Maternal and neonatal outcomes of spontaneously conceived pregnancies in mothers over 45 years: a review of the literature.

Purpose: There is little published data on pregnancy outcomes in women who had conceived spontaneously after age 45 years. The aim of this review is to provide accurate information on the risks and probable outcomes of spontaneously conceived pregnancies in women over the age of 45 years, which will enable clinicians to counsel such women appropriately, carry out adequate risk assessment, and ensure better care for pregnancies in this population.

Design: A literature search was performed using EmBase and PubMed for English language articles published between 1970 and 2011, with extractable data on mothers aged ≥45 at the time of delivery and with ≥95% spontaneous conception in the study population.

Application of uterine compression suture in association with intrauterine balloon tamponade ('uterine sandwich') for postpartum hemorrhage.

We evaluated in a prospective observational study the use of a 'uterine sandwich' technique (uterine compression sutures in association with intrauterine tamponade) in women who had had unsuccessful medical treatment for postpartum hemorrhage. Ten of the 11 patients had cesarean sections (complicated by placenta previa and uterine atony) and one had a normal delivery. The median estimated blood loss and units of blood transfused were 1500ml (range 750-4000ml) and two units (range 0-9), respectively.