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https://www.readbyqxmd.com/read/29164970/a-feasibility-study-of-trauma-sensitive-obstetric-care-for-low-income-ethno-racial-minority-pregnant-abuse-survivors
#1
N R Stevens, T A Lillis, L Wagner, V Tirone, S E Hobfoll
PURPOSE: This study evaluated the feasibility and acceptability of an integrated (psychological and obstetric) intervention for pregnant abuse survivors with posttraumatic stress symptoms (PTS) from low-income, ethno-racial minority backgrounds. METHODS: Trauma-sensitive obstetrics to promote control, anxiety-reduction and empowerment (TO-CARE) offers cognitive-behavioral therapy (CBT) coping skills delivered over six sessions by therapists, coupled with trauma-sensitive obstetric care from specially-trained obstetric physicians...
November 22, 2017: Journal of Psychosomatic Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29117653/effect-of-delivery-and-episiotomy-on-the-emergence-of-urinary-incontinence-in-women-review-of-literature
#2
Krešimir Živković, Nikica Živković, Tomislav Župić, Damir Hodžić, Vjekoslav Mandić, Slavko Orešković
Episiotomy is obstetric procedure during which the incision extends the vestibule of the vagina during the second stage of labor. Episiotomy was extensively spread with gradual increase of rates in the first half of the 20th century and was performed medio-laterally in all nulliparous women with the idea to protect fetal head from trauma and pelvic floor from injuries. However, reports claiming that episiotomy had no such benefits were published. It was shown that routine medio-lateral episiotomy did not protect against the appearance of urinary incontinence after vaginal delivery, while the risk of anal incontinence could be increased...
December 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29115073/assessment-of-competence-in-emergency-medicine-among-healthcare-professionals-in-cameroon
#3
Sang Chul Kim, Young Sun Ro, Sang Do Shin, Dae Han Wi, Joongsik Jeong, Ju Ok Park, Kyong Min Sun, Kwangsoo Bae
Development of a competence-based curriculum is important. This study aimed to develop competence assessment tools in emergency medicine and use it to assess competence of Cameroonian healthcare professionals. This was a cross-sectional, descriptive study. Through literature review, expert survey, and discrimination tests, we developed a self-survey questionnaire and a scenario-based competence assessment tool for assessing clinical knowledge and self-confidence to perform clinical practices or procedures. The self-survey consisted of 23 domains and 94 questionnaires on a 5-point Likert scale...
December 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29094456/a-prospective-cause-of-death-classification-system-for-maternal-deaths-in-low-and-middle-income-countries-results-from-the-global-network-maternal-newborn-health-registry
#4
Omrana Pasha, Elizabeth M McClure, Sarah Saleem, Shiyam Sunder, Adrien Lokangaka, Antoinette Tshefu, Carl L Bose, Melissa Bauserman, Musaku Mwenechanya, Elwyn Chomba, Waldemar A Carlo, Ana L Garces, Lester Figueroa, K Michael Hambidge, Nancy F Krebs, Shivaprasad Goudar, Bhalachandra S Kodkany, Sangappa Dhaded, Richard J Derman, Archana Patel, Patricia L Hibberd, Fabian Esamai, Constance Tenge, Edward A Liechty, Janet L Moore, Dennis D Wallace, Marion Koso-Thomas, Menachem Miodovnik, Robert L Goldenberg
OBJECTIVE: To describe the causes of maternal death in a population-based cohort in six low and middle-income countries using a standardized, hierarchical, algorithmic cause of death (COD) methodology. DESIGN: A population-based, prospective observational study. SETTING: Seven sites in six low-middle income countries including the Democratic Republic of the Congo (DRC), Guatemala, India (2), Kenya, Pakistan and Zambia. POPULATION: All deaths amongst pregnant women resident in the study sites from 2014 to December 2016...
November 1, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29046273/upright-versus-lying-down-position-in-second-stage-of-labour-in-nulliparous-women-with-low-dose-epidural-bumpes-randomised-controlled-trial
#5
RANDOMIZED CONTROLLED TRIAL
(no author information available yet)
Objective To determine whether being upright in the second stage of labour in nulliparous women with a low dose epidural increases the chance of spontaneous vaginal birth compared with lying down.Design Multicentre pragmatic individually randomised controlled trial.Setting 41 UK hospital labour wards.Participants 3093 nulliparous women aged 16 or older, at term with a singleton cephalic presentation and in the second stage of labour with epidural analgesia.Interventions Women were allocated to an upright or lying down position, using a secure web based randomisation service, stratified by centre, with no masking of participants or clinicians to the trial interventions...
October 18, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29037175/a-ten-year-study-of-midwife-led-care-at-an-austrian-tertiary-care-center-a-retrospective-analysis-with-special-consideration-of-perineal-trauma
#6
Barbara Bodner-Adler, Oliver Kimberger, Julia Griebaum, Peter Husslein, Klaus Bodner
BACKGROUND: In contrast to other countries, Austria rarely offers alternative models to medical led-care. In an attempt to improve the facilities, a midwife-led care service was incorporated within the Department of Obstetrics and Fetomaternal Medicine. The aim of the present study was to analyze the maternal and neonatal outcomes of this approach. METHODS: Over a 10-years period, a total of 2123 low-risk women receiving midwife-led care were studied. Among these women, 148 required obstetric referral...
October 16, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29029368/who-accesses-surgery-at-district-level-in-sub-saharan-africa-evidence-from-malawi-and-zambia
#7
Jakub Gajewski, Rachel Dharamshi, Michael Strader, John Kachimba, Eric Borgstein, Gerald Mwapasa, Mweene Cheelo, Tracey McCauley, Leon Bijlmakers, Ruairi Brugha
OBJECTIVES: To examine age and gender distribution for the most common types of surgery in Malawi and Zambia. METHODS: Data were collected from major operating theatres in 8 district hospitals in Malawi and 9 in Zambia. Raw data on surgical procedures were coded by specialist surgeons for frequency analyses. RESULTS: In Malawi, female surgical patients had a mean age of 25 years, with 91% aged 16-40 years. Females accounted for 85%, and obstetric cases for 75%, of all surgical patients...
October 13, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28983443/rowers-self-reported-behaviors-attitudes-and-safety-concerns-related-to-exercise-training-and-competition-during-pregnancy
#8
Ashley Franklin, Joanna Mishtal, Teresa Johnson, Judith Simms-Cendan
Background The American College of Obstetrics and Gynecology notes that pregnant athletes require more supervision due to their involvement in strenuous training schedules throughout pregnancy. Currently, rowing is not mentioned in the guidelines despite its increasing popularity, high cardiovascular demands, and risk for abdominal trauma. Methods This study aimed to elicit information from competitive female rowers regarding exercise, training, and competition during pregnancy. We administered a survey consisting of 122 items to female Masters rowers in the United States, aged 21 to 49 years, from June to December 2013...
August 1, 2017: Curēus
https://www.readbyqxmd.com/read/28969732/delayed-reconstruction-of-a-traumatic-cloaca-following-obstetric-anal-sphincter-rupture
#9
Ali Ezer, Alper Parlakgumus
Permanent communication between the rectum and the vagina along with full thickness of anal sphincter faults can be a result of an unsuccessful primary repair of fourth degree obstetric trauma. This results into complete fecal incontinence and impaired quality of life. Anterior overlapping sphincteroplasty can be chosen as a method of treatment for fecal incontinence due to obstetric injuries. However, large perineal body reconstructions are generally pretty challenging tasks for surgeons. What we will describe here for the repair of a traumatic cloaca, occurred 23 years ago during vaginal delivery, is the use of a transpositional flap following overlapping sphincteroplasty...
September 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28962566/-i-stayed-with-my-illness-a-grounded-theory-study-of-health-seeking-behaviour-and-treatment-pathways-of-patients-with-obstetric-fistula-in-kenya
#10
Anne M Khisa, Grace M Omoni, Isaac K Nyamongo, Rachel F Spitzer
BACKGROUND: Obstetric fistula classic symptoms of faecal and urinary incontinence cause women to live with social stigma, isolation, psychological trauma and lose their source of livelihoods. There is a paucity of studies on the health seeking behaviour trajectories of women with fistula illness although women live with the illness for decades before surgery. We set out to establish the complete picture of women's health seeking behaviour using qualitative research. We sought to answer the question: what patterns of health seeking do women with obstetric fistula display in their quest for healing? METHODS: We used grounded theory methodology to analyse data from narratives of women during inpatient stay after fistula surgery in 3 hospitals in Kenya...
September 29, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28925279/-awareness-of-the-methods-of-primary-and-secondary-childbirth-trauma-prevention-among-parturients
#11
A Veverková, V Kališ, Z Rušavý
OBJECTIVE: To evaluate the awareness of fresh mothers regarding the primary prevention of pelvic floor disorders after childbirth. The secondary objective was to identify sources of information, reality of childbirth trauma prevention and attitude to pelvic floor muscle training. DESIGN: Prospective survey study. SETTING: Department of Gynecology and Obstetrics, University Hospital and Medical Faculty in Pilsen, Charles University. METHODS: We included 202 women after a vaginal delivery at our center from 6/2015 to 12/2015...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28916875/traumatic-injuries-to-the-pregnant-patient-a-critical-literature-review
#12
REVIEW
P Petrone, P Jiménez-Morillas, A Axelrad, C P Marini
INTRODUCTION: Trauma during pregnancy is the leading non-obstetrical cause of maternal death and a significant public health burden. This study reviews the most common causes of trauma during pregnancy, morbidity, and mortality, and the impact upon perinatal outcomes associated with trauma, providing a management approach to pregnant trauma patients. MATERIALS AND METHODS: A systematic review of the current literature from January 2006 to July 2016 was performed...
September 15, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28913144/effect-of-pigtail-catheter-application-on-obstetric-outcomes-in-in-vitro-fertilization-intracytoplasmic-sperm-injection-pregnancies-following-hyperstimulation-syndrome
#13
Pınar Çağlar Aytaç, Hakan Kalaycı, Selçuk Yetkinel, Didem Alkaş, Seda Yüksel Şimşek, Bülent Haydardedeoğlu, Esra Bulgan Kılıçdağ
OBJECTIVE: To evaluate the effects of percutaneous pigtail catheter drainage on the outcomes of intracytoplasmic sperm injection (ICSI) pregnancies following moderate or severe ovarian hyperstimulation syndrome (OHSS). MATERIALS AND METHODS: This retrospective study included 189 patients hospitalized for OHSS following ICSI treatment in a tertiary in vitro fertilization unit between 2006 and 2014. Pigtail catheters were applied in 63 patients; the other 126 patients did not need that treatment...
June 2017: Turk J Obstet Gynecol
https://www.readbyqxmd.com/read/28905356/impact-of-shoulder-dystocia-stratified-by-type-of-manoeuvre-on-severe-neonatal-outcome-and-maternal-morbidity
#14
Flurina Michelotti, Christopher Flatley, Sailesh Kumar
BACKGROUND: Shoulder dystocia is an uncommon and unpredictable obstetric emergency. It is associated with significant neonatal, maternal and medico-legal consequences. AIM: To ascertain the impact shoulder dystocia has on severe neonatal and maternal outcomes specific to the type of manoeuvre. MATERIALS AND METHODS: This was a retrospective study of 48 021 term singleton vaginal deliveries the Mater Mothers' Hospital in Brisbane between 2007 and 2015...
September 14, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28898615/breech-presentation-vaginal-versus-cesarean-delivery-which-intervention-leads-to-the-best-outcomes
#15
Andreia Fonseca, Rita Silva, Inês Rato, Ana Raquel Neves, Carla Peixoto, Zita Ferraz, Inês Ramalho, Ana Carocha, Nisa Félix, Sandra Valdoleiros, Ana Galvão, Daniela Gonçalves, Joana Curado, Maria João Palma, Isabel Lobo Antunes, Nuno Clode, Luís Mendes Graça
INTRODUCTION: The best route of delivery for the term breech fetus is still controversial. We aim to compare maternal and neonatal outcomes between vaginal and cesarean term breech deliveries. MATERIAL AND METHODS: Multicentric retrospective cohort study of singleton term breech fetuses delivered vaginally or by elective cesarean section from January 2012 - October 2014. Primary outcomes were maternal and neonatal morbidity or mortality. RESULTS: Sixty five breech fetuses delivered vaginally were compared to 1262 delivered by elective cesarean...
June 30, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28889193/are-obstetric-outcomes-affected-by-female-genital-mutilation
#16
Aswini A Balachandran, Swapna Duvalla, Abdul H Sultan, Ranee Thakar
INTRODUCTION AND HYPOTHESIS: Female genital mutilation (FGM) has been associated with adverse obstetric and neonatal outcomes, such as postpartum haemorrhage (PPH), perineal trauma, genital fistulae, obstructed labour and stillbirth. The prevalence of FGM has increased in the UK over the last decade. There are currently no studies available that have explored the obstetric impact of FGM in the UK. The aim of our study was to investigate the obstetric and neonatal outcomes of women with FGM when compared with the general population...
September 9, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28888700/surgical-repair-of-rectovaginal-fistula-using-the-modified-martius-procedure-a-step-by-step-guide
#17
Dan Wang, Juan Chen, Lan Zhu, Mingchen Sang, Fan Yu, Qing Zhou
STUDY OBJECTIVE: to demonstrate the surgical repair of rectovaginal fistula by the modified Martius procedure. DESIGN: step by step presentation of the procedure using video. SETTING: Rectovaginal fistula (RVF) is abnormal epithelialized connections between the vagina and rectum. Causes of rectovaginal fistula include obstetrical trauma, Crohn disease, pelvic irradiation and postsurgical complications. Many surgical interventions have been developed, from laparoscopic technique to muscle transposition and even rectal resection...
September 6, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28885402/tranexamic-acid-for-the-management-of-obstetric-hemorrhage
#18
Luis D Pacheco, Gary D V Hankins, Antonio F Saad, Maged M Costantine, Giuseppe Chiossi, George R Saade
Obstetric hemorrhage remains the most common cause of maternal mortality worldwide. It is believed that increased fibrinolytic activity, secondary to release and activation of endothelial tissue plasminogen activator, is involved in its pathogenesis. Tranexamic acid (TXA), an antifibrinolytic agent, has been shown to be beneficial in trauma patients if used within 3 hours of injury. A recent large randomized controlled trial showed that TXA given to hemorrhaging women within 3 hours after delivery was associated with decreased risk of death resulting from bleeding with no increase in thromboembolic complications...
October 2017: Obstetrics and Gynecology
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/28844826/pregnant-trauma-victims-experience-nearly-2-fold-higher-mortality-compared-to-their-nonpregnant-counterparts
#20
Neha A Deshpande, Lauren M Kucirka, Randi N Smith, Corrina M Oxford
BACKGROUND: Trauma is the leading nonobstetric cause of death in women of reproductive age, and pregnant women in particular may be at increased risk of violent trauma. Management of trauma in pregnancy is complicated by altered maternal physiology, provider expertise, potential disparate imaging, and distorted anatomy. Little is known about the impact of trauma on maternal mortality. OBJECTIVE: We sought to: (1) characterize nonviolent and violent trauma among pregnant women; (2) determine whether pregnancy is associated with increased mortality following traumatic injury; and (3) identify risk factors for trauma-related death in pregnant women...
August 24, 2017: American Journal of Obstetrics and Gynecology
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