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obstetrics medical complications

Lourdes A Blanco Esquivel, Jorge Macia Urbina, Hugo Mendieta Zerón
BACKGROUND: Severe obstetric morbidity constitutes a serious problem worldwide; however, an effective obstetrical prognosis scale is still missing. OBJECTIVE: To propose a modified Sequential Organ Failure Assessment Score (SOFA) score based on time before reaching specialized medical attention. METHOD: This was an ambispective, descriptive study, including all women treated at the Obstetrical Intensive Care Unit (OICU) of the "Mónica Pretelini Sáenz" Maternal-Perinatal Hospital (HMPMPS), Toluca, Mexico, from June 2009 to June 2013...
September 2016: Ghana Medical Journal
Hani Ibrahim Taman, Ahmed Mohamed Farid, Waleed Mohamed Abdelghaffar
BACKGROUND: Lumbar puncture is a difficult medical skill and is used for administering subarachnoid anesthetic medications. Estimation of skin to subarachnoid space depth (SSD) helps to reduce post spinal anesthetic complications. AIMS: To measure the SDD in overall Egyptian population and to find a formula for predicting SSD in Egyptian patients. SETTINGS AND DESIGN: Four hundred patients of American Society of Anesthesiologist class I and II adult Egyptian patients undergoing surgery using spinal anesthesia in general and obstetric surgery unit, Mansoura University main hospital, were included in this prospective, observational study...
September 2016: Anesthesia, Essays and Researches
Ronald Ching Wan Ma, Maria Ines Schmidt, Wing Hung Tam, Harold David McIntyre, Patrick M Catalano
The global epidemic of obesity has led to an increasing number of obese women of reproductive age. Obesity is associated with reduced fertility, and pregnancies complicated by maternal obesity are associated with adverse outcomes, including increased risk of gestational diabetes, pre-eclampsia, preterm birth, instrumental and caesarean births, infections, and post-partum haemorrhage. The medical and obstetric management of obese women is focused on identifying, addressing, and preventing some of these associated complications, and is a daunting challenge given the high percentage of patients with obesity and few therapeutic options proven to improve outcomes in this population...
October 10, 2016: Lancet Diabetes & Endocrinology
Chandni Prakash, Susan Hatters-Friedman, Charmian Moller-Olsen, Abigail North
INTRODUCTION: Pregnancy is a vulnerable period for recurrence of bipolar disorder. Discontinuation of mood stabilisers during pregnancy and the postpartum period can significantly increase the risk of recurrence of bipolar disorder. Lamotrigine is an anti-epileptic drug that has been approved for the maintenance treatment of bipolar disorder. Epilepsy literature has indicated that lamotrigine has a reassuring safety profile in pregnancy but there is little information on its effectiveness and safety in pregnant women with mental disorders...
August 15, 2016: Psychopharmacology Bulletin
A F Fransen, J van de Ven, E Schuit, Aac van Tetering, B W Mol, S G Oei
OBJECTIVE: To investigate whether simulation-based obstetric team training in a simulation centre improves patient outcome. DESIGN: Multicentre, open, cluster randomised controlled trial. SETTING: Obstetric units in the Netherlands. POPULATION: Women with a singleton pregnancy beyond 24 weeks of gestation. METHODS: Random allocation of obstetric units to a 1-day, multi-professional, simulation-based team training focusing on crew resource management (CRM) in a simulation centre or to no such team training...
October 10, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Helen M Ryan, Sumedha Sharma, Laura A Magee, J Mark Ansermino, Karen MacDonell, Beth A Payne, Keith R Walley, Peter von Dadelszen
OBJECTIVE: To assess the performance of the Acute Physiology and Chronic Health Evaluation II (APACHE II) mortality prediction model in pregnant and recently pregnant women receiving critical care in low-, middle-, and high-income countries during the study period (1985-2015), using a structured literature review. DATA SOURCES: Ovid MEDLINE, Embase, Web of Science, and Evidence-Based Medicine Reviews, searched for articles published between 1985 and 2015. STUDY SELECTION: Twenty-five studies (24 publications), of which two were prospective, were included in the analyses...
October 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
David O Akeju, Marianne Vidler, J O Sotunsa, M O Osiberu, E O Orenuga, Olufemi T Oladapo, A A Adepoju, Rahat Qureshi, Diane Sawchuck, Olalekan O Adetoro, Peter von Dadelszen, Olukayode A Dada
BACKGROUND: The dearth of health personnel in low income countries has attracted global attention. Ways as to how health care services can be delivered in a more efficient and effective way using available health personnel are being explored. Task-sharing expands the responsibilities of low-cadre health workers and allows them to share these responsibilities with highly qualified health care providers in an effort to best utilize available human resources. This is appropriate in a country like Nigeria where there is a shortage of qualified health professionals and a huge burden of maternal mortality resulting from obstetric complications like pre-eclampsia...
September 30, 2016: Reproductive Health
Gustaf Brander, Mina Rydell, Ralf Kuja-Halkola, Lorena Fernández de la Cruz, Paul Lichtenstein, Eva Serlachius, Christian Rück, Catarina Almqvist, Brian M D'Onofrio, Henrik Larsson, David Mataix-Cols
Importance: Perinatal complications may increase the risk of obsessive-compulsive disorder (OCD). Previous reports were based on small, retrospective, specialist clinic-based studies that were unable to rigorously control for unmeasured environmental and genetic confounding. Objective: To prospectively investigate a wide range of potential perinatal risk factors for OCD, controlling for unmeasured factors shared between siblings in the analyses. Design, Setting, and Participants: This population-based birth cohort study included all 2 421 284 children from singleton births in Sweden from January 1, 1973, to December 31, 1996, who were followed up through December 31, 2013...
October 5, 2016: JAMA Psychiatry
R L Goldenberg, J B Griffin, B D Kamath-Rayne, M Harrison, D J Rouse, K Moran, B Hepler, A H Jobe, E M McClure
OBJECTIVE: Stillbirths are among the most common adverse pregnancy outcomes, with 98% occurring in low-income countries. More than one-third occur in sub-Saharan Africa (SSA). However, the medical conditions causing stillbirths and interventions to reduce stillbirths from these conditions are not well documented. We estimated the reductions in stillbirths possible with combinations of interventions. DESIGN: We developed a computerised model to estimate the impact of various interventions on stillbirths caused by the most common conditions...
October 5, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Katherine Rhoades, Sarah Telliard, Tiffany Stanfill Thomas, Jennifer L Barkin
OBJECTIVE: We examined 1) women's perceptions regarding self-care, 2) applications of self-care, and 3) barriers to practicing effective self-care. METHODS: Four focus groups were conducted in a low-income, pregnant population. Focus group recruitment and discussions took place at a large medical center in a medically underserved area of central Georgia. Thirty-two adult pregnant women attending a high-risk obstetric clinic were included. Data related to holistic self-care were identified and grouped into one of three categories: women's valuations of self-care, applications of self-care, and barriers to self-care...
September 30, 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Xiangming Che, Wenyu Zhang, Mingjun Xu
STUDY OBJECTIVE: Postdural puncture headache (PDPH) is the most common symptom of accidental dural puncture, a frequent complication of intraspinal anesthesia. We developed a postoperative intervention technique to prevent and treat PDPH in accidental dural puncture patients, including epidural pumping of saline. This retrospective study aimed to retrospectively evaluate this new technique for PDPH prevention and treatment. DESIGN: Retrospective study. SETTING: Beijing Obstetrics and Gynecology Hospital affiliated to the Capital Medical University, between January 2006 and December 2012...
November 2016: Journal of Clinical Anesthesia
Sarah H Koning, Klaas Hoogenberg, Kirsten A Scheuneman, Mick G Baas, Fleurisca J Korteweg, Krystyna M Sollie, Bertine J Schering, Aren J van Loon, Bruce H R Wolffenbuttel, Paul P van den Berg, Helen L Lutgers
BACKGROUND: To evaluate the neonatal and obstetric outcomes of pregnancies complicated by gestational diabetes mellitus (GDM). Screening and treatment - diet-only versus additional insulin therapy - were based on the 2010 national Dutch guidelines. METHODS: Retrospective study of the electronic medical files of 820 singleton GDM pregnancies treated between January 2011 and September 2014 in a university and non-university hospital. Pregnancy outcomes were compared between regular care treatment regimens -diet-only versus additional insulin therapy- and pregnancy outcomes of the Northern region of the Netherlands served as a reference population...
September 29, 2016: BMC Endocrine Disorders
Alemi Kebede, Kalkidan Hassen, Aderajew Nigussie Teklehaymanot
BACKGROUND: Most obstetric complications occur unpredictably during the time of delivery, but they can be prevented with proper medical care in the health facilities. Despite the Ethiopian government's efforts to expand health service facilities and promote health institution-based delivery service in the country, an estimated 85% of births still take place at home. OBJECTIVE: The review was conducted with the aim of generating the best evidence on the determinants of institutional delivery service utilization in Ethiopia...
2016: International Journal of Women's Health
H Le Liepvre, A Dinh, B Idiard-Chamois, E Chartier-Kastler, V Phé, A Even, G Robain, P Denys
STUDY DESIGN: A retrospective observational study. OBJECTIVE: To describe specificities of pregnancy in a traumatic spinal cord-injured (SCI) population managed by a coordinated medical care team involving physical medicine and rehabilitation (PMR) physicians, urologists, infectious diseases' physicians, obstetricians and anaesthesiologists. SETTING: NeuroUrology Department in a University Hospital, France. METHODS: All consecutive SCI pregnant women managed between 2001 and 2014 were included...
September 27, 2016: Spinal Cord
Surakshith L Gowda, Ambarisha Bhandiwad, N K Anupama
BACKGROUND: Litigation in medical practice is becoming a global problem. So it is necessary to know what constitutes negligence and what is required to prove it and how far it is preventable. OBJECTIVES: To analyze the prevalence and reasons for litigations in Obstetrics and Gynaecology for medical negligence and deficiency in service. To analyze on what grounds negligence was proved and to know whether it was preventable. MATERIALS AND METHODS: It is a retrospective analysis of the judgments obtained from all the District Consumer Courts of South India and was specifically analyzed for reasons in filing the case, nature of settlement, and factors considered in deciding negligence especially in the field of obstetrics and gynecology...
October 2016: Journal of Obstetrics and Gynaecology of India
Aruna Kumar, Neha Agrawal
PURPOSE: Maternal brought in dead are the patient who dies in the need of adequate medical care. These deaths are often not analyzed sincerely as they are not institutional deaths. Our aim is to find out actual life threatening cause of delay leading to death. METHOD: Patients brought dead to casualty were seen by the doctors on duty in Department of Obstetrics and Gynaecology,Gandhi Medical College, Bhopal round the clock. Cause of death was analyzed by verbal autopsy of attendants and referral letter from the institute...
October 2016: Journal of Obstetrics and Gynaecology of India
Toby Shipway, Elaine Johnson, Sheridan Bell, Jodie Martin, Peter Clark
OBJECTIVE: There has been much newspaper and online news coverage of in-flight obstetric births on commercial aircraft over several decades. This case series reviews several cases of in-flight birth and immediate maternal and neonatal outcomes from air medical retrievals in the Northern Territory of Australia over a 3-year period. METHODS: This is a retrospective written case note and electronic medical retrieval record analysis of 4 patients undergoing in-flight, at altitude, obstetric birth...
September 2016: Air Medical Journal
Kikelomo Wright, Aduragbemi Banke-Thomas, Olatunji Sonoiki, Babatunde Ajayi, Onaedo Ilozumba, Oluwarotimi Akinola
Limited attention has been given to opinions of women receiving emergency obstetric care (EmOC) in developing countries. We organized focus groups with 39 women who received this care from Lagos public facilities. Availability of competent personnel and equipment were two positive opinions highlighted. Contrarily, women expressed concerns regarding the seeming unresponsiveness of the service to nonmedical aspects of care, associated stress of service utilization, and high treatment costs. There is a need to leverage the positive perception of women regarding the available technical resources while improving institutional care components like administrative processes, basic amenities, and costs toward increasing utilization and preventing complications...
September 9, 2016: Health Care for Women International
Hend S Saleh, Walid A Abdelsalam, Hala E Mowafy, Azza A Abd ElHameid
Gestational diabetes mellitus (GDM) complicates a significant number of pregnancies. Blood glucose control improves perinatal outcomes. Medical nutrition therapy is the foundation in management. Aim of This Study. To evaluate efficacy of metformin in comparison to insulin for managing GDM. Methods. In prospective randomized comparative study, 150 antenatal women whose pregnancies had been complicated by GDM and did not respond to diet alone were recruited from antenatal clinics at Obstetrics Department in Zagazig University Hospitals from November 2012 to December 2014...
2016: International Journal of Reproductive Medicine
R Su, W Zhu, Y Wei, C Wang, H Feng, L Lin, M Hod, E Hadar, H Yang
OBJECTIVE: Birth weight is an important indicator for childhood and adulthood diseases. Published studies lack information on the relative contribution of women's own birth weight to the course of her pregnancy, not only for maternal but especially to neonatal outcome. The aim of the study was to evaluate the relationship of maternal birth weight on maternal and perinatal complications during pregnancy. STUDY DESIGN: Medical and obstetrical data were collected from 5479 women at 15 hospitals in Beijing, by a systemic cluster sampling survey conducted from 20 June 2013 to 30 November 2013...
September 1, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
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