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https://www.readbyqxmd.com/read/29324608/quality-assurance-practices-in-obstetric-care-a-survey-of-hospitals-in-california
#1
Lisbet S Lundsberg, Henry C Lee, Grace Villarin Dueñas, Kimberly D Gregory, Holly K Grossetta Nardini, Christian M Pettker, Jessica L Illuzzi, Xiao Xu
OBJECTIVE: To assess hospital practices in obstetric quality management activities and identify institutional characteristics associated with utilization of evidence-supported practices. METHODS: Data for this study came from a statewide survey of obstetric hospitals in California regarding their organization and delivery of perinatal care. We analyzed responses from 185 hospitals that completed quality assurance sections of the survey to assess their practices in a broad spectrum of quality enhancement activities...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29297950/effects-of-vaginal-progesterone-for-maintenance-tocolysis-on-uterine-electrical-activity
#2
Miha Lucovnik, Andreja Trojner Bregar, Lea Bombac, Ksenija Gersak, Robert E Garfield
AIM: The effectiveness of vaginal progesterone for maintenance tocolysis after arrested preterm labor remains controversial. Myometrial contractility can be assessed objectively and non-invasively after progesterone treatment by monitoring uterine electromyography (EMG). We examined the effects of vaginal progesterone on uterine EMG after successful acute tocolysis. METHODS: This was a randomized, double-blind, single-center study performed between 2012 and 2015...
January 3, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29291413/impact-of-recommended-changes-in-labor-management-for-prevention-of-the-primary-cesarean-delivery
#3
Claire Thuillier, Sophie Roy, Violaine Peyronet, Thibaud Quibel, Aurélie Nlandu, Patrick Rozenberg
BACKGROUND: The dramatic rise in cesarean delivery (CD) rates worldwide in recent decades, without evidence of a concomitant decrease in cerebral palsy rates, has raised concerns about its potential negative consequences for maternal and infant health. In 2014, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine jointly published an Obstetric Care Consensus for safe prevention of the primary cesarean delivery. OBJECTIVE: We sought to assess whether modification of our protocol to implement these recommendations helped to decrease our primary CD rate safely...
December 29, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29275823/is-there-a-role-for-placental-senescence-in-the-genesis-of-obstetric-complications-and-fetal-growth-restriction
#4
REVIEW
Zakia Sultana, Kaushik Maiti, Lee Dedman, Roger Smith
The placenta ages as pregnancy advances, yet its continued function is required for a successful pregnancy outcome. Placental aging is a physiological phenomenon; however, there are some placentas that show signs of aging earlier than others. Premature placental senescence and aging are implicated in a number of adverse pregnancy outcomes, including fetal growth restriction, preeclampsia, spontaneous preterm birth, and intrauterine fetal death. Here we discuss cellular senescence, a state of terminal proliferation arrest, and how senescence is regulated...
December 22, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29232667/correlation-between-subpubic-arch-angle-and-mode-of-delivery-in-large-for-gestational-age-fetuses
#5
Tullio Ghi, Andrea Dall'Asta, Alice Suprani, Elisa Aiello, Andrea Musarò, Costanza Bosi, Giuseppe Pedrazzi, Ariane Kiener, Domenico Arduini, Tiziana Frusca, Giuseppe Rizzo
OBJECTIVES: A narrow subpubic arch angle (SPA) has been associated with a higher risk of operative delivery and prolonged labor. The aim of this study was to evaluate the correlation between SPA and labor outcome in a cohort of women delivering a large-for-gestational-age (LGA) fetus. METHODS: An observational study involving two Italian tertiary centers (Parma and Rome) was carried out. Nulliparous women referred to the antepartum clinic between 35 and 39 weeks due to an increased risk of having an LGA fetus at birth were prospectively selected for the study purpose...
December 13, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29229362/french-validation-and-adaptation-of-the-grobman-nomogram-for-prediction-of-vaginal-birth-after-cesarean-delivery
#6
Jean-Baptiste Haumonte, Mélina Raylet, Marie Christophe, Franck Mauviel, Armelle Bertrand, Raoul Desbriere, Claude d'Ercole
OBJECTIVE: To validate Grobman nomogram for predict vaginal birth after cesarean delivery (VBAC) in a French population and adapt it. STUDY DESIGN: Multicenter retrospective study of maternal and obstetric factors associated with VBAC between May 2012 and May 2013 in 6 maternity. External validation and adaptation of the prenatal and intrapartum Grobman nomograms for vaginal birth prediction after cesarean delivery in a French cohort RESULTS: The study included 523 women with previous cesarean deliveries; 70% underwent a trial of labor for a subsequent delivery (n=367) with a success rate of 65% (n=240)...
December 8, 2017: Journal of Gynecology Obstetrics and Human Reproduction
https://www.readbyqxmd.com/read/29138035/defining-failed-induction-of-labor
#7
William A Grobman, Jennifer Bailit, Yinglei Lai, Uma M Reddy, Ronald J Wapner, Michael W Varner, John M Thorp, Kenneth J Leveno, Steve N Caritis, Mona Prasad, Alan T N Tita, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
BACKGROUND: While there are well-accepted standards for the diagnosis of arrested active-phase labor, the definition of a "failed" induction of labor remains less certain. One approach to diagnosing a failed induction is based on the duration of the latent phase. However, a standard for the minimum duration that the latent phase of a labor induction should continue, absent acute maternal or fetal indications for cesarean delivery, remains lacking. OBJECTIVE: The objective of this study was to determine the frequency of adverse maternal and perinatal outcomes as a function of the duration of the latent phase among nulliparous women undergoing labor induction...
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29112649/racial-and-ethnic-differences-in-utilization-of-labor-management-strategies-intended-to-reduce-cesarean-delivery-rates
#8
Lynn M Yee, Maged M Costantine, Madeline Murguia Rice, Jennifer Bailit, Uma M Reddy, Ronald J Wapner, Michael W Varner, John M Thorp, Steve N Caritis, Mona Prasad, Alan T N Tita, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
OBJECTIVE: To examine whether racial and ethnic differences exist in the frequency of and indications for cesarean delivery and to assess whether application of labor management strategies intended to reduce cesarean delivery rates is associated with patient's race and ethnicity. METHODS: This is a secondary analysis of a multicenter observational obstetric cohort. Trained research personnel abstracted maternal and neonatal records of greater than 115,000 pregnant women from 25 hospitals (2008-2011)...
November 3, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29066439/pulmonary-hypertension-and-pregnancy-outcomes-insights-from-the-national-inpatient-sample
#9
Erin Thomas, Jie Yang, Jianjin Xu, Fabio V Lima, Kathleen Stergiopoulos
BACKGROUND: Pregnant women with pulmonary hypertension (PH) are at risk for adverse cardiac outcomes, particularly at the time of labor and delivery. The purpose of this study is to define the impact of PH on pregnancy outcomes and the risk of major adverse cardiac events (MACE). METHODS AND RESULTS: The National Inpatient Sample was screened for hospital admissions of women delivering during the years 2003 to 2012. The primary outcome was MACE, a composite of death, cardiac arrest, cardiogenic shock, myocardial infarction, respiratory failure, arrhythmia, stroke, and embolic event...
October 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29052016/prediction-of-vaginal-birth-after-one-ceasarean-delivery-for-non-progressive-labor
#10
Yossi Mizrachi, Elad Barber, Michal Kovo, Jacob Bar, Samuel Lurie
PURPOSE: A model exists that predicts the probability of vaginal birth after cesarean (VBAC). That model is not stratified by indication at first cesarean. The aim of the study was to identify factors that may predict successful VBAC in patients operated for arrest of dilatation or descent at their first cesarean. METHODS: Retrospective analysis of all women with trials of labor after one cesarean (TOLAC) for non-progressive labor between November 2008 and October 2015 was performed (n = 231)...
October 20, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29037483/new-labor-management-guidelines-and-changes-in-cesarean-delivery-patterns
#11
Joshua I Rosenbloom, Molly J Stout, Methodius G Tuuli, Candice L Woolfolk, Julia D López, George A Macones, Alison G Cahill
BACKGROUND: In 2010 the Consortium on Safe Labor published labor curves. It was proposed that the rate of cesarean delivery could be lowered by avoiding the diagnosis of arrest of dilation before 6 cm. However, there is little information on the uptake of the guidelines and on changes in cesarean delivery rates that may have occurred. OBJECTIVE: The objective of the study was to test the following hypotheses: (1) among patients laboring at term, rates of arrest of dilation disorders have decreased, leading to a decrease in the rate of cesarean delivery; (2) in the second stage, pushing duration prior to diagnosis of arrest of descent has increased, also leading to a reduction in the rate of cesarean delivery for this indication...
October 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29016512/trial-of-labor-compared-with-cesarean-delivery-in-superobese-women
#12
MULTICENTER STUDY
Jennifer L Grasch, Jennifer L Thompson, J Michael Newton, Amy W Zhai, Sarah S Osmundson
OBJECTIVE: To examine whether labor compared with planned cesarean delivery is associated with increased maternal and neonatal morbidity. METHODS: We conducted a retrospective cohort study of all women with body mass indexes (BMIs) at delivery of 50 or greater delivering a live fetus at 34 weeks of gestation of greater between January 1, 2008, and December 31, 2015. Pregnancies with multiple gestations and major fetal anomalies were excluded. The primary outcome was a composite of maternal and neonatal morbidity and was estimated to be 50% in superobese women based on institutional data...
November 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29016497/discontinuing-oxytocin-infusion-in-the-active-phase-of-labor-a-systematic-review-and-meta-analysis
#13
REVIEW
Gabriele Saccone, Andrea Ciardulli, Jason K Baxter, Joanne N Quiñones, Liany C Diven, Bor Pinar, Giuseppe Maria Maruotti, Pasquale Martinelli, Vincenzo Berghella
OBJECTIVE: To evaluate the benefits and harms of discontinuation of oxytocin after the active phase of labor is reached. DATA SOURCES: Electronic databases (ie, MEDLINE, Scopus, ClinicalTrials.gov, EMBASE, ScienceDirect, the Cochrane Library at the CENTRAL Register of Controlled Trials, Scielo) were searched from their inception until April 2017. METHODS OF STUDY SELECTION: We included all randomized controlled trials comparing discontinuation (ie, intervention group) and continuation (ie, control group) of oxytocin infusion after the active phase of labor is reached, either after induction or augmentation of labor...
November 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28948341/the-impact-of-a-new-standard-labor-protocol-on-maternal-and-neonatal-outcomes
#14
Dingran Wang, Shenglong Ye, Liyuan Tao, Yongqing Wang
PURPOSE: To analyze the clinical outcomes following the implementation of a new standard labor procedure. METHODS: This was a retrospective analysis that included a study group consisting of patients managed based on a new standard labor protocol and a control group comprising patients managed under an old standard labor protocol. The following maternal and perinatal outcomes were compared in the two groups: the indications for a cesarean section and the incidence of cesarean section, postpartum hemorrhage, fetal distress, neonatal asphyxia and pediatric intervention...
September 25, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28926807/ambient-temperature-and-risk-of-cardiovascular-events-at-labor-and-delivery-a-case-crossover-study
#15
Sandie Ha, Kelly Nguyen, Danping Liu, Tuija Männistö, Carrie Nobles, Seth Sherman, Pauline Mendola
BACKGROUND: Extreme ambient temperatures are linked to cardiac events in the general population, but this relationship is unclear among pregnant women. We estimated the associations and attributable risk between ambient temperature and the risk of cardiovascular event at labor/delivery, and investigated whether these associations vary by maternal race/ethnicity. METHODS: We identified 680 women with singleton deliveries affected by cardiovascular events across 12 US sites (2002-2008)...
November 2017: Environmental Research
https://www.readbyqxmd.com/read/28877399/cops-and-docs-the-challenges-for-ed-physicians-balancing-the-police-state-laws-and-emtala
#16
Kristin E Malcolm, James G Malcolm, Daniel T Wu, Kevin A Spainhour, Kevin P Race
State laws are awash with discord concerning whether a police officer's request or court order necessarily obligates physicians to perform a body fluid analysis of an arrested, conscious, nonconsenting suspect. Police typically bring arrestees directly to the emergency department (ED), and federal courts have begun to wrestle with the implications of the Emergency Medical Treatment and Labor Act (EMTALA), which requires that anyone presenting to the ED be screened for treatment. Some state laws require health care providers to comply with any police request for lab analysis, while other states offer more leeway to physicians...
October 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28768474/progesterone-in-women-with-arrested-premature-labor-a-report-of-a-randomised-clinical-trial-and-updated-meta-analysis
#17
Stephen Wood, Yacov Rabi, Selphee Tang, Rollin Brant, Susan Ross
BACKGROUND: Progesterone may be effective in prevention of premature birth in some high risk populations. Women with arrested premature labor are at risk of recurrent labor and maintenance therapy with standard tocolytics has not been successful. METHODS: Randomized double blinded clinical trial of daily treatment with 200 mg vaginal progesterone in women with arrested premature labor and an updated meta-analysis. RESULTS: The clinical trial was terminated early after 41 women were enrolled...
August 2, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28742525/impact-factors-on-fetal-descent-rates-in-the-active-phase-of-labor-a-retrospective-cohort-study
#18
Nina Kimmich, Jana Juhasova, Christian Haslinger, Nicole Ochsenbein-Kölble, Roland Zimmermann
AIM: To assess fetal descent rates of nulliparous and multiparous women in the active phase of labor and to evaluate significant impact factors. METHODS: In a retrospective cohort study at the University Hospital of Zurich, Switzerland, we evaluated 6045 spontaneous vaginal deliveries with a singleton in vertex presentation between January 2007 and July 2014 at 34 0/7 to 42 0/7 gestational weeks. Median fetal descent rates and their 10th and 90th percentiles were assessed in the active phase of labor and different impact factors were evaluated...
July 25, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28688227/impact-factors-on-cervical-dilation-rates-in-the-first-stage-of-labor
#19
Jana Juhasova, Martina Kreft, Roland Zimmermann, Nina Kimmich
AIMS: To assess cervical dilation rates of nulliparous and multiparous women in the active first stage of labor and to evaluate significant impact factors. METHODS: In a retrospective cohort study between January 2007 and July 2014 at the University Hospital of Zurich in Switzerland, we analyzed 8378 women with singleton pregnancies in vertex presentation with a vaginal delivery at 34+0 to 42+5 gestational weeks. Median cervical dilation rates were calculated and different impact factors evaluated...
July 8, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28681341/sexual-risks-and-policing-among-male-migrant-and-non-migrant-market-vendors-in-central-asia
#20
Phillip Marotta, Nabila El-Bassel, Assel Terlikbayeva, Gaukhar Mergenova, Sholpan Primbetova, Elwin Wu, Louisa Gilbert
The following study examined associations between sexual risk behaviors and policing among external migrant, internal migrant, and non-migrant male market workers in Almaty, Kazakhstan. Negative binomial regression and logistic regressions examined associations between sexual risk behaviors and policing (questioning by market officials and migration police, and arrest) for 1342 external, internal, and non-migrant workers recruited using respondent-driven sampling (RDS). Incidence rate ratios (IRR) and adjusted odds ratios (OR) were stratified by migration status...
July 5, 2017: Journal of Urban Health: Bulletin of the New York Academy of Medicine
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