Spécificités obstétricales et anesthésiques de la prise en charge d’une hémorragie du post-partum (HPP) associée à la césarienne

Parant, Olivier; Guerby, Paul; Bayoumeu, F.

doi:10.1016/j.jgyn.2014.10.004

Cited by 20 publications

(4 citation statements)

References 76 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As for the uterine inertias, we find 11 uterine inertias 6% (11/188) in group B versus no patient in group A. This rate of uterine inertias although it remains in the average of what is described in the literature (3% -15%) [16] It is high compared to group A where there is no inertia. However, the two groups of patients are comparable in their inclusion criteria, the techniques for performing cesarean sections were the same (according to Pfannenstiel), although there are no arguments to favor one cesarean technique over another.…”

Section: Discussion Of the Resultssupporting

confidence: 48%

Oxytocin and Uterine Atony during Cesarean Section

Abdelmounaim¹,

Rjafallah²,

Nhiri³

et al. 2021

OJOG

View full text Add to dashboard Cite

In our medical practice, in particular obstetrics, it is difficult to change certain consolidated dogmas, but the necessity and the current situation of our obstetrical exercise pushed us to find new technical supports, to make the exercise of our specialty as stripped of pitfalls as possible. Our work is summarized in a prospective comparative study, aimed at evaluating the existence or not of a difference between the administration of oxytocin just before the hysterotomy in a cesarean section and its administration after fetal extraction. We used a set of criteria to include patients in our study. This study took place over a period of one year (2020) in the Mother and Child regional center, in Meknes Imperial city, Morocco, involving a total number of 364 patients. With a group A comprising 176 patients 48% (176/364) who received oxytocin just before the hysterotomy and a group B of 188 patients 52% (188/364) who received it classically after fetal extraction. The difference was very significant as detailed in the article. Conclusion: the very convincing results of our study and the difference between the two groups, allowed us to demonstrate the effectiveness of our process and to endorse its use in our routine practice, with the perspective of conducting a prospective randomized study on a larger series.

show abstract

Section: Discussion Of the Resultssupporting

confidence: 48%

Oxytocin and Uterine Atony during Cesarean Section

Abdelmounaim¹,

Rjafallah²,

Nhiri³

et al. 2021

OJOG

View full text Add to dashboard Cite

show abstract

“…Postpartum hemorrhage (PPH) is the leading direct cause of maternal mortality worldwide [1].PPH is de ned as 500 mL or more of blood loss from the genital tract following a normal vaginal delivery (NVD) or 1000 mL or more following a cesarean section within 24 hours of birth [2][3][4][5][6].Postpartum hemorrhage is the most common complication of Placenta Accrete Spectrum (PAS). It may lead to uncontrollable bleeding and threaten the lives of mother and baby [7].…”

Section: Introductionmentioning

confidence: 99%

MRI–radiomics–clinical–based nomogram for prediction postpartum hemorrhage in patients with suspected placenta accrete spectrum before cesarean section

Hu,

Huang,

Chen

et al. 2024

Preprint

View full text Add to dashboard Cite

Purpose To develop and validate the nomogram by combining MRI-derived radiomics and clinical features for predicting postpartum hemorrhage in high-risk placenta accreta spectrum (PAS) patients before cesarean section. Methods The T2WI sagittal MR images and clinical data of 70 postpartum hemorrhage (+) pregnant women and 104 postpartum hemorrhage (-) pregnant women were retrospectively collected from two centers. These pregnancies were divided into a training (n = 105), an independent validation (n = 28), and an external validation (n = 41) cohort. Radiomic features were extracted, and radiomics signature were constructed. Clinical features were analyzed retrospectively. The clinical model, the radiomic model, and the clinicoradiomic model were compared. The nomogram of the optimal model was constructed to predict the risk of postpartum hemorrhage.The diagnostic performance was assessed using the area under the receiver operating characteristic curve (AUC) and the DeLong test. Decision curve analysis (DCA) was performed to determine the performance of the best predictive model. Results Eighteen radiomic features showed a strong correlation with PPH. Four MRI features were selected as clinical features.The clinicoradiomic model resulted in the best discrimination ability for risk prediction of PPH, with an AUC of 0.956 (95% CI, 0.9101.000), 0.781(95% CI, 0.606 0.955), and 0.702 (95% CI, 0.541 0.864) in the training, independent validation and external validation cohorts respectively. The clinicoradiomic nomogram, incorporating radiomics signature and four MRI features, was developed. The calibration was good and DCA confirmed the clinical utility of the nomogram. Conclusion Obstetricians can use the nomogram to noninvasively predict PPH and guide them in creating reasonable preoperative treatment plans.

show abstract

“…Post-partum hemorrhage (PPH) is the leading cause of maternal mortality and an important cause of severe maternal morbidity worldwide [ 1 – 3 ]. The estimated incidence of PPH in women delivered by cesarean section (CS) is 3–15%, compared to 2–4% in those delivered vaginally [ 4 , 5 ]. Rates of CS are increasing worldwide [ 6 ] and could be one of the factors associated with the increasing rates of PPH [ 3 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Timing of oxytocin administration to prevent post-partum hemorrhage in women delivered by cesarean section: A systematic review and metanalysis

et al. 2021

View full text Add to dashboard Cite

Background There is no consensus on the best timing for prophylactic oxytocin administration during cesarean section (CS) to prevent post-partum hemorrhage (PPH). Objectives Assess the effects of administrating prophylactic oxytocin at different times during CS. Methods We searched nine databases to identify relevant randomized controlled trials (RCT). We pooled results and calculated average risk ratios (RR), mean differences (MD), and 95% confidence intervals (CI). We used GRADE to assess the overall evidence certainty. Results We screened 13,389 references and included four trials. We found no statistically significant differences between oxytocin given before versus after fetal delivery on PPH (RR 0.60, 95%CI 0.15–2.47; 1 RCT, N = 300) or nausea/vomiting (RR 1.21, 95%CI 0.69–2.13; 1 RCT, N = 300). There was a significant reduction in the need for additional uterotonics when oxytocin was given immediately before uterine incision versus after fetal delivery (RR 0.37, 95%CI 0.18–0.73; I2 = 0%; 2 RCTs; N = 301). Oxytocin given before fetal delivery significantly reduced intra-operative blood loss (MD -146.77mL, 95%CI -168.10 to -125.43; I2 = 0%; 3 RCTs, N = 601) but did not change the incidence of blood transfusion (RR 0.50, 95%CI 0.13–1.95; I2 = 0%; 2 RCTs, N = 301) or hysterectomy (RR 3.00; 95%CI 0.12–72.77; I2 = 0%; 2 RCTs, N = 301). One trial (N = 100) compared prophylactic oxytocin before versus after placental separation and found no significant differences on PPH, additional uterotonics, or nausea/vomiting. Conclusions In women having pre-labor CS, there is limited evidence indicating no significant differences between prophylactic oxytocin given before versus after fetal delivery on PPH, nausea/vomiting, blood transfusion, or hysterectomy. Earlier oxytocin administration may reduce the volume of blood loss and need for additional uterotonics. There is very limited evidence suggesting no significant differences between prophylactic oxytocin given before versus after placental separation on PPH, need for additional uterotonic, or nausea/vomiting. The overall certainty of the evidence was mostly low or very low due to imprecision. Protocol: CRD42020186797.

show abstract

Spécificités obstétricales et anesthésiques de la prise en charge d’une hémorragie du post-partum (HPP) associée à la césarienne

Cited by 20 publications

References 76 publications

Oxytocin and Uterine Atony during Cesarean Section

Oxytocin and Uterine Atony during Cesarean Section

MRI–radiomics–clinical–based nomogram for prediction postpartum hemorrhage in patients with suspected placenta accrete spectrum before cesarean section

Timing of oxytocin administration to prevent post-partum hemorrhage in women delivered by cesarean section: A systematic review and metanalysis

Contact Info

Product

Resources

About