scholarly journals Updated Protocol for Management of Placenta Previa

2018 ◽  
Vol 9 (1) ◽  
pp. 26-30
Author(s):  
Utpala Mazumder ◽  
Afroza Kutubi ◽  
Salma Rouf
Keyword(s):  
Imaging Modality ◽  
Pregnancy Termination ◽  
Placenta Previa ◽  
Maternal Blood ◽  
Postoperative Management ◽  
Uterine Contractions ◽  
Uterine Growth ◽  
Intrauterine Surgery ◽  
Hemorrhage Risk ◽  
Emergency Hysterectomy

Background: Antepartum hemorrhage complicates 2-5% of pregnancies, whichapproximately one-third are due to placenta previa. Placenta previa is acondition derived to an abnormal implantation of the embryos in thelower uterine segment. In placenta previa hemorrhage is more likely to occur during third trimester,as a consequence of the development of the lower uterine segment and of the dilation of the cervix due to the uterine contractions; alsovaginal examination may lead to an antepartum hemorrhage. Risk factors for the development of placenta previa include prior cesarean delivery, pregnancy termination, intrauterine surgery, smoking, multifetal gestation, increasing parity, maternal age and the rising rates of Cesarean section. Placenta previa is associated with adverse consequences for both mother and children, such as Intra-Uterine Growth Restriction (IUGR), preterm birth, antenatal and intra-partum hemorrhage, maternal blood transfusion and emergency hysterectomy. Placenta previa has been diagnosed increasingly in recent decades, due to mostly to the widespread use of ultrasound (US). Apart from ultrasound a valid imaging modality to study and investigate placenta in antepartum period seems to be magnetic resonance (MR).Careful monitoring of high risk pregnancies is of utmost importance. Avoidance of unnecessary caesarean sections and early week’s pregnancy terminations can minimize the placenta previa. In diagnosed cases, preoperative planning, preoperative decisions and good postoperative management can safe a mother and child.J Shaheed Suhrawardy Med Coll, June 2017, Vol.9(1); 26-30

Bed-rest exercise, activity restriction, and high-risk pregnancies: a feasibility study

2011 ◽  
Vol 36 (4) ◽  
pp. 577-582 ◽  
Author(s):  
Chantale R. Brun ◽  
J. Kevin Shoemaker ◽  
Alan Bocking ◽  
Jo-Anne Hammond ◽  
Monica Poole ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Risk ◽  
Feasibility Study ◽  
Exercise Intervention ◽  
Bed Rest ◽  
Maternal Blood ◽  
Exercise Session ◽  
Activity Restriction ◽  
Uterine Contractions ◽  
Risk Pregnancy

This feasibility study investigated the response of maternal heart rate, blood pressure, and uterine contractions to a 30-min bed-rest exercise session (while listening to music) in hospitalized women with varying diagnoses of high-risk pregnancy. Eleven antenatal women who were hospitalized for activity restriction were assigned randomly to either a bed-rest exercise and music group (n = 6) or a bed-rest and music group (n = 5) that involved no exercise. The key findings were that there were no changes in maternal blood pressure or in the number of uterine contractions following the exercise intervention. A supervised bed-rest exercise intervention may, therefore, provide minimal risks and help alleviate the physiological effects of hospital activity restriction.

scholarly journals OXYTOCIN DOSE ANALYSIS OF BREASTMILK PRODUCTION THROUGH INDUCTION LABOR

2019 ◽  
Vol 2 (01) ◽  
pp. 01-03
Author(s):  
Sara Nurmala ◽  
Cantika Zaddana
Keyword(s):  
Breast Milk ◽  
Pregnant Women ◽  
Placenta Previa ◽  
The Body ◽  
Cephalopelvic Disproportion ◽  
Uterine Contractions ◽  
Uterine Muscle ◽  
Natural Hormone ◽  
History Of ◽  
Narrow Pelvis

Breast milk is the only first food that can be consumed by newborns until the age reaches six months. therefore it is very important to know by the mother who is pregnant and will give birth about the importance of breast milk. Oxytocin drugs have similar functions to the natural hormone oxytocin produced by the body. This drug serves to trigger or strengthen the contraction of the uterine muscle. Therefore, oxytocin can be used to stimulate (induce) labor and stop bleeding after childbirth. In addition, this drug can also help stimulate the release of breast milk in breastfeeding mothers. Oxytocin should be avoided by pregnant women who can not give birth normally, for example because it has a narrow pelvis, suffering from placenta previa, or having a too strong uterine contractions. Oxytocin is also prohibited for pregnant women with cephalopelvic disproportion, impaired fetal conditions, uterine damage, or a history of caesarean section. In this study we see whether there is effect of different doses of oxytocin on the quantity of breastmilk produced. oxytocin doses were administered with 3 doses of 5 UI, 10 UI and 15 UI. the dose of oxytocin is administered once per incidence of labor. maternal results obtained by oxytocin induction of 5 UI and 10 UI obtained breastmilk averaging 10 ml in the first 24 hours after delivery. and a mother with oxytocin induction 15 UI received an average breastmilk of 10 ml at 24 hours after delivery.

The Use of Mersilene Tape in Transabdominal Cerclage

2017 ◽  
Vol 752 ◽  
pp. 64-70
Author(s):  
Claudia Mehedințu ◽  
Ana Maria Rotaru ◽  
Marina Antonovici ◽  
Mihaela Plotogea ◽  
Elvira Brătilă ◽  
...  
Keyword(s):  
Biomechanical Properties ◽  
Uterine Wall ◽  
Medical Procedures ◽  
Genital Tract Infection ◽  
Uterine Contractions ◽  
Cervical Incompetence ◽  
Intrauterine Pressure ◽  
Uterine Growth ◽  
Mersilene Tape ◽  
Lower Genital Tract Infection

Aim: The purpose of this article is to show the use and utility of mersilene tape in medical procedures, such as transabdominal cerclage (TAC). Material and methods: Based on their biomechanical properties, we present our experience with mersilene tape used as treatment for cervical incompetence. Cervical insufficiency or cervical incompetence is defined as asymptomatic cervical shortening and dilatation with the absence of detectable uterine contractions. The mechanical properties of cervical tissue are derived from its extracellular matrix and its most important constituent the fibrillar collagen, alongside other constituents such as proteoglycans, hyaluronic acid, elastin, and water. In the absence of the uterine contractions, the cervix is loaded by intrauterine pressure (including the weight of the growing fetus and amniotic sac), the gravity as well as passive pressure from the uterine wall. These forces also depend on the support action of pelvic floor structures and abdominal wall. The static load resulting from the combination of uterine growth, hydrostatic pressure and gravity seems to be the dominant determinants that cause cervical shortening. The placement of the mersilene tape acts as a barrier between the intrauterine pressure and the cervix. The main advantage of the TAC procedure is the placement of the nonabsorbable suture (mersilene tape at the level of the internal os, avoiding the placement of a vaginal foreign body and subsequently increasing the risk of ascending lower genital tract infection, decreased incidence of slippage, and the ability to leave the stitch in place between pregnancies. Results: The follow-up was without complications regarding the pregnancies treated with transabdominal cerclage. None of the pregnancies terminated prematurely as related to the presence of the tape, but it necessitates to be performed a caesarean section for delivery. Conclusions: Mersilene tape is safe and useful in different medical procedures, including transabdominal cerclage during pregnancy.

scholarly journals EMERGENCY OBSTETRIC HYSTERECTOMY

2015 ◽  
Vol 22 (01) ◽  
pp. 100-105
Author(s):  
Sarwat Ara ◽  
Umbreen Umbreen ◽  
Fouzia Fouzia
Keyword(s):  
Placenta Previa ◽  
Post Partum ◽  
Mortality And Morbidity ◽  
Tertiary Center ◽  
Maternal Morbidity And Mortality ◽  
Life Threatening ◽  
Emergency Hysterectomy ◽  
Associated Risk Factors ◽  
Hospital Study ◽  
Ruptured Uterus

Background: Emergency hysterectomy in obstetric practice is generallyperformed in the setting of life-threatening hemorrhage which fails to be controlled byconservative management. Objective: To review 8 years’ experience of emergency obstetrichysterectomy in a teaching hospital. Study Design: A retrospective descriptive study based onhospital data of 156 patients undergoing emergency Obstetric hysterectomy. Settings: Obs. &Gynae. Department Unit-I, PMC Allied Hospital Faisalabad. Methods: This was a retrospectivereview carried out from March 2004 to Feb 2012 Main outcome measures were frequency,indications, associated risk factors and maternal morbidity and mortality associated withemergency peripartum/obstetric hysterectomy. Results: During 8 years there were total 156(0.38%, 3.8 per 1000) emergency obstetric hysterectomies out of which there were 46 caesarianhysterectomies, 65 post partum, 45 for ruptured uterus with total number of delivery 40062.Number of hysterectomies was 48 in the first 4 years of the study (March 2004- Feb 2008) andduring the last 4 years (March 2008- Feb 2012) it was 108. Maximum obstetric hysterectomieswere in para 3-5 (53.20%) and in 26-30 years age group (35.89%). The most common indicationfor hysterectomy was uterine atony (44.23%) followed by uterine rupture (28.85%), Placentaaccreta (14.745%) and placenta previa (11.53%). The maternal mortality was 6.41% (10patients). In this series 80% patients were referred from other areas. Conclusions: Frequencyof emergency Obstetric hysterectomy is high in our tertiary center and it is continuouslyincreasing due to increased referral of patients. The mortality and morbidity of performingobstetric hysterectomy is higher in patients referred from outside hospital.

FREQUENCY OF EMERGENCY OBSTETRICAL HYSTERECTOMY, ITS INDICATIONS AND MATERNAL OUTCOME IN SAIDU TEACHING HOSPITAL, SWAT.

1969 ◽  
Vol 2 (2) ◽  
pp. 192-195
Author(s):  
Sania Tanweer Khattak ◽  
Tabassum Naheed Kausar ◽  
Imran ud Din Khattak ◽  
Muhammad Khan ◽  
Mukamal Shah
Keyword(s):  
Placenta Previa ◽  
Massive Hemorrhage ◽  
Maternal Outcome ◽  
Uterine Atony ◽  
Maternal Complications ◽  
Gynecology And Obstetrics ◽  
Life Saving ◽  
Emergency Hysterectomy ◽  
Operative Notes ◽  
Ruptured Uterus

Background: Emergency obstetrical hysterectomy (EOH) is one of the most common major surgicalprocedures performed in gynecology and obstetrics. It is a life saving procedure in case of severehemorrhage. Aims and objectives. The objective of this study was to determine the frequency, indications and maternaloutcome of emergency obstetrical hysterectomy. Study Design: Descriptive study. Place and duration of study: Study was carried out in the department of Obstetrics and Gynecology, SaiduTeaching Hospital, Swat from January 2007 to December 2011. Patients and Methods: During the study period a total of 29570 patients were delivered. Out of those 254patients underwent emergency hysterectomy. Records of all the patients were analyzed. The parametersanalyzed were age, parity, socioeconomic status, booking status, indication for operation, operative notes,maternal outcome complications and post-operative status. Results: Total numbers of deliveries during the study period were 29570 and 254 emergency obstetricalhysterectomies were performed. Frequency being 0.86%, only 12% of pregnant women were booked.Commonest indications of EOH were ruptured uterus in 90 women (35.43%), uterine atony in 82 women(32.28%), placental abruption in 31 women (12.22%), couveliar uterus in 13 women (5.12%) and placentaprevia in 9 women (3.54%).Commonest maternal complications were urinary tract infection in 16(6.30%)patients followed by disseminated intravascular coagulation (DIC) in 11 (4.33%) patients and 28(11.02%)patients died. Regarding parity 140(55.12%) were multiparous, 103(40.55%) patients were grandmultiparous and 11(4.33%) patients were primiparous. Conclusion: EOH, although a frequent life saving operation, was associated with significant maternalmortality, mostly due to the effects of massive hemorrhage. The most frequent indication for EOH wasruptured uterus followed by uterine atony and placenta previa. Key words: EOH, Rupture uterus, maternal outcome, postpartum hemorrhage.

scholarly journals Effect of 30 % nutrient restriction in the first half of gestation on maternal and fetal baboon serum amino acid concentrations

2012 ◽  
Vol 109 (8) ◽  
pp. 1382-1388 ◽  
Author(s):  
Thomas J. McDonald ◽  
Guoyao Wu ◽  
Mark J. Nijland ◽  
Susan L. Jenkins ◽  
Peter W. Nathanielsz ◽  
...  
Keyword(s):  
Amino Acids ◽  
Amino Acid ◽  
Maternal Blood ◽  
Nutrient Restriction ◽  
Adult Disease ◽  
Amino Acid Availability ◽  
Lower Body Weight ◽  
Uterine Growth ◽  
The Impact ◽  
Amino Acid Concentrations

Mechanisms linking maternal nutrient restriction (MNR) to intra-uterine growth restriction (IUGR) and programming of adult disease remain to be established. The impact of controlled MNR on maternal and fetal amino acid metabolism has not been studied in non-human primates. We hypothesised that MNR in pregnant baboons decreases fetal amino acid availability by mid-gestation. We determined maternal and fetal circulating amino acid concentrations at 90 d gestation (90dG, term 184dG) in control baboons fed ad libitum (C, n 8) or 70 % of C (MNR, n 6). Before pregnancy, C and MNR body weights and circulating amino acids were similar. At 90dG, MNR mothers had lower body weight than C mothers (P< 0·05). Fetal and placental weights were similar between the groups. MNR reduced maternal blood urea N (BUN), fetal BUN and fetal BUN:creatinine. Except for histidine and lysine in the C and MNR groups and glutamine in the MNR group, circulating concentrations of all amino acids were lower at 90dG compared with pre-pregnancy. Maternal circulating amino acids at 90dG were similar in the MNR and C groups. In contrast, MNR fetal β-alanine, glycine and taurine all increased. In conclusion, maternal circulating amino acids were maintained at normal levels and fetal amino acid availability was not impaired in response to 30 % global MNR in pregnant baboons. However, MNR weight gain was reduced, suggesting adaptation in maternal–fetal resource allocation in an attempt to maintain normal fetal growth. We speculate that these adaptive mechanisms may fail later in gestation when fetal nutrient demands increase rapidly, resulting in IUGR.

Sign in / Sign up

Export Citation Format

Share Document