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

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.

Analysis of Pregnancy Characteristics and Perinatal Outcome of Mediastinal Uterus in China

Background: To analyze the complications and outcome of mediastinal uterine pregnancy, and put forward targeted prevention and treatment measures. Methods: A total of 248 pregnant women with mediastinal uterus treated were enrolled from Jan 2015 to Dec 2018 in the Maternal and Child Health Hospital of Hubei Province, China. The data, including complications of pregnancy, gestational weeks, mode of delivery, postpartum hemorrhage, placental condition and perinatal prognosis, were collected and analyzed. Results: There were 12 cases with abnormal fetal position in the previous cesarean section. The total number of cases with abnormal fetal position was 99(49.75%). For women with abnormal fetal position during mediastinal uterine pregnancy, there was a significant increase in the incidence of placental abruption (P<0.05). The average gestational age at termination of pregnancy was 37+5weeks. There were 55 cases (22.18%) of premature and 49 cases (19.75%) of premature rupture of membranes, including 29 cases of abnormal fetal position and premature rupture of membranes, mediastinal uterus preterm birth, premature rupture of membranes (P<0.05). There were 13 cases (5.24%) of postpartum hemorrhage, natural birth without neonatal asphyxia, five cases (2.02%) of neonatal asphyxia, preterm birth, and 51 cases (20.56%) of placental adhesion. Of these, 37 cases were cesarean, 13 were spontaneous production, and 71 were fetal umbilical cord winding. Conclusion: The pregnancy induced spontaneous abortion, premature delivery, premature rupture of membranes and abnormal fetal position in mediastinal uterus are significantly higher than normal pregnancy. The complications during delivery are significantly higher than in normal pregnant women.

Effect of Prenatal Yoga on Changes in Fetal Position in Pregnancy

Based on a preliminary study, there were 18.31% who had a breech delivery, it would result in complications in the baby such as asphyxia, bleeding or soft tissue edema, damage to the medulla oblongata, damage to the cervical spine joints, and even death due to severe asphyxia. determine the effect of Prenatal Yoga on Changes in Fetal Position in Pregnant Women. This type of observational research uses a quasi-experimental design with pre-test and post-pest with control group design. The research was conducted in the city of Kediri. The sample in this study was 32, namely third trimester pregnant women with gestational age > 28 weeks who experienced breech, latitude, and obligate fetal positions which were divided into 2 groups of 16 intervention groups (Prenatal Yoga) and 16 people as controls (pregnancy exercise). The sampling technique used is simple random sampling. Bivariate analysis using Mann Whitney Test. The results obtained are Z = -2.626 and -value 0.009 <0.05 so that Ho is rejected and it can be concluded that there is an effect of Prenatal Yoga on Changes in Fetal Position in Pregnant Women in Kediri City. Yoga exercises to help change the position of the fetus are more focused on providing a wide space in the abdomen, flexing the muscles of the uterus and pelvis. Three movements were used in this study, namely cat cow, downward-facing dog and puffy pose. Suggestions for health workers that prenatal yoga can be a solution and can be applied to help change the position of the fetus from malpresentation to head position.

Analysis of Factors that Influence the Occuration of Early Rapture of Money in Particular Patients in Pragaan Public Health Center, Sumenep Regency

Pregnancy is a moment that is highly desired by husband and wife. This can make the family more harmonious because it has a child who is always coveted. But in reality, sometimes pregnancy is accompanied by several obstacles, such as premature rupture of membranes. The purpose of this study is to analyzethe effect of economic status, fetal position and family support on the incidence of premature rupture of membranes in inpartu patients at the Pragaan Health Center, Sumenep Regency. The design of this research is an observational quantitative research with a cross sectional approach with the focus of the research being directed at analyzingthe effect of economic status, fetal position and family support on the incidence of premature rupture of membranes in inpartu patients at the Pragaan Health Center, Sumenep Regency. The total population of 160 respondents and a sample of 100 respondents were taken by Accidental Sampling technique. The findings show that almost half of the respondents haveeconomic status middle class category as many as 42 respondents (42%).Almost half of the respondents experienced an anterior fetal position as many as 39 respondents (39%). Most of the respondents have family support in the less category as many as 62 respondents (62%). Most of the respondents experienced premature rupture of membranes as many as 56 respondents (56%). Based on the results of the Logistics Regression analysis shows that the p-value <0.05 then H1 is accepted so it is concluded that there is an effect of economic status, fetal position and family support for the incidence of premature rupture of membranes in inpartu patients at the Pragaan Health Center, Sumenep Regency. It is hoped that both pregnant women can manage the needs and things that must be done during pregnancy until delivery, starting from maintaining a lifestyle and even monitoring the development of the fetus in order to reduce the incidence of KTD.

Limb body wall complex complicating a dichorionic diamniotic twin pregnancy: MRI for demonstration of fetal morphology

Limb body wall complex (LBWC) is a rare, lethal malformation characterised by body wall defects, craniofacial and limb anomalies with or without various other organ anomalies. We report a case of dichorionic diamniotic twin pregnancy discordant for LBWC, diagnosed by ultrasound (US) and confirmed by MRI at 21 weeks’ gestation, managed expectantly and delivered at 35 weeks by emergency caesarean section with a favourable outcome of the unaffected twin. The anomalous twin, who died soon after birth, had a sizeable thoracoabdominal wall defect, eviscerated liver and bowel loops attached to the placenta, short cord, ectopia cordis, lung hypoplasia, kyphoscoliosis, right upper limb amelia and left clubfoot with polydactyly. MRI helps to demonstrate the fetal morphology better when there are limitations to the US due to unfavourable fetal position, multifetal gestation, maternal obesity or reduced liquor. In twin pregnancies, the management will depend on ensuring the survival of the unaffected twin.

Penguin Suit and Fetal Position Finite Element Model to Prevent Low Back Pain in Spaceflight

BACKGROUND: This study aimed to investigate the biomechanical effects of different interventions on astronauts lumbar intervertebral discs in a microgravity environment during spaceflight and in a gravity environment when the astronaut returns.METHODS: A finite element model of the L4L5 lumbar segment was developed with eight loading schemes representing different interventions. The loading schemes included no intervention, wearing a penguin suit, sleeping in a fetal position, wearing a penguin suit combined with sleeping in the fetal position, reclining for 4 or 16 h/d, and maintaining upright posture for 4 or 16 h/d.RESULTS: Without intervention, the microgravity environment led to increased central pore pressure, radial displacement, and water content in the lumbar intervertebral disc. Wearing a penguin suit combined with sleeping in the fetal position can reduce disc pore pressure, axial stress, radial displacement, and water content to 0.156 MPa, 11.50 kPa, 0.538 mm, and 1.390%, respectively. When astronauts return to the gravity environment, staying upright for 4 h can reduce the pore pressure, axial stress, radial displacement, and water content of the intervertebral disc to 0.222 MPa, 10.72 kPa, 0.373 mm, and 0.219%, respectively.CONCLUSION: This study showed that wearing a penguin suit and sleeping in the fetal position both have the potential to protect the lumbar intervertebral disc from the negative effects caused by microgravity. Remaining in the upright posture for 4 h per day may help squeeze out the water in the intervertebral disc safely when astronauts return to the gravity environment.Zhang S, Wang K, Zhu R, Jiang C, Niu W. Penguin suit and fetal position finite element model to prevent low back pain in spaceflight. Aerosp Med Hum Perform. 2021; 92(5):312318.