Obstetric Complications in Women With Congenital Uterine Anomalies According to the 2013 European Society of Human Reproduction and Embryology and the European Society for Gynaecological Endoscopy Classification

Panagiotopoulos, Michail; Tseke, Paraskevi; Michala, Lina

doi:10.1097/aog.0000000000004627

Cited by 23 publications

(18 citation statements)

References 57 publications

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“…The incidence of uterine anomalies is suspected to be 3%–5% among infertile women, and a septate uterus is known to have higher risks of early spontaneous abortions or obstetrical complications. 20 , 21 Even an arcuate uterus is associated with an increased risk of preterm birth and fetal growth restriction. 22 Several studies have shown elevated incidences of uterine anomalies in women with PCOS.…”

Section: Discussionmentioning

confidence: 99%

Shapes of the uterine cavity are different in women with polycystic ovary syndrome

Fujii¹,

Oguchi²

2023

Reprod Medicine & Biology

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Purpose A cross‐sectional study was conducted to evaluate differences in uterine morphology between women with or without polycystic ovary syndrome. Methods The authors recruited 333 infertile reproductive‐age women including 93 with polycystic ovary syndrome diagnosed using the criteria of the Japanese Society of Obstetrics Gynecology‐2007. Shapes of uterine cavity were measured by transvaginal three‐dimensional ultrasound. Results The polycystic ovary syndrome group had a significantly deeper indentation (2.2 ± 0.4 mm vs. 0.0 ± 0.2 mm, p < 0.0001) and a significantly more acute indentation angle (162.9 ± 2.2 deg vs. 175.2 ± 1.3 deg, p < 0.0001) than the control group. Conclusion The depth and the apical angle of fundal indentation of uterine cavity are different in women with polycystic ovary syndrome.

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Section: Discussionmentioning

confidence: 99%

Shapes of the uterine cavity are different in women with polycystic ovary syndrome

Fujii¹,

Oguchi²

2023

Reprod Medicine & Biology

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“…The risk of repeat dystocia is low (around 10%). However, additional risk factors such as increased fetal weight and diabetes in the current pregnancy may lead toward cesarean delivery. ‐ Plan cesarean : >4500 g fetus—diabetics : estimated risk of shoulder dystocia >15% 17 Mechanical obstacle to vaginal birth (macrocephaly) 21 ‐ Offer vaginal birth : Fetal ventriculomegaly, but normal head circumference measured, and in the absence of other obstetric indications. ‐ Plan cesarean delivery : Fetal macrocephaly, only when the head circumference is >40 cm, large head 19 …”

Section: Indications For Cesarean Delivery and Vaginal Delivery When ...mentioning

confidence: 99%

Section: Indications For Cesarean Delivery and Vaginal Delivery When ...mentioning

confidence: 99%

FIGO good practice recommendations for cesarean delivery: Prep‐for‐Labor triage to minimize risks and maximize favorable outcomes

Barnea,

Inversetti,

Di Simone

2023

Intl J Gynecology & Obste

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Cesarean delivery is an abdominal surgical procedure performed for child delivery when the vaginal route is not feasible or desired due to maternal/fetal indications. All childbirth facilities should be able to safely perform a cesarean, which is not the current reality. For planned cesarean delivery, the facility must be prepared for the patient. In contrast, for unplanned arrivals at the facility, FIGO's Prep‐for‐Labor triage method allows rapid decision‐making on whether cesarean delivery can be safely performed on site or whether transfer to an advanced care center is needed. A checklist of staff/tools for safe on‐site cesarean delivery is provided to enable timely decision‐making. Maternal complications following cesarean are three‐fold higher than vaginal delivery. To prevent nonmedically indicated cesarean by favoring vaginal delivery, up‐to‐date safe and effective guidance is provided, defining labor, second stage length, and status before an arrested labor is confirmed. Whether cesarean delivery is planned or emergency, the Misgav Ladach simplified procedure is proposed as it is suitable for both low‐ and high‐risk cases, including twins, thereby reducing both operative morbidity and postoperative recovery. A trial of labor after first cesarean (TOLAC) should be pursued when feasible, for which the indications, contraindications, safeguards, and steps of safe labor induction are delineated. Implementation of these good practice recommendations will improve childbirth by reducing excessive nonindicated cesareans, while precisely defining the resources and postoperative care required for safe performance on site. Enabling safe childbirth by cesarean and TOLAC, even at sites with low rates currently, will significantly improve maternal and fetal outcomes.

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“…There are no reliable diagnostic tests or markers to predict or prevent the occurrence of placental abruption. Its risk factors include advanced maternal age, multiparity, smoking, cocaine and drug use, pre-eclampsia, chronic hypertension, premature rupture of membranes, trauma, polyhydramnios, structural uterine anomalies, and a history of placental abruption [7][8][9][10] . This study aims to identify risk factors for placental abruption and evaluate maternal and fetal outcomes of patients with placental abruption in a tertiary hospital in Hong Kong.…”

Section: Introductionmentioning

confidence: 99%

Incidence, risk factors, and clinical outcomes of placental abruption in a tertiary hospital in Hong Kong: a retrospective case-control study

Shek

Kwong

et al. 2023

Hong Kong Journal of Gynaecology, Obstetrics and Midwifery

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Introduction:This study aims to identify risk factors for placental abruption and evaluate maternal and fetal outcomes of patients with placental abruption in a tertiary hospital in Hong Kong. Methods: Medical records of patients with placental abruption treated at the Tuen Mun Hospital between January 2017 and December 2021 were retrospectively reviewed. Data retrieved included patient demographics, alcohol/ substance abuse and smoking status, obstetric history, antenatal characteristics, body mass index at first antenatal visit, clinical presentation, intrapartum events, complications, and maternal and perinatal outcomes. Each patient was matched with a control who delivered just before the patient. Results: Of 22 990 deliveries and 23 230 live births, there were 86 placental abruption cases; the incidence was 0.37%. After adjusting for confounders, the risk factor for placental abruption was a history of antepartum haemorrhage. Compared with controls, patients with placental abruption had higher rates of caesarean sections (91.9% vs 23.3%, p<0.001), postpartum haemorrhage (62.8% vs 15.1%, p<0.001), uterine atony (31.4% vs 3.5%, p<0.001), blood transfusion (25.6% vs 3.5%, p<0.001), and disseminated intravascular coagulopathy (7.0% vs 0%, p=0.029). Compared with controls, neonates complicated with placental abruption had lower Apgar score at 1 minute (7 vs 8, p<0.001), higher preterm birth rate (64.0% vs 9.3%, p<0.001), lower birth weight (2296.4 g vs 3088.8 g, p<0.001), and more perinatal morbidities. Patients with a Couvelaire uterus had higher rates of uterine atony (56.3% vs 27.0%, p=0.026), postpartum haemorrhage (93.8% vs 61.9%, p=0.014), disseminated intravascular coagulopathy (25.0% vs 3.2%, p=0.014), blood transfusion (68.8% vs 17.5%, p<0.001), and secondary intervention (25.0% vs 1.6%, p=0.005). Neonates born from patients with a Couvelaire uterus had higher rates of acidosis (umbilical cord blood pH <7.1) [53.3% vs 5.8%, p<0.001], lower Apgar score at 1 minute (25.0% vs 4.8%, p=0.028), and hypoxic-ischaemic encephalopathy (12.5% vs 0%, p=0.039). Conclusion:Clinicians should be vigilant for placental abruption in patients with antepartum haemorrhage, especially in high-risk patients with a history of placental abruption, hypertension, or pre-eclampsia. Early and consistent antenatal care is imperative to identify those with risk factors. Proper education and timely preventive management should be provided to improve maternal and fetal outcomes.

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Obstetric Complications in Women With Congenital Uterine Anomalies According to the 2013 European Society of Human Reproduction and Embryology and the European Society for Gynaecological Endoscopy Classification

Cited by 23 publications

References 57 publications

Shapes of the uterine cavity are different in women with polycystic ovary syndrome

Shapes of the uterine cavity are different in women with polycystic ovary syndrome

FIGO good practice recommendations for cesarean delivery: Prep‐for‐Labor triage to minimize risks and maximize favorable outcomes

Incidence, risk factors, and clinical outcomes of placental abruption in a tertiary hospital in Hong Kong: a retrospective case-control study

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