Database : MEDLINE
Search on : Uterine and Hemorrhage [Words]
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[PMID]: 29515748
[Au] Autor:Aka KE; Apollinaire Horo G; Fomba M; Kouyate S; Koffi AK; Konan S; Fanny M; Effi B; Kone M
[Ad] Address:Department of Obstetrics and Gynecology, University Hospital of Yopougon, Abidjan, Ivory Coast.
[Ti] Title:A rare case of important and recurrent abnormal uterine bleeding in a post partum woman caused by cavernous hemangioma: a case report and review of literature.
[So] Source:Pan Afr Med J;28:130, 2017.
[Is] ISSN:1937-8688
[Cp] Country of publication:Uganda
[La] Language:eng
[Ab] Abstract:The cavernous hemangioma is a rare benign vascular tumor. About 50 cases of this disease were found in the literature over the last century and only 9 cases of cavernous hemangioma on the pregnant uterus were published it comes into cavernous or capillary form. The symptomatology is not unequivocal and when it occurs during pregnancy or postpartum, it causes life-threatening cataclysmic hemorrhage. Antenatal diagnosis is difficult and requires a multidisciplinary approach with pathologists, radiologists and gynecologists to avoid these complications or unnecessary hysterectomies. The diagnosis is histological. Hysterectomy is possible after failure of conservative treatment means. We report a rare case, a novel mixed cavernous hemangioma of the body associated with a capillary hemangioma of the cervix in a patient of 28 years 5th visors with recurrent genital bleeding in the postpartum period leading to a hysterectomy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Process
[do] DOI:10.11604/pamj.2017.28.130.10084

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[PMID]: 29516584
[Au] Autor:Nakamura E; Samejima K; Takayanagi N; Ono Y; Matsunaga S; Nagai T; Takai Y; Saitoh M; Baba K; Seki H
[Ad] Address:Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
[Ti] Title:Retrospective study of umbilical cord ulceration related to congenital intestinal atresia: A single-center report.
[So] Source:J Obstet Gynaecol Res;, 2018 Mar 08.
[Is] ISSN:1447-0756
[Cp] Country of publication:Australia
[La] Language:eng
[Ab] Abstract:AIM: Umbilical cord ulceration (UCU) is a disease in which an ulcer forms in the umbilical cord in the pregnant uterus and is accompanied by hemorrhaging from the same site. UCU occurs in fetuses with congenital upper-intestinal atresia (CUIA); however, its onset mechanism remains unclear. Here, we report our investigation of cases of UCU in our hospital. METHODS: Among the 9825 deliveries performed between 2007 and 2016 at this hospital, 20 fetuses were diagnosed with CUIA, 4 (20%) of which had UCU. There was no difference in the backgrounds of the fetuses with UCU (UCU group: 4 fetuses) and those without (non-UCU group: 16 fetuses). RESULTS: There was no intergroup difference in gestational age at delivery. Four cases in the UCU group had maternal age 35 weeks (26-39), weeks of delivery 35 weeks (35-36) and weight 2178.5 g (1600-2640); three out of four fetuses were female; and the location of gastrointestinal obstruction was in the duodenum in one case and in the jejunum in three cases. Death occurred in three of four fetuses in the UCU group versus none in the non-UCU group. CONCLUSION: We performed a retrospective statistical investigation on the risk of UCU onset in cases from this hospital; however, we could not identify any prognostic factors for its onset. We investigated a total of 27 past reported UCU cases and the 4 cases in this study. Mean gestational age at onset was 33.3 ± 2.7 for all 27 cases. Various methods for the early discovery of UCU have been reported in the past; however, there is currently no gold standard. Based on this report and a review of past papers, for CUIA, it is desirable to perform in-hospital management from gestational week 30 onward and decide proper delivery timing on a case-by-case basis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1111/jog.13611

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Clinical Trials Registry
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[PMID]: 29490690
[Au] Autor:Ducloy-Bouthors AS; Jeanpierre E; Saidi I; Baptiste AS; Simon E; Lannoy D; Duhamel A; Allorge D; Susen S; Hennart B
[Ad] Address:Pole anesthésie réanimation, maternité Jeanne de Flandre, centre hospitalier regional et universitaire, 2 avenue Oscar Lambret, 59037, Lille, France. anne-sophie.bouthors@chru-lille.fr.
[Ti] Title:TRAnexamic acid in hemorrhagic CESarean section (TRACES) randomized placebo controlled dose-ranging pharmacobiological ancillary trial: study protocol for a randomized controlled trial.
[So] Source:Trials;19(1):149, 2018 Mar 01.
[Is] ISSN:1745-6215
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Evidence increases that a high or a standard dose of tranexamic acid (TA) reduces postpartum bleeding. The TRACES pharmacobiological substudy aims to establish a therapeutic strategy in hemorrhagic (H) Cesarean section (CS) with respect to the intensity of fibrinolysis by using innovative assays. METHOD/DESIGN: The TRACES trial is a multicenter, randomized, double-blind, placebo-controlled, TA dose-ranging study that measures simultaneously plasmatic and uterine and urine TA concentrations and the plasmin peak inhibition tested by a simultaneous thrombin plasmin generation assay described by Van Geffen (novel hemostasis assay [NHA]). Patients undergoing H CS (>800 mL) will receive blindly TA 0.5 g or 1 g or placebo. A non-hemorrhagic (NH) group will be recruited to establish plasmin generation profile. Venous blood will be sampled before, at the end, and then at 30, 60, 120, and 360 min after injection. Uterine bleeding will be sampled after injection. Urine will be sampled 2 h and 6 h after injection. The number of patients entered into the study will be 114 H + 48 NH out of the 390 patients of the TRACES clinical trial. DISCUSSION: To explore the two innovative assays, a preliminary pilot study was conducted. Blood samples were performed repeatedly in patients undergoing either a H (>800 mL) or NH (<800 mL) CS and in non-pregnant women (NP). H patients received TA (0-2 g). Dose-dependent TA plasmatic concentrations were determined by LC-MS/MS quantification. Plasmin generation and its inhibition were tested in vitro and in vivo using the simultaneous thrombin-plasmin generation assay (STPGA). The pilot study included 15 patients in the H group, ten patients in the NH group, and seven patients in the NP group. TA plasmatic concentration showed a dose-dependent variation. STPGA inter-assay variation coefficients were < 20% for all plasmin parameters. Inter-individual dispersion of plasmin generation capacity was higher in H and NH groups than in NP group. Profile evolution over time was different between groups. This preliminary technical validation study allows TRACES pharmacobiological trial to be conducted. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02797119. Registered on 13 June 2016.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[Cl] Clinical Trial:ClinicalTrial
[St] Status:In-Data-Review
[do] DOI:10.1186/s13063-017-2421-6

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Braga, Angélica de Fátima de Assunçäo
Braga, Franklin Sarmento da Silva
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[PMID]: 29506860
[Au] Autor:Teixeira CEFA; Braga AFA; Braga FSDS; Carvalho VH; Costa RMD; Brighenti GIT
[Ad] Address:Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Anestesiologia, Campinas, SP, Brasil.
[Ti] Title:Anestesia para parto cesáreo em paciente portadora de síndrome de Klippel­Trenaunay. [Anesthesia for cesarean delivery in a patient with Klippel-Trenaunay syndrome].
[So] Source:Rev Bras Anestesiol;, 2018 Mar 02.
[Is] ISSN:1806-907X
[Cp] Country of publication:Brazil
[La] Language:por
[Ab] Abstract:INTRODUCTION: Klippel-Trenaunay syndrome is a rare congenital vascular disease characterized by cutaneous hemangiomas, varicosities, and limb asymmetry, which may evolve with coagulation disorders and hemorrhage as more frequent complications in pregnant patients. Pregnancy is not advised in women with this syndrome due to increased obstetric risk. CASE REPORT: Female patient, 29 years old, 99kg, 167cm, BMI 35.4kg.m , physical status ASA III, with 27 weeks of gestational age and diagnosis of Klippel-Trenaunay syndrome. She was admitted to attempt inhibition of preterm labor. As manifestations of Klippel-Trenaunay syndrome, the patient presented with cerebral and cutaneous hemangioma, mainly in the trunk and lumbar region, paresis in the left upper and lower limbs, and limb asymmetry, requiring the use of a walking stick. Physical examination revealed absence of airway vascular malformations and Mallampati class 3. Laboratory tests were normal and abdominal angiotomography showed irregular uterus, with multiple varices and vessels of arterial origin and bilateral periadnexal varices. She evolved with failure in preterm labor inhibition, and cesarean section under total intravenous anesthesia was indicated. Monitoring, central and peripheral venous access, radial artery catheterization, and diuresis were performed. Cesarean section was performed with median incision and longitudinal uterine body section for fetal extraction. Two episodes of arterial hypotension were seen intraoperatively. The postoperative evolution was uneventful. The choice of anesthesia was dependent on the clinical manifestations and the lack of imaging tests proving the absence of neuraxial hemangiomas.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher

  5 / 13957 MEDLINE  
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[PMID]: 29451883
[Au] Autor:Melese T; Habte D; Tsima BM; Mogobe KD; Nassali MN
[Ad] Address:Department of Obstetrics and Gynecology, University of Botswana, Gaborone, Botswana.
[Ti] Title:Management of post abortion complications in Botswana -The need for a standardized approach.
[So] Source:PLoS One;13(2):e0192438, 2018.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Post abortion complications are the third leading cause of maternal death after hemorrhage and hypertension in Botswana where abortion is not legalized. This study aimed at assessing the management of post abortion complications in Botswana. METHODS: A retrospective study was conducted at four hospitals in Botswana in 2014. Socio-demographic, patient management and outcomes data were extracted from patients' medical records. Descriptive statistics and chi-square test were used to analyze and present the data. RESULT: A total of 619 patients' medical records were reviewed. The duration of hospital stay prior to uterine evacuation ranged from less than an hour to 480 hours. All the patients received either prophylactic or therapeutic antibiotics. Use of parenteral antibiotics was significantly associated with severity of abortion, second trimester abortion, use of blood products and the interval between management's decision and uterine evacuation. Uterine evacuation for retained products of conception was achieved by metallic curettage among 516 (83.4%) patients and by vacuum aspiration in 18 (2.9%). At all the study sites, Misoprostol or Oxytocin were used concurrently with surgical evacuation of the uterus. None use of analgesics or anesthetics in the four hospitals ranged between 12.4% to 28.8%. CONCLUSION: There is evidence of delayed patient care and prolonged hospital stay. Metallic curette was the primary method used for uterine evacuation across all the facilities. Pain management and antibiotics use was not standardized. A protocol has to be developed with the aim of standardizing post abortion care.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180304
[Lr] Last revision date:180304
[St] Status:In-Data-Review
[do] DOI:10.1371/journal.pone.0192438

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[PMID]: 29499526
[Au] Autor:Saccone G; Caissutti C; Ciardulli A; Berghella V
[Ad] Address:Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
[Ti] Title:Uterine massage for preventing postpartum hemorrhage at cesarean delivery: Which evidence?
[So] Source:Eur J Obstet Gynecol Reprod Biol;223:64-67, 2018 Feb 23.
[Is] ISSN:1872-7654
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:BACKGROUND: Cesarean delivery could be complicated by postpartum hemorrhage (PPH), the first cause of maternal death. OBJECTIVES: To evaluate the efficacy of uterine massage in preventing postpartum hemorrhage at cesarean delivery. DATA SOURCES: Electronic databases from their inception until October 2017. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS: We included all RCTs comparing uterine massage alone or as part of the active management of labor before or after delivery of the placenta, or both, with non-massage in the setting of cesarean delivery. DATA COLLECTION AND ANALYSIS: The primary outcome was PPH, defined as blood loss >1000 mL. Meta-analysis was performed using the random effects model of DerSimonian and Laird, to produce summary treatment effects in terms of mean difference (MD) or relative risk (RR) with 95% confidence interval (CI). RESULTS: Only 3 RCTs comparing uterine massage vs no uterine massage were found. The quality of these 3 trials in general was very low with high or unclear risk of bias. All of them included only women in the setting of spontaneous vaginal delivery and none of them included cesarean delivery, and therefore the meta-analysis was not feasible. CONCLUSIONS: There is not enough evidence to determine if uterine massage prevents postpartum hemorrhage at cesarean delivery.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[St] Status:Publisher

  7 / 13957 MEDLINE  
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[PMID]: 29409879
[Au] Autor:Yamashita M; Kumasawa K; Nakamura H; Kimura T
[Ad] Address:Department of Obstetrics and Gynecology, Graduate School of Medicine, Osaka University, Osaka, Japan. Electronic address: uri_ton@hotmail.com.
[Ti] Title:Soluble FLT-1 rules placental destiny.
[So] Source:Biochem Biophys Res Commun;496(4):1243-1249, 2018 02 19.
[Is] ISSN:1090-2104
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Placenta previa is an abnormality in which the placenta covers the internal uterine os, and it can cause serious morbidity and mortality in both mother and fetus due to catastrophic hemorrhage. Some pregnant women recover from placenta previa due to a phenomenon called "migration." However, the mechanism of "migration" of the placenta has not been elucidated. METHODS: Human placentas were collected from patients with placenta previa and those with no abnormal placentation (control). A microarray analysis was performed to detect the genes up- or down-regulated only in the caudal part in the previa group. Specific mRNA expression was evaluated using real-time quantitative reverse transcription PCR (qRT-PCR). Unilateral uterine artery ablation of 8.5 dpc mice was performed to reproduce the reduction of placental blood supply, and weights of the placentas and fetuses were evaluated in 18.5 dpc. Specific mRNA expression was also evaluated in mice placentas. RESULTS: According to the result of the microarray analysis, we focused on soluble fms-like tyrosine kinase-1 (sFLT-1) and hypoxia-inducible factor-1 (HIF-1) alpha. The sFLT-1 expression level is locally high in the caudal part of the human placenta in patients with placenta previa. In mice experiments, the weights of the placentas and fetuses were significantly smaller in the ablation side than those in the control side, and the sFlt-1 expression level was significantly higher in the ablation side than in the control side. DISCUSSION: Our study suggests that "migration" of the placenta is derived from placental degeneration at the caudal part of the placenta, and sFlt-1 plays a role in this placental degeneration.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[St] Status:In-Process

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[PMID]: 29424516
[Au] Autor:Hernández-Escobar CE; Carrillo-Martínez MA; Arroyo-Lemarroy T; ZamoraMorales MT; Garza-García GA; Campos-Sanmiguel E
[Ti] Title:Malformación arteriovenosa uterina como causa de hemorragia uterina súbita. Utilidad del ultrasonido Doppler de consultorio, otros métodos de imagen y tratamiento de mínima invasion. [Uterine arteriovenous malformation as cause of uterine bleeding of sudden onset. Doppler ultrasound utility, other imaging methods and the minimally invasive treatment].
[So] Source:Ginecol Obstet Mex;84(8):535-41, 2016 08.
[Is] ISSN:0300-9041
[Cp] Country of publication:Mexico
[La] Language:spa
[Ab] Abstract:Background: Uterine arteriovenous malformation is a rare disorder that can cause sudden life-threatening vaginal bleeding. Objetive: To present the clinical features in addition to the use of office gynecologic ultrasound and other imaging techniques in the diagnosis and minimally-invasive treatment of a patient with sudden vaginal bleeding resulting from a uterine arteriovenous malformation. Case report: A 31 year old woman presented sudden onset vaginal bleeding requiring the transfusion of 3 units of red blood cells. An initial diagnosis of uterine arteriovenous malformation was made using an office gynecological ultrasound and Color Doppler sonography. The patient was referred to interventional radiology for confirmation of the diagnosis and patient care. The diagnosis and localization of the uterine arteriovenous malformation was confirmed using magnetic resonance imaging. Therapeutic management proceeded with superselective angiography and embolization of the supplying arteries resulting in immediate symptomatic resolution. Conclusion: The use of office gynecologic ultrasound in combination with other imaging techniques is an important tool in the diagnosis and localization of uterine arteriovenous malformation. Embolization of supplying arteries is considered a safe and effective therapeutic option due to advances in radiologic intervention techniques. Advantages of this procedure include a minimally-invasive technique, low morbidity and preservation of uterine function.
[Mh] MeSH terms primary: Arteriovenous Malformations/complications
Uterine Artery Embolization/methods
Uterine Hemorrhage/etiology
Uterus/blood supply
[Mh] MeSH terms secundary: Adult
Arteriovenous Malformations/diagnostic imaging
Arteriovenous Malformations/therapy
Female
Humans
Magnetic Resonance Imaging
Ultrasonography, Doppler, Color
Uterine Hemorrhage/therapy
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Js] Journal subset:IM
[Da] Date of entry for processing:180210
[St] Status:MEDLINE

  9 / 13957 MEDLINE  
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[PMID]: 29424510
[Au] Autor:Solórzano-Vázquez JF; Hernández-Higareda S; Segura-Zavala JM; OsegueraTorres LF; De la Rosa-Hernández SS
[Ti] Title:Pérdida sanguínea e indicación de hemoderivados en pacientes con cesárea-histerectomía por acretismo placentario. [Blood loss and use of blood products in cases of cesarean hysterectomy for placenta accrete].
[So] Source:Ginecol Obstet Mex;84(8):491-7, 2016 08.
[Is] ISSN:0300-9041
[Cp] Country of publication:Mexico
[La] Language:spa
[Ab] Abstract:Background: Placenta accreta (abnormal insertion of the placenta or part of the myometrium ) endangers the lives of pregnant women. It is a public health problem because it can be complicated by obstetric hemorrhage , the latter being the main cause of maternal death worldwide. Objetive: To estimate the blood loss and the use of blood products in patients who underwent cesarean ­ hysterectomy for placenta accreta. Material and methods: A descriptive study was conducted in HGO UMAE CMNO IMSS in patients who underwent cesarean ­ hysterectomy for placenta accreta in a period of 4 years. Results: 106 cases of placenta accreta were studied, 23% had a massive bleeding of > 3000 cc. Packed red blood cells were transfused in 68% of events, fresh frozen plasma in platelet concentrates 29% and 6%. The history of uterine curettage was observed in 64 % and cesarean section 1 or 2 occasions in 76 % of cases. Conclusion: An early detection of placenta accreta in patients with risk factors to avoid emergency surgery is desired. Being prepared with blood products and appropriate use is a cornerstone in the management of this condition. The average blood loss was determined in cases of accreta in cesarean hysterectomy was 2523 milliliters.
[Mh] MeSH terms primary: Blood Loss, Surgical
Cesarean Section/methods
Hysterectomy/methods
Placenta Accreta/surgery
[Mh] MeSH terms secundary: Adult
Blood Transfusion/methods
Female
Humans
Mexico
Pregnancy
Retrospective Studies
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Js] Journal subset:IM
[Da] Date of entry for processing:180210
[St] Status:MEDLINE

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[PMID]: 29490413
[Au] Autor:Moleiro ML; Guedes-Martins L; Mendes A; Marques C; Braga J
[Ad] Address:Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal.
[Ti] Title:Sutura de Pereira modificada como uma opção eficaz para tratar a hemorragia causada por atonia uterina. Modified Pereira Suture as an Effective Option to Treat Postpartum Hemorrhage due to Uterine Atony.
[So] Source:Rev Bras Ginecol Obstet;40(2):92-95, 2018 Feb.
[Is] ISSN:1806-9339
[Cp] Country of publication:Brazil
[La] Language:eng
[Ab] Abstract:Nowadays, postpartum hemorrhage is the major cause of maternal mortality and morbidity worldwide. Uterine atony is its main cause; thus, prophylactic measures, as well as medical and surgical fast approaches, have been developed to manage it. The uterine compression sutures are a possible treatment that preserves the uterus and, consequently, the fertility potential. Bearing that in mind, we report two cases of postpartum hemorrhage after caesarean section, successfully treated with a new modification of Pereira suture - longitudinal and transverse uterine sutures were applied after no response was registered to the first-line therapies. Both women recovered, and the postpartum evaluation revealed a normal uterus with an adequate blood supply, suggesting potential fertility, as described in the literature regarding this kind of therapeutic approach.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[St] Status:In-Process
[do] DOI:10.1055/s-0037-1613690


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