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Mechanical ventilation obstetric

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https://www.readbyqxmd.com/read/27751799/performance-of-the-obstetric-early-warning-score-in-critically-ill-patients-for-the-prediction-of-maternal-death
#1
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 upon 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 (i...
October 14, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27649091/european-consensus-guidelines-on-the-management-of-respiratory-distress-syndrome-2016-update
#2
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...
September 21, 2016: Neonatology
https://www.readbyqxmd.com/read/27586209/critically-ill-obstetric-patients-requiring-mechanical-ventilation-in-rural-western-india-a-retrospective-analysis
#3
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/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
#4
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
#5
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/27289809/obstetric-delivery-in-mechanically-ventilated-critically-ill-pregnant-women
#6
S E Lapinsky, J A Rojas-Suarez, T M Crozier, D N Vasquez, N Barrett, G Bourjeily
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27209560/obstetric-admissions-to-icus-in-finland-a-multicentre-study
#7
Pia Seppänen, Reijo Sund, Mervi Roos, Riitta Unkila, Merja Meriläinen, Mika Helminen, Tero Ala-Kokko, Tarja Suominen
In this study, the objective was to describe and analyse reasons for obstetric admissions to the ICU, severity of illness, level and types of interventions, adverse events and patient outcomes. In a retrospective database study, we identified 291 obstetric patients during pregnancy and puerperium from four Finnish university hospitals. Most were admitted in the post-partum period and hypertensive disorders were the main indications for admissions, followed by obstetric haemorrhage. The median length of stay was 21hours...
August 2016: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/27166014/maternal-and-neonatal-outcomes-of-attempted-vaginal-compared-with-planned-cesarean-delivery-in-triplet-gestations
#8
Justin R Lappen, David N Hackney, Jennifer L Bailit
BACKGROUND: The prevailing obstetric practice of planned cesarean delivery for triplet gestations is largely empiric and data on the optimal route of delivery are limited. OBJECTIVE: The primary objectives of this study are to determine the likelihood of success in an attempted vaginal delivery and assess maternal and neonatal outcomes of attempted vaginal vs planned cesarean delivery of triplets using a multiinstitution obstetric cohort. STUDY DESIGN: We performed a retrospective cohort study using data from the Consortium on Safe Labor, identifying triplet pregnancies with delivery at a gestational age ≥28 weeks...
October 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27058433/is-transducer-hygiene-sufficient-when-vaginal-probes-are-used-in-the-clinical-routine
#9
EDITORIAL
E Merz
Vaginal ultrasound probes are semi-critical Group A medical products which must be disinfected following the manufacturer's instructions after every patient examination. According to the "Essential Requirements for Medical Devices (Directive 93/42/EEC, Annex I, paragraph 13)" the manufacturer's instructions for use for reusable products must contain suitable instructions for preparation processes. This presumes both an effective and material-compatible method. Evidence of effectiveness must be validated.In the Editorial in issue 1 Ultraschall in der Medizin/European Journal of Ultrasound 2005 we discussed the topic of transducer hygiene and stated that proper handling and cleaning as well as disinfection of probes in daily use are indispensable...
April 2016: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/26959213/association-of-the-duration-of-active-pushing-with-obstetric-outcomes
#10
MULTICENTER STUDY
William A Grobman, Jennifer Bailit, Yinglei Lai, Uma M Reddy, Ronald J Wapner, Michael W Varner, Steve N Caritis, Mona Prasad, Alan T N Tita, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
OBJECTIVE: To estimate the associations between the duration of active pushing during the second stage of labor and maternal and neonatal outcomes. METHODS: We performed an observational study in which data were obtained by trained abstractors from maternal and neonatal charts of deliveries at 25 hospitals over a 3-year period. In this secondary analysis, women with no prior cesarean delivery who had a term, singleton, cephalic gestation and reached complete dilation were analyzed...
April 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26889839/antipsychotic-use-in-hospitalized-adults-rates-indications-and-predictors
#11
Shoshana J Herzig, Michael B Rothberg, Jamey R Guess, Jennifer P Stevens, John Marshall, Jerry H Gurwitz, Edward R Marcantonio
OBJECTIVES: To investigate patterns and predictors of use of antipsychotics in hospitalized adults. DESIGN: Retrospective cohort study. SETTING: Academic medical center. PARTICIPANTS: Individuals aged 18 and older hospitalized from August 2012 to August 2013, excluding those admitted to obstetrics and gynecology or psychiatry or with a psychotic disorder. MEASUREMENTS: Use was ascertained from pharmacy charges...
February 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/26858174/antithrombin-iii-for-critically-ill-patients
#12
REVIEW
Mikkel Allingstrup, Jørn Wetterslev, Frederikke B Ravn, Ann Merete Møller, Arash Afshari
BACKGROUND: Critical illness is associated with uncontrolled inflammation and vascular damage which can result in multiple organ failure and death. Antithrombin III (AT III) is an anticoagulant with anti-inflammatory properties but the efficacy and any harmful effects of AT III supplementation in critically ill patients are unknown. This review was published in 2008 and updated in 2015. OBJECTIVES: To examine:1. The effect of AT III on mortality in critically ill participants...
February 8, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26816959/morbidity-and-mortality-pattern-in-late-preterm-infants-at-a-tertiary-care-hospital-in-jammu-kashmir-northern-india
#13
Ghulam Nabi Rather, Muzafar Jan, Wasim Rafiq, Imran Gattoo, Sheikh Quyoom Hussain, Mohmad Latief
INTRODUCTION: The morbidity and mortality pattern in late preterm infants is higher than term infants (gestational age ≥ 37weeks). The main reason behind that is the relative physiologic and metabolic immaturity, though there is no significant difference in the weight or the size of the two groups. AIM: The present study was undertaken to study the incidence, early neonatal morbidity and mortality (within first 7 days of life) in late preterm infants (34 - 36 6/7 weeks)...
December 2015: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/26600446/respiratory-failure-and-mechanical-ventilation-in-the-pregnant-patient
#14
REVIEW
David Schwaiberger, Marcin Karcz, Mario Menk, Peter J Papadakos, Susan E Dantoni
Fewer than 2% of all peripartal patients need intensive care unit admission. But due to some anatomic and physiologic changes in pregnancy, respiratory failure can be promoted. This article reviews several obstetric and nonobstetric diseases that lead to respiratory failure and the treatment of these. Furthermore, invasive and noninvasive ventilation in pregnancy is discussed and suggestions of medication during ventilation are given.
January 2016: Critical Care Clinics
https://www.readbyqxmd.com/read/26450404/vaginal-progesterone-to-prevent-preterm-birth-in-pregnant-women-with-a-sonographic-short-cervix-clinical-and-public-health-implications
#15
Agustin Conde-Agudelo, Roberto Romero
Vaginal progesterone administration to women with a sonographic short cervix is an efficacious and safe intervention used to prevent preterm birth and neonatal morbidity and mortality. The clinical and public health implications of this approach in the United States have been critically appraised and compared to other therapeutic interventions in obstetrics. Vaginal progesterone administration to women with a transvaginal sonographic cervical length (CL) ≤25 mm before 25 weeks of gestation is associated with a significant and substantial reduction of the risk for preterm birth from <28 to <35 weeks of gestation, respiratory distress syndrome, composite neonatal morbidity and mortality, admission to the neonatal intensive care unit, and mechanical ventilation...
February 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26355021/mechanical-ventilation-in-critically-ill-pregnant-women-a-case-series
#16
MULTICENTER STUDY
S E Lapinsky, J A Rojas-Suarez, T M Crozier, D N Vasquez, N Barrett, K Austin, G A Plotnikow, K Orellano, G Bourjeily
BACKGROUND: Approximately 0.1-0.2% of pregnancies are complicated by respiratory failure requiring mechanical ventilatory support, but few data exist to inform clinical management. This study aimed to characterize current practice and the effect of delivery on respiratory function. METHODS: A retrospective review was performed of pregnant women who received mechanical ventilation for more than 24h, from four intensive care units in institutions with large-volume obstetric units...
November 2015: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/26241425/medical-and-obstetric-outcomes-among-pregnant-women-with-congenital-heart-disease
#17
Jennifer L Thompson, Elena V Kuklina, Brian T Bateman, William M Callaghan, Andra H James, Chad A Grotegut
OBJECTIVE: To estimate nationwide trends in the prevalence of maternal congenital heart disease (CHD) and determine whether women with CHD are more likely than women without maternal CHD to have medical and obstetric complications. METHODS: The 2000-2010 Nationwide Inpatient Sample was queried for International Classification of Diseases, 9th Revision, Clinical Modification codes to identify delivery hospitalizations of women with and without CHD. Trends in the prevalence of CHD were determined and then rates of complications were reported for CHD per 10,000 delivery hospitalizations...
August 2015: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26193688/electronic-fetal-monitoring-patterns-associated-with-respiratory-morbidity-in-term-neonates
#18
Lucy Liu, Methodius G Tuuli, Kimberly A Roehl, Anthony O Odibo, George A Macones, Alison G Cahill
OBJECTIVE: The purpose of this study was to identify electronic fetal monitoring patterns that are associated with neonatal respiratory morbidity. STUDY DESIGN: In an on-going prospective cohort study of >8000 consecutive term, vertex, nonanomalous singleton pregnancies during labor, we performed this analysis within the first 5000 women as a representative sample. Electronic fetal monitoring patterns in the 30 minutes preceding delivery were extracted by trained obstetrics research nurses, who were blinded to clinical data, using the National Institute of Child Health and Human Development system; the data were compared between those with respiratory morbidity and healthy infants (no morbidities)...
November 2015: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26137193/predictors-of-maternal-mortality-among-critically-ill-obstetric-patients
#19
A S Adeniran, B O Bolaji, A A Fawole, O O Oyedepo
AIM: Evaluation of the predictors of maternal mortality among critically ill obstetric patients managed at the intensive care unit (ICU). METHODS: A case control study to evaluate the predictors of maternal mortality among critically ill obstetric patients managed at the intensive care unit (ICU) of the University of Ilorin Teaching Hospital, Ilorin, Nigeria from 1st January 2010 to 30th June 2013. Participants were critically ill obstetric patients who were admitted and managed at the ICU during the study period...
March 2015: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/26136883/complete-recovery-from-paraneoplastic-anti-nmdar-encephalitis-associated-with-a-small-ovarian-teratoma-following-a-laparoscopic-salpingo-oophorectomy-a-case-report
#20
Kenji Imai, Takeshi Fukuda, Takuma Wada, Masaru Kawanishi, Makoto Yamauchi, Yasunori Hashiguchi, Tomoyuki Ichimura, Tomoyo Yasui, Toshiyuki Sumi
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a severe but treatment-responsive disorder, initially identified in young women with an ovarian teratoma. Symptoms include mood, behavior and personality irregularities that resemble acute psychosis. The present study reports the rare case of a patient with anti-NMDAR encephalitis and severe neurological symptoms, that exhibited a rapid recovery following a laparoscopic salpingo-oophorectomy. The 39-year-old woman was admitted to the Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine (Osaka, Japan) with a 5-day history of fever and stomach ache...
May 2015: Experimental and Therapeutic Medicine
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