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Caesarean management

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https://www.readbyqxmd.com/read/28428245/thematic-analysis-of-us-stakeholder-views-on-the-influence-of-labour-nurses-care-on-birth-outcomes
#1
Audrey Lyndon, Kathleen Rice Simpson, Joanne Spetz
BACKGROUND: Childbirth is a leading reason for hospital admission in the USA, and most labour care is provided by registered nurses under physician or midwife supervision in a nurse-managed care model. Yet, there are no validated nurse-sensitive quality measures for maternity care. We aimed to engage primary stakeholders of maternity care in identifying the aspects of nursing care during labour and birth they believe influence birth outcomes, and how these aspects of care might be measured...
April 20, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28407220/patient-controlled-analgesia-with-remifentanil-versus-alternative-parenteral-methods-for-pain-management-in-labour
#2
REVIEW
Stephanie Weibel, Yvonne Jelting, Arash Afshari, Nathan Leon Pace, Leopold Hj Eberhart, Johanna Jokinen, Thorsten Artmann, Peter Kranke
BACKGROUND: Multiple analgesic strategies for pain relief during labour are available. Recently remifentanil, a short-acting opioid, has recently been used as an alternative analgesic due to its unique pharmacological properties. OBJECTIVES: To systematically assess the effectiveness of remifentanil intravenous patient-controlled analgesia (PCA) for labour pain, along with any potential harms to the mother and the newborn. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (9 December 2015), ClinicalTrials...
April 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28403929/-conservative-placenta-percreta-management-using-uterine-arterial-embolization-procedure-a-series-of-12-cases
#3
C Hennetier, M Daudruy Brasseur, S Patrier, E Clavier, M L Thibault, E Verspyck
We report a retrospective series of 12 placentas percreta with bladder invasion and for which an expected initially multidisciplinary conservative surgical treatment associated with uterine artery embolization was programmed. Conservative surgical treatment was only performed in 7 women. Radical surgical treatment was necessary during the caesarean section and complicated by massive hemorrhage in three women and secondary in two other women for infectious diseases. Radical surgical treatment was associated with partial cystectomy complicated with urinary disorder sequelae in three women...
March 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28401537/effect-of-prophylactic-placement-of-internal-iliac-artery-balloon-catheters-on-outcomes-of-women-with-placenta-accreta-an-impact-study
#4
S Feng, Z Liao, H Huang
We performed an impact study on the introduction of routine placement of internal iliac artery balloon catheters for the management of haemorrhage during caesarean section in women with placenta accreta. We identified 11 women, with prenatally diagnosed placenta accreta/increta/percreta before this change in practice, who acted as controls, and 30 women who had iliac artery balloons placed. The balloons were inflated in 27 cases. The median (IQR [range]) intra-operative blood loss was 1100 (800-2600 [500-6000]) ml in controls, compared with 1000 (600-2513 [400-15000]) ml in women with iliac artery balloons (p = 0...
April 12, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28397667/-uterine-artery-pseudoaneurysm-is-a-rare-delayed-complication-after-caesarean-section
#5
Julie Lyngsø, Janne Kainsbak, Marianne Østergård
Uterine artery pseudoaneurysm is a rare complication after caesarean section and may be the cause of acute and potentially life-threatening secondary post-partum haemorrhage. In this case report, we present the clinical presentation and management of a case of uterine artery pseudoaneurysm manifesting as delayed post-partum bleeding after caesarean section. The case report emphasizes the importance of performing Doppler-flow when diagnosing the existence of a uterine artery pseudoaneurysm ultrasonically.
January 30, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28338231/caesarean-risk-in-obese-women-at-term-a%C3%A2-retrospective-cohort-analysis
#6
Rachael Nugent, Caroline de Costa, Venkat Vangaveti
BACKGROUND: Obesity in pregnancy is a growing health problem conferring higher risk to both the woman and her infant. Internationally, peak bodies offer little guidance regarding the method and timing of delivery in these patients. Our hypothesis is that induction of labour (IOL) at term will not increase the caesarean section (CS) rate when compared to expectant management. AIMS: To compare perinatal outcomes between IOL and expectant management in obese women at term...
March 24, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28326541/manipulating-the-baby-biome-what-are-the-issues
#7
Lai-Yang Lee, Suzanne M Garland, Michelle L Giles, Andrew J Daley
Establishing a baby biome through the controversial practice of 'vaginal seeding' has generated interest among the general public and healthcare providers alike. We discuss the potential risks of this practice and offer a harm minimisation approach to managing women requesting vaginal microbiome transfer after delivery by caesarean section.
March 22, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28321251/analgesic-effects-of-preincision-ketamine-on-postspinal-caesarean-delivery-in-uganda-s-tertiary-hospital-a-randomized-clinical-trial
#8
Richard Mwase, Tonny Stone Luggya, John Mark Kasumba, Humphrey Wanzira, Andrew Kintu, Joesph V B Tindimwebwa, Daniel Obua
Background. Good postoperative analgesic management improves maternal satisfaction and care of the neonate. Postoperative pain management is a challenge in Mulago Hospital, yet ketamine is accessible and has proven benefit. We determined ketamine's postoperative analgesic effects. Materials and Methods. We did an RCT among consenting parturients that were randomized to receive either intravenous ketamine (0.25 mg/kg) or placebo after spinal anesthetic. Pain was assessed every 30 mins up to 24 hours postoperatively using the numerical rating scale...
2017: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/28320312/the-effect-of-an-electronic-cognitive-aid-on-the-management-of-st-elevation-myocardial-infarction-during-caesarean-section-a-prospective-randomised-simulation-study
#9
Michael St Pierre, Bjoern Luetcke, Dieter Strembski, Christopher Schmitt, Georg Breuer
BACKGROUND: Cognitive aids have come to be viewed as promising tools in the management of perioperative critical events. The majority of published simulation studies have focussed on perioperative crises that are characterised by time pressure, rare occurrence, or complex management steps (e.g., cardiac arrest emergencies, management of the difficult airway). At present, there is limited information on the usefulness of cognitive aids in critical situations with moderate time pressure and complexity...
March 20, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28317421/a-prospective-cohort-study-evaluating-the-cost-effectiveness-of-carbetocin-for-prevention-of-postpartum-haemorrhage-in-caesarean-sections
#10
Yasmin Luni, Aditya Borakati, Arti Matah, Katie Skeats, Padma Eedarapalli
Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Prophylaxis with oxytocic medication is recommended by the WHO to prevent its occurrence. Carbetocin is a newer oxytocic, with potential to lower PPH rates, reduce the total use of oxytocic drugs and lead to financial savings. Meta-analyses have confirmed a reduction in the use of additional oxytocic medication with the use of carbetocin compared to oxytocin. However, there are few studies evaluating the costs of carbetocin prophylaxis...
March 20, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28317045/fibrolamellar-variant-of-hepatocellular-carcinoma-presenting-during-pregnancy-management-dilemmas
#11
Nagalapuram Vishnu, Aditya V Kulkarni, Sreenivasan Vidhyalakshmi, Swaminathan Sambandam, Prerna Garg, Venkatakrishnan LeelaKrishnan, Krishnaveni Janarthan, Gursharan Singh, Maninder Kaur, T V Chitra, Biku Joseph John
The Fibrolamellar variant of Hepatocellular Carcinoma (FLHCC) is a rare form of liver cancer that presents in the 3(rd) decade of life, is rarely associated with cirrhosis or chronic Hepatitis B/C virus infection, and usually presents with normal serum alpha-fetoprotein (AFP) levels. FLHCC presenting during pregnancy is extremely rare, with only 4 cases reported. We present a case of FLHCC in pregnancy and discuss the dilemmas in management. A 26 year-old primigravida, 26 weeks of gestation presented with a month's history of obstructive jaundice secondary...
February 2017: Ann Hepatobiliary Pancreat Surg
https://www.readbyqxmd.com/read/28302414/effect-of-panchakarma-and-ayurvedic-treatment-in-postpartum-rheumatoid-arthritis-amavata-a-case-study
#12
Shailesh V Deshpande, Vaishali S Deshpande, Shraddha S Potdar
Dream of a mother is to get involved actively in upbringing of child, which is impeded if she is suffering from painful condition like rheumatoid arthritis (RA) in postpartum phase. It causes physical incapacity and psychological trauma as well. Present case is a patient who developed RA one month after full term delivery by caesarean section. In view of symptoms, she was diagnosed as case of amavata. She received Ayurvedic treatment - Simhanada guggulu, Pratapalankeshwara rasa, Dashamoola katutraya kashaya and combination of Swarnabhupati rasa, Tapyadi loha, Mahavatavidhvansa, Chopachini (Smilax china), Shunthi (Zinziber officinale) and Guduchi (Tinospora cordifolia) for four months and course of kala basti (medicated enema) along with application of medicated oil (Vishagharbha taila abhyanga) and sudation (bashpa sweda) for ten days...
January 2017: Journal of Ayurveda and Integrative Medicine
https://www.readbyqxmd.com/read/28302138/congenital-giant-left-atrial-appendage-aneurysm-a-case-report
#13
Yan Chen, Yun Mou, Li-Jun Jiang, Shen-Jiang Hu
BACKGROUND: Congenital left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly with potentially serious complications, including life-threatening systemic thromboembolism, atrial tachyarrhythmia, and cardiac dysfunction. Currently, early surgical intervention is generally recommended to prevent these complications. CASE PRESENTATION: We present a case of congenital giant LAAA in a female patient who successfully completed pregnancy and underwent caesarean section with no obvious complications...
March 16, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28294506/changes-in-management-policies-for-extremely-preterm-births-and-neonatal-outcomes-from-2003-to-2012-two-population-based-studies-in-10-european-regions
#14
M Bonet, M Cuttini, A Piedvache, E M Boyle, P H Jarreau, L Kollée, R F Maier, D W A Milligan, P Van Reempts, T Weber, H Barros, J Gadzinowki, E S Draper, J Zeitlin
OBJECTIVE: to investigate changes in maternity and neonatal unit policies towards extremely preterm infants (EPTI) between 2003 and 2012 and concurrent trends in their mortality and morbidity in ten European regions. DESIGN: population-based cohort studies in 2003 (MOSAIC study) and 2011/12 (EPICE study) and questionnaires from hospitals. SETTING: 70 hospitals in ten European regions. POPULATION: infants born at <27 weeks of gestational age (GA) in hospitals participating in both the MOSAIC and EPICE studies (1240 in 2003, 1293 in 2011/2012)...
March 14, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28285555/factors-affecting-the-rates-of-caesarean-sections-in-cases-with-premature-rupture-of-membranes-prom-at-term
#15
Muberra Namli Kalem, Aydın Köşüş, Zeynep Kamalak, Nermin Köşüş, Ziya Kalem
The aim of this retrospective study was to investigate the factors affecting the rates of caesarean section in cases with premature rupture of membranes (PROM) in term pregnancies. Eighty-two term PROM patients who presented to Turgut Ozal University and Erzurum Nene Hatun Hospitals between 2012 and 2014 were included. The effects of demographics, nulliparity, active-latent phase durations, presence of meconium and chorioamnionitis, requirement of oxytocin and cervical dilation at the initial examination on C/S rates were assessed...
March 13, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28281576/incidence-and-outcomes-of-uterine-rupture-among-women-with-prior-caesarean-section-who-multicountry-survey-on-maternal-and-newborn-health
#16
Kenichiro Motomura, Togoobaatar Ganchimeg, Chie Nagata, Erika Ota, Joshua P Vogel, Ana Pilar Betran, Maria Regina Torloni, Kapila Jayaratne, Seung Chik Jwa, Suneeta Mittal, Zenaida Dy Recidoro, Kenji Matsumoto, Mikiya Fujieda, Idi Nafiou, Khalid Yunis, Zahida Qureshi, Joao Paulo Souza, Rintaro Mori
Caesarean section (CS) is increasing globally, and women with prior CS are at higher risk of uterine rupture in subsequent pregnancies. However, little is known about the incidence, risk factors, and outcomes of uterine rupture in women with prior CS, especially in developing countries. To investigate this, we conducted a secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health, which included data on delivery from 359 facilities in 29 countries. The incidence of uterine rupture among women with at least one prior CS was 0...
March 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28270448/management-of-pregnancy-and-obstetric-complications-in-prehospital-trauma-care-prehospital-resuscitative-hysterotomy-perimortem-caesarean-section
#17
EDITORIAL
Emir Battaloglu, Keith Porter
The need for prehospital resuscitative hysterotomy/perimortem caesarean section is rare. The procedures can be daunting and clinically challenging for practitioners. Maternal death can be averted by swift and decisive action. This guideline serves to inform prehospital practitioners about conducting maternal resuscitation following cardiac arrest, provides an evidence-based framework to support decision making and highlights areas for improvement in prehospital care.
March 7, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28268196/prenatal-ultrasound-diagnosis-and-outcome-of%C3%A2-placenta-previa-accreta-after-cesarean-delivery-a-systematic-review-and-meta-analysis
#18
REVIEW
Eric Jauniaux, Amar Bhide
BACKGROUND: Women with a history of previous cesarean delivery, presenting with a placenta previa, have become the largest group with the highest risk for placenta previa accreta. OBJECTIVE: The objective of the study was to evaluate the accuracy of ultrasound imaging in the prenatal diagnosis of placenta accreta and the impact of the depth of villous invasion on management in women presenting with placenta previa or low-lying placenta and with 1 or more prior cesarean deliveries...
March 6, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28267223/fundal-pressure-during-the-second-stage-of-labour
#19
REVIEW
G Justus Hofmeyr, Joshua P Vogel, Anna Cuthbert, Mandisa Singata
BACKGROUND: Fundal pressure during the second stage of labour (also known as the 'Kristeller manoeuvre') involves application of manual pressure to the uppermost part of the uterus directed towards the birth canal, in an attempt to assist spontaneous vaginal birth and avoid prolonged second stage or the need for operative birth. Fundal pressure has also been applied using an inflatable belt. Fundal pressure is widely used, however methods of its use vary widely. Despite strongly held opinions in favour of and against the use of fundal pressure, there is limited evidence regarding its maternal and neonatal benefits and harms...
March 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28266776/gestational-age-at-diagnosis-of-early-onset-fetal-growth-restriction-and-impact-on-management-and-survival-a-population-based-cohort-study
#20
I Monier, P-Y Ancel, A Ego, I Guellec, P-H Jarreau, M Kaminski, F Goffinet, J Zeitlin
OBJECTIVE: To investigate the impact of gestational age (GA) at diagnosis of fetal growth restriction (FGR) on obstetric management and rates of live birth and survival for very preterm infants with early-onset FGR. DESIGN: Population-based cohort study. SETTING: All maternity units in 25 French regions in 2011. POPULATION: Fetuses diagnosed with FGR before 28 weeks of gestation among singleton births between 22 and 31 weeks of gestation without severe congenital anomalies...
March 7, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
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