Severe Secondary Postpartum Hemorrhage: A Historical Cohort

Dossou, Mathieu; Debost‐Legrand, Anne; Déchelotte, Pierre; Lémery, D.; Vendittelli, Françoise

doi:10.1111/birt.12164

Cited by 52 publications

(58 citation statements)

References 25 publications

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“…4,15 Retained products of contraception was documented as a possible cause in maximum number of patients (72%) which is consistent with previous studies. 5,6 It signifies the role of unskilled and unhealthy delivery practices as a leading risk factor for secondary PPH.…”

Section: Discussionmentioning

confidence: 99%

“…Similar pattern of etiology has been reported in previous studies. 5,6 All of the patients were given antibiotics (100%) as policy of the hospital and dilatation curettage/suction evacuation was done in (80%) as most of our patients had RPOCs. Hysterectomy was done in one patient in whom bleeding did not stop even after curettage.…”

Section: Discussionmentioning

confidence: 99%

“…While uterine atony is the leading cause of primary PPH, retained products of conception cause secondary PPH most of the time. 1,[3][4][5][6] Secondary PPH can be caused by numerous other etiologies the significant among which are , primary subinvolution of placental bed, endometritis, pseudoanuerysm of the uterine artery, non union of uterine incision etc. [6][7][8][9] Other rare causes of PPH have also been reported.…”

Section: Introductionmentioning

confidence: 99%

“…1,[3][4][5][6] Secondary PPH can be caused by numerous other etiologies the significant among which are , primary subinvolution of placental bed, endometritis, pseudoanuerysm of the uterine artery, non union of uterine incision etc. [6][7][8][9] Other rare causes of PPH have also been reported. 10,11 While there is plenty of data available in world literature regarding primary PPH, secondary PPH has not been studied with similar zeal.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Secondary postpartum haemorrhage in a tertiary care hospital of North India: a retrospective analysis

Nigeen

Farooq

Afzal

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Postpartum haemorrhage (PPH) is a very common complication that follows delivery. It is one of the leading causes of maternal mortality both in developing and developed countries. Primary PPH has been studied a lot, but data regarding secondary PPH is sparse. Our objective was to study the clinical characteristics and outcome of patients presenting with secondary PPHMethods: A retrospective descriptive study done at Lalla Ded hospital Srinagar, a tertiary care hospital of North India, between June 2015 and December 2015.Results: Fifty patients with secondary PPH were studied out of whom 36 were delivered outside this hospital and referred. Fourteen patients who delivered in this hospital developed secondary PPH. Mean age of patients was 35±3 years. Retained products of contraception (RPOCs) was the leading cause in 36 (72%) of patients followed by endometritis in ten (20%). Mean hemoglobin concentration was 8.7±1.9grams ranging from 4.4 grams to 12.9 grams. Mean hospital stay was 6.3±1.5 days ranging from 1 day to 20 days. Curettage was done in 40 (80%) of patients including 36 having RPOC s and check curettage in four patients. Fourteen (28%) patients required blood transfusion. One patient required hysterectomy. None of the patients died.Conclusions: Secondary PPH has been studied very little. Our results show retained products of contraception as a leading cause of secondary PPH which is probably related to poor management of third stage of labour. There is crucial role of active management of third stage of labour in preventing secondary PPH. Majority of secondary PPH patients require dilatation and curettage with other supportive measures only. Surgical intervention is rarely required. Blood loss is usually mild to moderate. Prognosis is good if medical intervention is sought early.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Secondary postpartum haemorrhage in a tertiary care hospital of North India: a retrospective analysis

Nigeen

Farooq

Afzal

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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“…Retained placenta may be one of the main causes of death due to hemorrhage in low income countries but its pathophysiology is largely unknown [2, 3]. …”

Section: Introductionmentioning

confidence: 99%

Oxidative stress and inflammation in retained placenta: a pilot study of protein and gene expression of GPX1 and NFκB

Endler¹,

Saltvedt²,

Eweida³

et al. 2016

BMC Pregnancy Childbirth

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BackgroundRetained placenta is associated with severe postpartum hemorrhage. Its etiology is unknown and its biochemistry has not been studied. We aimed to assess whether levels of the antioxidative enzyme Glutathione Peroxidase 1 (GPX1) and the transcription factor Nuclear Factor κβ (NFκβ), as markers of oxidative stress and inflammation, were affected in retained placentas compared to spontaneously released placentas from otherwise normal full term pregnancies.MethodsIn a pilot study we assessed concentrations of GPX1 by ELISA and gene (mRNA) expression of GPX1, NFκβ and its inhibitor Iκβα, by quantitative real-time-PCR in periumbilical and peripheral samples from retained (n = 29) and non-retained (n = 31) placental tissue.ResultsMedian periumbilical GPX1 concentrations were 13.32 ng/ml in retained placentas and 17.96 ng/ml in non-retained placentas (p = 0.22), peripheral concentrations were 13.27 ng/ml and 19.09 ng/ml (p = 0.08). Retained placental tissue was more likely to have a low GPX1 protein concentration (OR 3.82, p = 0.02 for periumbilical and OR 3.95, p = 0.02 for peripheral samples). Median periumbilical GPX1 gene expressions were 1.13 for retained placentas and 0.88 for non-retained placentas (p = 0.08), peripheral expression was 1.32 and 1.18 (p = 0.46). Gene expressions of NFκβ and Iκβα were not significantly different between retained and non-retained placental tissue.ConclusionsWomen with retained placenta were more likely to have a low level of GPX1 protein concentration in placental tissue compared to women without retained placenta and retained placental tissue showed a tendency of lower median concentrations of GPX1 protein expression. This may indicate decreased antioxidative capacity as a component in this disorder but requires a larger sample to corroborate results.

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Enhanced myometrial vascularity and AVM: A review on diagnosis and management

Moradi

Banihashemian

Sadighi

et al. 2023

J of Clinical Ultrasound

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Uterine Arteriovenous malformations (AVM) are vascular disorders characterized by complex high‐flow tangles of abnormal vessels connecting arteries and veins with bypassing capillaries. Recently, the terminology applied to describe uterine AVMs has been modified. Most AVMs are acquired. The term enhanced myometrial vascularity (EMV) is used to describe any condition in which any uterine pathology may lead to increased myometrial vascularity regardless of the absence or presence of residual tissue of gestation.

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Severe Secondary Postpartum Hemorrhage: A Historical Cohort

Abstract: Secondary PPH is rare. Accurate diagnosis is based most often on histopathologic findings.

Cited by 52 publications

References 25 publications

Secondary postpartum haemorrhage in a tertiary care hospital of North India: a retrospective analysis

Secondary postpartum haemorrhage in a tertiary care hospital of North India: a retrospective analysis

Oxidative stress and inflammation in retained placenta: a pilot study of protein and gene expression of GPX1 and NFκB

Enhanced myometrial vascularity and AVM: A review on diagnosis and management

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