oxytocin and Blood-Coagulation-Disorders

Postpartum haemorrhage is the leading cause of maternal death in France and worldwide. Guidelines help to conduct a timed management and to reduce maternal morbidity and mortality. Rescue and surgical care, transfusion and monitoring have to be previously organized.

Topics: Anemia, Iron-Deficiency; Biomarkers; Blood Banks; Blood Coagulation Disorders; Blood Transfusion; Delivery, Obstetric; Emergencies; Female; Fibrinolysis; Hemostatics; Humans; Oxytocin; Postpartum Hemorrhage; Practice Guidelines as Topic; Pregnancy; Pregnancy Complications, Hematologic

Topics: Abortifacient Agents; Abortion, Induced; Abortion, Legal; Blood Coagulation Disorders; Female; Hemorrhage; Humans; Hypernatremia; Hypertonic Solutions; Infections; Osmolar Concentration; Oxytocin; Phospholipids; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Second; Pregnanediones; Progesterone; Prostaglandins; Sodium Chloride; Time Factors; Vacuum Extraction, Obstetrical; Water Intoxication

Topics: Blood Coagulation Disorders; Cervix Uteri; Dilatation; Electricity; Female; Fetal Death; Humans; Hypertonic Solutions; Infant, Newborn; Jaundice, Neonatal; Labor, Induced; Labor, Obstetric; Oxytocin; Pregnancy; Prostaglandins; Regional Blood Flow; Sodium Chloride; Time Factors; Urination; Uterus; Water Intoxication

Postpartum haemorrhage (PPH) remains the leading cause for maternal mortality worldwide. Hypofibrinogenaemia has been identified as a major risk factor for progress towards severe PPH. The efficacy of fibrinogen concentrate supplementation in PPH has been shown in various clinical settings but the level of evidence is not sufficient to prove the benefit, evaluate the risks, and determine the value, timing and dose of fibrinogen supplementation in PPH. The FIDEL trial objective is to evaluate the impact of a therapeutic strategy based on the early administration of human fibrinogen concentrate compared to the current practice based on late administration in severe PPH patients requiring second line uterotonics.. This is a prospective multicentre, randomised, double-blind, placebo-controlled trial. A total of 412 patients will be randomised if they meet the following criteria: female patients≥18 years old, vaginal delivery, PPH requiring IV administration of prostaglandins (sulprostone) after 20 to 30minutes of oxytocin failure. The participants are assigned to receive either fibrinogen 3g or placebo infusions. The primary endpoint is a composite endpoint defined as the percentage of patients losing at least 4g/dL of Hb, and/or requiring a transfusion of at least 2 units of packed red blood cells, within the 48hours following fibrinogen administration.. The purpose of this study is to demonstrate the efficacy and safety of an early fibrinogen concentrate infusion in uncontrolled active PPH.

Topics: Adolescent; Adult; Blood Coagulation Disorders; Delivery, Obstetric; Dinoprostone; Double-Blind Method; Female; Fibrinogen; Hemostatics; Humans; Monitoring, Physiologic; Oxytocics; Oxytocin; Patient Safety; Postpartum Hemorrhage; Pregnancy; Prospective Studies; Treatment Failure; Young Adult

The world's understanding of COVID-19 continues to evolve as the scientific community discovers unique presentations of this disease. This case report depicts an unexpected intraoperative coagulopathy during a cesarean section in an otherwise asymptomatic patient who was later found to have COVID-19. This case suggests that there may be a higher risk for intrapartum bleeding in the pregnant, largely asymptomatic COVID-positive patient with more abnormal COVID laboratory values.. The case patient displayed D-Dimer elevations beyond what is typically observed among this hospital's COVID-positive peripartum population and displayed significantly more oozing than expected intraoperatively, despite normal prothrombin time, international normalized ratio, fibrinogen, and platelets.. There is little published evidence on the association between D-Dimer and coagulopathy among the pregnant population infected with SARS-CoV-2. This case report contributes to the growing body of evidence on the effects of COVID-19 in pregnancy. A clinical picture concerning for intraoperative coagulopathy may be associated with SARS-CoV-2 infection during cesarean sections, and abnormal COVID laboratory tests, particularly D-Dimer, may help identify the patients in which this presentation occurs.

Topics: Adult; Antifibrinolytic Agents; Betacoronavirus; Blood Coagulation Disorders; Blood Loss, Surgical; Breech Presentation; C-Reactive Protein; Cautery; Cesarean Section; Coronavirus Infections; COVID-19; Female; Fibrin Fibrinogen Degradation Products; Fibrinogen; Hemostasis, Surgical; Humans; International Normalized Ratio; Methylergonovine; Oligohydramnios; Oxytocics; Oxytocin; Pandemics; Platelet Count; Pneumonia, Viral; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Complications, Infectious; Prothrombin Time; SARS-CoV-2; Tranexamic Acid; Uterine Inertia

The delivery haemorrhage is actually a problem of public health. It is responsible of 31.5 % of the maternal death in Tunisia. The goal of this work is to study the frequency of this complication, its gravity, its risk factors, its etiologists and its methods of treatment. It is a retrospective study. of 65 cases of delivery haemorrhage recorded to the obstetric gynaecology service "C" of the centre of motherhood and neonatology of Tunis during 4 years. The frequency of the delivery haemorrhage in our study is 1.19%. The middle age of the patient is of 31 years. Their middle parity is 2.4. Factors of risk taking out again our set are: gestational toxemia (35.4%), primiparity (33.8%), advanced maternal age (30.7%), pre-existent anaemia (24.6%). the uterine surdistension (21.3%), an abnormal middle length of labour (69.6%). use of oxytocin during labour (34%), induction (21.5%). Etiologists in our set are: atone in 63% of cases, retained placenta in 31.2% des cases, coagulopathie (9.2%), placenta previa (1.5%), uterine inversion (1.5%). The hold must be in charge multidisciplinary, systematized, precocious and dynamic.

Topics: Adult; Age Factors; Anemia; Blood Coagulation Disorders; Female; Humans; Labor Stage, Second; Maternal Age; Oxytocics; Oxytocin; Parity; Placenta, Retained; Postpartum Hemorrhage; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Hematologic; Retrospective Studies; Risk Factors; Tunisia; Uterine Inertia

Placental abruption resulting in fetal death may seriously affect maternal health, especially when clotting disorders arise. The prevailing view is that the clotting system will only normalize after the uterus has been evacuated and therefore prompt delivery, often by induction of labor, is advocated. Over a 3-year period, 16 cases (0.35%) of intra-uterine fetal death due to placental abruption occurred at Leiden University Hospital. Five cases were complicated by severe clotting disorders. All women delivered vaginally. No maternal deaths occurred. In contrast to most authors, we present data showing that in four out of five cases the clotting system started to normalize before the uterus was emptied. We suggest that an expectant approach until recovery of the coagulopathy is safer than aiming at a quick delivery. After stabilization of the clotting disorder, one may then consider evacuation of the uterus, if need be by induction of labor.

Topics: Abruptio Placentae; Adult; Blood Coagulation Disorders; Blood Component Transfusion; Cesarean Section; Female; Fetal Death; Humans; Oxytocin; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy Complications, Hematologic; Pregnancy Trimester, Third; Prostaglandins; Uterine Hemorrhage

Topics: Blood Coagulation Disorders; Female; Humans; Methylergonovine; Oxytocin; Placenta Diseases; Postpartum Hemorrhage; Pregnancy; Prostaglandins; Uterine Inertia

Topics: Abortion, Induced; Adenocarcinoma; Blood Coagulation Disorders; Carcinoma in Situ; Carcinoma, Squamous Cell; Curettage; Dilatation; Embryo, Mammalian; Female; Fetus; Gestational Age; Humans; Hypernatremia; Hypertonic Solutions; Lymphatic Metastasis; Oxytocin; Pregnancy; Prognosis; Thromboplastin; United States; Uterine Cervical Neoplasms; Uterine Neoplasms; Vaginal Smears

Topics: Aprotinin; Blood Coagulation Disorders; Cesarean Section; Cyanosis; Embolism, Amniotic Fluid; Female; Fibrinogen; Humans; Hypotension; Infusions, Parenteral; Oxytocin; Plasminogen; Polyhydramnios; Posture; Pregnancy; Pregnancy Complications, Cardiovascular; Shock; Syndrome; Uterine Hemorrhage; Vena Cava, Inferior

Topics: Blood Coagulation Disorders; Blood Coagulation Tests; Female; Humans; Obstetric Labor Complications; Oxytocin; Polyvinyl Alcohol; Pre-Eclampsia; Pregnancy

Topics: Blood Coagulation Disorders; Female; Humans; Injections, Intramuscular; Injections, Intravenous; Obstetric Labor Complications; Oxytocin; Postpartum Hemorrhage; Pregnancy

Topics: Blood Coagulation Disorders; Female; Fibrinogen; Humans; Labor, Induced; Oxytocin; Perfusion

Topics: Afibrinogenemia; Anti-Bacterial Agents; Australia; Blood Coagulation Disorders; Erythroblastosis, Fetal; Female; Fetal Death; Humans; Infant, Newborn; Labor, Induced; Oxytocin; Pregnancy; Pregnancy Complications, Hematologic; Rh-Hr Blood-Group System; Stillbirth

Topics: Abortion, Induced; Abortion, Missed; Abortion, Spontaneous; Blood Coagulation Disorders; Female; Humans; Oxytocin; Pregnancy