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Jan Van Der Meulen - One of the best experts on this subject based on the ideXlab platform.
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Risk of placenta previa in second birth after first birth cesarean section: a population-based study and meta-analysis
BMC pregnancy and childbirth, 2011Co-Authors: Ipek Gurol-urganci, David A Cromwell, Leroy C. Edozien, Gordon C. S. Smith, Chidimma Onwere, Tahir Mahmood, A Templeton, Jan Van Der MeulenAbstract:Background: Objective: To compare the risk of placenta previa at second birth among women who had a cesarean section (CS) at first birth with women who delivered vaginally. Methods: Retrospective cohort study of 399,674 women who gave birth to a singleton first and second baby between April 2000 and February 2009 in England. Multiple logistic regression was used to adjust the estimates for maternal age, ethnicity, deprivation, placenta previa at first birth, inter-birth interval and pregnancy complications. In addition, we conducted a meta-analysis of the reported results in peer-reviewed articles since 1980. Results: The rate of placenta previa at second birth for women with vaginal first births was 4.4 per 1000 births, compared to 8.7 per 1000 births for women with CS at first birth. After adjustment, CS at first birth remained associated with an increased risk of placenta previa (odds ratio = 1.60; 95% CI 1.44 to 1.76). In the meta-analysis of 37 previously published studies from 21 countries, the overall pooled random effects odds ratio was 2.20 (95% CI 1.96-2.46). Our results from the current study is consistent with those of the meta-analysis as the pooled odds ratio for the six population-based cohort studies that analyzed second births only was 1.51 (95% CI 1.39-1.65). Conclusions: There is an increased risk of placenta previa in the subsequent pregnancy after CS delivery at first birth, but the risk is lower than previously estimated. Given the placenta previa rate in England and the adjusted effect of previous CS, 359 deliveries by CS at first birth would result in one additional case of placenta previa in the next pregnancy. Background Placenta previa can have serious adverse consequences for both mother and baby, including an increased risk of maternal and neonatal mortality[1-3], fetal growth restriction and preterm delivery[4], antenatal and Intrapartum Hemorrhage[5-7], and women may require a blood transfusion[8] or even an emergency hysterectomy. It is a relatively uncommon condition, with an overall incidence in England of 6.3 per 1000 births[9], but incidence rates are higher among women with advanced maternal age, multiple gestation, high parity, or who smoke or use illegal drugs[10]. The risk of placenta previa is also reported to be higher among women with previous uterine surgery, including cesarean section[11].
Ipek Gurol-urganci - One of the best experts on this subject based on the ideXlab platform.
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Risk of placenta previa in second birth after first birth cesarean section: a population-based study and meta-analysis
BMC pregnancy and childbirth, 2011Co-Authors: Ipek Gurol-urganci, David A Cromwell, Leroy C. Edozien, Gordon C. S. Smith, Chidimma Onwere, Tahir Mahmood, A Templeton, Jan Van Der MeulenAbstract:Background: Objective: To compare the risk of placenta previa at second birth among women who had a cesarean section (CS) at first birth with women who delivered vaginally. Methods: Retrospective cohort study of 399,674 women who gave birth to a singleton first and second baby between April 2000 and February 2009 in England. Multiple logistic regression was used to adjust the estimates for maternal age, ethnicity, deprivation, placenta previa at first birth, inter-birth interval and pregnancy complications. In addition, we conducted a meta-analysis of the reported results in peer-reviewed articles since 1980. Results: The rate of placenta previa at second birth for women with vaginal first births was 4.4 per 1000 births, compared to 8.7 per 1000 births for women with CS at first birth. After adjustment, CS at first birth remained associated with an increased risk of placenta previa (odds ratio = 1.60; 95% CI 1.44 to 1.76). In the meta-analysis of 37 previously published studies from 21 countries, the overall pooled random effects odds ratio was 2.20 (95% CI 1.96-2.46). Our results from the current study is consistent with those of the meta-analysis as the pooled odds ratio for the six population-based cohort studies that analyzed second births only was 1.51 (95% CI 1.39-1.65). Conclusions: There is an increased risk of placenta previa in the subsequent pregnancy after CS delivery at first birth, but the risk is lower than previously estimated. Given the placenta previa rate in England and the adjusted effect of previous CS, 359 deliveries by CS at first birth would result in one additional case of placenta previa in the next pregnancy. Background Placenta previa can have serious adverse consequences for both mother and baby, including an increased risk of maternal and neonatal mortality[1-3], fetal growth restriction and preterm delivery[4], antenatal and Intrapartum Hemorrhage[5-7], and women may require a blood transfusion[8] or even an emergency hysterectomy. It is a relatively uncommon condition, with an overall incidence in England of 6.3 per 1000 births[9], but incidence rates are higher among women with advanced maternal age, multiple gestation, high parity, or who smoke or use illegal drugs[10]. The risk of placenta previa is also reported to be higher among women with previous uterine surgery, including cesarean section[11].
Richard L. Berkowitz - One of the best experts on this subject based on the ideXlab platform.
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Prophylactic and emergent arterial catheterization for selective embolization in obstetric Hemorrhage
American journal of perinatology, 1992Co-Authors: Manuel Alvarez, Charles J. Lockwood, Alessandro Ghidini, Peter Dottino, Harold A. Mitty, Richard L. BerkowitzAbstract:Treatment of obstetric Hemorrhage by the selective embolization of damaged pelvic vessels under fluoroscopy holds promise as an alternative to surgical intervention. Unfortunately, the effectiveness of selective embolization is often compromised by its use in emergent settings following the failure of primary operative approaches. Therefore we compared the efficacy of prophylactic versus emergent catheter placement for selective embolization in nine patients with or at risk for obstetric Hemorrhage. In four patients with acute obstetric Hemorrhage catheterization and embolization was carried out following the failure of initial medical and surgical approaches. In five patients determined to be at risk for Intrapartum Hemorrhage based on sonographic findings, catheters were inserted into the hypogastric vessels prior to elective cesarean delivery. Three of these five patients subsequently required selective embolization. In comparison to patients undergoing selective embolization following prophylactic catheter placement, patients in the emergent group all had a coagulopathy at the time of embolization, sustained substantially greater blood loss, and had an increased rate of postpartum complications. Finally, there was a significant reduction in total embolization time and therefore in radiation exposure in patients undergoing prophylactic catheter placement prior to selective embolization. These data support the conclusion that in patients determined to be at risk for Intrapartum or postpartum Hemorrhage the prophylactic placement of catheters allows for selective embolization in a hemodynamically intact patient with stable coagulation indices, theoretically reducing the risk of maternal morbidity and possibly mortality.
David A Cromwell - One of the best experts on this subject based on the ideXlab platform.
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Risk of placenta previa in second birth after first birth cesarean section: a population-based study and meta-analysis
BMC pregnancy and childbirth, 2011Co-Authors: Ipek Gurol-urganci, David A Cromwell, Leroy C. Edozien, Gordon C. S. Smith, Chidimma Onwere, Tahir Mahmood, A Templeton, Jan Van Der MeulenAbstract:Background: Objective: To compare the risk of placenta previa at second birth among women who had a cesarean section (CS) at first birth with women who delivered vaginally. Methods: Retrospective cohort study of 399,674 women who gave birth to a singleton first and second baby between April 2000 and February 2009 in England. Multiple logistic regression was used to adjust the estimates for maternal age, ethnicity, deprivation, placenta previa at first birth, inter-birth interval and pregnancy complications. In addition, we conducted a meta-analysis of the reported results in peer-reviewed articles since 1980. Results: The rate of placenta previa at second birth for women with vaginal first births was 4.4 per 1000 births, compared to 8.7 per 1000 births for women with CS at first birth. After adjustment, CS at first birth remained associated with an increased risk of placenta previa (odds ratio = 1.60; 95% CI 1.44 to 1.76). In the meta-analysis of 37 previously published studies from 21 countries, the overall pooled random effects odds ratio was 2.20 (95% CI 1.96-2.46). Our results from the current study is consistent with those of the meta-analysis as the pooled odds ratio for the six population-based cohort studies that analyzed second births only was 1.51 (95% CI 1.39-1.65). Conclusions: There is an increased risk of placenta previa in the subsequent pregnancy after CS delivery at first birth, but the risk is lower than previously estimated. Given the placenta previa rate in England and the adjusted effect of previous CS, 359 deliveries by CS at first birth would result in one additional case of placenta previa in the next pregnancy. Background Placenta previa can have serious adverse consequences for both mother and baby, including an increased risk of maternal and neonatal mortality[1-3], fetal growth restriction and preterm delivery[4], antenatal and Intrapartum Hemorrhage[5-7], and women may require a blood transfusion[8] or even an emergency hysterectomy. It is a relatively uncommon condition, with an overall incidence in England of 6.3 per 1000 births[9], but incidence rates are higher among women with advanced maternal age, multiple gestation, high parity, or who smoke or use illegal drugs[10]. The risk of placenta previa is also reported to be higher among women with previous uterine surgery, including cesarean section[11].
Leroy C. Edozien - One of the best experts on this subject based on the ideXlab platform.
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Risk of placenta previa in second birth after first birth cesarean section: a population-based study and meta-analysis
BMC pregnancy and childbirth, 2011Co-Authors: Ipek Gurol-urganci, David A Cromwell, Leroy C. Edozien, Gordon C. S. Smith, Chidimma Onwere, Tahir Mahmood, A Templeton, Jan Van Der MeulenAbstract:Background: Objective: To compare the risk of placenta previa at second birth among women who had a cesarean section (CS) at first birth with women who delivered vaginally. Methods: Retrospective cohort study of 399,674 women who gave birth to a singleton first and second baby between April 2000 and February 2009 in England. Multiple logistic regression was used to adjust the estimates for maternal age, ethnicity, deprivation, placenta previa at first birth, inter-birth interval and pregnancy complications. In addition, we conducted a meta-analysis of the reported results in peer-reviewed articles since 1980. Results: The rate of placenta previa at second birth for women with vaginal first births was 4.4 per 1000 births, compared to 8.7 per 1000 births for women with CS at first birth. After adjustment, CS at first birth remained associated with an increased risk of placenta previa (odds ratio = 1.60; 95% CI 1.44 to 1.76). In the meta-analysis of 37 previously published studies from 21 countries, the overall pooled random effects odds ratio was 2.20 (95% CI 1.96-2.46). Our results from the current study is consistent with those of the meta-analysis as the pooled odds ratio for the six population-based cohort studies that analyzed second births only was 1.51 (95% CI 1.39-1.65). Conclusions: There is an increased risk of placenta previa in the subsequent pregnancy after CS delivery at first birth, but the risk is lower than previously estimated. Given the placenta previa rate in England and the adjusted effect of previous CS, 359 deliveries by CS at first birth would result in one additional case of placenta previa in the next pregnancy. Background Placenta previa can have serious adverse consequences for both mother and baby, including an increased risk of maternal and neonatal mortality[1-3], fetal growth restriction and preterm delivery[4], antenatal and Intrapartum Hemorrhage[5-7], and women may require a blood transfusion[8] or even an emergency hysterectomy. It is a relatively uncommon condition, with an overall incidence in England of 6.3 per 1000 births[9], but incidence rates are higher among women with advanced maternal age, multiple gestation, high parity, or who smoke or use illegal drugs[10]. The risk of placenta previa is also reported to be higher among women with previous uterine surgery, including cesarean section[11].