s):  
L. Moroni ◽  
L. Giudice ◽  
G. A. Ramirez ◽  
S. Sartorelli ◽  
A. Cariddi ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Clinical Characteristics ◽  
Granulomatosis With Polyangiitis ◽  
Balloon Catheter ◽  
Subglottic Stenosis ◽  
Damage Accrual ◽  
The Mean ◽  
The One

Background:Subglottic stenosis (SGS) is defined as airway narrowing below the vocal cords and is a common and potentially life-threatening manifestation of Granulomatosis with Polyangiitis (GPA), with an estimated prevalence of 16-23% (1). Balloon catheter dilation is effective in GPA-related SGS, but relapses are frequent. Little is known about the role of immunosuppression in this setting.Objectives:to analyse the clinical characteristics of a monocentric GPA cohort, describe phenotype differences among patients with and without SGS and investigate the role of surgical and medical treatments on relapse risk and general outcome.Methods:Biopsy-proven patients with SGS were identified by review of medical charts among a cohort of patients with GPA, classified according to the algorithm of the European Medicine Agency (2). The clinical characteristics of patients with SGS were retrospectively collected over a median follow-up time of 15.9 years and compared to those of patients without SGS.Results:Fourteen patients with SGS-GPA were identified, with a female to male ratio of 1:1 and a prevalence of 29.2% among the cohort. The mean ± SD age at GPA onset was 30.8 ± 14.4 years, with a mean time from GPA diagnosis to SGS onset of 4.7 ± 4.2 years. ANCA were positive in 78.6% (54.0% anti-PR3, 18.1% anti-MPO and 27.9% IFI only). The mean Birmingham Vasculitis Activity Score (BVAS) at onset was 10.0 ± 5.6. The main clinical manifestations associated with SGS were crusty rhinitis (100%), sinusitis (78%), pulmonary disease (72.7%), otitis/mastoiditis (50%), glomerulonephritis (42.9%), orbital pseudotumor (28.6%). Six patients (42.9%) received medical treatment only, other six (42.9%) had one to three balloon dilations and two (14.2%) underwent four or more procedures. Eight patients had no SGS relapse (maximum one dilation) and they all received immunosuppression with rituximab (RTX), cyclophosphamide (CYC) or azathioprine (AZA). All patients who received no immunosuppression, methotrexate (MTX) or mycophenolate (MMF) had at least one relapse. Patients treated with MTX or MMF had a mean relapse-free survival of 13.1 months, which was comparable to the one of patients not receiving medical treatment (40.2 months; p=NS) and shorter than the one of patients receiving CYC or RTX (153.2 months; p=0.032). CYC use also inversely correlated with the number of surgical procedures (r=-0.691, p=0.006). Compared to patients without SGS (31 consecutive patients with at least 4 years of follow-up), patients with SGS-GPA had an earlier disease onset (mean age 30.8 vs 50.4 years; p<0.001), but with lower BVAS (mean 10.0 vs 15.3; p=0.013) and showed a higher prevalence of crusty rhinitis (100% vs 67.7%; p=0.019). No difference was observed in damage accrual over time between the two groups.Conclusion:Subglottic stenosis is highly prevalent in patients with GPA and may define a milder disease subset occurring more frequently in younger patients. MTX and MMF might be insufficient to prevent SGS relapses requiring balloon dilation. Aggressive immunosuppression (CYC or RTX) might have a non-redundant role in this setting and reduce the risk of relapses.References:[1]Quinn KA, et al. Subglottic stenosis and endobronchial disease in granulomatosis with polyangiitis. Rheumatology 2019; 58 (12), 2203-2211.[2]Watts R, et al. Development and validation of a consensus methodology for the classification of the ANCA associated vasculitides and polyarteritis nodosa for epidemiological studies. Ann Rheum Dis 2007; 66: 222-7.Disclosure of Interests:Luca Moroni: None declared, Laura Giudice: None declared, Giuseppe Alvise Ramirez: None declared, Silvia Sartorelli: None declared, adriana cariddi: None declared, Angelo Carretta: None declared, Enrica Bozzolo: None declared, Lorenzo Dagna Grant/research support from: The Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR) received unresctricted research/educational grants from Abbvie, Bristol-Myers Squibb, Celgene, Janssen, Merk Sharp & Dohme, Mundipharma Pharmaceuticals, Novartis, Pfizer, Roche, Sanofi-Genzyme, and SOBI., Consultant of: Prof Lorenzo Dagna received consultation honoraria from Abbvie, Amgen, Biogen, Bristol-Myers Squibb, Celltrion, Novartis, Pfizer, Roche, Sanofi-Genzyme, and SOBI.

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