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https://www.readbyqxmd.com/read/29905165/liver-disease-during-pregnancy-a-challenging-clinical-issue
#1
Ivana Mikolasevic, Tajana Filipec-Kanizaj, Ivan Jakopcic, Iva Majurec, Alemka Brncic-Fischer, Nikola Sobocan, Irena Hrstic, Tea Stimac, Davor Stimac, Sandra Milic
One of the least studied topics in the field of obstetrics is liver disease during pregnancy, which creates a challenge for both gynecologists and hepatologists. Approximately 3% of pregnant women are affected by some form of liver disease during pregnancy. Some of these conditions can be fatal for both the mother and child. In addition, 3 types of liver disease need to be differentiated during pregnancy. One type is liver disease directly related to pregnancy, which can occur at a specific time during pregnancy...
June 15, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29902983/health-providers-pass-knowledge-and-abilities-acquired-by-training-in-obstetric-emergencies-to-their-peers-the-average-treatment-on-the-treated-effect-of-pronto-on-delivery-attendance-in-mexico
#2
Jimena Fritz, Héctor Lamadrid-Figueroa, Gustavo Angeles, Alejandra Montoya, Dilys Walker
BACKGROUND: A significant proportion of newborn and maternal deaths can be prevented through simple and cost-effective strategies. The main aim of this study was to evaluate the impact of the PRONTO obstetric-emergency management training for improving evidence-based birth attendance practices among providers attending the training at 12 hospitals in three states of Mexico from 2010 to 2012, and to estimate dissemination of the training within the hospitals. METHODS: The average treatment on the treated effect of the PRONTO intervention for the probability of performing certain practices during birth attendance was estimated in a sample of 310 health providers...
June 15, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29902160/imaging-placental-function-current-technology-clinical-needs-and-emerging-modalities
#3
Chengxi Wu, Carolyn L Bayer
The function of the placenta is challenging to characterize and as a result is understudied, despite the growing awareness of the impact of the placental environment on human health and development. Medical imaging has the potential to improve our ability to screen for diseases associated with placental insufficiency, and improve the monitoring and treatment of complex obstetric patients. This review provides an overview of clinical and preclinical imaging modalities currently available for assessing placental function, with an emphasis on emerging preclinical imaging modalities; as a group, these emerging modalities provide exceptional contrast and sensitivity for multimodal functional and molecular imaging of the placenta...
June 14, 2018: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29899607/improvements-in-essential-newborn-care-and-newborn-resuscitation-services-following-a-capacity-building-and-quality-improvement-program-in-three-districts-of-uttar-pradesh-india
#4
Manoja Kumar Das, Chetna Chaudhary, Sadhu Charan Mohapatra, Vinod Kumar Srivastava, Najam Khalique, Santosh Kumar Kaushal, Rajesh Khanna, Surojit Chatterji
Background: Neonatal death remains a global challenge contributing to 45% of underfive deaths. With rising institutional delivery, to accelerate decline in neonatal mortality rate (NMR) improvement in the quality of perinatal care requires attention. Objectives: This implementation research targeted improving service delivery readiness for quality of newborn care at public health facilities in three districts of Uttar Pradesh, India, with high NMR. Materials and Methods: This before-after study assessed the facility readiness and quality of newborn services at 42 health facilities...
April 2018: Indian Journal of Community Medicine
https://www.readbyqxmd.com/read/29894797/diagnosis-and-outcomes-of-pregnant-women-with-zika-virus-infection-in-two-municipalities-of-risaralda-colombia-second-report-of-the-zikerncol-study
#5
Alfonso J Rodriguez-Morales, Jaime A Cardona-Ospina, Valeria Ramirez-Jaramillo, Javier A Gaviria, Gloria María González-Moreno, Juan D Castrillón-Spitia, Alejandra López-Villegas, Estefania Morales-Jiménez, Valentina Ramírez-Zapata, German Eduardo Rueda-Merchán, Adriana M Trujillo, Fredy A Tabares-Villa, Valentina Henao-SanMartin, David R Murillo-Garcia, Johana Andrea Herrera-Soto, Marta Liliana Buitrago-Cañas, Matthew H Collins, Juan Carlos Sepúlveda-Arias, José J Londoño, Héctor D Bedoya-Rendón, Javier de Jesús Cárdenas-Pérez, Sandra X Olaya, Guillermo J Lagos-Grisales
BACKGROUND: Zika virus (ZIKV) infection has emerged as a significant threat for pregnant women and newborns in populations living in or visiting Latin America. We previously reported a preliminary analysis in Sucre, Colombia, as the first group of pregnant women with RT-PCR-confirmed ZIKV (ZIKa enEmbarazadas yReciénNacidos enCOLombia, ZIKERNCOL). METHODS: In this second report, findings of the first 86 pregnant women from La Virginia and Dosquebradas (municipalities), Risaralda, Colombia, with RT-PCR-confirmed ZIKV infection are reported...
June 9, 2018: Travel Medicine and Infectious Disease
https://www.readbyqxmd.com/read/29894515/tolerogenic-%C3%AE-2-glycoprotein-i-dna-vaccine-and-fk506-as-an-adjuvant-attenuates-experimental-obstetric-antiphospholipid-syndrome
#6
Ya-Hsuan Chao, Der-Yuan Chen, Joung-Liang Lan, Kuo-Tung Tang, Chi-Chien Lin
DNA vaccines have recently emerged as a therapeutic agent for treating autoimmune diseases, such as multiple sclerosis. Antiphospholipid antibody syndrome (APS) is an autoimmune disease characterized by β2-glycoprotein I (β2-GPI)-targeting antiphospholipid antibodies (APAs) and vascular thrombosis or obstetrical complications. To examine the therapeutic potential of a β2-GPI DNA vaccine, we administered a vaccine mixed with FK506 as an adjuvant to a mouse model of obstetric APS. First, the pCMV3-β2-GPI DNA vaccine, which encodes the full-length human β2-GPI gene, was constructed...
2018: PloS One
https://www.readbyqxmd.com/read/29891914/obstetric-and-vascular-antiphospholipid-syndrome-same-antibodies-but-different-diseases
#7
REVIEW
Pier Luigi Meroni, Maria Orietta Borghi, Claudia Grossi, Cecilia Beatrice Chighizola, Paolo Durigutto, Francesco Tedesco
Recurrent thrombosis and miscarriages are the main clinical manifestations of antiphospholipid syndrome (APS). Although most patients display both clinical signs, some patients can have isolated vascular or obstetric variants. Emerging data raise the question of whether obstetric and vascular APS are the same or different diseases. An important difference between the two conditions is that a thrombophilic state is a common feature in vascular APS, whereas clot occlusions of the decidual spiral arteries are seldom observed in obstetric APS, and infarctions are found in only one-third of APS placentae...
June 11, 2018: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/29889745/simulation-in-obstetrics
#8
Andrew J Satin
Simulation in obstetrics is a widely accepted and valuable tool that benefits all levels of learners from medical students to maternal-fetal medicine subspecialists. What began as an adjunct to medical education now has a rapidly expanding role in acquisition of new and innovative procedures, team and unit training, and safety and quality initiatives. The number of obstetric simulation peer-reviewed reports has increased exponentially in recent years, yet only a small percentage of reports primarily addresses clinical outcomes...
June 6, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29888150/postpartum-magnesium-sulfate-overdose-a-multidisciplinary-and-interprofessional-simulation-scenario
#9
Adam Garber, Purnima M Rao, Chandrew Rajakumar, George A Dumitrascu, Genevieve Rousseau, 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 the quality and relevance of objectives for nursing participants. The curriculum was prepared to train OB/GYN and anesthesiology residents and labor and delivery nurses to hone crisis resource management skills and to recognize and manage rare/critical medical events in an obstetrical setting...
April 7, 2018: Curēus
https://www.readbyqxmd.com/read/29886318/prevention-of-shoulder-dystocia-a-randomized-controlled-trial-to-evaluate-an-obstetric-maneuver
#10
Olivier Poujade, Elie Azria, Pierre-François Ceccaldi, Carine Davitian, Carine Khater, Paul Chatel, Emilie Pernin, Nizar Aflak, Martin Koskas, Agnès Bourgeois-Moine, Laurence Hamou-Plotkine, Morgane Valentin, Jean-Paul Renner, Carine Roy, Candice Estellat, Dominique Luton
OBJECTIVE: Shoulder dystocia is a major obstetric emergency defined as a failure of delivery of the fetal shoulder(s). This study evaluated whether an obstetric maneuver, the push back maneuver performed gently on the fetal head during delivery, could reduce the risk of shoulder dystocia. STUDY DESIGN: We performed a multicenter, randomized, single-blind trial to compare the push back maneuver with usual care in parturient women at term. The primary outcome, shoulder dystocia, was considered to have occurred if, after delivery of the fetal head, any additional obstetric maneuver, beginning with the McRoberts maneuver, other than gentle downward traction and episiotomy was required...
June 4, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29883744/prevalence-and-associated-birth-outcomes-of-co-use-of-cannabis-and-tobacco-cigarettes-during-pregnancy
#11
Victoria H Coleman-Cowger, Emmanuel A Oga, Erica N Peters, Katrina Mark
Use of Cannabis and use of tobacco overlap, and co-use of Cannabis and tobacco has increased over the past decade among adults. The current study aims to document the prevalence and correlates of co-use of Cannabis and tobacco cigarettes among adult pregnant women utilizing secondary data from a larger study that compared and validated screeners for illicit and prescription drug use during pregnancy. Pregnant women (N = 500; 71% African American; 65% never married, average age of 28 years) were recruited from two urban University obstetric clinics between January and December 2017...
June 5, 2018: Neurotoxicology and Teratology
https://www.readbyqxmd.com/read/29871607/support-provided-by-midwives-to-women-during-labour-in-a-public-hospital-limpopo-province-south-africa-a-participant-observation-study
#12
Maria S Maputle
BACKGROUND: Physical presence during labour offer women opportunity of having positive childbirth experiences as well as childbirth outcomes. The study aimed to determine what support provided by midwives during intrapartum care at a public hospital in Limpopo Province. The study was conducted at a tertiary hospital in Limpopo Province. METHODS: A participant observation approach was used to achieve the objectives of the study. The population comprised of all women who were admitted with labour and for delivery and midwives who were providing midwifery care in the obstetric unit of a tertiary public hospital in Limpopo Province...
June 5, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29866726/can-india-s-primary-care-facilities-deliver-a-cross-sectional-assessment-of-the-indian-public-health-system-s-capacity-for-basic-delivery-and-newborn-services
#13
Jigyasa Sharma, Hannah H Leslie, Mathilda Regan, Devaki Nambiar, Margaret E Kruk
OBJECTIVES: To assess input and process capacity for basic delivery and newborn (intrapartum care hereafter) care in the Indian public health system and to describe differences in facility capacity between rural and urban areas and across states. DESIGN: Cross-sectional study. SETTING: Data from the nationally representative 2012-2014 District Level Household and Facility Survey, which includes a census of community health centres (CHC) and sample of primary health centres (PHC) across 30 states and union territories in India...
June 4, 2018: BMJ Open
https://www.readbyqxmd.com/read/29866238/amniotic-fluid-embolism
#14
Nadia Nawaz, Ahmed Raheem Buksh
Amniotic fluid embolism is a rare and severe problem in obstetric patients. We experienced a 21-year primigravida who underwent emergency cesarean section due to sudden collapse and fetal distress after rupture of membranes in labour. Subsequently, she developed intraoperative coagulopathy, hemorrhage, hypotension, and respiratory collapse requiring ventilation. Both maternal and neonatal lives were saved with full recovery and discharged in stable condition. The clinical diagnosis of amniotic fluid embolism (AFE) was made, which is a very rare complication of pregnancy/puerperium with varying presentation, ranging from cardiac arrest, circulatory collapse and death through mild degrees of organ system dysfunction with or without coagulopathy...
June 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29863216/a-look-through-time-historical-analysis-of-obstetrics-and-gynecology-texts-highlights-changes-in-medicine
#15
Jared T Roeckner, Amy B Peebles
OBJECTIVE: Our objective was to analyze systematically the preface and foreword of each edition of Williams Obstetrics and Te Linde's Operative Gynecology to gain insight into historical changes in medicine. METHODS: The preface and foreword from 24 editions of Williams Obstetrics and 11 editions of Te Linde's Operative Gynecology were obtained. Documents were assessed for the inclusion of predefined key words or topics, including sex-specific pronoun usage, insurance, fertility regulation, government regulation/laws, documentation burden, malpractice, race, medicine as "art" or medicine as "science," and others...
June 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29862717/-design-and-application-of-high-risk-pregnancy-monitoring-warning-internet-platform-based-on-internet-of-things
#16
Heqing Lu, Xiaofeng Zhang, Bin Li
Through illustrating the designing of high-risk pregnancy maternal-fetal monitoring system based on the internet of things, this paper introduced the specific application of using wearable medical devices to provide maternal-fetal mobile medical services. With the help of big data and cloud obstetrics platform, the monitoring and warning network was further improved, the level-to-level administration of high-risk pregnancy was realized, the level of perinatal health care was enhanced and the risk of critical emergency of pregnancy decreased...
September 30, 2017: Zhongguo Yi Liao Qi Xie za Zhi, Chinese Journal of Medical Instrumentation
https://www.readbyqxmd.com/read/29862026/linking-household-and-health-facility-surveys-to-assess-obstetric-service-availability-readiness-and-coverage-evidence-from-17-low-and-middle-income-countries
#17
Mufaro Kanyangarara, Victoria B Chou, Andreea A Creanga, Neff Walker
Background: Improving access and quality of obstetric service has the potential to avert preventable maternal, neonatal and stillborn deaths, yet little is known about the quality of care received. This study sought to assess obstetric service availability, readiness and coverage within and between 17 low- and middle-income countries. Methods: We linked health facility data from the Service Provision Assessments and Service Availability and Readiness Assessments, with corresponding household survey data obtained from the Demographic and Health Surveys and Multiple Indicator Cluster Surveys...
June 2018: Journal of Global Health
https://www.readbyqxmd.com/read/29851114/a-framework-for-healthcare-interventions-to-address-maternal-morbidity
#18
REVIEW
Tabassum Firoz, Affette McCaw-Binns, Veronique Filippi, Laura A Magee, Maria L Costa, Jose G Cecatti, Maria Barreix, Richard Adanu, Doris Chou, Lale Say
The maternal health agenda is undergoing a paradigm shift from preventing maternal deaths to promoting women's health and wellness. A critical focus of this trajectory includes addressing maternal morbidity and the increasing burden of chronic and noncommunicable diseases (NCD) among pregnant women. The WHO convened the Maternal Morbidity Working Group (MMWG) to improve the scientific basis for defining, measuring, and monitoring maternal morbidity. Based on the MMWG's work, we propose paradigms for conceptualizing maternal health and related interventions, and call for greater integration between maternal health and NCD programs...
May 2018: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29849283/occult-iliac-deep-vein-thrombosis-in-second-trimester-pregnancy-clues-on-bedside-ultrasound
#19
Roopa Avula, Michael Niemann, Nicole Dorinzi, Kristine Robinson, Melinda Sharon, Joseph Minardi
Isolated pelvic deep vein thromboses (DVT) are rare and difficult to diagnose, but they are more common in pregnant women and carry an increased risk of embolization. Pulmonary embolism is the most common non-obstetric cause of death in pregnancy. Compression ultrasound is the first-line imaging test for suspected lower extremity DVT, but it cannot usually aid in directly visualizing or easily diagnosing isolated pelvic DVT. Nonetheless, point-of-care ultrasound (POCUS) may provide valuable clues to help rule in pelvic DVT and expedite initiation of anticoagulant therapy...
August 2017: Clinical practice and cases in emergency medicine
https://www.readbyqxmd.com/read/29848311/birth-preparedness-and-complication-readiness-among-pregnant-women-admitted-in-a-rural-hospital-in-rwanda
#20
Patrick Smeele, Richard Kalisa, Marianne van Elteren, Jos van Roosmalen, Thomas van den Akker
BACKGROUND: With an aim to prevent adverse pregnancy outcomes, 'birth preparedness and complication readiness' (BP/CR) promotes timely access to skilled maternal and neonatal services. Objective of this study was to assess implementation of BP/CR among pregnant women admitted with obstetric emergencies in rural Rwanda. METHODS: A cross-sectional study among pregnant women who were referred to Ruhengeri hospital between July and November 2015. The 'Safe Motherhood questionnaire' as developed by Jhpiego's Maternal and Neonatal Health Program was used to collect data...
May 30, 2018: BMC Pregnancy and Childbirth
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