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Spontaneous Monochorionic Triamniotic Triplet Pregnancy: A Case Report

Open Journal of Obstetrics and Gynecology 2023年第6期13卷 1075-1080页

作者： Al Hussain Al Hazmi Ola Tayeb Afrah Al Mutairi mufareh asiri Maternity Hospital King Saud Medical City Riyadh KSA

Background: Monochorionic triamniotic (MCTA) triplet pregnancy is a rare entity associated with a high risk of complications. In most previously reported cases, the pregnancy was conceived with the use of assisted reproductive technologies, and these cases were associated with complications. Case Presentation: We report a 28-year-old woman with a spontaneously conceived MCTA triplet pregnancy diagnosed at the gestational age of 26 weeks. All fetuses had normal amniotic fluid and umbilical artery Doppler findings were normal. The estimated weight of fetuses was 848 g, 891 g, and 1 kg, respectively. The patient was managed conservatively with a plan to monitor fetal growth every two weeks and a Doppler study twice weekly. On the 8th day of admission, the patient developed labor pains. Per vaginal examination revealed 1 - 2 cm cervical dilatation. Cesarean section was performed, and three girls were delivered with a single placenta (birth weight: 820, 925, and 960 g, respectively). Conclusion: Monochorionic triplet pregnancy is associated with a higher risk of fetal morbidity and mortality. Therefore, awareness of its complications can facilitate better management of such cases.

关键词： Monochorionic Triamniotic Triplet Pregnancy Case Report

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Pregnancy Outcomes in Pregnant Patients with COVID-19: A Multicenter Study

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Open Journal of Obstetrics and Gynecology 2023年第1期13卷 13-25页

作者： mufareh asiri Salem Al Suwaidan Afaf Altweijry Abdulsamed Almdefa Saad Alonze Theba Saud Maternity Hospital King Saud Medical City Riyadh KSA Research Center King Saud Medical City Riyadh KSA

Introduction: Acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. The presence of COVID-19 in a pregnant patient can raise concerns, as other types of coronaviruses were associated with many adverse outcomes. This study aims to study the effect of COVID-19 on pregnancy outcomes. Methods: A prospective cross-sectional cohort study within Central First Health Care Cluster (multicentric), Riyadh, included all pregnant women with a singleton pregnancy diagnosed as COVID-19-positive. The primary outcome is the severity of COVID during pregnancy in terms of ICU admission and mortality. The participants were divided into three groups (preterm less than 37 weeks, the term from 37 - 40 weeks, and late-term after 40 weeks. In addition, parameters included: Gestational age at diagnosis, symptoms at presentation (cough, fever), presence of congenital anomalies, IUFD, mode of delivery, presence of PPH, newborn Apgar score, cord PH, need for NICU admission, and the newborn becoming infected with COVID-19 were also measured as secondary outcomes. Results: One hundred pregnant, COVID-19-positive women met the inclusion criteria;the average age of participants was 31.2 years (SD ± 6.4). Asymptomatic patients represented 54% of participants. Most of the deliveries occurred at 36 weeks or less as preterm delivery. Cesarean sections represented 55% of our population. Four-term mothers (12.5%), more than 37 weeks, need ICU admission compared to 13 (25%) preterm cases diagnosed with preeclampsia. No maternal death. Conclusion: COVID-19 during pregnancy can increase ICU admission. A high rate of preterm labor, miscarriage, cesarean section, and newborn testing positive for COVID-19 were observed among our population. No congenital anomalies related to COVID-19 were observed.

关键词： Pregnancy COVID-19 Preterm Labor Miscarriage Saudi Arabia

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Blood Consumption in Placental Abnormalities

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Open Journal of Obstetrics and Gynecology 2022年第10期12卷 1092-1101页

作者： mufareh asiri Salem Al Suwaidan Nawal Al Harbi Abuobeida Ahmed Reem Alanazi Razan Al Harbi Najla Al Ajmi Maternity Hospital King Saud Medical City Riyadh KSA Research Center King Saud Medical City Riyadh KSA

Introduction: Hemorrhage is one of the most common causes of maternal morbidity and mortality. This study was conducted to investigate how much abnormal placentation can affect blood bank capacity and to measure the burden on the blood bank caused by excessive use of blood and blood products. Methodology: This is a retrospective study conducted at King Saud Medical City Maternity Hospital in Riyadh, Kingdom of Saudi Arabia, from January 2019-September 2020. It includes 170 cases diagnosed with abnormal placentation (low-lying placenta or placenta previa, accreta, increta, or percreta). The primary purpose was to measure consumption of blood and blood products in cases of placental abnormalities and to investigate how much this affects blood bank capacity. A secondary aim was to report rates of admission to the ICU and maternal mortality. Results: This study included 170 women with placental abnormalities. Placental previa had occurred in 96 cases, followed by placenta accreta in 46 cases, placenta increta in 13 cases, placenta percreta in 8 cases, and low-lying placenta in 7 cases. Most patients (93) were treated with a Bakri balloon to prevent hemorrhage, but 38 patients had a hysterectomy. The average estimation of blood loss was 2210 ml, with no maternal mortality. An average of 3.39 units of packed red blood cells (PRBC) with a maximum of 20 units, 2.12 units of fresh frozen plasma (FFP) with a maximum of 20 units, and 0.7 units of packed platelets (PP) with maximum of 12 units consumed per patient. Eighty-seven patients (51.2%) were admitted to the ICU and 83 others (48.8%) were admitted to the high dependency unit. Conclusion: Blood and blood product volumes had a linear relationship with the severity of placental abnormalities and estimated blood loss. Therefore, blood bank services should be available to save mothers’ life.

关键词： Placenta Previa Placenta Accreta Spectrum (PAS) Hemorrhage Maternal Mortality Hysterectomy

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