Abruptio Placentae

Researchers have investigated the relation between 40-year-old women's pregnancy history and later risk of dying of cardiovascular diseases. Within each level of total number of pregnancies women had by age 40, mortality risk increased with increasing number of complicated pregnancies. Researchers from University of Bergen have investigated the relation between 40-year-old women's pregnancy history and later risk of dying of cardiovascular diseases. It is established that women with a complication of pregnancy are at about 2-fold increased risk of later cardiovascular disease. However, most previous studies have focused on individual complications and not full pregnancy histories. "Pregnancy history is a unique feature of women's health, readily available at no cost, and relevant to the most frequent cause of death facing women," says Associate Professor, Liv Grimstvedt Kvalvik at the Department of Global Public Health and Primary Care, University of Bergen, Norway She has, together with Researchers at National Institute of Environmental Health Sciences, USA and colleagues at the University of Bergen, investigated the link between a woman's total pregnancy history at 40 years of age and her relative risk of dying from atherosclerotic cardiovascular disease (ASCVD). The article is published in the Journal of the American Heart Association. Five-time and even higher risk of dying of cardiovascular disease. The study combined several Norwegian registries covering the period 1967 to 2020. More than 800,000 women surviving to 40 years of age were identified. The main outcome was the time to ASVC mortality through age 69 years. The exposure was a woman's number of recorded pregnancies, from zero to four, and the number of those with complications, such as preterm delivery before 35 gestational weeks, preeclampsia (high blood pressure and protein in the urine), placental abruption (when the placenta separates from the uterus), perinatal death, and term or near-term birth weight less than 2700 grams. They found that pregnancy history at 40 years of age is strongly associated with ASCVD mortality: "Among women reaching 40 years of age, risk of ASCVD mortality through 69 years of age increased with the number of complicated pregnancies in a strong dose-response fashion," says Kvalvik. Within each level of total number of pregnancies women had by age 40, mortality risk increased with increasing number of complicated pregnancies. Women with more than one complicated pregnancy by 40 years of age can have an increased risk of 3-5-fold and even greater. In comparison, women with the lowest with 3 pregnancies without complications, had the lowest ASCVD mortality risk. Might benefit from interventions at an early age. "There is increasing scientific evidence supporting the associations between adverse pregnancy outcomes and later CVD, even as women with complications may be unaware of their increased CVD risk," says Kvalvik and adds: "Our findings support the potential use of complete pregnancy history to identify relatively young women who might benefit from interventions to reduce cardiovascular mortality and morbidity before other clinical indicators of CVD risk have fully emerged."

BEIJING, Sept. 13, 2023 /PRNewswire/ -- At 1.28 am, obstetrician Zhang Qian finally heard the loud cry of a baby. It was a healthy baby girl. Zhang breathed a sigh of relief performing after a nerve-racking hour-long C-section on a Moroccan patient. While in surgery at a Moroccan hospital, Zhang felt aftershock tremors from the earthquake that had rocked the North African country just two hours prior. A powerful quake struck Morocco Friday night, with the toll expected to rise as rescuers struggle to reach hard-hit remote areas. Baby born in earthquake Zhang and obstetrics nurse Liu Yan, from the Shanghai No.8 People's Hospital, are members of the Chinese medical team in Morocco. The hospitals they serve are in Ben Guerir, a town 70 kilometers away from the western city of Marrakech which was hardest-hit by the earthquake. Zhang was en route from the hospital to her apartment in Ben Guerir when the earthquake suddenly occurred. "I felt the whole apartment building shake when I entered," she recalled. "I froze for a second before quickly running out." Then Zhang received a call from the hospital asking her to return to work. She rushed to the hospital, where the square in front of the hospital was filled with anxious doctors and patients. The tremor made the hospital unsafe. Not long after, an ambulance transporting a hemorrhaging pregnant patient roared up the driveway. Worse still, after conducting a quick medical examination, Zhang found the patient to be hypertensive, presented signs of abruptio placentae. "She was in critical condition and needed a C-section as soon as possible," Zhang said. Only an hour had passed since the earthquake and having to conduct an hour-long surgery in the hospital building brought with it glaring risks. "But both the expectant mother and her baby would have died without timely intervention," Zhang told the Global Times. "We decided to ignore the risk to help them." When nurse Liu rushed to the hospital's operating room and saw the distressed expectant mother, she echoed Zhang's sentiments. "She had suffered 200 ml of blood loss probably from the placenta, almost equal to total blood loss from the baby in-utero," said Liu, who has nearly 30 years of working experience. The emergency C-section started amid aftershocks. Zhang and Liu headed the surgery, supported by four local medical staffers including two nurse anesthetists, an itinerant nurse, and a midwife. It was the only surgery performed at the hospital that night. Fortunately, a 3.9-kilogram baby girl was smoothly born in the end, and her mother was also in stable condition. Zhang and Liu don't remember how many "Shukran" - the Arabic word for "Thank you" - they've received from their Moroccans counterparts in the days since the earthquake. The new mother and her husband, as well as other patients and staffers at the hospital, all expressed their gratitude and admiration for the caring and dedicated Chinese medical personnel. Hu said she was later told that there were several waves of dangerous aftershocks while they were in the operating room in the hospital. "But I was far too focused on the surgery to feel any of them or be afraid," she told the Global Times. "The only thing I was afraid of at that time was an unexpected complication with woman and her baby." More helping hands from China The work at the hospital becomes normal now for Zhang and Liu, who both belong to the medical team that China has been assigning to Morocco since 1975, serving local patients at public hospitals across the country. The earthquake won't change their original schedule of them remaining in Morocco, the Global Times learned. Moreover, China's rescue efforts continue to reach the areas hardest hit by the earthquake, including the Al Haouz region, 50 kilometers south of Marrakech. The Red Cross Society of China has announced that it will provide the Moroccan Red Crescent with financial emergency humanitarian assistance worth $200,000. The China International Development Cooperation Agency also said that it stands ready to provide emergency humanitarian assistance based on the needs of those most affected by the disaster, according to the Chinese Ministry of Foreign Affairs. "China stands ready to continue to provide help to Morocco in light of its needs, to the best of our capability," Foreign Ministry spokesperson Mao Ning said on Monday's press briefing. At the grassroots level, Chinese nationals residing in Morocco have also actively reached out to help. In a video she shared online, Xiaoshuang (pseudonym), a sea cucumber dealer, stands in front of a lorry fitted with a big container, surrounded by many buckets of drinking water. She says to the camera that she will fill the container with the drinking water and send it to Al Haouz. "I'm on my way to the disaster area," Xiaoshuang told the Global Times on Monday morning local time. Chinese vlogger and photographer Jiang Cheng lives in the famous port city of Casablanca in northwestern Morocco. Early in the morning after the earthquake, he boarded a Chinese friend's car and went to Al Haouz. At first Jiang just wanted to shoot some videos and photos there, but he soon felt he needed to step up and help. "I'm contacting my Chinese friends to collectively transport foodstuffs to the hardest hit areas," Jiang told the Global Times. "My heart broke when witnessing the dire situation there." Jiang added that as far as he knows, many Chinese communities and individuals in Morocco are discussing the collection and transportation of supplies to earthquake victims and their families. Chinese enterprises were also seen at the earthquake's hard hit areas. On social media, some users shared photos of a Chinese-invested heavy equipment and manufacturing enterprise sending excavators and loaders to the rescue scenes, the Global Times found. Fears, tears and relief For many Chinese nationals residing in Morocco, experiencing the sudden earthquake was full of fears, tears, relief and the desire to help others. Line (pseudonym), for instance, was on a camping trip in the mountains just tens of kilometers from the earthquake's epicenter. The tremor was very strong, but no tourists were hurt, she said. "When we drove out of the mountains in the early morning, it was like we were on the run," she told the Global Times. "There were falling rocks everywhere, and some of the road barriers had collapsed. I felt like we might fall off the mountain at any moment." Tang, another Chinese tourist visiting Morocco, was at a surf club on the beach, about 100 kilometers from the epicenter. At the time, she was engaged in her post-shower beauty routine when she first felt the tremor, which alarmed, and then terrified her. When the shaking continued, however, she quickly put on her clothes and ran outside. "No one even turned on the lights when we ran downstairs, and some people didn't even have their shoes on," she told the Global Times. "My companion even banged her head on the way down." All of the surfers made it to the main street, and later to an open space on higher ground. "Even our dog was scared and came to find us," she said. "Everyone slept outside and the club provided blankets and drinking water." Ma Jun, who has been living in Morocco for years, was hundreds of kilometers from the epicenter, but also felt the tremor so strongly that when the earthquake struck he rushed outside with his shirt inside-out. "We all ran out and stayed outside immediately," he recalled. "The street was full of locals spending the night outside and in their cars." Ma told the Global Times that he returned to his room to rest after a long period outside, but slept in his jacket and shoes for fear of aftershocks. It was the first time that Jiang had experienced earthquake. He recalled that he didn't realize it was an earthquake, until the quake lasted some two minutes. "Then I put on my clothes and rushed downstairs with my valuables. My house's rolling gate heavily clanged due to the shakes." Jiang praised the Chinese Embassy in Morocco for its quick response. "It published useful information online that night soon after the earthquake happened, such as the contact numbers for help and some rescue resources," he told the Global Times. As of press time, there have been no reports of Chinese casualties resulting from the earthquake. Through the past three days, Jiang said he has barely slept in the last three days. Images of collapsed buildings, dead bodies, and distraught people in Al Haouz continue to haunt him. "I've been living in Morocco since 2016, and it has become my second home," Jiang told the Global Times. "I hope everything will be better soon. And I will continue to contribute to [rescue and reconstruction efforts] together with many other Chinese compatriots here." SOURCE Global Times

THURSDAY, June 15, 2023 -- Women with obsessive-compulsive disorder (OCD) have increased risk of adverse pregnancy, delivery, and neonatal outcomes, according to a study published online June 14 in JAMA Network Open . Lorena Fernández de la Cruz, Ph.D., from the Karolinska Institutet in Stockholm, and colleagues examined the associations of maternal OCD with pregnancy, delivery, and neonatal outcomes in two studies. In the Swedish cohort, 8,312 pregnancies in women with OCD were compared with 2,137,348 pregnancies in unexposed women, while in the cohort from British Columbia (BC), Canada, 2,341 pregnancies in women with OCD were compared with 821,759 pregnancies in unexposed women. The researchers found that maternal OCD was associated with increased risks of gestational diabetes, elective cesarean delivery, preeclampsia, induction of labor, emergency cesarean delivery, and postpartum hemorrhage in the Swedish cohort (adjusted risk ratios [aRRs], 1.40, 1.39, 1.14, 1.12, 1.16, and 1.13, respectively). In the BC cohort, significantly higher risk was seen for emergency cesarean delivery and antepartum hemorrhage or placental abruption (aRR, 1.15 and 1.48, respectively). In both cohorts, offspring of women with OCD had increased risk of low Apgar score at 5 minutes (aRRs, 1.62 and 2.30 in Sweden and BC, respectively), preterm birth (aRRs, 1.33 and 1.58, respectively), low birth weight (aRRs, 1.28 and 1.40, respectively), and neonatal respiratory distress (aRRs, 1.63 and 1.47, respectively). The risk of these outcomes was increased for women with OCD taking serotonin reuptake inhibitors during pregnancy. "Improved collaboration between psychiatry and obstetric services, as well as improved maternal and neonatal care for women with OCD and their children, is warranted," the authors write. Two authors disclosed ties to the publishing and medical technology industries. Abstract/Full Text Posted June 2023