Intrauterine Bakri balloon tamponade plus cervical cerclage for the prevention and treatment of postpartum haemorrhage in late pregnancy complicated with acute aortic dissection: Case series

In this study, a treatment method was assessed for the prevention and treatment of postpartum bleeding after combined surgery in patients having late pregnancy with the complication of acute Stanford type A aortic dissection. The clinical records of ten patients receiving treatment at the Second Xiangya Hospital of Central South University between March 2012 and March 2021 were retrospectively analysed. All patients were diagnosed with acute Stanford type A aortic dissection according to computed tomography angiography of the thoracic and abdominal aorta. Aortic valve function was assessed using two-dimensional echocardiography. All patients experienced uterine-incision delivery under systemic anaesthesia. During the operation, intrauterine Bakri balloon tamponade and cervical cerclage were performed. Postpartum bleeding was effectively controlled for all patients. The extracorporeal circulation time was 230–295 min, the postpartum 24 h bleeding volume was 500–870 mL, the volume of physiological saline injected into the balloon was 290–515 mL, and the intrauterine balloon compression time was 28–51 h. No postpartum bleeding occurred. A 42-days follow-up showed no late postpartum bleeding, poor uterine incision healing, or puerperal infection, and no uterine removal was performed. Intrauterine Bakri balloon tamponade plus cervical cerclage can effectively prevent intra- and postoperative postpartum bleeding in pregnant patients with aortic dissection.

Breast feeding as gift of nature: what it provides for mother and baby? (Lecture)

The priority of breast feeding is a well-known fact many times described in pediatric scientific literature. However we decided to summarize in a brief review all positive influences of breast feeding both for a baby and for mother and for society in general. For infant one should mention an optimal growth, protection from infections, reduced risk of adult diseases, better mental development. For mother it means better recovery after delivery, weight control, lower risk of postpartum bleeding. Economic profit for family budget is connected with the price of infant formulas which are unnecessary in breast feeding.

Assessment on the Effect of Active Management of Third Stage of Labour With and Without Uterine Massage on Maternal Outcome among Postnatal Mothers

The most common cause of maternal death worldwide is postpartum hemorrhage (PPH) and Active Management of Third Stage of Labour (AMTSL) is the most important prophylactic intervention for prevention of PPH. A study was undertaken to assess the effect of AMTSL with and without uterine massage on maternal outcome among postnatal mothers in a selected hospital, WB. In this quasi-experimental study, Total 60 (Experimental Group-30, Control Group-30) postnatal mothers who undergone spontaneous vaginal delivery were selected by non-probability purposive sampling technique followed by randomization. The uterine massage is applied for 1 min immediately after placental delivery to 2 hours of postpartum at every 15 mins interval. The results revealed that there was no statistically significant difference of mean amount of postpartum bleeding between experimental and control group at 1st hour, 2nd hour, 24 hours, and 48 hours [t1= 1.06, t2= 1.52, t3=0.47, t4=0.26 at df (58), p>0.05]. The general condition (BP, Pulse, Respiration) after 1st hour, 2nd hour, 24 hours and 48 hours were comparable and statistically not significant between the two groups. There was no significant association between amount of postpartum bleeding and obstetrical parameters like parity, gravida, POG, presence of episiotomy, birth weight, time of placental delivery, presence of tear and time of initiation of breast feeding etc. for both groups. Based on the results of the current study, it can be concluded that the mothers who received the uterine massage along with AMTSL get no additional benefit as compared to control group. Keywords: Active management of third stage of labour (AMTSL); Uterine massage; Maternal outcome; Postnatal mother.

Chipatala cha pa Foni, Malawi's 'Health Center by Phone,' improving information giv ving information given about pr en about pregnancy-r egnancy-related sympt elated symptoms

The Health Center by Phone, or "Chipatala cha pa Foni" (CCPF), was developed by Malawi’s Ministry of Health and VillageReach as a community-based hotline in the Balaka district of Malawi. CCPF was identified as an existing national health strategy with potential for providing Malawi’s women and their families important postpartum hemorrhage information. Because CCPF archives de-identified audio recordings of all calls, 28 telephone transcripts were qualitatively examined to assess whether women experiencing pregnancy-related complications such as postpartum bleeding call CCPF, and how hotline workers respond to them.

Hemostatic Effect and Safety of TXA: An Umbrella Review

Aim To evaluate the hemostatic effect and safety of tranexamic acid (TXA). Methods Meta-analyses were retrieved from databases. Risk ratios (RR), odds ratios (OR), weighted mean difference (WMD), standard mean difference (SMD) and 95% confidence intervals (CI) were extracted to compare the effeteness of TXA in reducing TBL, transfusion rate, Hb drop, mortality, DVT, PE. Results In total, 136 trials (396 comparisons) including 17 kinds of surgeries were retrieved. The evidence for TXA using in total knee arthroplasty (TKA), total hip arthroplasty (THA), postpartum bleeding, intertrochanteric fractures, orthopaedic surgery, spinal surgery, shoulder arthroplasty, hip fracture surgery, cardiac surgery, menstrual bleeding, plastic surgery, myomectomy, nasal surgery was assessed as possible for the association of reducing TBL. The evidence for TXA using in TKA, THA, postpartum bleeding, orthopaedic surgery, shoulder arthroplasty was assessed as probable for the association of reducing transfusion rate. The evidence for TXA using in liver surgery, spinal surgery, hip fracture surgery, cancer, cardiac surgery was considered to be possible for the association of reducing transfusion rate. The evidence for TXA using in intertrochanteric fractures, orthopaedic surgery, hip fracture surgery was assessed as probable for the association of reducing Hb drop. The evidence for TXA using in TKA, THA, postpartum bleeding, shoulder arthroplasty was considered to be possible for the association of reducing Hb drop. The evidence for TXA using in trauma, gastrointestinal bleeding was assessed as probable for the association of reducing mortality. Conclusion This umbrella review indicated that TXA were regarded as effective to reduce TBL, transfusion rate, Hb drop, mortality, and did not increase the incidence of DVT and PE. However, more convincing evidence should be provided to further clarify the level of efficacy and safety of TXA.