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medical complications in obstetrician

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https://www.readbyqxmd.com/read/29109640/obstetric-critical-care-requirements-felt-by-the-obstetricians-an-experience-based-study
#1
Mohan Deep Kaur, Jyoti Sharma, Prasoon Gupta, Tarun Deep Singh, Saurav Mitra Mustafi
Background and Aims: Pregnancy is a state of physiological stress to a woman's health. Concomitant complications and infections during pregnancy may necessitate intensive monitoring and management of such patients in critical care settings. This study aims to determine the perceptions about the requirement of obstetric critical care based on the experience of obstetricians. Material and Methods: An observational, questionnaire-based study was conducted in 200 obstetricians working in various settings, who were approached during obstetric conferences...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29103877/ethical-considerations-in-the-care-of-complicated-twin-pregnancies
#2
Naomi T Laventhal, Marjorie C Treadwell
Twin gestations are increasing in prevalence worldwide, and are potentially subject to medical complications which present uniquely complex ethical and psychosocial challenges for the pregnant patient and obstetrician to navigate. In this article, we explore these issues as they relate to medical decision-making in cases of discordant growth and discordant anomalies in both monochorionic and dichorionic twin pregnancies, including those affected by twin-twin transfusion syndrome, with particular attention to scenarios in which the individual fetuses hold competing interests...
November 2, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29080737/no-271-delayed-child-bearing
#3
Jo-Ann Johnson, Suzanne Tough
OBJECTIVE: To provide an overview of delayed child-bearing and to describe the implications for women and health care providers . OPTIONS: Delayed child-bearing, which has increased greatly in recent decades, is associated with an increased risk of infertility, pregnancy complications, and adverse pregnancy outcome . This guideline provides information that will optimize the counselling and care of Canadian women with respect to their reproductive choices . OUTCOMES: Maternal age is the most important determinant of fertility, and obstetric and perinatal risks increase with maternal age ...
November 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29070512/debate-identifying-and-treating-subclinical-thyroid-dysfunction-in-pregnancy-emerging-controversies
#4
Ines I Velasco, Peter Nicholas Taylor
Thyroid hormones are essential for an adequate growth and development of the foetus. In addition to the classical association between maternal hypothyroidism and neurological impairment in the progeny, other adverse reproductive events have been associated with maternal thyroid dysfunction including infertility, miscarriage and preterm delivery. Although all scientific societies endorse the treatment of overt hypothyroidism; the management and/or treatment of subclinical hypothyroidism, hypothyroxinemia or antithyroid antibody-positive women should be considered with caution...
October 25, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29033113/a-new-facilitating-technique-for-postpartum-hysterectomy-at-full-dilatation-cervical-clamp
#5
Ozan Dogan, Cigdem Pulatoglu, Murat Yassa
BACKGROUND: Postpartum hysterectomy is a life saving emergency procedure in the management of uncontrollable severe maternal hemorrhage that every obstetrician should be closely acquainted with despite developments in medical and non-surgical interventions for obstetric hemorrhage. It can be difficult to detect the real boundaries of the cervix at full effacement and dilatation in patients who undergo emergency hysterectomy after vaginal delivery. METHODS: Hereby we propose a simple and effective method to ease the operation by placing two atraumatic ring forceps to the anterior and posterior sides of the cervix during the preoperative vaginal examination and leave the two ring forceps while taking the patient into surgery...
October 9, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28963690/new-medical-risks-affecting-obstetrics-after-implementation-of-the-two-child-policy-in-china
#6
Qiang Li, Dongrui Deng
China recently instituted a two-child policy in response to its aging population, declining workforce and demographic dividend, and the need to develop asocial economy. Additionally, women generally delay having a second child because of the overwhelming pressure in their lives. With the improvements in assisted fertility technologies in recent years, the number of elderly women attempting to bear children has increased. The quality of woman's eggs and a man's sperm declined dramatically with increasing age, leading to an increased risk of pregnancy-related complications among older women...
September 30, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28951653/symptomatic-fibroid-management-systematic-review-of-the-literature
#7
REVIEW
Yelena Havryliuk, Robert Setton, John J Carlow, Barry D Shaktman
BACKGROUND AND OBJECTIVES: Symptomatic uterine fibroids are a societal and healthcare burden with no clear consensus among medical professionals as to which procedural treatment is most appropriate for each symptomatic patient. Our purpose was to determine whether recommendations can be made regarding best practice based on review and analysis of the literature since 2006. DATABASE: A systematic search of journal articles relevant to the treatment of symptomatic uterine fibroids was performed within PubMed, clinical society websites, and medical device manufacturers' websites...
July 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28935064/no-231-guidelines-for-the-management-of-vasa-previa
#8
Robert Gagnon
OBJECTIVES: To describe the etiology of vasa previa and the risk factors and associated condition, to identify the various clinical presentations of vasa previa, to describe the ultrasound tools used in its diagnosis, and to describe the management of vasa previa. OUTCOMES: Reduction of perinatal mortality, short-term neonatal morbidity, long-term infant morbidity, and short-term and long-term maternal morbidity and mortality. EVIDENCE: Published literature on randomized trials, prospective cohort studies, and selected retrospective cohort studies was retrieved through searches of PubMed or Medline, CINAHL, and the Cochrane Library, using appropriate controlled vocabulary (e...
October 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28859781/no-261-prenatal-screening-for-fetal-aneuploidy-in-singleton-pregnancies
#9
David Chitayat, Sylvie Langlois, R Douglas Wilson
OBJECTIVE: To develop a Canadian consensus document on maternal screening for fetal aneuploidy (e.g., Down syndrome and trisomy 18) in singleton pregnancies. OPTIONS: Pregnancy screening for fetal aneuploidy started in the mid 1960s, using maternal age as the screening test. New developments in maternal serum and ultrasound screening have made it possible to offer all pregnant patients a non-invasive screening test to assess their risk of having a fetus with aneuploidy to determine whether invasive prenatal diagnostic testing is necessary...
September 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28859770/no-245-alcohol-use-and-pregnancy-consensus-clinical-guidelines
#10
George Carson, Lori Vitale Cox, Joan Crane, Pascal Croteau, Lisa Graves, Sandra Kluka, Gideon Koren, Marie-Jocelyne Martel, Deana Midmer, Irena Nulman, Nancy Poole, Vyta Senikas, Rebecca Wood
OBJECTIVE: To establish national standards of care for the screening and recording of alcohol use and counselling on alcohol use of women of child-bearing age and pregnant women based on the most up-to-date evidence. EVIDENCE: Published literature was retrieved through searches of PubMed, CINAHL, and the Cochrane Library in May 2009 using appropriate controlled vocabulary (e.g., pregnancy complications, alcohol drinking, prenatal care) and key words (e.g., pregnancy, alcohol consumption, risk reduction)...
September 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28830851/barriers-and-facilitators-for-the-use-of-a-medical-mobile-app-to-prevent-work-related-risks-in-pregnancy-a-qualitative-analysis
#11
Adeline V Velu, Monique Dm van Beukering, Frederieke G Schaafsma, Monique Hw Frings-Dresen, Ben Wj Mol, Joris Am van der Post, Marjolein Kok
BACKGROUND: The number of women participating in the labor market in Europe has increased over the last several decades. At the same time, there is growing evidence that certain conditions of employment during pregnancy may have a negative influence on pregnancy outcomes. In order to better inform pregnant women, we aim to develop an app to help assess the health risk as a result of personal and work-related factors and provide personal advice for these women and their health care providers...
August 22, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28807810/unique-learning-system-for-uterine-artery-embolization-for-symptomatic-myoma-and-adenomyosis-for-obstetrician-gynecologists-in-cooperation-with-interventional-radiologists-evaluation-of-uae-from-the-point-of-view-of-gynecologists-who-perform-uae
#12
Shu Soeda, Tsuyoshi Hiraiwa, Megumi Takata, Norihito Kamo, Hirofumi Sekino, Shinji Nomura, Manabu Kojima, Hyo Kyozuka, Takeharu Ozeki, Shiro Ishii, Tadanobu Tameda, Kimisato Asano, Makoto Miyazaki, Toshifumi Takahashi, Takafumi Watanabe, Yasunori Taki, Keiya Fujimori
STUDY OBJECTIVE: To evaluate a unique learning system for uterine artery embolization (UAE) and examine its feasibility and clinical outcomes for the treatment of symptomatic uterine leiomyomas and adenomyosis when performed by obstetrician-gynecologists in cooperation with interventional radiologists (IVRs). DESIGN: Retrospective study (Canadian Task Force classification II-2). SETTING: University hospital. PATIENTS: One hundred seventy-three patients who underwent UAE for symptomatic leiomyomas and adenomyosis...
August 12, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28751846/consensus-document-of-the-italian-association-of-hospital-cardiologists-anmco-italian-society-of-pediatric-cardiology-sicp-and-italian-society-of-gynaecologists-and-obstetrics-sigo-pregnancy-and-congenital-heart-diseases
#13
Innocenzo Bianca, Giovanna Geraci, Michele Massimo Gulizia, Gabriele Egidy Assenza, Chiara Barone, Marcello Campisi, Annalisa Alaimo, Rachele Adorisio, Francesca Comoglio, Silvia Favilli, Gabriella Agnoletti, Maria Gabriella Carmina, Massimo Chessa, Berardo Sarubbi, Maurizio Mongiovì, Maria Giovanna Russo, Sebastiano Bianca, Giuseppe Canzone, Marco Bonvicini, Elsa Viora, Marco Poli
The success of cardiac surgery over the past 50 years has increased numbers and median age of survivors with congenital heart disease (CHD). Adults now represent two-thirds of patients with CHD; in the USA alone the number is estimated to exceed 1 million. In this population, many affected women reach reproductive age and wish to have children. While in many CHD patients pregnancy can be accomplished successfully, some special situations with complex anatomy, iatrogenic or residual pathology are associated with an increased risk of severe maternal and fetal complications...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28734829/feasibility-of-prophylactic-salpingectomy-during-vaginal%C3%A2-hysterectomy
#14
Danielle D Antosh, Rachel High, Heidi W Brown, Sallie S Oliphant, Husam Abed, Nisha Philip, Cara L Grimes
BACKGROUND: The American Congress of Obstetricians and Gynecologists recommends that "the surgeon and patient discuss the potential benefits of the removal of the fallopian tubes during a hysterectomy in women at population risk of ovarian cancer who are not having an oophorectomy," resulting in an increasing rate of salpingectomy at the time of hysterectomy. Rates of salpingectomy are highest for laparoscopic and lowest for vaginal hysterectomy. OBJECTIVE: The primary objective of this study was to determine the feasibility of bilateral salpingectomy at the time of vaginal hysterectomy...
July 20, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28717976/-trauma-surgery-in-pacific-small-island-developing-states-sids
#15
REVIEW
H Oberli, C Martin
BACKGROUND: The small developing countries in the Pacific are grouped together as Small Island Development States (SIDS) because they face similar problems which they cannot cope with nationally. They are developing countries, so-called low and lower middle income countries (LMIC), are economically weak and the islands of the different nations are widely scattered. Approximately 80% of the 10 million inhabitants live in rural regions. EPIDEMIOLOGY AND SURGICAL CAPACITY: Over 40% of patients in the surgical departments of hospitals are hospitalized for injuries, and this tendency is increasing...
October 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28680470/a-case-of-successfully-managed-pregnancy-in-a-patient-with-complex-cyanotic-congenital-heart-disease
#16
J Y Liu, W K Tan, E L Tan, J L Tan, L K Tan
Medical advances have increased survival of patients with congenital heart disease. However, cardiac disease in pregnancy carries significant maternal and fetal risks, posing enormous challenges to obstetricians. Cyanotic congenital heart disease is associated with maternal complications such as arrhythmias, thromboembolic events and death. Fetal complications include small for gestational age, miscarriage and prematurity. Cyanotic congenital heart disease patients who continue their pregnancies require holistic multidisciplinary team care with early and coordinated planning for delivery...
June 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28632532/postpartum-tubal-sterilization-making-the-case-for-urgency
#17
Michael G Richardson, Sarah J Hall, Lisa C Zuckerwise
The parturient who requests postpartum sterilization has given consideration to and has made decisions regarding this aspect of her medical care long before her delivery. She arrives at parturition expecting the postpartum procedure to be performed as intended. The American Congress of Obstetricians and Gynecologists has reaffirmed its opinion that postpartum sterilization is an urgent procedure, owing to the safety and superior effectiveness of tubal sterilization via minilaparotomy in the immediate postpartum period, and the adverse consequences for mothers, babies, and society when the procedure is not actualized as desired and intended...
June 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28593772/-complications-arising-out-of-insufficient-reporting-of%C3%A2-clinical-data-to-the-pathologist-investigating-placentas
#18
Š Hadravská, M Dubová, P Mukenšnabl, O Daum
OBJECTIVE: To inform gynecologists-obstetricians about the problems associated with pathological examination of placentas, with special regard to the possibility of crucial role of complete and relevant clinical data in establishing the correct pathological diagnosis. DESIGN: Case report and overview of the problems associated with examination of placentas by pathologist. SETTING: Sikl´s Institute of Pathology, Faculty Hospital and Medical Faculty Pilzen of the Charles University in Prague; Biopticka laborator, s...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28549980/trends-in-malpractice-claims-for-obstetric-and-gynecologic-procedures-2005-through-2014
#19
Laura M Glaser, Farah A Alvi, Magdy P Milad
BACKGROUND: Interest in medical malpractice and areas of medicolegal vulnerability for practicing obstetricians and gynecologists has grown substantially, and many providers report changing surgical practice out of fear of litigation. Furthermore, education on medical malpractice and risk management is lacking for obstetrics and gynecology trainees. Recent obstetric and gynecologic malpractice claims data are lacking. We report on recent trends in malpractice claims for obstetrics and gynecology procedures, and compare these trends to those of other medical specialties...
September 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28540849/pre-eclampsia-overview-on-the-role-of-biomarkers-in-2016
#20
Henry Paridaens, Damien Gruson
Preeclampsia which affects approximatively 2% of pregnancies is a major cause of maternal and perinatal morbidity and mortality. Pathogenesis of pre-eclampsia is nowadays increasingly understood. It implies multiple actors and biomarkers appear to be playing a major role. New uses of those biomarkers for risk stratification and diagnosis of predisposed preeclamptic patients followed by obstetricians is an hot topic. The combined approach of biomarkers, medical history and obstetrical ultrasounds enables risk estimation in the first quarter and later on...
June 1, 2017: Annales de Biologie Clinique
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