Search

Your search keyword '"Ropacka, Mariola"' showing total 16 results
Start Over Author "Ropacka, Mariola"
16 results on '"Ropacka, Mariola"'

1. Maternal and neonatal outcomes in planned versus emergency cesarean delivery for placenta accreta spectrum

Author

Morlando, Maddalena, Schwickert, Alexander, Stefanovic, Vedran, Gziri, Mina M., Pateisky, Petra, Chalubinski, Kinga M., Nonnenmacher, Andreas, Morel, Olivier, Braun, Thorsten, Bertholdt, Charline, Beekhuizen, Heleen J. Van, Collins, Sally L., Calda, Pavel, Chantraine, Fredric, Duvekot, Johannes J., Fox, Karin A., Gronbeck, Lene, Henrich, Wolfgang, Martinelli, Pasquale, Paavonen, Jorma, Petit, Philippe, Rijken, Marcus, Ropacka, Mariola, Tikkanen, Minna, Weichert, Alexander, Weizsäcker, Katharina, International Society For Placenta Accreta Spectrum (IS‐PAS), HUS Gynecology and Obstetrics, Department of Obstetrics and Gynecology, Helsinki University Hospital Area, University of Helsinki, UCL - (SLuc) Service d'obstétrique, UCL - SSS/IREC/SLUC - Pôle St.-Luc, Università degli studi di Napoli Federico II, Università degli studi della Campania 'Luigi Vanvitelli', Freie Universität Berlin, Humboldt-Universität zu Berlin, Cliniques Universitaires Saint-Luc [Bruxelles], Université médicale de Vienne, Autriche, Service d'Obstétrique et de Gynécologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Erasmus University Medical Center [Rotterdam] (Erasmus MC), Nuffield (Nuffield), University of Oxford [Oxford], John Radcliffe Hospital [Oxford University Hospital], Morlando, Maddalena, Schwickert, Alexander, Stefanovic, Vedran, Gziri, Mina M, Pateisky, Petra, Chalubinski, Kinga M, Nonnenmacher, Andrea, Morel, Olivier, Braun, Thorsten, Bertholdt, Charline, Van Beekhuizen, Heleen J, Collins, Sally L, Obstetrics and Gynaecology, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Gynecological Oncology, and Obstetrics & Gynecology

Subjects
Emergency Medical Services, Databases, Factual, Maternal Health, Cohort Studies, maternal morbidity, placenta accreta spectrum, 0302 clinical medicine, Retrospective Studie, Pregnancy, 3123 Gynaecology and paediatrics, 030212 general & internal medicine, gestational age, ComputingMilieux_MISCELLANEOUS, 030219 obstetrics & reproductive medicine, Obstetrics, Pregnancy Outcome, Obstetrics and Gynecology, Gestational age, General Medicine, Pregnancy Complication, 3. Good health, Europe, Gestation, Female, medicine.symptom, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit, Human, United State, Adult, medicine.medical_specialty, Referral, Placenta accreta, Gestational Age, Hemorrhage, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Placenta Accreta, 03 medical and health sciences, abnormally invasive placenta, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Humans, Vaginal bleeding, Infant Health, Risk factor, Retrospective Studies, Antepartum hemorrhage, business.industry, Cesarean Section, neonatal morbidity, medicine.disease, Confidence interval, United States, Pregnancy Complications, Cohort Studie, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Introduction: Placenta accreta spectrum (PAS) is a condition often resulting in severe maternal morbidity. Scheduled delivery by an experienced team has been shown to improve maternal outcomes; however, the benefits must be weighed against the risk of iatrogenic prematurity. The aim of this study is to investigate the rates of emergency delivery seen for antenatally suspected PAS and compare the resulting outcomes in the 15 referral centers of the International Society for PAS (IS-PAS). Material and methods: Fifteen centers provided cases between 2008 and 2019. The women included were divided into two groups according to whether they had a planned or an emergency cesarean delivery. Delivery was defined as “planned” when performed at a time and date to suit the team. All the remaining cases were classified as “emergency”. Maternal characteristics and neonatal outcomes were compared between the two groups according to gestation at delivery. Results: In all, 356 women were included. Of these, 239 (67%) underwent a planned delivery and 117 (33%) an emergency delivery. Vaginal bleeding was the indication for emergency delivery in 41 of the 117 women (41%). There were no significant differences in terms of blood loss, transfusion rates or major maternal morbidity between planned and emergency deliveries. However, the rate of maternal intensive therapy unit admission was increased with emergency delivery (45% vs 33%, P =.02). Antepartum hemorrhage was the only independent predictor of emergency delivery (aOR: 4.3, 95% confidence interval 2.4-7.7). Emergency delivery due to vaginal bleeding was more frequent with false-positive cases (antenatally suspected but not confirmed as PAS at delivery) and the milder grades of PAS (accreta/increta). The rate of infants experiencing any major neonatal morbidity was 25% at 34+1 to 36+0 weeks and 19% at >36+0 weeks. Conclusions: Emergency delivery in centers of excellence did not increase blood loss, transfusion rates or maternal morbidity. The single greatest risk factor for emergency delivery was antenatal hemorrhage. When adequate expertise and resources are available, to defer delivery in women with no significant antenatal bleeding and no risk factors for pre-term birth until >36+0 weeks can be considered to improve fetal outcomes. Further studies are needed to investigate this fully.

Published
2021

2. Association of peripartum management and high maternal blood loss at cesarean delivery for placenta accreta spectrum (PAS)

Author

Schwickert, Alexander, Beekhuizen, Heleen J. Van, Bertholdt, Charline, Fox, Karin A., Kayem, Gilles, Morel, Olivier, Rijken, Marcus J., Stefanovic, Vedran, Strindfors, Gita, Weichert, Alexander, Weizsaecker, Katharina, Braun, Thorsten, Calda, Pavel, Chalubinski, Kinga M., Chantraine, Frederic, Collins, Sally, Duvekot, Johannes J., Gronbeck, Lene, Henrich, Wolfgang, Martinelli, Pasquale, Mhallem Gziri, Mina, Morlando, Maddalena, Nonnenmacher, Andreas, Paavonen, Jorma, Pateisky, Petra, Petit, Philippe, Ropacka, Mariola, Tikkanen, Minna, International Society For Placenta Accreta Spectrum (IS‐PAS), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Erasmus University Medical Center [Rotterdam] (Erasmus MC), Service d'Obstétrique et de Gynécologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Baylor College of Medecine, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), University Medical Center [Utrecht], University of Helsinki, Stockholm South Hospital, Medicine Charles University and General Faculty Hospital in Prague, Medizinische Universität Wien = Medical University of Vienna, Centre Hospitalier Universitaire de Liège (CHU-Liège), John Radcliffe Hospital [Oxford University Hospital], Rigshospitalet [Copenhagen], Copenhagen University Hospital, University of Naples Federico II, Cliniques Universitaires Saint-Luc [Bruxelles], University of the Study of Campania Luigi Vanvitelli, Helsinki University Hospital, Poznan University of Medical Sciences [Poland] (PUMS), Obstetrics and Gynaecology, BIRKER, Juliette, Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Helsingin yliopisto = Helsingfors universitet = University of Helsinki, University of Naples Federico II = Università degli studi di Napoli Federico II, Department of Obstetrics and Gynecology, University Management, HUS Gynecology and Obstetrics, Gynecological Oncology, and Obstetrics & Gynecology

Subjects
Databases, Factual, medicine.medical_treatment, [INFO.INFO-IM] Computer Science [cs]/Medical Imaging, Blood Loss, Surgical, Uterotonic, high&#8208, Conservative Treatment, Cohort Studies, 0302 clinical medicine, 3123 Gynaecology and paediatrics, Pregnancy, 030212 general & internal medicine, Embolization, hysterectomy, ComputingMilieux_MISCELLANEOUS, 030219 obstetrics & reproductive medicine, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Obstetrics, Obstetrics and Gynecology, General Medicine, 3. Good health, Europe, medicine.anatomical_structure, postpartum hemorrhage, Female, cesarean, Tranexamic acid, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit, medicine.drug, Adult, medicine.medical_specialty, placenta, Placenta accreta, Placenta Percreta, high-risk pregnancy, Placenta Accreta, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, [SDV.IB.MN] Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 03 medical and health sciences, abnormally invasive placenta, Placenta, risk pregnancy, medicine, Peripartum Period, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Humans, Patient Care Team, Hysterectomy, business.industry, Cesarean Section, uterine scar, medicine.disease, Arterial occlusion, United States, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

INTRODUCTION: Placenta accreta spectrum (PAS) carries a high burden of adverse maternal outcomes, especially significant blood loss, which can be life-threatening. Different management strategies have been proposed but the association of clinical risk factors and surgical management options during cesarean delivery with high blood loss is not clear. MATERIAL AND METHODS: In this international multicenter study, 338 women with PAS undergoing cesarean delivery were included. Fourteen European and one non-European center (USA) provided cases treated retrospectively between 2008 and 2014 and prospectively from 2014 to 2019. Peripartum blood loss was estimated visually and/or by weighing and measuring of volume. Participants were grouped based on blood loss above or below the 75th percentile (>3500 ml) and the 90th percentile (>5500 ml). RESULTS: Placenta percreta was found in 58% of cases. Median blood loss was 2000 ml (range: 150-20 000 ml). Unplanned hysterectomy was associated with an increased risk of blood loss >3500 ml when compared with planned hysterectomy (adjusted OR [aOR] 3.7 [1.5-9.4], p = 0.01). Focal resection was associated with blood loss comparable to that of planned hysterectomy (crude OR 0.7 [0.2-2.1], p = 0.49). Blood loss >3500 ml was less common in patients undergoing successful conservative management (placenta left in situ, aOR 0.1 [0.0-0.6], p = 0.02) but was more common in patients who required delayed hysterectomy (aOR 6.5 [1.7-24.4], p = 0.001). Arterial occlusion methods (uterine or iliac artery ligation, embolization or intravascular balloons), application of uterotonic medication or tranexamic acid showed no significant effect on blood loss >3500 ml. Patients delivered by surgeons without experience in PAS were more likely to experience blood loss >3500 ml (aOR 3.0 [1.4-6.4], p = 0.01). CONCLUSIONS: In pregnant women with PAS, the likelihood of blood loss >3500 ml was reduced in planned vs unplanned cesarean delivery, and when the surgery was performed by a specialist experienced in the management of PAS. This reinforces the necessity of delivery by an expert team. Conservative management was also associated with less blood loss, but only if successful. Therefore, careful patient selection is of great importance. Our study showed no consistent benefit of other adjunct measures such as arterial occlusion techniques, uterotonics or tranexamic acid.

Published
2021

5. A multicenter observational survey of management strategies in 442 pregnancies with suspected placenta accreta spectrum

Author

Beekhuizen, Heleen, Stefanovic, Vedran, Schwickert, Alexander, Henrich, Wolfgang, Fox, Karin, Mhallem Gziri, Mina, Sentilhes, Loïc, Gronbeck, Lene, Chantraine, Frederic, Morel, Oliver, Bertholdt, Charline, Braun, Thorsten, Rijken, Marcus, Duvekot, Johannes, Calda, Pavel, Chalubinski, Kinga, Collins, Sally, Martinelli, Pasquale, Morlando, Maddalena, Nonnenmacher, Andreas, Paavonen, Jorma, Pateisky, Petra, PETIT, Philippe, Ropacka, Mariola, Tikkanen, Minna, Tutschek, Boris, Weichert, Alexander, Weizsäcker, Katharina von, Erasmus University Medical Center [Rotterdam] (Erasmus MC), University of Helsinki, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Baylor College of Medecine, Cliniques Universitaires Saint-Luc [Bruxelles], CHU Bordeaux [Bordeaux], University of Copenhagen = Københavns Universitet (KU), Centre Hospitalier Universitaire de Liège (CHU-Liège), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service d'Obstétrique et de Gynécologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), University Medical Center [Utrecht], UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - (SLuc) Service d'obstétrique, Obstetrics and Gynaecology, HUS Gynecology and Obstetrics, Department of Obstetrics and Gynecology, Helsinki University Hospital Area, Gynecological Oncology, and Obstetrics & Gynecology

Subjects
medicine.medical_specialty, Placenta accreta, medicine.medical_treatment, Obstetric Surgical Procedures, Prenatal diagnosis, Hemorrhage, Placenta Accreta, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Conservative Treatment, Hysterectomy, 03 medical and health sciences, placenta accreta spectrum, 0302 clinical medicine, 3123 Gynaecology and paediatrics, Pregnancy, Placenta, Original Research Articles, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Humans, 030212 general & internal medicine, Original Research Article, ComputingMilieux_MISCELLANEOUS, Patient Care Team, Laparotomy, 030219 obstetrics & reproductive medicine, cesarean section, business.industry, Obstetrics, Vaginal delivery, Obstetrics and Gynecology, Gestational age, Abortion, Induced, General Medicine, medicine.disease, 3. Good health, Placenta previa, abnormal invasive placenta, medicine.anatomical_structure, postpartum hemorrhage, Female, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

INTRODUCTION: Management options for women with placenta accreta spectrum (PAS) comprise termination of pregnancy before the viable gestational age, leaving the placenta in situ for subsequent reabsorption of the placenta or delayed hysterectomy, manual removal of placenta after vaginal delivery or during cesarean section, focal resection of the affected uterine wall, and peripartum hysterectomy. The aim of this observational study was to describe actual clinical management and outcomes in PAS in a large international cohort. MATERIAL AND METHODS: Data from women in 15 referral centers of the International Society of PAS (IS-PAS) were analyzed and correlated with the clinical classification of the IS-PAS: From Grade 1 (no PAS) to Grade 6 (invasion into pelvic organs other than the bladder). PAS was usually diagnosed antenatally and the operators performing ultrasound rated the likelihood of PAS on a Likert scale of 1 to 10. RESULTS: In total, 442 women were registered in the database. No maternal deaths occurred. Mean blood loss was 2600 mL (range 150-20 000 mL). Placenta previa was present in 375 (84.8%) women and there was a history of a previous cesarean in 329 (74.4%) women. The PAS likelihood score was strongly correlated with the PAS grade (P

Published
2021

6. Developing a database for multicenter evaluation of placenta accreta spectrum

Author

Braun, Thorsten, Beekhuizen, Heleen J. Van, Morlando, Maddalena, Morel, Olivier, Stefanovic, Vedran, Al Naimi, Ammar, Bertholdt, Charline, Calda, Pavel, Chalubinski, Kinga M, Pateisky, Petra, Chantraine, Fredric, Petit, Philippe, Collins, Sally, Duvekot, Johannes J, Fox, Karin, Gronbeck, Lene, Henrich, Wolfgang, Nonnenmacher, Andreas, Schwickert, Alexander, Martinelli, Pasquale, Mhallem Gziri, Mina, Paavonen, Jorma, Tikkanen, Minna, Rijken, Marcus, Ropacka, Mariola, Strindfors, Gita, Weichert, Alexander, Weizsäcker, Katharina Von, International Society For Placenta Accreta Spectrum (IS‐PAS), Freie Universität Berlin, Humboldt-Universität zu Berlin, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Università degli studi della Campania 'Luigi Vanvitelli', Service d'Obstétrique et de Gynécologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), University of Helsinki, First Faculty of Medicine Charles University [Prague], Medizinische Universität Wien = Medical University of Vienna, Centre Hospitalier Universitaire de Liège (CHU-Liège), University of Oxford [Oxford], John Radcliffe Hospital [Oxford University Hospital], Baylor College of Medicine (BCM), Baylor University, Copenhagen University Hospital, Università degli studi di Napoli Federico II, Cliniques Universitaires Saint-Luc [Bruxelles], University Medical Center [Utrecht], Poznan University of Medical Sciences [Poland] (PUMS), Obstetrics and Gynaecology, Gynecological Oncology, Obstetrics & Gynecology, Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Braun, Thorsten, van Beekhuizen, Heleen J, Morlando, Maddalena, Morel, Olivier, and Stefanovic, Vedran

Subjects
Societies, Scientific, Databases, Factual, Placenta accreta, online database, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Placenta Accreta, computer.software_genre, Imaging data, 03 medical and health sciences, placenta accreta spectrum, 0302 clinical medicine, Pregnancy, abnormally invasive placenta, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Medicine, Humans, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, 030219 obstetrics & reproductive medicine, Data collection, case reporting form, Database, business.industry, Online database, Obstetrics and Gynecology, General Medicine, medicine.disease, Current analysis, 3. Good health, Female, business, computer, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit, Human
Abstract

Studies of rare, but complex clinical conditions require multicenter cooperation. The International Society for Placenta accreta spectrum (IS-PAS) have established a secure web-based database to analyze pregnancies complicated by PAS. By repeated in-person meetings of the IS-PAS, a core dataset was established. Then, a custom-made, secure online database, capable of receiving strictly anonymized patient-related textual and imaging data and allowing statistical queries was designed, tested, amended and implemented. Between 2008 and 2019, 14 IS-PAS centers across Europe and one center in the USA contributed data for all their PAS cases, containing pregnancy data for a total of 442 pregnant women. Data were analyzed by a designated data analysis sub-group of the IS-PAS. Center characteristics are presented. Based on experiences with previous versions, our new online database now allows an all-encompassing data collection. It has shown its usefulness in the current analysis project.

Published
2021
Full Text
View/download PDF

7. Association of peripartum management and high maternal blood loss at cesarean delivery for placenta accreta spectrum (PAS):A multinational database study

Author

Schwickert, Alexander, van Beekhuizen, Heleen J., Bertholdt, Charline, Fox, Karin A., Kayem, Gilles, Morel, Olivier, Rijken, Marcus J., Stefanovic, Vedran, Strindfors, Gita, Weichert, Alexander, Weizsaecker, Katharina, Braun, Thorsten, Calda, Pavel, Chalubinski, Kinga M., Chantraine, Frederic, Collins, Sally, Duvekot, Johannes J., Gronbeck, Lene, Henrich, Wolfgang, Martinelli, Pasquale, Mhallem Gziri, Mina, Morlando, Maddalena, Nonnenmacher, Andreas, Paavonen, Jorma, Pateisky, Petra, Petit, Philippe, Ropacka, Mariola, Tikkanen, Minna, Schwickert, Alexander, van Beekhuizen, Heleen J., Bertholdt, Charline, Fox, Karin A., Kayem, Gilles, Morel, Olivier, Rijken, Marcus J., Stefanovic, Vedran, Strindfors, Gita, Weichert, Alexander, Weizsaecker, Katharina, Braun, Thorsten, Calda, Pavel, Chalubinski, Kinga M., Chantraine, Frederic, Collins, Sally, Duvekot, Johannes J., Gronbeck, Lene, Henrich, Wolfgang, Martinelli, Pasquale, Mhallem Gziri, Mina, Morlando, Maddalena, Nonnenmacher, Andreas, Paavonen, Jorma, Pateisky, Petra, Petit, Philippe, Ropacka, Mariola, and Tikkanen, Minna

Abstract

Introduction: Placenta accreta spectrum (PAS) carries a high burden of adverse maternal outcomes, especially significant blood loss, which can be life-threatening. Different management strategies have been proposed but the association of clinical risk factors and surgical management options during cesarean delivery with high blood loss is not clear. Material and methods: In this international multicenter study, 338 women with PAS undergoing cesarean delivery were included. Fourteen European and one non-European center (USA) provided cases treated retrospectively between 2008 and 2014 and prospectively from 2014 to 2019. Peripartum blood loss was estimated visually and/or by weighing and measuring of volume. Participants were grouped based on blood loss above or below the 75th percentile (>3500 ml) and the 90th percentile (>5500 ml). Results: Placenta percreta was found in 58% of cases. Median blood loss was 2000 ml (range: 150-20 000 ml). Unplanned hysterectomy was associated with an increased risk of blood loss >3500 ml when compared with planned hysterectomy (adjusted OR [aOR] 3.7 [1.5-9.4], p = 0.01). Focal resection was associated with blood loss comparable to that of planned hysterectomy (crude OR 0.7 [0.2–2.1], p = 0.49). Blood loss >3500 ml was less common in patients undergoing successful conservative management (placenta left in situ, aOR 0.1 [0.0–0.6], p = 0.02) but was more common in patients who required delayed hysterectomy (aOR 6.5 [1.7–24.4], p = 0.001). Arterial occlusion methods (uterine or iliac artery ligation, embolization or intravascular balloons), application of uterotonic medication or tranexamic acid showed no significant effect on blood loss >3500 ml. Patients delivered by surgeons without experience in PAS were more likely to experience blood loss >3500 ml (aOR 3.0 [1.4–6.4], p = 0.01). Conclusions: In pregnant women with PAS, the likelihood of blood loss >3500 ml was reduced in planned vs unplanned cesarean deliver

Published
2021

9. Maternal Side-Effects After Multiple Courses of Antenatal Corticosteroids (MACS): The Three- Month Follow-Up of Women in the Randomized Controlled Trial of MACS for Preterm Birth Study

Author

Murphy, Kellie E., Hannah, Mary E., Willan, Andrew R., Ohlsson, Arne, Kelly, Edmond N., Matthews, Stephen G., Saigal, Saroj, Asztalos, Elizabeth, Ross, Sue, Delisle, Marie-France, Tomat, Laura, Amankwah, Kofi, Guselle, Patricia, Gafni, Amiram, Lee, Shoo K., Anthony Armson, B., Group, for the MACS Collaborative, Murphy, Kellie E., Amankwah, Kofi, Armson, B. Anthony, Asztalos, Elizabeth, Delisle, MarieFrance, Gafni, Amiram, Guselle, Patricia, Hannah, Mary E., Hewson, Sheila A., Kelly, Edmond N., Lee, Shoo K., Matthews, Stephen G., Ohlsson, Arne, Ross, Sue, Rovet, Joanne, Saigal, Saroj, Sananes, Renee, Schmid, Isabelle, Willan, Andrew R., Kwiatkowski, Leonardo, Tortorella, Susana Marisa, Bertin, Marta Susana, Castaldi, José Luis, Deguer, Carlos, Klun, Milton, Besegato, Cintia, Izbizky, Gustavo, Vaneri, Maria Cristina, Fustinana, Carlos Alberto, Otano, Lucas, Palermo, Mario S.F., Murua, Emerson Javier, Valera, Dolores Montes, Sampietro, Hector, Monaco, Antonio, Savransky, Argentina Ricardo, Dunaiewsky, Armando, Basualdo, Maria Natalia, Andina, Elsa, Di Marco, Ingrid, Rivero, Mabel, Feu, Maria Celeste, Garcia, Sergio, Aguirre, Jesus Daniel, Morales, Elba Mirta, Ayala, Liana Elisa, De Sagastizabal, Maria Teresa, Abreo, Griselda, Uranga, Alfredo, Martin, Raquel de Lourdes, Arias, Carlos, Gorostiaga, Raul Abalos, Curioni, Miguel, Alvarado, Jorge, Fuchtner, Carlos, Flores, Desiree Mostajo, Tonoli Tessari, Dilma Maria, Madi, Jose Mauro, de Lorenzi, Dino Roberto Soares, Mattana, Maria do Carmo, Brunstein, Carla, Trapani, Alberto, Schmaltz, Luiza, de Souza, Goianice Ribero, de Assis, Maria Elaine, Melo Melgaco, Irene Angela, Moreira de Sa, Renato Augusto, Bornia, Rita Guerios, Demianczuk, Nestor N, Penttinen, Elizabeth, Butt, Kimberly, Hay, Kathryn, Sandwich, Vicki, Armson, B Anthony, Vincer, Michael, Allen, Victoria, Fanning, Cora, Kulkarni, Ramesh, Laplante, Joanne, Carson, George D, Williams, Suzanne, Holfeld, Sandy, Olatunbosun, Femi, Dalton, Shirley, Henry, April, Haughian, Janna, Moutquin, Jean-Marie, Blouin, Daniel, Bédard, Suzanne Kocsis, Murphy, Kellie, Ohlsson, Arne, Kelly, Edmond, Jordan, Anne, Shapiro, Jodi, Asztalos, Elizabeth, Barrett, Jon, Cohen, Howard, Andrews, Leigh, Owen, Holly, Delisle, Marie-France, Popovska, Vesna, Soanes, Shelley, Helewa, Michael E, Kenny-Lodewyks, Doris, Gomez, Ricardo, Silva, Karla, Poblete, Jorge Figueroa, Ferrand, Pedro, Belmar, Cristian, Vera, Claudio, Su, Qi Feng, Gu, Wei, Liu, Zhi Wei, Flores, Martha Marrugo, Santoro, Carlos Malabet, Ortiz, Edgar Ivan, Torres, Javier, Rodriguez, Adriana, Hvidman, Lone, Mouritzen, Anne, Vikre-Jørgensen, Jennifer, Hopp, Hartmut, Nonnenmacher, Andreas, Braig, Ute, Berg, Christoph, Bizjak, Gabriele, Gembruch, Ulrich, Schwarzer, Verena, Hoyme, U B, Bittrich, Hans-Jorg, Oletzky, Britta, Schneider, Joachim, Hollwitz, Bettina, Oehler, Katrin, Dressler, Frank, Ertan, A Kubilay, Hentschel, Juliane, Mack, Annegret, Schmidt, W., Faber, Renaldo, Stepan, Holger, Kuhnert, Maritta, Stiller, Susanne, Kuschel, Bettina, Schneider, K.T.M., Zimmermann, Andrea, Krause, Michael, Gröbe, H, Terzioglu, Neslisah, Seelbach-Goebel, Birgit, Falkert, Andreas, Mueller, Karin, Voss, Hana, Major, Tamas, Zoärd, Krasznai, Bartha, Tünde, Bea, Polonkai, Zsadänyi, Judit, Nachum, Zohar, Peniakov, Marina, Hallak, Mordechai, Harlev, Avraham, Harel, Linda, Chayen, Benny, Siev, Sima, Samberg, Ichel, Wolff, Leslie, Sadan, Oscar, Elyassi, Anat, Baider, Carolina, Kohelet, David, Golan, Abraham, Mankuta, David, Bar-Oz, Benjamin, Combs, Danielle, Rosen, Doron J.D., Kaneti, Hagai Y., Tzachi, Tal, Zausmer, Janice, Maman, Maor, Perri, Tamar, Taitelboum, Shani, Simchen, Michal, Shalev, Gilat, Goldinfeld, Michael, Levine, Orit, El-Zibdeh, Mazen Y, Al-Faris, Lama T, Ayyash, Hussein A, Ugarte, Pedro Saona, Preis, Krzysztof, Domzalska-Popadiuk, Iwona, Swiatkowska-Freund, Malgorzata, Janczewska, Iwona, Wilczynski, Jan, Krekora, Michael, Kesiak, Marcin, Gulczynska, Ewa, Ropacka, Mariola, Madejczyk, Mateusz, Rozycka, Joanna, Breborowicz, Grzegorz H, Szymankiewicz, Marta, Borzova, Nadezhda, Posiseeva, Lubov V, Khodjaeva, Zulfiya, Vikhlyaeva, Ekaterina, Palacio, Montse, Salvia, Dolors, Botet, Francesc, Massanes, Marta, Lopez, Marta, Hösli, Irene, Holzgreve, Wolfgang, Voekt, Cora A., Belhia, Fadhil, Hohlfeld, Patrick, Prince-dit-Clottu, Edmond, Beinder, Ernst, von Mandach, Ursula, Fauchere, Jean-Claude, Roumen, Frans J.M.E., Pieters, Mijntje, Smits, Frans, Bolaji, Ibrahim I, Adiotomre, Pauline, Al-Taher, Hamed, Barnes, Hayley, Abdul-Kadir, Rezan, Chi, Claudia, Van Someren, Vivienne, Dexter, Scott, Samelson, Renee, Horgan, Michael J, Valentini, Cathryn, Pardanani, Setul, Bebbington, Michael, Chazotte, Cynthia, Kilpatrick, Sarah, Drahos, Jessica L., Saldana, Luis, Mount, Beverly, Warner, Barbara, Wedig, Kathy, Lysikiewicz, Andrzej, Bsat, Fadi, Fleming, Jennie, Lee, Alison, Hoffman, Despina, Bracken, Michael, Crowley, Patricia, Donner, Allan, Duley, Lelia, and Tyson, Jon

Abstract

A single course of antenatal corticosteroids (ACS) is associated with a reduction in respiratory distress syndrome and neonatal death. Multiple Courses of Antenatal Corticosteroids Study(MACS), a study involving 1858 women, was a multicentre randomized placebo-controlled trial of multiple courses of ACS, given every 14 days until 33+6 weeks or birth, whichever came first. The primary outcome of the study, a composite of neonatal mortality and morbidity, was similar for the multiple ACS and placebo groups (12.9% vs. 12.5%), but infants exposed to multiple courses of ACS weighed less, were shorter, and had smaller head circumferences. Thus for women who remain at increased risk of preterm birth, multiple courses of ACS (every 14 days) are not recommended. Chronic use of corticosteroids is associated with numerous side effects including weight gain and depression The aim of this postpartum assessment was to ascertain if multiple courses of ACS were associated with maternal side effects.

Published
2011
Full Text
View/download PDF

10. Treatment Options for the Twin?Twin Transfusion Syndrome: A Review

Author

Ropacka, Mariola, Markwitz, Wieslaw, and Blickstein, lsaac

Abstract

AbstractThis article reviews the treatment options of the twin?twin transfusion syndrome (TTTS). No single therapy is associated with a uniformly improved outcome for the involved twins and success is primarily related to gestational age and severity at diagnosis. Treatment options for severe cases include digitalization, ligation of the umbilical cord, serial amniocenteses, septostomy, laser occlusion of placental vessels, and selective feticide. These modalities are associated with significant risks of complications, and variable results of fetal morbidity and mortality. Therefore, they should be considered when risks of withholding treatment clearly outweigh those associated with intervention.

Published
2002
Full Text
View/download PDF

11. The possible role of the PK1 and its receptor in the etiology of the preeclampsia.

Author

Szuber M, Markwitz W, Ropacka M, and Breborowicz GH

Subjects
Female, Gastrointestinal Hormones metabolism, Gene Expression physiology, Humans, Myometrium physiology, Placenta physiology, Pre-Eclampsia metabolism, Pregnancy, RNA, Messenger metabolism, Receptors, G-Protein-Coupled metabolism, Signal Transduction physiology, Vascular Endothelial Growth Factor, Endocrine-Gland-Derived metabolism, Gastrointestinal Hormones genetics, Pre-Eclampsia etiology, Pre-Eclampsia physiopathology, Receptors, G-Protein-Coupled genetics, Vascular Endothelial Growth Factor, Endocrine-Gland-Derived genetics
Abstract

Objective: Preeclampsia (PE) is a hypertensive complication of the pregnancy. In our study we investigated the expression, localization, and signaling pathways of PK1 and PKR1 in third-trimester human placenta and myometrium and assessed the correlation between the PK1 and PKR1 expression and signaling and the incidence of the PE., Materials & Methods: We designed two study groups: pregnant PE patients and healthy, pregnant women. After collection, tissue was placed in RNAlater for RNA extraction, fixed in 4% neutral buffered formalin, and wax embedded for immunohistochemistry or placed in RPMI and transported to the laboratory for in vitro culture. We have collected and processed placental and myometrial biopsies from 40 patients - 19 were PE patients., Results: Only the PK1 mRNA expression comparison between PE and CTRL in placenta showed statistically significant difference (p=0.004). There was statistically significant difference in cell signaling in myometrium controls in 30 minutes after ligand. The rise in pERK/tERK ratio is clearly visible in time intervals 20 and 30 minutes in controls, although with no statistical significance. There was no difference in PK1 and PKR1 localization in the placenta and myometrium in the groups., Conclusions: The number of PKR1 is not reduced in PE. The reduced PK1 mRNA expression is not than dependent on PKR1 mRNA expression. The data shows that ST produces much more PK1 in healthy pregnant women than those suffering from PE. We can conclude that in PE the production of PK1 is impaired and so are the endocrine functions of the ST.

Published
2011

12. [Avoiding common mistakes in FHR monitoring. (Part I). Too short monitoring].

Author

Markwitz W and Ropacka M

Subjects
Diagnosis, Differential, Female, Fetal Distress diagnosis, Humans, Infant, Newborn, Practice Guidelines as Topic, Pregnancy, Prenatal Care methods, Time Factors, Cardiotocography methods, Diagnostic Errors prevention & control, Heart Rate, Fetal physiology, Prenatal Diagnosis methods
Published
2008

13. [CTG--sinusoidal tracing].

Author

Markwitz W and Ropacka M

Subjects
Adult, Female, Fetal Monitoring, Humans, Cardiotocography, Fetal Distress diagnosis, Fetal Hypoxia diagnosis
Published
2007

14. [Practical cardiotocography].

Author

Markwitz W and Ropacka M

Subjects
Clinical Competence, Female, Fetal Distress prevention & control, Humans, Infant, Newborn, Obstetric Labor, Premature diagnosis, Pregnancy, Pregnancy Outcome, Cardiotocography methods, Fetal Distress diagnosis, Image Interpretation, Computer-Assisted methods
Published
2007

15. [Fetal brain blood flow velocity monitoring in high risk pregnancies].

Author

Dubiel M, Korszun P, Ropacka M, and Breborowicz G

Subjects
Blood Flow Velocity, Central Nervous System Vascular Malformations diagnosis, Central Nervous System Vascular Malformations diagnostic imaging, Central Nervous System Vascular Malformations physiopathology, Cerebral Veins diagnostic imaging, Cerebral Veins embryology, Female, Fetal Diseases diagnostic imaging, Gestational Age, Hemorheology, Humans, Infant, Newborn, Predictive Value of Tests, Pregnancy, Ultrasonography, Doppler, Color, Central Nervous System Vascular Malformations embryology, Cerebral Veins abnormalities, Cerebrovascular Circulation, Fetal Diseases diagnosis, Pregnancy, High-Risk, Ultrasonography, Prenatal
Abstract

Objectives: Blood velocity in the fetal vein of Galen and straight sinus is normally even and without fluctuation. Transverse sinus blood velocity pattern shows a characteristic triphasic shape. The aim of this study was to establish whether blood flow velocity pulsations in the Galen vein, straight sinus and transverse sinus velocimetry in high-risk pregnancies are related to an adverse outcome., Materials and Methods: The Galen vein, straight sinus and transverse sinus were located by color Doppler ultrasound in 110 pregnancies complicated by pregnancy-induced hypertension and intra-uterine growth retardation with blood velocity recorded by pulsed Doppler. The incidences of blood velocity pulsations in Galen vein and straight sinus as well as peak systolic velocity, lowest diastolic velocity and resistance index (RI) from transverse sinus were correlated to pregnancy outcome, including emergency operative intervention and/or neonatal distress. Umbilical artery and venous and uterine and middle cerebral artery blood velocity was also recorded at the same time., Results: Pulsating blood velocity in the Galen vein and transverse sinus was found in 40 and 10 cases, respectively. Signs of brain sparing in the middle cerebral artery were seen in 23 fetuses. Abnormal values for RI, peak systolic velocity and lowest diastolic velocity from transverse sinus were found in 20.6 and 18 cases, respectively. Galen vein pulsations were highly significantly related to adverse outcome of pregnancy and significantly more frequent in the present study than in the umbilical vein. Parameters studied in straight sinus and transverse sinus showed poor correlation with outcome of pregnancy., Conclusions: Venous pulsations in the Galen vein are significantly correlated to adverse outcome of high-risk pregnancy. Straight sinus and transverse sinus velocimetry was not associated with perinatal outcome and might not be useful in predicting fetal distress.

Published
2003

16. Treatment options for the twin-twin transfusion syndrome: a review.

Author

Ropacka M, Markwitz W, and Blickstein I

Subjects
Female, Humans, Pregnancy, Fetofetal Transfusion therapy
Abstract

This article reviews the treatment options of the twin-twin transfusion syndrome (TTTS). No single therapy is associated with a uniformly improved outcome for the involved twins and success is primarily related to gestational age and severity at diagnosis. Treatment options for severe cases include digitalization, ligation of the umbilical cord, serial amniocenteses, septostomy, laser occlusion of placental vessels, and selective feticide. These modalities are associated with significant risks of complications, and variable results of fetal morbidity and mortality. Therefore, they should be considered when risks of withholding treatment clearly outweigh those associated with intervention.

Published
2002
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results