1/10. Successful term pregnancy after bilateral uterine artery embolization for postpartum hemorrhage.BACKGROUND: Selective bilateral uterine artery embolization has been used since the 1970s for the conservative treatment of postpartum hemorrhage. The fertility rate after the embolization procedure is yet to be determined. CASE: A 30-year-old woman presented with placental abruption and subsequently delivered preterm at 29 weeks' gestation. Her delivery was complicated by postpartum hemorrhage, for which selective bilateral uterine artery embolization was performed with successful cessation of the hemorrhage. Three months later, the patient presented with a spontaneous pregnancy. Her pregnancy resulted in an appropriately grown fetus delivered at 39 weeks' gestation. CONCLUSION: This is one of the earliest reported successful pregnancies after a bilateral uterine artery embolization procedure performed for postpartum hemorrhage. This case adds to a growing literature demonstrating that pregnancy after embolization is possible, and can occur soon after the procedure.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
2/10. Traumatic aortic rupture during pregnancy.A 29-year-old woman, in her third trimester of pregnancy, underwent emergency Caesarian section for placental abruption following a road traffic accident. Following transfer, an abrupt change in the diameter of the aorta was noted on CT scan. aortography confirmed aortic rupture distal to the left subclavian artery and Dacron graft replacement of this segment was carried out, utilizing a left atrial to descending aorta partial bypass through a centrifugal pump. The mother is alive and well at 4 months follow-up.- - - - - - - - - - ranking = 0.14285714285714keywords = artery (Clic here for more details about this article) |
3/10. The use of Doppler umbilical artery waveforms in placental abruption; a report of two cases.In a prospective study, the predictive value of Doppler umbilical arterial velocimetry waveforms in detecting the fetus at risk was examined in ten patients with abruptio placenta. One patient suffered intra-uterine fetal death within 8 h of obtaining a normal reactive cardiotocograph and normal umibilical artery waveforms. In another patient with severe placental abruption, following 2500 ml of blood loss, the umbilical artery waveforms were normal. In this study, umbilical artery waveforms failed to predict fetal outcome in cases of placental abruption.- - - - - - - - - - ranking = 1647.199843634keywords = umbilical artery, umbilical, artery (Clic here for more details about this article) |
4/10. abruptio placentae after percutaneous umbilical cord sampling: a case report.The use of umbilical cord sampling is becoming more widespread. The full risk of the procedure, however, is not completely known. Reported here is a case of abruptio placentae immediately after percutaneous umbilical cord sampling.- - - - - - - - - - ranking = 54.451435050531keywords = umbilical (Clic here for more details about this article) |
5/10. Fetal and uteroplacental flow velocity waveforms in abruptio placentae: report of two cases.This paper reports two cases of abruptio placentae assessed using pulsed Doppler at 29 and 30 weeks of gestation. Transvaginal pulsed Doppler showed abnormal uterine artery FVWs in both cases. One fetus with normal umbilical and normal middle cerebral artery FVWs was not acidotic and only midly hypoxic, whereas the other fetus with normal umbilical and abnormal middle cerebral artery FVWs was severely acidotic and hypoxic at birth. It is suggested that Doppler assessment of fetal blood distribution is of great value for the rapid diagnosis of fetal asphyxia, and that uteroplacental FVWs provide reliable information on which to base the diagnosis of abruptio placentae.- - - - - - - - - - ranking = 18.579049778748keywords = umbilical, artery (Clic here for more details about this article) |
6/10. Resuscitating fresh stillbirths.Guidelines for duration of resuscitation of freshly-stillborn term infants and their long term outcome are unclear. The predictive factors of both cerebral palsy and early neonatal demise include Apgar scores of 3 or less at 10 minutes, perinatal acidaemia and neonatal seizures. We describe the case of severe perinatal asphyxia (umbilical artery pH at birth of 6.75, Apgar scores of 0.1 and 5 0.1 5 at 1.5 and 10 minutes and neonatal hypertonia) in a term pregnancy, where the infant made an uneventful recovery and was discharged home well. Guidelines for neonatal resuscitation are discussed.- - - - - - - - - - ranking = 272.99695788601keywords = umbilical artery, umbilical, artery (Clic here for more details about this article) |
7/10. Critical remarks on external cephalic version under tocolysis. Report on a case of antepartum fetal death.SALING and MULLER-HOLVE recently proposed an improved method of external cephalic version brought about a renewed interest in this obstetric procedure. In spite of the undisputed advantages in individual cases we posed the following questions: 1. The extent of the decreased cesaerean section rate 2. The fetal risk We estimate a decrease of cesarean sections by about 1.5% under the assumption that a breech presentation in primiparae is an indication of cesarean section and that 70% of the version attempts would be successful. The estimate includes some cases of multi-parae breech presentations which would have been operated without external version. The resulting decrease of the cesarean section rate is generally not very important and has a greater impact only in individual cases. We have some misgivings about the fetal risk. We report here on a case of intrauterine fetal death after failed external version. A 28 year-old primiparae without known pregnancy complications was admitted with a breech presentation in the 37th week of gestation. The biparietal diameter of the fetal head was appropriate and the placenta was posterior. Cardiotocogram before and after the unsuccessful version were in part misinterpreted. Seven hours after the version the fetal death was confirmed. Histological examination of the placenta showed a severe dissociated maturation disturbance in addition to a 10 X 8 cm large abruptio which had not been noted clinically. A prediabetes was suspected. The fetus itself showed no anomalies. This was interpreted as a severely placentogenically prestressed infant and prediabetes. The extent of the placental disturbance was unknown and had not been appreciated from the ultrasound examination. The placenta had acute infarcts and a circumscript abruption. The CTG was misinterpreted in part. In another case of version the postoperative cardiotocogram showed pathologic patterns. The birth occurred three weeks later without problems with a well child and an umbilical artery pH of 7.31...- - - - - - - - - - ranking = 272.99695788601keywords = umbilical artery, umbilical, artery (Clic here for more details about this article) |
8/10. retinopathy of prematurity in infants of birth weight > 2000 g after haemorrhagic shock at birth.BACKGROUND: The risk of retinopathy of prematurity (ROP) is associated with low birth weight and low gestational age. For ROP screening examination is recommended in infants weighing < or = 1500 g or of less than 32 weeks' gestational age. methods: From 1991 ROP screening was performed in 452 premature infants with either a birth weight < or = 1500 g (n = 303) or a birth weight > 1500 g (n = 149) and who required additional oxygen supplementation or underwent surgery with general anaesthesia before estimated term. RESULTS: Unexpectedly, three infants with birth weights between 2080 and 2325 g and a gestational age of 32 or 33 weeks developed stage 2 or 3 ROP. One of these underwent cryocoagulation. In three infants, preterm birth was induced by sudden placental abruption with severe prenatal blood loss followed by haemorrhagic shock. The umbilical cord packed cell volume was reduced to 0.14-0.19 (normal 0.43-0.63). All three infants underwent surgery with general anaesthesia within the first weeks of life. Of the remaining 449 infants none with a birth weight > 1650 g developed any stage of ROP. CONCLUSION: Severe prenatal blood loss requiring blood transfusions and surgery with general anaesthesia may induce higher stages of ROP even in infants with birth weights exceeding the usual screening criteria.- - - - - - - - - - ranking = 9.0752391750884keywords = umbilical (Clic here for more details about this article) |
9/10. Laceration of umbilical artery and abruptio placentae secondary to amniocentesis.A case of a lacerated umbilical artery causing an abruptio placentae and subsequent emergency cesarean section is presented, with a review of the complications of amniocentesis. A search of the literature has failed to reveal that this particular complication has been previously reported.- - - - - - - - - - ranking = 1364.98478943keywords = umbilical artery, umbilical, artery (Clic here for more details about this article) |
10/10. Hemodynamic changes with paradoxical blood flow in expectant management of abruptio placentae.BACKGROUND: Because the early diagnosis of abruption often is missed or misinterpreted, emergency situations frequently do not permit adequate management. CASE: A woman of 26-weeks' gestation was transferred with symptoms and laboratory findings typical for abruption. Ultrasound, including Doppler, revealed a subchorionic hematoma, pathologic blood flow in the uterine arteries, low pulsatility index values in the fetal cerebral and umbilical arteries (paradoxical blood flow), and high maximal velocities in the fetal aorta. Repeated Doppler and laboratory examinations revealed a gradual restoration to normal of the arterial uterine blood flow pattern, of paradoxical blood flow, aortic maximal velocities, and laboratory values. CONCLUSION: Serial Doppler measurements considering the paradoxical pattern illustrate pathophysiologic mechanisms of abruption that may assist in deciding whether to deliver immediately or to continue intense surveillance.- - - - - - - - - - ranking = 9.0752391750884keywords = umbilical (Clic here for more details about this article) |
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