Ayati S, Vahidroodsari F, Talebian M,
Volume 69, Issue 6 (9-2011)
Abstract
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Background: Placenta accreta is a life-threatening complication after previous cesarean
delivery. The aim of this case report is to present a case of placenta percreta
with bladder involvement and subsequent maternal death.
Case
presentation: The patient was a 37-year
old who had an unwanted pregnancy due to tubectomy failure two years afterwards.
She was hospitalized at 26th and 30th week of gestation
because of gross hematuria. Sonography reported placenta previa. Cesarean section
was performed at 34th gestational week. Due to severe hemorrhage, hysterectomy with resection of some
part of the bladder was done. Died at the operating room after four hours of
severe uncontrollable hemorrhage.
Conclusion: The increasing prevalence of different forms of placenta accreta is the result
of the ever-increasing rate of cesarean deliveries. One of the strategies to
prevent this catastrophic obstetric complication is decreasing the number of cesarean
deliveries without appropriate indications.
Mohammad Sarani , Zahra Shahraki , Mahboobeh Shirazi , Soleiman Saravani ,
Volume 72, Issue 9 (12-2014)
Abstract
Background: Maternal mortality is one of the most important indicators of women health standard in developing countries. This study aimed to determine the prevalence of risk factors and etiology of maternal mortality in a geographic region of Iran.
Methods: This descriptive- analytic cross sectional study included all pregnant women who died during pregnancy and six weeks after delivery due to pregnancy related fac-tor. The study was done in Sistan region in the north of Sistan and Baluchestan Prov-ince of Iran from April 2002 to March 2014. The immigrant women were excluded. Data were collected using 3 parts questionnaire. The validity and reliability of ques-tioner were approved by experts in this field. Data were analyzed using the statistical software SPSS version 18, Chi-square test and ANOVA analysis were performed.
Results: The total number of deliveries during this time period was 60496. The total number of maternal mortality was 57 patients which means 94.2 out of 100.000 live births. Most of the dead mothers had more than 35 years old (46.9%), gestational age was more than 22 weeks (77.2%), gravidity more than 4 (21.1%), pregnancy interval lower than two years (46.9%) and 75.4% of death was in post-partum. The main cause of mortality was post-partum hemorrhage (19.3%).
Conclusion: Based on our findings, some factors including multiparity, pregnancy his-tory more than 4 times, short interval between pregnancies lower than 2 years and ma-ternal age more than 35 years were some risk factors for maternal death. Maternal mortality in the postpartum period was more than pre-delivery period. Bleeding was the main cause of maternal mortality. Therefore monitoring of vital signs in the post-partum period and the proper management of bleeding are very important. It is sug-gested that risk assessment should be done for pregnant women in delivery ward for detecting high risk pregnant women. Suitable management for these women especially for patients with postpartum hemorrhage plays an important role to decrease the ma-ternal mortality.
