Peripartum Hysterectomy

Amarin, Zouhair

doi:10.5772/60942

Cited by 5 publications

(6 citation statements)

References 58 publications

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“…After branching from the internal iliac artery, the tortuous UtA traversed inferiorly and medially, formed a hairpin loop in the pelvis, and subsequently carried blood superiorly and laterally to radial and spiral arteries. This anatomy has been partly described in embolization procedures for peripartum hemorrhage, 16,17 however, there is limited knowledge of its normal and pathophysiologic anatomical variation. We observed substantial bilateral UtA anatomical and hemodynamic heterogeneity, which may reflect variations in placental location, molecular signals that promote UtA remodeling and growth, body habitus, and variations in patient position during imaging.…”

Section: Discussionmentioning

confidence: 99%

Assessment of uterine artery geometry and hemodynamics in human pregnancy with 4d flow mri and its correlation with doppler ultrasound

Hwuang

Vidorreta

Schwartz

et al. 2018

Magnetic Resonance Imaging

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Background: Uterine artery (UtA) hemodynamics might be used to predict risk of hypertensive pregnancy disorders, including preeclampsia and intrauterine growth restriction. Purpose or Hypothesis: To determine the feasibility of 4D flow MRI in pregnant subjects by characterizing UtA anatomy, computing UtA flow, and comparing UtA velocity, and pulsatility and resistivity indices (PI, RI) with transabdominal Doppler ultrasound (US). Study Type: Prospective cross-sectional study from June 6, 2016, to May 2, 2018. Population or Subjects or Phantom or Specimen or Animal Model: Forty-one singleton pregnant subjects (age [range] = 27.0 ± 5.9 [18–41] years) in their second or third trimester. We additionally scanned three subjects who had prepregnancy diabetes or chronic hypertension. Field Strength/Sequence: The subjects underwent UtA and placenta MRI using noncontrast angiography and 4D flow at 1.5T. Assessment: UtA anatomy was described based on 4D flow-derived noncontrast angiography, while UtA flow properties were characterized by net flow, systolic/mean/diastolic velocity, PI and RI through examination of 4D flow data. PI and RI are standard hemodynamic parameters routinely reported on Doppler US. Statistical Tests: Spearman’s rank correlation, Wilcoxon signed rank tests, and Bland-Altman plots were used to preliminarily investigate the relationships between flow parameters, gestational age, and Doppler US. Results: 4D flow MRI and UtA flow quantification was feasible in all subjects. There was considerable heterogeneity in UtA geometry in each subject between left and right UtAs and between subjects. Mean 4D flow-based parameters were: mean bilateral flow rate = 605.6 ± 220.5 mL/min, PI = 0.72 ± 0.2, and RI = 0.47 ± 0.1. Bilateral flow did not change with gestational age. We found that MRI differed from US in terms of lower PI (mean difference −0.1) and RI (mean difference < −0.1) with Wilcoxon signed rank test P = 0.05 and P = 0.13, respectively. Data Conclusion: 4D flow MRI is a feasible approach for describing UtA anatomy and flow in pregnant subjects. Level of Evidence: Technical Efficacy: Stage 1

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Section: Discussionmentioning

confidence: 99%

Assessment of uterine artery geometry and hemodynamics in human pregnancy with 4d flow mri and its correlation with doppler ultrasound

Hwuang

Vidorreta

Schwartz

et al. 2018

Magnetic Resonance Imaging

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“…The balloon should be left in place for 4-6 h, and, preferably, it should be removed during daytime hours. The balloon should be deflated and left in place for few minutes to ensure that bleeding does not reoccur [71,72].…”

Section: Recommendationsmentioning

confidence: 99%

Approaches to Hysterectomy

Amarin¹

2015

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He holds a master's degree in medical science, Glasgow, and in medical education, Maastricht. He is a pioneer of in vitro fertilization (IVF), and he was the first to develop microsurgical epididymis sperm aspiration for clinical use. He discovered a surgical procedure for critical ovarian hyperstimulation syndrome. Professor Amarin has published more than 100 papers and has received eight awards. ContentsPreface XI Section Comparative Analyses of Symptoms in Women Before andAfter Hysterectomy 1

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“…Peripartum hysterectomy (PH) is one of the most dramatic surgeries in modern obstetrics. It is usually undertaken in urgent, life‐threatening conditions like massive uncontrollable hemorrhage secondary to abnormal placentation, uterine atony, uterine rupture, or sepsis to prevent the death of the mother 1–3 . The procedure is associated with higher maternal and neonatal morbidity and mortality, it deprives the woman of the possibility of future pregnancy and negatively affects her quality of life 1,4 …”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] The procedure is associated with higher maternal and neonatal morbidity and mortality, it deprives the woman of the possibility of future pregnancy and negatively affects her quality of life. 1,4…”

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confidence: 99%

Peripartum hysterectomy: A 9‐year population‐based study in Slovakia

Adamec

Vargová

Krištúfková

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo assess the incidence of peripartum hysterectomy (PH) in Slovakia. Additionally, we wanted to describe reasons for the procedure, associated clinical circumstances, and complications.MethodsThis was a descriptive, population‐based study among women who underwent PH in Slovakia between January 2012 and December 2020. Peripartum hysterectomy was defined as surgical removal of the uterus from the peripartum period up to 42 days postpartum. Data were obtained retrospectively from the standardized questionnaires that are completed in Slovakia for any case of PH. The background population consisted of all other women who delivered during the study period.ResultsOf the 436 136 births, there were 397 cases of PH, giving an incidence of 0.91 per 1000 births. It was higher with advanced maternal age, multiparity, multiple pregnancies, and cesarean deliveries. The main reasons for the procedure were placental pathologies and uterine atony in 52.9% and 33.0%, respectively. A total of 150 (37.8%) women required admission to an intensive care unit. The mortality rate was 1.5%.ConclusionThe incidence of PH is relatively high in Slovakia when compared with other European countries, highlighting the need to improve prenatal diagnosis of morbidly adherent placenta and the management of peripartum hemorrhage.

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Peripartum Hysterectomy

Cited by 5 publications

References 58 publications

Assessment of uterine artery geometry and hemodynamics in human pregnancy with 4d flow mri and its correlation with doppler ultrasound

Assessment of uterine artery geometry and hemodynamics in human pregnancy with 4d flow mri and its correlation with doppler ultrasound

Approaches to Hysterectomy

Peripartum hysterectomy: A 9‐year population‐based study in Slovakia

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