The Importance of the Novel Postpartum Uterine Ultrasonographic Scale in Numerical Assessments of Uterine Involution Regarding Perinatal Maternal and Fetal Outcomes

Background: Uterine involution assessments are critical for the prevention of postpartum hemorrhage. Various methods have been used worldwide. Methods: The PUUS (Postpartum Uterine Ultrasonographic Scale) method evaluates, by transabdominal ultrasonography, the length of the endometrium of the uterine cavity occupied by blood or debris, from grade 0 (no blood) to grade 4 (over three-quarters of the endometrial length occupied by blood/debris). A total of 131 consecutive patients admitted for delivery in the Elena Doamna Obstetrics and Gynecology University Hospital in Iasi, Romania, were prospectively evaluated using the PUUS method. The mean age was 27.72 years old, and they were examined during the first 24–48 h after vaginal delivery, or in the first 48–72 h after cesarean delivery. For patients with a PUUS grade greater than 1, re-examination was preformed daily in the following days, until the PUUS grade decreased to 1 or 0. Results: By standardizing uterine involution in a numerical fashion, we precisely demonstrate that uterine involution varied with the method of delivery (vaginal/cesarean) and with the number of vials of oxytocin received intrapartum, but not with the number of vials of ergometrine maleate received, and not with the origin of the parturient (rural/urban)

Pregnancy during Adolescence and Associated Risks: An 8-Year Hospital-Based Cohort Study (2007–2014) in Romania, the Country with the Highest Rate of Teenage Pregnancy in Europe

Aim. To determine pregnancy and delivery outcomes among teenagers. Materials and Methods. An 8-year retrospective comparative hospital-based cohort study is analysing singleton pregnancy comorbidities and delivery parameters of a teenage group under the age of 20 compared with a young adult group 20–24 years of age in a university hospital. Results. Teenage is a risk factor for preterm birth <37 weeks (1.21 [1.08–1.35]), foetal growth restriction (1.34 [1.21–1.48]), episiotomy (1.27 [1.21–1.34]), uterine revision (1.15 [1.06–1.25]), APGAR <7 at 1 min (2.42 [1.21–1.67]), cephalopelvic disproportion (1.26 [1.07–1.48]), and postpartum haemorrhage (1.42 [1.25–1.62]); however, caesarean delivery occurs less frequently in teenagers than in adults (0.75 [0.70–0.80]). The following comorbidities are risk factors for teenage pregnancy (risk ratio [CI 95%]): anaemia (1.13 [1.10–1.17]), low urinary tract infection (1.10 [1.03–1.18]), pediculosis (2.42 [1.90–3.00]), anogenital condyloma (1.50 [1.04–2.17]), and trichomoniasis (1.74 [1.12–2.68]). The risks for hepatitis B and hepatitis C, premature rupture of membranes, and placenta praevia were lower compared with those in the young adult group, respectively, 0.43 (0.26–0.71), 0.90 (0.85–0.96), and 0.29 (0.20–0.41), while the risk for gestational diabetes and preeclampsia were the same in both groups. Conclusion. Considering the high risks for teenage pregnancy, this information should be provided to pregnant adolescent women and their caregivers