CT scan assessment of intrauterine balloon tamponade failure for the treatment of atonic postpartum haemorrhage: implications for treatment

Kondoh, Eiji; Chigusa, Yoshitsugu; Ueda, Akihiko; Mogami, Haruta; Yamaguchi, Ken; Mandai, Masaki

doi:10.1111/1471-0528.16724

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…This is refractory atonic PPH, which can be diagnosed by dCT, known as PPH resistant to treatment showing arterial contrast extravasation on dCT (PRACE), which is considered a truly critical PPH. 1 Given the recent advances in our understanding of the pathogenesis of refractory atonic PPH and the shape of the postpartum uterine cavity, we outline our thoughts on the use of IBT for the treatment of atonic PPH. Key words: intrauterine balloon tamponade, postpartum hemorrhage, PRACE, uterine atony.…”

Section: Heera Tuladharmentioning

confidence: 99%

Maternal Fetal Medicine

2023

J of Obstet and Gynaecol

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The most prominent culprit of fetal growth restriction (FGR) is poor placentation (early pregnancy) and placental damage (late pregnancy). Until recent years, there was no specific way to solve this matter, and we all herded to the timing of delivery as the best deal. Many have tried to offer a different kinds of interventions: heparin or low-molecular heparin, acetylsalicylic acid, phosphodiesterase inhibitors, VEGF gene therapy, nanoparticles, microRNA, statins, nitric oxide donors, hydrogen sulfide, proton pump inhibitors, melatonin, creatine, n-acetylcysteine, and insulinlike growth factor 1 and 2 (IGF1 and IGF2); but all still did not provide convincing evidence. It will be a game-changer for FGR management if we can rejuvenate poor placenta. Conditioned media (CM) captivated from the culture process of the human umbilical cordmesenchymal stem cells (hUC-MSCs) is considered to have rich sources of growth factors, exosomes, microvesicles, and other essential advantageous substances which are studied intensively around the globe in recent years. Conditioned media of hUC-MSCs, by its potential to stimulate vascularization, immunomodulatory behavior, and anti-apoptotic features, could be a novel therapy in the upcoming years to treat fetal growth restriction in particular causal of placental damage due to immunological disease. Even though our study was still limited to animals, the results were encouraging. Conditioned media of MSCs could repair narrow and stiff vessels of poor placenta to be comparable to normal. The balance of pro-angiogenic and anti-angiogenic substances could be restored to normal, shown with the increasing levels of PLGF and decreasing levels of sFlt-1. And for the end results, we could push the length and the weight of the babies to the normal standard.

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Section: Heera Tuladharmentioning

confidence: 99%