MATERNAL NEAR-MISS –A CASE REPORT ON SUCCESSFUL MANAGEMENT OF INTRACTABLE ATONIC POST PARTUM HEMORRHAGE

Gossypiboma refers to a retained sponge in the surgical bed. We present a 40- year-old female from Terai region of Nepal presented with long standing abdominal discomfort which on further radiological examination complex adnexal mass was suspected. She had a history of emergency laparotomy for post-partum hemorrhage more than a decade ago. She underwent surgery for suspicious complex adnexal mass. On exploring fiber formed partly degenerated content was revealed, which on histopathology reveal foamy macrophages, degenerated material and fiber strands and finally diagnosis of Gossypioma was made. Prevention of gossypiboma is much better than cure.

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Novel pathophysiological cause for post-partum hemorrhage: Case report of post-partum hemorrhage with occult abnormal artery diagnosed on pelvic angiography

Journal of Obstetrics and Gynaecology Research ◽

10.1111/jog.12743 ◽

2015 ◽

Vol 41 (9) ◽

pp. 1469-1472

Author(s):

Shigenori Iwagaki ◽

Tatsuhiko Miyazaki ◽

Tomoko Mizuno ◽

Hiroshi Kondo ◽

Ken-Ichirou Morishige

Keyword(s):

Case Report ◽

Post Partum ◽

Post Partum Hemorrhage

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Case report and literature review: Hyperpyrexia as side effect following the administration of sub-lingual misoprostol in the management of post-partum hemorrhage☆

Colombian Journal of Anesthesiology ◽

10.1097/01819236-201341010-00012 ◽

2013 ◽

Vol 41 (1) ◽

pp. 65-68

Author(s):

Fabio H. Martínez Pacheco ◽

Claudia Patricia Zambrano Benítez

Keyword(s):

Case Report ◽

Literature Review ◽

Side Effect ◽

Post Partum ◽

Post Partum Hemorrhage

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MATERNAL NEAR MISS ANALYSIS AT TERTIARY CARE REFERRAL HOSPITAL

10.36106/ijsr/3827312 ◽

2021 ◽

pp. 1-3

Author(s):

Chavan L G ◽

Bangal V B ◽

Mange K R

Keyword(s):

Severe Hypertension ◽

Kidney Diseases ◽

Post Partum ◽

Tertiary Care ◽

Severe Anaemia ◽

Near Miss ◽

World Health ◽

Maternal Near Miss ◽

Cross Sectional ◽

Systematic Analysis

Introduction-The World Health Organization defines a maternal near-miss case as "a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy. Material and Methods- Prospective cross-sectional observational study was carried out over a period of two years. Systematic analysis of all maternal near miss cases was done in relation to causes, contributory factors, and associated socio demographic factors. Results-There were 22,318 deliveries including 87 maternal near miss cases during study period. Severe anemia (28.74%), severe hypertension (22.99%), ante-partum hemorrhage, post partum hemorrhage (18.39%), post-operative sepsis (9.2%), renal failure and hepatic dysfunction were major causes associated with maternal near miss situation. Conclusion- Severe anaemia, obstetric haemorrhage, severe hypertension and its complications, respiratory infection, sepsis, Liver and kidney diseases are mainly responsible for maternal near miss situation.

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Characteristics and preventability of Obstetric ICU admissions in Far North Queensland

10.21203/rs.2.13943/v1 ◽

2019 ◽

Author(s):

Skandarupan Jayaratnam ◽

Sebastian Jacob-Rodgers ◽

Caroline deCosta

Keyword(s):

Maternal Morbidity ◽

Post Partum ◽

Clinical Status ◽

Developed Countries ◽

Near Miss ◽

Severe Maternal Morbidity ◽

Maternal Near Miss ◽

Near Misses ◽

Icu Admission ◽

Far North

Abstract Background The rarity of maternal deaths in developed countries has increased interest in reviewing cases of severe maternal morbidity or maternal ‘near miss’. Assessment and determining preventability among near misses is therefore important in improving the provision of maternity care. The aims of this study were to (i) describe the epidemiology of intensive care unit (ICU) admission in Far North Queensland (ii) determine the validity of the WHO near miss criteria in determining cases of severe maternal morbidity and (iii) determining preventability of severe maternal outcomes of pregnant and post-partum patients requiring admission to the ICU. Methods Retrospective observational study included all patients pregnant or within 42 days of termination of pregnancy admitted to the Cairns Hospital ICU between 1st January 2013 and 31 December 2017. Cases were reviewed by a team of Obstetricians using the modified Geller model of preventability to determine reasons for admission to ICU and to determine whether the ‘near miss’ was preventable or not.Results Sixty-nine out of 12081 (0.6%) women admitted for Obstetric care were transferred to the ICU with a total of 31 cases fulfilled WHO near miss criteria. The most common primary obstetric related diagnosis for ICU admission were hypertensive disease of pregnancy and obstetric haemorrhage. Indirect obstetric causes contributed to approximately 40% of ICU admissions. Among the 31 cases of WHO near miss, 10 cases were deemed preventable with the most common reason for preventability related to lack of recognition of high-risk clinical status. Conclusion Maternal ‘near miss’ and rates of Obstetric admission to the ICU at Cairns Hospital are reassuringly low. An audit of near miss cases describing preventability is feasible and informs areas for improvement in the management of ‘near miss’ cases.

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Case report and literature review: Hyperpyrexia as side effect following the administration of sub-lingual misoprostol in the management of post-partum hemorrhage

Colombian Journal of Anesthesiology ◽

10.1016/j.rcae.2012.08.005 ◽

2013 ◽

Vol 41 (1) ◽

pp. 65-68

Author(s):

Fabio H. Martínez Pacheco ◽

Claudia Patricia Zambrano Benítez

Keyword(s):

Case Report ◽

Literature Review ◽

Side Effect ◽

Post Partum ◽

Post Partum Hemorrhage

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Trans-Arterial Embolization On A Catastrophic Primary Postpartum Hemorrhage Due To Arterial Aneurysm With Arteriovenous Fistula At Bilateral Lower Vagina: A Case Report

10.21203/rs.3.rs-714094/v1 ◽

2021 ◽

Author(s):

Cheng-Hsien Wu ◽

Yon-Cheong Wong ◽

Patricia Wanping Wu ◽

Ho-Yen Chueh

Keyword(s):

Case Report ◽

Postpartum Hemorrhage ◽

Post Partum ◽

Arterial Embolization ◽

Arterial Aneurysm ◽

Post Partum Hemorrhage ◽

Arteriovenous Fistulas ◽

Arterial Aneurysms ◽

Primary Management

Abstract Background: Failure of the primary management at controlling the post-partum hemorrhage (PPH) is occasionally encountered. A catastrophic cause of PPH as vagina arterial aneurysms with AVF is rare and not reported in English literature.Case presentations: We present a 34-year-old woman of arterial aneurysms with arteriovenous fistulas (AVF) at bilateral lower vagina causing intractable PPH with aggressive bleeding. By trans-arterial embolization (TAE) the bleeding is successfully controlled, and patient then could recover smoothly.Conclusion: These vascular anomalies being fierce culprit of the PPH would result in primary management failure. Knowledge of the possible etiology of post-partum hemorrhage is crucial for treatment management. This case report aims to point out a pivotal role of TAE at detecting and treating this unusual cause of PPH.

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A study on maternal near miss cases in Government Medical College Shivpuri, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20193149 ◽

2019 ◽

Vol 8 (8) ◽

pp. 3047 ◽

Cited By ~ 1

Author(s):

Uma Jain

Keyword(s):

Post Partum ◽

Systemic Infection ◽

Clinical Intervention ◽

Near Miss ◽

Maternal Near Miss ◽

Hypertensive Disorder ◽

Important Indicator ◽

Common Cause ◽

Medical Disorders ◽

Hypertensive Disorder Of Pregnancy

Background: Obstetrics near miss is an important indicator that reflects the quality of obstetrics care in a health facility. It assesses and monitors the activities aimed for prevention of maternal mortality. The aim and objective of this study was to find out the incidence, the prevalence and causes of maternal near miss due to severe obstetric complications and to identify the gapes and contextualize corrective measures to be taken in our facility.Methods: This is a retrospective study done in department of Obstetrics and Gynecology in GMC associated with DHS Shivpuri MP. The study was done during a period from 1st January 2018 to 30 April 2019.Results: In this study the hospital maternal near miss incidence ratio was 14.34%. In our study we found the most common morbidity was (30.18%) hypertensive disorder of pregnancy. These 159 near miss diagnoses were comprised of (30.18 %) cases of Hypertensive disorder of pregnancy, (27.67%) cases of major obstetric hemorrhage, (6.91) Severe systemic infection or sepsis, (4.40%) Labour related disorders. In Medical disorders very Severe Anemia, (1.88%) was most common cause of near miss. The most common cause of death was post-partum hemorrhage 37.5% and most of the patients referred from periphery in very critical condition. The median time taken to get clinical intervention among cases was 20-40 minutes after admission.Conclusions: Hemorrhage and hypertension disorders are the leading causes of MNM. Prompt diagnosis and adequate management of near miss cases can reduce mortality rates.

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