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Caesarean management

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https://www.readbyqxmd.com/read/28226340/oral-oxycodone-for-acute-postoperative-pain-a-review-of-clinical-trials
#1
Chi Wai Cheung, Stanley Sau Ching Wong, Qiu Qiu, Xianyu Wang
BACKGROUND: Opioids are the mainstay of pain management for acute postsurgical pain. Oral oxycodone is an opioid that can provide effective acute postoperative pain relief. OBJECTIVES: To evaluate the use of oral oxycodone for acute postoperative pain management. STUDY DESIGN: This is a narrative review based on published articles searched in PubMed and Medline from 2003 to 2015 on oral oxycodone for acute postoperative pain management. METHODS: Clinical trials related to the use of oral oxycodone for acute postoperative pain management were searched via PubMed and Medline from 2003 to 2015...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28220407/favourable-outcome-in-two-pregnancies-in-a-patient-with-3-hydroxy-3-methylglutaryl-coa-lyase-deficiency
#2
David Santosa, Markus G Donner, Stephan Vom Dahl, Markus Fleisch, Thomas Hoehn, Ertan Mayatepek, Katrin Heldt, Tim Niehues, Dieter Häussinger
In patients with 3-hydroxy-3-methylglutaryl(HMG)-CoA lyase deficiency (OMIM 246450), five pregnancies have been described worldwide, which were either terminated or resulted in severe metabolic sequelae during pregnancy or delivery. Here, we report on a patient with HMG-CoA lyase deficiency, who underwent two uncomplicated pregnancies. The 19-year-old patient was admitted because of recurrent vomiting and nausea. Diagnostics revealed pregnancy at week 8 of gestation. Metabolic analyses revealed normal lactate and blood glucose levels and normal acid-base status...
February 21, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#3
C McDonald, J Laurie, S Janssens, C Zazulak, P Kotze, K Shekar
Mortality during pregnancy in a well-resourced setting is rare, but acute pulmonary embolism is one of the leading causes. We present the successful use of extracorporeal cardiopulmonary resuscitation (eCPR) in a 22-year old woman who experienced cardiopulmonary collapse following urgent caesarean section in the setting of a sub-massive pulmonary embolus. Resources and personnel to perform eCPR were not available at the maternity hospital and were recruited from an adjacent pediatric hospital. Initial care used low blood flow extracorporeal membrane oxygenation (ECMO) with pediatric ECMO circuitry, which was optimized when the team from a nearby adult cardiac hospital arrived...
January 9, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28208931/pseudo-exstrophy-of-bladder-with-unilateral-renal-agenesis-a-rare-combination-of-two-anomalies
#4
Abdolhamid Amouei, Mohammad Baghi Yazdi, Fatemeh Ehsani, Mojtaba Babaei Zarch
Pseudo-exstrophy of bladder is an uncommon condition characterized by the major musculoskeletal defects without urinary system defects. A two-day-old female neonate was presented with pseudo-exstrophy of the bladder and unilateral renal agenesis- A rare combination of two anomalies. She was born at 37 weeks gestational age with caesarean section delivery. The X-ray of hip revealed pubic diastasis. Ultrasonography clearly showed absence of the left kidney with a normal right kidney. The patient was treated successfully with proper surgical management...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28199872/fertility-and-obstetric-outcomes-after-curettage-versus-expectant-management-in-randomised-and-non-randomised-women-with-an-incomplete-evacuation-of-the-uterus-after-misoprostol-treatment-for-miscarriage
#5
M Lemmers, M A C Verschoor, K Overwater, P M Bossuyt, D Hendriks, M Hemelaar, J M Schutte, A H Adriaanse, W M Ankum, J A F Huirne, B W J Mol
OBJECTIVE: To assess fertility and obstetric outcomes in women treated with curettage or undergoing expectant management for an incomplete miscarriage after misoprostol treatment. STUDY DESIGN: Between June 2012 and July 2014, we conducted a multicentre randomised clinical trial (RCT) with a parallel cohort study for non-randomised women, treated according to their preference. In the RCT 30 women were allocated curettage and 29 expectant management. In the cohort 197 women participated; 65 underwent curettage and 132 women underwent expectant management...
January 30, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28182812/management-and-outcomes-of-fetal-hydrops-in-a-tertiary-care-centre-in-singapore
#6
Xin Yi Thong, Le Ye Lee, Dawn Ak Chia, Yee Chee Wong, Arijit Biswas
Introduction: Fetal hydrops is a serious condition which can be caused by immune and non-immune aetiologies. We aimed to review the management of fetal hydrops at our hospital. Materials and Methods: A retrospective review of all cases of fetal hydrops diagnosed in our institution from 2006 to 2013 was carried out. Results: Out of the 30 cases of fetal hydrops diagnosed antenatally, 17 were cases of Bart's hydrops which were all terminated in-utero. Of the remaining 13 cases, 11 cases consisted of non-immune causes of hydrops...
January 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28179198/cesarean-scar-ectopic-pregnancy-laparoscopic-resection-and-total-scar-dehiscence-repair-a-case-report
#7
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/28178769/improving-post-caesarean-analgesia-where-to-next
#8
Alexander Butwick
The provision of effective pain relief to mothers after caesarean section (CS) is a priority for both obstetric and anaesthesia providers. To meet this goal, multimodal analgesic regimens have been endorsed to manage pain and reduce opioid requirements after CS. Post-CS, typical oral analgesic regimens may comprise paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), and an oral opioid. The inclusion of paracetamol and NSAIDs is important as each drug has an opioid sparing effect, thereby reducing the incidence of opioid related side-effects...
February 8, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28153548/neonatal-and-maternal-outcomes-of-pregnancy-with-maternal-cardiac-disease-the-normandy-study-years-2000-2014
#9
Vincent Bonnet, Thérèse Simonet, Fabien Labombarda, Patricia Dolley, Paul Milliez, Michel Dreyfus, Jean-Luc Hanouz
Pregnancies complicated by congenital or acquired heart diseases are at high risk of maternal, obstetrical and neonatal poor outcomes. During the period 2000-2014, 197 pregnancies occurring in 147 women with heart disease were managed in our institution. A maternal cardiac event complicated 13 pregnancies. Obstetrical and neonatal complications occurred respectively in 35.0 % (95 % CI [28.3 - 41.7]) and 37.0 % (95 % CI [30.3 - 43.7]) of pregnancies. All complications were more frequent amongst cardiomyopathies or obstructive and conotruncal lesions, whereas left-to-right shunts were less prone to present with complications...
January 30, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28150262/-the-relationship-among-physical-activity-during-the-third-trimester-maternal-pre-pregnancy-body-mass-index-gestational-weight-gain-and-pregnancy-outcomes
#10
Chia-Hui Chen, Ya-Ling Tzeng, Tsung-Ho Ying, Pi-Chao Kuo
BACKGROUND: Most pregnant women tend to reduce physical activities during pregnancy because they are uncertain of the amount of moderate-level physical activity they should do. As the influence of physical activity during the third trimester remains unclear, it is important to clarify the pregnancy outcomes of physical activity during pregnancy and weight management among Taiwanese women. PURPOSE: To examine the potential association between physical activity during the third trimester of pregnancy and the birth weight or delivery mode of the baby in order to see whether weight gain during pregnancy affects birth weight and delivery mode and to estimate the associations between pre-pregnancy body mass index and birth weight...
February 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28138191/intestinal-obstruction-due-to-congenital-malrotation-complicating-a-multiple-pregnancy-a-rare-case-report
#11
Yuzhu Yin, Chuo Li, Chengfang Xu, Lingling Wu, Ni Deng, Hongying Hou, Bin Wu
Intestinal obstruction due to congenital intestinal malrotation is usually diagnosed in neonates but may, in rare cases, occur during pregnancy. The absence of specific symptoms in combination with its low incidence makes timely detection of intestinal malrotation-related obstruction difficult in expectant mothers. We present a rare case of a 23-year-old woman with a twin pregnancy following in vitro fertilization-embryo transfer (IVF-ET) who presented with symptoms of intestinal obstruction at 22+4 weeks of gestation...
February 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28133720/heart-rate-variability-as-a-predictor-of-hypotension-following-spinal-for-elective-caesarean-section-a-prospective-observational-study
#12
D G Bishop, C Cairns, M Grobbelaar, R N Rodseth
Post-spinal hypotension remains a common and clinically-important problem during caesarean section, and accurate pre-operative prediction of this complication might enhance clinical management. We conducted a prospective, single-centre, observational study of heart rate variability in 102 patients undergoing elective caesarean section in a South African regional hospital. We performed Holter recording for ≥ 5 min in the hour preceding spinal anaesthesia. The low-frequency/high-frequency ratio component of heart rate variability was compared, using a logistic regression model, with baseline heart rate and body mass index (BMI) as a predictor of hypotension (defined as systolic arterial pressure < 90 mmHg) occurring from the time of spinal insertion until 15 min after delivery of the baby...
January 30, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28131100/blood-pressure-patterns-in-women-with-gestational-hypertension-or-mild-preeclampsia-at-term
#13
K van der Tuuk, P Tajik, C M Koopmans, P P van den Berg, B W J Mol, M G van Pampus, H Groen
OBJECTIVE: Gestational hypertension (GH) and mild preeclampsia (PE) represent the most common medical complications of pregnancy, with the majority of cases developing at or near term. There is little knowledge of the course of blood pressure over time in these women. We explored the pattern of systolic and diastolic blood pressure over time in women with GH or mild PE at term participating in the HYPITAT trial, and we attempted to identify clinical factors influencing these blood pressure patterns and the impact of severe hypertension on clinical management...
January 19, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28127984/pregnancy-and-neonatal-outcomes-in-women-with-type-1-diabetes-mellitus
#14
L Durackova, A Kristufkova, M Korbel
AIM: The aim of study was to compare some perinatal outcomes in mothers with type 1 diabetes mellitus (T1DM). MATERIAL AND METHODS: All patients with T1DM delivered at the 1st Department of Obstetrics and Gynaecology of Faculty of Medicine, Comenius University in Bratislava from January 1st 2009 to December 31th 2015 were included to the study. RESULTS: Out of 118 diabetic mothers, 46.6 % had vasculopathy and 53. 4 % were without microvascular complications...
2017: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/28116412/-anaesthesia-for-canine-caesarean-section-an-evidence-based-approach
#15
Michaele Alef
In recent years, several new studies on anaesthesia for caesarean section have been published. This paper refers to these and ground-breaking research on risk factors affecting the puppies. Based on the available evidence, a recommendation for an anaesthetic procedure is given and in addition, alternatives are discussed. Induction with propofol or alfaxalone and maintenance by inhalation anaesthesia appears to be the method with the least risk. Intraoperatively, an adequate and low-risk analgesia is achieved by an epidural anaesthesia...
February 9, 2017: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
https://www.readbyqxmd.com/read/28110176/the-management-of-hiv-in-pregnancy-a-10-year-experience
#16
Sonia F Raffe, Charlotte Savage, Louisa A Perry, Amie Patel, Tricia Keith, Richard Howell, Robert Bradley, Rob Bomont, Katy Fidler, Yvonne Gilleece
OBJECTIVE: The package of care to reduce HIV mother to child transmission (MTCT) has evolved significantly since trials of ante and intrapartum antiretroviral therapy (ART) in 1994. In the UK MTCT rate has fallen from 25.6% in the 1990s to 0.46%. We review the management of HIV in pregnancy in Brighton in the context of evolving guidelines. STUDY DESIGN: HIV, obstetric and neonatal notes of all HIV positive women, pregnant between 2003 and 2014, were reviewed. RESULTS: 97 pregnancies in 75 women were identified, resulting in 79 live births...
January 3, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28109314/sickle-cell-disease-and-pregnancy-outcomes-a-study-of-the-community-based-hospital-in-a-tribal-block-of-gujarat-india
#17
Gayatri Desai, Ankit Anand, Pankaj Shah, Shobha Shah, Kapilkumar Dave, Hardik Bhatt, Shrey Desai, Dhiren Modi
BACKGROUND: Sickle cell disease (SCD) is a hereditary blood disorder prevalent in tribal regions of India. SCD can increase complications during pregnancy and in turn negatively influence pregnancy outcomes. This study reports the analysis of tribal maternal admissions in the community-based hospital of SEWA Rural (Kasturba Maternity Hospital) in Jhagadia block, Gujarat. The objective of the study is to compare the pregnancy outcomes among SCD, sickle cell trait and non-SCD admissions...
January 21, 2017: Journal of Health, Population, and Nutrition
https://www.readbyqxmd.com/read/28106904/planned-early-delivery-versus-expectant-management-for-hypertensive-disorders-from-34-weeks-gestation-to-term
#18
REVIEW
Catherine Cluver, Natalia Novikova, Corine M Koopmans, Helen M West
BACKGROUND: Hypertensive disorders in pregnancy are significant contributors to maternal and perinatal morbidity and mortality. These disorders include well-controlled chronic hypertension, gestational hypertension (pregnancy-induced hypertension) and mild pre-eclampsia. The definitive treatment for these disorders is planned early delivery and the alternative is to manage the pregnancy expectantly if severe uncontrolled hypertension is not present, with close maternal and fetal monitoring...
January 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28106628/neonatal-micrognathia-national-trends-in-early-mandibular-surgery
#19
Hillary E Jenny, Benjamin B Massenburg, E Hope Weissler, Peter J Taub
BACKGROUND: Micrognathia is a congenital anomaly that may pose breathing and feeding limitations in newborns, sometimes necessitating invasive management. The present study aims to identify the complications associated with receiving mandibular surgery during the birth stay in order to better predict which patients may benefit from early surgical intervention. METHODS: A retrospective cohort study was performed using the 2000 to 2012 kids' inpatient databases. We included all live newborn infants born in the hospital through vaginal delivery or caesarean section...
March 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28103822/emergency-obstetric-and-neonatal-care-availability-use-and-quality-a-cross-sectional-study-in-the-city-of-lubumbashi-democratic-republic-of-the-congo-2011
#20
Abel Mukengeshayi Ntambue, Françoise Kaj Malonga, Karen D Cowgill, Michèle Dramaix-Wilmet, Philippe Donnen
BACKGROUND: While emergency obstetric and neonatal care (EmONC) is a proxy indicator for monitoring maternal and perinatal mortalities, in Democratic Republic of the Congo (DRC), data on this care is rarely available. In the city of Lubumbashi, the second largest in DRC with an estimated population of 1.5 million, the availability, use and quality of EmONC are not known. This study aimed to assess these elements in Lubumbashi. METHODS: This cross-sectional survey was conducted in April and May 2011...
January 19, 2017: BMC Pregnancy and Childbirth
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