1
|
Shaamash AH, AlQasem MH, Mahfouz AA, Al Ghamdi DS, Eskandar MA. Major placenta previa among patients with and without previous cesarean section: Maternal characteristics, outcomes and risk factors. Eur J Obstet Gynecol Reprod Biol 2024; 296:280-285. [PMID: 38493552 DOI: 10.1016/j.ejogrb.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/23/2024] [Accepted: 03/08/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES To compare maternal characteristics and outcomes among patients having major placenta previa (PP) with and without previous cesarean section (CS). And to determine if previous CS alone is a risk factor for associated adverse maternal outcomes in these patients. MATERIALS AND METHODS This is a retrospective analysis including two groups of major PP patients, with previous CS (n = 184) and without CS (n = 115); who were admitted to Abha Maternity and Children's Hospital over the last ten-years (January 2012-December 2021), Aseer region, Saudi Arabia. RESULTS Compared to those without previous CS, major PP patients with previous CS had significantly advanced ages with higher mean numbers of gravidity and parity, but significantly less rates of previous uterine surgery and IVF pregnancies. Moreover, they were more likely to acquire higher rates of adverse maternal outcomes. In the same way, these patients had an increased Odds Ratios of cesarean hysterectomy (OR of 20.462), urinary tract injuries (OR of 12.361), associated PAS (OR of 4.375), moderate/ heavy intra-operative bleeding (OR of 2.153) and the need for transfusion of 3+ units of packed RBCs (OR of 1.849). CONCLUSION (1) Patients with combined existence of major PP and previous CS had significantly higher rates of adverse maternal outcomes (2) Alone, prior CS in major PP patients increased the Odds Ratios of cesarean hysterectomy, urinary tract injuries, diagnosis of PAS, excessive intra-operative bleeding and repeated packed RBCs transfusions. (3) Among our PP patients with previous CS, the increased rate and OR of PAS diagnosis could in-part explain the adverse maternal outcomes.
Collapse
Affiliation(s)
- Ayman H Shaamash
- Department of Obstetrics and Gynecology, College of Medicine, King Khalid University and Abha Maternity and Children's Hospital (AMCH), Saudi Arabia.
| | - Mehad H AlQasem
- Department of Obstetrics and Gynecology, College of Medicine, King Khalid University and Abha Maternity and Children's Hospital (AMCH), Saudi Arabia.
| | - Ahmed A Mahfouz
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Saudi Arabia.
| | - Deama S Al Ghamdi
- Department of Obstetrics and Gynecology, College of Medicine, King Khalid University and Abha Maternity and Children's Hospital (AMCH), Saudi Arabia.
| | - Mamdoh A Eskandar
- Department of Obstetrics and Gynecology, College of Medicine, King Khalid University and Abha Maternity and Children's Hospital (AMCH), Saudi Arabia.
| |
Collapse
|
2
|
Zhao H, Li X, Yang S, Liu T, Zhan J, Zou J, Lin C, Li Y, Du N, Xiao X. Risk factors of emergency cesarean section in pregnant women with severe placenta accreta spectrum: a retrospective cohort study. Front Med (Lausanne) 2023; 10:1195546. [PMID: 37502363 PMCID: PMC10370267 DOI: 10.3389/fmed.2023.1195546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/21/2023] [Indexed: 07/29/2023] Open
Abstract
Introduction Placenta accreta spectrum (PAS) may cause enormous and potentially life-threatening hemorrhage in the intrapartum and postpartum periods in emergency cesarean section. How to reduce the occurrence of emergency cesarean section in patients with severe PAS is the key to reducing the adverse outcomes of them. This study aimed to investigate the impact of emergency cesarean section on the perioperative outcomes of pregnant women with PAS and neonates, and also aimed to explore the risk factors of emergency cesarean section in pregnant women with PAS. Materials and methods A retrospective investigation was conducted among 163 pregnant women with severe PAS. Of these, 72 were subjected to emergency cesarean sections. Data on the perioperative characteristics of the mothers and neonates were collected. Multivariable linear regression analysis was used to detect associations between maternal and perioperative characteristics and volume of intraoperative bleeding. Binary logical regression was used to analyze the association between maternal preoperative characteristics and emergency cesarean section. Linear regression analysis is used to analyze the relationship between gestational age and emergency cesarean section. Results The risks of emergency cesarean section increase 98, 112, 124, and 62% when the pregnant women with PAS accompanied by GHD, ICP, more prior cesarean deliveries and more severe PAS type, respectively. Noteworthy, the risk of emergency cesarean section decreases 5% when pre-pregnancy BMI increases 1 kg/m2 (OR: 0.95; CI: 0.82, 0.98; p = 0.038). Moreover, there is no significant linear correlation between emergency cesarean section and gestational age. Conclusion GHD, ICP, multiple prior cesarean deliveries and severe PAS type may all increase the risk of emergency cesarean section for pregnant women with PAS, while high pre-pregnancy BMI may be a protective factor due to less activity level. For pregnant women with severe PAS accompanied by these high risk factors, more adequate maternal and fetal monitoring should be carried out in the third trimester to reduce the risk of emergency cesarean section.
Collapse
Affiliation(s)
- Hu Zhao
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Xin Li
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Shuqi Yang
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Tianjiao Liu
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jun Zhan
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Juan Zou
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Changsheng Lin
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Yalan Li
- The Fourth People’s Hospital of Chengdu, Psychosomatic Medical Center, Chengdu, China
| | - Na Du
- The Fourth People’s Hospital of Chengdu, Psychosomatic Medical Center, Chengdu, China
| | - Xue Xiao
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
3
|
Taye LR, Basumatari B, Das MC, Mahanta P. Ultrasonographical Evaluation of Placenta Previa in Scarred and Unscarred Uterus in a Tertiary Care Centre. Cureus 2023; 15:e42586. [PMID: 37641748 PMCID: PMC10460470 DOI: 10.7759/cureus.42586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 08/31/2023] Open
Abstract
Objectives Placenta previa is characterised as the placenta implant in the lower uterine segment, wholly or partially covering the internal os. Uterine scars from surgical operations are a potential factor of placenta previa. The present study aims to estimate the role of ultrasound in determining the incidence of placenta previa in the scarred and unscarred uterus. Also, it aims to evaluate the types of placenta previa in the scarred and unscarred uterus. Methods This hospital-based, prospective, observational study was performed from September 2021 to August 2022 among patients referred to the Department of Radiology, Fakhruddin Ali Ahmed Medical College and Hospital (FAAMCH), Barpeta, Assam. Written informed consent was obtained from the subjects. Transabdominal and transvaginal ultrasonography methods were used to assess placenta previa. The data analysis was performed using Statistical Package for the Social Sciences (SPSS) version 21 (IBM Corp., Armonk, NY) considering a p-value < 0.05 as significant. Results Out of the 517 subjects with bleeding per vagina, 41 (7.9%) were diagnosed with placenta previa by ultrasonography. The mean maternal age was 27.80 ± 5.36 years, and the most prevalent age group was 20-24 years (31.71%). The majority (70.73%) of cases had scarred uterus. The most prevalent placental position was fundo-body anterior. Complete placenta previa was present in 26% of the total cases in the present study. Conclusion The incidence of placenta previa in the scarred uterus was higher than that of the unscarred uterus. The high prevalence of placenta previa in women with scarred uterus necessitates improved monitoring and management to avoid disastrous outcomes.
Collapse
Affiliation(s)
- Lakshmi R Taye
- Radiology, Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, IND
| | | | - Manik C Das
- Radiology, Nalbari Medical College and Hospital, Nalbari, IND
| | - Putul Mahanta
- Forensic Medicine and Toxicology, Nalbari Medical College and Hospital, Nalbari, IND
| |
Collapse
|
4
|
Singh J, Kaur M, Rasane P, Kaur S, Kaur J, Sharma K, Gulati A. Nutritional management and interventions in complications of pregnancy: A systematic review. Nutr Health 2023:2601060231172545. [PMID: 37128673 DOI: 10.1177/02601060231172545] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Background: Pregnancy, also known as the "gestation period" which lasts for 37-40 weeks, has been marked as the period of "physiological stress" in a woman's life. A wide range of symptoms, from nausea to ectopic pregnancy, are usually aligned with risk factors like abortion, miscarriage, stillbirth, etc. An estimated total of 15% of total pregnant women face serious complications requiring urgent attention for safe pregnancy survival. Over the past decades, several changes in the environment and nutrition habits have increased the possibility of unfavourable changes during the gestation phase. The diagnostic factors, management and nutritional interventions are targeted and more emphasis has been laid on modifying or managing the nutritional factors in this physiologically stressed phase. Aims: This review focuses on dietary modifications and nutritional interventions for the treatment of complications of pregnancy. Nutritional management has been identified to be one of the primary necessities in addition to drug therapy. It is important to set a healthy diet pattern throughout the gestation phase or even before by incorporating key nutrients into the maternal diet. Methods: The published literature from various databases including PubMed, Google Scholar and ScienceDirect were used to establish the fact of management and treatment of complications of pregnancy. Results: The recommendations of dietary supplements have underlined the concept behind the eradication of maternal deficiencies and improving metabolic profiles. Conclusion: Therefore, the present review summarises the dietary recommendations to combat pregnancy-related complications which are necessary in order to prevent and manage the same.
Collapse
Affiliation(s)
- Jyoti Singh
- Department of Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab, India
| | - Mansehaj Kaur
- Department of Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab, India
| | - Prasad Rasane
- Department of Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab, India
| | - Sawinder Kaur
- Department of Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab, India
| | - Jaspreet Kaur
- Department of Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab, India
| | - Kartik Sharma
- International Center of Excellence in Seafood Science and Innovation (ICE-SSI), Faculty of Agro-Industry, Prince of Songkla University, Hat Yai, Thailand
| | - Amisha Gulati
- Department of Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab, India
| |
Collapse
|
5
|
Xiong W, Li X, Liu T, Ding R, Cheng L, Feng D, Duan D, Su M, Li Y, Yang X, Wei S. Potential resolution of placenta previa from the 28th-to the 36th-week of pregnancy: A retrospective longitudinal cohort study. Placenta 2022; 126:164-170. [PMID: 35841836 DOI: 10.1016/j.placenta.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/13/2022] [Accepted: 07/06/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Placenta previa greatly contributes to severe antenatal and post-partum hemorrhage. Previous studies have mainly focused on the risk factors of placenta previa, with very few studies reporting which factors may affect the potential resolution of 28th-week previa. This study aimed to investigate the impact of maternal characteristics on potential resolution of placenta previa from the 28th-to the 36th-week of pregnancy. METHODS A retrospective longitudinal sub-cohort investigation was carried out among 368 pregnant women with 28th-week previa from the Longitudinal Placenta Previa Study (LoPPS). Logistic regression analysis was used to discover the connections between maternal covariates and the placental potential resolution. Multivariable linear regression analysis was used to detect the associations between perioperative characteristics and volume of intraoperative bleeding. RESULTS Among pregnant women whose placenta completely or partially covered the internal os at the 28th-week of pregnancy, 37.5% were without placenta previa at the 36th-week and 25.8% converted into marginal placenta previa. There were significant correlation between placenta previa type and GHD (Beta: 2.808, 95% CI: 1.642, 7.138; p = 0.041), type of 28th-week previa (Beta: 6.767, 95% CI: 1.592, 18.767; p < 0.001), and number of prior cesarean sections (Beta: 3.326, 95% CI: 1.580, 9.081; p < 0.001). DISCUSSION 62.5% of the pregnant women with 28th-week placenta previa were still with previa at the 36 weeks of gestation (25.8% with marginal and 36.7% with partial/complete placenta previa). This proportion is even higher for 28th-week complete placenta previa. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2100054068, December 8, 2021.
Collapse
Affiliation(s)
- Wen Xiong
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Xin Li
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Tianjiao Liu
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Rui Ding
- Chongqing Medical University, Chongqing, 400016, China
| | - Linbo Cheng
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Dan Feng
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Duan Duan
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Mi Su
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Yalan Li
- The Fourth People's Hospital of Chengdu, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Xiao Yang
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China.
| | - Sumei Wei
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China.
| |
Collapse
|
6
|
Huang L, Li X, Liu T, Wei L, Fan C, Tang D, Xiong W, Li Y, Wei S, Xiong Z. Effect of intrahepatic cholestasis of pregnancy on infantile food allergy: A retrospective longitudinal study cohort in Southwest China. Eur J Obstet Gynecol Reprod Biol 2022; 272:110-115. [PMID: 35303672 DOI: 10.1016/j.ejogrb.2022.03.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/14/2022] [Accepted: 03/11/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Intrahepatic cholestasis of pregnancy has been consistently associated with a higher incidence of adverse pregnancy outcomes. Previous studies mainly focused on the effects of intrahepatic cholestasis of pregnancy on pregnant mothers and fetuses, and few studies reported the postpartum growth and development of fetuses in pregnant women with intrahepatic cholestasis of pregnancy. The aim of this study was to investigate impact of maternal serum total bile acid levels on maternal and neonatal outcomes as well as child growth and food allergy. MATERIAL AND METHODS A retrospective longitudinal cohort investigation was carried out among 751 pregnant women with intrahepatic cholestasis of pregnancy at 30-32 weeks of gestation from the Longitudinal Intrahepatic Cholestasis of Pregnancy Study (LoICPS). Data on the characteristics of the mothers and neonates were collected. Infant growth data and food sensitivities were also collected. RESULTS In our cohort, the average maternal serum total bile acid level was 35.09±30.02 μmol/L, with 58.8% of mothers suffering from mild intrahepatic cholestasis of pregnancy and 29.2% suffering from severe intrahepatic cholestasis of pregnancy. Positive correlations were found between maternal serum total bile acid levels and twin pregnancy (beta-value: 11.55, 95% CI: 2.89 - 20.20. P = 0.009) and meconium stained amniotic fluid (beta-value: 14.64, 95% CI: 9.41 - 19.87. P < 0.001). In addition, the infants of mothers with severe intrahepatic cholestasis of pregnancy were more likely to be allergic to foods at 6 months. CONCLUSIONS This study suggested that despite pregnant women with intrahepatic cholestasis of pregnancy taking ursodeoxycholic acid tablets and cesarean section before expected date of childbirth, the perinatal outcome of newborns partially improving, the incidence of infantile food allergy was still increased.
Collapse
Affiliation(s)
- Liqiong Huang
- The Second Affiliated Hospital of Chongqing Medical University, Chongqing 610000, China; Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Xin Li
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Tianjiao Liu
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Lu Wei
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Conghong Fan
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Dongmei Tang
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Wen Xiong
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Yalan Li
- The Fourth People's Hospital of Chengdu, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China.
| | - Sumei Wei
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China.
| | - Zhengai Xiong
- The Second Affiliated Hospital of Chongqing Medical University, Chongqing 610000, China.
| |
Collapse
|
7
|
Fu M, Bu H, Fang Y, Wang C, Zhang L, Zhang Y, Sun X, Li M, Jin C, Xu Y, Chen L. Parallel Loop Binding Compression Suture, a Modified Procedure for Pernicious Placenta Previa Complicated With Placenta Increta. Front Surg 2021; 8:786497. [PMID: 34912843 PMCID: PMC8666452 DOI: 10.3389/fsurg.2021.786497] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/08/2021] [Indexed: 11/20/2022] Open
Abstract
Objective: To evaluate the efficacy and safety of parallel loop binding compression suture of the lower uterus during cesarean section in pernicious placenta previa complicated with placenta increta. Methods: This retrospective study was performed in patients with pernicious placenta previa complicated with placenta increta or percreta between November 2014 and December 2020 at the Qilu Hospital of Shandong University. Patients underwent parallel loop binding compression suture surgery were defined as study group, and patients underwent traditional surgery with figure-of-eight sutures as the main hemostatic method were defined as control group. Postpartum hemorrhage was evaluated as the primary outcome. The secondary outcomes included age, gestational weeks, operative time, fetal childbirth time, prevention of hysterectomy, blood transfusion, duration of postoperative catheterization, duration of antibiotic treatment, and postoperative hospitalization (days). Additionally, neonatal outcomes were evaluated. Results: A total of 124 patients were enrolled in the study, including 38 patients receiving parallel loop binding compression suture surgery in the study group, and 86 patients in the control group. With parallel loop binding compression suture, the average operation time was significantly reduced (109.0 ± 33.5 vs. 134.4 ± 54.2 min, p = 0.00), and the volume of blood lost were also decreased (2152.6 ± 1169.4 vs. 2960.5 ± 1963.6 ml, p = 0.02), which correspondingly reduced RBC transfusion (7.2 ± 3.5 vs. 10.3 ± 8.7 units, p = 0.03) and FFP transfusion (552.6 ± 350.3 vs. 968.0 ± 799.8 ml, p = 0.00). The fetal childbirth time was extended (14.1 ± 5.6 vs. 11.0 ± 8.0 min, p = 0.03), however, there was no increase in NICU admission rates (36.9 vs. 34.9%, p = 0.83). Except for one premature infant (32 weeks) death in the control group, all infants at our hospital were safely discharged after treatment. Conclusion: Parallel loop binding compression suture is an effective, swift, practical, and safe method to reduce postpartum bleeding in women with pernicious placenta previa, complicated with placenta increta. Besides, it has no adverse effects on newborns.
Collapse
Affiliation(s)
- Mengdi Fu
- Department of Gynecology and Obstetrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Hualei Bu
- Department of Gynecology and Obstetrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yan Fang
- Department of Gynecology and Obstetrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chunling Wang
- Department of Anesthesia, Qilu Hospital, Shandong University, Jinan, China
| | - Li Zhang
- Department of Anesthesia, Qilu Hospital, Shandong University, Jinan, China
| | - Yang Zhang
- Department of Radiology, Qilu Hospital, Shandong University, Jinan, China
| | - Xiao Sun
- Department of Ultrasound, Qilu Hospital, Shandong University, Jinan, China
| | - Mingbao Li
- Department of Gynecology and Obstetrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chengjuan Jin
- Department of Obstetrics and Gynecology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yintao Xu
- Department of Gynecology and Obstetrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lijun Chen
- Department of Gynecology and Obstetrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| |
Collapse
|
8
|
Zhang M, Chen W, Liu C, Sui J, Wang D, Wang Y, Meng X, Wang Y, Yue C. Nursing-sensitive quality indicators for pernicious placenta previa in obstetrics: A Delphi study based across Chinese institutions. Nurs Open 2021; 8:3461-3468. [PMID: 33960732 PMCID: PMC8510706 DOI: 10.1002/nop2.895] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 11/17/2022] Open
Abstract
AIM To identify a set of scientific, systematic and clinically applicable nursing-sensitive quality indicators for pernicious placenta previa (PPP). DESIGN A modified Delphi-Consensus Technique. METHODS According to literature retrieval published between 2009-2019, 38 nursing-sensitive quality indicators were chosen and a questionnaire was designed. An online survey was conducted in 20 hospitals in China, and data of experts' opinions were collected and analysed by improved Delphi method. RESULTS 38 nursing-sensitive quality indicators were identified. The response rates in the two rounds of expert consultation were 97.4% and 100%, and the authoritative coefficients were 0.89 and 0.92. The coefficients of variation ranged from 0.04-0.28. The nursing-sensitive quality indicators were successfully constructed based on the modified Delphi technique.
Collapse
Affiliation(s)
- Meng Zhang
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Weiping Chen
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Cuiping Liu
- School of NursingQingdao UniversityQingdaoChina
| | - Jing Sui
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Dawei Wang
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Yan Wang
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Xin Meng
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Yiqian Wang
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Chongyu Yue
- Department of ObstetricsAffiliated Hospital of Qingdao UniversityQingdaoChina
| |
Collapse
|
9
|
Savukyne E, Liubiniene L, Strelcoviene Z, Nadisauskiene RJ, Vaboliene E, Machtejeviene E, Kaupas R, Lauzikiene D. Experience of Managing Suspected Placenta Accreta Spectrum with or without Internal Iliac Artery Balloon Occlusion in Two Lithuanian University Hospitals. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:345. [PMID: 33918344 PMCID: PMC8065721 DOI: 10.3390/medicina57040345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 03/25/2021] [Accepted: 03/30/2021] [Indexed: 11/29/2022]
Abstract
Background and objectives: Placenta previa and placenta accreta spectrum are considered major causes of massive postpartum hemorrhage. Objective: To determine whether the placement of an occlusion balloon catheter in the internal iliac artery could reduce bleeding and other related complications during cesarean delivery in patients with placenta previa and placenta accreta spectrum. Materials and Methods: A retrospective analysis was conducted at two tertiary obstetric units of Lithuania. From January 2016 to November 2019 patients with placenta previa and antenatally suspected invasive placenta were included in the intervention group and underwent cesarean delivery with endovascular procedure. From January 2014 to December 2015 patients with placenta previa and suspected placenta accreta spectrum were included in the non-intervention group. The primary outcomes were reduction in intraoperative blood loss and transfusion volumes in the intervention group. Secondary outcomes were the incidence of hysterectomy and maternal complications. Results: Nineteen patients underwent cesarean delivery with preoperative endovascular procedure, and 47 women underwent elective cesarean delivery. The median intraoperative blood loss (1000 (400-4500) mL vs. 1000 (400-5000) mL; p = 0.616) and the need for red blood cell transfusion during operation (26% vs. 23%; p = 0.517) did not differ significantly between the patients groups. Seven patients in the intervention group and two patients in the non-intervention group underwent perioperative hysterectomy (p = 0.002). None of the patients had complications related to the endovascular procedure. Conclusion: The use of intermittent balloon occlusion catheter in patients with placenta pathology is a safe method but does not significantly reduce intraoperative blood loss during cesarean delivery.
Collapse
Affiliation(s)
- Egle Savukyne
- Department of Obstetrics and Gynaecology, Hospital of Lithuanian University of Health Sciences, Kauno Klinikos, Eiveniu st. 2, 50161 Kaunas, Lithuania; (Z.S.); (R.J.N.); (E.V.); (E.M.)
- Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, A.Mickevicius st. 7, 44307 Kaunas, Lithuania;
| | - Laura Liubiniene
- Department of Obstetrics and Gynaecology, Hospital of Lithuanian University of Health Sciences, Kauno Klinikos, Eiveniu st. 2, 50161 Kaunas, Lithuania; (Z.S.); (R.J.N.); (E.V.); (E.M.)
- Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, A.Mickevicius st. 7, 44307 Kaunas, Lithuania;
| | - Zita Strelcoviene
- Department of Obstetrics and Gynaecology, Hospital of Lithuanian University of Health Sciences, Kauno Klinikos, Eiveniu st. 2, 50161 Kaunas, Lithuania; (Z.S.); (R.J.N.); (E.V.); (E.M.)
- Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, A.Mickevicius st. 7, 44307 Kaunas, Lithuania;
| | - Ruta Jolanta Nadisauskiene
- Department of Obstetrics and Gynaecology, Hospital of Lithuanian University of Health Sciences, Kauno Klinikos, Eiveniu st. 2, 50161 Kaunas, Lithuania; (Z.S.); (R.J.N.); (E.V.); (E.M.)
- Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, A.Mickevicius st. 7, 44307 Kaunas, Lithuania;
| | - Edita Vaboliene
- Department of Obstetrics and Gynaecology, Hospital of Lithuanian University of Health Sciences, Kauno Klinikos, Eiveniu st. 2, 50161 Kaunas, Lithuania; (Z.S.); (R.J.N.); (E.V.); (E.M.)
- Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, A.Mickevicius st. 7, 44307 Kaunas, Lithuania;
| | - Egle Machtejeviene
- Department of Obstetrics and Gynaecology, Hospital of Lithuanian University of Health Sciences, Kauno Klinikos, Eiveniu st. 2, 50161 Kaunas, Lithuania; (Z.S.); (R.J.N.); (E.V.); (E.M.)
- Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, A.Mickevicius st. 7, 44307 Kaunas, Lithuania;
| | - Rytis Kaupas
- Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, A.Mickevicius st. 7, 44307 Kaunas, Lithuania;
- Department of Interventional Radiology, Hospital of Lithuanian University of Health Sciences, Kauno Klinikos, Eiveniu st. 2, 50161 Kaunas, Lithuania
| | - Dalia Lauzikiene
- Department of Obstetrics and Gynaecology, Vilnius University Hospital Santaros Klinikos, Santariskiu st. 2, 08661 Vilnius, Lithuania;
| |
Collapse
|
10
|
Liu J, Wu T, Peng Y, Luo R. Grade Prediction of Bleeding Volume in Cesarean Section of Patients With Pernicious Placenta Previa Based on Deep Learning. Front Bioeng Biotechnol 2020; 8:343. [PMID: 32426340 PMCID: PMC7203465 DOI: 10.3389/fbioe.2020.00343] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 03/27/2020] [Indexed: 12/29/2022] Open
Abstract
In order to predict the amount of bleeding in the cesarean section of the patients with Pernicious Placenta Previa (PPP), this study proposed an automatic blood loss prediction method based on Magnetic Resonance Imaging (MRI) uterus image. Firstly, the DeepLab-V3 + network was used to segment the original MRI abdominal image to obtain the uterine region image. Then, the uterine region image and the corresponding blood loss data were trained by Visual Geometry Group Network-16 (VGGNet-16) network. The classification model of blood loss level was obtained. Using a dataset of 82 positive samples and 128 negative samples, the proposed method achieved accuracy, sensitivity and specificity of 75.61, 73.75, and 77.46% respectively. The experimental results showed that this method can not only automatically identify the uterine region of pregnant women, but also objectively determine the level of intraoperative bleeding. Therefore, this method has the potential to reduce the workload of the attending physician and improve the accuracy of experts' judgment on the level of bleeding during cesarean section, so as to select the corresponding hemostasis measures.
Collapse
Affiliation(s)
- Jun Liu
- Department of Information Engineering, Nanchang Hangkong University, Nanchang, China
| | - Tao Wu
- Department of Information Engineering, Nanchang Hangkong University, Nanchang, China
| | - Yun Peng
- NuVasive, San Diego, CA, United States
| | - Rongguang Luo
- Department of Medical Imaging and Interventional Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| |
Collapse
|
11
|
Intrauterine sutures in cesarean section for placenta previa: some concerns. Arch Gynecol Obstet 2018; 299:593-594. [PMID: 30542794 DOI: 10.1007/s00404-018-5013-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 12/07/2018] [Indexed: 10/27/2022]
|