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related to obstetrics

Riitta M Antila-Långsjö, Johanna U Mäenpää, Heini S Huhtala, Eija I Tomás, Synnöve M Staff
BACKGROUND: Cesarean scar defect (isthmocele) is a known complication after cesarean delivery. It has become more common due to a rising cesarean delivery rate. Isthmocele has been associated with various gynecological and obstetric problems such as uterine rupture, cesarean scar pregnancy and bleeding disorders. OBJECTIVE: To prospectively investigate factors associated with the risk for isthmocele assessed by sonohysterography. STUDY DESIGN: A prospective observational cohort study was conducted in 401 non-pregnant women who were recruited within three days of cesarean delivery...
September 18, 2018: American Journal of Obstetrics and Gynecology
Rebecca Deans, Thierry Vancaillie, William Ledger, Jinzhu Liu, Jason A Abbott
STUDY QUESTION: What are the live birth rate and risks of obstetric complications following the surgical management of intrauterine adhesions (IUA) such as Asherman syndrome (AS)? SUMMARY ANSWER: The live birth rate is 63.7%, and obstetric complications including placentation issues, prematurity and postpartum hysterectomy require that pregnancies in women after treatment for IUA should be considered moderate to high risk. WHAT IS KNOWN ALREADY: Studies reviewing short-term surgical, menstrual and fertility outcomes following hysteroscopic management are reassuring, with success correlated to the severity of IUA...
September 18, 2018: Human Reproduction
Sunil T Pandya, Kiran Mangalampally
Pregnancy is a normal physiologic process with the potential for pathologic states. Pregnancy has several unique characteristics including an utero-placental interface, a physiologic stress that can cause pathologic states to develop, and a maternal-foetal interface that can affect two lives simultaneously or in isolation. Critical illness in pregnant women may result from deteriorating preexisting conditions, diseases that are co-incidental to pregnancy, or pregnancy-specific conditions. Successful maternal and neonatal outcomes for parturients admitted to a maternal critical care facility are largely dependent on a multidisciplinary input to medical or surgical condition from critical care physicians, obstetric anaesthesiologists, obstetricians, obstetric physicians, foetal medicine specialists, neonatologists, and concerned specialists...
September 2018: Indian Journal of Anaesthesia
D J N Wong, S K Harris, S R Moonesinghe
BACKGROUND: Cancellation of planned surgery impacts substantially on patients and health systems. This study describes the incidence and reasons for cancellation of inpatient surgery in the UK NHS. METHODS: We conducted a prospective observational cohort study over 7 consecutive days in March 2017 in 245 NHS hospitals. Occurrences and reasons for previous surgical cancellations were recorded. Using multilevel logistic regression, we identified patient- and hospital-level factors associated with cancellation due to inadequate bed capacity...
October 2018: British Journal of Anaesthesia
Shoichi Magawa, Hiroaki Tanaka, Fumi Furuhashi, Shintaro Maki, Masafumi Nii, Kuniaki Toriyabe, Tomoaki Ikeda
PURPOSE: Hepatitis due to herpes simplex virus (HSV) during pregnancy is rare, it is often not included in the differential disease. However, hepatitis leads to maternal death; hence, early diagnosis is necessary. Hepatic enzyme elevation in late pregnancy is often associated with obstetric-related diseases, such as acute gestational fatty liver and HELLP syndrome (hemolytic anemia, elevated liver enzymes, low platelet count). These pregnancy-related diseases often improve maternal condition after completion of pregnancy, but in patients with HSV hepatitis, invasive treatment, such as cesarean section, may lead to deterioration of maternal condition after completion of pregnancy...
September 20, 2018: Journal of Maternal-fetal & Neonatal Medicine
Ana Olga Mocumbi, Keila K Jamal, Amam Mbakwem, Maylene Shung-King, Karen Sliwa
This position paper summarises the current knowledge on the epidemiology, diagnosis and management of women of childbearing age with rheumatic heart disease (RHD) in Africa, as well as the available data on their use of reproductive health services. The aim is to provide guidance to health professionals on aspects of sexual and reproductive health in women with RHD. It reviews the diagnosis, management and counselling of women with RHD throughout their reproductive life. Additionally, this publication discusses potential ways of integrating obstetric and cardiovascular care at peripheral levels of the health systems, as a way of improving outcomes and reducing maternal mortality rates related to cardiovascular disease in Africa...
September 18, 2018: Cardiovascular Journal of Africa
Yousef S Khader, Mohammad S Alyahya, Nihaya A Al-Sheyab, Khulood K Shattnawi, Hind Rajeh Saqer, Anwar Batieha
Objectives: This study aimed to assess the maternal and newborn services in Jordanian hospitals to provide policymakers, health professionals, and researchers with a clear picture about the current status of maternal and newborn health services. Methods: A total of 32 main hospitals that provide maternity services in Jordan were assessed. The study involved direct observations of these hospitals and interviews with basic health and hospital staff, with the purpose of assessing and evaluating the availability of various services for mothers and newborns, availability of resources, equipment and supplies, documentation and staff training, and provision of the health care services...
2018: Journal of Multidisciplinary Healthcare
Danielly Scaranello Santana, Fernanda Garanhani Surita, José Guilherme Cecatti
Twin pregnancy accounts for 2 to 4% of total births, with a prevalence ranging from 0.9 to 2.4% in Brazil. It is associated with worse maternal and perinatal outcomes. Many conditions, such as severe maternal morbidity (SMM) (potentially life-threatening conditions and maternal near-miss) and neonatal near-miss (NNM) still have not been properly investigated in the literature. The difficulty in determining the conditions associated with twin pregnancy probably lies in its relatively low occurrence and the need for larger population studies...
September 2018: Revista Brasileira de Ginecologia e Obstetrícia
Amanda von Bismarck, Birgit Ertl-Wagner, Sophia Stöcklein, Franziska Schöppe, Christoph Hübener, Linda Hertlein, Dominique Baron-Tomlinson, Sven Mahner, Maria Delius, Uwe Hasbargen, Marie Franz
PURPOSE:  Antepartal MR pelvimetry is used to assess the viability of vaginal breech delivery. We evaluated the reliability of MR pelvimetric measurements as well as incidental findings noted by different clinicians and assessed potential reference values. METHODS:  In this monocentric study, the radiologic database was searched for obstetric MR pelvimetries with singleton breech pregnancies between 1999 and 2016. 99 consecutive MR pelvimetries were included...
September 19, 2018: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Kandice J Varcin, John P Newnham, Andrew J O Whitehouse
There is an emerging body of evidence demonstrating that maternal obesity at the time of conception increases the risk for Autism Spectrum Disorders (ASD) among offspring. We explored whether pre-pregnancy weight was related to autistic-like traits among offspring not diagnosed with ASD. A large sample of women, recruited during the second trimester of pregnancy, had their height measured and reported their pre-pregnancy weight. These measurements were then converted to a Body Mass Index (BMI) using the formula: (weight in kilograms)/(height in metres2 )...
September 19, 2018: Autism Research: Official Journal of the International Society for Autism Research
G Glover, R Williams, G Tompkins, J Oyinlola
INTRODUCTION: Providing safe, high-quality admitted-patient care for people with intellectual disabilities (IDs) requires consideration for their special needs particularly in relation to communication and consent. To make allowance for these special requirements, it would be helpful for hospitals to know how often they are likely to arise. This study set out to identify the amount and patterns of use of acute, non-psychiatric hospital admitted-patient care in England by people with ID...
September 16, 2018: Journal of Intellectual Disability Research: JIDR
Arunaz Kumar, Euan M Wallace, Cathy Smith, Debra Nestel
PROBLEM: Interprofessional training programs for obstetric emergencies have been introduced for up-skilling birth unit staff in hospitals but not frequently used in training midwives and paramedicine staff for home birth emergency. BACKGROUND: Practical Obstetric Multiprofessional Training (PROMPT) has previously been described in the home birth setting using in-situ simulation training of home births for midwifery and paramedicine staff. AIM: The aim of this study was to evaluate the benefit of the home birth simulation in clinical practice and to explore how the simulation program prepared the midwives for a birth-related emergency in a publicly funded home birth program...
September 13, 2018: Women and Birth: Journal of the Australian College of Midwives
Rudolph L Gleason, Mahlet Yigeremu, Tequam Debebe, Sisay Teklu, Daniel Zewdeneh, Michael Weiler, Nate Frank, Lorenzo Tolentino, Shehab Attia, J Brandon Dixon, Catherine Kwon, Anastassia Pokutta-Paskaleva, Katie A Gleason
Cephalopelvic disproportion (CPD)-related obstructed labor is accountable for 3-8% of the maternal deaths worldwide. The consequence of CPD-related obstructive labor in the absence of a Caesarian section (C/S) is often maternal or perinatal mortality or morbidity to the mother and/or the infant. Accurate and timely referral of at-risk mothers to health facilities where C/S is a delivery option could reduce maternal mortality in the developing world. The goal of this work was to develop and test the feasibility of a safe, low-cost, easy-to-use, portable tool, using a Microsoft Kinect 3D camera, to identify women at risk for obstructed labor due to CPD...
2018: PloS One
Rhoia Clara Neidenbach, Eckart Lummert, Matthias Vigl, Reinhard Zachoval, Michael Fischereder, Andrea Engelhardt, Claudia Pujol, Renate Oberhoffer, Nicole Nagdyman, Peter Ewert, Michael Hauser, Harald Kaemmerer
Background: As a result of improved surgical and therapeutical management, more than 90% of patients with congenital heart disease (CHD) reach adulthood. However, the natural course of CHD is complicated by noncardiac medical problems. Aim of the study was to evaluate noncardiac comorbidities in a contemporary cohort of adults with CHD (ACHD). Methods: In a tertiary care center for ACHD, 821 consecutive patients, admitted to the outpatient clinic, were evaluated for clinically relevant noncardiac comorbidities...
August 2018: Cardiovascular Diagnosis and Therapy
Mette Østergaard Thunbo, Marianne Sinding, Pauline Bogaard, Anne Sofie Korsager, Jens Brøndum Frøkjær, Lasse Riis Østergaard, Astrid Petersen, Anne Sørensen
INTRODUCTION: Pregnancy complicated by diabetes mellitus (DM) is a central obstetric problem often complicated by fetal macrosomia and increased risk of intrapartum asphyxia. This risk might be explained by fetoplacental vascular abnormalities. This study aimed to investigate the fetoplacental vascular volume by placental CT angiography in normal pregnancies and in pregnancies complicated by type 1 DM (T1DM), diet controlled gestational DM (GDMd), and insulin treated gestational DM (GDMi)...
September 2018: Placenta
Andrea Frudinger, Rainer Marksteiner, Johann Pfeifer, Eva Margreiter, Johannes Paede, Marco Thurner
BACKGROUND: In an earlier pilot study with 10 women, we investigated a new approach for therapy of faecal incontinence (FI) due to obstetric trauma, involving ultrasound-guided injection of autologous skeletal muscle-derived cells (SMDC) into the external anal sphincter (EAS), and observed significant improvement. In the current study, we tested this therapeutic approach in an extended patient group: male and female patients suffering from FI due to EAS damage and/or atrophy. Furthermore, feasibility of lower cell counts and cryo-preserved SMDC was assessed...
September 13, 2018: Stem Cell Research & Therapy
Shi Wu Wen, Ruth Rennicks White, Natalie Rybak, Laura M Gaudet, Stephen Robson, William Hague, Donnette Simms-Stewart, Guillermo Carroli, Graeme Smith, William D Fraser, George Wells, Sandra T Davidge, John Kingdom, Doug Coyle, Dean Fergusson, Daniel J Corsi, Josee Champagne, Elham Sabri, Tim Ramsay, Ben Willem J Mol, Martijn A Oudijk, Mark C Walker
OBJECTIVE: To determine the efficacy of high dose folic acid supplementation for prevention of pre-eclampsia in women with at least one risk factor: pre-existing hypertension, prepregnancy diabetes (type 1 or 2), twin pregnancy, pre-eclampsia in a previous pregnancy, or body mass index ≥35. DESIGN: Randomised, phase III, double blinded international, multicentre clinical trial. SETTING: 70 obstetrical centres in five countries (Argentina, Australia, Canada, Jamaica, and UK)...
September 12, 2018: BMJ: British Medical Journal
Si-da Xi, Yu-Lan Zhu, Chan Chen, Han-Qiu Liu, Wei-Wei Wang, Fang Li
Botulinum neurotoxin A (BTX-A) intervention has long-term benefits for children with obstetric brachial plexus palsy (OBPP). Although cortical plasticity has been widely studied, plasticity in white matter has not received as much attention. Here, six children with OBPP underwent functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) before and 6 months after BTX-A treatment. Surface electromyography (EMG) was recorded. The aim was to investigate changes in the corticospinal tract (CST) as an example longitudinal observation of white matter plasticity...
August 28, 2018: Journal of the Neurological Sciences
Sean T O'Leary, Sarah E Brewer, Jennifer Pyrzanowski, Juliana Barnard, Carter Sevick, Anna Furniss, Amanda F Dempsey
OBJECTIVES: To assess among pregnant and recently delivered women the timing of thinking about and seeking information about childhood vaccines and the preferred modes of vaccine education. STUDY DESIGN: An e-mail survey among women in 9 urban and rural obstetrics practices in Colorado was conducted from February to April 2014, timed so that approximately one-half had delivered and one-half were still pregnant, designed to assess the frequency of thinking about and seeking information about vaccines in relation to estimated or actual delivery date...
September 5, 2018: Journal of Pediatrics
Athanasios F Kallianidis, Joke M Schutte, Jos van Roosmalen, Thomas van den Akker
OBJECTIVES: Maternal mortality is rare in high-resource settings. This hampers studies of the association between maternal mortality and mode of birth, although this topic remains of importance, given the changing patterns in mode of birth with increasing cesarean section rates in most countries. Purpose of this study was to examine incidence of cesarean section-related maternal mortality in the Netherlands and association of surgery with the chain of morbid events leading to death. STUDY DESIGN: We performed a retrospective cohort study using the Confidential Enquiry into Maternal Deaths, including all 2,684,946 maternities in the Netherlands between January 1st, 1999, and December 31st, 2013, registered in the Dutch Perinatal Registry...
August 30, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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