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Obstetrics emergency

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https://www.readbyqxmd.com/read/29034750/parallel-vertical-compression-sutures-to-control-bleeding-in-cases-of-placenta-previa-and-accreta
#1
Magdy A Mohamed, Ahmed H Mohammed
OBJECTIVE: To evaluate the effectiveness of full-thickness vertical compression suture and intrauterine catheter in cases with placenta previa/accreta. STUDY DESIGN: This study was conducted on Obstetrics and Gynecology emergency unit of Sohag University Hospital. Two longitudinal parallel full-thickness suture was taken using delayed absorbable suture (No. 2 Vicryl…) the entry of needle through anterior wall of lower uterine segment just above the internal os 2-3 cm medial to lateral aspect of lower uterine segment then completely piercing the posterior wall and then return from posterior wall to anterior wall 1-2 cm below incision line of the uterus...
October 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29033113/a-new-facilitating-technique-for-postpartum-hysterectomy-at-full-dilatation-cervical-clamp
#2
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/29017467/association-between-very-advanced-maternal-age-and-adverse-pregnancy-outcomes-a-cross-sectional-japanese-study
#3
Kohei Ogawa, Kevin Y Urayama, Shinji Tanigaki, Haruhiko Sago, Shoji Sato, Shigeru Saito, Naho Morisaki
BACKGROUND: While several studies have demonstrated the increased risk of pregnancy complications for women of advanced age, few studies have focused on women with very advanced age (≥ 45), despite the increasing rate of pregnancy among such women. Furthermore, how such risks of increase in age differ by maternal characteristics are also poorly understood. Thus, we aimed to clarify pregnant outcomes among women with very advanced age and how the effect of age differs by method of conception and parity...
October 10, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29017359/antenatal-scoring-system-in-predicting-the-success-of-planned-vaginal-birth-following-one-previous-caesarean-section
#4
Aida Kalok, Shahril A Zabil, Muhammad Abdul Jamil, Pei Shan Lim, Mohamad Nasir Shafiee, Nirmala Kampan, Shamsul Azhar Shah, Nor Azlin Mohamed Ismail
This was a prospective observational study to determine the predictive factors for a successful vaginal birth after caesarean section (VBAC) and to develop a relevant antenatal scoring system. Patients with one previous caesarean section were included in this study. All data including maternal demographics, obstetric history, pregnancy progress and outcomes were collected and analysed. A total of 142 out of the 186 women (76.3%) had successful VBAC. History of previous vaginal delivery and non-recurrent indications for previous caesarean section were the significant predictive factors for a successful VBAC...
October 10, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29016578/profile-of-caesarean-section-at-kathmandu-medical-college
#5
Apurwa Prasad, Garima Bhandari, Rachana Saha
BACKGROUND: There is a world-wide rise in caesarean section rateduring the last three decades and has been a cause of alarm and needs an in-depth study. The objective of this study was to determine the rate and clinical indications of Caesarean Section. METHODS: A hospital based study was carried out from 15th June 2015 to 15th January 2016 in Department of Obstetrics and Gynecology at Kathmandu Medical College, Sinamangal, Nepal. Patients who delivered by caesarean section were included in the study...
September 8, 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28994352/the-impact-of-a-multi-level-maternal-health-programme-on-facility-delivery-and-capacity-for-emergency-obstetric-care-in-zambia
#6
Elizabeth G Henry, Donald M Thea, Davidson H Hamer, William DeJong, Kebby Musokotwane, Kenneth Chibwe, Godfrey Biemba, Katherine Semrau
In 2012, Saving Mothers, Giving Life (SMGL), a multi-level health systems initiative, launched in Kalomo District, Zambia, to address persistent challenges in reducing maternal mortality. We assessed the impact of the programme from 2012 to 2013 using a quasi-experimental study with both household- and health facility-level data collected before and after implementation in both intervention and comparison areas. A total of 21,680 women and 75 non-hospital health centres were included in the study. Using the difference-in-differences method, multivariate logistic regression, and run charts, rates of facility-based birth (FBB) and delivery with a skilled birth provider were compared between intervention and comparison sites...
October 10, 2017: Global Public Health
https://www.readbyqxmd.com/read/28983910/-your-lack-of-planning-does-not-constitute-my-emergency-caring-for-obstetric-patients-with-mental-illness
#7
EDITORIAL
K McCombe
No abstract text is available yet for this article.
October 5, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28979638/-fight-against-maternal-mortality-in-rural-areas-decentralization-of-emergency-obstetric-cares-in-burkina-faso
#8
Souleymane Kaboré, Clément Ziemlé Méda, Issiaka Sombié, Léon Blaise Savadogo, Robert Karama, Koabié Bakouan, Djénéba Sanon Ouédraogo, Norbert Coulibaly, Robert Lucien Kargougou, Emanuel Lankoandé, Ramatou Windsouri Sawadogo, Karen Gosch
INTRODUCTION: In order to cover the shortage of midwives (MWs) in the health district of Tougan, Burkina Faso, a strategy for the decentralization of emergency obstetric cares, based on ad hoc interventions undertaken by MW to manage obstetric complications in health centers (HCs), has been developed in rural areas. This study aimed to describe this experience and to analyze the achieved results. METHODS: We conducted a cross-sectional, analytical, intervention study based on a review of routine data from all the parturients treated from 2013 to 2015...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28976059/spontaneous-intraperitoneal-hemorrhage-in-the-third-trimester-of-pregnancy-clinical-suspicion-made-the-difference
#9
Sameer Hamadeh, Bishr Addas, Nasreen Hamadeh, Jessica Rahman
A case of spontaneous hemoperitoneum resulting from ruptured vessels in the uterine-ovarian plexus, in the third trimester of pregnancy is described. This is a rare and challenging obstetric emergency. Acute abdominal pain is the main presenting symptom. Clinical suspicion and rapid intervention consisting of emergency cesarean section with ligation of bleeding vessels resulted in favorable outcomes for both mother and baby. The importance of prompt action in the case of deteriorating vital signs is emphasized to achieve success in their management...
October 4, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28968282/recent-advances-of-simulation-in-obstetric-anesthesia
#10
Leslie A Schornack, Curtis L Baysinger, May C M Pian-Smith
PURPOSE OF REVIEW: Simulation training in obstetric anesthesia has become widespread in recent years. Simulations are used to train staff and trainees, assess and improve team performance, and evaluate the work environment. This review summarizes current research in these categories. RECENT FINDINGS: Simulation to improve individual technical skills has focused on induction of general anesthesia for emergent cesarean delivery, an infrequently encountered scenario by anesthesia trainees...
September 28, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28967511/does-surgical-site-infection-after-caesarean-section-in-polish-hospitals-reflect-high-quality-patient-care-or-poor-postdischarge-surveillance-results-from-a-3-year-multicenter-study
#11
Anna Różańska, Andrzej Jarynowski, Katarzyna Kopeć-Godlewska, Jadwiga Wójkowska-Mach, Agnieszka Misiewska-Kaczur, Marzena Lech, Małgorzata Rozwadowska, Marlena Karwacka, Joanna Liberda, Joanna Domańska
BACKGROUND: Caesarean sections (CSs) are associated with a high infection risk. Surgical site infection (SSI) incidence is among the markers of effectiveness of infection prevention efforts. The aim of this study was to analyze risk factors for SSI, incidence, and microbiology in patients who underwent CS. METHODS: The study was conducted during 2013-2015 using active infection surveillance in 5 Polish hospitals according to the European Centre for Disease Prevention and Control surveillance network known as HAI-Net...
September 26, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28965442/the-impact-of-curve-severity-on-obstetric-complications-and-regional-anesthesia-utilization-in-pregnant-patients-with-adolescent-idiopathic-scoliosis-a-preliminary-analysis
#12
Emily W Chan, Stephen R Gannon, Chevis N Shannon, Jeffrey E Martus, Gregory A Mencio, Christopher M Bonfield
OBJECTIVE Adolescent idiopathic scoliosis (AIS), the most common type of scoliosis, often presents immediately prior to a woman's childbearing years; however, research investigating the impact of AIS on women's health, particularly pregnancy delivery outcomes, is sparse, with existing literature reporting mixed findings. Similarly limited are studies examining the change in scoliotic curve during or after pregnancy. Therefore, this study aims to determine 1) the impact of scoliotic curvature on obstetric complications (preterm births, induction of labor, and urgent/emergency caesarean section delivery), 2) regional anesthetic decision making and success during delivery for these patients, and 3) the effect of pregnancy on curve progression...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28964728/-vaginal-delivery-in-case-of-breech-presentation-impact-of-a-service-s-incentive
#13
L Hejl, E Perdriolle-Galet, E Gauchotte, R Callec, O Morel
OBJECTIVES: The mode of delivery in podalic presentation was controvertible since the 2000s, which led to a high rate of caesarean section. In our center, the delivery mode was physician-dependent before 2012. Since 2012, the management of podalic presentations was supervised by a protocol allowing a collegiate management to promote vaginal delivery. The objective of this study was to evaluate the impact of this policy on neonatal outcomes and obstetric practices. METHODS: A retrospective study was carried out with comparison of 135 patients who gave birth in 2008 with 110 patients who gave birth in 2014, before and after the implementation of the protocol in a type III university maternity hospital...
September 27, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/28962566/-i-stayed-with-my-illness-a-grounded-theory-study-of-health-seeking-behaviour-and-treatment-pathways-of-patients-with-obstetric-fistula-in-kenya
#14
Anne M Khisa, Grace M Omoni, Isaac K Nyamongo, Rachel F Spitzer
BACKGROUND: Obstetric fistula classic symptoms of faecal and urinary incontinence cause women to live with social stigma, isolation, psychological trauma and lose their source of livelihoods. There is a paucity of studies on the health seeking behaviour trajectories of women with fistula illness although women live with the illness for decades before surgery. We set out to establish the complete picture of women's health seeking behaviour using qualitative research. We sought to answer the question: what patterns of health seeking do women with obstetric fistula display in their quest for healing? METHODS: We used grounded theory methodology to analyse data from narratives of women during inpatient stay after fistula surgery in 3 hospitals in Kenya...
September 29, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28960252/does-previous-caesarean-section-at-full-dilatation-increase-the-likelihood-of-subsequent-spontaneous-preterm-birth
#15
Angela Cong, Bradley de Vries, Joanne Ludlow
BACKGROUND: There is emerging evidence that caesarean section at full dilatation is associated with an increased risk of subsequent spontaneous preterm birth. AIM: To investigate the association between caesarean section at full dilatation and spontaneous preterm birth in subsequent pregnancies. MATERIALS AND METHODS: This was a retrospective cohort study of women who had two consecutive births at Royal Prince Alfred Hospital, 1989-2015. Our main comparison group was women who had emergency caesarean sections during the first stage of labour...
September 28, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28959508/autonomic-dysreflexia-in-the-peripartum-patient-a-multidisciplinary-and-interprofessional-simulation-scenario
#16
Purnima M Rao, Adam Garber, Chandrew Rajakumar, Genevieve Rousseau, George Dumitrascu, Glenn D Posner
This case is one of an eight-case multidisciplinary curriculum designed and implemented at the University of Ottawa by simulation educators with specialty training in obstetrics and gynecology (ob/gyn) and anesthesiology. Consultation with a nurse educator maintained quality and relevance of objectives for nursing participants. The curriculum was prepared to train ob/gyn and anesthesiology residents and nurses to hone crisis resource management skills and to recognize and manage rare/critical medical events in an obstetrical setting...
July 25, 2017: Curēus
https://www.readbyqxmd.com/read/28953119/cervical-excision-procedure-a-trend-of-decreasing-length-of-excision-observed-in-a-multicenter-survey
#17
Andrea Ciavattini, Nicolò Clemente, Carlo Antonio Liverani, Paolo Cattani, Luca Giannella, Giovanni Delli Carpini, Stefano Morini, Monica Buttignol, Francesco Sopracordevole
OBJECTIVES: The aim of the present study was to observe the trend of length of cone excisions in women treated with cervical excision procedure in five institutions of Central and Northern Italy. MATERIALS AND METHODS: A multicenter retrospective cohort study was conducted on women who underwent a cervical excision procedure between January 2006 and December 2014. The pertinent clinical, histopathological, and sociodemographic characteristics of each woman were collected...
October 2017: Journal of Lower Genital Tract Disease
https://www.readbyqxmd.com/read/28950830/a-survey-based-study-of-zika-virus-communication-preferences-among-pregnant-women-in-georgia-united-states
#18
Mallory K Ellingson, Catherine M Bonk, Allison T Chamberlain
BACKGROUND: Because of the particularly severe perinatal outcomes associated with antenatal Zika virus infection, it is important for prenatal care providers to communicate Zika virus risks and strategies for prevention to their patients. Although face-to-face communication is ideal, clinic visits may not allow for in-depth discussion of all concerns. While previous studies have shown prenatal providers to be pregnant women's most trusted sources of health information, there is little knowledge on what secondary communication modalities pregnant women prefer for receiving information from their providers about an evolving public health emergency...
September 26, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28946844/woman-centred-care-during-pregnancy-and-birth-in-ireland-thematic-analysis-of-women-s-and-clinicians-experiences
#19
Andrew Hunter, Declan Devane, Catherine Houghton, Annmarie Grealish, Agnes Tully, Valerie Smith
BACKGROUND: Recent policy and service provision recommends a woman-centred approach to maternity care. Midwife-led models of care are seen as one important strategy for enhancing women's choice; a core element of woman-centred care. In the Republic of Ireland, an obstetric consultant-led, midwife-managed service model currently predominates and there is limited exploration of the concept of women centred care from the perspectives of those directly involved; that is, women, midwives, general practitioners and obstetricians...
September 25, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28945616/new-models-of-care
#20
Hal C Lawrence
The practice of obstetrics and gynecology continues to evolve. Changes in the obstetrician-gynecologists workforce, reimbursement, governmental regulations, and technology all drive new models of care. The advent of the obstetric hospitalist is one new model, and the development of team-based care is another. Increasingly, obstetrician-gynecologists are becoming employees of health care delivery systems, and others are focusing the scope of their practices to subspecialites. As new practice models emerge, the specialty of obstetrics and gynecology will continue to change to meet the health care needs of women...
September 22, 2017: Clinical Obstetrics and Gynecology
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