Articles: placenta-previa-surgery.
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Letter Case Reports
Recombinant factor VIIa in massive obstetric haemorrhage.
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J. Matern. Fetal. Neonatal. Med. · Dec 2007
Case ReportsIn utero laser treatment of type II vasa previa.
Vasa previa, defined as fetal vessels coursing within the membranes between the presenting part and the cervix, occurs in approximately 1:2500-5000 pregnancies. Type II vasa previa consists of fetal vessels crossing over the internal os connecting a bilobed placenta or a succenturiate lobe with the main placental mass. These vessels are prone to compression during labor or may tear when membranes rupture potentially resulting in fetal exsanguination and neonatal death. ⋯ The purpose of this communication is to report the successful in utero laser ablation of type II vasa previa at 22.5 weeks of gestation. Subsequent ruptured membranes did not result in untoward fetal consequences. Risks and benefits of this novel procedure are discussed.
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The study was conducted to determine whether placenta previa increases bleeding during gemeprost-induced termination of second-trimester pregnancy. ⋯ The use of gemeprost for second-trimester pregnancy termination in women with placenta previa seems to be relatively safe and does not increase intraoperative blood loss in the majority of cases.
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Comparative Study
[Anesthetic management for cesarean section involving placenta previa].
There are few consistent anesthetic guidelines how to manage cesarean section in the presence of placenta previa. Main problem may be hemorrhage, as occasionary unexpected massive bleeding leads to life-threatening hemorrhage. ⋯ These results indicate that regional and general anesthesia did not differ in the intraoperative incidence. In all cases at least two anesthesiologists and at least two venous lines are necessary to manage cesarean section in the presence of placenta previa.
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Case Reports
Anesthesia for cesarean section in a patient with placenta previa and methylenetetrahydrofolate reductase deficiency.
We describe the anesthetic management of a patient with placenta previa presenting for a cesarean section, who had methylenetetrahydrofolate reductase (MTHFR) deficiency. Methylenetetrahydrofolate reductase deficiency increases homocysteine levels in the body and, therefore, predisposes to thrombosis. After a cerebrovascular accident at 8 weeks of gestational age, the patient received anticoagulants throughout the course of her pregnancy. ⋯ Thus, we chose a subarachnoid block because the patient remained hemodynamically stable, and anticoagulation had been stopped 8 hours before surgery. To our knowledge, there is no reported case of a parturient with MTHFR deficiency complicated with a cerebrovascular accident and associated with placenta previa presenting for a cesarean section. Anesthetic considerations are discussed in patients presenting with placenta previa associated with MTHFR deficiency.