Relationships between the Gestation Time Post-abortion Placental Adherence and Postpartum Hemorrhage
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Objective Discussion of relationships between the gestation time post-abortion and placental adherence and postpartum hemorrhage.Method Analysis of data on the gestation time post-abortion,placental adherence and postpartum hemorrhage of 792 cases of parturients who delivered in hospital between 2007 and 2009 and had a history of induced abortion.Results Comparison between gestation within 3 months post-abortion and gestation within 3-6 months post-abortion,there is a significant deviation of incidence rate of placental adherence and postpartum hemorrhage,(P0.01).Comparison between gestation within 3-6 months post-abortion and gestation within 6-12 months post-abortion,there is a relative significant deviation of incidence rate of placental adherence and postpartum hemorrhage,(P0.05).Comparison between gestation within6-12 months post-abortion and gestation over 12 months post-abortion,there is no significant deviation of incidence rate of placental adherence and postpartum hemorrhage,(P 0.01).Conclusion the shorter the intervals between post-abortion and re-gestation,the higher the incidence rate of placental adherence and postpartum hemorrhage.Cite
Objective To explore the relationship between artificial abortion and postpartum hemorrhage.Methods A total of 3679 primiparas in our hospital from January,2010 to June,2012 were divided into 3 groups according to the number of abortions: Group A of women with one or no miscarriage﹙n﹦2601﹚;Group B of women with two miscarriages﹙n﹦602﹚and Group C of women with three or more miscarriages﹙n﹦476﹚.The incidence o of postpartum hemorrhage in the 3 groups and the cause of hemorrhage were analyzed.Results The incidence of postpartum hemorrhage in Group A,Group B and Group C were 3.88%,8.14% and 12.18% respectively(P0.05).The incidence of postpartum hemorrhage in puerperants with placental adherence and placental presentation in Group A,Group B and Group C were 5.88%,18.44% and 28.36% respectively(P0.05).The total incidence of postpartum herrhage in puerperants with placental adherence and placental presentation of the three groups was 71.18%,and placental adherence caused more cases of postpartum hemorrhage than placental presentation﹙χ2﹦19.97,P 0.05).Conclusion Placental adherence and placental presentation are the main causes of postpartum hemorrhage,and the incidence of postpartum hemorrhage increases with the frequency of artificial abortion.
Presentation (obstetrics)
Group B
postpartum bleeding
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Objective:To explore the effect of of progesterone treatment on early abortion and outcome of perinatal infants.Methods:A total of 361 cases of early spontaneous abortion were selected as the observation group,340 early pregnant women as the control group.Serum progesterone levels before and after treatment,pregnancy complications,mode of delivery,gestational age,birth weight,Apgar score were measured and compared.Results:After treatment,serum progesterone levels were significantly increased in teo groups(P0.05),and the difference between two groups was not significant(P0.05).There was no significant difference in incidence of preterm delivery,placenta previa,premature rupture of membrane,placental abruption,gestational hypertension,diabetes,live birth number,neonatal length,birth weight,1minApgar score≤7proportions,macrosomia,full-term low birth weight,fetal distress and neonatal malformation rate between two groups(P0.05).Conclusion:Progesterone treatment of early abortion is safe and effective,it can improve the perinatal outcome.
Placenta previa
Apgar score
Placental abruption
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Objective:To investigate the difference of maternal and perinatal outcome with expectant management and gestational age at delivery of pre-eclampsia.Methods:67 cases meeting pre-eclampsia who underwent expectant management were enrolled in this study. Patients were divided into 4 groups: group A (n=6) with onset before 32 weeks of gestation, group B (n=2) with onset during 32-33 weeks of gestation, group C (n=16) with onset during 34-36 weeks of gestation, group D (n=43) with onset ≥37 weeks of gestation. Main outcome measures included prolongation of gestation, perinatal mortality rate and major complication.Results: The average pregnancy prolongation was (46.2±18.2) days, (19.0±7.1) days, (12.2±9.0) days, (5.2±7.8) days, respectively in groups A, B ,C, D. The onset gestational age and the gestational age at delivery was closely associated with the perinatal outcome. Perinatal mortality onsetting before 32 weeks of gestation was significantly higher than that onsetting after 32 weeks of gestation. Major complication morbidity onsetting before 34 weeks of gestation was significantly higher than that onsetting before 34 weeks of gestation. Perinatal mortality before 32 weeks of gestational age at delivery was significantly higher than that after 32 weeks of gestational age at delivery.Conclusion:Perinatal mortality and major complication morbidity are significantly higher than that onsetting after 32 weeks of gestation. Expectant management should be carried out to 32 weeks of gestation even 34 weeks in well-selected patients and should be selected reasonable gestational age at delivery.
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AbstractBackground/Aims:To evaluate the effect of gestational weight gain on the amount of postpartum bleeding.Methods: An observational study reviewed medical records of with low-risk singleton pregnancies who delivered vaginally at 37 weeks of gestation or beyond between May 1 and November 1, 2018 at a tertiary referral center. Demographic and clinical characteristics were obtained from the medical records. The relationship between the increased rate in BMI during pregnancy and amount of blood loss in the postpartum first hour was evaluated. Results:A total of 411 women was included in the study. In the study population, the mean blood loss was 57.3±43.9 ml in the 3rd stage of labor and 113.2±76.9 ml in the postpartum first hour. No correlation was found between the increase in BMI during pregnancy and blood loss during the 3rd stage of labor (r=0.006) and postpartum first hour (r=0.037). Nulliparity, history of postpartum hemorrhage in previous pregnancy, premature rupture of membranes, and episiotomy were found to be risk factors for increased postpartum blood loss during the 1st hour (p< 0.05). Conclusions: Increase in BMI was not related with the amount of postpartum bleeding in women with low-risk pregnancy who had a vaginal delivery.
Episiotomy
Vaginal bleeding
Medical record
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The aim of this study was to elucidate the feasibility and safety of vaginal delivery (VD) when placental abruption causes fetal demise.We conducted a retrospective study of women who were managed for placental abruption with intrauterine fetal death at Kyoto University Hospital during the period from 1995 to 2015.Sixteen cases were identified during the study period. VD was attempted in 15 cases and was accomplished in 14 (93.3%) cases. The median gestational age was 36 (24-39) weeks, and there were eight primiparas. The median Bishop score on admission was 2.5 (1-9). Eight pregnancies were complicated with pregnancy-induced hypertension. The median duration of labor was 5 h and 18 min (30 min-12 h 43 min), and the median amount of hemorrhage was 2503 (445-6808) mL. Fresh frozen plasma (≥ 20 U) and red cell concentrate (≥ 10 U) were administered in 10 (71%) and 9 (64%) cases, respectively. Two cases required uterine artery embolization for post-partum hemorrhage, while there was no case of maternal death or hysterectomy. Patients with Bishop score > 3 (n = 6) experienced shorter-duration deliveries (P = 0.020) and had significantly larger blood loss volume (P = 0.020) compared to patients with Bishop score ≤ 3. The duration of labor was negatively correlated with the amount of blood loss (R2 = -0.56, P = 0.039).After placental abruption with intrauterine fetal death, VD is feasible and safe regardless of gestational age, parity, cervical maturity, and duration of labor when intensive medical resources are available.
Placental abruption
Vaginal bleeding
Uterine Artery Embolization
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Objective To explore the influence of delivery route on pregnancy outcome in twin pregnancy.Methods The date of 120 cases of twin pregnancy from 2008 to 2010 were retrospectively analyzed,among which 76 cases performed cesarean section and 44 underwent vaginal delivery.Results The rate of neonatal asphyxia and case fatality at 34 weeks of gestation were significantly higher than that of 34 weeks of gestation,with statistical meaning(P0.01);the rate of neonatal asphyxia and case fatality of second fetal were higher than that of first fetal,and had significantly difference with cesarean section cases(P0.01);the weeks of gestation and postpartum hemorrhage had no striking difference between the two groups.Conclusion Compared with vaginal delivery,cesarean section for twin pregnancy can decrease the rate of neonatal asphyxia and case fatality.
Case fatality rate
Twin Pregnancy
Elective cesarean section
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Moreover, the first trimester ultrasonography provides a valuable e valuation for predicting pregnancy outcomes. Our purpose was to determine whether ultrasonography of placental location at 11 - 14 weeks of gestation (first trimester) can predict neonatal and maternal pregnancy outcomes. The observational and prospective st udy from July 2011 to October 2012 was conducted on the 200 pregnant women with previous cesarean. Placental locations were determined by ultrasonog raphy at 11 - 14 weeks’ gestation, and then were classified into four groups including anterior high , anterior low , posterior high and posterior low. Parameters such as Preterm Labor, Preterm Premature Rupture of Membrane , neonatal Birth Weight , occurrence of bleeding throughout pregnancy were followed up. Our results showed that the anterior low group had highest rate of bleeding throughout pregnancy compared with groups of posterior low, anterior high and posterior high (40 %, 34 %, 4 %, 6 %, respectively, p < = 0.001); furthermore, there was significant correlation between rising the number of previous cesareans and increasing the incidence of the anterior low placental implantation (P value = 0.03). Anterior low group had lowest average of neonatal birth weight (p - value < 0.001), while anterior high group had highest average of neonatal birth weight compared wit h other groups. We believe that the ultrasound procedure was valid and enabled us to evaluate the pregnancies at first stages of pregnancy (11 - 14 weeks ) . Therefore, it can be used in evaluating the pregnancies to categorize them as being at risk for an adv erse ante partum, intra partum and neonatal outcomes.
Section (typography)
Second trimester
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To evaluate pregnancy outcome after spontaneous labor by day of gestation between 40(+0) and 41(+6) weeks of gestation.Evaluation of prospectively collected labor ward data.University Hospital, Denmark.Unselected consecutive cohort of 14 678 spontaneously starting deliveries between 280 and 293 days of gestation during the years 2000-2006.Data were registered in a computer program after each delivery by a midwife and the entries further evaluated by a specialist in obstetrics. Complication rates were compared using Fisher's exact test.Maternal complication rates for each gestation day, including cesarean delivery, maternal blood transfusion, episiotomy, operative vaginal delivery, third and fourth degree perineal lacerations and perinatal morbidity.The cesarean delivery rate increased from 6% on day 280 to 11% on day 293. Cesarean delivery increased from 40 to 41 weeks gestation (7.3 vs. 9.5%, p<0.005), as did maternal transfusion (0.5 vs. 1.2%, p<0.001) and cesarean section on the indication fetal distress (1.5 versus 2.4%, p<0.005), but perineal lacerations did not. Likewise, there was an increase in episiotomy rates (3.0 vs. 3.5%, p=0.08), operative vaginal delivery (5.8 vs. 6.5%, p=0.07) and admission to neonatal intensive care (1.4 versus 2.0%, p=0.009), but no increase in 5 minute Apgar scores <7 or low umbilical artery acid-base values.Deliveries starting spontaneously in an unselected cohort showed an increase in maternal complications, meconium-stained amniotic fluid and admission to the neonatal intensive care unit.
Apgar score
Episiotomy
Umbilical artery
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Objective:To investigate the proper time of termination of pregnancy and the method of delivery for patients with severe pre-eclampsia.Methods:Total 155 patients with severe pre-eclampsia from 28 to 41 weeks' gestation were admitted,maternal and natal pregnancy outcome were analyzed retrospectively.Results:All mothers were cured and were discharged home,101 cases were terminated by caesarean section(65.16%).No neonatal death happened in mature newborns,there were 14 cases neonatal death in preterm infants,the mortality increased significantly in those newborns less than 34 weeks' gestation and weight lower than 1 500 g.Pregnancy women with different weeks' gestation had no significant difference in the age,blood pressure and delivery type(P0.05),had significant difference in the 24-hour proteinuria(P0.05).There were very significant difference in newborn weight,neonatal asphyxia and neonatal morbility among newborns with different weeks' gestation(P0.01).There were no significant difference in asphyxia and morbility for newborns with different delivery type(P0.05).Conclusion:Pregnancy can be terminated actively in patients with severe pre-eclampsia who has more than 34 weeks' gestation and expected fetus weight more than 1 500 g,caesarean section may be the major method of termination of pregnancy.
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