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https://www.readbyqxmd.com/read/28088109/carbetocin-versus-oxytocin-for-prevention-of-post-partum-haemorrhage-at-caesarean-section-in-the-united-kingdom-an-economic-impact-analysis
#1
Helen A van der Nelson, Tim Draycott, Dimitrios Siassakos, Christopher W H Yau, Anthony J Hatswell
OBJECTIVE: To determine the economic impact of the introduction of carbetocin for the prevention of postpartum haemorrhage (PPH) at caesarean section, compared to oxytocin. STUDY DESIGN: The model is a decision tree conducted from a UK National Health Service perspective. 1500 caesarean sections (both elective and emergency) were modelled over a 12 month period. Efficacy data was taken from a published Cochrane meta-analysis, and costs from NHS Reference costs, the British National Formulary and the NHS electronic Medicines Information Tool...
January 3, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28087067/-successful-use-of-sugammadex-for-caesarean-section-in-a-patient-with-myasthenia-gravis
#2
Lokman Soyoral, Ugur Goktas, Muhammed Bilal Cegin, Volkan Baydi
Myasthenia gravis is an autoimmune disorder that is characterized by muscle weakness that fluctuates, worsening with exertion, and improving with rest. Diagnosis of myasthenia gravis is made following clinical and physical examination and is confirmed by serum immunoassays to measure autoantibody levels. Myasthenia gravis especially when associated with pregnancy is a high-risk disease, and its course is unpredictable. We described the second report about use of sugammadex after rocuronium for a caesarean delivery with myasthenia gravis, but, unlike our case that formerly was diagnosed with myasthenia gravis, the patient was extubated on postoperative successfully and we did not encounter any respiratory problems...
January 10, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28077411/incidence-of-surgical-site-infection-following-caesarean-section-a-systematic-review-and-meta-analysis-protocol
#3
Khalid B M Saeed, Richard A Greene, Paul Corcoran, Sinéad M O'Neill
INTRODUCTION: Caesarean section (CS) rates have increased globally during the past three decades. Surgical site infection (SSI) following CS is a common cause of morbidity with reported rates of 3-15%. SSI represents a substantial burden to the health system including increased length of hospitalisation and costs of postdischarge care. The definition of SSI varies with the postoperative follow-up period among different health systems, resulting in differences in the reporting of SSI incidence...
January 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28076828/perinatal-risk-factors-for-low-and-moderate-five-minute-apgar-scores-at-term
#4
Shimona Lai, Christopher Flatley, Sailesh Kumar
OBJECTIVE: To evaluate the specific maternal and perinatal variables associated with a low (≤3) or moderate (4-6) Apgar score, compared to a high (≥7) score. STUDY DESIGN: This was a retrospective, cohort study of 58429 term singleton babies born at the Mater Mother's Hospital in Brisbane, Australia in 2007-2013. Maternal demographics, socio-economic status using the Australian Socioeconomic Index for Areas (SEIFA) score, obstetric factors, and birth outcomes were compared for neonates grouped into three categories based on their five-minute Apgar: low (≤3), moderate (4-6) and high (≥7)...
January 6, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28075507/labour-induction-near-term-for-women-aged-35-or-over-an-economic-evaluation
#5
Kate F Walker, Melina Dritsaki, George Bugg, Marion Macpherson, Carol McCormick, Nicky Grace, Chris Wildsmith, Lucy Bradshaw, Gordon Cs Smith, James G Thornton
OBJECTIVE: Induction of labour at 39 weeks for nulliparous women aged 35 years and over may prevent stillbirths and does not increase caesarean births, so it may be popular. But the overall costs and benefits of such a policy have not been compared. DESIGN: A cost-utility analysis alongside a randomised controlled trial (the 35/39 trial). SETTING: Obstetric departments of 38 UK National Health Service hospitals and one UK primary care trust...
January 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28075336/multilevel-analysis-of-factors-associated-with-wasting-and-underweight-among-children-under-five-years-in-nigeria
#6
Blessing J Akombi, Kingsley E Agho, Dafna Merom, John J Hall, Andre M Renzaho
Wasting and underweight reflect poor nutrition, which in children leads to retarded growth. The aim of this study is to determine the factors associated with wasting and underweight among children aged 0-59 months in Nigeria. A sample of 24,529 children aged 0-59 months from the 2013 Nigeria Demographic and Health Survey (NDHS) was used. Multilevel logistic regression analysis that adjusted for cluster and survey weights was used to identify significant factors associated with wasting/severe wasting and underweight/severe underweight...
January 8, 2017: Nutrients
https://www.readbyqxmd.com/read/28074994/-normoglycemic-diabetic-ketoacidosis-in-pregnancy-report-of-one-case
#7
Margarita Rivas M, Pamela Belmar Z, Pilar Durruty A, Lilian Sanhueza M, Gloria López S
Normoglycemic diabetic ketoacidosis should be suspected in pregnant women presenting nausea, vomiting, abdominal pain and anorexia. We report a 39 years old woman with a 32 weeks pregnancy who sought emergency care due to hyperemesis. She was hospitalized with the following diagnoses: pregnancy hypertension syndrome, gestational diabetes, morbid obesity and poor prenatal control. The evaluation of the feto-placental unit showed perception of fetal movements, non-reactive non-stress baseline record and a biophysical profile of 6/8...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28072700/is-prophylactic-tranexamic-acid-administration-effective-and-safe-for-postpartum-hemorrhage-prevention-a-systematic-review-and-meta-analysis
#8
Chunbo Li, Yuping Gong, Lingling Dong, Bingying Xie, Zhiyuan Dai
BACKGROUND: To assess the efficacy and safety of tranexamic acid (TA) in reducing blood loss and lowering transfusion needs for patients undergoing caesarean section (CS) or vaginal delivery (VD). METHODS: An electronic literature search of PubMed, EMBASE, OVID, Cochrane library, Scopus, Central, and Clinical trials.gov was performed to identify studies that evaluating the usage of TA in CS or VD. The methodological quality of included trials was assessed and data extraction was performed...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28068953/pregnant-human-peripheral-leukocyte-migration-during-several-late-pregnancy-clinical-conditions-a-cross-sectional-observational-study
#9
Jun Takeda, Xin Fang, David M Olson
BACKGROUND: Parturition at term and preterm is characterized by sterile inflammatory processes occurring in the absence of infection whereby peripheral leukocytes infiltrate gestational tissues in response to chemotactic signals. In response to a homing signal, recruited leukocytes undergo diapedesis and extravasate through capillaries, migrating into stromal tissue. There they interact with resident immune and stromal cells to produce a mixture of matrix metalloproteinases, prostaglandins and cytokines including interleukin-1β (IL-1β) and IL-6 that in turn transform the uterus from pregnancy to parturition...
January 10, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28068945/why-women-bleed-and-how-they-are-saved-a-cross-sectional-study-of-caesarean-section-near-miss-morbidity
#10
S Maswime, E J Buchmann
BACKGROUND: Maternal deaths from 'bleeding during and after caesarean section' (BDACS) have increased in South Africa, and have now become the largest sub-cause of deaths from obstetric haemorrhage. The aim of this study was to describe risk factors and causes of near-miss related to BDACS and interventions used to arrest haemorrhage and treat its effects. METHODS: Cross-sectional prospective study in 13 urban public hospitals in South Africa, from July to December 2014...
January 9, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28068929/are-freestanding-midwifery-units-a-safe-alternative-to-obstetric-units-for-low-risk-primiparous-childbirth-an-analysis-of-effect-differences-by-parity-in-a-matched-cohort-study
#11
Louise Fischer Christensen, Charlotte Overgaard
BACKGROUND: Intrapartum complications and the use of obstetric interventions are more common in primiparous childbirth than in multiparous childbirth, leading to concern about out of hospital birth for primiparous women. The purpose of this study was to determine whether the effect of birthplace on perinatal and maternal morbidity and the use of obstetric interventions differed by parity among low-risk women intending to give birth in a freestanding midwifery unit or in an obstetric unit in the North Denmark Region...
January 9, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28065966/implementation-of-warning-tool-to-improve-maternal-newborn-health-outcomes-in-a-developing-country
#12
Sana Sheikh, Rahat Qureshi, Sidrah Nausheen, Rozina Sikandar
OBJECTIVE: To improve health outcomes through the implementation of national early warning sign tool for babies delivered through emergency caesarean section in off-work hours. METHODS: This comparative clinical study was conducted at the Aga Khan Hospital for Women and Children, Karachi, from April to August 2014, and comprised women who had an emergency caesarean section. Maternal and perinatal outcomes were compared of patients in Group A and Group B which represented individuals before and after the implementation of the national early warning score respectively...
January 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28065366/-characteristics-of-induced-labors-at-marqu%C3%A3-s-de-valdecilla-university-hospital
#13
Marta González-Maestro, Izaskun Laurrieta-Saiz, Casandra García-González, Marta López-Mirones, Oihane Terán-Muñoz, Alicia Alonso-Salcines
OBJECTIVE: Induction of labor (IOL) is a common obstetric practice which has increased in recent decades. The main objective of this study is to describe the characteristics of induced labor at Marqués de Valdecilla University Hospital. METHOD: A descriptive, retrospective study was performed between January 1st and April 30t(h) of 2014, by reviewing medical histories. A standardised registration has been used to collect data. RESULTS: There were a total of 376 IOL, the incidence was 35...
January 3, 2017: Enfermería Clínica
https://www.readbyqxmd.com/read/28064099/an-enhanced-recovery-programme-after-caesarean-delivery-increases-maternal-satisfaction-and-improves-maternal-neonatal-bonding-a-case-control-study
#14
Anne Laronche, Luiza Popescu, Dan Benhamou
OBJECTIVES: Enhanced recovery programmes (ERP) have been shown to improve postoperative outcomes. The aim of our study was to investigate the impact of an ERP after caesarean delivery on maternal feelings and satisfaction towards mother-child bonding initiation, in comparison with traditional postoperative care. STUDY DESIGN: A comparative, prospective and multicentre study was conducted in three maternity units of the Paris area: one applied traditional postoperative care while the two others applied an ERP, were included patients after elective or emergency caesarean delivery who had given birth to full-term healthy singleton newborns...
December 30, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28062422/spontaneous-rupture-of-renal-angiomyolipoma-during-pregnancy
#15
Li Ao, Eriko Ogasahara, Yasuhiko Okuda, Shuji Hirata
A renal angiomyolipoma (AML) is a rare benign tumour of kidney origin. Pregnancy is known to be associated with an increased risk of tumour rupture causing hypovolaemic shock, which is usually managed surgically or through an embolisation procedure. However, having surgery during pregnancy predisposes the mother to a preterm delivery, and the unknown influences of radiation exposure to the fetus make the management of such cases very challenging. A 30-year-old pregnant woman had a sudden onset of gross haematuria at the 20th week of her pregnancy...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28060792/expression-of-x-linked-toll-like-receptor-4-signalling-genes-in-female-versus-male-neonates
#16
David N O'Driscoll, Chiara DeSanti, Paul J McKiernan, Victoria McEneaney, Eleanor J Molloy, Catherine M Greene
BACKGROUND: Male neonates display poorer disease prognosis and outcomes compared to females. Immune genes which exhibit higher expression in umbilical cord blood (UCB) of females may contribute to the female immune advantage during infection and inflammation. The aim of this study was to quantify expression of Toll-like receptor (TLR) 4 signalling genes encoded on the X-chromosome in UCB from term female versus male neonates. METHODS: UCB samples were collected from term neonates (n=26) born by elective Caesarean section and whole blood was collected from adults (n=20)...
January 6, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28057109/-prevalence-of-and-risk-factors-for-delayed-onset-of-lactation-in-chinese-lactating-women-in-2013
#17
S Jiang, Y F Duan, X H Pang, Y Bi, J Wang, L Y Zhao, S A Yin, Z Y Yang
Objective: To study the prevalence of delayed onset of lactation (later than 3 days) in lactating women in China and to analyze its influencing factors. Methods: Data were extracted from Chinese National Nutrition and Health Surveillance-Mothers, from mothers with children under 2 years of age (in 2013). A total of 11 178 women who were lactating or had lactated were selected from 55 counties of 30 provinces (excluding the Tibet Autonomous Region) in China, using the multi-stage stratified cluster randomization sampling method...
December 6, 2016: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
https://www.readbyqxmd.com/read/28056921/bifidobacterium-adolescentis-protects-against-necrotizing-enterocolitis-and-upregulates-tollip-and-sigirr-in-premature-neonatal-rats
#18
Wenshen Wu, Yanli Wang, Jingjing Zou, Fang Long, Huiheng Yan, Lijuan Zeng, Yunbin Chen
BACKGROUND: Necrotizing enterocolitis (NEC) is a serious gastrointestinal disorder that is often seen in premature infants. Probiotics decrease the risk of NEC; however, the mechanism by which probiotics work is not clear. The goal of this study was to evaluate the preventive effect of Bifidobacterium adolescentis in an NEC rat model. METHODS: Sprague-Dawley neonatal rats were obtained by caesarean section after 20-21 d gestation and randomly divided into the following 3 groups: dam fed (DF), formula fed (FF), and formula + B...
January 5, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28055024/prenatally-diagnosed-congenital-diaphragmatic-hernia-optimal-mode-of-delivery
#19
C M Burgos, B Frenckner, M Luco, M T Harting, P A Lally, K P Lally
OBJECTIVE: To evaluate if the delivery mode of infants with prenatally diagnosed congenital diaphragmatic hernia (CDH) affects the outcome. STUDY DESIGN: Data from the CDH Study Group database of infants with prenatal diagnosis between 2001-2015 were divided into four delivery mode groups: vaginal spontaneous, vaginal induced, elective caesarean section, and emergent caesarean section. Outcomes were analyzed in relation to the time of day of delivery and the gestational age at birth...
January 5, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28051809/pregnancy-related-changes-of-antiretroviral-pharmacokinetics-an-argument-for-tdm
#20
Francesco R Simonetti, Dario Cattaneo, Nadia Zanchetta, Vania Giacomet, Valeria Micheli, Nadia Ciminera, Cristina Gervasoni
Here we describe a case of an HIV-infected young woman with extensive drug-resistant virus, who was successfully switched from a raltegravir-based regimen to a dolutegravir-based intensified antiretroviral regimen a few days before scheduled caesarean section because of the still detectable viral load. The trough concentrations of all antiretroviral drugs before and after delivery are also described.Our case underlines both the difficult management of young women, HIV-infected at young age with very limited treatment options and the great variability in the pregnancy-related physiologic changes affecting the pharmacokinetics of antiretrovirals...
January 4, 2017: Antiviral Therapy
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