SEARCH · PubMed Health

Results for “Placenta, Retained”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 541 records · Page 30Linked to original sources

PubMed2001

A comparative study of vaginal misoprostol and intravenous oxytocin for induction of labour in women with intra uterine fetal death in Mulago Hospital, Uganda.

BACKGROUND: Intrauterine fetal death is a major problem in obstetrics particularly in developing countries such as Uganda. Induction of labour in cases of fetal death using the available method of oxytocin is often difficult, expensive and frustrating. OBJECTIVES: To compare the effectiveness of vaginal misoprostol and intravenous oxytocin in induction of labour in women with intrauterine fetal death. METHODS: One hundred and twenty mothers were allocated in a randomised controlled way to one of the two induction groups. Oxytocin infusion was titrated based on patient response. The starting dose was 50 mcg (1/4 tablet) in misoprostol group and the dose was doubled every six hours till effective contractions were achieved. The two groups were compared for induction to delivery intervals, costs of the drugs and their safety during induction. RESULTS: The success rate within 48 hours of induction was 100% in the misoprostol group and 96.7% in oxytocin group. The mean induction to delivery time was significantly longer in the oxytocin group compared with the misoprostol group (23.3 versus 12.4 hours; p= 0.004). In the gestational age before 28 weeks, the induction to delivery interval in oxytocin group, was more than twice that used in misoprostol. However beyond 28 weeks, there was no significant difference. Women with intact membranes had induction to delivery interval of 27.9 hours in the oxytocin group and 14.7 hours in the misoprostol group (p=0.002). When the membranes were ruptured, the values were 10.5 and 8.5 hours respectively (p=0.6). The induction to delivery time in cases with Bishop's score < 6 was 29.8 hours in the oxytocin group and 15.9 hours in misoprostol group (p=0.001). The corresponding values for Bishop's scores > 6 were 10 and 7.9 hours respectively (p=0.6). The majority of patients in misoprostol group (62%), required less than one tablet for successful induction. Misoprostol was cheaper (0.65 US dollars than oxytocin (7.86 US dollars) Retained placenta occurred in only 3.3% of the patients in the misoprostol group. There were no cases of ruptured uterus in both groups. CONCLUSION: Intravaginal misoprostol is more effective and cheaper than intravenous oxytocin for inducing labour in patients with intrauterine fetal death.

Abortifacient Agents, Nonsteroidal↗

PubMed1992

Puerperium and breast-feeding.

The issues related to breast-feeding and problems of the puerperium are often obfuscated by the general but outdated practice of recommending cessation of lactation. This article examines recent literature (June 1991 to May 1992) on breast-feeding and the treatment of puerperal problems, emphasizing that breast-feeding may be maintained during virtually all treatment modalities. Additionally, the use of drugs to support or suppress lactation has been of interest, and the increased attention to the fertility impact of breast-feeding, breast-feeding and maternal health, and human immunodeficiency virus and breast-feeding has resulted in several new articles of note. In general, the recent study of breast-feeding has identified many positive side effects, while other articles confirm that the treatment for retained placenta, postpartum pain, and puerperal infection, as discussed in recent literature, do not contraindicate breast-feeding.

Breast Feeding↗

PubMed2003

Uterine rupture in a primigravid patient and anesthetic implications: a case report.

Uterine rupture is an unexpected, relatively uncommon occurrence in the general obstetric population, but it is a potentially devastating complication. Uterine rupture of the unscarred uterus is extremely rare. Awareness of the risk factors as well as the signs and symptoms of uterine rupture are essential for an early diagnosis and prompt treatment. The patient is a 38-year-old female, gravida 3, para 0, at 38 weeks' gestation undergoing an elective labor induction. The induction of labor and epidural analgesia progress relatively uneventfully. Following approximately 1.5 hours of "pushing," a viable male infant was delivered. Newborn Apgar scores were 6 at 1 minute and 9 at 5 minutes. An hour after delivery the patient began complaining of syncope; at this time bleeding was greater than expected and the obstetrician decided a dilatation and curettage for retained placenta was necessary. A dilatation and curettage was negative, and an ultrasound of the abdomen revealed the presence of significant blood clots, laparotomy was performed, and uterine rupture was identified. The patient developed disseminated intravascular coagulation, uterine bleeding continued, and the patient ultimately required a hysterectomy.

Adult↗

PubMed1992

[Dystrophia myotonica and pregnancy].

We describe the maternal and neonatal complications of pregnancy in two patients with myotonic dystrophy. The disease leads to an increased spontaneous abortion rate, hydramnios, prolonged first and second stages of labour, retained placenta, postpartum haemorrhages and anaesthetic sensitivity in the mother. The neonatal problems are caused by the congenital form of the disease. The major clinical features of congenital myotonic dystrophy are bilateral facial weakness, hypotonia, neonatal distress, feeding difficulties, talipes, tent-shaped mouth, mental retardation and delayed motor development. Relatives of a known myotonic dystrophy patient should be advised to let themselves be examined for this disease. If the disease is diagnosed, information should be given regarding possibilities for prenatal diagnosis. Pregnancy in myotonic dystrophy patients should be monitored by a gynaecologist. Labour has to take place in a hospital with intensive care facilities for mother and child.

Adult↗

PubMed2003

Angiographic embolization for emergent and prophylactic management of obstetric hemorrhage: a four-year experience.

BACKGROUND: To retrospectively evaluate the efficacy and safety of emergent and prophylactic arterial embolization for obstetric hemorrhage within the past 4 years. METHODS: We retrospectively collected 21 obstetric patients with treatment of selective arterial embolization between 1999 and 2002. Two groups of patients were identified. The first group consisted of 15 patients who experienced postpartum hemorrhage and underwent emergent embolization. The second group was made up of 6 patients who underwent prophylactic embolization with risk factors of severe obstetric bleeding. They had abnormal placentation antepartum diagnosed and accepted termination of pregnancy followed by hysterectomy. RESULTS: In the first group, 12 of 15 cases had a favorable outcome treated by single embolization session. One patient expired 4 days after embolization due to severe disseminated intravascular coagulopathy and multiple organ failure. One retained placenta with recurrent bleeding was controlled by repeated selective arterial embolization. One uterine subinvolution with persistent mild bleeding and genital tract infection was improved by conservative treatment. Further surgical procedure was not necessary for all cases. One woman delivered her next baby 13 months after embolization. In the second group, all women had abnormal placentation with histopathological confirmation, including 1 accreta, 3 increta, and 2 percreta. No immediate complication was noted after embolization. The estimated blood loss during operation ranged from 300 to 3000 mL (mean, 1770 mL). CONCLUSIONS: Our study indicates that selective arterial embolization should be the early management for intractable postpartum hemorrhage after conservative treatment fails and before more invasive surgical intervention is considered. Our experience also confirms the effectiveness and safety of prophylactic selective arterial embolization for anticipated high morbidity or mortality of obstetric surgery.

Adult↗

PubMed1992

Obstetrics and childbirth at the Aitape Health Centre, Papua New Guinea.

Routinely collected obstetric data at the Aitape Health Centre, Papua New Guinea over the years 1986, 1988 and 1989 were analyzed and compared with figures from western New Guinea of about thirty years ago and with those of rural African hospitals. Data from 924 deliveries were analyzed. 30% were born before arrival (BBA). The number of abnormal deliveries was high. This was in part due to the high frequency of twin births (4.5%). Among the BBAs puerperal sepsis and stillbirth were significantly higher than among those who delivered in the health centre. The stillbirth frequency was 3.4%. The sex ratio male:female at birth was 120.9. The large number of retained placentae with manual removal (5.2%) was related to high parity; 33.5% of the women delivering at the health centre were para-4 or more. 20% of male and 24% of female newborns had low birthweight (less than 2500g).

Birth Weight↗

PubMed2004

[Risk factors of postpartum hemorrhage during labor and clinical and pharmacological prevention].

Prevention of postpartum hemorrhage (PPH) is a major concern in regards to its impact on maternal morbidity and mortality. While established risk factors can be identified among risk factors of PPH during labor after multivariate analysis: prolonged labor, oxytocin stimulation of labor, cesarean section, instrumental delivery, genital lacerations and episiotomy, prolonged third stage of labor, retained placenta; other risk factors are still uncertain: induction of labor, hyperthermia or chorioamniotitis, analgesia or anesthesia, macrosomia, various cesarean section techniques. Isolated identified risk factors have a moderate incidence on PPH, but their cumulation in one patient is a potential high risk. Among active management schemes of third stage of labor for PPH prevention, the most efficient technique seems to be direct injection of oxytocin when the baby's shoulders are delivered, associated with controlled cord traction. If this technique is a must for high-risk patients for PPH, and seems efficient for every patient, a correctly performed procedure requires the presence of a competent professional in addition to the midwife or obstetrician in charge of delivery, and a permanent attention so the length of third stage of labor is shortened. The alternative use of prophylactic misoprostol in the third stage of labor is less effective than injectable uterotonics in reducing PPH, and is associated with more side effects (severe shivering, pyrexia, diarrhea). None of other described prophylactic methods have proved efficiency: early suckling, umbilical blood drainage, oxytocin umbilical vein injection, among others. A decrease in PPH prevalence should be obtained by particular attention on data from the early postpartum period, active diffusion of effective prophylactic techniques, and an appropriate choice in regards to each delivery unit organization.

Delivery, Obstetric↗

PubMed2005

[The duration of expulsion and the separation of the afterbirth in breeding cows--a contribution to the improvement of parturition monitoring].

The objective of this study was to obtain data on the duration of the expulsion and afterbirth stages and on the rate of contractions of the abdominal muscles in dams with eutocia (n = 81; heifers: 11; cows: 70). We also looked into the questions of whether and at which stage of expulsion there were differences in these parameters between cows and heifers as well as purebred Simmental (n = 49) and Simmental X Limousin (n = 21). The total period of expulsion (period from appearance of the phalanxes in the rima vulvae until the complete expulsion of the calf) was 19.7 +/- 2.1 minutes. It took 17.3 +/- 2.3 minutes for the head to emerge. Further expulsion required 1.9 +/- 1.7 minutes. At an average of 40.1 +/- 1.5 minutes, the expulsion stage was longer in heifers than in cows, in which it lasted 18 +/- 2.1 minutes (p < 0.01). The differences are due to the time that the head took to emerge. While this stage of labor lasted 15.3 +/- 2.3 minutes in cows, this interval was clearly longer in heifers, lasting 38.1 +/- 1.5 minutes (p < 0.01). No statistically significant difference was observed in the course of further expulsion and there were not any differences detected between purebred Simmental and Simmental X Limousin. An average of 67.5 +/- 1.6 abdominal contractions were required for complete expulsion, 56.5 +/- 1.7 contractions of the abdominal muscles were necessary until the head appeared. After 9.3 +/- 1.6 abdominal presses, the calf had completely emerged. There was a statistically significant difference between cows (52.8 +/- 1.7) and heifers (93.3 +/- 1.6) until the expulsion of the head (p < 0.01). No breed-specific differences were observed. Separation of the afterbirth was observed in 95.0% of the animals up to the eighth hour post partum. Retarded separation and retained placenta were recorded in 2.5% of the animals in each case. 82.7% of the animals performed placentophagy. No placentophagy was observed when the placenta was retarded. No differences were detected between heifers and cows and the breeds with regard to the separation of the afterbirth and the incidence of placentophagy.

Age Factors↗

PubMed2005

[Amniotic embolism--a case in forensic medicine practice and literature review].

The author describes a case of vaginal delivery in which the mother dies. Because of a retained placenta parts in cavum uteri, the physician peroformed revisio cavi uteri instrumentalis, in which wall of the uterus is perforated, about 3 cm in length. A justice commission of seven persons associate the bleeding out of the uterus and the death of the mother with the perforation of the uterus. We consider that the death of the mother is due to amniotic embolism and not due to the perforation of the uterus. We cite contemporary scientific data.

Adult↗

PubMed2005

Obstetric characteristics and neonatal outcome of unplanned out-of-hospital term deliveries: a prospective, case-control study.

OBJECTIVE: To describe the obstetric characteristics and neonatal outcomes in unplanned out-of-hospital deliveries. STUDY DESIGN: Obstetric characteristics and neonatal outcomes were compared between 151 consecutive parturients with unplanned, out-of-hospital term deliveries and 151 hospital term deliveries. RESULTS: Women who delivered out of hospital tended to be older (32 +/- 5.5 vs. 28 +/- 5.0 years, p = 0.046) and less educated (4.4 +/- 5.1 vs. 6.5 +/- 5.0 years, p = 0.005) as compared to women who delivered in the hospital. Unplanned out-of-hospital deliveries resulted in statistically significant higher rate of low-birth-weight newborns (< 2,500 g) (OR= 3.9, 95% CI 2.0-7.7, p<0.001), postpartum hemorrhage (OR = 8.4, 95% CI 1.1-181.1, p = 0.018) and trended for higher rate of manual lysis of retained placenta and membranes (4.0% vs. 0%, p = 0.013). Higher rates of admission to the neonatal intensive care unit due to neonatal complications, such as polycythemia (12.6% vs. 0%, p < 0.001), hypoglycemia (9.3% vs. 0.6%, p = 0.001) and convulsions (3.3% vs. 0%, p = 0.024), were noted in the out-of-hospital delivery group as compared to the controls. Using a multivariable analysis, lower educational level (OR = 0.4, 95% CI 0.3-0.4, p < 0.001), maternal age > 35 (OR = 6.2, 95% CI 2.3-16.7, p < 0.001) and high parity (OR = 7.9, 95% CI 4.9-12.9, p<0.001) were found to be independent risk factors for an unplanned outof hospital delivery. CONCLUSION: Unplanned out-of-hospital birth is an important risk factor for such complications as postpartum hemorrhage, low birth weight and adverse neonatal outcome.

Adult↗

PubMed2005

Incidence of multifactorial diseases in Estonian dairy herds--a survey.

An important precondition of a well-functioning dairy production is knowledge about the incidence of environmentally evoked non-infectious diseases in a particular herd, in the region and in the country as a whole. The aim of this study was to determine the incidence rate of environmentally evoked multifactorial diseases in Estonian dairy herds, and to compare the disease incidence in small (< or = 100 cows) and large herds (101-300 cows). The disease incidence was recorded by local veterinarians in twelve production units with a total of 33 cowsheds and about 5000 dairy cows. Fourteen disease groups were formed. In order to describe the range of disease incidence, the relative frequency of each group of diseases was determined, as well as the incidence rate. The 95 % confidence interval was applied in order to assess the reliability of the incidence rates. The most common disorders of Estonian dairy cows are udder diseases, followed by uterine infection, metabolic diseases and retained placenta. The disease incidence in Estonian dairy herds is similar to that of other European countries. Most of the diseases occur more often in small herds than in large herds.

Animal Welfare↗

PubMedDate not supplied

Complications of home delivery: a retrospective analysis.

This study was conducted to analyze the cases who had attended Nepal Medical College Teaching Hospital (NMCTH) after home delivery in order to broadly review the complications. This is a retrospective descriptive study. The number of total deliveries during the study period of two years (April, 2002- April, 2004) was 1619, among which 88 (5.4%) were cases who attended after home delivery. Majority of women (35.2%) were primi, 57.9% belonged to 20-25 year age group, 17% were young primi, and 85.2% were full term deliveries whereas 9.1% were preterm. More than half of them (57.9%) had regular antenatal check up. Most of them came from within 1-2 km distance of NMCTH. 51.1% were brought only after 2 hrs of delivery. The most common reason for attending hospital was retained placenta (84.1%-74 cases) among whom 51 (68.9%) needed controlled cord traction, 8 cases (10.8%) needed manual removal, rest of the cases had placenta lying in the vagina. Fifteen (17%) cases had post partum hemorrhage, 9 cases (10.2%) were brought in a state of shock. 71.6% were anemic, 11 (12.5%) had Hb <7 gm%. Other complications included cervical, third degree perineal tear. Blood transfusion was needed in 19 (21.6%) cases. All cases improved with proper resuscitation, use of antibiotics and definitive management of complications. Most of them were discharged within 4 days of admission. Perinatal mortality rate was 65.9/1000 births. This study showed that home deliveries were associated with increased maternal morbidity especially the third stage complications. Studies done in developed countries have shown that home birth is safe for normal, low risk women, with adequate infrastructure and support i.e. given a well trained midwife and facilities to transfer to hospital if necessary. In our context, a community based obstetric service must be developed with emphasis on regular and quality antenatal care, health education to women and proper training of birth attendants.

Adolescent↗

PubMed2006

The relationship between herd level disease incidence and a return over feed index in Ontario dairy herds.

The objective of the current research was to examine the association of herd level disease incidence with the return over feed (ROF) (milk income minus feed cost) herd profit index offered through Canwest Dairy Herd Improvement. The lactational incidence risks (LIR) for displaced abomasum, retained placenta, clinical mastitis, milk fever, clinical ketosis, and lameness submitted by producers (n = 48) were similar to previous reports. However, there was no negative association of clinical disease LIR's with ROE Subclinical ketosis and subclinical mastitis cumulative incidence were determined during the early postpartum period by using a cow-side test for betahydroxybutyrate in milk and the California Mastitis Test, respectively. Subclinical mastitis was not associated with ROE However, a unit increase in the cumulative incidence of subclinical ketosis was associated with a decrease of dollars 0.015/cow/day in the ROE The results highlight the economic significance that subclinical ketosis may have in Ontario dairy herds.

Animal Feed↗

PubMed1991

[Epidemiologic and genetic analysis of veterinary data of German Brown cattle].

In totally 3740 cows of the breed German Brown Swiss distributed over 115 herds risk factors for the occurrence of diseases were analysed using a threshold model. Disease data were recorded by ten practitioners in southern Bavaria. The most frequent diseases were fertility disorders, followed by metabolic, udder and calving disorders. The influence of the herds could demonstrated clearly for all diseases analysed. The effect of the lactation number contributed significantly to the frequency of milk fever, mastitis, retained placenta, endometritis/metritis and ovary cysts. Heritability estimates vary between h2 = 0.5% and h2 = 4.2% with exception of anestrus/acyclia (h2 = 8.8%). With higher milk yield of cows the disease frequencies increase, especially fertility diseases. However, increasing herd milk yield is associated with decreasing disease frequencies. A depression of A.I.-parameters and an increase of culling rate caused by diseases could be observed. In the case of the occurrence of uterus- and ovary disorders days open are elongated by 58 days in comparison to cows without diseases. Recording of disease data for use in electronic data processing seems necessary, in order to diminish production diseases by breeding and herd control programmes. An important prerequisite in organization of disease data recording is an efficient cooperation between the veterinary practitioner, farmer, inseminator and the official milk recording organisation.

Animals↗

PubMed1991

[Complications of third stage labor and the puerperium in preterm and term deliveries].

Preterm delivery is the leading cause of perinatal morbidity and mortality worldwide. The purpose of the present study was to determine whether preterm delivery is associated with complications of the third stage of labor and of the puerperium. Retained placentas occurred more frequently in 99 women with preterm vaginal delivery than in 97 with term vaginal delivery (13.1% vs 1%, p = 0.003). There was a higher rate of endometritis in women delivering before term than in those delivering at term (10.1% vs 0%, p = 0.004). This study indicated that preterm labor and delivery is associated with higher rates of perinatal morbidity and mortality and with an increased risk of maternal complications.

Female↗

PubMed1991

An economic assessment of twin births in British dairy herds.

The effect of twinning on the subsequent health, production and reproductive performance of dairy cattle was studied by analysing the data derived from 19,755 calvings which occurred during three years on 37 farms. The data formed part of the database of a veterinary practice operating the DAISY dairy cow recording scheme for its dairy farmer clients. The average twinning rate was 2.5 per cent. For first calf heifers the rate was 0.9 per cent, and the rate increased with increasing parity to over 5 per cent for cows calving for their sixth and subsequent lactations. Although they produced more milk than their contemporaries, twin-bearing cows suffered an increased incidence of retained placenta and vulval discharges and their calving to conception interval was extended by 33 days. Furthermore, 35 per cent of these cows were culled compared with 21 per cent of their contemporaries. The benefit of having more calves for sale was reduced owing to 15 per cent of them being born dead. It is calculated that producing twins resulted in an average loss of income of 74 pounds/cow, a deficit of 15 per cent compared with cows having single calves.

Animals↗

PubMed1991

Prolonged third stage of labor: morbidity and risk factors.

Although retained placenta is a major cause of postpartum hemorrhage, there is no general agreement regarding when manual placental extraction is indicated to prevent hemorrhage. We sought to determine the following: 1) what duration of the third stage of labor is abnormal, 2) what duration is associated with complications, and 3) what antecedent conditions are associated with prolonged third stage. We studied 12,979 consecutive, singleton vaginal deliveries over an 11-year period. Third-stage duration had a log-normal distribution, with a geometric mean of 6.8 minutes, a median of 6 minutes, and an interquartile range of 4-10 minutes. A third stage of 30 minutes or longer occurred in 3.3% of the deliveries. The incidence of postpartum hemorrhage, transfusion, and D&C remained constant in third stages less than 30 minutes, then rose progressively, reaching a plateau at 75 minutes. The increase in these complications after 30 minutes was observed with both spontaneously delivered and manually extracted placentas. In a logistic regression analysis, factors significantly associated with prolonged third stage included: preterm delivery (odds ratio 3.81), delivery in a labor bed (odds ratio 2.17), preeclampsia (odds ratio 1.76), augmented labor (odds ratio 1.47), and nulliparity (odds ratio 1.45). Because there was no increase in hemorrhage until the third stage exceeded 30 minutes, we suggest that in the absence of bleeding, manual placental extraction is not indicated until 30 minutes have elapsed.

Female↗

PubMed1978

The prophylactic use of vitamin D3 in parturient paresis in the cow in a practice district in eastern Norway. A retrospective investigation.

The prophylactic effect in parturient paresis of an intramuscular injection of 10 million i.u. vitamin D3 one week prior to the expected calving date, was investigated in 84 cows which had previously suffered from parturient paresis. Clinical observations in connection with the development of parturient paresis after injection of vitamin D3 were compared with corresponding observations made on cows within the same population at the previous calving when no vitamin D3 was administered. The incidence of clinical parturient paresis in cows given vitamin D3 was 44.3 per cent. There were no significant differences in the incidence of parturient paresis in cows injected with vitamin D3 during the periods less than 2, 2--4, 5--8 and greater than 8 days before parturition. Average plasma calcium levels (mg/100 ml) before first calcium treatment, results of treatment, and the incidence of retained placenta in vitamin D3 injected cows did not differ significantly from corresponding data for cows with clinical parturient paresis which had not been given vitamin D3 before calving. It is concluded that vitamin D3 does not have any prophylactic effect in parturient paresis in cows in Eastern Norway.

Animals↗