1/8. Complications caused by extramembranous placement of intrauterine pressure catheters.A case report is described in which the inadvertent placement of a standard intrauterine pressure catheter in a laboring woman caused partial abruptio placentae and disseminated intravascular coagulation. Altering catheter placement technique and giving attention to aspects of placement can help avoid mishaps, and awareness of possible complications can lead to earlier diagnosis with increased appropriate intervention.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/8. A hypothesis to explain the occurence of inner myometrial laceration causing massive postpartum hemorrhage.BACKGROUND: Inner myometrial lacerations were found in three patients who developed uncontrollable postpartum massive bleeding despite the usual treatment for uterine atony. Because all the patients suffered from hemorrhage shock and their medical status deteriorated, their uteri were surgically removed to stop bleeding. After removal, one of them died. postpartum hemorrhage was caused by inner myometrial laceration. We hypothesized a cause of inner myometrial laceration, using the three resected uteri, an assumed model of the uterine body, and 34 women. methods: The subjects were 37 women, of whom three were patients with inner myometrial laceration, 23 were women without inner myometrial laceration who underwent cesarean section, and 11 were women in the first stage of labor. The three resected uteri were examined both macroscopically and microscopically. We measured the thickness of the wall of the uterine muscle at the widest point of the uterine corpus and the thickness of the myometrial wall at a transverse section of the uterine cervix, as well as the radius of the inner lumen at the widest point of the uterus in 23 women during cesarean section. We also measured the thickness of the myometrial wall at the widest point of the uterine corpus in 11 women at the end of the first stage of labor during ultrasonic examination. The data were then used to estimate the stress on the uterine muscle. RESULTS: The stress on the uterine cervix was stronger than that on the uterine corpus during labor. When the stress on the uterine muscle is stronger than a specific value, inner myometrial lacerations develop on the right and/or left side of the uterine cervix. These lacerations may involve large vessels. CONCLUSIONS: We have discovered another cause of postpartum hemorrhage which we have named inner myometrial laceration. These lacerations appeared to result from a strong stress on the uterine cervix caused by an abnormal rise in intrauterine pressure during labor.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
3/8. Primary aldosteronism in pregnancy.Aldosteronism is a rare complication of pregnancy. We report a case of a 26-year-old woman who became pregnant soon after a diagnosis of primary aldosteronism due to left adrenal adenoma was made. Only oral potassium supplementation was required in addition to routine prenatal care until 36 weeks' gestation. Subsequently, antihypertensive medication was needed to control elevated blood pressure. A healthy male infant was delivered by cesarean section because of abruptio placentae. The postoperative course was uneventful. Left adrenalectomy was conducted eight months after delivery under laparoscopic visualization. In this case report, we discuss management of aldosteronism in pregnancy and review the literature.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
4/8. tetany following resuscitation after abruptio placentae.BACKGROUND: serum ionized calcium and magnesium are normally decreased during later stages of pregnancy. A further rapid decline may be caused by the rapid infusion of blood bank products in which citrate is used as an anticoagulant/preservative. tetany, as reported here, may be precipitated by such infusions.CASE: A gravid woman presented in hemorrhagic shock due to abruptio placentae. Rapid infusion of packed red blood cells and fresh frozen plasma precipitated signs of tetany, muscle rigidity, posturing, high airway pressure during mechanical ventilation, etc. Ionized calcium and magnesium blood levels were very low (0.58 mmol/L and 1.0 mg/dL, respectively), but responded to rapid electrolyte administration.CONCLUSION: Binding of calcium and magnesium by citrate may lead to hypo-ionized calcemic and hypomagnesemic tetany after rapid replacement of blood products in the pregnant patient. This consequence is worsened when extreme alkalemia due to respiratory or metabolic causes is also present.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
5/8. Severe vasovagal attack: an unusual cause of abruptio placentae.CASE REPORT: abruptio placentae occurred in a 29 years old woman following a vasovagal episode. Her medical history was free from all the commonly accepted risk factors for abruption. DISCUSSION: We speculate that the restoration of placental blood flow caused a sudden increase in uteroplacental blood pressure, and induces rupture of some vessels, causing a progressively growing retroplacental hematoma and placental detachment.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
6/8. cocaine intoxication associated with abruptio placentae.Acute cocaine intoxication has been associated with elevated blood pressure and placental abruption. A retrospective analysis was performed comparing gestational age at the time of placental abruption and response to conventional therapy for elevated blood pressure between patients known to have ingested cocaine and those who were drug free. Data suggest that cocaine ingestion during pregnancy increases the risk of early placental abruption and an elevation of blood pressure that is not as responsive to conventional therapy as pregnancy-induced hypertension.- - - - - - - - - - ranking = 0.6keywords = pressure (Clic here for more details about this article) |
7/8. Placental abruption following placement of disposable intrauterine pressure transducer system.There have been few reported complications of intrauterine pressure monitoring. We present four cases of placental abruption following insertion of a disposable intrauterine pressure transducer system (INTRAN). All four patients had placental abruptions, which were evident soon after insertion of the disposable intrauterine pressure transducer system (all of our cases had predisposing factors or signs of placental abruption at presentation). Whether there was a preexisting placental abruption, which was caused, revealed, or worsened by insertion of the disposable intrauterine pressure transducer system is unclear. We encourage careful patient selection with gentle insertion of the system opposite the placental site.- - - - - - - - - - ranking = 1.6keywords = pressure (Clic here for more details about this article) |
8/8. Placental abruption after insertion of catheter tip intrauterine pressure transducers: a report of four cases.BACKGROUND: Although intrauterine pressure transducers have proven efficacious in the management of certain laboring women, their use has been associated with small but definite risks to both mother and fetus. The introduction of catheter tip pressure transducers has facilitated the evaluation of intrauterine pressure, but there has been a paucity of data regarding complication rates with these newer devices. CASES: We report four cases of placental abruption following insertion of catheter tip intrauterine pressure transducers. Two were associated with placental lacerations. None of these patients had definite risk factors for abruption, but they developed signs and symptoms typical of it after insertion of the catheters. Perinatal outcomes were good except in one neonate, who developed shock secondary to anemia. Three of the four cases occurred when 599 patients at our institution were monitored with catheter tip pressure transducers. CONCLUSION: Although the risk of injury is small, neonatal morbidity can be severe, and an evaluation of risk versus benefit should be made prior to insertion of these devices.- - - - - - - - - - ranking = 1.8keywords = pressure (Clic here for more details about this article) |