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https://www.readbyqxmd.com/read/28506945/urinary-fistula-a-continuing-problem-with-changing-trends
#1
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
#2
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...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28491174/diagnosis-of-abnormally-invasive-posterior-placentation-the-role-of-mr-imaging
#3
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
#4
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 (MAP) associated with prior cesarean section with or without placenta previa. Most cases of MAP are located anteriorly with involvement of the bladder. The lower uterine segment in increta and percreta cases is frequently thinned and deformed, with extensive vascular supply to the bulging placenta. This deformation of the lower segment makes identification of the cervico-vaginal interface and vaginal fornices difficult...
May 6, 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
#5
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...
April 26, 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
#6
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-resulting-from-local-anesthetic-allergy-during-emergent-cesarean-delivery-a-case-report
#7
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.
April 26, 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
#8
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...
April 4, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28331371/vacuum-assisted-cesarean-section
#9
REVIEW
Ross W McQuivey, Jon E Block
There has been a dramatic rise in the frequency of cesarean sections, surpassing 30% of all deliveries in the US. This upsurge, coupled with a decreasing willingness to allow vaginal birth after cesarean section, has resulted in an expansion of the use of vacuum assistance to safely extract the fetal head. By avoiding the use of a delivering hand or forceps blade, the volume being delivered through the uterine incision can be decreased when the vacuum is used properly. Reducing uterine extensions with their associated complications (eg, excessive blood loss) in difficult cases is also a theoretical advantage of vacuum delivery...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28323221/laparoscopic-promontohysteropexy-during-pregnancy
#10
L Pirtea, O Balint, C Secosan, R Ilina, D Grigoras
STUDY OBJECTIVE: to present a case of uterine prolapse in a 10 weeks pregnant patient that was successfully treated by laparoscopic promontohysteropexy. To our knowledge, this is the first case of laparoscopic promontopexy during pregnancy to ever be reported in literature. DESIGN: step by step explanation of the surgery using video SETTING: Uterine prolapse is a rare condition in young patients and extremely are in pregnant women. The incidence of uterine prolapse during pregnancy reported in literature is 1 per 10...
March 17, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28258945/the-performance-of-neck-circumference-and-other-airway-assessment-tests-for-the-prediction-of-difficult-intubation-in-obese-parturients-undergoing-cesarean-delivery
#11
J Eiamcharoenwit, N Itthisompaiboon, P Limpawattana, A Suwanpratheep, A Siriussawakul
BACKGROUND: Pregnancy and obesity each increase the chance of difficult tracheal intubation. This study assessed the performance of the neck circumference and other bedside tests for predicting difficult intubation, and aimed to identify the optimal cutoff point of the test(s) with the highest performance. METHODS: Parturients with a body mass index ≥30kg/m(2), undergoing a cesarean delivery employing conventional tracheal intubation, were enrolled. Preoperative neck circumference, sternomental distance and modified Mallampati test were examined...
February 5, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28246593/the-performance-of-the-intubation-difficulty-scale-among-obese-parturients-undergoing-cesarean-section
#12
Jatuporn Eiamcharoenwit, Napon Itthisompaiboon, Panita Limpawattana, Arunotai Siriussawakul
Background. There have not yet been any studies to validate the intubation difficulty scale (IDS) in obese parturients. Objectives of this study were to determine the performance of the IDS in defining difficult intubation (DI) and to identify the optimal cutoff points of the IDS among obese parturients. Methods. This was a prospective observational study. Parturients with a body mass index ≥ 30 kg/m(2) who underwent cesarean section utilizing endotracheal intubation were enrolled. The intubating performers were asked to assess the difficulty of endotracheal intubation and categorize it as easy, somewhat DI, and DI...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28235536/the-use-of-ultrasound-in-planned-cesarean-delivery-under-spinal-anesthesia-for-patients-having-nonprominent-anatomic-landmarks
#13
Mursel Ekinci, Hacı Ahmet Alici, Ali Ahiskalioglu, Ilker Ince, Mehmet Aksoy, Erkan Cem Celik, Aysenur Dostbil, Mine Celik, Pinar Karaca Baysal, Birzat Emre Golboyu, Ayşe Nur Yeksan
STUDY OBJECTIVE: The aim of the study was to compare conventional landmark method with ultrasound-guided spinal anesthesia in cesarean delivery cases where spinous processes and interspinous spaces were not prominent on physical examination. DESIGN: Randomized controlled clinical trial. SETTING: Operating rooms of university hospital of Erzurum, Turkey. PATIENTS: Sixty-four 18- to 45-year-old American Society of Anesthesiologists I-II patients scheduled for cesarean delivery under spinal anesthesia having hardly palpated anatomic landmarks on vertebral column...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28224086/early-robotic-repair-of-vesicouterine-fistula-a-case-report-and-literature-review
#14
Othman J Alamoudi, Mohammed A AlTheneyan, Naif Aldhaam, Maher Moazin
As cesarean sections become a more common mode of delivery, they have become the most likely cause of vesicouterine fistula formation. The associated pathology with repeat cesarean deliveries may make repair of these fistulas difficult. Early robotic-surgery offers a 3-dimensional view of the operative field and allows for intricate movements necessary for complex suturing and dissection. These qualities are advantageous in vesicouterine fistula repair. 42 years old female day 12 post-LSCS in author hospital with history of bladder injury and folly's catheter in place since OR complain of gross hematuria for 8 days...
February 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28222238/thrombolysis-with-intravenous-recombinant-tissue-plasminogen-activator-during-early-postpartum-period-a-review-of-the-literature
#15
REVIEW
Munetoshi Akazawa, Makoto Nishida
Thromboembolic events are one of the leading causes of maternal death during the postpartum period. Postpartum thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) is controversial because the treatment may lead to massive bleeding. Data centralization may be beneficial for analyzing the safety and effectiveness of systemic thrombolysis during the early postpartum period. We performed a computerized MEDLINE and EMBASE search. We collected data for 13 cases of systemic thrombolytic therapy during the early postpartum period, when limiting the early postpartum period to 48 hours after delivery...
February 21, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28179198/cesarean-scar-ectopic-pregnancy-laparoscopic-resection-and-total-scar-dehiscence-repair-a-case-report
#16
Sara Mahgoub, Victor Gabriele, Emilie Faller, Bruno Langer, Arnaud Wattiez, Lise Lecointre, Cherif Akladios
STUDY OBJECTIVE: Illustrate laparoscopic technique for resection of cesarean scar ectopic pregnancy, associated with isthmocele repair. DESIGN: Case report SETTING: Tertiary referral centre in Strasbourg, France. The study was approved by the local IRB. BACKGROUND: Cesarean scar pregnancy is a rare form of ectopic pregnancy. The major risk of this type of pregnancy is the early uterine rupture with massive bleeding and maternal life-threatening...
February 4, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28166080/stress-induced-gastric-ulcers-presenting-as-massive-rectal-bleeding-in-a-newborn
#17
A Joshi, P S Shrestha, S Dangol, N C Shrestha, P Poudyal, A Shrestha A
Severe gastrointestinal bleeding in newborn period is a serious but uncommon phenomenon that has a broad differential diagnosis. Primary duodenal ulcers are rare in children but stress induced ulceration in stomach occurs more often in neonatal period due to birth asphyxia, prolonged labour, cesarean deliveries, instrumentations, respiratory distress syndrome and sepsis. These present as acute onset of gastrointestinal bleeding commonly as altered gastric aspirate, hematemesis or malena. We report a case of a neonate with stress induced gastric bleeding following birth asphyxia who presented with massive gastrointestinal bleed manifesting as hematemesis and massive rectal bleeding...
April 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/28150406/preoperative-assessment-of-factors-associated-with-difficulty-in-performing-total-laparoscopic-hysterectomy
#18
Ako Saito, Tetsuya Hirata, Kaori Koga, Masashi Takamura, Shinya Fukuda, Kazuaki Neriishi, Gia Pastorfide, Miyuki Harada, Yasushi Hirota, Osamu Wada-Hiraike, Tomoyuki Fujii, Yutaka Osuga
AIM: Our objective was to determine the preoperative factors associated with difficulty in total laparoscopic hysterectomy (TLH). METHODS: This retrospective clinical study included 157 patients who underwent TLH for leiomyoma or adenomyosis between 2009 and 2013. All patients underwent magnetic resonance imaging (MRI) before surgery. We categorized patients as 'difficult' if the operation time was > 243 min, if total blood loss was > 500 mL, or if conversion to laparotomy was necessary...
February 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28128086/vesicular-contact-reaction-may-progress-into-erythema-multiforme
#19
Magdalena Czarnecka-Operacz, Dorota Jenerowicz, Joanna Szulczyńska-Gabor, Ewa Teresiak-Mikołajczak, Joanna Szyfter-Harris, Monika Bowszyc-Dmochowska
Dear Editor, Erythema multiforme is considered an acute skin condition, characterized by a self-limiting and sometimes recurrent course. It is regarded as a type IV hypersensitivity reaction associated with certain infections, medications, and other various triggers. Allergic contact dermatitis is in turn a delayed type of induced allergy as a result of cutaneous contact with a specific allergen to which the patient develops specific sensitivity. This type of cutaneous reaction is associated with inflammation manifesting with erythema, edema, and vesicles...
December 2016: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/28112692/symphysis-fundal-height-predicts-difficult-evolution-of-induced-labours
#20
Ugo Indraccolo, Lia Nardocci, Romolo Di Iorio, Marco Bonito, Salvatore Renato Indraccolo
BACKGROUND AND AIM: Symphysis-fundal-height (SFH) could be prove useful for the management of labour. This study aims to assess the behaviour of induced labours in relationship with SFH values. METHODS: Prospective observational study in a sample of 158 women underwent induction with intravaginal dinoprostone for different indications. SFH, SFH corrected for station, gestational age and parity were considered independent variables in multivariable models. Vaginal delivery, operative vaginal delivery, Cesarean section, Cesarean section for dystocia, Cesarean section for cardiotochographyc abnormalities, oxytocin infusion (for potentiating labour), need of Kristeller's maneuvre, epidural anesthesia (on demand), episiotomy, time from the first dose of dinoprostone to delivery, and time of active phase of labour were considered dependent variables in multivariable models...
January 16, 2017: Acta Bio-medica: Atenei Parmensis
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