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https://www.readbyqxmd.com/read/28931404/a-cluster-randomized-trial-to-reduce-major-perinatal-morbidity-among-women-with-one-prior-cesarean-delivery-in-qu%C3%A3-bec-prisma-trial-study-protocol-for-a-randomized-controlled-trial
#1
N Chaillet, E Bujold, B Masse, W A Grobman, P Rozenberg, J C Pasquier, A Shorten, M Johri, F Beaudoin, H Abenhaim, S Demers, W Fraser, M Dugas, S Blouin, E Dubé, R Gauthier
BACKGROUND: Rates of cesarean delivery are continuously increasing in industrialized countries, with repeated cesarean accounting for about a third of all cesareans. Women who have undergone a first cesarean are facing a difficult choice for their next pregnancy, i.e.: (1) to plan for a second cesarean delivery, associated with higher risk of maternal complications than vaginal delivery; or (b) to have a trial of labor (TOL) with the aim to achieve a vaginal birth after cesarean (VBAC) and to accept a significant, but rare, risk of uterine rupture and its related maternal and neonatal complications...
September 20, 2017: Trials
https://www.readbyqxmd.com/read/28805614/pregnancy-with-asymptomatic-uterine-complete-rupture-after-uterine-artery-embolization-for-postpartum-hemorrhage
#2
Hiroaki Soyama, Morikazu Miyamoto, Hidenori Sasa, Hiroki Ishibashi, Masashi Takano, Kenichi Furuya
OBJECTIVE: Uterine artery embolization has become an effective treatment for postpartum hemorrhage. The safety of pregnancy after uterine artery embolization for postpartum hemorrhage has been established. CASE REPORT: We present the case of a pregnant woman with asymptomatic uterine complete rupture who underwent uterine artery embolization for a previous placenta previa. She had not been diagnosed with uterine rupture until cesarean section was performed, and fortunately, we obtained the best maternal and neonatal outcomes...
August 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28737270/hospital-ownership-status-and-cesareans-in-the-united-states-the-effect-of-for-profit-hospitals
#3
Theresa Morris, Kelly McNamara, Christine H Morton
BACKGROUND: Given the increasing proportion of United States hospitals that are for-profit, we examined whether women who give birth in for-profit hospitals are more likely to have cesareans than women who give birth in not-for-profit hospitals. We hypothesized that cesareans are more likely to occur in for-profit hospitals because of the organizational emphasis on short-term financial indicators, including payment of shareholder dividends. METHODS: We used logistic regression and difference of means tests to analyze data from the Listening to Mothers III survey of women who gave birth in the United States in 2011 and 2012...
July 24, 2017: Birth
https://www.readbyqxmd.com/read/28710549/cervical-varicosities-may-predict-placenta-accreta-in-posterior-placenta-previa-a-magnetic-resonance-imaging-study
#4
Hiroki Ishibashi, Morikazu Miyamoto, Hiroshi Shinnmoto, Wakana Murakami, Hiroaki Soyama, Masaya Nakatsuka, Takahiro Natsuyama, Masashi Yoshida, Masashi Takano, Kenichi Furuya
PURPOSE: The aim of this study was to prenatally predict placenta accreta in posterior placenta previa using magnetic resonance imaging (MRI). METHODS: This retrospective study was approved by the Institutional Review Board of our hospital. We identified 81 patients with singleton pregnancy who had undergone cesarean section due to posterior placenta previa at our hospital between January 2012 and December 2016. We calculated the sensitivity and specificity of several well-known findings, and of cervical varicosities quantified using magnetic resonance imaging, in predicting placenta accreta in posterior placenta previa...
July 14, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28698181/risk-factors-for-surgical-site-infection-following-cesarean-delivery-a-retrospective-cohort-study
#5
Felicia Ketcheson, Christy Woolcott, Victoria Allen, Joanne M Langley
BACKGROUND: The rate of cesarean delivery is increasing in North America. Surgical site infection following this operation can make it difficult to recover, care for a baby and return home. We aimed to determine the incidence of surgical site infection to 30 days following cesarean delivery, associated risk factors and whether risk factors differed for predischarge versus postdischarge infection. METHODS: We identified a retrospective cohort in Nova Scotia by linking the provincial perinatal database to hospital admissions and physician billings databases to follow women for 30 days after they had given birth by cesarean delivery between Jan...
July 11, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28655800/improving-adherence-to-essential-birth-practices-using-the-who-safe-childbirth-checklist-with-peer-coaching-experience-from-60-public-health-facilities-in-uttar-pradesh-india
#6
Megan Marx Delaney, Pinki Maji, Tapan Kalita, Nabihah Kara, Darpan Rana, Krishan Kumar, Jenny Masoinneuve, Simon Cousens, Atul A Gawande, Vishwajeet Kumar, Bhala Kodkany, Narender Sharma, Rajiv Saurastri, Vinay Pratap Singh, Lisa R Hirschhorn, Katherine Ea Semrau, Rebecca Firestone
BACKGROUND: Adherence to evidence-based essential birth practices is critical for improving health outcomes for mothers and newborns. The WHO Safe Childbirth Checklist (SCC) incorporates these practices, which occur during 4 critical pause points: on admission, before pushing (or cesarean delivery), soon after birth, and before discharge. A peer-coaching strategy to support consistent use of the SCC may be an effective approach to increase birth attendants' adherence to these practices...
June 27, 2017: Global Health, Science and Practice
https://www.readbyqxmd.com/read/28646130/congenital-chloride-diarrhea-ccd-a-case-report-of-ccd-suspected-by-prenatal-ultrasonography-and-magnetic-resonance-imaging-mri
#7
Takakazu Kawamura, Tomizou Nishiguchi
BACKGROUND Congenital chloride diarrhea (CCD) is a rare autosomal recessive disorder that is difficult to distinguish from fetal lower intestinal obstruction. A prenatal diagnosis will make a contribution to the prognosis of the newborn. CASE REPORT We report a rare case of congenital chloride diarrhea (CCD) prenatally suspected by ultrasound and MRI. The prenatal ultrasound revealed signs of intestinal dilatation suggesting lower intestinal obstruction. MRI findings also revealed intestinal dilatation that continued from the rectum...
June 24, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28630830/bilateral-humerus-and-right-femur-fracture-in-a-newborn-after-cesarean-section-for-breech-presentation-in-a-twin-pregnancy-a-very-rare-case-report
#8
P Rahul, Amit Rakesh Grover, S M Ajoy
INTRODUCTION: The most common fractures during vaginal delivery occur in the clavicle, humerus, and femur. Cesarean section reduces the chances of a child having a birth injury. However, in some difficult extractions, long bone fractures may occur. Cesarean section further reduces the incidence of birth injuries, especially in a breech delivery. Maneuvers employed during cesarean section, energetic traction, improper uterine incisions, and contracted uterus may cause these injuries. In the medical literature, there are few articles highlighting the occurrence of long bone fractures during cesarean section...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28628578/neuraxial-anesthesia-in-obstetric-patients-receiving-thromboprophylaxis-with-unfractionated-or-low-molecular-weight-heparin-a-systematic-review-of-spinal-epidural-hematoma
#9
REVIEW
Lisa R Leffert, Heloise M Dubois, Alexander J Butwick, Brendan Carvalho, Timothy T Houle, Ruth Landau
Venous thromboembolism remains a major source of morbidity and mortality in obstetrics with an incidence of 29.8/100,000 vaginal delivery hospitalizations; cesarean delivery confers a 4-fold increased risk of thromboembolism when compared with vaginal delivery. Revised national guidelines now stipulate that the majority of women delivering via cesarean and women at risk for ante- or postpartum venous thromboembolism receive mechanical or pharmacological thromboprophylaxis. This practice change has important implications for obstetric anesthesiologists concerned about the risk of spinal epidural hematoma (SEH) among anticoagulated women receiving neuraxial anesthesia...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28604467/transnasal-humidified-rapid-insufflation-ventilatory-exchange-for-preoxygenation-before-cesarean-delivery-under-general-anesthesia-a-case-report
#10
Maryse Hengen, Rosalie Willemain, Alain Meyer, Bruno Langer, Girish P Joshi, Pierre Diemunsch
Transnasal humidified rapid-insufflation ventilatory exchange has been shown to improve oxygenation and increase apnea time in difficult airway cases. It may also be beneficial in patients vulnerable to rapid desaturation due to limited pulmonary reserve. We report the use of transnasal humidified rapid-insufflation ventilatory exchange for preoxygenation before a cesarean delivery under general anesthesia in a patient with respiratory distress because of pneumonia and heart failure from severe mitral stenosis...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28603475/oophoropexy-for-ovarian-torsion-a-new-easier-technique
#11
Tamer A Hosny
BACKGROUND: Oophoropexy for ovarian torsion is easy to be done by many tools either suturing to the lateral pelvic wall, plication of the ovarian ligament or even fixation to the back of the uterus, but it is little bit difficult to do it for pregnant women with less manipulation. OBJECTIVE: We propose that using trocar site closure needle can be easier and faster technique to do this. To assess the feasibility of using the trocar site closure needle to do oophoropexy in ovarian torsion and its possible applicability...
2017: Gynecological Surgery
https://www.readbyqxmd.com/read/28598915/anesthetic-and-obstetric-management-of-syringomyelia-during-labor-and-delivery-a-case-series-and-systematic-review
#12
REVIEW
Gráinne Patricia Garvey, Vibhangini S Wasade, Kellie E Murphy, Mrinalini Balki
BACKGROUND: Syringomyelia is a rare, slowly progressive neurological condition characterized by the presence of a syrinx within the spinal cord. Consensus regarding the safest mode of delivery and anesthetic management in patients with syringomyelia remains controversial and presents management dilemmas. This study reviews the cases of syringomyelia at our institution and provides a systematic review of the literature to guide decisions regarding labor and delivery management. METHODS: A retrospective review of cases at our hospital from 2002 to 2014 and a systematic review of the literature from 1946 to 2014 were undertaken...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28506945/urinary-fistula-a-continuing-problem-with-changing-trends
#13
Sunesh Kumar, Richa Vatsa, Juhi Bharti, Kallol Kumar Roy, Jai Bhagwan Sharma, Neeta Singh, Jyoti Meena, Seema Singhal
OBJECTIVE: Urinary fistula is a distressing complication after difficult vaginal deliveries, obstetric, and gynecologic surgeries. The present study describes a single center's experience in the management of urinary fistula at a tertiary care hospital. It was performed to analyze the etiology of genitourinary fistula, to assess the outcome after surgical repair, and to determine the changing trends in the etiology and management of urinary fistula. MATERIAL AND METHODS: This retrospective study was conducted over 5 years in the department of obstetrics and gynecology, All India Institute of Medical Sciences, New Delhi...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28504991/tablet-e-logbooks-four-thousand-clinical-cases-and-complications-e-logged-by-14-nondoctor-anesthesia-providers-in-nepal
#14
Shristi Shah, Oliver Ross, Stephen Pickering, Stephen Knoble, Indra Rai
BACKGROUND: To meet the need for essential surgery across rural Nepal, anesthesia at district level is delivered by nondoctor anesthetists. They require support to maintain confidence and competence, and upgraded professional registration to secure their status. To meet these needs, a distance-blended learning course was pioneered and delivered. A core course requirement was to log all clinical cases; these were logged on a new e-logbook. METHODS: Fourteen nondoctor anesthesia providers working in 12 different districts across Nepal were enrolled in the 1-year course...
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28491174/diagnosis-of-abnormally-invasive-posterior-placentation-the-role-of-mr-imaging
#15
Madison R Kocher, Douglas H Sheafor, Evelyn Bruner, Charles Newman, Julio Fernando Mateus Nino
Abnormally invasive placentation is becoming more common with a recent increase in cesarean sections and maternal age, among other risk factors. Ultrasonography is the first line-imaging, but it can be difficult to diagnose when limiting factors are present. Failure to recognize this serious placental abnormality precludes us from making the appropriate plan for the delivery and consequently can lead to fatal results. In this report, we present a case in which magnetic resonance imaging was used to diagnose posterior placenta increta missed by multiple sonographic examinations in a patient with previous myomectomies, and we also include a review of the literature on this topic...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28487113/a-technique-to-positively-identify-the-vaginal-fornices-during-complicated-postpartum-hysterectomy
#16
Michael A Belfort, Alireza A Shamshirsaz, Karin A Fox
The frequency of cesarean hysterectomy is increasing, predominantly driven by an increased incidence of morbidly adherent placenta associated with previous cesarean delivery with or without placenta previa. Most cases of morbidly adherent placenta are located anteriorly with involvement of the bladder. The lower uterine segment in increta and percreta cases frequently is thinned and deformed, with extensive vascular supply to the bulging placenta. This deformation of the lower segment makes identification of the cervicovaginal interface and vaginal fornices difficult...
August 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28456503/novel-oxytocin-receptor-variants-in-laboring-women-requiring-high-doses-of-oxytocin
#17
Erin L Reinl, Zane A Goodwin, Nandini Raghuraman, Grace Y Lee, Erin Y Jo, Beakal M Gezahegn, Meghan K Pillai, Alison G Cahill, Cristina de Guzman Strong, Sarah K England
BACKGROUND: Although oxytocin commonly is used to augment or induce labor, it is difficult to predict its effectiveness because oxytocin dose requirements vary significantly among women. One possibility is that women requiring high or low doses of oxytocin have variations in the oxytocin receptor gene. OBJECTIVES: To identify oxytocin receptor gene variants in laboring women with low and high oxytocin dosage requirements. STUDY DESIGN: Term, nulliparous women requiring oxytocin doses of ≤4 mU/min (low-dose-requiring, n = 83) or ≥20 mU/min (high-dose-requiring, n = 104) for labor augmentation or induction provided consent to a postpartum blood draw as a source of genomic DNA...
August 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28448397/prophylactic-pentazocine-reduces-the-incidence-of-pruritus-after-cesarean-delivery-under-spinal-anesthesia-with-opioids-a-prospective-randomized-clinical-trial
#18
RANDOMIZED CONTROLLED TRIAL
Masato Hirabayashi, Katsushi Doi, Noritaka Imamachi, Tomomune Kishimoto, Yoji Saito
BACKGROUND: The incidence of pruritus after cesarean delivery under spinal anesthesia with opioids is high, ranging from 50% to 100%. Pruritus is difficult to prevent; however, pentazocine has been shown to be an effective treatment. Despite this, the prophylactic effect of pentazocine on pruritus has not been defined. This randomized double-blind trial aimed to evaluate the effect of intraoperative IV pentazocine on the incidence of opioid-induced pruritus within the first 24 hours after administration of neuraxial opioids...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28448320/difficult-airway-management-caused-by-local-anesthetic-allergy-during-emergent-cesarean-delivery-a-case-report
#19
Courtney L Maxey-Jones, Alec Palmerton, Jocelyn R Farmer, Brian T Bateman
Difficult airway management in the gravid patient is a well-described phenomenon. We present a case of emergent cesarean delivery complicated by a "cannot intubate, cannot ventilate" scenario that was later determined to be secondary to an allergic, IgE-mediated reaction to epidurally administered local anesthetic.
August 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28379868/double-dilemma-management-of-a-pregnant-patient-with-a-difficult-airway-presenting-with-undiagnosed-placenta-percreta-a-case-report
#20
Yewande A Omowanile, Luke N Weiler, Jill M Mhyre, Faiza A Khan
Patients with abnormal placentation should undergo planned cesarean delivery with the option for hysterectomy based on severity. We report a case of a multigravida with a known difficult airway presenting for cesarean delivery. She was found to have an undiagnosed placenta percreta at the start of surgery after the epidural was placed. After team discussion, the procedure was aborted and rescheduled electively 2 days later under general anesthesia with preoperative placement of internal iliac artery balloon catheters...
July 1, 2017: A & A Case Reports
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