Search Our Scientific Publications & Authors

Ethiop J Health Sci 2021 Jan;31(1):35-42

Department of obstetrics and gynecology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Background: There is conflicting data on the rate and trends of maternal mortality in Ethiopia. There is no previous study done on the magnitude and trends of maternal death at Saint Paul's Hospital, an institution providing the largest labor and delivery services in Ethiopia. The objective of this study is to determine the magnitude, causes and contributing factors for maternal deaths in the institution. Read More

J Matern Fetal Neonatal Med 2021 Jun 21:1-7. Epub 2021 Jun 21.

Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Columbia University Irving Medical Center, New York, NY, USA.

Objective: Prior research demonstrated large increased risk for maternal mortality among women with epilepsy. The objective of this study was to estimate risk for adverse maternal outcomes during delivery hospitalizations among women with epilepsy.

Methods: Truven Health MarketScan databases were used to compare risk for adverse maternal outcomes during delivery hospitalizations based upon whether there was diagnosis of epilepsy and receipt of anti-epileptic drugs prior to delivery. Read More

Clin Trials 2021 Jun 22:17407745211024751. Epub 2021 Jun 22.

Institute of Applied Health Research, University of Birmingham, Birmingham, UK.

Background: There is an abundance of guidance for the interim monitoring of individually randomised trials. While methodological literature exists on how to extend these methods to cluster randomised trials, there is little guidance on practical implementation. Cluster trials have many features which make their monitoring needs different. Read More

Anaesthesist 2021 Jun 21. Epub 2021 Jun 21.

Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.

J Obstet Gynaecol 2021 Jun 21:1-7. Epub 2021 Jun 21.

Department of Obstetrics and Gynaecology, JIPMER, Puducherry, India.

The factors associated with the outcome of trial of labour after one previous Caesarean Section; a retrospective cohort study. A retrospective observational study was performed on all eligible consecutive singleton pregnancies planned for trial of labour after one previous Caesarean Section (TOLAC) over a period of 18 months to study the success rate of vaginal birth after Caesarean Section (VBAC) and to find out the factors associated with successful and failed TOLAC. All of the data were entered in electronic format and the data was analysed in detail. Read More

Am J Transl Res 2021 15;13(5):4995-5002. Epub 2021 May 15.

Department of Obstetrics, Tai'an City Central Hospital Tai'an 271000, Shandong Province, China.

Objective: To observe the efficacy of intrauterine Bakri balloon tamponade (IBBT) combined with ascending uterine artery ligation (AUAL) in the treatment of postpartum hemorrhage (PPH) due to uterine inertia after cesarean section.

Methods: A total of 92 patients with PPH due to uterine inertia after cesarean section were divided into a study group (n=46) and a control group (n=46) in accordance with the random number table. The control group was treated with IBBT alone, while the study group was treated with IBBT combined with AUAL. Read More

Am J Transl Res 2021 15;13(5):4544-4552. Epub 2021 May 15.

Department of Obstetrics and Gynecology, The People's Hospital of Zhuji Zhuji, Zhejiang Province, China.

Objective: To investigate the efficacy and safety of dydrogesterone and progesterone in the treatment of threatened miscarriage due to corpus luteum insufficiency.

Methods: A prospective cohort study was designed and a total of 1,285 patients with threatened miscarriage due to corpus luteum insufficiency were recruited, in which 665 participants received dydrogesterone treatment (dydrogesterone group), and the other 620 received progesterone treatment (progesterone group). The time for clinical symptom relief, changes of sex hormone levels in serum, the rate of miscarriage prevention, delivery outcome, and adverse effects were compared between the two groups. Read More

Middle East Fertil Soc J 2021 14;26(1):17. Epub 2021 Jun 14.

Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.

Background: The purpose of the present study was to evaluate obstetric, maternal, and neonatal outcomes in COVID-19 compared to healthy pregnant women in Iran.

Results: A case-control study was conducted on 55 COVID-19 as the case and 55 matched control pregnant women in Hormozgan, Iran. Patients were considered to be cases if they had a positive COVID-19 test plus a positive chest X-ray result. Read More

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2021 May;46(5):497-502

Department of Obstetrics, First Affiliated Hospital of Hainan Medical College, Haikou 570102, China.

Objectives: Human papillomavirus (HPV) is a kind of spherical DNA virus, which is related to many factors such as immune status and pregnancy. Due to the decrease of immunity, pregnant women are more likely to have HPV infection, which causes serious imbalance of vaginal microecology and is not beneficial to pregnancy outcome. Therefore, this study focuses on the impact of HPV infection on vaginal microecology and maternal and neonatal outcomes. Read More

Tech Vasc Interv Radiol 2021 Mar 17;24(1):100724. Epub 2021 Apr 17.

University of Alabama at Birmingham, Division Director of Interventional Radiology, Department of Radiology, Birmingham, AL.

Tech Vasc Interv Radiol 2021 Mar 18;24(1):100729. Epub 2021 Apr 18.

Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, 833 Chestnut Street, 1st Floor, Philadelphia, PA. Electronic address:

Since the introduction of uterine artery embolization as a treatment option for symptomatic leiomyomas, there has been a growing interest in expanding the role of interventional radiology (IR) in the evaluation and treatment of obstetrics and gynecology (OBGYN) patients. This review provides an overview of opportunities for collaboration between IR and OBGYN. This can include medically and/or surgically complex patients, efforts to reduce quantitative blood loss, obstetrical emergencies, and consideration of fertility or uterine preservation. Read More

Tech Vasc Interv Radiol 2021 Mar 16;24(1):100728. Epub 2021 Apr 16.

Emory University Hospital, Interventional Radiology, Department of Radiology and Imaging Sciences, Atlanta, GA.

Postpartum hemorrhage (PPH) affects approximately 14 million women yearly, accounts for 25% of delivery-related deaths in the world and is the main cause of emergency peripartum hysterectomy. Traditionally, PPH is defined as at least 500 mL of blood loss after vaginal delivery or 1000 mL of blood loss after cesarean-section. However, several authors have suggested a simpler definition to include women who experience hemodynamic instability after birth regardless of amount of blood loss. Read More

Tech Vasc Interv Radiol 2021 Mar 16;24(1):100727. Epub 2021 Apr 16.

University of Colorado, Aurora, CO.

Postpartum hemorrhage (PPH) is a common source of morbidity and mortality for delivering mothers worldwide, resulting in greater than 100,000 deaths per annum. Pathologic postpartum hemorrhage is defined as blood loss greater than 500 mL for vaginal deliveries and 1,000 mL for caesarean births, which occurs in up to 10% of deliveries. Severe postpartum hemorrhage can progress to shock, disseminated intravascular coagulation (DIC) and death. Read More

Int J Obstet Anesth 2021 May 25;47:103192. Epub 2021 May 25.

School of Medicine, Cardiff University, UK. Electronic address:

Background: The TEG 6s is an automated cartridge-based device with limited description of use in obstetric haemorrhage. The aim of this analysis was to describe the utility of TEG 6s in identifying abnormal laboratory results of coagulation and platelet count, and inform an interventional treatment algorithm for postpartum haemorrhage.

Methods: A prospective observational cohort study of 521 women with moderate to severe obstetric haemorrhage (>1000 mL blood loss), including 372 women with at least one TEG 6s test. Read More

Nurs Womens Health 2021 Jun 14. Epub 2021 Jun 14.

Objective: To examine the effect of an obstetric hemorrhage (OBH) safety bundle on health outcomes and to explore nurses' and physicians' perceptions of using the bundle.

Design: Descriptive longitudinal study, including review of electronic health records for 79,509 births, and clinician surveys.

Setting: Nine hospitals in the southwestern United States. Read More

Kurume Med J 2021 Jun 15. Epub 2021 Jun 15.

Department of Obstetrics and Gynecology Faculty of Medicine, Kagoshima University.

Objective: The main purpose was to clarify the optimal D-dimer cutoff level during pregnancy to exclude deep vein thrombosis (DVT) prior to Cesarean section. The secondary purpose was to determine whether D-dimer can predict severe postpartum hemorrhage (PPH) in Cesarean section patients.

Methods: Two hundred and seventy eight elective Cesarean section cases were enrolled. Read More

BMC Womens Health 2021 06 15;21(1):243. Epub 2021 Jun 15.

Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: We aimed to investigate the risk factors of placenta accreta spectrum (PAS) disorder, management options and maternal and neonatal outcomes of these pregnancies in a resource-limited clinical setting.

Methods: All women diagnosed with placenta accreta, increta, and percreta who underwent peripartum hysterectomy using a multidisciplinary approach in a tertiary center in Shiraz, southern Iran between January 2015 until October 2019 were included in this retrospective cohort study. Maternal variables, such as estimated blood loss, transfusion requirements and ICU admission, as well as neonatal variables such as, Apgar score, NICU admission and birthweight, were among the primary outcomes of this study. Read More

World Neurosurg 2021 Jun 12. Epub 2021 Jun 12.

Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.

Objective: Acute hemorrhage due to cerebral arteriovenous malformation (cAVM) during pregnancy is uncommon but life-threatening for both the mother and the fetus, and presents a great challenge to clinical management. However, there is still no consensus on the treatment strategy and the treatment timing of acute hemorrhage from cAVM during pregnancy. The aim of this study was to amalgamate published case series and our cases regarding the clinical management of pregnant patients under this special condition. Read More

J Pak Med Assoc 2021 Apr;71(4):1282-12568

Department of Endocrinology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India.

Sheehan syndrome is an underestimated cause of hypopituitarism, which can be either partial or complete. It results from ischaemic necrosis of anterior pituitary during peripartum period leading to loss of one or more pituitary cell lines. Hyperplasia of pituitary gland during pregnancy increases demand for blood supply and at the same time compresses the pituitary gland. Read More

J Matern Fetal Neonatal Med 2021 Jun 10:1-8. Epub 2021 Jun 10.

Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia.

Objective: To evaluate whether the implementation of care bundles has an impact on resource utilization in the care of patients with postpartum hemorrhage (PPH).

Methods: Retrospective, cross-sectional, observational study of 404 patients with stage II or greater PPH. Periods 2011-2014 and 2015-2017, before and after the introduction of care bundles, were compared. Read More

J Matern Fetal Neonatal Med 2021 Jun 10:1-9. Epub 2021 Jun 10.

Women's Wellness and Research Center, Doha, Qatar.

Background: We aimed to study the maternal characteristics and obstetric and neonatal outcomes in pregnant mothers with pre-eclampsia (PE) compared to normotensive.

Methods: This was a population-based retrospective data analysis. Data were obtained from the PEARL-Peristat Study perinatal registry (Perinatal Neonatal Outcomes Research Study in the Arabian Gulf) Qatar. Read More

J Matern Fetal Neonatal Med 2021 Jun 9:1-6. Epub 2021 Jun 9.

Lis Hospital for Women, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Objective: We aimed to assess the role of lactate and hemoglobin levels as predictors for the need for blood transfusion in post-partum hemorrhage (PPH).

Methods: A retrospective cohort study of women with PPH in a single university-affiliated tertiary medical center between August 2018 and June 2020. PPH was defined as an estimated excessive blood loss (of more than 500 ml following vaginal delivery and 1000 ml following a cesarean delivery) requiring at least one uterotonic drug and fluid resuscitation. Read More

Adv Anesth 2020 Dec;38:229-250

Department of Anesthesiology, Yale School of Medicine, 333 Cedar Street, PO Box 208051, New Haven, CT 06520-8051, USA.

Over the past 30 years, maternal mortality has increased in the United States to 18 deaths per 100,000 live births. Obstetric emergencies, including hemorrhage, hypertensive disorders in pregnancy, HELLP syndrome, and amniotic fluid embolism, and anesthesia complications, including high neuraxial blockade, local anesthetic systemic toxicity, and the difficult obstetric airway, contribute to maternal cardiac arrest and maternal and fetal morbidity and mortality. Expeditious intervention by the obstetric anesthesiologist is critical in these emergent scenarios, and knowledge of best practices is essential to improve maternal and fetal outcomes. Read More

Medicine (Baltimore) 2021 May;100(19):e25906

Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.

Background: Postpartum hemorrhage (PPH) is a major obstetric complication, and the real-time measurement of blood loss is important in the management and treatment of PPH. We designed a new two-set liquid collection bag (TSLCB) for measuring postpartum blood loss in vaginal delivery. The aim of this study was to evaluate the effectiveness of the TSLCB in separating the blood from the amniotic fluid during vaginal delivery and in determining the accuracy of the measured postpartum blood loss. Read More

Pak J Med Sci 2021 May-Jun;37(3):863-868

Ihsan Bagli, Department of Obstetrics and Gynecology, Health Sciences University, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.

Objective: This study was aimed to compare the shock index (SI) values between patients who required blood transfusion due to postpartum hemorrhage (PPH) and patients who received no blood transfusion.

Methods: We conducted this cross-sectional study at a tertiary center between January 2019 and June 2019. A total of 2534 patients who underwent vaginal delivery were included in this study. Read More

J Anaesthesiol Clin Pharmacol 2021 Jan-Mar;37(1):3-13. Epub 2021 Apr 10.

Department of Obstetrics and Gynaecology, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

In a developing country like India, with limited resources and access to healthcare facilities, dealing with massive hemorrhage is a major challenge. This challenge gets compounded by pre-existing anemia, hemostatic disorders, and logistic issues of timely transfer of such patients from peripheral hospitals to centers with adequate resources and management expertise. Despite the awareness amongst healthcare providers regarding management modalities of bleeding patients, no uniform Patient Blood Management (PBM) or perioperative bleeding management protocols have been implemented in India, yet. Read More

J Matern Fetal Neonatal Med 2021 Jun 7:1-6. Epub 2021 Jun 7.

Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, MedStar Washington Hospital Center, Washington, DC, USA.

Background: Postpartum hemorrhage is a major cause of maternal morbidity and mortality. Though the American College of Obstetricians and Gynecologists and quality improvement initiatives recommend the use of a quantitative measurement of blood loss, it is not known if the quantitative measurement compared to visual estimation of blood loss improves maternal outcomes.

Objective: To compare rates of red blood cell transfusion between a quantitative measurement and visual estimation of blood loss. Read More

Am J Obstet Gynecol MFM 2021 Jun 4:100417. Epub 2021 Jun 4.

Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.

Objective: This study aimed to review the effect of endometriosis on the prevalence of placenta previa, postpartum hemorrhage, and surgical outcomes in placenta previa patients with endometriosis.

Data Sources: In compliance with the Preferred Reporting Items for Systematic Reviews guidelines, a systematic review of the literature was conducted through December 31, 2020, using PubMed, Scopus, and the Cochrane Library.

Study Eligibility Criteria: Comparative studies between pregnant women with and without endometriosis, as well as studies that investigated the surgical outcomes in placenta previa patients with and without endometriosis, were included. Read More

Eur J Obstet Gynecol Reprod Biol 2021 May 8. Epub 2021 May 8.

University of Aberdeen, Institute of Applied Health Sciences, UK.

Introduction: With increasing caesarean section (c-section) rates, personalized communication of risk has become paramount. A reliable tool to predict complications would support evidence-based discussions around planned mode of birth. This systematic review aimed to identify, synthesize and quality appraise prognostic models of maternal complications of elective c-section. Read More