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Obstetric critical care

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https://www.readbyqxmd.com/read/28635575/-high-risk-obstetrics-in-tertiary-centres-anaesthetist-hybrid-operating-suite-and-obstetric-critical-care-unit
#1
C D van der Marel, A J Eggink, R J Stolker
The frequency of pregnancy-related morbidity has increased over recent decades, as has the number of patients with complex congenital cardiac anomalies reaching fertile age, resulting in an increasing number of high-risk pregnancies. In order to optimalise maternal and foetal outcome in these patients, not only is the availability of optimal in-hospital facilities (e.g. obstetric critical care unit, hybrid operating suite) important, but also a multidisciplinary approach which is mandatory for successful maternal and foetal outcome...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28625299/managing-major-obstetric-haemorrhage-pharmacotherapy-and-transfusion
#2
REVIEW
Rachel Collis, Emilia Guasch
Major obstetric haemorrhage is a leading cause of maternal mortality. A prescriptive approach to early recognition and management is critical to improving outcomes. Uterine atony is the primary cause of post-partum haemorrhage. First-line prevention and treatment include the administration of uterine tonic agents; other conservative measures include uterine cavity tamponade and uterine compression sutures. Interventional radiology procedures have been used for both prophylaxis and treatment, but a hysterectomy may be necessary if conservative measures fail...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28622146/relationship-between-various-maternal-conditions-and-lactic-acid-dehydrogenase-activity-in-umbilical-cord-blood-at-birth
#3
Evangelos Patavoukas, Josefina Åberg-Liesaho, Cecilia Pegelow Halvorsen, Birger Winbladh, Eva Wiberg-Itzel
BACKGROUND: Lactic acid dehydrogenase (LDH) is a valuable marker for some of the most important diseases in newborns and the plasma LDH activity in newborns correlates well with conditions such as asphyxia. If LDH should be considered as a useful tool also in obstetric care, key factors associated with maternal health before and during pregnancy which could affect umbilical cord LDH activity need to be known. The aims of this study were to explore relationships between selected maternal conditions and arterial lactic acid dehydrogenase activity (aLDH) in umbilical cord blood at delivery...
June 15, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28621050/maternal-morbidity-and-associated-factors-at-a-tertiary-care-centre-in-karachi-a-critical-analysis
#4
Haleema Akhter Hashmi, Sarwat Umer, Syed Ijlal Ahmed
AIM: The study was conducted to identify maternal morbidity and associated factors such intensive care unit admission and surgical intervention. METHODS: Pregnant and six-week post-partum women without any other comorbidy were recruited from January 2014 to December 2015 from the Department of Gynaecology and Obstetrics at Liaquat National Hospital, Karachi. A structurally designed questionnaire was used to record demographic data and factors related to the management and intervention of maternal conclusions...
June 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28619426/hospitalization-is-associated-with-subsequent-disability-in-multiple-sclerosis
#5
Allan Garland, Luanne M Metz, Charles N Bernstein, Christine A Peschken, Carol A Hitchon, Ruth Ann Marrie
BACKGROUND: Although an increasing amount of research has evaluated interactions between MS and comorbid chronic disease, few data exist regarding the interactions between MS and acute illness. As compared to age and sex-matched persons without MS, persons with MS experience higher rates of hospitalization and critical illness, and higher mortality rates and health care utilization following critical illness. We aimed to determine whether acute illness requiring hospitalization is associated with progression of multiple sclerosis (MS)...
May 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28619279/intra-abdominal-pressure-and-intra-abdominal-hypertension-in-critically-ill-obstetric-patients-a-prospective-cohort-study
#6
A Tyagi, S Singh, M Kumar, A K Sethi
BACKGROUND: Critically ill obstetric patients may have risk factors for intra-abdominal hypertension. This study evaluated the intra-abdominal pressure and its effect on organ function and the epidemiology of intra-abdominal hypertension. METHODS: Obstetric patients admitted to an Intensive Care Unit, with an anticipated stay greater than 24hours, were included. Intra-abdominal pressure was measured daily via a Foley catheter, based on intravesical pressure. RESULTS: One-hundred-and-one patients were enrolled...
May 10, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28584736/maternal-near-miss-audit-lessons-to-be-learnt
#7
REVIEW
Meenakshi Kalhan, Srishti Singh, Anita Punia, Jai Prakash
Mother and child constitute a large, vulnerable, and a priority group as the risk is involved with childbearing in women and of growth and development in children. For every woman who dies from pregnancy or childbirth-related causes, it is estimated that twenty more suffer from pregnancy-related illness or experience other severe complications. These women who nearly escape death are categorized under "near miss" which has been defined as "a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy...
April 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/28584433/critically-ill-obstetric-patients-in-a-general-critical-care-unit-a-5-years-retrospective-study-in-a-public-teaching-hospital-of-eastern-india
#8
Sugata Dasgupta, Tulika Jha, Priyojit Bagchi, Shipti Sradha Singh, Ramprasad Gorai, Sourav Das Choudhury
BACKGROUND: Critical care services are essential for the subset of obstetric patients suffering from severe maternal morbidity. Studies on obstetric critical care are important for benchmarking the issues which need to be addressed while managing critically ill obstetric patients. Although there are several published studies on obstetric critical care from India and abroad, studies from Eastern India are limited. The present study was conducted to fill in this lacuna and to audit the obstetric critical care admissions over a 5 years' period...
May 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28580447/association-of-regional-disparity-of-obstetrics-and-gynecologic-services-with-children-and-infants-mortality-rates-a-cross-sectional-study
#9
Sogand Tourani, Mohammad Zarezadeh, Mehdi Raadabadi, Fatemeh Pourshariati
BACKGROUND: Equity in distribution of resources is considered as an important priority in health care systems. Equitable distribution of obstetrics and gynecology (Ob/Gyn) services in the country level is critical in maternal and neonatal health for qualitative promotion of maternal care in pregnancy, delivery, and post-delivery periods. OBJECTIVE: The present study aimed at determining regional disparity of obstetrics and gynecology services and its association with children and infants mortality rates...
March 2017: International Journal of Reproductive Biomedicine (Yazd, Iran)
https://www.readbyqxmd.com/read/28569134/incidence-and-outcome-of-severe-ante-partum-hemorrhage-at-the-teaching-hospital-yalgado-ou%C3%A3-draogo-in-burkina-faso
#10
Martin Lankoande, Papougnezambo Bonkoungou, Sosthène Ouandaogo, Marcelin Dayamba, Ali Ouedraogo, Francis Veyckmans, Nazinigouba Ouédraogo
BACKGROUND: Hemorrhage is the main cause of maternal death during pregnancy. This study aims to evaluate incidence and outcomes of Severe Ante Partum Hemorrhage (SAPH) during the third trimester of pregnancy prior to delivery. METHODS: Analytical cross-sectional study with prospective data collection during 12 months in Yalgado Ouedraogo Hospital, Ouagadougou, Burkina Faso. In this context SAPH is specifically referring to Ante Partum Hemorrhage (APH) and Intra Partum Hemorrhage (IPH) in the 3rd trimester...
May 31, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28567280/solar-powered-oxygen-systems-in-remote-health-centers-in-papua-new-guinea-a-large-scale-implementation-effectiveness-trial
#11
Trevor Duke, Ilomo Hwaihwanje, Magdalynn Kaupa, Jonah Karubi, Doreen Panauwe, Martin Sa'avu, Francis Pulsan, Peter Prasad, Freddy Maru, Henry Tenambo, Ambrose Kwaramb, Eleanor Neal, Hamish Graham, Rasa Izadnegahdar
BACKGROUND: Pneumonia is the largest cause of child deaths in Papua New Guinea (PNG), and hypoxaemia is the major complication causing death in childhood pneumonia, and hypoxaemia is a major factor in deaths from many other common conditions, including bronchiolitis, asthma, sepsis, malaria, trauma, perinatal problems, and obstetric emergencies. A reliable source of oxygen therapy can reduce mortality from pneumonia by up to 35%. However, in low and middle income countries throughout the world, improved oxygen systems have not been implemented at large scale in remote, difficult to access health care settings, and oxygen is often unavailable at smaller rural hospitals or district health centers which serve as the first point of referral for childhood illnesses...
June 2017: Journal of Global Health
https://www.readbyqxmd.com/read/28561253/obstetric-disorders-in-the-icu
#12
Daniela N Vasquez, Lauren Plante, María N Basualdo, Gustavo G Plotnikow
Pregnant and postpartum patients represent a challenge to critical care physicians, as two patients in one have to be cared for and because specific obstetric disorders, not universally covered in formal critical care training, need to be managed. Pregnancy also alters physiologic norms, so that the critical care physician may either fail to recognize a value as abnormal in pregnancy or mistakenly identify as abnormal a value within the normal range for a pregnant woman. In this article, we will review the most frequent obstetric causes of admission of pregnant/postpartum patients to the intensive care unit (hypertensive disease of pregnancy, obstetric hemorrhage, and obstetric sepsis) along with their diagnostic criteria, clinical presentation, and recommended treatment...
April 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28559681/international-human-rights-and-the-mistreatment-of-women-during-childbirth
#13
Rajat Khosla, Christina Zampas, Joshua P Vogel, Meghan A Bohren, Mindy Roseman, Joanna N Erdman
International human rights bodies have played a critical role in codifying, setting standards, and monitoring human rights violations in the context of sexual and reproductive health and rights. In recent years, these institutions have developed and applied human rights standards in the more particular context of maternal mortality and morbidity, and have increasingly recognized a critical human rights issue in the provision and experience of care during and after pregnancy, including during childbirth. However, the international human rights standards on mistreatment during facility-based childbirth remain, in an early stage of development, focused largely on a discrete subset of experiences, such as forced sterilization and lack of access to emergency obstetric care...
December 2016: Health and Human Rights
https://www.readbyqxmd.com/read/28549789/systematic-approaches-to-adverse-events-in-obstetrics-part-i-event-identification-and-classification
#14
Christian M Pettker
Despite our best intentions to improve health when a patient presents for care, adverse events are ubiquitous in medical practice today. Known complications related to the course of a patient's illness or condition or to the characteristics of the treatment have been an openly stated part of taking care of patients for centuries. However, it is only in the past decade that preventable adverse events, instances of harm related to error and deviations in accepted practice have become a primary part of these conversations...
May 23, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28545473/defining-disrespect-and-abuse-of-newborns-a-review-of-the-evidence-and-an-expanded-typology-of-respectful-maternity-care
#15
REVIEW
Emma Sacks
Amid increased attention to quality of obstetric care and respectful maternity care globally, insufficient focus has been given to quality of care and respectful care for newborns in the postnatal period. Especially in low and middle income countries, where low utilisation of obstetric and neonatal services is of concern, it is plausible that poor quality of care or mistreatment of newborns or stillborn infants will influence future care seeking, both for the health care needs of the growing infant and for subsequent pregnancies...
May 25, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28529087/a-critical-analysis-of-australian-policies-and-guidelines-for-water-immersion-during-labour-and-birth
#16
Megan Cooper, Helen McCutcheon, Jane Warland
BACKGROUND: Accessibility of water immersion for labour and/or birth is often dependent on the care provider and also the policies/guidelines that underpin practice. With little high quality research about the safety and practicality of water immersion, particularly for birth, policies/guidelines informing the practice may lack the evidence necessary to ensure practitioner confidence surrounding the option thereby limiting accessibility and women's autonomy. AIM: The aims of the study were to determine how water immersion policies and/or guidelines are informed, who interprets the evidence to inform policies/guidelines and to what extent the policy/guideline facilitates the option for labour and birth...
May 18, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/28515515/the-parturient-in-the-interventional-radiology-suite-new-frontier-in-obstetric-anaesthesia
#17
REVIEW
Tasneem Dhansura, Nabila Shaikh
The anaesthesiologist's presence during interventional radiology (IR) is increasing due to increasingly ill patients and intricate procedures. The management of a parturient in IR suite is complex in terms of logistics of an unfamiliar procedure in an unfamiliar area. The literature available is largely written by radiologists with little attention paid to anaesthetic details and considerations. In the Indian scenario, in the absence of hybrid operating rooms (ORs), logistics involve transport of a parturient back and forth between the IR suite and the OR...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28506952/retrospective-evaluation-of-pregnant-women-with-celiac-disease
#18
Kemal Beksaç, Gökçen Örgül, Murat Çağan, Ergun Karaağaoğlu, Serap Arslan, Mehmet Sinan Beksaç
OBJECTIVE: To show celiac disease (CD) and its poor pregnancy outcome relationship, and to demonstrate the importance of a gluten-free diet together with low-dose low-molecular-weight heparin (LMWH) and low-dose corticosteroid (LDC) in the management of pregnancies with CD. MATERIAL AND METHODS: This study consisted of 2 groups of patients. Six patients with CD (control group) on a gluten-free diet were monitored during their first pregnancies within the framework of antenatal care program and their pregnancy outcomes were compared with eight poorly-treated pregnant patients with CD (study group) who were referred from other medical institutions...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28426506/applications-of-noninvasive-hemodynamic-monitoring-in-obstetric-management
#19
John T Sullivan
Clinicians managing obstetric patients are dependent on valid hemodynamic measurements to guide care. Heart rate and noninvasive blood pressure guide most current care. New hemodynamic monitors are being used to report research findings and are being investigated by clinicians for their value to supplement standard monitoring. These include arterial pulse contour analysis, Doppler velocimetry, and bioimpedance among others. This chapter serves to present these new devices with a critical review of their advantages and limitations, and most importantly the validity of their measurements...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28421900/the-magnitude-and-factors-related-to-facility-based-maternal-mortality-in-mozambique
#20
Leonardo Chavane, Martinho Dgedge, Olivier Degomme, Osvaldo Loquiha, Marc Aerts, Marleen Temmerman
Facility-based maternal mortality remains an important public health problem in Mozambique. A number of factors associated with health system functioning can be described behind the occurrence of these deaths. This paper aimed to evaluate the magnitude of the health facility-based maternal mortality, its geographical distribution and to assess the health facility factors implicated in the occurrence of these deaths. A secondary analysis was done on data from the survey on maternal health needs performed by the Ministry of Health of Mozambique in 2008...
May 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
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