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Obstetric critical care

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https://www.readbyqxmd.com/read/28928575/referrral-systems-development-and-survey-of-perioperative-and-critical-care-referral-to-anesthetists
#1
P L Narendra, Harihar V Hegde, Maroof Ahmad Khan, Dayanand G Talikoti, Samson Nallamilli
INTRODUCTION: Anesthetists come in contact with more than two-third of hospital patients. Timely referral to anesthetists is vital in perioperative and remote site settings. Delayed referrals, improper referrals, and referrals at inappropriate levels can result in inadequate preparation, perioperative complications, and poor outcome. METHODS: The self administered paper survey to delegates attending anesthesia conferences. Questions were asked on how high-risk, emergency surgical cases remote site and critical care patients were referred to anesthetists and presence of rapid response teams...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28922228/anesthesia-capacity-in-ghana-a-teaching-hospital-s-resources-and-the-national-workforce-and-education
#2
Mark A Brouillette, Alfred J Aidoo, Maria A Hondras, Nana A Boateng, Akwasi Antwi-Kusi, William Addison, Alec R Hermanson
BACKGROUND: Quality anesthetic care is lacking in low- and middle-income countries (LMICs). Global health leaders call for perioperative capacity reports in limited-resource settings to guide improved health care initiatives. We describe a teaching hospital's resources and the national workforce and education in this LMIC capacity report. METHODS: A prospective observational study was conducted at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, during 4 weeks in August 2016...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28910302/a-look-back-on-how-far-to-walk-systematic-review-and-meta-analysis-of-physical-access-to-skilled-care-for-childbirth-in-sub-saharan-africa
#3
Kerry L M Wong, Lenka Benova, Oona M R Campbell
OBJECTIVES: To (i) summarize the methods undertaken to measure physical accessibility as the spatial separation between women and health services, and (ii) establish the extent to which distance to skilled care for childbirth affects utilization in Sub-Saharan Africa. METHOD: We defined spatial separation as the distance/travel time between women and skilled care services. The use of skilled care at birth referred to either the location or attendant of childbirth...
2017: PloS One
https://www.readbyqxmd.com/read/28882128/institutional-maternal-and-perinatal-deaths-a-review-of-40-low-and-middle-income-countries
#4
Patricia E Bailey, Wasihun Andualem, Michel Brun, Lynn Freedman, Sourou Gbangbade, Malick Kante, Emily Keyes, Edwin Libamba, Allisyn C Moran, Halima Mouniri, Dahada Ould El Joud, Kavita Singh
BACKGROUND: Understanding the magnitude and clinical causes of maternal and perinatal mortality are basic requirements for positive change. Facility-based information offers a contextualized resource for clinical and organizational quality improvement. We describe the magnitude of institutional maternal mortality, causes of death and cause-specific case fatality rates, as well as stillbirth and pre-discharge neonatal death rates. METHODS: This paper draws on secondary data from 40 low and middle income countries that conducted emergency obstetric and newborn care assessments over the last 10 years...
September 7, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28871456/queueing-theoretic-analysis-of-labor-and-delivery-understanding-management-styles-and-c-section-rates
#5
Matthew Gombolay, Toni Golen, Neel Shah, Julie Shah
Childbirth is a complex clinical service requiring the coordinated support of highly trained healthcare professionals as well as management of a finite set of critical resources (such as staff and beds) to provide safe care. The mode of delivery (vaginal delivery or cesarean section) has a significant effect on labor and delivery resource needs. Further, resource management decisions may impact the amount of time a physician or nurse is able to spend with any given patient. In this work, we employ queueing theory to model one year of transactional patient information at a tertiary care center in Boston, Massachusetts...
September 4, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28851308/patterns-and-determinants-of-pathways-to-reach-comprehensive-emergency-obstetric-and-neonatal-care-cemonc-in-south-sudan-qualitative-diagrammatic-pathway-analysis
#6
Khalifa Elmusharaf, Elaine Byrne, Ayat AbuAgla, Amal AbdelRahim, Mary Manandhar, Egbert Sondorp, Diarmuid O'Donovan
BACKGROUND: Maternity referral systems have been under-documented, under-researched, and under-theorised. Responsive emergency referral systems and appropriate transportation are cornerstones in the continuum of care and central to the complex health system. The pathways that women follow to reach Emergency Obstetric and Neonatal Care (EmONC) once a decision has been made to seek care have received relatively little attention. The aim of this research was to identify patterns and determinants of the pathways pregnant women follow from the onset of labour or complications until they reach an appropriate health facility...
August 29, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28844823/addressing-maternal-deaths-due-to-violence-the%C3%A2-illinois-experience
#7
Abigail R Koch, Stacie E Geller
Homicide, suicide, and substance abuse accounted for nearly one fourth of all pregnancy-associated deaths in Illinois from 2002 through 2013. Maternal mortality review in Illinois has been primarily focused on obstetric and medical causes and little is known about the circumstances surrounding deaths due to homicide, suicide, and substance abuse, if they are pregnancy related, and if the deaths are potentially preventable. To address this issue, we implemented a process to form a second statewide maternal mortality review committee for deaths due to violence in late 2014...
August 24, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28836060/delays-contributing-to-the-development-and-repair-of-obstetric-fistula-in-northern-tanzania
#8
Cody Cichowitz, Melissa H Watt, Bariki Mchome, Gileard G Masenga
INTRODUCTION AND HYPOTHESIS: Delays in receiving obstetric care during labor contribute to high rates of maternal morbidity in sub-Saharan Africa. This exploratory study was conducted to identify important delays experienced during the development and subsequent repair of obstetric fistula in northern Tanzania. METHODS: Sixty women presenting to a tertiary hospital with obstetric fistula completed structured surveys about the birth experience that led to fistula development and their experiences seeking surgical repair...
August 23, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28835910/reintegration-of-women-post-obstetric-fistula-repair-experience-of-family-caregivers
#9
Kimberly Jarvis, Solina Richter, Helen Vallianatos, Lois Thornton
In northern Ghana, families traditionally function as the main provider of care. The role of family, however, is becoming increasingly challenged with the social shifts in Ghanaian culture moving from extended kinship to nuclear households. This has implications for the care of women post obstetric fistula (OF) repair and their family members who assist them to integrate back into their lives prior to developing the condition. This research is part of a larger critical ethnographic study which explores a culture of reintegration...
January 2017: Global Qualitative Nursing Research
https://www.readbyqxmd.com/read/28835213/evaluation-of-the-mobile-nurse-training-mnt-intervention-a-step-towards-improvement-in-intrapartum-practices-in-bihar-india
#10
Aritra Das, Dipty Nawal, Manoj Kumar Singh, Morchan Karthick, Parika Pahwa, Malay Bharat Shah, Tanmay Mahapatra, Kunal Ranjan, Indrajit Chaudhuri
BACKGROUND: Evidence shows that improving the quality of intrapartum care is critical for maternal survival. However, a significant rise in the proportion of facility-based births over the last decade in India - attributable to a cash transfer program - has not resulted in a corresponding reduction in maternal mortality, thanks, in part, to low-skilled care at facilities. The current study evaluated a mobile knowledge-based intervention aimed at improving quality of care by mentoring in-service staff nurses at public obstetric facilities...
August 23, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28833511/detection-and-care-practices-for-postpartum-depressive-symptoms-in-public-sector-obstetric-units-in-mexico-qualitative-results-from-a-resource-constrained-setting
#11
Jean Marie S Place, Betania Allen-Leigh, Deborah L Billings, Kiya M Dues, Filipa de Castro
BACKGROUND: Postpartum depression (PPD) is amenable to detection and treatment, but effectively addressing it is contingent on policies, practices, and health care providers working together to address the issue. The aim of this study is to describe a sample of health care providers' existing practices in public-sector obstetric units in Mexico related to detecting and offering care to women with depressive symptomology. METHODS: Semi-structured interviews with 40 health care providers (16 physicians, 13 nurses, three social workers, and eight psychologists) from one tertiary-level and two secondary-level, public-sector obstetric units, were conducted by members of a trained research team from May to July 2012...
August 22, 2017: Birth
https://www.readbyqxmd.com/read/28831501/non-traumatic-hemorrhage-is-controlled-with-reboa-in-acute-phase-then-mortality-increases-gradually-by-non-hemorrhagic-causes-direct-iabo-registry-in-japan
#12
Y Matsumura, J Matsumoto, K Idoguchi, H Kondo, T Ishida, Y Kon, K Tomita, K Ishida, T Hirose, K Umakoshi, T Funabiki
PURPOSE: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is now a feasible and less invasive resuscitation procedure. This study aimed to compare the clinical course of trauma and non-trauma patients undergoing REBOA. METHODS: Patient demographics, etiology, bleeding sites, hemodynamic response, length of critical care, and cause of death were recorded. Characteristics and outcomes were compared between non-trauma and trauma patients. Kaplan-Meier survival analysis was then conducted...
August 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28822238/the-environmental-injustice-of-beauty-framing-chemical%C3%A2-exposures-from-beauty-products-as-a-health%C3%A2-disparities-concern
#13
Ami R Zota, Bhavna Shamasunder
The obstetrics-gynecology community has issued a call to action to prevent toxic environmental chemical exposures and their threats to healthy human reproduction. Recent committee opinions recognize that vulnerable and underserved women may be impacted disproportionately by environmental chemical exposures and recommend that reproductive health professionals champion policies that secure environmental justice. Beauty product use is an understudied source of environmental chemical exposures. Beauty products can include reproductive and developmental toxicants such as phthalates and heavy metals; however, disclosure requirements are limited and inconsistent...
August 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28782423/maternal-anaemia-after-delivery-prevalence-and-risk-factors
#14
Carola Medina Garrido, Jaime León, Adriana Romaní Vidal
The purpose of this study was to assess the prevalence of postpartum anaemia and determine the clinical risk factors for this condition to provide a viable alternative to postpartum haemoglobin measurement. In total, 1415 patients at Hospital Universitario del Tajo, Madrid, who underwent postpartum haemoglobin testing were included, and risk factors for having an Hb level <10 g/dl were determined. We found that 29% of the mothers were anaemic, and birth canal lacerations, caesarean delivery, episiotomy and South American origin were identified as the main risk factors for this condition...
August 6, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28782392/model-of-obstetric-attention-based-on-critical-care-in-latin-america
#15
María F Escobar, Javier A Carvajal, Albaro J Nieto, Adriana Messa, Juan M Burgos, Maria P Echavarría, Marcela Granados
Purpose of this article. Report the results obtained following the implementation of an OCC (Obstetric Critical Care) model. MATERIALS AND METHODS: This is an observational prospective study in obstetric population with high complexity illness attended in a safety and quality model of attention in a specific unit supporting the concept of obstetric critical care. Records were used as the primary source for collecting information, using the standards of the Center for Clinical Research...
August 7, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28780684/travel-time-to-hospital-for-childbirth-comparing-calculated-versus-reported-travel-times-in-france
#16
Hugo Pilkington, Caroline Prunet, Béatrice Blondel, Hélène Charreire, Evelyne Combier, Marc Le Vaillant, Jeanne-Marie Amat-Roze, Jennifer Zeitlin
Objectives Timely access to health care is critical in obstetrics. Yet obtaining reliable estimates of travel times to hospital for childbirth poses methodological challenges. We compared two measures of travel time, self-reported and calculated, to assess concordance and to identify determinants of long travel time to hospital for childbirth. Methods Data came from the 2010 French National Perinatal Survey, a national representative sample of births (N = 14 681). We compared both travel time measures by maternal, maternity unit and geographic characteristics in rural, peri-urban and urban areas...
August 5, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28776636/bereaved-parents-experience-of-care-and-follow-up-after-stillbirth-in-sydney-hospitals
#17
Diana Bond, Camille Raynes-Greenow, Adrienne Gordon
BACKGROUND: Despite stillbirth being identified as one of the most traumatic events a woman can experience, there is a lack of evidence on which to inform best practice in hospital and follow-up care. AIMS: The aim of this study was to identify which strategies are most valued by parents regarding care following stillbirth in order to improve the support and management of grieving families. METHOD: Mixed methods questionnaires were sent to bereaved participants of the Sydney Stillbirth Study...
August 4, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28728520/in-and-out-hospital-mortality-rate-in-surgical-patients
#18
Philippe Dony, Magali Pirson, Jean G Boogaerts
BACKGROUND: Death rates after surgery are increasingly analysed for clinical audit and quality assessment. Many studies commonly provide information only on deaths that occur during hospital stay, known as in-hospital death rates. By using hospital data set linked to death certificate registry, we recorded in- and out-hospital deaths within 30 and 60 post-operative days. METHODS: The study included all consecutive surgical procedures (denominator) under general or locoregional anaesthesia in adult patients admitted for elective or non-elective inpatient surgery...
July 20, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28722621/health-care-access-during-the-ebola-virus-epidemic-in-liberia
#19
Patricia A McQuilkin, Kanagasabai Udhayashankar, Michelle Niescierenko, Louise Maranda
The Ebola virus disease (EVD) epidemic, which began in West Africa in December 2013, claimed more than 11,000 lives, with more than 4,800 of these deaths occurring in Liberia. The epidemic had an additional effect of paralyzing the health-care systems in affected countries, which led to even greater mortality and morbidity. Little is known about the impact that the epidemic had on the provision of basic health care. During the period from March to May 2015, we undertook a nationwide, community-based survey to learn more about health-care access during the EVD epidemic in Liberia...
July 10, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28711179/immediate-birth-an-analysis-of-women-and-their-babies-undergoing-time-critical-birth-in-a-tertiary-referral-obstetric-hospital
#20
M H Warren, J Kamania, A T Dennis
BACKGROUND: At our institution, the emergency obstetric 'code green' activates the system for immediate birth, usually by caesarean section. This study aimed to determine the incidence of immediate birth, indications, modes of anaesthesia, and short-term neonatal and maternal outcomes. METHOD: A review was performed for all women at the Royal Women's Hospital, Parkville, Australia who underwent immediate birth over a two-year period: January 1, 2013 to December 31, 2014...
June 16, 2017: International Journal of Obstetric Anesthesia
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