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Low risk obstetrics

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https://www.readbyqxmd.com/read/28635415/known-and-unknown-cerebral-arteriovenous-malformations-in-pregnancies-haemorrhage-risk-and-influence-on-obstetric-management
#1
Xianli Lv, Wei Li, Hongwei He, Chuhan Jiang, Youxiang Li
Objective The objective of this study was to evaluate the haemorrhage risk of known and unknown cerebral arteriovenous malformations and their obstetric management. Methods A retrospective review was performed and analysed 67 consecutive cases of arteriovenous malformation with pregnancy history. Results Sixty-seven cases of arteriovenous malformation with pregnancy histories were identified. In 14 cases (20.9%) of arteriovenous malformation diagnosed before pregnancy, 11 cases were treated (10 embolisation and one surgery), there was no haemorrhage in 14 pregnancies, 14 healthy babies were delivered by caesarean section in 12 pregnancies (85...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28633636/typology-of-birth-centres-in-the-netherlands-using-the-rainbow-model-of-integrated-care-results-of-the-dutch-birth-centre-study
#2
Inge C Boesveld, Marc A Bruijnzeels, Marit Hitzert, Marieke A A Hermus, Karin M van der Pal-de Bruin, M Elske van den Akker-van Marle, Eric A P Steegers, Arie Franx, Raymond G de Vries, Therese A Wiegers
BACKGROUND: The goal of integrated care is to offer a continuum of care that crosses the boundaries of public health, primary, secondary, and tertiary care. Integrated care is increasingly promoted for people with complex needs and has also recently been promoted in maternity care systems to improve the quality of care. Especially when located near an obstetric unit, birth centres are considered to be ideal settings for the realization of integrated care. At present, however, we know very little about the degree of integration in these centres and we do not know if increased levels of integration improve the quality of the care delivered...
June 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28632532/postpartum-tubal-sterilization-making-the-case-for-urgency
#3
Michael G Richardson, Sarah J Hall, Lisa C Zuckerwise
The parturient who requests postpartum sterilization has given consideration to and has made decisions regarding this aspect of her medical care long before her delivery. She arrives at parturition expecting the postpartum procedure to be performed as intended. The American Congress of Obstetricians and Gynecologists has reaffirmed its opinion that postpartum sterilization is an urgent procedure, owing to the safety and superior effectiveness of tubal sterilization via minilaparotomy in the immediate postpartum period, and the adverse consequences for mothers, babies, and society when the procedure is not actualized as desired and intended...
June 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28631513/the-effect-of-labour-pain-in-caesarean-delivery-on-neonatal-and-maternal-outcomes-in-a-term-low-risk-obstetric-population
#4
Meryem Kurek Eken, Gülçin Şahin Ersoy, Sinem Çetinkaya, Çetin Çam, Ateş Karateke
Planned caesarean delivery (CD) frequency is increasing in many countries, and elective CD accounts for 50% of preventable causes of neonatal respiratory morbidity. The clearing of fluid in the lungs is important for the establishment of normal gas exchange with inspired air. A defect in this clearance can result in respiratory problems in neonate, but on the other hand patients waiting for the onset of spontaneous labour pain, the increase in emergency CD, together with severe mortality and morbidity are causes of concern and cause anxiety and distrust of obstetricians...
June 20, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28630690/incidence-and-risk-factors-for-surgical-site-infections-in-obstetric-and-gynecological-surgeries-from-a-teaching-hospital-in-rural-india
#5
Ashish Pathak, Kalpana Mahadik, Manmat B Swami, Pulak K Roy, Megha Sharma, Vijay K Mahadik, Cecilia Stålsby Lundborg
BACKGROUND: Surgical site infections (SSI) are one of the most common healthcare associated infections in the low-middle income countries. Data on incidence and risk factors for SSI following surgeries in general and Obstetric and Gynecological surgeries in particular are scare. This study set out to identify risk factors for SSI in patients undergoing Obstetric and Gynecological surgeries in an Indian rural hospital. METHODS: Patients who underwent a surgical procedure between September 2010 to February 2013 in the 60-bedded ward of Obstetric and Gynecology department were included...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28628578/neuraxial-anesthesia-in-obstetric-patients-receiving-thromboprophylaxis-with-unfractionated-or-low-molecular-weight-heparin-a-systematic-review-of-spinal-epidural-hematoma
#6
Lisa R Leffert, Heloise M Dubois, Alexander J Butwick, Brendan Carvalho, Timothy T Houle, Ruth Landau
Venous thromboembolism remains a major source of morbidity and mortality in obstetrics with an incidence of 29.8/100,000 vaginal delivery hospitalizations; cesarean delivery confers a 4-fold increased risk of thromboembolism when compared with vaginal delivery. Revised national guidelines now stipulate that the majority of women delivering via cesarean and women at risk for ante- or postpartum venous thromboembolism receive mechanical or pharmacological thromboprophylaxis. This practice change has important implications for obstetric anesthesiologists concerned about the risk of spinal epidural hematoma (SEH) among anticoagulated women receiving neuraxial anesthesia...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28627069/who-delivers-where-the-effect-of-obstetric-risk-on-facility-delivery-in-east-africa
#7
Sandra Virgo, Giorgia Gon, Francesca L Cavallaro, Wendy Graham, Susannah Woodd
OBJECTIVES: Skilled attendance at birth is key for the survival of pregnant women. This study investigates whether women at increased risk of maternal and newborn complications in four East African countries are more likely to deliver in a health facility than those at lower risk. METHODS: Demographic & Health Survey data for Kenya 2014, Rwanda 2014-15, Tanzania 2015-16 and Uganda 2011 were used to study women with a live birth in the three years preceding the survey...
June 19, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28622145/clinical-analyses-of-383-cases-with-maternal-cardiac-diseases
#8
Emine Aydin, Ozgur Ozyuncu, Dila Kasapoglu, Gokcen Orgul, Necla Ozer, Murat Yurdakok, M Sinan Beksac
AIM: To evaluate the pregnancy outcomes of women with heart disease. MATERIALS AND METHODS: In this retrospective study, 383 pregnant women with cardiac diseases were examined. The cases were classified according to the World Health Organization (WHO) classification. The distribution of the cases according to class, congenital heart diseases, mean birthweight, mean gestational week at delivery, type of delivery [cesarean section (CS) or vaginal delivery], and cardivascular events (during pregnancy and puerperium) were evaluated...
June 5, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28620265/panel-of-seven-long-noncoding-rna-as-a-candidate-prognostic-biomarker-for-ovarian-cancer
#9
Xiaohui Zhan, Chuanpeng Dong, Gang Liu, Yixue Li, Lei Liu
Ovarian cancer is one of the most common and lethal gynecological malignancies. The diagnosis of ovarian cancer is often at an advanced stage. Accumulated evidence suggests that long noncoding RNAs (lncRNAs) play important roles during ovarian tumorigenesis. In this study, using the lncRNA-mining approach, we analyzed lncRNA expression profiles of 493 ovarian cancer patients from Gene Expression Omnibus datasets, and identified a signature group of seven lncRNAs (BC037530, AK021924, AK094536, AK094536, BC062365, BC004123 and BC007937) associated with patient survival in the training dataset GSE9891...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28619771/revealed-versus-concealed-criteria-for-placental-insufficiency-in-an-unselected-obstetric-population-in-late-pregnancy-ratio37-randomised-controlled-trial-study-protocol
#10
Francesc Figueras, Eduard Gratacos, Marta Rial, Ilan Gull, Ladislav Krofta, Marek Lubusky, Cruz-Martinez Rogelio, Cruz-Lemini Mónica, Martinez-Rodriguez Miguel, Pamela Socias, Cristina Aleuanlli, Mauro C Parra Cordero
INTRODUCTION: Fetal growth restriction (FGR) affects 5%-10% of all pregnancies, contributing to 30%-50% of stillbirths. Unfortunately, growth restriction often is not detected antenatally. The last weeks of pregnancy are critical for preventing stillbirth among babies with FGR because there is a pronounced increase in stillbirths among growth-restricted fetuses after 37 weeks of pregnancy. Here we present a protocol (V.1, 23 May 2016) for the RATIO37 trial, which evaluates an integrated strategy for accurately selecting at-risk fetuses for delivery at term...
June 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28619692/a-randomized-trial-of-motivational-interviewing-and-facilitated-contraceptive-access-to-prevent-rapid-repeat-pregnancy-among-adolescent-mothers
#11
Jack Stevens, Robyn Lutz, Ngozi Osuagwu, Dana Rotz, Brian Goesling
BACKGROUND: Most interventions designed to reduce teen pregnancy rates have not focused on pregnant and/or parenting adolescents. Therefore, a large randomized controlled trial was conducted regarding a motivational interviewing program entitled Teen Options to Prevent Pregnancy in a low income sample of adolescent mothers. This program recommended monthly sessions between a participant and a registered nurse over 18 months. This program also featured facilitated birth control access through transportation assistance and a part-time contraceptive clinic...
June 12, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28616828/perinatal-and-maternal-outcomes-at-term-in-low-risk-pregnancies-according-to-nice-criteria-comparison-between-a-tertiary-obstetrical-hospital-and-midwife-attended-units
#12
Tanja Ignatov, Holm Eggemann, Serban Dan Costa, Atanas Ignatov
PURPOSE: The aim of this study was to evaluate the perinatal and maternal outcomes at term at a single tertiary, university hospital in women with low-risk pregnancies. PATIENTS AND METHODS: We performed a retrospective cohort study of women with low-risk pregnancies, who delivered at University Women's Hospital Magdeburg between January 2010 and December 2014. Data were compared with data published by Brocklehurst et al. 2011. RESULTS: Of the 6052 women investigated, 2014 were classified as low risk according to the NICE criteria and were eligible for analysis...
June 14, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28613398/fetal-and-umbilical-doppler-ultrasound-in-high-risk-pregnancies
#13
REVIEW
Zarko Alfirevic, Tamara Stampalija, Therese Dowswell
BACKGROUND: Abnormal blood flow patterns in fetal circulation detected by Doppler ultrasound may indicate poor fetal prognosis. It is also possible that false positive Doppler ultrasound findings could lead to adverse outcomes from unnecessary interventions, including preterm delivery. OBJECTIVES: The objective of this review was to assess the effects of Doppler ultrasound used to assess fetal well-being in high-risk pregnancies on obstetric care and fetal outcomes...
June 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28608122/patterns-of-lymph-node-metastases-in-apparent-stage-i-low-grade-epithelial-ovarian-cancer-a-multicenter-study
#14
Lucas Minig, Florian Heitz, David Cibula, Jamie N Bakkum-Gamez, Anna Germanova, Sean C Dowdy, Eleftheria Kalogera, Ignacio Zapardiel, Kristina Lindemann, Philipp Harter, Giovanni Scambia, Marco Petrillo, Cristina Zorrero, Vanna Zanagnolo, José Miguel Cárdenas Rebollo, Andreas du Bois, Christina Fotopoulou
OBJECTIVE: The aim of this study was to determine oncological outcomes and incidence of lymph node (LN) metastases in women who underwent systematic pelvic and paraaortic lymphadenectomy for surgical staging of apparent stage I low-grade epithelial ovarian cancer (LGEOC). MATERIALS AND METHODS: A retrospective study was performed at nine institutions across Europe and the US, and patients who underwent surgical staging for presumed stage I LGEOC between 2000 and 2016 were included...
June 12, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28607782/placental-chorangiosis-increased-risk-for-cesarean-section
#15
Shariska S Petersen, Raminder Khangura, Dmitry Davydov, Ziying Zhang, Roopina Sangha
We describe a patient with Class C diabetes who presented for nonstress testing at 36 weeks and 4 days of gestation with nonreassuring fetal heart tones (NRFHT) and oligohydramnios. Upon delivery, thrombosis of the umbilical cord was grossly noted. Pathological analysis of the placenta revealed chorangiosis, vascular congestion, and 40% occlusion of the umbilical vein. Chorangiosis is a vascular change of the placenta that involves the terminal chorionic villi. It has been proposed to result from longstanding, low-grade hypoxia in the placental tissue and has been associated with such conditions such as diabetes, intrauterine growth restriction (IUGR), and hypertensive conditions in pregnancy...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28606903/estimating-the-incidence-and-the-economic-burden-of-third-and-fourth-degree-obstetric-tears-in-the-english-nhs-an-observational-study-using-propensity-score-matching
#16
Martina Orlovic, Alexander William Carter, Joachim Marti, Elias Mossialos
OBJECTIVE: Obstetric care is a high-risk area in healthcare delivery, so it is essential to have up-to-date quantitative evidence in this area to inform policy decisions regarding these services. In light of this, the objective of this study is to investigate the incidence and economic burden of third and fourth-degree lacerations in the English National Health Service (NHS) using recent national data. METHODS: We used coded inpatient data from Hospital Episode Statistics (HES) for the financial years from 2010/2011 to 2013/2014 for all females that gave birth during that period in the English NHS...
June 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28606111/is-time-of-birth-a-predictor-of-adverse-perinatal-outcome-a-hospital-based-cross-sectional-study-in-a-low-resource-setting-tanzania
#17
Andrew Mgaya, Januarius Hinju, Hussein Kidanto
BACKGROUND: Inconsistent evidence of a higher risk of adverse perinatal outcomes during off-hours compared to office hours necessitated a search for clear evidence of an association between time of birth and adverse perinatal outcomes. METHODS: A cross-sectional study conducted at a tertiary referral hospital compared perinatal outcomes across three working shifts over 24 h. A checklist and a questionnaire were used to record parturients' socio-demographic and obstetric characteristics, mode of delivery and perinatal outcomes, including 5th minute Apgar score, and early neonatal mortality...
June 12, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28605006/treating-periodontal-disease-for-preventing-adverse-birth-outcomes-in-pregnant-women
#18
REVIEW
Zipporah Iheozor-Ejiofor, Philippa Middleton, Marco Esposito, Anne-Marie Glenny
BACKGROUND: Periodontal disease has been linked with a number of conditions, such as cardiovascular disease, stroke, diabetes and adverse pregnancy outcomes, all likely through systemic inflammatory pathways. It is common in women of reproductive age and gum conditions tend to worsen during pregnancy. Some evidence from observational studies suggests that periodontal intervention may reduce adverse pregnancy outcomes. There is need for a comprehensive Cochrane review of randomised trials to assess the effect of periodontal treatment on perinatal and maternal health...
June 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28604452/utility-and-actual-use-of-european-and-spanish-guidelines-on-the-management-of-endometrial-cancer-among-gynecologic-oncologists-in-spain
#19
Ignacio Zapardiel, Claudia Blancafort, David Cibula, Ibon Jaunarena, Mikel Gorostidi, Antonio Gil-Moreno, Javier De Santiago
OBJECTIVE: The aim of the study was to analyze the current management of endometrial cancer across Spain and to evaluate the use and applicability of the national and international guidelines. MATERIALS AND METHODS: An electronic 30-question survey was distributed among all Spanish Society of Obstetrics and Gynecology-registered specialists dedicated to gynecologic oncology in Spain by e-mail. Data were collected anonymously and analyzed using SPSS program. RESULTS: One hundred forty-five (17...
June 10, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28599577/a-retrospective-comparison-of-pregnancy-outcomes-between-women-with-alpha-thalassaemia-1-trait-and-normal-controls
#20
Kuntharee Traisrisilp, Phudit Jatavan, Theera Tongsong
The objective of this retrospective cohort study was to compare pregnancy outcomes between low-risk pregnant women with alpha-thalassaemia-1 trait and normal controls. The database of the Maternal-Foetal Medicine unit was used to identify low-risk singleton pregnant women complicated by alpha-thalassaemia-1 trait who gave birth between January 2002 and October 2014. The low-risk pregnancies with non-carrier status for thalassaemia were assigned into the control group, with a control-to-case ratio of 10:1. During the study period, 595 women with alpha-thalassaemia-1 trait and 5950 normal controls were identified...
June 9, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
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