Acta obstetricia et gynecologica Scandinavica
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Acta Obstet Gynecol Scand · Apr 2013
Use of Bakri balloon tamponade in the treatment of postpartum hemorrhage: a series of 50 cases from a tertiary teaching hospital.
Massive postpartum hemorrhage (PPH) is one of the most serious complications during delivery. Hysterectomy is commonly performed when other conventional treatment attempts fail. Bakri balloon tamponade (BBT) is a novel conservative management option for PPH. Little is known of the effectiveness of this procedure. We report a large case series from a tertiary teaching hospital. ⋯ BBT is a simple, readily available, effective and safe procedure for the management of PPH in selective cases. BBT does not exclude the use of other procedures if necessary. Even if BBT failed, it may provide temporary tamponade and time to prepare for other interventions or transportation from local hospital to tertiary centre. We suggest that BBT should be included in the PPH protocol.
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Acta Obstet Gynecol Scand · Mar 2013
Insufficient pain relief in vacuum extraction deliveries: a population-based study.
To investigate the pain relief used in association with vacuum extraction assisted deliveries and to identify risk factors for not receiving pain relief during the procedure. ⋯ A considerable number of women are delivered by vacuum extraction without pain relief. The high proportion might reflect that clinical staff do not always consider pain relief to be of high priority in vacuum extraction deliveries or that they fear impaired pushing forces.
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Acta Obstet Gynecol Scand · Mar 2013
Classification of stillbirths and risk factors by cause of death--a case-control study.
To investigate risk factors for stillbirths by cause, using the Causes of Death and Associated Conditions (CODAC) classification system for perinatal deaths. ⋯ Two-thirds of all stillbirths (68%) were caused by or associated with placental pathology. Risk factors differed somewhat according to cause, apart from smoking and small-for-gestational age, which were significant risk factors across the causal groups.
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Acta Obstet Gynecol Scand · Jan 2013
ReviewThe development of fast-track principles in gynecological surgery.
Fast-track is a multimodal strategy aimed at reducing the physiological burden of surgery to achieve an enhanced postoperative recovery. The strategy combines unimodal evidence-based interventions in the areas of preoperative preparation, anesthesia, surgical factors and postoperative care. The advantages of fast-track most likely extend to gynecology, although so far have scarcely been reported. ⋯ Studies of fast-track within the field of non-elective gynecological surgery are lacking. Widespread education is needed to improve the rate of implementation of fast-track. Close involvement of the entire surgical team is imperative to ensure a structured perioperative care aiming for enhanced postoperative recovery.
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Acta Obstet Gynecol Scand · Jan 2013
Intrapartum monitoring of high-risk deliveries with ST analysis of the fetal electrocardiogram: an observational study of 6010 deliveries.
To evaluate the clinical use of ST analysis (STAN) for intrapartum monitoring of high-risk pregnancies. ⋯ ST analysis is a useful tool for identification of fetuses at risk of intrapartum hypoxia. Despite the restricted use of fetal blood sampling, we found a low proportion of cord metabolic acidosis and newborn morbidity.