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https://www.readbyqxmd.com/read/28213600/caesarean-sections-and-for-profit-status-of-hospitals-systematic-review-and-meta-analysis
#1
Ilir Hoxha, Lamprini Syrogiannouli, Xhyljeta Luta, Kali Tal, David C Goodman, Bruno R da Costa, Peter Jüni
OBJECTIVE: Financial incentives may encourage private for-profit providers to perform more caesarean section (CS) than non-profit hospitals. We therefore sought to determine the association of for-profit status of hospital and odds of CS. DESIGN: Systematic review and meta-analysis. DATA SOURCES: MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews from the first year of records through February 2016. ELIGIBILITY CRITERIA: To be eligible, studies had to report data to allow the calculation of ORs of CS comparing private for-profit hospitals with public or private non-profit hospitals in a specific geographic area...
February 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#2
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/28208947/delayed-uterine-necrosis-rare-cause-of-nonhealing-wound
#3
Aruna Nigam, Neha Gupta, Arifa A Elahi, Zeeba S Jairajpuri, Swaraj Batra
Uterine necrosis is a very rare condition and most of the reported cases occurred after pelvic arterial embolization for post-partum haemorrhage, embolization of fibroid uterus or application of B-Lynch sutures. A case of delayed myometrial necrosis is reported in post-cesarean patient where no embolization or uterine compression sutures have been applied. Patient presented with foul smelling discharge from the gaped abdominal wound following caesarean section. Abdomen was closed after exploration and lavage...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208945/perinatal-outcome-of-second-twin-with-respect-to-mode-of-delivery-an-observational-study
#4
Rujul Rashmin Jhaveri, Trupti K Nadkarni
INTRODUCTION: With the advent of assisted reproductive techniques, multi-fetal pregnancies are on the rise. While caesarean section is the defined mode of delivery for triplets and higher order pregnancies, the picture for twin delivery is not so clear. While a trial for vaginal delivery is attempted, the second twin is considered vulnerable to complications. Whether this translates into worsened perinatal outcomes is not well defined. AIM: To study the perinatal outcome and to identify the various factors influencing the perinatal outcome of second twin with respect to mode of delivery...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208944/the-effect-of-fetal-gender-on-the-delivery-outcome-in-primigravidae-women-with-induced-labours-for-all-indications
#5
Angeliki Antonakou, Dimitrios Papoutsis
INTRODUCTION: There is increasing evidence of a gender-related phenomenon where the presence of a male fetus may have an adverse effect on the outcome of pregnancy. AIM: The aim of this study was to investigate the effect of fetal gender on the delivery outcome in primigravidae women with induced labours. MATERIALS AND METHODS: This was an observational cohort study of primigravidae women who had Induction Of Labour (IOL) for all indications during a two-year period...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208943/role-of-prophylactic-tranexamic-acid-in-reducing-blood-loss-during-elective-caesarean-section-a-randomized-controlled-study
#6
Sj Dhivya Lakshmi, Reena Abraham
INTRODUCTION: Obstetric haemorrhage accounts for 20-25% of maternal mortality and morbidity. Anti-fibrinolytics are being widely used in field of surgery. It is also used to reduce heavy menstrual blood loss. AIM: To analyse the effectiveness of Tranexamic Acid (TXA) in reducing blood loss during elective caesarean section. MATERIALS AND METHODS: This interventional, randomized, parallel group study was done in the Department of Obstetrics and Gynaecolgy, PSG IMSR, Coimbatore, from June 2014 to May 2015...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208931/pseudo-exstrophy-of-bladder-with-unilateral-renal-agenesis-a-rare-combination-of-two-anomalies
#7
Abdolhamid Amouei, Mohammad Baghi Yazdi, Fatemeh Ehsani, Mojtaba Babaei Zarch
Pseudo-exstrophy of bladder is an uncommon condition characterized by the major musculoskeletal defects without urinary system defects. A two-day-old female neonate was presented with pseudo-exstrophy of the bladder and unilateral renal agenesis- A rare combination of two anomalies. She was born at 37 weeks gestational age with caesarean section delivery. The X-ray of hip revealed pubic diastasis. Ultrasonography clearly showed absence of the left kidney with a normal right kidney. The patient was treated successfully with proper surgical management...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28207498/an-analysis-of-variations-of-indications-and-maternal-fetal-prognosis-for-caesarean-section-in-a-tertiary-hospital-of-beijing-a-population-based-retrospective-cohort-study
#8
Yajun Liu, Xin Wang, Liying Zou, Yan Ruan, Weiyuan Zhang
In recent decades, we have observed a remarkable increase in the rate of caesarean section (CS) in both developed and developing countries, especially in China. According to the World Health Organization (WHO) systematic review, if the increase in CS rate was between 10% and 15%, the maternal and neonatal mortality was decreased. However, above this level, increasing the rate of CS is no longer associated with reduced mortality. To date, no consensus has been reached on the main factors driving the cesarean epidemic...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28203331/mothers-attitudes-toward-feeding-twin-babies-in-the-first-six-months-of-life-a-sample-from-sakarya-turkey
#9
Nursan Cinar, Dilek Kose, Muge Alvur, Ozlem Dogu
BACKGROUND: It is stated in the literature that a mother's breast milk is sufficient for more than one baby. OBJECTIVES: This descriptive study aimed to determine whether twin babies are breastfed during their first six months of life. MATERIALS AND METHODS: We studied the twin birth cases in a state hospital in Sakarya, Turkey between October 2011 and March 2013. The population of the study consisted of entire mothers who had delivered twins in the maternity ward of the hospital...
October 2016: Iranian Journal of Pediatrics
https://www.readbyqxmd.com/read/28199872/fertility-and-obstetric-outcomes-after-curettage-versus-expectant-management-in-randomised-and-non-randomised-women-with-an-incomplete-evacuation-of-the-uterus-after-misoprostol-treatment-for-miscarriage
#10
M Lemmers, M A C Verschoor, K Overwater, P M Bossuyt, D Hendriks, M Hemelaar, J M Schutte, A H Adriaanse, W M Ankum, J A F Huirne, B W J Mol
OBJECTIVE: To assess fertility and obstetric outcomes in women treated with curettage or undergoing expectant management for an incomplete miscarriage after misoprostol treatment. STUDY DESIGN: Between June 2012 and July 2014, we conducted a multicentre randomised clinical trial (RCT) with a parallel cohort study for non-randomised women, treated according to their preference. In the RCT 30 women were allocated curettage and 29 expectant management. In the cohort 197 women participated; 65 underwent curettage and 132 women underwent expectant management...
January 30, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28199745/bacterial-n-formyl-peptides-reduce-pma-and-e-coli-induced-neutrophil-respiratory-burst-in-term-neonates-and-adults
#11
Maria E Stålhammar, Lena Douhan Håkansson, Richard Sindelar
Neutrophil migration and respiratory burst is the prerequisite for efficient first line defense against invading microorganisms. However, migration and respiratory burst can be compromised in adults and especially in newborn infants, where sustained neutrophil accumulation, uncontrolled burst and reduced scavenging of ROS might cause inadvertent tissue damage due to uncontrolled inflammation. The aim of this study was to investigate the modulatory effect of the chemoattractants formyl-methionyl-leucyl-phenylalanine (fMLP) and IL-8 on respiratory burst in neutrophils from term newborn infants and adults...
February 15, 2017: Scandinavian Journal of Immunology
https://www.readbyqxmd.com/read/28198343/-skin-to-skin-caesarean-section-a-hype-or-better-patient-care
#12
F J Korteweg, H D de Boer, J M van der Ploeg, H D Buiter, D P van der Ham
A caesarean section (CS) is one of the most common surgical procedures performed in the world, for which there are minimal variations in the surgical approach. During the last few years the "skin-to-skin" CS, also coined "natural" or "gentle" CS, is on the rise; parental participation, slow delivery and direct skin-to-skin contact are important aspects. Most Dutch hospitals offer some form of "skin-to-skin" CS but there are local differences in availability and performance of the procedure. Since 2011, the standard procedure in the Martini Hospital in Groningen is the "skin-to-skin" CS (for both elective and emergency CS, 24/7)...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28197657/gestational-diabetes-and-adverse-perinatal-outcomes-from-716-152-births-in-france-in-2012
#13
Cécile Billionnet, Delphine Mitanchez, Alain Weill, Jacky Nizard, François Alla, Agnès Hartemann, Sophie Jacqueminet
AIMS/HYPOTHESIS: The aim of this study was to assess the risk of adverse perinatal outcomes in gestational diabetes mellitus (GDM) in a large national cohort. METHODS: All deliveries taking place after 22 weeks in France in 2012 were included by extracting data from the hospital discharge database and the national health insurance system. The diabetic status of mothers was determined by the use of glucose-lowering agents and by hospital diagnosis. Outcomes were analysed according to the type of diabetes and, in the GDM group, whether or not diabetes was insulin-treated...
February 15, 2017: Diabetologia
https://www.readbyqxmd.com/read/28191626/intermittent-auscultation-ia-of-fetal-heart-rate-in-labour-for-fetal-well-being
#14
REVIEW
Ruth Martis, Ova Emilia, Detty S Nurdiati, Julie Brown
BACKGROUND: The goal of fetal monitoring in labour is the early detection of a hypoxic baby. There are a variety of tools and methods available for intermittent auscultation (IA) of the fetal heart rate (FHR). Low- and middle-income countries usually have only access to a Pinard/Laënnec or the use of a hand-held Doppler device. Currently, there is no robust evidence to guide clinical practice on the most effective IA tool to use, timing intervals and length of listening to the fetal heart for women during established labour...
February 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28183709/consequences-of-delivery-at-home-in-a-woman-without-prenatal-care
#15
Nakul Kumar, Lisa Gilbert, Terry Ellis, Sandeep Krishnan
This is a case report of a 39-year-old multigravida woman without allopathic prenatal care who, after three previous caesarean sections, attempted to deliver her fourth child at home with the help of a direct entry midwife. During labour, fetal movement and fetal heart tones became undetectable, at which time the patient was referred by the midwife to the hospital. The patient was diagnosed with uterine rupture, bladder rupture and fetal demise; she was rushed to emergency surgery. The patient's lack of allopathic prenatal care, attempt of vaginal birth after three previous caesarean sections, coupled with her desire for delivery at home, led to her complicated course...
February 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28183565/minimum-effective-fluid-volume-of-colloid-to-prevent-hypotension-during-caesarean-section-under-spinal-anesthesia-using-a-prophylactic-phenylephrine-infusion-an-up-down-sequential-allocation-study
#16
Christian Loubert, Pierre-Olivier Gagnon, Roshan Fernando
STUDY OBJECTIVE: The aim of this study was to de termine the minimum effective fluid volume (MEFV) of hydroxyethyl starch 130/0.4 (HES) infused in a preload fashion which would prevent hypotension in 50% of parturients undergoing caesarean section. A secondary objective was to measure the hemodynamic effect of fluid loading on the subjects. DESIGN: This is a prospective, double-blinded, dose-finding study using an up-down sequential allocation design. SETTING: In the operating room...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28179699/referral-pattern-of-emergencies-in-obstetrics-implications-for-defining-scope-of-services-and-policy
#17
Rahat Najam Qureshi, Rozina Sikandar, Zahra Hoodbhoy, Raffat Bano, Nigar Jabeen
OBJECTIVE: To analyse referral pattern of high-risk obstetric cases from secondary to tertiary care hospitals and to assess their maternal and neonatal outcomes. METHODS: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised all referred obstetric cases from secondary-level hospitals to tertiary-level care within and outside the Hospital between January 2011 and December 2014. Day and time of referral, reason for referral as well as maternal and neonatal outcomes were collected...
December 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28179198/cesarean-scar-ectopic-pregnancy-laparoscopic-resection-and-total-scar-dehiscence-repair-a-case-report
#18
Sara Mahgoub, Victor Gabriele, Emilie Faller, Bruno Langer, Arnaud Wattiez, Lise Lecointre, Cherif Akladios
STUDY OBJECTIVE: Illustrate laparoscopic technique for resection of cesarean scar ectopic pregnancy, associated with isthmocele repair. DESIGN: Case report SETTING: Tertiary referral centre in Strasbourg, France. The study was approved by the local IRB. BACKGROUND: Cesarean scar pregnancy is a rare form of ectopic pregnancy. The major risk of this type of pregnancy is the early uterine rupture with massive bleeding and maternal life-threatening...
February 4, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28178769/improving-post-caesarean-analgesia-where-to-next
#19
Alexander Butwick
The provision of effective pain relief to mothers after caesarean section (CS) is a priority for both obstetric and anaesthesia providers. To meet this goal, multimodal analgesic regimens have been endorsed to manage pain and reduce opioid requirements after CS. Post-CS, typical oral analgesic regimens may comprise paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), and an oral opioid. The inclusion of paracetamol and NSAIDs is important as each drug has an opioid sparing effect, thereby reducing the incidence of opioid related side-effects...
February 8, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28176441/the-impact-of-subcutaneous-tissue-suturing-at-cesarean-section-on-wound-complications-a-meta-analysis
#20
Vasilios Pergialiotis, Anastasia Prodromidou, Despina N Perrea, Stergios K Doumouchtsis
BACKGROUND: Cesarean wound complications are frequently observed in everyday practice. OBJECTIVES: To study whether subcutaneous tissue closure following cesarean section results in decreased wound complications. SEARCH STRATEGY: We systematically searched Medline (1966-2016), Scopus (2004-2016), ClinicalTrials. gov (2008-2016) and Cochrane Central Register of Controlled Trials CENTRAL (1999-2016) databases together with reference lists from included studies...
February 8, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
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