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Obstetrics emergency

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https://www.readbyqxmd.com/read/29240463/assessing-the-validity-of-a-multidisciplinary-mini-clinical-evaluation-exercise
#1
Susan Humphrey-Murto, Mylène Côté, Debra Pugh, Timothy J Wood
Construct: The purpose of this study was to provide validity evidence for the mini-clinical evaluation exercise (mini-CEX) as an assessment tool for clinical skills in the workplace. BACKGROUND: Previous research has demonstrated validity evidence for the mini-CEX, but most studies were carried out in internal medicine or single disciplines, therefore limiting generalizability of the findings. If the mini-CEX is to be used in multidisciplinary contexts, then validity evidence should be gathered in similar settings...
December 14, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29224660/postpartum-hemorrhage
#2
Janice Newsome, Jonathan G Martin, Zachary Bercu, Jay Shah, Haris Shekhani, Gail Peters
Interventional radiologists are often called for emergent control of abnormal uterine bleeding. Bleeding, even heavy bleeding as a result of uterine fibroids is not a common emergent procedure; instead, pregnancy and pregnancy related conditions, trauma and malignancy associated with bleeding can be the source of many interventional radiology on call events or procedures. Postpartum hemorrhage (PPH) is the most common cause, and is defined as blood loss of 500mL after vaginal delivery or 1000mL after cesarean section...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29219937/relationship-between-maternal-characteristics-and-postpartum-hemorrhage-a-meta-analysis-study
#3
Aysegul Durmaz, Nuran Komurcu
BACKGROUND: Postpartum hemorrhage (PPH) is a leading cause of maternal death in low-income countries and the primary cause of approximately one of every four maternal deaths worldwide. PURPOSE: The aim of this study was to determine the antenatal risk factors of PPH and its effects. METHODS: The literature from nine databases was reviewed, and studies published between 2000 and 2012 were analyzed using terms such as "postpartum hemorrhage," "prevention of postpartum hemorrhage," and "management of postpartum hemorrhage...
December 6, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29219140/-near-miss-obstetric-events-and-maternal-mortality-in-a-tertiary-care-hospital
#4
Shravya Tallapureddy, Revathi Velagaleti, Himabindu Palutla, Chaitanya Venkata Satti
Obstetric near-miss or severe acute maternal morbidity is gaining interest internationally as a new indicator of the quality of obstetric care. This is a retrospective study conducted using "The WHO Near-Miss Approach" to provide insight into obstetric emergencies, near-miss cases, and maternal deaths in our hospital. The maternal near-miss ratio was 8.4/1000 live births, maternal near-miss to mortality ratio was 5.3:1. Hemorrhage was the leading cause (43.7%) of morbidity in near-miss cases while hypertensive disorders were the leading cause in maternal deaths (66...
October 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/29212509/incremental-cost-and-cost-effectiveness-of-low-dose-high-frequency-training-in-basic-emergency-obstetric-and-newborn-care-as-compared-to-status-quo-part-of-a-cluster-randomized-training-intervention-evaluation-in-ghana
#5
Michelle Willcox, Heather Harrison, Amos Asiedu, Allyson Nelson, Patricia Gomez, Amnesty LeFevre
BACKGROUND: Low-dose, high-frequency (LDHF) training is a new approach best practices to improve clinical knowledge, build and retain competency, and transfer skills into practice after training. LDHF training in Ghana is an opportunity to build health workforce capacity in critical areas of maternal and newborn health and translate improved capacity into better health outcomes. METHODS: This study examined the costs of an LDHF training approach for basic emergency obstetric and newborn care and calculates the incremental cost-effectiveness of the LDHF training program for health outcomes of newborn survival, compared to the status quo alternative of no training...
December 6, 2017: Globalization and Health
https://www.readbyqxmd.com/read/29212457/the-decision-delivery-interval-in-emergency-caesarean-section-and-its-associated-maternal-and-fetal-outcomes-at-a-referral-hospital-in-northern-tanzania-a-cross-sectional-study
#6
Birjna A Hirani, Bariki L Mchome, Nicholaus S Mazuguni, Michael J Mahande
BACKGROUND: Decision delivery interval (DDI) is the time line between a decision to conduct an emergency caesarean section and actual delivery of the baby. Prolong DDI constitute a third phase delay in provision of emergency obstetric care. Intervention designed to minimize DDI are vital, in attempt to prevent maternal morbidity and neonatal morbidity and mortality. The feasibility and practicability of the recommended DDI in recent studies have been questioned especially in limited resource setting and therefore the objective of our study was to determine the DDI and its associated fetalmaternal outcomes at a tertiary referral hospital in Tanzania...
December 7, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29208037/uterine-rupture-in-a-primigravid-patient-an-uncommon-but-severe-obstetrical-event-a-case-report
#7
Lotte Posthumus, Marielle Eveline Donker
BACKGROUND: A spontaneous rupture of the unscarred uterus in a primigravid patient is extremely rare and is associated with high perinatal and maternal morbidity and mortality. CASE PRESENTATION: A 34-year-old white primigravid woman, 31 + 3 weeks of gestation, presented with pre-eclampsia and developed a sudden acute abdomen. An emergency laparotomy was performed and a uterine rupture was found as the cause of the event. A stillborn girl was born. CONCLUSION: A rupture of the pregnant uterus should always be considered in a pregnant woman presenting with abdominal pain, even in a primigravid patient...
December 6, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29207784/emergency-peripartum-hysterectomy-a-14-year-experience-at-a-tertiary-care-centre-in-india
#8
S Tahmina, Mary Daniel, Preetha Gunasegaran
Introduction: Emergency Peripartum Hysterectomy (EPH), although relatively infrequent in present day obstetrics, is a life-saving procedure in the event of a massive postpartum haemorrhage. Aim: To assess incidence, risk factors, indications and complications of peripartum hysterectomies at a tertiary care teaching hospital in India. Materials and Methods: A retrospective study was conducted at 650-bedded tertiary care medical teaching hospital in Southern India...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29202964/obstetrical-complications-of-endometriosis-particularly-deep-endometriosis
#9
REVIEW
Umberto Leone Roberti Maggiore, Annalisa Inversetti, Matteo Schimberni, Paola Viganò, Veronica Giorgione, Massimo Candiani
Over the past few years, a new topic in the field of endometriosis has emerged: the potential impact of the disease on pregnancy outcomes. This review aims to summarize in detail the available evidence on the relationship between endometriosis, particularly deep endometriosis (DE), and obstetrical outcomes. Acute complications of DE, such as spontaneous hemoperitoneum, bowel perforation, and uterine rupture, may occur during pregnancy. Although these events represent life-threatening conditions, they are rare and unpredictable...
December 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29202962/introduction-from-pathogenesis-to-therapy-deep-endometriosis-remains-a-source-of-controversy
#10
Jacques Donnez
Deep endometriosis remains a source of controversy. A number of theories may explain its pathogenesis and many arguments support the hypothesis that genetic or epigenetic changes are a prerequisite for development of lesions into deep endometriosis. Deep endometriosis is frequently responsible for pelvic pain, dysmenorrhea, and/or deep dyspareunia, but can also cause obstetrical complications. Diagnosis may be improved by high-quality imaging. Therapeutic approaches are a source of contention as well. In this issue's Views and Reviews, medical and surgical strategies are discussed, and it is emphasized that treatment should be designed according to a patient's symptoms and individual needs...
December 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29202731/economic-evaluation-of-emergency-obstetric-care-training-a-systematic-review
#11
Aduragbemi Banke-Thomas, Megan Wilson-Jones, Barbara Madaj, Nynke van den Broek
BACKGROUND: Training healthcare providers in Emergency Obstetric Care (EmOC) has been shown to be effective in improving their capacity to provide this critical care package for mothers and babies. However, little is known about the costs and cost-effectiveness of such training. Understanding costs and cost-effectiveness is essential in guaranteeing value-for-money in healthcare spending. This study systematically reviewed the available literature on cost and cost-effectiveness of EmOC trainings...
December 4, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29202307/the-impact-of-free-healthcare-on-women-s-capability-a-qualitative-study-in-rural-burkina-faso
#12
Oumar Mallé Samb, Valery Ridde
In March 2006, the government of Burkina Faso implemented an 80% subsidy for emergency obstetric and neonatal care (EmONC). To complement this subsidy, an NGO decided to cover the remaining 20% in two districts of the country, making EmONC completely free for women there. In addition, the NGO instituted fee exemptions for children under five years of age in those two districts. We conducted a qualitative study in 2011 to examine the impact of these free healthcare interventions on women's capability. We conducted semi-structured interviews with 40 women, 16 members of health centre management committees, and eight healthcare workers in three health districts, as well as a documentary analysis...
November 28, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/29195637/professional-confidence-among-swedish-final-year-midwifery-students-a-cross-sectional-study
#13
Lena Bäck, Bharati Sharma, Annika Karlström, Katarina Tunon, Ingegerd Hildingsson
OBJECTIVE: Previous international studies have shown that midwifery students do not feel confident in many areas where they are supposed to practice independently. The knowledge about Swedish midwifery students' confidence is fairly under investigated. The purpose of the present study was to explore final years' midwifery students' professional confidence in basic midwifery skills according to ICM competencies and associated factors. METHODS: A cross-sectional survey where all midwifery programs in Sweden were invited to participate...
December 2017: Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives
https://www.readbyqxmd.com/read/29194062/cost-effectiveness-analysis-of-intraoperative-cell-salvage-for-obstetric-hemorrhage
#14
Grace Lim, Vladyslav Melnyk, Francesca L Facco, Jonathan H Waters, Kenneth J Smith
BACKGROUND: Cost-effectiveness analyses on cell salvage for cesarean delivery to inform national and societal guidelines on obstetric blood management are lacking. This study examined the cost-effectiveness of cell salvage strategies in obstetric hemorrhage from a societal perspective. METHODS: Markov decision analysis modeling compared the cost-effectiveness of three strategies: use of cell salvage for every cesarean delivery, cell salvage use for high-risk cases, and no cell salvage...
December 1, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29191200/emergency-general-surgery-in-rwandan-district-hospitals-a-cross-sectional-study-of-spectrum-management-and-patient-outcomes
#15
Christophe Mpirimbanyi, Alexandre Nyirimodoka, Yihan Lin, Bethany L Hedt-Gauthier, Jackline Odhiambo, Theoneste Nkurunziza, Joaquim M Havens, Jack Omondi, Emile Rwamasirabo, Faustin Ntirenganya, Gabriel Toma, Joel Mubiligi, Scheilla Bayitondere, Robert Riviello
BACKGROUND: Management of emergency general surgical conditions remains a challenge in rural sub-Saharan Africa due to issues such as insufficient human capacity and infrastructure. This study describes the burden of emergency general surgical conditions and the ability to provide care for these conditions at three rural district hospitals in Rwanda. METHODS: This retrospective cross-sectional study included all patients presenting to Butaro, Kirehe and Rwinkwavu District Hospitals between January 1st 2015 and December 31st 2015 with emergency general surgical conditions, defined as non-traumatic, non-obstetric acute care surgical conditions...
December 1, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29189694/committee-opinion-no-726-hospital-disaster-preparedness-for-obstetricians-and-facilities-providing-maternity-care
#16
(no author information available yet)
Large-scale catastrophic events and infectious disease outbreaks highlight the need for disaster planning at all community levels. Features unique to the obstetric population (including antepartum, intrapartum, postpartum and neonatal care) warrant special consideration in the event of a disaster. Pregnancy increases the risks of untoward outcomes from various infectious diseases. Trauma during pregnancy presents anatomic and physiologic considerations that often can require increased use of resources such as higher rates of cesarean delivery...
December 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29189692/committee-opinion-no-726-summary-hospital-disaster-preparedness-for-obstetricians-and-facilities-providing-maternity-care
#17
(no author information available yet)
Large-scale catastrophic events and infectious disease outbreaks highlight the need for disaster planning at all community levels. Features unique to the obstetric population (including antepartum, intrapartum, postpartum and neonatal care) warrant special consideration in the event of a disaster. Pregnancy increases the risks of untoward outcomes from various infectious diseases. Trauma during pregnancy presents anatomic and physiologic considerations that often can require increased use of resources such as higher rates of cesarean delivery...
December 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29184859/risk-factors-for-massive-postpartum-bleeding-in-pregnancies-in-which-incomplete-placenta-previa-are-located-on-the-posterior-uterine-wall
#18
Hyun Jung Lee, Young Jai Lee, Eun Hee Ahn, Hyeon Chul Kim, Sang Hee Jung, Sung Woon Chang, Ji Yeon Lee
Objective: To identify factors associated with massive postpartum bleeding in pregnancies complicated by incomplete placenta previa located on the posterior uterine wall. Methods: A retrospective case-control study was performed. We identified 210 healthy singleton pregnancies with incomplete placenta previa located on the posterior uterine wall, who underwent elective or emergency cesarean section after 24 weeks of gestation between January 2006 and April 2016...
November 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/29181210/bilateral-tubal-pregnancy-without-known-risk-factor
#19
Hyacinthe Zamané, Barnabé Yameogo, Paul Dantola Kain, François Gueswendé Xavier Kaboré, Yobi Alexis Sawadogo, Sibraogo Kiemtoré, Sidbewenné Yacinthe Kaboré, Blandine Bonané Thiéba
Spontaneous bilateral ectopic gestation is very rare. The authors report a case diagnosed and taken care of at Yalgado Ouedraogo Teaching Hospital, Ouagadougou. It was a 30-year-old patient with no known pathological history. She had presented at the obstetric emergencies with a state of hypovolemic shock by haemoperitoneum with digestive disorders, pelvic pain, vaginal bleeding, and a mention of delayed menstruation. The ultrasound coupled with the urinary immunological pregnancy test confirmed the diagnosis of ruptured ectopic pregnancy and a bilateral form was suspected...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29179271/-relationship-between-the-risk-of-emergency-cesarean-section-for-nullipara-with-the-prepregnancy-body-mass-index-or-gestational-weight-gain
#20
R F Zhao, W Y Zhang, L Zhou
Objective: To investigate the risk of emergency cesarean section during labor with the pre-pregnancy body mass index or gestational weight gain. Methods: A total of 6 908 healthy nullipara with singleton pregnancy and cephalic presentation who was in term labor in Beijing Obstetrics and Gynecology Hospital from August 1(st), 2014 to September 30(th), 2015 were recruited. They were divided into two groups, the vaginal delivery group (92.88%, 6 416/6 908) and the emergency cesarean section group (7.12%, 492/6 908)...
November 25, 2017: Zhonghua Fu Chan Ke za Zhi
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