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https://www.readbyqxmd.com/read/28231684/emergency-peripartum-hysterectomy-a-challenge-or-an-obstetrical-defeat
#1
(no author information available yet)
OBJECTIVES: Peripartum hysterectomy remains an obstetric nightmare. Most obstetricians consider it a defeat. The aim of our study was to assess the prevalence, indications, procedures and complications of emergency peripartum hysterectomy (EPH) in the 2nd Department of Obstetrics & Gynecology, Medical University of Warsaw during a 7 year period (2007-2013). METHODS: A retrospective evaluation of 21,144 deliveries was performed. We analyzed all cases of EPH, including the maternal characteristics, obstetrical history, course of pregnancy and delivery, type of surgery and complications...
October 24, 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/28231285/the-mother-s-autonomy-in-decision-making-madm-scale-patient-led-development-and-psychometric-testing-of-a-new-instrument-to-evaluate-experience-of-maternity-care
#2
Saraswathi Vedam, Kathrin Stoll, Kelsey Martin, Nicholas Rubashkin, Sarah Partridge, Dana Thordarson, Ganga Jolicoeur
OBJECTIVE: To develop and validate a new instrument that assesses women's autonomy and role in decision making during maternity care. DESIGN: Through a community-based participatory research process, service users designed, content validated, and administered a cross-sectional quantitative survey, including 31 items on the experience of decision-making. SETTING AND PARTICIPANTS: Pregnancy experiences (n = 2514) were reported by 1672 women who saw a single type of primary maternity care provider in British Columbia...
2017: PloS One
https://www.readbyqxmd.com/read/28228908/diagnosis-of-neonatal-neuroblastoma-with-postmortem-magnetic-resonance-imaging
#3
James Davis, Nathan Novotny, Jacqueline Macknis, Zeynep Alpay-Savasan, Luis F Goncalves
Postmortem magnetic resonance imaging (MRI) is emerging as a valuable tool to accompany traditional autopsy and has potential for use in cases when traditional autopsy is not possible. This case report will review the use of postmortem MRI with limited tissue sampling to differentiate between metastatic neuroblastoma and hepatoblastoma which could not be clearly differentiated with prenatal ultrasound, prenatal MRI, or emergent postnatal ultrasound. The mother presented to our institution at 27 weeks gestation after an obstetric ultrasound at her obstetrician's office identified a large abdominal mass...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28227415/ultrasound-transducer-positioning-aid-for-fetal-heart-rate-monitoring
#4
Paul Hamelmann, Alex Kolen, Lars Schmitt, Rik Vullings, Hans van Assen, Massimo Mischi, Libertario Demi, Judith van Laar, Jan Bergmans, Paul Hamelmann, Alex Kolen, Lars Schmitt, Rik Vullings, Hans van Assen, Massimo Mischi, Libertario Demi, Judith van Laar, Jan Bergmans, Alex Kolen, Judith Van Laar, Paul Hamelmann, Libertario Demi, Lars Schmitt, Rik Vullings, Hans Van Assen, Massimo Mischi, Jan Bergmans
Fetal heart rate (fHR) monitoring is usually performed by Doppler ultrasound (US) techniques. For reliable fHR measurements it is required that the fetal heart is located within the US beam. In clinical practice, clinicians palpate the maternal abdomen to identify the fetal presentation and then the US transducer is fixated on the maternal abdomen where the best fHR signal can be obtained. Finding the optimal transducer position is done by listening to the strength of the Doppler audio output and relying on a signal quality indicator of the cardiotocographic (CTG) measurement system...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225423/committee-opinion-no-688-management-of-suboptimally-dated-pregnancies
#5
(no author information available yet)
The American College of Obstetricians and Gynecologists considers first-trimester ultrasonography to be the most accurate method to establish or confirm gestational age. Pregnancies without an ultrasonographic examination confirming or revising the estimated due date before 22 0/7 weeks of gestation should be considered suboptimally dated. This document provides guidance for managing pregnancies in which the best clinical estimate of gestational age is suboptimal. There is no role for elective delivery in a woman with a suboptimally dated pregnancy...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28225422/clinical-updates-in-women-s-health-care-summary-structural-heart-disease-primary-and-preventive-care-review
#6
Tiberio Frisoli, Michele Doughty Voeltz
Reproductive-aged women with structural heart disease who become pregnant as well as postreproductive-aged women with this condition represent a significant proportion of patients seen by obstetrician- gynecologists. Usually, their conditions are complex, and a basic knowledge of the anatomy and physiology of the heart is required. Additionally, understanding the effect of pregnancy on women with structural heart disease is critically important to optimizing maternal and fetal outcomes. This monograph addresses the pathophysiology, signs and symptoms, screening and diagnosis, basic management, and suggested counseling for an obstetric-gynecologic patient with structural heart disease...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28225420/committee-opinion-no-690-summary-carrier-screening-in-the-age-of-genomic-medicine
#7
(no author information available yet)
Carrier screening, whether targeted or expanded, allows individuals to consider their range of reproductive options. Ultimately, the goal of genetic screening is to provide individuals with meaningful information that they can use to guide pregnancy planning based on their personal values. Ethnic-specific, panethnic, and expanded carrier screening are acceptable strategies for prepregnancy and prenatal carrier screening. Because all of these are acceptable strategies, each obstetrician-gynecologist or other health care provider or practice should establish a standard approach that is consistently offered to and discussed with each patient, ideally before pregnancy...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28225418/committee-opinion-no-688-summary-management-of-suboptimally-dated-pregnancies
#8
(no author information available yet)
The American College of Obstetricians and Gynecologists considers first-trimester ultrasonography to be the most accurate method to establish or confirm gestational age. Pregnancies without an ultrasonographic examination confirming or revising the estimated due date before 22 0/7 weeks of gestation should be considered suboptimally dated. This document provides guidance for managing pregnancies in which the best clinical estimate of gestational age is suboptimal. There is no role for elective delivery in a woman with a suboptimally dated pregnancy...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28219965/a-public-health-response-to-opioid-use-in-pregnancy
#9
Stephen W Patrick, Davida M Schiff
The use of opioids during pregnancy has grown rapidly in the past decade. As opioid use during pregnancy increased, so did complications from their use, including neonatal abstinence syndrome. Several state governments responded to this increase by prosecuting and incarcerating pregnant women with substance use disorders; however, this approach has no proven benefits for maternal or infant health and may lead to avoidance of prenatal care and a decreased willingness to engage in substance use disorder treatment programs...
February 20, 2017: Pediatrics
https://www.readbyqxmd.com/read/28217821/physicians-experiences-as-patients-with-statin-side-effects-a-case-series
#10
Hayley J Koslik, Athena Hathaway Meskimen, Beatrice Alexandra Golomb
Physicians are among those prescribed statins and therefore, subject to potential statin adverse effects (AEs). There is little information on the impact of statin AEs on physicians affected by them. We sought to assess the character and impact of statin AEs occurring in physicians and retired physicians, and to ascertain whether/how personal experience of AEs moderated physicians' attitude toward statin use. Seven active or retired physicians from the United States communicated with the Statin Effects Study group regarding their personal experience of statin AEs...
December 2017: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/28217518/a-2016-clinical-practice-pattern-in-the-management-of-primary-hypothyroidism-among-doctors-from-different-clinical-specialties-in-new-delhi
#11
Vineet Surana, Sameer Aggarwal, Deepak Khandelwal, Rajiv Singla, Saptarshi Bhattacharya, Sachin Chittawar, Sanjay Kalra, Deep Dutta
BACKGROUND: This study aimed to document practices in managing hypothyroidism among doctors in New Delhi, with special focus on subclinical hypothyroidism, pregnancy, and old age, and to compare it with global practices. METHODS: During an academic program attended by 394 doctors, all participants were given a questionnaire designed based on thyroid practices survey done by Burch et al. to evaluate the practice patterns. Questions were based on evaluating doctor's preferred choices in diagnosis, therapy, and follow-up of hypothyroidism in different scenarios...
January 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28217389/management-of-parturients-in-active-labor-with-arnold-chiari-malformation-tonsillar-herniation-and-syringomyelia
#12
Ramsis F Ghaly, Tatiana Tverdohleb, Kenneth D Candido, Nebojsa Nick Knezevic
BACKGROUND: Arnold-Chiari malformation Type 1 (ACM-1) in parturients is a topic of ongoing discussion between obstetricians and anesthesiologists. The primary unanswered question remains; How should the anesthesia provider proceed with labor analgesia and anesthesia for cesarean section when confronted with an advanced, asymptomatic, or minimally symptomatic case of ACM-1 during labor? CASE DESCRIPTION: A 24-year-old, ASA II, G1P0 full-term parturient presented to Labor and Delivery for vaginal delivery...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28216926/urological-disorders-and-pregnancy-an-overall-experience
#13
Debasmita Mandal, Mriganka Mouli Saha, Dillip Kumar Pal
AIM: Pregnancy is an anatomical and physiological altered state and the presence of various urological problems not only aggravates the disease itself, but also results in unfavourable pregnancy outcome. Aim is to highlight obstetric outcome in pregnant women with urological problems. MATERIALS AND METHODS: Longitudinal prospective cohort study conducted in tertiary care hospital, IPGME and R, Kolkata from Jan 2011 to Dec 2012. All pregnant women with urological problems were included as subjects...
January 2017: Urology Annals
https://www.readbyqxmd.com/read/28215984/the-cost-of-nurse-midwifery-care-use-of-interventions-resources-and-associated-costs-in-the-hospital-setting
#14
Molly R Altman, Sean M Murphy, Cynthia E Fitzgerald, H Frank Andersen, Kenn B Daratha
INTRODUCTION: Obstetrical care often involves multiple expensive, and often elective, interventions that may increase costs to patients, payers and the health care system with little effect on patient outcomes. The objectives of this study were to examine the following hospital related outcomes: 1) use of labor and birth interventions, 2) inpatient duration of stay, and 3) total direct health care costs for patients attended by a certified nurse-midwife (CNM) compared with those attended by an obstetrician-gynecologist (OB-GYN), within an environment of safe and high-quality care...
February 15, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28213060/prediction-of-cesarean-delivery-in-the-term-nulliparous-woman-results-from-the-prospective-multi-center-genesis-study
#15
Naomi Burke, Gerard Burke, Fionnuala Breathnach, Fionnuala Mcauliffe, John J Morrison, Michael Turner, Samina Dornan, John R Higgins, Amanda Cotter, Michael Geary, Peter Mcparland, Sean Daly, Fiona Cody, Pat Dicker, Elizabeth Tully, Fergal D Malone
BACKGROUND: In contemporary practice many nulliparous women require intervention during childbirth such as operative vaginal delivery or Cesarean delivery (CD). Despite the knowledge that the rising CD rate is associated with increasing maternal age, obesity and larger infant birthweight, we lack a reliable method to predict the requirement for such potentially hazardous obstetric procedures during labor and delivery. This issue is important as there are higher rates of morbidity and mortality associated with unplanned CD performed in labor compared to scheduled Cesarean deliveries...
February 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28211155/utah-obstetricians-opinions-of-planned-home-birth-and-conflicting-nice-acog-guidelines-a-qualitative-study
#16
Emily Rainey, Sara Simonsen, Joseph Stanford, Kimberley Shoaf, Jami Baayd
BACKGROUND: The United Kingdom's National Institute for Health and Care Excellence (NICE) recently published recommendations that support planned home birth for low-risk women. The American College of Obstetricians and Gynecologists (ACOG) remains wary of planned home birth, asserting that hospitals and birthing centers are the safest birth settings. Our objective was to examine opinions of obstetricians in Salt Lake City, Utah about home birth in the context of rising home birth rates and conflicting guidelines...
February 17, 2017: Birth
https://www.readbyqxmd.com/read/28210863/healthcare-professionals-response-to-intrapartum-death-a-cross-sectional-study
#17
Karen McNamara, S Meaney, O O'Connell, M McCarthy, R A Greene, K O'Donoghue
BACKGROUND: Exposure to adverse perinatal events can impact on the way healthcare professionals (HCPs) provide patient care. The aim of this study was to document the experiences of HCPs following exposure to intrapartum death (IPD), to identify opinions surrounding education and suitable support strategies, and to ascertain if involvement with an IPD had any impact on clinical practice. METHODS: A questionnaire study, with open and closed questions, was developed and set in a tertiary maternity hospital...
February 17, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28203387/an-overview-of-available-drugs-for-management-of-opioid-abuse-during-pregnancy
#18
REVIEW
Jillian Laslo, Jon-Michael Brunner, Daniel Burns, Emily Butler, Autumn Cunningham, Ryan Killpack, Courtney Pyeritz, Kimberly Rinard, Jennifer Childers, Joseph Horzempa
The prevalence of opioid abuse in the United States has been steadily increasing over the last several years among many major demographics, including pregnant women. Rise in prenatal opioid abuse has resulted in subsequent escalation of neonatal abstinence syndrome incidence, prompting the US Congress to pass the Protecting Our Infants Act of 2015. This act specifically calls for a critical review of current treatment options for prenatal opioid abuse which may ultimately lead to the development of better therapies and a decreased incidence of neonatal abstinence syndrome...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28202330/ethical-issues-in-cesarean-delivery
#19
REVIEW
Frank A Chervenak, Laurence B McCullough
Cesarean delivery is the most common and important surgical intervention in obstetric practice. Ethics provides essential guidance to obstetricians for offering, recommending, recommending against, and performing cesarean delivery. This chapter provides an ethical framework based on the professional responsibility model of obstetric ethics. This framework is then used to address two especially ethically challenging clinical topics in cesarean delivery: patient-choice cesarean delivery and trial of labor after cesarean delivery...
January 23, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28198038/likelihood-of-cesarean-delivery-after-applying-leading-active-labor-diagnostic-guidelines
#20
Jeremy L Neal, Nancy K Lowe, Julia C Phillippi, Sharon L Ryan, Amy M Knupp, Mary S Dietrich, Stephen F Thung
BACKGROUND: Friedman, the United Kingdom's National Institute for Health and Care Excellence (NICE), and the American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine (ACOG/SMFM) support different active labor diagnostic guidelines. Our aims were to compare likelihoods for cesarean delivery among women admitted before vs in active labor by diagnostic guideline (within-guideline comparisons) and between women admitted in active labor per one or more of the guidelines (between-guideline comparisons)...
February 15, 2017: Birth
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