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Intrapartum

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https://www.readbyqxmd.com/read/28922987/admissions-for-hypoglycaemia-after-35%C3%A2-weeks-of-gestation-perinatal-predictors-of-cost-of-stay
#1
Theodore Dassios, Anne Greenough, Stamatina Leontiadi, Ann Hickey, Nick Kametas
BACKGROUND: Hypoglycaemia accounts for approximately one tenth of term admissions to neonatal units, can cause long-term neurodevelopmental impairment and is associated with significant burden to the affected infants, families and the health system. OBJECTIVE: To define the prevalence, length and cost of admissions for hypoglycaemia in infants born at greater than 35 weeks gestation and to identify antenatal and perinatal predictors of those outcomes. MATERIAL AND METHODS: This was a retrospective audit of infants admitted for hypoglycaemia between 1/1/2012 and 31/12/2015, in a level three neonatal intensive care unit at King's College Hospital NHS Foundation Trust, London...
September 18, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28917139/a-good-abortion-experience-a-qualitative-exploration-of-women-s-needs-and-preferences-in-clinical-care
#2
Anna L Altshuler, Alison Ojanen-Goldsmith, Paul D Blumenthal, Lori R Freedman
What do women ending their pregnancies want and need to have a good clinical abortion experience? Since birth experiences are better studied, birth stories are more readily shared and many women who have had an abortion have also given birth, we sought to compare women's needs and preferences in abortion to those in birth. We conducted semi-structured intensive interviews with women who had both experiences in the United States and analyzed their intrapartum and abortion care narratives using grounded theory, identifying needs and preferences in abortion that were distinct from birth...
September 8, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28915526/-exit-a-possible-intervention-for-new-and-earlyborn-babies-with-severe-hydrops-fetalis-and-hydrothoraces-on-both-sides
#3
Sandra Koch, Jochen Essers, Ortraud Beringer, Frank Reister, Helmut Hummler, Anja Moewes
The EXIT (ex utero intrapartum treatment) procedure is an established method of respiratory protection, originally used in the delivery of fetuses with congenital obstructive airway diseases (tumors in the throat area, hygromas, so-called congenital high airway obstruction syndrome (CHAOS)). Meanwhile, the procedure is also carried out in large perinatal centers for pronounced diaphragmatic hernia or other special indications (EXIT to ECMO, congenital lung airway malformations (CCAM), pulmonary atresia). We present our experience with adapted EXIT procedures in 5 preterm infants with secondary generalized hydrops fetalis and pronounced bilateral hydrothoraces...
September 15, 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28915123/placental-examination-in-nonmacerated-stillbirth-versus-neonatal-mortality
#4
Jerzy Stanek
AIM: To retrospectively statistically compare clinical and placental phenotypes of nonmacerated fetuses and live-born perinatal deaths in 3rd trimester pregnancies. METHODS: Twenty-five clinical and 47 placental phenotypes were statistically compared among 93 cases of nonmacerated (intrapartum, or recent antepartum death) 3rd trimester fetal deaths (Group 1), 118 3rd trimester neonatal deaths (Group 2) and 4285 cases without perinatal mortality (Group 3). RESULTS: Sixteen clinical and placental phenotypes were statistically significantly different between Group 3 and the two groups of perinatal deaths, which included eight placental phenotypes of fetal vascular malperfusion and eight other placental phenotypes of various etiology (amnion nodosum, 2-vessel umbilical cord, villous edema, increased extracellular matrix of chorionic villi, erythroblasts in fetal blood and trophoblastic lesions of shallow placentation)...
September 18, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28913129/evaluating-the-content-and-quality-of-intrapartum-care-in-vaginal-births-an-example-of-a-state-hospital
#5
Zekiye Karaçam, Döndü Arslan Kurnaz, Gizem Güneş
OBJECTIVE: The purpose of the research was to assess the content and quality of the intrapartum care offered in vaginal births in Turkey, based on the example of a state hospital. MATERIALS AND METHODS: This cross-sectional study was conducted between January 1(st), 2013 and December 31(st), 2014 at Aydın Maternity and Children's Hospital. The study sample consisted of 303 women giving vaginal birth, who were recruited into the study using the method of convenience sampling...
March 2017: Turk J Obstet Gynecol
https://www.readbyqxmd.com/read/28893895/all-hypertensive-disorders-of-pregnancy-increase-the-risk-of-future-cardiovascular-disease
#6
Jane Tooher, Charlene Thornton, Angela Makris, Robert Ogle, Andrew Korda, Annemarie Hennessy
Hypertensive disorders of pregnancy are associated with vascular dysfunction in the pregnancy and an increased risk of long-term cardiovascular disease (CVD) in the mother. What remains to be understood is whether the length, severity of the disease, the treatment of hypertension in pregnancy, or the subtype of hypertensive disorders of pregnancy are significant predictors of future CVD. We undertook a retrospective cohort study to review all women who gave birth at a tertiary hospital in Sydney between the years 1980 and 1989 (n=31 656)...
September 11, 2017: Hypertension
https://www.readbyqxmd.com/read/28892306/effect-of-locally-tailored-labour-management-guidelines-on-intrahospital-stillbirths-and-birth-asphyxia-at-the-referral-hospital-of-zanzibar-a-quasi-experimental-pre-post-study-the-partoma-study
#7
Nanna Maaløe, Natasha Housseine, Tarek Meguid, Birgitte Bruun Nielsen, Aksel Karl Georg Jensen, Rashid Saleh Khamis, Ali Gharib Mohamed, Mbweni Makame Ali, Said Mzee Said, Jos van Roosmalen, Ib Christian Bygbjerg
OBJECTIVE: To evaluate effect of locally-tailored labour management guidelines (PartoMa guidelines) on intrahospital stillbirths and birth asphyxia. DESIGN: Quasi-experimental pre-post-study investigating the causal pathway through changes in clinical practice. SETTING: Tanzanian low-resource referral hospital, Mnazi Mmoja Hospital. POPULATION: Facility deliveries during baseline (1(st) October 2014 till 31(st) January 2015) and the ninth till twelfth intervention month (1(st) October 2015 till 31(st) January 2016)...
September 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28889406/intrapartum-transperineal-ultrasound-used-to-predict-cases-of-complicated-operative-vacuum-and-forceps-deliveries-in-nulliparous-women
#8
José Antonio Sainz, José Antonio García-Mejido, Adriana Aquise, María José Bonomi, Carlota Borrero, Paloma De la Fuente, Ana Fernández-Palacín
INTRODUCTION: The objective of this study was to investigate the predictive value of intrapartum transperineal ultrasound in the identification of complicated operative(vacuum or forceps) deliveries in nulliparous women. MATERIAL AND METHODS: Prospective observational study of nulliparous women with an indication for operative-delivery who underwent intrapartum transperineal ultrasound before fetal extraction. Managing obstetricians were blinded to the ultrasound data...
September 10, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28886747/women-s-views-and-experiences-of-two-alternative-consent-pathways-for-participation-in-a-preterm-intrapartum-trial-a-qualitative-study
#9
Alexandra Sawyer, Celine Chhoa, Susan Ayers, Angela Pushpa-Rajah, Lelia Duley
BACKGROUND: The Cord Pilot Trial compared alternative policies for timing of cord clamping at very preterm birth at eight UK hospitals. In addition to standard written consent, an oral assent pathway was developed for use when birth was imminent. The aim of this study was to explore women's views and experiences of two alternative consent pathways to participate in the Cord Pilot Trial. METHODS: We conducted a qualitative study using semi-structured interviews. A total of 179 participants in the Cord Pilot Trial were sent a postal invitation to take part in interviews...
September 9, 2017: Trials
https://www.readbyqxmd.com/read/28886213/prospective-study-of-the-effect-of-maternal-body-mass-index-on-labor-progress-in-nulliparous-women-in-egypt
#10
Ahmed M Maged, Doaa S Belal, Heba M Marie, Hamsa Rashwan, Suzy Abdelaziz, Amir A Gabr, Ahmed R Elzayat
OBJECTIVE: To evaluate the impact of maternal body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) on labor progress in nulliparous women. METHODS: The present prospective cohort study enrolled primigravidae admitted to Kasr Al Ainy hospital, Cairo University, Egypt, during active labor between February 1, 2016, and February 28, 2017. Patients were classified into three equal groups using their BMI at admission: underweight (<18...
September 8, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28882582/group-b-streptococcal-infection-in-neonates-and-colonization-in-pregnant-women-an-epidemiological-retrospective-analysis
#11
Ching-Yi Cho, Yi-Hsuan Tang, Yu-Hsuan Chen, Szu-Yao Wang, Yi-Hsin Yang, Ting-Hao Wang, Chang-Ching Yeh, Keh-Gong Wu, Mei-Jy Jeng
BACKGROUND: Group B Streptococcus (GBS) infection is one of the major causes of neonatal morbidity and mortality. Universal GBS screening with intrapartum antibiotic prophylaxis (IAP) in pregnant women were initiated in 2012 in Taiwan. This study aimed to analyze the most recent maternal GBS colonization rate and the changes in neonatal GBS infection rate from 2011 to 2016. METHODS: All pregnant women and their live born neonates between January 2011 and June 2016 were retrospectively reviewed...
August 23, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28882116/thistle-trial-of-hands-on-interprofessional-simulation-training-for-local-emergencies-a-research-protocol-for-a-stepped-wedge-clustered-randomised-controlled-trial
#12
Erik Lenguerrand, Catherine Winter, Karen Innes, Graeme MacLennan, Dimitrios Siassakos, Pauline Lynch, Alan Cameron, Joanna Crofts, Alison McDonald, Kirsty McCormack, Mark Forrest, John Norrie, Siladitya Bhattacharya, Tim Draycott
BACKGROUND: Many adverse pregnancy outcomes in the UK could be prevented with better intrapartum care. Training for intrapartum emergencies has been widely recommended but there are conflicting data about their effectiveness. Observational studies have shown sustained local improvements in perinatal outcomes associated with the use of the PRactical Obstetric Multi-Professional Training - (PROMPT) training package. However this effect needs to be investigated in the context of randomised study design in settings other than enthusiastic early adopter single-centres...
September 7, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28870180/awareness-attitudes-and-perceptions-regarding-hiv-and-pmtct-amongst-pregnant-women-in-guinea-bissau-a-qualitative-study
#13
Noel Vieira, Dlama Nggida Rasmussen, Inês Oliveira, Aureliano Gomes, Peter Aaby, Christian Wejse, Morten Sodemann, Lucy Reynolds, Holger W Unger
BACKGROUND: The human immunodeficiency virus (HIV) continues to be a major cause of maternal and infant mortality and morbidity in sub-Saharan Africa. Prevention of mother-to-child transmission of HIV (PMTCT) strategies have proven effective in decreasing the number of children infected in utero, intrapartum and during the breastfeeding period. This qualitative study explores knowledge and perceptions of HIV amongst pregnant women, healthcare workers' experiences of the national PMTCT services, and barriers to PMTCT, during a period of programme scale-up in urban Guinea-Bissau (2010-11)...
September 4, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28867889/massive-maternal-haemorrhage-a-rare-case-of-ruptured-uterine-varix
#14
Shikha Sharma, Pankaj Yadav, Anshuja Singla
Haemoperitoneum anytime during pregnancy is a rare but catastrophic event. With advancement in antenatal and intrapartum care, the maternal survival has improved manyfold. Management involves immediate resuscitation with volume correction followed by surgery, mostly laparotomy. This case is of a booked primigravida, with otherwise uneventful pregnancy, who suffered a massive haemoperitoneum. On laparotomy, the only cause found was a small uterine varix on the posterior uterine surface. The patient survived after multiple transfusions, but it led to a fresh stillborn baby...
October 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28867885/serious-visual-ocular-complications-in-pre-eclampsia-and-eclampsia
#15
Thangappah Radha Bai Prabhu
INTRODUCTION: Complete loss of vision is an uncommon ocular complication of pre-eclampsia/eclampsia. The conditions which lead to visual loss in pre-eclampsia include cortical blindness, retinal detachment, retinal vascular thrombosis and optic nerve atrophy. OBJECTIVES: The objective was to describe the cause, clinical course and prognosis in blindness complicating pre-eclampsia. METHODOLOGY: This is a prospective observational study conducted at the Govt...
October 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28863031/association-between-intrapartum-magnesium-administration-and-the-incidence-of-maternal-fever-a-retrospective-cross-sectional-study
#16
Elizabeth M S Lange, Scott Segal, Carlo Pancaro, Cynthia A Wong, William A Grobman, Gregory B Russell, Paloma Toledo
BACKGROUND: Intrapartum maternal fever is associated with several adverse neonatal outcomes. Intrapartum fever can be infectious or inflammatory in etiology. Increases in interleukin 6 and other inflammatory markers are associated with maternal fever. Magnesium has been shown to attenuate interleukin 6-mediated fever in animal models. We hypothesized that parturients exposed to intrapartum magnesium would have a lower incidence of fever than nonexposed parturients. METHODS: In this study, electronic medical record data from all deliveries at Northwestern Memorial Hospital (Chicago, Illinois) between 2007 and 2014 were evaluated...
September 1, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28854913/reduced-growth-velocity-across-the-third-trimester-is-associated-with-placental-insufficiency-in-fetuses-born-at-a-normal-birthweight-a-prospective-cohort-study
#17
Teresa M MacDonald, Lisa Hui, Stephen Tong, Alice J Robinson, Kirsten M Dane, Anna L Middleton, Susan P Walker
BACKGROUND: While being small-for-gestational-age due to placental insufficiency is a major risk factor for stillbirth, 50% of stillbirths occur in appropriate-for-gestational-age (AGA, > 10th centile) fetuses. AGA fetuses are plausibly also at risk of stillbirth if placental insufficiency is present. Such fetuses may be expected to demonstrate declining growth trajectory across pregnancy, although they do not fall below the 10th centile before birth. We investigated whether reduced growth velocity in AGA fetuses is associated with antenatal, intrapartum and neonatal indicators of placental insufficiency...
August 31, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28853525/-principles-of-causality-between-peripartum-events-and-cerebral-palsy
#18
REVIEW
Isaac Blickstein
Understanding the intrapartum development of cerebral palsy (CP) may improve obstetrical management, would decrease the incidence of CP, and would help the court in judging whether CP is a result of negligence. In 1999, the Australian task force, and in 2003 the American task force, published their consensus regarding the criteria to establish intrapartum development of CP (recently reaffirmed by the American task force). The rationale is that CP is the end product of a continuum starting with an intrapartum hypoxic event that continues with the birth of an asphyxiated neonate, that exhibit specific neurological manifestations, and ends with a specific type of CP...
August 2017: Harefuah
https://www.readbyqxmd.com/read/28851782/evaluating-maternity-units-a-prospective-cohort-study-of-freestanding-midwife-led-primary-maternity-units-in-new-zealand-clinical-outcomes
#19
Celia P Grigg, Sally K Tracy, Mark Tracy, Rea Daellenbach, Mary Kensington, Amy Monk, Virginia Schmied
OBJECTIVE: To compare maternal and neonatal birth outcomes and morbidities associated with the intention to give birth in a freestanding primary level midwife-led maternity unit (PMU) or tertiary level obstetric-led maternity hospital (TMH) in Canterbury, Aotearoa/New Zealand. DESIGN: Prospective cohort study. PARTICIPANTS: 407 women who intended to give birth in a PMU and 285 women who intended to give birth at the TMH in 2010-2011. All of the women planning a TMH birth were 'low risk', and 29 of the PMU cohort had identified risk factors...
August 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28851241/obesity-s-impact-on-intrapartum-electronic-fetal-monitoring
#20
Brian Brocato, David Lewis, Madhuri Mulekar, Susan Baker
OBJECTIVE: To evaluate the impact maternal obesity has on the percentage of unmonitored electronic fetal monitoring (EFM). STUDY DESIGN: Women undergoing induction of labor at term were categorized into three groups: Group 1 (body mass index (BMI) < 30 kg/m(2)), Group 2 (30 < BMI < 40 kg/m(2)) and Group 3 (BMI ≥ 40 kg/m(2)). External EFM tracings were reviewed from the time of induction of labor until amniotomy; the percentage of time off of EFM was calculated...
August 30, 2017: Journal of Maternal-fetal & Neonatal Medicine
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