1/43. uterine artery embolization--a successful treatment to control bleeding cervical pregnancy with a simultaneous intrauterine gestation.A case of a woman suffering from a bleeding heterotopic cervical pregnancy is described. The concurrent cervical pregnancy and intrauterine gestation were diagnosed by ultrasound and bleeding was initially controlled with selective fluoroscopic uterine artery embolization. A selective fetal reduction was done with ultrasound-guided intracardiac potassium chloride. uterine artery embolization has been used successfully to control haemorrhage in cervical pregnancies when the main goal was to allow preservation of the uterus, thus maintaining potential fertility. This is the first report of arterial embolization used to control bleeding for maintaining a concurrent intrauterine heterotopic pregnancy in an in-vitro fertilization patient. Unfortunately, subsequent conservative measures led to undesired outcome. This procedure initially controlled the bleeding without disrupting the intrauterine fetal cardiac activity.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/43. choriocarcinoma co-existent with an intact pregnancy: case report and review of the literature.A patient presenting with antepartum haemorrhage due to a vaginal metastasis of choriocarcinoma is reported. Following delivery she was successfully treated with chemotherapy and surgery. This report details this unusual presentation and reviews the literature on this rare condition.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
3/43. Twin pregnancy with a complete hydatidiform mole and co-existing fetus following in-vitro fertilization: case report.hydatidiform mole with a co-existing live fetus is a rare event. We report the case of a 41 year old Caucasian woman who attended for in-vitro fertilization. Three embryos, containing two apparently normal pronuclei, were transferred into the uterus. A twin pregnancy with a live fetus and a complete mole ensued. The pregnancy was managed conservatively until 28 weeks gestation when, following an episode of major antepartum haemorrhage, a live female infant was delivered by Caesarean section. The mole, weighing over 1.7 kg, was successfully evacuated. Following delivery, serum human chorionic gonadotrophin concentrations returned to baseline and remain within the normal range at 24 months. Both mother and daughter are well on assessment 24 months later.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
4/43. fertility following ligation of internal iliac arteries for life-threatening obstetric haemorrhage: case report.Bilateral ligation of internal iliac (hypogastric) arteries (BIL) is a life-saving operation in cases of massive obstetric haemorrhage. This operation preserves reproductive function as opposed to the more commonly performed emergency hysterectomy in such situations. We report on effectiveness and future fertility in 12 women who had internal iliac ligation to control severe obstetric haemorrhage: in 10 out of the 12 women, BIL was successful. Of the two women who subsequently needed emergency hysterectomy, one woman died of disseminated intravascular coagulation. Of the eight women we were able to follow-up to assess reproductive performance, two did not desire future fertility. Three had subsequent pregnancies (50%), of whom two proceeded to term. We conclude that BIL is a safe and effective procedure for treating life-threatening obstetric haemorrhage with preservation of future fertility. This technique should be performed more often when indicated.- - - - - - - - - - ranking = 7keywords = haemorrhage (Clic here for more details about this article) |
5/43. Expectant management of placenta accreta following stillbirth at term: a case report.placenta accreta is a rare complication of pregnancy with high rates of morbidity and mortality. We report a case of expectant management. This strategy may prevent catastrophic postpartum haemorrhage requiring peripartum hysterectomy.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
6/43. Cervico-isthmic pregnancy: an extremely rare case diagnosed during labour.This case report describes a cervico-isthmic pregnancy ending in a live vaginal birth at 37 2 weeks' gestation. The case remained undiagnosed throughout pregnancy when after a fairly normal labour a massive haemorrhage occurred. After an unsuccessful effort to control the bleeding conservatively, a total abdominal hysterectomy was carried out. During the operation the diagnosis of cervico-isthmic pregnancy was confirmed, which was in accordance with the pathology report.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
7/43. Recurrent bleeding from the lower segment scar--a late complication of Caesarean section.hysterectomy became necessary six months after Caesarean section because of recurrent severe haemorrhage from the uterine scar.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
8/43. A case of uterine artery pseudoaneurysms.Uterine artery pseudoaneurysms is a rare cause of haemorrhage but is potentially life-threatening and can occur after common gynaecological operations such as a Caesarean section or a hysterectomy. A 33-year-old woman who developed secondary postpartum haemorrhage after a Caesarean section was diagnosed to have uterine artery pseudoaneurysms on ultrasound scan. She was treated with bilateral uterine artery embolisation via selective catherisation of uterine arteries. Good outcome with the aneurysms remaining obliterated was obtained. Angiographic embolisation is a safe and effective method of treating postpartum haemorrhage in haemodynamically stable patients and should be an option before resorting to surgery in appropriately selected cases.- - - - - - - - - - ranking = 3keywords = haemorrhage (Clic here for more details about this article) |
9/43. Complete recovery after 2 h of cardiopulmonary resuscitation following high-dose prostaglandin treatment for atonic uterine haemorrhage.We report the case of a 31-year-old woman who delivered twins by Caesarean section in whom atonic uterine haemorrhage developed 6 h postoperatively. During conservative treatment with the high-dose prostaglandin analogs sulprostone (PGE(2)) and dinoprost (PGF(2alpha)), acute pulmonary oedema and cardiac decompensation developed and, subsequently, the patient suffered cardiopulmonary arrest. After a 2h-period of cardiopulmonary resuscitation (CPR), it was possible to restore and stabilize circulation under the highest dose of catecholamines. Despite 2h of CPR, the patient was discharged from hospital 3 months later without any major physical or neurocognitive deficit.- - - - - - - - - - ranking = 5keywords = haemorrhage (Clic here for more details about this article) |
10/43. Probable dystonic reaction after a single dose of cyclizine in a patient with a history of encephalitis.A patient underwent an emergency Caesarean section under general anaesthesia for an antepartum haemorrhage. Following delivery of a live infant, cyclizine was administered in accordance with departmental anti-emetic protocol. On awakening she was confused, slow to articulate and had slurred speech. A computed tomography (CT) scan, which was performed to exclude an intracranial event, was normal. Her symptoms were suggestive of a lingual-facial-buccal dyskinesia as seen with dopamine antagonists. A presumptive diagnosis of a dystonic reaction to cyclizine was made. She received two doses of procyclidine before her symptoms completely resolved. cyclizine has had a resurgence in popularity owing to the recent withdrawal of droperidol and anaesthetists should be aware that, although extremely rare, dystonic reactions may occur with this agent.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
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