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https://www.readbyqxmd.com/read/27895930/obstetric-patients-in-intensive-care-unit-perspective-from-a-teaching-hospital-in-pakistan
#1
Rahat Qureshi, Sheikh Irfan Ahmed, Amir Raza, Ayesha Khurshid, Uzma Chishti
OBJECTIVE: Review of obstetric cases admitted to the intensive care unit. DESIGN: Ten year retrospective review of individual patients' medical records. PARTICIPANTS: Records of obstetric patients admitted from 2005-2014. SETTING: Aga Khan University Hospital Karachi. MAIN OUTCOME MEASURES: Diagnosis at the time of admission, associated risk factors, and intervention required aspects of management and rate of mortality...
November 2016: JRSM Open
https://www.readbyqxmd.com/read/27780154/maternal-and-neonatal-outcomes-following-expectant-management-of-preterm-prelabour-rupture-of-membranes-before-viability
#2
Winnie Huiyan Sim, Edward Araujo Júnior, Fabricio Da Silva Costa, Penelope Marie Sheehan
AIM: To assess the contemporary maternal and neonatal outcomes following expectant management of preterm premature rupture of membranes (PPROM) prior to 24 weeks' gestation and to identify prognostic indicators of this morbid presentation. METHODS: We performed a systematic review in the Pubmed and EMBASE databases to identify the primary (perinatal mortality, severe neonatal morbidity and serious maternal morbidity) and secondary (neonatal survival and morbidity) outcomes following expectant management of previable PPROM...
October 25, 2016: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/27651620/analysis-of-near-miss-and-maternal-mortality-at-tertiary-referral-centre-of-rural-india
#3
Archana D Rathod, Rohidas P Chavan, Vijay Bhagat, Sandhya Pajai, Atul Padmawar, Prachi Thool
OBJECTIVE: (1) To determine the incidence of near-miss, maternal death and mortality index; (2) to compare near-miss cases as per WHO criteria with that of maternal mortality; and (3) to study the causes of near-miss and maternal deaths. STUDY DESIGN: Retrospective cohort study. SETTING: Shri Vasantrao Naik Govt. Medical College, Yavatmal, India. STUDY POPULATION: All cases of near-miss as per newer WHO criteria and maternal deaths...
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27622109/internal-pudendal-artery-perforator-island-flap-for-management-of-recurrent-benign-rectovaginal-fistula
#4
Haitham H Khalil, Marco N Malahias, Sharad Karandikar, Charles Hendrickse
The management of recurrent rectovaginal fistula after obstetric injury and cryptoglandular sepsis is considered a major surgical challenge. The fistula poses a significant negative psychosocial and sexual morbidity. In addition, the poor quality of local tissues due to previous attempts at surgical repair adds to this challenge. There are few data regarding the management of persistent or recurrent fistula in the literature; however, several studies reported high failure rates after 2 or more procedures. We present 4 cases managed successfully in a multidisciplinary approach involving fistulectomy and immediate reconstruction with an internal pudendal artery perforator island flap...
August 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27603542/what-is-the-best-initial-empirical-treatment-of-suspected-sepsis-in-a-newborn-readmitted-soon-after-discharge-home-in-an-era-of-increased-resistance-to-antibiotics-a-report-of-two-cases
#5
Elio Castagnola, Livia Gargiullo, Salvatore Renna, Anna Loy, Francesco Risso, Andrea Moscatelli, Ivana Baldelli, Giuliana Cangemi, Roberto Bandettini
Background Colonization/infection by antibiotic-resistant bacteria is becoming a major threat to health care systems. Case report Two septic neonates were readmitted in our hospital few days after hospital discharge. In both of them, microbiological workup revealed an infection caused by multiresistant pathogens. Noteworthy, one baby had received intensive care management for 4 weeks, whereas the other had been vaginally delivered and sent home on his second day of life. Conclusion These cases suggest that in countries and/or hospital with high prevalence of colonization/infection by resistant pathogens in nurseries, neonatal intensive care units, and obstetric wards, the choice of initial therapy of suspected sepsis in a neonate readmitted from home soon after discharge should take into account the possibility of an infection due to a multiresistant pathogen...
September 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27499647/combined-uterine-and-urinary-bladder-rupture-an-unusual-complication-of-obstructed-labor-in-a-primigravida
#6
Idris Usman Takai, Abdulkadir Abubakar
BACKGROUND: Combined uterine and urinary bladder rupture following prolonged obstructed labor is indeed a momentous uro-obstetric emergency. The urinary bladder involvement is distinctly rare in the absence of factors that predispose the bladder to be adherent to the lower uterine segment and is quite unusual in a primigravida. OBJECTIVE: To report a rare case of uterine rupture involving urinary bladder secondary to a prolonged obstructed labor in a primigravida from a low resource setting...
2016: International Journal of Women's Health
https://www.readbyqxmd.com/read/27386763/intensive-care-and-pregnancy-epidemiology-and-general-principles-of-management-of-obstetrics-icu-patients-during-pregnancy
#7
Laurent Zieleskiewicz, Anne Chantry, Gary Duclos, Aurelie Bourgoin, Alexandre Mignon, Catherine Deneux-Tharaux, Marc Leone
In developed countries, the rate of obstetric ICU admissions (admission during pregnancy or the postpartum period) is between 0.5 and 4 per 1000 deliveries and the overall case-fatality rate is about 2%. The most two common causes of obstetric ICU admissions concerned direct obstetric pathologies: obstetric hemorrhage and hypertensive disorders of pregnancy. This review summarized the principles of management of critically ill pregnant patient. Its imply taking care of two patients in the same time. A coordinated multidisciplinary team including intensivists, anesthesiologists, obstetricians, pediatricians and pharmacists is therefore necessary...
October 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27353174/simple-vaginal-trachelectomy-as-a-fertility-sparing-treatment-to-manage-high-grade-dyskaryosis-following-multiple-large-loop-excision-of-the-transformation-zone
#8
Claire Grace Scrivener, Robert Gornall, Philip Rolland
A 34-year-old nullipara, wishing to start a family, presented to colposcopy clinic. Her most recent cervical cytology result showed high-grade dyskaryosis. Having undergone four large loop excisions of the transformation zone during the past 6 years, this woman had no remaining vaginal cervix. In order to excise presumed high-grade cervical intraepithelial neoplasia while mitigating obstetric risk, she underwent a simple vaginal trachelectomy and isthmic cerclage. 6 months later, the patient had a negative test of cure...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27313811/maternal-and-fetal-outcomes-in-term-premature-rupture-of-membrane
#9
Tigist Endale, Netsanet Fentahun, Desta Gemada, Mamusha Aman Hussen
BACKGROUND: Premature rupture of membrane (PROM) is linked to significant maternal prenatal mortalities and morbidity. In Ethiopia, where maternal mortality is still high, the maternal and fetal outcomes in PROM is very important to decrease maternal and child mortality and for better management and prevention of complications. Thus, this study aimed to detect the maternal and fetal outcomes and associated factors in term PROM at Mizan-Aman General Hospital, south-west Ethiopia. METHODS: A retrospective cross sectional study was conducted using data available at Mizan-Aman General Hospital during a period of 3 years (January 2011 to December 2013)...
2016: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27300560/is-maternal-blood-procalcitonin-level-a-reliable-predictor-for-early-onset-neonatal-sepsis-in-preterm-premature-rupture-of-membranes
#10
Orkun Cetin, Zuhal Dilek Aydın, Fatma Ferda Verit, Ali Galip Zebitay, Erbil Karaman, Sadi Elasan, Mehtap Turfan, Oguz Yucel
BACKGROUND: This study is aimed at comparing the early diagnostic accuracy of maternal blood white blood cell (WBC) count, C-reactive protein (CRP) and procalcitonin in predicting early onset neonatal sepsis (EONS) among early preterm premature rupture of membrane (PPROM) pregnancies. METHODS: A total of 57 consecutive pregnancies, complicated with PPROM, between 24 and 34 gestational weeks were recruited to the study at Suleymaniye Maternity Education and Research Hospital, Istanbul, Turkey between January 2012 and January 2013...
June 15, 2016: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/27213855/medical-disease-as-a-cause-of-maternal-mortality-the-pre-imminence-of-cardiovascular-pathology
#11
REVIEW
A O Mocumbi, K Sliwa, P Soma-Pillay
Maternal mortality ratio in low- to middle-income countries (LMIC) is 14 times higher than in high-income countries. This is partially due to lack of antenatal care, unmet needs for family planning and education, as well as low rates of birth managed by skilled attendants. While direct causes of maternal death such as complications of hypertension, obstetric haemorrhage and sepsis remain the largest cause of maternal death in LMICs, cardiovascular disease emerges as an important contributor to maternal mortality in both developing countries and the developed world, hampering the achievement of the millennium development goal 5, which aimed at reducing by three-quarters the maternal mortality ratio until the end of 2015...
March 2016: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/27190690/emergency-peripartum-hysterectomies-at-a-district-general-hospital-in-united-kingdom-10-year-review-of-practice
#12
J Chester, P Sidhu, S Sharma, F Israfil-Bayli
Peripartum haemorrhage is an obstetric emergency which requires effective and timely management. A retrospective analysis was conducted at a single centre district hospital, over a 10-year period to describe factors that would lead to a peripartum hysterectomy. We sought to establish intraoperative and postoperative risks and review outcomes and complications associated with the procedure. A total of 29 cases (incidence 0.8 per 1000) were reviewed over 2001-2011. The mean parity was 1.8 and the mean maternal age was 33 years...
2016: Scientifica
https://www.readbyqxmd.com/read/27132208/evaluating-the-management-of-493-patients-presenting-with-bacteremia-in-23-northern-french-hospitals
#13
S Alfandari, P Cabaret, S Nguyen, D Descamps, A Vachée, C Cattoen, N Van Grunderbeeck
OBJECTIVES: We aimed to update the epidemiology of bacteremia and evaluate their management and short-term outcome. METHODS: We conducted a prospective multicenter survey from October to November 2011. Consecutive patients with at least one positive blood culture (BC) were included in the study. We evaluated the type and adequacy of empirical and documented antibiotic therapy, time to active antibiotic therapy, compliance with guidelines, and 10-day outcome. RESULTS: A total of 23 public and private hospitals and 633 patients (493 true pathogens and 140 contaminants) were included in the study...
June 2016: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/27104602/staphylococcus-infections-in-pregnancy-maternal-and-neonatal-risks
#14
Jan M Kriebs
Staphylococcus aureus is carried by up to one third of the general population; about 2% are carriers for methicillin-resistant S. aureus (MRSA). Infections caused by the antibiotic-resistant form include skin and soft tissue infections, as well as pneumonia, sepsis, and wound infections. Although the risks of hospital-associated systemic infections have decreased with attention to infection control procedures, serious obstetric illness remains a concern. This article describes the range of MRSA infection in the setting of pregnancy and discusses risks to both mother and newborn associated with active MRSA infection during pregnancy and childbirth...
April 2016: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/26825182/pregnancy-associated-severe-sepsis
#15
Lavi Oud
PURPOSE OF REVIEW: This article examines the contemporary knowledge and uncertainties about the burden of pregnancy-associated severe sepsis (PASS), and its manifestations, management, and outcomes. RECENT FINDINGS: There are relatively sparse data on PASS, related in part to infrequent reports and varying use of terminology and case definitions. PASS remains rare, although its incidence appears to be rapidly rising in some high-resource countries, affecting especially women with limited resources, minorities, and those with chronic illness...
April 2016: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/26778884/intensive-care-management-and-outcome-of-women-with-hypertensive-diseases-of-pregnancy
#16
Charles Osalumese Imarengiaye, Theodore Ojeide Isesele
INTRODUCTION: The burden of hypertensive diseases on the health care is enormous given to the high population in Sub-Saharan Africa and related disproportionate representation in global maternal mortality. MATERIALS AND METHODS: All women with hypertensive diseases of pregnancy who got admitted into the general ICU of the University of Benin Teaching Hospital between January 2006 and December 2010 were studied. Only the records of women who completed 28 weeks of gestation and were admitted during labour and delivery or puerperium to the ICU were examined...
September 2015: Nigerian Medical Journal: Journal of the Nigeria Medical Association
https://www.readbyqxmd.com/read/26676884/antithrombin-anti-inflammatory-properties-and-clinical-applications
#17
Jerrold H Levy, Roman M Sniecinski, Ian J Welsby, Marcel Levi
Many humoral and cellular components participate in bidirectional communication between the coagulation and inflammation pathways. Natural anticoagulant proteins, including antithrombin (AT), tissue factor pathway inhibitor, and protein C, suppress proinflammatory mediators. Conversely, inflammation blunts anticoagulant activity and, when uncontrolled, promotes systemic inflammation-induced coagulation, such as those that occur in disseminated intravascular coagulation and severe sepsis. This review discusses the mechanisms of action and clinical use of AT concentrate in critically ill patients and in the settings of perioperative anticoagulation management for surgery and obstetrics...
April 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/26610697/prophylactic-antibiotics-for-manual-removal-of-retained-placenta-during-vaginal-birth-a-systematic-review-of-observational-studies-and-meta-analysis
#18
REVIEW
Ezinne C Chibueze, Alexander J Q Parsons, Erika Ota, Toshiyuki Swa, Olufemi T Oladapo, Rintaro Mori
BACKGROUND: Manual removal of the placenta is an invasive obstetric procedure commonly used for the management of retained placenta. However, it is unclear whether antibiotic prophylaxis is beneficial in preventing infectious morbidity. We conducted a systematic review to determine the efficacy and safety of routine use of antibiotics for preventing adverse maternal outcomes related to manual placenta removal following vaginal birth. METHODS: A detailed search of MEDLINE, EMBASE, Cochrane library and the CINAHL databases was conducted for non-randomized studies involving women undergoing manual placenta delivery after vaginal births and where antibiotic prophylaxis use was compared with no treatment or placebo to prevent maternal infection...
November 26, 2015: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/26591760/uterine-rupture-a-retrospective-analysis-of-causes-complications-and-management-outcomes-at-muhimbili-national-hospital-in-dar-es-salaam-tanzania
#19
Hussein L Kidantou, Ipyana Mwampagatwa, Jos Van Roosmalen
Rupture of the gravid uterus is an obstetric catastrophe that is associated with complications that include massive blood loss, hysterectomy, and damage to the genitourinary tract. It is a serious complication that is associated with high maternal and perinatal morbidity and mortality. We conducted a retrospective review of case notes (from 2003 to 2009) to determine the incidence, causes, complications and foetal/maternal outcome among women with a diagnosis of ruptured uterus at Muhimbili National Hospital (MNH) in Dar es Salaam Tanzania...
July 2012: Tanzania Journal of Health Research
https://www.readbyqxmd.com/read/26558184/changing-picture-of-renal-cortical-necrosis-in-acute-kidney-injury-in-developing-country
#20
Jai Prakash, Vijay Pratap Singh
Renal cortical necrosis (RCN) is characterized by patchy or diffuse ischemic destruction of all the elements of renal cortex resulting from significantly diminished renal arterial perfusion due to vascular spasm and microvascular injury. In addition, direct endothelial injury particularly in setting of sepsis, eclampsia, haemolytic uremic syndrome (HUS) and snake bite may lead to endovascular thrombosis with subsequent renal ischemia. Progression to end stage renal disease is a rule in diffuse cortical necrosis...
November 6, 2015: World Journal of Nephrology
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