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related to obstetrics

Shirley Greenbaum, Gili Greenbaum, Jacob Moran-Gilad, Adi Y Weintruab
The bacterial composition of the vaginal microbiome is thought to be related to health and disease states of women. This microbiome is particularly dynamic, with compositional changes related to pregnancy, menstruation, and disease states such as bacterial vaginosis. In order to understand these dynamics and their impact on health and disease, ecological theories have been introduced to study the complex interactions between the many taxa in the vaginal bacterial ecosystem. The goal of this review is to introduce the ecological principles that are used in the study of the vaginal microbiome and its dynamics, and to review the application of ecology to vaginal microbial communities with respect to health and disease...
November 14, 2018: American Journal of Obstetrics and Gynecology
Edward Jegasothy, Jillian Patterson, Deborah Randall, Tanya A Nippita, Judy M Simpson, David O Irving, Jane B Ford
BACKGROUND: While red blood cell transfusion rates have declined in most Australian medical specialties, obstetric transfusion rates have instead been increasing. Obstetric transfusions are mostly linked to postpartum haemorrhage, the rates of which have also increased over time. This study used two methodological approaches to investigate recent trends in obstetric transfusion in New South Wales (NSW) and the extent to which this was influenced by changing maternal and pregnancy characteristics...
November 16, 2018: BMC Medical Research Methodology
Christopher W H Yau, Elena Pizzo, Chetankumar Prajapati, Tim Draycott, Erik Lenguerrand
BACKGROUND: Obstetric brachial plexus injuries (OBPIs) are rare but can have significant implications for those affected, their caregivers and the health system. Symptoms can range from restricted movement to complete paralysis of the arm. We investigated health-related quality of life in adults with OBPIs and parents of children with permanent OBPIs, compared these with population norms, and investigated whether certain socio-demographic or clinical factors were associated with the quality of life in these cohorts...
November 15, 2018: Health and Quality of Life Outcomes
O Novák, P Vašek, M Gärtner, J Krhut
OBJECTIVE: Description of rare complication of long-term uterine prolaps. Desing: Case report. SETTING: Department of Obstetric and Gynecology, University Hospital Ostrava. CASE REPORT: A seventy-years-old pacient with longterm complete uterine prolaps underwent vaginal hysterectomy with colpoclesis at department of Obstetric and Gynecology of university hospital Ostrava in August 2017. The surgery was planned more than year ago, when patient had no symptoms...
2018: Ceská Gynekologie
Dexue Zu, Yi Zhuge
OBJECTIVE: To observe the changes of shock index (SI) and diastolic blood pressure (DBP) in postpartum hemorrhage patients, and the explore their relationship with postpartum hemorrhage and the clinical significance of early warning of hemorrhage risk. METHODS: 402 patients with postpartum hemorrhage (within 24 hours after delivery, the amount of bleeding in vaginal delivery ≥ 500 mL, and the amount of bleeding in caesarean delivery ≥ 1 000 mL) admitted to the obstetrics ward of Affiliated Hospital of Hangzhou Normal University from January 2014 to December 2017 were selected as the objective group and 416 without complications during delivery were selected as the control group in the same hospital at the same period...
October 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Angela McBrien, Lisa K Hornberger
OBJECTIVES: To explore the technical aspects and clinical utility of early fetal echocardiography and screening of the fetal heart in early pregnancy. Also, to document differences in cardiac structure and function which can be demonstrated in the late first/early second trimesters. METHODS: In addition to summarizing our own experiences of late first/early second trimester fetal echocardiography, we reviewed the literature to explore clinical indications for, technical aspects, safety, accuracy, strengths and weaknesses of early fetal echocardiography...
November 14, 2018: Birth Defects Research
Ozgur Ozyuncu, Gokcen Orgul, Atakan Tanacan, Fatih Aktoz, Naz Guleray, Erdem Fadiloglu, Mehmet Sinan Beksac
This is a retrospective study of 139 termination of pregnancies (TOPs) between November 2015 and November 2017 to demonstrate the indications. We have shown that 60.4%, 34.5% and 5% of the terminations were performed because of genetic disorders, foetal or obstetrical problems, and maternal causes, respectively. Congenital abnormalities (43.8%), anhydramniosis (17.2%) and chromosomal abnormalities (15.1%) were the most frequent causes of the TOPs. The central nervous system seemed to be the most frequent indicator found in our study...
November 14, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Ricardo Motta Pereira, Giovanna de Oliveira Fonseca, Ana Célia Cirino Costa Pereira, Gabrielly Antunes Gonçalves, Roberta Amaral Mafra
The humanization of care in childbirth and the choice of performing cesarean or vaginal delivery have long been discussed in Brazil and worldwide. The complexities of the factors surrounding this issue range from the quality of obstetric care through to the significance of childbirth for women. A new proposal for humanization of delivery was introduced by the Brazilian Ministry of Health, the objectives of which were to make changes to the current system of delivery practices regarding, access, care, quality and resolution, in order to make it a more human and less technical experience...
November 2018: Ciência & Saúde Coletiva
Lílian Machado Vilarinho de Moraes, Vanda Maria Ferreira Simões, Carolina de Abreu Carvalho, Rosângela Fernandes Lucena Batista, Maria Teresa Seabra Soares de Britto E Alves, Érika Bárbara Abreu Fonseca Thomaz, Marco Antônio Barbieri, Claudia Maria Coelho Alves
The objectives of this study were to estimate the involuntary pilgrimage by women in labor in search of childbirth care and to identify factors associated with this endeavor in two Brazilian cities. This was a cross-sectional study nested in the BRISA birth cohort, whose sample consisted of 10,475 women admitted to the selected maternity hospitals for delivery in São Luís (Maranhão State) and Ribeirão Preto (São Paulo State). Interviews were held with questionnaires that contained sociodemographic and obstetric variables...
November 8, 2018: Cadernos de Saúde Pública
Ayele Geleto, Catherine Chojenta, Abdulbasit Musa, Deborah Loxton
BACKGROUND: Nearly 15% of pregnancies end in fatal perinatal obstetric complications including bleeding, infections, hypertension, obstructed labour and complications of abortion. Globally, an estimated 10.7 million women have died due to obstetric complications in the last two decades, and two thirds of these deaths occurred in sub-Saharan Africa. Though the majority of maternal mortalities can be prevented, different factors can hinder women's access to emergency obstetric services...
November 13, 2018: Systematic Reviews
W Y Gu, X Tao, L L Zhang, L Wang, X R Zhou, Y Ning
Objective: To describe the clinicopathological features of synchronous mucinous metaplasia and neoplasia of the female genital tract (SMMN-FGT). Methods: The sample consisted of 7 cases of SMMN-FGT recorded from November 2014 to September 2017 at Obstetrics and Gynecology Hospital, Fudan University.PAP method was used in immunohistochemistry.Clinical histories were retrieved and pathological slides were reviewed. Results: The patients were 37 to 70 years old(mean 54 years old). All patients showed endometrial mucinous lesions associated with cervical lesions...
November 8, 2018: Zhonghua Bing Li Xue za Zhi Chinese Journal of Pathology
Carlos H S de Andrade, Renata C L Bitencourt, Ruanna K G de Freitas, Larissa F da Cunha, Daniela C Matos, Pedro I C Lira, Leila Barbosa, Andrea Lemos
BACKGROUND: Due to biological immaturity and unfavorable psychosocial conditions, it is conjectured that teenage pregnancy may be associated with disorders such as pelvic girdle pain. The evidence for risk factors for pelvic girdle pain in pregnant adolescents remains unclear. OBJECTIVES: To evaluate the factors associated with pelvic girdle pain related to pregnancy in adolescents. DESIGN: Case-control study. METHOD: Seventy three pregnant women with presence of pelvic girdle pain (case group) and 331 pregnant women without pelvic girdle pain (control group) aged between 10 and 19 years, with gestational age between 28 and 40 weeks were included...
September 25, 2018: Musculoskeletal Science & Practice
James L Whiteside, Carson T Kaeser, Beri Ridgeway
Value-based care, best clinical outcome relative to cost, is a priority in correcting the high costs for average clinical outcomes of health care delivery in the United States. Hysterectomy represents the most common and identifiable non-obstetric major surgical procedure among women. Surgical approaches to hysterectomy in the United States have changed in recent decades. For benign indications, clinical evidence identifies the superiority of vaginal hysterectomy to all other routes. These conclusions rest on clinical outcomes; however, cost differentials also exist across hysterectomy approach with the vaginal approach consistently possessing the lowest overall costs...
November 9, 2018: American Journal of Obstetrics and Gynecology
David Kotwinski, Laura Paton, Roger Langford
The delivery of oxygen is a key component of anaesthetic practice. High flow nasal oxygen therapy is a relatively new addition to more traditional means of oxygenation which provides heated and humidified flows of controlled oxygen/air mixes achieving rates of up to 120 litres/min. The physiological benefits include nasopharyngeal dead space washout, reduced work of breathing, alveolar recruitment, maintained mucociliary function and the ability to provide apnoeic oxygenation. This article considers the current evidence for high flow nasal oxygen therapy in perioperative anaesthetic care during pre-oxygenation and intubation, management of the difficult airway, oxygenation for shared airway surgery, extubation and postoperative support, obstetric and paediatric anaesthesia...
November 2, 2018: British Journal of Hospital Medicine
Joanna Miller, Emuejevoke Chuba, Stacie Deiner, Samuel DeMaria, Daniel Katz
Despite increasing representation in medicine, women continue to be a minority in academic practice and leadership, especially in male-dominated fields like anesthesiology. Differences in compensation and participation in leadership may represent barriers to career advancement for women in anesthesiology. Key factors for promotion in academic anesthesiology are research, funding, and publication. As such, designation as a first or senior author on a publication in a professional journal may act as currency for promotion...
November 9, 2018: Anesthesia and Analgesia
Haihong Chen, Chenxi Liu, Junjie Liu, Yuqing Tang, Xinping Zhang
BACKGROUND: The research evaluated the impact of intravenous antimicrobial restriction strategy (IARS) on different types of hospitals in China for evidence-based management, for outpatients implemented in 2016. METHODS: Based on panel data on antimicrobial use in 121 tertiary hospitals in Zhejiang, China, segmented regression analysis was used to evaluate the impact of IARS in children's hospitals (CHs), obstetrics and gynecology hospitals (OGHs), women's and children's hospitals (WCHs), traditional Chinese medicine hospitals (TCMHs) and general hospitals (GHs)...
November 11, 2018: Expert Review of Pharmacoeconomics & Outcomes Research
Naina Kumar, Amit K Singh
OBJECTIVE: Assess the relationship between maternal serum uric acid and severity of Hypertensive disorders of pregnancy in a rural tertiary care centre. MATERIALS AND METHODS: Present study was conducted in Obstetrics and Gynaecology department of rural tertiary care centre of Northern India over seven months (October 2016-May 2017) on 110 women admitted with a Hypertensive disorder of pregnancy (Gestational hypertension, Pre-eclampsia, Eclampsia) at ≥34 weeks gestation...
November 12, 2018: Current Hypertension Reviews
Íris Axelsdóttir, Gunilla Ajne
The decrease in pH in monochorionic (MC) second twin may exceed that of dichorionic (DC) second twin during vaginal twin delivery. The aim of this study was to investigate the effect of chorionicity on the umbilical artery pH of the second twin in relation to increased twin-to-twin delivery time interval (DTI) from 30 weeks of gestation. A hospital based cohort of all twin deliveries after 30 completed weeks of gestation with the first twin delivered vaginally between 2007 and 2012 in four delivery units in Stockholm county was conducted...
November 10, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Michael Geary, P James A Ruiter, Abdool S Yasseen
There are many ways to account for the return on investment (ROI) in healthcare: improved communication, teamwork, culture, patient satisfaction, staff satisfaction, and clinical outcomes are but a few. Some of these are easier to quantify and associate to an intervention than others. What if the outcomes listed were not just independent results, but beget one another? In 2001, the Society of Obstetricians and Gynaecologists of Canada created the Managing Obstetrical Risk Efficiently (MOREOB ) programme, to improve healthcare culture and patient outcomes in obstetrics by leveraging front-line ownership...
November 8, 2018: Journal of Interprofessional Care
Emily M Olson, Renee D Kramer, Crystal Gibson, Cynthia K Wautlet, Nicholas B Schmuhl, Deborah B Ehrenthal
INTRODUCTION: Long-acting reversible contraceptives (LARC), specifically implants and intrauterine devices (IUD), are highly effective, low maintenance forms of birth control. Practice guidelines from the American College of Obstetricians and Gynecologists, American Academy of Family Physicians, and American Academy of Pediatrics recommend that LARC be considered first-line birth control for most women; however, uptake remains low. In this study, we sought to understand practices and barriers to provision of LARC in routine and immediate postpartum settings as they differ between specialties...
October 2018: WMJ: Official Publication of the State Medical Society of Wisconsin
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