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Ryan GA, Crankshaw DJ, Morrison JJ. Effects of maternal parity on response of human myometrium to oxytocin and ergometrine in vitro. Eur J Obstet Gynecol Reprod Biol 2019; 242:99-102. [PMID: 31580965 DOI: 10.1016/j.ejogrb.2019.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/09/2019] [Accepted: 09/12/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study was to compare the effects of oxytocin and ergometrine on the intrinsic contractile parameters of human uterine smooth muscle at term between primiparous and multiparous women. STUDY DESIGN Myometrial biopsies were obtained from women undergoing planned caesarean section at term. The biopsies were dissected into eight uniform strips and mounted in tissue baths for isometric recording. The strips were challenged with increasing concentrations of oxytocin and ergometrine. Parameters of contractile activity, including mean contractile force (MCF) and maximum amplitude of contractions (MAMP) were recorded and analysed. Results were compared between primiparous (Group 1) and multiparous (Group 2) women. RESULTS Myometrial biopsies were obtained from n = 11 donors (88 tissue strips), of which n = 5 were Group 1 and n = 6 were Group 2. In relation to oxytocin, the MAMP value observed was significantly greater in Group 2 than in Group 1 (151 ± 18mN vs 67 ± 14mN, P < 0.01). Regarding ergometrine, the MCF response was greater in Group 2 samples (24 ± 10 mN) than that in Group 1 (18 ± 2mN) (P < 0.05). CONCLUSION Our findings highlight that women in a first pregnancy have a decreased response to both oxytocin and ergometrine in an in vitro setting when compared with women in a subsequent pregnancy, and this may have clinical implications regarding the management of postpartum haemorrhage in this cohort.
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Affiliation(s)
- Gillian A Ryan
- Department of Obstetrics and Gynaecology, National University of Ireland Galway, Galway University Hospital, Ireland; Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland.
| | - Denis J Crankshaw
- Department of Obstetrics and Gynaecology, National University of Ireland Galway, Galway University Hospital, Ireland; Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland
| | - John J Morrison
- Department of Obstetrics and Gynaecology, National University of Ireland Galway, Galway University Hospital, Ireland; Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland
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Schlembach D, Helmer H, Henrich W, von Heymann C, Kainer F, Korte W, Kühnert M, Lier H, Maul H, Rath W, Steppat S, Surbek D, Wacker J. Peripartum Haemorrhage, Diagnosis and Therapy. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry No. 015/063, March 2016). Geburtshilfe Frauenheilkd 2018; 78:382-399. [PMID: 29720744 PMCID: PMC5925693 DOI: 10.1055/a-0582-0122] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 02/08/2018] [Accepted: 02/26/2018] [Indexed: 12/12/2022] Open
Abstract
Purpose
This is an official interdisciplinary guideline, published and coordinated by the German Society of Gynaecology and Obstetrics (DGGG), the Austrian Society of Gynaecology and Obstetrics (OEGGG) and the Swiss Society of Gynaecology and Obstetrics (SGGG). The guideline was developed for use in German-speaking countries and is backed by the German Society of Anaesthesiology and Intensive Medicine (DGAI), the Society of Thrombosis and Haemostasis Research (GTH) and the German Association of Midwives. The aim is to provide a consensus-based overview of the diagnosis and management of peripartum bleeding obtained from an evaluation of the relevant literature.
Methods
This S2k guideline was developed from the structured consensus of representative members of the various professional associations and professions commissioned by the Guideline Commission of the DGGG.
Recommendations
The guideline encompasses recommendations on definitions, risk stratification, prevention and management.
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Affiliation(s)
| | - Hanns Helmer
- Universitätsklinik für Frauenheilkunde, Klinische Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Wien, Austria
| | - Wolfgang Henrich
- Klinik für Geburtsmedizin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christian von Heymann
- Klinik für Anästhesie, Intensivmedizin und Schmerztherapie, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Franz Kainer
- Geburtshilfe und Pränatalmedizin, Klinik Hallerwiese, Nürnberg, Germany
| | | | - Maritta Kühnert
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Gießen-Marburg, Marburg, Germany
| | - Heiko Lier
- Klinik für Anästhesie und operative Intensivmedizin, Universitätsklinik Köln, Köln, Germany
| | - Holger Maul
- Geburtshilfe & Pränatalmedizin, Asklepios Klinik Barmbek, Hamburg, Germany
| | - Werner Rath
- Gynäkologie und Geburtshilfe, Universitätsklinikum RWTH Aachen, Aachen, Germany
| | | | - Daniel Surbek
- Universitätsklinik für Frauenheilkunde, Geburtshilfe und feto-maternale Medizin, Bern, Switzerland
| | - Jürgen Wacker
- Klinik für Gynäkologie und Geburtshilfe, Fürst-Stirum-Klinik Bruchsal, Bruchsal, Germany
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Bertholdt C, Menard S, Delorme P, Lamau MC, Goffinet F, Le Ray C. Intraoperative adverse events associated with extremely preterm cesarean deliveries. Acta Obstet Gynecol Scand 2018; 97:608-614. [PMID: 29336477 DOI: 10.1111/aogs.13290] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 01/06/2018] [Indexed: 12/17/2022]
Abstract
INTRODUCTION At the same time as survival is increasing among premature babies born before 26 weeks of gestation, the rates of cesarean deliveries before 26 weeks is also rising. Our purpose was to compare the frequency of intraoperative adverse events during cesarean deliveries in two gestational age groups: 24-25 weeks and 26-27 weeks. MATERIAL AND METHODS This single-center retrospective cohort study included all women with cesarean deliveries performed before 28+0 weeks from 2007 through 2015. It compared the frequency of intraoperative adverse events between two groups: those at 24-25 weeks of gestation and at 26-27 weeks. Intraoperative adverse events were a classical incision, transplacental incision, difficulty in fetal extraction (explicitly mentioned in the surgical report), postpartum hemorrhage (≥500 mL of blood loss), and injury to internal organs. A composite outcome including at least one of these events enabled us to analyze the risk factors for intraoperative adverse events with univariate and multivariable analysis. Stratified analyses by the indication for the cesarean were performed. RESULTS We compared 74 cesarean deliveries at 24-25 weeks of gestation and 214 at 26-27 weeks. Intraoperative adverse events occurred at higher rates in the 24-25-week group (63.5 vs. 30.8%, p < 0.001). After adjustment for confounding factors, this group remained at significantly higher risk of intraoperative adverse events [adjusted odds ratio 5.04 (2.67-9.50)], even after stratification by indication for the cesarean. CONCLUSION These results should help obstetricians and women making decisions about cesarean deliveries at these extremely low gestational ages.
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Affiliation(s)
- Charline Bertholdt
- Port-Royal Maternity Unit, Cochin Hospital, Paris-Descartes University, DHU Risk and Pregnancy, Assistance Publique-Hôpitaux de Paris, Paris, France.,Obstetric and Gynecology Unit, Regional University Hospital Center of Nancy, Nancy, France
| | - Sophie Menard
- Port-Royal Maternity Unit, Cochin Hospital, Paris-Descartes University, DHU Risk and Pregnancy, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Pierre Delorme
- Port-Royal Maternity Unit, Cochin Hospital, Paris-Descartes University, DHU Risk and Pregnancy, Assistance Publique-Hôpitaux de Paris, Paris, France.,National Institute of Health and Medical Research (Inserm), UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Paris-Descartes University, Paris, France
| | - Marie-Charlotte Lamau
- Port-Royal Maternity Unit, Cochin Hospital, Paris-Descartes University, DHU Risk and Pregnancy, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - François Goffinet
- Port-Royal Maternity Unit, Cochin Hospital, Paris-Descartes University, DHU Risk and Pregnancy, Assistance Publique-Hôpitaux de Paris, Paris, France.,National Institute of Health and Medical Research (Inserm), UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Paris-Descartes University, Paris, France
| | - Camille Le Ray
- Port-Royal Maternity Unit, Cochin Hospital, Paris-Descartes University, DHU Risk and Pregnancy, Assistance Publique-Hôpitaux de Paris, Paris, France.,National Institute of Health and Medical Research (Inserm), UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Paris-Descartes University, Paris, France
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Kayem G, Deneux-Tharaux C. [Increased risk of maternal death by postpartum hemorrhage in France: Are French practices involved?]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2017; 45:259-261. [PMID: 28479074 DOI: 10.1016/j.gofs.2017.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Indexed: 06/07/2023]
Affiliation(s)
- G Kayem
- Inserm UMR 1153, équipe de recherche en épidémiologie obstétricale périnatale et pédiatrique (EPOPé), centre de recherche en épidémiologie et statistiques Sorbonne Paris Cité, DHU risques et grossesse, Paris-Descartes université, 53, avenue de l'Observatoire, 75014 Paris, France; Service de gynécologie obstétrique, hôpital Trousseau, université Pierre-et-Marie-Curie, AP-HP, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France.
| | - C Deneux-Tharaux
- Inserm UMR 1153, équipe de recherche en épidémiologie obstétricale périnatale et pédiatrique (EPOPé), centre de recherche en épidémiologie et statistiques Sorbonne Paris Cité, DHU risques et grossesse, Paris-Descartes université, Paris, France
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Gauchotte E, De La Torre M, Perdriolle-Galet E, Lamy C, Gauchotte G, Morel O. Impact of uterine balloon tamponade on the use of invasive procedures in severe postpartum hemorrhage. Acta Obstet Gynecol Scand 2017; 96:877-882. [DOI: 10.1111/aogs.13130] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 03/02/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Emilie Gauchotte
- Gynecology and Obstetrics Department; Maternity; Regional University Hospital (CHRU); Nancy France
| | - Manuela De La Torre
- Gynecology and Obstetrics Department; Maternity; Regional University Hospital (CHRU); Nancy France
- University of Lorraine; Vandœuvre-lès-Nancy France
| | - Estelle Perdriolle-Galet
- Gynecology and Obstetrics Department; Maternity; Regional University Hospital (CHRU); Nancy France
| | - Catherine Lamy
- Gynecology and Obstetrics Department; Maternity; Regional University Hospital (CHRU); Nancy France
| | | | - Olivier Morel
- Gynecology and Obstetrics Department; Maternity; Regional University Hospital (CHRU); Nancy France
- University of Lorraine; Vandœuvre-lès-Nancy France
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Postpartum hemorrhage: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF). Eur J Obstet Gynecol Reprod Biol 2016; 198:12-21. [DOI: 10.1016/j.ejogrb.2015.12.012] [Citation(s) in RCA: 164] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 10/27/2015] [Accepted: 12/10/2015] [Indexed: 12/31/2022]
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Prise en charge initiale par l’anesthésiste-réanimateur d’une hémorragie du post-partum dans les suites d’un accouchement par voie basse. ACTA ACUST UNITED AC 2014; 43:1009-18. [DOI: 10.1016/j.jgyn.2014.09.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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8
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Haumonté JB, Sentilhes L, Macé P, Cravello L, Boubli L, d’Ercole C. Prise en charge chirurgicale d’une hémorragie du post-partum. ACTA ACUST UNITED AC 2014; 43:1083-103. [DOI: 10.1016/j.jgyn.2014.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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9
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Rossignol M, Rozenberg A. Modalités d’un transfert inter-hospitalier dans le cadre d’une hémorragie sévère du post-partum. ACTA ACUST UNITED AC 2014; 43:1123-32. [DOI: 10.1016/j.jgyn.2014.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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