Biomedical subjects

Karrie Francois

Publications and source records attributed to Karrie Francois.

3 recordsLinked to original sources

PubMed2005

Is peripartum hysterectomy more common in multiple gestations?

OBJECTIVE: To compare the occurrence of peripartum hysterectomy between singleton and multiple gestations. METHODS: This was a historical cohort study comparing the occurrence of peripartum hysterectomy between singleton and multiple gestations at Banner Good Samaritan Regional Medical Center, Phoenix, Arizona, from January 1, 1996, to December 31, 2001. RESULTS: During the study years, 42,595 singleton, 1,131 twin, 164 triplet, 35 quadruplet, and 2 quintuplet deliveries occurred. A total of 100 peripartum hysterectomies were performed. Of these hysterectomies, 88 occurred in singletons, 5 in twins, 6 in triplets, and 1 in quadruplets. The overall occurrence of peripartum hysterectomy was 2.28 per 1,000, and the occurrence of emergent peripartum hysterectomy was 1.73 per 1,000. Multiple gestations had a significantly greater risk of emergent peripartum hysterectomy than singletons (odds ratio [OR] 6.04, 95% confidence interval [CI] 3.28-11.11; P < .001). This difference was more pronounced among higher-order multiple gestations: twins (OR 2.95, 95% CI 1.22-7.13, P = .03), triplets (OR 25.22, 95% CI 11.02-57.77, P < .001), and quadruplets (OR 19.53, 95% CI 3.34-114.69, P = .04). When compared with singletons, higher-order multiple gestations had nearly a 24-fold increased risk of emergent peripartum hysterectomy (OR 23.97, 95% CI 11.05-51.99, P < .001). CONCLUSION: Multiple gestations have a significantly higher occurrence of emergent peripartum hysterectomy than singletons. This information should be used in counseling and managing patients with these pregnancies.

Adult↗

PubMed2003

Is placenta previa more common in multiple gestations?

OBJECTIVE: This study was undertaken to compare the occurrence of placenta previa at delivery between singleton and multiple gestations. STUDY DESIGN: A historical cohort study was performed of placenta previa cases at Good Samaritan Regional Medical Center, Phoenix, Ariz, from January 1, 1997, to December 31, 2000. RESULTS: During the study, 29,268 deliveries (28,372 singleton and 896 multiple gestations) occurred at Good Samaritan Regional Medical Center. Placenta previa complicated 51 (0.18%) singleton gestations and 4 (0.46%) multiple gestations (P =.09). Singleton and multiple gestations with placenta previa were similar with respect to maternal demographic variables, prior uterine surgery (excluding cesarean section), and gestational age at delivery. Multiple gestations with placenta previa were more likely to have had a prior cesarean section (P <.001). There were no differences between the singleton and multiple gestations with placenta previa and need for cesarean hysterectomy and blood transfusion. CONCLUSION: The occurrence and complications of placenta previa do not differ between singleton and multiple gestations.

Adult↗

PubMed2003

Association of vasa previa at delivery with a history of second-trimester placenta previa.

OBJECTIVE: To evaluate whether vasa previa at delivery is associated with a history of second-trimester placenta previa. STUDY DESIGN: Retrospective, case-control study of all vasa previa cases at Good Samaritan Regional Medical Center from January 1, 1991, to May 1, 2001. Cases were identified by ICD-9 codes and confirmed by chart review. Each case was matched in a 1:4 ratio with controls based upon normal placentation at delivery, ultrasound documentation of midtrimester placental location, maternal parity and gestational age at delivery. RESULTS: During the study period, 13 cases of vasa previa were identified. Nine cases (9/13, 69.2%) of vasa previa at delivery had a second-trimester placenta previa as documented by midtrimester ultrasonography, whereas 2 controls (2/52, 3.8%) had a second-trimester placenta previa (P < .000001, OR = 56.3, 95% CI = 8.9-354.1). CONCLUSION: There is a highly significant association between vasa previa at delivery and a history of second-trimester placenta previa.

Adult↗