scholarly journals Total Placenta Previa with High-risk MAP and Transverse Lie Fetal Position

2021 ◽  
Vol 1 (2) ◽  
pp. 78-84
Author(s):  
Raden Theodorus Soepraptomo ◽  
Fitri Hapsari ◽  
Teddy Wijaya
Keyword(s):  
High Risk ◽  
Multidisciplinary Approach ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Risk Map ◽  
Secondary Complications ◽  
Repeat Surgery ◽  
Mortality And Morbidity ◽  
Fetal Position ◽  
Transverse Lie

Placenta accreta is one of the emergency conditions and has resulted in increased mortality and morbidity of pregnant women due to the massive obstetric hemorrhage. Placenta accreta can lead to secondary complications including coagulopathy, multisystem organ failure, acute respiratory distress syndrome, need for repeat surgery, and death. Assessment by anesthesia should be carried out as early as possible before surgery to reduce or even eliminate morbidity and mortality. In this report, we present the case of a patient with total placenta previa and high-risk MAP score with a transverse lie fetal position. The various anesthetic treatments and transfusion strategies are discussed with a multidisciplinary approach to delivery.

scholarly journals Total Placenta Previa with High-risk MAP and Transverse Lie Fetal Position

2020 ◽  
Vol 1 (2) ◽  
pp. 78-84
Author(s):  
Teddy Wijaya
Keyword(s):  
High Risk ◽  
Multidisciplinary Approach ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Risk Map ◽  
Secondary Complications ◽  
Repeat Surgery ◽  
Mortality And Morbidity ◽  
Fetal Position ◽  
Transverse Lie

Placenta accreta is one of the emergency conditions and has resulted in increased mortality and morbidity of pregnant women due to the massive obstetric hemorrhage. Placenta accreta can lead to secondary complications including coagulopathy, multisystem organ failure, acute respiratory distress syndrome, need for repeat surgery, and death. Assessment by anesthesia should be carried out as early as possible before surgery to reduce or even eliminate morbidity and mortality. In this report, we present the case of a patient with total placenta previa and high-risk MAP score with a transverse lie fetal position. The various anesthetic treatments and transfusion strategies are discussed with a multidisciplinary approach to delivery.

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 Study on fetomaternal outcome in antepartum haemorrhage

2020 ◽  
Vol 9 (11) ◽  
pp. 4554
Author(s):  
Naimish D. Nathwani ◽  
Rupa C. Vyas ◽  
Sapana R. Shah ◽  
Purvi M. Parikh
Keyword(s):  
Multidisciplinary Approach ◽  
Placental Abruption ◽  
Placenta Previa ◽  
Mode Of Delivery ◽  
Blood Products ◽  
Mortality And Morbidity ◽  
Antepartum Haemorrhage ◽  
Lower Segment Caesarean Section ◽  
Maternal Mortality And Morbidity ◽  
Care Facilities

Background: Any bleeding from or into the genital tract after the period of viability, but before the birth of the baby is termed as antepartum haemorrhage (APH).Methods: 110 cases of bleeding per vaginal (pv) after 28 weeks of gestation were studied retrospectively from August 2018 to June 2019 and were grouped as placenta previa, placental abruption and indeterminate.Results: 35.45% cases were of placenta previa, 53.63% cases were of placental abruption and 10.90% cases were of indeterminate. Majority were delivered by lower segment caesarean section (LSCS) and most of the cases required blood transfusion.Conclusions: APH cannot reliably be predicted .It is major cause of maternal and perinatal mortality and morbidity. Multidisciplinary approach and senior input is necessary in making decision about timing and mode of delivery. Presently increase in use of ultrasonography (USG) for placental localisation and to diagnose abruption, improved obstetrical and anesthetic facilities, increase in use in blood products to correct anemia and advanced neonatal care facilities, all of these have played important role in decreasing perinatal as well as maternal mortality and morbidity

scholarly journals Case Report: Anaesthetic Management of Placenta Percreta

2022 ◽  
Vol 9 (1) ◽  
pp. 39-44
Author(s):  
Subir Kumar Ghosh ◽  
Babita Ramdev ◽  
Noorjit Sidhu
Keyword(s):  
Case Report ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Bladder Wall ◽  
Hemodynamic Instability ◽  
Placenta Percreta ◽  
Elective Cesarean Section ◽  
Mortality And Morbidity ◽  
Risk Pregnancy ◽  
Perioperative Bleeding

Background: The placenta is a complicated organ and is partially understood. It is the essential part for physiological changes leading to a successful pregnancy. Placenta percreta is the most severe and least common form of placenta accreta in which villi penetrate the entire myometrial thickness and reach or traverse the serosa to encroach adjacent organs. Patients with placenta percreta are at a greater risk of life-threatening perioperative bleeding as well as massive and deadly thromboembolic events. Case report: Our patient was a 34-year-old gravida 5female who underwent elective cesarean section at 37 weeks of gestation with a diagnosis of placenta accreta or percreta. Intraoperative findings showed placenta percreta with bladder wall involvement. Hence, hysterectomy was done. Anticipated intraoperative haemorrhage and hemodynamic instability were managed properly. Discussion: Placenta percreta is the most serious among abnormal placentation, sometimes leading to catastrophic blood loss and very high maternal mortality and morbidity up to 10%. The most important risk factor in placenta percreta is placenta previa (low lying placenta) after cesarean delivery. Our patient met all these risk factors. Prenatal diagnosis of an invasive placenta is paramount for reducing maternal morbidity and mortality by implementing a multidisciplinary approach. Keywords: haemorrhage, placenta percreta, hysterectomy, high-risk pregnancy.

Successful Conservative Management of Recurrent Focal Placenta Accreta, A Case Study

2017 ◽  
Vol 9 (3) ◽  
Author(s):  
AlSaif Batool ◽  
Aljarrash Majeda
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Fetal Outcome ◽  
Elective Cesarean Section ◽  
Mortality And Morbidity ◽  
Uterine Anomalies ◽  
Elective Cesarean ◽  
Almost All

Placenta accreta refers to an abnormality of placental implantation in which the anchoring placental villi attach to myometrium rather than decidua, resulting in a morbidly adherent placenta . It is a life-threatening diagnosis increasing in number due to the growing number of caesarean sections. For most patients, the method of choice is elective cesarean section followed by hysterectomy. For women who wish to preserve fertility, a conservative procedure may be considered. Almost all reported cases have known major risk factors which are previous caesarean section , current placenta previa , previous uterine surgery and known uterine anomalies .We report here an extremely rare case of recurrent focal placental accreta in 35 years old Saudi female, G3P2+0. 39 weeks pregnant, previous 1 cesarean section, breech with current focal accreta discovered late at 38wk +.Our case doesn’t have known major or even controversial minor risk factors in her 1st accreta.Risk factors for the second accreta were previous focal accreta at fundus and previous 1. In addition this is a successful uterine conservation for the 2nd time with no complications apart from mild bleeding of 2 liters- (the average usual bleeding is 6100 ). known complications for placental accreta include:Severe vaginal bleeding: 53 %, Sepsis: 6%, Secondary hysterectomy: 19% , death: 0.3 % 1 .Cesarean-hysterectomy is the best management of placenta accreta because it has reduced mortality and morbidity as well as injuries to nearby organs and hospital stay. It is important to report this case in order to keep in mind screening for suspicious of placenta accreta during perinatal US even if the patient has no risk factors in order to have planned delivery which will improve the mother and fetal outcome including most importantly decreasing the mortality rate due to postpartum hemorrhage and will increase the likelihood of successful uterine conservation especially in low parity patient.

scholarly journals Relationship Between the Second Trimester Maternal Serum AFP of Aneuploidy in Pregnancies and Placenta Accreta: A Cohort Study

2021 ◽  
Author(s):  
Fengge Wang ◽  
Longchun Su ◽  
Ruixia Zhai ◽  
Miao Liu ◽  
Fangxiang Dong ◽  
...  
Keyword(s):  
High Risk ◽  
Cesarean Section ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Laboratory Data ◽  
Maternal Serum ◽  
Second Trimester ◽  
Previous Cesarean Section ◽  
Diagnostic Challenge ◽  
Previous Cesarean

Abstract Objectives At present, placenta previa-accreta is a growing concern and is still a diagnostic challenge for obstetricians. This study aimed to investigated whether second trimester serum Alpha-fetoprotein (AFP) differed among pregnancies with placenta previa-accreta and placenta previa controls and healthy pregnant controls. Methods A retrospective chart review was performed. In 1 January 2016–30 February 2021, a total of 504 pregnant women were identified and included in our analysis as follows: 105 cases of placenta previa-accreta, 122 cases of placenta previa controls, and 277 cases of BMI-matched, healthy pregnant controls. AFP multiples of the median (MoM) were acquired from laboratory data files. Results AFP MoM of placenta previa-accreta group was significantly higher than those of the placenta previa controls and healthy pregnant controls group (p < 0.001, p < 0.001). Serum AFP was significantly positively associated with placenta accreta after adjusted age, BMI, and gestational week at time of blood sampling (β: 0.60; 95% CI: 0.52–0.68; p < 0.001). In addition, previous cesarean section history (β: 3.41; 95% CI: 2.18–5.34; p < 0.001) was also significantly associated with placenta accreta. Conclusion Increased second trimester serum AFP was significantly positively associated with placenta accreta. Such finding suggests the potential role of AFP in identifying pregnancies that are at high risk for placenta accreta. Second trimester biomarker of AFP can be used to raise a suspicion toward characterizing women into high-risk and low-risk groups for placenta accreta. In addition, previous cesarean section history may be a risk factor for accreta in placenta previa patients.

Contraception and thrombophilia

2009 ◽  
Vol 29 (02) ◽  
pp. 193-196 ◽  
Author(s):  
H. Rott ◽  
A. Kruempel ◽  
G. Kappert ◽  
U. Nowak-Göttl ◽  
S. Halimeh
Keyword(s):  
Chronic Illness ◽  
High Risk ◽  
Children And Adolescents ◽  
Hormonal Contraception ◽  
Hormonal Contraceptives ◽  
Thromboembolic Events ◽  
Contraceptive Methods ◽  
Secondary Complications ◽  
Increased Risk ◽  
Coagulation Proteins

SummaryThe risk of thromboembolic events (TE) is increased by acquired or inherited thrombo -philias (IT). We know that some hormonal contraceptives also increase the risk of thrombosis, thus, the use of such contraceptives are discussed as contraindications in women with IT. TEs are infrequent events in children and adolescents and in the majority of cases are associated with secondary complications from underlying chronic illness. Although adolescents are not typically considered to be at high-risk for TE, this cohort is frequently using hormonal contraception, leading to an increased risk in cases with unknown IT. The risk of TE with pregnancy alone is higher than associated with combined hormonal contra -ception. Progestin-only methods have not been found to increase the risk of TE with only moderate changes of coagulation proteins compared to normal reference values. Conclusion: Thrombophilic women are good candidates for progestin-only contraceptive methods.

Trends and forecasts of the global availability of food

2020 ◽  
Vol 16 (7) ◽  
pp. 1297-1316
Author(s):  
O.N. Terent'eva
Keyword(s):  
High Risk ◽  
Growth Rates ◽  
Statistical Data ◽  
Economic Security ◽  
Agricultural Products ◽  
Mortality And Morbidity ◽  
National Economic ◽  
Production Growth ◽  
Country Analysis ◽  
Cross Country

Subject. The stable supply of food to people is a cornerstone for the national economic security, while a lack of food or its expensiveness may undermine the economy, principles of power, and cause panics and wars. Malnutrition and hunger are critical indicators of the insufficient foods supply. Objectives. The article indicates which countries have high risk of hunger, and predicts its further movement. I also evaluate factual trends in the availability of food across countries. Methods. The study refers to statistical data in public domain, including the FAOSTAT. I apply methods of ranking, abstraction, prediction. Results. I performed the cross-country analysis and discovered that 117 countries demonstrated signs of malnutrition. The article sets forth a technique for splitting countries into five groups by level of hunger risk. The article compares data on hunger in the countries and consequences of mortality and morbidity. I ranked countries by key types of agricultural products and explained their production growth rates for a span of 18 years. I predicted how countries would be ranked in terms of hunger from 2030 to 2050, and found the extent to which the hunger risk will escalate in more flourishing countries. Conclusions and Relevance. Hunger and shortage of food seem invincible in the countries where people are hungry or very hungry. Sometimes it appears almost impossible for respective governments to solve the issue. Triggering the systemic hunger, such factors and premises are beyond control of starving countries. Hence, the international community should provide their support and aid to them.

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