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Ventilation obstetric

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https://www.readbyqxmd.com/read/28335653/anesthesia-management-of-complete-versus-incomplete-placenta-previa-a-retrospective-cohort-study
#1
Sharon Orbach-Zinger, Carolyn F Weiniger, Amir Aviram, Alexander Balla, S Fein, L A Eidelman, A Ioscovich
PURPOSE: Placenta previa (PP) is a major cause of obstetric hemorrhage. Clinical diagnosis of complete versus incomplete PP has a significant impact on the peripartum outcome. Our study objective is to examine whether distinction between PP classifications effect anesthetic management. METHODS AND MATERIALS: This multi center, retrospective, cohort study was performed in two tertiary university-affiliated medical centers between the years 2005- 2013. Electronic delivery databases were reviewed for demographic, anesthetic, obstetric hemorrhage, and postoperative outcomes for all cases...
March 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28321847/antenatal-corticosteroids-for-accelerating-fetal-lung-maturation-for-women-at-risk-of-preterm-birth
#2
REVIEW
Devender Roberts, Julie Brown, Nancy Medley, Stuart R Dalziel
BACKGROUND: Respiratory morbidity including respiratory distress syndrome (RDS) is a serious complication of preterm birth and the primary cause of early neonatal mortality and disability. While researching the effects of the steroid dexamethasone on premature parturition in fetal sheep in 1969, Liggins found that there was some inflation of the lungs of lambs born at gestations at which the lungs would be expected to be airless. Liggins and Howie published the first randomised controlled trial in humans in 1972 and many others followed...
March 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28282767/pulmonary-edema-in-preeclampsia-an-indonesian-case-control-study
#3
Manggala Pasca Wardhana, Erry Gumilar Dachlan, Gustaaf Dekker
OBJECTIVE: To analyze risk factors, obstetric outcome and the need for mechanical ventilation in preeclampsia complicated by pulmonary edema. MATERIALS AND METHODS: Case-control study using medical record on preeclampsia complicated by pulmonary edema patients in East Java tertiary referral hospital over 2 years. A simple scoring system was developed to predict the need for mechanical ventilation, using logistic regression. RESULTS: 1106 cases of preeclampsia were admitted, with 62 cases (5...
March 1, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28264207/hemostatic-resuscitation-in-peripartum-hysterectomy-pre-and-postmassive-transfusion-protocol-initiation
#4
Eryn H Dutta, Aaron T Poole, Faranak Behnia, Holly E Dunn, Shannon M Clark, Luis D Pacheco, George R Saade, Gary D V Hankins
Background Massive transfusion protocols (MTPs) have been examined in trauma. The exact ratio of packed red blood cells (PRBC) to other blood replacement components in hemostatic resuscitation in obstetrics has not been well defined. Objective The objective of this study was to evaluate hemostatic resuscitation in peripartum hysterectomy comparing pre- and postinstitution of a MTP. Study Design We conducted a retrospective, descriptive study of women undergoing peripartum hysterectomies from January 2002 to January 2015 who received ≥ 4 units of PRBC...
March 6, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28178046/acute-respiratory-distress-syndrome-in-pregnant-women
#5
Barret Rush, Pawel Martinka, Brett Kilb, Robert C McDermid, John H Boyd, Leo Anthony Celi
OBJECTIVE: To estimate the rate of acute respiratory distress syndrome (ARDS) in pregnant patients as well as to investigate clinical conditions associated with mortality. METHODS: We used the Nationwide Inpatient Sample from 2006 to 2012 to identify a cohort of pregnant patients who underwent mechanical ventilation for ARDS. A multivariate model predicting in-hospital mortality was created. RESULTS: A total of 55,208,382 hospitalizations from the 2006-2012 Nationwide Inpatient Samples were analyzed...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28099290/increased-perinatal-morbidity-and-mortality-among-asian-american-and-pacific-islander-women-in-the-united-states
#6
Maryam Siddiqui, Mohammed Minhaj, Ariel Mueller, Avery Tung, Barbara Scavone, Sarosh Rana, Sajid Shahul
BACKGROUND: Asian American/Pacific Islanders (AAPIs) are the fastest-growing racial group in the United States. Despite a higher socioeconomic status, AAPI women experience higher rates of maternal morbidity and mortality. METHODS: Using the National Inpatient Sample, we performed a retrospective cohort analysis of women who were hospitalized for delivery from 2002 to 2013. The primary outcome variable was inpatient mortality rate, and the presence of severe maternal morbidities was estimated using the Bateman Comorbidity Index, a validated tool for predicting obstetric morbidity...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28003691/all-india-difficult-airway-association-2016-guidelines-for-the-management-of-unanticipated-difficult-tracheal-intubation-in-obstetrics
#7
Venkateswaran Ramkumar, Ekambaram Dinesh, Sumalatha Radhakrishna Shetty, Amit Shah, Pankaj Kundra, Sabyasachi Das, Sheila Nainan Myatra, Syed Moied Ahmed, Jigeeshu Vasishtha Divatia, Apeksh Patwa, Rakesh Garg, Ubaradka S Raveendra, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh
The various physiological changes in pregnancy make the parturient vulnerable for early and rapid desaturation. Severe hypoxaemia during intubation can potentially compromise two lives (mother and foetus). Thus tracheal intubation in the pregnant patient poses unique challenges, and necessitates meticulous planning, ready availability of equipment and expertise to ensure maternal and foetal safety. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for the safe management of the airway in obstetric patients...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27926646/treatment-of-a-pregnant-patient-in-a-persistent-vegetative-state
#8
Matthew P Romagano, William E Scorza, Stephen E Lammers, Carole Dorr, John C Smulian
BACKGROUND: Brain injury leading to a persistent vegetative state during pregnancy involves difficult medical and ethical decisions. CASE: A 21-year-old multigravid woman entered a persistent vegetative state at 20 1/7 weeks of gestation after cardiac arrest with postanoxic brain injury from a suspected drug overdose. The clinical disciplines responsible for her case formed a collaborative care plan involving ventilator, nutrition, and medication support of the mother and regular fetal monitoring and ultrasound testing...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27895930/obstetric-patients-in-intensive-care-unit-perspective-from-a-teaching-hospital-in-pakistan
#9
Rahat Qureshi, Sheikh Irfan Ahmed, Amir Raza, Ayesha Khurshid, Uzma Chishti
OBJECTIVE: Review of obstetric cases admitted to the intensive care unit. DESIGN: Ten year retrospective review of individual patients' medical records. PARTICIPANTS: Records of obstetric patients admitted from 2005-2014. SETTING: Aga Khan University Hospital Karachi. MAIN OUTCOME MEASURES: Diagnosis at the time of admission, associated risk factors, and intervention required aspects of management and rate of mortality...
November 2016: JRSM Open
https://www.readbyqxmd.com/read/27824748/oregon-s-hard-stop-policy-limiting-elective-early-term-deliveries-association-with-obstetric-procedure-use-and-health-outcomes
#10
Jonathan M Snowden, Ifeoma Muoto, Blair G Darney, Brian Quigley, Mark W Tomlinson, Duncan Neilson, Steven A Friedman, Joanne Rogovoy, Aaron B Caughey
OBJECTIVE: To evaluate the association of Oregon's hard-stop policy limiting early elective deliveries (before 39 weeks of gestation) and the rate of elective early-term inductions and cesarean deliveries and associated maternal-neonatal outcomes. METHODS: This was a population-based retrospective cohort study of Oregon births between 2008 and 2013 using vital statistics data and multivariable logistic regression models. Our exposure was the Oregon hard-stop policy, defined as the time periods prepolicy (2008-2010) and postpolicy (2012-2013)...
December 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27816155/respiratory-considerations-including-airway-and-ventilation-issues-in-critical-care-obstetric-patients
#11
REVIEW
Holly Ende, Dirk Varelmann
Critical care management of the obstetric patient can present unique challenges. Parturients who present with respiratory distress can suffer from a multitude of etiologies, and each diagnosis must be pursued as appropriate to the clinical picture. Normal physiologic changes of pregnancy may obscure the presentation and diagnosis, and irrelevant of the cause, pregnancy may complicate the management of hypoxic and hypercarbic respiratory failure in this patient population. In addition to these concerns, both anticipated and unanticipated difficult airway management, including difficulty ventilating and intubating, are more common during pregnancy and may be encountered during endotracheal tube placement...
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27766977/factors-associated-with-the-use-of-supplemental-oxygen-or-positive-pressure-ventilation-in-the-delivery-room-in-infants-born-with-a-gestational-age%C3%A2-%C3%A2-%C3%A2-34%C3%A2-weeks
#12
Maria Elisabeth Moreira, Ana Paula Esteves Pereira, Saint Clair Gomes Junior, Ruth Guinsburg, Maria Fernanda Branco de Almeida, Silvana Granado Gama, Maria do Carmo Leal
BACKGROUND: Approximately 5-10 % of newborns require some form of resuscitationupon delivery; several factors, such as maternal abnormal conditions, gestational age and type of delivery could be responsible for this trend. This study aimed to describe the factors associated with the need for positive pressure ventilation (PPV) via a mask or endotracheal tube and the use of supplemental O2 in newborns with a gestational age greater than 34 weeks in Brazil. METHODS: We performed a cross-sectional study and obtained data from the Birth in Brazil Survey...
October 17, 2016: Reproductive Health
https://www.readbyqxmd.com/read/27751799/performance-of-the-obstetric-early-warning-score-in-critically-ill-patients-for-the-prediction-of-maternal-death
#13
Angel Paternina-Caicedo, Jezid Miranda, Ghada Bourjeily, Andrew Levinson, Carmelo Dueñas, Camilo Bello-Muñoz, José A Rojas-Suarez
BACKGROUND: Every day, about 830 women die worldwide from preventable causes related to pregnancy and childbirth. Obstetric early warning scores have been proposed as a potential tool to reduce maternal morbidity and mortality, based on the identification of predetermined abnormal values in the vital signs or laboratory parameters, to generate a rapid and effective medical response. Several early warning scores have been developed for obstetrical patients, but the majority are the result of a clinical consensus rather than statistical analyses of clinical outcome measures (ie, maternal deaths)...
January 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27649091/european-consensus-guidelines-on-the-management-of-respiratory-distress-syndrome-2016-update
#14
David G Sweet, Virgilio Carnielli, Gorm Greisen, Mikko Hallman, Eren Ozek, Richard Plavka, Ola Didrik Saugstad, Umberto Simeoni, Christian P Speer, Máximo Vento, Gerard H A Visser, Henry L Halliday
Advances in the management of respiratory distress syndrome (RDS) ensure that clinicians must continue to revise current practice. We report the third update of the European Guidelines for the Management of RDS by a European panel of expert neonatologists including input from an expert perinatal obstetrician based on available literature up to the beginning of 2016. Optimizing the outcome for babies with RDS includes consideration of when to use antenatal steroids, and good obstetric practice includes methods of predicting the risk of preterm delivery and also consideration of whether transfer to a perinatal centre is necessary and safe...
2017: Neonatology
https://www.readbyqxmd.com/read/27637445/a-case-review-in-flight-births-over-a-4-year-period-in-the-northern-territory-australia
#15
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
https://www.readbyqxmd.com/read/27586209/critically-ill-obstetric-patients-requiring-mechanical-ventilation-in-rural-western-india-a-retrospective-analysis
#16
Smruti B Vaishnav, Bhalendu Vaishnav, Kailas N Desai, Nitin S Raithatha, Neeta S Bose
BACKGROUND: There is a dearth of studies on the clinical profile and therapeutic aspects of critically ill obstetric patients from rural areas, especially those requiring tertiary care support and ventilator therapy. METHODS: We retrospectively analysed the aetiological, clinical, interventional and outcome-related factors of obstetric patients requiring mechanical ventilation in western India. We analysed factors that influence seeking of antenatal care, pregnancy and its complications, severity assessment score, indications and initiation of mechanical ventilation, multiorgan failure and their correlation with maternal mortality...
March 2016: National Medical Journal of India
https://www.readbyqxmd.com/read/27555967/management-of-maternal-cardiac-arrest-in-the-third-trimester-of-pregnancy-a-simulation-based-pilot-study
#17
Jacquelyn Adams, Jose R Cepeda Brito, Lauren Baker, Patrick G Hughes, M David Gothard, Michele L McCarroll, Jocelyn Davis, Angela Silber, Rami A Ahmed
Objective. To evaluate confidence, knowledge, and competence after a simulation-based curriculum on maternal cardiac arrest in an Obstetrics & Gynecologic (OBGYN) residency program. Methods. Four simulations with structured debriefing focusing on high yield causes and management of maternal cardiac arrest were executed. Pre- and post-individual knowledge tests (KT) and confidence surveys (CS) were collected along with group scores of critical performance steps evaluated by content experts for the first and final simulations...
2016: Critical Care Research and Practice
https://www.readbyqxmd.com/read/27530490/medical-and-obstetric-outcomes-among-pregnant-women%C3%A2-with-tuberculosis-a-population-based-study%C3%A2-of%C3%A2-7-8%C3%A2-million%C3%A2-births
#18
Amira El-Messidi, Nicholas Czuzoj-Shulman, Andrea R Spence, Haim Arie Abenhaim
BACKGROUND: Worldwide, tuberculosis remains a major health concern, with an estimated 9.6 million people infected in the year 2014, of which one-third were women. Tuberculosis is estimated to be even more prevalent in pregnant women than the general population. To date there has been conflicting evidence on the maternal and neonatal complications of tuberculosis in pregnancy. OBJECTIVE: We sought to determine trends in the incidence of tuberculosis in pregnancy and to examine the associations between tuberculosis in pregnancy and maternal and fetal complications...
December 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27506722/retrospective-descriptive-study-of-an-intensive-care-unit-at-a-ugandan-regional-referral-hospital
#19
Stephen S Ttendo, Adam Was, Mark A Preston, Emmanuel Munyarugero, Vanessa B Kerry, Paul G Firth
BACKGROUND: We describe delivery and outcomes of critical care at Mbarara Regional Referral Hospital, a Ugandan secondary referral hospital serving a large, widely dispersed rural population. METHODS: Retrospective observational study of ICU admissions was performed from January 2008 to December 2011. RESULTS: Of 431 admissions, 239 (55.4 %) were female, and 142 (33.2 %) were children (<18 years). The median length of stay was 2 (IQR 1-4) days, with 365 patients (85 %) staying less than 8 days...
August 9, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27492967/perinatal-management-what-has-been-learned-through-the-network
#20
Sanjay Chawla, Elizabeth E Foglia, Vishal Kapadia, Myra H Wyckoff
The Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (NRN) has examined the effects of various obstetrical perinatal interventions and neonatal delivery room practices on the newborn with particular focus on those born preterm. Studies exploring the effects and safety of various antepartum maternal medications and the effects of the route and timing of delivery are examined. The NRN has contributed key studies to the evidence base for the International Liaison Committee on Resuscitation neonatal resuscitation guidelines...
October 2016: Seminars in Perinatology
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