News
New CT-based indicator helps doctors predict life-threatening postpartum bleeding cases

Researchers from Kumamoto University in Japan have identified a distinctive CT imaging pattern that can predict which women experiencing severe postpartum hemorrhage (PPH) are most likely to need life-saving interventions.
The new finding, termed PRACE (Postpartum hemorrhage, Resistance to treatment, and Arterial Contrast Extravasation), was observed in nearly one-third of patients undergoing dynamic CT scans and was strongly associated with the need for emergency procedures such as uterine artery embolization.
Postpartum hemorrhage remains a leading cause of maternal death worldwide.
While most cases can be managed with medications and basic interventions, a significant number become life-threatening and require more invasive treatment.
Until now, there has been no reliable way to identify in advance which cases would prove resistant to standard therapies.
In a nationwide study involving 43 advanced medical centres across Japan, researchers analyzed 352 cases of severe PPH and found that 205 underwent dynamic CT scanning.
Of these, 58 cases (32.2 per cent) showed the PRACE pattern, characterised by contrast agent leaking into the uterine cavity during the early phase of imaging—signaling active arterial bleeding.
Patients with PRACE had more than triple the likelihood of needing uterine artery embolization (UAE) compared to those without the finding (86.2 per cent vs. 28.7 per cent), and were more likely to suffer from blood clotting abnormalities and require large-volume transfusions.
The presence of PRACE was the single strongest predictor for the need for UAE, with an odds ratio of 27.74.
“PRACE is a game-changer in how we assess and respond to critical postpartum bleeding,” said Professor Eiji Kondoh of Kumamoto University’s Faculty of Life Sciences.
“By using dynamic CT imaging, we can now detect early signs of treatment-resistant bleeding and act swiftly to save lives.”
The researchers suggest that incorporating dynamic CT into emergency obstetric care protocols may significantly improve maternal outcomes.
They also propose updating the traditional “4 Ts” classification of postpartum hemorrhage (Tone, Trauma, Tissue, Thrombin) to include a fifth—“CT findings”—to better stratify risk.
Cancer
Ovarian cancer cases rising among younger adults, study finds

Ovarian cancer cases are rising among younger adults in England, with bowel cancer showing a similar pattern, a new study suggests.
Researchers said excess weight is a key contributor, but is unlikely on its own to explain the pattern.
The authors wrote: “These patterns suggest that while similar risk factors across ages are likely, some cancers may have age-specific exposures, susceptibilities, or differences in screening and detection practices.”
They added: “Although overweight and obesity are linked to 10 of the 11 cancers evaluated and account for a substantial proportion of cancer cases, both BMI-attributable and BMI-non-attributable incidence rates have increased, though the latter more slowly, suggesting other contributors.”
The study analysed cancer incidence, meaning new diagnoses, in England between 2001 and 2019 across more than 20 cancer types, comparing adults aged 20 to 49 with those aged 50 and over.
Among younger women, cases of 16 out of 22 cancers increased significantly over the period, while among younger men, 11 out of 21 cancers increased significantly.
In particular, there was a significant rise in 11 cancers with known behavioural risk factors among adults under 50. These were thyroid, multiple myeloma, liver, kidney, gallbladder, bowel, pancreatic, endometrial, mouth, breast and ovarian cancers.
Rates of all 11 also rose significantly among adults aged 50 and over, with the notable exceptions of bowel and ovarian cancer.
Five cancers, endometrial, kidney, pancreatic, multiple myeloma and thyroid cancer, increased significantly faster in younger than in older women, while multiple myeloma increased faster in younger than in older men.
The researchers looked at established risk factors including smoking, alcohol intake, diet, physical inactivity and body mass index, a measure used to assess whether someone is underweight, a healthy weight, overweight or obese.
With the exception of mouth cancer, all 11 cancers were associated with obesity. Six, liver, bowel, mouth, pancreatic, kidney and ovarian, were also linked to smoking.
Four, liver, bowel, mouth and breast, were associated with alcohol intake. Three, bowel, breast and endometrial, were linked to physical inactivity, and one, bowel, was associated with dietary factors.
But apart from excess weight, trends in those risk factors over the past one to two decades were stable or improving among younger adults.
That suggests other factors may also play a part, including reproductive history, early-life or prenatal exposures, and changes in diagnosis and detection.
The study noted that red meat consumption fell among younger adults, while fibre intake remained stable or slightly improved in both sexes between 2009 and 2019, although more than 90 per cent of younger adults were still not eating enough fibre in 2018.
Established behavioural risk factors accounted for a substantial share of cancer cases.
Excess weight was the risk factor associated with most cancers in 2019, ranging from 5 per cent for ovarian cancer to 37 per cent for endometrial cancer.
The researchers said the findings were based on observational data, meaning the study could identify patterns but could not prove cause and effect.
They also noted there were no consistent long-term national data for several risk factors, that the analysis was limited to England rather than the UK, and that cancer remains far more common overall in older adults despite the rise in cases among younger people.
Pregnancy
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