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https://www.readbyqxmd.com/read/29222251/preventing-venous-thromboembolism-during-pregnancy-and-postpartum-crossing-the-threshold
#1
REVIEW
Leslie Skeith
When should a patient with a known thrombophilia or prior venous thromboembolism (VTE) receive low-molecular-weight heparin (LMWH) prophylaxis during pregnancy and/or the postpartum period? Accurately predicting thrombotic and bleeding risks and knowing what to do with this information is at the heart of decision-making in these challenging scenarios. This article will explore the concept of a risk threshold from clinician and patient perspectives and provide guidance for the use of antepartum and postpartum LMWH prophylaxis in women with a known thrombophilia or prior VTE...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29218129/pubic-symphysis-diastasis-a-case-series-and-literature-review
#2
Jaya Jethra Chawla, Devendra Arora, Namrita Sandhu, Megha Jain, Anju Kumari
Separation of pubic symphysis during delivery is a rare complication resulting in considerable and prolonged morbidity for parturient women. The usual presentation is that of something giving way in the region of the symphysis pubis sometimes with an audible crack at the time of delivery. Unbearable pain on moving from side-to-side and on performing any weight-bearing activity (such as walking or climbing stairs) precludes ambulation in the immediate postpartum period. This could be accompanied by disruption of the sacroiliac joint, hemorrhage, or urine incontinence in severe cases...
November 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/29216830/factors-associated-with-birth-preparedness-and-complication-readiness-in-southern-ethiopia-a-community-based-cross-sectional-study
#3
Eshetu Andarge, Aderajew Nigussie, Mekitie Wondafrash
BACKGROUND: Birth preparedness and complication readiness (BP/CR) is a strategy to promote use of skilled maternal and neonatal care so that they can get timely skilled care, particularly during child birth. There is minimal evidence on the factors associated with BP/CR among pregnant women in Ethiopia. Hence, this study aimed to assess the factors influencing BP/CR among pregnant women in Southern Ethiopia for the purpose of improving utilization of skilled attendant at birth. METHODS: A community based cross-sectional study was conducted among 707 pregnant women in Southern Ethiopia in March 2015...
December 8, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29215519/foley-plus-oxytocin-compared-with-oxytocin-for-induction-after-membrane-rupture-a-randomized-controlled-trial
#4
A Dhanya Mackeen, Danielle E Durie, Monique Lin, Christopher K Huls, Emma Qureshey, Michael J Paglia, Haiyan Sun, Anthony Sciscione
OBJECTIVE: To evaluate the use of a transcervical Foley catheter plus oxytocin infusion compared with oxytocin infusion alone for labor induction and cervical ripening in women 34 weeks of gestation or greater with prelabor rupture of membranes. METHODS: This is a randomized, multicenter trial of women with a live, singleton gestation at 34 weeks of gestation or greater with prelabor rupture of membranes, an unfavorable cervical examination (less than 2 cm or 80% effaced), and no contraindication to labor...
December 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29215514/misoprostol-with-foley-bulb-compared-with-misoprostol-alone-for-cervical-ripening-a-randomized-controlled-trial
#5
Zainab Al-Ibraheemi, Lois Brustman, Brianne E Bimson, Natalie Porat, Barak Rosenn
OBJECTIVE: To test the hypothesis that cervical ripening using a combination of misoprostol and a transcervical Foley bulb leads to delivery within a shorter time compared with misoprostol alone. METHODS: This randomized controlled trial was offered to women admitted for cervical ripening. Inclusion criteria were gestational age 37 weeks or greater with intact membranes, singleton fetus, cephalic presentation, and Bishop score 6 or less. Exclusion criteria included, among others, prior uterine surgery, ruptured membranes, and any contraindication to vaginal delivery...
December 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29215512/term-elective-induction-of-labor-and-pregnancy-outcomes-among-obese-women-and-their-offspring
#6
Cassandra M Gibbs Pickens, Michael R Kramer, Penelope P Howards, Martina L Badell, Aaron B Caughey, Carol J Hogue
OBJECTIVE: To evaluate whether elective induction of labor between 39 through 41 weeks of gestation, as compared with expectant management, is associated with reduced cesarean delivery and other adverse outcomes among obese women and their offspring. METHODS: We conducted a retrospective cohort study using the 2007-2011 California Linked Patient Discharge Data-Birth Cohort File of 165,975 singleton, cephalic, nonanomalous deliveries to obese women. For each gestational week (39-41), we used multivariable logistic regression models, stratified by parity, to assess whether elective induction of labor or expectant management was associated with lower odds of cesarean delivery and other adverse outcomes...
December 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29212131/predicting-vaginal-delivery-in-nulliparous-women-undergoing-induction-of-labor-at-term
#7
T Kawakita, U M Reddy, C C Huang, T C Auguste, D Bauer, R T Overcash
No abstract text is available yet for this article.
December 6, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/29211491/complications-and-care-related-to-pregnancy-labor-and-delivery-among-active-component-service-women-u-s-armed-forces-2012-2016
#8
Shauna Stahlman, Catherine T Witkop, Leslie L Clark, Stephen B Taubman
Diagnoses of "complications of pregnancy, childbirth, and the puerperium" include both morbid complications and indications for routine care of pregnant women. During 2012-2016, a total of 55,601 U.S. service members with live births (n=63,879) had 657,060 medical encounters with primary diagnoses of "pregnancy complications." The most frequent diagnoses were "other" specified conditions complicating pregnancy, childbirth, or the puerperium. Numbers of medical encounters with a primary (first-listed) diagnosis of any pregnancy-related complication or indication for care decreased marginally each year between 2012 (n=178,703) and 2016 (n=146,282)...
November 2017: MSMR
https://www.readbyqxmd.com/read/29205981/pregnancy-and-delivery-after-a-cesarean-section
#9
Marja Vääräsmäki, Tytti Raudaskoski
One out of seven of all parturients and one out of five primigravid women deliver by caesarean section. Of four women having undergone caesarean section, three will give birth vaginally, provided that the indication for surgery has been temporary by nature. Spontaneous beginning of labor and a previous vaginal delivery improve the chances of succesful of vaginal delivery. Rupture of the uterus in subsequent pregnancies is the most feared sequel to a caesarean section, with an occurrence of 0.2 to 1.5%. Delivery by caesarean is indicated in case of previous rupture of the uterus, hysterotomy through vertical incision, and more than two previous caesarean sections...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29203813/comparison-of-single-and-double-balloon-catheters-for-labor-induction-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#10
Raed Salim, Naama Schwartz, Noah Zafran, Sivan Zuarez-Easton, Gali Garmi, Shabtai Romano
OBJECTIVE: There is a paucity of head-to-head randomized trials that compare single- and double-balloon catheters, and the results of the available data in terms of time from catheter insertion to delivery and delivery mode are mixed. This meta-analysis of randomized controlled trials compares the efficacy of single- and double-balloon catheters in women undergoing labor induction. STUDY DESIGN: Searches were made in MEDLINE, EMBASE, PubMed, ClinicalTrials.gov, and the Cochrane Library from inception through June 2016...
December 4, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29202976/perinatal-outcomes-after-natural-conception-versus-in%C3%A2-vitro-fertilization-ivf-in-gestational-surrogates-a-model-to-evaluate-ivf-treatment-versus-maternal-effects
#11
Irene Woo, Rita Hindoyan, Melanie Landay, Jacqueline Ho, Sue Ann Ingles, Lynda K McGinnis, Richard J Paulson, Karine Chung
OBJECTIVE: To study the perinatal outcomes between singleton live births achieved with the use of commissioned versus spontaneously conceived embryos carried by the same gestational surrogate. DESIGN: Retrospective cohort study. SETTING: Academic in vitro fertilization center. PATIENT(S): Gestational surrogate. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Pregnancy outcome, gestational age at birth, birth weight, perinatal complications...
December 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29202469/h3k27me3-dynamics-dictate-evolving-uterine-states-in-pregnancy-and-parturition
#12
Patrice Nancy, Johan Siewiera, Gabrielle Rizzuto, Elisa Tagliani, Ivan Osokine, Priyanka Manandhar, Igor Dolgalev, Caterina Clementi, Aristotelis Tsirigos, Adrian Erlebacher
Uncovering the causes of pregnancy complications such as preterm labor requires greater insight into how the uterus remains in a noncontractile state until term and then surmounts this state to enter labor. Here, we show that dynamic generation and erasure of the repressive histone modification tri-methyl histone H3 lysine 27 (H3K27me3) in decidual stromal cells dictate both elements of pregnancy success in mice. In early gestation, H3K27me3-induced transcriptional silencing of select gene targets ensured uterine quiescence by preventing the decidua from expressing parturition-inducing hormone receptors, manifesting type 1 immunity, and most unexpectedly, generating myofibroblasts and associated wound-healing responses...
November 27, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29202146/purls-does-azithromycin-have-a-role-in-cesarean-sections
#13
Gregory Castelli, Allison Flaherty, Jennie B Jarrett
A 26-year-old G1P0 at 40w1d presents in spontaneous labor and is dilated to 4 cm. The patient reached complete cervical dilation after artificial rupture of membranes and oxytocin augmentation. After 4 hours of pushing, there has been minimal descent of the fetal vertex beyond +1 station with significant caput succedaneum. Her physician decides to proceed with cesarean delivery. What antibiotics should be administered prior to incision to reduce postoperative infection?
December 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/29200473/effect-of-premature-rupture-of-membranes-on-induction-of-labor-a-historical-cohort-study
#14
Sven Kehl, Christel Weiss, Ulf Dammer, Friederike Baier, Florian Faschingbauer, Matthias W Beckmann, Marc Sütterlin, Jutta Pretscher
Objective: The aim of this study was to assess the influence of premature rupture of membranes (PROM) on the induction of labor. Material and Method: This historical cohort study analyzed 1861 inductions of labor at term using misoprostol which occurred between 2010 and 2015. Exclusion criteria included intrauterine fetal death, previous cesarean section, and fetal structural or chromosomal anomalies. Induction of labor for PROM (PROM group) was compared to induction for other indications (no-PROM group); the primary outcome measure was the cesarean section rate...
November 2017: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/29198530/hospitalizations-for-ambulatory-care-sensitive-conditions-among-children-with-chronic-and-complex-diseases
#15
Ryan J Coller, Michelle M Kelly, Mary L Ehlenbach, Evan Goyette, Gemma Warner, Paul J Chung
OBJECTIVE: To evaluate ambulatory-care sensitive (ACS) hospitalizations for children with noncomplex chronic diseases (NC-CD) and children with medical complexity (CMC), and identify associations with ambulatory care characteristics. Although ACS hospitalizations are potentially preventable in general populations, the specific ambulatory care predictors and influence of medical complexity on them is poorly understood. STUDY DESIGN: Retrospective cohort study of NC-CD and CMC hospitalizations at a children's hospital during 2007-2014, excluding labor/delivery and children over 21 years...
November 30, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29198155/delayed-second-twin-delivery-benefits-and-risks
#16
Mohamed Farghali, Ibrahim Abdelazim, Khaled Abdelrazek
BACKGROUND: An increasing number of reports describe the delayed second twin delivery for days, or weeks with good results in the majority of the cases, and different survival rate between centers, without reported randomized controlled trials (RCTs). OBJECTIVES: This study was designed to evaluate the suggested management of the delayed second twin delivery in the Sabah Maternity Hospital regarding its outcome, possible risks, and benefits. PATIENTS AND METHODS: Forty-seven twin pregnancies with preterm labor of the first fetus between 20-30 weeks, and delayed delivery of the second twin were included in this study...
December 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29190877/measurement-of-retropubic-tissue-thickness-using-intrapartum-transperineal-ultrasound-to-assess-cephalopelvic-disproportion
#17
Chung Ming Chor, Wai Yin Winnie Chan, Wing Ting Ada Tse, Daljit Singh Sahota
Purpose: First, to describe a new method of assessing cephalopelvic disproportion by measuring the retropubic tissue thickness (RTT), and second, to determine whether RTT was associated with an eventual delivery by cesarean section. Methods: Three-dimensional transperineal ultrasound scans were performed on 129 laboring nulliparous women to obtain 3-dimensional volume datasets for assessing RTT. RTT was measured off-line by three operators (A, B, and C) as the shortest distance between the capsule of the pubic symphysis and the outer border of the fetal skull...
August 11, 2017: Ultrasonography
https://www.readbyqxmd.com/read/29187210/state-of-newborn-care-in-south-sudan-s-displacement-camps-a-descriptive-study-of-facility-based-deliveries
#18
Samira Sami, Kate Kerber, Solomon Kenyi, Ribka Amsalu, Barbara Tomczyk, Debra Jackson, Alexander Dimiti, Elaine Scudder, Janet Meyers, Jean Paul De Charles Umurungi, Kemish Kenneth, Luke C Mullany
BACKGROUND: Approximately 2.7 million neonatal deaths occur annually, with highest rates of neonatal mortality in countries that have recently experienced conflict. Constant instability in South Sudan further strains a weakened health system and poses public health challenges during the neonatal period. We aimed to describe the state of newborn facility-level care in displaced person camps across Juba, Malakal, and Maban. METHODS: We conducted clinical observations of the labor and delivery period, exit interviews with recently delivered mothers, health facility assessments, and direct observations of midwife time-use...
November 29, 2017: Reproductive Health
https://www.readbyqxmd.com/read/29185054/vacuum-extraction-in-low-birth-weight-%C3%A2-2500%C3%A2-g-neonates
#19
Amir Aviram, Eran Ashwal, Liran Hiersch, Yariv Yogev
PURPOSE: To evaluate the impact of vacuum extraction on birth injuries among low birth weight neonate (2000-2499 g). METHODS: Retrospective cohort study of women with singleton pregnancies > 34 weeks, birth weight of 2000-3500 g, undergoing vacuum extraction, between 2007 and 2014. Outcomes were compared between neonates who weighed 2000-2499 g and 2500-3500 g. RESULTS: Out of 62,102 deliveries, 5064 (8.2%) met the inclusion criteria, of which 269 (5...
November 28, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29185016/the-radiological-myometrial-appearance-after-cesarean-section-is-it-associated-with-postpartum-complications-and-subsequent-delivery-outcome
#20
Naama R Bogot, Misagv Rottenstreich, Rinad M Nabulsi, Yonatan Turner, Rivka Farkash, Arnon Samueloff, Sorina Grisaru-Granovsky
PURPOSE: To evaluate whether the characteristics of the radiological uterine myometrial discontinuity (RMD) is associated with maternal-neonatal outcomes and post-cesarean section (CS) complications. A secondary aim was to describe the evolution of the CT uterine surgical incision and the related outcome of a subsequent trial of labor after cesarean (TOLAC). METHODS: Single center retrospective cohort study of CT scans was performed within 6 weeks from cesarean delivery...
November 28, 2017: Abdominal Radiology
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