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Obstetrics and Gynecology Clinics of North America

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https://www.readbyqxmd.com/read/28160898/multilevel-barriers-to-optimizing-care-in-underserved-women
#1
EDITORIAL
Wanda Kay Nicholson
No abstract text is available yet for this article.
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28160897/reducing-barriers-to-invest-in-improved-health-care
#2
EDITORIAL
William F Rayburn
No abstract text is available yet for this article.
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28160896/patient-centered-care-to-address-barriers-for-pregnant-women-with-opioid-dependence
#3
REVIEW
Mary Beth Sutter, Sarah Gopman, Lawrence Leeman
Pregnant women affected by substance use often encounter barriers to treatment, including housing insecurity, poverty, mental health issues, social stigma, and access to health care. Providers may lack the resources needed to provide quality care. Clinicians offering prenatal care to women with substance use disorder are encouraged to support family-centered, multidisciplinary care to women and their infants, focusing on harm reduction. Collaboration between providers of maternity care, substance abuse treatment, case management, family primary care, and pediatric developmental care can improve outcomes during pregnancy and through the early years of parenting...
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28160895/disparities-in-fibroid-incidence-prognosis-and-management
#4
REVIEW
Shannon K Laughlin-Tommaso, Vanessa L Jacoby, Evan R Myers
Health disparities in fibroid prevalence, prognosis, and treatment exist for underserved women. Access to fibroid treatment alternatives can have significant effect on choices and outcomes of fibroid disease.
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28160894/addressing-health-care-disparities-among-sexual-minorities
#5
REVIEW
Kesha Baptiste-Roberts, Ebele Oranuba, Niya Werts, Lorece V Edwards
There is evidence of health disparities between sexual minority and heterosexual populations. Although the focus of lesbian, gay, bisexual, and transgender health research has been human immunodeficiency virus/acquired immunodeficiency syndrome and sexually transmitted infection among men who have sex with men, there are health disparities among sexual minority women. Using the minority stress framework, these disparities may in part be caused by individual prejudice, social stigma, and discrimination. To ensure equitable health for all, there is urgent need for targeted culturally sensitive health promotion, cultural sensitivity training for health care providers, and intervention-focused research...
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28160893/leveraging-opportunities-for-postpartum-weight-interventions
#6
REVIEW
Alexander Berger, Wanda Kay Nicholson
Approximately 20 million US women are considered overweight or obese. African American women share a disproportionate burden of obesity. To date, few studies have assessed the effects of behavioral interventions, tailored to the specific lifestyle challenges of postpartum African American women. Efforts to address the disparate rates of obesity in African American women should include assessment of knowledge and knowledge gaps, development and testing of behavioral interventions, and translation of evidence into clinical practice...
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28160892/family-planning-american-style-redux-unintended-pregnancy-improves-barriers-remain
#7
REVIEW
Lauren Thaxton, Eve Espey
This article discusses barriers to reducing unintended pregnancy. Numerous factors may explain the high rate of unintended pregnancy in the United States, including inadequate sex education, confusing media messages about sex, cultural attitudes about sex and young parenting, conflation of contraception with abortion, inadequate health care access, burdensome contraceptive dispensing practices, and hospital merger limitations on care. Successful and promising approaches to expanding access to reproductive health care and reducing unintended pregnancy are discussed...
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28160891/reassessing-unintended-pregnancy-toward-a-patient-centered-approach-to-family-planning
#8
REVIEW
Jessica E Morse, Shanthi Ramesh, Andrea Jackson
Underserved women, especially those with low incomes and from racial and ethnic minorities, experience a disproportionate share of unintended pregnancies in the United States. Although unintended pregnancy rates are general markers of women's health and status, they may not accurately capture women's experiences of these pregnancies or their social circumstances. A patient-centered approach to family planning optimizes women's reproductive preferences, is cognizant of historical harms and current disparities, and may more comprehensively address the issue of unintended pregnancy...
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28160890/quality-of-care-and-disparities-in-obstetrics
#9
REVIEW
Elizabeth A Howell, Jennifer Zeitlin
Growing attention is being paid to obstetric quality of care as patients are pressing the health care system to measure and improve quality. There is also an increasing recognition of persistent racial and ethnic disparities prevalent in obstetric outcomes. Yet few studies have linked obstetric quality of care with racial and ethnic disparities. This article reviews definitions of quality of care, health disparities, and health equity as they relate to obstetric care and outcomes; describes current efforts and challenges in obstetric quality measurement; and proposes 3 steps in an effort to develop, track, and improve quality and reduce disparities in obstetrics...
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28160889/is-there-a-shortage-of-obstetrician-gynecologists
#10
REVIEW
Jody Stonehocker, Joyce Muruthi, William F Rayburn
Projections of supply and demand for obstetricians-gynecologists suggest a current minimal or modest shortage that will worsen in the future. The US adult female population is expected to increase by more than 20% by 2045 and represents a key driver for increased demand for health care services. The annual number of obstetrician-gynecologists (ob-gyn) residency graduates has increased negligibly, whereas the proportion accepted into fellowships increased steadily, reducing those in general practice. The gradual increase in proportion of ob-gyns who are women coincides with desires for more work-life balance and earlier retirement from clinical practice...
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28160888/hearing-the-silenced-voices-of-underserved-women-the-role-of-qualitative-research-in-gynecologic-and-reproductive-care
#11
REVIEW
Angela K Lawson, Erica E Marsh
In order to provide effective evidence-based health care to women, rigorous research that examines women's lived experiences in their own voices is needed. However, clinical health research has often excluded the experiences of women and minority patient populations. Further, clinical research has often relied on quantitative research strategies; this provides an interesting but limited understanding of women's health experiences and hinders the provision of effective patient-centered care. This article defines qualitative research and its unique contributions to research, and provides examples of how qualitative research has given insights into the reproductive health perspectives and behaviors of underserved women...
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28160887/racial-and-ethnic-disparities-in-health-and-health-care
#12
REVIEW
Sarahn M Wheeler, Allison S Bryant
A health disparity is defined as an increased burden of an adverse health outcome or health determinant within a specific subset of the population. There are well-documented racial and ethnic disparities throughout health care at the patient, provider, and health care system levels. As the minority populations within the United States grow to record numbers, it is increasingly important to invest in efforts to characterize, understand, and end racial and ethnic disparities in health care. Inequities in health outcomes and care pose real threats to the entire nation's well-being...
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27816165/contemporary-obstetric-intensive-care
#13
EDITORIAL
Carolyn M Zelop, Stephanie R Martin
No abstract text is available yet for this article.
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27816164/an-end-to-happiness%C3%A2-attention-to-the-critically-ill-parturient
#14
EDITORIAL
William F Rayburn
No abstract text is available yet for this article.
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27816163/obstetric-transport
#15
REVIEW
Julie Scott
Obstetric transport is a specialized medical transport for maternal, fetal, and neonatal concerns. Perinatal regionalization of care provides a broader geographic availability of obstetric services with defined levels of maternal and neonatal care so that women can be transported to centers with increased resources and capabilities to reduce morbidity and mortality. The Emergency Medical Treatment and Active Labor Act provides regulatory guidance for care of laboring women who require transfer to a higher level of care...
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27816162/cardiac-arrest-and-resuscitation-unique-to-pregnancy
#16
REVIEW
Terri-Ann Bennett, Vern L Katz, Carolyn M Zelop
Maternal cardiopulmonary arrest (MCPA) is a catastrophic event that can cause significant morbidity and mortality. A prepared, multidisciplinary team is necessary to perform basic and advanced cardiac life support specific to the anatomic and physiologic changes of pregnancy. MCPA is a challenging clinical scenario for any provider. Overall, it is an infrequent occurrence that involves 2 patients. However, key clinical intervention performed concurrently can save the life of both mother and baby.
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27816161/trauma-and-considerations-unique-to-pregnancy
#17
REVIEW
Christy Pearce, Stephanie R Martin
Trauma complicates 6% to 7% of all pregnancies and requires multidisciplinary education and training for both trauma and obstetric teams to achieve the best outcome. It is important to understand the mechanisms of certain adverse maternal and fetal/neonatal outcomes incurred as a result of trauma, as well as caveats to pregnancy physiology that make some injuries more likely and detection of maternal compromise more difficult. This article focuses on these caveats and how to incorporate these into ongoing trauma protocols and offers suggestions for the formation of obstetric trauma response team...
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27816160/amniotic-fluid-embolism
#18
REVIEW
Amir A Shamshirsaz, Steven L Clark
Amniotic fluid embolism remains one of the most devastating conditions in obstetric practice with an incidence of approximately 1 in 40,000 deliveries and a reported mortality rate ranging from 20% to 60%. The pathophysiology involves an abnormal maternal response to fetal tissue exposure associated with breaches of the maternal-fetal physiologic barrier during parturition. This response and its subsequent injury involve activation of proinflammatory mediators similar to that seen with the classic systemic inflammatory response syndrome...
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27816159/obesity-and-the-critical-care-pregnant-patient
#19
REVIEW
Garrett K Lam
The rise of obesity among gravid women has been tracked and documented in many first-world countries, but a dramatic rise has been noted over the last 15 years. Definitions of "normal-weight, overweight and obese" have been defined; however, new terms are used to describe more severe degrees of obesity. Obesity in any form or degree increases morbidities in mothers. The unique physiologic characteristics of the obese gravida set up unique challenges in her management, especially in an acute setting such as labor...
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27816158/management-of-acute-kidney-injury-in-pregnancy-for-the-obstetrician
#20
REVIEW
Anjali Acharya
Acute kidney injury (AKI) is a complex disorder that occurs in several clinical settings. During pregnancy, there are additional unique conditions that contribute to AKI. The clinical manifestations of AKI during pregnancy range from a minimal elevation in serum creatinine to renal failure requiring renal replacement therapy, similar to AKI in the general population. Recent epidemiologic studies in the general population show an increase in mortality associated with AKI, particularly when dialysis is required...
December 2016: Obstetrics and Gynecology Clinics of North America
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