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Cureus 2022 May 24;14(5):e25299. Epub 2022 May 24.

Anesthesiology, Perioperative and Pain Medicine, Stanford University Medical Center, Stanford, USA.

Objective: Racial and ethnic disparities in peripartum blood loss and postpartum hemorrhage (PPH) have not been adequately evaluated. We sought to compare postpartum blood loss and PPH in African American and Hispanic parturients compared to other groups.

Methods: This was a secondary analysis of an observational study at a tertiary academic center of a historical (August 2016 to January 2017) and interventional (August 2017 to January 2018) cohort of 7618 deliveries. Read More

J Nutr Sci 2022 13;11:e46. Epub 2022 Jun 13.

Department of Paediatric and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway.

Worldwide, there are limited data on the prevalence of postpartum anaemia and iron status. The aims of the present study were to assess the prevalence of anaemia and iron deficiency (ID) by three iron indicators 14 weeks postpartum, their relations to haemoglobin (Hb) and associations with ethnicity and clinical factors in a multi-ethnic population. We conducted a population-based cohort study of 573 women followed from early pregnancy. Read More

BMC Pregnancy Childbirth 2022 Jun 25;22(1):515. Epub 2022 Jun 25.

Obstetrics and Gynaecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Objective: This study aims to assess delayed versus early umbilical cord clamping in preeclamptic mothers undergoing scheduled caesarean delivery regarding the maternal intra-operative blood loss and neonatal outcomes.

Methods: A clinical trial was conducted on 62 near-term preeclamptic mothers (36-38 weeks) who were planned for caesarean delivery. They were randomly assigned into two groups. Read More

Am J Perinatol 2022 Jun 25. Epub 2022 Jun 25.

Obstetrics & Gynecology, University of Texas Health Sciences Center at Houston, Houston, United States.

The most common treatment for placenta accreta spectrum disorders (PAS) is planned primary cesarean-hysterectomy. However, other management strategies may improve outcomes and/or allow fertility preservation. This is a series of 11 patients with PAS managed by leaving the placenta in situ at a single academic center in the U. Read More

Int J Gynaecol Obstet 2022 Jun 25. Epub 2022 Jun 25.

Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Ramat-Gan, Israel.

Objective: To study the association between the method of induction of labor (IOL) and perinatal outcomes, among women undergoing labor after cesarean (LAC) with no prior vaginal delivery.

Method: A retrospective study including all women with no prior vaginal delivery undergoing IOL for LAC between 3/2011 - 1/2021. Oxytocin administration following prelabor rupture of membranes, oxytocin administration only, extraamniotic balloon and amniotomy were compared. Read More

BMC Pregnancy Childbirth 2022 Jun 24;22(1):513. Epub 2022 Jun 24.

Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Stanford University School of Medicine, Stanford, USA.

Background: To assess if simulation-based training (SBT) of B-Lynch suture and uterine balloon tamponade (UBT) for the management of postpartum hemorrhage (PPH) impacted provider attitudes, practice patterns, and patient management in Guatemala, using a mixed-methods approach.

Methods: We conducted an in-country SBT course on the management of PPH in a governmental teaching hospital in Guatemala City, Guatemala. Participants were OB/GYN providers (n = 39) who had or had not received SBT before. Read More

Am J Perinatol 2022 Jun 24. Epub 2022 Jun 24.

Objective: To determine whether a trial of labour after caesarean section (TOLAC) with a macrosomic neonate is associated with adverse outcomes. Methods A retrospective cohort study was conducted in a population motivated for TOLAC. Women attempting TOLAC with a neonatal birthweight >4000g were compared to women attempting TOLAC with neonatal birthweights between 3500g-4000g. Read More

Womens Health (Lond) 2022 Jan-Dec;18:17455057221104297

One Heart Worldwide, Lalitpur, Nepal.

Objectives: While Nepal has made significant improvements in maternal and newborn health overall, the lack of maternal and newborn health-related knowledge in the more rural parts of the country has led to significant disparities in terms of both maternal and newborn health service utilization and maternal and newborn health outcomes. This study aimed to assess whether viewing culturally adapted maternal and newborn health educational films had a positive impact on (1) the maternal and newborn health knowledge levels among pregnant women and (2) the postpartum hemorrhage-related knowledge levels among Female Community Health Volunteers in rural Nepal.

Methods: Four locations were selected for their remoteness and comparatively high number of pregnancies. Read More

Medicina (Kaunas) 2022 Jun 7;58(6). Epub 2022 Jun 7.

Division of Gynaecology and Obstetrics, University Medical Centre, 1000 Ljubljana, Slovenia.

Several reports indicate that women with von Willebrand disease (VWD) are at an increased risk of bleeding and other complications during pregnancy and childbirth. The aim of this study was to investigate the effect of VWD on the course of pregnancy, childbirth, and the postpartum period. This was a retrospective study that compared many variables between women with VWD ( = 26) and women without VWD ( = 297,111) who gave birth between 2002 and 2016 in Slovenia. Read More

Life (Basel) 2022 Jun 15;12(6). Epub 2022 Jun 15.

Department of Obstetrics and Gynecology, University Hospital of Bern, 3010 Bern, Switzerland.

Management of severe postpartum hemorrhage (PPH) includes transcatheter pelvic arterial embolization (TAE). Data regarding subsequent fertility and obstetrical outcomes is limited, as most fertility outcomes derive from TAE in uterine fibroma. The purpose of our study was to evaluate the long-term outcomes of patients undergoing TAE, particularly concerning subsequent fertility and following pregnancies. Read More

Int J Environ Res Public Health 2022 Jun 16;19(12). Epub 2022 Jun 16.

United Nations Population Fund, Technical Division, New York, NY 10158, USA.

Tranexamic acid (TXA) effectively reduces bleeding in women with postpartum hemorrhage (PPH) in hospital settings. To guide policies and practices, this rapid scoping review undertaken by two reviewers aimed to examine how TXA is utilized in lower-level maternity care settings in low-resource settings. Articles were searched in EMBASE, MEDLINE, Emcare, the Maternity and Infant Care Database, the Joanna Briggs Institute Evidence-Based Practice Database, and the Cochrane Library from January 2011 to September 2021. Read More

Healthcare (Basel) 2022 May 27;10(6). Epub 2022 May 27.

CNRS, SIGMA Clermont, Institut Pascal, CHU Clermont-Ferrand, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France.

Substandard care, which can result from a delayed recognition of the severity of blood loss, can increase maternal morbidity. Our objectives were to assess the incidence of postpartum hemorrhage (PPH) and of second-line procedures in maternity units according to the quality of their PPH protocol. We used a mixed design, a prospective cohort (3442 women with PPH after vaginal delivery; February-July 2011), and an audit of the written protocols (177 French maternity units; September 2010-June 2011). Read More

Singapore Med J 2022 06 24. Epub 2022 Jun 24.

Department of Maternal and Fetal Medicine, KK Women's and Children's Hospital, Singapore.

Introduction: Red cell transfusion is expensive and not without risks. Despite the availability of transfusion guidelines, studies report a wide interhospital variation in transfusion rates. This retrospective cohort study was conducted to define the incidence of red cell transfusion in a multi-ethnic obstetric population and to evaluate current transfusion practice with regard to indications and appropriateness. Read More

PLoS Med 2022 Jun 23;19(6):e1004029. Epub 2022 Jun 23.

The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia.

Background: Globally, the majority of newborns requiring resuscitation at birth are full term or late-preterm infants. These infants typically have their umbilical cord clamped early (ECC) before moving to a resuscitation platform, losing the potential support of the placental circulation. Physiologically based cord clamping (PBCC) is clamping the umbilical cord after establishing lung aeration and holds promise as a readily available means of improving early newborn outcomes. Read More

Neurol Int 2022 May 31;14(2):488-496. Epub 2022 May 31.

Neurology Department, NYU Langone Health, New York, NY 10017, USA.

(1) Background: Reversible cerebral vasoconstriction syndrome (RCVS) encompasses a clinical and radiological diagnosis characterized by recurrent thunderclap headache, with or without focal deficits due to multifocal arterial vasoconstriction and dilation. RCVS can be correlated to pregnancy and exposure to certain drugs. Currently, the data on prevalence of RCVS in the postpartum period is lacking. Read More

Ann Med Surg (Lond) 2022 Jun 4;78:103931. Epub 2022 Jun 4.

Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand.

Background: The study analyzed an optimal misoprostol dosage in prevention of postpartum hemorrhage (PPH). Also evaluated the side effects that might be related to dose of misoprostol.

Material And Methods: A randomised study was performed in mothers who received cesarean section. Read More

J Obstet Gynaecol India 2022 Jun 25;72(3):265-267. Epub 2022 Apr 25.

KB Bandra Bhabha Hospital, Mumbai, India.

In this manuscript the authors describe the Ellavi balloon tamponade device and its use in the management of atonic postpartum hemorrhage. Additionally the manuscript discusses a case in which this device was used. Read More

Maedica (Bucur) 2022 Mar;17(1):80-87

Department of Nephrology, AIIMS, New Delhi, India.

This study aimed to investigate the incidence, clinical characteristics, and outcomes of acute kidney injury (AKI) during pregnancy in Indian population. A prospective observational study was conducted in pregnant patients admitted to Pt. B. Read More

Asian J Surg 2022 Jun 18. Epub 2022 Jun 18.

Department of Obstetrics and Gynecology, Hebei Yanda Hospital, Langfang, Hebei Province, 065201, PR China.

Asian J Surg 2022 Jun 17. Epub 2022 Jun 17.

Department of Gynecology and Obstetrics,West China Second Hospital,Sichuan University, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, Sichuan, 610041, China. Electronic address:

BMC Pregnancy Childbirth 2022 Jun 20;22(1):502. Epub 2022 Jun 20.

Obstetrics Department, Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Rd, Shanghai, People's Republic of China.

Background: Placenta previa accreta is a life-threatening pregnancy complication, and reducing blood loss during operative treatment remains a major challenge. The aim of our study was to investigate the effect of prophylactic abdominal aortic balloon occlusion (AABO) during caesarean section in women with placenta previa accreta.

Methods: A retrospective study of women with placenta previa accreta was conducted in a tertiary hospital from January 1, 2015, to December 31, 2020. Read More

Am J Obstet Gynecol 2022 Jun 17. Epub 2022 Jun 17.

Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France.

Background: Although prophylactic tranexamic acid administration at cesarean delivery resulted in a lower incidence of calculated estimated blood loss > 1000 mL or red-cell transfusion by day 2, its failure to reduce the incidence of hemorrhage-related secondary clinical outcomes (TRAAP2 trial) makes its use questionable. The magnitude of its effect may differ in women at higher risk of blood loss, including those with multiple pregnancies.

Objective: To compare the effect of tranexamic acid vs placebo to prevent blood loss at cesarean delivery among women with multiple pregnancies. Read More

J Perinat Med 2022 Jun 21. Epub 2022 Jun 21.

Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA.

Objectives: To determine whether the maternal plasma concentrations of cytokines are higher in pregnant women with postpartum hemorrhage (PPH) compared to pregnant women without PPH.

Methods: A retrospective case-control study included 36 women with PPH and 72 matched controls. Cases and controls were matched for gestational age at delivery, labor status, delivery route, parity, and year of sample collection. Read More

Int J Circumpolar Health 2022 Dec;81(1):2090066

St. John's, Newfoundland and Labrador, Health Sciences Library, Canada.

We conducted a scoping review to determine incidence and risk factors for postpartum haemorrhage (PPH) in rural Indigenous women. We systematically searched PubMed (Medline), EMBASE, and CINAHL for all peer-reviewed articles and grey literature regarding Indigenous ethnicity, rural settings, and PPH incidence, risk factors, or maternal outcomes published from inception to 11 January 2021. Eleven articles were deemed relevant after screening and quality assessment using the National Institutes of Health scoring system for mixed study reviews. Read More

Evid Based Complement Alternat Med 2022 9;2022:1249779. Epub 2022 Jun 9.

Department of Obstetrics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, Shandong, China.

Objective: To investigate the effect of Baogong Zhixue granules combined with tranexamic acid injection on the hemodynamics and reproductive system in patients with postpartum hemorrhage (PPH) after cesarean section.

Methods: The data of 90 puerperae undergoing cesarean section in our hospital from January 2019 to January 2020 were retrospectively analyzed. According to the order of admission, they were equally divided into the control group (CG) and experimental group (EG). Read More

Evid Based Complement Alternat Med 2022 8;2022:4417790. Epub 2022 Jun 8.

Maternity Ward of Jiangsu Hai'an County People's Hospital, No. 17 Zhongba Middle Road, Hai'an City 226600, Jiangsu Province, China.

Objective: To study the effect of nifedipine combined with systematic nursing on pregnancy outcomes in patients with gestational hypertension.

Methods: According to the random number table method, 120 patients with gestational hypertension treated in our hospital were divided into the control group (60 cases) and observation group (60 cases). The control group was given magnesium sulfate treatment, the observation group was given magnesium sulfate combined with nifedipine, and the two groups of patients were given systematic nursing. Read More

Front Med (Lausanne) 2022 26;9:842428. Epub 2022 May 26.

Obstetrical Department, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Background: To investigate the influence of HbA1c level and GWG on pregnancy outcomes in pregnant women with GDM.

Methods: A total of 2,171 pregnant women with GDM were retrospectively included and categorized as follows: (1) normal (HbA1c <6%) and elevated (HbA1c ≥6%) HbA1c groups according to the HbA1c level in the second trimester, and (2) inadequate, appropriate, and excessive GWG groups according to the IOM guidelines.

Results: In pregnant women with GDM, advanced age and high pre-pregnancy BMI were high-risk factors for elevated HbA1c. Read More

Front Med (Lausanne) 2022 3;9:872490. Epub 2022 Jun 3.

Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.

Objective: Adverse pregnancy outcomes have been related to obesity and thinness; however, the changing trends of the specific outcome with pre-pregnancy BMI remain unknown. The aim of this study was to investigate the change in risk trends of specific adverse outcomes for different pre-pregnancy BMI and analyze the recommended BMI range for pre-pregnancy counseling.

Methods: Data were extracted from the medical records of 39 public hospitals across 14 provinces in China from 2011 to 2012. Read More

Cureus 2022 May 17;14(5):e25062. Epub 2022 May 17.

First Department of Obstetrics and Gynecology, Alexandra Hospital, National & Kapodistrian University of Athens, Athens, GRC.

Background Although peripartum hysterectomy (PH) is a life-saving procedure in cases of abnormal placentation and postpartum hemorrhage, it can be associated with major obstetric and anesthetic complications. This retrospective study aimed to evaluate the incidence, etiology, perioperative anesthetic and obstetric management, complications, and fetal outcomes in women undergoing PH in a single tertiary referral hospital in Greece. Methodology This was a retrospective analysis of medical records of women who underwent emergency or elective PH in our hospital between January 2015 and December 2018. Read More

Zhongguo Zhong Yao Za Zhi 2022 May;47(10):2811-2818

Department of Nutrition and Toxicology, School of Public Health, Hangzhou Normal University Hangzhou 311121, China Center for Uterine Cancer Diagnosis and Therapy Research, the Affiliated Women's Hospital, Zhejiang University Hangzhou 310006, China.

The present study evaluated the effect of Shenqi Jiangtang Granules(SJG) combined with western medicine on the adverse pregnancy outcomes in women with gestational diabetes mellitus(GDM). PubMed, Web of Science, CNKI, Wanfang, and VIP were searched for clinical randomized controlled trials(RCTs) of SJG combined with western medicine against GDM. The included RCTs were assessed for risks using the assessment criteria recommended by the Cochrane handbook for systematic reviews of interventions. Read More