J Gynecol Obst Bio R
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J Gynecol Obst Bio R · Jun 2002
[Severe post-partum hemorrhage: descriptive study at the Robert-Debré Hospital maternity ward].
To analyze the prevalence, cause, treatment, and risk factors of severe post-partum hemorrhage (transfusion, surgery, radiology) observed at the maternity ward of the Robert-Debré Hospital, Paris. Method. This retrospective cohort was collected from a database including 19182 deliveries from 1992 to 1998. The entire medical file was reviewed in cases of severe hemorrhage. ⋯ The prevalence of severe pot-partum hemorrhage is low in our experience. The methodology used for this retrospective cohort does not enable an explanation. Intensive obstetrical care is necessary in case of abnormal placenta insertion. In 10 out of 44 cases, severe post-partum hemorrhage occurred in a context of insufficient monitoring, late or erroneous diagnosis, or incorrect treatment.
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J Gynecol Obst Bio R · Jun 2002
Comparative Study[Microvolume dosage of lactate in cord blood for the evaluation of the neonatal well-being].
A preliminary experience about a new microvolume lactate meter (Lactate Pro) is reported from 200 consecutive term deliveries. Comparison between lactate and pH in umbilical artery revealed a significant negative correlation between the two variables (r=-0.0693; p<0.0001). For the diagnosis of acidosis (pH<7.15) a lactate cutoff value at 6 mmol/l had a sensitivity of 50% and a specificity of 92% in a population with a prevalence of 8%. ⋯ A lactate value higher than 6mmol/L predicted a metabolic acidosis (BE>- 8 mmol/l) with a sensitivity of 50% and a specificity of 94% from a collective with a prevalence of 16%. Considering the simplicity of the method, lactate measurements in cord blood could be extended to all birth centers for a systematic evaluation of the fetal condition in combination with the APGAR score. According to the minimal sampling volume (5 microliter) and the better prediction of metabolic acidosis this new method could replace the determination of the pH on fetal scalp.