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https://www.readbyqxmd.com/read/29350128/between-a-rock-a-bye-and-a-hard-place-mood-disorders-during-the-peripartum-period
#1
Michael Thomson, Verinder Sharma
Mood disorders including major depressive disorder and bipolar disorder are common during and after pregnancy. Timely identification and appropriate management of mood episodes is essential to maximize maternal well-being and minimize adverse outcomes. Failure to do so results in maternal suffering and impaired child bonding, and has the potential for devastating outcomes including suicide and infanticide. Women are routinely screened for unipolar depression during or after pregnancy but not for bipolar disorder, in spite of the fact that childbirth is associated with a major risk for onset or exacerbation of bipolar disorder...
December 2017: CNS Spectrums
https://www.readbyqxmd.com/read/29324570/long-term-outcomes-after-overlapping-sphincteroplasty-for-cloacal-like-deformities
#2
Pedro A Maldonado, Donald Mcintire, Marlene M Corton
OBJECTIVE: The aim of this study was to report subjective, long-term outcomes and describe patient demographics, presenting symptoms, perioperative management, and complications after overlapping sphincteroplasty repair for chronic fourth-degree lacerations (cloacal-like deformities). METHODS: In this retrospective study, hospital records were reviewed for women who underwent overlapping anal sphincteroplasty for a cloacal-like deformity of the perineum at a single institution from 1996 to 2013...
January 10, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29313912/complications-in-obstetric-anaesthesia
#3
REVIEW
L Maronge, D Bogod
'Obstetric anaesthesia is a litigious area of medical practice - patient expectations are high, and many of the interventions undertaken by anaesthetists are performed urgently or emergently, frequently out of hours. The complications that occur during obstetric practice are not unique to this area of anaesthesia, but some of the physiological and anatomical changes that take place during pregnancy can affect the frequency with which these happen. In this narrative review, we hope to cover a few of the more common complications in obstetric anaesthesia, as well as some of the more severe, yet less frequently occurring problems...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29310986/multidisciplinary-obstetric-critical-care-delivery-the-concept-of-the-virtual-intensive-care-unit
#4
REVIEW
Michael P Leovic, Hailey N Robbins, Roman S Starikov, Michael R Foley
With an increasing prevalence of chronic medical conditions and the associated potential for decompensation to critical illness among modern day parturients, we present here the concept of the "virtual" intensive care unit. We challenge the traditional association of the word "unit" to extend beyond a fixed physical setting to portray an individualized, predetermined patient care team capable of managing these complex patients in a variety of settings. In this model, obstetric critical care is provided through a multidisciplinary patient care team, with emphasis on early identification of complicated pregnancies, detailed antepartum planning, anticipation of complications, and retrospective review of clinical outcomes aimed at continued quality improvement...
January 5, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29310618/epidemiology-of-unplanned-out-of-hospital-births-attended-by-paramedics
#5
Gayle McLelland, Lisa McKenna, Amee Morgans, Karen Smith
BACKGROUND: Over the previous two decades the incidence and number of unplanned out of hospital births Victoria has increased. As the only out of hospital emergency care providers in Victoria, paramedics would provide care for women having birth emergencies in the community. However, there is a lack of research about the involvement of paramedics provide for these women and their newborns. This research reports the clinical profile of a 1-year sample caseload of births attended by a state-wide ambulance service in Australia...
January 8, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29310480/can-sonographic-measurements-and-changes-in-cervical-length-during-pregnancy-predict-preterm-labour-in-an-asymptomatic-low-risk-population
#6
Omer Weitzner, Tal Biron-Shental, Yair Daykan, Osnat Ezra, Ofer Markovitch
OBJECTIVE: This study measured cervical length (CL) at 14-16 and 21-24 weeks of gestation and assessed whether the difference between measurements is predictive of preterm delivery (PTD). METHOD: This retrospective, cohort study included patients with two consecutive CL measured with transvaginal sonography at 14-16 weeks of gestation (CL1) and 21-24 weeks (CL2). Electronic medical records were reviewed for demographic, medical and obstetric history; complications during the current pregnancy and delivery data...
January 8, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29304810/socioeconomic-status-can-affect-pregnancy-outcomes-and-complications-even-with-a-universal-healthcare-system
#7
Min Kyoung Kim, Seung Mi Lee, Sung-Hee Bae, Hyun Joo Kim, Nam Gu Lim, Seok-Jun Yoon, Jin Yong Lee, Min-Woo Jo
BACKGROUND: Low socioeconomic status can increase the risk of adverse pregnancy outcomes, but it remains unclear whether this negative association is attributed to inadequate prenatal care. Korea has been adopting a universal healthcare system. All Korean citizens must be enrolled National Health Insurance (NHI) or be recipient of Medical Aid (MA). In addition, Korean government launched a financial support system for antenatal care for all pregnant women in 2008. Therefore, in theory, there is no financial barrier to receive prenatal cares regardless of someone's social class...
January 5, 2018: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29300255/peripartum-perineal-hernia-a-case-report-and-a-review-of-the-literature
#8
Katherine N Hines, Gopal H Badlani, Catherine A Matthews
OBJECTIVES: This article reviews the literature for the management and repair of perineal hernias and presents a previously undescribed case of perineal bladder herniation after intrapartum pubic symphysis rupture. METHODS: A review of the literature was completed through the PubMed database using the search terms "bladder," "canal of Nuck," "labial hernia," "gynecology," "hernia," "obstetrics," "perineal hernia," "postpartum," "pubic diastasis," "pubic symphysis," "vaginal delivery," "symphyseal rupture," and "symphyseal separation...
January 3, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29285448/maternal-and-neonatal-outcome-in-mothers-with-gestational-diabetes-mellitus
#9
G Thiruvikrama Prakash, Ashok Kumar Das, Syed Habeebullah, Vishnu Bhat, Suryanarayana Bettadpura Shamanna
Introduction: Gestational diabetes mellitus (GDM) is common and is accompanied with other comorbidities. Challenges to treatment exist at our institute as it serves women with low income. This study assessed the burden of comorbidities and the outcome of GDM. Methods: This was a prospective, observational study of women with gestational diabetes attending the obstetrics department from September 2012 to April 2014. GDM was diagnosed based on the International Association of Diabetes and Pregnancy Study Groups criteria...
November 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29272998/risk-factors-and-outcome-of-patients-with-eclampsia-at-a-tertiary-hospital-in-egypt
#10
Ahmad Mahran, Hashem Fares, Reham Elkhateeb, Mahmoud Ibrahim, Haitham Bahaa, Ahmad Sanad, Alaa Gamal, Mohamed Zeeneldin, Eissa Khalifa, Ahmed Abdelghany
BACKGROUND: Eclampsia is a major cause of maternal and neonatal morbidity and mortality in low and middle income countries. The aim of this study was to assess the risk factors and maternal and perinatal outcome in patients with eclampsia in order to get reliable data that helps in reducing the incidence and improving the outcome in an area with high incidence of eclampsia. METHODS: Retrospective study including 250 patients diagnosed with eclampsia at Minia Maternity University Hopsital, Minia, Egypt in the period between January 2013 and December 2014...
December 22, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29261548/prospective-observational-study-of-intraoperative-anesthetic-events-in-district-hospitals-in-namibia
#11
Andrew J Ottaway, Leonard Kabongo
BACKGROUND: Access to safe surgery and anesthesia care is grossly inadequate in low- and middle-income countries, with a shortage of anesthesia providers contributing to this crisis. In Namibia, medical officers typically receive no >3 months of informal training in anesthesia. This study sought to determine the prevalence, currently unknown, of intraoperative adverse anesthetic events in this setting. Further, we assessed surgical volume, complications, and mortality outcomes at the district hospital level...
December 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29227585/effect-of-ultrafiltration-on-placental-fetal-blood-flow-in-pregnancy-of-woman-undergoing-chronic-hemodialysis
#12
Luiz Paulo José Marques, Paulo Roberto Silva Marinho, Regina Rocco, Caroline de Azevedo Martins, Henrique Novo Costa Pereira, Ana Clara Lopes Barbosa Ferreira
INTRODUCTION: Patient who was undergoing hemodialysis (HD) thrice weekly usually gain 1 to 4 kg of weight in interdialytic period, mainly due to fluid accumulation by ingestion of water. Ultrafiltration (UF) during HD will be need to remove fluid excess to avoid severe medical complications secondary to fluid overload. However, in pregnant woman UF can increase the episodes of intradialytic hypotension which may lead to placental ischemic injury and predispose to fetal distress. There is little information about safe fluid amount withdrawn by UF during pregnancy...
December 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29224680/pregnancy-in-systemic-lupus-erythematosus-and-antiphospholipid-syndrome
#13
REVIEW
Rebecca Fischer-Betz, Christof Specker
Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease with a high prevalence in females of childbearing age. Pregnancy in SLE nowadays has favorable outcomes for the majority of women. However, flares of disease activity, preeclampsia, fetal loss, and preterm birth are well-known risks in such pregnancies. Anti-SS-A(Ro)/SS-B(La) antibodies put fetuses at risk for congenital heart block and neonatal lupus. Several risk factors for adverse pregnancy outcomes have been identified. Women with antiphospholipid antibodies or antiphospholipid syndrome and lupus nephritis represent a group with high risk for obstetric complications...
June 2017: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/29217972/clinical-aspects-and-antenatal-diagnosis-of-invasive-placenta-a-review-of-ten-years-experience-of-a-multi-profile-hospital-in-lithuania
#14
Jelena Volochovič, Diana Ramašauskaitė, Ramunė Šimkevičiūtė
Background: Invasive placenta is a rare obstetrical pathology that is life-threatening to mother and child. It is important to diagnose this pathology as early as possible and to plan further optimal care of patients in order to minimize life-threatening complications. The aim of this study was to analyze the frequency of cases of invasive placenta, the peculiarities of their clinical manifestation in women who gave birth from 2006 to 2015, to evaluate diagnostic and treatment options of this pathology, and to review their changes when the level of services provided by the institution changes...
2017: Acta Medica Lituanica
https://www.readbyqxmd.com/read/29208875/predicting-neonatal-hyperbilirubinemia-using-first-day-serum-bilirubin-level-in-late-preterm-and-term-healthy-newborn
#15
K A Khan, J Alam, N Nahar, S K Dey, M A Mannan, M Shahidullah
Hyperbilirubinemia is a common problem during the neonatal period and is the most common reason for readmission after early hospital discharge of the healthy near term and term infants. This early discharge policy along with limited follow-up facilities in developing countries and inadequate communication between physicians and parents necessitates a prognostic test to predict hyperbilirubinemia in these newborns; for early and effective management and prevention of potential complication before it occurred...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29207784/emergency-peripartum-hysterectomy-a-14-year-experience-at-a-tertiary-care-centre-in-india
#16
S Tahmina, Mary Daniel, Preetha Gunasegaran
Introduction: Emergency Peripartum Hysterectomy (EPH), although relatively infrequent in present day obstetrics, is a life-saving procedure in the event of a massive postpartum haemorrhage. Aim: To assess incidence, risk factors, indications and complications of peripartum hysterectomies at a tertiary care teaching hospital in India. Materials and Methods: A retrospective study was conducted at 650-bedded tertiary care medical teaching hospital in Southern India...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29202962/introduction-from-pathogenesis-to-therapy-deep-endometriosis-remains-a-source-of-controversy
#17
Jacques Donnez
Deep endometriosis remains a source of controversy. A number of theories may explain its pathogenesis and many arguments support the hypothesis that genetic or epigenetic changes are a prerequisite for development of lesions into deep endometriosis. Deep endometriosis is frequently responsible for pelvic pain, dysmenorrhea, and/or deep dyspareunia, but can also cause obstetrical complications. Diagnosis may be improved by high-quality imaging. Therapeutic approaches are a source of contention as well. In this issue's Views and Reviews, medical and surgical strategies are discussed, and it is emphasized that treatment should be designed according to a patient's symptoms and individual needs...
December 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29195637/professional-confidence-among-swedish-final-year-midwifery-students-a-cross-sectional-study
#18
Lena Bäck, Bharati Sharma, Annika Karlström, Katarina Tunon, Ingegerd Hildingsson
OBJECTIVE: Previous international studies have shown that midwifery students do not feel confident in many areas where they are supposed to practice independently. The knowledge about Swedish midwifery students' confidence is fairly under investigated. The purpose of the present study was to explore final years' midwifery students' professional confidence in basic midwifery skills according to ICM competencies and associated factors. METHODS: A cross-sectional survey where all midwifery programs in Sweden were invited to participate...
December 2017: Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives
https://www.readbyqxmd.com/read/29179955/the-utility-of-bedside-simulation-for-training-in-critical-care-obstetrics
#19
REVIEW
Jean-Ju Sheen, Colleen Lee, Dena Goffman
Over the last 2 decades, the maternal mortality ratio in the United States has doubled from 7.4/100,000 live births in 1986 to 14.5/100,000 today. Despite great advances in health care, increasing rates of maternal morbidity and mortality in the United States have prompted calls to action to reverse this disturbing trend. Assisted reproductive technology has allowed women to delay childbearing to more advanced ages, resulting in a greater number of pregnancies complicated by one or more of the diseases associated with aging, such as cardiovascular disease, cancer, type 2 diabetes, and hypertension...
November 24, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/29166810/anesthetic-management-of-amniotic-fluid-embolism-a-multi-center-retrospective-cohort-study
#20
Shiri Skolnik, Alexander Ioscovich, Leonid A Eidelman, Atara Davis, Anat Shmueli, Amir Aviram, Sharon Orbach-Zinger
INTRODUCTION: Amniotic fluid embolism (AFE) is a rare and potentially lethal obstetric complication, commonly occurring during labor, delivery, or immediately postpartum. There is a paucity of data regarding incidence, risk factors, and clinical management. Our primary objective in this study was to evaluate clinical presentation of AFE and delineate anesthesia management of these cases. METHODS: This 10 years retrospective multi-center cohort study was performed in five tertiary university-affiliated medical centers, between the years 2005 and 2015...
November 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
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