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Obstetric emergency

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https://www.readbyqxmd.com/read/28645984/facilitators-and-barriers-to-participation-of-private-sector-health-facilities-in-government-led-schemes-for-maternity-services-in-india-a-qualitative-study
#1
Vikas Yadav, Somesh Kumar, Sudharsanam Balasubramaniam, Ashish Srivastava, Suranjeen Pallipamula, Parvez Memon, Dinesh Singh, Saurabh Bhargava, Greeshma Ann Sunil, Bulbul Sood
OBJECTIVE: Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilisation of their presence, resources and expertise for providing quality maternal and newborn health services. This study explores the perception of various stakeholders on expectations, benefits, barriers and facilitators to private sector participation in government-led schemes-specifically Janani Suraksha Yojana (JSY)-for maternity service delivery...
June 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28644074/reinforcing-marginality-maternal-health-interventions-in-rural-nicaragua
#2
Birgit Kvernflaten
To achieve Millennium Development Goal 5 on maternal health, many countries have focused on marginalized women who lack access to care. Promoting facility-based deliveries to ensure skilled birth attendance and emergency obstetric care has become a main measure for preventing maternal deaths, so women who opt for home births are often considered 'marginal' and in need of targeted intervention. Drawing upon ethnographic data from Nicaragua, this paper critically examines the concept of marginality in the context of official efforts to increase institutional delivery amongst the rural poor, and discusses lack of access to health services among women living in peripheral areas as a process of marginalization...
June 23, 2017: Anthropology & Medicine
https://www.readbyqxmd.com/read/28641929/initiation-and-engagement-with-methadone-treatment-among-pregnant-and-postpartum-women
#3
Kristin M Mattocks, Robin Clark, Linda Weinreb
PURPOSE: The purpose of this study was to explore perceptions of experiences and challenges with methadone maintenance treatment (MMT) and obstetrical care among pregnant and postpartum women enrolled in a methadone maintenance program. RESEARCH DESIGN: The study featured a grounded theory approach including two focus groups with pregnant and postpartum methadone users at a methadone maintenance clinic in Worcester, Massachusetts. Two research team members conducted and recorded focus groups, which took approximately 45 minutes to 1 hour...
June 19, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28641119/maternal-progesterone-levels-are-modulated-by-maternal-bmi-and-predict-birth-weight-sex-specifically-in-human-pregnancies
#4
Anke Diemert, Janina Goletzke, Claus Barkmann, Robert Jung, Kurt Hecher, Petra Arck
OBJECTIVE: Successful pregnancy outcome is the result of a tailored adaptation of the maternal endocrine and immune system throughout gestation. We aimed to investigate if maternal endocrine, anthropometric and life style factors assessed longitudinally throughout pregnancy allow prediction of birth weight. STUDY DESIGN: Data on maternal factors and obstetrical characteristics from 220 pregnancies from a German prospective pregnancy cohort were analyzed using univariate and multivariate regression models...
June 3, 2017: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/28637644/does-attendance-at-a-specialist-antenatal-clinic-improve-clinical-outcomes-in-women-with-class-iii-obesity-compared-with-standard-care-a-retrospective-case-note-analysis
#5
Fiona C Denison, Heather MacGregor, Laura I Stirrat, Kerrie Stevenson, Jane E Norman, Rebecca M Reynolds
OBJECTIVES: To determine whether attendance at a specialised multidisciplinary antenatal clinic for women with class III obesity (BMI >40 kg/m(2)) is associated with improved clinical outcomes compared with standard antenatal care. DESIGN: Retrospective cohort study using routinely collected data from electronic patient record. SETTING: Community and hospital based antenatal care. PARTICIPANTS: Women with a singleton pregnancy with class III obesity booked for antenatal care and delivered in one of two hospitals in NHS Lothian, Scotland, UK between 2008 and 2014...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28633726/small-bowel-intussusception-in-a-pregnant-woman-a-case-report
#6
Roxana Covali, Lucian Ambrosie, Micea Onofriescu, Alexandru Luca, Gabriela Dumachita-Sargu, Violeta Aursulesei, Dumitru Gafitanu
INTRODUCTION: Intussusception usually is associated with children, rarely with adults. CASE PRESENTATION: A 42-year-old pregnant woman (29 weeks' gestation) reported mild pain in the upper aspect of the abdomen after an intense physical effort. Ultrasound examination found a normally evolving pregnancy and a bowel obstacle, without bowel distention. Because it was not a surgical emergency at the time of evaluation, she was sent to the hospital's Obstetrics Department...
2017: Permanente Journal
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
#7
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/28630543/pregnancy-and-the-40-year-prison-sentence-how-abortion-is-murder-became-institutionalized-in-the-salvadoran-judicial-system
#8
Jocelyn Viterna, Jose Santos Guardado Bautista
Using the case of El Salvador, this article demonstrates how the anti-abortion catchphrase "abortion is murder" can become embedded in the legal practice of state judicial systems. In the 1990s, a powerful anti-abortion movement in El Salvador resulted in a new legal context that outlawed abortion in all circumstances, discouraged mobilization for abortion rights, and encouraged the prosecution of reproduction-related "crimes." Within this context, Salvadoran women initially charged with the crime of abortion were convicted of "aggravated homicide" and sentenced to up to 40 years in prison...
June 2017: Health and Human Rights
https://www.readbyqxmd.com/read/28629455/an-investigation-of-the-relationship-between-autonomy-childbirth-practices-and-obstetric-fistula-among-women-in-rural-lilongwe-district-malawi
#9
Julika Ayla Kaplan, Jonathan Kandodo, Joseph Sclafani, Susan Raine, Jennifer Blumenthal-Barby, Alison Norris, Abigail Norris-Turner, Elly Chemey, John Michael Beckham, Zara Khan, Reginald Chunda
BACKGROUND: Obstetric fistula is a childbirth injury caused by prolonged obstructed labor that results in destruction of the tissue wall between the vagina and bladder. Although obstetric fistula is directly caused by prolonged obstructed labor, many other factors indirectly increase fistula risk. Some research suggests that many women in rural Malawi have limited autonomy and decision-making power in their households. We hypothesize that women's limited autonomy may play a role in reinforcing childbirth practices that increase the risk of obstetric fistula in this setting by hindering access to emergency care and further prolonging obstructed labor...
June 19, 2017: BMC International Health and Human Rights
https://www.readbyqxmd.com/read/28625305/decision-to-delivery-interval-is-30%C3%A2-min-the-magic-time-what-is-the-evidence-does-it-work
#10
REVIEW
J H Tomlinson, D N Lucas
Emergency caesarean section is required when delivery can reduce the risk to the life of the mother or foetus. When a caesarean section is indicated for foetal compromise, a decision-to-delivery interval of 30 min (or less) has been suggested as the ideal time frame within which an obstetric team should achieve delivery. In theory, a short decision-to-delivery interval may minimise intra-uterine hypoxia and improve neonatal outcome. Current medical evidence does not support this time frame. There are certain indications for caesarean section that necessitate a much shorter decision-to-delivery interval, but evidence suggests that the majority of neonates may be safely delivered within a longer interval of time...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28625281/the-petra-perinatal-emergency-team-response-assessment-scale-a-high-fidelity-simulation-validation-study
#11
Mrinalini Balki, David Hoppe, David Monks, Lynn Sharples, Mary Ellen Cooke, Lawrence Tsen, Rory Windrim
OBJECTIVE: The objective of this study was to establish the validity and reliability of a new interdisciplinary teamwork assessment scale, the Perinatal Emergency Team Response Assessment (PETRA), to assess team dynamics during a simulated obstetric crisis. METHODS: This observational cohort study was conducted using high-fidelity simulation and multidisciplinary obstetric teams in order to evaluate the validity and reliability of the previously developed PETRA scale for the assessment of teamwork in the management of obstetric crises...
July 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28622635/management-of-parturients-with-factor-xi-deficiency-10year-case-series-and-review-of-literature
#12
REVIEW
Lynda Verghese, Efterpi Tingi, Jecko Thachil, Charles Hay, Louise Byrd
This is an article reviewing the management of pregnant women with factor XI (FXI) deficiency. Retrospective review of the electronic records of 67 pregnancies in 25 women with FXI deficiency over a ten-year period was undertaken. All women received care at St Mary's Tertiary Referral Obstetric/Haematology Clinic for some or all of their pregnancies. Outcome measures included antenatal complications, mode of delivery, anaesthesia provided and postpartum haemorrhage (PPH) and management required. A positive bleeding history was identified in 50% of women prior to pregnancy...
June 6, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28621560/the-risks-associated-with-prenatal-antidepressant-exposure-time-for-a-precision-medicine-approach
#13
Lars Henning Pedersen
Introduction The prevalence of depression in pregnancy is over 10% and a significant proportion of pregnant women use antidepressant medication. The safety of antidepressants in pregnancy is controversial, partly due to methodological challenges. The conflicting results in the literature may, however, also be due to differences in risks between the study populations related to variations in e.g. degree of depression, type of antidepressant, and lifestyle. Areas covered The literature on the safety of antidepressants in pregnancy is vast and thousands of papers have been published mainly in the last decades...
June 16, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28619038/the-experiences-of-women-with-maternal-near-miss-and-their-perception-of-quality-of-care-in-kelantan-malaysia-a-qualitative-study
#14
Mohd Noor Norhayati, Nik Hussain Nik Hazlina, Ab Razak Asrenee, Zaharah Sulaiman
BACKGROUND: Maternal mortality has been the main way of ascertaining the outcome of maternal and obstetric care. However, maternal morbidities occur more frequently than maternal deaths; therefore, maternal near miss was suggested as a more useful indicator for the evaluation and improvement of maternal health services. Our study aimed to explore the experiences of women with maternal near miss and their perception of the quality of care in Kelantan, Malaysia. METHODS: A qualitative phenomenological approach with in-depth interview method was conducted in two tertiary hospitals in Kelantan, Malaysia...
June 15, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28616417/the-comparison-the-effect-of-training-by-means-of-simulation-and-oral-method-on-midwives-skill-in-management-of-shoulder-dystocia
#15
Masoumeh Kordi, Fatemeh Erfanian, Farzaneh Rashidi Fakari, Fatemeh Dastfan, Keivan Shariati Nejad
INTRODUCTION: Shoulder dystocia is one of the obstetric emergencies that are accompanied to serious risks for mother and fetus. It necessitates making the method of training of shoulder dystocia management more efficient, i.e., better management and giving services with higher quality. Thus, this study was carried out to compare the impact of training by simulation and oral technique on the skill of the employed midwives in obstetric clinics at Mashhad city (Iran) in shoulder dystocia management during 2012...
2017: Journal of Education and Health Promotion
https://www.readbyqxmd.com/read/28602173/clinical-significance-and-prognostic-value-of-femoral-lymph-node-metastasis-in-figo-stage-iii-vulvar-carcinoma
#16
H Tu, P Sun, H F Gu, X K Zhang, H Huang, T Wan, J H Liu
OBJECTIVES: To determine the clinical significance and prognostic value of femoral lymph node metastasis (FLNM) in patients with International Federation of Gynecology and Obstetrics (FIGO) stage III vulvar carcinoma. METHODS: The medical records of patients with vulvar carcinoma who underwent inguinofemoral lymphadenectomy between 1990 and 2013 were retrospectively reviewed. RESULTS: Of 66 patients with stage III vulvar carcinoma, 42 had superficial lymph node metastasis (SLNM) only and 24 had FLNM...
May 31, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28601830/interfacility-transfer-of-pregnant-women-using-publicly-funded-emergency-call-centre-based-ambulance-services-a-cross-sectional-analysis-of-service-logs-from-five-states-in-india
#17
Samiksha Singh, Pat Doyle, Oona Mr Campbell, Laura Oakley, Gv Ramana Rao, Gvs Murthy
OBJECTIVE: To estimate the proportion of interfacility transfers (IFTs) transported by '108' ambulances and to compare the characteristics of the IFTs and non-IFTs to understand the pattern of use of '108' services for pregnant women in India. DESIGN: A cross-sectional analysis of '108' ambulance records from five states for the period April 2013 to March 2014. Data were obtained from the call centre database for the pregnant women, who called '108'. MAIN OUTCOMES: Proportion of all pregnancies and institutional deliveries in the population who were transported by '108', both overall and for IFT...
June 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28600919/group-a-streptococci-infection-a-systematic-clinical-review-exemplified-by-cases-from-an-obstetric-department
#18
REVIEW
Line Winther Gustafson, Jan Blaakær, Rikke Bek Helmig
Group A streptococci infection has re-emerged since the 1980s and onward, despite the awareness of the etiology and the use of penicillin. It now accounts for more than 75,000 deaths worldwide every year. Postpartum women have a 20-fold increased incidence of group A streptococci disease compared to non-pregnant women. This review focuses on the epidemiology, pathophysiology, clinical presentation, prevention and treatment of group A streptococcal infection in pregnancy. SEARCH STRATEGY: We searched the following electronic databases from 1980-March 2016: PubMed-Medline, Embase, SveMed+, Bibliotek...
June 1, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28599396/five-years-experience-in-an-anesthesiology-antenatal-clinic-for-high-risk-patients
#19
Daniel Shatalin, Yaacov Gozal, Sorina Grisaru-Granovsky, Alexander Ioscovich
INTRODUCTION: The aim, of this study is to describe our approach and outcomes in an outpatient anesthesia/analgesia antepartum clinic among ambulatory high-risk obstetric patients. METHODS: This was a retrospective evaluation of the activity of the anesthesiology antenatal clinic from its inception in 2010 until 2016 (a 5-year period). The clinic works in collaboration with the Department of Obstetrics and Gynecology. The catchment area of the study University Affiliated Hospital attends a multiethnic population characterized by high parity...
May 24, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28596069/validation-of-the-effect-questionnaire-for-competence-based-clinical-teaching-in-residency-training-in-lithuania
#20
Eglė Vaižgėlienė, Žilvinas Padaiga, Daiva Rastenytė, Algimantas Tamelis, Kęstutis Petrikonis, Rima Kregždytė, Cornelia Fluit
BACKGROUND AND AIM: In 2013, all residency programs at the Lithuanian University of Health Sciences were renewed into a competency-based medical education curriculum. To assess the quality of clinical teaching in residency training, we chose the EFFECT (evaluation and feedback for effective clinical teaching) questionnaire designed and validated at the Radboud University Medical Centre in the Netherlands. The aim of this study was to validate the EFFECT questionnaire for quality assessment of clinical teaching in residency training...
May 26, 2017: Medicina
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