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Gu DF, Deng C. Balloon displacement during caesarean section with pernicious placenta previa: A case report. World J Clin Cases 2023; 11:8574-8580. [PMID: 38188213 PMCID: PMC10768502 DOI: 10.12998/wjcc.v11.i36.8574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/26/2023] [Accepted: 12/15/2023] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND For the past few years, preventive interventional therapy has been widely used domestically and overseas, bringing great benefits to pregnant women at high-risk for complications, such as pernicious placenta previa (PPP) and placenta accreta. Nevertheless, there are still few reports on surgical complications related to interventional therapy, and its safety should be a concern. CASE SUMMARY We report a 36-year-old pregnant woman with PPP who underwent balloon implantation in the lower segment of the abdominal aorta before caesarean section. However, the balloon shifted during the operation, which damaged the arterial vessels after filling, resulting in severe postpartum haemorrhage in the patient. Fortunately, after emergency interventional stent implantation, the patient was successfully relieved of the massive haemorrhage crisis. CONCLUSION It seems that massive postoperative bleeding has been largely avoided in preventive interventional therapy in high-risk pregnant women with placenta-related diseases, but surgical complications related to intervention therapy can also cause adverse consequences. It is equally important for clinical doctors to learn how to promptly identify and effectively treat these rare complications.
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Affiliation(s)
- Deng-Feng Gu
- Department of Anesthesiology, The First Affiliated Hospital of Shihezi University, Shihezi 832000, Xinjiang Uighur Autonomous Region, China
| | - Chao Deng
- Department of Anesthesiology, The First Affiliated Hospital of Shihezi University, Shihezi 832000, Xinjiang Uighur Autonomous Region, China
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Wang J, Yang H. Effect of carboprost tromethamine injection combined with modified B-lynch suture and carboprost methylate suppositories in parturients with placenta previa. Am J Transl Res 2021; 13:7812-7818. [PMID: 34377258 PMCID: PMC8340154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/24/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the clinical value of carboprost tromethamine injection combined with modified B-lynch suture and carboprost methylate suppositories in the treatment of placenta previa parturients with postpartum hemorrhage after cesarean section. METHODS A total of 102 parturients with placenta previa and postpartum hemorrhage after cesarean section in our hospital were selected as the study subjects, and they were divided into Group A (carboprost tromethamine injection combined with modified B-lynch suture, n=35), Group B (carboprost methylate suppositories, n=34), and Group C (carboprost tromethamine injection, n=33) in accordance with a random number table. The amounts of hemorrhaging and clinical indices in the three groups were recorded, and the rescue effects were compared among the three groups. RESULTS The amount of hemorrhaging in Group A was significantly lower than that in Groups B and C during surgery and 24 h after surgery (P < 0.05). There were markedly improved clinical indices in Groups A, B and C, showing statistical significance (P < 0.05). There were statistically significant differences in hemostatic failure rate, hysterectomy, postoperative abdominal pain and puerperal infection between Groups A and B (P < 0.05). The intraoperative indices, postoperative infection, effective hemostasis rate and rate of advanced postpartum hemorrhage in Group A were remarkably higher than those in Groups B and C (P < 0.05), showing statistical significance (P < 0.05). There were statistically significant differences in blood oxygen saturation and pulse among the three groups before surgery and 2 h after surgery (P < 0.05). CONCLUSION Carboprost tromethamine injection combined with modified B-lynch suture and carboprost methylate suppositories can reduce the amount of hemorrhaging and the risk of postoperative infection in placenta previa patients with postpartum hemorrhage after cesarean section.
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Affiliation(s)
- Jianli Wang
- Department of Obstetrics, The First Hospital of Shanxi Medical University Taiyuan 030000, Shanxi, China
| | - Hailan Yang
- Department of Obstetrics, The First Hospital of Shanxi Medical University Taiyuan 030000, Shanxi, China
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NAWSHERWAN, KHAN A, BEGUM N, AHMED Z, MUBARIK S, HAQ IU, NABI G, ULLAH N, FAN C, WANG S. Low Birth Weight, and Low Ponderal Index Mediates the Association between Preeclampsia, Placenta Previa, and Neonatal Mortality. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:654-662. [PMID: 32548045 PMCID: PMC7283188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 09/20/2019] [Indexed: 10/31/2022]
Abstract
BACKGROUND A retrospective study was conducted to assess the mediation role of low birth weight, and low ponderal index between the preeclampsia, placenta previa, and neonatal mortality in the tertiary hospital of Hubei Province, China. METHODS A total of 12772 neonatal births were included for data analysis. Birth weight, birth length, and neonatal mortality were recorded after birth. Sobel test based on mediation regression was used to evaluate the effect of mediator variables. RESULTS Approximately, 383 (3%) and 409 (3.2%) women experienced preeclampsia and placenta previa respectively. After adjusting for covariates, the indirect effect of preeclampsia on neonatal mortality mediated by low birth weight and low ponderal index was [β 2.59 (95% CI: 0.74 - 4.44)], and [β 3.94 (95% CI: 1.50 - 6.38)] respectively. Moreover, the indirect effect of placenta previa on neonatal mortality mediated by the low birth weight was [β 1.74 (95% CI: 0.16 - 3.31)], and low ponderal index was [β 3.21 (95% CI: 0.95 - 5.48)]. The estimated mediation proportion between the preeclampsia and neonatal mortality accounting for possible mediation by low birth weight and low ponderal index was 44.5% and 34.5% respectively. Furthermore, 47.9% by low birth weight and 33.2% by low ponderal index mediate the association between placenta previa and neonatal mortality. CONCLUSION Low birth weight, and low ponderal index partially mediates the association between preeclampsia, placenta previa and neonatal mortality.
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Affiliation(s)
- NAWSHERWAN
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
| | - Abbas KHAN
- Department of Food Science, College of Food Science and Engineering, Jilin University, Changchun, China
| | - Nabila BEGUM
- Department of Advanced Innovation Center for Food Nutrition and Human Health, Laboratory of Molecular Sensory Science, College of Food and Chemical Engineering, Beijing Technology and Business University, Beijing, China
| | - Zahoor AHMED
- Department of Food Science, School of Food Science and Engineering, South China University of Technology, Guangzhou, China
| | - Sumaira MUBARIK
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
| | - Ijaz Ul HAQ
- Department of Food Science, College of Food and Pharmaceutical Science, Huaian, Jiangsu, China
| | - Ghulam NABI
- Key Laboratory of Animal Physiology, Biochemistry and Molecular Biology of Hebei Province, College of Life Sciences, Hebei Normal University, Shijiazhuang, China
| | - Naeem ULLAH
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, China
| | - Cuifang FAN
- Department of Obstetrics and Gynecology, Renmin Hospital, Wuhan University, Wuhan, Hubei, China
| | - Suqing WANG
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Academy for Preventive Medicine, Wuhan, Hubei, China
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Shinohara S, Okuda Y, Hirata S. Association between birth weight and massive haemorrhage in pregnancy with a low-lying placenta: a 9-year single-centre retrospective cohort study in Japan. J OBSTET GYNAECOL 2018; 39:22-26. [PMID: 29884097 DOI: 10.1080/01443615.2018.1454413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
A low-lying placenta is a well-known cause of a massive intrapartum haemorrhage. We aimed to evaluate whether neonatal birth weight deviation from the nationwide average could predict a massive haemorrhage during a delivery in the women with a low-lying placenta. This study included 40 women. The main outcomes were a massive haemorrhage and a neonatal birth weight deviation. We used a receiver operating characteristic curve analysis to determine the optimal birth weight deviation cut-off for predicting a massive haemorrhage. A multiple logistic regression model was used to identify the variables significantly associated with a massive haemorrhage. The best cut-off for predicting a massive haemorrhage was a birth weight deviation of +0.51 standard deviations (SDs) from the nationwide average. A birth weight deviation of ≥ +0.51 SDs was significantly associated with an increased massive haemorrhage risk. Impact statement What is already known on this subject? A low-lying placenta is a well-known cause of a massive intrapartum haemorrhage. Therefore, when managing pregnancies with a low-lying placenta, the possibility of severe perinatal bleeding should be considered, and it is desirable to determine reliable predictors of a haemorrhage. However, few studies have reported the predictive factors of a massive haemorrhage in patients with a low-lying placenta. What do the results of this study add? We demonstrated that a birth weight deviation from the nationwide average was significantly associated with a massive intrapartum haemorrhage in patients with a low-lying placenta. To our knowledge, this is the first study to clarify the association between a neonatal birth weight and a massive intrapartum haemorrhage incidence and to determine the optimal birth weight deviation cut-off for predicting a massive haemorrhage in patients with a low-lying placenta. What are the implications of these findings for clinical practice and/or further research? An accurate risk stratification using the foetal weight as a marker for a predicting massive intrapartum haemorrhage may help in the management of patients with a low-lying placenta. Studies with a larger sample size are required to confirm our findings.
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Affiliation(s)
- Satoshi Shinohara
- a Department of Obstetrics and Gynecology, Faculty of Medicine , University of Yamanashi , Chuo , Japan
| | - Yasuhiko Okuda
- a Department of Obstetrics and Gynecology, Faculty of Medicine , University of Yamanashi , Chuo , Japan
| | - Shuji Hirata
- a Department of Obstetrics and Gynecology, Faculty of Medicine , University of Yamanashi , Chuo , Japan
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