AccessMyLibrary provides FREE access to over 30 million articles from top publications available through your library.
Create a link to this page
Copy and paste this link tag into your Web page or blog:
Know your options for peripartum hemorrhage: a leading cause of maternal mortality, hemorrhage accounts for up to 18% of pregnancy-related deaths.(Obstetrics)
ASHEVILLE, N.C. -- Peripartum hemorrhage is one of the leading causes of maternal mortality, making it important to understand the myriad options for controlling bleeding, David C. Mayer, M.D., said at the Southern Obstetric and Gynecologic Seminar.
"Unfortunately, over the decades, hemorrhage has never been moved out of the top three causes of maternal mortality," said Dr. Mayer of the department of anesthesiology at the University of North Carolina at Chapel Hill.
Peripartum hemorrhage accounts for as much as 18% of pregnancy-related deaths in the United States, according to one estimate.
Resuscitation is the first goal in the management of peripartum hemorrhage (PPH). Make sure there is an adequate number of intravenous lines and maintain adequate volume by using crystalloids, colloids, packed red blood cells, fresh frozen plasma, or platelets, as necessary. Get baseline blood laboratory tests, including a coagulation profile, and monitor arterial blood gas levels and urinary output. Invasive monitoring with arterial or central venous lines may be necessary, as may consultation with specialists, cautioned Dr. Mayer.
There are a number of options to control bleeding: pharmacologic (such as prostaglandins), autologous blood transfusion, and selective arterial embolization. Pharmacologic therapy includes oxytocics, ergot alkaloids, prostaglandins, and recombinant activated factor VII (rFVIIa). Keep in mind almost all studies of pharmacologic therapies are based on routine elective cesarean sections.
"It may have very little applicability to a patient with an atonic uterus," Dr. Mayer said.
Oxytocin (Pitocin) is the pharmacologic therapy that most obstetricians go to first to control bleeding. The drug can be used as prophylaxis in women who are at high risk for PPH, with doses of 10-40 U/L administered intravenously. "For uterine atony, I'm very aggressive with oxytocin, except for giving a large bolus," Dr. Mayer said during the meeting.
- Performance of tall fescue germplasms bred for high- and low-ergot alkaloids....
- Crop Science Hill, N.S. Bouton, J.H. Thompson, F.N. Hawkins, L. Hoveland, C.S. McCann, M.A. March 1, 2002 700+ words
...deterrence (Siegel, 1990) but the ergot alkaloids are responsible for the livestock...The second is that reduction of ergot alkaloids may concomitantly reduce the fitness...fescue germplasms selected for low-ergot alkaloids (GA-961, 963, and 964) and two...
- Determination of ergot alkaloid content in tall fescue by near-infrared...
- Crop Science Roberts, C.A. Benedict, H.R. Hill, N.S. Kallenbach, R.L. Rottinghaus, G.E. March 1, 2005 700+ words
...strains of this endophyte produce ergot alkaloids, a class of mycotoxins that causes...Neotyphodium that produce little or no ergot alkaloids (Bouton et al., 2002); the strains...advancement is quantitative methodology for ergot alkaloids. Ergot alkaloids have been ...
- Study results from School of Pharmaceutical Sciences, Department of...
- Newspaper article from: Biotech Week December 10, 2008 700+ words
...with the structure of the amino acid ergot alkaloids, induces neurite outgrowth in PC12...the involvement of the structure of ergot alkaloids in the effect of bromocriptine. Ergot alkaloids have been divided into two groups...
- Researchers from National Veterinary Institute detail findings in life sciences.
- Newspaper article from: Medical Devices & Surgical Technology Week September 21, 2008 700+ words
...are presented in the report 'Lactam ergot alkaloids (ergopeptams) as predominant alkaloids...identified as lactam (non-cyclol) ergot alkaloids. The structural information was obtained...The data for one of the lactam ergot alkaloids were coinciding with ergocristam...
- Monoclonal antibodies for detection of Neotyphodium coenophialum.
- Crop Science Hiatt, E.E., III Hill, N.S. Bouton, J.H. Mims, C.W. July 1, 1997 700+ words
...fescue as forage is the production of ergot alkaloids in plants inhabited by the endophytic...1993). However, production of ergot alkaloids can be detrimental to animals grazing...endophyte but are incapable of producing ergot alkaloids. The feasibility of this strategy...
- Antimigraine Medications
- Encyclopedia entry from: Gale Encyclopedia of Neurological Disorders Frey, Rebecca January 1, 2005 700+ words
...to recur within 24 hours of the first dose. ERGOT ALKALOIDS Ergot alkaloids are an older group of drugs that include such...effect of the alkaloid. Like the triptans, the ergot alkaloids are used to treat moderate-to-severe migraines...
- Migraine drugs.(DRUGS, PREGNANCY, AND LACTATION)
- Magazine article from: OB GYN News Briggs, Gerald G. January 15, 2005 700+ words
...may cause newborn toxicity, and methysergide and other ergot alkaloids are contraindicated in pregnancy. Other migraine drugs...few or no data available for gabapentin and topiramate. Ergot alkaloids may inhibit lactation; high doses have been associated...
- Intake and digestion of 'Jesup' tall fescue hays with a novel fungal endophyte,...
- Magazine article from: Crop Science Burns, J.C. Fisher, D.S. January 1, 2006 700+ words
...Reduced gains have been largely attributed to ingestion of ergot alkaloids produced by the endophyte (Aldrich et al., 1993a, 1993b...related to ambient temperature, concentration and type of ergot alkaloids present in the plant, the quantity of alkaloids in the...
