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labour management

Lucilla Poston, Rishi Caleyachetty, Sven Cnattingius, Camila Corvalán, Ricardo Uauy, Sharron Herring, Matthew W Gillman
Obesity in women of reproductive age is increasing in prevelance worldwide. Obesity reduces fertility and increases time taken to conceive, and obesity-related comorbidities (such as type 2 diabetes and chronic hypertension) heighten the risk of adverse outcomes for mother and child if the woman becomes pregnant. Pregnant women who are obese are more likely to have early pregnancy loss, and have increased risk of congenital fetal malformations, delivery of large for gestational age infants, shoulder dystocia, spontaneous and medically indicated premature birth, and stillbirth...
October 10, 2016: Lancet Diabetes & Endocrinology
G Vetter, A Knipprath, A Niklaus, N Kalberer, I Hösli
Introduction: It is estimated that after premature rupture of membranes (PROM) at term, 60% of all women go into labour within 48 h, 95% within 72 h. Often labour is induced after 24 h because the risk of maternal and neonatal infection rises. The majority of clinicians advise hospital care to allow monitoring and detection of problems. But for low-risk patients who meet strict inclusion criteria, sometimes home management is possible. This study examines the safety and costs of home management. Material and Methods: We included 239 patients with PROM at term, 202 of them with hospital and 37 with home management...
October 13, 2016: Zeitschrift Für Geburtshilfe und Neonatologie
Kari Bø, Raul Artal, Ruben Barakat, Wendy Brown, Michael Dooley, Kelly R Evenson, Lene A H Haakstad, Karin Larsen, Bengt Kayser, Tarja I Kinnunen, Michelle F Mottola, Ingrid Nygaard, Mireille van Poppel, Britt Stuge, Gregory A L Davies
This is Part 2 of 5 in the series of evidence statements from the IOC expert committee on exercise and pregnancy in recreational and elite athletes. Part 1 focused on the effects of training during pregnancy and on the management of common pregnancy-related symptoms experienced by athletes. In Part 2, we focus on maternal and fetal perinatal outcomes.
October 12, 2016: British Journal of Sports Medicine
R S Monteiro, D P Dob, M R Cauldwell, M A Gatzoulis
Women with a single ventricle circulation palliated with the Fontan operation require specialist multidisciplinary management. We report 14 such cases with successful pregnancies and detail the pathophysiology encountered. A combined obstetric and cardiac service between Chelsea and Westminster Hospital and Royal Brompton Hospital provides care for women with heart disease, and maintains a prospective database of referred women. We searched this database for women with a known Fontan circulation and reviewed the case notes and electronic patient records between January 1994 and December 2015...
September 7, 2016: International Journal of Obstetric Anesthesia
H Virgin, E Oddby, J G Jakobsson
INTRODUCTION: Epidural analgesia is commonly used for management of pain during childbirth. Need for emergent Caesarean section e.g. because of signs of foetal distress or lack of progress is however not an uncommon event. In females having an established epidural; general anaesthesia, top-up of the epidural or putting a spinal are all possible options. Dosing of the spinal anaesthesia in females having epidural is a matter of discussion. PRESENTATION OF CASE: We describe a healthy 32 years, 0 para mother in gestation week 36 having labour epidural analgesia but due to foetal distress scheduled for an emergent Caesarean section category 2 that developed upper extremity weakness and respiratory depression after administration of standard dose high density bupivacaine/morphine/fentanyl intrathecal anaesthesia...
October 3, 2016: International Journal of Surgery Case Reports
Debra Betts, Caroline A Smith, Hannah G Dahlen
BACKGROUND: Threatened miscarriage is a common complication of early pregnancy increasing the risk of miscarriage or premature labour. Currently there is limited evidence to recommend any biomedical pharmacological or self-care management, resulting in a 'watchful waiting' approach. The objective of this study was to examine the feasibility of offering acupuncture as a therapeutic treatment for women presenting with threatened miscarriage. METHODS: A mixed methods study involving a randomised controlled trial and semi structured interviews...
October 7, 2016: BMC Pregnancy and Childbirth
Eric Mayor, Adrian Bangerter
AIM: To document the prevalence of perturbations of handover meetings and understand how nurses manage temporal, physical and social meeting boundaries in response to perturbations. BACKGROUND: Handovers are joint activities performed collaboratively by participating nurses. Perturbations of handover are frequent and may potentially threaten continuity of care. DESIGN: We observed and videotaped handovers during five successive days in four nursing care units in two Swiss hospitals in 2009...
November 2015: Nurs Open
R L Goldenberg, J B Griffin, B D Kamath-Rayne, M Harrison, D J Rouse, K Moran, B Hepler, A H Jobe, E M McClure
OBJECTIVE: Stillbirths are among the most common adverse pregnancy outcomes, with 98% occurring in low-income countries. More than one-third occur in sub-Saharan Africa (SSA). However, the medical conditions causing stillbirths and interventions to reduce stillbirths from these conditions are not well documented. We estimated the reductions in stillbirths possible with combinations of interventions. DESIGN: We developed a computerised model to estimate the impact of various interventions on stillbirths caused by the most common conditions...
October 5, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Mandie Scamell, Roa Altaweli, Christine McCourt
BACKGROUND: The expansion of the medicalisation of childbirth has been described in the literature as being a global phenomenon. The vignette described in this paper, selected from an ethnographic study of routine intervention in Saudi Arabian hospitals illustrates how the worldwide spread of the bio-medical model does not take place within a cultural vacuum. AIM: To illuminate the ways in which the medicalisation of birth may be understood and practised in different cultural settings, through a vignette of a specific birth, drawn as a typical case from an ethnographic study that investigated clinical decision-making in the second stage of labour in Saudi Arabia...
September 28, 2016: Women and Birth: Journal of the Australian College of Midwives
Sharon Newnam, Alan Petersen, Helen Keleher, Alex Collie, Adam Vogel, Rod McClure
BACKGROUND: Case managers within injury compensation systems are confronted with various emotional demands. OBJECTIVE: Employing the concept of emotional labour, this paper explores distinctive aspects of these demands. METHODS: The findings are drawn from focus groups with 21 Australian case managers. RESULTS: Case managers work was characterised by extra-role commitments, emotional control, stress and balancing tensions arising from differing stakeholder expectations about outcomes related to compensation and return to work...
September 28, 2016: Work: a Journal of Prevention, Assessment, and Rehabilitation
Outi Anneli Tuominen, Heljä Lundgren-Laine, Wiveka Kauppila, Maija Hupli, Sanna Salanterä
Aim This article describes the development and testing of an Excel-based scheduling solution for the flexible allocation and reallocation of nurses to cover sudden, unplanned absences among permanent nursing staff. Method A quasi-experimental, one group, pre- and post-test study design was used ( Box 1 ) with total sampling. Participants (n=17) were selected purposefully by including all ward managers (n=8) and assistant ward managers (n=9) from one university hospital department. The number of sudden absences among the nursing staff was identified during two 4-week data collection periods (pre- and post-test)...
September 30, 2016: Nursing Management (Harrow)
Ogochukwu Chantelle Umadia, Dimuthu Vinayagam, Juan Gutierrez Henares, Asma Khalil
AIM: To identify the independent risk factors for PE development in twin pregnancies and explore the associated perinatal outcomes. METHODS: A retrospective cohort study of twin pregnancies was performed at St George's University Hospital, London. Maternal and neonatal data were obtained from the hospital's computerised database. The Chi-square test, Mann-Whitney U test and univariate and multiple-logistic regression analyses were performed. RESULTS: We identified a total of 1250 twin pregnancies who were under the care of SGH from 1999 to 2015...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Kokui Elikplim Pomevor, Augustine Adomah-Afari
Purpose The purpose of this paper is to assess available human resources for neonatal care and their skills, in order to explore health providers' perceptions of quality of neonatal care in health facilities in Ghana. Design/methodology/approach Data were gathered using qualitative interviews with health providers working in the maternity and paediatric wards and midwives; direct observation; and documentary review at a regional hospital, a municipal hospital and four health centres in a municipality in a region in Southern Ghana...
October 10, 2016: International Journal of Health Care Quality Assurance
Lily Lee, Jessica Dy, Hussam Azzam
OBJECTIVE: The purpose of this guideline is to provide guidance for the intrapartum management of spontaneous labour, whether normal or abnormal, in term, healthy women, and to provide guidance in the management of first and second stage dystocia to increase the likelihood of a vaginal birth and optimize birth outcomes. EVIDENCE: Published literature was retrieved through searches of PubMed and the Cochrane Library in October 2011 using appropriate, controlled vocabulary (e...
September 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Priyankur Roy, M S Sujatha, Ambarisha Bhandiwad, Bivas Biswas, Anumita Chatterjee
AIM: The third stage of labour commences after the delivery of the foetus and ends with the delivery of the placenta and its membranes. Postpartum haemorrhage is the most common cause of maternal mortality and accounts for about 25 % of maternal deaths in India. OBJECTIVES: The present study was designed to evaluate the effectiveness of placental blood drainage after spontaneous vaginal delivery as part of active management of third stage of labour in decreasing the duration, blood loss, and complications of the third stage, against no drainage of placental blood...
October 2016: Journal of Obstetrics and Gynaecology of India
Georgy Joy Eralil
OBJECTIVE: Aim of this audit is to analyse indication and proportion of babies delivered by elective caesarean section at less than 39(+0) weeks of gestation exposed to antenatal corticosteroids performed in a Premier Hospital, Hywel Dda Health University. The second aim was to learn how an audit can be done and used for improving clinical practice. METHODS: Present study involved all patients who underwent elective caesarean delivery before 39 weeks completed period of gestation in August and September 2014...
October 2016: Journal of Obstetrics and Gynaecology of India
Sadiah Ahsan Pal, Mariam Iqbal Ali
Diabetes mellitus complicates <5% of all pregnancies in Pakistan, but is a major cause of perinatal morbidity and mortality, as well as maternal morbidity. Appropriate glycaemic control is not only important throughout pregnancy but is equally important during the intra-partum period. Increased blood glucose levels 4-6 hours prior to delivery increase the chances of hypoglycaemia in neonates. It is essential to optimize blood glucose levels during the intra-partum period as avoiding maternal hyperglycaemia will prevent foetal hyperglycaemia, and hence reduce the chances of neonatal hypoglycaemia and foetal acidaemia...
September 2016: JPMA. the Journal of the Pakistan Medical Association
Isabelle L Lange, Lydie Kanhonou, Sourou Goufodji, Carine Ronsmans, Véronique Filippi
As one of many similar policies in the region, in 2009 Benin launched a free c-section policy in publicly funded hospitals intended to decrease the barriers to facility delivery and the heavy financial burdens on women and their families. We conducted a qualitative study for eight months between 2012 and 2014 to understand women's experiences of care in maternity wards. We carried out semi-structured interviews with 30 women who had delivered via c-section at five hospitals. Two of these hospitals became case study sites where in-depth research was undertaken that consisted of participant observation in each maternity ward and 32 further interviews with women who had complicated, vaginal and c-section deliveries...
November 2016: Social Science & Medicine
Ziad A Haidar, Patricia C Vowels, Hind N Moussa, Baha M Sibai
BACKGROUND: Although rare, trauma in pregnancy can cause uterine rupture. In a periviable pregnancy, uterine rupture can lead to premature delivery and significant morbidity. CASE: A 29-year-old woman with four prior CSs presented with uterine rupture and a protruding morbidly adherent placenta at 23+4 weeks of gestation. Since the pregnancy was highly desired, the defect was repaired and the decision made to continue with the pregnancy. The patient presented at 29+3 weeks of gestation with preterm labour and subsequently delivered a healthy male infant of 1130 grams...
August 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Ayodele O Majekodunmi, Charles Dongkum, Tok Langs, Alexandra Shaw, Susan Welburn
This study investigated the productivity and management of sheep and cattle kept by Fulani pastoralists of Bokkos local government area on the Jos Plateau, North-Central Nigeria. Despite the challenges related to insecurity and restricted access to natural resources, results show large breeding herds with above average productivity and reproductive performance. The management strategy was focused on providing both milk and increased cattle numbers for pastoralists and beef to satisfy the high market demand...
September 16, 2016: Tropical Animal Health and Production
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