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Obstetrics complications

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https://www.readbyqxmd.com/read/28938429/effect-of-preconception-impaired-glucose-tolerance-on-pregnancy-outcomes-in-women-with-polycystic-ovary-syndrome
#1
Daimin Wei, Bo Zhang, Yuhua Shi, Lin Zhang, Shigang Zhao, Yanzhi Du, Lizhen Xu, Richard S Legro, Heping Zhang, Zi-Jiang Chen
Context: Women with polycystic ovary syndrome (PCOS) commonly have intrinsic insulin resistance and are recommended to undergo an oral glucose tolerance test (OGTT) for diabetes screening. However, the effect of preconception impaired glucose tolerance (IGT) on pregnancy is still unclear. Objective: To prospectively assess the effect of preconception IGT on pregnancy outcomes. Design, Setting, Patients, Intervention(s) and Main Outcome Measure(s): This was a secondary analysis of a multicenter randomized trial in 1508 women with PCOS comparing live birth and obstetric complications between fresh and frozen embryo transfer...
August 14, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28938298/safety-and-efficacy-of-epidural-analgesia
#2
Elke M E Bos, Markus W Hollmann, Philipp Lirk
PURPOSE OF REVIEW: Epidural analgesia remains a widely used analgesic technique. This article aims to assess the safety of epidural analgesia by balancing efficacy and complications, of epidural analgesia for acute, labor and chronic pain. RECENT FINDINGS: Main indications for epidural analgesia include major open abdominal surgery, thoracotomy and labor analgesia. Past and current literature show that epidural analgesia leads to statistically significant, but possibly clinically less meaningful, reductions in pain scores compared with intravenous analgesia...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28937446/costs-of-robotic-assisted-versus-traditional-laparoscopy-in-endometrial-cancer
#3
Riikka-Liisa K Vuorinen, Minna M Mäenpää, Kari Nieminen, Eija I Tomás, Tiina H Luukkaala, Anssi Auvinen, Johanna U Mäenpää
OBJECTIVES: The purpose of this study was to compare the costs of traditional laparoscopy and robotic-assisted laparoscopy in the treatment of endometrial cancer. METHODS AND MATERIALS: A total of 101 patients with endometrial cancer were randomized to the study and operated on starting from 2010 until 2013, at the Department of Obstetrics and Gynecology of Tampere University Hospital, Tampere, Finland. Costs were calculated based on internal accounting, hospital database, and purchase prices and were compared using intention-to-treat analysis...
October 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28934836/pregnancy-in-women-with-hypertrophic-cardiomyopathy-data-from-the-european-society-of-cardiology-initiated-registry-of-pregnancy-and-cardiac-disease-ropac
#4
S Goland, I M van Hagen, G Elbaz-Greener, U Elkayam, A Shotan, W M Merz, S C Enar, I R Gaisin, P G Pieper, M R Johnson, R Hall, A Blatt, J W Roos-Hesselink
Aims: We report the maternal and foetal outcomes at birth and after 6 months in a cohort of pregnant women with hypertrophic cardiomyopathy (HCM). Although most women with HCM tolerate pregnancy well, there is an increased risk of obstetric and cardiovascular complications. Methods and results: All pregnant women with HCM entered into the prospective worldwide Registry of Pregnancy and Cardiac disease (ROPAC) were included in this analysis. The primary endpoint was a major adverse cardiovascular event (MACE), which included death, heart failure (HF), thrombo-embolic event, and arrhythmia...
September 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28934320/household-costs-and-time-to-seek-care-for-pregnancy-related-complications-the-role-of-results-based-financing
#5
Jobiba Chinkhumba, Manuela De Allegri, Jacob Mazalale, Stephan Brenner, Don Mathanga, Adamson S Muula, Bjarne Robberstad
Results-based financing (RBF) schemes-including performance based financing (PBF) and conditional cash transfers (CCT)-are increasingly being used to encourage use and improve quality of institutional health care for pregnant women in order to reduce maternal and neonatal mortality in low-income countries. While there is emerging evidence that RBF can increase service use and quality, little is known on the impact of RBF on costs and time to seek care for obstetric complications, although the two represent important dimensions of access...
2017: PloS One
https://www.readbyqxmd.com/read/28930860/preoperative-infrarenal-abdominal-aorta-balloon-catheter-occlusion-combined-with-bakri-tamponade-reduced-maternal-morbidity-of-placenta-increta-percreta
#6
Chanjuan Zeng, Mengyuan Yang, Yiling Ding, Ling Yu, Wen Deng, Yu Hu, Xiujuan Gong
BACKGROUND: Placenta increta/percreta is an increasingly common and life-threatening obstetric complication. It poses a management challenge to clinicians. The present study aimed to evaluate efficacy and safety of preoperative placement of infrarenal abdominal aorta balloon catheter (IAABC) alone or combined with Bakri tamponade for the management of cases with placenta increta/percreta. METHODS: We retrospectively analyzed all cases with placenta increta/percreta at a tertiary referral teaching hospital in China between the year 2014 and 2017...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28929879/safer-muslim-motherhood-social-conditions-and-maternal-mortality-in-the-muslim-world
#7
Kylea Laina Liese, Angela B Maeder
The greatest variation in maternal mortality is among poor countries and wealthy countries that rely on emergency obstetric technology to save a woman's life during childbirth. However, substantial variation in maternal mortality ratios (MMRs) exists within and among poor countries with uneven access to advanced obstetric services. This article examines MMRs across the Muslim world and compares the impact of national wealth, female education, and skilled birth attendants on maternal mortality. Understanding how poor countries have lowered MMRs without access to expensive obstetric technologies suggests that certain social variables may act protectively to reduce the maternal risk for life-threatening obstetric complications that would require emergency obstetric care...
September 20, 2017: Global Public Health
https://www.readbyqxmd.com/read/28928575/referrral-systems-development-and-survey-of-perioperative-and-critical-care-referral-to-anesthetists
#8
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/28927497/decision-to-delivery-time-and-perinatal-complications-in-emergency-cesarean-section
#9
Günther Heller, Erik Bauer, Stefanie Schill, Teresa Thomas, Frank Louwen, Friedrich Wolff, Björn Misselwitz, Stephan Schmidt, Christof Veit
BACKGROUND: A decision-to-delivery interval (DDI) of no more than 20 minutes has long been considered a requirement for cesarean sections, even though there have hardly been any studies on this topic. We retrospectively investigated data relevant to DDI for emergency cesarean sections performed for the most common indications, namely, suspected and documented fetal asphyxia. METHODS: We analyzed data on emergency in-hospital cesarean sections in the period 2008-2015...
September 4, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28925277/-large-hematoma-early-postoperative-complication-after-the-transobturator-tape-procedure
#10
O Szabová, M Gärtner, P Vašek, M Juráková
OBJECTIVE: To present a case report of the occurrence of large hematoma after the transobturator tape procedure. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology, University Hospital Ostrava. CONCLUSION: The risk of vessel injury during the transobturator procedure is rare, but it is possible. The surgeons should be aware of the possibility and know possible solution. Conservative management of hematomas has been recommended when the patient is hemodynamically stable only without other secondary complications...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28925276/-suburethral-sling-removal-due-to-chronic-pain
#11
P Homola, G Hensel, Z Škorničková, M Košťál
OBJECTIVE: To point out one possible complication after suburethral tape insertion. To present methods of treatment, especially partial or total removal of the tape. Few successful cases of treatment are shown in case reports. DESIGN: Case report. SETTING: Department of obstetrics and gynecology, Pardubice hospital. OBSERVATION: Chronic pain after insertion of suburethral tape is a rare complication. There are several possible causes, such as tape erosion with chronic inflamation, post-colposuspension syndrome, myo-fascial syndrome, nerve damage during tape implantation or due to overproduction of fibrous tissue...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28921586/down-syndrome-maternal-serum-markers-in-oocyte-donation-and-other-assisted-reproductive-technologies
#12
Aurore Bonnin, Françoise Muller, Marie-Victoire Senat, Corinne Sault, Armelle Galland, Joëlle Taieb, Sophie Dreux, Jean Bouyer, Alexandra Benachi
OBJECTIVE: Because maternal serum markers (PAPP-A, hCGβ, and AFP) used for Down syndrome (DS) screening have been described as predictors of obstetrical complications and because assisted reproductive technology (ART) pregnancies are known to be at increased risk for obstetrical complications, it is unclear whether or not correction factors should be applied to the calculated risk of DS. The purpose of this study was to evaluate DS maternal serum markers in oocyte donation (OD) and ART pregnancies in comparison with natural pregnancies...
September 16, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28919404/emergency-in-the-clinic-a-simulation-curriculum-to-improve-outpatient-safety
#13
Eve Espey, Gillian Baty, John Rask, Michelle Chungtuyco, Brenda Pereda, Lawrence Leeman
BACKGROUND: Emergency response skills are essential when events such as seizure, anaphylaxis or hemorrhage occur in the outpatient setting. As services and procedures increasingly move outside the hospital, training to manage complications may improve outcomes. OBJECTIVE: The objective of this study was to evaluate a simulation-based curriculum in outpatient emergency management skills with the outcome measures of graded objective performance and learner self-efficacy...
September 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28917612/thyroid-stimulating-hormone-anti-thyroid-antibodies-and-pregnancy-outcomes
#14
Torie C Plowden, Enrique F Schisterman, Lindsey A Sjaarda, Neil J Perkins, Robert Silver, Rose Radin, Keewan Kim, Noya Galai, Alan H DeCherney, Sunni L Mumford
BACKGROUND: Overt thyroid dysfunction has been associated with adverse obstetrical outcomes. However, less is known regarding subclinical hypothyroidism or thyroid autoimmunity and their relationship to pregnancy complications. OBJECTIVE: To examine the association between pre-pregnancy anti-thyroid antibodies and subclinical hypothyroidism and preterm delivery (PTD), gestational diabetes (GDM), and preeclampsia. STUDY DESIGN: Secondary analysis of a prospective cohort of 18-40 year old women with 1-2 prior pregnancy losses (n=1193) participating in a multi-center randomized, placebo-controlled trial of low-dose aspirin...
September 13, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28915802/determinants-of-pre-eclampsia-eclampsia-among-women-attending-delivery-services-in-selected-public-hospitals-of-addis-ababa-ethiopia-a-case-control-study
#15
Teklit Grum, Abiy Seifu, Mebrahtu Abay, Teklit Angesom, Lidiya Tsegay
BACKGROUND: Pre-eclampsia is a pregnancy-specific hypertensive disorder usually occurs after 20 weeks of gestation. It is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. In Ethiopia, the major direct obstetric complications including pre-eclampsia/eclampsia account for 85% of the maternal deaths. Unlike deaths due to other direct causes, pre-eclampsia/ eclampsia related deaths appear to be increasing and linked to multiple factors, making prevention of the disease a continuous challenge...
September 15, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28915206/laparoscopic-colorectal-surgery-in-patients-with-previous-abdominal-surgery-a-single-center-experience-and-literature-review
#16
Erdinc Kamer, Turan Acar, Fevzi Cengiz, Evren Durak, Mehmet Haciyanli
To present the outcomes of laparoscopic colorectal surgery in colorectal cancer patients with a previous history of abdominal surgery. Data of a total of 121 patients with primary colorectal cancer who underwent laparoscopic surgery were retrospectively analyzed. The patients were divided into 2 groups as those with previous abdominal surgery (PAS, n=34) and those without (non-PAS, n=87). Gastric and colonic surgeries were the most common procedures in the major PAS group, whereas gynecologic and obstetric surgeries and appendectomy were the most common procedures in the minor PAS group...
September 14, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28915160/current-insights-in-obstetric-antiphospholipid-syndrome
#17
Karen Schreiber, Massimo Radin, Savino Sciascia
PURPOSE OF REVIEW: Antiphospholipid syndrome (APS) is defined as the association of thrombotic events and/or obstetric morbidity in patients persistently positive for antiphospholipid antibodies (aPL). In this review, we will highlight the most important clinical presentations of APS with a focus on the obstetric morbidity, the current management strategies and the outlook for the future. RECENT FINDINGS: The use of aspirin and heparin has improved the pregnancy outcome in obstetric APS and approximately 70% of pregnant women with APS have a successful pregnancy outcome...
September 14, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28913590/challenges-of-anticoagulation-therapy-in-pregnancy
#18
REVIEW
Annemarie E Fogerty
Thrombotic complications in pregnancy represent a major cause of morbidity and mortality. Pregnancy is a primary hypercoagulable state due to enhanced production of clotting factors, a decrease in protein S activity, and inhibition of fibrinolysis. These physiologic changes will yield a collective rate of venous thromboembolism (VTE) of about 1-2 in 1000 pregnancies for the general obstetric population, which represents a five- to tenfold increased risk in pregnancy compared to age-matched non-pregnant peers...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28913146/fetomaternal-outcomes-in-pregnant-women-with-hepatitis-e-infection-still-an-important-fetomaternal-killer-with-an-unresolved-mystery-of-increased-virulence-in-pregnancy
#19
Namrata Kumar, Vinita Das, Anjoo Agarwal, Amita Pandey, Smriti Agrawal
OBJECTIVE: Hepatitis is a prevalent infection in developing countries. While hepatitis B and C are deepening their roots in the developed world, hepatitis A and E are common in the developing world. The uniqueness of hepatitis is in its transformation from a relatively self-limiting disease in the non-pregnant state, to a highly virulent disease during pregnancy. MATERIALS AND METHODS: This retrospective observational study was conducted in the Department of Obstetrics and Gynecology, King George's Medical University, Lucknow, for a period of six months from June 2016 to November 2016 [probably during an endemic peak of hepatitis E virus (HEV)] to observe the clinical outcomes in HEV-infected pregnant women...
June 2017: Turk J Obstet Gynecol
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
#20
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
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