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Caesarean management

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https://www.readbyqxmd.com/read/28930860/preoperative-infrarenal-abdominal-aorta-balloon-catheter-occlusion-combined-with-bakri-tamponade-reduced-maternal-morbidity-of-placenta-increta-percreta
#1
Chanjuan Zeng, Mengyuan Yang, Yiling Ding, Ling Yu, Wen Deng, Yu Hu, Xiujuan Gong
BACKGROUND: Placenta increta/percreta is an increasingly common and life-threatening obstetric complication. It poses a management challenge to clinicians. The present study aimed to evaluate efficacy and safety of preoperative placement of infrarenal abdominal aorta balloon catheter (IAABC) alone or combined with Bakri tamponade for the management of cases with placenta increta/percreta. METHODS: We retrospectively analyzed all cases with placenta increta/percreta at a tertiary referral teaching hospital in China between the year 2014 and 2017...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28918404/combined-caesarean-with-splenectomy-in-pregnancy-with-portal-hypertension-defining-plausibility
#2
Manjunath Maruti Pol, Latika Uniyal Chawla, Yashwant Singh Rathore, Ritesh Goel
24-year-old woman at 28 weeks gestation was referred from peripheral hospital with diagnosis of pregnancy with portal hypertension. She had received multiple transfusion for pancytopaenia in the past and had undergone endoscopic sclerotherapy for oesophageal varices. Initially, she was admitted in our hospital at 28 weeks gestation for blood transfusion and was evaluated by multispecialty team of doctors. She was advised splenectomy for transfusion-dependent pancytopaenia secondary to hypersplenism in non-cirrhotic portal hypertension...
September 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28904664/-pregnancy-and-delivery-in-patients-with-a-personal-history-of-cesarean-section-in-dakar-epidemiological-clinical-therapeutic-and-prognostic-aspects
#3
Cyr Espérance Koulimaya-Gombet, Abdoul Aziz Diouf, Moussa Diallo, Anna Dia, Codou Sène, Jean Charles Moreau, Alassane Diouf
The aim of our study was to determine hospitalization rate for vaginal birth after cesarean section in Pikine, to evaluate the quality of the management of pregnant women with previous cesarean section and to determine prognostic factors of the outcome of a trial of scar. We conducted a retrospective study based on medical records and operational protocols of patients who underwent vaginal birth after cesarean section over the period 1 January 2010 - 31 December 2011. We analyzed socio-demographic data, pregnancy follow-up, therapeutic modalities and prognosis...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28903630/comparison-of-results-of-bakri-balloon-tamponade-and-caesarean-hysterectomy-in-management-of-placenta-accreta-and-increta-a-retrospective-study
#4
Şehmus Pala, Remzi Atilgan, Melike Başpınar, Ebru Çelik Kavak, Şeyda Yavuzkır, Alparslan Akyol, Burçin Kavak
The aim of this study was to compare the postoperative results of the patients who were treated with Bakri balloon tamponade or hysterectomy for placenta accreta and increta. Patients who were diagnosed with placenta accreta or increta preoperatively and intraoperatively and treated with Bakri balloon tamponade (Group 1) or caesarean hysterectomy (Group 2) were compared in regards to the postoperative results. Among the 36 patients diagnosed with placenta accreta or increta, 19 patients were treated with Bakri balloon tamponade while 17 cases were treated with hysterectomy...
September 14, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28901007/pharmacological-and-mechanical-interventions-for-labour-induction-in-outpatient-settings
#5
REVIEW
Joshua P Vogel, Alfred O Osoti, Anthony J Kelly, Stefania Livio, Jane E Norman, Zarko Alfirevic
BACKGROUND: Induction of labour is carried out for a variety of indications and using a range of methods. For women at low risk of pregnancy complications, some methods of induction of labour or cervical ripening may be suitable for use in outpatient settings. OBJECTIVES: To examine pharmacological and mechanical interventions to induce labour or ripen the cervix in outpatient settings in terms of effectiveness, maternal satisfaction, healthcare costs and, where information is available, safety...
September 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28899735/a-randomised-comparison-of-bolus-phenylephrine-and-ephedrine-for-the-management-of-spinal-hypotension-in-patients-with-severe-preeclampsia-and-fetal-compromise
#6
R A Dyer, A Emmanuel, S C Adams, C J Lombard, M J Arcache, A Vorster, C A Wong, N Higgins, A R Reed, M F James, Y Joolay, S Schulein, D van Dyk
BACKGROUND: Studies in healthy patients undergoing elective caesarean delivery show that, compared with phenylephrine, ephedrine used to treat spinal hypotension is associated with increased fetal acidosis. This has not been investigated prospectively in women with severe preeclampsia. METHODS: Patients with preeclampsia requiring caesarean delivery for a non-reassuring fetal heart tracing were randomised to receive either bolus ephedrine (7.5-15mg) or phenylephrine (50-100µg), to treat spinal hypotension...
August 11, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28876691/a-four-year-across-surgical-discipline-perioperative-and-intraoperative-experience-of-patient-management-in-a-tertiary-academic-hospital-a-review
#7
S Patel, Z M Koto, M Balabyeki
BACKGROUND: There has been a growing trend in the surgical literature to report mortality and morbidity after surgery with preoperative risk adjustment to facilitate meaningful comparisons of surgical outcomes between different surgeons and hospitals. This is a review of the rate of injuries caused by surgeons unintentionally whilst performing procedures in the field of obstetrics and gynaecology, for example, caesarean sections and hysterectomies. METHOD: Data was collected retrospectively over the past four years at Dr George Mukhari Academic Hospital utilising the database and theatre records correlated with patient files...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876580/a-four-year-across-surgical-discipline-perioperative-and-intraoperative-experience-of-patient-management-in-a-tertiary-academic-hospital-a-review-at-dr-george-mukhari-academic-hospital
#8
S Patel, Z M Koto, S Mutambirwa
BACKGROUND: The occurrence of iatrogenic injuries related to obstetric and gynaecological procedures can have a significant impact on morbidity as well as mortality to these patients. In this study we reviewed patients presenting with iatrogenic injuries post caesarean section and hysterectomies in order to classify types of injuries frequently encountered as well as the management of these injuries. METHOD: Over a four year period, the records of all patients presenting with iatrogenic injuries post obstetric and gynaecological procedures were reviewed...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28867860/ayurvedic-management-of-recurrent-abortions-due-to-uterine-fibroid
#9
Shailendra Dadarao Katakdound
Uterine fibroids are present in 30-70% of women of reproductive age. Uterine fibroids distort the uterine cavity. Therefore there is consensus of a negative impact on both the clinical pregnancy and delivery rates.[2] In addition, studies have also reported an increased risk of spontaneous miscarriage with submucosal fibroids. In biomedicine, myomectomy is considered the treatment of choice and Assisted Reproductive Technology is advised to overcome infertility. In Hārita Saṃhitā treatment is given for recurrent abortion (Garbhasrāvī)...
January 2017: Ancient Science of Life
https://www.readbyqxmd.com/read/28858685/laparoscopy-during-pregnancy-case-report-and-key-points-to-improve-laparoscopic-management
#10
REVIEW
Josep Estadella, Pia Español, Beatriz Grandal, Marta Gine, Juan Parra
A 34-year-old woman in her 19th week of gestation was admitted to the Emergency Department of our hospital for acute abdominal pain. The patient was diagnosed with haemoperitoneum. Laparoscopy was performed and revealed acute bleeding from a crumbly superficial uterine vascular network. Haemostasis was achieved and both mother and foetus recovered well after surgery. A caesarean section was performed at 38 weeks, delivering a healthy newborn and revealing that the pregnancy had developed in a rudimentary hemiuterus...
August 18, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28851782/evaluating-maternity-units-a-prospective-cohort-study-of-freestanding-midwife-led-primary-maternity-units-in-new-zealand-clinical-outcomes
#11
Celia P Grigg, Sally K Tracy, Mark Tracy, Rea Daellenbach, Mary Kensington, Amy Monk, Virginia Schmied
OBJECTIVE: To compare maternal and neonatal birth outcomes and morbidities associated with the intention to give birth in a freestanding primary level midwife-led maternity unit (PMU) or tertiary level obstetric-led maternity hospital (TMH) in Canterbury, Aotearoa/New Zealand. DESIGN: Prospective cohort study. PARTICIPANTS: 407 women who intended to give birth in a PMU and 285 women who intended to give birth at the TMH in 2010-2011. All of the women planning a TMH birth were 'low risk', and 29 of the PMU cohort had identified risk factors...
August 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28851399/a-mixed-methods-feasibility-and-external-pilot-study-to-inform-a-large-pragmatic-randomised-controlled-trial-of-the-effects-of-surgical-wound-dressing-strategies-on-surgical-site-infections-bluebelle-phase-b-study-protocol-for-a-randomised-controlled-trial
#12
Barnaby C Reeves, Lazaros Andronis, Jane M Blazeby, Natalie S Blencowe, Melanie Calvert, Joanna Coast, Tim Draycott, Jenny L Donovan, Rachael Gooberman-Hill, Robert J Longman, Laura Magill, Jonathan M Mathers, Thomas D Pinkney, Chris A Rogers, Leila Rooshenas, Andrew Torrance, Nicky J Welton, Mark Woodward, Kate Ashton, Katarzyna D Bera, Gemma L Clayton, Lucy A Culliford, Jo C Dumville, Daisy Elliott, Lucy Ellis, Hannah Gould-Brown, Rhiannon C Macefield, Christel McMullan, Caroline Pope, Dimitrios Siassakos, Sean Strong, Helen Talbot
BACKGROUND: Surgical site infections (SSIs) are common, occurring in up to 25% of > 4 million operations performed in England each year. Previous trials of the effect of wound dressings on the risk of developing a SSI are of poor quality and underpowered. METHODS/DESIGN: This study is a feasibility and pilot trial to examine the feasibility of a full trial that will compare simple dressings, no dressing and tissue-glue as a dressing. It is examining the overall acceptability of trial participation, identifying opportunities for refinement, testing the feasibility of and validating new outcome tools to assess SSI, wound management issues and patients' wound symptom experiences...
August 29, 2017: Trials
https://www.readbyqxmd.com/read/28832100/consensus-on-use-of-insulins-in-gestational-diabetes
#13
Kalyan Kumar Gangopadhyay, J J Mukherjee, R K Sahay
INTRODUCTION: Gestational Diabetes Mellitus (GDM), diabetes diagnosed during pregnancy is associated with maternal (caesarean delivery, hypoglycaemia, hyperbilirubinaemia, shoulder dystocia, pre-term delivery and birth trauma) and fetal (Hyperbilirubinaemia in offspring, Neonatal hypoglycaemia, Macrosomia) complications. Despite, insulin being the standard treatment for GDM cases, there is no existing comprehensive consensus update on use of insulin in Indian patients with GDM. OBJECTIVE: To provide simple and easily implementable guidelines to healthcare physicians on use of insulin in GDM...
March 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28814587/a-case-of-cardiopulmonary-arrest-due-to-spontaneous-coronary-artery-dissection-in-a-pregnant-woman
#14
Emiko Ejima, Yoshinobu Murasato
We present the case of a young pregnant woman with cardiopulmonary arrest due to acute coronary syndrome. Emergent coronary angiography (CAG) and intravascular ultrasound (IVUS) showed extensive coronary artery dissection in the left anterior descending artery, which was treated with primary percutaneous coronary intervention. After managing the heart failure and disseminated intravascular coagulation, a dead fetus was delivered via caesarean section 4 days after admission to the hospital. Follow-up CAG and IVUS at 18 months showed persistent dissection in the non-stented site; hence, another stent was implanted...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28800668/-epidemiology-risk-factors-and-risk-stratification-of-venous-thromboembolism-in-pregnancy-and-the-puerperium
#15
Panagiotis Tsikouras, Georg-Friedrich von Tempelhoff, Werner Rath
Venous thromboembolism (VTE) remains a leading cause of direct maternal deaths in the developed countries. The incidence of VTE has increased significantly during the past two decades. The absolute risk of VTE is estimated 0.6-2.2 per 1000 deliveries. Compared with age-matched non-pregnant women, the daily risk of VTE is increased 7- to 10-fold for antepartum VTE, but it is 15- to 35-fold for postpartum VTE. The incidence of pulmonary embolism (PE) during the first 6 weeks postpartum is nearly 15-fold higher compared to the incidence in pregnancy, and remains significantly increased up to 12 weeks postpartum...
August 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28796431/acute-kidney-injury-in-a-postpartum-woman-with-paroxysmal-nocturnal-hemoglobinuria-a-case-report-and-literature-review
#16
Masatoshi Nishimoto, Masaru Matsui, Hideo Tsushima, Kaori Tanabe, Miho Tagawa, Ken-Ich Samejima, Yasuhiro Akai, Yoshihiko Saito
Paroxysmal nocturnal hemoglobinuria is a rare clonal hematopoietic stem cell disorder characterized by intravascular hemolysis, hemoglobinuria, and inflammatory thrombotic state. Intravascular hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) can lead to acute and chronic renal injury through hemoglobin-mediated toxicity. A 32-year-old pregnant woman with myelodysplastic syndrome was admitted to our hospital with severe preeclampsia. Shortly after an urgent caesarean section, she became obtunded and showed signs of acute kidney injury (AKI) with anuria, severe intravascular hemolysis, and hypermagnesemia...
August 10, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28795885/the-influence-of-amniotic-membrane-extracts-on-cell-growth-depends-on-the-part-of-membrane-and-childbirth-mode-selected-a-proof-of-concept-study
#17
M Litwiniuk, M Radowicka, A Krejner, T Grzela
OBJECTIVE: The amniotic membrane (AM) is a rich source of biologically active factors, important for wound healing and is widely used in various clinical applications, including tissue engineering, reconstructive surgery and wound management. The aim of the present proof-of-concept study was to assess the influence of amniotic membrane extracts on in vitro proliferation of main cells involved in tissue regeneration. The assessment was done in regards to the content of selected biologically active factors in amniotic membrane extracts...
August 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28795682/effects-of-antenatal-diet-and-physical-activity-on-maternal-and-fetal-outcomes-individual-patient-data-meta-analysis-and-health-economic-evaluation
#18
Ewelina Rogozińska, Nadine Marlin, Louise Jackson, Girish Rayanagoudar, Anneloes E Ruifrok, Julie Dodds, Emma Molyneaux, Mireille Nm van Poppel, Lucilla Poston, Christina A Vinter, Fionnuala McAuliffe, Jodie M Dodd, Julie Owens, Ruben Barakat, Maria Perales, Jose G Cecatti, Fernanda Surita, SeonAe Yeo, Annick Bogaerts, Roland Devlieger, Helena Teede, Cheryce Harrison, Lene Haakstad, Garry X Shen, Alexis Shub, Nermeen El Beltagy, Narges Motahari, Janette Khoury, Serena Tonstad, Riitta Luoto, Tarja I Kinnunen, Kym Guelfi, Fabio Facchinetti, Elisabetta Petrella, Suzanne Phelan, Tânia T Scudeller, Kathrin Rauh, Hans Hauner, Kristina Renault, Christianne Jm de Groot, Linda R Sagedal, Ingvild Vistad, Signe Nilssen Stafne, Siv Mørkved, Kjell Å Salvesen, Dorte M Jensen, Márcia Vitolo, Arne Astrup, Nina Rw Geiker, Sally Kerry, Pelham Barton, Tracy Roberts, Richard D Riley, Arri Coomarasamy, Ben Willem Mol, Khalid S Khan, Shakila Thangaratinam
BACKGROUND: Diet- and physical activity-based interventions in pregnancy have the potential to alter maternal and child outcomes. OBJECTIVES: To assess whether or not the effects of diet and lifestyle interventions vary in subgroups of women, based on maternal body mass index (BMI), age, parity, Caucasian ethnicity and underlying medical condition(s), by undertaking an individual patient data (IPD) meta-analysis. We also evaluated the association of gestational weight gain (GWG) with adverse pregnancy outcomes and assessed the cost-effectiveness of the interventions...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28782423/maternal-anaemia-after-delivery-prevalence-and-risk-factors
#19
Carola Medina Garrido, Jaime León, Adriana Romaní Vidal
The purpose of this study was to assess the prevalence of postpartum anaemia and determine the clinical risk factors for this condition to provide a viable alternative to postpartum haemoglobin measurement. In total, 1415 patients at Hospital Universitario del Tajo, Madrid, who underwent postpartum haemoglobin testing were included, and risk factors for having an Hb level <10 g/dl were determined. We found that 29% of the mothers were anaemic, and birth canal lacerations, caesarean delivery, episiotomy and South American origin were identified as the main risk factors for this condition...
August 6, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28760068/a-novel-and-dedicated-multidisciplinary-service-to-manage-breech-presentation-at-term-3-years-of-experience-in-a-tertiary-care-maternity-unit
#20
Patrick Hickland, Phyl Gargan, Jacquie Simpson, Niamh McCabe, Janitha Costa
OBJECTIVE: In order to provide uniform and unbiased multidisciplinary counselling on the options available, including vaginal breech delivery (VBD) and external cephalic version (ECV), the latter of which could then be performed, a weekly Breech Clinic was introduced to a tertiary care maternity unit in Northern Ireland in June 2013, replacing the traditional ECV Clinic introduced in June 2012. METHODS: Retrospective data collection was undertaken using clinic proformas, Northern Ireland Maternity System data and case notes of women who attended the clinics (ECV and Breech) from June 2012 to May 2015...
August 9, 2017: Journal of Maternal-fetal & Neonatal Medicine
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