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https://www.readbyqxmd.com/read/28525510/zika-virus-obstetric-and-pediatric-anesthesia-considerations
#1
Jacqueline L Tutiven, Benjamin T Pruden, James S Banks, Mario Stevenson, David J Birnbach
As of November 2016, the Florida Department of Health (FDH) and the Centers for Disease Control and Prevention have confirmed more than 4000 travel-related Zika virus (ZIKV) infections in the United States with >700 of those in Florida. There have been 139 cases of locally acquired infection, all occurring in Miami, Florida. Within the US territories (eg, Puerto Rico, US Virgin Islands), >30,000 cases of ZIKV infection have been reported. The projected number of individuals at risk for ZIKV infection in the Caribbean and Latin America approximates 5 million...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28522320/risks-and-consequences-of-puerperal-uterine-inversion-in-the-united-states-2004-2013
#2
Sarah L Coad, Leanne S Dahlgren, Jennifer A Hutcheon
BACKGROUND: Puerperal uterine inversion is a rare, potentially life-threatening obstetrical emergency. The current literature consists of small case series and a single nationwide study from Europe with only 15 cases. OBJECTIVE: We aimed to define the incidence, temporal trends and outcomes in women with uterine inversion using a nationally representative United States (US) cohort. STUDY DESIGN: We used the Nationwide Inpatient Sample, a 20% sample of US hospital admissions, to identify all deliveries from 2004 to 2013...
May 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28515515/the-parturient-in-the-interventional-radiology-suite-new-frontier-in-obstetric-anaesthesia
#3
REVIEW
Tasneem Dhansura, Nabila Shaikh
The anaesthesiologist's presence during interventional radiology (IR) is increasing due to increasingly ill patients and intricate procedures. The management of a parturient in IR suite is complex in terms of logistics of an unfamiliar procedure in an unfamiliar area. The literature available is largely written by radiologists with little attention paid to anaesthetic details and considerations. In the Indian scenario, in the absence of hybrid operating rooms (ORs), logistics involve transport of a parturient back and forth between the IR suite and the OR...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28492980/-haemostatic-management-in-postpartum-haemorrhage-nationwide-survey-in-germany
#4
L Kaufner, K Ghantus, A Henkelmann, U Friedrichs, K Weizsäcker, A Schiemann, C von Heymann
BACKGROUND: In order to ensure evidence-based haemostatic management of postpartum haemorrhage (PPH, blood loss >500 ml) consistent with guidelines appropriate structural conditions must be fulfilled regardless of different levels (1-3) in perinatal care. The aim of the survey was to identify differences in haemostatic management in PPH under consideration of the different levels of perinatal care in Germany. MATERIALS AND METHODS: An electronic questionnaire assessing the structural and therapeutic preconditions for haemostatic management was sent to 533 anaesthesiology departments serving obstetric units...
May 10, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28461767/can-mhealth-improve-access-to-safe-blood-for-transfusion-during-obstetric-emergency
#5
Aminur Rahman, Sadika Akhter, Monjura Khatun Nisha, Syed Shariful Islam, Fatema Ashraf, Monjur Rahman, Nazneen Begum, Mahbub Elahi Chowdhury, Anne Austin, Iqbal Anwar
PURPOSE: Of the 99% maternal deaths that take place in developing countries, one-fourth is due to postpartum hemorrhage (PPH). PPH accounts for one-third of all blood transfusions in Bangladesh where the transfusion process is lengthy as most facilities do not have in-house blood bank facilities. In this context, the location where blood is obtained and the processes of obtaining blood products are not standardized, leading to preventable delays in collecting blood, when it is needed...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28451416/laparoscopic-local-extraperitoneal-para-aortic-lymphadenectomy-description-of-a-novel-technique
#6
Xuyin Zhang, Jingxin Ding, Keqin Hua
The aim of the present study was to introduce and describe a novel technique, which has been termed 'laparoscopic local extraperitoneal para-aortic lymphadenectomy', and to evaluate its feasibility and safety. In this retrospective case study, a series of 21 patients were selected who underwent laparoscopic local extraperitoneal para-aortic lymphadenectomy for gynecological malignancies between March and August 2014 at the Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. All the surgical procedures were performed by the same operational team...
March 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28436465/the-clinical-efficacy-of-fibrinogen-concentrate-in-massive-obstetric-haemorrhage-with-hypofibrinogenaemia
#7
Shigetaka Matsunaga, Yasushi Takai, Eishin Nakamura, Sumiko Era, Yoshihisa Ono, Koji Yamamoto, Hiroo Maeda, Hiroyuki Seki
Massive obstetric haemorrhage remains a major cause of maternal death attributable to hypofibrinogenaemia. Transfusion of large volumes of fresh frozen plasma (FFP) is required to normalise fibrinogen levels. We compared the efficacy of FFP (F group) with that of FFP plus fibrinogen concentrate (F + F group) in massive obstetric haemorrhage. In this retrospective study, we compared the medical charts (2004-2016) of 137 patients with <150 mg/dl fibrinogen treated with F + F (n = 47; after August 2009) or F (n = 56; before August 2009)...
April 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28434005/chorioamniotic-membrane-separation-after-fetoscopic-laser-photocoagulation
#8
Mayumi Takano, Masahiko Nakata, Susumu Murata, Masahiro Sumie, Mineto Morita
INTRODUCTION: This study aimed to investigate the risk factors, incidence, and influence on the perinatal outcome of chorioamniotic membrane separation (CMS) after fetoscopic laser photocoagulation (FLP). MATERIAL AND METHODS: This retrospective study included 312 women who underwent FLP for twin-to-twin transfusion syndrome (TTTS). Clinical records were used to review obstetrical examinations, complications, operative data, ultrasonographic findings, and perinatal and neonatal follow-up data in all patients...
April 22, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28409600/postpartum-hemorrhage-prevention-and-treatment
#9
Ann Evensen, Janice M Anderson, Patricia Fontaine
Postpartum hemorrhage is common and can occur in patients without risk factors for hemorrhage. Active management of the third stage of labor should be used routinely to reduce its incidence. Use of oxytocin after delivery of the anterior shoulder is the most important and effective component of this practice. Oxytocin is more effective than misoprostol for prevention and treatment of uterine atony and has fewer adverse effects. Routine episiotomy should be avoided to decrease blood loss and the risk of anal laceration...
April 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28398928/anesthetic-management-of-mitochondrial-encephalopathy-with-lactic-acidosis-and-stroke-like-episodes-melas-syndrome-in-a-high-risk-pregnancy-a-case-report
#10
Josh D Bell, Kushlin Higgie, Mital Joshi, Joshua Rucker, Sahar Farzi, Naveed Siddiqui
MELAS syndrome (mitochondrial encephalopathy, lactic acidosis, and stroke-like symptoms) is a rare and complex mitochondrial disorder. We present the in-hospital course of a 36-year-old gravida 2, para 0 with MELAS syndrome and severe preeclampsia, complicated by hyponatremia, hyperkalemia, and diabetes. A retained placenta with postpartum hemorrhage required urgent instrumental delivery under spinal anesthesia, transfusion, and intensive care unit admission for pulmonary edema, effusions, and atelectasis. Postpartum endometritis and sepsis also were encountered...
April 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28384942/recent-advances-in-the-management-of-major-postpartum-haemorrhage-a-review
#11
REVIEW
P Reddi Rani, Jasmina Begum
Postpartum haemorrhage (PPH) is a leading cause of maternal mortality and morbidity worldwide and 75-90% of these haemorrhage results from uterine atony. Delayed and substandard obstetrics care can kill a woman within hours of Major Obstetric Haemorrhage (MOH). Prenatal identification of at risk women, prompt assessment of blood loss, effective management and involvement of multidisciplinary teams is of utmost importance to save the lives of these women. However, even with the best prenatal care, PPH occurs, it can occur without any risk factors...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28383377/evaluation-of-introduction-of-a-delayed-cord-clamping-protocol-for-premature-neonates-in-a-high-volume-maternity-center
#12
Lilly Y Liu, Joe M Feinglass, Janine Y Khan, Susan E Gerber, William A Grobman, Lynn M Yee
OBJECTIVE: To evaluate adherence to a delayed cord clamping protocol for preterm births in the first 2 years after its introduction, perform a quality improvement assessment, and determine neonatal outcomes associated with protocol implementation and adherence. METHODS: This is a retrospective cohort study of women delivering singleton neonates at 23-32 weeks of gestation in the 2 years before (preprotocol) and 2 years after (postprotocol) introduction of a 30-second delayed cord clamping protocol at a large-volume academic center...
May 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28374955/rhd-alleles-among-pregnant-women-with-serologic-discrepant-weak-d-phenotypes-from-a-multiethnic-population-and-risk-of-alloimmunization
#13
Carolina Bonet Bub, Maria Giselda Aravechia, Thiago Henrique Costa, José Mauro Kutner, Lilian Castilho
BACKGROUND: A considerable number of RHD alleles responsible for weak and partial D phenotypes have been identified. Serologic determination of these phenotypes is often doubtful and makes genetic analysis of RHD gene highly desirable in transfusion recipients and pregnant women. We analyzed the RHD gene in a cohort of pregnant women with doubtful D phenotypes. METHODS: RHD genotyping was performed on 104 cases with D typing discrepancies or with history of serologic weak D phenotype...
April 4, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28367647/risk-for-postpartum-hemorrhage-transfusion-and-hemorrhage-related-morbidity-at-low-moderate-and-high-volume-hospitals
#14
Audrey A Merriam, Jason D Wright, Zainab Siddiq, Mary E D'Alton, Alexander M Friedman, Cande V Ananth, Brian T Bateman
OBJECTIVE: The objective of this study was to characterize risk for and temporal trends in postpartum hemorrhage across hospitals with different delivery volumes. STUDY DESIGN: This study used the Nationwide Inpatient Sample (NIS) to characterize risk for postpartum hemorrhage from 1998 to 2011. Hospitals were classified as having either low, moderate or high delivery volume (≤1000, 1001 to 2000, >2000 deliveries per year, respectively). The primary outcomes included postpartum hemorrhage, transfusion, and related severe maternal morbidity...
April 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28367018/blood-transfusion-practices-in-a-tertiary-care-center-in-northern-india
#15
Sonam Kumari
BACKGROUND: Blood transfusion plays vital roles in the medical and surgical practice. To achieve optimum use of blood, transfusion has to be appropriate and judicious consuming minimal resources and manpower. OBJECTIVE: To evaluate the pattern of blood transfusion requests and utilization with the aim of determining transfusion practice. MATERIALS AND METHODS: Blood request forms and cross-match worksheets at the blood bank were analyzed over a 6-month period...
April 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28347198/endomyometritis-after-cesarean-delivery-in-the-era-of-antibiotic-prophylaxis-incidence-and-risk-factors
#16
Laura J Moulton, Mark Lachiewicz, Xiaobo Liu, Oluwatosin Goje
PURPOSE: To identify the rate of endomyometritis (PPE) after cesarean delivery (CD) in the era of antibiotic prophylaxis and determine risk factors. METHODS: A single institution retrospective study was performed in women undergoing CD. Data regarding obstetrical and surgical variables were collected. Diagnosis of PPE was made clinically. RESULTS: Among 2419 patients, the rate of PPE was 1.6% (n = 38) and was associated with lower age (27...
March 27, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28335653/anesthesia-management-of-complete-versus-incomplete-placenta-previa-a-retrospective-cohort-study
#17
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/28331607/-simplified-international-recommendations-for-the-implementation-of-patient-blood-management-sir4pbm
#18
Patrick Meybohm, Bernd Froessler, Lawrence T Goodnough, Andrew A Klein, Manuel Muñoz, Michael F Murphy, Toby Richards, Aryeh Shander, Donat R Spahn, Kai Zacharowski
BACKGROUND: More than 30% of the world's population are anemic with serious medical and economic consequences. Red blood cell transfusion is the mainstay to correct anemia, but it is also one of the top five overused procedures and carries its own risk and cost burden. Patient blood management (PBM) is a patient-centered and multidisciplinary approach to manage anemia, minimize iatrogenic blood loss, and harness tolerance to anemia in an effort to improve patient outcome. Despite resolution 63...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#19
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28320352/a-comparison-of-intrapartum-interventions-and-adverse-outcomes-by-parity-in-planned-freestanding-midwifery-unit-and-alongside-midwifery-unit-births-secondary-analysis-of-low-risk-births-in-the-birthplace-in-england-cohort
#20
Jennifer Hollowell, Yangmei Li, Kathryn Bunch, Peter Brocklehurst
BACKGROUND: For low risk women, there is good evidence that planned birth in a midwifery unit is associated with a reduced risk of maternal interventions compared with planned birth in an obstetric unit. Findings from the Birthplace cohort study have been interpreted by some as suggesting a reduced risk of interventions in planned births in freestanding midwifery units (FMUs) compared with planned births in alongside midwifery units (AMUs). However, possible differences have not been robustly investigated using individual-level Birthplace data...
March 21, 2017: BMC Pregnancy and Childbirth
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