The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
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J. Matern. Fetal. Neonatal. Med. · Nov 2014
Morbidly adherent placenta previa in current practice: prediction and maternal morbidity in a series of 23 women who underwent hysterectomy.
To assess the prediction and maternal morbidity of morbidly adherent placenta previa (PP) when currently available management options are used. ⋯ 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.
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J. Matern. Fetal. Neonatal. Med. · Nov 2014
ReviewCerclage, progesterone and α-hydroxyprogeterone caproate treatment in women at risk for preterm delivery.
The most significant action of progesterone appears to be on the cervix and in prevention rather than on treatment of preterm delivery. In women with singleton gestations, no prior PTB, and CL <20 mm at <24 weeks, vaginal progesterone, either 90 mg gel or 200 mg suppository, is associated with reduction of both preterm birth (PTB) and perinatal morbidity/mortality. Cerclage is as effective as vaginal progesterone in women with CL <25 mm. ⋯ It is reasonable to support an approach with CL screening of women with prior PTB starting at 16 to 19 weeks and administration of progesterone to women with a short cervix. Cerclage may be offered to those with a CL<25 mm. A combination of traditional tocolytics, corticosteroids and progesterone might be beneficial.
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J. Matern. Fetal. Neonatal. Med. · Nov 2014
Prediction of postpartum blood transfusion--risk factors and recurrence.
The aim was to find clinically useful risk factors for postpartum transfusion and to assess the joint predictive value in a population of women with a first and second delivery. ⋯ Prediction of postpartum transfusion is difficult. Retained placental tissue is the strongest predictor of postpartum blood transfusion in vaginal deliveries. Retained placental tissue is usually diagnosed for the first time when the bleeding starts, which limits the clinical value of prediction. We need tools for an early diagnosis of retained placenta to intervene early before transfusion is needed.
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J. Matern. Fetal. Neonatal. Med. · Nov 2014
Decision-to-delivery interval in suspected placental abruption - association with pregnancy outcome.
To determine the association between decision to delivery interval (DDI) and short-term perinatal outcome in cases of suspected placental abruption delivered by cesarean section (CS). ⋯ In cases of suspected placental abruption, fetal short-term morbidity is probably related to the indication for CS and not only to DDI.