Objective: To evaluate the demographic profile, high risk factors, fetomaternal outcome and management options in morbidly adherent placenta (MAP).
Study Design: Retrospective analysis.
Methodology: Review of 20 case records of women with MAP during year 2001-2006.
Results: The mean age and parity of the women was 27.7 ± 4.2 years and 2.5 respectively. 70 % women had previous uterine scar, and similar number had placenta previa. 60 % women presented with antepartum hemorrhage and 20 % with retained placenta. 85 % women underwent hysterectomy with 5 % requiring internal iliac artery ligation, another 5 % partial cystectomy and 15 % bladder repair. Blood loss was between one and nine litres requiring an average of six units whole blood and 4 units FFP. There were six (30 %) maternal deaths. 55 % of the newborns were preterm and the perinatal mortality was 33.3 %.
Conclusion: Cesarean section and placenta previa are significant risk factors. MAP is associated with high fetomaternal morbidity and mortality.
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http://dx.doi.org/10.1007/s13224-012-0149-5 | DOI Listing |
J Clin Orthop Trauma
February 2025
University of Edinburgh, Edinburgh, United Kingdom.
Background: Scotland has one of the highest rates of obesity in the developed world which increases risk of lower limb osteoarthritis resulting in total joint arthroplasty (TJA). This paper aimed to investigate (1) current practice of orthopaedic consultants in Scotland in managing end-stage hip and knee osteoarthritis in obese patients, (2) adherence to National guidelines, and (3) understanding of complication risks in lower limb TJA for BMI≥40.
Methods: A 15-question online survey was sent to all active members of Scottish Committee for Orthopaedics and Trauma (SCOT) between February and March 2023 to understand the current practices for managing obese patients with lower limb arthritis requiring joint replacement surgery.
Amino Acids
January 2025
Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
Recent studies have suggested that the interaction between diet and an individual's genetic predisposition can determine the likelihood of obesity and various metabolic disorders. The current study aimed to examine the association of dietary branched-chain amino acids(BCAAs) and aromatic amino acids(AAAs) with the expression of the leptin and FTO genes in the visceral and subcutaneous adipose tissues of individuals undergoing surgery. This cross-sectional study was conducted on 136 Iranian adults, both men and women, aged ≥18 years.
View Article and Find Full Text PDFBMC Pregnancy Childbirth
January 2025
Department of Obstetrics and Gynaecology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, 151001, India.
Background: Placenta accreta spectrum (PAS) disorder is a fatal condition responsible for obstetric haemorrhage, which contributes to increased feto-maternal morbidity and mortality. The main contributing factor is a scarred uterus, often from a previous cesarean delivery, myomectomy, or uterine instrumentation. The occurrence of PAS in an unscarred uterus is extremely rare, with only anecdotal cases reported so far in the literature.
View Article and Find Full Text PDFTrop Doct
December 2024
Professor and Head, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India.
Placenta accreta spectrum (PAS) represents a complex obstetric condition characterised by the abnormal invasion of anchoring villi and trophoblast into the myometrium. This case report explores two instances where the diagnosis of PAS was overlooked during antenatal care leading to significant complications during conservative management. Both patients presented with heavy menstrual bleeding and raised beta human chorionic gonadotrophin (β-hCG), mimicking gestational trophoblastic disease.
View Article and Find Full Text PDFUltrasound Obstet Gynecol
January 2025
Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK.
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