Hemorrhage;Postpartum Period; Uterine Inertia; prevention & control; 777 postpartum women were studied at Tu Du Obstetric and Gynecology Hospital, HCM city. Rectal misoprostol of 400mg was well tolerated and effective to reduce hemorrhage amount and to shorten the 3rd phase of labor just after the delivery. The procedure is simple with low cost, easy to use in remote areas of the country contributing in lowering obstetric accidents and mortality.
Hemorrhage ; Postpartum Period ; Uterine Inertia ; prevention & control

Pregnancy ; Female ; Humans ; Postpartum Hemorrhage/prevention & control* ; Oxytocics

OBJECTIVETo investigate the clinical efficacy of estrogen in preventing postpartum hemorrhage and shortening the birth process during induced abortion.

METHODSTotally 320 puerperants for termination of pregnancy for medical reasons were randomly assigned into 2 groups, the estrogen group (n=175) and the control group (n=145), and the former were given oral estrostilben 3 mg thrice a day from the day before acrinol injection to the end of delivery. The amount of blood loss 2 h after delivery, cases of postpartum hemorrhage, and the duration of total birth process were recorded.

RESULTSSignificant differences were noted in blood loss 2 h after delivery between estrodiol and control groups (123.3-/+81.8 vs 206.3-/+114.4 ml). Two cases of postpartum hemorrhage were found in estrogen group and 10 in control group. The duration from acrinol injection to delivery was similar between the two groups (31-/+11 vs 33-/+12 h), but the former had significant shorter duration from contraction onset to delivery than the latter (6.03-/+3.19 vs 9.7-/+5.9 h). No side-effects were found in either group.

CONCLUSIONEstrogen given before delivery can be effective in stimulating uterine contraction for preventing postpartum hemorrhage and shortening the birth process in women undergoing induced abortion.

Abortion, Induced ; adverse effects ; Adult ; Estrogens ; therapeutic use ; Female ; Humans ; Labor Onset ; drug effects ; Postpartum Hemorrhage ; etiology ; prevention & control ; Pregnancy ; Time Factors ; Treatment Outcome ; Uterine Contraction ; drug effects

ABNORMALITIES during pregnancy are regarded as pathological pregnancy. Early detection of anomalies is urgent to take measures as soon as possible to prevent serious pregnancy complications. Procoagulant-anticoagulant imbalance is often the pathological basis of many pathological pregnancy conditions, leading to a hypercoagulable state. We compared the thromboelastographic parameters between pathological pregnancy and normal pregnancy patients, evaluated the value of thromboelastography in early detecting pathological pregnancy and predicting postpartum hemorrhage.
Diabetes, Gestational ; blood ; Female ; Humans ; Postpartum Hemorrhage ; blood ; prevention & control ; Pre-Eclampsia ; blood ; Pregnancy ; Pregnancy Complications, Hematologic ; blood ; Thrombelastography ; methods ; Venous Thrombosis ; blood

Abnormal attachment of the placenta (Placenta accreta, increta, and percreta) is an uncommon but potentially lethal cause of maternal mortality from massive postpartum hemorrhage. A 33-yr-old woman, who had been diagnosed with a placenta previa, was referred at 30 weeks gestation. On ultrasound, a complete type of placenta previa and multiple intraplacental lacunae, suggestive of placenta accreta, were noted. For further evaluation of the placenta, pelvis MRI was performed and revealed findings suspicious of a placenta increta. An elective cesarean delivery and subsequent hysterectomy were planned for the patient at 38 weeks gestation. On the day of delivery, endovascular catheters for balloon occlusion were placed within the hypogastric arteries, prior to the cesarean section. In the operating room, immediately after the delivery of the baby, bilateral hypogastric arteries were occluded by inflation of the balloons in the catheters previously placed within. With the placenta retained within the uterus, a total hysterectomy was performed in the usual fashion. The occluding balloons were deflated after closure of the vaginal cuff with hemostasis. The patient had stable vital signs and normal laboratory findings during the recovery period; she was discharged six days after delivery without complications. The final pathology confirmed a placenta increta.
Adult ; Arteries/*surgery ; *Catheterization ; Cesarean Section ; Female ; Gestational Age ; Humans ; Hysterectomy/*methods ; Placenta/*blood supply/ultrasonography ; Placenta Accreta/*surgery/ultrasonography ; Placenta Previa/*surgery/ultrasonography ; Postpartum Hemorrhage/*prevention & control ; Pregnancy ; Treatment Outcome

OBJECTIVE: To evaluate the value of selective arterial occlusion in the treatment of placenta percreta in late trimester of pregnancy. METHODS: Fifteen clinical patients ( gestational age ≥34 weeks), diagnosed with placenta percreta in Xiangya Hospital of Central South University from January 2003 to December 2010, were retrospectively analyzed. According to whether the selective arterial occlusion was used or not, the 15 patients were divided into 2 groups: an arterial occlusion group (n=8) and a non-arterial occlusion group (n=7). Based on the time of occlusion, the arterial occlusion group was divided into a prophylactic occlusion subgroup (n=4) and a remedial occlusion subgroup (n=4) (including 1 patient who was performed after the iliac artery balloon was taken out ). The blood loss, the rate of hysterectomy and complications were compared between the arterial occlusion group and the non-arterial occlusion group. RESULTS: In all 15 patients, the average amount of blood loss was 3813 mL, and the rate of hysterectomy was 73.3% (11/15). The recent complication rate was 20.0% (3/15, including 2 blood coagulation dysfunctions and 1 lower extremity thrombosis), and long-term complication was not found. The average amount of blood loss in the occlusion group was 2512 mL, the hysterectomy rate was 62.5%(5/8); while the average amount of bleeding was 5549 mL and the hysterectomy rate was 85.7% in the non-occlusion group (6/7). There was significant difference between the 2 groups (P<0.05). The average amount of blood loss and the rate of hysterectomy in the prophylactic occlusion subgroup were lower than those in the remedial occlusion subgroup (1350 mL vs 3600 mL, 60.0% vs 66.7%, P<0.05). CONCLUSION Patients with placenta percreta in the third trimester of pregnancy may encounter severe postpartum hemorrhage, and the rate of hysterectomy is high. The amount of blood loss and the rate of hysterectomy may be reduced by the selective arterial occlusion before or in the cesarean section, but cannot be avoided completely.
Adult ; Balloon Occlusion ; methods ; Embolization, Therapeutic ; Female ; Humans ; Hysterectomy ; statistics & numerical data ; Iliac Artery ; Placenta Accreta ; therapy ; Postpartum Hemorrhage ; prevention & control ; Pregnancy ; Pregnancy Trimester, Third ; Retrospective Studies ; Treatment Outcome