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https://www.readbyqxmd.com/read/29324608/quality-assurance-practices-in-obstetric-care-a-survey-of-hospitals-in-california
#1
Lisbet S Lundsberg, Henry C Lee, Grace Villarin Dueñas, Kimberly D Gregory, Holly K Grossetta Nardini, Christian M Pettker, Jessica L Illuzzi, Xiao Xu
OBJECTIVE: To assess hospital practices in obstetric quality management activities and identify institutional characteristics associated with utilization of evidence-supported practices. METHODS: Data for this study came from a statewide survey of obstetric hospitals in California regarding their organization and delivery of perinatal care. We analyzed responses from 185 hospitals that completed quality assurance sections of the survey to assess their practices in a broad spectrum of quality enhancement activities...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29304391/incidence-and-risk-factors-of-third-and-fourth-degree-perineal-tears-in-a-single-italian-scenario
#2
Matteo Frigerio, Stefano Manodoro, Davide P Bernasconi, Debora Verri, Rodolfo Milani, Patrizia Vergani
OBJECTIVE: This study aimed to evaluate III and IV degree tears rates and related risk factors in a single Italian centre. The secondary goal was to build a predictive model based on identified risk factors. STUDY DESIGN: This was a retrospective cohort study. All vaginal deliveries from 2011 to 2015 in a single Italian University Hospital were analysed. Univariate analysis was applied to evaluate the overall association between each factor and severe tear. Multivariate logistic regression was used to build a predictive model for the absolute risk of severe tear...
December 26, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29304317/strategies-to-improve-management-of-shoulder-dystocia-under-the-ahrq-safety-program-for-perinatal-care
#3
Jill McArdle, Asta Sorensen, Christina I Fowler, Samantha Sommerness, Katrina Burson, Leila Kahwati
OBJECTIVE: To assess implementation of safety strategies to improve management of births complicated by shoulder dystocia in labor and delivery units. DESIGN: Mixed-methods implementation evaluation. SETTING/LOCAL PROBLEM: Labor and delivery units (N = 18) in 10 states participating in the Safety Program for Perinatal Care (SPPC). Shoulder dystocia is unpredictable, requiring rapid and coordinated action. PARTICIPANTS: Key informants were labor and delivery unit staff who implemented SPPC safety strategies...
January 2, 2018: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/29303230/planned-birth-at-or-near-term-for-improving-health-outcomes-for-pregnant-women-with-gestational-diabetes-and-their-infants
#4
REVIEW
Linda M Biesty, Aoife M Egan, Fidelma Dunne, Eugene Dempsey, Pauline Meskell, Valerie Smith, G Meabh Ni Bhuinneain, Declan Devane
BACKGROUND: Gestational diabetes is a type of diabetes that occurs during pregnancy. Women with gestational diabetes are more likely to experience adverse health outcomes such as pre-eclampsia or polyhydramnios (excess amniotic fluid). Their babies are also more likely to have health complications such as macrosomia (birthweight > 4000 g) and being large-for-gestational age (birthweight above the 90th percentile for gestational age). Current clinical guidelines support elective birth, at or near term in women with gestational diabetes to minimise perinatal complications, especially those related to macrosomia...
January 5, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29301466/immediate-perinatal-outcomes-of-postterm-deliveries
#5
Or Maoz, Tamar Wainstock, Eyal Sheiner, Asnat Walfisch
OBJECTIVE: To investigate whether postterm pregnancy (≥42 0/7 weeks' gestation) increases the risk for adverse perinatal outcome. STUDY DESIGN: In this population based cohort study, all singleton deliveries occurring between 1991 and 2014 in a tertiary medical center were included. Pregnancy and perinatal outcomes were compared between postterm and term deliveries (37 0/7 to 41 6/7 weeks' gestation). Preterm deliveries, unknown gestational age, congenital malformations, and multiple gestations, were excluded...
January 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29297839/reproductive-parameters-and-birth-statistics-for-a-herd-of-asian-elephants-elephas-maximus-in-north-america-over-a-20-year-period
#6
Wendy K Kiso, Ellen Wiedner, Ramiro Isaza, William Lindsay, Janice Aria, Gary Jacobson, Kathy Jacobson, Dennis Schmitt
We reviewed medical records documenting 28 pregnancies occurring within a herd of Asian elephants ( Elephas maximus) over a 20-yr (1994-2014) period at a private facility in the southeastern United States. Twenty-six pregnancies resulted in live calves and two ended in stillbirths. The 26 live births represented the offspring of 11 cows and 5 bulls. Twenty-four calves survived their first year, including two critically ill calves born after dystocias. Male and female calves occurred in almost equal numbers...
December 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29278829/efficacy-of-maternal-and-biological-parameters-at-the-time-of-diagnosis-of-gestational-diabetes-mellitus-in-predicting-neonatal-morbidity
#7
Guillaume Ducarme, François Desroys Du Roure, Aurélie Le Thuaut, Joséphine Grange, Jérôme Dimet, Ingrid Crepin-Delcourt
OBJECTIVE: Gestational diabetes mellitus (GDM) is independently associated with an increased risk of maternal-fetal complications. Improved glycemic control allows reducing perinatal morbidity and mortality and, specifically, the risk of macrosomia and shoulder dystocia which are the most common complications associated with GDM. Nonetheless, a need for early antenatal predictor of neonatal morbidity in women suffering from GDM is required. The objective of the study was to evaluate the efficacy of different maternal, biological, and antenatal parameters at the time of diagnosis of GDM or perinatal variables as predictors of neonatal morbidity...
December 19, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29277165/reasons-and-risk-factors-for-beef-calf-and-youngstock-on-farm-mortality-in-extensive-cow-calf-herds
#8
K Mõtus, A Viltrop, U Emanuelson
Raising calves and youngstock is an essential part of beef production. High on-farm mortality (unassisted death and euthanasia) is a consequence of poor animal health and welfare, and is economically unfavourable. The present study aimed to identify the reasons and risk factors for beef calf and youngstock on-farm mortality, using registry data for the years 2013 to 2015. Cox regression models were applied for the data of four age groups: calves up to 30 days (n=21 075), calves 1 to 5 months (n=21 116), youngstock 6 to 19 months (n=22 637) and youngstock ⩾20 months of age (n=9582)...
December 26, 2017: Animal: An International Journal of Animal Bioscience
https://www.readbyqxmd.com/read/29276166/accelerated-titration-of-oxytocin-in-nulliparous-women-with-labour-dystocia-results-of-the-action-pilot-randomized-controlled-trial
#9
Jessica Dy, Jenna Rainey, Mark C Walker, William Fraser, Graeme N Smith, Ruth Rennicks White, Patti Waddell, Ghayath Janoudi, Daniel J Corsi, Shu Qin Wei
OBJECTIVE: The primary objective was to determine the feasibility of a large RCT assessing the effectiveness of an accelerated oxytocin titration (AOT) protocol compared with a standard gradual oxytocin titration (GOT) in reducing the risk of CS in nulliparous women diagnosed with dystocia in the first stage of labour. The secondary objective was to obtain preliminary data on the safety and efficacy of the foregoing AOT protocol. METHODS: This was a multicentre, double-masked, parallel-group pilot RCT...
December 21, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29258525/advancing-perinatal-patient-safety-through-application-of-safety-science-principles-using-health-it
#10
Jennifer Webb, Asta Sorensen, Samantha Sommerness, Beth Lasater, Kamila Mistry, Leila Kahwati
BACKGROUND: The use of health information technology (IT) has been shown to promote patient safety in Labor and Delivery (L&D) units. The use of health IT to apply safety science principles (e.g., standardization) to L&D unit processes may further advance perinatal safety. METHODS: Semi-structured interviews were conducted with L&D units participating in the Agency for Healthcare Research and Quality's (AHRQ's) Safety Program for Perinatal Care (SPPC) to assess units' experience with program implementation...
December 19, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29237479/birth-delivery-method-affects-expression-of-immune-genes-in-lung-and-jejunum-tissue-of-neonatal-beef-calves
#11
Carla Surlis, Keelan McNamara, Eoin O'Hara, Sinead Waters, Marijke Beltman, Joseph Cassidy, David Kenny
BACKGROUND: Caesarean section is a routine veterinary obstetrical procedure employed to alleviate dystocia in cattle. However, CS, particularly before the onset of labour, is known to negatively affect neonatal respiration and metabolic adaptation in humans, though there is little published information for cattle. The aim of this study was to investigate the effect of elective caesarean section (ECS) or normal trans-vaginal (TV) delivery, on lung and jejunal gene expression profiles of neonatal calves...
December 14, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/29221671/population-based-risk-factors-for-shoulder-dystocia
#12
Palmira Santos, Jennifer Gaudet Hefele, Grant Ritter, Jennifer Darden, Cassandra Firneno, Ann Hendrich
OBJECTIVE: To re-examine the risk factors for shoulder dystocia given the increasing rates of obesity and diabetes in pregnant women. DESIGN: Retrospective observational study. SETTING: Five hospitals located in Wisconsin, Florida, Maryland, Michigan, and Alabama. PARTICIPANTS: We evaluated 19,236 births that occurred between April 1, 2011, and July 25, 2013. METHODS: Data were collected from electronic medical records and used to evaluate the risk of shoulder dystocia...
December 5, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/29172068/gestational-diabetes-predictors-of-response-to-treatment-and-obstetric-outcome
#13
Amanda Ali, Sangeetha Shastry, Ratnasingam Nithiyananthan, Amira Ali, Ramesh Ganapathy
OBJECTIVE: Evaluate patient characteristics that are predictors of treatment response and outcomes in gestational diabetes STUDY DESIGN: Retrospective cohort of 265 women with gestational diabetes treated with diet/metformin and/or insulin in a single centre over 2 years. RESULTS: Multinomial logistic regression showed that (after adjusting for age and ethnicity) women who were of normal weight were more likely to be on diet and women who were obese were more likely to be on metformin or metformin and insulin(p=0...
January 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29155140/pregnancy-and-parturition-negatively-impact-vaginal-angle-and-alter-expression-of-vaginal-mmp-9
#14
Sallie Oliphant, Timothy Canavan, Stacy Palcsey, Leslie Meyn, Pamela Moalli
BACKGROUND: Parity is the greatest risk factor for the development of pelvic organ prolapse. The normally supported vagina is pulled up and back over the levator ani. Loss of vaginal angulation has been associated with prolapse and may represent injury to the vaginal supportive tissues. OBJECTIVE: We proposed and examined the following hypotheses: (1) pregnancy and delivery impact vaginal support, leading to loss of vaginal angle; (2) vaginal angulation is restored postpartum; and (3) uncomplicated vaginal delivery (VD) is associated with accelerated remodeling of the vaginal fibrillar matrix...
November 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29145063/prevalence-causes-resolution-and-consequences-of-bovine-dystocia-in-italy
#15
Ippolito De Amicis, Maria Cristina Veronesi, Domenico Robbe, Alessia Gloria, Augusto Carluccio
The aim of this study was to report prevalences and causes of dystocias in dairy and beef cattle, in primiparous and multiparous cows, as well as the mortality rate of calves and cows, obtained after 11 years of records across various farms in Italy. On a total of 14,575 records from dairy Italian Friesian cows, beef Romagnola and Marchigiana cows, a prevalence of 5.6% was observed, with a significant higher prevalence in primiparous (p < 0.0001), and dairy cows (p < 0.0001). Dystocias of fetal origin were higher than the ones of maternal origin (p < 0...
November 7, 2017: Theriogenology
https://www.readbyqxmd.com/read/29139556/delivery-outcomes-of-large-for-gestational-age-newborns-stratified-by-the-presence-or-absence-of-gestational-diabetes-mellitus
#16
Hadar Rosen, Anat Shmueli, Eran Ashwal, Liran Hiersch, Yariv Yogev, Amir Aviram
OBJECTIVE: To evaluate separate and combined contributions of gestational diabetes mellitus (GDM) and large-for-gestational age (LGA) on delivery outcomes. METHODS: In a retrospective cohort study of term singleton deliveries between 2007 and 2014 in Tel Aviv, Israel, outcomes were compared between non-GDM/AGA pregnancies (reference) and three study groups: non-GDM/LGA, GDM/appropriate for gestational age (AGA) and GDM/LGA. RESULTS: Overall, there were 62 102 deliveries, of which 53 201 (85...
November 15, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29132336/study-protocol-the-labor-progression-study-laps-does-the-use-of-a-dynamic-progression-guideline-in-labor-reduce-the-rate-of-intrapartum-cesarean-sections-in-nulliparous-women-a-multicenter-cluster-randomized-trial-in-norway
#17
Stine Bernitz, Rebecka Dalbye, Pål Øian, Jun Zhang, Torbjørn Moe Eggebø, Ellen Blix
BACKGROUND: The increasing rate of intrapartum cesarean sections is subject of attention and concern as it is associated with adverse outcomes. Labor dystocia is one of the most frequent indications for cesarean sections even though there is no consensus on criteria for labor dystocia. Traditionally the progression of labor follows guidelines based on Friedman's curve from the mid 1950s. In 2010 Zhang presented a new labor curve and a dynamic guideline for labor progression based on contemporary research...
November 13, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29119576/natural-course-of-fetal-axillary-lymphangioma-based-on-prenatal-ultrasound-studies
#18
Theera Tongsong, Suchaya Luewan, Jiraporn Khorana, Sirinart Sirilert, Cholaros Charoenratana
This series and literature review aimed to prenatally characterize the nature of axillary lymphangioma. A total of 30 cases, including our 5 cases, were analyzed. Insights gained from this review are as follows: Septate and nonseptate cysts seem to be different entities. The nonseptate type tends to be small and transient but more highly associated with aneuploidies. Septate cysts are very rarely associated with other abnormalities and hydrops fetalis, unlike cystic hygroma colli, but are more progressive with gestational age and associated with adverse outcomes...
November 9, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29119568/unchanged-mitochondrial-phenotype-but-accumulation-of-lipids-in-the-myometrium-in-obese-pregnant-women
#19
Christiane Marie Bourgin Folke Gam, Lea Hüche Larsen, Ole Hartvig Mortensen, Line Engelbrechtsen, Steen Seier Poulsen, Klaus Qvortrup, Elisabeth Reinhart Mathiesen, Peter Damm, Bjørn Quistorff
KEY POINTS: Obesity during pregnancy and childbirth is associated with labour dystocia leading to instrumental or operative delivery, but the underlying pathophysiological mechanisms remain unclear and insufficient uterine contractility has been suggested. This study examined whether reduced myometrial mitochondrial capacity or quantity could contribute as a pathophysiological mechanism to labour dystocia. Data did not support reduced myometrial mitochondrial capacity or quantity in the myometrium at term in obese women, but a reduced myocyte density with increased triglyceride content was demonstrated, which could lead to poorer uterine contractility...
November 9, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/29112649/racial-and-ethnic-differences-in-utilization-of-labor-management-strategies-intended-to-reduce-cesarean-delivery-rates
#20
Lynn M Yee, Maged M Costantine, Madeline Murguia Rice, Jennifer Bailit, Uma M Reddy, Ronald J Wapner, Michael W Varner, John M Thorp, Steve N Caritis, Mona Prasad, Alan T N Tita, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
OBJECTIVE: To examine whether racial and ethnic differences exist in the frequency of and indications for cesarean delivery and to assess whether application of labor management strategies intended to reduce cesarean delivery rates is associated with patient's race and ethnicity. METHODS: This is a secondary analysis of a multicenter observational obstetric cohort. Trained research personnel abstracted maternal and neonatal records of greater than 115,000 pregnant women from 25 hospitals (2008-2011)...
November 3, 2017: Obstetrics and Gynecology
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