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[PMID]: 29504438
[Au] Autor:Accordino F; Pintucci A; Manni MU; Meregalli V; Locatelli A
[Ad] Address:a Department of Obstetrics and Gynecology , San Gerardo Hospital , MBBM Foundatuibm University of Milano - Bicocca , Monza , Monza e Brianza, Italy.
[Ti] Title:Re to: Tale of rudimentary horn pregnancy and literature review.
[So] Source:J Matern Fetal Neonatal Med;:1-31, 2018 Mar 04.
[Is] ISSN:1476-4954
[Cp] Country of publication:England
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:Publisher
[do] DOI:10.1080/14767058.2018.1448775

  2 / 6907 MEDLINE  
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[PMID]: 29493389
[Au] Autor:De Silva S
[Ad] Address:University College Hospital London, Bloomsbury, London, UK.
[Ti] Title:Perioperative care of pregnant women with previous uterine surgery.
[So] Source:J Perioper Pract;28(3):59-61, 2018 Mar.
[Is] ISSN:1750-4589
[Cp] Country of publication:England
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:In-Process
[do] DOI:10.1177/1750458918755961

  3 / 6907 MEDLINE  
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[PMID]: 29426264
[Au] Autor:Mousavi AS; Hashemi N; Kashanian M; Sheikhansari N; Bordbar A; Parashi S
[Ad] Address:a Department of Obstetrics & Gynecology , Iran University of Medical Sciences, Hazrate Rasoole Akram Teaching Hospital , Tehran , Iran.
[Ti] Title:Comparison between maternal and neonatal outcome of PPROM in the cases of amniotic fluid index (AFI) of more and less than 5 cm.
[So] Source:J Obstet Gynaecol;:1-5, 2018 Feb 09.
[Is] ISSN:1364-6893
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:The study was performed on pregnant women with a gestational age of 26-32 weeks of pregnancy, who had been admitted to the hospital with a confirmed diagnosis of premature rupture of membranes. In all eligible women, ultrasounds were performed for the evaluation of amniotic fluid index. Then, the women were divided into two groups according to amniotic fluid index of ≥5 cm and <5 cm. These women were followed and monitored up to delivery. The women of the two groups did not have significant difference between them according to age, gestational age at the time of ruptured membrane, body mass index, gravidity, parity, gestational age at delivery and route of delivery. Maternal morbidities including chorioamnionitis, placental abruption, uterine atony after delivery and retention of placenta did not show significant difference between the two groups. There was no significant difference between the two groups' amniotic fluid index <5 cm and amniotic fluid index ≥5 cm, regarding neonatal morbidities, except for neonatal sepsis and neonatal death, which were higher in the amniotic fluid index <5 cm group [7(14.6%) versus 1(2.3%), p = .039, RR = 7.7 (95%CI 0.04-0.06) and 11(30.9%) versus 2(4.7%), p = .013, RR = 6.095 (95%CI = 1.26-29.31)]. In the subgroups of two categories of gestational ages of 26 -29 and 30 -34 , neonatal morbidities were higher in the amniotic fluid index <5 cm group. The results suggest that amniotic fluid index <5 cm should be considered as a warning sign for predicting poor prognosis of pregnancy complicated by preterm premature rupture of membranes. Impact statement What is already known on this subject? In a retrospective study in 1993, the relationship between oligohydramnios (which was defined as the largest single packet of fluid less than 2 × 2 cm) at the time of hospital admission, and the outcome of mother, foetus and neonates in a gestational age of less than 35 weeks of pregnancy was evaluated. In the oligohydramnios group, chorioamnionitis and funistis were more common. Also, the mean gestational age at the time of delivery and neonatal weight was less than that of the normal amniotic fluid group. According to these results, it was concluded that a low amniotic fluid volume in the women with preterm premature rupture of membranes (PPROM) can be considered as a prognostic factor in the cases of conservative management of PPROM. In contrast, the other study, which was performed on a larger sample size (290 patients), could not show more cases of amnionitis in the cases of amniotic fluid index (AFI) of less than 5 cm; however, the latency period was shorter in comparison with AFI of more than 5 cm. What do the results of this study add? Chorioamnionitis, placental abruption and uterine atony after delivery, retention of placenta and route of delivery did not show a significant difference between the two groups. Respiratory distress syndrome (RDS), need of surfactant and intubation, intra ventricular haemorrhage (IVH) and duration of neonatal intensive care unit (NICU) admission did not show a significant difference between the two groups; however, the rate of neonatal sepsis and neonatal death were higher in the AFI <5 cm group. What are the implications of these findings for clinical practice and/or further research? The results suggest that AFI <5 cm should be considered as a warning sign for predicting poor prognosis of pregnancy complicated by PPROM.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:Publisher
[do] DOI:10.1080/01443615.2017.1394280

  4 / 6907 MEDLINE  
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[PMID]: 29390265
[Au] Autor:Liu SY; Zeng B; Deng JB
[Ti] Title:Massive retroperitoneal hemorrhage secondary to femoral artery puncture: A case report and review of literature.
[So] Source:Medicine (Baltimore);96(50):e8724, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: A rare case of massive bleeding with rupture of the branch artery deriving from uterine artery was reported in the present study. PATIENT CONCERNS: A 29-year old female patient received embolism of malformed cerebral vessels. Ten hours after the operation, a sudden drop in blood pressure occurred. The patient developed coma and shock, and again underwent interventional angiography, which revealed bleeding at the right femoral artery puncture site of the first interventional procedure. The bleeding sign disappeared by pressure dressing. At 19 hours after stable condition, blood pressure fell again, and it was considered that recurrent bleeding occurred at the femoral artery puncture point. Therefore surgical suture of punctured blood vessel was performed. Then the condition was stabilized again. After another 20 hours, the third times blood pressure dropped. The third interventional angiography displayed a rupture of the branch artery deriving from the right uterine artery. Blood pressure of the patient elevated after embolism of right uterine artery, and the condition gradually stabilized. DIAGNOSES: The massive bleeding with rupture of the branch artery deriving from uterine artery seconded huge retroperitoneal hematoma after femoral artery puncture. INTERVENTIONS: The patient underwent three times interventional treatment including an embolism of malformed cerebral vessels, a right femoral artery interventional treatment, an embolism of the branch artery deriving from the right uterine artery and one time of surgical suture of punctured blood vessel. OUTCOMES: Half a month of comprehensive treatment later, the patient was discharged from the hospital. LESSONS: Massive bleeding with rupture of branch of artery deriving from the uterine artery following grain retroperitoneal hemorrhage is extremely rare, to the best of our knowledge, it has not been previously reported. The rupture of branch of artery deriving from the uterine artery should be considered as one the differential diagnosis in the retroperitoneal hemorrhage when the bleeding cause was not found. Endovascular trans-arterial embolism was a safe, effective, and minimally invasive therapeutic option.
[Mh] MeSH terms primary: Femoral Artery/injuries
Hemorrhage/etiology
Punctures/adverse effects
Retroperitoneal Space
[Mh] MeSH terms secundary: Adult
Female
Femoral Artery/surgery
Hemorrhage/therapy
Humans
Rupture, Spontaneous
Uterine Artery/injuries
Uterine Artery Embolization
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008724

  5 / 6907 MEDLINE  
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[PMID]: 29254394
[Au] Autor:Cramer SF; Heller DS
[Ad] Address:1 Rochester General Hospital, University of Rochester, New York, NY, USA.
[Ti] Title:A Review and Reconsideration of Nonneoplastic Myometrial Pathology.
[So] Source:Int J Surg Pathol;26(2):104-119, 2018 Apr.
[Is] ISSN:1940-2465
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:From 1861 to 1962, clinicopathologic research tried to explain the association of abnormal uterine bleeding with uterine enlargement. The etiology was theorized as metropathy, suggesting that myometrial dysfunction may predispose to abnormal uterine bleeding. Research reached a nadir in 1962, when a major review dismissed myometrial hypertrophy as a plausible explanation after prior rejections of the theories of chronic myometritis, fibrosis uteri, and subinvolution as causes of bleeding. Subsequent to this arose a crusade against unnecessary hysterectomies in the 1970s. Although myometrial hyperplasia was proposed in 1868, it is only in the past 25 years that tangible evidence has supported that idea. It now appears that clinically enlarged uteri are due to globoid outward bulging of the uterus, caused by increased intramural pressure-often unrelated to either uterine weight or myometrial thickness. Abnormal (dysfunctional) uterine bleeding may often be due to spontaneous rupture of thrombosed dilated endometrial vessels, due to the combined effects of obstructed venous drainage by increased intramural pressure, and Virchow's triad. Despite a century-old known association of parity with naturally occurring outer wall myometrial scars (fibrosis uteri with elastosis), it was not previously suggested that these may reflect healing reactions to muscle tears during labor and delivery. We now suggest that smaller, similar inner wall elastotic scars in the nerve-rich inner myometrium may explain many cases of pelvic pain. This review suggests that diverse pressure-related lesions may be present in clinically abnormal uteri that have been called "normal" since the crusade against unnecessary hysterectomy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:In-Process
[do] DOI:10.1177/1066896917748194

  6 / 6907 MEDLINE  
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[PMID]: 29482706
[Au] Autor:Chughtai NG; Rizvi RM
[Ad] Address:Department of Urogynecology, The Aga Khan University Hospital, Karachi.
[Ti] Title:A Rare Case: Rupture of Internal Pudendal and Uterine Artery in a Vaginal Delivery.
[So] Source:J Coll Physicians Surg Pak;28(3):S49-S50, 2018 Mar.
[Is] ISSN:1681-7168
[Cp] Country of publication:Pakistan
[La] Language:eng
[Ab] Abstract:The management of puerperal hematomas after normal delivery has always been challenging for obstetricians. Vulvar, vulvovaginal, or paravaginal hematomas are common. On the other hand, retroperitoneal hematomas are uncommon and can be life-threatening. The diagnosis of vascular injury is rarely made preoperatively as atonic or traumatic postpartum hemorrhage (PPH), uterine rupture and amniotic fluid embolism are more common differential diagnoses. Injury to internal pudendal and uterine vessels is extremely rare in cases of vaginal delivery and, therefore, the literature on this topic is very scarce. We present a rare case of both internal pudendal and uterine artery rupture in a normal vaginal delivery, which led to massive postpartum hemorrhage. The diagnosis was made on Magnetic Resonance imaging (MRI) and arterial embolization was performed. This case stresses on the need for careful post-delivery monitoring for revealed postpartum hemorrhage. Vascular injury is a rare life-threatening cause of obstetric shock, and active; and timely operative intervention can prevent morbidity and mortality.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[St] Status:In-Process
[do] DOI:10.29271/jcpsp.2018.03.S49

  7 / 6907 MEDLINE  
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[PMID]: 28471117
[Au] Autor:Zhang N; Lou WH; Zhang XB; Lin JH; Di W
[Ad] Address:Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200126, China.
[Ti] Title:Antepartum hemorrhage from previous-cesarean-sectioned uterus as a potential sign of uterine artery pseudoaneurysm.
[So] Source:J Zhejiang Univ Sci B;18(5):441-444, 2017 May.
[Is] ISSN:1862-1783
[Cp] Country of publication:China
[La] Language:eng
[Ab] Abstract:Postpartum hemorrhage (PPH), a leading cause of maternal mortality, can occur within 24 h of delivery (primary PPH), or during the period from 24 h after delivery to Week 6 of puerperium (secondary PPH). It requires health professionals to be alert to the symptoms to ensure prompt diagnosis and treatment, especially in the case of rupture of a uterine artery pseudoaneurysm (UAP) due to its life-threatening consequence (Baba et al., 2014). Most of the published case reports or case serials describe UAP as a possible cause of delayed PPH after traumatic procedures during delivery or pregnancy termination, including cesarean section (CS), manual removal of the placenta, or dilation and curettage (D&C) (Wald, 2003). Herein, we report a case of prior CS-related UAP manifesting as primary PPH after an uncomplicated vaginal delivery. This case required emergency embolization and is notable for several reasons. Antepartum hemorrhage of the previously scarred uterus was a potential sign of the ruptured UAP, and color Doppler sonography sometimes deceived the physician as the characteristic features of UAP did not appear to be present.
[Mh] MeSH terms primary: Aneurysm, False/diagnosis
Aneurysm, False/etiology
Cesarean Section/adverse effects
Postpartum Hemorrhage/diagnosis
Postpartum Hemorrhage/etiology
Uterine Artery
[Mh] MeSH terms secundary: Adult
Aneurysm, False/therapy
Female
Humans
Postpartum Hemorrhage/therapy
Pregnancy
Treatment Outcome
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[Js] Journal subset:IM
[Da] Date of entry for processing:170505
[St] Status:MEDLINE
[do] DOI:10.1631/jzus.B1600528

  8 / 6907 MEDLINE  
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[PMID]: 29472419
[Au] Autor:Davis AA
[Ad] Address:Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.
[Ti] Title:A womb like a broken heart.
[So] Source:BMJ Case Rep;2018, 2018 Feb 22.
[Is] ISSN:1757-790X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Uterine perforation during hysteroscopic operative procedures is a potential complication well known to gynaecologists. Uterine septa are a commonly encountered Müllerian anomaly related to pregnancy loss and infertility. Hysteroscopic resection of septa has shown to improve pregnancy outcome. There are limited case reports of uterine rupture in subsequent pregnancies after hysteroscopic septal resection. Our patient had a hysteroscopic septal resection done a year prior which was complicated by a uterine fundal perforation, left to spontaneously heal after immediate sealing with cautery. The patient conceived spontaneously soon after and underwent an emergency caesarean section for severe pre-eclampsia. Intraoperatively, after removal of the placenta, we discovered a 3 cm symmetrical circular defect at the fundus of the uterus with no myometrium or serosa. The potentially disastrous consequences of this silent uterine rupture were mitigated due to another life-threatening condition which prevented the onset of labour.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180223
[Lr] Last revision date:180223
[St] Status:In-Process

  9 / 6907 MEDLINE  
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[PMID]: 29420394
[Au] Autor:Hehir MP; Rouse DJ; Miller RS; Ananth CV; Wright JD; Siddiq Z; DʼAlton ME; Friedman AM
[Ad] Address:Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital New York, New York; the Division of Research, Department of Obstetrics and Gynecology, Women and Infants Hospital, Warren Alpert Medical School at Brown University, Providence, Rhode Island; and the Department of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, New York.
[Ti] Title:Second-Stage Duration and Outcomes Among Women Who Labored After a Prior Cesarean Delivery.
[So] Source:Obstet Gynecol;131(3):514-522, 2018 Mar.
[Is] ISSN:1873-233X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To characterize probabilities of vaginal delivery based on second-stage duration along with maternal and neonatal risks for women undergoing labor after cesarean delivery. METHODS: This unplanned secondary analysis of the Maternal-Fetal Medicine Units Cesarean Registry, a prospective observational cohort, assessed outcomes in women with a prior uterine scar and included women with a previous cesarean delivery without prior vaginal delivery who reached the second stage of labor. The primary outcome was mode of delivery by second-stage duration. Secondary outcomes included assessment of individual adverse maternal (chorioamnionitis, atony, endometritis, hysterectomy, uterine rupture or dehiscence, and red cell transfusion) and neonatal (cord pH less than 7.10, Apgar score less than 6 at 5 minutes, neonatal intensive care unit admission, and ventilatory support) outcomes. RESULTS: Of 4,579 women with a previous cesarean delivery who reached the second stage of labor, 4,147 (90.6%) delivered vaginally. As second stage increased, successful vaginal delivery rates decreased: 97.3% at less than 1 hour (95% CI 96.6-97.9%), 91.5% at 1 to less than 2 hours (95% CI 89.8-93.1%), 78.5% at 2 to less than 3 hours (95% CI 74.5-82.1%), 62.3% at 3 to less than 4 hours (95% CI 55.2-69.1%), and 45.6% at 4 hours or greater (95% CI 37.7-53.7%). Risk of all adverse maternal outcomes increased with the length of the second stage. Specifically, risk of uterine rupture or dehiscence increased with second-stage length from less than 1 hour (0.7%), 1 to less than 2 hours (1.4%), 2 to less than 3 hours (1.5%), to 3 hours or greater (3.1%) (P<.001 for differential risk across the second stage). Risk of neonatal outcomes did not differ significantly by second-stage length. CONCLUSION: Although many women with a longer second stage (greater than 3 hours) will achieve successful vaginal delivery, these patients may be at increased risk for adverse maternal outcomes and should have close observation of fetal heart rate monitoring, maternal vital signs, and symptoms suggestive of uterine rupture or dehiscence.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180222
[Lr] Last revision date:180222
[St] Status:In-Data-Review
[do] DOI:10.1097/AOG.0000000000002478

  10 / 6907 MEDLINE  
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[PMID]: 29448806
[Au] Autor:Chen CS; Park S; Shin JH; Nouri Y; Kim JW; Yoon HK; Ko GY
[Ad] Address:1 Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
[Ti] Title:Endovascular treatment for the control of active vaginal bleeding from uterine cervical cancer treated with radiotherapy.
[So] Source:Acta Radiol;:284185118758133, 2018 Jan 01.
[Is] ISSN:1600-0455
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Background Endovascular treatment has become a significant therapeutic option for the management of intractable bleeding in gynecologic malignancies. However, the endovascular treatment types were almost never mentioned when active bleeding from different arteries was identified. Purpose To present angiographic details and evaluate clinical efficacy of endovascular treatments to control active vaginal bleeding in uterine cervical cancer patients treated with radiotherapy. Material and Methods In this retrospective study, six, consecutive cervical cancer patients treated with radiotherapy who underwent endovascular treatment for active vaginal bleeding were included. Angiographic findings, endovascular treatment details, and clinical outcomes were obtained. Results Ten endovascular procedures were technically successful, in which bleeding arteries were the internal iliac artery/its branches (n = 5), external iliac artery (EIA) (n = 3), uterine artery (n = 1), and superior rectal artery (n = 1), and bleeding manifested as contrast extravasation (n = 6), pseudoaneurysm (n = 1), or both (n = 3). Three of the four repeated procedures showed different bleeding sites from the primary ones. Stent graft was inserted to preserve the patency of the bleeding EIA in two patients. For another EIA rupture, both proximal and distal embolization were performed, followed by femoral-to-femoral bypass to preserve blood flow. Bleeding control within one month was achieved in 80% (8/10). One minor complication, mild transient pelvic pain, occurred in one patient. Conclusions Various endovascular treatment was feasible and effective to control active vaginal bleeding from cervical cancer. Repeated procedures showed commonly different bleeding foci and stent graft insertion was effective for preserving the patency of the large bleeding artery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180216
[Lr] Last revision date:180216
[St] Status:Publisher
[do] DOI:10.1177/0284185118758133


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