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Obstetric hemorrhage

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https://www.readbyqxmd.com/read/28107771/a-prospective-study-of-maternal-fetal-and-neonatal-outcomes-in-the-setting-of-cesarean-section-in-low-and-middle-income-countries
#1
Margo S Harrison, Omrana Pasha, Sarah Saleem, Sumera Ali, Elwyn Chomba, Waldemar A Carlo, Ana L Garces, Nancy F Krebs, K Michael Hambidge, Shivaprasad S Goudar, Bhala Kodkany, Sangappa Dhaded, Richard J Derman, Archana Patel, Patricia L Hibberd, Fabian Esamai, Edward A Liechty, Janet L Moore, Dennis Wallace, Elizabeth M McClure, Menachem Miodovnik, Marion Koso-Thomas, Jose Belizan, Robert L Goldenberg
Cesarean section (CS) rates are increasing globally with an unclear effect on pregnancy outcomes. The study objective was to quantify maternal and perinatal morbidity and mortality in low- and middle-income countries associated with CS compared to vaginal delivery (VD) both within and across sites MATERIAL AND METHODS: A prospective population-based study including home and facility births in 337,153 women with a VD and 47,308 women with a CS from 2010 to 2015 was performed in Guatemala, India, Kenya, Pakistan, Zambia, and Democratic Republic of Congo...
January 20, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28099749/a-systematic-review-of-maternal-near-miss-and-mortality-due-to-postpartum-hemorrhage
#2
REVIEW
Salome Maswime, Eckhart Buchmann
BACKGROUND: Postpartum hemorrhage (PPH) is the principal direct cause of maternal mortality worldwide. Analysis of maternal near miss could increase understanding of survival among women with life-threatening PPH. OBJECTIVES: To determine the near-miss ratio and maternal mortality index for PPH globally. SEARCH STRATEGY: A prevalence systematic review was conducted of English-language articles published from 1995 to 2014. Suitable articles were identified from the Scopus, PubMed, Embase, and Grey Literature databases...
January 6, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099725/maternal-and-newborn-outcomes-at-a-tertiary-care-hospital-in-lusaka-zambia-2008-2012
#3
Bellington Vwalika, Marie C D Stoner, Mulindi Mwanahamuntu, K Cherry Liu, Eugene Kaunda, Getrude G Tshuma, Somwe W Somwe, Yusuf Ahmed, Elizabeth M Stringer, Jeffrey S A Stringer, Benjamin H Chi
OBJECTIVE: To measure key obstetric and neonatal outcomes recorded at a tertiary hospital in Zambia over a 5-year period. METHODS: A retrospective analysis was conducted among women who had delivered at the University Teaching Hospital in Lusaka, between January 1, 2008, and December 31, 2012. Data were extracted from electronic medical records. The main outcomes were maternal mortality, cesarean delivery, prenatal or intrapartum hemorrhage, stillbirth, a 5-minute Apgar score of less than 7, and admission to the neonatal intensive care unit...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099637/factors-associated-with-maternal-death-in-an-intensive-care-unit
#4
Suzanne Vieira Saintrain, Juliana Gomes Ramalho de Oliveira, Maria Vieira de Lima Saintrain, Zenilda Vieira Bruno, Juliana Lima Nogueira Borges, Elizabeth De Francesco Daher, Geraldo Bezerra da Silva
Objective: To identify factors associated with maternal death in patients admitted to an intensive care unit. Methods: A cross-sectional study was conducted in a maternal intensive care unit. All medical records of patients admitted from January 2012 to December 2014 were reviewed. Pregnant and puerperal women were included; those with diagnoses of hydatidiform mole, ectopic pregnancy, or anembryonic pregnancy were excluded, as were patients admitted for non-obstetrical reasons...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099290/increased-perinatal-morbidity-and-mortality-among-asian-american-and-pacific-islander-women-in-the-united-states
#5
Maryam Siddiqui, Mohammed Minhaj, Ariel Mueller, Avery Tung, Barbara Scavone, Sarosh Rana, Sajid Shahul
BACKGROUND: Asian American/Pacific Islanders (AAPIs) are the fastest-growing racial group in the United States. Despite a higher socioeconomic status, AAPI women experience higher rates of maternal morbidity and mortality. METHODS: Using the National Inpatient Sample, we performed a retrospective cohort analysis of women who were hospitalized for delivery from 2002 to 2013. The primary outcome variable was inpatient mortality rate, and the presence of severe maternal morbidities was estimated using the Bateman Comorbidity Index, a validated tool for predicting obstetric morbidity...
January 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28098575/obstetric-anesthesia-liability-concerns
#6
Joanna M Davies, Linda S Stephens
Obstetric practice carries a high risk of medical liability and involves both obstetricians and anesthesiologists. Analysis of data from the Anesthesia Closed Claims Project database shows an increase in the proportion of anesthesia claims for maternal death and brain damage between the 1990s and 2000 and later, primarily due to hemorrhage. The proportion of claims for newborn brain damage remained unchanged while those for maternal nerve injury and minor injuries decreased. Use of massive transfusion protocols and clinical drills have been shown to improve outcomes from hemorrhage...
January 16, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28092247/-emergency-obstetric-causes-and-immediate-response-team-in-a-secondary-hospital
#7
Luis Rafael López-Ocaña, Norma Angélica Hernández-Pineda, Polita Rocío Cruz-Cruz, Manuel Ramiro-H, Víctor Octavio Pérez Del Valle-Ibarra
BACKGROUND: The aim of this work is to describe the causes of the obstetric emergency, which motivates the activation of the Immediate Response Team at a second level hospital of the Instituto Mexicano del Seguro Social, which has not an Intensive Care Unit for Adult Patients. METHODS: Retrospective observational study of the causes of obstetric emergency that occurred in the domains of Admission, Hospitalization, Labor, Delivery Room, Operating Room and Recovery of the Hospital General de Zona 53 of the IMSS, during the years 2014 and 2015...
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28090643/the-use-of-instructional-design-guidelines-to-increase-effectiveness-of-postpartum-hemorrhage-simulation-training
#8
Brena C P de Melo, Ana R Falbo, Arno M M Muijtjens, Cees P M van der Vleuten, Jeroen J G van Merriënboer
OBJECTIVE: To compare learning outcomes of postpartum hemorrhage simulation training based on either instructional design guidelines or best practice. METHODS: A pretest-post-test non-equivalent groups study was conducted among obstetrics and gynecology residents in Recife, Brazil, from June 8 to August 30, 2013. The instructional design group included 13 teams, whereas the best practice group included seven teams. A standardized task checklist was used for scenario analysis and the proportion of correctly executed tasks compared (post-test minus pretest)...
December 16, 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28090230/epidemiology-of-pregnancy-associated-icu-utilization-in-texas-2001-2010
#9
Lavi Oud
BACKGROUND: ICU admission is uncommon among obstetric patients. Nevertheless, the epidemiology of ICU utilization is considered to be a useful proxy for study of severe maternal morbidity and near-miss events. However, there is paucity of population-level studies in obstetric patients in the United States. METHODS: The Texas Inpatient Public Use Data File and state-based reports were used to identify pregnancy-associated hospitalizations and those involving admission to ICU (n = 158,410) for the years 2001 - 2010...
February 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28068990/risk-factors-for-severe-postpartum-hemorrhage-a-case-control-study
#10
Lill Trine Nyfløt, Irene Sandven, Babill Stray-Pedersen, Silje Pettersen, Iqbal Al-Zirqi, Margit Rosenberg, Anne Flem Jacobsen, Siri Vangen
BACKGROUND: In high-income countries, the incidence of severe postpartum hemorrhage (PPH) has increased. This has important public health relevance because severe PPH is a leading cause of major maternal morbidity. However, few studies have identified risk factors for severe PPH within a contemporary obstetric cohort. METHODS: We performed a case-control study to identify risk factors for severe PPH among a cohort of women who delivered at one of three hospitals in Norway between 2008 and 2011...
January 10, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28050332/secondary-postpartum-hemorrhage-due-to-spontaneous-uterine-artery-rupture-after-normal-vaginal-delivery-managed-by-selective-arterial-embolization
#11
Mili Thakur, Henry O Adekola, Radwan Asaad, Bernard Gonik
Secondary postpartum hemorrhage due to an intraperitoneal bleed following a vaginal delivery is extremely rare. We present a case of spontaneous rupture of the uterine artery following a normal vaginal delivery with a delayed presentation, which resulted in significant morbidity. This case discusses the presentation and management of this rare obstetrical emergency. The report also discusses the role of selective arterial embolization in management of secondary postpartum hemorrhage.
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28024660/a-novel-approach-to-detecting-postpartum-hemorrhage-using-contrast-enhanced-ultrasound
#12
Kenji Imai, Tomomi Kotani, Hiroyuki Tsuda, Tomoko Nakano, Akihiro Hirakawa, Fumitaka Kikkawa
The aim of this study was to estimate the efficacy of contrast-enhanced ultrasound (CEUS) in detecting postpartum hemorrhage (PPH) after cesarean section. This is the first study of CEUS in obstetric hemorrhage. A total of 37 patients, operated at Nagoya University Hospital, underwent CEUS. We evaluated the findings of CEUS, which were qualitatively defined as positive when pooling or leakage of contrast agent was observed in the uterine cavity, by measuring the amount of bleeding during the first 4 h after cesarean section...
December 23, 2016: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28002983/the-more-you-lose-the-more-you-miss-accuracy-of-postpartum-blood-loss-visual-estimation-a-systematic-review-of-the-literature
#13
Mariateresa Natrella, Edoardo Di Naro, Matteo Loverro, Neta Benshalom-Tirosh, Giuseppe Trojano, Dan Tirosh, Limor Besser, Maria Teresa Loverro, Salvatore Andrea Mastrolia
Midwives and nurses have a key role in monitoring postpartum period. They represent the first line professional figure in quantifying blood loss, initiating early diagnosis of obstetric hemorrhage, and mobilizing a team response, if needed. These actions are crucial in determining maternal outcome in postpartum hemorrhage. In our review we aimed to: 1) Provide a picture of postpartum hemorrhage including its pathophysiology, epidemiology, and associated complications; 2) Discuss diagnosis of this dangerous postpartum event; and, 3) Especially evaluate the efficiency of the employment of visual blood loss estimation as a rapid way to suspect postpartum hemorrhage and activate the patient assessment...
December 21, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28002642/modification-of-obstetric-emergency-simulation-scenarios-for-realism-in-a-home-birth-setting
#14
Janelle Komorowski, Tia Andrighetti, Melissa Benton
INTRODUCTION: Clinical competency and clear communication are essential for intrapartum care providers who encounter high-stakes, low-frequency emergencies. The challenge for these providers is to maintain infrequently used skills. The challenge is even more significant for midwives who manage births at home and who, due to low practice volume and low-risk clientele, may rarely encounter an emergency. In addition, access to team simulation may be limited for home-birth midwives. This project modified existing validated obstetric simulation scenarios for a home-birth setting...
December 21, 2016: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/27998318/management-of-severe-dengue-hemorrhagic-fever-and-bleeding-complications-in-a-primigravida%C3%A2-patient-a-case-report
#15
Hori Hariyanto, Corry Quando Yahya, Primartanto Wibowo, Oloan E Tampubolon
BACKGROUND: The incidence of dengue hemorrhagic fever is increasing among the adult population living in endemic areas. The disease carries a 0.73% fatality rate for the general population, but what happens when the disease strikes a special subpopulation group, the obstetrics? Perhaps the important question specific to this special subpopulation revolves around the right time and mode of delivery under severe coagulopathy and plasma leakage in conditions of imminent delivery. CASE PRESENTATION: A 24-year-old primigravid Sundanese woman presented to our intensive care unit due to acute pulmonary edema secondary to massive plasma leakage caused by severe dengue...
December 20, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27993924/limited-effectiveness-of-a-skills-and-drills-intervention-to-improve-emergency-obstetric-and-newborn-care-in-karnataka-india-a-proof-of-concept-study
#16
Beena Varghese, Jayanna Krishnamurthy, Blaze Correia, Ruchika Panigrahi, Maryann Washington, Vinotha Ponnuswamy, Prem Mony
OBJECTIVE: The majority of the maternal and perinatal deaths are preventable through improved emergency obstetric and newborn care at facilities. However, the quality of such care in India has significant gaps in terms of provider skills and in their preparedness to handle emergencies. We tested the feasibility, acceptability, and effectiveness of a "skills and drills" intervention, implemented between July 2013 and September 2014, to improve emergency obstetric and newborn care in the state of Karnataka, India...
December 23, 2016: Global Health, Science and Practice
https://www.readbyqxmd.com/read/27987297/misdiagnosis-of-obstetrical-cases-and-the-clinical-and-cost-consequences-to-patients-a-cross-sectional-study-of-urban-providers-in-the-philippines
#17
Riti Shimkhada, Orville Solon, Diana Tamondong-Lachica, John W Peabody
BACKGROUND: Misdiagnosis may be a significant and under-recognized quality of care problem. In birthing facilities located in anurban Philippine setting, we investigated the diagnostic accuracy for three obstetric conditions: cephalopelvic disproportion (CPD), post-partum hemorrhage (PPH), and pre-eclampsia. DESIGN: Identical simulated cases were used to measure diagnostic accuracy for every provider (n=103). We linked misdiagnosis - identified by the simulated cases - to obstetrical complications of the patients at the participating facilities...
2016: Global Health Action
https://www.readbyqxmd.com/read/27977018/postpartum-hemorrhage-following-vaginal-delivery-risk-factors-and-maternal-outcomes
#18
C M Miller, S Cohn, S Akdagli, B Carvalho, Y J Blumenfeld, A J Butwick
OBJECTIVE: Limited understanding of risk factors exists for postpartum hemorrhage (PPH) post-vaginal delivery. The aim of this study was to identify risk factors for PPH post-vaginal delivery within a contemporary obstetric cohort. STUDY DESIGN: Retrospective case-control study. PPH was classified by an estimated blood loss ⩾500 ml. Risk factors for PPH were identified using univariable and multivariable logistic regression. We secondarily investigated maternal outcomes and medical and surgical interventions for PPH management...
December 15, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27957708/hypertension-in-pregnancy
#19
Roopa Malik, Viral Kumar
Hypertensive disorders of pregnancy remain an unresolved and unpreventable problem in obstetrics. They remain one of the leading member of deadly triad causing maternal mortality, the other two being hemorrhage and sepsis which are preventable. The incidence of hypertensive disorders worldwide is 12 %. We have discussed various terminologies used to describe hypertension during pregnancy, risk factors, etiopathogenesis, pathophysiology, management guidelines, complications and long term consequences of hypertensive disorders of pregnancy in this chapter...
December 13, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27942344/acute-care-trauma-surgeon-s-role-in-obstetrical-gynecologic-emergencies-the-obcat-alert
#20
Seong K Lee, Eddy H Carrillo, Andrew Rosenthal, Rafael Sanchez, Chauniqua Kiffin, Dafney L Davare
BACKGROUND: Overwhelming hemorrhage or other intra-abdominal complications may be associated with obstetrical or gynecologic (OB/GYN) procedures and may require the surgical training of an Acute Care/Trauma Surgeon. The OB Critical Assessment Team (OBCAT Alert) was developed at our institution to facilitate a multidisciplinary response to complex OB/GYN cases. We sought to review and characterize the Acute Care/Trauma Surgeon's role in these cases. METHODS: We conducted a retrospective review of all emergency consults during an OB/GYN case at our institution from 2008 to 2015...
2016: World Journal of Emergency Medicine
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