WorldWideScience

Sample records for placenta previa estudio

  1. Ultrasonography evaluations of placenta previa

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hak Seo; Yim, Neung Jae; Oh, Eun Ock [Korea General Hospital, Seoul (Korea, Republic of); Park, Soo Soung [Chung Ang University College of Medicine, Seoul (Korea, Republic of)

    1984-12-15

    Diagnostic ultrasound has become one of the most useful tools in the practice of obstetrics. It has been of particular utility in the placental localization. We analyzed 34 patients of placenta previa scanned by ultrasound. The results were as follows; 1. The age of patient ranged from 22 to 39 years, showing the highest incidence in 26 to 30 years. 2. The accuracy of correct localization was 70.6%. 3. Among 13 cases diagnosed by ultrasound as total placenta previa, 2 cases were partial placental previa and 1 was low-lying placenta at the time of delivery. 4. Among 9 cases diagnosed by ultrasound as partial placenta previa, 1 case was total placenta previa and 1 case was low-lying placenta and 1 case was upper segment placenta. 5. Among 10 cases diagnosed by ultrasound as low-lying placenta, 2 cases were partial placenta previa. 6. Among 2 cases diagnosed by ultrasound as upper segment placenta, 1 case was total placenta previa and 1 case was partial placenta previa. 7. Among 9 cases done serial ultrasound, 3 cases revealed that the placenta migrates toward fundus in the course of pregnancy. Therefore, the placental scanning should be repeated in the last month before term to decide the mode of delivery. Conclusively, ultrasonography is the imaging modality of choice in the evaluation of placenta localization because it provides speedy and repeatable way without any known risk to both mother and fetus itself. Careful performance and accurate interpretation should be needed for more correct placental localization.

  2. Abnormal Placentation: Placenta Previa, Vasa Previa, and Placenta Accreta.

    Science.gov (United States)

    Silver, Robert M

    2015-09-01

    Placental disorders such as placenta previa, placenta accreta, and vasa previa are all associated with vaginal bleeding in the second half of pregnancy. They are also important causes of serious fetal and maternal morbidity and even mortality. Moreover, the rates of previa and accreta are increasing, probably as a result of increasing rates of cesarean delivery, maternal age, and assisted reproductive technology. The routine use of obstetric ultrasonography as well as improving ultrasonographic technology allows for the antenatal diagnosis of these conditions. In turn, antenatal diagnosis facilitates optimal obstetric management. This review emphasizes an evidence-based approach to the clinical management of pregnancies with these conditions as well as highlights important knowledge gaps.

  3. MATERNAL AND FOETAL OUTCOME IN PLACENTA PREVIA

    Directory of Open Access Journals (Sweden)

    Basa Akkamamba

    2016-11-01

    Full Text Available BACKGROUND The aim of the study is to study the-  Risk factors for placenta previa.  Signs of placenta previa.  Modes of delivery.  Maternal and foetal outcome.  Incidence of placenta previa. MATERIALS AND METHODS This is a longitudinal prospective study group consisting of 75 cases of pregnancies with placenta previa. Analysis of maternal and neonatal outcome in cases of placenta previa occurring over a period of 2 years from November 2013 to October 2016. This study was carried out at Government General Hospital, Kakinada, attached to Rangaraya Medical College. RESULTS Maternal morbidity in placenta previa is due to antepartum, intrapartum and postpartum complications. Maternal mortality due to placenta previa was nil. Perinatal death with minor placenta previa was 5.12% with major placenta previa was 47.22%. The general perinatal mortality was 28 per 1000 live births and that due to placenta previa 280 per 1000 live births, i.e. approximately 4 times higher than general perinatal mortality rate. The maternal mortality rate due to placenta previa in this study was nil. CONCLUSIONS In the present study, incidence of antepartum haemorrhage was 0.87% and placenta previa contributed to 37.12% of cases. The general perinatal mortality was 28 per 1000 live births and that due to placenta previa 280 per 1000 live births, i.e. approximately 4 times higher than general perinatal mortality rate. The maternal mortality rate due to placenta previa in this study was nil. But, maternal morbidity was high that is more than 60% of cases had antenatal, intranatal and postnatal complications and anaemia worsened the clinical state of patient.

  4. Effect of Placenta Previa on Fetal Growth

    Science.gov (United States)

    HARPER, Lorie M.; ODIBO, Anthony O.; MACONES, George A.; CRANE, James P.; CAHILL, Alison G.

    2011-01-01

    Objective To estimate the association between placenta previa and abnormal fetal growth. Study Design Retrospective cohort study of consecutive women undergoing ultrasound between 15–22 weeks. Groups were defined by the presence or absence of complete or partial placenta previa. The primary outcome was intrauterine growth restriction (IUGR), defined as a birth weight placenta previa on fetal growth restriction. Results Of 59,149 women, 724 (1.2%) were diagnosed with a complete or partial previa. After adjusting for significant confounding factors (black race, gestational diabetes, preeclampsia, and single umbilical artery,), the risk of IUGR remained similar (adjusted odds ratio 1.1, 95% CI 0.9–1.5). The presence of bleeding did not impact the risk of growth restriction. Conclusion Placenta previa is not associated with fetal growth restriction. Serial growth ultrasounds are not indicated in patients with placenta previa. PMID:20599185

  5. Placenta associated pregnancy complications in pregnancies complicated with placenta previa

    National Research Council Canada - National Science Library

    Yael Baumfeld; Reli Herskovitz; Zehavi Bar Niv; Salvatore Andrea Mastrolia; Adi Y. Weintraub

    2017-01-01

    Objectives: The purpose of our study was to examine the hypothesis that pregnancies complicated with placenta previa have an increased risk of placental insufficiency associated pregnancy complications...

  6. Placenta associated pregnancy complications in pregnancies complicated with placenta previa

    Directory of Open Access Journals (Sweden)

    Yael Baumfeld

    2017-06-01

    Conclusions: Our study demonstrated an increased rate of placental insufficiency associated complications in women with placenta previa. This is of clinical relevance and suggests that a careful surveillance for women with placenta previa may help in minimizing maternal, fetal and neonatal complications.

  7. Placenta associated pregnancy complications in pregnancies complicated with placenta previa.

    Science.gov (United States)

    Baumfeld, Yael; Herskovitz, Reli; Niv, Zehavi Bar; Mastrolia, Salvatore Andrea; Weintraub, Adi Y

    2017-06-01

    The purpose of our study was to examine the hypothesis that pregnancies complicated with placenta previa have an increased risk of placental insufficiency associated pregnancy complications (IUGR, preeclampsia, placental abruption and perinatal mortality). Our study included all deliveries that occurred at Soroka University Medical Center (Beer Sheva, Israel) between January 1998 and December 2013. Of them 1,249 were complicated by placenta previa and represented our study group. A composite outcome was created to include conditions associated with placental insufficiency. It included hypertensive disorders (i.e. gestational hypertension, mild and severe preeclampsia, HELLP and eclampsia), small for gestational age neonates and placental abruption. Patients with pregnancy complicated by placenta previa had significantly different obstetrical characteristics including bad obstetric history (8% vs. 4%, p placenta previa had higher rates of vaginal bleeding in the second half of pregnancy (3% vs. 0%, p placenta (4% vs. 0.5%, p placenta previa group (21% vs. 13%, p placenta previa. This is of clinical relevance and suggests that a careful surveillance for women with placenta previa may help in minimizing maternal, fetal and neonatal complications. Copyright © 2017. Published by Elsevier B.V.

  8. Placenta previa and maternal hemorrhagic morbidity.

    Science.gov (United States)

    Gibbins, Karen J; Einerson, Brett D; Varner, Michael W; Silver, Robert M

    2017-02-21

    Placenta previa is associated with maternal hemorrhage, but most literature focuses on morbidity in the setting of placenta accreta. We aim to characterize maternal morbidity associated with previa and to define risk factors for hemorrhage. This is a secondary cohort analysis of the NICHD Maternal-Fetal Medicine Units Network Cesarean Section Registry. This analysis included all women undergoing primary Cesarean delivery without placenta accreta. About 496 women with previa were compared with 24,201 women without previa. Primary outcome was composite maternal hemorrhagic morbidity. Non-hemorrhagic morbidities and risk factors for hemorrhage were also evaluated. Maternal hemorrhagic morbidity was more common in women with previa (19 versus 7%, aRR 2.6, 95% CI 1.9-3.5). Atony requiring uterotonics (aRR 3.1, 95% CI 2.0-4.9), red blood cell transfusion (aRR 3.8, 95% CI 2.5-5.7), and hysterectomy (aRR 5.1, 95% CI 1.5-17.3) were also more common with previa. For women with previa, factors associated with maternal hemorrhage were pre-delivery anemia, thrombocytopenia, diabetes, magnesium use, and general anesthesia. Placenta previa is an independent risk factor for maternal hemorrhagic morbidity. Some risk factors are modifiable, but many are intrinsic to the clinical scenario.

  9. Placenta previa percreta with bladder invasion

    Directory of Open Access Journals (Sweden)

    Siniša Šijanović

    2011-02-01

    Full Text Available A 43- year old woman, with ten previous deliveries and history of two cesarean sections was admitted to our Department at 32 weeks of gestation with massive vaginal hemorrhage from an ultrasound diagnosed placenta previa. An emergency cesarean section with vertical abdominal incision was performed. A healthy 2300 g female infant was delivered. Attempts to manually remove the placenta caused massive hemorrhage. The lower uterine segment was widened due to placenta previa with suspicious placental invasion of the posterior wall of the bladder. Persistent hemorrhage demanded bilateral anterior internal iliac artery ligation and suture ligation of the bleeding vessels with supracervical hysterectomy done.

  10. Placenta accreta with placenta previa. Case report

    National Research Council Canada - National Science Library

    Hernández-Ojeda, Humberto; Torres-Hernández, Rosa María; Rivera-Hernández, Jorge Onasis

    2014-01-01

    The placenta praevia and acretism placental were concurrently and are conditions of abnormal placenta, in which the villus sampling invade the myometrium at the site of implantation and is associated...

  11. [Placenta accreta with placenta previa. Case report].

    Science.gov (United States)

    Hernández-Ojeda, Humberto; Torres-Hernández, Rosa María; Rivera-Hernández, Jorge Onasis

    2014-08-01

    The placenta praevia and acretism placental were concurrently and are conditions of abnormal placenta, in which the villus sampling invade the myometrium at the site of implantation and is associated with the partial or complete absence of the decidua. Clinical case: Patient's 32 years of age, with 34 weeks pregnancy. Obstetric history of previous cesarean section, transvaginal bleeding several times; the diagnosis by ultrasound showed placenta praevia occlusive. Surgical treatment was abdominal total hysterectomy.

  12. Obstetric complications of placenta previa percreta

    Directory of Open Access Journals (Sweden)

    Sparić Radmila

    2014-01-01

    Full Text Available Introduction. Placenta previa is related to severe maternal and fetal morbidity. The increasing incidence of cesarean delivery rate causes a marked increase in abnormally invasive placenta over the past decades. The abnormally invasive placenta is becoming the foremost cause of obstetric hemorrhage and postpartum hysterectomy, causing a significant maternal and fetal morbidity and even mortality. Maternal morbidity in such cases also comprise politransfusion, development of disseminated intravascular coagulation, uterine rupture, cystostomy, fistula formation, ureteral stricture, intensive care unit admission, infection, and prolonged hospitalization, adult respiratory distress syndrome, renal failure, septicemia and even death. Case report. A 38-year-old gravida 3, para 2, was admitted to our hospital at 27 weeks of gestation as an emergency due to vaginal bleeding, previously diagnosed with an anterior placenta previa. Following tocolytic therapy, bleeding stopped. The patient was informed on the diagnosis and the possibility of lifethreatening hemorrhage necessitating preterm delivery. She was given corticosteroids to enhance fetal lung maturity. At 28 weeks of gestation, she experienced massive vaginal bleeding, and a decision was made to perform emergency cesarean section. We made a corporeal transverse uterine incision well above the uterovesical fold and tortuous vessels, at the same time avoiding the superior edge of the placenta. The placenta was found to be densely adherent to the lower uterine segment, penetrating through it and infiltrating the posterior wall of the urinary bladder. An attempt to remove the placenta resulted in injury to the bladder wall and the uterine rupture at a previous cesarean scar. The decision was made to perform total abdominal hysterectomy with placenta left in situ. At present, both mother and the baby are well. Conclusion. Anticipation and the surgeon's judgment are leading factors for surgery, from the

  13. [Management of placenta previa and accreta].

    Science.gov (United States)

    Kayem, G; Keita, H

    2014-12-01

    Produce recommendations for the management of placenta previa and placenta accrete. A literature search was conducted using Medline and the Cochrane Library over a period from 1950 to 31/12/2013. Recommendations of the latest scientific societies have also been consulted. In cases of placenta previa, if bleeding episode before 34weeks gestation occurs, a short hospitalization and tocolysis may help stop bleeding (grade C). Vaginal delivery is preferable when the distance between the internal cervical os and the placental edge is greater than 20mm. When this distance is less than 20mm, vaginal delivery is possible (professional consensus). Caesarean section is recommended in cases of placenta overlapping the internal os (professional consensus). Antenatal screening placenta accreta could improve care (EL3). Upon discovery of a placenta accreta during childbirth, it is better to avoid a forced removal of the placenta (grade C). Conservative treatment or cesarean hysterectomy are possible (grade C). The management of placental abnormalities should be planned and managed with a multidisciplinary team (professional consensus). The use of blood-saving techniques such as "cell saver" is possible in situations where early intraoperative bleeding would be>1500mL (grade C). There are no studies that have sufficient methodological value to recommend an anesthetic technique [general anaesthesia (GA) or neuraxial anaesthesia] over another in the context of placental abnormalities (grade B). When a major bleeding risk is identified, GA can be chosen in order to avoid emergency conversions in difficult conditions (professional consensus). Placental insertion abnormalities require anesthetic and obstetric coordination. Delivery must be planned in a suitable structure. Copyright © 2014. Published by Elsevier Masson SAS.

  14. Risk Factors of Neonatal Anemia in Placenta Previa

    Directory of Open Access Journals (Sweden)

    Dong Gyu Jang, Yun Sung Jo, Sung Jong Lee, Gui Se Ra Lee

    2011-01-01

    Full Text Available Objectives: Placenta previa is a major cause of neonatal anemia. The purpose of this study was to elucidate the risk factors of neonatal anemia in placenta previa.Methods: The study was conducted on 158 placenta previa patients at 3 hospitals in affiliation with the Catholic Medical Center, Seoul, Korea from May 1999 through December 2009. The subjects were divided in to 2 groups: 47 placenta previa patients with neonatal anemia, and 113 placenta previa patients without neonatal anemia. The subjects' characteristics were compared. Logistic regression was used to control for confounding factors.Results: Anterior placental location (OR 2.48; 95% CI: 1.20-5.11 was an independent risk factor of neonatal anemia after controlling for potential confounders.Conclusion: To manage neonatal anemia in placenta previa patients, obstetricians should do their best to detect placental location. Pediatricians should consider the high possibility of neonatal anemia in cases involving anterior placental location.

  15. Risk Factors of Neonatal Anemia in Placenta Previa

    Science.gov (United States)

    Jang, Dong Gyu; Jo, Yun Sung; Lee, Sung Jong; Lee, Gui Se Ra

    2011-01-01

    Objectives: Placenta previa is a major cause of neonatal anemia. The purpose of this study was to elucidate the risk factors of neonatal anemia in placenta previa. Methods: The study was conducted on 158 placenta previa patients at 3 hospitals in affiliation with the Catholic Medical Center, Seoul, Korea from May 1999 through December 2009. The subjects were divided in to 2 groups: 47 placenta previa patients with neonatal anemia, and 113 placenta previa patients without neonatal anemia. The subjects' characteristics were compared. Logistic regression was used to control for confounding factors. Results: Anterior placental location (OR 2.48; 95% CI: 1.20-5.11) was an independent risk factor of neonatal anemia after controlling for potential confounders. Conclusion: To manage neonatal anemia in placenta previa patients, obstetricians should do their best to detect placental location. Pediatricians should consider the high possibility of neonatal anemia in cases involving anterior placental location. PMID:21960747

  16. Risk factors of neonatal anemia in placenta previa.

    Science.gov (United States)

    Jang, Dong Gyu; Jo, Yun Sung; Lee, Sung Jong; Lee, Gui Se Ra

    2011-01-01

    Placenta previa is a major cause of neonatal anemia. The purpose of this study was to elucidate the risk factors of neonatal anemia in placenta previa. The study was conducted on 158 placenta previa patients at 3 hospitals in affiliation with the Catholic Medical Center, Seoul, Korea from May 1999 through December 2009. The subjects were divided in to 2 groups: 47 placenta previa patients with neonatal anemia, and 113 placenta previa patients without neonatal anemia. The subjects' characteristics were compared. Logistic regression was used to control for confounding factors. Anterior placental location (OR 2.48; 95% CI: 1.20-5.11) was an independent risk factor of neonatal anemia after controlling for potential confounders. To manage neonatal anemia in placenta previa patients, obstetricians should do their best to detect placental location. Pediatricians should consider the high possibility of neonatal anemia in cases involving anterior placental location.

  17. Abnormal placentation: evidence-based diagnosis and management of placenta previa, placenta accreta, and vasa previa.

    Science.gov (United States)

    Rao, Kiran Prabhaker; Belogolovkin, Victoria; Yankowitz, Jerome; Spinnato, Joseph A

    2012-08-01

    Placenta previa, placenta accreta, and vasa previa cause significant maternal and perinatal morbidity and mortality. With the increasing incidence of both cesarean delivery and pregnancies using assisted reproductive technology, these 3 conditions are becoming more common. Advances in grayscale and Doppler ultrasound have facilitated prenatal diagnosis of abnormal placentation to allow the development of multidisciplinary management plans to achieve the best outcomes for mother and baby. We present a comprehensive review of the literature on abnormal placentation including an evidence-based approach to diagnosis and management.

  18. Effect of placenta previa on fetal growth restriction and stillbirth.

    Science.gov (United States)

    Yeniel, A Ozgur; Ergenoglu, A Mete; Itil, Ismail Mete; Askar, Niyazi; Meseri, Reci

    2012-08-01

    To examine the association between placenta previa and adverse perinatal outcomes such as low birth weight, preterm delivery, stillbirth and fetal growth restriction (FGR). This retrospective cohort study includes 12,034 delivered pregnant women who were recruited for the study between 2004 and 2010 in Ege University Hospital. Data were collected by browsing the clinic's archives. The association between placenta previa and adverse perinatal outcomes was determined via Chi-square tests and Student's t test. Logistic regression analysis was used to adjust for confounding factors in evaluating the association between placenta previa and the adverse perinatal outcomes. There was no significant relationship between placenta previa and FGR or stillbirth. Low birth weight and preterm delivery were significantly higher in the placenta previa group. According to logistic regression analysis, low birth weight was associated with an OR of 3.01 (95 % CI 2.05-4.52) and preterm delivery was associated with an OR of 8.14 (95 % CI 5.60-11.83); while, placenta previa did not affect FGR and stillbirth significantly. Although there is no consensus on the association between placenta previa and FGR in previous studies, we suggest that placenta previa is not a reason for placental insufficiency. Management of placenta previa especially depends on maternal hemodynamic parameters such as heavy hemorrhage and hypotensive shock rather than fetal well-being protocols based on serial growth ultrasound and fetal Doppler investigation.

  19. Predictors for Emergency Cesarean Delivery in Women with Placenta Previa

    NARCIS (Netherlands)

    Ruiter, Laura; Eschbach, Sanne J; Burgers, Mara; Rengerink, Katrien Oude; Pampus, Mariëlle G van; Goes, Birgit Y van der; Mol, Ben W J; Graaf, Irene M de; Pajkrt, Eva

    2016-01-01

    Objective The objective of this study was to identify the predictors of emergency delivery in women with placenta previa. Methods This is a retrospective study of pregnancies complicated by placenta previa, scheduled for a cesarean delivery between 2001 and 2011. Using univariable and multivariable

  20. Predictors for Emergency Cesarean Delivery in Women with Placenta Previa

    NARCIS (Netherlands)

    Ruiter, Laura; Eschbach, Sanne J; Burgers, Mara; Rengerink, Katrien Oude; Pampus, Mariëlle G van; Goes, Birgit Y van der; Mol, Ben W J; Graaf, Irene M de; Pajkrt, Eva

    2016-01-01

    Objective The objective of this study was to identify the predictors of emergency delivery in women with placenta previa. Methods This is a retrospective study of pregnancies complicated by placenta previa, scheduled for a cesarean delivery between 2001 and 2011. Using univariable and multivariable

  1. Does previa location matter? Surgical morbidity associated with location of a placenta previa.

    Science.gov (United States)

    Young, B C; Nadel, A; Kaimal, A

    2014-04-01

    To evaluate the effect of placenta previa location (anterior vs posterior) on cesarean morbidity. Retrospective cohort of women undergoing cesarean for placenta previa. The rate of hysterectomy and blood transfusion in the setting of anterior previa was compared with posterior previa. Planned stratified analysis based on delivery history was performed. Logistic regression was performed to control for potential confounders. Two hundred and eighty-five women undergoing cesarean delivery for placenta previa were identified. Women undergoing primary cesareans with an anterior previa had higher rates of blood transfusion (adjusted odds ratio (aOR) 3.13 95% confidence interval (CI) (1.18 to 8.36) and hysterectomy (7.4% vs 0, P=0.001) compared with those with a posterior previa; similarly, women undergoing repeat cesarean with anterior previa had higher rates of hysterectomy (aOR 4.60 95% CI (1.02 to 20.7). The majority of hysterectomies (93.8%) were due to abnormal placentation. An anterior placenta previa increases the risk of hysterectomy for both primary and repeat cesareans due to abnormal placentation. In the absence of accreta, blood transfusion remained a significant cause of maternal morbidity in both anterior and posterior placenta previas. This information may be useful for operative planning.

  2. Placenta previa and immediate outcome of the term offspring.

    Science.gov (United States)

    Walfisch, Asnat; Sheiner, Eyal

    2016-10-01

    Immediate neonatal outcome in pregnancies complicated by placenta previa is largely dependent on gestational age. We aimed to investigate whether placenta previa increases the risk for perinatal mortality and immediate morbidity of the offspring born at term. A population-based cohort study included all singleton pregnancies, with and without placenta previa, delivered at term. Maternal and pregnancy characteristics as well as immediate neonatal morbidity and mortality were compared. Deliveries occurred between the years 1991-2013 in a tertiary medical center. Multiple pregnancies, and fetal congenital malformations were excluded. During the study period 233,123 consecutive term deliveries met the inclusion criteria; 0.2 % of the babies were born to mothers diagnosed with placenta previa. Women with placenta previa were significantly older and more likely to have had a previous cesarean section. Pregnancies were more likely to be complicated with pathological presentations and cesarean hysterectomies. Babies born at term following pregnancies with placenta previa were more likely to weigh less than 2500 g (OR 2.78 CI 1.9-3.9, p placenta previa pregnancies involve higher maternal morbidity rates, term offsprings are not at an increased risk for immediate adverse outcome.

  3. Determinants of placenta previa: a case-control study

    Directory of Open Access Journals (Sweden)

    Fatemeh Shobeiri

    2017-06-01

    Full Text Available Background: The risk factors of placenta previa differ around the world. This study evaluated risk factors of pregnancies complicated with placenta previa during a 5-year period in a referral center in Hamadan, Iran. Methods: This case control study was conducted in Hamadan city (Hamadan Province of Iran from April 2013 to March 2017. The cases were women whose deliveries were complicated by placenta previa and the controls were those who delivered without placenta previa. We recruited 130 cases and 130 controls. Multivariate unconditional logistic regression analysis was conducted, and odds ratios (ORs and 95% confidence intervals (CIs were calculated. Results: The OR of placenta previa was 4.08 (95% CI= 1.44, 11.58 by maternal age, 4.08 (95% CI =1.44, 11.58 by preterm labor, and 6.64 (95% CI =1.09, 40.45 by prior operations of the uterine cavity, compared to normal deliveries and after adjusting for other variables. Multiparity, prior spontaneous abortions, and prior cesarean sections were not statistically significant risk factors for placenta previa, when adjusted for other variables.  Conclusion: Our study suggests that high maternal age and prior operations of the uterine cavity are risk factors for placenta previa.

  4. Ultrasonographic findings of placenta lacunae and a lack of a clear zone in cases with placenta previa and normal placenta.

    Science.gov (United States)

    Hamada, Shoko; Hasegawa, Junichi; Nakamura, Masamitsu; Matsuoka, Ryu; Ichizuka, Kiyotake; Sekizawa, Akihiko; Okai, Takashi

    2011-11-01

    To evaluate whether the frequencies of placenta lacunae and lack of a clear zone are higher in cases of placenta previa compared with those without it. Ultrasonographic findings just before delivery, including placenta lacunae and lack of a clear zone were prospectively evaluated in consecutive subjects. After collection, a case-control study with 1:5 matched pairs was conducted. The frequencies of ultrasonographic findings were analyzed in cases with placenta previa and normal placenta. Seventy cases with placenta previa and 350 cases with normal placentas were observed. Five and zero cases with abnormal placental adherence were observed in cases with placenta previa and normal placenta, respectively. Lack of a clear zone was observed in 60 and 1.5% of cases with and without the placental adherence (p = 0.001). Placenta lacunae and lack of a clear zone were observed in 31.4 and 9.7% of cases with and without placenta previa [odds ratio (OR) 4.2]. Lack of a clear zone was observed in 5.7 and 0.9% of cases with and without placenta previa (OR 7.0). Placenta lacunae and lack of a clear zone are frequently observed in placenta previa even when there is no adherence of the placenta. Copyright © 2011 John Wiley & Sons, Ltd.

  5. Prevalence of placenta previa among deliveries in Mainland China

    Science.gov (United States)

    Fan, Dazhi; Wu, Song; Wang, Wen; Xin, Lihong; Tian, Guo; Liu, Li; Feng, Jinping; Guo, Xiaoling; Liu, Zhengping

    2016-01-01

    Abstract Background: Placenta previa is characterized by the abnormal placenta overlying the endocervical os, and it is known as one of the most feared adverse maternal and fetal-neonatal complications in obstetrics. Objectives: We aimed to obtain overall and regional estimates of placenta previa prevalence among deliveries in Mainland China. Methods: The research was performed a systematic review, following the Meta-analysis of observational studies in epidemiology (MOOSE) guidelines for systematic reviews of observational studies, and the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement for reporting systematic reviews and meta-analysis. Electronic databases were searched and included hospital-based studies that reported placenta previa prevalence in Mainland China. Random-effects meta-analyses were used to pool prevalence estimates of placenta previa. Meta-regression analyses were performed to explore sources of heterogeneity across the included studies. For exploring the geographical distributions of placenta previa, the ArcGIS software (Esri) was used to construct the map of prevalence. Results: A total of 80 articles and 86 datasets (including 1,298,548 subjects and 14,199 placenta previa cases) from 1965 through 2015 were included. The pooled overall prevalence of placenta previa among deliveries was 1.24% (95% confidence interval [CI], 1.12–1.36) in Mainland China during 1965 to 2015. And, the trend in the prevalence of placenta previa was steady. The occurrence rate of placenta previa in the region groups Northeast, North, Northwest, Central China, East, South, and Southwest was 1.20%, 1.01%, 1.10%, 1.15%, 0.93%, 1.42%, and 2.01%, respectively. The prevalence map based on a geographic information system showed an unequal geographic distribution. Conclusions: The results showed that placenta previa is currently a high-burden disease in Mainland China. This review would be useful for the design of placenta previa

  6. Conservative management of placenta previa complicated by abnormal placentation.

    Science.gov (United States)

    Bręborowicz, Grzegorz H; Markwitz, Wiesław; Gaca, Michał; Koziołek, Agnieszka; Ropacka-Lesiak, Mariola; Dera, Anna; Brych, Mariusz; Szymankiewicz-Bręborowicz, Marta; Kruszyński, Grzegorz; Gruca-Stryjak, Karolina; Madejczyk, Mateusz; Szpera-Goździewicz, Agata; Krzyścin, Mariola

    2013-07-01

    Abnormal implantation of placenta previa is life-threatening condition. The purpose of this study was to evaluate the impact of the conservative management of pregnancies with such complication on maternal morbidity rate and the chance for uterine preservation (fertility). Eleven patients with abnormal implantation of placenta previa were analyzed prospectively. This complication was diagnosed antenatally by two-dimensional ultrasound and color flow Doppler. The following outcomes were analyzed: need for blood transfusion, admission and duration of stay in intensive care unit, infections, coagulopathies, time between cesarean section and delivery of placenta, hysterectomy and preservation of uterus. Among the 20 085 women who had a singleton gestation, 11 (0.054%) were identified with placenta previa with abnormal placentation. In five patients (group A), hysterectomy was performed because of hemorrhage or placenta ablation. In six patients (group B), conservative management succeeded and placenta were preserved. In group A, placenta were delivered earlier (2 d-8 weeks) in comparison with group B (6-15 weeks). Estimated blood loss during the delayed delivery of placenta was higher in the group with hysterectomy (respectively, 450-1600 and 300-500 ml). Conservative management of placenta previa with abnormal implantation decreases the risk of severe hemorrhage at the time of delivery and can preserve fertility.

  7. Effect of Placenta Previa on Preeclampsia

    Science.gov (United States)

    Ying, Hao; Lu, Yi; Dong, Yi-Nuo; Wang, De-Fen

    2016-01-01

    Background The correlation between gestational hypertension-preeclampsia (GH-PE) and placenta previa (PP) is controversial. Specifically, it is unknown whether placenta previa has any effect on the various types of preeclampsia (PE), and the role PP with concurrent placenta accreta (PA) play in the occurrence of GH-PE are not well understood. Objective The aim of this study was to identify the effects of PP on GH, mild and severe preeclampsia (MPE and SPE), and early- and late-onset preeclampsia (EPE and LPE). Another aim of the study was to determine if concurrent PA impacts the relationship between PP and GH-PE. Methods A retrospective single-center study of 1,058 patients having singleton pregnancies with PP was performed, and 2,116 pregnant women were randomly included as controls. These cases were collected from a tertiary hospital and met the inclusion criteria for the study. Clinical information, including PP and the gestational age at the onset of GH-PE were collected. Binary and multiple logistic regression analyses were conducted after the confounding variables were controlled to assess the effects of PP on different types of GH-PE. Results There were 155 patients with GH-PE in the two groups. The incidences of GH-PE in the PP group and the control group were 2.5% (26/1058) and 6.1% (129/2116), respectively (P = 0.000). Binary and multiple regression analyses were conducted after controlling for confounding variables. Compared to the control group, in the PP group, the risk of GH-PE was reduced significantly by 78% (AOR: 0.216; 95% CI: 0.135–0.345); the risks of GH and PE were reduced by 55% (AOR: 0.451; 95% CI: 0.233–0.873) and 86% (AOR: 0.141; 95% CI: 0.073–0.271), respectively; the risks of MPE and SPE were reduced by 73% (AOR: 0.269; 95% CI: 0.087–0828) and 88% (AOR: 0.123; 95% CI: 0.055–0.279), respectively; and the risks of EPE and LPE were reduced by 95% (AOR: 0.047; 95% CI: 0.012–0.190) and 67% (AOR: 0.330; 95% CI: 0.153–0

  8. Prediction of adherent placenta in pregnancy with placenta previa using ultrasonography and magnetic resonance imaging.

    Science.gov (United States)

    Tanimura, Kenji; Yamasaki, Yui; Ebina, Yasuhiko; Deguchi, Masashi; Ueno, Yoshiko; Kitajima, Kazuhiro; Yamada, Hideto

    2015-04-01

    Adherent placenta is a life-threatening condition in pregnancy, and is often complicated by placenta previa. The aim of this prospective study was to determine prenatal imaging findings that predict the presence of adherent placenta in pregnancies with placenta previa. The study included 58 consecutive pregnant women with placenta previa who underwent both ultrasonography and magnetic resonance imaging prenatally. Ultrasonographic findings of anterior placental location, grade 2 or higher placental lacunae (PL≥G2), loss of retroplacental hypoechoic clear zone (LCZ) and the presence of turbulent blood flow in the arteries were evaluated, in addition to MRI findings. Forty-three women underwent cesarean section alone; 15 women with adherent placenta underwent cesarean section followed by hysterectomy with pathological examination. To determine imaging findings that predict adherent placenta, univariate and multivariate logistic regression analyses were performed. Univariate logistic regression analyses demonstrated that anterior placental location, PL≥G2, LCZ, and MRI were associated with the presence of adherent placenta. Multivariate analyses revealed that LCZ (pplacenta in women with placenta previa. This prospective study demonstrated for the first time that US findings, especially LCZ, might be useful for identifying patients at high risk for adherent placenta among pregnant women with placenta previa. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. RISK FACTORS OF PLACENTA PREVIA AMONG RURAL INDIAN WOMEN

    Directory of Open Access Journals (Sweden)

    Santu

    2014-11-01

    Full Text Available OBJECTIVE: The present study was to find out risk factors of placenta previa among rural Indian women. METHODS: This was a retrospective observational study conducted over two years. 220 women with placenta previa were taken as cases and 440 women without placenta previa were taken as control. RESULTS: Advanced maternal age (OR 2.7; 95% CI: 1.84-3.97, increased parity (OR 1.58; 95% CI: 1.13-2.22, previous abortions (OR 2.25; 95% CI: 1.5-3.35, previous uterine surgery (OR 5.91; 95% CI: 3.56-9.87, uterine anomalies (OR 4.64; 95% CI: 1.41-15.27 and tobacco chewing (OR 3.58; 95% CI: 1.04-12.37 are the potential risk factors. No significant associations have been found with socio economic status, religion, previous history of placenta previa, infertility treatment and sex of the newborn. CONCLUSION: Placenta previa have some identifiable risk factors. Tobacco chewing is a novel potential risk factor

  10. Placenta previa after prior abortion: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Manoochehr Karami

    2017-07-01

    Full Text Available There is controversy regarding the role of prior abortion on placenta previa in subsequent pregnancies. We conducted an updated, comprehensive meta-analysis of placenta previa after prior abortion. The search was conducted from PubMed, Web of Science and Scopus databases from the database inception to January 31, 2017. The heterogeneity across studies was evaluated by Q-test and I2 statistical test. Publication bias was assessed by Begg's test and Egger's test. Results of odds ratio (OR estimates with their corresponding 95% confidence intervals (CI were pooled using random-effects modeling. The literature search included 872 articles up until January 2017 with 2,134,529 participants. Based on OR estimates obtained from case-control and cohort studies, we found a significant association between prior spontaneous abortions and placenta previa (1.77; 95% CI: 1.60, 1.94 and between prior induced abortions and placenta previa (1.36; 95% CI: 1.02, 1.69. The meta-analysis study herein showed that prior abortion is a risk factor for placenta previa.

  11. Smoking and placenta previa: a meta-analysis.

    Science.gov (United States)

    Shobeiri, Fatemeh; Jenabi, Ensiyeh

    2017-01-04

    Previous studies found a positive association between placenta previa and smoking during pregnancy. However, the results of these studies are inconsistent. The aim was to perform meta-analysis of the association between smoking during pregnancy and placenta previa. Major electronic databases, including PubMed, Web of Science, and Scopus were searched until June 2015. The heterogeneity across studies was explored by Q-test and I(2) statistic. The possibility of publication bias was assessed using Begg's and Egger's tests. The results were reported using odds ratio (OR) estimate with its 95% confidence intervals using a random-effects model. The literature search yielded 991 publications until October 2015 with 9,094,443 participants. Based on the random effect model, compared to nonsmoker women, the estimated OR and RR of placenta previa was 1.42 (95% CI: 1.30, 1.54) and 1.27 (95% CI: 1.18, 1.35), respectively. There is sufficient documents based on the observational studies that smoking during pregnancy is significantly associated with an increased risk of placenta previa. Therefore, smoking during pregnancy can be considered as a predictor of placenta previa.

  12. [Maternal outcomes in pregnant women with pernicious placenta previa].

    Science.gov (United States)

    Zhu, Chang-kun; Wang, Fei; Zhou, Yu-mei; Ying, Jun; Chen, Dan-qing

    2015-05-01

    To analyze the maternal outcomes of pregnant women with pernicious placenta previa (PPP). Clinical data of 470 patients with placenta previa admitted in Women's Hospital Zhejiang University School of Medicine from August 2012 to August 2014 were collected and retrospectively analyzed. The patients were divided into pernicious group(n=101) and non-pernicious group(n=369) according to the history of cesarean section and location of placenta attached to the uterine. The general profiles, maternal outcomes of two groups were compared. The age, gravidity and rate of recurrent cavity surgery of pernicious group [(32.5 ± 4.1) y, 3.4 ± 1.2, 28.7%] were higher than those of non-pernicious group [(30.7 ± 4.5) y, 2.1 ± 1.4,13.6%] (Pplacenta accrete was significantly associated with postpartum massive hemorrhage in pernicious group (Pplacenta previa.

  13. The cervix as a natural tamponade in postpartum hemorrhage caused by placenta previa and placenta previa accreta: a prospective study.

    Science.gov (United States)

    El Gelany, Saad A A; Abdelraheim, Ahmed R; Mohammed, Mo'men M; Gad El-Rab, Mohammed T; Yousef, Ayman M; Ibrahim, Emad M; Khalifa, Eissa M

    2015-11-11

    Placenta previa and placenta accreta carry significant maternal and fetal morbidity and mortality. Several techniques have been described in the literature for controlling massive bleeding associated with placenta previa cesarean sections. The objective of this study was to evaluate the efficacy and safety of the use of the cervix as a natural tamponade in controlling postpartum hemorrhage caused by placenta previa and placenta previa accreta. This prospective study was conducted on 40 pregnant women admitted to our hospital between June 2012 and November 2014. All participating women had one or more previous cesarean deliveries and were diagnosed with placenta previa and/or placenta previa accreta. Significant bleeding from the placental bed during cesarean section was managed by inverting the cervix into the uterine cavity and suturing the anterior and/or the posterior cervical lips into the anterior and/or posterior walls of the lower uterine segment. The technique of cervical inversion described above was successful in stopping the bleeding in 38 out of 40 patients; yielding a success rate of 95%. We resorted to hysterectomy in only two cases (5%). The mean intra-operative blood loss was 1572.5 mL, and the mean number of blood units transfused was 3.1. The mean time needed to perform the technique was 5.4 ± 0.6 min. The complications encountered were as follows: bladder injury in the two patients who underwent hysterectomy and wound infection in one patient. Postoperative fever that responded to antibiotics occurred in 1 patient. The mean duration of the postoperative hospital stay was 3.5 days This technique of using the cervix as a natural tamponade appears to be safe, simple, time-saving and potentially effective method for controlling the severe postpartum hemorrhage (PPH) caused by placenta previa/placenta previa accreta. This technique deserves to be one of the tools in the hands of obstetricians who face the life-threatening hemorrhage of placenta

  14. Relationship between placenta location and resolution of second trimester placenta previa.

    Science.gov (United States)

    Feng, Yun; Li, Xue-Yin; Xiao, Juan; Li, Wei; Liu, Jing; Zeng, Xue; Chen, Xi; Chen, Kai-Yue; Fan, Lei; Chen, Su-Hua

    2017-06-01

    This prospective study was conducted to assess the rate of resolution of second trimester placenta previa in women with anterior placenta and posterior placenta, and that in women with and without previous cesarean section. In this study, placenta previa was defined as a placenta lying within 20 mm of the internal cervical os or overlapping it. We recruited 183 women diagnosed with previa between 20(+0) weeks and 25(+6) weeks. They were grouped according to their placenta location (anterior or posterior) and history of cesarean section. Comparative analysis was performed on demographic data, resolution rate of previa and pregnancy outcomes between anterior group and posterior group, and on those between cesarean section group and non-cesarean section group. Women with an anterior placenta tended to be advanced in parity (P=0.040) and have increased number of dilatation and curettage (P=0.044). The women in cesarean section group were significantly older (P=0.000) and had more parity (P=0.000), gravidity (P=0.000), and dilatation and curettage (P=0.048) than in non-cesarean section group. Resolution of previa at delivery occurred in 87.43% women in this study. Women with a posterior placenta had a higher rate of resolution (P=0.030), while history of cesarean section made no difference. Gestational age at resolution was earlier in posterior group (P=0.002) and non-cesarean section group (P=0.008) than in anterior group and cesarean section group correspondingly. Placenta location and prior cesarean section did not influence obstetric outcomes and neonatal outcomes. This study indicates that it is more likely to have subsequent resolution of the previa when the placenta is posteriorly located for women who are diagnosed with placenta previa in the second trimester.

  15. Frequency of placenta previa in women with history of previous caesarean and normal vaginal deliveries.

    Science.gov (United States)

    Bashir, Adeela; Jadoon, Humaira Naz; Abbasi, Aziz-un-Nisa

    2012-01-01

    Placenta previa is known to be associated with previous caesarean deliveries, advanced maternal age, increasing parity, smoking, curettage and myomectomy. This study was carried out to compare the frequency of placenta previa, in women with previous caesareans versus those with normal vaginal deliveries. It was one year study conducted at the Department of Obstetrics and Gynaecology Unit B, Ayub Teaching Hospital, Abbottabad. One hundred women were included in the study, 50 in Group A with previous caesarean deliveries, and 50 in Group B with previous normal vaginal deliveries. Frequency of placenta previa in both groups was analysed. Placenta previa was found in one (2%) woman in Group A, and in two women (4%) in Group B. It was not found in para 4 or less in both groups. One woman in Group A and two women in Group B with parity 4 or more had placenta previa (p placenta previa, while with previous 2 scars one had placenta previa (p placenta previa in Group A and both women with placenta previa in Group B were more than 25 years old. Placenta previa was not found in women below 25 years of age. Previous one caesarean section did not increase the frequency of placenta previa. Increasing number of scars, increasing maternal age beyond 25 years and increasing parity beyond 4 were associated with placenta previa.

  16. Placenta previa: outcomes in scarred and unscarred uterus

    Directory of Open Access Journals (Sweden)

    Rajshree Dayanand Katke

    2016-08-01

    Conclusions: In conclusion, primary prevention in the form of reduction in the rate of primi cesearean section must be done in order to prevent likelihood of placenta previa in scarred uteri. Early diagnosis by Ultrasound and planned delivery should be the goal. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2728-2732

  17. Type and location of placenta previa affect preterm delivery risk related to antepartum hemorrhage.

    Science.gov (United States)

    Sekiguchi, Atsuko; Nakai, Akihito; Kawabata, Ikuno; Hayashi, Masako; Takeshita, Toshiyuki

    2013-01-01

    To evaluate whether type and location of placenta previa affect risk of antepartum hemorrhage-related preterm delivery. We retrospectively studied 162 women with singleton pregnancies presenting placenta previa. Through observation using transvaginal ultrasound the women were categorized into complete or incomplete placenta previa, and then assigned to anterior and posterior groups. Complete placenta previa was defined as a placenta that completely covered the internal cervical os, with the placental margin >2 cm from the os. Incomplete placenta previa comprised marginal placenta previa whose margin adjacent to the internal os and partial placenta previa which covered the os but the margin situated within 2 cm of the os. Maternal characteristics and perinatal outcomes in complete and incomplete placenta previa were compared, and the differences between the anterior and the posterior groups were evaluated. Antepartum hemorrhage was more prevalent in women with complete placenta previa than in those with incomplete placenta previa (59.1% versus 17.6%), resulting in the higher incidence of preterm delivery in women with complete than in those with incomplete placenta previa [45.1% versus 8.8%; odds ratio (OR) 8.51; 95% confidence interval (CI) 3.59-20.18; p placenta previa, incidence of antepartum hemorrhage did not significantly differ between the anterior and the posterior groups. However, gestational age at bleeding onset was lower in the anterior group than in the posterior group, and the incidence of preterm delivery was higher in the anterior group than in the posterior group (76.2% versus 32.0%; OR 6.8; 95% CI 2.12-21.84; p = 0.002). In incomplete placenta previa, gestational age at delivery did not significantly differ between the anterior and posterior groups. Obstetricians should be aware of the increased risk of preterm delivery related to antepartum hemorrhage in women with complete placenta previa, particularly when the placenta is located on the anterior

  18. Clinical Analysis of Placenta Previa Complicated with Previous Caesarean Section

    Institute of Scientific and Technical Information of China (English)

    Liang-kun Ma; Na Han; Jian-qiu Yang; Xu-ming Bian; Jun-tao Liu

    2012-01-01

    Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section.Methods The clinical data of 29 patients with placenta previa complicated with a previous caesarean section (RCS group) admitted in Peking Union Medical College Hospital during a period from 2003 to 2011 were retrospectively reviewed and compared with those of 243 patients with placenta previa without a previous caesarean section (FCS group) during the same period.Results There was no difference in the mean age (28.9±3.6 vs.28.1±4.5 years) and the average gravidity (2.35 ± 1.48 vs.2.21 ± 1.53) between RCS group and FCS group (all P>0.05).The RCS group had more preterm births (24.1% vs.13.2%),complete placenta previa (55.2% vs.4.9%),placenta accreta (34.5% vs.2.5%),more blood loss during caesarean section (1412±602 vs.648 ±265 mL),blood transfusion (51.7% vs.4.9%),disseminated intravascular coagulation (13.8% vs.2.1%),and obstetric hysterectomy ( 13.8 % vs.0.8 %) than the F C S group (all P< 0.05).The preterm infant rate ( 30.0% vs.13.0%),neonatal asphyxia rate (10.0% vs.4.9%),and perinatal mortality rate (6.7% vs.0.4%) of the RCS group were higher than those of the FCS group (all P<0.05).Conclusions More patients had complete placenta previa and placenta accreta,postpartum hemorrhage,transfusion,uterine packing,obstetric hysterectomy,and perinatal morbidity in the placenta previa patients with previous caesarean section.The patient should be informed of the risk and unnecessary first cesarean sections should be avoided.

  19. Persistence of placenta previa in twin gestations based on gestational age at sonographic detection.

    Science.gov (United States)

    Kohari, Katherine S; Roman, Ashley S; Fox, Nathan S; Feinberg, Jessica; Saltzman, Daniel H; Klauser, Chad K; Rebarber, Andrei

    2012-07-01

    The purpose of this study was to evaluate the gestational age at sonographic detection of placenta previa as a predictor of previa persistence until delivery in twin gestations. A retrospective cohort of twin pregnancies with placenta previa in a single ultrasound unit was analyzed from 2005 to 2010. Pregnancies were ascertained from a database. Diagnoses were confirmed by transvaginal imaging. Previa was categorized as complete if the placenta completely covered the internal os or marginal if the inferior placental edge reached within 2 cm. Gestational ages were grouped into intervals from 15 to 35 weeks. The study outcome was placenta previa at delivery. Only twin pregnancies at 25 weeks' gestation and later were analyzed using nonparametric statistics as appropriate, with P Placenta previa was detected in 120 twin pregnancies in the second trimester: 32 complete and 88 marginal. Of those with placenta previa at 15 to 19, 20 to 23, 24 to 27, 28 to 31, and 32 to 35 weeks, previa persisted until delivery in 8.3%, 19.2%, 50%, 75%, and 92.5%, respectively. Only at 15- to 19- and 20- to 23-week intervals was complete previa more likely to persist than marginal previa (P placenta previa persistence in twins is dependent on the gestational age at sonographic detection. Only at earlier gestations does the type of previa affect its persistence. As gestational age advances, the likelihood of resolution of placenta previa diminishes regardless of the type noted.

  20. Cervical varicosities may predict placenta accreta in posterior placenta previa: a magnetic resonance imaging study.

    Science.gov (United States)

    Ishibashi, Hiroki; Miyamoto, Morikazu; Shinnmoto, Hiroshi; Murakami, Wakana; Soyama, Hiroaki; Nakatsuka, Masaya; Natsuyama, Takahiro; Yoshida, Masashi; Takano, Masashi; Furuya, Kenichi

    2017-07-14

    The aim of this study was to prenatally predict placenta accreta in posterior placenta previa using magnetic resonance imaging (MRI). This retrospective study was approved by the Institutional Review Board of our hospital. We identified 81 patients with singleton pregnancy who had undergone cesarean section due to posterior placenta previa at our hospital between January 2012 and December 2016. We calculated the sensitivity and specificity of several well-known findings, and of cervical varicosities quantified using magnetic resonance imaging, in predicting placenta accreta in posterior placenta previa. To quantify cervical varicosities, we calculated the A/B ratio, where "A" was the minimum distance from the most dorsal cervical varicosity to the deciduous placenta, and "B" was the minimum distance from the most dorsal cervical varicosity to the amniotic placenta. The appropriate cut-off value of the A/B ratio was determined using a receiver operating characteristic (ROC) curve. Three patients (3.7%) were diagnosed as having placenta accreta. The sensitivity and specificity of the well-known findings were 0 and 97.4%, respectively. Furthermore, the A/B ratio ranged from 0.02 to 0.79. ROC curve analysis revealed that the area under the combined placenta accreta and A/B ratio curve was 0.96. When the cutoff value of the A/B ratio was set 0.18, the sensitivity and specificity were 100 and 91%, respectively. It was difficult to diagnose placenta accreta in the posterior placenta previa using the well-known findings. The quantification of cervical varicosities could effectively predict placenta accreta.

  1. The role of shear wave elastography in the assessment of placenta previa-accreta.

    Science.gov (United States)

    Alıcı Davutoglu, Ebru; Ariöz Habibi, Hatice; Ozel, Ayşegül; Yuksel, Mehmet Aytac; Adaletli, Ibrahim; Madazlı, Riza

    2017-05-09

    To evaluate the value of shear wave elastography (SWE) in the prediction of morbidly adherent placenta. Forty-three women with normal placental location and 26 women with anteriorly localized placenta previa were recruited for this case-control study. Placental elasticity values in both the groups were determined by SWE imaging. SWE values were higher in the placenta previa group in all regions than in normal localized placentas (p placenta previa with and without morbidly adherent placenta (p > .05). Placental stiffness is significantly higher in placenta previa than normal localized placentas. However, we could not demonstrate any statistically significant difference in the elasticity values between the placenta previa with and without accreta.

  2. PLACENTA PREVIA PERCRETA CON INVASION VESICAL

    OpenAIRE

    Perucca,Ernesto; Cazenave,Henry; Barra,Alejandro; Ochoa,Nelson; Villagrán,Gabriel; Espinoza,Rosemary; Estay,Ricardo; Bustamante,Rodrigo; Siebert,Alejandra

    2002-01-01

    Se presentan 3 nuevos casos de placenta percreta con invasión a vejiga ocurridos en nuestro Servicio. Uno de ellos fue diagnosticado durante el embarazo, los otros dos casos fueron hallazgos intraoperatorios. La evolución clínica de las tres pacientes fue satisfactoria

  3. Placenta Accreta and Total Placenta Previa in the 19th Week of Pregnancy

    Science.gov (United States)

    Findeklee, S.; Costa, S. D.

    2015-01-01

    Placentation disorders are the result of impaired embedding of the placenta in the endometrium. The prevalence of these disorders is estimated to be around 0.3 %. A history of previous prior uterine surgery (especially cesarean section and curettage) is the most common risk factor. Impaired placentation is differentiated into deep placental attachment; marginal, partial and total placenta previa; and placenta accreta, increta and percreta. Treatment depends on the severity of presentation and ranges from expectant management to emergency hysterectomy. In most cases, preterm termination of pregnancy is necessary. We report here on the case of a 39-year-old woman with placenta accreta and total placenta previa who underwent hysterectomy in the 19th week of pregnancy. PMID:26366004

  4. Diagnosis of Placenta Accreta by Uterine Artery Doppler Velocimetry in Patients With Placenta Previa.

    Science.gov (United States)

    Cho, Hee Young; Hwang, Han Sung; Jung, Inkyung; Park, Yong Won; Kwon, Ja-Young; Kim, Young Han

    2015-09-01

    To evaluate the potential value of uterine artery Doppler velocimetry in diagnosing placenta accreta. Clinical records of all deliveries between April 1991 and March 2013 were retrospectively analyzed. Cases of intrauterine growth restriction, pregnancy-induced hypertension, multiple pregnancies, fetal anomalies, chromosomal abnormalities, and maternal medical illnesses such as cardiovascular disease, renal disease, and diabetes mellitus were excluded. A total of 11,210 cases were evaluated, including 403 cases of placenta previa without accreta (placenta previa) and 39 cases of placenta previa with accreta (placenta accreta). All patients underwent uterine artery Doppler velocimetry to measure the mean resistive index and pulsatility index (PI) in the third trimester. The analysis included participant characteristics such as age, parity, abortion history, previous cesarean delivery, gestational age at delivery, neonatal sex, and birth weight. The mean uterine artery PI was significantly lower in the placenta accreta group compared to previa alone (0.51 versus 0.57; P = .002). The odds ratios for placenta accreta were 2.4 for 2 or more previous abortions (P = .011) and 5.3 and 7.0 for 1 and 2 or more previous cesarean deliveries (P = .001 and .005). With an increase in the mean PI by 0.01, the odds ratio for placenta accreta decreased by 0.94 (P placenta accreta compared to those without accreta. The diagnostic accuracy of placenta accreta can be potentially improved if uterine artery Doppler values and the history of cesarean delivery are combined. © 2015 by the American Institute of Ultrasound in Medicine.

  5. [Risk factors of peripartum hysterectomy in placenta previa: a retrospective study of 3 840 cases].

    Science.gov (United States)

    Lyu, B; Chen, M; Liu, X X

    2016-07-25

    To investigate the risk factors of peripartum hysterectomy in placenta previa through retrospective study of 3 840 placenta previa cases. The clinical data of 3 840 patients with placenta previa who delivered in West China Second University Hospital between Jan 2005 and June 2014 were analyzed retrospectively. The relationship of certain factors and peripartum hysterectomy was analyzed, including maternal age, residence place, parity, prior curettage, prior cesarean section, twin or multiple pregnancy, antenatal vaginal bleeding, type of placenta previa, suspected placenta accreta, antenatal level of hemoglobin and gestational age at delivery. The prevalence of placenta previa was 4.84%(3 840/79 304)in West China Second University Hospital during the study period, and the incidence of preipartum hysterectomy in patients with placenta previa was 2.76%(106/3 840). One-factor analysis demonstrated that residence place, parity, times of prior curettage, prior cesarean section, prenatal vaginal bleeding, anterior placenta, type of placenta previa, placenta accreta, antenatal anemia and gestational age at delivery were potential risk factors for peripartum hysterectomy(Pplacenta(OR=4.8, 95%CI:2.1-10.7), complete placenta previa(OR=5.9, 95%CI: 1.8-42.5), placenta accreta(OR=11.2, 95%CI:6.8-18.6), antenatal hemoglobinplacenta previa(Pplacenta, complete placenta previa, placenta accreta, antenatal anemia and delivery before 34 gestational weeks are high risk factors of peripartum hysterectomy in placenta previa patients. Perinatal care and risk evaluation before cesarean section are important to improve perinatal outcomes and reduce peripartum hysterectomy.

  6. Intraoperative aortic balloon occlusion in patients with placenta previa and/or placenta accreta: a retrospective study

    Directory of Open Access Journals (Sweden)

    Fangyuan Luo

    2017-04-01

    Conclusion: Intraoperative aortic balloon occlusion is a relatively safe method for treating placenta previa and/or placenta accreta during scheduled and emergency CS and might be helpful to prevent hysterectomy and embolization in women wishing to preserve fertility.

  7. MATERNAL AND PERINATAL OUTCOME IN PREGNANCIES COMPLICATED BY PLACENTA PREVIA

    Directory of Open Access Journals (Sweden)

    Rajendra

    2015-06-01

    Full Text Available AIMS AND OBJECTIVES: To evaluate the maternal and perinatal outcome of pregnancies complicated with placenta previa at tertiary care centre and to evaluate the potential risk factors involved in pregnancies complicated with placenta previa at tertiary care C ent re. METHOD: We carried out 2 year retrospective observational study during period from November 2009 to October 2011 Tertiary care hospital and medical college. ANC cases with history of bleeding per vaginum after 28 weeks attending ANC clinic and emergenc y ward were included in study with appropriate age parity matched controls with other complications like pregnancy induced hypertension, abruption placentae, multiple gestation were excluded. Demographic data, medical and surgical histories, all the events regarding maternal and perinatal mortality were recorded. Data was analysed by using appropriate software . RESULTS: 136 cases of placenta previa were analysed and found prevalence of placenta previa was 1.36%. During the present study 41.80% cases were bo oked and 58.20% cases were unbooked. Maximum number of cases in present study were in the age group of 18 - 24 years. Previous caesarean (57.49% and previous abortion (42.53% found important risk factors.41.04% cases were delivered at 33 - 36 weeks of gestat ion followed by 33.58% in 28 - 32 weeks of gestation. Expectant management was given to 37.32% of cases while 62.68% cases were managed on active basis. In present study maternal morbidity were postpartum hemorrhage (56.71%, sepsis (37.31%, urinary tract i nfection (5.22%, wound infection (5.22%,wound gape (4.47%, hysterectomy (2.23%, prolonged hospital stay >10 days (17.91%. There were two (1.49% maternal mortality in present study. Maximum number of infants i.e . 58.20% had bir th eight between 1.6 to 2.4kg. O ut of this 16.41% were of 1.6 - 2kg and 41.79% comprised of 2.1 - 2.4 kg. 39.55% infant required NICU admission and 60.45% of cases were with mother. Perinatal

  8. Risk Factors and Consequent Outcomes of Placenta Previa: Report From a Referral Center.

    Science.gov (United States)

    Saleh Gargari, Soraya; Seify, Zahra; Haghighi, Ladan; Khoshnood Shariati, Maryam; Mirzamoradi, Masoumeh

    2016-11-01

     Because of an unknown factor, the frequency of complicated pregnancy with placenta previa has been raised during past decade. This study was designed to deepen our understanding of risk factors and outcomes of placenta previa in our country. This study investigated 694 cases of placenta previa comparing with 600 healthy pregnant women with not overlie placenta in two referral and tertiary Obstetrics and Gynecological Hospital in Iran on the basis of the clinical and para-clinical analysis, in order to find the probable risk factors for occurrence of placenta previa and its effect on maternal and neonatal complications. The most important risk factor for the occurrence of placenta previa was advanced maternal age (Pplacenta previa based on the type of risk factors which can provide the best possible management to decrease the morbidity and mortality of their related complications.

  9. A danish national cohort study on neonatal outcome in singleton pregnancies with placenta previa

    DEFF Research Database (Denmark)

    Nørgaard, Lone N; Pinborg, Anja; Lidegaard, Ojvind

    2012-01-01

    Objective. To describe the incidence of placenta previa and to assess neonatal morbidity and mortality in pregnancies with placenta previa after adjustment for previous cesarean section, smoking, multiparity, maternal age and in-vitro fertilization. Design. National cohort study. Setting. Danish ...... score, being transferred to neonatal intensive care and for death.......Objective. To describe the incidence of placenta previa and to assess neonatal morbidity and mortality in pregnancies with placenta previa after adjustment for previous cesarean section, smoking, multiparity, maternal age and in-vitro fertilization. Design. National cohort study. Setting. Danish....... Main outcome measures. Gestational age, birthweight, Apgar score after 5min, stillbirth, neonatal mortality and admittance to neonatal intensive care unit. Results. The incidence of placenta previa in Denmark was 0.54% in 2006. Neonates born after pregnancies with placenta previa had a higher risk...

  10. [A retrospective analysis on the pernicious placenta previa from 2008 to 2014].

    Science.gov (United States)

    Yu, L; Hu, K J; Yang, H X

    2016-03-01

    To investigate the incidence changes, clinical characteristics and pregnant outcomes of pernicious placenta previa. A retrospective cohort analysis on 316 cases with placenta previa in the Peking University First Hospital from January 2008 to December 2014. The research group were 60 cases with the patients of placenta previa with the history of cesarean section, and the control group were placenta previa without the history of cesarean section. Compared with the incidence, intraoperative blood loss, the pregnancy outcomes and so on. (1) The average incidence rate of placenta previa during the past 7 years was 10.96 ‰ (316/28 837). And the cases of pernicious placenta previa was 60 (2.08‰, 60/28 837), the incidence of pernicious placenta previa was rising from 2008 to 2014 (0.91‰-3.08‰). (2) There were 145 cases of placenta privia had been translation from other hospitals in the past 7 years. The referral rate of pregnant women with placenta previa was 45.9% (145/316), and the referral rate of pernicious placenta previa (63.3%, 38/60) was significantly higher than that of non-pernicious placenta previa group (41.8%, 107/256; χ(2)=9.080, P=0.003). Referral the outcomes of these patients were good, and no maternal death occurred. (3) The placenta in the research group were mainly adhered in the front wall of the uterine, and the incidence was 38.5% (15/39), higher than that in the group of non-pernicious placenta previa (12.1%, 21/174; χ(2)=57.636, Pplacenta increased in research group was 53.3% (32/60), higher than that in the group of non-pernicious placenta previa, compared with the control group, there was significant difference (15.6%, 40/256; χ(2)= 39.041, Pplacenta previa were respectively 4.7% (12/256), 12.9% (33/256), 1.2% (3/256), 8.6% (22/256), compared those in other two groups, there were not significant difference (Pplacenta previa increased year by year, patients with placenta previa has a history of cesarean section often combined with

  11. Multidisciplinary management of invasive placenta previa.

    Science.gov (United States)

    Walker, Melissa G; Allen, Lisa; Windrim, Rory C; Kachura, John; Pollard, Lindsay; Pantazi, Sophia; Keating, Sarah; Carvalho, Jose C A; Kingdom, John C P

    2013-05-01

    Objectif : Évaluer l’efficacité d’une approche d’équipe multidisciplinaire visant l’atténuation de la morbidité maternelle grave chez les femmes qui présentent un placenta prævia invasif. Méthodes : Nous avons mené une étude prospective auprès de 33 femmes qui présentaient un placenta prævia et increta-percreta (diagnostiqué par échographie et/ou imagerie par résonance magnétique) et qui accouchaient au Mount Sinai Hospital de Toronto, à la suite du lancement (en janvier 2008) d’une approche d’équipe visant les femmes qui présentaient une telle placentation. Nous avons inclus les accouchements chez les femmes visées jusqu’en juin 2012. Nous avons analysé les dossiers prénataux (services externes et services hospitaliers) en vue d’y repérer l’utilisation par l’obstétricien titulaire de six composantes d’équipe prédéfinies : (1) consultation prénatale en médecine fœto-maternelle; (2) consultation en chirurgie gynécologique; (3) IRM prénatale; (4) consultation en radiologie interventionnelle et mise en place préopératoire de sondes à ballonnet dans les divisions antérieures des artères iliaques internes; (5) planification à l’avance de la date de chirurgie; et (6) chirurgie menée par des membres de l’équipe chirurgicale vouée aux cas de placenta invasif. Les détails de l’évolution prénatale, de l’accouchement et de la période postpartum ont été consignés afin d’établir un score composite de morbidité maternelle grave en cinq points fondé sur la présence ou l’absence de ce qui suit : (1) admission à l’USI à la suite de l’accouchement; (2) transfusion de plus de deux unités de sang; (3) anesthésie générale (administration ou conversion); (4) temps opératoire se situant dans le quartile le plus élevé (> 125 minutes); et (5) complications postopératoires significatives (réhospitalisation, hospitalisation postpartum prolongée et/ou embolie pulmonaire). R

  12. Central placenta previa with placenta percreta partially invading bladder: a case report

    Directory of Open Access Journals (Sweden)

    Hasina Banu

    2015-06-01

    Full Text Available Placenta previa, placenta accreta, increta and percreta are increasing day by day due to increased number of cesarean sections now days, but central placenta previa with placenta percreta invading bladder is a very rare obstetrical complication. A case of central placenta previa with placenta percreta partially invading bladder in woman who was G2P1L1 with 32+6 weeks of gestation and with history of previous cesarean section is presented in this manuscript. The patient was managed with intrapartum cesarean hysterectomy with bilateral ureter J stents and bladder repair following cesarean delivery of a preterm baby. Total estimated blood loss was 6000 mL. The patient was discharged on 28th December 2014 that is 29th day of admission with a healthy baby. The aim of this study is to bring awareness of such case and to discuss the risk factor, presentation, diagnosis, management and choice of anesthesia for the same. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 859-862

  13. A Case Report and Literature Review of Midtrimester Termination of Pregnancy Complicated by Placenta Previa and Placenta Accreta.

    Science.gov (United States)

    Matsuzaki, Satoko; Matsuzaki, Shinya; Ueda, Yutaka; Tanaka, Yusuke; Kakuda, Mamoru; Kanagawa, Takeshi; Kimura, Tadashi

    2015-04-01

    Objective Concurrent placenta previa and placenta accreta increase the risk of massive obstetric hemorrhage. Despite extensive research on the management of placenta previa (including placenta accreta, increta, and percreta), the number and quality of previous studies are limited. We present a case of placenta accreta requiring an induced second-trimester abortion because of premature rupture of the membranes (PROM). Study Design Case report and review of the literature. Results A 41-year-old female presented at 20 weeks of gestation with placenta previa and PROM. Ultrasonography revealed placenta accreta with multiple placental lacunae. She then developed massive hemorrhaging just prior to a planned termination of pregnancy. We performed a hysterectomy with the intent of preserving life because of the failure of the placenta to detach and blood loss totaling 4,500 mL. Conclusion Previous studies suggest that second-trimester pregnancy terminations in cases of placenta previa which are not complicated with placenta accreta do not have a particularly high risk of hemorrhage. However, together with our case, the literature suggests that placenta previa complicated with placenta accreta presents a significant risk of hemorrhage both during delivery and intraoperatively. Further reports are needed to evaluate the most appropriate treatment options.

  14. A Case Report and Literature Review of Midtrimester Termination of Pregnancy Complicated by Placenta Previa and Placenta Accreta

    Directory of Open Access Journals (Sweden)

    Satoko Matsuzaki

    2015-04-01

    Full Text Available Objective - Concurrent placenta previa and placenta accreta increase the risk of massive obstetric hemorrhage. Despite extensive research on the management of placenta previa (including placenta accreta, increta, and percreta, the number and quality of previous studies are limited. We present a case of placenta accreta requiring an induced second-trimester abortion because of premature rupture of the membranes (PROM. Study Design - Case report and review of the literature. Results - A 41-year-old female presented at 20 weeks of gestation with placenta previa and PROM. Ultrasonography revealed placenta accreta with multiple placental lacunae. She then developed massive hemorrhaging just prior to a planned termination of pregnancy. We performed a hysterectomy with the intent of preserving life because of the failure of the placenta to detach and blood loss totaling 4,500 mL. Conclusion - Previous studies suggest that second-trimester pregnancy terminations in cases of placenta previa which are not complicated with placenta accreta do not have a particularly high risk of hemorrhage. However, together with our case, the literature suggests that placenta previa complicated with placenta accreta presents a significant risk of hemorrhage both during delivery and intraoperatively. Further reports are needed to evaluate the most appropriate treatment options.

  15. Influence of placental position on obstetric morbidity in placenta previa

    Directory of Open Access Journals (Sweden)

    Shripad S. Hebbar

    2014-06-01

    Conclusions: It is difficult to assign a maternal or perinatal morbidity risk to a particular type of placental location. The need for specialized surgical intervention such as uterine / internal iliac artery ligation, peripartum hysterectomy can arise irrespective of placental location, whether underneath the surgical incision (anterior, proximity to main uterine trunks (lateral or encountered after the delivery of the baby (posterior. Pregnancies complicated by placenta previa must be delivered in the hospitals having expertise of senior and skilled surgeons and well equipped blood bank and good neonatal intensive care unit. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 585-591

  16. Uterine artery embolization, not cesarean section, as an option for termination of pregnancy in placenta previa.

    Science.gov (United States)

    Huang, Lingling; Awale, Reenu; Tang, Hui; Zeng, ZhiShan; Li, FuRong; Chen, Yue

    2015-04-01

    To summarize our experiences in the treatment of labor induction in placenta previa using uterine artery embolization. We retrospectively analyzed the clinical data of seven patients with placenta previa who underwent antepartum uterine artery embolization before vaginal delivery. After antepartum embolization, five patients with placenta previa had successful vaginal deliveries and two cases of placenta previa with accreta underwent emergency hysterectomy. Some complications were reported in this experience. The follow-up study showed that most patients resumed their normal menstruation and some of them were able to conceive. For the management of placenta previa, uterine artery embolization is a minimally invasive technique that helps to avoid cesarean section. The impact on menstruation and fertility is yet to be seen. Copyright © 2015. Published by Elsevier B.V.

  17. Placenta previa and the risk of delivering a small-for-gestational-age newborn.

    Science.gov (United States)

    Räisänen, Sari; Kancherla, Vijaya; Kramer, Michael R; Gissler, Mika; Heinonen, Seppo

    2014-08-01

    To evaluate whether there is an association between placenta previa and delivery of a small-for-gestational-age (SGA) newborn and to quantify the contribution of individual risk factors for SGA that are associated with placenta previa stratified by maternal parity. A cross-sectional study using the Finnish Medical Birth Register during 2000-2010. All singleton births (N=596,562) were included; major congenital anomalies were excluded. An association between SGA (less than 2 standard deviations below the mean) and placenta previa was modeled by parity-specific unadjusted and adjusted statistical models. Placenta previa complicated 625 of 249,476 singleton births among nulliparous women (2.50/1,000) and 915 of 347,086 singleton births among multiparous women (2.64/1,000). Among nulliparous women, the most common risk factor for placenta previa was in vitro fertilization; placenta previa was not associated with an increased prevalence of SGA controlling for maternal age, smoking, in vitro fertilization, socioeconomic status, and preeclampsia (adjusted odds ratio [OR] 0.81, 95% confidence interval [CI] 0.57-1.17). Among multiparous women, placenta previa was associated with a twofold increased risk of SGA controlling for maternal age, parity, prior preterm birth, prior caesarean delivery, prior SGA newborn, prior preeclampsia, smoking, in vitro fertilization, socioeconomic status, and preeclampsia (adjusted OR 2.08, 95% CI 1.50-2.89). Furthermore, only one-fourth of the association between SGA and placenta previa could be explained by controlling for risk factors clustering with placenta previa among multiparous women. Placenta previa is associated with impaired fetal growth in multiparous but not nulliparous women. II.

  18. Placenta previa: an outcome-based cohort study in a contemporary obstetric population.

    Science.gov (United States)

    Lal, Ann K; Hibbard, Judith U

    2015-08-01

    The objective of the study is to characterize the maternal and neonatal morbidities of women with placenta previa. This retrospective group study used the Consortium on Safe Labor electronic database, including 12 clinical centers, and 19 hospitals. Patients with placenta previa noted at the time of delivery were included. Maternal and neonatal variables were compared to a control group of women undergoing cesarean delivery with no previa. Logistic regression and general linear regression were used for the analysis, with p placenta previa group and 18,617 in the control group. Neonates born to mothers with placenta previa had lower gestational ages and birth weights. In univariate analysis only, these neonates were at increased risk of lower 5 min Apgar scores, neonatal intensive care unit admission, anemia, respiratory distress syndrome, mechanical ventilation, and intraventricular hemorrhage. There was no association of placenta previa with small for gestational age infants, congenital anomalies or death. As previously shown, women with placenta previa have significantly more maternal morbidities. Increased maternal morbidity was noted; however, only those neonatal morbidities associated with preterm delivery occurred in the placenta previa group.

  19. Clinical study of placenta previa and its effect on maternal health and fetal outcome

    Directory of Open Access Journals (Sweden)

    Sarojini

    2016-10-01

    Conclusions: Advancing maternal age, multiparity, prior cesarean section, and prior abortions are independent risk factors for placenta previa. Placenta praevia remains a risk factor for adverse maternal and perinatal outcome. The detection of placenta previa should encourage a careful evaluation with timely delivery to reduce the associated maternal and perinatal complications. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3496-3499

  20. A Case of Vaginal Stillbirth in the Presence of Placenta Previa at 33 Weeks of Gestation.

    Science.gov (United States)

    Chinen, Yukiko; Kinjo, Tadatsugu; Nitta, Hayase; Kinjo, Yui; Masamoto, Hitoshi; Aoki, Yoichi

    2016-01-01

    It was demonstrated that second- and third-trimester therapeutic termination of pregnancy (TOP) is feasible in cases with placenta previa. We report a 34-year-old woman with complex fetal malformations associated with placenta previa. An ultrasound examination at 21 weeks of gestation revealed fetal growth restriction (FGR) and complex fetal malformations associated with a placenta previa. After extensive information, the parents opted for careful observation. Thereafter, FGR gradually progressed and we observed arrest of end-diastolic velocity of the umbilical artery. Finally, intrauterine fetal death (IUFD) was confirmed at 33 weeks of gestation. Two days after IUFD, the patient experienced labor pain. The placenta and dead fetus weighing 961 g were vaginally delivered, and total bleeding was 270 mL. Although further studies to confirm the dynamic change of the uteroplacental blood flow are necessary to avoid the risk of maternal hemorrhage, vaginal TOP with placenta previa after feticide or IUFD would be feasible.

  1. Cervical varix complicated by placenta previa: A case report and literature review.

    Science.gov (United States)

    Tanaka, Mie; Matsuzaki, Shinya; Kumasawa, Keiichi; Suzuki, Yosuke; Endo, Masayuki; Kimura, Tadashi

    2016-07-01

    Uterine cervical varix is rare, and its clinical course is poorly understood. Therefore, we present a case report of cervical varix complicating placenta previa before describing our findings in the context of an electronic database search of relevant reports. In the case report, we describe the clinical course and imaging results of a 35-year-old woman who was diagnosed with cervical varix complicated by placenta previa. Investigation by magnetic resonance imaging, serial ultrasonography, and speculum confirmed the diagnosis, and a healthy baby was successfully delivered at 36 weeks of gestation by cesarean section. An electronic search identified nine previous cases of cervical varix complicated by placenta previa in the literature. Clinicians should be aware of cervical varices when managing placenta previa to avoid iatrogenic rupture or misdiagnosis of placenta accreta by magnetic resonance imaging. © 2016 Japan Society of Obstetrics and Gynecology.

  2. [Diagnosis of placenta previa accreta by two dimensional ultrasonography and color doppler in patients with cesarean section].

    Science.gov (United States)

    Shi, Huafang; Pi, Pixiang; Ding, Yiling

    2012-09-01

    To determine the accuracy of two dismensional sonography and color doppler in diagnosing placenta previa accreta in patients with previous cesarean section. Forty-one patients with previous cesarean sections were confirmed to have partial or total placenta previa in the current pregnancy and were given ultrasound examinations after the 28th week of gestation. Specific ultrasound features of the placenta and its interphase with the uterus and the bladder for placenta accreta were checked by two-dimensional ultrasonography and color Doppler. All the patients were traced until delivery. The golden standard in diagnosis was the intraoperative finding and the pathologic exam. Twenty-two patients had ultrasonographic evidence of placenta previa, 20 of which were later confirmed placenta previa accreta intraoperatively. Nineteen patients had no ultrasound evidence of placenta previa, and 1 of which was later confirmed placenta previa accreta. The sensitivity and specificity of antenatal ultrasound diagnosis of placenta previa accreta were 95.24% and 94.74% respectively. The most prominent feature to suggest placenta accreta in twodismensional sonography was the presence of multiple lakes that represented dilated vessels extending from the placenta through the myometrium. The most prominent color Doppler feature was the presence of interphase hypervascularity with abnormal vessels linking the placenta to the bladder, and the rate was 95.24%. Placenta previa accreta can be diagnosed made with a thorough two dimensional ultrasonographic and color Doppler examination in patients with previous cesarean scar and placenta previa.

  3. Intraoperative bleeding control during cesarean delivery of complete placenta previa with transient occlusion of uterine arteries.

    Science.gov (United States)

    Kim, Ju Hyun; Joung, Eun-Ju; Lee, Soo-Jung; Kwack, Jae Young; Kwon, Yong Soon

    2015-11-01

    There are few methods to control heavy intra-operative bleeding during cesarean delivery of placenta previa. Transient occlusion of uterine arteries (TOUA) during operation has previously been reported as a quick and safe method to control intra-operative uterine bleeding. We reported 2 cases of cesarean delivery with complete placenta previa in which TOUA was performed to safely reduce intra-operative complication, especially heavy intra-operative bleeding. In the 2 cases, cesarean deliveries were safe and without any complications under the TOUA method. TOUA can be a good method to control heavy intra-operative bleeding during cesarean delivery of complete placenta previa with risk of heavy bleeding.

  4. Stereological Analysis of Human Placenta in Cases of Placenta Previa in Comparison with Normally Implanted Controls

    Science.gov (United States)

    Heidari, Zahra; Sakhavar, Nahid; Mahmoudzadeh-Sagheb, Hamidreza; Ezazi-Bojnourdi, Tahmine

    2015-01-01

    Background Placenta previa (PP) is an obstetric complication that can affect maternal and fetal morbidity and mortality. Its prevalence is rising due to cesarean sections. There is no quantitative data of placenta in PP. In this study, quantitative parameters of placenta in cases with PP in comparison with normally implanted controls were investigated. Methods In this quasi experimental study, placentas from pregnancies with PP and normally implanted controls (n = 10) were obtained from women who underwent cesarean section. Three full-thickness columns of each placenta were sampled using systematic uniform random sampling (SURS). Columns were cut into slices and slices were sectioned with 4 µm thickness. SURS selected sections were stained by Masson's trichrome. Stereological analysis was done on 8-10 SURS microscopic fields of each section. Absolute volume and volume density of chorionic villi, intervillous space, syncytiotrophoblast, fibrin and blood vessels in chorionic villi were estimated in both groups. Statistical analysis was done using Mann Whitney-U test and significant level was set at p placenta. These changes probably can be influential on the evolution and survival of fetus. PMID:25927025

  5. Successful outcome of placenta previa percreta with bladder invasion

    Directory of Open Access Journals (Sweden)

    Syeda Sayeeda

    2017-06-01

    Full Text Available A 41 year old multiparous lady, with previous history of one cesarean section presented at her 24 weeks of gestation with frank hematuria. The case was diagnosed as placenta previa percreta with the bladder involvement by ultrasound doppler and confirmed by MR urogram. So, peripartum hysterectomy was planned. On opening of the abdomen, a hugely distended bladder was found, which when retracted engorged blood vessels were found over the lower segment of uterus. Baby was delivered by giving a transverse incision in the upper segment. By keeping placenta in situ, total abdominal hysterectomy was done with quick successive clamping. Severe per-operative bleeding was occurred. Bladder irrigation started following total abdominal hysterectomy. Continuous small clots were coming out through catheter. A large old blood clot was removed by cystostomy done by an urologist. A sprouting vessel and a linear injury were noticed at the base of the bladder. The vessel was ligated and the injury was repaired. After proper hemostasis, the abdomen was closed in layers. The patient was shifted to ICU. Patient developed complications like MI, watery diarrhoea, low grade fever which was managed accordingly. She was discharged healthy on her 19th post-operative day.

  6. Placenta previa. A 13 years experience at a tertiary care center in Western Saudi Arabia.

    Science.gov (United States)

    Abduljabbar, Hassan S; Bahkali, Nedaa M; Al-Basri, Samera F; Al Hachim, Estabrq; Shoudary, Ibrahim H; Dause, Wesam R; Mira, Mohammed Y; Khojah, Mohammed

    2016-07-01

    To review cases of placenta previa in the last 13 years in a tertiary teaching hospital to identify risk factors for maternal morbidity.  A retrospective analysis of all cases of placenta previa managed at King Abdulaziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia from January 2001 to December 2013.    The total number of deliveries was 55,862 deliveries, and 11,412 (20.3%) delivered by cesarean section (C/S). The charts of 230 cases diagnosed with placenta previa was reviewed, and different variables were collected and analyzed. Diagnoses were achieved in 94% of them using ultrasound. The prevalence rate of placenta previa was 4.1 per 1000 births. Cesarean section was carried out as an emergency procedure in 130 (56.5%) women and as elective in 100 (43.5%) women. Of them, 26 patients were admitted to the intensive care unit (ICU) (11.3%), all of which received blood transfusion >6 units and 22 patients had a hysterectomy for uncontrollable bleeding.   Placenta previa is one of the leading causes of maternal morbidity and mortality. Every hospital must have a protocol, or algorithm for the management of placenta previa. Risk factors for maternal morbidity included complete previa, history of previous C/S, emergency C/S at a gestational age of less than 36 weeks, and estimated blood loss more than 2000 ml.

  7. A comparative study of neonatal outcomes in placenta previa versus cesarean for other indication at term.

    Science.gov (United States)

    Schneiderman, Megan; Balayla, Jacques

    2013-07-01

    Currently, no ACOG guidelines address the issue of the optimal timing of delivery in placenta previa. Though there is an increased risk of neonatal morbidity and mortality when electively delivered preterm, it is unclear whether adverse neonatal outcomes exist when these pregnancies make it beyond term. By comparing neonatal outcomes amongst pregnancies with placenta previa versus those from cesarean for another indication at term, the objective of this study was to determine whether placenta previa is an independent risk factor for adverse neonatal outcomes at term. We conducted a population-based cohort-study using the CDC's Linked Birth-Infant Death data from the United States. The effect of placenta previa on the risk of adverse neonatal outcomes was estimated using unconditional logistic regression analysis, adjusting for relevant confounders. Our cohort consisted of 3,550,842 deliveries meeting inclusion criteria. The incidence of placenta previa at term was 1.3/1000 (n = 4,492), accounting for 40.6% of all previa cases. Relative to cesareans for other indications, pregnancies with placenta previa had an increased risk of IUGR 3.20 [2.50-4.10], SGA 2.70 [2.45-2.97], respiratory distress 3.82 [2.91-5.00], prolonged ventilation 3.41 [2.70-4.32] and neonatal anemia 6.87 [4.43-10.65]. Rates of meconium aspiration syndrome, seizures, birth injury and overall infant mortality do not appear to be affected by this condition. Relative to cesareans for other indications, placenta previa is associated with increased morbidity, but not mortality, at term. This information might be helpful in the development of future guidelines, which are currently needed to guide and standardize clinical practice regarding the optimal timing of delivery in placenta previa.

  8. Risk Factors and Consequent Outcomes of Placenta Previa: Report From a Referral Center

    Directory of Open Access Journals (Sweden)

    Soraya Saleh Gargari

    2016-12-01

    Full Text Available  Because of an unknown factor, the frequency of complicated pregnancy with placenta previa has been raised during past decade. This study was designed to deepen our understanding of risk factors and outcomes of placenta previa in our country. This study investigated 694 cases of placenta previa comparing with 600 healthy pregnant women with not overlie placenta in two referral and tertiary Obstetrics and Gynecological Hospital in Iran on the basis of the clinical and para-clinical analysis, in order to find the probable risk factors for occurrence of placenta previa and its effect on maternal and neonatal complications. The most important risk factor for the occurrence of placenta previa was advanced maternal age (P<0.001 and history of stillbirth (OR=117.2, CI=58.3-236.0. In the other hand, the most substantial outcome of this disorder was a reduction of gestational age (P<0.001 and low birth weight neonatally (P<0.001. The conservative follow-up should be programmed for women with placenta previa based on the type of risk factors which can provide the best possible management to decrease the morbidity and mortality of their related complications.

  9. Maternal Morbidity in Women with Placenta Previa Managed with Prediction of Morbidly Adherent Placenta by Ultrasonography

    Directory of Open Access Journals (Sweden)

    Midori Fujisaki

    2017-01-01

    Full Text Available Objective. To determine maternal morbidity in women with placenta previa managed with prediction of morbidly adherent placenta (MAP by ultrasonography. Methods. A retrospective cohort study was undertaken comprising forty-one women who had placenta previa with or without risk factors for MAP. Women who had all three findings (bladder line interruption, placental lacunae, and absence of the retroplacental clear zone were regarded as high suspicion for MAP and underwent cesarean section followed by hysterectomy. We attempted placental removal for women having two findings or less. Results. Among 28 women with risk, nine with high suspicion underwent hysterectomy and were diagnosed with MAP. Three of 19 women with two findings or less eventually underwent hysterectomy and were diagnosed with MAP. The sensitivity and positive predictive value for the detection of MAP were 64% and 100%. The pathological severity of MAP was significantly correlated with the cumulative number of findings. There were no cases of MAP among 13 women without risk. There was no difference of blood loss between women with high suspicion and those without risk (2186±1438 ml versus 1656±848 ml, resp.; p=0.34. Conclusion. Management with prediction of MAP by ultrasonography is useful for obtaining permissible morbidity.

  10. Maternal Morbidity in Women with Placenta Previa Managed with Prediction of Morbidly Adherent Placenta by Ultrasonography

    Science.gov (United States)

    Maki, Yohei; Oohashi, Masanao

    2017-01-01

    Objective. To determine maternal morbidity in women with placenta previa managed with prediction of morbidly adherent placenta (MAP) by ultrasonography. Methods. A retrospective cohort study was undertaken comprising forty-one women who had placenta previa with or without risk factors for MAP. Women who had all three findings (bladder line interruption, placental lacunae, and absence of the retroplacental clear zone) were regarded as high suspicion for MAP and underwent cesarean section followed by hysterectomy. We attempted placental removal for women having two findings or less. Results. Among 28 women with risk, nine with high suspicion underwent hysterectomy and were diagnosed with MAP. Three of 19 women with two findings or less eventually underwent hysterectomy and were diagnosed with MAP. The sensitivity and positive predictive value for the detection of MAP were 64% and 100%. The pathological severity of MAP was significantly correlated with the cumulative number of findings. There were no cases of MAP among 13 women without risk. There was no difference of blood loss between women with high suspicion and those without risk (2186 ± 1438 ml versus 1656 ± 848 ml, resp.; p = 0.34). Conclusion. Management with prediction of MAP by ultrasonography is useful for obtaining permissible morbidity. PMID:28523191

  11. Longitudinal parallel compression suture to control postopartum hemorrhage due to placenta previa and accrete

    Directory of Open Access Journals (Sweden)

    Guang-Tai Li

    2016-04-01

    Conclusion: Longitudinal parallel compression suture is a safe, easy, effective, practical, and conservative surgical technique to stop intractable PPH from the lower uterine segment, particularly in women who have a cesarean scar and placenta previa/accreta.

  12. Placenta previa and risk of major congenital malformations among singleton births in Finland.

    Science.gov (United States)

    Kancherla, Vijaya; Räisänen, Sari; Gissler, Mika; Kramer, Michael R; Heinonen, Seppo

    2015-06-01

    Placenta previa has been associated with adverse birth outcomes, but its association with congenital malformations is inconclusive. We examined the association between placenta previa and major congenital malformations among singleton births in Finland. We performed a retrospective population register-based study on all singletons born at or after 22+0 weeks of gestation in Finland during 2000 to 2010. We linked three national health registers: the Finnish Medical Birth Register, the Hospital Discharge Register, and the Register of Congenital Malformations, and examined several demographic and clinical characteristics among women with and without placenta previa, in association with major congenital malformations. We estimated adjusted odds ratios and 95% confidence intervals using multivariable logistic regression models. The prevalence of placenta previa was estimated as 2.65 per 1000 singleton births in Finland (95% confidence interval, 2.53-2.79). Overall, 6.2% of women with placenta previa delivered a singleton infant with a major congenital malformation, compared with 3.8% of unaffected women (p ≤ 0.001). Placenta previa was positively associated with almost 1.6-fold increased risk of major congenital malformations in the offspring, after controlling for maternal age, parity, fetal sex, smoking, socio-economic status, chorionic villus biopsy, In vitro fertilization, pre-existing diabetes, depression, preeclampsia, and prior caesarean section (adjusted odds ratio = 1.55; 95% confidence interval, 1.27-1.90). Using a large population-based study, we found that placenta previa was weakly, but significantly associated with an increased risk of major congenital malformations in singleton births. Future studies should examine the association between placenta previa and individual types of congenital malformations, specifically in high-risk pregnancies. © 2015 Wiley Periodicals, Inc.

  13. Efficacy and Safety of Prophylactic Uterine Artery Embolization in Pregnancy Termination with Placenta Previa.

    Science.gov (United States)

    Pei, Renguang; Wang, Guoxiang; Wang, Heping; Huang, Xinyu; Yan, Xiaoxing; Yang, Xiaohua

    2017-03-01

    To appraise the efficacy and safety of prophylactic uterine artery embolization in pregnancy termination with placenta previa. A cohort of 54 consecutive patients with placenta previa underwent prophylactic uterine artery embolization before vaginal delivery from February 2012 to March 2015. Vaginal delivery was attempted in all patients. Cesarean section or hysterectomy was introduced when vaginal delivery failed. Vaginal delivery succeeded in 50 patients (93.6%) and failed in 4 patients (6.4%), thereupon converted to cesarean delivery. No patients resorted to hysterectomy. Six patients (11.1%) underwent blood transfusion. None of clinical characteristics, including maternal age, gestational age, history of abortion, history of cesarean delivery, and volume of vaginal bleeding, was significantly associated with complete placenta previa (P > 0.05). However, patients with complete placenta previa had a significantly lower successful rate of vaginal delivery than did patients without complete placenta previa (81 vs 100%, P = 0.038). The rate of complications was 3.7%. No major complications were observed. Uterine artery embolization is an effective and safe technique to assist pregnancy termination with placenta previa, which may lower the risk of cesarean section, hysterectomy, and blood transfusion.

  14. Transabdominal ultrasonography as a screening test for second-trimester placenta previa.

    Science.gov (United States)

    Quant, Hayley S; Friedman, Alexander M; Wang, Eileen; Parry, Samuel; Schwartz, Nadav

    2014-03-01

    To determine the test characteristics of transabdominal ultrasonography as a screening test for second-trimester placenta previa. This secondary analysis of a prospective cohort study evaluated the distance from the placental edge to the internal os (placenta-cervix distance) through both transabdominal and transvaginal ultrasonography during the anatomic survey. Patients were recruited in the Maternal-Fetal Medicine Ultrasound Unit at the Hospital of the University of Pennsylvania, an urban tertiary care center. Transabdominal placenta-cervix distance cutoffs with high sensitivity for detection of previa and low-lying placenta were identified, and test characteristics were calculated. Follow-up ultrasound data, pregnancy, and delivery outcomes for those with second-trimester previa or low-lying placenta were obtained. One thousand two hundred fourteen women were included in the analysis. A transabdominal placenta-cervix distance cutoff of 4.2 cm was 93.3% sensitive and 76.7% specific for detection of previa with a 99.8% negative predictive value at a screen-positive rate of 25.0%. A cutoff of 2.8 cm was 86.7% sensitive and 90.5% specific with a 99.6% negative predictive value at a screen-positive rate of 11.4%. Only 9.8% (four of 41) of previas and low-lying placentas persisted through delivery. Transabdominal ultrasonography is an effective screening test for second-trimester placenta previa. At centers not performing universal transvaginal ultrasonography at the time of the anatomic survey, evidence-based transabdominal placenta-cervix distance cutoffs can optimize the identification of patients who require further surveillance for previa.

  15. Changes in first trimester screening test parameters in pregnancies complicated by placenta previa and association with hyperemesis gravidarum.

    Science.gov (United States)

    Tülek, Fırat; Kahraman, Alper; Taşkın, Salih; Özkavukçu, Esra; Söylemez, Feride

    2014-01-01

    To assess the possible changes in first trimester screening test parameters in pregnancies complicated with placenta previa and to determine whether there is an association between hyperemesis gravidarum and placenta previa. A total of 131 singleton spontaneously conceived pregnancies that were complicated by placenta previa and delivered between May 2006 and May 2013 were evaluated from birth charts. Ninety patients without placenta previa were selected amongst patients who delivered within the same period of time as the control group. Cases of low lying placenta (n=52) within the study group were assessed as a separate group. The rest of the cases was considered to be in a different group. Beta human chorionic gonadotropin (BhCG) multiples of medians (MoMs) and nuchal translucency (NT) MoMs were significantly higher in the placenta previa group in comparison with the low lying placenta and control groups. Apgar scores at both the 1st and 5th minutes were significantly lower in the placenta previa group. Hyperemesis gravidarum was found to be significantly more frequent in the placenta previa group. The prevalence of hyperemesis gravidarum in the first trimester is higher in pregnancies complicated by placenta previa. Paying more attention to the development of placenta previa in the routine pregnancy follow-up of patients with hyperemesis gravidarum could be considered.

  16. Prenatal Diagnosis and Perinatal Management of Placenta Previa Accreta: Past, Present and Future

    Directory of Open Access Journals (Sweden)

    Min-Min Chou

    2004-06-01

    Full Text Available The reported incidence of placenta accreta varies widely in the English literature, from 1:540 to 1:93,000 deliveries. In Taiwan, the quoted incidence ranges from 1:625 to 1:1,652 deliveries in tertiary medical centers. Massive obstetric hemorrhage is still the leading cause of pregnancy-related death, and placenta previa accreta remains one of the major predisposing factors. With the increasing rates of cesarean delivery and uterine curettage for abortion, both placenta previa and accreta are steadily increasing in frequency. Therefore, more cases of placenta previa accreta can be expected in obstetric practice. In several recent series, placenta accreta has emerged as the major indication for peripartum hysterectomy, accounting for 40% to 60% of cases. It has, therefore, become a challenging problem of increasing clinical significance in obstetrics.

  17. Safety of cesarean delivery through placental incision in patients with anterior placenta previa.

    Science.gov (United States)

    Hong, Deok-Ho; Kim, Eugene; Kyeong, Kyu-Sang; Hong, Seung Hwa; Jeong, Eun-Hwan

    2016-03-01

    To demonstrate the safety of fetal delivery through placental incision in a placenta previa pregnancy. We examined the medical records of 80 women with singleton pregnancy diagnosed with placenta previa who underwent cesarean section between May 2010 and May 2015 at the Department of Obstetrics and Gynecology, Chungbuk National University Hospital. Among the women with placenta previa, those who did not have the placenta in the uterine incision site gave birth via conventional uterine incision, while those with anterior placenta previa or had placenta attached to the uterine incision site gave birth via uterine incision plus placental incision. We compared the postoperative hemoglobin level and duration of hospital stay for the mother and newborn of the two groups. There was no difference between the placental incision group and non-incision group in terms of preoperative and postoperative hemoglobin change, the amount of blood transfusions required by the mother, newborns with 1-min or 5-min Apgar scores below 7 points or showing signs of acidosis on umbilical cord blood gas analysis result of pH below 7.20. Moreover, neonatal hemoglobin levels did not differ between the two groups. Fetal delivery through placental incision during cesarean section for placenta previa pregnancy does not negatively influence the prognosis of the mother or the newborn, and therefore, is considered a safe surgical technique.

  18. Frequency of placenta previa in previously scarred and non scarred uterus.

    Science.gov (United States)

    Majeed, Tayyaba; Waheed, Fatima; Mahmood, Zahid; Saba, Kanwal; Mahmood, Hamis; Bukhari, Mulazim Hussain

    2015-01-01

    To determine the frequency of placenta Previa in patients coming to a tertiary care unit with previously scarred and non-scarred uterus. A descriptive cross sectional study was carried on 114 cases who underwent caesarean sections (37 cases out of 645 cases with non scarred uterus and 77 cases from 721 cases with scarred uterus) in the department of obstetrics and gynecology Lady Willingdon Hospital from January 2008- December 2011. Most patients (47.36%) were between 26-30 years age group, presented with gestational age between 36-40 weeks (70.17%), were mostly G2-4, while frequency of placenta Previa in non-scarred uterus was 32.45% (37 cases), and frequency in previously scarred uterus was 67.54% (77 cases). Major degree Previa was found in 88 cases (77.19%). There were 5.70% cases of placenta Previa from non-scarred uteruses and 10.67% cases of placenta Previa (10.67%) from already scarred uteruses. Stratification revealed a higher trend of the morbidity with the increase in number of previous caesarean sections. A significantly higher frequency of placenta Previa was found among patients coming to a tertiary care hospital with previously scarred uterus.

  19. Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients.

    Science.gov (United States)

    Cho, Hee Young; Park, Yong Won; Kim, Young Han; Jung, Inkyung; Kwon, Ja-Young

    2015-01-01

    The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation. We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL. Sixty-four patients (46.7%) required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1%) had placenta previa totalis. The overall success rate was 75% (48/64) for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all pcesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance.

  20. A 5-year review of pattern of placenta previa in Ilorin, Nigeria.

    Science.gov (United States)

    Omokanye, L O; Olatinwo, A W O; Salaudeen, A G; Ajiboye, A D; Durowade, K A

    2017-01-01

    Placenta previa, a major cause of obstetric hemorrhage, is potentially life-threatening to the mother and frequently results in high perinatal morbidity and mortality. This is a retrospective study of all cases of placenta previa managed at the University of Ilorin Teaching Hospital over a 5-year from January 2011 to December 2015. A pro forma template was used to harvest information from case notes of patients involved in the study. There were a total of 10,250 deliveries over the 5-year study and 164 cases of placenta previa were managed during this period; giving an incidence of 1.6% of the total deliveries. Of these patients, 65.9% were unbooked while 34.1% were booked. 110 (67%) were above 30 years of age and 51.2% were grand multiparous women. The majority (81.7%) of the patients belonged to the low socioeconomic class. Painless vaginal bleeding (62.2%), intrapartum hemorrhage (22.6%), and abnormal lie presentation (8.5%) were the most common mode of presentation. Vaginal delivery occurred in (29.3%) of patients while 70. 7% were delivered through cesarean section. There was a significant association between patients' age, parity, booking status, and types of placenta previa (P placenta previa (P placenta previa are advanced maternal age above 35 years, grand multiparity, and booking status. Early recognition, appropriate referral of these patients and availability of ultrasound facilities, blood transfusion facilities, improvement in neonatal facilities and trained personnel will go a long way in reducing the perinatal mortality from placenta previa.

  1. Ki-67 proliferation index in patients with placenta previa percreta in the third trimester.

    Science.gov (United States)

    Hilali, Nese; Kocarslan, Sezen; Vural, Mehmet; Incebiyik, Adnan; Camuzcuoglu, Aysun; Camuzcuoglu, Hakan

    2015-02-01

    The purpose of this study was to investigate proliferative capacity of placenta previa percreta in the third trimester via evaluating Ki-67 proliferating index. The paraffin blocks of placental tissues, which were obtained from the patients who underwent hysterectomy for placenta previa percreta (n = 12, gestational age > 28 weeks), from legal abortions (n = 12, gestational age  38 weeks), between January 2011 and April 2013, were included into the study. The paraffin blocks of the patients were stained with Ki-67 (proliferating cell marker) immunohistochemically, and Ki-67 proliferation index levels were calculated. Ki-67 proliferation index levels were higher in patients with legal abortions than patients with placenta percreta or noncomplicated cesarean delivery group. However, any statistically significant difference was not detected between the percreta and noncomplicated groups (p > 0.05). The tissue samples of the patients with placenta previa percreta exhibited low proliferative capacity similar to the samples of normal placentation group.

  2. Effect of placenta previa on neonatal respiratory disorders and amniotic lamellar body counts at 36-38weeks of gestation.

    Science.gov (United States)

    Tsuda, Hiroyuki; Kotani, Tomomi; Sumigama, Seiji; Mano, Yukio; Hua, Li; Hayakawa, Hiromi; Hayakawa, Masahiro; Sato, Yoshiaki; Kikkawa, Fumitaka

    2014-01-01

    Pregnancies with placenta previa are significantly associated with preterm delivery and cesarean section. Therefore particular attention should be paid to the incidence of neonatal respiratory disorders in pregnancies with placenta previa. The purpose of this study is to examine the relationship between placenta previa and neonatal respiratory disorders, including respiratory distress syndrome (RDS) and transient tachypnea of the newborn (TTN), and to evaluate the impact of placenta previa on the amniotic lamellar body count (LBC) values. We analyzed the data from 186 registered elective cesarean cases without fetal or maternal complications at 36-38weeks of gestation. Amniotic fluid samples were analyzed immediately without centrifugation, and the LBC was measured using a platelet channel on the Sysmex XE-2100. RDS was present in four neonates (2.2%) and TTN in 12 neonates (6.5%). The rate of TTN was significantly higher and the LBC values were significantly lower in the placenta previa group than in the control group (P=0.002 and P=0.024). The adjusted odds ratio for neonatal TTN was 7.20 (95% confidence interval: 6.58-7.88) among females with placenta previa. In placenta previa, warning bleeding was a significant factor protecting against neonatal respiratory disorders (P=0.046). Placenta previa in itself is a risk factor for neonatal TTN. When an elective cesarean section is performed in cases with uncomplicated placenta previa, special care should be taken to monitor for neonatal TTN even at 36-38weeks of gestation. © 2013.

  3. Intraoperative aortic balloon occlusion in patients with placenta previa and/or placenta accreta: a retrospective study.

    Science.gov (United States)

    Luo, Fangyuan; Xie, Lan; Xie, Ping; Liu, Siwei; Zhu, Yue

    2017-04-01

    To introduce the primary experience of using aortic balloon catheters during cesarean section for placenta previa and/or placenta accreta. From January 2013 to May 2015, 43 patients who were preoperatively diagnosed with major placenta previa and/or placenta accreta and who underwent prophylactic aortic catheterization before caesarean section (CS) were included in the study. We analyzed the clinical data of the study population. Surgery- and catheterization-related complications were also reported. Major placenta previa or placenta accreta was surgically confirmed in 42 patients, 28 of whom had both conditions. The mean patient age was 32.3 ± 5.5 years, whereas the median gestational age at delivery was 260 (range, 153-280) days. Twenty-nine (67.4%) patients had previously undergone CS, and 13 (30%) patients had undergone emergency surgery for antenatal hemorrhage. The median estimated blood loss during surgery was 500 (range, 100-3,000) mL, and the median duration of occlusion was 20 (range, 5-32) minutes. Hysterectomy was performed in five (11.6%) patients and uterine artery embolization in two (4.6%) patients. Two patients with placenta percreta experienced surgery-related complications, and two patients required hospital readmission. No major catheterization-related complications were observed. Forty-two live births were recorded, and the Apgar score of the infants at 5 minutes was > 7. Intraoperative aortic balloon occlusion is a relatively safe method for treating placenta previa and/or placenta accreta during scheduled and emergency CS and might be helpful to prevent hysterectomy and embolization in women wishing to preserve fertility. Copyright © 2017. Published by Elsevier B.V.

  4. Prevalence of placenta previa among deliveries in Mainland China: A PRISMA-compliant systematic review and meta-analysis.

    Science.gov (United States)

    Fan, Dazhi; Wu, Song; Wang, Wen; Xin, Lihong; Tian, Guo; Liu, Li; Feng, Jinping; Guo, Xiaoling; Liu, Zhengping

    2016-10-01

    Placenta previa is characterized by the abnormal placenta overlying the endocervical os, and it is known as one of the most feared adverse maternal and fetal-neonatal complications in obstetrics. We aimed to obtain overall and regional estimates of placenta previa prevalence among deliveries in Mainland China. The research was performed a systematic review, following the Meta-analysis of observational studies in epidemiology (MOOSE) guidelines for systematic reviews of observational studies, and the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement for reporting systematic reviews and meta-analysis. Electronic databases were searched and included hospital-based studies that reported placenta previa prevalence in Mainland China. Random-effects meta-analyses were used to pool prevalence estimates of placenta previa. Meta-regression analyses were performed to explore sources of heterogeneity across the included studies. For exploring the geographical distributions of placenta previa, the ArcGIS software (Esri) was used to construct the map of prevalence. A total of 80 articles and 86 datasets (including 1,298,548 subjects and 14,199 placenta previa cases) from 1965 through 2015 were included. The pooled overall prevalence of placenta previa among deliveries was 1.24% (95% confidence interval [CI], 1.12-1.36) in Mainland China during 1965 to 2015. And, the trend in the prevalence of placenta previa was steady. The occurrence rate of placenta previa in the region groups Northeast, North, Northwest, Central China, East, South, and Southwest was 1.20%, 1.01%, 1.10%, 1.15%, 0.93%, 1.42%, and 2.01%, respectively. The prevalence map based on a geographic information system showed an unequal geographic distribution. The results showed that placenta previa is currently a high-burden disease in Mainland China. This review would be useful for the design of placenta previa planning and implementation adequate health care systems and treatment

  5. The effect of placenta previa on fetal growth and pregnancy outcome, in correlation with placental pathology.

    Science.gov (United States)

    Weiner, E; Miremberg, H; Grinstein, E; Mizrachi, Y; Schreiber, L; Bar, J; Kovo, M

    2016-12-01

    To compare the clinical characteristics and placental histopathology between pregnancies complicated by placenta previa and controls. Between 2009 and 2015, cesarean deliveries (CDs) of 119 pregnancies with placenta previa were identified from which maternal outcomes, neonatal outcomes and placental pathology were reviewed. Results were compared with CDs matched for maternal age and pregnancy complications (control group, n=119). Placental lesions were classified into maternal and fetal vascular supply lesions and inflammatory response. Composite neonatal outcome was defined as one or more of early neonatal complications. Small-for-gestational age (SGA) was defined as birth weight ⩽10th percentile. Placentas from the previa group had higher rates of weights previa group as compared with controls. After controlling for potential confounding bias using multivariable logistic regression models, placenta previa remained statistically significantly associated with placental maternal (adjusted odds ratio (aOR) 2.48, 95% confidence interval (CI) 1.2-4.9, P=0.009) and fetal (aOR 7.05, 95% CI 2.4-20.2, Pplacenta previa in the current study. These findings may suggest that abnormal placentation is accompanied by suboptimal implantation that interferes with fetal growth.

  6. Placenta previa and long-term morbidity of the term offspring.

    Science.gov (United States)

    Walfisch, Asnat; Beharier, Ofer; Shoham-Vardi, Ilana; Sergienko, Ruslan; Landau, Daniella; Sheiner, Eyal

    2016-08-01

    The long-term impact of placenta previa on term infants is unknown. We aimed to investigate whether abnormal placentation increases the risk for long-term morbidity of the term offspring. A population-based cohort study compared the incidence of long-term hospitalizations up to the age of 18 due to cardiovascular, endocrine, neurological, hematological, respiratory and urinary morbidity of children born at term in pregnancies diagnosed with placenta previa and those without. Deliveries occurred between the years 1991-2013 in a tertiary medical center. Multiple pregnancies, and fetal congenital malformations were excluded. Kaplan-Meier survival curves were used to compare cumulative morbidity incidence over time. A multivariable generalized estimating equation (GEE) logistic regression model analysis was used to control for confounders and for maternal clusters. During the study period 233,123 term deliveries met the inclusion criteria; 0.2% (n=502) of the children were born to mothers with placenta previa. During the follow-up period, children born to mothers with placenta previa did not have an increased risk for long-term cardiovascular, endocrine, hematological, neurological, respiratory, and urinary morbidity. Term offsprings of mothers diagnosed with placenta previa do not appear to be at an increased risk for long-term morbidity up to the age of 18. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. HUBUNGAN PARITAS DAN RIWAYAT SC DENGAN KEJADIAN PLACENTA PREVIA DI RSUD ARIFIN ACHMAD PEKANBARU

    Directory of Open Access Journals (Sweden)

    wan anita

    2017-02-01

    Full Text Available Penyebab angka kematian ibu (AKI yang utama adalah perdarahan, dimana perdarahan yang sering terjadi pada ibu hamil salah satunya adalah plasenta previa. Plasenta previa adalah plasenta yang letaknya abnormal, yaitu pada segmen bawah uterus sehingga menutupi sebagian atau seluruh pembukaan jalan lahir. Penelitian ini dilakukan karena masih tingginya angka plasenta previa di RSUD Arifin Achmad Pekanbaru, yaitu 135 kasus tahun 2013. Tujuan penelitian ini untuk mengetahui hubungan paritas dan riwayat SC dengan kejadian plasenta previa pada ibu bersalin di ruang Camar I RSUD Arifin Achmad Pekanbaru. Desain penelitian adalah analitik kuantitatif dengan pendekatan cross sectional. Sampel adalah  ibu bersalin yang mengalami plasenta previa tahun 2013 yang berjumlah 135 kasus. Teknik pengambilan sampel ini total sampling. Analisis yang digunakan adalah analisis univariat dengan distribusi frekuensi dan analisis bivariat dengan uji chi square. Hasil penelitian menunjukkan terdapat hubungan paritas 1 dan >3 terhadap kejadian placenta previa (p value = 0,034 dan tidak terdapat hubungan ada riwayat SC dengan  kejadian placenta previa (p value = 0,052. Dari hasil penelitian dapat disarankan untuk menurunkan insiden plasenta previa diharapkan kepada petugas kesehatan untuk memberikan informasi tentang pentingnya merencanakan kehamilan yang aman dan ibu hamil untuk selalu memeriksakan kehamilan untuk melihat perkembangan kehamilannya.

  8. Direct puncture embolization of the internal iliac artery during cesarean delivery for pernicious placenta previa coexisting with placenta accreta.

    Science.gov (United States)

    Chen, Zhenyu; Li, Ju; Shen, Jian; Jin, Jiaxi; Zhang, Wei; Zhong, Wan

    2016-12-01

    To evaluate direct puncture embolization of the internal iliac artery with hemostatic gelatin sponge particles to treat pernicious placenta previa coexisting with placenta accreta during cesarean delivery. A retrospective study was conducted of data from women with pernicious placenta previa and placenta accreta who underwent direct puncture embolization of the internal iliac artery during cesarean delivery at a center in China between September 1, 2013, and February 28, 2015. Information regarding surgical procedures, operative data, and outcomes during hospitalization were obtained from medical records. The procedure was successful in all 16 cases included. Mean operative time was 78 minutes (range 65-90) and mean estimated blood loss was 1550 mL (range 1000-2500). Complications such as fever, buttock pain, or acute limb ischemia were not observed. The procedure was performed after partial cystectomy for two patients with bladder invasion. Postoperative Doppler imaging indicated uterine recovery and normalized uterine blood flow in all patients. Direct puncture embolization of the internal iliac artery during cesarean delivery was a safe, effective, simple, and rapid method to control hemorrhage among women with pernicious placenta previa and placenta accreta. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  9. Ultrasonographic diagnosis of placenta previa: comparison between transabdominal and transperineal ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jin Wook; Byun, Woo Mok; Hwang, Mi Soo; Chang, Jae Chun; Park, Bok Hwan; Cho, Kil Ho; Lee, Tae Hyeung [Yeungnam University College of Medicine, Daegu (Korea, Republic of)

    1994-12-15

    Sometimes, the diagnosis of placenta previa by transabdominal ultrasonography may be difficult, especially in the third trimester of pregnancy, because of obscuration of internal os of the cervix by overlying placenta as advancing pregnancy. In such situations, however, the transperineal ultrasonography may offer an additional view of internal os of the cervix without obscuration by overlying fetal parts or placenta. We evaluated forty pregnant women in whom placenta previa were suspected clinically, with both transabdominal and transperineal ultrasonography. The menstrual age at the time of ultrasonography, ranged from 27 to 36 weeks. We compared the diagnostic accuracy of each procedure with the final diagnosis at the time of delivery. Transabdominalul trasonography provided to correct diagnosis in 25 cases. In remaining 15 cases, the confident diagnosis could not be made because of poor visualization of internal os of the cervix. However, transperineal ultrasonography provided the correct diagnosis in all 40 cases. We conclude that the transperineal ultrasonography is relatively easy and convenient technique and valuable for detection of placenta previa, especially when the diagnosis of placenta previa is difficult by transabdominal ultrasonography

  10. A Case of Vaginal Stillbirth in the Presence of Placenta Previa at 33 Weeks of Gestation

    Science.gov (United States)

    Chinen, Yukiko; Kinjo, Tadatsugu; Nitta, Hayase; Kinjo, Yui; Masamoto, Hitoshi

    2016-01-01

    It was demonstrated that second- and third-trimester therapeutic termination of pregnancy (TOP) is feasible in cases with placenta previa. We report a 34-year-old woman with complex fetal malformations associated with placenta previa. An ultrasound examination at 21 weeks of gestation revealed fetal growth restriction (FGR) and complex fetal malformations associated with a placenta previa. After extensive information, the parents opted for careful observation. Thereafter, FGR gradually progressed and we observed arrest of end-diastolic velocity of the umbilical artery. Finally, intrauterine fetal death (IUFD) was confirmed at 33 weeks of gestation. Two days after IUFD, the patient experienced labor pain. The placenta and dead fetus weighing 961 g were vaginally delivered, and total bleeding was 270 mL. Although further studies to confirm the dynamic change of the uteroplacental blood flow are necessary to avoid the risk of maternal hemorrhage, vaginal TOP with placenta previa after feticide or IUFD would be feasible. PMID:27579202

  11. Prophylactic Hypogastric Artery Ballooning in a Patient with Complete Placenta Previa and Increta

    Science.gov (United States)

    Yi, Kyong Wook; Seo, Tae-Seok; So, Kyeong A; Paek, Yu Chin; Kim, Hai-Joong

    2010-01-01

    Abnormal attachment of the placenta (Placenta accreta, increta, and percreta) is an uncommon but potentially lethal cause of maternal mortality from massive postpartum hemorrhage. A 33-yr-old woman, who had been diagnosed with a placenta previa, was referred at 30 weeks gestation. On ultrasound, a complete type of placenta previa and multiple intraplacental lacunae, suggestive of placenta accreta, were noted. For further evaluation of the placenta, pelvis MRI was performed and revealed findings suspicious of a placenta increta. An elective cesarean delivery and subsequent hysterectomy were planned for the patient at 38 weeks gestation. On the day of delivery, endovascular catheters for balloon occlusion were placed within the hypogastric arteries, prior to the cesarean section. In the operating room, immediately after the delivery of the baby, bilateral hypogastric arteries were occluded by inflation of the balloons in the catheters previously placed within. With the placenta retained within the uterus, a total hysterectomy was performed in the usual fashion. The occluding balloons were deflated after closure of the vaginal cuff with hemostasis. The patient had stable vital signs and normal laboratory findings during the recovery period; she was discharged six days after delivery without complications. The final pathology confirmed a placenta increta. PMID:20358016

  12. Relation between Birth Weight and Intraoperative Hemorrhage during Cesarean Section in Pregnancy with Placenta Previa.

    Science.gov (United States)

    Soyama, Hiroaki; Miyamoto, Morikazu; Ishibashi, Hiroki; Takano, Masashi; Sasa, Hidenori; Furuya, Kenichi

    2016-01-01

    Placenta previa, one of the most severe obstetric complications, carries an increased risk of intraoperative massive hemorrhage. Several risk factors for intraoperative hemorrhage have been identified to date. However, the correlation between birth weight and intraoperative hemorrhage has not been investigated. Here we estimate the correlation between birth weight and the occurrence of intraoperative massive hemorrhage in placenta previa. We included all 256 singleton pregnancies delivered via cesarean section at our hospital because of placenta previa between 2003 and 2015. We calculated not only measured birth weights but also standard deviation values according to the Japanese standard growth curve to adjust for differences in gestational age. We assessed the correlation between birth weight and the occurrence of intraoperative massive hemorrhage (>1500 mL blood loss). Receiver operating characteristic curves were constructed to determine the cutoff value of intraoperative massive hemorrhage. Of 256 pregnant women with placenta previa, 96 (38%) developed intraoperative massive hemorrhage. Receiver-operating characteristic curves revealed that the area under the curve of the combination variables between the standard deviation of birth weight and intraoperative massive hemorrhage was 0.71. The cutoff value with a sensitivity of 81.3% and specificity of 55.6% was -0.33 standard deviation. The multivariate analysis revealed that a standard deviation of >-0.33 (odds ratio, 5.88; 95% confidence interval, 3.04-12.00), need for hemostatic procedures (odds ratio, 3.31; 95% confidence interval, 1.79-6.25), and placental adhesion (odds ratio, 12.68; 95% confidence interval, 2.85-92.13) were independent risk of intraoperative massive hemorrhage. In patients with placenta previa, a birth weight >-0.33 standard deviation was a significant risk indicator of massive hemorrhage during cesarean section. Based on this result, further studies are required to investigate whether

  13. Asymptomatic "placental prolapse" with cervical funneling in a patient with complete placenta previa.

    Science.gov (United States)

    Adekola, Henry; Lam-Rachlin, Jennifer; Bronshtein, Elena; Abramowicz, Jacques S

    2015-02-01

    We describe the transvaginal sonographic findings in a patient with complete placenta previa and increased risk of preterm birth owing to a prior history of mid-trimester pregnancy loss in whom we observed a short cervix and prolapse of the placenta and fetal membranes into the endocervical canal. We believe that this could lead to antepartum hemorrhage and mandate close observation when diagnosed. We introduced the term "placental prolapse" to describe our finding.

  14. Topical application of recombinant activated factor VII during cesarean delivery for placenta previa.

    Science.gov (United States)

    Schjoldager, Birgit T B G; Mikkelsen, Emmeli; Lykke, Malene R; Præst, Jørgen; Hvas, Anne-Mette; Heslet, Lars; Secher, Niels J; Salvig, Jannie D; Uldbjerg, Niels

    2017-06-01

    During cesarean delivery in patients with placenta previa, hemorrhaging after removal of the placenta is often challenging. In this condition, the extraordinarily high concentration of tissue factor at the placenta site may constitute a principle of treatment as it activates coagulation very effectively. The presumption, however, is that tissue factor is bound to activated factor VII. We hypothesized that topical application of recombinant activated factor VII at the placenta site reduces bleeding without affecting intravascular coagulation. We included 5 cases with planned cesarean delivery for placenta previa. After removal of the placenta, the surgeon applied a swab soaked in recombinant activated factor VII containing saline (1 mg in 246 mL) to the placenta site for 2 minutes; this treatment was repeated once if the bleeding did not decrease sufficiently. We documented the treatment on video recordings and measured blood loss. Furthermore, we determined hemoglobin concentration, platelet count, international normalized ratio, activated partial thrombin time, fibrinogen (functional), factor VII:clot, and thrombin generation in peripheral blood prior to and 15 minutes after removal of the placenta. We also tested these blood coagulation variables in 5 women with cesarean delivery planned for other reasons. Mann-Whitney test was used for unpaired data. In all 5 cases, the uterotomy was closed under practically dry conditions and the median blood loss was 490 (range 300-800) mL. There were no adverse effects of recombinant activated factor VII and we did not measure factor VII to enter the circulation. Neither did we observe changes in thrombin generation, fibrinogen, activated partial thrombin time, international normalized ratio, and platelet count in the peripheral circulation (all P values >.20). This study indicates that in patients with placenta previa, topical recombinant activated factor VII may diminish bleeding from the placenta site without initiation

  15. Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients.

    Directory of Open Access Journals (Sweden)

    Hee Young Cho

    Full Text Available The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation.We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL.Sixty-four patients (46.7% required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1% had placenta previa totalis. The overall success rate was 75% (48/64 for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all p<0.05. The drainage amount over 1 hour was 500 mL (20-1200 mL in the balloon failure group and 60 mL (5-500 mL in the balloon success group (p<0.01.Intrauterine tamponade with a Bakri balloon is an adequate adjunct management for postpartum hemorrhage following cesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance.

  16. Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients

    Science.gov (United States)

    Cho, Hee Young; Park, Yong Won; Kim, Young Han; Jung, Inkyung; Kwon, Ja-Young

    2015-01-01

    Purpose The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation. Methods We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL. Results Sixty-four patients (46.7%) required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1%) had placenta previa totalis. The overall success rate was 75% (48/64) for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all ptamponade with a Bakri balloon is an adequate adjunct management for postpartum hemorrhage following cesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance. PMID:26263014

  17. Early preterm delivery due to placenta previa is an independent risk factor for a subsequent spontaneous preterm birth.

    Science.gov (United States)

    Erez, Offer; Novack, Lena; Klaitman, Vered; Erez-Weiss, Idit; Beer-Weisel, Ruthy; Dukler, Doron; Mazor, Moshe

    2012-08-10

    To determine whether patients with placenta previa who delivered preterm have an increased risk for recurrent spontaneous preterm birth. This retrospective population based cohort study included patients who delivered after a primary cesarean section (n = 9983). The rate of placenta previa, its recurrence, and the risk for recurrent preterm birth were determined. Patients who had a placenta previa at the primary CS pregnancy had an increased risk for its recurrence [crude OR of 2.65 (95% CI 1.3-5.5)]. The rate of preterm birth in patients with placenta previa in the primary CS pregnancy was 55.9%; and these patients had a higher rate of recurrent preterm delivery than the rest of the study population (p placenta previa in the primary CS pregnancy, those who delivered preterm had a higher rate of recurrent spontaneous preterm birth regardless of the location of their placenta in the subsequent delivery [OR 3.09 (95% CI 2.1-4.6)]. In comparison to all patients with who had a primary cesarean section, patients who had placenta previa and delivered preterm had an independent increased risk for recurrent preterm birth [OR of 3.6 (95% CI 1.5-8.5)]. Women with placenta previa, who deliver preterm, especially before 34 weeks of gestation, are at increased risk for recurrent spontaneous preterm birth regardless to the site of placental implantation in the subsequent pregnancy. Thus, strict follow up by high risk pregnancies specialist is recommended.

  18. Prevalence of antepartum hemorrhage in women with placenta previa: a systematic review and meta-analysis

    Science.gov (United States)

    Fan, Dazhi; Wu, Song; Liu, Li; Xia, Qing; Wang, Wen; Guo, Xiaoling; Liu, Zhengping

    2017-01-01

    Antepartum hemorrhage (APH) is an important cause of perinatal mortality and maternal morbidity in pregnant women with placenta previa in the world. However, the epidemiological characteristics are not completely understood. We performed an initial systematic review and meta-analysis to assess the prevalence of APH in pregnant women with placenta previa. It was totally performed following the Preferred Reporting Items for Systematic reviews and Meta-Analysis statement. PubMed, Elsevier Science Direct, and the Cochrane Library were searched before April 2016. A meta-analysis with a random-effects model based on a proportions approach was performed to determine the prevalence. Stratified analyses, meta-regression method, and sensitivity analysis were utilized to analyze the heterogeneity. A total of 29 articles were included. The pooled overall prevalence of APH among pregnant women with placenta previa was 51.6% (95% CI 42.7–60.6) in a heterogeneous set of studies (I2 = 97.9). Correlation analysis found that there was a positive correlation between prevalence and percentage of multiparous (r = 0.534, P = 0.027) and a negative correlation between prevalence and survey year (r = −0.400, P = 0.031). In conclusion, the prevalence of APH was a high condition among pregnant women with placenta previa. PMID:28067303

  19. Fetomaternal outcome in placenta previa - a retrospective study in teaching hospital

    Directory of Open Access Journals (Sweden)

    Manohar Rangaswamy

    2016-09-01

    Conclusions: Managing a case of placenta previa during pregnancy poses a great challenge to every obstetrician in present day obstetrics due its increased risk of maternal and perinatal complications. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3081-3084

  20. The association of placenta previa and assisted reproductive techniques: a meta-analysis.

    Science.gov (United States)

    Karami, Manoochehr; Jenabi, Ensiyeh; Fereidooni, Bita

    2017-06-06

    Several epidemiological studies have determined that assisted reproductive techniques (ART) can increase the risk of placenta previa. To date, only a meta-analysis has been performed for assessing the relationship between placenta previa and ART. This meta-analysis was conducted to estimate the association between placenta previa and ART in singleton and twin pregnancies. A literature search was performed in major databases PubMed, Web of Science, and Scopus from the earliest possible year to April 2017. The heterogeneity across studies was explored by Q-test and I(2) statistic. The publication bias was assessed using Begg's and Egger's tests. The results were reported using odds ratio (OR) and relative risk (RR) estimates with its 95% confidence intervals (CI) using a random-effects model. The literature search yielded 1529 publications until September 2016 with 1,388,592 participants. The overall estimate of OR was 2.67 (95%CI: 2.01, 3.34) and RR was 3.62 (95%CI: 0.21, 7.03) based on singleton pregnancies. The overall estimate of OR was 1.50 (95%CI: 1.26, 1.74) based on twin pregnancies. We showed based on odds ratio reports in observational studies that ART procedures are a risk factor for placenta previa.

  1. Acute and massive bleeding from placenta previa and infants' brain damage.

    Science.gov (United States)

    Furuta, Ken; Tokunaga, Shuichi; Furukawa, Seishi; Sameshima, Hiroshi

    2014-09-01

    Among the causes of third trimester bleeding, the impact of placenta previa on cerebral palsy is not well known. To clarify the effect of maternal bleeding from placenta previa on cerebral palsy, and in particular when and how it occurs. A descriptive study. Sixty infants born to mothers with placenta previa in our regional population-based study of 160,000 deliveries from 1998 to 2012. Premature deliveries occurring atplacenta accreta were excluded. Prevalence of cystic periventricular leukomalacia (PVL) and cerebral palsy (CP). Five infants had PVL and 4 of these infants developed CP (1/40,000 deliveries). Acute and massive bleeding (>500g within 8h) occurred at around 30-31 weeks of gestation, and was severe enough to deliver the fetus. None of the 5 infants with PVL underwent antenatal corticosteroid treatment, and 1 infant had mild neonatal hypocapnia with a PaCO2 placenta previa at around 30 weeks of gestation may be a risk factor for CP, and requires careful neonatal follow-up. The underlying process connecting massive placental bleeding and PVL requires further investigation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Placenta previa and pre-eclampsia: analyses of 1645 cases at Medani Maternity Hospital, Sudan

    Directory of Open Access Journals (Sweden)

    Ishag eAdam

    2013-02-01

    Full Text Available A retrospective case- control study was conducted to investigate the risk factors for pre-eclampsia -including the protective effect of placenta previa -at Medani Maternity Hospital, Sudan. Medical files of the patients during the period 2003 to 2010 were reviewed for age, parity, education level, prenatal care, placenta previa and hemoglobin level. Women with pre-eclampsia were the cases, and women with normal pregnancy were the controls. There were 54339 singleton deliveries and 1765 women with pre-eclampsia in the hospital, giving the incidence of pre-eclampsia of 3.2%. The risk factors for pre-eclampsia were; women with age > 35 year (OR= 1.4, 95% CI: 1.1-1.8, primiparity (OR = 3.3, 95% CI: 2.7–4.0, para > 5 (OR= 3.1, 95% CI: 2.4–4.0 and anemia (OR= 3.3, 95% CI: 2.8–3.9. The risk of pre-eclampsia was inversely increased with education level and prenatal care attendance. The prevalence of placenta previa was 0(0% and 55 (3.3%, P< 0.001 in pre-eclamptic and control women, respectively. Placenta previa was a significant protective factor of pre-eclampsia (OR= 0.3, 95% CI: 0.1–0.7. Although, the socio-demographic risk factors for pre-eclampsia observed among women at Medani hospital were similar to those found in other settings; placenta previa was associated with decreased incidence of pre-eclampsia.

  3. Placenta Previa and Pre-Eclampsia: Analyses of 1645 Cases at Medani Maternity Hospital, Sudan

    Science.gov (United States)

    Adam, Ishag; Haggaz, AbdElrahium D.; Mirghani, Omer A.; Elhassan, Elhassan M.

    2013-01-01

    A retrospective case-control study was conducted to investigate the risk factors for pre-eclampsia – including the protective effect of placenta previa – at Medani Maternity Hospital, Sudan. Medical files of the patients during the period 2003–2010 were reviewed for age, parity, education level, prenatal care, placenta previa, and hemoglobin level. Women with pre-eclampsia were the cases, and women with normal pregnancy were the controls. There were 54,339 singleton deliveries and 1765 women with pre-eclampsia in the hospital, giving the incidence of pre-eclampsia of 3.2%. The risk factors for pre-eclampsia were; women with age >35 years (OR = 1.4, 95% CI: 1.1–1.8), primiparity (OR = 3.3, 95% CI: 2.7–4.0), para >5 (OR = 3.1, 95% CI: 2.4–4.0), and anemia (OR = 3.3, 95% CI: 2.8–3.9). The risk of pre-eclampsia was inversely increased with education level and prenatal care attendance. The prevalence of placenta previa was 0 (0%) and 55 (3.3%), P Placenta previa was a significant protective factor of pre-eclampsia (OR = 0.3, 95% CI: 0.1–0.7). Although, the socio-demographic risk factors for pre-eclampsia observed among women at Medani hospital were similar to those found in other settings; placenta previa was associated with decreased incidence of pre-eclampsia. PMID:23450096

  4. Transecting versus avoiding incision of the anterior placenta previa during cesarean delivery.

    Science.gov (United States)

    Verspyck, Eric; Douysset, Xavier; Roman, Horace; Marret, Stephane; Marpeau, Loïc

    2015-01-01

    To compare maternal outcomes after transection and after avoiding incision of the anterior placenta previa during cesarean delivery. In a retrospective study, records were reviewed for women who had anterior placenta previa and delivered by cesarean after 24 weeks of pregnancy at a tertiary center in Rouen, France. During period A (January 2000 to December 2006), the protocol was to systematically transect the placenta when it was unavoidable. During period B (January 2007 to December 2010), the technique was to avoid incision by circumventing the placenta and passing a hand around its margin. Logistic regression was used to identify independent risk factors associated with maternal transfusion of packed red blood cells. Eighty-four women were included (period A: n=43; period B: n=41). During period B, there was a reduction in frequency of intraoperative hemorrhage (>1000 mL) (P=0.02), intraoperative hemoglobin loss (P=0.005), and frequency of blood transfusion (P=0.02) as compared with period A. In multivariable analysis, period B was associated with a reduced risk of maternal transfusion (odds ratio 0.27; 95% confidence interval 0.09-0.82; P=0.02). Avoiding incision of the anterior placenta previa was found to reduce frequency of maternal blood transfusion during or after cesarean delivery. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  5. Previous prelabor or intrapartum cesarean delivery and risk of placenta previa.

    Science.gov (United States)

    Downes, Katheryne L; Hinkle, Stefanie N; Sjaarda, Lindsey A; Albert, Paul S; Grantz, Katherine L

    2015-05-01

    The purpose of this study was to examine the association between previous cesarean delivery and subsequent placenta previa while distinguishing cesarean delivery before the onset of labor from intrapartum cesarean delivery. We conducted a retrospective cohort study of electronic medical records from 20 Utah hospitals (2002-2010) with restriction to the first 2 singleton deliveries of nulliparous women at study entry (n=26,987). First pregnancy delivery mode was classified as (1) vaginal (reference), (2) cesarean delivery before labor onset (prelabor), or (3) cesarean delivery after labor onset (intrapartum). Risk of second delivery previa was estimated by previous delivery mode with the use of logistic regression and was adjusted for maternal age, insurance, smoking, comorbidities, previous pregnancy loss, and history of previa. Most first deliveries were vaginal (82%; n=22,142), followed by intrapartum cesarean delivery (14.6%; n=3931), or prelabor cesarean delivery (3.4%; n=914). Incidence of second delivery previa was 0.29% (n=78) and differed by previous delivery mode: vaginal, 0.24%; prelabor cesarean delivery, 0.98%; intrapartum cesarean delivery, 0.38% (Pprevia (adjusted odds ratio, 2.62; 95% confidence interval, 1.24-5.56). There was no significant association between previous intrapartum cesarean delivery and previa (adjusted odds ratio, 1.22; 95% confidence interval, 0.68-2.19). Previous prelabor cesarean delivery was associated with a >2-fold significantly increased risk of previa in the second delivery, although the approximately 20% increased risk of previa that was associated with previous intrapartum cesarean delivery was not significant. Although rare, the increased risk of placenta previa after previous prelabor cesarean delivery may be important when considering nonmedically indicated prelabor cesarean delivery. Published by Elsevier Inc.

  6. Prior Prelabor or Intrapartum Cesarean Delivery and Risk of Placenta Previa

    Science.gov (United States)

    Downes, Katheryne L.; Hinkle, Stefanie N.; Sjaarda, Lindsey A.; Albert, Paul S.; Grantz, Katherine L.

    2015-01-01

    Objective To examine the association between previous cesarean delivery and subsequent placenta previa while distinguishing cesarean delivery prior to onset of labor from intrapartum cesarean delivery. Study Design Retrospective cohort study of electronic medical records from 20 Utah hospitals (2002–2010) with restriction to the first two singleton deliveries of women nulliparous at study entry (n=26,987). First pregnancy delivery mode was classified as 1) vaginal (reference); 2) cesarean delivery prior to labor onset (prelabor); or 3) cesarean delivery after labor onset (intrapartum). Risk of second delivery previa was estimated by prior delivery mode using logistic regression and adjusted for maternal age, insurance, smoking, co-morbidities, prior pregnancy loss, and history of previa. Results The majority of first deliveries were vaginal (82%, n=22,142), followed by intrapartum cesarean delivery (14.6%, n=3,931), or prelabor cesarean delivery (3.4%, n=914). Incidence of second delivery previa was 0.29% (n=78) and differed by prior delivery mode: vaginal, 0.24%; prelabor cesarean delivery, 0.98%; intrapartum cesarean delivery, 0.38% (Pprevia (adjusted odds ratio, 2.62 [95% confidence interval, 1.24–5.56]). There was no significant association between prior intrapartum cesarean delivery and previa [adjusted odds ratio, 1.22 (95% confidence interval, 0.68–2.19)]. Conclusion Prior prelabor cesarean delivery was associated with a more than two-fold significantly increased risk of previa in the second delivery, while the approximately 20% increased risk of previa associated with prior intrapartum cesarean delivery was not significant. Although rare, the increased risk of placenta previa after prior prelabor cesarean delivery may be important when considering non-medically indicated prelabor cesarean delivery. PMID:25576818

  7. Case with pyoderma gangrenosum abruptly emerging around the wound of cesarean section for placenta previa with placenta accrete.

    Science.gov (United States)

    Nonaka, Taro; Yoshida, Kunihiko; Yamaguchi, Masayuki; Aizawa, Atsuko; Fujiwara, Hiroshi; Enomoto, Takayuki; Takakuwa, Koichi

    2016-09-01

    A 39-year-old woman underwent emergency cesarean section (CS) due to placenta previa totalis with massive bleeding. Two major problems emerged in this patient after CS was carried out. One was partial retention of the placenta due to placenta accreta. Another major and more serious problem was pyoderma gangrenosum (PG) widely appearing at the skin of the abdomen around the CS wound. Conservative treatment was performed for the retained placenta, and it had completely disappeared by 76 days after the CS. The diagnosis of PG was promptly made in consultation with a plastic surgeon and a dermatologist when a wide ulcer emerged around the CS wound, and high-dose prednisolone was administered as treatment. At 90 days following the CS, near-complete epithelialization was achieved. This extremely rare case reflects the importance of rapid diagnosis and treatment of PG.

  8. [The Application of Internal Iliac Artery Balloon Occlusion in Pernicious Placenta Previa].

    Science.gov (United States)

    Qi, Xiao-Rong; Liu, Xing-Hui; You, Yong; Wang, Xiao-Dong; Zhou, Rong; Xing, Ai-Yun; Zhang, Li; Ning, Gang; Zhao, Fu-Min; Li, Kai-Ming

    2016-07-01

    To evaluate the clinical application value of internal iliac artery balloon occlusion in pernicious placenta previa. We retrospectively reviewed the medical records of the patients of pernicious placenta previa in a single center from Jan, 2010 to Jan, 2015. The patients were divided into two groups, internal iliac artery balloon occlusion group and the control group without endovascular intervention. Blood loss in operation, volume of transfused blood products, caesarean hysterectomy, operating time, hospital days after operation and postoperative morbidity were compared between the two groups. The balloon occlusion group had significantly less blood loss, the volume of transfused blood products, caesarean hysterectomy, hospital day after operation than the control group had. There was no statistical difference in operating time, intensive care units (ICU), hypotension, infection, hypoxemia, bladder injury, bowel obstruction, neonatal asphyxia between the two groups. The balloon occlusion group had significantly higher rate in coagulopathy, hypoalbuminemia, electrolyte imbalance. Among the patients whose uterus were preserved, the blood loss was not significantly difference between the two groups. Among the patients with the complication of placenta accreta, caesarean hysterectomy was less in balloon group, and blood loss between the two groups was not significantly different. Among the patients without placenta accrete, the blood loss was less in balloon group, and caesarean hysterectomy between the two groups was not significantly different. The risk of hysterectomy in balloon group was related to placenta accreta, uterine arteries engorgement, placental invasive serosa, taking placenta by hand, placental invasive bladder, barrel-shaped thickening of lower uterine segment, unable to remove placenta. Internal iliac artery balloon occlusion is an effective treatment for pernicious placenta previa.

  9. [Application of temporary balloon occlusion of the abdominal aorta in the treatment of complete placenta previa complicated with placenta accreta].

    Science.gov (United States)

    Cui, S H; Zhi, Y X; Zhang, K; Zhang, L D; Shen, L N; Gao, Y N

    2016-09-25

    Objective: To investigate the value of temporary balloon occlusion of the abdominal aorta in the treatment of complete placenta previa with placenta accreta. Methods: From January 2015 to February 2016, 24 cases of complete placenta previa with placenta accreta were treated with temporary balloon occlusion of the abdominal aorta(the study group)before cesarean, and 24 cases of complete placenta previa with placenta accreta did not receive balloon occlusion(the control group). The operation time, intraoperative blood loss, intraoperative blood transfusion volume, the perioperative hemoglobin level, the hysterectomy rate and the related complications were compared retrospectively.Also, the hospitalization time, the blood coagulation parameters after operation, including activated partial thromboplastin time(APTT), fibrinogen(FIB), D-Dimer and reperfusion injury parameters including creatine phosphokinase(CK), creatine phosphokinase isoenzyme(CK-MB), lactate dehydrogenase(LDH)and serum creatinine were compared between the 2 groups. Results: The blood loss[750 ml(400- 2 000 ml)vs 2 000 ml(1 500- 2 375 ml); Z=-3.214, P=0.001]and blood transfusion volume[200 ml(0-800 ml)vs 800 ml(0-1 200 ml); Z=- 2.173, P=0.030]in the study group were lower than in the control group. The hemoglobin difference between before and after operation in the study group was lower than the control group[(12.8±13.4)g/L vs(22.9±20.1)g/L; t=-2.041, P=0.047]. In the study group, there were still bleeding in 13 cases after releasing the balloon, 5 of them received uterine artery embolization, 5 cases received uterine artery ligation, and 3 cases received uterine packing. One case had venous thrombosis in the right lower limb. Two cases(8%,2/24)in the control group had hysterectomy, while none in the study group, there was no statistical significance(P= 0.489). Conclusions: Temporary balloon occlusion of the abdominal aorta can effectively reduce blood loss and blood transfusion in the treatment of

  10. Evaluation of “J”-shaped Uterine Incision during Caesarean Section in Patients with Placenta Previa:A Retrospective Study

    Institute of Scientific and Technical Information of China (English)

    邹丽; 钟少平; 赵茵; 朱剑文; 陈莉娟

    2010-01-01

    This study evaluated the efficacy and safety of "J"-shaped uterine incision for caesarean section for patients diagnosed with placenta previa.A total of 55 consecutive cases of placenta previa treated in Union Hospital were retrospectively analyzed over a period of two years and 10 months.The subjects were divided into two groups with respect to the uterine incision.Twenty-four pregnant women with placenta previa who were indicated for caesarean section underwent the procedure using a new "J"-shaped uterine...

  11. Temporary balloon occlusion of the internal iliac arteries to prevent massive hemorrhage during cesarean delivery among patients with placenta previa

    NARCIS (Netherlands)

    Broekman, Evelien A.; Versteeg, Henneke; Vos, Louwerens D.; Dijksterhuis, Marja G.; Papatsonis, Dimitri N.

    2015-01-01

    Objective To evaluate the effectiveness of temporary balloon occlusion of the internal iliac artery before uterine incision to prevent massive obstetric hemorrhage during cesarean delivery among patients with anterior placenta previa. Methods In a retrospective cohort study conducted at Amphia

  12. Effect of routine rapid insertion of Bakri balloon tamponade on reducing hemorrhage from placenta previa during and after cesarean section.

    Science.gov (United States)

    Soyama, Hiroaki; Miyamoto, Morikazu; Sasa, Hidenori; Ishibashi, Hiroki; Yoshida, Masashi; Nakatsuka, Masaya; Takano, Masashi; Furuya, Kenichi

    2017-06-24

    To evaluate the effectiveness of routine rapid insertion of a Bakri balloon during cesarean section for placenta previa based on a retrospective control study. Women with singleton pregnancies who underwent cesarean section for placenta previa at our institution between 2003 and 2016 were enrolled. Between 2015 and 2016, women who routinely underwent balloon tamponade during cesarean section were defined as the balloon group. Between 2003 and 2014, women who underwent no hemostatic procedures except balloon tamponade were defined as the non-balloon group. The clinical outcomes of the two groups were retrospectively analyzed. Of the 266 women with placenta previa, 50 were in the balloon group and 216 were in the non-balloon group. The bleeding amounts were significantly smaller in the balloon group than in the non-balloon group: intraoperative bleeding (991 vs. 1250 g, p placenta previa.

  13. The Incidence of Postpartum Hemorrhage in Pregnant Women with Placenta Previa: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Fan, Dazhi; Xia, Qing; Liu, Li; Wu, Shuzhen; Tian, Guo; Wang, Wen; Wu, Song; Guo, Xiaoling; Liu, Zhengping

    2017-01-01

    The global burden of postpartum hemorrhage (PPH) in women with placenta previa is a major public health concern. Although there are different reports on the incidence of PPH in different countries, to date, no research has reviewed them. The aim of this study was to calculate the average point incidence of PPH in women with placenta previa. A systematic review and meta-analysis of observational studies estimating PPH in women with placenta previa was conducted through literature searches in four databases in Jul 2016. This study was totally conducted according to the MOOSE guidelines and in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standard. From 1148 obtained studies, 11 included in the meta-analysis, which involved 5146 unique pregnant women with placenta previa. The overall pooled incidence of PPH was 22.3% (95% CI 15.8-28.7%). In the subgroup, the prevalence was 27.4% in placenta previas, and was 14.5% in low-lying placenta previa; the highest prevalence was estimated in Northern America (26.3%, 95%CI 11.0-41.6%), followed by the Asia (20.7%, 95%CI 12.8-28.6%), Australia (19.2%, 95% CI 17.2-21.1%) and Europe (17.8%, 95% CI, 11.5%-24.0%). The summary estimate of the incidence of PPH among women with placenta previa was considerable in this systematic review. The results will be crucial in prevention, treatment, and identification of PPH among pregnant women with placenta previa and will be contributed to the planning and implantation of relevant public health strategies.

  14. Placenta previa associated with severe bleeding leading to hospitalization and delivery: a retrospective population-based cohort study.

    Science.gov (United States)

    Mastrolia, Salvatore Andrea; Baumfeld, Yael; Loverro, Giuseppe; Yohai, David; Hershkovitz, Reli; Weintraub, Adi Yehuda

    2016-11-01

    The aim of our study was to compare maternal and neonatal outcomes in women with placenta previa complicated with severe bleeding leading to hospitalization until delivery versus those without severe bleeding episodes. This is a population-based retrospective cohort study including all pregnant women with placenta previa who delivered at our medical center in the study period, divided into the following groups: 1) women with severe bleeding leading to hospitalization resulting with delivery (n = 32); 2) patients with placenta previa without severe bleeding episodes (n = 1217). Out of all women with placenta previa who delivered at our medical center, 2.6% (32/1249) had an episode of severe bleeding leading to hospitalization and resulting with delivery. The rate of anemia was lower (43.8% versus 63.7%, p = 0.02) while the need for blood transfusion higher (37.5% versus 21.1%, p = 0.03) in the study group. The rate of cesarean sections was significantly different between the groups, and a logistic regression model was constructed in order to find independent risk factors for cesarean section in our patients. To the best of our knowledge, this is the first study to evaluate the impact of severe bleeding on the outcome of pregnancies complicated with placenta previa. Our study demonstrates that, in women with placenta previa, severe bleeding does not lead to increased adverse maternal or neonatal outcomes.

  15. Sonoembryological evaluations of the development of placenta previa and velamentous cord insertion.

    Science.gov (United States)

    Hasegawa, Junichi

    2015-01-01

    Longitudinal and cross-sectional investigations using ultrasound examinations during pregnancy can be used to clarify the mechanisms and pathophysiology of abnormal fetal and placental development. Such sonoembryological assessments are useful as a method for clarifying the etiology of disease. In the present review, we describe current knowledge based on our experience with applying sonoembryological methods to determine the developmental mechanisms of placenta previa and velamentous cord insertion.

  16. Safe spinal anesthesia in a woman with chronic renal failure and placenta previa

    OpenAIRE

    2010-01-01

    Beyazit ZencirciKahramanmaras, TurkeyBackground: Chronic renal failure is strongly associated with poor pregnancy outcome. Women dependent on hemodialysis before conception rarely achieve a successful live birth.Case presentation: A 31-year-old multiparous Turkish woman was scheduled for cesarean section under spinal anesthesia at 37 weeks and five days’ gestation because of hemorrhage due to secondary placenta previa. Spinal anesthesia with 8 mg of hyperbaric bupivacaine was succes...

  17. Serial Change in Cervical Length for the Prediction of Emergency Cesarean Section in Placenta Previa.

    Directory of Open Access Journals (Sweden)

    Jae Eun Shin

    Full Text Available To evaluate whether serial change in cervical length (CL over time can be a predictor for emergency cesarean section (CS in patients with placenta previa.This was a retrospective cohort study of patients with placenta previa between January 2010 and November 2014. All women were offered serial measurement of CL by transvaginal ultrasound at 19 to 23 weeks (CL1, 24 to 28 weeks (CL2, 29 to 31 weeks (CL3, and 32 to 34 weeks (CL4. We compared clinical characteristics, serial change in CL, and outcomes between the emergency CS group (case group and elective CS group (control group. The predictive value of change in CL for emergency CS was evaluated.A total of 93 women were evaluated; 31 had emergency CS due to massive vaginal bleeding. CL tended to decrease with advancing gestational age in each group. Until 29-31 weeks, CL showed no significant differences between the two groups, but after that, CL in the emergency CS group decreased abruptly, even though CL in the elective CS group continued to gradually decrease. On multivariate analysis to determine risk factors, only admissions for bleeding (odds ratio, 34.710; 95% CI, 5.239-229.973 and change in CL (odds ratio, 3.522; 95% CI, 1.210-10.253 were significantly associated with emergency CS. Analysis of the receiver operating characteristic curve showed that change in CL could be the predictor of emergency CS (area under the curve 0.734, p < 0.001, with optimal cutoff for predicting emergency cesarean delivery of 6.0 mm.Previous admission for vaginal bleeding and change in CL are independent predictors of emergency CS in placenta previa. Women with change in CL more than 6 mm between the second and third trimester are at high risk of emergency CS in placenta previa. Single measurements of short CL at the second or third trimester do not seem to predict emergency CS.

  18. Serial Change in Cervical Length for the Prediction of Emergency Cesarean Section in Placenta Previa.

    Science.gov (United States)

    Shin, Jae Eun; Shin, Jong Chul; Lee, Young; Kim, Sa Jin

    2016-01-01

    To evaluate whether serial change in cervical length (CL) over time can be a predictor for emergency cesarean section (CS) in patients with placenta previa. This was a retrospective cohort study of patients with placenta previa between January 2010 and November 2014. All women were offered serial measurement of CL by transvaginal ultrasound at 19 to 23 weeks (CL1), 24 to 28 weeks (CL2), 29 to 31 weeks (CL3), and 32 to 34 weeks (CL4). We compared clinical characteristics, serial change in CL, and outcomes between the emergency CS group (case group) and elective CS group (control group). The predictive value of change in CL for emergency CS was evaluated. A total of 93 women were evaluated; 31 had emergency CS due to massive vaginal bleeding. CL tended to decrease with advancing gestational age in each group. Until 29-31 weeks, CL showed no significant differences between the two groups, but after that, CL in the emergency CS group decreased abruptly, even though CL in the elective CS group continued to gradually decrease. On multivariate analysis to determine risk factors, only admissions for bleeding (odds ratio, 34.710; 95% CI, 5.239-229.973) and change in CL (odds ratio, 3.522; 95% CI, 1.210-10.253) were significantly associated with emergency CS. Analysis of the receiver operating characteristic curve showed that change in CL could be the predictor of emergency CS (area under the curve 0.734, p placenta previa. Women with change in CL more than 6 mm between the second and third trimester are at high risk of emergency CS in placenta previa. Single measurements of short CL at the second or third trimester do not seem to predict emergency CS.

  19. Consecutive cervical length measurements as a predictor of preterm cesarean section in complete placenta previa.

    Science.gov (United States)

    Sekiguchi, Atsuko; Nakai, Akihito; Okuda, Naotaka; Inde, Yusuke; Takeshita, Toshiyuki

    2015-01-01

    To evaluate whether consecutive cervical length measurements can predict preterm cesarean section in women with complete placenta previa. Seventy-one women with complete placenta previa were retrospectively categorized into women who delivered preterm due to massive hemorrhage (the preterm cesarean section group, n = 28) and those delivered at term (the control group, n = 43). Maternal characteristics, delivery outcomes, and cervical lengths serially measured at least every 2 weeks from 24 weeks' gestation until delivery were compared. The relationship between cervical length and preterm cesarean section was analyzed. Cervical length gradually decreased with advancing gestational age. After 26 weeks' gestation, this decrease was significantly more rapid in the preterm cesarean section group. Cervical length before cesarean section in the preterm cesarean section group was significantly shorter than that in the control group. Just before cesarean section, 71.4% of the preterm cesarean section group presented with cervical lengths of ≤35 mm, whereas only 34.9% of the control group had cervical lengths of ≤35 mm (odds ratio 4.67, 95% confidence interval 1.66-13.10, p = 0.006). In women with complete placenta previa, decrease in cervical length to ≤35 mm was associated with increased risk of preterm cesarean section due to massive hemorrhage. © 2014 Wiley Periodicals, Inc.

  20. Aortic balloon occlusion for controlling intraoperative hemorrhage in patients with placenta previa increta/percreta.

    Science.gov (United States)

    Wang, Ying-Lan; Su, Fang-Ming; Zhang, Hai-Ying; Wang, Fang; Zhe, Rui-Lian; Shen, Xin-Ying

    2017-11-01

    To investigate whether abdominal aortic balloon occlusion (ABO) effectively reduces intraoperative hemorrhage in patents with placenta previa increta/increta. Forty-three women were diagnosed as placenta previa increta/percreta by ultrasound and MRI. These patients' assessments were taken by their chief physician, and they were under necessity of previous cesarean section as confirmed by the committee of experts during consultation. There was no significant difference in disease risk rating between them in whole process. Although our department provided a more appropriate method, 10 of 43 patients chose intraoperative aortic balloon occlusion (IABO). Other 33 patients who refused that suggestion were considered as control group. Fully informed consents were obtained from all patients in this study group. The intraoperative blood loss, blood transfusion, rate of hysterectomy and complications of mothers and fetus of IABO group and control group were analyzed. The median intraoperative blood loss was 1000 ml in the IABO group compared with 2000 ml in the control group (p  0.05). No IABO-related complications were observed in the mother and fetus. IABO is an effective and safe method to control intraoperative blood loss and blood transfusion in patients with placenta previa increta/percreta.

  1. Which type of placenta previa requires blood transfusion more frequently? A new concept of indiscernible edge total previa.

    Science.gov (United States)

    Baba, Yosuke; Takahashi, Hironori; Ohkuchi, Akihide; Usui, Rie; Matsubara, Shigeki

    2016-11-01

    During cesarean section (CS) for placenta previa (PP), the size/area/portion of the lower uterine segment occupied by the placenta may affect the bleeding amount and the subsequent need for a blood transfusion (BT). We propose a new concept, indiscernible edge total PP (IEPP), when vaginal ultrasound does not discern the lower placental edge because the placenta covers the visible lower segment. We characterized IEPP, focusing on its allogeneic BT requirement. We classified PP (n = 307) into four types: marginal, partial, discernible edge total PP (DEPP) and IEPP: internal ostium (os)-placental edge distance measurable or unmeasurable on vaginal ultrasound in DEPP or IEPP, respectively. We determined the clinical characteristics according to the four types; the relationship between the intraoperative blood loss and os-edge distance in DEPP; and risk factors for allogeneic BT. The following were significantly higher/larger in cases of IEPP: previous CS; anterior placentation; lacunae; elective cesarean hysterectomy; intraoperative blood loss; autologous BT; allogeneic BT; intensive care unit admission; and an abnormally invasive placenta (AIP). In DEPP, the os-edge distance was weakly correlated with the bleeding amount (r = 0.214). Multivariate logistic regression analysis showed that previous CS, lacunae, AIP and IEPP were independent risk factors for allogeneic BT (odds ratios 3.8, 3.1, 13.8 and 4.6, respectively). After excluding patients undergoing hemostatic procedures during CS, IEPP remained the only independent risk factor for allogeneic BT (odds ratio 5.2). The new concept of IEPP may be useful for predicting BT in CS for patients with PP. © 2016 Japan Society of Obstetrics and Gynecology.

  2. The association between placenta previa and leukocyte and platelet indices - a case control study.

    Science.gov (United States)

    Ersoy, Ali O; Ozler, Sibel; Oztas, Efser; Ersoy, Ebru; Kirbas, Ayse; Danisman, Nuri

    2016-01-01

    Despite medical advances, rising awareness, and satisfactory care facilities, placenta previa (PP) remains a challenging clinical entity due to the risk of excessive obstetric hemorrhage. Etiological concerns gave way to life-saving concerns about the prediction of maternal outcomes due to hemorrhage. Our study aimed to detect an early predictive marker of placenta previa. Ninety-three pregnant patients diagnosed with PP and 247 controls were recruited for this retro-spective study. Platelet and leukocyte indices were compared between the two groups. The groups were similar with regard to age distribution (31.2 ± 5.1 years [mean ± SD] in the PP group and 31.7 ± 4.2 years in controls), body mass index (BMI) (27.7 ± 3.6 kg/m2 in the PP group and 27.4 ± 4.6 kg/m2 in controls), and most characteristics of the obstetric history. Total leukocyte count, neutrophil count, and neutrophil-to-lymphocyte ratio were significantly higher in the PP group. Mean platelet volume (MPV) and large platelet cell ratio (P-LCR) values were significantly lower in the PP group as compared to controls, with regard to third trimester values. However, patients who were diagnosed postnatally with placenta percreta had lower MPV and P-LCR values than other patients with PP. There were no statistically significant differences between the two groups as far as first trimester values were concerned. Platelet and leukocyte indices in the third trimester of pregnancy may be valuable predictors of placenta previa and placenta percreta. More comprehensive studies are needed to address this issue.

  3. A combined ultrasound and clinical scoring model for the prediction of peripartum complications in pregnancies complicated by placenta previa.

    Science.gov (United States)

    Yoon, So-Yeon; You, Ji Yeon; Choi, Suk-Joo; Oh, Soo-Young; Kim, Jong-Hwa; Roh, Cheong-Rae

    2014-09-01

    To generate a combined ultrasound and clinical model predictive for peripartum complications in pregnancies complicated by placenta previa. This study included 110 singleton pregnant women with placenta previa delivered by cesarean section (CS) from July 2011 to November 2013. We prospectively collected ultrasound and clinical data before CS and observed the occurrence of blood transfusion, uterine artery embolization and cesarean hysterectomy. We formulated a scoring model including type of previa (0: partials, 2: totalis), lacunae (0: none, 1: 1-3, 2: 4-6, 3: whole), uteroplacental hypervascularity (0: normal, 1: moderate, 2: severe), multiparity (0: no, 1: yes), history of CS (0: none, 1: once, 2: ≥ twice) and history of placenta previa (0: no, 1: yes) to predict the risk of peripartum complications. In our study population, the risk of perioperative transfusion, uterine artery embolization, and cesarean hysterectomy were 26.4, 1.8 and 6.4%, respectively. The type of previa, lacunae, uteroplacental hypervascularity, parity, history of CS, and history of placenta previa were associated with complications in univariable analysis. However, no factor was independently predictive for any complication in exact logistic regression analysis. Using the scoring model, we found that total score significantly correlated with perioperative transfusion, cesarean hysterectomy and composite complication (pplacenta previa. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Placental histopathology lesions and pregnancy outcome in pregnancies complicated with symptomatic vs. non-symptomatic placenta previa.

    Science.gov (United States)

    Weiner, Eran; Miremberg, Hadas; Grinstein, Ehud; Schreiber, Letizia; Ginath, Shimon; Bar, Jacob; Kovo, Michal

    2016-10-01

    The mechanisms involved in bleeding in cases of placenta previa (PP) and the effect on pregnancy outcome is unclear. We aimed to compare pregnancy outcome and placental histopathology in pregnancies complicated with symptomatic (bleeding) vs. non-symptomatic PP, and to study the effects of the co-existence of histopathological retro-placental hemorrhage (RPH) in cases of symptomatic PP on neonatal and maternal outcomes. Labor and maternal characteristics, neonatal outcome and placental histopathology lesions of pregnancies with PP, delivered between 24 and 42weeks, during 2009-2015, were reviewed. Results were compared between PP who had elective cesarean delivery (CD) (previa group) and PP with bleeding necessitating emergent CD (symptomatic previa group). Placental lesions were classified to lesions consistent with maternal malperfusion or fetal thrombo-occlusive disease (vascular and villous changes), and inflammatory lesions. Compared to the previa group (n=63), the symptomatic previa group (n=74) was characterized by older patients (pPlacentas within the symptomatic previa group were smaller, with higher rates of weightplacenta previa is associated with increased placental malperfusion lesions suggesting an association of maternal malperfusion with abnormal placental separation. The coexisting finding of RPH with symptomatic placenta previa can be seen as a marker for more extensive/severe placental separation, hence the association with maternal transfusion requirements and poorer fetal outcome. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Feed-forward Control Nursing Model in Expectant Treatment of Placenta Previa.

    Science.gov (United States)

    Zhu, Yanfei; Zhang, Shuxuan; Shan, Wenxian; Hu, Ming

    2017-02-01

    We studied the possible advantages of feed-forward control nursing model in the treatment of placenta previa. We enrolled 60 pregnant women who were receiving treatment for expectant placenta previa between January 2010 and January 2016 and randomly divided them into the control group and the observation group with 30 cases in each group. In the control group, we offered specialist nursing which included examination, body positioning, vaginal bleeding record, psychological consultation and medication observation. Feed-forward control nursing was applied in the observation group which included establishing feed-forward control nursing improvement team, conducting quality control of nursing defects and putting forward ideas for improvements and verifying improvement outcomes. The observation group got significantly higher success rate and lower complication rate compared with control group. Gestational age and fetal weights improved apparently in the observation group. When we compared the amount of postpartum bleeding and pregnancy bleeding in two groups we did not find any statistically significant difference (P>0.05). Patients' satisfaction rate toward our nursing services was much higher in the observation group and the rate of nursing errors was significantly lower in this group. All differences were statistically significant (Pplacenta previa can improve treatment success rate, decrease complications and upgrade nursing quality.

  6. Diagnosis of Placenta Previa and Placenta Implantation With MRI%前置胎盘及胎盘植入的MRI诊断

    Institute of Scientific and Technical Information of China (English)

    刘静; 罗莎

    2015-01-01

    ObjectiveTo explore the application value of MRI in the prenatal diagnosis of front disc and implantation of placenta previa. Methods Retrospective analysis of our hospital 16 cases of placental MRI examination conifrmed byoperation and pathology after cesarean section. Results8 cases of central placenta previa, 5 cases of partialplacenta previa, 2 cases of marginal placenta previa, low-lying placenta 1 cases, 2 cases of Placenta Adhesion, 2 cases of placenta implantation, including 1 cases of transmural implantation, placenta in the posterior inferior wall in 11 cases, 4 cases of anterior inferior wall, 2 cases of lateral wall.Conclusion MRI on placenta previa placenta implantation in the clinical diagnosis and timely and reasonable treatment plan have some certain signiifcance.%目的:探讨MRI在诊断产前前置前盘及植入性前置胎盘的应用价值。方法剖宫产后回顾性分析我院经手术及病理证实的16例胎盘MRI检查。结果中央性前置胎盘8例,部分性前置胎盘5例,边缘性前置胎盘2例,低置胎盘1例,胎盘粘连2例,胎盘植入2例,其中1例透壁植入,胎盘位于后下壁11例,前下壁4例,侧壁2例。结论 MRI对前置胎盘及胎盘植入诊断对临床及时合理制定治疗方案有一定意义。

  7. Placenta Previa Percreta: A Case Report of Successful Management via Conservative Surgery

    Directory of Open Access Journals (Sweden)

    Silvia Canonico

    2013-01-01

    Full Text Available Placenta percreta is one of the most serious complications of placenta previa and is frequently associated with severe obstetric hemorrhage usually necessitating hysterectomy. We present a case of placenta previa percreta diagnosed by ultrasound and magnetic resonance imaging techniques, in which we accomplished conservative management of postpartum hemorrhage. The management we propose includes the following steps: preventive catheterization of the descending aorta via transhumeral access; Stark cesarean delivery; uterotonics drugs; Affronti endouterine square hemostatic sutures; intrauterine application of Bakri balloon and partial filling with 100 mL of normal saline; B Lynch suture, hysterorrhaphy, and filling a Bakri balloon with up to 500 mL of normal saline; reversible radiological embolization; and/or surgical ligation of the uterine arteries. The bleeding stopped following placement of Affronti sutures combined with external (B-Lynch suture and internal (Bakri balloon uterine compression. Our experience indicates that this conservative method can be considered an option in the management of selected cases of pregnancy at high risk for intrapartum hemorrhage.

  8. [Risk factors of pregnancy termination at second and third trimester in women with scarred uterus and placenta previa].

    Science.gov (United States)

    Tian, Ji-shun; Pan, Fei-xia; He, Sai-nan; Hu, Wen-sheng

    2015-05-01

    To investigate the risk factors of pregnancy termination at second and third trimester in women with scarred uterus and placenta previa. Clinical data of 24 pregnant women of second and third trimester with a scarred uterus and placenta previa,who requested termination in Women's Hospital Zhejiang University School of Medicine from July 2009 to June 2014, were retrospectively analyzed. The method of mifepristone combined with ethacridine lactate was adopted for all cases. Mifepristone combined with ethacridine lactate and uterine artery embolization were routinely given for patients with complete placenta previa. Cesarean section was performed for patients who failed to delivery or underwent massive vaginal bleeding before delivery. Age, gestational weeks, gravidity and parity, times of previous cesarean section, the interval from previous operation, the position and the type of placenta previa, placenta accretet, the indication and method of termination, postpartum hemorrhage, successful rate of labor induction, placental retention ratio and uterus rupture were documented. The successful rate of labor induction was 83.3%. The analysis showed that age, gestational weeks, gravidity and parity and times of previous cesarean section were not risk factors for failed labor induction, however the interval time from previous operation was related to induction failure (Pplacenta adhered to the antetheca of the uterus or placenta accrete increased risk to have cesarean section. There were no significant differences in postpartum hemorrhage, the successful rate of labor induction, placental retention ratio and the rate of uterine rupture between patients with uterine artery embolization and those without. The labor induction would be feasible for women with a scarred uterus and placenta previa in second and third-trimester pregnancy. The previous operation ≥ 13 years, the antetheca placenta or placenta accrete might increase the incidence of labor induction, while the

  9. Early preterm delivery due to placenta previa is an independent risk factor for a subsequent spontaneous preterm birth

    Directory of Open Access Journals (Sweden)

    Erez Offer

    2012-08-01

    Full Text Available Abstract Background To determine whether patients with placenta previa who delivered preterm have an increased risk for recurrent spontaneous preterm birth. Methods This retrospective population based cohort study included patients who delivered after a primary cesarean section (n = 9983. The rate of placenta previa, its recurrence, and the risk for recurrent preterm birth were determined. Results Patients who had a placenta previa at the primary CS pregnancy had an increased risk for its recurrence [crude OR of 2.65 (95% CI 1.3-5.5]. The rate of preterm birth in patients with placenta previa in the primary CS pregnancy was 55.9%; and these patients had a higher rate of recurrent preterm delivery than the rest of the study population (p Conclusions Women with placenta previa, who deliver preterm, especially before 34 weeks of gestation, are at increased risk for recurrent spontaneous preterm birth regardless to the site of placental implantation in the subsequent pregnancy. Thus, strict follow up by high risk pregnancies specialist is recommended.

  10. Placenta Prévia: Fatores de risco para o Acretismo Placenta Previa: Risk Factors for Accretion

    Directory of Open Access Journals (Sweden)

    Maria Regina Torloni

    2001-08-01

    Full Text Available Objetivo: investigação dos fatores de risco associados ao acretismo em pacientes com placenta prévia (PP. Métodos: foi realizada uma análise retrospectiva caso-controle de todos os prontuários de pacientes com diagnóstico de PP que tiveram seus partos na Maternidade Escola Vila Nova Cachoeirinha (São Paulo entre 1986 e 1998. O grupo com acretismo foi comparado ao grupo sem acretismo quanto à idade, paridade, antecedentes de abortamentos, curetagens e cesarianas, o tipo de PP e a área predominante de inserção placentária. Para avaliar a associação entre a variável dependente (acretismo placentário e as variáveis independentes (características maternas e placentária foram utilizados o teste do chi², análise univariada e multivariada, considerando-se significantes os valores de p Purpose: to investigate risk factors associated with accretion in placenta previa (PP patients. Methods: this was a retrospective case-control study of all the records of patients who delivered between 1986-1998 at Maternidade Escola de Vila Nova Cachoeirinha (São Paulo with a diagnosis of placenta previa. The groups with and without accretion were compared regarding age, parity, previous history of miscarriage, curettage and cesarean section, type of PP and predominant area of placental attachment. Possible associations between the dependent (accretion and independent (maternal and placental characteristics variables were evaluated using the chi² test, univariate and multivariate analyses. Results: reviewing 245 cases of PP, two risk factors were significantly associated with accretion: central placenta previa (odds ratio (OR: 2.93 and two or more previous cesarean sections(OR: 2.54. Based on these data, a predictive model was constructed, according to which a patient with central PP and two more previous cesarean sections has a 44.4% risk for accretion. Conclusions: results of the current study may help obstetricians in the classification of their

  11. Expression of Nestin in Embryonic Tissues and its Effects on Clinicopathological Characteristics of Patients with Placenta Previa.

    Science.gov (United States)

    Qiao, Yan-Yan; Chu, Ping

    2017-08-18

    In this study, we examined expression of nestin in the spinal cord, lung, kidney, stomach, colon and intestine tissues at different stages of embryos in patients with placenta previa. Fetuses of 75 patients with placenta previa were assigned to case group and 80 fetuses from healthy pregnant women with normal placenta who voluntarily terminated pregnancy to control group. Clinical data of pregnant women were collected at the time of admission. Blood from elbow vein was collected to determine expression of serum nestin. Tissues from spinal cord, lung, kidney, stomach, colon and intestine in 3-7 months fetuses of the two groups were extracted. Expression of nestin in tissues was detected by immunohistochemistry, western blotting and RT-qPCR. The mRNA expression of nestin in the case group was increased. Nestin expression was correlated with the gestational age, age of foetus and type of placenta previa in patients with placenta previa. Positive nestin expression was detected in the spinal cord, lung, kidney, stomach, intestine and colon tissues in normal and placenta previa embryo at Stage I. The positive cell density and nestin expression decreased at Stage II, and further decreased at Stage III. The case group had higher nestin mRNA and protein levels throughout human fetal development. Findings of this study suggested that, nestin, as a specific marker of neural precursor cells, was expressed in various tissues of the embryo in patients with placenta previa and nestin expression was lower with increased maturation of the embryo. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. Improving the Accuracy of Diagnosing Placenta Previa on Transvaginal Ultrasound by Distinguishing between the Uterine Isthmus and Cervix: A Prospective Multicenter Observational Study.

    Science.gov (United States)

    Hasegawa, Junichi; Kawabata, Ikuno; Takeda, Yoshiharu; Aoki, Hiroaki; Fukami, Takehiko; Tajima, Atsushi; Miyakoshi, Kei; Otsuki, Katsufumi; Shinozuka, Norio; Matsuda, Yoshio; Iwashita, Mitsutoshi; Okai, Takashi; Nakai, Akihito

    2017-01-01

    To clarify whether distinguishing between the uterine isthmus and cervix can improve the accuracy of diagnosing placenta previa at term. A multicenter prospective observational study was conducted among pregnant women with suspected placenta previa at 20-24 weeks' gestation. Subjects were divided into the open isthmus group and closed isthmus group. The accuracy of diagnosing placenta previa at term was compared between the 2 groups. We screened 9,341 patients, and 53 (0.6%) met the inclusion criteria. Nineteen cases with an open isthmus and 34 with a closed isthmus were followed. The accuracy for diagnosing placenta previa or a low-lying placenta at term was 94.7% in the open isthmus group and 26.5% in the closed isthmus group (p placenta previa was obtained by using transvaginal ultrasound at 20-24 weeks' gestation after the isthmus opened by carefully distinguishing between the cervix and isthmus. © 2016 S. Karger AG, Basel.

  13. Longitudinal parallel compression suture to control postopartum hemorrhage due to placenta previa and accrete.

    Science.gov (United States)

    Li, Guang-Tai; Li, Xiao-Fan; Wu, Baoping; Li, Guangrui

    2016-04-01

    To assess the efficacy and safety of longitudinal parallel compression suture to control heavy postpartum hemorrhage (PPH) in patients with placenta previa/accreta. Fifteen women received a longitudinal parallel compression suture to stop life-threatening PPH due to placenta previa with or without accreta during cesarean section. The suture apposed the anterior and posterior walls of the lower uterine segment together using an absorbable thread A 70-mm round needle with a Number-1 absorbable thread was used. The point of needle entry was 1 cm above the upper margin of the cervix and 1 cm from the right lateral border of the lower segment of the anterior wall. The suture was threaded through the uterine cavity to the serosa of the posterior wall. Then, it was directed upward and threaded from the posterior to the anterior wall at ∼1-2 cm above the upper boundary of the lower uterine segment and 3-cm medial to the right margin of the uterus. Both ends of the suture were tied on the anterior aspect of uterus. The left side was sutured in the same way. The success rate of the procedure was 86.7% (13/15). Two of 15 cases were concurrently administered gauze packing and achieved satisfactory hemostasis. All patients resumed a normal menstrual flow, and no postoperative anatomical or physiological abnormalities related to the suture were observed. Three women achieved further pregnancies after the procedure. Longitudinal parallel compression suture is a safe, easy, effective, practical, and conservative surgical technique to stop intractable PPH from the lower uterine segment, particularly in women who have a cesarean scar and placenta previa/accreta. Copyright © 2016. Published by Elsevier B.V.

  14. A Case of Type 2 Youssef's Syndrome following Caesarean Section for Placenta Previa Totalis

    Science.gov (United States)

    Obuz, Funda

    2016-01-01

    Vesicouterine fistula is a rare type of urogenital fistulas. It is most commonly observed after cesarean section (C/S) due to iatrogenic reasons. In this article, a case of a vesicouterine fistula which developed after C/S operation is presented. This was the patient's second C/S and this time placenta previa totalis was the primary pathology. Since it is a rare complication, we found it interesting, and, in this article, this clinical problem was discussed with details about diagnosis and treatment in light of the literature. PMID:27803827

  15. Prenatal MRI diagnosis of placenta previa complicated with placenta accreta%前置胎盘合并胎盘植入的MRI产前诊断

    Institute of Scientific and Technical Information of China (English)

    钟华; 李丽红; 代海洋; 黎昕; 刘锦文

    2014-01-01

    目的:探讨前置胎盘合并胎盘植入的产前MRI诊断价值。材料与方法回顾性分析经手术病理证实的48例前置胎盘患者的临床及MRI资料,包括前置胎盘合并胎盘植入者12例,总结分析其MRI影像学特征。结果 MRI术前诊断前置胎盘43例,其中完全性前置胎盘31例,部分型前置胎盘9例,边缘型前置胎盘3例,总体诊断符合率为89.5%(43/48)。MRI术前正确诊断胎盘植入9例,诊断符合率为75.0%(9/12)。结论 MRI对前置胎盘及胎盘植入有较高的诊断价值,综合MR不同成像序列可提高术前诊断准确率。%Objective: To investigate the prenatal MRI imaging features of placenta previa complicated with placenta accreta.Materials and Methods:The clinical and MRI data of 48 cases of placenta previa including 12 placenta accreta conifrmed by clinic and surgery were retrospectively analyzed.Results: Forty-three cases of placenta previa were diagnosed by MRI pre-operation, including 31 cases of complete placenta previa, 9 cases of partial placenta previa and 3 cases of marginal placenta previa. The overall diagnose accordance rate was 89.5% (43/48). Nine cases of placenta accreta were diagnosed by MRI pre-operation, the diagnose accordance rate was 75.0% (9/12).Conclusions:MRI has a high accuracy for the diagnosis of placenta previa, the combination of different MR sequence can make accurate diagnosis possible.

  16. Assessment of total placenta previa by magnetic resonance imaging and ultrasonography to detect placenta accreta and its variants.

    Science.gov (United States)

    Peker, Nuri; Turan, Volkan; Ergenoglu, Mete; Yeniel, Ozgur; Sever, Ahmet; Kazandi, Mert; Zekioglu, Osman

    2013-03-01

    To evaluate the importance of ultrasonography (US) and magnetic resonance imaging (MRI) in detecting placental adherence defects. Patients diagnozed with total placenta previa (n = 40) in whom hysterectomy was performed due to placental adherence defects (n = 20) or in whom the placenta detached spontaneously after a Cesarean delivery (n = 20) were included into the study between June 2008 and January 2011, at the Department of Obstetrics and Gynecology Ege University (lzmir Turkey). Gray-scale US was used to check for any placental lacunae, sub-placental sonolucent spaces or a placental mass invading the vesicouterine plane and bladder Intra-placental lacunar turbulent blood flow and an increase in vascularization in the vesicouterine plane were evaluated with color Doppler mode. Subsequently all patients had MRI and the results were compared with the histopathologic examinations. The sensitivity of MRI for diagnosis of placental adherence defects before the operation was 95%, with a specificity of 95%. In the presence of at least one diagnostic criterion, the sensitivity and specificity of US were 87.5% and 100% respectively, while the sensitivity of color Doppler US was 62.5% with a specificity of 100%. Currently MRI appears to be the gold standard for the diagnosis of placenta accreta. None of the ultrasonographic criteria is solely sufficient to diagnose placental adherence defects, however they assist in the diagnostic process.

  17. Clinical analysis of 50 cases of placenta previa%前置胎盘50例临床分析

    Institute of Scientific and Technical Information of China (English)

    孔蓉; 李豫萍

    2015-01-01

    前置胎盘是一种临床较为常见的疾病,对产妇和胎儿产生较大的影响。本文简要介绍50例前置胎盘患者,探讨临床治疗效果。%Placenta previa is a clinical common disease,which has a greater impact on maternal and fetal.In this paper,the author briefly introduces 50 cases of placenta previa to provide a discussion.

  18. Management of Neuraxial Anaesthesia for Emergent Caesarean Section for Placenta Previa.

    Science.gov (United States)

    Günaydın, Berrin; Kurdoğlu, Mertihan; Güler, İsmail; Bashiri, Mehrnoosh; Büyüktaşkın, Fırat; Keleşoğlu, Mine Dağgez; İnan, Gözde

    2016-02-01

    Abnormal placental attachments, such as placenta accreta, increta or percrata, can result in increased morbidity and mortality because of the risk of severe postpartum haemorrhage. We aimed to present the management of spinal anaesthesia and surgical approach for emergent caesarean section because of vaginal bleeding in a multiparous pregnant woman with placenta previa at 36 weeks' gestation. Hyperbaric bupivacaine 12 mg, fentanyl 10 μg and morphine 150 μg were intrathecally administered for spinal anaesthesia. Oxytocin, methyl ergonovin and tranexamic acid were administered after umbilical cord clamping. Breech delivery of the baby was provided by a vertical incision to the uterus for avoiding placental harm. Subtotal hysterectomy was performed leaving the placenta in situ. Two units of red blood cells were transfused during the operation, lasting approximately 40 min. The patient was uneventfully discharged on the postoperative fourth day. In conclusion, a single-shot spinal anaesthesia was successfully maintained without conversion to general anaesthesia until the end of the hysterectomy in the patient in whom placenta increta was observed during caesarean delivery.

  19. Safe spinal anesthesia in a woman with chronic renal failure and placenta previa

    Directory of Open Access Journals (Sweden)

    Beyazit Zencirci

    2010-05-01

    Full Text Available Beyazit ZencirciKahramanmaras, TurkeyBackground: Chronic renal failure is strongly associated with poor pregnancy outcome. Women dependent on hemodialysis before conception rarely achieve a successful live birth.Case presentation: A 31-year-old multiparous Turkish woman was scheduled for cesarean section under spinal anesthesia at 37 weeks and five days’ gestation because of hemorrhage due to secondary placenta previa. Spinal anesthesia with 8 mg of hyperbaric bupivacaine was successfully performed. Invasive blood pressure, central venous pressure, and heart rate were stable during the surgery. The mother returned to regular hemodialysis on the first postoperative day.Conclusion: Pregnancy is uncommon in women with chronic renal failure requiring chronic dialysis. Rates of maternal hypertension, pre-eclampsia, anemia, and infection in the pregnant chronic dialysis patient are high. However, our findings suggest that with careful, close, and effective monitoring preoperatively and intraoperatively, spinal anesthesia can be safely performed for cesarean section in patients undergoing hemodialysis.Keywords: chronic renal failure, pregnancy, spinal anesthesia, hemodialysis, placenta previa

  20. Reducing intraoperative lower segment blood loss in placenta previa with Ashok Anand stitch

    Directory of Open Access Journals (Sweden)

    Ashok R. Anand

    2013-04-01

    Full Text Available Background: To avoid the need for blood transfusions and reducing complications in cases of placenta previa during cesarean section delivery by a new simple innovative technique developed by Dr ASHOK ANAND known as Ashok Anand’s stitch. Methods: This stitch is based on the reasoning that taking the stitch bilaterally occludes the collaterals supplying the lower segment. As these are end arteries, their occlusion causes hemostasis in the lower segment. Sample size: 20 cases in each study group. Blood loss was estimated by standardized visual method (fixed container and mop. Results: By applying this technique in 20 cases, there was significant reduction in the blood loss compared to the control group, thereby reducing the need for blood transfusion (p value <0.05. Conclusions: Ashok Anand’s stitch is a simple and effective technique in controlling lower segment bleeding in cases of placenta previa during cesarean section thus avoiding the need for blood transfusions for operative blood loss and obstetric hysterectomy. The technique is easy to apply, less invasive and does not require any special instruments. It can be life-saving. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 135-140

  1. Frequency, Risk Factors, and Adverse Fetomaternal Outcomes of Placenta Previa in Northern Tanzania

    Directory of Open Access Journals (Sweden)

    Elizabeth Eliet Senkoro

    2017-01-01

    Full Text Available Background and Objective. Placenta previa (PP is a potential risk factor for obstetric hemorrhage, which is a major cause of fetomaternal morbidity and mortality in developing countries. This study aimed to determine frequency, risk factors, and adverse fetomaternal outcomes of placenta previa in Northern Tanzania. Methodology. A retrospective cohort study was conducted using maternally-linked data from Kilimanjaro Christian Medical Centre birth registry spanning 2000 to 2015. All women who gave birth to singleton infants were studied. Adjusted odds ratios (ORs with 95% confidence intervals for risk factors and adverse fetomaternal outcomes associated with PP were estimated in multivariable logistic regression models. Result. A total of 47,686 singleton deliveries were analyzed. Of these, the frequency of PP was 0.6%. Notable significant risk factors for PP included gynecological diseases, alcohol consumption during pregnancy, malpresentation, and gravidity ≥5. Adverse maternal outcomes were postpartum haemorrhage, antepartum haemorrhage, and Caesarean delivery. PP increased odds of fetal Malpresentation and early neonatal death. Conclusion. The prevalence of PP was comparable to that found in past research. Multiple independent risk factors were identified. PP was found to have associations with several adverse fetomaternal outcomes. Early identification of women at risk of PP may help clinicians prevent such complications.

  2. Frequency, Risk Factors, and Adverse Fetomaternal Outcomes of Placenta Previa in Northern Tanzania

    Science.gov (United States)

    Senkoro, Elizabeth Eliet; Mwanamsangu, Amasha H.; Chuwa, Fransisca Seraphin; Msuya, Sia Emmanuel; Mnali, Oresta Peter

    2017-01-01

    Background and Objective. Placenta previa (PP) is a potential risk factor for obstetric hemorrhage, which is a major cause of fetomaternal morbidity and mortality in developing countries. This study aimed to determine frequency, risk factors, and adverse fetomaternal outcomes of placenta previa in Northern Tanzania. Methodology. A retrospective cohort study was conducted using maternally-linked data from Kilimanjaro Christian Medical Centre birth registry spanning 2000 to 2015. All women who gave birth to singleton infants were studied. Adjusted odds ratios (ORs) with 95% confidence intervals for risk factors and adverse fetomaternal outcomes associated with PP were estimated in multivariable logistic regression models. Result. A total of 47,686 singleton deliveries were analyzed. Of these, the frequency of PP was 0.6%. Notable significant risk factors for PP included gynecological diseases, alcohol consumption during pregnancy, malpresentation, and gravidity ≥5. Adverse maternal outcomes were postpartum haemorrhage, antepartum haemorrhage, and Caesarean delivery. PP increased odds of fetal Malpresentation and early neonatal death. Conclusion. The prevalence of PP was comparable to that found in past research. Multiple independent risk factors were identified. PP was found to have associations with several adverse fetomaternal outcomes. Early identification of women at risk of PP may help clinicians prevent such complications. PMID:28321338

  3. Placenta previa

    Science.gov (United States)

    ... to a history of surgery, C-section, or abortion In vitro fertilization Women who smoke, use cocaine, ... provider can diagnose this condition with a pregnancy ultrasound. Treatment Your provider will carefully consider the risk ...

  4. Invasive placenta previa: Placental bulge with distorted uterine outline and uterine serosal hypervascularity at 1.5T MRI - useful features for differentiating placenta percreta from placenta accreta.

    Science.gov (United States)

    Chen, Xin; Shan, Ruiqin; Zhao, Lianxin; Song, Qingxu; Zuo, Changting; Zhang, Xinjuan; Wang, Shanshan; Shi, Honglu; Gao, Fei; Qian, Tianyi; Wang, Guangbin; Limperopoulos, Catherine

    2017-08-02

    To characterise MRI features of invasive placenta previa and to identify specific features for differentiating placenta percreta (PP) from placenta accreta (PA). Forty-five women with PP and 93 women with PA who underwent 1.5T placental MRI were included. Two radiologists independently evaluated the MRI features of invasive placenta previa, including our novel type of placental bulge (i.e. placental bulge type-II, characterized by placental bulge with distorted uterine outline). Pearson's chi-squared or Fisher's two-sided exact test was performed to compare the MRI features between PP and PA. Logistic stepwise regression analysis and the area under the receiver operating characteristic curve (AUC) were performed to select the optimal features for differentiating PP from PA. Significant differences were found in nine MRI features between women with PP and those with PA (P <0.05). Placental bulge type-II and uterine serosal hypervascularity were independently associated with PP (odds ratio = 48.618, P < 0.001; odds ratio = 4.165, P = 0.018 respectively), and the combination of the two MRI features to distinguish PP from PA yielded an AUC of 0.92 for its predictive performance. Placental bulge type-II and uterine serosal hypervascularity are useful MRI features for differentiating PP from PA. • Placental bulge type-II demonstrated the strongest independent association with PP. • Uterine serosal hypervascularity is a useful feature for differentiating PP from PA. • MRI features associated with abnormal vessels increase the risk of massive haemorrhage.

  5. ClinicalAnalysisofDangerousPlacentaPreviaComplicatedwithPlacentaAccreta%凶险性前置胎盘并发胎盘植入的临床分析

    Institute of Scientific and Technical Information of China (English)

    王凌燕

    2013-01-01

    目的探讨凶险性前置胎盘并发胎盘植入的发病率、诊断方法、治疗及预防措施。方法对我院65例凶险性前置胎盘进行回顾性分析,其中并发胎盘植入29例。结果本研究凶险性前置胎盘并发胎盘植入发生率为44.62%(29/65),其产后出血量>2000mL发生率、弥漫性血管内凝血(DIC)发生率、产褥感染率及子宫切除率高于未并发胎盘植入者;早产率及新生儿预后情况两者无显著差异(P>0.05)。结论凶险性前置胎盘并发胎盘植入者,产后出血量大,易致失血性休克、DIC、产褥感染,增加子宫切除风险;降低剖宫产率,是减少凶险性前置胎盘并发胎盘植入的关键。%Objective To discuss the incidence, diagnostic methods ,treatment methods and prevention of dangerous placenta previa complicated with placenta accreta. Methods Retrospective analysis 65 cases of dangerous placenta previa admitted to our hospital in June 2007-2012, including 29 cases complicated with placenta accreta. Results In the present study the incidence rate of dangerous placenta previa complicated with placenta accreta was 44.62%(29/65). The postpartum incidence and hemorrhage, the incidence of disseminated intravascular coagulation (DIC), puerperal infection rate and the rate of hysterectomy of dangerous placenta praevia complicated with placenta accreta in patients was more than not complicated with placenta accreta in patients. The rate of preterm birth and neonatal prognosis has no signiifcant difference between them (P>0.05). Conclusion Dangerous placenta praevia complicated with placenta accreta in patients have a high incidence of postpartum hemorrhage, prone to cause hemorrhagic shock, DIC, puerperal infection, increase the risk of uterine resection. The key to reduce the dangerous placenta previa complicated with placenta accreta is reducing the rate of cesarean section.

  6. Clinical analysis of placenta previa complicated with placenta accreta%前置胎盘合并胎盘植入的临床分析

    Institute of Scientific and Technical Information of China (English)

    卢培玲; 辛崇敏; 徐宝兰

    2011-01-01

    目的 探讨前置胎盘合并胎盘植入的高危因素、临床特点、诊断及治疗.方法 对日照市中医医院4年间8 964例产妇中12例前置胎盘合并胎盘植入的患者资料进行分析.结果 在8 964例产妇中前置胎盘发生率为0.97%(87/8 964);87例前置胎盘患者均为多孕次产妇,经产妇占58.62%(51/87),高龄产妇占65.52%(57/87).前置胎盘合并胎盘植入的发生率为0.13%(12/8 964),占前置胎盘的13.79%(12/87),有前次剖宫产史者占83.33%(10/12),凶险型前置胎盘并胎盘植入至原子宫切口瘢痕处3例,占25.00%(3/12).植入组前次剖宫产史率明显高于对照组(χ2=17.789,P<0.01).结论 随着剖宫产率的提高,前置胎盘合并胎盘植入发生率也在不断升高,前置胎盘合并胎盘植入的发生与瘢痕子宫密切相关,因此要重视对其进行早期诊断及合理治疗,改善母婴结局.%Objective To investigate the risk factors, clinical features, diagnosis and treatment of placenta previa complicated with placenta accrete. Methods 12 cases of placenta previa complicated with placenta accreta diagnosed in Rizhao Hospital of Traditional Chinese Medicine in recent 4 years were analyzed. Results Among 8 964 deliveries, the incidence of placenta previa was 0.97% ( 87/8 964 ). All of 87 cases of placenta previa were multiple pregnancy women. Multipara occupied 58.62%( 51/87 ) and elder gravida occupied 65.52% ( 57/87 ). The incidence of placenta previa complicated with placenta accreta was 0.13%( 12/8 964 ), occupying 13.79%( 12/87 ) of the placenta previa. Patients with previous cesarean section histrory accounted for 83.33%( 10/12 ). There were 3 cases of dangerous placenta previa complicated with placenta accreta at original uterine incesion scar, occuping 25.00% ( 3/12 ). The rate of previous cesarean section histroy in the group with placenta accreta was obviously higher than that in control group ( X2 = 17. 789, P < 0.01 ). Conclusion The

  7. Effects of Complete and Partial Placenta Previa on Pregnancy Outcomes in Patients with Placenta Previa%完全性和部分性前置胎盘对产妇妊娠结局的影响

    Institute of Scientific and Technical Information of China (English)

    周紫琼

    2015-01-01

    目的:探讨完全性和部分性前置胎盘类型对产妇妊娠结局的影响。方法选取2011年1月至2013年1月于南方医科大学附属深圳妇幼保健院产科进行生产的200例产妇为研究对象,其中完全性(完全组)和部分性前置胎盘(部分组)孕妇各100例,待孕妇生产后,比较两组产妇妊娠结局、生产方式以及新生儿状况。结果完全组产妇胎盘粘连、产后出血的发生率高于部分组[42.0%(42/100)比28.0%(28/100);52.0%(52/100)比36.0%(36/100)],差异有统计学意义(P<0.05);完全组产妇剖宫产分娩方式的比例显著高于部分组(100.0%比93.0%),差异有统计学意义( P <0.05)。完全组孕妇新生儿出现早产、窒息的比例显著高于部分组,差异有统计学意义( P<0.05)。结论孕妇的前置胎盘类型对妊娠结局有重要影响,较部分性胎盘前置孕妇,完全性胎盘前置孕妇的临床症状表现更为明显,预后也更差,在实际治疗中,应加强对完全性胎盘前置孕妇的临床干预。%Objective To explore the effects of complete and partial placenta previa on pregnancy out-come in patients with placenta previa .Methods A total of 200 pregnant women with placenta previa deliv-ered in Shenzhen Maternal and Child Health Hospital Affiliated to Southern Medical University from Jan . 2011 to Jan.2013 were selected as research objects,including 100 cases of complete placenta previa,and 100 cases of partial placenta previa,after production,the pregnancy outcomes,modes of production and neonatal status of the two groups were compared.Results Incidences of placenta adhesion,postpartum hemorrhage of complete placenta previa group were higher than those of the partial placenta previa group[42.0%(42/100) vs 28.0%(28/100);52.0%(52/100) vs 36.0%(36/100)],the differences were statistically significant (P<0.05);cesarean section delivery rate of the

  8. Successful use of BT-Cath(®) balloon tamponade in the management of postpartum haemorrhage due to placenta previa.

    Science.gov (United States)

    Uygur, D; Altun Ensari, T; Ozgu-Erdinc, A S; Dede, H; Erkaya, S; Danisman, A N

    2014-10-01

    To investigate efficacy of the BT-Cath(®) in cases of uncontrollable haemorrhage due to placenta previa. Retrospective study of women treated with the BT-Cath in the event of postpartum haemorrhage (PPH) due to placenta previa, despite optimal management with medical treatment. Between 2011 and 2013, 237 women had placenta previa (0.45%) at the study hospital. This study evaluated 53 women who underwent uterine tamponade with a BT-Cath. Haemostasis was achieved in 45 women (85%), and hysterectomy was required in six women (11%). Two women required repeat laparotomy. The mean duration of balloon tamponade was 9.8h (standard deviation 6.4h). When the relationship between balloon volume and treatment success was evaluated, the area under the receiver operating characteristic curve was 0.803 (95% confidence interval 0.633-0.973; p=0.007) and the optimal cut-off point was 220ml, with sensitivity of 88% and specificity of 71%. The intra-uterine BT-Cath is simple to use, even among clinicians with little experience, and is an effective treatment choice in patients with PPH due to placenta previa when medical treatment is unsuccessful. Minimal inflation of the balloon, a shorter period of intra-uterine balloon tamponade and early deflation of the balloon are recommended. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Anterior placentation as a risk factor for massive hemorrhage during cesarean section in patients with placenta previa.

    Science.gov (United States)

    Baba, Yosuke; Matsubara, Shigeki; Ohkuchi, Akihide; Usui, Rie; Kuwata, Tomoyuki; Suzuki, Hirotada; Takahashi, Hironori; Suzuki, Mitsuaki

    2014-05-01

    In placenta previa (PP), anterior placentation, compared with posterior placentation, is reported to more frequently cause massive hemorrhage during cesarean section (CS). Whether this is due to the high incidence of placenta accreta, previous CS, or a transplacental approach in anterior placenta is unclear. We attempted to clarify this issue. We retrospectively analyzed the relation between the bleeding amount during CS for PP and various factors that may cause massive hemorrhage (>2400 mL) (n = 205) in a tertiary center. If the preoperatively ultrasound-measured distance from the internal cervical ostium to the placental edge was longer in the uterine anterior wall than in the posterior wall, we defined it as anterior previa, and vice versa. Patients with accreta, previous CS, total previa, and anterior placentation bled significantly more than their counterparts. Multivariate logistic regression analysis showed that accreta (odds ratio [OR] 12.6), previous CS (OR 4.7), total previa (OR 4.1), and anterior placentation (OR 3.5) were independent risk factors of massive hemorrhage. Anterior placentation, namely, the placenta with a longer os-placental edge distance in the anterior wall than in the posterior wall, was a risk of massive hemorrhage during CS for PP. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  10. Temporary balloon occlusion of the internal iliac arteries to prevent massive hemorrhage during cesarean delivery among patients with placenta previa

    NARCIS (Netherlands)

    Broekman, Evelien A.; Versteeg, Henneke; Vos, Louwerens D.; Dijksterhuis, Marja G.; Papatsonis, Dimitri N.

    2015-01-01

    Objective To evaluate the effectiveness of temporary balloon occlusion of the internal iliac artery before uterine incision to prevent massive obstetric hemorrhage during cesarean delivery among patients with anterior placenta previa. Methods In a retrospective cohort study conducted at Amphia Hospi

  11. Association between placenta previa and risk of hypertensive disorders of pregnancy: a meta-analysis based on 7 cohort studies.

    Science.gov (United States)

    Yin, X-A; Liu, Y-S

    2015-06-01

    The aim of this research is to evaluate the association between placenta previa and hypertensive disorders of pregnancy (HDP). A computerized literature search was carried out on PubMed to collect relevant articles on the association between placenta previa and HDP before November 2013. Pooled relative risk (RR) and 95% confidence intervals (CIs) were used to assess the strength of the associations. A total of 7 cohort studies were identified according to the inclusion criteria. Overall, a significantly inverse correlation between placenta previa and HDP was found when all study results were pooled into the meta-analysis (RR = 0.55, 95% CI: 0.32-0.97). For subgroup analyses, the same results were found in pregnancy-induced hypertension (PIH) group (RR = 0.36, 95% CI: 0.23-0.57) but not in other HDPs group (RR = 0.94, 95% CI: 0.44-2.00). This meta-analysis suggested a reduced risk for PIH in women with placenta previa.

  12. 4种类型前置胎盘妊娠结局分析%Pregnancy outcome analysis of four types of placenta previa

    Institute of Scientific and Technical Information of China (English)

    郑霖

    2015-01-01

    Objective:To explore the types of placenta previa and the pregnancy outcome.Methods:According to the types of placenta previa,136 cases of patients with placenta previa were divided into the central placenta previa group(n=53),the partial placenta previa group(n=16),the marginal placenta previa group(n=36) and the low placenta previa group(n=31).Results:The prenatal blood loss,postnatal blood loss,incidence of placenta implantation,incidence of hysterectomy,incidence of preterm infants, neonatal asphyxia rate,pediatric transferation rate of the central placenta previa were higher than the rest three types of placenta previa.The cesarean delivery rate of the partial placenta previa was highest followed by the central placenta previa.Conclusion:The pregnancy outcome of placenta previa was closely related to the types,and the low placenta previa and marginal placenta previa could had trial vaginal production,the partial placenta previa and central placenta previa need cesarean delivery.The harm of the partial placenta previa and central placenta previa to the maternal and infant were most serious.%目的:探讨前置胎盘的类型、妊娠结局。方法:收治前置胎盘患者136例。按照前置胎盘的类型,将其分为中央性前置胎盘组(n=53)、部分性前置胎盘组(n=16)、边缘性前置胎盘组(n=36)和低置胎盘(n=31)。结果:中央性前置胎盘产前出血量、产后出血量、胎盘植入发生率、子宫切除发生率、早产儿发生率、新生儿窒息率、转儿科率均高于其余3种类型前置胎盘。部分性前置胎盘剖宫产率最高,中央性前置胎盘次之。结论:前置胎盘的妊娠结局与类型密切相关,低置、边缘性前置胎盘可经阴道试产,部分性及中央性前置需行剖宫产。前置胎盘对母婴的危害以中央性、部分性前置胎盘最严重。

  13. Placenta abruptio

    Science.gov (United States)

    ... Philadelphia, PA: Elsevier; 2017:chap 18. Hull AD, Resnik R. Placenta previa, placenta accreta, abruptio placentae, and vasa previa. In: Creasy RK, Resnik R, Iams JD, Lockwood CJ, Moore TR, Greene ...

  14. 凶险性前置胎盘23例临床分析%Clinical analysis of 23 cases of pernicious placenta previa

    Institute of Scientific and Technical Information of China (English)

    赵晶; 王晓静

    2016-01-01

    Objective To explore the clinical characteristics of pernicious placenta previa,Improve the knowledge and prevention of pernicious placenta previa in clinical. Methods From June 2013 to December 2014 in our hospital 94 patients with placenta previa,analyze pernicious placenta previa group and non- pernicious placenta previa group differences before and after deliver. Results Pernicious placenta previa group bleeding time was significantly later than non- pernicious group,the difference was statistically significant (P0.05);②Pernicious placenta previa group intrapartum hemorrhage,postpartum hemorrhage,placental implantation rate,hysterectomy rate was significantly higher, the difference was statistically significant (P0.05);②观察组在产时发生大出血、产后大出血、胎盘植入、切除子宫的概率都明显高于对照组(P<0.05);③观察组新生儿1分钟Apgar评分窒息发生率明显高于对照组,差异具有统计学意义(P<0.05)。结论凶险性前置胎盘给孕产妇和新生儿带来极大的威胁,积极采取有效的防治措施对改善母儿预后具有重要意义。

  15. Increased levels of cell-free human placental lactogen mRNA at 28-32 gestational weeks in plasma of pregnant women with placenta previa and invasive placenta.

    Science.gov (United States)

    Kawashima, Akihiro; Sekizawa, Akihiko; Ventura, Walter; Koide, Keiko; Hori, Kyouko; Okai, Takashi; Masashi, Yoshida; Furuya, Kenichi; Mizumoto, Yoshifumi

    2014-02-01

    We compared the levels of cell-free human placental lactogen (hPL) messenger RNA (mRNA) in maternal plasma at 28 to 32 weeks of gestation between women with diagnosis of placenta previa or invasive placenta and women with an uneventful pregnancy. Sensitivity and specificity of hPL mRNA for the prediction of invasive placenta were further explored. Plasma hPL mRNA were quantified by real-time reverse-transcriptase polymerase chain reaction in women with placenta previa (n = 13), invasive placenta (n = 5), and normal pregnancies (n = 92). Median (range) hPL mRNA was significantly higher in women with placenta previa, 782 (10-2301) copies/mL of plasma, and in those with invasive placenta, 615 (522-2102) copies/mL of plasma, when compared to normal pregnancies, 90 (4-4407) copies/mL of plasma, P placenta among women with placenta previa. In conclusion, expression of hPL mRNA is increased in plasma of women with placenta previa and invasive placenta at 28 to 32 weeks of gestation.

  16. MRI diagnosis of pernicious placenta previa%凶险性前置胎盘的 MRI 诊断

    Institute of Scientific and Technical Information of China (English)

    张艳; 袁军; 黄明刚

    2014-01-01

    Objective To explore the MRI diagnostic value for pernicious placental abnormalities.Methods MRI findings of 1 5 patients with pernicious placenta previa were retrospectively analyzed after cesarean section.Results Among all cases,total placenta previa was,1 1 cases and partial placenta previa was 4 cases.The placenta located in the anterior wall in 8 cases,posterior wall in 4 cases,lateral wall in 3 cases.4 cases were diagnosed as normal placenta,6 cases as adhesion,4 cases as implanted,and 1 case as penetrating.These cases had certain special MR features.Conclusion MRI is helpful in diagnosing the location and type of the perni-cious placenta,and showing whether complicated with previa implantation and penetrating.%目的:探讨 MRI 对凶险性前置胎盘伴种植异常的诊断价值。方法15例临床诊断凶险性前置胎盘的患者行 MRI 平扫,于剖宫产术后进行回顾性分析。结果完全性前置胎盘11例,不全性前置胎盘4例,胎盘位于前壁8例,后壁4例,侧壁3例,胎盘子宫分界正常4例,粘连6例,植入4例,穿通1例,各具有一定影像学特征。结论 MR 对凶险性前置胎盘位置、种类及伴有胎盘植入、穿通具有一定的诊断价值。

  17. 前置胎盘胎盘植入研究进展%Research Progress on the Placenta Accrete of Placenta Previa

    Institute of Scientific and Technical Information of China (English)

    池一婵; 隗伏冰(综述); 唐莉(审校)

    2015-01-01

    前置胎盘是常见的妊娠晚期出血性疾病,可危及母儿生命。胎盘植入与前置胎盘、剖宫产史等因素高度相关。出血多且采取保守治疗无效时应及时行子宫切除术。对于凶险性前置胎盘要引起高度重视,切实做好术前准备、术中有效处理,以减少出血量及子宫切除率。该文就前置胎盘胎盘植入病因、对母儿影响、临床表现及诊断、治疗、预防等方面的研究进展予以综述。%Placenta previa is one of the most common hemorrhagic diseases in late trimester of preganancy ,it may threaten the maternal and fetal life .Placenta accrete is associated with previous cesarean section and pla-centa previa,hysterectomy would be performed if massive bleeding could not be alleviated with conservative treatment.Dangerous type of placenta previa should be paid a lot of attention ,in order to make necessary pre-operative preparation and conduct effective intraoperative treatment to control massive bleeding and hysterec-tomy rate.Here is to make a review of the research progress on the pathogenesis,impact on mothers and infants,clinical manifestations,diagnosis,treatment,and prevention of placenta previa.

  18. Placenta previa with early opening of the uterine isthmus is associated with high risk of bleeding during pregnancy, and massive haemorrhage during caesarean delivery.

    Science.gov (United States)

    Goto, M; Hasegawa, J; Arakaki, T; Takita, H; Oba, T; Nakamura, M; Sekizawa, A

    2016-06-01

    To demonstrate the relationship between the timing of opening of the uterine isthmus and bleeding during pregnancy and caesarean section in patients with placenta previa. A prospective observational study was conducted at a single perinatal centre. All patients with placenta previa, diagnosed between 20 and 22 weeks of gestation, who were followed up at the study hospital and underwent caesarean section were enrolled. The condition of the uterine isthmus was examined every 2 weeks. The timing (in gestational weeks) of complete opening of the uterine isthmus was determined. Patients were divided into two groups: patients in whom the uterine isthmus opened before 25 weeks of gestation (EO-previa), and patients in whom the uterine isthmus opened after 25 weeks of gestation (LO-previa). The frequency of bleeding during pregnancy and the amount of intra-operative bleeding were compared between the two groups. Forty-four cases of EO-previa and 55 cases of LO-previa were analysed. Complete placenta previa at delivery was observed more frequently in the EO-previa group than in the LO-previa group (88.6% vs 47.3%, pprevia group (48%) than in the LO-previa group (25%) (p=0.021). The frequency of massive haemorrage (>2500ml) during caesarean section was higher in the EO-previa group than in the LO-previa group (25% vs 9%, p=0.033). Placenta previa was associated with a high risk of bleeding leading to emergency caesarean section during pregnancy, and massive haemorrhage during caesarean section in patients in whom the uterine isthmus opened before 25 weeks of gestation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. 凶险型前置胎盘与普通型前置胎盘对孕妇的危害性分析%Hazard analysis on pregnant women with pernicious placenta previa and common type of placenta previa

    Institute of Scientific and Technical Information of China (English)

    陶萍; 张铨富

    2015-01-01

    目的:探索研究凶险型前置胎盘以及普通型前置胎盘对孕产妇的危害性,寻求针对性的治疗和护理方法。方法选择我院收治的凶险型前置胎盘以及普通型前置胎盘孕产妇共计100例作为研究对象并按照疾病类型进行分组研究,凶险型患者属于研究组,普通型患者属于对照组,每组各50例。将两组患者手术情况以及胎儿情况等进行对比分析。结果研究组进行手术治疗时间以及术中出血量均显著多于对照组(P<0.05);研究组产后出血比例为90.00%,显著高于对照组的36.00%(P<0.05)。研究组胎盘植入比例、子宫切除比例以及输血比例均显著高于对照组(P<0.05)。研究组早产儿发生率、重度窒息率、气管插管率以及并发症发生率和死亡率均高于对照组,但差异不具有统计学意义( P>0.05)。结论前置胎盘具有较大的危害性,尤其是凶险型前置胎盘危险性更大,应当引起高度重视,选择正确的手术方式,有效减少术中和产后出血,可以有效降低子宫切除的风险。%Objective To explore the harmfulness of placenta previa and normal placenta previa on pregnant women , to seek treatment and nursing methods of .Methods The placenta previa in our hospital and the general type of maternal placenta previa as research object and grouping study , patients with placenta previa as the study group , patients with normal placenta previa as control group .The two groups of patients with operation and fetal condition were analyzed .Results The study group operation time was significantly longer than the control group, the amount of bleeding was significantly more than that of the control group (P0.05).Conclusions Placenta previa has great harmfulness , especially the pernicious placenta previa is more dangerous , should attach great importance to , the choice of correct operation , effectively reduce the

  20. Comportamiento de la placenta previa en el Hospital Ginecoobstétrico "América Arias", período 2003-2005 Behavior of placenta praevia in "América Arias" Gynecoobstetric Hospital from 2003 to 2005

    Directory of Open Access Journals (Sweden)

    Ariana Isla Valdés

    2008-09-01

    Full Text Available Se realizó un estudio retrospectivo y descriptivo en el Hospital Ginecoobstétrico "América Arias" para identificar la relación que existe entre la aparición de la placenta previa y la presencia de algunas variables obstétricas, además de su repercusión en la morbimortalidad materna y perinatal en el período comprendido desde enero de 2003 hasta diciembre de 2005. Se revisaron 62 historias clínicas, que se corresponden con igual número de mujeres que presentaron placenta previa en esta fecha, y se encontró que el aumento de la frecuencia de la placenta previa se relacionó fundamentalmente con la edad mayor que 30 años (75,5 % de los casos, la paridad elevada (58 % de las mujeres eran multíparas, y la cesárea y los legrados previos (32,3 y 25,8 % de las gestantes, respectivamente. Al 67,8 % de los casos se les hizo el diagnóstico en la atención primaria. Las complicaciones maternas más frecuentes fueron la anemia posparto (29 % de los casos y el alumbramiento distócico (17,7 % de las mujeres, mientras que en el recién nacido, el bajo peso y el distrés respiratorio (29 y 25,8 % de los neonatos, respectivamente.A retrospective and descriptive study was undertaken at "América Arias" Gynecoobstetric Hospital to identify the relationship existing between the appearance of placenta praevia and the presence of some obstetric variables, in addition to its impact on maternal and perinatal morbimortality from January 2003 to December 2005. 62 medical histories corresponding to the same number of females that presented placenta praevia on this date were reviewed. It was found that the increase of the frequency of placenta praevia was mainly related to age over 30 (75.5 % of the cases, an elevated parity (58 % of the females were multiparous, and the cesareans and the previous induced abortions (32.3 and 25.8 % of the pregnant women, respectively 67.8 % of the cases were diagnosed at the primary health care level. The most common

  1. The Clinical Analysis of Dangerous Placenta Previa and Ordinary Placenta Previa%凶险性前置胎盘与普通型前置胎盘的临床病例分析

    Institute of Scientific and Technical Information of China (English)

    张海玲; 王冰; 张庆

    2015-01-01

    Objective:To analyze the clinical feature and treatment of dangerous placenta previa. Methods:The clinical data of 9 640 people who delivered in our hospital in July 2012—June 2014 were reviewed retrospectively, including 1 284 cases with once or more history of cesarean section, accounted for 1.3% (128/9 640) of the delivery of pregnant women at the same period. 128 cases of placenta previa, accounted for 2.6% (34/1 284) of the scar uterus pregnant women at the same period. Including 94 cases (73.4%) of ordinary placenta previa and 34 cases (26.6%) of dangerous placenta previa. Results:The incidence of dangerous placenta previa complicated by placenta accreta was significantly higher than that of common placenta previa group (χ2=11.04, P=0.00). The duration of operation, amount of bleeding in or after operation and the amount of blood transfusion were higher than the common placenta previa group (P0.05), but the amended Hb value in dangerous placenta previa group was lower than the ordinary placenta previa group after operation (P<0.05). Conclusions:The rate of dangerous placenta previa complicated by placenta accreta was high, the operation was difficult, liable to accur severe intrapartum and postpartum hemorrhage, so it was dangerous to mother and perinatal fetus. Elective surgery with full preparation and by experienced obstetrician is the key to successful treatment. Strictly for the first time cesarean section pointer, in order to reduce the incidence of dangerous placenta previa.%目的:探讨凶险性前置胎盘的临床特点及处理方法。方法:回顾性分析2012年7月—2014年6月郑州大学第二附属医院(我院)分娩的9640例孕妇,其中瘢痕子宫孕妇1284例,前置胎盘128例,包括普通型前置胎盘94例(占73.4%),凶险性前置胎盘34例(占26.6%),前置胎盘占同期分娩孕妇的1.3%(128/9640),凶险性前置胎盘孕妇占同期瘢痕子宫孕妇的2.6%(34/1284),分析

  2. The frequency and clinical significance of intra-amniotic infection and/or inflammation in women with placenta previa and vaginal bleeding: an unexpected observation

    Science.gov (United States)

    Madan, Ichchha; Romero, Roberto; Kusanovic, Juan Pedro; Mittal, Pooja; Chaiworapongsa, Tinnakorn; Dong, Zhong; Mazaki-Tovi, Shali; Vaisbuch, Edi; Savasan, Zeynep Alpay; Yeo, Lami; Kim, Chong Jai; Hassan, Sonia S.

    2012-01-01

    Objective Idiopathic vaginal bleeding, a common complication of pregnancy, increases the risk of SGA neonate, pre-eclampsia and preterm delivery and can be the only clinical manifestation of intra-amniotic infection and/or inflammation (IAI). Placenta previa is thought to be protective against ascending intrauterine infection, yet an excess of histologic chorioamnionitis has been reported in this condition. The aim of this study was to determine the frequency and clinical significance of IAI in women with placenta previa and vaginal bleeding in the absence of preterm labor. Study design A retrospective cohort study including 35 women with placenta previa and vaginal bleeding placenta previa and IAI had a higher rate of delivery within 48 hours (80% (4/5) vs. 19% (4/21); p=0.008) than those without IAI. Conclusions Patients with placenta previa presenting with vaginal bleeding have intra-amniotic infection in 5.7% of the cases, and intra-amniotic infection and/or inflammation in 17.9%. Intra-amniotic infection and/or inflammation in patients with placenta previa and vaginal bleeding is a risk factor for preterm delivery within 48 hours. PMID:20146660

  3. Research progress of placenta previa risk factors%前置胎盘高危因素的研究进展

    Institute of Scientific and Technical Information of China (English)

    严瑾; 孔祥; 唐丽娟; 郑英

    2016-01-01

    In recent years ,the incidence of placenta previa has been rising in China .Placenta previa can lead to maternal anemia ,postpartum hemorrhage ,hemorrhagic shock ,premature labor and neonatal asphyxia and other complications ,and it is a major cause of maternal and neonatal death in the maternity .It is important to identify the risk factors leading to placenta previa for reducing the incidence of placenta previa .This article reviews the research progress of placenta previa risk factors , in order to provide reference for reducing the incidence of placenta previa .%我国近年前置胎盘发病率呈明显上升趋势。前置胎盘可引起贫血、产后出血、失血性休克、早产及新生儿窒息等多种并发症,是导致产妇及新生儿死亡的重要原因。了解前置胎盘的高危因素,有助于预防和降低前置胎盘发生风险。笔者拟就目前对前置胎盘高危因素的研究进展进行综述,旨在为降低前置胎盘发病率提供参考依据。

  4. Can 3-dimensional power Doppler indices improve the prenatal diagnosis of a potentially morbidly adherent placenta in patients with placenta previa?

    Science.gov (United States)

    Haidar, Ziad A; Papanna, Ramesha; Sibai, Baha M; Tatevian, Nina; Viteri, Oscar A; Vowels, Patricia C; Blackwell, Sean C; Moise, Kenneth J

    2017-08-01

    Traditionally, 2-dimensional ultrasound parameters have been used for the diagnosis of a suspected morbidly adherent placenta previa. More objective techniques have not been well studied yet. The objective of the study was to determine the ability of prenatal 3-dimensional power Doppler analysis of flow and vascular indices to predict the morbidly adherent placenta objectively. A prospective cohort study was performed in women between 28 and 32 gestational weeks with known placenta previa. Patients underwent a two-dimensional gray-scale ultrasound that determined management decisions. 3-Dimensional power Doppler volumes were obtained during the same examination and vascular, flow, and vascular flow indices were calculated after manual tracing of the viewed placenta in the sweep; data were blinded to obstetricians. Morbidly adherent placenta was confirmed by histology. Severe morbidly adherent placenta was defined as increta/percreta on histology, blood loss >2000 mL, and >2 units of PRBC transfused. Sensitivities, specificities, predictive values, and likelihood ratios were calculated. Student t and χ(2) tests, logistic regression, receiver-operating characteristic curves, and intra- and interrater agreements using Kappa statistics were performed. The following results were found: (1) 50 women were studied: 23 had morbidly adherent placenta, of which 12 (52.2%) were severe morbidly adherent placenta; (2) 2-dimensional parameters diagnosed morbidly adherent placenta with a sensitivity of 82.6% (95% confidence interval, 60.4-94.2), a specificity of 88.9% (95% confidence interval, 69.7-97.1), a positive predictive value of 86.3% (95% confidence interval, 64.0-96.4), a negative predictive value of 85.7% (95% confidence interval, 66.4-95.3), a positive likelihood ratio of 7.4 (95% confidence interval, 2.5-21.9), and a negative likelihood ratio of 0.2 (95% confidence interval, 0.08-0.48); (3) mean values of the vascular index (32.8 ± 7.4) and the vascular flow index

  5. Temporary balloon occlusion of the internal iliac arteries to prevent massive hemorrhage during cesarean delivery among patients with placenta previa.

    Science.gov (United States)

    Broekman, Evelien A; Versteeg, Henneke; Vos, Louwerens D; Dijksterhuis, Marja G; Papatsonis, Dimitri N

    2015-02-01

    To evaluate the effectiveness of temporary balloon occlusion of the internal iliac artery before uterine incision to prevent massive obstetric hemorrhage during cesarean delivery among patients with anterior placenta previa. In a retrospective cohort study conducted at Amphia Hospital Breda (Breda, Netherlands), data were analyzed from women with anterior placenta previa who delivered by cesarean between January 1, 2001, and September 30, 2012. Cases with and without balloon occlusion of the internal iliac artery were included. The primary outcomes were the amount of blood loss during cesarean delivery, drop of hemoglobin level, and blood loss of more than 1000 mL. Of 68 eligible women, 42 (62%) had temporary balloon occlusion and 26 (38%) had no balloon occlusion. Median blood loss was 800 mL (interquartile range [IQR] 488-1113) in the balloon group and 1000 mL (IQR 694-1307) in the no balloon group (P=0.06). Blood loss of 1000 mL or more was recorded in 16 (38%) women in the balloon group and 18 (69%) in the no balloon group (P=0.01). Temporary balloon occlusion of the internal iliac artery before uterine incision during cesarean delivery could potentially reduce blood loss among patients with anterior placenta previa. Large, randomized controlled trials are needed to confirm the results. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  6. Increased Levels of Cell-Free Human Placental Lactogen mRNA at 28-32 Gestational Weeks in Plasma of Pregnant Women With Placenta Previa and Invasive Placenta

    OpenAIRE

    2014-01-01

    We compared the levels of cell-free human placental lactogen (hPL) messenger RNA (mRNA) in maternal plasma at 28 to 32 weeks of gestation between women with diagnosis of placenta previa or invasive placenta and women with an uneventful pregnancy. Sensitivity and specificity of hPL mRNA for the prediction of invasive placenta were further explored. Plasma hPL mRNA were quantified by real-time reverse-transcriptase polymerase chain reaction in women with placenta previa (n = 13), invasive place...

  7. 38例前置胎盘的超声诊断体会%The Experience of Ultrasound Diagnosis on 38 Cases of Placenta Previa

    Institute of Scientific and Technical Information of China (English)

    姜玉学

    2014-01-01

    Objective The value of ultrasound on diagnosis for placenta previa is to be discussed. Methods Analyze the data of ultrasound diagnosis selected from 38 patients of placenta previa. Results Al of 38 patients who were diagnosed by ultrasound examination as placenta previa were choose to terminate pregnancy by cesarean section when the pregnancy was termed. 11 Patients were of complete placenta previa and the other 27 patients were of partial placenta previa, all of them had vaginal bleeding in different degree. Conclusion When applying B ultrasound to diagnose placenta previa, the weeks of gestation should be noted, the placenta would occupy half space of uterine when the gestation period has passed half. The diagnostic accuracy of ultrasound examination on placenta previa reaches 90%to 95%. The diagnosis can be examined through abdomen, vagina or rectum.%目的:探讨前置胎盘的超声影像诊断价值。方法选取38例前置胎盘患者超声诊断资料进行分析。结果超声诊断为前置胎盘的38例患者足月后均以剖宫产终止妊娠。完全性前置胎盘患者11例,部分性前置胎盘患者27例,均有不同程度阴道出血。结论 B型超声诊断前置胎盘时须注意妊娠周数,妊娠中期胎盘占据宫腔一半的面积。对前置胎盘诊断准确率达90%~95%,经腹、阴道及直肠均可。

  8. The frequency and clinical significance of intra-uterine infection and inflammation in patients with placenta previa and preterm labor and intact membranes.

    Science.gov (United States)

    Park, C-W; Moon, K C; Park, J S; Jun, J K; Yoon, B H

    2009-07-01

    Histologic placental and/or intra-amniotic inflammation is frequently documented during ascending intra-uterine infections in patients with preterm labor and intact membranes. Placenta previa can be a clinical situation that shows the successive schema of histologic placental and intra-amniotic inflammation during the process of ascending intra-uterine infections. However, a paucity of information exists about the frequency and clinical significance of intra-uterine infections and inflammation in patients with placenta previa and preterm labor and intact membranes. The purpose of this study was to examine this issue. Amniocentesis was performed on 42 patients with placenta previa and preterm labor and intact membranes (gestational age or =23 ng/ml). Non-parametric statistics were used for analysis. 1) Intra-amniotic inflammation was present in 16.7% (7/42), proven AF infection in 4.9% (2/41), and histologic chorioamnionitis in 19.0% (8/42) of patients with placenta previa and preterm labor; 2) Patients with intra-amniotic inflammation had significantly higher rates of a positive AF culture, histologic chorioamnionitis, funisitis, and a shorter interval-to-delivery than those without intra-amniotic inflammation (pplacenta previa and preterm labor and intact membranes. The intra-amniotic inflammatory response was stronger when inflammation was present in the chorionic plate and choriodecidua, than when it was restricted to the choriodecidua only, which was exposed to the cervical canal in placenta previa.

  9. 凶险性前置胎盘伴胎盘植入处理体会%Treatment experience of dangerous placenta previa complicated with placenta accrete

    Institute of Scientific and Technical Information of China (English)

    周庆红; 周晓红

    2015-01-01

    目的:研究凶险性前置胎盘伴胎盘植入的诊断及治疗。方法:收治凶险性前置胎盘并胎盘植入孕妇18例,对其具体情况进行回顾分析。结果:产前彩超胎盘植入时检出率55.55%(10/18),10例行MRI检查,检出率100%(10/10),8例行“8”缝扎剥离面及结扎双侧子宫血管。7例行“8”缝扎剥离面及结扎双侧子宫血管后效果不佳,急行子宫动脉栓塞治疗,保留子宫成功。3例直接行子宫切除。结论:凶险性前置胎盘伴胎盘植入易产后出血,充分术前准备,个体化,多方式治疗,降低并发症。%Objective:To explore the diagnosis and treatment of dangerous placenta previa complicated with placenta accreta. Methods:18 cases of pregnant women with dangerous placenta previa complicated with placenta accreta were selected,the clinical data were retrospectively analyzed.Results:The detection rate of prenatal ultrasound placenta implantation was 55.55%(10/18),10 patients were given MRI examination,the detection rate was 100% (10/10),8 cases were given "8" suture wound surface and bilateral uterine vessel ligation.The effect of "8" suture wound surface and bilateral uterine vessel ligation in 7 cases was poor, they were given emergency uterine artery embolization treatment,uterus was successfully retained.3 patients were given hysterectomy.Conclusion:Postpartum hemorrhage in dangerous placenta previa complicated with placenta accreta was easy to occur,we should have adequate preoperative preparation and individualized treatment in many ways,so as to reduce the complications.

  10. Increased Levels of Cell-Free miR-517a and Decreased Levels of Cell-Free miR-518b in Maternal Plasma Samples From Placenta Previa Pregnancies at 32 Weeks of Gestation.

    Science.gov (United States)

    Hasegawa, Yuri; Miura, Kiyonori; Higashijima, Ai; Abe, Shuhei; Miura, Shoko; Yoshiura, Koh-ichiro; Masuzaki, Hideaki

    2015-12-01

    The aim of this study was to clarify the association between placenta previa and circulating levels of cell-free pregnancy-associated placenta-specific microRNAs (miRNAs) in maternal plasma. Twenty singleton pregnancies with placenta previa (placenta previa group) and 26 uncomplicated pregnancies (control group) were recruited. Blood sampling was performed at 32 weeks of gestation, and cesarean delivery in all cases of placenta previa was performed at a mean gestational age of 37 weeks. The maternal plasma concentrations of cell-free pregnancy-associated placenta-specific miRNAs (miR-517a and miR-518b) were measured by absolute quantitative real-time reverse transcription-polymerase chain reaction. Plasma concentrations of cell-free miR-517a were significantly higher in the placenta previa group than that in the control group (P = .011), while the plasma concentration of cell-free miR-518b was significantly lower in the placenta previa group than that in the control group (P = .004). Plasma concentrations of cell-free miR-517a in placenta previa were significantly higher in placenta previa with alert bleeding later group than those in placenta previa without alert bleeding group or control group (P = .030 or .047, respectively) and correlated with the volume of hemorrhage at delivery (R and P value: .512 and .025). Plasma concentrations of cell-free miR-517a and miR-518b at 32 weeks of gestation were altered in pregnant women with placenta previa, and the circulating level of cell-free miR-517a in placenta previa may be a predictive marker for the risks of alert bleeding later and massive hemorrhage at delivery. © The Author(s) 2015.

  11. Risk of placenta previa in second birth after first birth cesarean section: a population-based study and meta-analysis

    Directory of Open Access Journals (Sweden)

    Gurol-Urganci Ipek

    2011-11-01

    Full Text Available Abstract Background Objective: To compare the risk of placenta previa at second birth among women who had a cesarean section (CS at first birth with women who delivered vaginally. Methods Retrospective cohort study of 399,674 women who gave birth to a singleton first and second baby between April 2000 and February 2009 in England. Multiple logistic regression was used to adjust the estimates for maternal age, ethnicity, deprivation, placenta previa at first birth, inter-birth interval and pregnancy complications. In addition, we conducted a meta-analysis of the reported results in peer-reviewed articles since 1980. Results The rate of placenta previa at second birth for women with vaginal first births was 4.4 per 1000 births, compared to 8.7 per 1000 births for women with CS at first birth. After adjustment, CS at first birth remained associated with an increased risk of placenta previa (odds ratio = 1.60; 95% CI 1.44 to 1.76. In the meta-analysis of 37 previously published studies from 21 countries, the overall pooled random effects odds ratio was 2.20 (95% CI 1.96-2.46. Our results from the current study is consistent with those of the meta-analysis as the pooled odds ratio for the six population-based cohort studies that analyzed second births only was 1.51 (95% CI 1.39-1.65. Conclusions There is an increased risk of placenta previa in the subsequent pregnancy after CS delivery at first birth, but the risk is lower than previously estimated. Given the placenta previa rate in England and the adjusted effect of previous CS, 359 deliveries by CS at first birth would result in one additional case of placenta previa in the next pregnancy.

  12. Risk of placenta previa in second birth after first birth cesarean section: a population-based study and meta-analysis

    Science.gov (United States)

    2011-01-01

    Background Objective: To compare the risk of placenta previa at second birth among women who had a cesarean section (CS) at first birth with women who delivered vaginally. Methods Retrospective cohort study of 399,674 women who gave birth to a singleton first and second baby between April 2000 and February 2009 in England. Multiple logistic regression was used to adjust the estimates for maternal age, ethnicity, deprivation, placenta previa at first birth, inter-birth interval and pregnancy complications. In addition, we conducted a meta-analysis of the reported results in peer-reviewed articles since 1980. Results The rate of placenta previa at second birth for women with vaginal first births was 4.4 per 1000 births, compared to 8.7 per 1000 births for women with CS at first birth. After adjustment, CS at first birth remained associated with an increased risk of placenta previa (odds ratio = 1.60; 95% CI 1.44 to 1.76). In the meta-analysis of 37 previously published studies from 21 countries, the overall pooled random effects odds ratio was 2.20 (95% CI 1.96-2.46). Our results from the current study is consistent with those of the meta-analysis as the pooled odds ratio for the six population-based cohort studies that analyzed second births only was 1.51 (95% CI 1.39-1.65). Conclusions There is an increased risk of placenta previa in the subsequent pregnancy after CS delivery at first birth, but the risk is lower than previously estimated. Given the placenta previa rate in England and the adjusted effect of previous CS, 359 deliveries by CS at first birth would result in one additional case of placenta previa in the next pregnancy. PMID:22103697

  13. Major Placenta Previa: Rate, Maternal and Neonatal Outcomes Experience at a Tertiary Maternity Hospital, Sohag, Egypt: A Prospective Study

    Science.gov (United States)

    Ahmed, Salah Roshdy; Aitallah, Abdusaeed; Abdelghafar, Hazem M.

    2015-01-01

    Introduction Major degree placenta is a serious health issue and is associated with high fetal-maternal morbidity and mortality. Literature from developing countries is scant. Aim To determine the prevalence and maternal and neonatal outcomes among women with major placenta previa (PP). Materials and Methods A prospective descriptive study of 52 singleton pregnancies with PP was evaluated in this study. The study was conducted at Sohag University Hospital, Egypt from January through June 2014. Outcome measures, including the prevalence of PP, maternal and neonatal outcomes, and case-fatality rate. Results The total number of deliveries performed during the study period was 3841, of them, 52 cases were placenta previa. Thus, the prevalence of PP was 1.3%. The mean of previous cesarean scars was 2.2±1.4. Of women with PP, 26.4% (n=14) had placenta accreta. In total, 15.1% (n=8) of women underwent an obstetric hysterectomy. From the total no. of babies, 13.2% (n=7) were delivered fresh stillborn babies. Of the surviving babies (n=45), 20% (n=9) required admission to NICU. The frequencies of bowel and bladder injuries were 3.8% (n=2) and 13.2% (n=7) respectively. There was no maternal death in this study. Conclusion The rate of PP is comparable to previous studies, however, the rate of placenta accreta is high. Also, there are high rates of neonatal mortality and intraoperative complications which can be explained by accreta. The study highlights the need to revise maternity and child health services. PMID:26674539

  14. Evaluation of interobserver variability and diagnostic performance of developed MRI-based radiological scoring system for invasive placenta previa.

    Science.gov (United States)

    Ueno, Yoshiko; Maeda, Tetsuo; Tanaka, Utaru; Tanimura, Kenji; Kitajima, Kazuhiro; Suenaga, Yuko; Takahashi, Satoru; Yamada, Hideto; Sugimura, Kazuro

    2016-09-01

    To evaluate the interobserver variability and diagnostic performance of a developed magnetic resonance imaging (MRI)-based scoring system for invasive placenta previa. Prenatal MR images of 70 women were retrospectively evaluated, 18 of whom were diagnosed with invasive placenta. The six MR features (dark band on T2 -weighted images, intraplacental abnormal vascularity, placental bulge, heterogeneous placenta, myometrial thinning, and placental protrusion sign) were scored on 5-point Likert scale separately, and the cumulative radiological score (CRS) was defined as the sum of each score. Two more experienced radiologists (readers A and B) and two less experienced residents (readers C and D) calculated the CRS. Interobserver variability was assessed by measuring the intraclass correlation coefficient. Diagnostic performance was evaluated by means of receiver operating characteristic (ROC) analysis. Interobserver variability for CRS was excellent for the more experienced radiologists (0.85), and good for all readers (0.72) and the less experienced residents (0.66). The area under the ROC curve (Az) and accuracy (Acc) for CRS were significantly higher or equivalent to those of other MR features for all readers (Az and Acc for reader A; CRS, 0.92, 91.4%; intraplacental T2 dark band, 0.83, P = 0.009, 81.4%, P = 0.03; intraplacental abnormal vascularity, 0.9, P = 0.3, 90.0%, P = 1.00; placental bulge, 0.81, P = 0.0008, 80.0%, P = 0.02; heterogeneous placenta, 0.85, P = 0.11, 74.3%, P = 0.002; myometrial thinning, 0.84, P = 0.06, 60.0%, P placenta previa. J. Magn. Reson. Imaging 2016;44:573-583. © 2016 International Society for Magnetic Resonance in Medicine.

  15. 前置胎盘、胎盘粘连及胎盘植入与人工流产的关系研究%Relationship research of placenta previa,adherent placenta and placenta implantation

    Institute of Scientific and Technical Information of China (English)

    刘秀华

    2014-01-01

    目的:研究前置胎盘、胎盘粘连及胎盘植入与人工流产的相关性。方法对入我院进行分娩的3280例孕妇资料进行分析,选择其中342例发生胎盘异常孕妇进行研究,包括未经人工流产和人工流产的孕妇前置胎盘、胎盘粘连及胎盘植入的发生率;人工流产的次数与前置胎盘、胎盘粘连及胎盘植入的关系以及围产期感染相关因素的研究。结果未经人工流产孕妇胎盘总的异常率为3.7%,人工流产孕妇胎盘总的异常率为14.3%,两组胎盘异常总发生率比较显著差异(P<0.05);流产次数越多,胎盘异常发生率随着次数增高而增高;围产期感染与产前贫血、宫腔感染和产妇营养不良关系密切(P<0.05)。结论前置胎盘、胎盘粘连及胎盘植入与人工流产的关系密切,多次人工流产易导致胎盘异常情况的发生,又易由于胎盘异常导致产后出血,育龄女性应尽量避免人工流产。%Objective To study the correlation between placenta previa, adherent placenta and placenta implantation. Methods Data of 3280 pregnant women delivered in our hospital were analyzed, of which 342 pregnant women with abnormal placenta were selected for research, including the incidences of placenta previa, adherent placenta and placenta implantation of the pregnant women having gone and having not gone through induced abortion, relationship between the times of induced abortion and the placenta previa, adherent placenta and placenta implantation, and study on perinatal infection related factors. Results The total abnormal placenta rate of the pregnant women having not gone through induced abortion was 3.7%and that of those having gone through induced abortion was 14.3%, with significant difference between the total incidences of abnormal placenta(P < 0.05).The incidence of abnormal placenta went up as the times of induced abortion rose; Perinatal infection was closely related to

  16. Anesthetic management of a parturient with placenta previa totalis undergoing preventive uterine artery embolization before placental expulsion during cesarean delivery: a case report.

    Science.gov (United States)

    Lee, Jae Woo; Song, In Ae; Ryu, Junghee; Park, Hee-Pyoung; Jeon, Young-Tae; Hwang, Jung-Won

    2014-10-01

    Placenta previa totalis can cause life-threatening massive postpartum hemorrhage, and careful anesthetic management is essential. Preventive uterine artery embolization (UAE) before placental expulsion was introduced to reduce postpartum bleeding in cases of placenta previa totalis. We describe the case of a 40-year-old woman (gravida 0, para 0) with placenta previa totalis and uterine myomas who underwent intraoperative UAE, which was preoperatively planned at the strong recommendation of the anesthesiologist, immediately after delivery of a fetus and before removal of the placenta during cesarean delivery under spinal-epidural anesthesia. After confirming embolization of both uterine arteries, removal of the placenta resulted in moderate bleeding. The estimated blood loss was 2.5 L, and 5 units of red blood cells were transfused. The parturient was discharged uneventfully on postoperative day 4. This case shows that the bleeding risk is reduced by intraoperative UAE in a patient with placenta previa totalis, and anesthesiologists have an important role in a multidisciplinary team approach.

  17. 凶险型前置胎盘妊娠38例临床分析%Clinical analysis of 38 pregnant cases with pernicious placenta previa

    Institute of Scientific and Technical Information of China (English)

    王马列; 梁润彩

    2014-01-01

    目的:探讨凶险型前置胎盘的诊治及妊娠结局,提高对凶险型前置胎盘的认识水平,为临床上对凶险型前置胎盘母儿预后咨询提供依据。方法收集并分析38例凶险型前置胎盘及45例普通前置胎盘孕妇的临床资料,包括母体一般情况、产前超声检查、MRI 检查、胎盘病理及母儿围生结局。结果凶险型前置胎盘组胎盘植入、子宫切除、产后出血、输血、产妇转 ICU 的发生率及出血量均较普通前置胎盘组明显升高(P 均<0.05),新生儿胎龄小于36周比例、转新生儿 ICU 率及新生儿呼吸窘迫综合征发生率稍高于普通前置胎盘组,但比较差异无统计学意义(P 均>0.05)。凶险型前置胎盘中非胎盘植入组与普通前置胎盘组母儿发病率比较差异无统计学意义(P >0.05)。结论凶险型前置胎盘易并发胎盘植入,子宫切除率高,孕产妇不良结局风险较普通前置胎盘增加,但围生儿不良结局风险无明显增加。%Objective To investigate the diagnosis,treatment and pregnancy outcome of pernicious placenta previa and deepen the understanding of pernicious placenta previa,offering clinical evidence for such cases.Methods Clinical data of 38 cases with pernicious placenta previa and 45 cases with placenta previa were retrospectively analyzed,including general maternal state,ultrasonic and magnetic resonance imaging ex-aminations,placental pathology and perinatal outcomes of both mother and fetus.Results The incidence of placenta accreta,hysterectomy,blood loss,postpartum hemorrhage,blood transfusion and maternal intensive care unit admissions in pernicious placenta previa group was significantly higher than those in placenta previa group (all P 0.05).The incidence of maternal and perinatal morbidity be-tween pernicious placenta previa without placenta accreta and placenta previa groups did not significantly differ (P >0.05).Conclusions The incidence

  18. Clinical analysis on 23 cases of pernicious placenta previa%凶险型前置胎盘23例临床分析

    Institute of Scientific and Technical Information of China (English)

    卢昆林; 胡燕; 曹清

    2012-01-01

    Objective To improve the understanding of the pernicious placenta previa by analyzing the harm of the pernicious placenta previa to the pregnant women. Methods Retrospectively analyzed the data from 23 cases with the pernicious placenta previa, 8 cases in placenta accreta group and 15 cases in non-placenta accreta group were compared and analyzed. Results The incidence , the amount of postoperative hemorrhage and the incidence of cesarean hysterectomy in placenta accreta group were significant higher than that of non-placenta accreta group ( P < 0. 01). Conclusion Pernicious placenta previa with placenta accreta can cause great physical and mental harm to the pregnant women, mastering cesarean indications correctly to reduce cesarean section rate was the key point of reducing the incidence of pernicious placenta praevia.%目的 分析凶险型前置胎盘对孕妇的危害性,提高对凶险型前置胎盘的认识.方法 回顾性分析23例凶险型前置胎盘孕妇的临床资料,将其分为植入组8例,非植入组15例进行对比分析.结果 胎盘植入组产后出血发生率、产后出血量及子宫切除率与非植入组比较明显增高(P<0.01).结论 植入型凶险型前置胎盘给产妇生理、精神造成巨大伤害.掌握好剖宫产指征从而降低剖宫产率是减少凶险型前置胎盘发生的关键.

  19. The risk of placental abruption and placenta previa in pregnant women with chronic hepatitis B viral infection: a systematic review and meta-analysis.

    Science.gov (United States)

    Huang, Q T; Chen, J H; Zhong, M; Xu, Y Y; Cai, C X; Wei, S S; Hang, L L; Liu, Q; Yu, Y H

    2014-08-01

    Several epidemiological studies have found a positive association between chronic hepatitis B virus (CHB) infection and the risk of placental abruption and placenta previa, but various studies have reported conflicting findings. The objective was to systematically review the literature to determine a possible association between CHB infection and these two placental complications. We conducted a computerized search in electronic database through March 1, 2014, supplemented with a manual search of reference lists, to identify original published research on placental abruption and placenta previa rates in women with CHB infection. Data were independently extracted, and relative risks were calculated. The meta-analysis was performed using Stata version 10.0 software. Five studies involving 9088 placenta previa cases were identified. No significant association between CHB infection and placenta previa was identified (OR = 0.98, 95% CI = 0.60-1.62). Five studies involving 15571 placental abruption cases were identified. No significant association between CHB infection and placental abruption was identified (OR = 1.42, 95% CI, 0.93-2.15). The immune response against the virus represents a key factor in determining infection outcomes. No observation of significant increased risk of the placental complications could be partially explained by the complex immune response during CHB infection. Our meta-analysis found no evidence of significant associations between CHB infection and increased risk of placental abruption as well as placenta previa. Further well-designed studies were warranted to assess any potential association between CHB infection and increased risk of placental abruption as well as placenta previa. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. 凶险型前置胎盘并胎盘植入的超声诊断价值%The sonographic diagnostic value of pernicious placenta previa and placenta accreta

    Institute of Scientific and Technical Information of China (English)

    马芬; 李燕; 陶溢潮; 陈奕; 田荣华

    2016-01-01

    Objective To evaluate the ultrasonographic features and the ultrasonic value of pernicious placenta previa and placenta accrete, and to improve the prenatal diagnosis rate.Methods Clinical data and imaging features of 22 patients with pernicious placenta previa and placenta accreta were retrospective analyzed.Results Twenty-two cases with placenta previa and placenta implantation were complete placenta previa, 13 cases with placenta previa and implantation were diagnosed by prenatal ultrasound,9 cases with placenta accreta were missed diagnosis,and 2 cases with placenta praevia were misdiagnosis. Conclusion The observation is focused on the essence of placenta,lacenta rear keyed vocal myometrium,bladder with uterine serous hyperechoic and the corresponding blood flow changes combined with a variety of ultrasonic methods,to advance the detection rate of pernicious placenta previa combined with placenta accreta and reduce misdiagnosis.%目的 探讨凶险型前置胎盘并胎盘植入的声像图特征和超声诊断价值,提高产前诊断率.方法 回顾分析我院产后经临床和病理证实的22例凶险型前置胎盘并胎盘植入患者的临床资料及超声表现.结果 22例凶险型前置胎盘并胎盘植入均为完全型前置胎盘,产前超声准确诊断前置胎盘并胎盘植入13例,漏诊胎盘植入9例;误诊前置胎盘类型2例.结论 联合应用多种超声检查方法,重点观察胎盘实质、胎盘后方子宫肌层、子宫膀胱浆膜强回声带及相应血流变化,可以提高凶险型前置胎盘并胎盘植入的检出,减少误漏诊的发生.

  1. Clinical analysis of 12 cases placenta previa combined with placenta accreta%前置胎盘合并胎盘植入12例临床分析

    Institute of Scientific and Technical Information of China (English)

    兰景尤; 周雪勤

    2014-01-01

    Objective To investigate the high risk factors,diagnosis and management of placenta previa combined with placenta accreta .Methods The clinical data of 12 cases of placenta previa combined with placenta accrete ( placenta accreta group ) and 82 cases of placenta previa ( placenta previa group ) were analyzed retrospective-ly.Results The age, gravidity, the types of placenta previa and uterine operation history were high risk factors of placenta accreta;The incidences of premature delivery , neonatal asphyxia and postpartum hemorrhage of placenta ac-creta group were higher than those of placenta previa group ( all P<0.05 );The accuracy rate of prenatal color doppler ultrasound in the diagnosis of placenta previa with accreta was 83.3%(10/12).Placenta thickening, the hypoecho of uterine wall muscle layer at the rear of placenta band of being thinning (≤1 mm) or disappeaing , placental parenchy-ma′s rich blood flow , placental cavity gap were characteristic sonogram of placenta previa combined with placenta ac -creta;Expectant treatment and timely termination of pregnancy were the main treatment methods .Conclusion Over 30 years of age ,pregnancy over three times , central type of placenta previa and uterine operation history are high risk factors.Color Doppler ultrasound is currently the most convenient method in diagnosis of placenta accreta .The indi-vidual treatment can improve maternal and neonatal outcomes .%目的:探讨前置胎盘合并胎盘植入的高危因素、诊断及治疗方法。方法对82例前置胎盘(前置胎盘组)和前置胎盘合并胎盘植入12例(胎盘植入组)孕产妇的临床资料进行回顾性分析。结果孕妇的年龄、孕次、前置胎盘类型及子宫手术史是发生胎盘植入的高危因素;胎盘植入组早产、新生儿窒息和产后出血的发生率均高于前置胎盘组( P<0.05);产前彩色多普勒超声诊断前置胎盘合并胎盘植入的正确率为83.3%(10/12),胎

  2. 凶险性前置胎盘12例临床分析%Clinical analysis of 12 cases with overwhelming placenta previa

    Institute of Scientific and Technical Information of China (English)

    齐丽华; 高金山

    2015-01-01

    Objective:To explore the dangers of overwhelming placenta previa to maternal and its diagnosis and treatment and preventive measures.Methods:The placenta implantation,postpartum hemorrhage and hysterectomy of 86 cases of patients with placenta previa were analyzed retrospectively.Results:The incidence of placenta implantation,postpartum hemorrhage loss and hysterectomy rate of the patients with overwhelming placenta previa were higher than that of the patients with non-overwhelming placenta previa(P<0.05).Conclusion:Overwhelming placenta previa had great harm to maternal.Mastering caesarean indications, noticing antenatal examination and pregnancy care,well postpartum rescue measures were the keys process.%目的:探讨凶险性前置胎盘对产妇的危害及其诊断、处理和预防措施。方法:回顾性分析前置胎盘患者86例胎盘植入、产后出血和子宫切除情况。结果:凶险性前置胎盘患者胎盘植入的发生率、产后出血量及子宫切除率均高于非凶险性前置胎盘患者(P<0.05)。结论:凶险性前置胎盘对产妇有极大危害。掌握剖宫产指征、注意产前检查和孕期保健、作好产后抢救措施是处理关键。

  3. 前置胎盘患者产后出血的高危因素分析%High risk factors of postpartum hemorrhage in placenta previa.

    Institute of Scientific and Technical Information of China (English)

    杜习羽; 王洁; 董玉楠; 肖立

    2011-01-01

    目的 探讨前置胎盘患者发生产后出血的相关高危因素.方法 回顾性分析2009年1月至2010年8月间,在我院住院分娩的287例前置胎盘病例产前各相关因素及妊娠结局.结果 高龄产妇、多次孕产史、剖官产史、中央型前置胎盘、有产前出血史、胎盘粘连或植入的前置胎盘孕妇与产后出血有显著相关性,中央型前置胎盘终止妊娠较晚者也与产后出血显著相关.结论 对高危因素的前置胎盘病人应早诊断并适时、正确地处理,适时终止妊娠,尽可能降低该病对母婴的危害.%Objective To investigate the risk factors of postpartum haemorrhage in placenta previa. Methods A retrospective analysis of 287 cases with placenta previa from January 2009 to August 2010 was performed. Results The relative factors of postpartum haemorrhaga in placenta previa were older age, multiple pregnancy history,history of cesarean section, central placenta previa, history of antcpartum hemorrhage, adhesive placenta or implantable placenta. Late termination of pregnancy with central placenta previa were also significantly associated with postpartum hemorrhage. Conclusion Those patients who have risk factors should be early diagnosed and correctly disposed and timely terminated pregnancy. It will minimize harm on mothers and children.

  4. Prenatal ultrasound diagnosis and outcome of placenta previa accreta after cesarean delivery: a systematic review and meta-analysis.

    Science.gov (United States)

    Jauniaux, Eric; Bhide, Amar

    2017-07-01

    Women with a history of previous cesarean delivery, presenting with a placenta previa, have become the largest group with the highest risk for placenta previa accreta. The objective of the study was to evaluate the accuracy of ultrasound imaging in the prenatal diagnosis of placenta accreta and the impact of the depth of villous invasion on management in women presenting with placenta previa or low-lying placenta and with 1 or more prior cesarean deliveries. We searched PubMed, Google Scholar, clinicalTrials.gov, and MEDLINE for studies published between 1982 and November 2016. Criteria for the study were cohort studies that provided data on previous mode of delivery, placenta previa, or low-lying placenta on prenatal ultrasound imaging and pregnancy outcome. The initial search identified 171 records, of which 5 retrospective and 9 prospective cohort studies were eligible for inclusion in the quantitative analysis. The studies were scored on methodological quality using the Quality Assessment of Diagnostic Accuracy Studies tool. The 14 cohort studies included 3889 pregnancies presenting with placenta previa or low-lying placenta and 1 or more prior cesarean deliveries screened for placenta accreta. There were 328 cases of placenta previa accreta (8.4%), of which 298 (90.9%) were diagnosed prenatally by ultrasound. The incidence of placenta previa accreta was 4.1% in women with 1 prior cesarean and 13.3% in women with ≥2 previous cesarean deliveries. The pooled performance of ultrasound for the antenatal detection of placenta previa accreta was higher in prospective than retrospective studies, with a diagnostic odds ratios of 228.5 (95% confidence interval, 67.2-776.9) and 80.8 (95% confidence interval, 13.0-501.4), respectively. Only 2 studies provided detailed data on the relationship between the depth of villous invasion and the number of previous cesarean deliveries, independently of the depth of the villous invasion. A cesarean hysterectomy was performed in

  5. Predictors of Perinatal Mortality Associated with Placenta Previa and Placental Abruption: An Experience from a Low Income Country

    Science.gov (United States)

    Berhan, Yifru

    2014-01-01

    A retrospective cohort study design was used to assess predictors of perinatal mortality in women with placenta previa and abruption between January 2006 and December 2011. Four hundred thirty-two women (253 with placenta previa and 179 with placental abruption) were eligible for analysis. Binary logistic regression, Kaplan-Meier survival curve, and receiver operating characteristic (ROC) curve were used. On admission, 77% of the women were anaemic (<12 gm/dL) with mean haemoglobin level of 9.0 ± 3.0 gm/dL. The proportion of overall severe anaemia increased from about 28% on admission to 41% at discharge. There were 50% perinatal deaths (neonatal deaths of less than seven days of age and fetal deaths after 28 weeks of gestation). In the adjusted odds ratios, lengthy delay in accessing hospital care, prematurity, anaemia in the mothers, and male foetuses were independent predictors of perinatal mortality. The haemoglobin level at admission was more sensitive and more specific than prematurity in the prediction of perinatal mortality. The proportion of severe anaemia and perinatal mortality was probably one of the highest in the world. PMID:25002975

  6. Cervical inversion as a novel technique for postpartum hemorrhage management during cesarean delivery for placenta previa accreta/increta.

    Science.gov (United States)

    Sakhavar, Nahid; Heidari, Zahra; Mahmoudzadeh-Sagheb, Hamidreza

    2015-02-01

    To describe the use of cervical inversion for postpartum hemorrhage (PPH) management during cesarean delivery for placenta previa accreta/increta. In a retrospective, descriptive study, data were reviewed for cases in which cervical inversion was used to manage PPH during cesarean delivery at a center in Zahedan, Iran, between July 2, 2011, and September 25, 2014. Cervical inversion was applied when placental bleeding was persistent and the sites could not be clearly located. The cervix is inverted using ring forceps or straight Allis forceps, after which the placental bed is sutured to control bleeding. After bleeding is controlled, the cervix is returned to its original position. Cervical inversion was successfully applied to 10 cases. Mean time to completion of cervical inversion was 4.1 ± 0.7 minutes. In all 10 cases, the bleeding was stopped within 3-5 minutes from the beginning of the cervical inversion procedure. No apparent complications were reported, and blood transfusions or obstetric hysterectomies were not necessary. Cervical inversion is a simple, cost-effective, and time-saving procedure for PPH management in placenta previa accreta/increta. It could become a routine procedure for preserving the uterus and fertility of affected women. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  7. Mifepristone combined with ethacridine lactate for the second-trimester pregnancy termination in women with placenta previa and/or prior cesarean deliveries.

    Science.gov (United States)

    Chen, Chunqin; Lin, Feikai; Wang, Xiaoyun; Jiang, Yaping; Wu, Sufang

    2017-01-01

    This study was aimed to evaluate the safety and efficacy of the second-trimester medical abortions using mifepristone and ethacridine lactate in women with placenta previa and/or prior cesarean deliveries. The patients who underwent a second-trimester pregnancy termination from January 2009 to December 2015 were retrospectively analyzed. The eligible patients were assigned to four groups based on placentation and cesarean history. The abortion interval (AI), blood loss, hospital stays, incidence of curettage, and transfusion were reviewed. Two women underwent cesarean sections for placenta increta. Finally, 443 patients were enrolled in this study, including 92 with placenta previa, 153 with prior cesarean deliveries, 36 with the both factors, and 236 with normal placentation and no cesarean delivery history. All the included cases had a successful vaginal delivery. There was no significant difference in AI, hospital stay, rate of hemorrhage, and transfusion among the four groups. Patients with prior cesarean section had higher blood loss than the normal group (P = 0.0017), as well as patients with both placenta previa and prior cesarean (P = 0.0018). However, there was no obvious blood loss in patients with placenta previa when compared with normal placetal patients (P = 0.23). No uterine rupture occurred in all patients. Mifepristone combined with ethacridine lactate is safe and effective for patients with low placentation or/and prior cesarean in the second-trimester pregnancy termination.

  8. 瘢痕子宫合并前置胎盘临床分析%Clinical analysis of scar uterus combined with placenta previa on maternal pregnancy outcome

    Institute of Scientific and Technical Information of China (English)

    程春花; 李根霞; 崔世红; 许雅娟

    2013-01-01

    目的 探讨瘢痕子宫合并前置胎盘对母婴妊娠结局的影响.方法 回顾性分析郑州大学第三附属医院2011年11月至2012年11月住院分娩148例前置胎盘患者的临床资料,其中瘢痕子宫合并前置胎盘者74例为观察组,单纯前置胎盘组74例为对照组.比较两组间产后出血量、子宫切除率、胎盘植入及早产等发生率.结果 瘢痕子宫合并前置胎盘组与对照组相比,产后出血发生率高、产后出血量多(P<0.01).瘢痕子宫合并前置胎盘组子宫切除率、胎盘植入率明显升高(P<0.01),新生儿的早产率也明显升高(P<0.05).结论 瘢痕子宫合并前置胎盘对母儿影响大,术前应提高警惕,做好充分术前准备,必要时及时切除子宫.%Objective To explore the influence of scar uterus combined with placenta previa on maternal pregnancy outcom.Methods Retrospective analysis of our hospital from 2011 November to 2012 November hospitalized childbirth the clinical data of 148 patients with placenta previa,the merger of scar uterus placenta previa 74 cases as the observation group,pure placenta previa group 74 cases as control group.Comparison of postpartum blood loss between the two groups,uterus resection rate,and the incidence of preterm birth placenta increta.Results Merger of scar uterus placenta previa group compared with control group,the high incidence of postpartum hemorrhage,postpartum blood loss (P < 0.01).Scar uterus uterus resection rate,rate of placenta implantation combined placenta previa group increased significantly (P < 0.01),neonatal preterm birth rates also increased significantly (P < 0.05).Conclusion Scar uterus combined with placenta previa big influence on mothers and infants preoperative should be vigilant,makes adequate preoperative preparation,timely removal of the uterus when necessary.

  9. 凶险型前置胎盘并发胎盘植入33例临床治疗探讨%Clinical analysis on 33 cases of pernicious placenta previa with placenta accreta

    Institute of Scientific and Technical Information of China (English)

    田宁; 范玲

    2014-01-01

    T he aim is to study the perioperative management .We analyze the clinical complications of pernicious placenta previa complicated with placenta accrete ,taking totally 33 patients of pernicious placenta previa complicated with placenta accrete ,who had admitted to our hospital from January 2009 to December 2013 ,as the samples ,and summarize the clinical complications of the disease and perioperative management . T he results show that the incidence rate of pernicious placenta previa complicated with placenta accreta was 21 .15% .All patients of pernicious placenta previa complicated with placenta accrete were treated by operation ,and the uterus resection rate was 24 .24% (8/33) . T hus the patients of pernicious placenta previa should alert complicated placenta accrete .T he uterus resection rate increases for cases of pernicious placenta previa complicated with placenta accreta ,so they should be given adequate preoperative preparation ,the intraoperative bleeding should combine a variety of methods to control bleeding ,timely hysterectomy was necessary when the treatment was ineffective .%为了分析凶险型前置胎盘并发胎盘植入的临床并发症,探讨其围术期处理,选择首都医科大学附属北京妇产医院2009年1月-2013年12月确诊为凶险型前置胎盘合并胎盘植入的33例病例,研究该疾病的临床并发症和围术期处理.结果显示,凶险型前置胎盘并发胎盘植入发生率为21.15%,所有病例均采用手术终止妊娠,其中子宫切除率为24.24%(8/33).认为凶险型前置胎盘患者应警惕并发胎盘植入,凶险型前置胎盘合并胎盘植入的子宫切除率高,应进行充分的术前准备,术中需要结合多种止血方法控制出血,止血无效者需适时切除子宫.

  10. 凶险型前置胎盘并发胎盘植入的临床分析%Clinical analysis of pernicious placenta previa complicated with placenta accreta

    Institute of Scientific and Technical Information of China (English)

    黄莺; 孙海燕; 隋霜

    2012-01-01

    目的 探讨凶险型前置胎盘并发胎盘植入的高危因素及围产期处理.方法 回顾性分析188例凶险型前置胎盘患者的临床资料.结果 凶险型前置胎盘并发胎盘植入发生率为21.80%(41/188).凶险型前置胎盘并发胎盘植入的高危因素包括:孕妇高龄、流产次数≥2次、剖宫产2次.所有凶险型前置胎盘并发胎盘植入者均采用手术治疗,其中子宫切除率为26.82% (11/41),未并发胎盘植入者子宫切除率为0.96% (8/147),差异有统计学意义(χ2=16.141,P<0.01).结论 对高龄、有多次剖宫产史或多次流产史的凶险型前置胎盘患者应警惕并发胎盘植入,前置胎盘并发胎盘植入的子宫切除率增高.%Objective To investigate the high risk factors and perinatal management of pernicious placenta previa complicated with placenta accreta. Methods The data of 188 cases of patients with pernicious placenta previa was retrospectively analyzed. Results The incidence rate of pernicious placenta previa complicated with placenta accreta was 21. 8% ( 41/188 ), and the high risk factors of it included maternal advanced age, abortion frequency ≥2 and 2 times of cesarean section. All cases of pernicious placenta previa complicated with placenta accreta were treated by operation, and the uterus resection rate was 26. 82% ( 11/41 ). The uterus resection rate of cases without placenta accreta was 0. 96% ( 8/147 ). The difference was statistically significant (X2 = 16. 141, P < 0. 01 ). Conclusion Patients of pernicious placenta previa with advanced age, history of several times of cesarean section and abortion should alert complicated placenta accrete. The uterus resection rate increases for cases of placenta previa complicated with placenta accreta.

  11. The value of MRI in the diagnosis of placenta previa%MRI对前置胎盘的诊断价值

    Institute of Scientific and Technical Information of China (English)

    姚文君; 杨硕; 郑穗生; 王龙胜; 鲍芳

    2015-01-01

    目的:探讨MRI对前置胎盘及合并胎盘植入的诊断价值。方法回顾分析手术及病理证实的15例前置胎盘患者的临床及MRI资料,包括1例前置胎盘合并胎盘植入及1例前置胎盘合并胎盘粘连,分析并总结其MRI诊断要点。结果完全性前置胎盘共6例,MRI对于完全性前置胎盘的诊断正确率为100.0%,但其中1例完全性前置胎盘合并胎盘粘连MRI术前漏诊,诊断符合率83.3%;部分性前置胎盘共3例,正确诊断2例,诊断符合率66.7%;边缘性前置胎盘共6例,诊断符合率为100.0%。而超声检查除1例完全性前置胎盘合并胎盘粘连漏诊外,其余病例均符合。结论 MRI对前置胎盘具有较高的诊断价值,多方位多角度观察有助于前置胎盘的明确分型。%Objective To investigate the value of MRI in diagnosis of placenta previa and its combination of placenta accrete. Mate-rials and Methods Retrospective analysis the clinical data and MRI features of 15 Cases of placenta previa,whichconfirmed by operation and pathology, including 1 case of placentaaccreta,and 1 case with adherent placenta, analyze and summarize the diagnostic poinst of MRI ima-ging. Results There are 6 cases of complete placenta previa,thediagnosisofMRI was correct,1 case with adherent placenta were not diag-nosed by MRI pre-operation,accordance rate was 83. 3%;3 cases of partial placenta previa,MR diagnosed 2 cases,thediagnoseaccordance rate was 66. 7%;6 cases of marginal placenta previa,thediagnose accordance rate was 100. 0%. US was not diagnose 1 case with adherent placenta,the rest of cases were diagnosed correctly. Conclusions MRI has a high diagnostic value of placenta previa, multi direction and multi angle observation make classification clearly.

  12. Morbidly adherent placenta previa in current practice: prediction and maternal morbidity in a series of 23 women who underwent hysterectomy.

    Science.gov (United States)

    Alchalabi, Haifa'a; Lataifeh, Isam; Obeidat, Basil; Zayed, Faheem; Khader, Yousef S; Obeidat, Nail

    2014-11-01

    To assess the prediction and maternal morbidity of morbidly adherent placenta previa (PP) when currently available management options are used. This is a retrospective study of all women with PP/morbidly adherent placenta previa (MAPP) delivered at our hospital over a period of 9 years. Data were obtained through hospital registry and medical records search. A total of 81 PP were identified, 23 (28.4%) of them had MAPP. All MAPP had previous lower segment cesarean section (LSCS). The following are associated with increased odds of MAPP versus PP, LSCS (OR for each additional LSCS was 2.9 (95% confidence interval: 1.8, 4.5, p ≤ 0.005), age ≥35 years (OR 4.3 (95% CI: 1.4, 12.7, p = 0.008). Anterior or central placenta (OR = 11.6; p = 0.028). Women with previous PP were at risk. Fifteen women were diagnosed by ultrasound [sensitivity 0.65 (0.43, 0.83) and PPV 0.79 (0.54, 0.93)]. MAPP was associated with risk of massive transfusion, bladder injury, DIC and admission to intensive care unit (ICU) (p < 0.005, 0.008, 0.036 and 0.008, respectively). One maternal death was reported in the MAPP group. MAPP is associated with high morbidity and mortality. As the diagnosis is often not certain before delivery, we recommend that all PP and previous LSCS are assumed to be morbidly adherent, and should be managed in properly equipped centers.

  13. Experience in the Treatment of Pernicious Placenta Previa%凶险性前置胎盘的治疗体会

    Institute of Scientific and Technical Information of China (English)

    石淑颖

    2016-01-01

    Objective To explore treatment methods and the clinical effect of the pernicious placenta previa patients, to improve and perfect measures of placenta previa.Methods 10 cases of placenta previa patients were selected from our hospital, the pernicious placenta previa patients were treated from Prepare the preoperative, intraoperative and postoperative care.Results There were 8 cases of patients with placenta implantation in 10 cases of placenta previa patients, 6 cases occurred postoperative bleeding, 2 cases treated with topical hemostatic suture hemostasis, retained the uterus, the other 4 cases were Bleeding shock, treated with performing a hysterectomy and aftercare back to normal.Conclusion The risk of dangerous placenta previa is great, should strength the medical staff awareness, rational preoperative assessment, timely effective hemostasis and postoperative effective nursing may give a timely and effective treatment for patients with pernicious placenta previa.%目的探讨凶险性前置胎盘的治疗方法及临床效果,提高并完善凶险性前置胎盘的应对措施。方法对我院接收的10例凶险性前置胎盘患者进行分析,从术前准备、术中处理和术后护理三方面对凶险性前置胎盘患者进行干预。结果10例凶险性前置胎盘患者中8例伴有胎盘植入,其中6例患者在术后发生大出血,2例通过局部缝扎止血成功止血,保留住子宫,其他4例出现大失血休克,通过子宫切除手术和后期护理恢复正常。结论凶险性前置胎盘危险性极大,要加强医务人员的重视程度,术前的整体合理评估、术中及时有效止血和术后有效护理可以对凶险性前置胎盘患者予以及时、有效救治。

  14. Clinical analysis on 45 cases of pernicious central placenta previa%凶险型中央性前置胎盘45例临床分析

    Institute of Scientific and Technical Information of China (English)

    黄蕾; 杨晓

    2015-01-01

    Objective To investigate the high risk factors and treatment outcome of pernicious central placenta previa. Methods A total of 45 cases of pernicious central placenta previa in our hospital from October 2011 to February 2014 were se-lected. Then the retrospective analysis was performed on the age,gestational week,abortion times,cesarean delivery times,com-plicating placenta increta rate,intraoperative and postoperative bleeding volume and treatment outcome. Results The incidence rate of pernicious central placenta previa complicating placenta increta was 26.67%(12/45);the predilection high risk factors of pernicious central placenta previa complicating placenta increta included abortion times greater than or equal to twice ,cesarean section times greater than or equal to twice ,and placenta adhesion and bleeding history found in previous operation;the occur-rence rate of above factors,and intraoperative and postoperative bleeding volume with 1 000-3 000 mL and more than 3 000 mL in pernicious central placenta previa complicating placenta increta were significantly higher than those without complicating pla-centa increta,the difference was statistically significant(P3000 mL的发生率明显高于未植入者,差异均有统计学意义(P<0.05);45例患者均采用手术治疗,其中子宫切除率达26.67%(12/45),并发胎盘植入者的子宫切除率为66.67%(8/12)。结论瘢痕子宫是发生胎盘植入的主要高危因素,容易形成凶险型中央性前置胎盘,对母婴危害极大,及时采取有效的预防措施及适时实施子宫切除术能有效减少产后出血率,避免产妇死亡。

  15. Accreta complicating complete placenta previa is characterized by reduced systemic levels of vascular endothelial growth factor and by epithelial-to-mesenchymal transition of the invasive trophoblast.

    Science.gov (United States)

    Wehrum, Mark J; Buhimschi, Irina A; Salafia, Carolyn; Thung, Stephen; Bahtiyar, Mert O; Werner, Erica F; Campbell, Katherine H; Laky, Christine; Sfakianaki, Anna K; Zhao, Guomao; Funai, Edmund F; Buhimschi, Catalin S

    2011-05-01

    We sought to characterize serum angiogenic factor profile of women with complete placenta previa and determine if invasive trophoblast differentiation characteristic of accreta, increta, or percreta shares features of epithelial-to-mesenchymal transition. We analyzed gestational age-matched serum samples from 90 pregnant women with either complete placenta previa (n = 45) or uncomplicated pregnancies (n = 45). Vascular endothelial growth factor (VEGF), placental growth factor, and soluble form of fms-like-tyrosine-kinase-1 were immunoassayed. VEGF and phosphotyrosine immunoreactivity was surveyed in histological specimens relative to expression of vimentin and cytokeratin-7. Women with previa and invasive placentation (accreta, n = 5; increta, n = 6; percreta, n = 2) had lower systemic VEGF (invasive previa: median 0.8 [0.02-3.4] vs control 6.5 [2.7-10.5] pg/mL, P = .02). VEGF and phosphotyrosine immunostaining predominated in the invasive extravillous trophoblasts that coexpressed vimentin and cytokeratin-7, an epithelial-to-mesenchymal transition feature and tumorlike cell phenotype. Lower systemic free VEGF and a switch of the interstitial extravillous trophoblasts to a metastable cell phenotype characterize placenta previa with excessive myometrial invasion. Published by Mosby, Inc.

  16. ACCRETA COMPLICATING COMPLETE PLACENTA PREVIA IS CHARACTERIZED BY REDUCED SYSTEMIC LEVELS OF VASCULAR ENDOTHELIAL GROWTH FACTOR AND EPITHELIAL-TO-MESENCHYMAL TRANSITION OF THE INVASIVE TROPHOBLAST

    Science.gov (United States)

    Wehrum, Mark J.; Buhimschi, Irina A.; Salafia, Carolyn; Thung, Stephen; Bahtiyar, Mert O.; Werner, Erica F.; Campbell, Katherine H.; Laky, Christine; Sfakianaki, Anna K.; Zhao, Guomao; Funai, Edmund F.; Buhimschi, Catalin S.

    2011-01-01

    OBJECTIVE To characterize serum angiogenic factor profile of women with complete placenta previa and determine if invasive trophoblast differentiation characteristic of accreta, increta or percreta shares features of epitehelial-mesenchymal-transition (EMT). STUDY DESIGN We analyzed gestational age matched serum samples from 90 pregnant women with either complete placenta previa (n=45) or uncomplicated pregnancies (n=45). Vascular-endothelial-growth-factor (VEGF), placental-growth-factor (PlGF) and soluble fms-like-tyrosine-kinase-1 (sFlt-1) were immunoassayed. VEGF and phosphotyrosine (P-Tyr) immunoreactivity was surveyed in histological specimens relative to expression of vimentin and cytokeratin-7. RESULTS Women with previa and invasive placentation [accreta (n=5); increta (n=6); percreta (n=2)] had lower systemic VEGF (invasive previa: median [IQR]: 0.8[0.02–3.4] vs. control: 6.5[2.7–10.5] pg/mL, P=0.02). VEGF and P-Tyr immunostaining predominated in the invasive extravillous trophoblasts (EVT) which co-expressed vimentin and cytokeratin-7, a EMT feature and tumor-like cell phenotype. CONCLUSIONS Lower systemic free VEGF and a switch of the interstitial EVT to a metastable cell phenotype characterize placenta previa with excessive myometrial invasion. PMID:21316642

  17. RANDOMISED CONTROL STUDY OF USE OF PROGESTERONE V / S PLACEBO FOR MANAGEMENT OF SYMPTOMATIC PLACENTA PREVIA BEFORE 34 WEEKS OF GESTATION IN A TERTIARY CARE CENTRE

    Directory of Open Access Journals (Sweden)

    Shibram

    2015-04-01

    Full Text Available INTRODUCTI ON: APH complicates 3 - 5% of pregnancies and is a leading cause of perinatal and maternal mortality worldwide. Progesterone is essential in maintenance of pregnancy and helps in prolongation of pregnancy. Different trials have been done to show the efficacy and safety of progesterone in prevention of preterm birth but study related to use in expectant management of symptomatic placenta previa is very limited. AIMS AND OBJECTIVE: The objective of our study is to determine the effectiveness of intramascular 17 alpha hydroxy progesterone Caproate therapies vs. placebo in conservative management of patient with symptomatic placenta previa before 34 weeks of gestation. MATERIALS AND METHOD S: It is a randomized control study with 100 pregnant women attending Obstetric deptt. a t Nilratan Sircar Medical College and Hospital, Kolkata with symptomatic placenta previa having episode of warning haemorrhage before 34 weeks of gestation and fulfilling inclusion criteria were enrolled for the study in a two year period from January 2013 to December 2014. Statistical analysis was performed using student t - test and chai - square test where appropriate. RESULTS AND ANALYSIS: In our study prolongation of pregnancy in progesterone receiving group is statistically significant (p - value<0.001, significant difference were also found in gestational age at delivery ( p value of 0.0288, birth - weight (p - value of 0.0470. CON CLUSION: In this study use of 17 alpha hydroxy progesterone in expectant management of symptomatic placenta previa tends to be beneficial than placebo.

  18. Conservative management of post-partum hemorrhage secondary to placenta previa-accreta with hypogastric artery ligation and endo-uterine hemostatic suture.

    Science.gov (United States)

    Rauf, Melekoglu; Ebru, Celik; Sevil, Eraslan; Selim, Buyukkurt

    2017-02-01

    The aim of this study was to investigate maternal and neonatal outcomes of conservative management of post-partum hemorrhage due to placenta previa-accreta using hypogastric artery ligation and endo-uterine hemostatic suture to lower uterine segment. The records of 38 patients who were managed conservatively with hypogastric artery ligation and endo-uterine hemostatic suture to control post-partum hemorrhage secondary to placenta previa-accreta between April 2014 and January 2016, were reviewed retrospectively. Placenta previa-accreta was diagnosed according to gray-scale, color and 3-D power Doppler ultrasonography in addition to the intraoperative findings based on fragmentary or difficult separation of the placenta. In the case of conservative treatment protocol failure, cesarean hysterectomy was performed. Of these patients, 55.2% were between 25 and 35 years old; 97.5% were multiparous; 71.2% had two or more previous cesarean section and 68.5% had preterm delivery. Women with placenta accreta had a median estimated blood loss of 450 mL; 57.8% of patients had blood transfusion (mean intraoperative transfusion, 2 units packed red blood cells; range, 0-9 units). Median duration of operation was 112.5 min (range, 45-305 min) and 32 patients (84.3%) with placenta accreta did not undergo cesarean hysterectomy. Conservative treatment of post-partum hemorrhage secondary to placenta previa-accreta with hypogastric artery ligation and endo-uterine hemostatic sutures to the lower segment of the uterus is associated with lower hysterectomy rate compared with the other conservative methods reported in the literature. © 2016 Japan Society of Obstetrics and Gynecology.

  19. Clinical analysis of placenta previa cesarean delivery in 52 cases%前置胎盘剖宫产52例临床分析

    Institute of Scientific and Technical Information of China (English)

    王蕾

    2015-01-01

    目的:探讨前置胎盘剖宫产术中子宫切口方式和出血量之间的关系。方法:2012年1月-2013年1月收治前置胎盘剖宫产孕妇52例,比较不同子宫切口与相应的出血量。结果:直接切开胎盘组出血量最多,切开胎盘组与推开胎盘组和避开胎盘组比较,出血量均有显著性差异。结论:前置胎盘剖宫产术前应做B超检查明确胎盘位置,采用避开胎盘的子宫切口以减少术中出血量,减少母婴并发症。%Objective:To explore the relationship between intraoperative uterine incision approach between bleeding amount of placenta previa cesarean delivery.Methods:52 pregnant women with placenta previa cesarean delivery were selected from January 2012 to January 2013.The different uterine incisions and the corresponding blood amounts were compared.Results:The bleeding amount of directly cutting placenta group was largest,the cutting placenta group was compared with the pushing placenta group and the avoiding placenta group,the bleeding volume were significantly different.Conclusion:Placenta previa cesarean section should make B ultrasound examination before operation to clear the placenta.Using avoiding placenta uterine incision reduce intraoperatve blood volume,reduce the complications of mothers and infants.

  20. Clinical analysis of 17 cases of placenta previa with placenta accreta%前置胎盘合并胎盘植入17例临床分析

    Institute of Scientific and Technical Information of China (English)

    游一平; 雷莹娟

    2005-01-01

    目的探讨前置胎盘合并胎盘植入的高危因素及处理方法.方法回顾性分析我院2000年1月~2004年11月住院治疗的139例前置胎盘,其中合并胎盘植入17例.结果前置胎盘合并胎盘植入发生率12.23%;很少发生产前出血的中央型前置胎盘多有胎盘植入;胎盘植入组即使产前出血,其次数及出血量较无胎盘植入者低.结论对不发生或极少发生产前出血,有多次孕产史的中央型前置胎盘,要考虑胎盘植入.浆膜面全肌层缝扎止血法可成功保留子宫,值得推广应用.%[Objective] To explore the high risk factors and management of placenta previa complicated with placenta accreta. [Method] Retrospectively analyzed all the 139 cases of placenta previa hospitalized in the hospital from 2000 January to 2004 November, of which 17 cases complicated with placenta accreta. [Result] The incidence rate of placenta previa with placenta aacreta was 12.23%; the patient with central placenta previa who seldom occurred antepartum hemorrhage was complicated with placenta accreta; and even if antepartum hemorrhage happened in the group of placenta accreta, the times and quantity of henorrhage were lower than non-placenta accreta group. [Conclusion] When there is no or little hemorrhage during third trimester in patients with central placenta previa and many parities, placenta accreta must be considered. Transfixion hemostasis of all muscular layer through serous membrane can reserve uterus successfully and it is worth generalizing.

  1. Clinical analysis of 120 cases of pernicious placenta previa with and without placenta accrete%植入性与非植入性凶险型前置胎盘120例临床分析

    Institute of Scientific and Technical Information of China (English)

    林莉; 郭晓辉; 胡芷洋

    2013-01-01

    目的 分析植入性凶险型前置胎盘对孕产妇的危害性,提高对植入性凶险型前置胎盘的认识和重视.方法 对25例植入性凶险型前置胎盘与95例非植入性前置胎盘的病例进行对比分析.结果 中央性前置胎盘合并植入者达43.8%,植入组产后出血率、产后出血量及子宫切除率与非植入组对比有显著性差异(P<0.01).结论 凶险型前置胎盘孕妇产前应明确有无胎盘植入,应做好术中及术后出血的抢救措施,以保证孕产妇生命安全.%Objective To analysis the complications of pernicious placenta previa with placenta accreta. Methods Retrospective analysis of pernicious placenta cases of previa with and without placenta accreta was performed. Results A total of 43. 8% total pernicious placenta previa cases were complicated with placenta accreta. Compared with non - accreta group, the accreta group had higher chance of postpartum hemorrhage, and risk of hysterectomy (P < 0.01). Conclusion The risk of placenta accreta should be considered in prenatal care for cases with pernicious placenta previa, and prophylaxic management is recommended to prevent hemorrhage.

  2. 超声在前置胎盘诊断中的应用%Application of ultrasound in diagnosis of placenta previa

    Institute of Scientific and Technical Information of China (English)

    脱淑梅; 蔺茹; 李富萍

    2013-01-01

    Placenta previa is the first cause of antepartum hemorrhage and the main cause of perinatal hysterectomy. Ultrasound can be used to predict the natural history of placenta previa and antepartum hemorrhage, and to screen related diseases such as placenta implantation and vasa previa. The application of ultrasound has improved the diagnosis and treatment of placenta previa, and vaginal ultrasound has been widely accepted. However, there are still many clinical problems, such as how to predict the period that pregnancy can keep with ultrasound, and these problems need to be further explored. This article reviewed the role of ultrasound in the diagnosis of placenta previa.%前置胎盘是产前出血的第1位原因和围生期子宫切除的主要原因,超声可用于预测前置胎盘的自然转归、产前出血,并能对前置胎盘相关疾病如胎盘植入和血管前置进行筛查.利用超声已经提高了前置胎盘的诊治水平,阴道超声也已被广泛接受,但超声在前置胎盘的诊断中仍存在很多临床问题,如用超声预测妊娠所能维持的时间等,这些问题还有待于进一步探索.该文对超声在前置胎盘诊断中的作用进行了综述.

  3. A late-preterm, early-term stratified analysis of neonatal outcomes by gestational age in placenta previa: defining the optimal timing for delivery.

    Science.gov (United States)

    Balayla, Jacques; Wo, Bi Lan; Bédard, Marie-Josée

    2015-01-01

    Though no official guidelines address the issue of the optimal timing of delivery in placenta previa, common practice is to conduct delivery between 36 and 37 weeks gestation. Given the rising concerns regarding unnecessary premature deliveries, the objective of this study was to compare neonatal outcomes among pregnancies complicated by placenta previa delivered at the late-preterm period (35, 36 weeks) relative to the early-term period (37 and 38 weeks). We conducted a retrospective, population-based, cohort study using the CDC’s Linked Birth-Infant Death data files from the U.S. for the year 2004. We stratified the cohort according to gestational age and placenta previa status. Using 38 weeks gestation as reference controls, the effect of delivery in a pregnancy with placenta previa at 35, 36 and 37 weeks gestation on the risk of several neonatal outcomes was estimated using logistic regression analysis, adjusting for relevant confounders. We analyzed a total of 4 118 956 births, of which 5675 (0.1%) met inclusion criteria. Late-preterm delivery was associated with lower birthweight and increased adequacy of care. Relative to neonates born at 38 weeks, birth at 35, 36 and 37 weeks was associated with no greater odds of meconium passage, fetal distress, fetal anemia, neonatal seizures, increased ventilator needs, or infant death at 1 year. However, odds of 5-min APGAR scores placenta previa is associated with fewer complications and no greater risk than late-preterm delivery. This information may be helpful in the development of future guidelines, which are currently needed to guide the management of these pregnancies.

  4. The value of ultrasound and magnetic resonance imaging in diagnostics and prediction of morbidity in cases of placenta previa with abnormal placentation.

    Science.gov (United States)

    Algebally, Ahmed M; Yousef, Reda Ramadan Hussein; Badr, Sanaa Sayed Hussein; Al Obeidly, Amal; Szmigielski, Wojciech; Al Ibrahim, Abdullah A

    2014-01-01

    The purpose of the study was to evaluate the role of ultrasound (US) and magnetic resonance imaging (MRI) in the diagnostics and management of abnormal placentation in women with placenta previa and to compare the morbidity associated with that to placenta previa alone. The study includes 100 pregnant women with placenta previa with and without abnormal placentation. The results of MRI and US in abnormal placentation were compared with post-operative data. The patients' files were reviewed for assessment of operative and post-operative morbidity. The results of our statistical analysis were compared with data from the literature. US and MRI showed no significant difference in sensitivity and specificity in diagnosing abnormal placentation (97-100% and 94-100%, respectively). MRI was more sensitive than US for the detection of myometrial invasion and the type of abnormal placentation (73.5% and 47%, respectively). The difference between pre- and post-operative hemoglobin values and estimated blood loss were the most significant risk factors for abnormal placentation, added to risk factors known for placenta previa. Post-partum surgical complications and prolonged hospital stay were more common in the cases of placenta previa with abnormal placentation, however statistically insignificant. US and MRI are accurate imaging modalities for diagnosing abnormal placentation. MRI was more sensitive for the detection of the degree of placental invasion. The patient's morbidity increased in cases with abnormal placentation. There was no significant difference in post operative-complications and hospitalization time due to pre-operative planning when the diagnosis was established with US and MRI.

  5. Placenta previa percreta left in situ - management by delayed hysterectomy: a case report

    Directory of Open Access Journals (Sweden)

    Stefanovic Vedran

    2011-08-01

    Full Text Available Abstract Introduction Placenta percreta is an obstetric emergency often associated with massive hemorrhage and emergency hysterectomy. Case presentation We present the case of a 30-year-old African woman, gravida 7, para 5, with placenta percreta managed by an alternative approach: the placenta was left in situ, methotrexate was administered, and a delayed hysterectomy was successfully performed. Conclusions Further studies are needed to develop the most appropriate management option for the most severe cases of abnormal placentation. Delayed hysterectomy may be a reasonable strategy in the most severe cases.

  6. Placenta previa symptom, pathology and diagnosis%胎盘前置状态与前置胎盘的病理和诊断问题

    Institute of Scientific and Technical Information of China (English)

    李儒芝; 李笑天

    2011-01-01

    The placenta previa is divided into low-lying placenta, marginal, partial, or complete placenta previa. Its diagnosis is based on ultrasound. The distance from the placental edge to the internal cervicai os could be accurately measured by transvaginal sonography, which is valuable in planning route of delivery.%胎盘前置状态的消失与否取决于胎盘的位置.前置胎盘或胎盘前置状态,明确诊断需要做影像学检查:超声检查和核磁共振成像.经阴道超声检查可以准确地测量胎盘边缘和宫颈内口之间的距离,这对决定前置胎盘患者的分娩方式县有价值.

  7. Diagnosis and treatment strategy for placenta previa and placenta accreta%前置胎盘并胎盘植入诊断和处理策略

    Institute of Scientific and Technical Information of China (English)

    杨延冬; 杨慧霞

    2011-01-01

    Placenta previa associated with placenta abnormally firm attachment may cause obstetrical massive hemorrhage resulting in peripartum hysterectomy and maternal mortality. The standardized management strategy includes early accurate diagnosis,reasonably expected therapy, timely termination of pregnancy, emphasis on perioperative management,appropriate management of postpartum hemorrhage,trying to conservative treatment, and timely hysterectomy, to reduce maternal morbidity and mortality and improve maternal and perinatal outcomes by multidisciplinary corporation.%前置胎盘并胎盘植入常常导致产前尤其产时、产后不可预见且不易控制的大出血,大大增加了产科子宫切除的几率,严重威胁孕、产妇生命.多学科合作提高前置胎盘并胎盘植入的产前诊断率,合理期待治疗、适时终止妊娠;同时,重视围术期处理、做好防治产后出血的准备,尽量保守治疗、适时子宫切除,以降低孕、产妇并发症和死亡率,改善围生儿结局和产妇生活质量.

  8. Value of prenatal diagnosis of pernicious placenta previa with placenta accreta%胎盘植入合并凶险型前置胎盘的产前诊断及意义

    Institute of Scientific and Technical Information of China (English)

    陈旭日

    2015-01-01

    Objective To investigate the prenatal diagnosis of pernicious placenta previa with placenta increta. Methods Collecting the patients were treated in our hospital from June 2005 to October 2014 , 16 cases were placenta implantation and placenta previa, 34 cases were placenta implantation without placenta previa and 78 cases were placenta previa complicated with placenta accreta, a total of 128 cases of patients as the research object. Prenatal ultrasound diagnosis rate and ultrasonography characteristics were retrospective analized. Results The detection rate of placenta implantation of the combined group was significantly higher than combined group placenta previa (P<0.05); Detection rate with the dangerous type of placenta were higher than the common group significantly (P<0.01). In placenta previa, ratio of patients with an age of more than 35 years the proportion with placenta implantation and uterine cavity operation with more than 2 times compared with placent a accreta patients, the difference was statistically significant (P<0.01). Conclusion Prenatal ultrasound diagnosis of placenta previa complicated with placenta accrete has a positive meaning to decrease the mother and fetal death risk.%目的:探讨胎盘植入合并凶险型前置胎盘的产前诊断及其意义。方法选取2005年6月至2014年10月我院收治的16例胎盘植入合并凶险型前置胎盘、34例胎盘植入未合并凶险型前置胎盘以及78例凶险型前置胎盘未合并胎盘植入,总计128例患者作为研究对象,回顾性分析产前超声检查诊断检出率以及超声检查特点。结果合并前置胎盘组胎盘植入检出率明显高于未合并组,差异具有统计学意义(P<0.05);合并凶险型胎盘检出率较合并普通型组检出率高,差异具有统计学意义(P<0.01)。在凶险型前置胎盘中,合并胎盘植入的患者年龄≥35岁比例以及宫腔操作次数≥2次的比例较未合并胎盘植入患者高

  9. Clinical analysis of 20 cases of pernicious placenta previa%凶险性前置胎盘20例临床分析

    Institute of Scientific and Technical Information of China (English)

    李晓云; 曹永利

    2013-01-01

    Objective To study the diagnosis and preventive measures of pernicious placenta previa. Methods The clinical data of 20 patients with pernicious placenta previa in our hospital during the period from Dec. 2004 to Dec. 2012 were retrospectively analyzed. Results Of the 20 patients with pernicious placenta previa, 18 pa-tients had the amount of bleeding more than 500 ml, including 6 cases of placenta implantation and 5 cases of uterine resection. All the patients discharged after proper treatment. Conclusion For the patients with pernicious placenta previa, early diagnosis and early treatment, and perioperative treatment can improve the maternal and child pregnancy outcome.%目的 探讨凶险性前置胎盘的诊断和防治措施.方法 回顾性分析2004 年12 月至2012 年12 月期间我院诊治的20 例凶险性前置胎盘患者的临床资料.结果 20 例患者中18 例出血量≥500 ml,6 例胎盘植入,5 例子宫切除,经过对症处理后,本组患者均痊愈出院.结论 尽早诊断、尽早治疗,并做好围术期的处理是改善凶险性前置胎盘患者母婴妊娠结局的关键.

  10. Value Diagnosis of Placenta Previa MRI%磁共振成像在前置胎盘诊断中的价值分析

    Institute of Scientific and Technical Information of China (English)

    赵嵩; 陈志敏; 安莲英; 彭丽霞; 崔蕾蕾; 许志琴

    2016-01-01

    目的:探讨磁共振成像(MRI)对前置胎盘的诊断价值,为评估预后而提供依据。方法回顾性分析58例前置胎盘患者的临床资料,其中26例前置胎盘患者并发胎盘植入;对所有患者进行MRI及超声检查,并分析对比MRI及超声检查对前置胎盘的诊断符合情况;将58例前置胎盘患者是否并发胎盘植入进行分组,分为胎盘植入组和对照组,对比两组患者的MRI影像特征,分析前置胎盘并发胎盘植入的特异性MRI影像特征。结果 MRI对前置胎盘的诊断符合率为100%,未出现漏诊及误诊的病例,超声对前置胎盘的诊断符合率为79.31%,其中漏诊1例,误诊11例;MRI与超声对前置胎盘的诊断符合率具有显著性差异(P<0.05);胎盘植入组和对照组的MRI影像特征对比,胎盘植入组和对照组的子宫下段变形或局部隆起、T2WI像出现低信号暗带、植入局部流空血管影增多均具有统计学差异(P<0.05)。结论 MRI对前置胎盘的诊断价值显著大于超声,诊断符合率高,且并发胎盘植入的患者具有特征性MRI征象,有利于评估前置胎盘的预后,为临床及时采取干预措施而提供依据。%Objective To investigate the magnetic resonance imaging (MRI) of the diagnostic value of placenta previa, and provide the basis for assessing the prognosis. Methods Retrospective analysis of clinical data of 58 cases of patients with placenta previa, in which 26 cases of patients with placenta previa placenta accreta, all patients MRI and ultrasound, and the analysis and comparison of MRI and ultrasonography in the diagnosis of placenta previa compliance, the 58 cases of patients with placenta previa combined with placenta implantation whether grouped into placental implantation and control groups, comparing MRI imaging features two groups of patients, analytical specificity MRI imaging features of placenta previa placenta accreta.Results MRI in the

  11. 56 Patients with Placenta Previa Cesarean Delivery Operation%前置胎盘患者56例剖宫产手术观察

    Institute of Scientific and Technical Information of China (English)

    刘帅; 刘颖; 刘莉; 刘明盛; 陈娇

    2015-01-01

    目的:探讨剖宫手术在前置胎盘治疗中的临床价值。方法选择我院2011年1月至2014年1月妇产科收治入院的进行剖宫产术的56例前置胎盘患者的临床资料进行回顾性分析。分别比较前置胎盘患者的产后出血量、胎盘前置的不同类型以及胎盘的粘连植入情况,观察患者的手术治疗效果。结果在56例前置胎盘患者中,中央型前置胎盘32例,占57.14%;边缘型前置胎盘9例,占16.07%;部分型前置胎盘15例,26.79%。胎盘发生粘连和(或)植入的患者有33例,占58.93%;中央型前置胎盘患者产后出血量明显多于边缘型与部分型前置胎盘患者(P<0.05);56例患者均为剖宫产术,患者均止血成功,有3例患者因产后出血按摩子宫,注射宫缩药物、结扎子宫动脉和髂内动脉均无效而切除子宫,且全为中央型前置胎盘患者,有2例合并胎盘粘连或植入,1例产后肠梗阻。新生儿57例全部存活。早产儿17例。足月儿39例。2例低体质量儿(35+4周,37+4周)。结论剖宫产术是治疗前置胎盘,保证母儿安全的重要方法。%Objective To study the caesarean section palace in a clinical value in the treatment of placenta previa. Methods Our hospital between January 2011 and January 2014 maternity admitted during the period of cesarean section of the clinical data of 56 patients with placenta previa were retrospectively analyzed. Postpartum haemorrhage amount of patients with placenta previa were compared, the different types of placenta previa and adhesion of the placenta implantation, observe effect of surgical treatment for patients. Results in the 56 patients with placenta previa, central type of placenta previa 32 cases, accounting for 57.14%;borderline placenta previa, 9 cases (16.07%);some type of placenta previa, 15 cases by 26.79%. Placenta conglutination and (or) of patients implanted with 33 cases, accounted for 58.93%;the central

  12. 凶险性前置胎盘29例临床分析%Clinical analysis of 29 dangerous placenta previa cases

    Institute of Scientific and Technical Information of China (English)

    刘晓玲

    2015-01-01

    目的:探讨凶险性前置胎盘的临床诊断及治疗经验。方法回顾性分析29例凶险性前置胎盘患者的临床资料。根据术中发现胎盘植入和非植入分为植入组15例和非植入组14例。观察两组孕妇产前出血情况、前置胎盘类型与胎盘植入关系、剖宫产术中出血量、产后出血情况及术中处理情况。结果植入组和非植入组产前出血发生率相比,差异有统计学意义(P<0.05),植入组边缘性前置胎盘3例,部分性1例,完全性11例,非植入组分别为10例、2例、2例,两组差异有统计学意义(P<0.05)。结论严格掌握好剖宫产的指征,降低剖宫产率是减少凶险性前置胎盘的根本所在,产前及时诊断,术前做好充分准备,可有效改善预后。%Objective To investigate experience of clinical diagnosis and treatment for dangerous placenta previa.Methods Clinical data of 29 dangerous placenta previa patients were retrospectively analyzed. They were divided into placenta implantation group with 15 cases and non-implantation group with 14 cases. Observation was made on antenatal hemorrhage, relationship between placenta previa type and placenta implantation, intraoperative bleeding volume in caesarean section, postpartum hemorrhage, and surgical condition of the two groups.Results The difference of antenatal hemorrhage rate between implantation group and non-implantation group had statistical significance (P<0.05). The implantation group had 3 cases of marginal placental previa, 1 case of partial placenta previa, and 1 case of total placenta previa. The non-implantation group had these placenta previa types in 10 cases, 2 cases and 2 cases. The difference between the two groups had statistical significance (P<0.05).Conclusion The basis of reducing dangerous placenta previa is strict follow of caesarean section indication and decrease of caesarean section rate. Timely antenatal diagnosis and full preoperative preparation

  13. 前置胎盘合并胎盘植入的产前彩色多普勒超声诊断价值%Diagnostic Value of placenta previa complicated with placenta increta by prenatal Color Doppler sonography

    Institute of Scientific and Technical Information of China (English)

    韩新洪; 解左平; 邱合荣

    2011-01-01

    Objective: To approach sonographic feature and the prenatal diagnostic value of placenta previa complicated with placenta increta. Methods: 289 cases with placenta previa underwent rout prenatal sonography to observe the sate of placenta increta. Results: 14 cases with placenta increta were detected by sonography, 12 cases were confirmed by clinic and pathology. The diagnose accordance rate was 85.7% (12/14). 5 cases were missed diagnosed, 2 cases were misdiagnosed. Conclusion: With the typical sonographic feature, prenatal sonography of placenta previa complicated with placenta increta help to the clinic diagnosis and handle.%目的 探讨前置胎盘合并胎盘植入的产前彩色多普勒超声的声像图特点及诊断价值.方法 对289例前置胎盘患者行常规产前超声检查,重点观察胎盘植入情况.结果 超声诊断胎盘植入14例,产后经临床及病理确诊12例,诊断符合率85.7%(12/14).5例漏诊,2例误诊.结论 前置胎盘合并胎盘植入的彩色多普勒超声具有较典型声像图特点,产前超声检查能为临床诊断及处理提供帮助.

  14. Effects on pregnancy outcome of complete and partial placenta previapatients with placenta previa%完全性和部分性前置胎盘对产妇妊娠结局的影响

    Institute of Scientific and Technical Information of China (English)

    周紫琼

    2015-01-01

    Objective To explore effects of complete and partial placenta previapatients with placenta previa on pregnancy outcome. Methods Selected 200 cases of pregnant women with placenta previa,there were 100 cases in each group,after production,compared two groups of maternal condition,mode of production and neonatal status. Results The proportion of antepartum hemorrhage, postpartum hemorrhage,prenatal and puerperal blood transfusion and hemorrhagic shock and other adverse symptoms of complete placenta previa group were higher than partial placenta previa group.plane section was higher,the risk of asphyxia death of complete placenta previa group newborn infantswas more,they have significant differences (P < 0.05). Conclusion Pregnant women with placenta previa type has important influence on theoutcome of pregnancy,compared partial placenta previa pregnant women,clinical symptoms of complete placenta previa pregnant women is more obvious,prognosis is poorer, in an actual treatment,should strengthen thecomplete clinical intervention in pregnant women with placenta praevia.%目的:探求比较完全性和部分性两种前置胎盘类型对产妇妊娠结局的影响。方法回顾性分析2011年1月~2013年1月于我院生产的前置胎盘孕妇200名作为研究对象,其中完全性和部分性前置胎盘孕妇各100例,待孕妇生产后,比较两组产妇生产后母体情况、生产方式以及新生婴儿状况。结果完全性前置胎盘产妇在产前出血、产后出血、产前产后输血以及失血性休克等不良症状比例均高于部分性前置胎盘组,产妇选择剖宫产生产方式比例更高,完全性前置胎盘组新生婴儿出现窒息、死亡的潜在风险更大,差异有统计学意义(P <0.05)。结论孕妇的前置胎盘类型对妊娠结局有着重要的影响,较部分性胎盘前置孕妇,完全性胎盘前置孕妇的临床症状表现更为明显,预后也更差,在实际治疗中,应加

  15. Placenta: How It Works, What's Normal

    Science.gov (United States)

    ... the most common placental problems include placental abruption, placenta previa and placenta accreta. These conditions can cause potentially ... nutrients. In some cases, early delivery is needed. Placenta previa. This condition occurs when the placenta partially or ...

  16. 中央性前置胎盘并发胎盘植入22例临床分析%Clinical analysis of 22 cases of complete placenta previa with placenta increta

    Institute of Scientific and Technical Information of China (English)

    颜秋霞; 郭晓燕; 雷慧中; 温穗文

    2013-01-01

    目的:探讨中央性前置胎盘并发胎盘植入的高危因素及处理方法。方法:回顾性分析2010年1月-2013年6月广东省清远市人民医院产科收治的95例中央性前置胎盘患者(其中22例并发胎盘植入)的临床资料。结果:我院近4年来中央性前置胎盘的发生率为0.8%(95/12261),中央性前置胎盘并发胎盘植入的发生率为23.2%(22/95);中央性前置胎盘并发胎盘植入的高危因素包括:孕妇年龄≥35岁、有剖宫产史;中央性前置胎盘并发胎盘植入者产时产后出血量明显多于未并发胎盘植入者(P=0.000)。结论:对高龄的、有剖宫产史的中央性前置胎盘患者应警惕并发胎盘植入;为减少中央性前置胎盘并发胎盘植入因严重的产时产后出血对母儿造成的危害,强调术前预测和诊断,制定手术方案,做好术前的充分准备。%Objective:To discuss the high risk factors and peripartum management of complete placenta previa complicated with placenta increta. Methods:The 95 cases of complete placenta previa hospitalized in The People's Hospital of Qingyuan from January 2010 to June 2013 were analyzed retrospectively which 22 cases complicated with placenta increta. Results:The incidence of complete placenta previa was 0.8%(95/12261) in recent 3.5 years, and the morbidity of placenta increta among women with complete placenta previa was 23.2%(22/95);The high risk factors of complete placenta previa with placenta increta included more than 35 years old, previous cesarean delivery; The amount of postpartum hemorrhage in placenta increta group was significantly higher than that in non-placenta increta group. Conclusions:Placenta increta must be considered if the pregnant woman with complete placenta previa complicated with previous cesarean delivery or if she was more than 35 years old;To reduce the side effect to mother and fetus because of serious puerperal hemorrhage, peripartum clinical

  17. 前置胎盘类型与妊娠结局的相关性分析%The correlation analysis of placenta previa and pregnancy outcomes

    Institute of Scientific and Technical Information of China (English)

    何静

    2013-01-01

    目的 探讨前置胎盘(PP)类型与妊娠结局的相关性,为临床前置胎盘患者的诊断和处置提供依据.方法 本研究选取2010年1月-2011年12月间在我院进行产前超声诊断为胎盘前置,并最后诊断为胎盘前置的96例患者作为研究对象.从前置类型来看,将患者分为完全性(36例)、部分性(43例)、边缘性(17例)3组.观察并比较3组患者的临床特征、母亲妊娠结局和围生儿结局.结果 完全性组的年龄、孕次和剖宫产史率高于边缘性和部分性,方差分析显示,3组间的差异均具有统计学意义(P<0.05).不同前置胎盘类型在胎盘粘连、胎盘植入、产后出血和子宫切除间的差异均具有统计学意义(P<0.05).完全性前置胎盘组的新生儿窒息、围生儿死亡率和早产率间高于部分性组和边缘性组,卡方检验显示,3组间的差异均具有统计学意义(P<0.05).结论 完全性胎盘前置具有更差的妊娠结局和围生儿状况.因此,对于完全性前置胎盘患者,应加强产前保健和监护,并做好充分准备,以改善妊娠结局和围生儿状况.%Objective To investigate the correlation of placenta previa (PP) and pregnancy outcome,aimed at providing basis for clinical diagnosis and management of placenta previa. Methods 96 placenta previa patients treated and final diagnosed in This study selected in January 2010 -December 2011 in our hospital were selected in our study. All patients were divided into completely (36 cases) group,partial (43 cases) group and marginal (17 cases) group. The clinical characteristics, maternal outcome of pregnancy and perinatal child outcome of three groups were observed and compared. Results The age,pregnancies and history of cesarcan section rate of complete group is higher than the marginal and partial groups. Analysis of variance showed the differences among the three groups were statistically significant (P <0. 05). The placenta accreta, placenta accrcta

  18. 凶险性前置胎盘129例临床分析%Clinical analysis of 129 cases of pernicious placenta previa

    Institute of Scientific and Technical Information of China (English)

    米热阿依・尕依提; 焦永慧

    2015-01-01

    Objective To analyze the clinical characteristics of pernicious placenta previa and its harm to moth‐ers and infants ,so as to deepen understanding of it .Methods To retrospectively analyze pregnant women‐related fac‐tors and pregnancy outcomes of 129 cases of pernicious placenta previa between central type of placenta previa group and non‐central type of placenta prvia group form January 2012 to June 2014 .Results Compared with the non‐cen‐tral type of placenta previa group ,the time from last pregnancy was statistically shorter and the time for the first va‐ginal bleeding during this pregnancy was statistically sooner in the central type of placenta previa group (P 0 .05) .Conclusion Central type of pernicious placenta previa has significantly more bleeding volume and is more liable to acquire placenta increta and DIC with much harm to mothers and infants .So ,diagnosis and operation‐related preparation before the operation , cooperation between different departments ,operation technique and control bleeding during the operation are vital to the effective treatment .In addition ,strictly mastering indications of cesarean section ,reducing rate of cesarean sec‐tion ,doing well birth control and decreasing times of abortion can effectively prevent occurrence of pernicious placenta previa .%目的:分析凶险性前置胎盘的临床特点及对母婴的危害性,进一步提高对凶险性前置胎盘的认识。方法对2012年1月至2014年6月新疆维吾尔自治区人民医院收治的129例凶险性前置胎盘中的中央型组与非中央型组孕产妇相关因素及妊娠结局进行回顾性分析。结果凶险性前置胎盘中央型与非中央型距前次妊娠间隔及发生产前出血时间差异有统计学意义(P<0.05),流产次数、剖宫产次数、术中出血量、弥散性血管内凝血(DIC)发生率、胎盘植入率及子宫切除率比较差异有统计学意义(P<0.05),两组孕妇年龄

  19. Effect of low B-Lynch suture on menstrual cycle recovery and sex hormone levels in patients after cesarean section for placenta previa

    Institute of Scientific and Technical Information of China (English)

    Su-Lan Zhang; Wan-Cheng Feng; Yan Mi

    2016-01-01

    Objective:To explore the effect of low B-Lynch suture on the menstrual cycle recovery and sex hormone levels in patients after cesarean section for placenta previa.Methods:A total of 40 patients who were admitted in our hospital from August, 2013 to August, 2015 for cesarean section due to placenta previa were included in the study and randomized into the observation group and the control group. The patients in the observation group were given low B-lynch suture, while in the control group, yarns were plugged in the uterus. The bleeding during operation and 24 h after operation, the postpartum lochia duration, and menstrual cycle recovery in the two groups were observed. The postpartum FSH, E2, and LH levels in the two groups were determined.Results:The amount of bleeding during operation and 24 h after operation in the observation group was significantly less than that in the control group (P0.05). The comparison of FSH, E2, and LH levels between the two groups was not statistically significant (P>0.05).Conclusions:Low B-Lynch suture can effectively reduce the amount of bleeding after cesarean section for placenta previa, and has no effect on the menstrual recovery and ovarian function with a simple operation and less postoperative complications; therefore, it deserves to be widely recommended in the clinic.

  20. 前置胎盘剖宫产产后出血的影响原因%Influence reasons of postpartum hemorrhage after placenta previa caesarean section

    Institute of Scientific and Technical Information of China (English)

    阙贵珍; 杨佩娴; 谭秀红

    2015-01-01

    目的:探讨前置胎盘剖宫产产后出血的影响原因。方法前置胎盘剖宫产产后出血的40例患者作为研究对象,分析导致产后出血的原因。结果中央型前置胎盘患者的出血量明显多于其他两种类型,有胎盘植入或粘连、有剖宫产史的患者出血量明显多于无胎盘植入或粘连和剖宫产史产妇,相比差异具有统计学意义(P<0.05);出血量与孕产妇年龄、胎盘附着部位、产妇流产频率无关。结论针对中央型前置胎盘,在产妇实施剖宫产手术时,需借助彩超对胎盘定位,确认子宫切口,从而确保手术的安全和新生儿的顺畅出生。%Objective To investigate the influence reasons of postpartum hemorrhage after placenta previa caesarean section. Methods There were 40 patients with postpartum hemorrhage after placenta previa caesarean section as the study subjects. Their causes of postpartum hemorrhage were analyzed. Results Patients with central placenta previa had larger bleeding volume than the other two types, and patients with history of placenta implantation, adhesion, and caesarean section had larger bleeding volume than patients without these history. The difference had statistical significance (P<0.05). Bleeding volume had no relationship with age, placenta adherent parts, and abortion frequency of pregnant women. Conclusion For central placenta previa in caesarean section, color Doppler ultrasound should be applied to positioning placenta and confirming uterine incision, so as to guarantee surgical and fetal safety.

  1. Application Value of the Fast Magnetic Resonance Imaging Technique in the Diagnosis of Placenta Previa%MRI快速成像技术在前置胎盘诊断中的应用价值

    Institute of Scientific and Technical Information of China (English)

    王建伟; 王敏; 季丽雅

    2016-01-01

    Objective To evaluate the application value of the fast magnetic resonance imaging technique in the diagnosis of placenta previa.Methods 25 patients diagnosed with placenta previa underwent the single shot fast spin echo (SSFSE) sequence and fast imaging employing steady state acquisition (FIESTA) sequence scanning. The MRI features and clinic appearances of these 25 cases were analyzed.Results One out of the 25 cases was marginal placenta previa, 6 cases were partial placenta previa, 18 cases were complete placenta previa. Nine cases were placenta previa complicated with placenta accrete: 3 out of the 9 cases were placenta adhesion, 5 of 9 were placenta increta, 1 of 9 was placenta penetration. MRI could show the relationship between the placenta and the internal cervical oriifces straightly. The linear low signal intensity of the myometrium was discontinued in the cases complicated with placenta accrete, relatively high signal of the placenta intruded into the myometrium from the discontinued place.Conclusion The fast MRI technique has high clinical application value in the diagnosis of the placenta previa and placenta accrete.%目的:探讨MRI快速成像技术在前置胎盘诊断中的应用价值。方法采用单激发快速自旋回波(SSFSE)序列和快速稳态进动采集(FIESTA)序列,对25例前置胎盘孕妇行MRI扫描,观察和分析前置胎盘的MRI表现。结果25例前置胎盘中,边缘型前置胎盘1例,部分型前置胎盘6例,完全型前置胎盘18例;前置胎盘合并胎盘植入9例,其中胎盘粘连3例,胎盘植入5例,胎盘穿透1例。MRI可直观地显示前置胎盘与子宫颈内口之间的关系,合并有胎盘植入的病例,可见子宫肌层的低信号线影局部中断,相对高信号的胎盘组织由此侵入到肌层。结论 MRI快速成像技术在前置胎盘及胎盘植入的诊断中有较高的临床应用价值。

  2. 中央性前置胎盘并发胎盘植入102例临床观察%Clinical observation of 102 cases of central placenta previa placenta accrete

    Institute of Scientific and Technical Information of China (English)

    胥琳璟; 鲁顺琼; 赖思强; 张月桃

    2016-01-01

    Objective To observe the central placenta previa placenta into the risk factors,and explore its treatment meth-od.Method 270 cases were retrospectively analyzed of clinical data central placenta previa patients,including 102 cases of patients with central placenta previa placental implantation,which as the observation group,the rest of the 168 cases of patients with pre -central placenta as a control group,the risk factors of central placenta previa placenta implantation were observed perinatal situation two groups of patients.Results Central placenta previa combined with placenta into risk factors include age factor (age ≥35 years),fertility factors (maternal),cesarean factors (had a history of cesarean section)as well as factors of postpartum hemorrhage (postpartum bleeding ≥800 ml),etc.Conclusion For senior citizens,history of cesarean section and placenta previa central post-partum hemorrhage in patients with a history of excessive concurrency to be highly vigilant placenta accreta,assessment before sur-gery,to reduce the harm to the mother and child.%目的:观察中央性前置胎盘并发胎盘植入的危险因素和临床情况。方法:选取收治的270例中央性前置胎盘患者的临床资料进行回顾性分析,其中有102例中央性前置胎盘患者并发胎盘植入,将其作为观察组,其余的168例中央性前置胎盘患者作为对照组,分析中央性前置胎盘并发胎盘植入的危险因素,观察两组患者的围生期情况。结果:中央性前置胎盘并发胎盘植入的危险因素包括年龄因素(年龄≥35岁)、生育情况因素(经产妇)、剖宫产史因素(有过剖宫产史)以及产后出血量因素(产后出血量≥800 ml)等。结论:对于高龄、有剖宫产史以及有产后出血过多史的中央性前置胎盘患者要高度警惕其并发胎盘植入,做手术前的评估,降低对母婴的危害。

  3. Attachment position of placenta previa and cesarean uterine incision%前置胎盘附着位置与剖宫产子宫切口选择

    Institute of Scientific and Technical Information of China (English)

    贺晶; 梁琤

    2011-01-01

    在剖宫产术前可通过病史资料和影像学检查来了解前置胎盘附着位置,而剖宫产术中直视所见虽是最终诊断,但却是滞后的诊断,故其只能作为对术前评估不足的补充.剖宫产术是前置胎盘终止妊娠的主要方式,而选择子宫切口沿着胎盘边缘相比必须"打洞"穿过胎盘组织取胎者的母源性失血和新生儿贫血发生率显著降低.对不同前置胎盘的患者的术式选择应个别对待,根据超声胎盘定位及术中评估等制定个体化手术方案,只要选对子宫的切口,尽量避免胎盘"开窗",可有效减少母儿不良预后.%The history data and imaging of patient before cesarean section can make us understand the placenta position of placenta previa, cesarean section in orthoptic seen, though the final diagnosis, but is lagging behind the diagnosis, it only as to preoperative assessment insufficient added. Cesarean section is the main treatment of placenta previa, and incision choosing along the edge of placenta compares with incision must be "hole" cross the placenta, which will reduce the rate of mother's blood loss and neonatal anemia significantly. Surgical treatment of patients with different placenta previa should be selected, according to preoperative ultrasound placenta positioning and intraoperative assessment to set individualized operation program. If you choose the incision of uterus rightly, avoiding placenta "window", you can effectively reduce mother and neonatal adverse outcomes.

  4. Exploration on pregnancy outcomes of patients with pernicious placenta previa%凶险型前置胎盘的妊娠结局探讨

    Institute of Scientific and Technical Information of China (English)

    卢红梅; 孙丽洲

    2014-01-01

    目的:探讨凶险型前置胎盘产妇的妊娠结局及对围生儿的影响。方法回顾性分析282例前置胎盘产妇的临床资料,根据有无剖宫产史分为凶险型前置胎盘46例和非凶险型前置胎盘236例,比较分析两组间剖宫产、产后出血、胎盘粘连、胎盘植入、子宫切除等发生率,以及两组间早产、新生儿出生体重、Apgar评分、新生儿死亡等指标的差异。结果①凶险型组产妇产后出血、胎盘植入、子宫切除的发生率均显著高于非凶险型组(χ2值分别为42.336、58.509、27.957,均P<0.01),而两组间剖宫产和胎盘粘连的发生率差异无统计学意义(χ2值分别为3.088、3.864,均P>0.05);②凶险型组新生儿早产发生率显著高于非凶险型组(χ2=31.090,P<0.01),新生儿出生体重显著低于非凶险型组(t=13.368,P<0.01),而两组间新生儿出生1分钟、5分钟Apgar评分比较无统计学差异( t 值分别为1.970、1.493,均P>0.05)、新生儿死亡率比较差异无统计学意义(χ2=0.693,P>0.05)。结论凶险型组产后出血、胎盘植入、子宫切除及早产的发生率显著高于非凶险型组,医生应注重对有剖宫产史孕妇的孕期管理及病情评估,并适时进行预防性处置是改善母儿妊娠结局的有效手段。%Objective To explore the pregnancy outcomes of patients with pernicious placenta previa and the perinatal influence.Methods A retrospective analysis was conducted on clinical data of 282 puerperas with placenta previa.They were divided into pernicious placenta previa group (46 cases) and non-pernicious placenta previa group (236 cases) according to the history of cesarean section and placental location.The incidences of cesarean section, postpartum hemorrhage, placenta adherence, placenta implantation and uterine excision were compared between two groups, and the differences in

  5. 前置胎盘合并剖宫产史临床分析%Clinical analysis of placenta previa complicated with previous caesarean section

    Institute of Scientific and Technical Information of China (English)

    马良坤; 韩娜; 杨剑秋; 边旭明; 刘俊涛

    2012-01-01

    目的 探讨前置胎盘合并剖宫产史患者的临床特点及处理.方法 回顾性分析2003年1月至2011年10月北京协和医院前置胎盘合并剖宫产史(再次剖宫产组,RCS组)患者母婴结局,并与同期前置胎盘行初次剖宫产(初次剖宫产组,FCS组)进行比较.结果 RCS组及FCS组分别有29例及243例患者.两组的平均年龄、孕周差异无统计学意义(P>0.05).RCS组患者手术时间长,产后出血量多,早产、产后出血、胎盘植入、输血、弥漫性血管内凝血和产科子宫切除的发生率均高于FCS组,差异有统计学意义(P<0.05),RCS组早产儿、新生儿窒息发生率及围产儿死亡率均高于FCS组(P<0.05).结论 前置胎盘合并剖宫产史更易发生胎盘植入,产后出血、产科子宫切除及围产儿病率高,需要高度重视.%Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section. Methods Twenty - nine cases of placenta previa complicated with previous caesarean section (RCS group) treated in Peking Union Medical College Hospital from 2003 to 2011 were retrospectively reviewed and compared with 243 cases of placenta previa complicated without previous caesarean section (FCS group) at the same time. Results The mean age and the average gravidity of RCS group and FCS group had no difference. The RCS group had longer operation time, more preterm birth, postpartum hemorrhage volume, blood transfusion, placenta accreta, disseminated intravascular coagulation and obstetric hysterectomy than FCS group (PPlacenta previa with previous caesarean section has more placenta accreta, postpartum hemorrhage, obstetric hysterectomy and perinatal morbidity rate. We need to pay more attention to these cases.

  6. The process of placenta previa in mid-pregnancy induction of labor%中期妊娠引产胎盘前置的处理

    Institute of Scientific and Technical Information of China (English)

    王蕴慧

    2012-01-01

    中期妊娠胎盘前置引产过程面临大量出血的风险,引产前细致的超声检查是发现胎盘前置类型的必要措施,有条件者行MRI检查有助于鉴别是否存在胎盘植入.引产方式可选择依沙吖啶羊膜腔注射、米非司酮+米索前列醇引产.引产前应做好输血输液准备并应在有剖宫取胎及子宫切除术技术条件的医院实施.完全性前置胎盘状态或伴有胎盘植入者推荐子宫动脉栓塞联合依沙吖啶或米非司酮加米索前列醇引产.%Women with placenta previa in second-trimester pregnancy have a high risk of serious bleeding during induced labour. Before induced labour, careful ultrasonography is a necessary screening test in order to find placenta previa, and MRI is useful in diagnosing whether complicated with placenta accre-ta. Rivanol or mifepristone-misoprostol can be chose. Sufficient blood and liquid should be prepared before induced labor and it should be done in the hospital which can provide emergency cesarean section or hysterectomy. Uterine artery embolization (UAE) combining with rivanol or mifepristone-misoprostol is recommended for women with central placenta previa or placental accreta.

  7. Clinical Analysis of 32 Dangerous Placenta Previas%32例凶险性前置胎盘的临床分析

    Institute of Scientific and Technical Information of China (English)

    陈洁

    2013-01-01

    Objective To analyze the causes and consequences of clinical analysis of dangerous placenta previa in order to the recognition of this one and have better precaution and therapy methods to it.Methods We have retrospective clinical analysis on 32 dangerous placenta previa examples from January 2000 to December 2009 in our hospital.Results 32 dangerous placenta previa examples are diagnosed by clinical manifestation of indolence vaginal bleeding and B-ultrasound.Most of these ones is operated by C-sect until foetus are matured. Conclusion Along with the height of C-sect rate,the rate of clinical dangerous placenta previa is heightened and the rate of postnatal hemorrhage is heightened.It harms to mother and baby.So only have we to grasp C-sect indication and decrease C-sect rate,we will decrease the rate of clinical dangerous plcenta previa.%目的分析凶险型前置胎盘病因和后果,提高对凶险型前置胎盘的认识,而更好地预防和治疗。方法对2000年1月~2011年12月收治的32例凶险型前置胎盘进行回顾性分析。结果32例凶险性前置胎盘主要是通过无痛性阴道出血的临床表现和B超确诊,大部分经过期待治疗至胎儿成熟而剖宫产终止妊娠。结论近年来随着剖宫产率的上升,凶险型前置胎盘发生率也随之急剧上升,发生产后大出血的几率增高,严重危害母婴安全。所以只有严格掌握剖宫产指征,定期产检,才是减少该病发生的关键。

  8. [Severe respiratory distress with stubborn hypoxemia in newborn infants whose mothers had had placenta previa].

    Science.gov (United States)

    Brioude, R; Bourgeois, M; Canet, J

    1975-01-01

    The study of 16 newborn of birthweight less than or equal to 2,200 g characterized by a common point: the presence of PLACENTA PRAEVIA IN THE MOTHER, enabled us to come to grips with the severe respiratory distress that these newborn can have. From the clinical standpoint: there is always early respiratory distress. From the radiological standpoint: by far the most dominant pathology was interstitial edema, giving rise to a WET LUNG. From the biochemical standpoint: the blood gases were characterized in a certain number of cases by hypoxemia which was refractory to the usual forms of treatment. From the mechanical standpoint: measurements carried out in 4 patients confirmed the extraordinary fall in these patients' compliance. The clinical, radiological, blood gas and mechanical analysis enabled one to differenciate 2 main types of indications for artificial ventilation: -- acute hypoxemia, -- the idea of an increased need for oxygen. In these 2 types of indications for artificial ventilation, it was apparent that the treatment of choice is constant positive pressure which may or may not be combined with intermittent positive pressure. With this treatment technique, none of the patients progressed to massive atelectasis. It can be said that with the advent of techniques of ventilation by high pressure combining IPP with CPP, one has definitively eliminated from this pathological picture, the principal cause of death: --anoxia due to massive alveolar collapse.

  9. Clinical Analysis of 80 Cases of Central Placenta Previa With Placenta Implantation%中央性前置胎盘并发胎盘植入80例临床研究

    Institute of Scientific and Technical Information of China (English)

    赵丽娟

    2016-01-01

    Objective To study the central placenta previa complicated with placenta implantation of risk factors and treatment methods,to provide basis for clinical. Methods Selection in December 2016 to February 2013 hospital make a diagnosis and give treatment of 80 cases of patients with central placenta previa complicated with placenta implanted materials were analyzed,and the set as experimental group,select during the same period of 145 cases of hospitalized patients with central placenta previa as the control group,analysis of risk factors central placenta previa and two groups of cases in the perinatal period. Results Incidence of central placenta previa complicated with placenta implantation trial with age,pregnant women abortion is close to times and the history of cesarean section(P<0.05). Group the bleeding in the perinatal period is higher than the control group(P<0.05). Patients without bleeding patients less than control group(P < 0.05). Conclusion The risk factors of central placenta previa more,should make ful preoperative preparation,formulate reasonable operation scheme,reduce the bleeding in the perinatal period.%目的:研究中央性前置胎盘并发胎盘植入的高危因素及处理方法,为临床提供依据。方法选取2013年12月~2016年2月医院诊治的80例中央性前置胎盘并发胎盘植入患者资料进行分析,设为试验组,选取同期入院的145例中央性前置胎盘患者为对照组,分析中央性前置胎盘的高危因素及两组围生期情况。结果试验组中央性前置胎盘并发胎盘植入发病率与孕妇年龄、流产次数及剖宫产史关系密切(P<0.05);试验组围生期出血量高于对照组(P<0.05);试验组无出血患者少于对照组(P<0.05)。结论中央性前置胎盘的高危因素相对较多,术前应做好充分的准备,制定合理的手术方案,降低围生期出血量。

  10. 凶险型前置胎盘65例临床分析%CLINICAL ANALYSIS OF 65 CASES OF PERNICIOUS PLACENTA PREVIA

    Institute of Scientific and Technical Information of China (English)

    季淑英; 姬明杰; 李桂荣; 冯小明; 杨小杰

    2014-01-01

    Objective To analyze the clinical characters of pernicious placenta previa ,and to prepare well pre-operation ,choose appropriate operation manner ,reduce intraoperative blood loss ,decrease the proba-bility of metrectomy .Methods A retrospective analysis in 65 cases with pernicious placenta previa was performed ,the data of placenta accrete ,the rate of neonatal asphyxia ,probability of metrectomy and intra-operative blood loss were collected .The operation manner was chosen according to the characters of the placenta previa ,comparison of the probability of metrectomy and intraoperative blood loss between cases with different operation manner were performed .Results Forty -five from a total of 65 cases occurred placenta accrete ,7 cases of neonatal asphyxia and 6 cases of metrectomy .A total of 65 cases with perni-cious placenta previa were divided into 4 groups according to the treatment ,45 cases occurred placenta ac-crete ,7 cases of neonatal asphyxia and 6 cases of metrectomy .The intraoperative blood loss ,rate of me-trectomy and complication of maternal (DIC ,death) in group C ,which were treated by lower segment ce-sarean section after bilateral uterine artery chemoembolization induced by radiation ,were significantly lower than those from other 3 groups .Conclusion Pernicious placenta previa heavily threatens maternal ,a con-firmed preoperative diagnosis is necessary ,well preparation before operation and rescue measure for intrao-perative bleeding ,and interventional embolization w hen needed ,can reduce the complication and maternal mortality .%目的:分析凶险型前置胎盘的临床特点,如何充分术前准备,据病情选择适当的手术方式,减少术中出血,降低子宫切除几率。方法对65例凶险型前置胎盘病例胎盘植入情况、新生儿窒息率、子宫切除几率、术中出血情况等多项指标进行回顾性分析,根据术中胎盘前置及植入情况选择不同处理方式,并比较各种处

  11. Clinical research on the different placenta previa type and bleeding in the pregnancy%不同前置胎盘类型与孕期出血状况临床研究

    Institute of Scientific and Technical Information of China (English)

    李富萍; 赵有红; 脱淑梅

    2012-01-01

    Objective To investigate the risk factors lead to the occurrence of placenta prevla and antepartum hemorrhage between different types of placenta previa. Methods To comparatively analyze 198 cases of placenta previa patients and 198 patients in the control group on risk factors for bleeding before 34 weeks and compare different types of placenta obstetric risk factors and the incidence of ari1.epar1.uiri haemorrhage. Results There were significantly differences in obstetric risk factors between placenta previa group and control group (P < 0.05), the difference was no statistically significant in the type of placenta previa (P > 0.05). The incidence of anteparlum haemorrhage in the type of placenta previa showed no significant difference (P > 0.05). Conclusion Obstetric risk factors is related to placenta previa, but is not related to the types of placenta previa; the type of placenta previa is not associated with antepartum bleeding.%目的 探讨导致前置胎盘发生的高危因素及不同类型前置胎盘产前出血状况.方法 采用回顾性病例对照研究设计,对比分析198例前置胎盘病例组和198例对照组有关危险因素,并比较不同胎盘类型的产科危险因素及孕34周前出血状况.结果 产科高危因素在前置胎盘组与对照组之间比较差异有统计学意义(P0.05);不同前置胎盘类型在孕34周前发生产前出血几率比较,差异无统计学意义(P>0.05).结论 产科高危因素与前置胎盘的形成有关,但与前置胎盘类型无关;前置胎盘类型并不能预测产前是否能发生突破性大出血.

  12. Treatment and nursing experience of patients with placenta previa antepartum haemorrhage%前置胎盘产前出血患者治疗护理体会

    Institute of Scientific and Technical Information of China (English)

    刘鹏

    2014-01-01

    To analyze the treatment and nursing experience of patients with placenta previa antepartum haemorrhage. Methods:36 cases with placenta previa antepartum haemorrhage were selected from January 2012 to January 2014.They were given symptomatic treatment.The nursing measures were summarized and analyzed.Results:In 36 cases with placenta previa antepartum haemorrhage,after timely and effective treatment,scientific and rational nursing intervention,no 1 case died.The incidence rate of postpartum hemorrhage was significantly reduced,and the postpartum hemorrhage also had been effectively controlled.At the same time,no 1 neonatal died,and the survival rate was 100%.Conclusion:Overall strengthening the rescue and nursing measures of placenta previa antepartum haemorrhage have the positive significance to guarantee the maternal and child health and safety,and improve the cure rate.%目的:探讨前置胎盘产前出血患者的治疗护理体会。方法:2012年1月-2014年1月收治前置胎盘产前出血患者36例,给予对症治疗,并就护理措施进行总结、分析。结果:本组36例前置胎盘产前出血患者,在经过及时、有效的治疗以及科学、合理的护理干预后,无1例患者死亡;且产后大出血发生率明显减少;而产前出血也得到了有效的控制。同时,新生儿也无1例死亡,存活率100%。结论:全面加强前置胎盘产前出血患者的救护措施,对保障母婴健康、安全,提高治愈率具有积极的意义。

  13. Decrease of uteroplacental blood flow after feticide during second-trimester pregnancy termination with complete placenta previa: quantitative analysis using contrast-enhanced ultrasound imaging.

    Science.gov (United States)

    Poret-Bazin, H; Simon, E G; Bleuzen, A; Dujardin, P A; Patat, F; Perrotin, F

    2013-11-01

    Contrast enhanced ultrasound (CEUS) was used to quantify the dynamic changes in uteroplacental blood flow before and after the interruption of fetal villus circulation resulting from feticide during a second trimester pregnancy termination in a patient with complete placenta previa. Quantitative analysis was performed on time-intensity curves acquired 24 h before and 48 h and 120 h after feticide and demonstrated the persistence of utero-placental blood flow with a progressive and two-step reduction in intervillous space and uteroplacental blood flow. Our results suggest that placental blood flow reduction after interruption of fetal circulation is a progressive and delayed mechanism.

  14. Clinical Analysis of Intravascular Coagulation Application in Pernicious Placenta previa Treatment%介入治疗用于凶险性前置胎盘临床分析

    Institute of Scientific and Technical Information of China (English)

    蔡一铃

    2014-01-01

    Objective To analysis the clinical effect of interventional therapy in pernicious placenta previa treatment. Methods Retrospective analysis of 24892 parturient women clinical data in Chengdu Women’s&Children’s Central Hospital from January 2011 to June 2012. Results The incidence of pernicious placenta previa and placenta increta is lower in those parturient women with delivery gestational age greater than or equal to 37 than those parturient women with delivery gestational age less than 37. The incidence of central type of placenta previa is higher than that of partial placenta praevia and marginal placenta previa (P2000ml、产褥感染、早产、新生儿窒息、新生儿死亡发生率均明显比非介入治疗低(P<0.05)。结论介入治疗用于凶险性前置胎盘的临床效果良好,值得推广。

  15. Analysis of 32 cases of postpartum hemorrhage clinical review of placenta previa%前置胎盘产后出血32例临床诊疗回顾性分析

    Institute of Scientific and Technical Information of China (English)

    卜春梅

    2013-01-01

    Objective to investigate the clinical analysis of placenta previa bleeding treatment process and impact analysis for placenta previa bleeding factors. Methods retrospective analysis of 68 cases of placenta previa postpartum hemorrhage in our hospital from september 2010 to november 2013 admitted, and to observe the relationship between the type of placenta previa, placental area, the number of abortions and postpartum hemorrhage between. Results after clinical placenta previa postpartum hemorrhage in 68 patients in this group analysis found suffering from central placenta previa, placenta larger, too much will cause an increase in the number of abortions amount of postpartum hemorrhage. Conclusion the results of this study show that the incidence of placenta previa both for maternal or fetal life and health have resulted in a greater threat to pregnant women to reduce the pain and smooth production, the clinical response to placenta previa taken early detection, early treatment and proper the mode of delivery.%目的:探讨分析前置胎盘出血临床诊疗过程以及对于前置胎盘出血影响因素的分析。方法回顾分析我院在2011年09月至2013年11月内收治的32例前置胎盘产后出血患者,并观察前置胎盘的种类、胎盘面积、流产次数与产后出血量之间的关系。结果经过对本组32例前置胎盘产后出血患者的临床分析发现,患中央性前置胎盘、胎盘面积较大、流产次数过多会造成产后出血量的增加。结论本次研究结果表明,前置胎盘的发生无论对于产妇或者是胎儿的生命健康均造成了较大的威胁,为减少孕妇痛苦以及顺利生产,临床中应对前置胎盘采取早发现、早处理以及正确的分娩方式。

  16. Placenta abruption - definition

    Science.gov (United States)

    ... PA: Elsevier Saunders; 2014:chap 178. Hull AD, Resnik R. Placenta previa, placenta accreta, abruptio placentae, and ... R, Iams JD, et al, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 7th ed. ...

  17. 中央性前置胎盘并发胎盘植入59例临床分析%Clinical analysis of 59 cases of complete placenta previa with placenta increta

    Institute of Scientific and Technical Information of China (English)

    王明; 张力; 刘兴会; 卫蔷

    2011-01-01

    Objective:To discuss the high risk factors and peripartum management of complete placenta previa complicated with placenta increta. Method: Retrospectively analyzed all the 896 cases of complete placenta previa hospitalized in West China Second Hospital of Sichuan University from January 2000 to December 2009 .of which 59 cases complicated with placenta increta. Result : ( 1) The incidence of complete placenta previa was 2. 26% in recent 10 years,and the morbidity of placenta increta among women with complete placenta previa was 6. 58% ( 59/896) . (2) The high risk factors of complete placenta previa with placenta increta included more than 35 years old,not less than twice abortions and previous cesarean delivery.(3) The amount of postpartum hemorrhage in placernta increta group was significantly higher than that in non- placenta increta group. The mean postpartum hemorrhage in placenta increta group was 2846.19ml. ( 4 ) Surgical treatment was done in all placenta increta patients ( 15 cases received cesarean hysterectomy,44 cases received conservative surgical therapies). The incidence of cesarean hysterectomy in placenta increta group was 25. 42% ( 15/59). But in nonplacenta increta group it was 0. 96% ( 8/837) . Conclusion : ( 1) Placenta increta must be considered if the pregnant woman with complete placenta previa complicated with previous cesarean delivery or multiple abortions, or if she was more than 35 years old. (2) To reduce the side effect to mother and fetus because of serious puerperal hemorrhage,peripartun clinical management is necessary. ( 3) The conservative surgical treatment is very important as well as hysterectomy.%目的:探讨中央性前置胎盘并发胎盘植入的高危因素及围生期处理.方法:回顾性分析2000年1月~2009年12月四川大学华西第二医院产科收治的896例中央性前置胎盘患者(其中59例并发胎盘植入)的临床资料.结果:(1)我院近10年来中央性前置胎盘的发生率为2

  18. 分析经腹部及会阴部超声联合诊断前置胎盘的诊断价值%The Analysis of Diagnostic Value of Placenta Previa in Abdominal Combined with Perineal Ultrasound

    Institute of Scientific and Technical Information of China (English)

    潘雪松; 李秋梅; 林进; 梁理娟; 李凤谊

    2016-01-01

    Objective:To analyze the diagnostic value of placenta previa in abdominal combined with perineal ultrasound.Method: 86 cases of placenta previa form May 2012 to June 2014 in our hospital were treated, they underwent transabdominal ultrasound and simple abdominal and perineal ultrasound combined diagnostic mode for testing. Recorded ultrasound diagnosis of patients with placenta previa and the coincidence rate of diagnosis, and the results were analyzed and compared.Result: Simple transabdominal ultrasound diagnostic results showed that low placenta was 16 cases, 3 cases misdiagnosis, marginal placenta previa 23 cases, 4 cases of misdiagnosis, partial placenta previa 4 cases, 7 cases misdiagnosed, 24 cases of central placenta previa ,5 cases misdiagnosis, the total rate was 77.9% in line with placenta previa. After abdominal perineal ultrasound diagnosis showed , low placenta was 19 cases, 26 cases of marginal placenta previa, 1 case misdiagnosis, 9 cases of partial placenta previa, 2 cases misdiagnosis, 28 cases of central placenta previa, 1 case misdiagnosis, the total placenta previa compliance rate was 95.3%. The partial placenta previa diagnostic of the study group program compliance rate was higher than the control group (P 0.05).The placenta previa diagnostic accuracy (95.3%) of the study group was significantly higher than the control group (77.9%), the difference was significant (χ2= 11.2927,P=0.0008). 68 cases of placenta previa maternal via abdomen perineum ultrasound detection showed that 25 cases of maternal placental thickening, 19 cases of complete placenta previa, 15 cases of placenta implantation , 4 cases of hysterectomy,6 cases of marginal placenta previa, vascular performance bulky, vascular branch to reduce low birth weight.Conclusion:Abdominal and perineal ultrasound combined diagnostic program has a high diagnostic value, it can improve the diagnosis of placenta previa compliance rate ,and it is suitable for long-term clinical application.%

  19. Maternal factors influencing neonatal birth weight in placenta previa%前置胎盘患者新生儿出生体重的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    单虹

    2015-01-01

    目的:探讨前置胎盘患者新生儿出生体重的影响因素。方法回顾性分析2011年1月至2014年12月响水县人民医院住院分娩的单胎妊娠前置胎盘60例患者的临床资料。前置胎盘患者作为研究组,同期无胎盘异常的单胎妊娠产妇60例为对照组。分析前置胎盘患者新生儿出生体重的影响因素。结果研究组新生儿出生体重低于对照组,差异有统计学意义( P<0.05)。研究组早产发生率明显高于对照组,差异有统计学意义( P<0.05)。结论前置胎盘患者分娩的新生儿出生体重较低,前置胎盘对新生儿出生体重的影响主要是由于早产的发生率升高。在前置胎盘患者,随分娩时孕周的增加,新生儿出生体重增加。%Objective To evaluate maternal factors influencing neonatal birth weight in placenta previa .Methods During the study period from Jan 2011 to Dec 2014, 60 singleton pregnancy women with placenta previa hospitalized in The People’ s Hospital of Xiangshui County were selected as study objects;60 singleton pregnancy women without placenta previa were randomly selected as control group.The characteristics of pregnant women and the birth weight of neonates were evaluated restrospctively .Statistical analysis using regression models was performed to analyzed the influence factors on neonatal weight in placenta previa .Results Neonates born after a pregnancy complicated with placenta previa had significantly lower birth weight ( P<0.05 ) .Women with placenta previa had higher incidence of preterm delivery (P<0.05).Conclusion Placenta previa is associated with low neonatal birth weight , and this association is chiefly due to preterm delivery .With the increase of gestational age , the neonatal birth weight increases accordingly in placenta previa .

  20. Uterine Healing after Therapeutic Intrauterine Administration of TachoSil (Hemostatic Fleece in Cesarean Section with Postpartum Hemorrhage Caused by Placenta Previa

    Directory of Open Access Journals (Sweden)

    Katrine Fuglsang

    2012-01-01

    Full Text Available Background. Application of hemostatic fleece (TachoSil directly onto the bleeding surfaces of the lower uterine segment has been used to obtain hemostasis during cesarean section caused by placenta previa. Methods. Eleven of 15 patients treated with TachoSil for excessive postpartum haemorrhage due to placenta previa were enrolled. An evaluation of the cesarean section scar by transvaginal ultrasound, the uterine cavity and endometrium by hysteroscopy, and the endometrium by biopsy were made. The main outcome measures were intrauterine adhesions, recovery of endometrium at the site of TachoSil application, visible remnants of TachoSil, and scar healing. Results. Eight patients had small remnants of TachoSil in the uterine cavity together with signs of resorption. All had a normal endometrial mucosa, and none had adhesions in the uterine cavity. All cesarean section scars were healed without defects. Conclusion. TachoSil did not seem to impair healing of the endometrium or scar formation in the uterus after intrauterine application. Resorption of TachoSil seems to progress individually. Intrauterine treatment with TachoSil is a valuable supplement to the traditional treatment of post partum haemorrhage and may help retain reproductive capability. This is a small study, and it will require more studies to confirm the reproducibility.

  1. Clinical evaluation of balloon occlusion of the lower abdominal aorta in patients with placenta previa and previous cesarean section: A retrospective study on 43 cases.

    Science.gov (United States)

    Chen, Manru; Xie, Lan

    2016-10-01

    This study investigated the efficacy of balloon occlusion of the lower abdominal aorta in cesarean section surgery for the patients with placenta previa and previous cesarean section. The patients who had placenta previa and underwent cesarean section (CS) were evaluated. The patients treated with CS to terminate the pregnancy were used as control group (23 cases); the patients treated with the preset abdominal aorta balloon before CS was taken as study group (20 cases). The investigated indicators included the intraoperative blood loss, blood loss within postoperative 24 h, the transfusion amount of red cell suspension (RCS), hospital stay, incidence rate of disseminated intravascular coagulation (DIC), the asphyxia, premature delivery and the mortality of the newborns. The two groups are comparable. The intraoperative blood loss, blood loss within postoperative 24 h, the transfusion amount of RCS and the percentage of uterus resection in the study group were significantly lower (P < 0.05) than that in the control group. The percentage of uterine cavity filling with ribbon gauze in the study group was higher than the control group (P < 0.05). The balloon occlusion of lower abdominal aorta seems effective in reducing postpartum hemorrhage and the blood transfusion and decreasing the risk of hysterectomy without harming the newborns. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  2. Pregnancy Complications: Placenta Previa

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  3. Clinical Harm of Scar Uterus Complicated With Placenta Previa%瘢痕子宫合并前置胎盘的临床危害研究

    Institute of Scientific and Technical Information of China (English)

    王东福

    2016-01-01

    目的:分析瘢痕子宫合并前置胎盘患者的临床高危因素。方法根据2012年4月~2015年4月我院的40例瘢痕子宫合并前置胎盘患者作为观察组,同期选取40例正常产妇作为对照组,对比两组的妊娠结局。结果子宫切除、产后出血、剖宫产、胎盘植入等发生率对比为观察组比对照组低,差异具有统计学意义,P<0.05;观察组出现胎儿窘迫、早产、围产儿窒息和死亡的几率低于对照组,P<0.05。结论临床中瘢痕子宫合并前置胎盘引起的分娩并发症比较多,围产期的不良状况发生率更高,对母婴安全危害性较大。%Objective To analyze the clinical risk factors of patients with uterine scar uterus complicated with placenta previa.MethodsFrom April 2012 to April 2015 years, 40 patients with uterine scar complicated with placenta previa were taken as the observation group. In the same time, selected 40 cases of normal pregnant women as control group, compared pregnancy outcome in two groups.Results The rate of removal of the uterus, postpartum hemorrhage, splits the palace production, placenta implantation were lower in the observation group than those of the control group. The difference was statistically signiifcant,P<0.05, the rate of fetal distress, preterm labor, confining the suffocation and death event were lower in the observation group than the control group,P<0.05.Conclusion There are many complications in the clinical treatment of uterine scar uterus complicated with placenta placenta. The incidence rate of perinatal adverse condition is higher, which is more harmful to the safety of mother and infant.

  4. Analysis of 37 cases of placenta previa risk factors and pregnancy outcome%前置胎盘危险因素及妊娠结局37例研究

    Institute of Scientific and Technical Information of China (English)

    龚俊; 马海燕; 董芳芳

    2013-01-01

    Objective To investigate the risk factors and pregnancy outcome of placenta previa. Methods 39 cases of placenta previa cases in the hospital were retrospectively analyzed,and made the same period 50 cases of normal maternal as control group.Results In placenta previa group,maternal age,maternal time and the number of abortions were higher than control group,the proportion of maternal with history of cesarean section and placenta previa history was also significantly higher(P<0.05 or 0.01),the rate of cesarean section,obstetric complications and neonatal asphyxia rate were higher than that of the control group (P<0.05). Conclusion Variety of factors related to the formation of placenta previa,and placenta previa could lead to adverse pregnancy outcomes.Strengthen prenatal care could reduce the incidence of placenta previa,and also help to reduce the rate of preterm birth,cesarean section rate and neonatal asphyxia.%  目的探讨前置胎盘的危险因素及对妊娠结局的影响.方法对我院收治的37例前置胎盘病例进行回顾性分析,并与同期50例正常产妇作对照.结果研究组孕产妇年龄、孕产次、流产次数均高于对照组,有剖宫产史者和前置胎盘史者所占比例也明显高于对照组(P<0.05或P<0.01),剖宫产率、产科并发症以及新生儿窒息率等均高于对照组(P<0.01).结论前置胎盘的形成与多种因素有关,可导致不良的妊娠结局,加强产前保健可以降低前置胎盘发生率,也有利于降低早产率、剖宫产率以及新生儿窒息率.

  5. 1 case of hemorrhagic shock with placenta previa complicated with placenta implantation into internal ostium of the uterus%前置胎盘伴胎盘植入子宫内口致出血性休克1例

    Institute of Scientific and Technical Information of China (English)

    丁艳春

    2014-01-01

    In this paper,The author explored 1 case of hemorrhagic shock with placenta previa complicated with placenta implantation into internal ostium of the uterus.The patient suffered from hemorrhagic shock after cesarean and uterus resection, because the cause of bleeding was placenta implantation into internal ostium of the uterus inreoperation.So the doctors should check endometrial situation in a cesarean section surgery carefully,find and treat the problem timely so as to avoide secondary operation and patients with life-threatening.%探讨前置胎盘伴胎盘植入子宫内口至出血性休克1例,剖宫产后患者出现失血性休克,再次手术发现出血是胎盘植入子宫内口所引起,故行子宫切除术。告诫临床医生在以剖宫产手术终止妊娠时详细检查子宫内膜情况,发现问题及时处理,以免行二次手术危及患者生命。

  6. 产前超声检查在前置胎盘并胎盘植入诊断中的重要性评价%The Importance of Prenatal Ultrasound in Diagnosis of Placenta Previa Pla-centa Implantation and Evaluation

    Institute of Scientific and Technical Information of China (English)

    许崇惠

    2016-01-01

    Objective Evaluate the importance of prenatal ultrasound diagnosis of placenta previa and placenta implanta-tion. Methods Selected in our hospital in August 2013 to 2015 December 202 cases of placenta previa patients as the ob-ject of study, all patients were in production before the color Doppler ultrasound in the diagnosis of, review analysis the pa-tient's imaging characteristics, determine whether complicated with placenta accreta occurred and the pathology result as the basis, to calculate the accuracy of ultrasound in the diagnosis of. Results The 202 patients with placenta previa, by col-or Doppler ultrasound and pathology diagnosis of complicated with placenta accreta patients have 24 cases and 21 cases, detection rate was 11.4%and 10.4%respectively, no significant difference (P> 0.05), the ultrasound misdiagnosis in 3 cas-es, the total detection accuracy rate is 87.5%. Among them, placenta previa and placenta implantation in the anterior wall of the placenta and in the posterior wall of the placenta when diagnosis accurate rate is 94.12% (16 / 17) and 71.43% (5 / 7), placenta previa and placenta implantation in wall placenta diagnostic accuracy is significantly reduced, compared with sta-tistical difference (P0.05),经超声检查,误漏诊3例,总的检出准确率为87.5%。其中,前置胎盘并胎盘植入在前壁胎盘时和在后壁胎盘时的诊断准确率分别为94.12%(16/17)和71.43%(5/7),前置胎盘并胎盘植入在后壁胎盘时的诊断准确率显著降低,比较差异有统计学意义(P<0.05)。前置胎盘并胎盘植入在后壁胎盘时,出现3例产后大出血情况,并发症发生率为42.86%,前置胎盘并胎盘植入在后壁胎盘时,无一例并发症发生。结论产前超声诊断操作简便、重复性好、经济性好、准确率高,是比较理想的前置胎盘并前壁胎盘植入诊断方法。

  7. 多种超声方法联合诊断前置胎盘的临床评价%Clinical Evaluation of Combined Diagnosis of Placenta Previa of Various Ultrasound Method

    Institute of Scientific and Technical Information of China (English)

    洪丹

    2014-01-01

    目的:探讨多种超声方法联合诊断前置胎盘的应用价值。方法对拟诊断为前置胎盘的54例患者均先行经腹部超声检查,其中42例出血明显的患者行经会阴超声检查,余患者再行经阴道超声检查。结果临床拟诊前置胎盘54例均先行经腹部超声检查诊断前置胎盘48例,诊断符合率86.1%;有阴道出血史的42例患者再联合经会阴超声检查后诊断前置胎盘40例,诊断符合率95.24%;无阴道出血史的12例患者再联合经阴道超声检查后诊断前置胎盘11例,诊断符合率91.67%。结论经腹部超声有选择的联合经会阴超声或经阴道超声检查能明显提高前置胎盘的诊断率,有较好的临床应用价值。%Objective The application value of combined diagnosis of placenta previa ofvarious ultrasound method. Methods The diagnosis of 54cases of placenta previa underwent transabdominal sonography,including 42 cases of bleeding were underwent transperineal ultrasonography. Results Clinical y diagnosed 54 cases of placenta previa underwent transabdominal ultrasound diagnosis of 48 cases of placenta previa,diagnostic accordance rate was 86.1%;42 patients with waginal bleeding history combined with transperineal ultrasound examination confirmed the diagnosis of 40 casesof placenta previa,diagnosis coincidence rate 95.24%;no combined transvaginal ultrasound diagnosis 11cases of placenta prenia in 12patients with vaginal bleeding history,diagnosis coincidence rate 91.67%. Conclusion Combined with abdominal ultrasound has the choice of transperineal ultrasound and transvaginal ultrasound examination can improve the diagnosis of placenta previa rate,have a good clinlcal value.

  8. 辅助生育中子宫内膜异位症与前置胎盘的相关性%The correlation between endometriosis and placenta previa in assisted reproductive technology

    Institute of Scientific and Technical Information of China (English)

    傅秀娟; 周勇; 金杭美

    2015-01-01

    Objective: To investigate placenta previa associated with endometriosis in assisted reproduc-tive technology.Methods: Consecutive 2 060 pregnancies conceived by assisted reproductive technology were recruited between 2008 and 2012 in Women’s Hospital, School of Medicine, Zhejiang University. The risk of pla-centa previa after assisted fertilization was analyzed. Relation of nine variables was examined, i.e. maternal age, BMI, gravidity, parity, previous abortion, previous cesarean delivery, endometriosis, ovulatory disorder, and male infertility, to placenta previa by logistic regression analysis. The correlation between endometriosis severity with placenta previa was analyzed by the nonparametric test of Spearman correlation analysis.Results: In 110 women with placenta previa, there were 69 cases complicated with endometriosis. We found that endometriosis (odds ratio=19.7; 95% CI=0.5-300.6) were signiifcantly associated with placenta previa. Endometriosis was more seri-ous more prone to placenta previa (the Kendall correlation coefifcient is 0.274, Spearman correlation coefifcient is 0.281, allP<0.001).Conclusion: Our ifndings suggest that endometriosis is associated with an increased risk of placenta previa in assisted reproductive technology. The higher degree of endometriosis, the more possible of placenta previa.%目的:探讨在辅助生育中子宫内膜异位症和前置胎盘的相关性。方法:回顾性分析2008年1月至2012年12月在浙江大学附属妇产科医院接受辅助生殖技术病例,根据纳入标准其中胚胎移植成功且并在单胎28周后分娩者有2060例,有110例发生了前置胎盘。回顾病史分析孕妇年龄、体质量指数、孕次、产次、流产次数、剖宫产史、子宫内膜异位症、排卵障碍、男性不孕等9个指标,分析它们与前置胎盘的相关性。同时对子宫内膜异位症分型与前置胎盘的相关性做进一步研究。结果:2060例观察资料中子宫内

  9. The diagnosis and experience of 30 cases of patients with placenta previa postpartum hemorrhage%前置胎盘产后出血3000例临床诊疗体会

    Institute of Scientific and Technical Information of China (English)

    陶红

    2014-01-01

    Objective to investigate the factors and associated treatments for patients with placenta previa placenta previa by exploring the position of postpartum hemorrhage. Methods 3000 patients with placenta previa were selected from april 2008 to January 2013 in our hospital. the effects of different types of placenta previa postpartum hemorrhage patients were analyzed. Results after treatment, three kinds of placenta previa bleeding in patients were small. 766 cases of borderline, 800 cases of some type of central placenta previa and 1234 cases of bleeding in 500 ml or less were 573(74.80%)、679(84.87%) and 600(48.62%)cases relatively. Bleeding and bleeding rates in patients with central placenta previa, placenta previa was significantly higher than the other two patients with a significant difference(P<0.05) and the end of pregnancy in patients with early postpartum hemorrhage was more than the end of pregnancy in patients with late postpartum hemorrhage with significant difference(P<0.05). Conclusion Placenta previa can significantly affect pregnant women with postpartum hemorrhage. If the patients were treanted with the right measures, it can significantly reduce the amount of bleeding and gets good clinical results.%目的:通过探讨前置胎盘患者产后出血的状况影响因素以及治疗方法。方法本次试验以我院2008年4月至2013年1月所收治的3000例前置胎盘患者为研究对象,观察不同的前置胎盘类型对患者产后出血量的影响。结果三种前置胎盘患者中出血量经过治疗均较少,766例边缘型、800例部分型和1234例中央型前置胎盘中出血量在500毫升以下的分别为573(74.80%)例、679(84.87%)例和600(48.62%)例。中央型前置胎盘的患者的出血量和出血率明显高于其他两种前置胎盘患者,差异显著(P<0.05),而结束妊娠早的患者产后出血明显多于结束妊娠晚的患者,差异显著(P<0.05)。结论胎盘前置会显著影响孕妇的产

  10. A retrospective analysis on the pernicious placenta previa from 2008 to 2014%2008-2014年凶险性前置胎盘的回顾性临床研究

    Institute of Scientific and Technical Information of China (English)

    余琳; 胡可佳; 杨慧霞

    2016-01-01

    Objective To investigate the incidence changes, clinical characteristics and pregnant outcomes of pernicious placenta previa. Methods A retrospective cohort analysis on 316 cases with placenta previa in the Peking University First Hospital from January 2008 to December 2014. The research group were 60 cases with the patients of placenta previa with the history of cesarean section, and the control group were placenta previa without the history of cesarean section. Compared with the incidence, intraoperative blood loss, the pregnancy outcomes and so on. Results (1) The average incidence rate of placenta previa during the past 7 years was 10.96‰ (316/28 837). And the cases of pernicious placenta previa was 60 (2.08‰, 60/28 837), the incidence of pernicious placenta previa was rising from 2008 to 2014 (0.91‰-3.08‰). (2) There were 145 cases of placenta privia had been translation from other hospitals in the past 7 years. The referral rate of pregnant women with placenta previa was 45.9%(145/316), and the referral rate of pernicious placenta previa (63.3%, 38/60) was significantly higher than that of non-pernicious placenta previa group (41.8%, 107/256; χ2=9.080, P=0.003). Referral the outcomes of these patients were good, and no maternal death occurred. (3) The placenta in the research group were mainly adhered in the front wall of the uterine, and the incidence was 38.5%(15/39), higher than that in the group of non-pernicious placenta previa (12.1%, 21/174; χ2=57.636, P<0.01). The incidence rate of complicated placenta increased in research group was 53.3% (32/60), higher than that in the group of non-pernicious placenta previa, compared with the control group, there was significant difference (15.6%, 40/256; χ2=39.041, P<0.01). (4) The incidence of blood loss was more than 1 000 ml, blood transfusion rate, the rate of hysterectomy and the rate of asphyxia of newborn in the research group were respectively 41.7% (25/60), 38.3%(23/60), 8.3%(5/60), 15

  11. 瘢痕子宫再次妊娠前置胎盘危险程度分析%Analysis on the Placenta Previa Danger Degree of Subsequent Pregnancy with Scar Uterus

    Institute of Scientific and Technical Information of China (English)

    姜百灵; 张方芳

    2013-01-01

    Objective:To study and analyze the placenta previa danger degree of subsequent pregnancy with scar uterus. Methods:160 subsequent pregnancy with scar uterus in our hospital from October 2009 to August 2012 were selected as observation group,and 160 women with primary cesarean section at the same time were selected as control group,then the placenta previa rate of different types and total rate,postpartum adverse situation rate and postpartum hemorrhage of two groups were analyzed and compared,and the postpartum adverse situation rate of observation group with and without placenta previa were compared.Results:The placenta previa rate of different types and total rate,postpartum adverse situation rate of observation group were higher than those of control group,postpartum hemorrhage was more than that of control group,while the postpartum adverse situation rate of observation group with placenta previa was higher than that without placenta previa,postpartum hemorrhage was more than that without placenta previa,all P<0.05,there were all significant differences.Conclusion:The placenta previa rate of subsequent pregnancy with scar uterus is higher,and the proportion of postpartum adverse situation is higher too.%目的:探讨分析瘢痕子宫再次妊娠前置胎盘的危险程度。方法:选取2009年10月~2012年8月本院的160例瘢痕子宫再次妊娠产妇为观察组,同期的160例初次剖宫产产妇为对照组,然后将两组产妇的不同类型及总的前置胎盘发生率、产后不良情况发生率、产后出血量进行统计及比较,然后将观察组中存在前置胎盘与不存在前置胎盘者的产后不良情况发生率及产后出血量进行比较。结果:观察组的不同类型及总的前置胎盘发生率、产后不良情况发生率高于对照组,产后出血量大于对照组,而观察组中存在前置胎盘者的产后不良情况发生率高于不存在前置胎盘者,产后出血量大于不存在前置胎

  12. Influence of placenta previa with placenta accrete on maternal and child outcomes and risk factors analysis%前置胎盘并胎盘植入对母婴结局的影响及危险因素分析

    Institute of Scientific and Technical Information of China (English)

    李洪梅

    2015-01-01

    目的:分析前置胎盘并胎盘植入对母婴结局的影响,并探讨前置胎盘并胎盘植入的危险因素。方法将155例前置胎盘患者依据合并胎盘植入与否分为两组,其中观察组为31例前置胎盘并胎盘植入患者,对照组为124例前置胎盘未合并胎盘植入患者。对两组母婴结局进行统计和分析,并对前置胎盘并胎盘植入的危险因素进行分析。结果观察组产后出血率、子宫切除率分别为58.1%、19.4%,均显著高于对照组的36.8%、4.0%(P=0.034、0.008)。观察组婴儿早产率和新生儿窒息率分别为54.8%、35.5%,显著高于对照组的30.6%、18.5%(P=0.012、0.042)。单因素分析结果显示,不同产次(字2=11.989,P=0.001)、剖宫产史(字2=17.774,P=0.000)、流产史(字2=4.899,P=0.027)、前置胎盘类型(字2=14.270,P=0.001)者,前置胎盘并胎盘植入发生率不同。Logistic回归分析显示,产次(P=0.000、OR=6.942、95%CI院2.483~16.172)、剖宫产史(P=0.000、OR=5.317、95%CI院1.028~10.946)、流产史(P=0.000、OR=16.847、95%CI院4.973~58.348)、前置胎盘类型(P=0.000、OR=10.761、95%CI院3.641~18.034)为前置胎盘并胎盘植入的独立危险因素。结论前置胎盘并胎盘植入可引起产后出血、早产、新生儿窒息,并增大了产妇子宫切除的概率。多产次、多剖宫产史、多流产次、中央性前置胎盘是前置胎盘患者出现胎盘植入的危险因素。%Objective To analyze the influence of placenta previa with placenta accreta on maternal and child out-comes, and investigate the risk factors of placenta accrete. Methods 155 patients with placenta previa were divided in-to two groups according to with or without placenta accrete. 31 patients of placenta previa with placenta accreta were in observation group, and 124 patients of placenta previa without placenta accreta were in control group. Maternal and neonatal outcomes of the two groups were statistically analyzed, and risk factors of

  13. Risk factors of placenta previa and its effects on pregnancy%前置胎盘的高危因素及其对妊娠结局的影响分析

    Institute of Scientific and Technical Information of China (English)

    钟春华; 黎笑容; 袁秀英; 林小琦; 陈武娟; 钟玲

    2014-01-01

    目的 探讨前置胎盘的高危因素及其对妊娠结局的影响.方法 对2008年3月至2013年3月在我院产科住院分娩的240例前置胎盘产妇和同期我院未患有前置胎盘的240例产妇进行病例对照分析.结果 病例组和对照组在年龄、文化水平、吸烟状况、分娩史、剖宫产史以及流产史上的分布有统计学差异(P<0.01).logistic回归结果显示高龄、吸烟、分娩史、剖宫产史以及流产史是前置胎盘发病的高危因素(P<0.01).前置胎盘在胎盘粘连、植入、早产、产后出血、新生儿窒息和围生儿死亡等妊娠结局指标上分布有统计学差异(P<0.05).结论 高龄、吸烟、分娩史、剖宫产史以及流产史的孕妇前置胎盘发病率高;前置胎盘易导致产妇胎盘粘连、胎盘植入、产后大出血、早产以及新生儿窒息.%Objective To explore the risk factors of placenta previa and its effects on pregnancy.Methods We preformed the case-control study basing on the data of 240 maternal with placenta previa and 240 maternal without placenta previa in our hospital from March 2008 to March 2013.Results Among two groups,distributions of age,education level,smoking status,history of childbirth,cesarean section and abortion were statistically significantly different (P < 0.01).The results of the logistic regression analysis showed high age,smoking habit and history of childbirth,cesarean section and abortion were risk factors for placenta previa.Meanwhile,distributions of maternal placenta accreta,placenta accreta,postpartum hemorrhage,premature birth and neonatal asphyxia were statistically significantly different among two groups (P < 0.05).Conclusions Pregnant women with high age,smoking habit and history of childbirth,cesarean section and abortion have a high risk of placenta previa; placenta previa can lead to maternal placenta accreta,placenta accreta,postpartum hemorrhage,premature birth and neonatal asphyxia.

  14. Risk Factors of Placenta Previa and Its Effects On Pregnancy Outcome%前置胎盘的危险因素分析及其对母儿转归的影响

    Institute of Scientific and Technical Information of China (English)

    屈兰芹

    2012-01-01

      目的:探讨前置胎盘发生的危险因素及其对母儿转归的影响.方法:对本院产科收治的70例前置胎盘患者(研究组)和同期收治的60例健康孕产妇(对照组)的临床资料进行分析,分析前置胎盘发生的危险因素及其对母儿转归的影响.结果:两组患者年龄、子宫畸形史、流产次数、分娩史、剖宫产史、盆腔炎史间比较,差异具有统计学意义(P<0.05).Logistic 回归分析发现高龄(OR=3.301)、多次流产史(OR=6.614)、子宫畸形史(OR=6.172)及剖宫史(OR=4.549)的患者出现前置胎盘的危险性相对较高.研究组与对照组在母儿转归中,胎盘粘连、胎盘植入、剖宫产、产后出血、出生体重、1 min Apgar 评分、新生儿窒息比较,差异有统计学意义(P<0.05).结论:年龄、子宫畸形史、流产次数、剖宫产史是前置胎盘发生的高危因素,应从源头控制前置胎盘的发生,有针对性地降低孕前置胎盘危险因素的暴露率.%  Objective :To investigate the high risk factors of placenta previa and its effects on pregnancy outcome.Method :70 pregnant and parturient women with placenta previa were chosen as study group and 60 pregnant and parturient women without placenta previa were chosen as the control group. Result :There were significant differences in age,abortion,with history of uterine malformation,childbearing,cesareau section and pelvic inflammatory between the two groups(P<0.05).Factors significantly associated with development of placenta previa were old age(OR=3.301), abortions(OR=6.614),history of uterine malformation(OR=6.172)and cesarean section(OR=4.549). There were significant differences in placenta accret,cesarean section,postpartum hemorhage,birth weight,first minute Apgar scores,neonatal asphyxia between the two groups(P<0.05). Conclusion :The high risk factors for placenta previa were old age,abortions,history of uterine malformation and cesarean section. It

  15. Relationship of lowly gestation sac and placenta previa in early pregnancy by ultrasonic diagnosis%超声诊断早期妊娠妊囊位置低下与前置胎盘的关系

    Institute of Scientific and Technical Information of China (English)

    高晓凤

    2013-01-01

    Objective To analyze the relationship of lowly gestation sac and placenta previa through ultrasonic diagnosis of location of gestation sac and if whether is or isn't placenta previa in early pregnancy of 1000 pregnant women, and deal with as soon as possible. Methods The location of gestation sac and if whether is or isn't placenta previa in early pregnancy of 1000 pregnant women collected in our hospital from May 2010 to November 2012 were ultrasonic detected. Results The patients with lowly gestation sac in early pregnancy were 216, and the patients with placenta previa were 78, of all 45 cases with lowly gestation sac combined with placenta previa. The incidence of the patients diagnosed lowly gestation sac in early pregnancy by ultrasonic inspection with placenta previa was higher. Conclusion The possibility of placenta previa is suggested if lowly gestation sac in early pregnancy was fined. So, the decision of prevent miscarriage or termination of pregnancy should be made. Lowly gestation sac in early pregnancy can provide important value for clinical treatment.%  目的通过超声诊断1000例孕妇早期妊娠妊囊的位置以及查看胎盘是否前置,以此进行分析妊囊位置低下和前置胎盘的关系,以便尽快做出各种处理方案。方法收集2010年5月~2012年11月前来我院就诊的1000名孕妇经超声观察孕妇早期妊娠妊囊位置情况,以及孕妇是否发生前置胎盘。结果早期妊娠妊囊位置低下的有216例,此外发生前置胎盘的有78例,其中妊囊位置低下且发生前置胎盘的孕妇共有45例,超声诊断孕妇早期妊娠妊囊位置低下,发生前置胎盘的几率较大。结论发现孕妇早期妊娠妊囊位置低下时,提示前置胎盘的可能性,因而应尽快做出保胎或者终止妊娠的决策,早期妊娠妊囊位置低下为临床治疗提供重要价值。

  16. Study on the relationship between complete,partial,marginal placenta previa and pregnancy outcome%完全性、部分性、边缘性前置胎盘与妊娠结局的关系研究

    Institute of Scientific and Technical Information of China (English)

    熊亚平

    2016-01-01

    Objective:To study and analyze the relationship between complete,partial,marginal placenta previa and pregnancy outcome.Methods:150 patients with placenta previa were selected.They were divided into the 3 groups on average.We analyzed the pregnancy outcome,pregnancy risk factors and the relationship between complete,partial and marginal placenta previa and pregnancy outcome.Results:The average age,average pregnant times and the history of cesarean section in the 3 groups were significantly different (P<0.05).The differences of the patients in the 3 groups with antepartum haemorrhage,inhibition of tocolytic therapy,prenatal blood transfusion,postpartum hemorrhage,postpartum blood transfusion,placenta sticky even,placenta accreta,premature delivery and uterine resection arithmetic difference were significant,with statistical significance(P<0.05). Conclusion:Pay attention to relationship between complete,partial,marginal placenta previa and pregnancy outcome,so as to improve the outcome of pregnancy,at the same time,the prognosis of the pregnant women and the prognosis of perinatal infants will be promoted.%目的:研究分析完全性、部分性、边缘性前置胎盘与妊娠结局的关系。方法:收治前置胎盘患者150例。平分为3组。分析妊娠结局、妊娠危害因素及完全性、部分性、边缘性前置胎盘与妊娠结局的关系。结果:3组患者的平均年龄、平均孕次以及剖宫产史差异有统计学意义(P<0.05);3组患者的产前出血、抑制宫缩治疗、产前输血、产后出血、产后输血、胎盘粘连、胎盘植入、早产以及子宫切除等差异具有统计学意义(P<0.05)。结论:关注完全性、部分性、边缘性前置胎盘与妊娠结局的关系,从而改善妊娠结局,同时促使产妇的预后以及围生儿的预后结果进一步提升。

  17. Clinical research on the antenatal hemorrhage of placenta previa of 158 patients in the later stages of pregnancy%158例孕晚期前置胎盘出血的临床分析

    Institute of Scientific and Technical Information of China (English)

    李艳

    2011-01-01

    Objective: To explore the related factors and emergency treatment of antenatal hemorrhage of placenta previa. Methods: 158 patients diagnosed as antenatal hemorrhage of placenta previa were analyzed retrospectively. Results: Of all the 158 patients, 147 patients (93.04%) performed cesarean section, and the other 11 cases (6.96%) performed vaginal delivery. All newborns including 7 cases of suffocation newboms (one was a severe suffocation case) had good prognosis except one death. 2 patients were performed hysterectomy for postpartum hemorrhage (one for placenta accreta), and the others were safe. Conclusion: Cesarean section is a main means to treat antenatal hemorrhage of placenta previa in the later stages of pregnancy, and can guarantee mothers and infants security to greatest extent.%目的:探讨前置胎盘产前大出血的相关因素,总结紧急处理措施.方法:对诊断前置胎盘出血158例患者进行回顾性分析.结果:剖宫产术147例(93.04%),阴道分娩11例(6.96%).158例中1例死胎,新生儿窒息7例(重度窒息1例),新生儿预后均良好.2例因产后大出血切除子宫(其中1例为胎盘植入),其余均母婴安全.结论:剖宫产术是处理晚孕期前置胎盘大出血的主要手段,可以最大限度地保证母婴安全.

  18. Clinical analysis on intraoperative hemorrhage status of pernicious placenta previa patients%12例凶险性前置胎盘术中出血情况的临床分析

    Institute of Scientific and Technical Information of China (English)

    李秀彦; 茹美艳

    2012-01-01

    OBJECTIVE To investigate the reason and precautionary measures of massive haemorrhage during repeated cesare-an section in pregnancy patients with scar uterous and placenta previa. METHODS The clinical data of 15S parturients patients who undergoing cesarean section again from 2009 to 2011 were analyzed retrospectively, 12 cases of all patients were with placenta previa, 143 cases were without. RESULTS The rate of massive haemorrhage, placenta accreta and threatened uterine rupture in group re-cesarean section (who with cicatricial uterus and placenta previa) were higher respectively than those whitout placenta previa-lntraoperauve massive hemorrhage occured in S cases who with the central type placenta praevia, and 4 cases were placenta previa and threatened uterine rupture. CONCLUSION Antetheca central placenta praevia plus placenta implantation is a chief factor of massive hemorrhage of intraoperative cesarean section. Making good preoperalive preparations, such as uterine artery embolization (UAE), is significant for the outcome of pregnancy.%目的 探讨癜痕子宫伴前置胎盘(凶险性前置胎盘)再次剖宫产患者术中大出血的发生原因以及预防措施.方法 收集分析2009年9月~2011年11月某院行单胎再次剖宫产155例患者的临床资料,其中伴前置胎盘者12例(观察组),瘢痕子宫不伴前置胎盘143例(对照组).癜痕子宫伴前置胎盘者12例术中出血原因进行归纳总结分析.结果 癜痕子宫伴前置胎盘组合并中央性前置胎盘,胎盘植入、先兆子宫破裂均高于癜痕子宫不伴前置胎盘组.5例瘢痕子宫伴前置胎盘剖宫产术中大出血均为胎盘植入,且5例均为中央性前置胎盘,4例是前壁胎盘合并先兆子宫破裂.结论 前壁中央性前置胎盘合并胎盘植入是瘢痕子宫伴前置胎盘剖宫产术中大出血主要原因.术前做好相应预防措施,必要时做好子宫动脉栓塞准备,尽可能保留子宫,对妊娠结局非常重要.

  19. 剖宫产至凶险型前置胎盘的临床治疗分析%Analysis of Clinical Treatment of Pernicious Placenta Previa Caused by Caesarean Section

    Institute of Scientific and Technical Information of China (English)

    裴英桂

    2016-01-01

    Objective To discuss the treatment effect of pregnant women with pernicious placenta previa caused by caesare-an section by sorting out the clinical treatment data of them. Methods 48 cases of pregnant women with pernicious placenta previa caused by caesarean section admitted and treated in our hospital from January 2014 to January 2015 were selected as the research group, 48 cases of pregnant women with common placenta previa were selected as the control group, and the postpartum hemorrhage volumes and hysterectomy rates were compared between the two groups. Results The difference in the morbidity of adherent placenta between the research group and the control group was obvious with statistical signifi-cance, (60.41%vs 33.33%), P<0.05. Conclusion The morbidity of pernicious placenta previa caused by caesarean section is lower, and the postoperative hemorrhage volume of it is obviously higher than that of common placenta previa, and we had better treat the pregnant women with pernicious placenta previa caused by caesarean section by total hysterectomy in order to ensure the life safety of them.%目的:整理该院剖宫产至凶险型前置胎盘孕产妇的临床治疗资料,探讨剖宫产至凶险型前置胎盘孕产妇的治疗效果。方法整群选取该院2014年1月—2015年1月收治的48例剖宫产至凶险型前置胎盘孕产妇,将其作为研究组,另选48例普通前置胎盘孕产妇作为对照组,比较两组孕产妇的产后出血量以及子宫切除率。结果研究组孕产妇出现胎盘粘连率为60.41%,对比组孕产妇出现胎盘粘连率为33.33%,两组患者的胎盘粘连发病率差异有统计学意义(P<0.05)。结论剖宫产至凶险型前置胎盘的发病率较低,在术后出血量上明显的高于普通前置胎盘,对出现凶险型前置胎盘的孕产妇宜进行子宫全切治疗,以保证孕产妇的生命安全。

  20. 植入型凶险性前置胎盘应用磁共振的临床分析%Clinical Analysis of Magnetic Resonance in the Application of Implantable Dangerous Placenta Previa

    Institute of Scientific and Technical Information of China (English)

    吕冲

    2016-01-01

    目的:探究对植入型凶险性前置胎盘的临床诊断中磁共振的临床应用情况。方法回顾性分析2013年7月—2015年6月在该院接诊的凶险性前置胎盘患者60例,其中植入型凶险性前置胎盘患者25例,结合患者的手术和病理检查结果为参考标准,对植入型凶险性前置胎盘患者进行核磁共振以及彩色多普勒超声检查的联合应用评估,同时患者分别为粘连胎盘、植入性胎盘以及穿透性胎盘,结床分析。结果在胎盘植入的临床诊断中磁共振与磁共振和彩超联合诊断的临床诊断价值无合患者的病症分型对患者的磁共振图像进行临统计学差异(P﹥0.05),但结合患者的病理分型对磁共振的诊断准确率进行判定显示差异有统计学意义(P﹤0.05),在穿透性胎盘的诊断中其应用价值最高,而在粘连性胎盘的诊断中其应用价值则相对较低,数据显示差异有统计学意义(P﹤0.05)。结论在植入型凶险性前置胎盘的临床诊断中应用磁共振具有较高的诊断准确性,同时对患者的临床分型也有一定的应用,值得在临床上推广应用。%Objective To discuss the clinical application situation of magnetic resonance in the clinical diagnosis of im-plantable dangerous placenta previa. Methods 60 cases of patients with dangerous placenta previa treated in our hospital from June 2013 to June 2015 were retrospectively analyzed, among them, 25 cases were implantable dangerous placenta previa and they were evaluated by the combined application of magnetic resonance and color Doppler ultrasonography ac-cording to the operative and pathological examination results and divided into the adherent placenta, implantable percreta and placenta percreta according to the clinical analysis. Results The difference in the clinical diagnostic value between the magnetic resonance diagnosis of placenta implantation and magnetic resonance combined with colour

  1. Clinical Value of Abdominal Color Doppler Ultrasound in Diagnosis of Placenta Previa Erupt Simultaneously Placenta Implantation%经腹彩色多普勒超声在前置胎盘并发胎盘植入诊断中的临床价值

    Institute of Scientific and Technical Information of China (English)

    梁振停

    2015-01-01

    目的:探讨经腹彩色多普勒超声在前置胎盘并发胎盘植入诊断中的临床价值。方法选取2012年4月~2015年4月在我院接受治疗的前置胎盘合并胎盘植入患者共100例,采用经腹彩色多普勒对所有患者进行检查,分析检查结果。结果经腹彩色多普勒超声诊断后,共诊断为前置胎盘并发胎盘植入的患者共52例,准确率为98.1%,漏诊患者1例,漏诊率为1.9%。结论采用经腹彩色多普勒超声对产妇的前置胎盘并发胎盘植入疾病进行诊断具有良好的临床价值。%Objective To explore the clinical value abdomen of color doppler ultrasound in diagnosis of placenta previa erupt simultaneously placenta implantation. Methods Selected 100 patients with placenta previa erupt simultaneously placenta increta from April 2012 to April 2015 in our hospital, the abdominal color doppler inspection on all of the patients, analyzed the test results. Results After abdominal color doppler ultrasonic diagnosis in diagnosis of placenta previa complicated with placenta implantation in patients with a total of 52 cases, accuracy was 98.1%, the missed diagnosis in patients with a total of 1 case, the missed diagnosis rate was 1.9%. Conclusion Use the color doppler lfow imaging in abdominal maternal placenta previa erupt simultaneously placenta increta disease diagnosis has good clinical value.

  2. Analysis on the Application Value of Transabdominal Color Doppler Ultrasound in Diagnosis of Placenta Previa Complicated with Placenta Accreta%经腹彩超在前置胎盘并发胎盘植入诊断中的应用价值分析

    Institute of Scientific and Technical Information of China (English)

    唐敦艳; 贺瑾

    2016-01-01

    Objective To analyze the application value of transabdominal color Doppler ultrasound in diagnosis of placenta previa complicated with placenta accreta. Methods 212 pregnant women with placenta praevia treated in our hospital from January 2011 to September 2015 were selected and given transabdominal color Doppler ultrasound examination. With the reference of surgical and pathological results, the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of transabdominal color Doppler ultrasound were calculated, and the causes were analyzed. Results Of 212 cases of placenta previa patients, the images of abdominal ultrasound in 23 cases showed placenta accreta: 18 cases were confirmed by surgical and pathological examination, 5 cases showed false positive;189 cases were not detected with placenta accreta by abdominal ultrasound, and 4 cases among these patients were confirmed with placenta accreta by surgical and pathological examination. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of abdominal ultrasound in diagnosis of placenta previa complicated with placenta accreta were 81.8%, 97.4%, 78.3%, 97.9%and 95.8%respectively. Conclusions Transabdominal color Doppler ultrasound has important application value in diagnosis of placenta previa complicated with placenta accrete. When patients exist risk factors of placenta previa complicated with placenta accreta, ultrasound examination should be paid special attention in order to improve the diagnostic accuracy.%目的:分析经腹彩超在前置胎盘并发胎盘植入诊断中的应用价值。方法以我院2011年1月至2015年9月收治的212例发生前置胎盘的孕妇为研究对象,对其进行经腹彩超检查。以手术及病理检查结果作为参照,计算经腹彩超的准确度、灵敏度、特异度、阳性预测值及阴性预测值,并分析其原因。结果212例前置胎盘患者中,23例经腹彩超

  3. 前置胎盘相关危险因素分析及对妊娠的影响%Analysis of risk factors associated with placenta previa and its effect on pregnancy

    Institute of Scientific and Technical Information of China (English)

    余苑婷

    2014-01-01

    目的:探讨前置胎盘的相关危险因素及对妊娠结局的影响。方法将3960例孕产妇中确诊为胎盘前置的60例设为观察组,随机选取60例同期正常孕产妇为对照组,比较两组的临床资料及妊娠结局,总结前置胎盘的危险因素。结果前置胎盘60例,发病率为1.5%,其中,中央型18例(30.0%),部分型5例(8.3%),边缘型37例(61.7%)。年龄≥35岁、文化程度低、有流产史、有分娩史、有剖宫产史及盆腔炎症史是导致前置胎盘发病的危险因素(P<0.05),妊娠结局比较发现观察组低体重儿数量、早产儿的例数及1 min Apgar评分及5 min Apgar评分≤7分新生儿明显高于对照组,产妇发生胎盘植入及产后出血的危险性明显增加(P<0.05)。结论高龄、文化程度低、产妇流产史、分娩史、剖宫产史、盆腔炎症史是导致胎盘前置的重要危险因素,前置胎盘可导致新生儿窒息,增加孕产妇胎盘植入、胎盘粘连及产后出血的发生率。%Objective To investigate risk factors associated with placenta previa and its effect on pregnancy outcome. Methods From December 2009 to December 2012, out of 3960 cases, selected 60 cases of pregnant women with placenta previa as observation group, 60 cases of normal pregnant women as control group, clinical information and pregnancy outcome of two groups were compared. Results 60 cases of placenta previa, the incidence rate was 1.5%, aged above 35 years old, low education level, history of abortion, history of childbirth, cesarean section history and the history of pelvic inflammatory disease were risk factors for onset of placenta previa(P<0.05), observation group and number of low birth weight children newborn 1min Apgar score ≤ 7 points, which was significantly higher than control group, occurrence of maternal placenta accreta and postpartum hemorrhage significantly increased(P<0.05). Conclusion Age, low education level, maternal abortion

  4. 283 例中央性前置胎盘产后出血高危因素分析%Analysis of 283 case of central placenta previa in patients with high-risk factors of postpartum hemorrhage

    Institute of Scientific and Technical Information of China (English)

    贾红梅; 胡贵平; 徐华东; 张永明; 陈斌; 马遥

    2015-01-01

    目的:观察中央性前置胎盘的临床表现及结局,探讨其产后出血的高危因素. 方法:回顾性分析我院2006年9月至2015年6月283例中央性前置胎盘患者的临床资料,根据是否并发产后出血而分为2组. 结果:产后出血组114例,产后未出血组169例;产后出血组的产前出血率、人工流产史发生率以及并发胎盘粘连、胎盘植入率均显著高于产后未出血组(P <0.05);Logistic 回归分析表明,双胎(OR =10.94,95%CI:1.120~106.871)、妊娠期合并胎盘粘连(OR=4.11, 95%CI:0.946~17.852)、产前出血(OR=2.60,95%CI:1.328~5.089)、产检次数(OR =1.13,95%CI: 1.026 ~1.243)以及并发贫血(OR =2.37,95%CI:1.078~5.206 )均是孕产妇发生产后出血的高危险因素,而高龄初产( OR=0.35 ,95%CI:0.117~1.057 )、妊娠期合并瘢痕子宫( OR=0.285 ,95%CI:0.057~1.441 )为中央性前置胎盘并发产后出血的保护因素. 结论:中央性前置胎盘常并发多种不良妊娠结局;双胎、妊娠期合并胎盘粘连、产前出血、并发贫血等可能为其并发产后出血的高危因素,高龄初产、妊娠期合并瘢痕子宫可能是中央性前置胎盘并发产后出血的保护因素.%Objective:To observe the clinical manifestation and outcome of central placenta previa and further explore the risk factors of postpartum hemorrhage with central placenta previa .Methods:283 patients with central placenta previa in our hospital between September ,2006 to June,2015 were retrospectively analyzed .According to the circumstance of postpartum hemorrhage , they were divided into two groups , postpartum hemorrhage group and no postpartum hemorrhage .Results: There were 114 cases in postpartum hemorrhage group and 169 cases in no postpartum hemorrhage group . Compared with no postpartum hemorrhage group , the rate of antepartum haemorrhage, abortion, placenta conglutination and placenta implantation were significantly higher in postpartum hemorrhage group ( P<0.05) .Logistic

  5. Comparación del nivel de condiciones previas de rendimiento de tenistas de élite (estudio de caso

    Directory of Open Access Journals (Sweden)

    Jiří Zháněl

    2015-04-01

    Full Text Available En el mundo del tenis de hoy en día, hay una clara tendencia hacia un juego físicamente exigente, en el que las condiciones previas motrices más importantes son la velocidad (acción y reacción, la fuerza (sobre todo la inicial y la explosiva, la fuerza resistencia y las habilidades específicas de coordinación. El presente estudio se basa en la teoría retrospectiva. El objetivo de la investigación fue el análisis longitudinal del nivel de condiciones previas somáticas y motrices de tenistas checos de élite (el tenista Tomas Berdych –TB– y la tenista Petra Kvitova –PK–. Con fecha 1 de junio de 2014, Tomas Berdych es el tenista número 1 de República Checa y el número 6 del mundo en el Ranking ATP (4330 puntos, habiendo logrado su mejor ranking hasta la fecha en 2013 (número 5 del mundo; con la misma fecha la tenista Petra Kvitova también es la tenista número 1 de República Checa y la número 6 del mundo en el Ranking WTA (4600 puntos, habiendo logrado su mejor ranking hasta la fecha en 2011 (número 2 del mundo. Los dos tenistas fueron evaluados longitudinalmente mediante la batería de test TENDIAG1, la cual contiene tres ítems somáticos y seis ítems motores. Los resultados de ambos tenistas claramente mostraron que, a lo largo de todo el periodo de monitorización, su puntuación total en la batería de test se encontraba por encima de la media de la población de tenistas. La evaluación de las diferencias entre sexos mostró un nivel significativamente más alto en la mayoría de ítems en el tenista TB, excepto en los ítems de flexibilidad del torso y de velocidad de reacción de brazos y piernas. La tenista PK obtuvo un mejor nivel en el índice de movilidad del hombro. Los resultados proporcionan interesantes conocimientos y sugerencias para el entrenamiento del tenis.

  6. 160例前置胎盘与产后出血相关因素调查分析%160 Cases of Placenta Previa and Postpartum Hemorrhage Correlation Fac-tor Analysis

    Institute of Scientific and Technical Information of China (English)

    刘艳

    2015-01-01

    Objective To analyze the related factors of postpartum hemorrhage in patients with placenta previa, provides the sci-ence for clinical treatment. Methods 160 patients with placenta previa, according to whether the postpartum hemorrhage were di-vided into the control group of 116 cases, the observation group of 44 cases. Results The patients in the observation group were significantly higher than the control group, the difference was statistically significant(P<0.05);the observation group maternal time is more than 2 times, a history of uterine surgery, preterm labor patients were significantly higher than the control group, the dif-ference was statistically significant(P<0.05);constituent ratio of different patients in the observation group and the control group of patients with placenta previa types, the difference was statistically significant (P<0.05);multiple factor analysis showed that age, parity and uterine surgery history and preterm labor patients more prone to postpartum hemorrhage, and marginal placenta previa, partial and complete placenta previa postpartum hemorrhage is more likely to appear. Postpartum hemorrhage is associated with many factors. Conclusion Patients with placenta previa, comprehensive consideration should be the treatment process.%目的:分析前置胎盘患者发生产后出血的相关因素,为临床治疗提供科学。方法160前置胎盘患者,按照是否出现产后出血分为对照组116例,观察组44例。结果单因素分析显示:观察组患者年龄明显高于对照组,差异有统计学意义(P<0.05);观察组孕产次≥2次、有子宫手术史、早产患者比例明显高于对照组,差异有统计学意义(P<0.05);观察组患者与对照组患者前置胎盘类型构成比不同,差异有统计学意义(P<0.05);多因素分析结果显示:年龄高、产次多、有子宫手术史及早产患者更容易出现产后出血,同时与边缘性前置胎盘比较,部分性和完全性

  7. Expectant treatment of placenta previa study of clinical observation and feasibility%期待疗法对前置胎盘的临床可行性研究

    Institute of Scientific and Technical Information of China (English)

    任红玲

    2013-01-01

    目的:通过观察前置胎盘期待疗法的临床效果,探讨其可行性。方法:将2006年1月于2011年12月住院分娩的前置胎盘患者120例中因出血、自发子宫收缩、孕足月、孕妇要求而剖宫产终止妊娠40例作为对照组,其余80例作为观察组进行期待疗法,比较两组患者在分娩孕周、产前、产后出血量、产褥感染、围生儿体质量、Apgar评分、病死率、呼吸道窘迫征等方面上的差异,并进行统计学处理。结果:两组产前出血无差异;期待治疗组产后出血少、孕周延长、产褥感染少、新生儿体质量增加、Apgar 改善、RDS 及死亡下降,有显著性差异。结论:在严密监测下期待治疗前置胎盘在确保母婴安全的前提下,延长孕龄、改善存活儿的预后、降低围生儿死亡率,具有可行性。%Objective:To study the clinic effect and feasibility of expectant treatment of placenta previa.Methods:120 cases of placenta previa delivered in hospital from January 2002 to December 2009 were divided into two groups:control group,40 cases of placenta previa were terminated pregnancy by uterine-incision delivery because of bleeding,spontaneous uterine contraction, or full term to pregnancy;observation group, the other 80 cases of placenta previa received expectant treatment. The delivery gestational weeks svndrome(RDS)of two groups were compared. Results:the difference of two groups in ante partum hemorrhage had no significance Observation group had less postpartum hemorrhage, longer gestional weeks,less puerperal infection, more weight of neonate,more inprove Apgar score,less RDS and case fatality rate which compared with control group. The difference of two groups had signicance. Conclusion:Expectant treatment of placenta previa in exact monitoring can prolong gestational age,improve the prognosis of survival infant, degrade the death rute of perinatal infant on the base of ensuring the safety of mother

  8. Discussion of interrupted circular suture dming caesarean section with placenta previa%前置胎盘剖宫产时环形间断缝合止血方法的探讨

    Institute of Scientific and Technical Information of China (English)

    张渺; 金燕志; 周子杰

    2001-01-01

    目的探讨环形间断缝合在前置胎盘剖宫产术时出血的止血效果。方法对54例前置胎盘剖宫产术病例进行总结。结果用环形间断缝合方法止血的9例病人手术时间少于子宫切除组(P<0.05),出血及输血少于子宫切除组,但无统计学差异(P>0.05),成功止血,保留子宫,且未发生术后合并症。结论环形间断缝合术是前置胎盘胎盘剥离面引起出血的有效止血方法之一。%Objective To discuss the value of interrupted circular suture in hemostasis of placenta previa during cesarean section. Methods We summarized 54 caesarean section patients with placenta previa. Results The hemostasis was succeeded in all of the 9 patients and uterus was retained without postpartum complications. The duration of operation was obviously shorter than that of hysterectomy( P<0.05). Bleeding and blood transfusion were less than that of hysterectomy, but without statistical difference (P>0.05). Conclusion Interrupted circular suture is one of the efficient methods in controlling postpartum bleeding during caesarean section with placenta previa.

  9. Clinical analysis and nursing on placenta previa (Attached 50 cases report)%前置胎盘临床分析及护理(附50例报告)

    Institute of Scientific and Technical Information of China (English)

    于雪梅

    2014-01-01

    To increase nursing quality and ensure safety of puerpera and neonate using analysis on the cause of placenta previa and best management method. Methods:50 patients with placenta previa were studied.According to the location type of the placenta previa,selecting the best opportunity to terminate the pregnancy.Results:3 cases were premature labor,there was a death one among them; 5 cases were spontaneous labor; 4 cases were emergency operation for hemorrhea,there was a death one among them for asphyxia ; 1 case was oxygen-deficiency cerebrosis; 38 cases were cesarean section. 45 neonates were good, their average weight was 2950g. 50 cases of puerpera have no postpartum infection.Conclusion:The placenta previa was associated with uterine cicatrization induced by multiparity, grand multiparity, cesarean section, induced abortion and so on. According to the condition of fetus maturity, hemorrhage and so on, waiting for an opportunity should be selected to termanate the pregnancy during enforcement period.%目的:分析前置胎盘成因及最佳处置方法,提高护理质量,尽保母婴平安。方法:收集前置胎盘50例,依胎盘位置分型,选择最佳时间终止妊娠。结果:早产3例1例死亡;自然分娩5例;大出血急诊手术4例1例窒息死亡、1例缺血缺氧性脑病;适时剖宫产38例。45例婴儿良好,平均体重3050克。50例产妇无产后感染。结论:前置胎盘与经产、多产、剖宫产、人工流产等致子宫瘢痕形成有关。实施期待期疗法,根据胎儿成熟、出血等情况适时终止妊娠,达到母亲安全婴儿健康。

  10. To Explore the Clinical Methods of Application Nursing in Puerperal With Placenta Previa%探讨前置胎盘产妇应用护理的临床方法

    Institute of Scientific and Technical Information of China (English)

    宋桂玲

    2016-01-01

    目的:探讨前置胎盘对产妇和临床护理的影响。方法选择40例前置胎盘产妇作为观察组,40例同期时间入院的正常产妇作为对照组,观察产妇不同对新生儿的影响是否不同。结果观察组中的产妇在出血、休克合胎盘植入等发病率高于对照组,差异具有统计学意义(P<0.05)。观察组中的新生儿在窒息、体重低和死亡等新生儿常见症状的发生率高于对照组,差异具有统计学意义(P<0.05)。结论前置胎盘对产妇和婴儿都存在威胁,未进行提前的预防和处理,会增加发病率和死亡率。%Objective To explore the effect of placenta placenta on maternal and clinical nursing.Methods 40 cases of placenta placenta were selected as the observation group, 40 cases of normal women were selected as control group, and the difference of the effect of different maternal.ResultsThe observation group, the incidence of maternal bleeding, shock and placenta were higher than the control group, was difference had statistically singnificance (P<0.05). In terms of production after maternal newborn, observation group in newborns in the common symptoms of neonatal asphyxia, low birth weight and death incidence also was obvious higher than that of the control group, was difference had statistically singnificance (P<0.05). Conclusion Placenta previa on maternal and infant there are very serious threat, if not with placenta previa puerpera to advance prevention and treatment will greatly increased the incidence and mortality of the disease.

  11. 高龄初产妇前置胎盘的高危因素与妊娠结局分析%Risk factors and outcomes of placenta previa among uniparas over thirty-five years old

    Institute of Scientific and Technical Information of China (English)

    张红卫; 郭利

    2014-01-01

    目的:了解高龄初产妇前置胎盘的发生率、高危因素及妊娠结局。方法以医院为基础收集资料,共纳入1065人为研究对象。用χ2检验分析比较高龄初产妇在人口学资料、妊娠分娩因素及妊娠并发症等条件下前置胎盘的发生率,用多因素Logistic回归模型分析前置胎盘的高危因素及不良结局。结果所有1065名高龄初产妇中,905人(85.0%)未发生产后出血,160人(15.0%)发生产后出血。160名产后出血的高龄初产妇中,13人(8.13%)发生前置胎盘;950名未产后出血的高龄初产妇中,12人(1.33%)发生前置胎盘。所有高龄初产妇中,前置胎盘发生率在是否产后出血、是否宫缩乏力者间的比较,差异有统计学意义(χ2值分别为24.53,12.10;P<0.05),在其他妊娠并发症中前置胎盘的发生率比较,差异无统计学意义( P>0.05)。在所有高龄初产妇中,未发现人口学及妊娠产前相关因素,前置胎盘的不良结局为早产(AOR:3.26,95%CI:1.43~7.44)、产后出血(AOR:5.38,95%CI:2.37~12.23);在产后出血的高龄初产妇中,前置胎盘的不良结局为早产(AOR:6.28,95%CI:1.65~23.82)。结论高龄初产妇是前置胎盘的高危人群,应尽快确认不良结局,以便及早采取应对措施。%Objective To investigate the incidence , risk factors and pregnancy outcomes of placenta previa among uniparas aged over thirty-five.Methods This hospital-based study included 1 065 objects from June 2011 to May 2012 .The chi-square test was used to compare the incidence of placenta plavia among demographic information , obstetric risk factors , and maternal pregnancy outcomes .And the multiple logistic model was used to identify the risk factors independently associated with placenta previa .Results Totals of 160 (15.0%) uniparas had postpartum hemorrhage

  12. 经腹彩色超声多普勒在前置胎盘并发胎盘植入诊断中的价值%The Value of Diagnosis by Abdominal Ultrasound Applied to Placenta Previa Complicated by Placenta Accreta

    Institute of Scientific and Technical Information of China (English)

    廖明华

    2015-01-01

    目的 探讨经腹彩超应用于前置胎盘并发胎盘植入诊断中的价值.方法 选取我院收治的125例前置胎盘患者作为研究对象,产前对其进行经腹彩色检查,预测是否存在并发胎盘植入,并进行跟踪调查,比较经腹彩超与产后病理诊断结果.结果 最终诊断结果为19例并发胎盘植入,经腹彩超诊断的敏感性为78.9%,特异性为97.6%,阳性和阴性预测值分别为83.3%、96.8%.结论 前置胎盘并发胎盘植入的发生率较高,产前应用经腹彩超对前置胎盘患者进行诊断,具有较高的敏感性和特异性,能够为临床工作提供有预见性的指导.%Objective Abdominal ultrasound is applied to investigate the concurrent placenta previa implantation diagnosis value.Methods Taking 125 cases of placenta previa in our hospital, checked them using transabdominal color before antenatal, predicted the existence of concurrent placenta accreta, and follow-up survey, comparing abdominal ultrasound and postnatal pathology results.Results Final diagnosis were that 19 cases complicated by placenta accreta, transabdominal ultrasound diagnostic sensitivity of 78.9% and a specificity of 97.6%, and positive and negative predictive values were 83.3%、96.8%.Conclusion Complicated by placenta previa implantation higher incidence of antenatal abdominal ultrasound to diagnose patients with placenta previa, with high sensitivity and specificity, to provide anticipatory guidance for clinical work.

  13. 凶险型前置胎盘对孕产妇的危害性研究%Research on the Perniciousness of Dangerous Placenta Previa on the Maternal

    Institute of Scientific and Technical Information of China (English)

    梁旭霞; 邬华; 张春; 李静; 陈慧

    2012-01-01

    Objective: To investigate the perniciousness of dangerous placenta previa on the maternal. Methods: 40 cases of dangerous placenta previa admitted in our hospital from March 2009 to March 2012 were selected, the clinical data were retrospectively analyzed. Results: The implanted placenta previa (implanted group) accounted for 55% of dangerous placenta previa, antepartum hemorrhage accounted for 81.8%, while 8 cases (44.4%) of antepartum hemorrhage occurred in non-implanted group (P0.05). Conclusion: For dangerous type of placenta previa maternal, it should strengthen the observation in surgery and place the shunt after surgery. In this way it could reduce the hazards for maternal with the maximum extent and ensure the safety of mother and child.%目的:探讨凶险型前置胎盘对孕产妇的危害性.方法:选择我院2009年3月至2012年3月收治的凶险性前置胎盘40例,对其临床资料进行回顾性分析.结果:植入型前置胎盘(植入组)占凶险型前置胎盘的55%(22例),非植入型前置胎盘(非植入组)占45%(18例).植入组产前出血18例,占81.8%,非植入组产前出血8例,占44.4%,差异有统计学意义.植入组完全性前置胎盘17例,占77.3%;部分性4例,占18.2%;边缘性1例,占4.5%.非植入组分别为5例,占27.8%;1例,占5.6%; 12例,占66.7%.两组之间比较差异具有统计学意义(P<0.05).两组术前Hb值无明显差异(P>0.05),术后非植入组Hb水平高于植入组,手术时间、术中出血量、产后出血均显著少于植入组,差异均有统计学意义(P<0.05).非植入组术中输血、切除子宫、应用宫腔纱条的百分率均显著低于植入组(P<0.05).两组术中刮宫、徒手剥胎盘的百分率比较均无明显差异(P>0.05).结论:对于凶险型前置胎盘孕产妇,产前应做好预防保健,术中加强观察,术中术后放置腹腔引流管,最大限度的降低对孕产妇的危害,确保母婴安全.

  14. 凶险型前置胎盘并发胎盘植入的临床特点及高危因素探讨%Objective to Investigate the Clinical Characteristics and Risk Factors of Placenta Previa Complicated with Placenta Accreta

    Institute of Scientific and Technical Information of China (English)

    黎春梅

    2016-01-01

    ABSTRACT:Objective: to analyze and discuss the clinical characteristics and risk factors of placenta previa complicated with placenta accreta. Methods: 150 cases of maternal discussed in this study were randomly selected in our hospital in January 2015 to 2016 during March were dangerous placenta previa, of which 75 cases of maternal pernicious placenta previa complicated with placenta accreta, divided into study group, 75 cases in other single dangerous placenta previa, divided into control group, comparative analysis clinical status by the women in the two groups.Results: study group with respect to age more than or equal to 35 years old, abortion is more than or equal to 2 times, section from the number is more than or equal to twice the number of mothers were than the control group, the group of data with statistical significance (P< 0.05). The rate of hysterectomy, blood transfusion and blood loss in the study group were higher than those in the control group, and the data were statistically significant (P<0.05).Conclusions: maternal age, cesarean section labor, abortion status are high risk factors of placenta previa complicated with placenta accreta, maternal pregnancy, the placenta mainly in the anterior wall of the uterus position, which belongs to the central type.%目的:分析讨论凶险型前置胎盘并发胎盘植入的临床特点和高危因素。方法:此研究中所讨论的150例产妇均随机选取于我院2015年1月至2016年3月期间所收治的凶险型前置胎盘产妇内,其中有75例产妇为凶险型前置胎盘并发胎盘植入,将其划分为研究组,另75例为单一性凶险型前置胎盘产妇,将其划分为对照组,对比分析两组产妇各临床状况。结果:研究组年龄≥35岁、流产次数≥2次、剖宫产次数≥2次的产妇数量均比对照组要高,组间数据有统计学意义(P<0.05)。研究组子宫切除率、术中输血率和术中出血量等均高于对照组,组间

  15. Clinical analysis of 30 cases on cesarean section of placenta previa with scarred uterine%前置胎盘合并瘢痕子宫剖宫产30例临床分析

    Institute of Scientific and Technical Information of China (English)

    丁卫

    2011-01-01

    Objective To analyze the harm of placenta previa with scarred uterine on mother and neonate,and improve the understanding of it. Methods 108 cases with placent previa from January 2008 to May 2010 in our hospital were analyzed retrospectively, among which there were 30 cases of scarred uterine, 78 cases of non-scarred uterine. Results 108 patients were terminated pregnancy through cesarean section. The Postpartum hemorrhage in scarred uterine's group was significantly higher than the group of non-scarred uterine (P<0.05). The incidences of placenta accreta, placenta adhesion, hysterectomy were significantly higher than non-scarred uterine group(P<0.05). However the birth weight was significantly lower than non-scarred uterus group (P<0.05).Preterm, fetal distress, neonatal asphyxia, perinatal mortality were significantly higher than non-scarred uterus group (P<0.05). Conclusion Placenta previa with the scarred uterine increased significantly the maternal and perinatal complications and risk.%目的 分析前置胎盘合并瘢痕子宫对孕产妇及围生儿的危害,提高对前置胎盘合并瘢痕子宫的认识.方法回顾性分析终止妊娠的前置胎盘108例,其中既往有剖宫产史30例(瘢痕子宫组),无剖宫产史78例(非瘢痕子宫组).结果:108例均行剖官产术终止妊娠.瘢痕子宫组产后出血量大于非瘢痕子宫组,其胎盘植入、胎盘粘连、子宫切除的发生率均高于非瘢痕子宫组,差异有统计学意义(P<0.05).瘢痕子宫组新生儿体质量低于非瘢痕子宫组,其早产、胎儿窘迫、新生儿窒息、围生儿死亡均高于非瘢痕子宫组,差异有统计学意义(P<0.05).结论 前置胎盘合并瘢痕子宫明显增加孕产妇及围生儿的并发症和危险性.

  16. Diagnosis of placenta previa accreta by two dimensional ultrasonography and color doppler in patients with cesarean section%二维超声及彩色多普勒对瘢痕子宫合并前置胎盘植入的诊断及临床分析

    Institute of Scientific and Technical Information of China (English)

    施华芳; 皮丕湘; 丁依玲

    2012-01-01

    目的:探讨二维超声及彩色多普勒诊断瘢痕子宫患者合并前置胎盘植入的准确性.方法:41例曾接受剖宫产的患者本次妊娠28周后行二维超声及彩色多普勒检查,探查胎盘与子宫及膀胱之间的特征性声像图表现,确认有部分型或完全性前置胎盘,并进一步判断是否有胎盘植入,对所有病例进行追踪,以手术所见及病检结果为诊断金标准.结果:在所有41例瘢痕子宫合并前置胎盘的患者中,二维超声及彩色多普勒提示22例合并前置胎盘植入,产后经手术和病检确诊20例,19例产前二维超声及彩色多普勒未提示胎盘植入者中,产后证实有胎盘植入1例,敏感性为95.24%,特异性为94.74%.在所有确诊胎盘植入的病例中,最常见的二维超声图像为在胎盘实质和基底部可见无回声腔隙,以及彩色多普勒在子宫胎盘膀胱之间探及丰富血彩,均为95.24%.结论:应用二维超声及彩色多普勒对瘢痕子宫合并前置胎盘植入有较高的敏感性和特异性,二者联合基本可以明确诊断.%Objective: To determine the accuracy of two dismensional sonography and color doppler in diagnosing placenta previa accreta in patients with previous cesarean section.Methods: Forty-one patients with previous cesarean sections were confirmed to have partial or total placenta previa in the current pregnancy and were given ultrasound examinations after the 28th week of gestation. Specific ultrasound features of the placenta and its interphase with the uterus and the bladder for placenta accreta were checked by two-dimensional ultrasonography and color Doppler. All the patients were traced until delivery. The golden standard in diagnosis was the intraoperative finding and the pathologic exam. Results: Twenty-two patients had ultrasonographic evidence of placenta previa, 20 of which were later confirmed placenta previa accreta intraoperatively. Nineteen patients had no ultrasound evidence of

  17. An analysis of related factors of postoperative hemorrhage of women with placenta previa following cesarean section%中央性前置胎盘剖宫产后出血相关因素分析

    Institute of Scientific and Technical Information of China (English)

    林小兵; 朱瑞丹

    2009-01-01

    目的:探讨影响前置胎盘剖宫产产后出血危险因素及相应的预防及临床处理方法.方法:中央性前置胎盘70例,分为剖宫产术中及术后出血≥1000ml的35例作为大出血组,同期手术中及术后出At500mL者胎盘面积显著大于出≤500mL者(t=4.723,P3次)及前壁胎盘是中央性前置胎盘剖宫产术中及术后大出血的高危因素.%ObjeetiveTo investigate influencing factors of postoperative hemorrhage(PPH)following cesarean section of wornen with placenta previa,and corresponding prevention and clinical management.Methods There were 70 cases of complete placental previa with PPH were divided into two groups:study group(n=35)which the blood loss of PPH exceeded 1000 ml,contrDl group(n=35),which the blood loss of PPH was less than 1000 ml.The risk factors were analyzed..Results The progesterone prodaetion times in hemorrhage group were significantly higher than the control group(P<0.01);The history of curettage and history of cesarean section in hemorrhage group were significantly higher than the control group(P<0.01 and 0.05);The proportion of pregnant women with central complete)placenta prevm was more than tllat of those pregnant women with incomplete(partial)or marginal placenta previa(X2=7.041,both P<0.01).The greater the placental area,themore the amount of postoperative hemorrhage and the placental area of those pregnant women withmore than 500mL of blood loss after the operation was singifieant larger than thatof those pregnant women with less than 500mLof blood loss(t=4.723,P<0.01).The amount of postoperative hemorrhage of those pregnant women whose placenta was implanted in anteriorwall of the uterus was more than that of those pregnant women whose placenta was implanted the posterior or lateral wall of the uterus(t=28.041,both P<0.001).The amount of plstoperative hemorrhage of those pregnant women with more than or equal two times of induced abortion was higher than thatof those pregnant women with

  18. Diagnostic value of MRI for placenta previa with placental implantation%磁共振在前置胎盘伴胎盘植入中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    高继勇; 梅海炳; 高军

    2011-01-01

    目的 探讨磁共振扫描对前置胎盘伴植入的诊断价值.方法 23 例临床诊断前置胎盘的患者行MRI平扫,术后进行回顾分析.结果 胎盘子宫分界正常10 例,粘连3 例,植入8 例,穿通2 例.术后及病理诊断为正常6例,粘连4 例,植入11 例,穿通2 例.术前MRI 诊断为植入及穿通者,与术后相符,术后诊断为植入者2 例报告为粘连,1 例报告为正常.术后诊断为粘连者,3 例术前报告为正常.结论 磁共振对前置胎盘伴有胎盘植入及穿通能提供准确的诊断.%Objective To investigate the MRI diagnostic value for placenta previa with placental implantation. Methods MRI of 23 patients with placenta previa was retrospectively analyzed. Results The boundaries of the placenta were clear from (10), adherent with (3), implanted in (8), or penetrating through (2) the myometrium on MRI. 6 cases were diagnosed as normal after surgery, 4 cases of adhesion, 11 cases were implanted, 2 cases of penetrating. The MRI diagnosis of placental implantation (8) and penetration (2) was confirmed operatively. Two cases of implantation were erroneously classified as placental adhesion and 1 case was misinterpreted as normal. 3 out of 4 cases of placental adhesion were missed on MRI. Conclusion MRI is helpful in diagnosing placental implantation.

  19. 35例瘢痕子宫合并前置胎盘妊娠结局分析%35 cases of uterine scar pregnancy outcome analysis of placenta previa

    Institute of Scientific and Technical Information of China (English)

    张金瑾

    2014-01-01

    目的:探讨瘢痕子宫合并前置胎盘对母婴妊娠结局的影响。方法选取2002年8月至2013年8月期间在我院住院分娩瘢痕子宫合并前置胎盘产妇35例为观察组,并选取同期单纯前置胎盘产妇35例作为对照组,观察比较两组产妇产后出血量、子宫切除率、胎盘植入等情况。结果观察组术中出血量、子宫切除率、胎盘植入率以及手术时间均高于对照组,两组比较差异具有统计学意义(P<0.01);观察组弥散性血管内凝血(DIC)、失血性休克、子宫切除等显著多于对照组,两组比较差异有统计学意义(P<0.01);观察组新生儿早产率、窒息发生率显著高于对照组,差异有统计学意义(P<0.01);观察组新生儿体重低于对照组,两组比较差异有统计学意义(t=5.897,P<0.05)。结论瘢痕子宫合并前置胎盘对妊娠结局具有重要影响,术前应予以高度重视,做好充分准备,必要时及时切除子宫。%Objective To investigate the merger placenta previa uterine scar pregnancy outcome for mother and child.Methods Thirty-five cases of placenta previa during the delivery of maternal uterine scar from August 2002 to August 2013 in our hospital were recrui-ted as the observation group,and the corresponding period of maternal placenta previa alone was selected as the control group.Maternal post-partum hemorrhage,hysterectomy rates,placenta accreta and so on of the two groups were compared.Results The blood loss,hysterectomy rates,placental implantation rate and operative time were higher in the observation group,and the difference was statistically significant (P<0.01);disseminated intravascular coagulation (DIC),hemorrhagic shock,and hysterectomy in the observation group happened more than the control group,and the difference was statistically significant (P<0.01);the rate of premature birth and asphyxia were significantly higher in the

  20. Influence of scarred uterus pregnancy on pregnancy outcome in patients with placenta previa%瘢痕子宫妊娠并发前置胎盘对妊娠结局的影响

    Institute of Scientific and Technical Information of China (English)

    邬华; 梁旭霞

    2013-01-01

    目的 探讨瘢痕子宫妊娠并发前置胎盘对妊娠结局的影响.方法 68例前置胎盘患者根据是否存在瘢痕子宫分为瘢痕子宫组32例和非瘢痕子宫组36例,比较2组患者的妊娠结局.结果 瘢痕子宫组患者剖宫产率、产后出血率、子宫切除率、新生儿早产发生率、窒息发生率和围生儿病死率均显著高于非瘢痕子宫组(P<0.05),瘢痕子宫组患者产后24 h出血量显著大于非瘢痕子宫组(P<0.05),瘢痕子宫组新生儿体质量显著低于非瘢痕子宫组(P<0.05).结论 瘢痕子宫妊娠并发前置胎盘可增加产妇剖宫产及新生儿早产、窒息、死亡的危险.%Objective To investigate the influence of scarred uterus pregnancy on pregnancy outcome in patients with placenta previa. Methods Sixty-eight patients with placenta previa were divided into scarred uterus group (n =32) and non-scarred uterus group(n =36) according to whether had scarred uterus, then the pregnancy outcome was compared between the two groups. Results The rates of cesarean section, postpartum hemorrhage, hysterectomia, omotocia, apnoea neonatorum and death in the scarred uterus group were significantly higher than those in the non-scarred uterus group(P <0.05), the bleeding of postpartum 24 hours in the scarred uterus group was significantly more than that in the non-scarred uterus group (P < 0. 05), but the body weight of neonates in the scarred uterus group was significantly lower than that in the non-scarred uterus group(P<0. 05). Conclusion The occurrence of scarred uterus pregnancy in patients with placenta previa can increase the risks of cesarean section, omotocia, asphyxia and death.

  1. 前置胎盘的发生率变化与人工流产史产妇比例变化的关系研究%Relationship between the incidence change in placenta previa and the proportion change of puerpera with abortion history

    Institute of Scientific and Technical Information of China (English)

    邹晓红; 苏庆霞; 谢图强

    2011-01-01

    目的 探讨前置胎盘发生率的变化,分析其与人流之间的关系并寻找预防前置胎盘相应的对策。方法 以回顾性分析方法对20年来我院的496例前置胎盘病例及既往人流产妇病例进行对比分析。结果 前置胎盘发生率为1.01%,前置胎盘的发生率近十五年来显著上升,中央型前置胎盘构成比显著升高(P<0.01),前置胎盘患者人流史比例高。既往人流产妇发生率为33.6%,既往人流产妇比例近十五年来显著上升(P<0.05)。结论 既往人流产妇比例增多可能是前置胎盘发生率上升的原因%Objective To explore the change of the placenta previa incidence, and analyze the relationship between abortion rate and it, looking for corresponding prevention countermeasures for placenta previa. Methods With retrospective analysis method, 496 cases of placenta previa in 20 years were analyzed comparing with those cases with past abortion puerpera history. Results The placenta previa incidence is 1.01%, and it increased significantly over the past 15 years. The constituent ratios of central type placenta previa significantly increased too. The abortion history has a high proportion in the placenta previa patients. The past puerpera abortion incidence was 33.6%, which rose dramatically over the past 15 years. Conclusion The past puerpera abortion incidence' s increasing may be the reason why incidence of the placenta previa rises.

  2. The Uterine Sandwich Method for Placenta Previa Accreta in Mullerian Anomaly: Combining the B-Lynch Compression Suture and an Intrauterine Gauze Tampon

    Directory of Open Access Journals (Sweden)

    Mustafa Kaplanoğlu

    2013-01-01

    Full Text Available Mullerian duct anomalies may cause obstetric complications, such as postpartum hemorrhage (PPH and placental adhesion anomalies. Uterine compression suture may be useful for controlling PPH (especially atony. In recent studies, uterine compression sutures have been used in placenta accreta. We report a case of PPH, a placenta accreta accompanying a large septae, treated with B-Lynch suture and intrauterine gauze tampon.

  3. Influência do internamento materno prolongado nos resultados maternos e perinatais de duas séries de pacientes com placenta prévia Influence of prolonged maternal stay in maternal and perinatal outcomes of two series of patients with placenta previa

    Directory of Open Access Journals (Sweden)

    Carlos Augusto Alencar Júnior

    2012-01-01

    Full Text Available OBJETIVO: Comparar os resultados maternos e perinatais de pacientes portadoras de placenta prévia, após adoção do internamento materno prolongado, com os de uma série histórica ocorrida em 1991. MÉTODOS: Estudo retrospectivo comparando 108 casos da doença - em pacientes hospitalizadas em uma instituição de ensino do estado do Ceará, nordeste do Brasil, no período de primeiro de janeiro de 2006 a 31 de dezembro de 2010 - com 101 casos ocorridos em 1991, na mesma instituição. Os seguintes dados maternos e perinatais foram coletados: idade materna, paridade, idade gestacional no momento do parto, via de parto, tempo de internamento materno, escores de Apgar ao primeiro e quinto minutos, peso ao nascimento, adequação do peso ao nascer, tempo de hospitalização neonatal, morbidade materna e neonatal e mortalidades (materna, fetal, neonatal e perinatal. As variáveis categóricas foram analisadas utilizando-se os testes do χ² de associação e exato de Fischer. Os resultados foram considerados significativos quando pPURPOSE: To compare the maternal and perinatal outcomes of patients with placenta previa, after the adoption of a prolonged maternal hospital stay, to those of a 1991 series. METHODS: We performed a retrospective study comparing 108 cases of placenta previa hospitalized in the Maternity School Assis Chateaubriand, Universidade Federal do Ceará, during the period from 01/01/2006 to 12/31/2010, with those obtained in 1991, when 101 cases of the pathology were observed at our institution. The following maternal and perinatal data were collected: maternal age, parity, gestational age at delivery, mode of delivery, maternal stay length, Apgar scores at the 1st and 5th minutes, birth weight, adequacy of birth weight, neonatal length stay, maternal and neonatal morbidity and mortality rates (maternal, fetal, neonatal and perinatal. Statistical analysis was performed using the χ² and Fisher's exact tests. The results were

  4. Prenatal diagnosis of vasa previa.

    Science.gov (United States)

    Bręborowicz, Grzegorz H; Markwitz, Wiesław; Szpera-Goździewicz, Agata; Dera-Szymanowska, Anna; Ropacka-Lesiak, Mariola; Szymański, Piotr; Kubiaczyk-Paluch, Beata

    2015-01-01

    Vasa previa is a rare condition in which unsupported by the placenta, umbilical cord blood vessels runs within the placental membranes between internal os of the cervix and presenting part of the fetus. We report an antenatal diagnostic procedure and management of a patient with low-lying placenta and velamentous cord insertion near to the internal os with two large fetal blood vessels coursing between the internal cervical os and fetal presenting part. An elective cesarean section was performed at 36 weeks gestation.

  5. Alteraciones neuropsicológicas en pacientes con VIH e historia previa de consumo de sustancias. Un estudio preliminar

    Directory of Open Access Journals (Sweden)

    Amalia García-Torres

    2015-01-01

    Full Text Available El virus de la inmunodeficiencia humana (VIH puede llegar a producir alteraciones cognitivas que interfieren de forma significativa en la vida diaria de las personas que lo padecen. Estos déficits pueden incrementarse cuando existe historia previa de consumo de sustancias psicoactivas. El objetivo de este trabajo es estudiar el perfil neuropsicológico de un grupo de pacientes con VIH e historia previa de consumo de drogas y compararlo con un grupo de pacientes ex drogodependientes seronegativos. Se administró una batería neuropsicológica a una muestra de 28 sujetos espa˜noles, 14 con VIH y 14 seronegativos, donde se evaluaron los 8 dominios cognitivos que suelen estar más afectados en el VIH: atención/memoria de trabajo, velocidad de procesamiento de la información, memoria/aprendizaje, abstracción/función ejecutiva, lenguaje/verbal y habilidades motoras. Los resultados mostraron peor ejecución del grupo con VIH en todos los dominios cognitivos. El menor rendimiento neuropsicológico del grupo con VIH podría deberse presumiblemente a la acción del virus. Independientemente de cuál sea la etiología del deterioro cognitivo, lo importante es detectar los déficits neuropsicológicos de la forma más precoz posible para mejorar la calidad de vida de los pacientes mediante la intervención neuropsicológica.

  6. Analysis of Clinical Outcome of Placenta Previa During Re-pregnancy with Scarred Uterus%疤痕子宫再次妊娠出现前置胎盘的临床结局分析

    Institute of Scientific and Technical Information of China (English)

    欧阳菱菱

    2015-01-01

    目的:分析疤痕子宫再次妊娠出现前置胎盘的临床结局。方法选择2012年5月至2014年5月期间我院收治的45例疤痕子宫再次妊娠合并前置胎盘的孕产妇作为研究组,选择同期收治的45例疤痕子宫再次妊娠孕产妇作为对照组。观察对比两组产后出血量、分娩时间、手术费用、子宫切除率、产后出血率及新生儿窒息率。结果研究组2 h 内的出血量及24 h 内的出血量显著高于对照组(P<0.05);分娩时间及手术费用显著高于对照组(P<0.05);子宫切除率、产后出血率、新生儿窒息率显著高于对照组(P<0.05)。结论疤痕子宫再次妊娠合并前置胎盘可以提高围生期母婴并发症概率,临床应给予足够的重视,着重强调孕期产检的重要性,不断提高手术技巧,以此保障母婴健康。%Objective To analyze the clinical outcome of placenta previa during re-pregnancy with scarred uterus.Method 45 pregnant women with placenta previa during re-pregnancy with scarred uterus who were admitted into our hospital from May 2012 to May 2014 were selected as observation group, 45 pregnant women during re-pregnancy with scarred uterus admitted during the same period as control group.The amount of postpartum bleeding, delivery time, surgery costs, hysterectomy rate, incidence of postpartum hemorrhage, and neonatal asphyxia rate of the two groups were observed and compared.Results The amount of postpartum bleeding of the observation group within 2 hours and 24 hours were evidently higher than those of the control group (P<0.05), the delivery time and surgery cost of the observation group were evidently higher than those of the control group (P<0.05), hysterectomy rate, incidence of postpartum hemorrhage, and neonatal asphyxia rate of the observation group were evidently higher than those of the control group (P<0.05).Conclusion The placenta previa during re-pregnancy with scarred uterus may

  7. 卡前列素氨丁三醇预防前置胎盘产后出血的临床疗效%Clinical effect of carboprost tromethamine injection in the prevention of the postpartum hemorrhage of placenta previa

    Institute of Scientific and Technical Information of China (English)

    李智卿

    2015-01-01

    Objective:To compare the treatment effect of carboprost tromethamine injection and oxytocin in the treatment of the postpartum hemorrhage of placenta previa. Methods:Eighty-six cases of the pregnant women with placenta previa were selected from Dec. 2012 to Aug 2014 and randomly divided into an oxytocin group with 29 cases, a treatment group (carboprost tromethamine injection) with 30 ones, and a combined group with 27 ones. In the operation, the oxytocin group was given oxytocin 20 u, the treatment group given the carboprost tromethamine injection 250μg, and the combined group given oxytocin 20 u and carboprost tromethamine injection 250μg. The 2 h and 24 h postpartum hemorrhage volume, the incidence of the postpartum hemorrhage, hemostasis time, blood transfusion rate and complications were observed. Results:The postoperative bleeding rate, blood transfusion rate, amount of bleeding after 2 and 24 hours operation, hemostasis time, hysterectomy incidence in the treatment group and the combined group were signiifcantly lower than those in the oxytocin group (P0.05). Conclusion:Carboprost tromethamine injection can effectively reduce the postpartum hemorrhage of placenta previa, the incidence of postpartum hemorrhage, hemostasis time, blood transfusion rate, uterine resection rate, and has less adverse reaction and better effect if combined with oxytocin.%目的:比较卡前列素氨丁三醇与缩宫素治疗前置胎盘产后出血的疗效。方法:选择2012年12月-2014年8月前置胎盘产妇86例,随机分为缩宫素组29例、治疗组(卡前列素氨丁三醇)30例,联合组27例。术中缩宫素组给予缩宫素20 u,治疗组给予卡前列素氨丁三醇250μg,联合组给予缩宫素20 u和卡前列素氨丁三醇250μg,观察产后2 h、24 h出血量、产后出血发生率、止血时间、输血率及并发症等。结果:治疗组和联合组的术后出血率、输血率、术后2 h和24 h出血量、止血时间、子宫

  8. Analysis of Clinical Characteristics and Pregnancy Outcomes of 32 Cases of Dangerous Placenta Previa%32例凶险型前置胎盘的临床特征及妊娠结局分析

    Institute of Scientific and Technical Information of China (English)

    李小叶

    2013-01-01

    [目的]分析凶险型前置胎盘的临床特点及妊娠结局,以提高对凶险型前置胎盘的诊疗的技术.[方法]以在本院住院分娩的凶险型前置胎盘32例为研究组,随机选择同期在本院住院分娩的普通型前置胎盘70例为对照组,运用统计学方法对其临床资料行回顾性分析.[结果]①研究组与对照组产前大出血发生率相比较差异无显著性(P>0.05);产后大出血、胎盘植入、子宫切除及弥散性血管内凝血(DIC)发生率均高于对照组,且差异有显著性(P0.05);研究组的早产儿发生率、新生儿重度窒息率均明显高于对照组,且差异有显著性(P0. 05). The incidence of postpartum hemorrhage, placen-tal implantation, hysterectomy and disseminated intravascular coagulation(DIC) in the study group were higher than those in the control group, and there was significant difference(P 0. 05). The rates of preterm birth and severe neonatal asphyxia in the study group were obviously higher than those in the control group, and there was significant difference(P <0. 05). [Conclusion]The main risk factors of dangerous placenta previa are postpartum hemorrhage, hysterectomy, preterm delivery and severe newborn asphyxia, which have great harm on pregnant women, parturients and perinatal infants. The prevention of dangerous placenta previa, antenatal care and monitoring, the prophylaxis of postpartum hemorrhage and rescue measures can greatly reduce the hazard for pregnant women, parturients and perinatal infants, and improve pregnancy outcome.

  9. A case report of vasa previa incidentally discovered.

    Science.gov (United States)

    Saghir, Salahiddine; Kouach, Jaouad; Agadr, Aomar

    2015-01-01

    Vasa previa is a rare but clinically important obstetrical complication that can be associated with a low-lying placenta or placenta previa. We aim to present one case of vasa previa diagnosed during the placenta examination after the caesarean indicated for triple uterus scar. A 26-year-old female was referred to our hospital at 30 weeks of gestation to provide a scheduled caesarean. Trans-abdominal ultrasound was performed; the placenta was positioned in the posterior side of the fundus. Fetal growth was found to be appropriate for gestational age. A healthy male infant weighing was successfully delivered via cesarean section at 38 weeks of gestation. This operation helped to prevent complications due to acute fetal bleeding. The identification and exclusion of vasa previa using trans-vaginal ultrasound are essential to ensure appropriate and timely treatment.

  10. A case report of vasa previa incidentally discovered

    Science.gov (United States)

    Saghir, Salahiddine; Kouach, Jaouad; Agadr, Aomar

    2015-01-01

    Vasa previa is a rare but clinically important obstetrical complication that can be associated with a low-lying placenta or placenta previa. We aim to present one case of vasa previa diagnosed during the placenta examination after the caesarean indicated for triple uterus scar. A 26-year-old female was referred to our hospital at 30 weeks of gestation to provide a scheduled caesarean. Trans-abdominal ultrasound was performed; the placenta was positioned in the posterior side of the fundus. Fetal growth was found to be appropriate for gestational age. A healthy male infant weighing was successfully delivered via cesarean section at 38 weeks of gestation. This operation helped to prevent complications due to acute fetal bleeding. The identification and exclusion of vasa previa using trans-vaginal ultrasound are essential to ensure appropriate and timely treatment. PMID:26405470

  11. Clinical Evaluation of Transvaginal and Transabdominal Ultrasound in Diagnosing Pernicious Placenta Previa with ROC Curve%ROC 曲线对经阴道及经腹超声诊断凶险型前置胎盘的临床评价

    Institute of Scientific and Technical Information of China (English)

    苗德萍; 王双

    2014-01-01

    Objective To explore the value of transvaginal ultrasound in diagnosing pernicious placenta previa. In order to raise the diagnostic accuracy of pernicious placenta previa and placenta accreta. Methods All of the 67 cases, which had the history of cesarean section and the placenta in the palace wall, treated by transabdominal ultrasonography,and then treated by transvaginal ultrasonography . Recorded two sets of data ,one was the relations between the placenta and the lower uterine seg-mentcervical internal , another was the relations between the placenta and uterine musclewall. Tracking operation diagnosis and pathologic diagnosis. Result In 67 patients ,33 cases of postoperative diagnosis of pernicious placenta previa,8 cases complicated with placenta accreta . The areas under ROC curve of transvaginal ultrasound and transabdominal ultrasound in diagnosing perni-cious placenta previa were 0. 985 vs 0. 793;The areas under ROC curve of transvaginal ultrasound and transabdominal ultrasound in diagnosing placenta accreta were 0. 867 vs 0. 787. There was significant differnce between transvaginal ultrasound and transabdo-mial ultrasound (P < 0. 05). Conclusion Transvaginal ultrasound could increase the diagnostic accuracy of pernicious placenta previa and placenta accreta.%目的:探讨经阴道超声对诊断凶险型前置胎盘的临床诊断价值,提高诊断凶险型前置胎盘及胎盘植入的准确性。方法对67例既往有剖宫产史,胎盘位于宫前壁患者先行经腹超声检查,再行经阴道超声检查,分别记录胎盘与子宫下段宫颈内口关系及胎盘与子宫肌壁关系两组数据。追踪手术及病理诊断结果。结果67例患者中33例术后诊断为凶险型前置胎盘,8例伴胎盘植入。 ROC 分析经阴道及经腹超声诊断凶险型前置胎盘的曲线下面积分别为0.985、0.793;经阴道及经腹超声诊断胎盘植入的曲线下面积分别为0.867、0.787。两种方法的 ROC 曲线及曲线下

  12. Expression of hypoxia-inducible factor-1α in placental tissues in patients with placenta previa%缺氧诱导因子-1α在前置胎盘患者胎盘组织中的表达及意义

    Institute of Scientific and Technical Information of China (English)

    谢家滨

    2012-01-01

    Objective To study the expression of hypoxia-inducible factor-1 α (HIF-1 α) in patients with placenta previa, and explore the effect in the pathophysiology of placenta previa. Methods The expression of HIF-1 α was detected in patients with placenta previa (group A) and normal pregnant women (group B) by using immunohisto-chemistry. Then the results were compared between the two groups. Results In group A, the positive expression rate of HIF-1α was 73.33% (22/30) and the average optical density was (202.87±18.54), significantly higher than those in group B [23.33% (7/30) and (118.51±10.62)], P<0.01. Conclusion The expression of HIF-la in placental tissues in patients with placenta previa was significantly higher than normal, which could serves as an important indicator for the early diagnosis of placenta previa.%目的 研究缺氧诱导因子-1α(HIF-1α)在前置胎盘患者胎盘组织中的表达,探讨其在前置胎盘发病及病理生理过程中的作用.方法 采用免疫组化法检测并比较前置胎盘患者及正常孕妇的胎盘组织中HIF-1α的表达情况.结果 前置胎盘孕妇组胎盘HIF-1α阳性表达率为73.33%(22/30),光密度值平均为(2 02.87+18.54),均明显高于正常孕妇组水平[HIF-1α阳性表达率为23.33%(7/30),光密度值平均为(118.51±10.62)],差异均具有极显著统计学意义(P<0.01).结论 HIF-1α前置胎盘患者胎盘组织中表达明显升高,有可能成为前置胎盘早期诊断的重要指标.

  13. 动脉序贯介入治疗对凶险型前置胎盘的疗效评价%Evaluation of artery sequential interventional therapy on pernicious placenta previa

    Institute of Scientific and Technical Information of China (English)

    王利民; 罗丹; 周辉; 谢聪; 刘星涛; 李立群; 赵虎; 张家佳; 侯倩男

    2015-01-01

    目的:评价动脉序贯介入治疗(髂内动脉置管+封堵/子宫动脉或髂内动脉栓塞)对凶险型前置胎盘( PPP)出血的治疗效果. 方法:选取在我院诊治的有胎盘植入高危因素的69例PPP患者,其中29例给予传统的治疗方法(对照组) ,40例给予动脉序贯介入治疗(观察组). 比较分析两组患者的术中出血量、输红悬量、子宫切除率、剖宫产手术时间、剖宫产术后24 h出血量、术后住院时间、术后抗生素使用时间及并发症(疼痛、发热、感染及其它并发症)发生率. 结果:观察组与对照组的术中出血量[(868. 5±549. 77) ml vs (1506. 90±1417. 39)ml]、输红悬量[(1. 50±1. 40)U vs (2. 72±2. 00)U]、子宫切除率(2. 50% vs 17. 24%)、剖宫产手术时间[(58. 86±20. 33)min vs (70. 83±29. 26)min]、术后疼痛发生率(81. 25% vs 48. 28%)、其它并发症发生率(0. 00% vs 10. 35%)比较,差异均有统计学意义(P0. 05). 两组产妇(子宫切除者除外)均于停止哺乳后1~3月月经恢复情况正常;42天常规新生儿体检,血象、肝功能及神经系统检查无明显异常、新生儿均无血液系统疾病. 结论:动脉序贯介入治疗PPP有效、可行,且对母婴安全.%Objective:To evaluate the effect of artery sequential interventional therapy ( internal iliac artery catheterization and occlusion/uterine artery or internal iliac artery emboli-zation) on the hemorrhage of pernicious placenta previa. Method:The total of 29 patients with pernicious placenta previa and risk factor of placenta accreta in our hospital were included as control group,who were given traditional method of treatment,while 40 patients with the same disease status as treatment group with artery sequential interventional therapy. The amount of blood loss during operation and red blood cell suspension transfusion,the rate of hysterectomy, cesarean time,the amount of cesarean section hemorrhage after 24 hours,duration of postopera-tive hospital stay

  14. Bakri球囊填塞治疗中央型前置胎盘临床疗效评价%Evaluation of the Clinical Effect of Bakri Balloon Packing in the Treatment of Central Placenta Previa

    Institute of Scientific and Technical Information of China (English)

    魏素梅; 杨霄; 闫咨儒

    2016-01-01

    Objective To evaluate the effectiveness,safety and usage skills of Bakri balloon packing in the treatment of postpartum hemorrhage of central placenta previa. Methods Retrospective analyze the clinical data of 272 cases of central placen-ta previa that appeared hemorrhage by treatment of Bakri balloon and intrauterine packing with gauze in the Department of Obstet-rics of Chengdu women and children's Center Hospital from January 2012 to December 2014. Bakri balloon was selected as the ex-perimental group(n=125),and intrauterine packing with gauze was selected as the control group(n=147). The blood loss in 24 hours,operation time,hospitalization time and incidence rate of adverse events after interventional operation or re-laparotomy when blood transfusion,hysterectomy and hemostasis were not performed were analyzed and compared between the two groups. Results There was no significant difference between the two groups in the general clinical data(P>0. 05). The amount of bleeding after 24 hours of the experimental group was significantly lower than that of control group ( P0. 05),but the control group was higher than that of experiment group. In the experimental group,5(4. 0%)cases of patient had fever,4(3. 2%)cases of patient had balloon prolapse,3(2. 4%)cases of patient had drainage tube plugging,resulting in hematocele in uterine cavity. In the control group,11(7. 48%)patients had fever,it was higher than the experimental group,but the difference was not statistically significant(P>0. 05). Conclusion BakriBakri balloon packing in the treatment of postpartum hemorrhage of the central placenta previa is safe and effective. We should confirm the injection volume of liquid Bakri balloon strictly according to the uterine cavity size and tension;patients should be tightly monitored within 24 hours after the balloon was placed successfully,keeping the drainage tube flow and improving the drainage effect.%目的:评估Bakri球囊填塞治疗中央型前置胎盘产后

  15. 介入技术在完全性前置胎盘和胎盘植入中的临床应用价值%Clinical Value of Interventional Radiologic Technique Combined with Cesarean Delivery in Placenta Previa and Placenta Accrete Patients

    Institute of Scientific and Technical Information of China (English)

    谢娅; 张颖; 彭铮

    2014-01-01

    Objective:To investigate the clinical value of interventional radiologic technique combined with cesarean delivery. Method:40 consecutive patients in our hospital with complete placenta previa or suspected placenta accrete were prospectively assessed from June 2011 to December 2013. 20 cases were treated by traditional cesarean delivery methods, termination of pregnancy as the control group. 20 patients were treated by obstetric joint intervention carried out new DSA in the operating room for abdominal aortic balloon placed+cesarean delivery+the iliac artery and uterine artery embolization, as the DSA group,the different outcomes of the two groups were compared. Result:There were no statistical significance in the neonatal Apgar scores of the two groups(P>0.05);intraoperative and postpartum blood loss,blood transfusion amount in the DSA group were significantly lower than the control group,the differences had statistical significance(P0.05);DSA组术中及产后失血量、输血量均明显低于对照组,差异均有统计学意义(P<0.05);DSA组子宫切除率显著低于对照组,母乳喂养率显著高于对照组,差异均有统计学意义(P<0.05)。结论:剖宫产术中腹主动脉放置球囊联合术后髂内动脉子宫动脉栓塞技术能够显著降低产时产后出血量、输血量、子宫切除率,并提高母乳喂养率。

  16. Influence of different attachment sites of placenta previa on maternal and child outcomes of re-pregnancy after cesarean section%前置胎盘不同附着位置对剖宫产后再次妊娠母婴结局的影响

    Institute of Scientific and Technical Information of China (English)

    刘俊; 谢小琴

    2014-01-01

    目的:探讨前置胎盘不同附着位置对剖宫产后再次妊娠母婴结局的影响。方法回顾性分析本院2011年1月~2013年12月收治的80例剖宫产后再次妊娠合并前置胎盘患者的临床资料,将胎盘附着于前壁的患者分为实验组,附着于后壁的患者为对照组,比较两组患者的一般资料、新生儿情况、妊娠结局和并发症发生情况。结果实验组患者胎盘植入、胎盘粘连、急诊剖宫产、子宫切除、弥散性血管内凝血、产后出血、出血量>1000 ml以及早产发生率均显著高于对照组,差异有统计学意义(P1000 ml and preterm birth of the experimental group were all significantly higher than those of the control group,with statistically significant differences (P<0.05). Conclusion In case of re-preg-nancy concurrent with placenta previa after cesarean section,the pregnancy outcomes of placenta previa attached to an-terior wall are poorer than those of placenta previa attached to posterior wall,and therefore the attachment site should be confirmed in advance in order to improve the pregnancy outcomes.

  17. Placentografía Ecográfica: Estudio “In situ” de la Placenta en el Tercer Trimestre de la Gestación.

    OpenAIRE

    Pérez Baena, Rafael

    2016-01-01

    La Placenta posee una funcionalidad tan exquisita, importante, amplia e indispensable para el desarrollo, integridad del feto y mantenimiento del embarazo que ya no es posible considerarla como un mero órgano de relación fetomaterna. No existe razón alguna para separar al feto de la placenta en su estudio, ni por su origen embriológico ni por la intima reciprocidad funcional que mantienen entre sí. Por ello, en la actualidad, superado el concepto de &ldquo...

  18. “La consulta previa como mecanismo de defensa de los derechos colectivos de los pueblos indígenas. Estudio de caso: Cabildo muisca de Bosa (2008-2012)”

    OpenAIRE

    Castaño Chiguasuque, David

    2014-01-01

    El presente estudio de caso hace un análisis y revisión de la consulta previa en un contexto suburbano como es la comunidad muisca de Bosa. Se describe cómo este mecanismo permite la defensa del territorio ante la expedición del plan parcial El Edén El Descanso que busca desarrollar en esta zona un proyecto de vivienda. En este sentido se hace una revisión de la documentación pública del Cabildo muisca de Bosa, del Distrito y del Ministerio del Interior que sirven de insumo para analizar las ...

  19. Analysis on maternal and fetal outcomes in 73 cases re-pregnant women with cesarean scar uterus complicating placenta previa%瘢痕子宫再次妊娠并发前置胎盘73例母婴结局分析

    Institute of Scientific and Technical Information of China (English)

    马红柳; 罗欣; 漆洪波; 彭方亮

    2016-01-01

    Objective To explore the maternal and fetal perioperative outcomes of re-pregnant women with cesarean scar uterus complicating placenta previa and its influential factors. Methods Seventy-three cases of cesarean scar uterus complicat-ing placenta previa delivered in the First Affiliated Hospital of Chongqing Medical University from January 2014 to December 2015 were retrospectively analyzed. The maternal general condition ,intraoperative situation as well as maternal and fetal outcome were compared. Seventy-three pregnant women were grouped according to whether complicating dangerous placenta previa occur-rence and whether previous pregnancy being elective cesarean section. Results (1)The probability of complicating dangerous placenta previa in re-pregnancy women with previous elective cesarean section was higher than that in re-preganat women with ce-sarean section after vaginal trial labor failure,the difference was statistically significant[40.00%(18/45) vs. 28.57%(8/28),P<0.01]. (2)The occurrence rates of placenta implantation,postpartum hemorrhage,hysterectomy,DIC,blood transfusion and poor neona-tal outcomes in the pregnant women with complicating dangerous placenta previa were significantly higher than those in the preg-nant women with non-dangerous placenta previa,the difference was statistically significant(P<0.05). Conclusion Re-pregnant women with cesarean scar uterus are easier to develop placenta previa;re-pregnancy women with previous elective cesarean sec-tion have the high occurrence rates of complicating dangerous placenta previa and poor maternal and neonatal outcomes;strictly mastering the indication of first cesarean section is the key to reduce the poor maternal and neonatal outcomes of re-pregnancy.%目的:探讨前次剖宫产后瘢痕子宫再次妊娠并发前置胎盘的母婴围生期结局及其影响因素。方法回顾性分析2014年1月至2015年12月于重庆医科大学附属第一医院住院分娩的瘢痕子宫(前次剖

  20. 子宫动脉化疗栓塞术联合药物用于前置胎盘中期引产%Uterine artery chemotherapy and embolization in combination with drugs for induction of labor in placenta previa mid-pregnancy

    Institute of Scientific and Technical Information of China (English)

    游艳琴; 高志英; 卢彦平

    2012-01-01

    目的 探讨子宫动脉化疗栓塞术(uterine artery chemotherapy and embolization,UACE)联合米非司酮及米索前列醇在前置胎盘中期引产中的临床疗效.方法 对5例中期妊娠合并前置胎盘患者行选择性双侧子宫动脉化疗栓塞术+米非司酮及米索前列醇引产.结果 5例患者总产程87-411(223.4±173.4)min;排胎时间为31.58-49.17(32.32±17.7)h;产时及产后2h出血量100-300(144±87)ml.结论 子宫动脉化疗栓塞术联合米非司酮及米索前列醇用于前置胎盘中期引产疗效确切,出血量及并发症少,安全可靠.%Objective To study the clinical efficiency of uterine artery chemotherapy and embolization(UACE) in combination with mifepristone and misoprostol for induction of labor in placenta previa mid-pregnancy. Methods Five placenta previa mid-pregnant women underwent UACE in combination with mifepristone and misoprostol for induction of labor. Results The total labor time of the 5 women was 87-411(223.4 ± 173.4)min. The discharge time of fetus was 31.58-49.17(32.32 ± 17.7)h. The total blood loss was 100-300(144 ± 87)ml during and after labor. Conclusion UACE in combination with drugs is a safe and effective method for the induction of labor in placenta previa mid-pregnancy with few complications and less blood loss.

  1. 欣母沛联合宫腔填纱治疗前置胎盘剖宫产产后出血32例的疗效%Effect of hemabate combined with gauze packing in the treatment of 32 cases of placenta previa intrauterine postpar-tum hemorrhage in cesarean section

    Institute of Scientific and Technical Information of China (English)

    倪洪燕

    2016-01-01

    Objective:To explore the clinical efficacy of hemabate combined with uterine packing treatment of placenta previa postpartum hemorrhage in cesarean section.Methods:64 patients with postpartum hemorrhage in placenta and placenta were se-lected.The control group was divided into two groups.The control group was treated with routine oxytocin and uterine cavity filling. The study group giving hemabate plus uterine cavity filling yarn.We compared two groups of hemorrhage and blood pressure,pulse and blood oxygen saturation changes and analysis complications.Results:2 h and 24 h hemorrhage in the study group were less than those in the control group,and the incidence of complications was lower than that of the control group(P<0.05).Conclusions:The hemabate combined with uterine cavity filling yarn treatment for the placenta previa cesarean section postpartum hemorrhage can effectively reduce the amount of bleeding,with fewer complications.%目的:探究前置胎盘剖宫产产后出血采用欣母沛联合宫腔填纱治疗的临床疗效。方法:收治前置胎盘剖宫产产后出血患者64例,分两组,对照组予以常规缩宫素+宫腔填纱,研究组给予欣母沛+宫腔填纱,比较两组出血情况以及血压、脉搏、血氧饱和度变化,并分析并发症情况。结果:研究组产后2 h及24 h出血量均少于对照组,且并发症发生率较对照组低(P<0.05)。结论:对前置胎盘剖宫产产后出血患者实施欣母沛联合宫腔填纱治疗,不仅能有效减少出血量,并且并发症也较少。

  2. 胎盘附着部位对凶险性前置胎盘妊娠结局的影响及高危因素分析%Maternal outcomes of placental position and analysis of high risk factor in pernicious placenta previa patients

    Institute of Scientific and Technical Information of China (English)

    江静颖

    2014-01-01

    目的:研究不同胎盘附着部位对凶险性前置母婴结局的影响,并分析其发生的高危因素。方法回顾性分析剖宫产后再次妊娠合并前置胎盘105例患者的临床资料,其中胎盘附着于子宫疤痕处46例(研究组),胎盘附着位置未跨越子宫疤痕处59例(对照组)。比较两组患者的一般情况、妊娠特点、妊娠结局及新生儿情况,分析讨论两组发生的相关因素。结果研究组胎盘粘连或植入、产后出血、输血、子宫切除及新生儿窒息发生率的发生率均高于对照组,平均出血量也高于对照组( P ﹤0.05)。回归分析显示妊娠距末次流产时间小于半年者,前次剖宫产术在二级及以下医院开展者,研究组发生率明显高于对照组,差异有统计学意义。结论凶险性前置胎盘,胎盘附着于子宫疤痕处者导致胎盘粘连或胎盘植入、产后出血、输血、子宫切除及新生儿窒息的风险显著增高,是实际意义上的凶险性前置胎盘。前次剖宫产术于二级及以下医院开展,流产后半年内再次妊娠为其发生的高危因素。应提高剖宫产缝合技术,降低剖宫产率,减少流产,降低凶险性前置胎盘的发生。%Objective To discuss the effects of placental position in placenta previa patients with scar uterine on maternal outcomes and to analyze high risk factors of pernicious placenta previa patients. Methods A retrospective study was conducted in 105 re-pregnant women with placenta previa after cesarean section. They were divided to study group( A)included 46 patients who got planted on the cesarean scars. The con_trol group included 59 patients who were planted beyond scars. The general characteristics,maternal outcomes,and neonatal outcomes of these two groups were analyzed to get high risk factor. Results There had no significant differences of age,gestational weeks,bleeding during pregnancy and antepartum hemorrhage

  3. Adenomyosis in pregnancy mimicking morbidly adherent placenta

    Science.gov (United States)

    Tongsong, Theera; Khunamornpong, Surapan; Sirikunalai, Panarat; Jatavan, Thanate

    2014-01-01

    The objective of this study was to illustrate a false-positive diagnosis of adherent placenta due to underlying adenomyosis. A 34-year-old woman was diagnosed for placenta previa totalis with adherent placenta at 33 weeks, based on the findings of loss of clear space or distinguishing outline separating the placenta and uterine wall, presence of intraplacental lacunae and densely atypical vessels in the lesion. Caesarean hysterectomy was performed at 35 weeks. Pathological findings revealed placenta previa totalis with adenomyosis beneath the placenta at the lower segment, with no adherent placenta. In conclusion, this report underlines the importance of possible false-positive test of prenatal ultrasound and MRI findings of adherent placenta caused by underlying adenomyosis which could obliterate the outline distinguishing the placenta and myometrium and atypical vessels secondary to decidualisation and hypervascularity from pregnancy. This case may probably encourage physician to beware of false-positive test of adherent placenta due to adenomyosis. PMID:24722709

  4. Estudio anatomopatológico en placentas de mujeres con hipertensión inducida por el embarazo

    OpenAIRE

    Zamora Vargas, Luis; Aguilar Salazar, Cintya; Cascante Campos, Yancy

    2008-01-01

    La hipertensión inducida por el embarazo (HIE) puede desembocar en una serie de síndromes dependiendo de la gravedad con que se presente y los signos y síntomas que lo acompañen. Sabemos que la interrupción del embarazo junto con la expulsión de la placenta termina con estos problemas. En total se estudiaron 28 placentas en donde los hallazgos más importantes fueron que el 100% de las muestras relacionadas a HIE presentaron patologías y el 87% de las muestras presentaron menos de un 50% de ár...

  5. Propuesta metodológica para mejorar el aprendizaje del tema de electroquímica en estudiantes de 10 grado de la Institución Educativa Cañaveral a través del estudio de sus ideas previas

    OpenAIRE

    Martínez Delgado, John Edison

    2013-01-01

    Este estudio presentado para optar por el título de Magíster en enseñanza de las Ciencias Exactas y Naturales, busca identificar los modelos que los estudiantes poseen para explicar fenómenos de carácter electroquímico a través del estudio de sus ideas previas. Los resultados de este estudio permitirán tener una base sólida para plantear una propuesta metodológica que sirva en futuras intervenciones didácticas, todo enmarcado en una ruta de orientación científica que contribuya al mejoram...

  6. PRENTAL DIAGNOSIS OF CREATINE KINASE DETECTION IN PERNICIOUS PLACENTA PREVIA%凶险型前置胎盘孕妇肌酸激酶检测的产前诊断价值

    Institute of Scientific and Technical Information of China (English)

    周晓

    2014-01-01

    目的:通过比较孕晚期凶险型前置胎盘孕妇和正常妊娠孕妇血清中肌酸激酶的差异,探讨其用于凶险型前置胎盘合并胎盘植入产前诊断的价值。方法回顾性分析2012年6月至2013年6月江西省妇幼保健院凶险型前置胎盘单胎孕妇92例,其中合并胎盘植入者38例,归入凶险型前置胎盘合并胎盘植入组,其余54例归入未合并胎盘植入组,再随机抽取同期分娩的既往有剖宫产史,本次为正常妊娠的孕妇50例作为对照组,比较三组孕妇血清肌酸激酶水平的差异。结果凶险型前置胎盘合并胎盘植入组CK数值为(128.6±19.8)U/L,未合并胎盘植入组为(67.7±21.2) U/L,单纯剖宫产史组为(65.1±20.3) U/L。凶险型前置胎盘合并胎盘植入时,孕妇血清肌酸激酶水平明显升高,差异具有统计学意义。而在中央型前置胎盘、部分型前置胎盘和边缘型前置胎盘中,肌酸激酶分别为(80.3±38.2) U/L、(77.1±36.0) U/L、(79.6±29.7) U/L,三者差异无统计学意义。结论孕妇血清肌酸激酶的测定对凶险型前置胎盘合并胎盘植入的产前预测有价值,与前置胎盘的类型无关。%Objective:Through comparing the content difference of serum creatine kinasebetween pregnant women with pernicious placenta priva and the normal ones to investigate its value in prenatal diagnosing pernicious placenta priva with placenta accreta.Methods:A total of 92 patients of pernicious placenta priva were retrospectively analyzed in Maternal and Child Care Service Centre of Jiangxi Province from June 2012 to June 2013, among them, 38 cases of pernicious placenta priva with placenta accrete after operation were classified into the study group with placenta accreta, others into the study group without placenta accrete, then 50 women having caesarean section ever but normal pregnance this time into the control group. The levels of serum creatine kinase among three groups were

  7. ISO 14006. Experiencias previas de estudios de arquitectura que han adoptado el estándar de ecodiseño UNE 150301:2003

    Directory of Open Access Journals (Sweden)

    Arana-Landín, G.

    2012-09-01

    Full Text Available This paper aims to analyze the pioneer UNE 150301 standard, as well as its adoption process and its practical results in the sector of architecture studios. First, the structure, the aim and the scope of norm UNE 150301 have been analysed. Second, the standard's implementation has been examined, concluding that 73% of the companies that have obtained the certificate are architecture studios. A case study has therefore been carried out with the participation of five architecture studios pioneers. These experiences have let us know the main aspects and difficulties of the process. In conclusion, the adoption of the standard UNE 150301 can be a helpful tool in order to reduce the environmental impact of the products and obtain some competitive advantages such as cost reduction, improvement in energy efficiency of the product and a better adaptation to acts and regulations.

    En este artículo se analiza la experiencia de implantación de la norma UNE 150301 de ecodiseño en el sector de los estudios de arquitectura. Tras el examen de la estructura de norma UNE 150301, de sus objetivos y de su alcance, se analiza su difusión, destacándose que el 73% de las empresas certificadas en España son estudios de arquitectura. A continuación se estudia el proceso de implantación real, mediante el estudio de caso que lo analiza en cinco estudios de arquitectura. El estudio realizado permite conocer de primera mano las principales claves y dificultades del proceso de implantación del estándar, así como los resultados obtenidos, entre los que destaca una reducción del impacto ambiental. Se constata, en suma, que la norma UNE 150301 es una herramienta que puede proporcionar ventajas competitivas interesantes a las empresas del sector de los estudios de arquitectura.

  8. 前置胎盘终止妊娠的时间对产后出血和新生儿预后的影响%To Explore the Effect of Terminated Pregnancy Time for the Patients With Placenta Previa on the Postpartum Hemorrhage and Newborn Prognosis

    Institute of Scientific and Technical Information of China (English)

    农芳琼

    2015-01-01

    Objective To study the inlfuence of different time of pregnancy termination to the patients with placenta previa on the postpartum hemorrhage and neonatal condition.Methods There were two groups of patients in this study. The patients with placenta previa who terminated pregnancy before 36 weeks of pregnancy were in the first group, while those who terminated pregnancy after 36 weeks of pregnancy were in the second group. There were 150 patients in each group. The data (including the incidence of prenatal and postpartum hemorrhage, the amount of postpartum hemorrhage, neonatal asphyxia, the situation of perinatal neonatal death) of the two groups were compared. The results including the incidence of maternal prenatal bleeding and postpartum hemorrhage of the ifrst groups were signiifcantly higher than those of the second group, with statistical signiifcant differences (P<0.05). The amount of postpartum hemorrhage of the ifrst group was obviously higher than that of the second group with the statistical significant difference (P<0.05). The number of patients with neonatal asphyxia and perinatal deaths of the ifrst group were more than those of the second groups with statistical signiifcant differences (P<0.05).Conclusion Cesarean section is still the first choice for the patients with placenta previa. We usually terminate pregnancy after 36 weeks of pregnancy, which will be better for the outcomes of maternal and neonatal.%目的:对存在前置胎盘症状的患者以不同的时间终止妊娠对产妇产后出血和新生儿产生的影响情况进行研究。方法选择在我院就诊的孕36周之前(含孕36周)终止妊娠的前置胎盘患者和孕36周以后终止妊娠的前置胎盘患者各150例,分别将其定义为研究1组和研究2组。对两组研究对象的产前出血率、产后出血率、产后平均出血量、新生儿窒息、围产期新生儿死亡等情况进行对比。结果研究1组产妇在产前出血率和产

  9. Estimulación del asa eferente previa al cierre de ileostomía de protección. Estudio prospectivo randomizado

    OpenAIRE

    Abellán Morcillo, Israel

    2014-01-01

    Objetivo Pretendemos evaluar la utilidad de una nueva técnica en la disminución del íleo postoperatorio tras el cierre de ileostomía de protección. Introducción El íleo paralítico postoperatorio representa la complicación más frecuente tras el cierre de ileostomía con un aumento de la morbilidad, estancia hospitalaria y gasto sanitario. Pacientes y método Este estudio prospectivo randomizado incluye a 70 pacientes intervenidos de cierre de ileostomía. En 35 pacientes se realizó previamente a ...

  10. Application value and timing of bloom occlusion in perioperative phase of pernicious placenta previa%球囊介入动脉闭塞术在凶险型前置胎盘围术期中的应用价值及时机

    Institute of Scientific and Technical Information of China (English)

    黄金瑞; 李敏清

    2015-01-01

    目的:探讨球囊介入动脉闭塞术在凶险型前置胎盘合并胎盘植入围术期中的应用价值及时机。方法回顾性分析2010年1月~2014年12月广西医科大学附属南宁市第一人民医院45例凶险型前置胎盘合并胎盘植入产妇的临床资料,其中24例在膀胱镜检查+双侧输尿管逆行插管术+球囊介入髂总动脉闭塞术下施行二次剖宫产术(介入组),21例直接行二次剖宫产术(对照组)。比较两组的术中出血量、输血量、产后出血率、子宫切除发生率、并发症发生率、围生儿情况及住院费用等。结果介入组术中出血量[(1596.08±156.25)mL]、输血量[浓缩红细胞:(4.42±2.10)U],血浆:(534.34±36.12)mL]、产后出血率(29.17%)均明显低于对照组[(2296.08±184.38)mL、(7.27±2.05)U、(1164.10±75.26)mL、47.62%],差异均有统计学意义(P0.05)。结论凶险型前置胎盘合并胎盘植入在球囊介入动脉闭塞术下行剖宫产术,具有有效、安全、创伤小等优点,是一种新型有效的治疗措施。%Objective To explore the application value and operation time of interventional therapy in perioperative phase of pernicious placenta previa with placenta implantation. Methods The clinical data of 45 cases of pernicious placenta previa with placenta implantation from January 2010 to December 2014 in the First People's Hospital of Nan-ning City, Guangxi Medical University, were retrospectively analyzed. 24 patients were given cesarean section using cystoscopy and retrograde catheterization and arterial embolization (intervention group), and another 21 patients were given traditional cesarean section (control group). The comparisons of intraoperative bleeding volume, transfused blood volume,womb excision incidence rate, postpartum hemorrhage rate, complication incidence rate, hospitalized cost, ges-tational age and neonatal asphyxia rate between the two groups were done. Results Compared to the control group, the research

  11. Aceitunas tipo negras. Estudio comparativo de tres procedimientos para ia conservación previa de frutos de la variedad gordal (O. europaea regalis

    Directory of Open Access Journals (Sweden)

    Garrido Fernández, A.

    1991-04-01

    Full Text Available This paper shows the physico-chemical and microbiological results of the brines from three procedures of previous conservation of Gordal cultivar olives and its effects on the main quality attributes of the final product: colour and texture. Two of them have used low NaCl levels and initial pH correction to facilitate the growth of lactic bacteria. The other has consisted of a solution highly acidified with acetic. In all procedures, a fermentation process has been found. During it the growth of lactic bacteria, mainly Lactobacillus plantarum and Pediococcus (that has predominated in some cases and yeats, which have coexisted with the previous mentioned microorganisms thought the whole conservation period, has been detected. The evolution of the physico-chemical characteristics has been different in the three processes, however they have not had any influence on the elaborated final product. For industrial work, the aerobic system is recommended due to its CO2 purging action which could have a favorable effect on shriveling. It would consist of putting the olives in a 6% NaCl brine, with the initial pH corrected with acetic to 4.00 units and bubbling air throughout the column at a rate of 0.3 l/h.l.c. during 8 h/day. The salt percentage should be raised to 8% once the lactic fermentation has finished.El trabajo presenta los resultados físico-químicos y microbiológicos de las salmueras de tres procedimientos de conservación previa de aceitunas de la variedad Gordal, así como sus efectos en los principales atributos de calidad del producto final: color y textura. Dos de ellos han consistido en la utilización de niveles bajos de NaCl y la corrección inicial del pH para facilitar el crecimiento de una flora láctica. El otro ha sido un medio fuertemente acidificado con acético. En todos ellos ha tenido lugar un proceso fermentativo en el que se han desarrollado bacterias lácticas, fundamentalmente Lactobacillus plantarum y Pediococcus (que

  12. Maternal Outcomes According to Placental Position in Placental Previa

    Directory of Open Access Journals (Sweden)

    Dong Gyu Jang, Ji Sun We, Jae Un Shin, Yun Jin Choi, Hyun Sun Ko, In Yang Park, Jong Chul Shin

    2011-01-01

    Full Text Available Purpose: The purpose of this retrospective cohort study was to elucidate whether the location of placenta below uterine incision in cesarean section is important in the development of maternal complications in placenta previa patients.Methods: The study was conducted on 409 patients 414 parturition at 3 hospitals in affiliation with the Catholic Medical Center, Seoul, Korea from May 1999 to December 2009. The subjects were divided to two groups: the group whose placenta was located in the anterior portion of the uterus (anterior group and the group whose placenta was located in the posterior portion of the uterus (posterior group. And then they are compared to each other. Logistic regression was used to control for confounding factors.Results: In the anterior group, regardless of confounding factors, the incidence of excessive blood loss (OR 2.97; 95% CI: 1.64-5.37, massive transfusion (OR 3.31; 95% CI: 1.33-8.26, placental accreta (OR 2.60, 95% CI: 1.40-4.83, and hysterectomy (OR 3.47, 95% CI: 1.39-8.68 was higher.Conclusion: Sonographic determination of the placental position where its location beneath the uterine incision is very important to predict maternal outcomes in placenta previa patients, and such cases, close attention should be paid for massive hemorrhage.

  13. Investigation of the Choice of Hemostatic Method and the Clinical Application Value in Placenta Previa Caesarean Section%前置胎盘剖宫产术中止血方案的选择及临床应用价值探讨

    Institute of Scientific and Technical Information of China (English)

    侯倩

    2016-01-01

    Objective To investigate the choice of hemostatic method and the clinical application value in placenta previa caesarean section.Methods 177 cases of placenta previa puerperae with hemorrhage in cesarean section treated in our hospital from March 2011 to February 2014 were selected as the research object.According to the random number table method , they were divided into A , B, C of three groups with 59 cases in each group.Group A group were treated with interrupted annular suture and group B were treated with 8-like suture while group C were treated with intrauterine packing with gauze.The intraoperatve blood loss , cases receiving blood transfusion , blood transfusion volume , course of surgery , hemostatic time and other treatment indexes were compared between the three groups.With 6 months of follow-up during behavioral period , the incidence of related complications and the rate of hysterectomy were recorded.Results ①The bleeding volume , cases receiving blood transfusion , blood transfusion volume , course of surgery , hemostatic time and other treatment indexes in group A were significantly lower than those in group B and C , followed by group B and the hemostatic effect in group C was the worst ( P<0.05 ); ②During the follow-up period , there were no significant differences in the incidence of complications and the rate of hysterectomy between group A they were lower than those in group C ( P<0.05 ) .Conclusion To adopt interrupted annular suture hemostasis in puerperae with hemorrhage during placenta previa cesarean section , the hemostatic effect is definite.It can effectively reduce the risk of postoperative complications and the uterine protection effect is ideal , which is worthy of clinical promotion.%目的:探讨前置胎盘剖宫产术中止血方案的选择及临床应用价值。方法选取佛山市顺德区妇幼保健院于2011年3月—2014年2月收治的177例剖宫产术中出血的前置胎盘产妇为研究对象,采用随

  14. Eficacia del uso odontológico de la anestesia tópica previa a la punción anestésica infiltrativa: Estudio doble ciego Effectiveness of dental use of topical anesthesia prior to puncture and infiltration of the anesthetic: Double-blind study

    OpenAIRE

    2011-01-01

    Objetivos: Comprobar la efectividad de la aplicación tópica de un gel de benzocaína en la reducción del dolor producido por el pinchazo y la infiltración anestésica de la mucosa vestibular de caninos superiores. Materiales y métodos: Realizamos un estudio doble ciego, sobre 152 pacientes (80 hombres y 72 mujeres), que precisaban anestesia en la mucosa vestibular de la zona canina. Valoramos el dolor del paciente al pinchazo y a la infiltración, y la existencia de experiencias previas dolorosa...

  15. RUPTURA UTERINA ESPONTANEA POR PLACENTA PERCRETA

    OpenAIRE

    2003-01-01

    La rotura uterina en un útero sin cicatriz previa, y temprano en el tercer trimestre, es un evento raro. Se expone el caso clínico de una paciente que se presenta con abdomen agudo, cursando embarazo de aproximadamente 25 semanas, se realiza laparotomía exploradora encontrando hemoperitoneo, feto y placenta libres en la cavidad peritoneal y útero roto en el fondo invadido por la placenta, que compromete epiplón mayor. Se realiza histerectomía y se confirma el diagnóstico con biopsia

  16. 前置胎盘患者自体血浆分离联合术中自体血回收的可行性%Feasibility of autologous plasmapheresis combined with intraoperative blood salvage during cesarean section in patients with placenta previa

    Institute of Scientific and Technical Information of China (English)

    卢子会; 周春波; 黄长顺; 严海雅

    2014-01-01

    Objective To evaluate the efficacy and safety of autologous plasmapheresis combined with intraoperative blood salvage during cesarean section in patients with placenta previa. Methods Sixty patients with placenta previa scheduled for elective cesarean section, were randomly divided into three groups with 20 cases in each group. In group I, blood was with-drawn before anesthesia, to sequester the autologous plasma for re- infusion. An autotransfusion device was used to col ect and re- infuse autologous RBC during the course of the operation in both groups I and II, while an al ogenic blood transfusion was conducted in group III as necessary. Hemoglobin(Hb), hematocrit (Hct), platelet count (Plt), prothrombin time (PT), activated par-tial thromboplastin (aPTT), fibrinogen (FIB) were detected at time points of entering operation room (T1), 10min after col ecting blood(T2), 10 min before autologous re- infusing(T3), 10 min after autologous blood re- infusing(T4), 6h after operation(T5) and 24h after operation (T6). Hemodynamic changes, fetal heart rate, Apger score, umbilical cord artery blood gas analysis, volumes of blood loss and blood transfusion of three groups were documented and compared. Results There were no significant differ-ences in hemodynamic changes, fetal heart rate, Apger score and umbilical cord artery blood gas analysis among three groups. The increase of Plt level of Group I was significantly different from Group II and Group III at T4 and T5 (P<0.05);PT level change in Group I had significant differences compared with Group II and Group III at T4 (P<0.05). The volumes of plasma transfusion in Group II and Group III had significant differences compared with Group I (P<0.05). The volumes of packed red blood cells (RBCs) transfusion in Group III had significant differences compared with Group I and Group II (P<0.05). Conclusion Autolo-gous plasmapheresis combined with intraoperative blood salvage is safe and feasible, which can reduce the al ogeneic

  17. Real increasing incidence of hysterectomy for placenta accreta following previous caesarean section.

    LENUS (Irish Health Repository)

    Higgins, Mary F

    2013-11-01

    Placenta accreta, morbid adherence to the uterus to the myometrium, is commonest in association with placenta previa in women previously delivered by caesarean section (CS). It has become proportionally a greater cause of major maternal morbidity and mortality as the frequency of other serious obstetric complications has declined. The aim of this study was to examine the incidence of placenta accreta in the context of a rising caesarean delivery rate.

  18. Placenta Percreta With Invasion into the Urinary Bladder

    Directory of Open Access Journals (Sweden)

    Zachary L. Smith

    2014-01-01

    Full Text Available Placenta percreta is a rare condition, which can lead to significant morbidity and potentially mortality. We present a case of a 38-year-old woman who presented at 24 weeks gestation with vaginal bleeding and was found to have complete placenta previa with placenta percreta invading the urinary bladder. Her hospital course was complicated by bilateral pulmonary emboli. She underwent an exploratory laparotomy, repeat Caesarean section, and total abdominal hysterectomy. Because of placental invasion into the bladder, the procedure was complicated by bladder and ureteral injuries for which urology carried out repair. Postoperatively, the patient had a persistent bladder leak until postoperative day #39.

  19. Prediction of vaginal bleeding and premature birth by ultrasound-measured cervical length in pregnant women with placenta previa%超声测量前置胎盘孕妇子宫颈管长度预测阴道出血与早产

    Institute of Scientific and Technical Information of China (English)

    袁晓兰; 刘国成; 王丽敏; 陈虹; 牛建民

    2011-01-01

    previa using ultrasound, and to explore the association between cervical length and premature birth or vaginal bleeding. Methods Between January 2005 and January 2010, 82 pregnant women with placenta previa who underwent prenatal examinations and delivery in our hospital were divided into three groups based on gestation weeks 28-30, 31-33 and 34-36. Ultrasound was used to measure the cervical length of pregnant women in three groups. The number of pregnant women with cervical length >30 mm or ≤ 30 mm was recorded. Data about vaginal bleeding, abdominal pain, symptomatic uterine contraction, pretmature birth, mean gestation age at delivery, birth weight and neonatal asphyxia rate between pregnant women with cervical length >30 mm or ≤30 mm in 3 groups were compared. The ROC curves of vaginal bleeding and premature delivery predicted by cervical length were generated. Area under curve (AUC) and critical point on the ROC were calculated. Results The number of pregnant women with cervical length >30 mm or ≤30 mm in three groups were 20, 8 of 28-30 weeks group, 19, 11 of 31-33 weeks group, 11, 13 of 34-36 weeks group respectively. Women with cervical length ≤30 mm were more likely to have vaginal bleeding, premature birth [28-30 weeks group: 87.5% vs 20% for vaginal bleeding, 75% vs 15% for premature birth; 31-33weeks group: 72.73% vs 26.32% for vaginal bleeding, 63.64% vs 21.05% for premature birth; 34-36 weeks group: 69.23% vs 27.27% for vaginal bleeding, 38.46% vs 18.18% for premature birth; all P<0.05]. The ratio of abdominal pain and symptomatic uterine contraction in pregnant women with cervical length ≤30 mm as compared to those with cervical length >30 mm. The mean gestation age and birth weight were lower in pregnant women with cervical length ≤ 30 mm than those in women with cervical length >30 mm among three groups (all P<0.05). In 28-30 and 31-33 weeks groups, the rates of neonatal asphyxia appeared higher in

  20. Localization of placenta in scanning by /sup 113m/In radiopharmaceuticals

    Energy Technology Data Exchange (ETDEWEB)

    Cho, O.K.; Oh, K.K.; Park, C.Y.; Choi, B.S.; Ha, C.H.; Chung, S.O.; Kwak, H.M.

    1975-01-01

    Placenta previa is a common grave complication of late pregnancy, usually manifestated clinically by painless antenatal vaginal bleeding. Digital and rectal examinations are dangerous, due to the possibility that profuse hemorrhage from the vagina may result. Various radiological examinations have been performed in placenta previa for diagnosis and localization. However radioisotopic methods are superior due to safety, simplicity and a lower radiation dose, both fetal and maternal, compared to plain radiography. Among radiopharmaceuticals, In/sup 113m/ (transferrin for blood pool scan) is useful, giving more satisfactory results without any complications or untoward reactions.

  1. Diseño de nuevos planes de estudios de medicina en el contexto del espacio europeo de educación superior: I.- Punto de partida y decisiones previas

    Directory of Open Access Journals (Sweden)

    Josep Carreras

    Full Text Available Hasta hace poco el proceso de construcción del Espacio Europeo de Educación Superior (EEES, por lo que respecta a los estudios de Medicina, se ha desarrollado con un ritmo más lento que en el caso de otras titulaciones; lo que, en parte, puede explicarse por las dificultades que las directrices comunitarias sobre la titulación de Medicina pueden suponer para la adaptación a la estructura de los estudios universitarios en dos ciclos (bachelor/master prevista en el proceso de Bolonia.En este artículo se analizan las normas comunitarias y la legislación promulgada hasta ahora en España en aplicación de los principios del EEES, y se comentan las posibilidades que de ellas se derivan para la estructuración de los futuros planes de estudios de la titulación de Medicina, en el marco del nuevo paradigma educativo: el diseño de los planes de estudios a partir de la definición de perfiles competenciales y de resultados de aprendizaje.

  2. Decreased placental and maternal serum TRAIL-R2 levels are associated with placenta accreta.

    Science.gov (United States)

    Oztas, Efser; Ozler, Sibel; Ersoy, Ali Ozgur; Ersoy, Ebru; Caglar, Ali Turhan; Uygur, Dilek; Yucel, Aykan; Ergin, Merve; Danisman, Nuri

    2016-03-01

    TNF-related apoptosis-inducing ligand receptor-2 (TRAIL-R2) is produced both by decidual and trophoblast cells during pregnancy and known to participate in apoptosis. In this study, we aimed to determine and to compare maternal serum and placental TRAIL-R2 levels in patients with placenta accreta, non-adherent placenta previa and in healthy pregnancies. We also aimed to analyze the association of placenta accreta with the occurrence of previous C-sections. A total of 82 pregnant women were enrolled in this case-control study (27 placenta accreta patients, 26 non-adherent placenta previa patients and 29 age-, and BMI-matched healthy, uncomplicated pregnant controls). TRAIL-R2 levels were studied in both maternal serum and placental tissue homogenates. Determining the best predictor(s) which discriminate placenta accreta was analyzed by multiple logistic regression analyses. Adjusted odds ratios and 95% confidence intervals were also calculated. Both placental and serum TRAIL-R2 levels were significantly lower in placenta accreta group (median 34.82 pg/mg and 19.85 pg/mL, respectively) when compared with both non-adherent placenta previa (median 39.24 pg/mg and 25.99 pg/mL, respectively) and the control groups (median 41.62 pg/mg and 25.87 pg/mL, respectively) (p placenta accreta (OR: 0.934 95% CI 0.883-0.987, p = 0.016 and OR:7.725 95% CI: 2.717-21.965, p placenta accreta, suggesting a possible role of apoptosis in abnormal trophoblast invasion. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Eficacia del uso odontológico de la anestesia tópica previa a la punción anestésica infiltrativa: Estudio doble ciego Effectiveness of dental use of topical anesthesia prior to puncture and infiltration of the anesthetic: Double-blind study

    Directory of Open Access Journals (Sweden)

    M. Cabo Valle

    2011-04-01

    Full Text Available Objetivos: Comprobar la efectividad de la aplicación tópica de un gel de benzocaína en la reducción del dolor producido por el pinchazo y la infiltración anestésica de la mucosa vestibular de caninos superiores. Materiales y métodos: Realizamos un estudio doble ciego, sobre 152 pacientes (80 hombres y 72 mujeres, que precisaban anestesia en la mucosa vestibular de la zona canina. Valoramos el dolor del paciente al pinchazo y a la infiltración, y la existencia de experiencias previas dolorosas o no dolorosas al pinchazo e infiltración de la solución anestésica. Resultados: Los resultados confirmaron la efectividad de la benzocaína para reducir el dolor del pinchazo (p0,005. Discusión: La efectividad de los anestésicos tópicos en la prevención del dolor al pinchazo al igual que en la disminución de la percepción del dolor ante la existencia de experiencias previas desagradables ha sido comprobada. La infiltración anestésica tiene gran variedad de variables que influyen en la sensación álgica, que no pueden ser controladas por la sola aplicación del anestésico tópico.Purpose: To test the effectiveness of topical benzocaine gel in reducing the pain of the puncture and infiltration of anaesthesia, in vestibular mucosa of upper canine. Material and Methods: We conducted a double blind study on 152 patients (80 men and 72 women, who needed anaesthesia in the buccal mucosa of the canine area. We value the patient's pain to pinprick and infiltration, and the existence of prior experience painful or not painful to puncture and infiltration of the anaesthetic. Results: The results confirmed the effectiveness of benzocaine to reduce the pain of a prick (p0.005.

  4. Estimulación del asa eferente previa al cierre de ileostomía de protección. Estudio prospectivo randomizado / Israel Abellán Morcillo

    OpenAIRE

    Abellán Morcillo, Israel

    2014-01-01

    Objetivo Pretendemos evaluar la utilidad de una nueva técnica en la disminución del íleo postoperatorio tras el cierre de ileostomía de protección. Introducción El íleo paralítico postoperatorio representa la complicación más frecuente tras el cierre de ileostomía con un aumento de la morbilidad, estancia hospitalaria y gasto sanitario. Pacientes y método Este estudio prospectivo randomizado incluye a 70 pacientes intervenidos de cierre de ileostomía. En 35 pacientes se realiz...

  5. Complete Hydatidiform Mole Presenting as a Placenta Accreta in a Twin Pregnancy with a Coexisting Normal Fetus: Case Report

    Directory of Open Access Journals (Sweden)

    Marijo Aguilera

    2012-01-01

    Full Text Available A twin pregnancy with a complete hydatidiform mole and a coexisting normal fetus (CHMF is a rare clinical scenario, and it carries many associated pregnancy and postnatal risks. Limited numbers of case studies exist reporting an outcome of live birth, and only three prior cases report the presentation of a hydatidiform mole as a placenta previa. We report a case of CHMF with the molar component presenting antenatally as a placenta previa, which ultimately resulted in placenta accreta at the time of delivery. A live male infant was delivered at 34 weeks’ gestation via planned cesarean section, and a hysterectomy was performed following unsuccessful removal of the molar component. We additionally utilized previously described methods of placing internal iliac balloons and ureteral stents prior to delivery. In such a high-risk pregnancy with a known molar previa component, these surgical preparation measures may be of benefit.

  6. Una metodología para el estudio de las ideas previas sobre química a través del análisis de expresiones gráficas

    Directory of Open Access Journals (Sweden)

    Didier L. Ruíz

    2015-01-01

    Full Text Available Se examinaron las respuestas gráficas de hombres y mujeres jóvenes, de 17 años en promedio, inscritos en cursos de nivelación en ciencias. Se encontró que predominan en toda la población alusiones a material de laboratorio y a experimentos. La categoría denominada Iconos/Iconemas (representaciones de sensaciones o sentimientos, o figuras geométricas aisladas aparece con frecuencia en la población de 17 años. Los análisis muestran que el porcentaje de población que incluye el cuerpo humano en sus expresiones nunca es superior al 30 %. Cuando aparecen figuras humanas sus escenarios dejan ver que son experimentadores, no se muestra el cuerpo humano como parte del estudio químico. Al indagar sobre la orientación vocacional, se encontró que los hombres prefieren carreras científicas y las mujeres optan por programas del área de la salud. El artículo concluye que es posible indagar y analizar la percepción esencial sobre el área de la química gracias al estudio de expresiones gráficas y considerar correspondencias entre edad, sexo y orientación vocacional. Esta información es útil tanto para planear y orientar las actividades de aula, como para inquirir paradigmas y concepciones, y establecer el grado de abstracción y el conocimiento de los estudiantes sobre el alcance y la aplicabilidad de la química.

  7. [Perioperative management of abdominal aortic balloon occlusion in patients complicated with placenta percteta: a case report].

    Science.gov (United States)

    Zeng, Hong; Wang, Yan; Wang, Yang; Guo, Xiang-yang

    2015-12-18

    When placenta previa complicated with placenta percreta, the exposure of operative field is difficult and the routine methods are difficult to effectively control the bleeding, even causing life-threatening results. A 31-year-old woman, who had been diagnosed with a complete type of placenta previa and placenta percreta with bladder invasion at 34 weeks gestation. Her ultrasound results showed a complete type of placenta previa and there was a loss of the decidual interface between the placenta and the myometrium on the lower part of the uterus, suggestive of placenta increta. For further evaluation of the placenta, pelvis magnetic resonance imaging was performed, which revealed findings suspicious of a placenta percreta. She underwent elective cecarean section at 36 weeks of gestation. Firstly, two ureteral stents were placed into the bilateral ureter through the cystoscope. After the infrarenal abdominal aorta catheter was inserted via the femoral artery (9 F sheath ), subarachnoid anesthesia had been established. A healthy 2 510 g infant was delivered, with Apgar scores of 10 at 1 min and 10 at 5 min. Immediately after the baby was delivered, following which there was massive haemorrhage and general anaesthesia was induced. The balloon catheter was immediately inflated until the wave of dorsal artery disappeared. With the placenta retained within the uterus, a total hysterectomy was performed. The occluding time was 30 min. The intraoperative blood loss was 2 500 mL. The occluding balloon was deflated at the end of the operation. The patient had stable vital signs and normal laboratory findings during the recovery period and the hemoglobin was 116 g/L. She was discharged six days after delivery without intervention-related complications. This case illustrates that temporary occlusion of the infrarenal abdominal aorta using balloon might be a safe and effective treatment option for patients with placenta previa complicated with placenta percreta, who were at high

  8. A Case of Placenta Increta Mimicking Submucous Leiomyoma

    Directory of Open Access Journals (Sweden)

    Ali Ekiz

    2014-01-01

    Full Text Available In recent years with the increase in cesarean section rates, the frequency of placenta accreta cases rises. It causes 33–50% of all emergency peripartum hysterectomies. We present a 42-year-old case who was caught with early postpartum hemorrhage due to retained placental products. The ultrasonography showed a 65 × 84 mm mass in the uterine cavity after the delivery. Due to presence of early postpartum hemorrhage which needs transfusion, an intervention decision was made. The patient underwent curettage but the mass could not be removed so that placental retention was ruled out. Submucous leiomyoma was made as first-prediagnosis. Hysterectomy operation was performed as a curative treatment. Placenta increta diagnosis was made as a final diagnosis with pathological examination. As a result, placental attachment disorders may be overlooked if it is not a placenta previa case.

  9. Maternal plasma levels of cell-free β-HCG mRNA as a prenatal diagnostic indicator of placenta accrete.

    Science.gov (United States)

    Zhou, J; Li, J; Yan, P; Ye, Y H; Peng, W; Wang, S; Wang, X Tong

    2014-09-01

    Several biomarkers, including maternal serum creatinine kinase and α-fetoprotein, have been described as potential tools for the diagnosis of placental abnormalities. This study aimed to determine whether maternal plasma mRNA levels of the β subunit of human chorionic gonadotropin (β-HCG) could predict placenta accreta prenatally. Sixty-eight singleton pregnant women with prior cesarean deliveries (CDs) were classified into three groups: normal placentation (35 women, control group); placenta previa alone (21 women, placenta previa group); and both placenta previa and placenta accreta (12 women, placenta previa/accreta group). Maternal plasma concentrations of cell-free β-HCG mRNA were measured by real-time reverse-transcription polymerase chain reaction and were expressed as multiples of the median (MoM). Cell-free β-HCG mRNA concentrations (MoM, range) were significantly higher in women with placenta accreta (3.65, 2.78-7.19) than in women with placenta previa (0.94, 0.00-2.97) or normal placentation (1.00, 0.00-2.69) (Steel-Dwass test, P placenta previa/accreta group, the concentration of cell-free β-HCG mRNA was significantly higher among women who underwent CDs with hysterectomy (4.41, 3.49-7.19) than among women whose CDs did not result in hysterectomy (3.20, 2.78-3.70) (Mann-Whitney U test, P = 0.012). An increased level of cell-free β-HCG mRNA in the maternal plasma of women with placenta accreta may arise from direct uteroplacental transfer of cell-free placental mRNA molecules. The concentration of cell-free β-HCG mRNA in maternal plasma may be applicable to the prenatal diagnosis of placenta accreta, especially to identify women with placenta accreta likely to require hysterectomy. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Analysis of influencing factors on massive hemorrhage during elective cesarean section in patients with placenta previa%前置胎盘导致选择性剖宫产产妇大出血的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    王娟; 晋雅凌; 李引弟

    2016-01-01

    pregnant woman with placenta praevia .Methods A total of 105 puerperas who were underwent elective caesarean section with placenta praevia in Obstetrics Department of Yan′an University Affiliated Hospital from April 2004 to February 2014 ,were chosen as study objects . According to the blood loss volume during elective caesarean section ,they were divided into massive hemorrhage(MH ) group (n= 47 , the average blood loss volume was 2 054 mL during elective caesarean section) and non‐massive hemorrhage (NMH) group(n=58 ,the average blood loss volume was 540 mL during elective caesarean section ) .Retrospective cohort study was used to research the maternal medical records ,and used statistical method to compare the differences between two groups of puerperas in maternal age ,body mass index(BMI) ,obstetric history ,hemoglobin(Hb) content , the highest diastolic and systolic blood pressure during pregnancy etc .,used unconditional multivariate logistic regression analysis to assess the independent factors for massive hemorrhage during elective caesarean section in pregnant woman with placenta praevia .All subjects of this study have signed the informed consent forms , and got the approval of Yan′an University Affiliated Hospital Ethics Committee .Results ① The proportion of caesarean section maternal age ≥ 34 years old and the incidence rate of placenta located to anterior in M H group were higher than those of NM H group ,but the highest diastolic and systolic blood pressure during pregnancy were lower than those of NM H group ,and all the differences above were statistically significant (P 0 .05 ) .② Unconditional multivariate logistic regression analysis results showed that maternal age ≥ 34 years old(OR=2 .09 ,95% CI:1 .16‐3 .71 , P<0.05) and placenta located to anterior (OR = 2 .21 , 95% CI:1 .21‐4 .03 ,P< 0 .05 ) were independent risk factors of massive hemorrhage during elective caesarean section in pregnant woman with placenta praevia .Conclusions

  11. Alternative management in a case of placenta accreta with previous caesarean

    Directory of Open Access Journals (Sweden)

    Rajani M. Parikh

    2012-12-01

    Full Text Available The rate of caesarean is increasing day by day, and with it the chance of repeat caesarean. This has led to a rise in the chance of occurrence of placenta accreta. Control of bleeding is the main goal in such cases, which usually necessitates hysterectomy. But alternative methods are useful when retaining fertility is important. We present this case of a 30 yr old female who was admitted as a case of central placenta previa with previous caesarean. Per operatively, placenta was attached along the incision and baby was delivered by separating the placenta attached above the upper margin of incision. On attempting to remove the placenta attached to lower part of incision, it was found to be adherent along the previous scar. So placenta was removed piece meal, some part was left behind. Box sutures were taken over that part and uterine packing was done to control the bleeding. Post operatively the patient was fine and given injection Methotrexate on 8th day following the regime of 1, 3, 5, 7 days. She failed to expulse the placenta by 6wks, so D&E was done and retained products were removed. Leaving the placenta in situ followed by Methotrexate and interval removal of placenta can thus be helpful in conserving the uterus and hence, the fertility. [Int J Reprod Contracept Obstet Gynecol 2012; 1(1.000: 58-60

  12. Conventional MRI features for predicting the clinical outcome of patients with invasive placenta

    Science.gov (United States)

    Chen, Ting; Xu, Xiao-Quan; Shi, Hai-Bin; Yang, Zheng-Qiang; Zhou, Xin; Pan, Yi

    2017-01-01

    PURPOSE We aimed to evaluate whether morphologic magnetic resonance imaging (MRI) features could help to predict the maternal outcome after uterine artery embolization (UAE)-assisted cesarean section (CS) in patients with invasive placenta previa. METHODS We retrospectively reviewed the MRI data of 40 pregnant women who have undergone UAE-assisted cesarean section due to suspected high risk of massive hemorrhage caused by invasive placenta previa. Patients were divided into two groups based on the maternal outcome (good-outcome group: minor hemorrhage and uterus preserved; poor-outcome group: significant hemorrhage or emergency hysterectomy). Morphologic MRI features were compared between the two groups. Multivariate logistic regression analysis was used to identify the most valuable variables, and predictive value of the identified risk factor was determined. RESULTS Low signal intensity bands on T2-weighted imaging (P placenta percreta (P = 0.011), and placental cervical protrusion sign (P = 0.002) were more frequently observed in patients with poor outcome. Low signal intensity bands on T2-weighted imaging was the only significant predictor of poor maternal outcome in multivariate analysis (P = 0.020; odds ratio, 14.79), with 81.3% sensitivity and 84.3% specificity. CONCLUSION Low signal intensity bands on T2-weighted imaging might be a predictor of poor maternal outcome after UAE-assisted cesarean section in patients with invasive placenta previa. PMID:28345524

  13. Consideraciones previas al estudio de los marcos relacionales

    Directory of Open Access Journals (Sweden)

    Aldo Hernández

    2005-01-01

    Full Text Available El propósito de este artículo es señalar algunos aspectos cruciales del análisis del comportamiento en el abordaje de la conducta compleja humana. En primera instancia se revisan algunos supuestos referidos a cómo se concibe el conocimiento científico en análisis del comportamiento, posteriormente se desarrollan algunas ideas referidas a lo que se entiende por comportamiento y finalmente el tipo de conceptualización que es apropiada para describir su dinámica

  14. Clinical Effects of Uterine Packing and Carboprost Tromethamine Injection for Placenta Previa Cesarean Section Patients With Postpartum Hemorrhage%宫腔填纱和卡前列素氨丁三醇注射液用于前置胎盘剖宫产产后出血患者治疗中的临床效果

    Institute of Scientific and Technical Information of China (English)

    苏燕

    2016-01-01

    ObjectiveTo analyze the clinical effect of uterine cavity filing and Carboprost Tromethamine Injection for the treatment of postpartum hemorrhage after cesarean section of placenta.Methods From March 2012 to March 2016,90 cases of postpartum hemorrhage were divided into the observation group and the control group,the patients in our hospital were divided into the observation group and the control group.The control group were treated with uterine cavity filing,and the observation group was treated with uterine cavity filing and Carboprost Tromethamine Injection. The treatment effect was compared.Results In the observation group,the amount of postpartum hemorrhage of 2 h and 24 h hemorrhage were(158.7±15.2)ml、(289.9±11.9)ml,were better than the control group. The difference of the data between the two groups was statisticaly significant(P0.05).Conclusion Uterine cavity filing and Carboprost Tromethamine Injection in the treatment of postpartum hemorrhage in placenta and placenta,and the treatment effect is good.%目的:分析宫腔填纱和卡前列素氨丁三醇注射液用于前置胎盘剖宫产产后出血患者治疗中的临床效果。方法将2012年3月~2016年3月我院收治的前置胎盘剖宫产产后出血患者90例作为对象,分为观察组与对照组,对照组给予宫腔填纱治疗,观察组施以宫腔填纱、卡前列素氨丁三醇注射液治疗,对比治疗效果。结果观察组产妇产后2 h出血量、产后24 h出血量分别为(158.7±15.2)ml、(289.9±11.9) ml,优于对照组,两组数据差异具有统计学意义(P<0.05);对比两组患者子宫切除情况,观察组与对照组比较,差异无统计学意义(P>0.05)。结论宫腔填纱和卡前列素氨丁三醇注射液用于前置胎盘剖宫产产后出血治疗中,治疗效果良好。

  15. Maternal Death Due to Placenta Percreta with Bladder Involvement: A Case Report

    Directory of Open Access Journals (Sweden)

    Sedigheh Ayati M.D.

    2011-06-01

    Full Text Available Background: Placenta accreta is a life-threatening complication after previous cesarean delivery. The aim of this case report is to present a case of placenta percreta with bladder involvement and subsequent maternal death.Case presentation: The patient was a 37-year old who had an unwanted pregnancy due to tubectomy failure two years afterwards. She was hospitalized at 26th and 30th week of gestation because of gross hematuria. Sonography reported placenta previa. Cesarean section was performed at 34th gestational week. Due to severe hemorrhage, hysterectomy with resection of some part of the bladder was done. Died at the operating room after four hours of severe uncontrollable hemorrhage. Conclusion: The increasing prevalence of different forms of placenta accreta is the result of the ever-increasing rate of cesarean deliveries. One of the strategies to prevent this catastrophic obstetric complication is decreasing the number of cesarean deliveries without appropriate indications.

  16. Analysis of first and second trimester maternal serum analytes for the prediction of morbidly adherent placenta requiring hysterectomy

    Directory of Open Access Journals (Sweden)

    Efser Oztas

    2016-11-01

    Full Text Available Morbidly adherent placenta (MAP is a growing concern currently and is still a diagnostic challenge for obstetricians. As emergency hysterectomy due to unscheduled delivery in MAP carries significant risks, we aimed to evaluate whether first and second trimester serum analytes may be used in the prediction of MAP requiring hysterectomy. A retrospective chart review of all identified cases of placenta previa totalis with and without MAP was performed. A total of 316 pregnant women diagnosed as placenta previa totalis were identified and included in the analysis. Cases were examined in three groups (Group 1: 204 nonadherent placenta previa patients; Group 2: 61 MAP patients managed with endouterine hemostatic square sutures and/or Bakri balloon tamponade; and Group 3: 51 patients with MAP requiring hysterectomy. Among all first and second trimester screening analytes only maternal serum alphafetoprotein (MS-AFP levels were significantly higher in patients with MAP requiring hysterectomy (p < 0.001. According to the Receiver Operating Characteristic (ROC analysis performed for the predictive value of MS-AFP levels, the area under the curve (AUC was 0.742 [95% confidence interval (CI: 0.505–0.979]. The best MS-AFP cut-off value was 1.25 multiple of the median (MoM with 85.94% sensitivity and 71.43% specificity (p = 0.036. The best predictors which affect the increased risk of hysterectomy, was further evaluated by multivariate logistic regression analyses. Only elevated maternal serum alphafetoprotein (MS-AFP was found to be an independent predictor of MAP requiring hysterectomy [odds ratio (OR = 25.329, 95% confidence interval (CI:1.487–43.143, p = 0.025]. In conclusion, increased second trimester MS-AFP levels independently predict morbidly adherent placenta requiring hysterectomy among women with placenta previa totalis.

  17. The Application of MRI for Diagnosis of Placenta Praevia Combined with Placenta Accrete%MRI技术在前置胎盘合并胎盘植入中的诊断应用体会

    Institute of Scientific and Technical Information of China (English)

    陈蕾; 徐梓毓; 王秀荣; 赖文娟; 吴武林; 娄明武

    2016-01-01

    目的:探讨MRI在前置胎盘合并胎盘植入诊断的临床效果。方法回顾性分析2014年8月-2015年2月在我院经手术证实为前置胎盘50例患者的MRI资料,分析其影像学特点。结果采用MRI技术检查的50例患者中,明确诊断为前置胎盘患者为45例,其中4例为边缘性前置胎盘,12例为部分性前置胎盘,29例为完全性前置胎盘,诊断准确性90.00%,前置胎盘患者中,诊断合并胎盘植入患者19例,准确性为79.17%。结论 MRI技术对前置胎胎盘及胎盘植入诊断率高,能明确具体部位及胎盘植入情况,值得在临床推广应用。%Objective To investigate the application of MRI for diagnosis of placenta praevia combined with placenta accrete. Methods Totally 50 cases of placenta praevia combined with placenta accrete admitted to our hospital from August 2014 to February 2015 who was diagnosed by MRI were retrospectively analyzed.Results Based on MRI examination, 45 cases of placenta praevia was conifrmed. There were 4 cases, 12 cases and 29 cases of marginal placenta previa, partial placenta previa and complete placenta previa respectively. The MRI based diagnosis currency is 90%. There were 19 cases of placenta praevia combined with placenta accrete among all placenta accrete cases which suggested a diagnosis accuracy of 79.17%.Conclusion MRI technology demonstrated a high efficiency for placenta praevia combined with placenta accrete and could be a value toll for diagnosis.

  18. Epidemiology, Etiology, Diagnosis, and Management of Placenta Accreta

    Directory of Open Access Journals (Sweden)

    Gali Garmi

    2012-01-01

    Full Text Available Placenta accreta is a severe pregnancy complication and is currently the most common indication for peripartum hysterectomy. It is becoming an increasingly common complication mainly due to the increasing rate of cesarean delivery. Main risk factor for placenta accreta is a previous cesarean delivery particularly when accompanied with a coexisting placenta previa. Antenatal diagnosis seems to be a key factor in optimizing maternal outcome. Diagnosis can be achieved by ultrasound in the majority of cases. Women with placenta accreta are usually delivered by a cesarean section. In order to avoid an emergency cesarean and to minimize complications of prematurity it is acceptable to schedule cesarean at 34 to 35 weeks. A multidisciplinary team approach and delivery at a center with adequate resources, including those for massive transfusion are both essential to reduce neonatal and maternal morbidity and mortality. The optimal management after delivery of the neonate is vague since randomized controlled trials and large cohort studies are lacking. Cesarean hysterectomy is probably the preferable treatment. In carefully selected cases, when fertility is desired, conservative management may be considered with caution. The current review discusses the epidemiology, predisposing factors, pathogenesis, diagnostic methods, clinical implications and management options of this condition.

  19. 前置胎盘与胎盘植入相关因素分析%Study on related factors for placenta praevia and placenta accreta

    Institute of Scientific and Technical Information of China (English)

    彭冬梅

    2012-01-01

    peripheral placenta,and their difforence was significant(P<0.05).The incidence rates of postpartum hemorrhage,neonatal asphyxia,and preterm hirth were signifi-cantly higher in combined group than that of placenta praevia group,and their difference was significant(P<0 05).Conclusion Placenta ac-creta is correlaed with placenta previa,and central placenta previa and pregnancy more than 3 times are risk factors for the occurrence of placenta accreta.The prevention of above mentioned risk factors is very important in improving maternal and infantile life quality.

  20. Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in Obstetrics

    Directory of Open Access Journals (Sweden)

    Fiona Urner

    2014-01-01

    Full Text Available The third stage of labor is associated with considerable maternal morbidity and mortality. The major complication is postpartum hemorrhage (PPH, which is the leading cause of maternal morbidity and mortality worldwide. Whereas in the event of PPH due to atony of the uterus there exist numerous treatment guidelines; for the management of retained placenta the general consensus is more difficult to establish. Active management of the third stage of labour is generally accepted as standard of care as already its duration is contributing to the risk of PPH. Despite scant evidence it is commonly advised that if the placenta has not been expelled 30 minutes after delivery, manual removal of the placenta should be carried out under anaesthesia. Pathologic adhesion of the placenta in the low risk situation usually is diagnosed at the time of delivery; therefore a pre- or intrapartum screening opportunity for placenta accreta would be desirable. But diagnosis of abnormalities of placentation other than placenta previa remains a challenge. Nevertheless the use of ultrasound and doppler sonography might be helpful in the third stage of labor. An improvement might be the implementation of standardized operating procedures for retained placenta which could contribute to a reduction of maternal morbidity.

  1. Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in Obstetrics

    Science.gov (United States)

    Zimmermann, Roland

    2014-01-01

    The third stage of labor is associated with considerable maternal morbidity and mortality. The major complication is postpartum hemorrhage (PPH), which is the leading cause of maternal morbidity and mortality worldwide. Whereas in the event of PPH due to atony of the uterus there exist numerous treatment guidelines; for the management of retained placenta the general consensus is more difficult to establish. Active management of the third stage of labour is generally accepted as standard of care as already its duration is contributing to the risk of PPH. Despite scant evidence it is commonly advised that if the placenta has not been expelled 30 minutes after delivery, manual removal of the placenta should be carried out under anaesthesia. Pathologic adhesion of the placenta in the low risk situation usually is diagnosed at the time of delivery; therefore a pre- or intrapartum screening opportunity for placenta accreta would be desirable. But diagnosis of abnormalities of placentation other than placenta previa remains a challenge. Nevertheless the use of ultrasound and doppler sonography might be helpful in the third stage of labor. An improvement might be the implementation of standardized operating procedures for retained placenta which could contribute to a reduction of maternal morbidity. PMID:24812585

  2. El derecho a la consulta previa de los pueblos indígenas en el Perú

    OpenAIRE

    Alva Arévalo, Amelia

    2010-01-01

    International audience; El presente estudio tiene por finalidad describir el tratamiento de la consulta previa en el Perú, como mecanismo de participación de los pueblos indígenas en las medidas legislativas y administrativas que les afecten directamente. Para ello nos hemos fijado los siguientes objetivos: i. Determinar el progreso del reconocimiento constitucional y legal, nacional e internacional, de este derecho; ii. Fijar los mecanismos institucionales creados para su ejercicio; y iii. E...

  3. HALLAZGOS INCIDENTALES EN RADIOGRAFÍAS PANORÁMICAS PREVIAS AL TRATAMIENTO DE ORTODONCIA

    OpenAIRE

    Leyva Altamirano, Jorge Luis

    2012-01-01

    El propósito de esta investigación fue determinar la frecuencia, características y localización de alteraciones o patologías de manera incidental en radiografías previas al tratamiento de Ortodoncia. Este estudio se basó en el análisis de las radiografías panorámicas de pacientes que acudieron a la clínica de Ortodoncia del CUEPI de la Universidad Michoacana de San Nicolás de Hidalgo, con el objetivo de encontrar alteraciones patológicas en pacientes sanos, sin alteraciones ...

  4. Utility of ultrasound and magnetic resonance imaging in prenatal diagnosis of placenta accreta: A prospective study

    Directory of Open Access Journals (Sweden)

    Bhawna Satija

    2015-01-01

    Full Text Available Context: Placenta accreta is the abnormal adherence of the placenta to the uterine wall and the most common cause for emergency postpartum hysterectomy. Accurate prenatal diagnosis of affected pregnancies allows optimal obstetric management. Aims: To summarize our experience in the antenatal diagnosis of placenta accreta on imaging in a tertiary care setup. To compare the accuracy of ultrasound (USG with color Doppler (CDUS and magnetic resonance imaging (MRI in prenatal diagnosis of placenta accreta. Settings and Design: Prospective study in a tertiary care setup. Materials and Methods: A prospective study was conducted on pregnant females with high clinical risk of placenta accreta. Antenatal diagnosis was established based on CDUS and MRI. The imaging findings were compared with final diagnosis at the time of delivery and/or pathologic examination. Statistical Analysis Used: The sensitivity, specificity, positive predictive value (PPV, and negative predictive value (NPV were calculated for both CDUS and MRI. The sensitivity and specificity values of USG and MRI were compared by the McNemar test. Results: Thirty patients at risk of placenta accreta underwent both CDUS and MRI. Eight cases of placenta accreta were identified (3 vera, 4 increta, and 1 percreta. All patients had history of previous cesarean section. Placenta previa was present in seven out of eight patients. USG correctly identified the presence of placenta accreta in seven out of eight patients (87.5% sensitivity and the absence of placenta accreta in 19 out of 22 patients (86.4% specificity. MRI correctly identified the presence of placenta accreta in 6 out of 8 patients (75.0% sensitivity and absence of placenta accreta in 17 out of 22 patients (77.3% specificity. There were no statistical differences in sensitivity (P = 1.00 and specificity (P = 0.687 between USG and MRI. Conclusions: Both USG and MRI have fairly good sensitivity for prenatal diagnosis of placenta accreta

  5. Utility of ultrasound and magnetic resonance imaging in prenatal diagnosis of placenta accreta: A prospective study

    Science.gov (United States)

    Satija, Bhawna; Kumar, Sanyal; Wadhwa, Leena; Gupta, Taru; Kohli, Supreethi; Chandoke, Rajkumar; Gupta, Pratibha

    2015-01-01

    Context: Placenta accreta is the abnormal adherence of the placenta to the uterine wall and the most common cause for emergency postpartum hysterectomy. Accurate prenatal diagnosis of affected pregnancies allows optimal obstetric management. Aims: To summarize our experience in the antenatal diagnosis of placenta accreta on imaging in a tertiary care setup. To compare the accuracy of ultrasound (USG) with color Doppler (CDUS) and magnetic resonance imaging (MRI) in prenatal diagnosis of placenta accreta. Settings and Design: Prospective study in a tertiary care setup. Materials and Methods: A prospective study was conducted on pregnant females with high clinical risk of placenta accreta. Antenatal diagnosis was established based on CDUS and MRI. The imaging findings were compared with final diagnosis at the time of delivery and/or pathologic examination. Statistical Analysis Used: The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for both CDUS and MRI. The sensitivity and specificity values of USG and MRI were compared by the McNemar test. Results: Thirty patients at risk of placenta accreta underwent both CDUS and MRI. Eight cases of placenta accreta were identified (3 vera, 4 increta, and 1 percreta). All patients had history of previous cesarean section. Placenta previa was present in seven out of eight patients. USG correctly identified the presence of placenta accreta in seven out of eight patients (87.5% sensitivity) and the absence of placenta accreta in 19 out of 22 patients (86.4% specificity). MRI correctly identified the presence of placenta accreta in 6 out of 8 patients (75.0% sensitivity) and absence of placenta accreta in 17 out of 22 patients (77.3% specificity). There were no statistical differences in sensitivity (P = 1.00) and specificity (P = 0.687) between USG and MRI. Conclusions: Both USG and MRI have fairly good sensitivity for prenatal diagnosis of placenta accreta; however

  6. Management of placenta percreta

    DEFF Research Database (Denmark)

    Clausen, Caroline; Lönn, Lars; Langhoff-Roos, Jens

    2014-01-01

    in the management of the conditions. A PubMed search was performed in April 2013 and the final review included 119 published placenta percreta cases. Conservative management, where the placenta is left in situ for resorption, seems to be associated with severe long-term complications of hemorrhage and infections...... cases for the local resection technique might in part explain the lower complication rates with that approach. Future prospective data collection activities should include intended as well as actual management, and long-term follow-up of all cases is of vital importance....

  7. De placenta bij rhesus antagonisme

    NARCIS (Netherlands)

    Wormgoor, Bernard Hendrikus

    1952-01-01

    In de inleiding worden de te behandelen problemen aan de orde gesteld. Het uitganspunt hiervan is de studie van de morphologie van de placenta. Bij het histologisch onderzoek van de placenta waren het vooral de afwijkingen in de placenta bij Erythroblastosis Foetalis (verderop aan te duiden als E.F.

  8. Accuracy of color Doppler ultrasonography and magnetic resonance imaging in diagnosis of placenta accreta: A survey of 82 cases

    Directory of Open Access Journals (Sweden)

    Sedigheh Ayati

    2017-08-01

    Full Text Available Background: Placenta adhesive disorder (PAD is one of the most common causes of postpartum hemorrhage and peripartum hysterectomy. The main risk factors are placenta previa and prior uterine surgery such as cesarean section. Diagnosis of placenta adhesive disorders can lead to a decrease of maternal mortality and morbidities. Objective: The purpose of this study was to compare the accuracy of color Doppler ultrasonography and magnetic resonance imaging (MRI in the diagnosis of PADs. Materials and Methods: In this is cross-sectional study, Eighty-two pregnant women who were high risk for PAD underwent color Doppler ultrasound and MRI after 18 weeks of gestation. The sonographic and MRI findings were compared with the final pathologic or clinical findings. P<0.05 was considered statistically significant. Results: Mean maternal age was 31.42±4.2 years. The average gravidity was third pregnancy. 46% of patients had placenta previa. The history of the previous cesarean section was seen in 79 cases (96%. The diagnosis of placenta adhesive disorder was found in 17 cases (21%. Doppler sonography sensitivity was 87% and MRI sensitivity was 76% (p=0.37. Doppler sonography specificity was 63% and MRI specificity was 83% (p=0.01. Conclusion: Women with high-risk factors for PAD should undergo Doppler ultrasonography at first. When results on Doppler sonography are equivocal for PAD, MRI can be performed due to its high specificity

  9. SUCCENTURIATE PLACENTA: AN INCIDENTAL FINDING DURING CESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Unmesh

    2015-12-01

    Full Text Available A 30 years, 4th Gravida with 3 abortions with history of 8 months amenorrhea was admitted to the hospital with chief complaints of leaking per vagina since 4 hours and was not associated with pain abdomen or bleeding per vaginum. Perceiving decreased fetal movements since 6 hours. She had 3 previous missed abortions followed by D and E. In the present pregnancy, gestational age was 32 weeks at the time of admission. Patient’s general condition was stable, all other investigation were found to be normal her pulse was 100 beats/min, tachycardia present, BP -100/70mmHg. On obstetric examination, uterus was 30 weeks size, 1-2 contraction lasting for 15- 20 seconds, Breech presentation, FHR was 124 per minute, regular, decreased liquor clinically. On vulvovaginal examination- Frank leaking per vagina present. Ultrasound showed single live intrauterine pregnancy of 29 weeks 3 days with breech presentation with oligohydramnios, Placenta was at fundal region, Biophysical profile was 6/8, FHR 124 bpm. After taking high risk consent in view of fetal prematurity, patient was posted for Emergency LSCS. And extracted a single live preterm female baby of weight of 1.45 kg by breech. During the cesarean section, on opening abdomen lower segment was found to be congested with torturous vessels. So we suspected missed diagnosis of placenta previa. After delivery of the baby, we found succenturiate lobe of the placenta occupying lower uterine segment with vessels running across the membrane.

  10. A comparative study of ultrasonography versus magnetic resonance imaging in the diagnosis of abnormally adherent low lying placenta

    Directory of Open Access Journals (Sweden)

    Mohd. Ashraf

    2016-05-01

    Conclusions: Prenatal diagnosis is a key factor in optimizing the counseling, treatment and outcome of patients with placental adhesive disorder. Any women with placenta previa and previous uterine surgery should undergo careful imaging to assess the presence of placental adhesive disorder. Magnetic resonance imaging appears better diagnostic aid as compared to ultrasonography in diagnosing placental adhesive disorder. [Int J Reprod Contracept Obstet Gynecol 2016; 5(5.000: 1428-1432

  11. 凶险性前置胎盘伴胎盘植入诊治探讨%The study of diagnosis and treatment about dangerous pretage placenta merging placenta implant

    Institute of Scientific and Technical Information of China (English)

    刘霞

    2015-01-01

    Objective:To improve the prenatal diagnosis rate and reduce postpartum bleeding and hysterectomy risk by an-alyzing the clinical features of dangerous pretage placenta merging implants the placenta. Methods:18 cases of dangerous pla-centa previa and 296 cases of normal placenta previa were retrospectively analyzed. Results:There was no significant difference in hemorrhage volume between dangerous group and ordinary type group(P ﹥ 0. 05). There was significant difference between the type of delivery(P ﹤ 0. 05). When merges placenta implant in the event of placenta accreta postpartum hemorrhage vol-ume,there was a significant difference in mete of flooding(P ﹤ 0. 05)and hysterectomy rate(P ﹤ 0. 05). Conclusion:Danger-ous placenta previa with placenta implantation has a great threat to pregnant,prenatal diagnosis,rescue level and maternal safe-ty should be strengthened.%目的:分析凶险性前置胎盘伴胎盘植入的临床特点,提高产前诊断率,减少产后出血和子宫切除风险。方法:对18例凶险性前置胎盘(凶险性组)与296例普通型前置胎盘(普通型组)的病例进行回顾性分析。结果:凶险性组与普通型组产前出血量比较,差异无统计学意义(P ﹥0.05),分娩方式差异有统计学意义(P ﹤0.05)。发生胎盘植入时,产后出血量比较,差异有统计学意义(P ﹤0.05)。子宫切除发生率比较,差异有统计学意义(P ﹤0.05)。结论:凶险性前置胎盘伴胎盘植入对孕产妇造成极大威胁,应努力做好产前诊断,提高危重症抢救水平,保障孕产妇安全。

  12. Ultrasound, normal placenta - Braxton Hicks (image)

    Science.gov (United States)

    ... performed at 17 weeks gestation. It shows the placenta during a normal (Braxton Hicks) contraction. Throughout the ... contracts to facilitate better blood flow through the placenta and the fetus. In this ultrasound, the placenta ...

  13. CONSERVATIVE MANAGEMENT OF SPONTANEOUS UTERINE PERFORATION IN CASE OF PLACENTA ACCRETA DURING CAES AREAN SECTION: CASE REPORT

    Directory of Open Access Journals (Sweden)

    Neha

    2013-02-01

    Full Text Available ABSTRACT: BACKGROUND: The incidence of placenta accrete has increased 10 f old in the past 50 years and now occurs with a frequency of 1 per 2 ,500 deliveries. Women who have had 2 or more cesarean deliveries with anterior or central pl acenta previa have nearly a 40% risk of developing placenta accreta. An abnormally adherent pl acenta, although an uncommon condition, assumes considerable significance clinic ally because of morbidity and at times mortality from severe hemorrhage, uterine perforatio n, and infection. Placenta accrete occurring in an unscarred uterus is exceedingly rar e. CASE PRESENTATION: A 25 year-old multigravida was admitted for emergency Caesarean S ection at 36 weeks with the diagnosis of preeclampsia. There were 2 small uterine perforations seen on posterior wall of uterus. The placenta was found to be densely adherent to the post erior uterine wall. Piecemeal excision of the placenta as close as possible to the uterine lini ng was then performed. The perforations were sutured with interrupted stitches. CONCLUSION: Spontaneous uterine perforation associated with placenta accreta can be managed cons ervatively with suturing & does not necessitate hysterectomy

  14. Caracteristicas de las personas que acuden a las consultas de demanda del centro de salud sin citación previa

    Directory of Open Access Journals (Sweden)

    Carlos Isanta Pomar

    2000-01-01

    Full Text Available FUNDAMENTO: El tiempo de espera para acceder a la consulta está considerado un indicador de satisfacción. Las visitas no urgentes, realizadas sin cita previa, provocan un incremento del tiempo de espera de los pacientes citados, con la consiguiente insatisfacción de los mismos. El objetivo del estudio persigue la valoración cuantitativa de este tipo de visitas y conocer las características de las mismas, para introducir las medidas destinadas a su corrección y racionalización. MÉTODOS: Estudio descriptivo. Se realizó un registro que recogiera las características de los pacientes que originan las consultas sin cita previa, como la edad y el sexo y las relativas a la consulta: motivo, modalidad, jornada laboral y si era realizada de forma directa o indirecta. RESULTADOS: El 14,19% de consultas a demanda no urgentes son sin citación previa. Con el análisis factorial de correspondencias múltiple se identifican dos perfiles de consultas: las directas, solicitadas por pacientes jóvenes, por enfermedad o tareas burocráticas, al final de la consulta de la mañana, estando ellos presentes, y las consultas indirectas, ocasionadas durante las consultas con cita previa por pacientes que solicitan recetas. CONCLUSIONES: Hay un elevado número de visitas sin cita previa. Son precisas medidas que puedan conducir a la utilización del sistema de organización de las consultas y a la mejora de aquellas situaciones que impliquen una falta de accesibilidad, con la finalidad última de mejorar la satisfacción de los usuarios de los servicios sanitarios públicos.

  15. Funcionalidad en el adulto mayor previa a su hospitalización a nivel nacional.

    OpenAIRE

    Varela Pinedo, Luis; Chavez Jimeno, Helver; Galvez Cano, Miguel; Mendez Silva, Francisco

    2013-01-01

    Objetivo: Determinar las características de la funcionalidad del adulto mayor en las 2 semanas previas a su hospitalización en el Perú, así como su asociación con otros síndromes y problemas geriátricos. Materiales y métodos: En base a la información del estudio “Valoración Geriátrica Integral en adultos mayores hospitalizados a nivel nacional”, que incluyó 400 pacientes de 60 años o más; se evaluó las características de la funcionalidad y se comparó los resultados de la funcionalidad con los...

  16. Funcionalidad en el adulto mayor previa a su hospitalización a nivel nacional

    OpenAIRE

    Luis Varela Pinedo; Helver Chávez Jimeno; Miguel Galvez Cano; Francisco Mendez Silva

    2005-01-01

    Objetivo: Determinar las características de la funcionalidad del adulto mayor en las 2 semanas previas a su hospitalización en el Perú, así como su asociación con otros síndromes y problemas geriátricos. Materiales y métodos: En base a la información del estudio "Valoración Geriátrica Integral en adultos mayores hospitalizados a nivel nacional", que incluyó 400 pacientes de 60 años o más; se evaluó las características de la funcionalidad y se comparó los resultados de la funcionalidad con los...

  17. Study on the relationship between ultrasonographic diagnosis for different types of placenta praevia and outcome of pregnancy%超声诊断不同类型前置胎盘与妊娠结局的相关关系

    Institute of Scientific and Technical Information of China (English)

    陈融; 陆振林; 陈鸣

    2015-01-01

    Objective To explore the relationship between ultrasound diagnosis for different types of placenta previa and outcome of preg-nancy. Methods Fifty patients clinically diagnosed as placenta previa were detected by abdominal ultrasound and perineal ultrasound,and the coincidence rate of placenta previa diagnosed by ultrasound and surgical diagnosis was compared,and the relationship between different types of placenta previa and outcome of pregnancy had been analyzed. Results The coincidence rates of placenta praevia partialis,marginal placenta praevia and complete placenta praevia by abdominal ultrasound diagnosis and surgery confirmed diagnosis were 72. 22% ,78. 57% and 77. 78%respectively. The coincidence rates of placenta praevia partialis,marginal placenta praevia and complete placenta praevia in diagnosis of perineum ultrasound and surgery confirmed diagnosis were 88. 89% ,92. 86% and 100% respectively. The difference in accuracy of diagnosis of placenta previa between these 2 methods was statistically significant( P ﹤ 0. 05). Complete placenta previa with placenta conglutination in comparison with placenta praevia partialis and marginal placenta praevia,placenta increta,would increase the probability of postpartum hemorrhage and hyster-ectomy,and the differences was statistically significant( P ﹤ 0. 05). The occurrence of asphyxia in perinatal infant,premature birth rate and mor-tality in 3 perinatal stages of complete placenta previa group were higher than those with partialis or marginal placenta praevia groups,with lower Apgar scores,and the differences was statistically significant( P ﹤ 0. 05). Conclusion Perineal ultrasound diagnosis of placenta previa in com-parison with abdominal ultrasound has higher value,and it is suitable for the diagnosis of different types of placenta previa. Patients with complete placenta previa have poorer outcome of pregnancy,hence its prenatal care and health care should be strengthened.%目的:探讨超声诊断不

  18. Placenta accreta and anesthesia: A multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    R S Khokhar

    2016-01-01

    Full Text Available Placenta accreta (an abnormally adherent placenta is one of the two leading causes of peripartum hemorrhage and the most common indication for peripartum hysterectomy. Placenta accreta may be associated with significant maternal hemorrhage at delivery owing to the incomplete placental separation. When placenta accreta is diagnosed before delivery, a multidisciplinary approach may improve patient outcome.

  19. Placenta accreta and anesthesia: A multidisciplinary approach.

    Science.gov (United States)

    Khokhar, R S; Baaj, J; Khan, M U; Dammas, F A; Rashid, N

    2016-01-01

    Placenta accreta (an abnormally adherent placenta) is one of the two leading causes of peripartum hemorrhage and the most common indication for peripartum hysterectomy. Placenta accreta may be associated with significant maternal hemorrhage at delivery owing to the incomplete placental separation. When placenta accreta is diagnosed before delivery, a multidisciplinary approach may improve patient outcome.

  20. Placenta accreta: the silent invader

    Directory of Open Access Journals (Sweden)

    Seema Dwivedi

    2016-05-01

    Conclusions: Incidence of placenta accrete has increased now a days because of increased incidence of cesarian sections, placenta accreta was seen in primi due to uterine procedures done deliberately in both diagnostic and therapeutic indications. Morbidly adherent placenta is always a nightmare for the obstetrician. Suspicion of a case on history, preoperative confirmation of diagnosis, planned management with bundle of care, with multi-disciplinary approach can save many patients from the clutches of inevitable death. [Int J Reprod Contracept Obstet Gynecol 2016; 5(5.000: 1501-1505

  1. Placenta accreta: adherent placenta due to Asherman syndrome

    DEFF Research Database (Denmark)

    Engelbrechtsen, Line; Langhoff-Roos, Jens; Kjer, Jens Jørgen

    2015-01-01

    It is important to be aware of the risk of abnormally invasive placenta in patients with a history of Asherman syndrome and uterine scarring. A prenatal diagnosis by ultrasonography is useful when planning of mode of delivery.......It is important to be aware of the risk of abnormally invasive placenta in patients with a history of Asherman syndrome and uterine scarring. A prenatal diagnosis by ultrasonography is useful when planning of mode of delivery....

  2. Placenta Praevia: Incidence, Risk Factors

    African Journals Online (AJOL)

    6,7,8,9 caesarean section, myomectomy or metroplasty . The risk of occurrence of ... erythroblastosis, assisted conception, structural .... 7,16 maternal death were reported from other studies . Placenta praevia is common in our environment.

  3. 穿透型胎盘植入行腹主动脉球囊置入的围术期管理1例%Perioperative management of abdominal aortic balloon occlusion in patients compli-cated with placenta percteta:a case report

    Institute of Scientific and Technical Information of China (English)

    曾鸿; 王妍; 王阳; 郭向阳

    2015-01-01

    SUMMARY When placenta previa complicated with placenta percreta, the exposure of operative field is difficult and the routine methods are difficult to effectively control the bleeding, even causing life-threatening results. A 31-year-old woman, who had been diagnosed with a complete type of placenta pre-via and placenta percreta with bladder invasion at 34 weeks gestation. Her ultrasound results showed a complete type of placenta previa and there was a loss of the decidual interface between the placenta and the myometrium on the lower part of the uterus, suggestive of placenta increta. For further evaluation of the placenta, pelvis magnetic resonance imaging was performed, which revealed findings suspicious of a placenta percreta. She underwent elective cecarean section at 36 weeks of gestation. Firstly, two ureteral stents were placed into the bilateral ureter through the cystoscope. After the infrarenal abdominal aorta catheter was inserted via the femoral artery ( 9 F sheath ) , subarachnoid anesthesia had been estab-lished. A healthy 2 510 g infant was delivered, with Apgar scores of 10 at 1 min and 10 at 5 min. Imme-diately after the baby was delivered, following which there was massive haemorrhage and general anaes-thesia was induced. The balloon catheter was immediately inflated until the wave of dorsal artery disap-peared. With the placenta retained within the uterus, a total hysterectomy was performed. The occluding time was 30 min. The intraoperative blood loss was 2 500 mL. The occluding balloon was deflated at the end of the operation. The patient had stable vital signs and normal laboratory findings during the recovery period and the hemoglobin was 116 g/L. She was discharged six days after delivery without intervention-related complications. This case illustrates that temporary occlusion of the infrarenal abdominal aorta using balloon might be a safe and effective treatment option for patients with placenta previa complicated with placenta percreta

  4. A Standardized Approach for Transfusion Medicine Support in Patients With Morbidly Adherent Placenta.

    Science.gov (United States)

    Panigrahi, Anil K; Yeaton-Massey, Amanda; Bakhtary, Sara; Andrews, Jennifer; Lyell, Deirdre J; Butwick, Alexander J; Goodnough, Lawrence Tim

    2017-08-01

    The incidence of placenta accreta (PA) has increased from 0.8 to 3.0 in 1000 pregnancies, driven by increased rates of cesarean deliveries (32.2% in 2014) of births in the United States. The average blood loss for a delivery complicated by PA ranges from 2000 to 5000 mL, frequently requiring substantial transfusion medicine support. We report our own institutional multidisciplinary approach for managing such patients, along with transfusion medicine outcomes, in this setting over a 5-year period. We reviewed records for patients referred to our program in placental disorders from July 1, 2009, to July 1, 2014. A placental disorders preoperative checklist was implemented to ensure optimal management of patients with peripartum hemorrhage. Of 136 patients whose placentas were reviewed postpartum, 21 had PA, 39 had microscopic PA, 17 had increta, 17 had percreta, and 42 had no accreta (of which 11 had placenta previa). For each subtype, the percentage of patients receiving blood products were 71% (PA), 28% (microscopic PA), 82% (increta), 82% (percreta), and 19% (no accreta). Among patients with PA or variants, 89% of patients with PA or variants underwent postpartum hysterectomy, compared to only 5% of patients with no or microscopic PA. Based on our experience and on the findings of our retrospective analysis, patients presenting with either antepartum radiological evidence or clinical suspicion of morbidly adherent placenta will benefit from a standardized protocol for clinical management, including transfusion medicine support. We found that massive hemorrhage is predictable when abnormal placentation is identified predelivery and that blood product support is substantial regardless of the degree of placental invasiveness. The protocol at our institution provides immediate access to sufficient volumes and types of blood products at delivery for patients at highest risk for life-threatening obstetric hemorrhage. Therefore, for patients with a diagnosis of morbidly

  5. Estudio citogenético en amniocitos de gestantes fumadoras

    OpenAIRE

    Chica Díaz, Rosa Ana de la

    2006-01-01

    Consultable des del TDX Títol obtingut de la portada digitalitzada Introducción: El tabaco tiene graves problemas para la salud del individuo ya que da lugar a la aparición de enfermedades como: pulmonar obstructiva crónica, cardiovascular o cáncer pero también tiene efectos adversos en el embarazo. Fumar durante la gestación tiene consecuencias como problemas de coagulación o accidentes obstétricos: embarazo extrauterino o placenta previa, y retraso de crecimiento. Recientemente se ha ...

  6. Estudio citogenético en amniocitos de gestantes fumadoras

    OpenAIRE

    Chica Díaz, Rosa Ana de la

    2005-01-01

    Consultable des del TDX Títol obtingut de la portada digitalitzada Introducción: El tabaco tiene graves problemas para la salud del individuo ya que da lugar a la aparición de enfermedades como: pulmonar obstructiva crónica, cardiovascular o cáncer pero también tiene efectos adversos en el embarazo. Fumar durante la gestación tiene consecuencias como problemas de coagulación o accidentes obstétricos: embarazo extrauterino o placenta previa, y retraso de crecimiento. Recientemente se ha ...

  7. 血管前置的产前超声筛查与诊断%Prenatal ultrasound screening and diagnosis of vasa previa

    Institute of Scientific and Technical Information of China (English)

    李胜利; 陈秀兰; 文华轩

    2011-01-01

    血管前置是导致围产儿死亡的一个危险因素,经阴道分娩围产儿死亡率高.超声检查是产前诊断血管前置最可靠且简便、易推广的检查方法.当产前超声检查发现低置胎盘、双叶胎盘、副胎盘、多叶胎盘、多胎妊娠、帆状胎盘等高危发病因素时,需详细检查宫颈内口,常规的检查方法是经腹超声检查,当因胎先露阻挡等原因显示宫颈内口不满意时,需结合经会阴超声检查或经阴道超声检查;经阴道超声检查是该3种检查方法中最可靠的显示方法,但合并阴道活动性出血或宫颈机能不全时不宜使用.对于产前诊断血管前置的病例,建议于临产前行选择性剖宫产术.%Vasa previa is a dangerous factor which may result in fetal demise. Vaginal delivery may lead to high fetal mortality. Ultrasound is the most reliable, simple and generalized way for diagnosis of prenatal vasa previa. If the following high risk factors are detected by prenatal ultrasound, such as low lying placenta, bi-lobed placenta, succenturiate lobe, multi-lobed placenta, multiple pregnancy and velamentous insertion of the cord, the internal cervical os is necassary for examination. Transabdominal ultrasound is the routine way to observe the internal cervical os. But if internal cervical os is not satisfied to observe internal cervical os because of fetal presentation,transperineal or transvaginal ultrasound is recommended. Transvaginal ultrasound is the most reliable way. However, it is not recommended to perform once the mother is complicated with active bleeding or cervical incompetence. Elective caesarean section should be offered prior to the onset of labour for cases that have been diagnosed of prenatal vasa previa.

  8. 胎盘植入产前超声诊断的临床应用价值%Clinical Value of Prenatal Ultrasound Diagnosis of Placenta Implantation

    Institute of Scientific and Technical Information of China (English)

    欧阳一兵; 郭晓燕; 温穗文; 余桂云

    2014-01-01

    in placenta previa patients and non -Pla-centa previa patients was 71.4%vs 5.0%, and incidence of placenta accreta in anterior placenta and non -anterior placenta was 53.3%vs15.8%,P<0.05.Conclusion Prenatal ultrasound diagnosis of placenta implantation could prevention of postpartum hemorrhage ,and it has an important value to keep mothers′and babies′safety.

  9. Histological and histochemical changes in placenta of diabetic pregnant females and its comparision with normal placenta

    Directory of Open Access Journals (Sweden)

    Vineeta Tewari

    2011-03-01

    Full Text Available Objective: To investigate the histological and histochemical changes in placenta of diabetic pregnant females and compare them with normal placenta. Methods: The histological and histochemical features of 60 placenta, 30 obtained from normal pregnant females and 30 from diabetic pregnant females, were studied. These placenta were obtained from Department of Obstetrics and Gynaecology, GSVM Medical College Kanpur and ERA ’s Lucknow Medical College and Hospital Lucknow. Results: On histological examination, the diabetic placenta showed increased syncytial knots, fibrinoid necrosis, trophoblastic basement membrane thickening, villous stromal fibrosis, villous oedema, crowding of villi, thickening of vessel wall and fibrin deposition. On histochemical study it was found that the PAS reactivity was stronger in diabetic placenta as compared to normal. Sudan Black reactivity was higher among diabetic placenta in comparison to normal placenta. Conclusions: It is concluded that distinct histological and histochemical changes could be seen in placenta of diabetic pregnant females.

  10. Los refranes en el quijote (Estudio critico de la traducción al esloveno

    Directory of Open Access Journals (Sweden)

    Juan Carlos Oven

    1991-12-01

    Full Text Available Antes de afrontar el tema de los refranes en el Quijote será útil acercarnos a este campo específico de la literatura con algunasconsideraciones previas que nos ayuden a iluminar determinados aspectos de este estudio.

  11. Postpartum MR diagnosis of retained placenta accreta

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Yumiko Oishi; Itai, Yuji [Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, 305-8575, Tsukuba, Ibaraki (Japan); Shigemitsu, Sadahiko [Department of Obstetrics and Gynecology, Ryugasaki Saiseikai General Hospital, Ryagasaki (Japan); Ichikawa, Yoshihito; Sohda, Satoshi; Yoshikawa, Hiroyuki [Department of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, 305-8575, Tsukuba, Ibaraki (Japan)

    2004-06-01

    Retained placenta accreta can cause catastrophic postpartum hemorrhage. This study aims to determine whether MR imaging can differentiate retained placenta accreta from postpartum hemorrhage caused by other conditions. Fourteen cases suspicious for retained placenta were examined with MR imaging. Signal intensity, the enhancing pattern of uterine contents, and flow voids within the myometrium were retrospectively studied. As hysterectomy was performed in only two cases, final diagnosis was based on clinical outcome and analysis of uterine contents. Final diagnoses were retained placenta accreta in seven cases, retained normally attached placenta in four, hematoma in two, and placental site trophoblastic tumor (PSTT) in one. All seven cases with placenta accreta had a very hyperintense area on T2-weighted images, showing transient early enhancement. None demonstrated delayed strong enhancement around the hyperintense area. In two cases with retained normally attached placenta and in both with hematomas, there were no hyperintense areas on T2-weighted images. Of these, only one showed transient early enhancement. Flow voids were observed in four cases with placenta accreta, one with normally attached placenta, and the case with PSTT. A markedly hyperintense area on T2-weighted images and transient early enhancement without delayed strong enhancement between the mass and the myometrium can indicate retained placenta accreta. (orig.)

  12. Optimal transport and the placenta

    Energy Technology Data Exchange (ETDEWEB)

    Morgan, Simon [Los Alamos National Laboratory; Xia, Qinglan [NON LANL; Salafia, Carolym [NON LANL

    2010-01-01

    The goal of this paper is to investigate the expected effects of (i) placental size, (ii) placental shape and (iii) the position of insertion of the umbilical cord on the work done by the foetus heart in pumping blood across the placenta. We use optimal transport theory and modeling to quantify the expected effects of these factors . Total transport cost and the shape factor contribution to cost are given by the optimal transport model. Total placental transport cost is highly correlated with birth weight, placenta weight, FPR and the metabolic scaling factor beta. The shape factor is also highly correlated with birth weight, and after adjustment for placental weight, is highly correlated with the metabolic scaling factor beta.

  13. Poder explicativo de algunos determinantes del rendimiento en los estudios universitarios

    OpenAIRE

    Tejedor Tejedor, Francisco Javier

    2003-01-01

    Presentamos un estudio sobre el poder explicativo de algunos determinantes del rendimiento académico en relación con la variable dependiente "calificaciones": residencia del alumno, situación familiar, notas previas, opción de estudios, motivación por los estudios, hábitos de estudio, dedicación a la tarea, condiciones de la docencia, satisfacción con la situación académica. La población de referencia ha sido el conjunto de alumnos de la Universidad de Salamanca matriculados desde 1993 ha...

  14. Trayectorias laborales de migrantes calificadas por razones de estudio

    OpenAIRE

    Rosa Emilia Bermúdez Rico

    2014-01-01

    En este artículo se analizan las trayectorias laborales de algunas profesionales universitarias colombianas que han realizado estudios de posgrado en México, y se abordan los principales patrones que caracterizan su inserción en el mercado laboral profesional, tanto en Colombia como en México. El propósito central es examinar la configuración de estas trayectorias laborales en relación a la experiencia de la movilidad por razones de estudio, tanto en la etapa previa a la migración internacion...

  15. Reoccurrence of retained placenta at vaginal delivery

    DEFF Research Database (Denmark)

    Løkkegaard, Ellen Christine Leth; Bergholt, Thomas; Nikolajsen, Sys

    2013-01-01

    To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery.......To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery....

  16. Reoccurrence of retained placenta at vaginal delivery

    DEFF Research Database (Denmark)

    Nikolajsen, Sys; Løkkegaard, Ellen Christine Leth; Bergholt, Thomas

    2013-01-01

    To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery.......To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery....

  17. Risk factors of peripartum hysterectomy in placenta previa:a retrospective study of 3 840 cases%前置胎盘孕妇围产期行子宫切除术的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    吕斌; 陈锰; 刘兴会

    2016-01-01

    Objective To investigate the risk factors of peripartum hysterectomy in placenta previa through retrospective study of 3 840 placenta previa cases. Methods The clinical data of 3 840 patients with placenta previa who delivered in West China Second University Hospital between Jan 2005 and June 2014 were analyzed retrospectively. The relationship of certain factors and peripartum hysterectomy was analyzed, including maternal age, residence place, parity, prior curettage, prior cesarean section, twin or multiple pregnancy, antenatal vaginal bleeding, type of placenta previa, suspected placenta accreta, antenatal level of hemoglobin and gestational age at delivery. Results The prevalence of placenta previa was 4.84% (3 840/79 304) in West China Second University Hospital during the study period, and the incidence of preipartum hysterectomy in patients with placenta previa was 2.76% (106/3 840). One-factor analysis demonstrated that residence place, parity, times of prior curettage, prior cesarean section, prenatal vaginal bleeding, anterior placenta, type of placenta previa, placenta accreta, antenatal anemia and gestational age at delivery were potential risk factors for peripartum hysterectomy (P<0.01). Variables with P<0.1 in one-factor analysis were introduced to multi-factor logistic regression analysis, which suggested that one prior cesarean section (OR=12.9,95%CI:6.3-26.3), two or more prior cesarean sections (OR=14.4, 95%CI:3.9-53.2), anterior placenta (OR=4.8, 95%CI:2.1-10.7), complete placenta previa (OR=5.9, 95%CI:1.8-42.5), placenta accreta (OR=11.2, 95%CI:6.8-18.6), antenatal hemoglobin<100 g/L (OR=1.7, 95%CI:1.0-2.8) and delivery before 34 gestational weeks (OR=3.2, 95%CI:1.6-6.3) were independent risk factors of peripartum hysterectomy in patients with placenta previa (P<0.05). Conclusions Prior cesarean section, anterior placenta, complete placenta previa, placenta accreta, antenatal anemia and delivery before 34 gestational weeks are high risk

  18. Placenta percreta: methotrexate treatment and MRI findings.

    Science.gov (United States)

    Heiskanen, Nonna; Kröger, Jaana; Kainulainen, Sakari; Heinonen, Seppo

    2008-02-01

    Our patient was a 24-year-old gravida 2 para 0 woman. After delivery, placenta percreta was noticed. There was no postpartum hemorrhage, and the patient desired future pregnancies. Although placenta percreta is rare, its sequelae include potentially lethal hemorrhage and loss of reproduction function. Placenta percreta was confirmed histologically and with ultrasonography and magnetic resonance imaging (MRI). Placenta percreta was treated conservatively with methotrexate. On follow-up, MRI showed a small calcified transmural extension of the placenta throughout the uterus in the right fundal area. Color Doppler ultrasonography showed no blood flow in the corresponding area, and maternal serum human chorionic gonadotropin (hCG) was undetectable. Use of MRI is a new method to detect abnormal placentation, and it could be used on follow-up in selective cases with other follow-up modalities. However, it seems likely that conservative management to preserve future fertility remains a secured and reasonable alternative when a patient has no active bleeding.

  19. Localization of the placenta in the 3 trimester of gestation with the use of a gamma-camera and radioactive sup(113m)In indium isotope

    Energy Technology Data Exchange (ETDEWEB)

    Brudnik, A.; Chromy, G.; Ulfik, A.; Bielawski, J.; Wasylewski, A. (Slaska Akademia Medyczna, Katowice (Poland))

    1980-01-01

    In 56 women, treated because of uterine bleedings in the 3 trimester of gestation the localization of the placenta was looked for with use of a gamma camera (Toshiba Co.) and indium radioisotope 113-In. The methodic procedures were elaborated for the application of the gamma-camera and the utilization of radioactive marker /sup 125/Sb in the anatomic reference areas. Full conformity of results with findings at cesarean section was met. Isotope placentography with the application of gamma camera gives a high percentage of adequate diagnoses, least dose of exposition, uncomplicated procedures. The negative diagnosis in suspected cases of placenta previa permitted to decrease the time of hospital stay in a number of cases observed because of uterine bleedings in the 3 trimester of pregnancy.

  20. Counseling in fetal medicine: evidence-based answers to clinical questions on morbidly adherent placenta.

    Science.gov (United States)

    D'Antonio, F; Palacios-Jaraquemada, J; Lim, P S; Forlani, F; Lanzone, A; Timor-Tritsch, I; Cali, G

    2016-03-01

    Although the incidence of morbidly adherent placenta (MAP) has risen progressively in the last two decades, there remains uncertainty about the diagnosis and management of this condition. The aim of this review is to provide up-to-date and evidence-based answers to common clinical questions regarding the diagnosis and management of MAP. Different risk factors have been associated with MAP; however, previous Cesarean section and placenta previa are the most frequently associated. Ultrasound is the primary method for diagnosing MAP and has a good overall diagnostic accuracy for its detection. When considering the different ultrasound signs of MAP, color Doppler seems to provide the best diagnostic performance. Magnetic resonance imaging has the same accuracy in diagnosing MAP as does ultrasound examination; its use should be considered when a resective procedure, such as hysterectomy, is planned as it can provide detailed information about the topography of placental invasion and predict difficulties that may arise in surgery. The optimal gestational age for delivery in pregnancies with MAP is yet to be established; planning surgery between 35 and 36 weeks of gestation provides the best balance between fetal maturity and the risk of unexpected episodes of heavy bleeding, which are more likely to occur with delivery after this timepoint, especially in severe cases of MAP. The optimal surgical approach to MAP depends on multiple factors, including availability of an experienced team, specific surgical skills and hospital resources. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  1. Contribución al estudio de los reacciones de hidratación del cemento portland por espectroscopia infrarroja II. Estudio de clínkeres y de cementos portland anhidros

    Directory of Open Access Journals (Sweden)

    Vázquez-Moreno, Tomás

    1976-06-01

    Full Text Available Not availableEn un artículo anterior (1 se dio cuenta de los trabajos realizados sobre la aplicación de la espectroscopia IR al estudio de las principales fases sintetizadas del clínker de cemento portland como fase previa al estudio de diversos clínkeres, obtenidos por nosotros en el laboratorio a partir de crudos industriales, y de distintos cementos portland comerciales anhidros.

  2. Optimal management strategies for placenta accreta.

    Science.gov (United States)

    Eller, A G; Porter, T F; Soisson, P; Silver, R M

    2009-04-01

    To determine which interventions for managing placenta accreta were associated with reduced maternal morbidity. Retrospective cohort study. Two tertiary care teaching hospitals in Utah. All identified cases of placenta accreta from 1996 to 2008. Cases of placenta accreta were identified using standard ICD-9 codes for placenta accreta, placenta praevia, and caesarean hysterectomy. Medical records were then abstracted for maternal medical history, hospital course, and maternal and neonatal outcomes. Maternal and neonatal complications were compared according to antenatal suspicion of accreta, indications for delivery, preoperative preparation, attempts at placental removal before hysterectomy, and hypogastric artery ligation. Early morbidity (prolonged maternal intensive care unit admission, large volume of blood transfusion, coagulopathy, ureteral injury, or early re-operation) and late morbidity (intra-abdominal infection, hospital re-admission, or need for delayed re-operation). Results Seventy-six cases of placenta accreta were identified. When accreta was suspected, scheduled caesarean hysterectomy without attempting placental removal was associated with a significantly reduced rate of early morbidity compared with cases in which placental removal was attempted (67 versus 36%, P=0.038). Women with preoperative bilateral ureteric stents had a lower incidence of early morbidity compared with women without stents (18 versus 55%, P=0.018). Hypogastric artery ligation did not reduce maternal morbidity. Scheduled caesarean hysterectomy with preoperative ureteric stent placement and avoiding attempted placental removal are associated with reduced maternal morbidity in women with suspected placenta accreta.

  3. Iron transportation across the placenta

    Directory of Open Access Journals (Sweden)

    Claudia M. de Oliveira

    2012-12-01

    Full Text Available According to the classification of placental types among animals, the transfer of iron through the placenta can occur via: absorption connected to transferin through the outer surface of the trophoblast in direct contact with circulating maternal blood; absorption of the erythrocytes by the chorionic epithelium in direct contact with accumulation of blood extravased from haemotophagous areas; absorption by the chorionic epithelium in direct contact with iron enriched secretions from the endometrial glands and absorption by extravasations of the blood in the maternal-fetal surface and the subsequent phagocytosis of the erythrocytes by trophoblast cells described in bovine, small ruminants, canine and feline. The function of erythrophagocytosis observed after the extravasation of blood in the maternal-fetal interface is undefined in several species. Possibly, the iron is transferred to the fetus through the trophoblastic erythrophagocytosis in the hemophogous area of the placenta and also in the endometrial glands. In this literature survey, new methods of studies regarding placental transfer involving iron and other nutrients necessary for survival and maintenance of embryonic fetus to birth are proposed.De acordo com a classificação dos tipos de placenta existentes entre os animais e em relação com a passagem de substâncias pela barreira inter-hemática, a transferência de ferro pode ser realizada através da: absorção de ferro ligado a transferrina através da superfície externa do trofoblasto em contato direto com o sangue materno circulante; absorção de eritrócitos pelo epitélio coriônico em contato direto com acúmulos de sangue materno extravasado em áreas hematófagas, absorção de ferro pelo epitélio coriônico em contato direto com secreções ricas em ferro provenientes de glândulas endometriais e fagocitose dos eritrócitos pelas células trofoblásticas, a qual foi descrita em bovinos, pequenos ruminantes, caninos e

  4. Funcionalidad en el adulto mayor previa a su hospitalización a nivel nacional

    Directory of Open Access Journals (Sweden)

    Luis Varela Pinedo

    2005-07-01

    Full Text Available Objetivo: Determinar las características de la funcionalidad del adulto mayor en las 2 semanas previas a su hospitalización en el Perú, así como su asociación con otros síndromes y problemas geriátricos. Materiales y métodos: En base a la información del estudio "Valoración Geriátrica Integral en adultos mayores hospitalizados a nivel nacional", que incluyó 400 pacientes de 60 años o más; se evaluó las características de la funcionalidad y se comparó los resultados de la funcionalidad con los principales síndromes y problemas geriátricos. Resultados: Se encontró una frecuencia de autonomía funcional de 53%, el bañarse y el vestirse fueron las Actividades Básicas de la Vida Diaria más comprometidas con 44,5% y 39% respectivamente. Se encontró relación significativa entre funcionalidad y edad, situación socioeconómica, caídas, incontinencia urinaria, mareos, desnutrición, déficit cognitivo y depresión Conclusiones: La frecuencia de dependencia funcional pre-hospitalización en la población adulta mayor es elevada. Se encontró que a mayor edad, presencia de problemas sociales, caídas, incontinencia urinaria, mareos, desnutrición, déficit cognitivo y depresión se asocia a deterioro funcional.(Rev Med Hered 2005;16:165-171.

  5. Autophagy in term normal human placentas.

    Science.gov (United States)

    Signorelli, P; Avagliano, L; Virgili, E; Gagliostro, V; Doi, P; Braidotti, P; Bulfamante, G P; Ghidoni, R; Marconi, A M

    2011-06-01

    Autophagy is an inducible catabolic process that responds to environment and is essential for cell survival during stress, starvation and hypoxia. Its function in the human placenta it is not yet understood. We collected 14 placentas: 7 at vaginal delivery and 7 at elective caesarean section after uneventful term pregnancies. The presence of autophagy was assessed in different placental areas by immunoblotting, immunohistochemistry and electron microscopy. We found that autophagy is significantly higher in placentas obtained from cesarean section than in those from vaginal delivery. Moreover there is a significant inverse relationship between autophagy and umbilical arterial glucose concentration.

  6. Abdomen agudo y embarazo: placenta percreta

    OpenAIRE

    2001-01-01

    La ruptura uterina espontánea por placenta percreta, sin historia de trauma o infección, es una patología extremadamente rara y responsable de una alta morbimortalidad materna. El diagnóstico prenatal de placenta percreta es importante para evitar resultados catastróficos debido a este desorden obstétrico, y diversos procedimientos son utilizados para lograr esta meta. Se presenta un caso de placenta percreta, con búsqueda de expedientes clínicos por esta patología, en el Hospital Monseñor Sa...

  7. Nursing of ritodrine hydrochloride in treatment of placenea previa state of threatened abortion%利托君治疗胎盘前置状态先兆流产的护理

    Institute of Scientific and Technical Information of China (English)

    沈志娟

    2012-01-01

    Objective:To discuss the nursing measures of placenta previa with threatened abortion using hydrochloric acid ritodrine therapy. Methods :32 cases of placenta previa in our state threatened abortion pregnant women,ritodrine hydrochloride 100 mg join 5% glucose intravenous infusion of 500 ml,maintain the uterine contraction after the change to oral,and well before medication pursing assessment, psychological nursing care,close observation in the medication process condition changes,drug reaction,giving life,diet nursing care. Results:32 cases of vaginal bleeding after drug use in pregnant women reduced, adverse reactions-have been eased .more than 30 cases of maternal gestational age 36 -weeks extension,strengthening mucle success rate 93.75%. Conclusion:Rational use of-ritodrine hydrochloride,could reduced the placenta previa threatened abortion bleeding,prolonged pregnancy cycle,improved the success rate of fetus.%目的:探讨胎盘前置状态先兆流产使用盐酸利托君治疗时的护理措施.方法:对我院胎盘前置状态先兆流产32例孕妇,给予100 mg盐酸利托君加入5%葡萄糖500 ml静脉滴注,维持宫缩消失后改为口服,并在用药前做好护理评估、心理护理,用药过程中严密观察病情变化、用药反应,给予生活、饮食护理.结果:32例孕妇用药后阴道出血减少,不良反应得到缓解,30例孕妇延长孕龄36周以上,保胎成功率为93.75%.结论:盐酸利托君的合理使用,可以减少胎盘前置状态先兆流产的出血,延长妊娠周数,提高保胎成功率.

  8. Abdomen agudo y embarazo: placenta percreta

    Directory of Open Access Journals (Sweden)

    Horacio Massotto Chaves

    2001-10-01

    Full Text Available La ruptura uterina espontánea por placenta percreta, sin historia de trauma o infección, es una patología extremadamente rara y responsable de una alta morbimortalidad materna. El diagnóstico prenatal de placenta percreta es importante para evitar resultados catastróficos debido a este desorden obstétrico, y diversos procedimientos son utilizados para lograr esta meta. Se presenta un caso de placenta percreta, con búsqueda de expedientes clínicos por esta patología, en el Hospital Monseñor Sanabria, desde 1994 hasta 1999, y con revisión de la bibliografía.Spontaneous uterine rupture, without a history of trauma or associated infection by placenta percreta is an extremely rare pathology and it's responsible for high maternal morbidity and mortality. The prenatal diagnosis of placenta precreta is important to avoid catastrophic results after the obstetrical disorder and different procedures are used to get to this goal. We present here a case of placenta percreta and a revision of cases with this diagnosis from 1994 to 1999 at the Monseñor Sanabria Hospital, and a review of the literature.

  9. Marcadores de estrés oxidativo en placentas de gestantes añosas

    Directory of Open Access Journals (Sweden)

    Silvia Suárez

    2007-12-01

    Full Text Available Introducción: Un factor de riesgo alto ginecoobstétrico que contribuye a la morbimortalidad materna perinatal es la edad materna mayor de 35 años. Es posible que el estado oxidativo en la placenta de la gestante añosa sea mayor a la de la gestante no añosa. Objetivo: Evaluar el estado oxidativo de la placenta en gestantes mayores de 35 años. Diseño: Estudio observacional y transversal. Lugar: Hospital Nacional Docente Materno Infantil San Bartolomé y Centro de Investigación de Bioquímica y Nutrición de la Universidad Nacional Mayor de San Marcos. Material biológico: 28 placentas de gestantes de 35 años o más y 28 placentas de gestantes de menos de 35 años, obtenidas de partos vaginales a término. Intervenciones: La muestra de placenta se homogenizó al 10% con buffer fosfato 10 mM, pH 7,4, se centrifugó a 2000 rpm por 5’. Parte del sobrenadante se usó para analizar lipoperoxidación y glutatión (GSH; el sobrenadante restante fue centrifugado a 42 000 rpm por 1 hora, para medir actividad de superóxido dismutasa (SOD. Principales medidas de resultados: Estado oxidativo de placentas obtenidas de mujeres añosas y no añosas. Resultados: La actividad de la SOD y el contenido de GSH placentarios en añosas fue 43,52 U/g de tejido y 4,67 µmol/mL x 10-²; para el grupo control fueron 54,13 U/g de tejido y 6,02 µmol/mL x 10-², respectivamente; en ambos hubo significancia estadística (p < 0,05. La medición de TBARS (lipoperoxidación no mostró diferencias significativas. Conclusiones: Las placentas obtenidas de mujeres añosas muestran menor capacidad de defensa antioxidante frente a las placentas obtenidas de mujeres no añosas.

  10. The placenta in toxicology. Part IV : Battery of toxicological test systems based on human placenta

    NARCIS (Netherlands)

    Göhner, Claudia; Svensson-Arvelund, Judit; Pfarrer, Christiane; Häger, Jan-Dirk; Faas, Marijke; Ernerudh, Jan; Cline, J Mark; Dixon, Darlene; Buse, Eberhard; Markert, Udo R

    2014-01-01

    This review summarizes the potential and also some limitations of using human placentas, or placental cells and structures for toxicology testing. The placenta contains a wide spectrum of cell types and tissues, such as trophoblast cells, immune cells, fibroblasts, stem cells, endothelial cells, ves

  11. Reproductive performance of Friesian mares after retained placenta and manual removal of the placenta

    NARCIS (Netherlands)

    Sevinga, M; Hesselink, JW; Barkema, H.W.

    2002-01-01

    Because the incidence of retained placenta in Friesian mares is estimated to be high, and no reports have been published on the reproductive performance of Friesian mares after retained placenta, we studied postpartum reproductive performance in Friesian brood mares with (n = 54) and without (n = 50

  12. Reingreso en prision de reclusos drogodependientes excarcelados a una comunidad terapeutica, en funcion de variables previas al tratamiento

    National Research Council Canada - National Science Library

    Ramos Barbero, Victoria; Carcedo Gonzalez, Rodrigo J

    2012-01-01

    El principal objetivo de este articulo es identificar las variables penales y penitenciarias previas al tratamiento asociadas al reingreso en prision, en una poblacion de reclusos drogodependientes...

  13. Endothelial and lipoprotein lipases in human and mouse placenta

    DEFF Research Database (Denmark)

    Lindegaard, Marie Louise Skakkebæk; Olivecrona, Gunilla; Christoffersen, Christina;

    2005-01-01

    Placenta expresses various lipase activities. However, a detailed characterization of the involved genes and proteins is lacking. In this study, we compared the expression of endothelial lipase (EL) and LPL in human term placenta. When placental protein extracts were separated by heparin...... protein associated with both cell types. In mouse placentas, lack of LPL expression resulted in increased EL mRNA expression. These results suggest that the cellular expression of EL and LPL in human placenta is different. Nevertheless, the two lipases might have overlapping functions in the mouse...... placenta. Our data also suggest that the major portions of both proteins are stored in an inactive form in human term placenta....

  14. Placenta percreta in primigravida, an unsuspected situation

    Directory of Open Access Journals (Sweden)

    Bhuvaneshwari Rajkumar

    2014-02-01

    Full Text Available Placenta percreta, the most severe form of placenta accreta, is a rare pregnancy disorder in which the placenta penetrates the uterine myometrium and serosa and can invade the surrounding organs. It is a potentially life-threatening condition with risk of severe maternal morbidity and mortality. Although recognized obstetric risk factors allow the identification of most cases during the prenatal period, diagnosis is occasionally made at the time of delivery. Both sonography and MRI have fairly good sensitivity for prenatal diagnosis of placenta accreta. Prenatal diagnosis allows management of these patients in specialized tertiary centers, where a multidisciplinary approach will improve the outcome. Even in undiagnosed cases discovered at the time of delivery involving a team of anesthesiologist, obstetrician, urologist, neonatologist, and blood bank officer is needed for successful management of these patients. In this report we present the case of a primigravida with no known risk factors who was diagnosed to have placenta percreta at the time of caesarean delivery. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 239-241

  15. Anestesia conductiva en cesáreas de gestantes con preeclampsia severa previa estabilización hemodinámica en el Hospital Gineco-Obstétrico "Enrique C. Sotomayor" período 2014. Propuesta de norma.

    OpenAIRE

    Castro Coello, Hamilton Michael

    2015-01-01

    Los trastornos hipertensivos en las gestantes son causa importante de morbilidad, discapacidad crónica y muerte entre las madres, los fetos y los recién nacidos; entre estos, la preeclampsia. Objetivo: Evaluar la anestesia conductiva en cesáreas de gestantes con preeclampsia severa previa estabilización hemodinámica en el hospital gineco-obstétrico "Enrique C. Sotomayor" período 2014. Materiales y métodos: Se elaboró un estudio observacional y prospectivo de una serie de casos de la muestra s...

  16. MRI diagnosis and classification of placenta increta in the third trimester of pregnancy%晚孕期胎盘植入的 MRI 诊断及分型

    Institute of Scientific and Technical Information of China (English)

    郑小丽; 徐坚民; 杨敏洁

    2015-01-01

    目的:探讨晚孕期各型胎盘植入 MRI 征象及其诊断价值。方法:回顾性分析2010年7月-2013年12月期间经手术及病理证实27例胎盘植入孕妇的临床资料。所有孕妇均行 MRI 检查。结果:粘连型3例,植入型15例,穿透型9例,均为前置胎盘。三型胎盘厚度及胎盘内流空血管数目分别为4.87 cm/5.0;5.31 cm/5.7;6.51 cm/6.8。3例粘连型2例胎盘附着面呈弧形,1例呈结节状膨出,肌层连续;15例植入型11例胎盘结节状膨出,11例肌层渐进性消失,10例肌层异常信号;9例穿透型4例胎盘结节状膨出,5例块状突出,超过肌层轮廓,2例肌层渐进性消失,7例肌层中断,肌层信号均见异常,4例膀胱肌层信号异常。结论:常规 MRI 序列对胎盘植入的诊断与分型具有较高的应用价值,部分病例存在征象重叠。%Objective:To assess the MRI manifestations and diagnostic value of different types of placenta increta in the third trimester of pregnancy.Methods:The clinical materials of 27 patients with placenta increta confirmed by surgery and pathology from Jul 2010 to Dec 2013 were retrospectively analyzed.All cases performed MR scanning before delivery. Results:Among the 27 pregnant women,3,15 and 9 cases were classified as placenta accreta,placenta increta and placenta percreta respectively All cases had placenta previa.The thickness of placenta and number of flow-void blood vessels within the placenta were 4.87cm and 5.0 in placenta accreta,5.31cm and 5.7 in placenta increta,6.51cm and 6.8 in placenta per-creta respectively.In the 3 patients with placenta accreta,the placental myometrial apposition interface was arc shape in 2 cases,and nodular protrusion with continuous myometrium in one case.Among the 15 cases of placenta increta,abnormal MR findings included nodular protrusion of placenta (n=11),progressive obliteration of normal myometrium (n=11)and abnormal signal

  17. Ideas previas sobre carga, fuerza y campo eléctrico en estudiantes universitarios. Consideraciones para su superación

    Directory of Open Access Journals (Sweden)

    Marianela Nava

    2008-05-01

    Full Text Available El presente trabajo trata sobre el valor didáctico de las ideas previas de los estudiantes para la construcción de nuevos saberes, que lo posibiliten para dar explicaciones acordes con el conocimiento científico. Luego del análisis de los datos, se plantea el diseño de situaciones didácticas, fundamentadas en Posner et al, Ausubel, Amestoy, Alonso et al, que permitan promover la construcción de conceptos, aplicable a diversos campos. El estudio se encuentra enmarcado en un paradigma cuali-cuantitativo, a nivel descriptivo. Una conclusión importante es que las nociones sobre campo eléctrico, resultaron más deficientes que las de carga, pero menos que las de fuerza eléctrica, siendo necesario fomentar la construcción de conceptos científicos en los estudiantes universitarios.

  18. Abdomen agudo y embarazo: placenta percreta

    Directory of Open Access Journals (Sweden)

    Horacio Massotto Chaves

    2001-10-01

    Full Text Available La ruptura uterina espontánea por placenta percreta, sin historia de trauma o infección, es una patología extremadamente rara y responsable de una alta morbimortalidad materna. El diagnóstico prenatal de placenta percreta es importante para evitar resultados catastróficos debido a este desorden obstétrico, y diversos procedimientos son utilizados para lograr esta meta. Se presenta un caso de placenta percreta, con búsqueda de expedientes clínicos por esta patología, en el Hospital Monseñor Sanabria, desde 1994 hasta 1999, y con revisión de la bibliografía.

  19. Nitroglycerin for management of retained placenta.

    Science.gov (United States)

    Abdel-Aleem, Hany; Abdel-Aleem, Mahmoud A; Shaaban, Omar M

    2015-11-12

    Retained placenta affects 0.5% to 3% of women following delivery, with considerable morbidity if left untreated. Use of nitroglycerin (NTG), either alone or in combination with uterotonics, may be of value to minimise the need for manual removal of the placenta in theatre under anaesthesia. To evaluate the benefits and harms of NTG as a tocolytic, either alone or in addition to uterotonics, in the management of retained placenta. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (14 January 2015), reference lists of retrieved studies and contacted experts in the field. Any adequately randomised controlled trial (RCT) comparing the use of NTG, either alone or in combination with uterotonics, with no intervention or with other interventions in the management of retained placenta. All women having a vaginal delivery with a retained placenta, regardless of the management of the third stage of labour (expectant or active). We included all trials with haemodynamically stable women in whom the placenta was not delivered at least within 15 minutes after delivery of the baby. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We included three randomised controlled trials (RCTs) with 175 women. The three published RCTs compared NTG alone versus placebo. The detachment status of retained placenta was unknown in all three RCTs. Collectively, among the three included trials, two were judged to be at low risk of bias and the third trial was judged to be at high risk of bias for two domains: incomplete outcome data and selective reporting. The three trials reported seven out of 23 of the review's pre-specified outcomes.The primary outcome "manual removal of the placenta" was reported in all three studies. No differences were seen between NTG and placebo for manual removal of the placenta (average risk ratio (RR) 0.83, 95% confidence interval (CI) 0.47 to 1.46; women = 175; I

  20. 彩色多普勒超声诊断胎盘植入的价值%The Value of Color Doppler Ultrasound in Diagnosis of Placenta Accrete

    Institute of Scientific and Technical Information of China (English)

    王玲红; 武超

    2014-01-01

    目的:评价彩色多普勒超声诊断胎盘植入的价值。方法:回顾性分析2012年1月-2013年10月在天津市中心妇产科医院超声诊断胎盘低置状态或低置胎盘或前置胎盘的住院患者93例,其中超声检查疑似胎盘植入者24例。经腹部超声及阴道超声着重扫查胎盘的位置及其厚度、胎盘内回声、胎盘附着处子宫肌层厚度及其与子宫肌层的关系、与子宫相邻的膀胱壁情况、胎盘附着处血流情况。结果:24例经彩色多普勒超声检查疑似胎盘植入,经手术病理确诊为胎盘植入20例,其中粘连性胎盘4例,植入性胎盘14例,穿透性胎盘2例。超声误诊5例,漏诊1例。彩色多普勒超声检查的敏感度为95.00%,特异度为93.15%,阳性预测值为79.17%,阴性预测值为98.55%。结论:彩色多普勒超声为产前检查胎盘植入的较好方法。%Objective:To evaluate the value of color Doppler ultrasound in the diagnosis of placenta accreta. Methods:Retrospective analysis of 93 cases diagnosed as placenta low state ,low-lying placenta or placenta previa through ultrasound examination in our hospital between January 2012 to October 2013. 24 cases were diagnosed as placenta implantation among them. Abdominal and transvaginal ultrasonography focus in observing the thickness ,position and internal echo of the placenta , the thickness of uterine muscle in placental site ,the relationship between the placenta and uterine muscle ,and the adjacent urinary bladder wall blood flow in placental site were also included. Results:24 patients were suspected of placenta implantation by color Doppler ultrasonography,20 cases were confirmed of placenta implantation by pathology after operation,including 4 cases of placenta adherence,14 cases of placenta accreta,2 cases of placenta penetration.,5 cases of misdiagnosis, missed diagnosis in 1 cases. Sensitivity and specificity of color Doppler ultrasonography was 95.00% and 93

  1. Review: Placenta, evolution and lifelong health.

    Science.gov (United States)

    Lewis, R M; Cleal, J K; Hanson, M A

    2012-02-01

    The intrauterine environment has an important influence on lifelong health, and babies who grew poorly in the womb are more likely to develop chronic diseases in later life. Placental function is a major determinant of fetal growth and is therefore also a key influence on lifelong health. The capacity of the placenta to transport nutrients to the fetus and regulate fetal growth is determined by both maternal and fetal signals. The way in which the placenta responds to these signals will have been subject to evolutionary selective pressures. The responses selected are those which increase Darwinian fitness, i.e. reproductive success. This review asks whether in addition to responding to short-term signals, such as a rise in maternal nutrient levels, the placenta also responds to longer-term signals representing the mother's phenotype as a measure of environmental influences across her life course. Understanding how the placenta responds to maternal signals is therefore not only important for promoting optimal fetal growth but can also give insights into how human evolution affected developmental history with long-term effects on health and disease.

  2. Modeling Oxygen Transport in the Human Placenta

    Science.gov (United States)

    Serov, Alexander; Filoche, Marcel; Salafia, Carolyn; Grebenkov, Denis

    Efficient functioning of the human placenta is crucial for the favorable pregnancy outcome. We construct a 3D model of oxygen transport in the placenta based on its histological cross-sections. The model accounts for both diffusion and convention of oxygen in the intervillous space and allows one to estimate oxygen uptake of a placentone. We demonstrate the existence of an optimal villi density maximizing the uptake and explain it as a trade-off between the incoming oxygen flow and the absorbing villous surface. Calculations performed for arbitrary shapes of fetal villi show that only two geometrical characteristics - villi density and the effective villi radius - are required to predict fetal oxygen uptake. Two combinations of physiological parameters that determine oxygen uptake are also identified: maximal oxygen inflow of a placentone and the Damköhler number. An automatic image analysis method is developed and applied to 22 healthy placental cross-sections demonstrating that villi density of a healthy human placenta lies within 10% of the optimal value, while overall geometry efficiency is rather low (around 30-40%). In a perspective, the model can constitute the base of a reliable tool of post partum oxygen exchange efficiency assessment in the human placenta. Also affiliated with Department of Chemistry and Biochemistry, UCLA, Los Angeles, CA 90095, USA.

  3. THE PLACENTA INFECTED BY HIV AND HPV

    Directory of Open Access Journals (Sweden)

    Castejón Sandoval OC

    2013-09-01

    Full Text Available Background: The connection HIV/HPV reaches the placenta through the maternal-fetal transmission from an infected uterus. In this connection HPV has epitheliotropic and cytolytic capabilities which can cause severe alterations to the structure of the placental villi associating with the activity of antivirals that can increase the proportion of these lesions. Objective: To evaluate morphological changes in placental villi of patient with coinfection HIV/HPV. Material and Method: Placenta obtained of patient with low socioeconomic resources and coinfection HIV/HPV at 38 weeks of pregnancy, without another signs of disease, live newborn, which was analized by Light microscopy. Normal placenta was used as control. A protocol of observation that described syncytial nodules,fibrinoid, edema, fibrosis, calcification and immaturity was used. Results: Stem villi appeared with vascular damage to the level of endothelium, muscular layer and tissue that surround to the vessels. Severe degenerative changes in the syncytium and stromal region were observed in different types of villi. Arborization of villi was scarcity. Fibrosis, deposition of fibrinoid and infarcts are notorious. Immature intermediate villi were seen abundant and degenerate. Conclusions: An unknown interaction of HIV/HPV has provoked on the structure of placental villi an effect higher compared when the viral activity of each one virus is produced individually. This viral attack leads to a destructive effect very strong on the placenta.

  4. Evolution of the Placenta in Eutherian Mammals

    DEFF Research Database (Denmark)

    Carter, Anthony Michael; Mess, A

    2007-01-01

    of eutherian mammals had an endotheliochorial placenta or a haemochorial one. Research has been stimulated by improved understanding of the relations between the orders of mammals provided by molecular phylogenetics. In part, the uncertainties arise from doubt about how to root the mammalian tree. Resolution...

  5. The types of placenta praevia, and the analysis of antepartum bleeding and pregnancy outcome%前置胎盘类型及产前出血与妊娠结局的分析

    Institute of Scientific and Technical Information of China (English)

    于冰; 黄惠英

    2011-01-01

    Objective To analyze the relation of the pregnancy outcome between the types of placenta praevia and the vaginal bleeding, and to approach the treatment of the placenta praevia and to improve the proguosis of the mother and the infant. Methods We retrospectively analyzed the clinic data of 112 placenta praevia accompany with vaginal bleeding lying - in women from Jan.1,2003 to Jun. 31,2009. Results The incidence rate of placenta praevia upgrade recently, there was close correlation between the type of placenta praevia, APH and PPH. The blood volume of APH of Placenta previa centralis is the largest( P<0.01 ), the average time of bleeding is the earliest(P<0.01) and also the blood volume of PPH is the largest(P<0.01), and the clinic result is more severe. The result of marginal placenta previa is converse. Partial placenta praevia is between both. Conclusions The result of mother and infant is more severe with earlier bleeding- time and larger blood volume of placenta praevia. There are different clinic results between different patients with placenta praevia. The type and the state of bleeding could be used to anticipate the clinic result. The key factor to improve result of placenta praevia is to prompt antepartum diagnosis. The key treatment is to control bleeding. Augmentation of planning family propaganda and elevation of technical level of doctor are the utility measure to prevent and therapy placenta praevia.%目的 分析前置胎盘类型、阴道出血状况与妊娠结局的关系,探讨前置胎盘的处理以改善母婴预后.方法 对本院2003年1月1日~2009年6月31日收治并分娩的112例前置胎盘伴产前出血患者的临床资料进行回顾性分析.结果 近年来前置胎盘的发生率在上升;前置胎盘类型与产前出血、产后出血密切相关,中央性前置胎盘发生产前出血量最多(P<0.01), 出血时间最早(P<0.01), 产后出血概率越大(P<0.01), 临床结局最严峻;边缘性前置胎盘则反

  6. PROFESORES PRINCIPIANTES E INICIACIÓN PROFESIONAL. ESTUDIO EXPLORATORIO

    Directory of Open Access Journals (Sweden)

    Raúl Eirín Nemiña

    2009-01-01

    Full Text Available En este trabajo presentamos los avances de un estudio llevado a cabo con profesores que acceden a la condición de funcionarios docentes. Comenzamos estudiando las aportaciones teóricas que sustentan el interés por el estudio del período de iniciación profesional. En el apartado empírico, mediante la aplicación de un cuestionario, hemos explorado cuestiones como la edad, sexo, experiencia docente previa, contexto del centro de trabajo y motivaciones iniciales de entrada a al profesión docente. También valoramos, apoyándonos en los hallazgos recogidos en la literatura sobre el tema, los problemas y preocupaciones que encaran los profesores de nuestra muestra.

  7. Review: Toward an integrated evolutionary understanding of the mammalian placenta.

    Science.gov (United States)

    Wildman, D E

    2011-03-01

    The placenta is fundamentally important for the success of pregnancy. Disruptions outside the normal range for placental function can result in pregnancy failure and other complications. The anatomy of the placenta varies greatly across mammals, as do key parameters in pregnancy such as neonatal body mass, length of gestation and number of offspring per pregnancy. An accurate understanding of the evolution of the mammalian placenta will require at minimum the integration of anatomical, developmental, physiological, genetic, and epigenetic data. Currently available data suggest that the placenta is a dynamic organ that has evolved rapidly in a lineage specific manner. Examination of the placenta from the perspective of human evolution shows that many anatomical features of the human placenta are relatively conserved. Despite the anatomical conservation of the human placenta there are many recently evolved placenta-specific genes (e.g. CGB, LGALS13, GH2) that are important in the development and function of the human placenta. Other mammalian genomes have also evolved specific suites of placenta-expressed genes. For example, rodents have undergone expansions of the cathepsin and prolactin families, and artiodactyls have expanded their suite of pregnancy-associated glycoproteins. In addition to lineage specific birth and death of gene family members, the pattern of imprinted loci varies greatly among species. Taken together, these studies suggest that a strategy reliant upon the sampling of placentally expressed and imprinted genes from a phylogenetically diverse range of species is appropriate for unraveling the conserved and derived aspects of placental biology.

  8. Consulta previa en casos de minería para comunidades indígenas y tribales

    Directory of Open Access Journals (Sweden)

    Claudia Jimena Abello

    2012-12-01

    Full Text Available Este artículo hace un recorrido sobre la jurisprudencia de la Corte Constitucional sobre consulta previa y la minería. El objetivo es establecer las principales reglas, que ha creado la Corte al ponderar el derecho a la consulta previa versus el derecho del Estado a la explotación de recursos naturales. También, se intentará dar un esvoso de lo que entiende la Corte Constitucional como consulta previa y el procedimiento a seguir. Finalmente se hace una pequeña reflexión sobre el multiculturalismo y los derechos diferenciales.

  9. Coagulation and Placenta-Mediated Complications

    Directory of Open Access Journals (Sweden)

    Anat Aharon

    2014-10-01

    Full Text Available Pregnancy is a physiological hypercoagulable state, preparing the mother for the hemostatic challenge of delivery. However, this is associated with an increased risk of venous thrombosis and placenta-mediated complications, which present major challenges for mother and fetus. Although these conditions are heterogeneous in their pathophysiology, hereditary and acquired thrombophilia has been associated with recurrent pregnancy loss and gestational vascular complications, such as early-onset pre-eclampsia and placental abruption. Prevention of such placenta-mediated complications, which collectively complicate up to 15% of pregnancies, is a major issue for women’s health. Prospective interventional studies stratified by current knowledge of pathophysiological mechanisms related to placental and systemic hemostatic alterations will impact on the management of pregnancies at risk of these complications.

  10. Placenta Percreta Presenting with Delayed Haematuria.

    Science.gov (United States)

    Wagaskar, Vinayak Gorakhanath; Daga, Sudarshan Omprakash; Patwardhan, Sujata Kiran

    2015-12-01

    Placenta percreta presents as life threatening complications with bladder invasion. A condition of placenta invading urinary bladder presented with differential diagnosis of gestational trophoblastic neoplasia on imaging and responded to chemotherapy. A 35-year-old primi-gravida presented at term with per vaginal bleeding. During caesarian section placental mass totally invading uterine myometrium was found. She was given single dose of Methotrexate. After 2 months she presented with gross haematuria with clot retention two times. Her MRI was suggestive of gestational trophoblastic neoplasia of size 19 X 10 X 13cm. Her beta-Human Chorionic Gonadotropin levels were 691.23 mIU/ml. She was given total four doses of methotrexate. At present size of mass was 1.6 X1.3X 1.1cm. Her beta Human Chorionic Gonadotropin level dropped down to 2mIU/ml. Patient was not willing for further intervention or for follow up.

  11. Metalloprotease Dependent Release of Placenta Derived Fractalkine

    OpenAIRE

    Monika Siwetz; Astrid Blaschitz; Julia Kremshofer; Jelena Bilic; Gernot Desoye; Berthold Huppertz; Martin Gauster

    2014-01-01

    The chemokine fractalkine is considered as unique since it exists both as membrane-bound adhesion molecule and as shed soluble chemoattractant. Here the hypothesis was tested whether placental fractalkine can be shed and released into the maternal circulation. Immunohistochemical staining of human first trimester and term placenta sections localized fractalkine at the apical microvillous plasma membrane of the syncytiotrophoblast. Gene expression analysis revealed abundant upregulation in pla...

  12. Impact of placenta praevia on obstetric outcome

    Directory of Open Access Journals (Sweden)

    Neelam Meena

    2015-02-01

    Conclusions: It was concluded that increased maternal age and parity, history of previous caesarean section are identified risk factors which are same as reported in western literature. Sonographic determination of the placental position where its location be-Neath the uterine incision is very important to predict maternal outcomes in placenta praevia patients, and such cases, close attention should be paid for massive haemorrhage. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 76-80

  13. Natural killer cells and HLA-G expression in the basal decidua of human placenta adhesiva.

    NARCIS (Netherlands)

    Beekhuizen, H.J. van; Joosten, I.; Lotgering, F.K.; Bulten, J.; Kempen, L.C.L.T. van

    2010-01-01

    Retained placenta is caused by abnormal adherence of the placenta to the uterine wall, leading to delayed expulsion of the placenta and causing postpartum haemorrhage. The mildest form of retained placenta is the placenta adhesiva (PA), of which the cause is unknown. The aim of our study was to expl

  14. Magnetic resonance imaging of the normal placenta.

    Science.gov (United States)

    Blaicher, Wibke; Brugger, Peter C; Mittermayer, Christoph; Schwindt, Jens; Deutinger, Josef; Bernaschek, Gerhard; Prayer, Daniela

    2006-02-01

    The goal of this study was to provide a representative description of the normal placenta with contrast medium-free magnetic resonance imaging (MRI) in order to determine a standard of reference. One hundred consecutive singleton pregnancies were investigated by MRI without application of a contrast medium. The mean gestational age (GA) at the time of investigation was 29.5 weeks (range 19-40). Patients with suspected utero-placental insufficiency (UPI) or placental anomalies were excluded. Signal intensities were assessed and correlated with the respective GA. Antenatal MRI without contrast medium was able to depict placental status and morphological changes during gestation. A regular homogeneous structure was found in weeks 19-23. Subsequently, sporadic, slightly marked lobules appeared, which increased in number and markedness with ongoing gestation. Stratification of the lobules was observed after 36 weeks. The ratio of placental and amniotic fluid signal intensities decreased significantly with higher GA and with placental grading. MRI is well suited as an imaging method for the placenta. Our data may be used as a reference in the assessment of the placenta on MRI, and may have further clinical impact with respect to the determination of UPI.

  15. Magnetic resonance imaging of the normal placenta

    Energy Technology Data Exchange (ETDEWEB)

    Blaicher, Wibke [Department of Gynecology and Obstetrics, University Hospital Vienna (Austria)]. E-mail: wibke.blaicher@meduniwien.ac.at; Brugger, Peter C. [Center of Anatomy and Cell Biology, University Hospital of Vienna (Austria); Mittermayer, Christoph [Department of Pediatrics, Division of Neonatology and Intensive Care, University Hospital of Vienna (Austria); Schwindt, Jens [Department of Pediatrics, Division of Neonatology and Intensive Care, University Hospital of Vienna (Austria); Deutinger, Josef [Department of Gynecology and Obstetrics, University Hospital Vienna (Austria); Bernaschek, Gerhard [Department of Gynecology and Obstetrics, University Hospital Vienna (Austria); Prayer, Daniela [Department of Radiology, Division of Neuroradiology, University Hospital of Vienna (Austria)

    2006-02-15

    The goal of this study was to provide a representative description of the normal placenta with contrast medium-free magnetic resonance imaging (MRI) in order to determine a standard of reference. One hundred consecutive singleton pregnancies were investigated by MRI without application of a contrast medium. The mean gestational age (GA) at the time of investigation was 29.5 weeks (range 19-40). Patients with suspected utero-placental insufficiency (UPI) or placental anomalies were excluded. Signal intensities were assessed and correlated with the respective GA. Antenatal MRI without contrast medium was able to depict placental status and morphological changes during gestation. A regular homogeneous structure was found in weeks 19-23. Subsequently, sporadic, slightly marked lobules appeared, which increased in number and markedness with ongoing gestation. Stratification of the lobules was observed after 36 weeks. The ratio of placental and amniotic fluid signal intensities decreased significantly with higher GA and with placental grading. MRI is well suited as an imaging method for the placenta. Our data may be used as a reference in the assessment of the placenta on MRI, and may have further clinical impact with respect to the determination of UPI.

  16. Automated vasculature extraction from placenta images

    Science.gov (United States)

    Almoussa, Nizar; Dutra, Brittany; Lampe, Bryce; Getreuer, Pascal; Wittman, Todd; Salafia, Carolyn; Vese, Luminita

    2011-03-01

    Recent research in perinatal pathology argues that analyzing properties of the placenta may reveal important information on how certain diseases progress. One important property is the structure of the placental blood vessels, which supply a fetus with all of its oxygen and nutrition. An essential step in the analysis of the vascular network pattern is the extraction of the blood vessels, which has only been done manually through a costly and time-consuming process. There is no existing method to automatically detect placental blood vessels; in addition, the large variation in the shape, color, and texture of the placenta makes it difficult to apply standard edge-detection algorithms. We describe a method to automatically detect and extract blood vessels from a given image by using image processing techniques and neural networks. We evaluate several local features for every pixel, in addition to a novel modification to an existing road detector. Pixels belonging to blood vessel regions have recognizable responses; hence, we use an artificial neural network to identify the pattern of blood vessels. A set of images where blood vessels are manually highlighted is used to train the network. We then apply the neural network to recognize blood vessels in new images. The network is effective in capturing the most prominent vascular structures of the placenta.

  17. Metalloprotease Dependent Release of Placenta Derived Fractalkine

    Directory of Open Access Journals (Sweden)

    Monika Siwetz

    2014-01-01

    Full Text Available The chemokine fractalkine is considered as unique since it exists both as membrane-bound adhesion molecule and as shed soluble chemoattractant. Here the hypothesis was tested whether placental fractalkine can be shed and released into the maternal circulation. Immunohistochemical staining of human first trimester and term placenta sections localized fractalkine at the apical microvillous plasma membrane of the syncytiotrophoblast. Gene expression analysis revealed abundant upregulation in placental fractalkine at term, compared to first trimester. Fractalkine expression and release were detected in the trophoblast cell line BeWo, in primary term trophoblasts and placental explants. Incubation of BeWo cells and placental explants with metalloprotease inhibitor Batimastat inhibited the release of soluble fractalkine and at the same time increased the membrane-bound form. These results demonstrate that human placenta is a source for fractalkine, which is expressed in the syncytiotrophoblast and can be released into the maternal circulation by constitutive metalloprotease dependent shedding. Increased expression and release of placental fractalkine may contribute to low grade systemic inflammatory responses in third trimester of normal pregnancy. Aberrant placental metalloprotease activity may not only affect the release of placenta derived fractalkine but may at the same time affect the abundance of the membrane-bound form of the chemokine.

  18. Fibulin-5 expression in the human placenta.

    Science.gov (United States)

    Gauster, Martin; Berghold, Veronika M; Moser, Gerit; Orendi, Kristina; Siwetz, Monika; Huppertz, Berthold

    2011-02-01

    Fibulin-5 is a secreted extracellular matrix glycoprotein and displays a diverse panel of biological functions, which can be segregated into elastogenic as well as extra-elastogenic functions. While elastogenic functions of fibulin-5 include essential roles in early steps of elastic fibre assembly, extra-elastogenic functions are widespread. Depending on the cell type used, fibulin-5 mediates cell adherence via a subset of integrins, antagonizes angiogenesis and inhibits migration as well as proliferation of endothelial and smooth muscle cells. In this study, we focused on the spatiotemporal expression of fibulin-5 in the human placenta. With progressing gestation, placental fibulin-5 expression increased from first trimester towards term. At term, placental fibulin-5 mRNA expression is lower when compared with other well-vascularized organs such as lung, kidney, heart, uterus and testis. In first trimester, placenta immunohistochemistry localized fibulin-5 in villous cytotrophoblasts and extravillous cytotrophoblasts of the proximal cell column. In term placenta, fibulin-5 was detected in the endothelial basement membrane and adventitia-like regions of vessels in the chorionic plate and stem villi. Cell culture experiments with the villous trophoblast-derived cell line BeWo showed that fibulin-5 expression was downregulated during functional differentiation and intercellular fusion. Moreover, cultivation of BeWo cells under low oxygen conditions impaired intercellular fusion and upregulated fibulin-5 expression. The spatiotemporal shift from the trophoblast compartment in first trimester to the villous vasculature at term suggests a dual role of fibulin-5 in human placental development.

  19. The placenta: a multifaceted, transient organ.

    Science.gov (United States)

    Burton, Graham J; Fowden, Abigail L

    2015-03-01

    The placenta is arguably the most important organ of the body, but paradoxically the most poorly understood. During its transient existence, it performs actions that are later taken on by diverse separate organs, including the lungs, liver, gut, kidneys and endocrine glands. Its principal function is to supply the fetus, and in particular, the fetal brain, with oxygen and nutrients. The placenta is structurally adapted to achieve this, possessing a large surface area for exchange and a thin interhaemal membrane separating the maternal and fetal circulations. In addition, it adopts other strategies that are key to facilitating transfer, including remodelling of the maternal uterine arteries that supply the placenta to ensure optimal perfusion. Furthermore, placental hormones have profound effects on maternal metabolism, initially building up her energy reserves and then releasing these to support fetal growth in later pregnancy and lactation post-natally. Bipedalism has posed unique haemodynamic challenges to the placental circulation, as pressure applied to the vena cava by the pregnant uterus may compromise venous return to the heart. These challenges, along with the immune interactions involved in maternal arterial remodelling, may explain complications of pregnancy that are almost unique to the human, including pre-eclampsia. Such complications may represent a trade-off against the provision for a large fetal brain.

  20. Paternally expressed genes predominate in the placenta.

    Science.gov (United States)

    Wang, Xu; Miller, Donald C; Harman, Rebecca; Antczak, Douglas F; Clark, Andrew G

    2013-06-25

    The discovery of genomic imprinting through studies of manipulated mouse embryos indicated that the paternal genome has a major influence on placental development. However, previous research has not demonstrated paternal bias in imprinted genes. We applied RNA sequencing to trophoblast tissue from reciprocal hybrids of horse and donkey, where genotypic differences allowed parent-of-origin identification of most expressed genes. Using this approach, we identified a core group of 15 ancient imprinted genes, of which 10 were paternally expressed. An additional 78 candidate imprinted genes identified by RNA sequencing also showed paternal bias. Pyrosequencing was used to confirm the imprinting status of six of the genes, including the insulin receptor (INSR), which may play a role in growth regulation with its reciprocally imprinted ligand, histone acetyltransferase-1 (HAT1), a gene involved in chromatin modification, and lymphocyte antigen 6 complex, locus G6C, a newly identified imprinted gene in the major histocompatibility complex. The 78 candidate imprinted genes displayed parent-of-origin expression bias in placenta but not fetus, and most showed less than 100% silencing of the imprinted allele. Some displayed variability in imprinting status among individuals. This variability results in a unique epigenetic signature for each placenta that contributes to variation in the intrauterine environment and thus presents the opportunity for natural selection to operate on parent-of-origin differential regulation. Taken together, these features highlight the plasticity of imprinting in mammals and the central importance of the placenta as a target tissue for genomic imprinting.

  1. Fundamentos históricos y principios ideológicos del intento de reforma de la censura previa en el siglo XVIII

    Directory of Open Access Journals (Sweden)

    Eva VELASCO MORENO

    2009-11-01

    Full Text Available RESUMEN: En este artículo se analizan los principios ideológicos que inspiraron el proyecto de reforma del sistema de censura previa español, a finales del siglo XVIII. Para ello me centro en el estudio de varios documentos relacionados con la cuestión: por un lado, la propuesta elaborada por el Consejo de Castilla —la llamada Idea— y, por otro, el informe que realizó la Real Academia de la Historia, en contestación a la solicitud de dicho órgano y que se basaba en trece informes de académicos. Dedicaré, no obstante, unas páginas previas a exponer el contexto histórico de clara afirmación regalista que explica, a mi juicio, por qué dicha reforma se planteó en 1770 y no antes o después.ABSTRACT: The main goal of this article is to analyze the ideological principles behind the legal attempts to reform the system of previous censorship in Spain, in 1770. In order to do so I study and use several documents and primary sources related to the issue. On one hand, the so called Idea that is the report that the Consejo de Castilla sent to the Academies asking for a reply and on the other hand, the final report that the Royal Academy of History sent to the Consejo. This report was based on thirteen reports written by the academicians. I also dedicate a section of the article to explain the key historical elements that from my point of view contribute to a better understanding of why the reform was schedule in 1770 and not before of after that year.

  2. Human placenta secretes apolipoprotein B-100-containing lipoproteins

    DEFF Research Database (Denmark)

    Munk-Madsen, Eva; Lindegaard, Marie Louise Skakkebæk; Andersen, Claus B;

    2004-01-01

    early during pregnancy in the placenta. To examine whether the human placenta produces lipoproteins, we examined apoB and microsomal triglyceride transfer protein (MTP) mRNA expression in placental biopsies. ApoB and MTP are mandatory for assembly and secretion of apoB-containing lipoproteins. Both...... genes were expressed in placenta and microsomal extracts from human placenta contained triglyceride transfer activity, indicating expression of bioactive MTP. To detect lipoprotein secretion, biopsies from term placentas were placed in medium with [(35)S]methionine and [(35)S]cysteine for 3-24 h. Upon...... lipoproteins secreted from placental tissue showed spherical particles with a diameter of 47 +/- 10 nm. These results demonstrate that human placenta expresses both apoB and MTP and consequently synthesize and secrete apoB-100-containing lipoproteins. Placental lipoprotein formation constitutes a novel pathway...

  3. Autophagy in the human placenta throughout gestation.

    Directory of Open Access Journals (Sweden)

    Tai-Ho Hung

    Full Text Available BACKGROUND: Autophagy has been reported to be essential for pre-implantation development and embryo survival. However, its role in placental development and regulation of autophagy during pregnancy remain unclear. The aims of this study were to (1 study autophagy by characterizing changes in levels of beclin-1, DRAM, and LC3B in human placenta throughout gestation; (2 determine whether autophagy is involved in regulation of trophoblast invasion in JEG-3 cells (a choriocarcinoma cell line; (3 examine the effects of reduced oxygen and glucose on the autophagic changes; and (4 investigate the effect of reoxygenation and supplementation of glucose after oxygen-glucose deprivation (OGD on the autophagic changes in primary cytotrophoblasts obtained from normal term pregnancy. METHODOLOGY/PRINCIPAL FINDINGS: An analysis of 40 placental samples representing different gestational stages showed (1 no significant differences in beclin-1, DRAM, and LC3B-II levels in placentas between early and mid-gestation, and late gestation with vaginal delivery; (2 placentas from late gestation with cesarean section had lower levels of LC3B-II compared to early and mid-gestation, and late gestation with vaginal delivery; levels of DRAM were also lower compared to placentas from early and mid-gestation; and (3 using explant cultures, villous tissues from early and late gestation had similar rates of autophagic flux under physiological oxygen concentrations. Knockdown of BECN1, DRAM, and LC3B had no effects on viability and invasion activity of JEG-3 cells. On the other hand, OGD caused a significant increase in the levels of LC3B-II in primary cytotrophoblasts, while re-supplementation of oxygen and glucose reduced these changes. Furthermore, there were differential changes in levels of beclin-1, DRAM, and LC3B-II in response to changes in oxygen and glucose levels. CONCLUSIONS/SIGNIFICANCE: Our results indicate that autophagy is involved in development of the human

  4. 胎盘植入保守治疗的临床分析%Clinical Analysis on Conservative Treatment of Placenta Implantation

    Institute of Scientific and Technical Information of China (English)

    屠京慧; 李莹

    2014-01-01

    Objective To investigate the conservative treatment method for placenta implantation. Methods The data of 26 placenta implantation patients who received conservative treatment in our hospital from 2008 to 2013 was analyzed retrospec-tively,the conservative treatment methods,postpartum blood loss,conservative treatment effect and outcomes of maternal and child were summarized. Results Among 26 patients,19 underwent cesarean section,the implanted placenta of 11/19 cases was removed,and the placenta implants of 8/11 cases was retained;7 underwent vaginal delivery,the implanted placenta of whom was retained. Among 19 cases who received cesarean section,the postpartum haemorrhage amount of 7 cases with placenta previa was significantly more than that of 12 patients with normal position placenta〔(1 514. 3 ± 177. 3) ml vs. (904. 2 ± 326. 4) ml, t=4. 534,P<0. 05〕. Placenta implantation was found among 7 vaginal delivery cases during vaginal delivery,postpartum av-erage blood loss was 1 142. 9 ml;Haemorrhage amount of 6 cases was more than 1 000 ml,including 4 cases from basic-level hospitals. Pregnancy outcomes:among 26 patients with placenta implantation who received conservative treatment,no maternal and neonatal death occurred,the conservative treatment failed among 1 case,and the case received whole hysterectomy,1 infec-ted case improved after anti-infective treatment;Placenta discharge time:12 patients discharged placentas organization within three months postpartum,3 patients discharged placentas organization after three months postpartum. Conclusion The postpar-tum haemorrhage amount of patients with placenta implantation and placenta previa is on the increase. Individualized conservative treatment plans for different types of placenta implantation according to the area size,depth and bleeding of placenta implanta-tion,with the addition of sufficient preoperative preparation,correct intrapartum treatment in a timely manner and strict postpar-tum follow

  5. Pathological And Clinical Evaluation of Hypertensive Pregnants and Their Placentas

    Directory of Open Access Journals (Sweden)

    Havva Erdem

    2015-10-01

    Full Text Available Aim: To investigate the effects of hypertension on the placenta and fetus in pregnancy. Method: 25 hypertensive pregnants, 114 control women, and their infants were included in the study. Results: There was significant correlation between to the body mass index, weight before pregnancy, gestational week, hematocrit, birth weight, placenta size and weight between two groups (p=.002, .003, .003, .004, .000, .050, .032, respectively. The age, gravida, parity, abortus, living child, height, weight gain in pregnancy, hemoglobin, placenta diameter and thickness, volume of clot were similar between groups. Conclusion: As a result, hypertension in pregnancy affects the development of the fetus and placenta as well.

  6. Ideas previas: experimentación acerca de ideas arraigadas e ideas inducidas sobre fracciones

    OpenAIRE

    Martínez, Alberto

    1998-01-01

    Mediante el análisis de algunos planteamientos constructivistas, y a través del diseño y realización de un diseño «cuasi experimental», se intenta indagar sobre la existencia de una mitificación del «constructo» de ideas previas en la enseñanza de las Matemáticas. Se llama la atención sobre la relatividad del calificativo de «previas» y, recordando la posición de Piaget al respecto, se propone la distinción entre ideas arraigadas e ideas superficiales. Dentro de estas últimas, las ideas induc...

  7. Development of the Preverbal Visual Assessment (PreViAs) questionnaire.

    Science.gov (United States)

    Pueyo, Victoria; García-Ormaechea, Inés; González, Inmaculada; Ferrer, Concepción; de la Mata, Guillermo; Duplá, María; Orós, Pedro; Andres, Eva

    2014-04-01

    Visual cognitive functions of preverbal infants are evaluated by means of a behavioral assessment. Parents or primary caregivers may be appropriate to certify the acquisition of certain abilities. To develop the PreViAs (Preverbal Visual Assessment) questionnaire to assess visual behavior of infants under 24 months of age and to assess the normative outcomes for each item at each age. The process was divided into three phases: scale development (items and domains generation), pilot testing, and exploratory analysis. The final version of the PreViAs questionnaire consisted of 30 items, each related to one or more of four domains (visual attention, visual communication, visual-motor coordination, and visual processing). For the exploratory analysis, 298 children (159 boys and 139 girls) were recruited. Their ages ranged from 0.1 to 24 months (mean, 11.2 months). Internal consistency of the questionnaire was high for all domains (Cronbach's α coefficients of 0.85-0.94). The PreViAs questionnaire is a useful scale for assessing visual cognitive abilities of infants under 24 months of age. It is easy and feasible to complete by primary caregivers. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Estudio de la Enseñanza Postgraduada Pública de Cirugía Bucal en España

    OpenAIRE

    Rodríguez Pérez,Manuel; Romero Olid, María Nuria; Vallecillo Capilla, Manuel Francisco

    2005-01-01

    El objetivo de este estudio de investigación es dar a conocer el tipo de enseñanza postgraduada pública en Cirugía Bucal que se está impartiendo actualmente en España, realizando un estudio descriptivo con relación a los contenidos teóricos y prácticos de los diferentes Máster, mediante encuestas contestadas por alumnos que han concluido el postgrado. Posteriormente se observa la posible relación existente con la edad, sexo y formación previa como odontólogo o estomatólogo. Los resultados mue...

  9. 三维彩色多普勒超声在胎盘植入中的诊断分析%Diagnosis analysis of three dimensional color Doppler ultrasound in placenta implantation

    Institute of Scientific and Technical Information of China (English)

    焦瑞宁

    2016-01-01

    accuracy was 74.29%;placenta previa was seen in all patients with prenatal placenta implantation,the rate of implanted area <1/2 in patients with prenatal placenta implantation was significantly lower than that in patients with postpartum placenta implantation (P<0.05).Conclusion Three dimensional color Doppler ultrasound is an effective method for the diagnosis of placenta implantation.The combination of blood flow parameters and characteristics of placenta is effective for early screening of placenta implantation.

  10. Estudio de la relación entre la dificultad quirúrgica en la exodoncia del tercer molar y las variables clínicas y séricas.

    OpenAIRE

    Fernández Sainz de Baranda, Beatriz

    2017-01-01

    Título: ESTUDIO DE LA RELACIÓN ENTRE LA DIFICULTAD QUIRÚRGICA DEL TERCER MOLAR Y LAS VARIABLES CLÍNICAS Y SÉRICAS. La exodoncia del tercer molar es actualmente, uno de los procedimientos más importantes en la clínica diaria odontológica. Debemos de tener en cuenta la dificultad quirúrgica que podamos encontrarnos previa o durante el acto quirúrgico. Por lo que la valoración de la dificultad quirúrgica previa tanto clínica como radiográfica, sea un acto fundamental. Tras la exodoncia de ter...

  11. The placenta in toxicology. Part III : Pathologic assessment of the placenta

    NARCIS (Netherlands)

    Cline, J Mark; Dixon, Darlene; Ernerudh, Jan; Faas, Marijke M; Göhner, Claudia; Häger, Jan-Dirk; Markert, Udo R; Pfarrer, Christiane; Svensson-Arvelund, Judit; Buse, Eberhard

    2014-01-01

    This short review is derived from the peer-reviewed literature and the experience and case materials of the authors. Brief illustrated summaries are presented on the gross and histologic normal anatomy of rodent and macaque placentas, including typical organ weights, with comments on differences fro

  12. Placenta changes in pregnancy with gestational diabetes.

    Science.gov (United States)

    Edu, Antoine; Teodorescu, Cristina; Dobjanschi, Carmen Gabriela; Socol, ZiŢa Zsuzsana; Teodorescu, Valeriu; Matei, Alexandru; Albu, Dinu Florin; Radulian, Gabriela

    2016-01-01

    Placental damage may be responsible for the fetal complications in pregnancies complicated by diabetes. We have analyzed the prevalence of gestational diabetes (GD) in a population of 109 pregnant women, the risk factors and the placental changes associated with gestational diabetes. Tests carried out were oral glucose tolerance test at 24-28 weeks of gestation, using the IADPSG (International Association of Diabetes and Pregnancy Study Groups) criteria for gestational diabetes, glycated hemoglobin, fasting insulin, total cholesterol, high density lipoprotein (HDL)-cholesterol, low density lipoprotein (LDL)-cholesterol, triglycerides, two-dimensional (2D) ultrasound and, also, there were analyzed macro and microscopic placental fragments from pregnant women with÷without GD. It has been recorded the weight of placenta at birth and there were analyzed the possible pathological changes. The prevalence of GD was 11.9%. We have applied the direct logistic regression to determine the impact of some factors over the probability of association with gestational diabetes. The most powerful predictor was the placental maturity grade, the patients with decreased maturity grade having chances 52.6 times higher than those with an increased placental maturity grade to associate gestational diabetes. Sizes of placentas in patients with gestational diabetes mellitus were significantly increased than in patients without this diagnosis (p=0.012) from week 24-28. Pathological changes were discovered in six of the 13 placentas of women with gestational diabetes mellitus, independent of the level of glycated hemoglobin (p=0.72). The level of hyperglycemia is only partially associated with the presence of placental changes, which may be caused by other maternal factors.

  13. Placenta-on-a-chip: a novel platform to study the biology of the human placenta.

    Science.gov (United States)

    Lee, Ji Soo; Romero, Roberto; Han, Yu Mi; Kim, Hee Chan; Kim, Chong Jai; Hong, Joon-Seok; Huh, Dongeun

    2016-01-01

    Studying the biology of the human placenta represents a major experimental challenge. Although conventional cell culture techniques have been used to study different types of placenta-derived cells, current in vitro models have limitations in recapitulating organ-specific structure and key physiological functions of the placenta. Here we demonstrate that it is possible to leverage microfluidic and microfabrication technologies to develop a microengi