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Caesarean management

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https://www.readbyqxmd.com/read/29137011/a-prospective-observational-study-evaluating-the-efficacy-of-prophylactic-internal-iliac-artery-balloon-catheterization-in-the-management-of-placenta-previa-accreta-a-strobe-compliant-article
#1
Yao Fan, Xun Gong, Nan Wang, Ketao Mu, Ling Feng, Fuyuan Qiao, Suhua Chen, Wanjiang Zeng, Haiyi Liu, Yuanyuan Wu, Qiong Zhou, Yuan Tian, Qiang Li, Meitao Yang, Fanfan Li, Mengzhou He, Rajluxmee Beejadhursing, Dongrui Deng
We studied the efficacy of prophylactic internal iliac artery balloon catheterization for managing severe hemorrhage caused by pernicious placenta previa.This prospective observational study was conducted in Tongji Hospital, Wuhan, China. One hundred sixty-three women past 32-week's gestation with placenta previa-accreta were recruited and managed. Women in the balloon group accepted prophylactic internal iliac artery balloon catheterization before scheduled caesarean delivery and controls had a conventional caesarean delivery...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136007/perinatal-mortality-associated-with-induction-of-labour-versus-expectant-management-in-nulliparous-women-aged-35-years-or-over-an-english-national-cohort-study
#2
Hannah E Knight, David A Cromwell, Ipek Gurol-Urganci, Katie Harron, Jan H van der Meulen, Gordon C S Smith
BACKGROUND: A recent randomised controlled trial (RCT) demonstrated that induction of labour at 39 weeks of gestational age has no short-term adverse effect on the mother or infant among nulliparous women aged ≥35 years. However, the trial was underpowered to address the effect of routine induction of labour on the risk of perinatal death. We aimed to determine the association between induction of labour at ≥39 weeks and the risk of perinatal mortality among nulliparous women aged ≥35 years...
November 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29127916/laparoscopic-management-of-a-small-bowel-obstruction-secondary-to-elipse-intragastric-balloon-migration-a-case-report
#3
Saud Al-Subaie, Hamad Al-Barjas, Salman Al-Sabah, Saud Al-Helal, Ashraf Alfakharani, Salah Termos
INTRODUCTION: The Elipse™ intragastric balloon (IGB) for weight loss is a swallowable capsule that is filled with 550mL of fluid and resides in the stomach for four months before being excreted from the gastrointestinal tract. Although initial data showed that use of this device is safe and free from serious complications, we report for the first time the successful management of an Elipse™ IGB-related adverse event. PRESENTATION OF CASE: A 41-year-old woman presented to our emergency department following two days of abdominal pain, vomiting, and constipation...
November 8, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29122557/-maternal-deaths-due-to-anesthesia-complications-results-from-the-french-confidential-enquiry-into-maternal-deaths-2010-2012
#4
D Chassard
Over the period 2010-2012, maternal mortality linked to anesthesia accounted for 2% of maternal deaths, with no significant change since 2007-2009. Of the 7 maternal deaths analyzed by the expert committee, anesthetic complications were in 5 cases the main cause of death: 4 attributed to direct causes related to anesthetic procedures during childbirth and 1 to indirect cause in connection with an ENT complication during pregnancy. The anesthetic causes of maternal mortality were for the 2010-2012 period: cardiac arrest under spinal anesthesia during caesarean section, local anesthetic intoxication with unsuccessful resuscitation after cardiac arrest without intralipid administration, acute respiratory distress syndrome in the postpartum period after pulmonary aspiration during caesarean section, cardiac arrest during caesarean section under general anesthesia in a context of non-Hodgkin lymphoma with mediastinal syndrome, unsuccessful endotracheal intubation in a context of cellulitis of the oral cavity floor...
November 6, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29116934/expectant-management-of-caesarean-scar-ectopic-pregnancy-a-systematic-review
#5
REVIEW
Pradeep Jayaram, Gbemisola Okunoye, Abdullah Awad Al Ibrahim, Rauf Ghani, Karim Kalache
AIM: The purpose of this review is to systematically review all the reported cases and case series of caesarean scar pregnancy (CSP) managed expectantly without any intervention in order to understand the outcomes of pregnancy which will guide clinicians and patients in making treatment choices. METHODS: An electronic search on PubMed, EMBASE and Cochrane databases and a manual search from references of the articles were performed. Studies were selected based on inclusion and exclusion criteria...
November 8, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29108473/caesarean-section-wound-infections-and-antibiotic-use-a-retrospective-case-series-in-a-tertiary-referral-hospital-in-the-gambia
#6
Alex Aulakh, Patrick Idoko, Suzanne T Anderson, Wendy Graham
Ours is the first published study to examine post-Caesarean section (CS) wound infections in The Gambia. We explored risk factors and clinical management retrospectively at a large referral hospital over a 12-month period. A total of 777 cases were identified and records for 682 (88%) were retrieved. The CS rate was 21.8% and the wound infection rate 13.2%. Risk factors included: length of labour; decision-to-incision time and stillbirth. Only 7.4% of women received preoperative antibiotic prophylaxis, but all women received multiple-dose, postoperative antibiotics...
January 1, 2017: Tropical Doctor
https://www.readbyqxmd.com/read/29107784/incidence-of-postpartum-anaemia-and-risk-factors-associated-with-vaginal-birth
#7
Ana Rubio-Álvarez, Milagros Molina-Alarcón, Antonio Hernández-Martínez
BACKGROUND: Postpartum anaemia is a frequent and potentially preventable complication that has serious repercussions on health and maternal well-being. AIM: Determine the incidence and perinatal risk factors associated with postpartum anaemia in women who gave birth vaginally. METHODS: An observational and analytical retrospective cohort study conducted at the Mancha-Centro Hospital during the 2010-2014 period. Data were collected from 2990 women who gave birth vaginally...
October 26, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/29096564/management-of-peripartum-hysterectomies-performed-on-patients-with-placenta-percreta-in-a-tertiary-central-hospital
#8
Sibel Sak, Mert Barut, Adnan Incebiyik, Hacer Uyanikoglu, Nese Hilali, Muhammet Sak
OBJECTIVE: The main objective of this study is to analyse the circumstances and management of peripartum hysterectomies performed on patients with placenta percreta. METHODS: This study included 37 patients who were diagnosed with placenta percreta, a condition in which the placenta invades the uterine wall, and who therefore underwent a peripartum hysterectomy. Their demographic characteristics, history of past caesareans, uterine surgery and curettage, duration of hospitalization, admission to an intensive care unit, neonatal outcomes, skin and uterus incision type, hypogastric artery ligation (HAL), complications, quantities of transfused ES (erythrocyte suspensions), and FFP (fresh frozen plasma), maternal morbidity and mortality and postoperative pathology results were retrospectively reviewed...
November 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29095319/malignant-pheochromocytoma-with-multiple-vertebral-metastases-causing-acute-incomplete-paralysis-during-pregnancy-literature-review-with-one-case-report
#9
REVIEW
Shuzhong Liu, An Song, Xi Zhou, Xiangyi Kong, William A Li, Yipeng Wang, Yong Liu
RATIONALE: We present a rare case of malignant pheochromocytoma with thoracic metastases during pregnancy that presented with symptoms of myelopathy and was treated with circumferential decompression, stabilization, and radiation. The management of this unique case is not well documented. The clinical manifestations, imaging results, pathological characteristics, treatment and prognosis of the case were analyzed. PATIENT CONCERNS: A 26-year-old pregnant woman with a history of paroxysmal hypertension during the second trimester presented with lower extremity weakness, numbness, urinary incontinence, and back pain...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29095305/umbilical-cord-mesenchyme-stem-cell-local-intramuscular-injection-for-treatment-of-uterine-niche-protocol-for-a-prospective-randomized-double-blinded-placebo-controlled-clinical-trial
#10
RANDOMIZED CONTROLLED TRIAL
Dazhi Fan, Shuzhen Wu, Shaoxin Ye, Wen Wang, Xiaoling Guo, Zhengping Liu
BACKGROUND: Uterine niche is defined as a triangular anechoic structure at the site of the scar or a gap in the myometrium at the site of a previous caesarean section. The main clinical manifestations are postmenstrual spotting and intrauterine infection, which may seriously affect the daily life of nonpregnant women. Trials have shown an excellent safety and efficacy for the potential of mesenchymal stem cells (MSCs) as a therapeutic option for scar reconstruction. Therefore, this study is designed to investigate the safety and efficacy of using MSCs in the treatment for the uterine niche...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29091965/emergency-obstetric-and-newborn-care-signal-functions-in-public-and-private-facilities-in-bangladesh
#11
Lumbini Roy, Taposh Kumar Biswas, Mahbub Elahi Chowdhury
BACKGROUND: Signal functions for emergency obstetric and newborn care (EmONC) are the major interventions for averting maternal and neonatal mortalities. Readiness of the facilities is essential to provide all the basic and comprehensive signal functions for EmONC to ensure emergency services from the designated facilities. The study assessed population coverage and availability of EmONC services in public and private facilities in Bangladesh. METHODS: An assessment was conducted in all the public and private facilities providing obstetric care in to in-patients 24 districts...
2017: PloS One
https://www.readbyqxmd.com/read/29090732/management-of-hypotension-with-vasopressors-at-caesarean-section-under-spinal-anaesthesia-have-we-found-the-holy-grail-of-obstetric-anaesthesia
#12
EDITORIAL
J P Campbell, G M Stocks
No abstract text is available yet for this article.
November 1, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29073687/-interdisciplinary-simulation-of-emergency-caesarean-section-to-improve-subjective-competence
#13
Markus Flentje, Martin Schott, Anna-Lena Woltemate, Jan-Peter Jantzen
The emergency caesaran section is a gynecological emergency situation which is potentially life-threatening for mother and child. In the management of these time-critical situations human factors as well as the competence of the crisis resource management team have been shown to be important factors for success. The concept "simulation" has not been validated as a training tool for professional competence of multidisciplinary teams in the delivery suite. The aim of this study was, to assess the competence gain by subjective evaluation of the team members after taking part in an emergency caesarian section training which is integrable into the daily clinic setting...
October 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/29070618/successful-obstetric-and-anaesthetic-management-of-a-pregnant-woman-with-achondroplasia
#14
Rauf Melekoglu, Ebru Celik, Sevil Eraslan
Achondroplasia is the most prevalent form of dwarfism, and there is little evidence about the optimal management of pregnant women with achondroplasia. We presented a 25-year-old primigravid woman with achondroplasia who was followed up during the pregnancy period and performed elective caesarean section with combined spinal-epidural anaesthesia at the 38th week of gestation. Frequent obstetric follow-up visits and invasive prenatal diagnostic tests should be offered during the antenatal period due to the increased risk for obstetric complications, such as premature delivery and fetal anomalies...
October 25, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29066656/successful-management-of-caesarean-scar-live-ectopic-pregnancies-with-local-kcl-and-systemic-methotrexate
#15
Monica Gupta, Alka Kriplani, Reeta Mahey, Isha Kriplani
Two cases of live caesarean scar ectopic pregnancies are presented. Beta human chorionic gonadotropin (b-hCG) values in both patients at presentation were 50 099 mIU and 297 969 mIU, respectively. Both were managed with intrasac potassium chloride injection to induce fetal demise and multiple dose methotrexate therapy. The time for b-hCG to become negative in both patients was 91 days and 119 days, respectively. Successful management of live caesarean scar pregnancies even with very high b-hCG is possible with minimally invasive approach...
October 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29062547/myasthaenia-gravis-clinical-management-issues-before-during-and-after-pregnancy
#16
REVIEW
Ali Hassan, Zakia M Yasawy
Myasthaenia gravis (MG) is an autoimmune neuromuscular disorder which is twice as common among women, often presenting in the second and third decades of life. Typically, the first trimester of pregnancy and first month postpartum are considered high-risk periods for MG exacerbations. During pregnancy, treatment for MG is usually individualised, thus improving its management. Plasma exchange and immunoglobulin therapies can be safely used to treat severe manifestations of the disease or myasthaenic crises. However, thymectomies are not recommended because of the delayed beneficial effects and possible risks associated with the surgery...
August 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29045765/oral-anti-diabetic-agents-for-women-with-established-diabetes-impaired-glucose-tolerance-or-previous-gestational-diabetes-planning-pregnancy-or-pregnant-women-with-pre-existing-diabetes
#17
REVIEW
Joanna Tieu, Suzette Coat, William Hague, Philippa Middleton, Emily Shepherd
BACKGROUND: While most guidance recommends the use of insulin in women whose pregnancies are affected by pre-existing diabetes, oral anti-diabetic agents may be more acceptable to women. The effects of these oral anti-diabetic agents on maternal and infant health outcomes need to be established in pregnant women with pre-existing diabetes or impaired glucose tolerance, as well as in women with previous gestational diabetes mellitus preconceptionally or during a subsequent pregnancy. This review is an update of a review that was first published in 2010...
October 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29041013/maternal-aneurysmal-subarachnoid-hemorrhage-during-pregnancy-as-an-interdisciplinary-task
#18
Friederike Sophie Fritzsche, Jan Regelsberger, Nils Ole Schmidt, Jakob Müller, Jan Hendrik Buhk, Anke Diemert, Manfred Westphal, Tobias Martens
Maternal aneurysmal subarachnoid hemorrhage (aSAH) during pregnancy presents a challenge regarding treatment and management. Due to the limited number of cases there are no treatment guidelines available. Thus, treatment is usually done on a case-by-case basis. Here we report on four cases of aSAH during pregnancy, describing the different management strategies and suggesting a possible treatment algorithm. Patients treated between 2003 and 2013 in our center were included in this retrospective study. Clinical data focused on time management concerning gestation week (GW), microsurgical or endovascular treatment, and outcome of the patients and the fetuses...
October 17, 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/29037170/multidisciplinary-consensus-on-screening-for-diagnosis-and-management-of-fetal-growth-restriction-in-the-netherlands
#19
Viki Verfaille, Ank de Jonge, Lidwine Mokkink, Myrte Westerneng, Henriëtte van der Horst, Petra Jellema, Arie Franx
BACKGROUND: Screening for, diagnosis and management of intrauterine growth restriction (IUGR) is often performed in multidisciplinary collaboration. However, variation in screening methods, diagnosis and management of IUGR may lead to confusion. In the Netherlands two monodisciplinary guidelines on IUGR do not fully align. To facilitate effective collaboration between different professionals in perinatal care, we undertook a Delphi study with uniform recommendations as our primary result, focusing on issues that are not aligned or for which specifications are lacking in the current guidelines...
October 16, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29025452/management-of-failed-spinal-anaesthesia-for-caesarean-section
#20
Gavin Wyndham Jones, Raphael Anthony Samuel, Bruce McClure Biccard
BACKGROUND: Failed spinal anaesthesia for caesarean section (CS) may be partial or complete and the subsequent discomfort is the most commonly cited cause of litigation in obstetric anaesthesia. OBJECTIVES: To determine if there is a standardised approach to: (i) testing the level of block of spinal anaesthesia; and (ii) the management of failed spinal anaesthesia for CS. METHODS: A structured questionnaire to ascertain the current practice of testing the level of block and management of three different scenarios of failed spinal anaesthesia was distributed to 51 government hospitals in KwaZulu-Natal, South Africa (SA)...
June 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
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