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Obstetrics emergency

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https://www.readbyqxmd.com/read/28539111/written-versus-verbal-consent-a-qualitative-study-of-stakeholder-views-of-consent-procedures-used-at-the-time-of-recruitment-into-a-peripartum-trial-conducted-in-an-emergency-setting
#1
J Lawton, N Hallowell, C Snowdon, J E Norman, K Carruthers, F C Denison
BACKGROUND: Obtaining prospective written consent from women to participate in trials when they are experiencing an obstetric emergency is challenging. Alternative consent pathways, such as gaining verbal consent at enrolment followed, later, by obtaining written consent, have been advocated by some clinicians and bioethicists but have received little empirical attention. We explored women's and staff views about the consent procedures used during the internal pilot of a trial (GOT-IT), where the protocol permitted staff to gain verbal consent at recruitment...
May 24, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28536980/a-retrospective-cohort-study-of-obstetric-outcomes-in-opioid-dependent-women-treated-with-implant-naltrexone-oral-methadone-or-sublingual-buprenorphine-and-non-dependent-controls
#2
Erin Kelty, Gary Hulse
BACKGROUND: Opioid pharmacotherapies play an important role in the treatment of opioid-dependent women; however, very little is known about the safety of naltrexone in pregnant patients. OBJECTIVE: This study examined the obstetric health of opioid-dependent women who were treated with implant naltrexone during pregnancy, and compared them with women treated with methadone and/or buprenorphine and a cohort of non-opioid-dependent controls. METHODS: Women treated with implant naltrexone, oral methadone or sublingual buprenorphine between 2001 and 2010, along with a cohort of age-matched controls, were linked with records from midwives, hospital and emergency departments (EDs) and the death registry to identify pregnancy and health events that occurred during pregnancy and in the post-partum period...
May 23, 2017: Drugs
https://www.readbyqxmd.com/read/28535940/-postpartum-hemorrhage-and-pregnancy-induced-hypertension-during-emergency-lower-segment-cesarean-section-dexmedetomidine-to-our-rescue
#3
Uma Hariharan
Dexmedetomidine is a highly selective α-2 agonist which has recently revolutionized our anesthesia and intensive care practice. An obstetric patient presented for emergency cesarean delivery under general anesthesia, with pre-eclampsia and postpartum hemorrhage. In carefully selected cases with refractory hypertension and postpartum hemorrhage, dexmedetomidine can be used for improving overall patient outcome. It was beneficial in controlling both the blood pressure and uterine bleeding during cesarean section in our patient...
May 20, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28533844/utility-of-first-trimester-obstetric-ultrasonography-before-13-weeks-of-gestation-a-retrospective-study
#4
Felix Uduma Uduma, Anelkan Abaslattai, Dianabasi Udoete Eduwem, Morgan Ekanem, Philip Chinedu Okere
INTRODUCTION: First trimester pregnancy is defined as twelve weeks after the last menstrual period. Ultrasonography has revolutionized validation and management of first trimester pregnancies. The aim was to analyze ultrasonographic findings of first trimester pregnancies in University of Uyo teaching hospital (UUTH), Uyo, Nigeria. METHODS: The departmental ultrasonographic records of pregnant women who were referred to Radiology department of UUTH, Uyo, Nigeria...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28533582/angular-ectopic-pregnancy-presenting-as-rupture-of-lateral-wall-of-the-uterus-late-presentation-in-gestation-week-20
#5
Malihe Hasanzadeh, Salme Dadgar, Yalda Arian, Yousef Yousefi
The differential diagnosis of acute abdominal pain in pregnancy is broad and can be complicated by atypical manifestations that are due to the anatomic distortions and physiologic changes of pregnancy. Due to the lack of clinical understanding, angular pregnancy does not appear to be recognized as a clinical entity and many cases are likely to go undiagnosed. This is a case report of a 34-year-old woman who was referred to the obstetrics emergency department with sudden abdominal pain and in a state of hypovolemic shock...
May 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28527610/multidisciplinary-delphi-development-of-a-scale-to-evaluate-team-function-in-obstetric-emergencies-the-petra-scale
#6
Mrinalini Balki, David Hoppe, David Monks, Mary Ellen Cooke, Lynn Sharples, Rory Windrim
OBJECTIVE: The objective of this study was to develop a new interdisciplinary teamwork scale, the Perinatal Emergency: Team Response Assessment (PETRA), for the management of obstetric crises, through consensus agreement of obstetric caregivers. METHODS: This prospective study was performed using expert consensus, based on a Delphi method. The study investigators developed a new PETRA tool, specifically related to obstetric crisis management, based on the existing literature and discussions among themselves...
June 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28523542/eating-disorders-and-epigenetics
#7
Lea Thaler, Howard Steiger
Eating disorders (EDs) are characterized by intense preoccupation with shape and weight and maladaptive eating practices. The complex of symptoms that characterize EDs often arise through the activation of latent genetic potentials by environmental exposures, and epigenetic mechanisms are believed to link environmental exposures to gene expression. This chapter provides an overview of genetic factors acting in the etiology of EDs. It then provides a background to the hypothesis that epigenetic mechanisms link stresses such as obstetric complications and childhood abuse as well as effects of malnutrition to eating disorders (EDs)...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28523399/anal-sphincter-injury-in-vaginal-deliveries-complicated-by-shoulder-dystocia
#8
Mark P Hehir, Zachary Rubeo, Karen Flood, Anne H Mardy, Colm O'Herlihy, Peter C Boylan, Mary E D'Alton
INTRODUCTION AND HYPOTHESIS: Shoulder dystocia is an obstetric emergency that occurs in 0.2-3% of all cephalic vaginal deliveries. We hypothesized that because of the difficult nature of deliveries complicated by shoulder dystocia, the condition may be associated with anal sphincter injury. We sought to identify risk factors for obstetric anal sphincter injury in women with shoulder dystocia. METHODS: This retrospective analysis included all cases of shoulder dystocia from 2007 to 2011 at two large tertiary referral centers, in the USA and Ireland...
May 18, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28522320/risks-and-consequences-of-puerperal-uterine-inversion-in-the-united-states-2004-2013
#9
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/28516847/who-is-at-risk-for-intimate-partner-violence-victimization-using-latent-class-analysis-to-explore-interpersonal-polyvictimization-and-polyperpetration-among-pregnant-young-couples
#10
Tiara C Willie, Adeya Powell, Jessica Lewis, Tamora Callands, Trace Kershaw
The purpose of our study was (a) to use latent class analyses to identify subgroups of interpersonal polyvictimizationand polyperpetration among young pregnant couples and (b) examine actor-partner effects of latent classes on current intimate partner violence (IPV) victimization. Data were collected from 296 pregnant young couples recruited at obstetrics and gynecology clinics. A 3-latent class model emerged for women: Polyvictim-Polyperpetrator, Nonvictim-Nonperpetrator, and Community and Prior IPV Victim...
May 17, 2017: Violence and Victims
https://www.readbyqxmd.com/read/28511450/emergency-peripartum-hysterectomy-indications-and-outcome-in-a-tertiary-care-setting
#11
Anshuja Singla, Rajlaxmi Mundhra, Latika Phogat, Sumita Mehta, Shalini Rajaram
INTRODUCTION: Emergency Peripartum Hysterectomy (EPH) is an important lifesaving procedure, mostly reserved for conditions deemed to be serious and life threatening, and not amenable to conservative methods. In the present scenario, the advent of newer medical and conservative surgical methods for controlling obstetric haemorrhage has influenced the incidence, trend and the outcomes of the procedure. AIM: To evaluate the demographic profile, indications, operative details, maternal morbidity and mortality and neonatal outcomes of women undergoing EPH...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28510652/international-migrants-use-of-emergency-departments-in-europe-compared-with-non-migrants-use-a-systematic-review
#12
Sarah H Credé, Elizabeth Such, Suzanne Mason
International migration across Europe is increasing. High rates of net migration may be expected to increase pressure on healthcare services, including emergency services. However, the extent to which immigration creates additional pressure on emergency departments (EDs) is widely debated. This review synthesizes the evidence relating to international migrants' use of EDs in European Economic Area (EEA) countries as compared with that of non-migrants. MEDLINE, EMBASE, CINAHL, The Cochrane Library and The Web of Science were searched for the years 2000-16...
May 16, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28506946/maternal-mortality-due-to-hypertensive-disorders-in-pregnancy-childbirth-and-the-puerperium-between-2012-and-2015-in-turkey-a-nation-based-study
#13
Bekir Keskinkılıç, Yaprak Engin-Üstün, Sema Sanisoğlu, Dilek Şahin Uygur, Hüseyin Levent Keskin, Selma Karaahmetoğlu, Ayşe Özcan, Meral Esen, Afra Alkan, Aysun Kabasakal, İrfan Şencan
OBJECTIVE: To analyze maternal deaths in Turkey due to hypertensive disorders. MATERIAL AND METHODS: In this retrospective study 812 maternal deaths were analyzed. Maternal demographic features, presence of antenatal care, medical and obstetric history, mode of delivery, and use emergency antihypertensive therapy were recorded. The delay model for each case was investigated. RESULTS: Hypertensive disorders accounted for 15.5% (n=126) out of all maternal mortality...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28499551/lessons-learned-from-a-single-institution-s-retrospective-analysis-of-emergent-cesarean-delivery-following-external-cephalic-version-with-and-without-neuraxial-anesthesia
#14
A Ainsworth, H P Sviggum, M C Tolcher, A L Weaver, M A Holman, K W Arendt
OBJECTIVES: To evaluate the risk of emergent cesarean delivery with the use of neuraxial anesthesia for external cephalic version in a single practice. BACKGROUND: Randomized trials have shown increased external cephalic version success when neuraxial anesthesia is used, without additional risk. We hypothesized that in our actual clinical practice, outside the confines of randomized trials, neuraxial anesthesia could be associated with an increased risk of emergent cesarean delivery...
April 2, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28499533/obstetric-emergencies-shoulder-dystocia-and-postpartum-hemorrhage
#15
REVIEW
Joshua D Dahlke, Asha Bhalwal, Suneet P Chauhan
Shoulder dystocia and postpartum hemorrhage represent two of the most common emergencies faced in obstetric clinical practice, both requiring prompt recognition and management to avoid significant morbidity or mortality. Shoulder dystocia is an uncommon, unpredictable, and unpreventable obstetric emergency and can be managed with appropriate intervention. Postpartum hemorrhage occurs more commonly and carries significant risk of maternal morbidity. Institutional protocols and algorithms for the prevention and management of shoulder dystocia and postpartum hemorrhage have become mainstays for clinicians...
June 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28498004/a-sequential-implementation-model-for-workforce-development-a-case-study-of-medical-residency-training-for-substance-use-concerns
#16
Patricia S O'Sullivan, Patrick Yuan, Derek D Satre, Maria Wamsley, Jason Satterfield
PROBLEM: In graduate medical education, residency programs are often educationally isolated from each other, with varying needs and patient populations, so strategies are needed when attempting to implement training in evidence-based practices across multiple residencies. INTERVENTION: Using implementation science as a guide, we adapted a community development model to sequentially implement an evidence-based intervention, Screening, Brief Intervention, and Referral to Treatment (SBIRT) for alcohol and drug use problems, across internal medicine, pediatrics, emergency medicine, psychiatry, and obstetrics and gynecology residency programs...
May 12, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28491126/developing-obstetric-medicine-training-in-latin-america
#17
José Rojas-Suarez, Niza Suarez, Oier Ateka-Barrutia
Maternal mortality is an important indicator of health in populations around the world. The distribution of maternal mortality ratio globally shows that middle- and low-income countries have ∼99% of the mortality burden. Most countries of Latin America are considered to be middle- or low-income countries, as well as areas of major inequities among the different social classes. Medical problems in pregnancy remain an important cause of morbidity and mortality in this region. Previous data indicate the need for a call to action for adequate diagnosis and care of medical diseases in obstetric care...
March 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28490355/regional-inequity-in-complete-antenatal-services-and-public-emergency-obstetric-care-is-associated-with-greater-burden-of-maternal-deaths-analysis-from-consecutive-district-level-facility-survey-of-karnataka-india
#18
M Himanshu, Carina Källestål
BACKGROUND: This equity focused evaluation analyses change in inter-district inequity of maternal health services (MHS) in Karnataka state between 2006-07 & 2012-13, alongside association of MHS inequity with distribution of maternal deaths. METHODS: Repeated cross-sectional analysis of inequity and decomposition was done on nine district level MHS indicators using Theil's T index. Data was obtained from population linked district level facility surveys and health information systems...
May 11, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28473030/-acute-caesarian-section-due-to-renal-tumour-with-spontaneously-emerged-perirenal-haematoma
#19
Mette Høltzermann, Astrid Helene Livbjerg, Anya Sook Eidhammer
A primipara at term was admitted to the labour ward with spontaneously emerged severe abdominal pain in the right flank and kidney. The patient was not known with any obstetric or urologic conditions. An acute caesarian section was performed due to the pain and pathological results of the cardiotocography, and a healthy child was delivered. During surgery, a haematoma was detected in the retroperitoneal space. A computed tomography (CT) of abdomen showed a Bosniak type IV tumour with surrounding haematoma in the kidney...
April 24, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28470071/nurses-knowledge-attitudes-and-practices-regarding-evidence-based-practice-in-the-prevention-of-mother-to-child-transmission-of-hiv-programme-in-malawi
#20
Chisomo Mulenga, Joanne R Naidoo
BACKGROUND: HIV continues to be a global public health concern with Malawi being among the worst affected countries. The prevalence of HIV among pregnant women is also very high, thereby raising concerns of mother-to-child transmission of the virus. Prevention of mother-to-child transmission (PMTCT) of HIV is therefore a priority in the efforts to curb the HIV pandemic. Keeping in mind that the area of HIV management is rapidly evolving, underpinning nursing care with evidence-based practice is essential and has been reported to reduce mother-to-child transmission...
April 12, 2017: Curationis
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