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Caesarean management

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https://www.readbyqxmd.com/read/28326541/manipulating-the-baby-biome-what-are-the-issues
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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...
March 13, 2017: Journal of Ayurveda and Integrative Medicine
https://www.readbyqxmd.com/read/28302138/congenital-giant-left-atrial-appendage-aneurysm-a-case-report
#7
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
#8
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
#9
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
#10
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
#11
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-placenta-previa-accreta-after-caesarean-delivery-a-systematic-review-and-meta-analysis
#12
REVIEW
Eric Jauniaux, Amar Bhide
BACKGROUND: Women with a history of previous caesarean delivery, presenting with a placenta previa have become the largest group with the highest risk for placenta previa accreta. OBJECTIVE: 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 one or more prior caesarean deliveries. STUDY DESIGN: Data sources: We searched PubMed, Google Scholar, clinicalTrials...
March 4, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28267223/fundal-pressure-during-the-second-stage-of-labour
#13
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
#14
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
https://www.readbyqxmd.com/read/28264832/retrospective-review-of-surgical-availability-and-readiness-in-8-african-countries
#15
D A Spiegel, B Droti, P Relan, S Hobson, M N Cherian, K O'Neill
OBJECTIVES: The purpose of this study was to assess surgical availability and readiness in 8 African countries using the WHO's Service Availability and Readiness Assessment (SARA) tool. SETTING: We analysed data for surgical services, including basic and comprehensive surgery, comprehensive obstetric care, blood transfusion, and infection prevention, obtained from the WHO's SARA surveys in Sierra Leone, Uganda, Mauritania, Benin, Zambia, Burkina Faso, Democratic Republic of Congo and Togo...
March 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28258944/caesarean-delivery-in-a-pregnant-woman-with-epidermolysis-bullosa-anaesthetic-challenges
#16
M Araújo, R Brás, R Frada, L Guedes-Martins, P Lemos
Epidermolysis bullosa is a heterogeneous group of hereditary diseases characterised by extreme fragility of skin and mucosa, with blister and lesion formation spontaneously or in response to trauma. Anaesthetic management of these patients is challenging with respect to positioning, monitoring, use of medical devices and airway management. These challenges are increased when managing labour. We report an elective caesarean delivery in a nulliparous woman with autosomal recessive dystrophic epidermolysis bullosa, managed successfully with spinal anaesthesia...
February 3, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28258943/anaesthesia-for-abnormally-invasive-placenta-a-single-institution-case-series
#17
N J Taylor, R Russell
BACKGROUND: Abnormally invasive placenta describes a spectrum of disorders resulting in pathological placental implantation. It is associated with the potential for severe maternal haemorrhage and poor fetal outcome. Increasing numbers of women are at risk owing to the rising incidence of uterine surgery and increasing maternal age. We report data over a five-year period describing anaesthetic management of cases of abnormally invasive placenta in a UK tertiary-referral maternity unit and assess how management has developed...
January 23, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28257562/planned-early-birth-versus-expectant-management-for-women-with-preterm-prelabour-rupture-of-membranes-prior-to-37-weeks-gestation-for-improving-pregnancy-outcome
#18
REVIEW
Diana M Bond, Philippa Middleton, Kate M Levett, David P van der Ham, Caroline A Crowther, Sarah L Buchanan, Jonathan Morris
BACKGROUND: Current management of preterm prelabour rupture of the membranes (PPROM) involves either initiating birth soon after PPROM or, alternatively, adopting a 'wait and see' approach (expectant management). It is unclear which strategy is most beneficial for mothers and their babies. This is an update of a Cochrane review published in 2010 (Buchanan 2010). OBJECTIVES: To assess the effect of planned early birth versus expectant management for women with preterm prelabour rupture of the membranes between 24 and 37 weeks' gestation for fetal, infant and maternal well being...
March 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28257538/multidisciplinary-approach-to-complicated-pregnancy
#19
Josip Andelo Borovac, Josko Bozic, Tina Ticinovic Kurir, Nikola Zaja, Kresimir Kolic, Vedran Hrboka
A nulliparous pregnant woman in her mid-20s and in the 32nd week of gestation presented to the emergency department with severe headache and vomiting. She had an uneventful medical history; however, the physical examination upon hospital admission revealed a hypertensive emergency, papilledema, and 2+ dipstick proteinuria. Upon establishing the diagnosis of preeclampsia, aggressive therapy with corticosteroids, antihypertensive medication, and seizure prophylaxis was initiated. Hemodynamic stability was achieved within 24 hours and the patient remained in the observation unit located within the gynecology clinic...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28251626/intrapartum-intervention-rates-and-perinatal-outcomes-following-induction-of-labour-compared-to-expectant-management-at-term-from-an-australian-perinatal-centre
#20
Yi Zhao, Christopher Flatley, Sailesh Kumar
BACKGROUND: Induction of labor (IOL) is a common obstetric intervention, yet its impact on intervention rates and perinatal outcomes is conflicting. AIMS: To evaluate the impact of IOL on intrapartum intervention rates and perinatal outcomes in women with singleton pregnancies at term. MATERIAL AND METHODS: This was a retrospective, cross-sectional study of term singleton deliveries at the Mater Mother's Hospital in Brisbane, Australia in 2007-2013...
February 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
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