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https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#1
C McDonald, J Laurie, S Janssens, C Zazulak, P Kotze, K Shekar
Mortality during pregnancy in a well-resourced setting is rare, but acute pulmonary embolism is one of the leading causes. We present the successful use of extracorporeal cardiopulmonary resuscitation (eCPR) in a 22-year old woman who experienced cardiopulmonary collapse following urgent caesarean section in the setting of a sub-massive pulmonary embolus. Resources and personnel to perform eCPR were not available at the maternity hospital and were recruited from an adjacent pediatric hospital. Initial care used low blood flow extracorporeal membrane oxygenation (ECMO) with pediatric ECMO circuitry, which was optimized when the team from a nearby adult cardiac hospital arrived...
January 9, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28177969/zika-virus-practical-information-for-the-plastic-and-reconstructive-surgeon
#2
Nicholas A Calotta, Justin M Sacks, Anand R Kumar
The ongoing Zika virus outbreak in South, Central, and, most recently, North America has become a global health care emergency. Originally thought to be a benign, self-limiting viral syndrome, the newest epidemic has provided convincing evidence that maternal Zika virus infection can lead to neonatal malformations, the so-called congenital Zika syndrome. The alarming number of microcephalic neonates being born during the current outbreak is most notable, though several other anomalies, such as arthrogryposis, redundant scalp tissue, and cranial collapse, have been reported...
February 8, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28162042/the-syrian-public-health-and-humanitarian-crisis-a-displacement-in-global-governance
#3
Sumaira Akbarzada, Tim K Mackey
Ongoing failure by the international community to resolve the Syrian conflict has led to destruction of critical infrastructure. This includes the collapse of the Syrian health system, leaving millions of internally displaced persons (IDPs) in urgent need of healthcare services. As the conflict intensifies, IDP populations are suffering from infectious and non-communicable disease risks, poor maternal and child health outcomes, trauma, and mental health issues, while healthcare workers continually exit the country...
February 4, 2017: Global Public Health
https://www.readbyqxmd.com/read/28046002/competition-for-materno-fetal-resource-partitioning-in-a-rabbit-model-of-undernourished-pregnancy
#4
Jorge Lopez-Tello, Maria Arias-Alvarez, Maria Angeles Jimenez-Martinez, Rosa Maria Garcia-Garcia, Maria Rodriguez, Pedro Luis Lorenzo Gonzalez, Ruben Bermejo-Poza, Antonio Gonzalez-Bulnes, Pilar Garcia Rebollar
The major goal of animal production is to obtain abundant and healthy meat for consumers. Maternal food restriction (MFR) is often applied in farms to reduce production costs. However, the suitability of MFR in livestock animals is questionable, as this management may compromise maternal fitness due to a severe negative energetic balance and can induce Intrauterine Growth Restriction (IUGR) and prenatal programming in the offspring. Here, we sought to determine, using pregnant rabbits, the consequences of MFR on maternal endocrine and metabolic status and conceptus development...
2017: PloS One
https://www.readbyqxmd.com/read/28031077/deployment-of-medical-relief-teams-of-the-indian-army-in-the-aftermath-of-the-nepal-earthquake-lessons-learned
#5
Ashutosh Chauhan, Bhushan Kumar Chopra
In April 2015 a 7.8-magnitude earthquake hit Nepal. As part of relief operations named Operation Maitri, the Indian Armed Forces deployed 3 field hospitals in the disaster zone. Rapid deployment of mobile surgical teams to far-flung, inaccessible areas was done by helicopters. In an operational deployment spanning 1 month, a total of 7532 patients were treated and 105 surgeries were carried out on 83 patients. One-fifth of the patients were less than 18 years of age. One-third of the patients had traumatic injuries directly attributable to the earthquake, whereas the remaining patients were treated for diseases of poor sanitation and hygiene as well as chronic illness that had been neglected owing to the collapse of the local health infrastructure...
December 29, 2016: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/27927722/age-dependent-control-of-energy-homeostasis-by-brown-adipose-tissue-in-progeny-subjected-to-maternal-diet-induced-fetal-programming
#6
Olivier Dumortier, Estelle Roger, Didier F Pisani, Virginie Casamento, Nadine Gautier, Patricia Lebrun, Hereroa Johnston, Pascal Lopez, Ez-Zoubir Amri, Céline Jousse, Pierre Fafournoux, Marc Prentki, Charlotte Hinault, Emmanuel Van Obberghen
Epidemiological and animal studies show that deleterious maternal environments predispose aging offspring to metabolic disorders and type 2 diabetes. Young progeny in a rat model of maternal low protein diet (LP) is normoglycemic despite collapsed insulin secretion. However, without further worsening of the insulin secretion defect glucose homeostasis deteriorates in aging LP descendants. Here we report that normoglycemic and insulinopenic 3-month-old LP progeny shows increased body temperature and energy dissipation in association with enhanced brown adipose tissue (BAT) activity...
December 7, 2016: Diabetes
https://www.readbyqxmd.com/read/27888446/cesarean-section-in-the-setting-of-severe-pulmonary-hypertension-requiring-extracorporeal-life-support
#7
Ryosuke Hara, Shuhei Hara, Chin Siang Ong, Gary Schwartz, Christopher Sciortino, Narutoshi Hibino
We describe the use of veno-arterial extracorporeal membrane oxygenation (ECMO) in a 35-year-old female with severe fixed pulmonary hypertension who went into cardiogenic shock during a Cesarean section. Pregnancy in the presence of severe pulmonary hypertension is typically contraindicated due to high maternal mortality rates. This patient visited our hospital at 37 weeks of gestation after experiencing dyspnea and chest pain. Clinical evaluation revealed severe fixed pulmonary hypertension. At the time of the planned delivery, femoral lines were placed; in case of emergency, ECMO became necessary during the delivery...
November 25, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27887572/maternal-smoking-impacts-key-biological-pathways-in-newborns-through-epigenetic-modification-in-utero
#8
Daniel M Rotroff, Bonnie R Joubert, Skylar W Marvel, Siri E Håberg, Michael C Wu, Roy M Nilsen, Per M Ueland, Wenche Nystad, Stephanie J London, Alison Motsinger-Reif
BACKGROUND: Children exposed to maternal smoking during pregnancy exhibit increased risk for many adverse health effects. Maternal smoking influences methylation in newborns at specific CpG sites (CpGs). Here, we extend evaluation of individual CpGs to gene-level and pathway-level analyses among 1062 participants in the Norwegian Mother and Child Cohort Study (MoBa) using the Illumina 450 K platform to measure methylation in newborn DNA and maternal smoking in pregnancy, assessed using the biomarker, plasma cotinine...
November 25, 2016: BMC Genomics
https://www.readbyqxmd.com/read/27870297/household-financial-distress-and-initial-endowments-evidence-from-the-2008-financial-crisis
#9
Arna Olafsson
This paper studies in utero exposure to the 2008 financial crisis. Exploiting the sudden and unexpected collapse of the Icelandic economy, I find that first-trimester exposure to the crisis led to a sizable and significant reduction in birth weight, increased the probability of a low birth weight ( < 2500 g), and decreased the probability of a high birth weight ( > 4000 g). I also find evidence that the collapse reduced the sex ratio, indicating selection in utero due to maternal prenatal stress exposure...
November 2016: Health Economics
https://www.readbyqxmd.com/read/27865449/characterizing-nuclear-and-mitochondrial-dna-in-spent-embryo%C3%A2-culture-media-genetic-contamination-identified
#10
Elizabeth R Hammond, Brent C McGillivray, Sophie M Wicker, John C Peek, Andrew N Shelling, Peter Stone, Larry W Chamley, Lynsey M Cree
OBJECTIVE: To characterize nuclear and mitochondrial DNA (mtDNA) in spent culture media from normally developing blastocysts to determine whether it could be used for noninvasive genetic assessment. DESIGN: Prospective embryo cohort study. SETTING: Academic center and private in vitro fertilization (IVF) clinic. PATIENT(S): Seventy patients undergoing intracytoplasmic sperm injection (ICSI) and 227 blastocysts. INTERVENTION(S): Culture media assessment, artificial blastocoele fluid collapse and DNA analysis using digital polymerase chain reaction (dPCR), long-range PCR, quantitative PCR (qPCR), and DNA fingerprinting...
January 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/27680784/a3-oxidative-stress-in-maternal-serum-as-endothelial-dysfunction-marker-in-preeclampsia-an-electron-paramagnetic-resonance-epr-pilot-study
#11
D Mannaerts, E Faes, J Gielis, J Briedé, P Cos, E Van Craenenbroeck, W Gyselaers, J Cornette, M Spaanderman, Y Jacquemyn
AIMS: Oxidative stress is crucial in the pathophysiology of preeclampsia. Reactive oxygen species (ROS) like the superoxide radical O2-, are produced by the ischemic placenta, causing systemic inflammation and endothelial dysfunction. EPR uses microwave radiation and a high magnetic field and is the most direct and reliable method to detect free radicals. We explored the feasibility of determining O2- concentration in maternal serum and compared pre-eclamptic and uncomplicated pregnancies...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27580649/investigating-the-pertussis-resurgence-in-england-and-wales-and-options-for-future-control
#12
Yoon Hong Choi, Helen Campbell, Gayatri Amirthalingam, Albert Jan van Hoek, Elizabeth Miller
BACKGROUND: In 2012 England and Wales experienced a resurgence of pertussis and an increase in infant deaths. This occurred 8 years after acellular pertussis (aP) vaccine replaced whole cell (wP) primary vaccine despite continued high coverage for the primary series and pre-school aP booster. We developed a mathematical model to describe pertussis transmission dynamics in England and Wales since the 1950s and used it to investigate the cause of the resurgence and the potential impact of additional vaccination strategies...
2016: BMC Medicine
https://www.readbyqxmd.com/read/27550975/safe-sleep-and-skin-to-skin-care-in-the-neonatal-period-for-healthy-term-newborns
#13
Lori Feldman-Winter, Jay P Goldsmith
Skin-to-skin care (SSC) and rooming-in have become common practice in the newborn period for healthy newborns with the implementation of maternity care practices that support breastfeeding as delineated in the World Health Organization's "Ten Steps to Successful Breastfeeding." SSC and rooming-in are supported by evidence that indicates that the implementation of these practices increases overall and exclusive breastfeeding, safer and healthier transitions, and improved maternal-infant bonding. In some cases, however, the practice of SSC and rooming-in may pose safety concerns, particularly with regard to sleep...
September 2016: Pediatrics
https://www.readbyqxmd.com/read/27534927/registered-nurses-experiences-of-caring-for-pregnant-and-postpartum-women-in-general-hospital-settings-a-systematic-review-and-meta-synthesis-of-qualitative-data
#14
REVIEW
Sara Bayes, Beverley Ewens
AIMS AND OBJECTIVES: To understand how nurses view and experience caring for pregnant and postpartum women in nonmaternity care settings. BACKGROUND: A degree of apprehension is perceived to exist among nurses in relation to caring for pregnant or postpartum women in nonmaternity care settings. The nature of nonmidwife nurses' concerns about caring for this group of women in these contexts, however, is not known. DESIGN: A six-step systematic approach was employed for this review...
August 18, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27530240/newborn-pulse-oximetry-screening-in-practice
#15
Abdul Qader Tahir Ismail, Matt Cawsey, Andrew K Ewer
The concept of using pulse oximetry (PO) as a screening test to identify newborn babies with critical congenital heart defects (CCHD) before life-threatening collapse occurs has been debated for some time now. Several recent large studies have consistently shown that PO screening adds value to existing screening techniques with over 90% of CCHDs detected. It can also help identify newborn babies with low oxygen saturations due to infection, respiratory disease and non-critical CCHD. Many countries have now introduced PO screening as routine practice, and as screening gains more widespread acceptance in the UK, we have focused more on the practical aspects of screening in this article...
August 16, 2016: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/27503214/excessive-bleeding-is-a-normal-cleansing-process-a-qualitative-study-of-postpartum-haemorrhage-among-rural-uganda-women
#16
Sam Ononge, Elialilia Sarikiaeli Okello, Florence Mirembe
BACKGROUND: Postpartum haemorrhage (PPH) remains the leading cause of maternal morbidity and mortality worldwide. The main strategy for preventing PPH is the use of uterotonic drugs given prophylactically by skilled health workers. However, in settings where many women still deliver at home without skilled attendants, uterotonics are often inaccessible. In such cases, women and their caregivers need to recognize PPH promptly so, as to seek expert care. For this reason, it is important to understand how women and their caregivers recognize PPH, as well as the actions they undertake to prevent and treat PPH in home births...
2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27492552/the-burden-of-maternal-morbidity-and-mortality-attributable-to-hypertensive-disorders-in-pregnancy-a-prospective-cohort-study-from-uganda
#17
Annettee Nakimuli, Sarah Nakubulwa, Othman Kakaire, Michael Odongo Osinde, Scovia Nalugo Mbalinda, Nelson Kakande, Rose Chalo Nabirye, Dan Kabonge Kaye
BACKGROUND: Hypertensive disorders of pregnancy are a major cause of morbidity and mortality. The objective was to estimate the disease burden attributable to hypertensive disorders of pregnancy in two referral hospitals in Uganda. METHODS: Through a prospective cohort study conducted in Jinja and Mulago hospitals in Uganda from March 1, 2013 and February 28, 2014, hypertension-related cases were analyzed. Maternal near miss cases were defined according to the WHO criteria...
2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27275795/control-of-postpartum-hemorrhage-using-vacuum-induced-uterine-tamponade
#18
Yuditiya Purwosunu, Widyastuti Sarkoen, Sabaratnam Arulkumaran, Jan Segnitz
BACKGROUND: Postpartum hemorrhage is the leading cause of maternal mortality worldwide. Vacuum-induced uterine tamponade is a possible alternative approach to balloon tamponade systems for the treatment of postpartum hemorrhage resulting from atony. METHOD: In a prospective proof-of-concept investigation of 10 women with vaginal deliveries in a hospital setting who failed first-line therapies for postpartum hemorrhage, tamponade was used. Vacuum-induced uterine tamponade was created through a device inserted transvaginally into the uterine cavity...
July 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27275041/amniotic-fluid-embolism
#19
REVIEW
Kiranpreet Kaur, Mamta Bhardwaj, Prashant Kumar, Suresh Singhal, Tarandeep Singh, Sarla Hooda
Amniotic fluid embolism (AFE) is one of the catastrophic complications of pregnancy in which amniotic fluid, fetal cells, hair, or other debris enters into the maternal pulmonary circulation, causing cardiovascular collapse. Etiology largely remains unknown, but may occur in healthy women during labour, during cesarean section, after abnormal vaginal delivery, or during the second trimester of pregnancy. It may also occur up to 48 hours post-delivery. It can also occur during abortion, after abdominal trauma, and during amnio-infusion...
April 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27211568/maternal-collapse-challenging-the-four-minute-rule
#20
M D Benson, A Padovano, G Bourjeily, Y Zhou
INTRODUCTION: The current approach to, cardiopulmonary resuscitation of pregnant women in the third trimester has been to adhere to the "four-minute rule": If pulses have not returned within 4min of the start of resuscitation, perform a cesarean birth so that birth occurs in the next minute. This investigation sought to re-examine the evidence for the four-minute rule. METHODS: A literature review focused on perimortem cesarean birth was performed using the same key words that were used in formulating the "four-minute rule...
April 2016: EBioMedicine
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