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Obstetrics emergency

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https://www.readbyqxmd.com/read/28711179/immediate-birth-an-analysis-of-women-and-their-babies-undergoing-time-critical-birth-in-a-tertiary-referral-obstetric-hospital
#1
M H Warren, J Kamania, A T Dennis
BACKGROUND: At our institution, the emergency obstetric 'code green' activates the system for immediate birth, usually by caesarean section. This study aimed to determine the incidence of immediate birth, indications, modes of anaesthesia, and short-term neonatal and maternal outcomes. METHOD: A review was performed for all women at the Royal Women's Hospital, Parkville, Australia who underwent immediate birth over a two-year period: January 1, 2013 to December 31, 2014...
June 16, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28701153/cost-effectiveness-of-an-ambulance-based-referral-system-for-emergency-obstetrical-and-neonatal-care-in-rural-ethiopia
#2
Sandro Accorsi, Edgardo Somigliana, Hagos Solomon, Tsegaye Ademe, Jofrey Woldegebriel, Biadgo Almaz, Mohammed Zemedu, Fabio Manenti, Akalu Tibebe, Pasquale Farese, Aberra Seifu, Serena Menozzi, Giovanni Putoto
BACKGROUND: To estimate the cost-effectiveness of an ambulance-based referral system an dedicated to emergency obstetrics and neonatal care (EmONC) in remote sub-Saharan settings. METHODS: In this prospective study performed in Oromiya Region (Ethiopia), all obstetrical cases referred to the hospital with the ambulance were consecutively evaluated during a three-months period. The health professionals who managed the referred cases were requested to identify those that could be considered as undoubtedly effective...
July 12, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28693621/increasing-utilisation-of-skilled-facility-based-maternal-healthcare-services-in-rural-zambia-the-role-of-safe-motherhood-action-groups
#3
Cephas Sialubanje, Karlijn Massar, Larah Horstkotte, Davidson H Hamer, Robert A C Ruiter
BACKGROUND: Community-centred health interventions, such as Safe Motherhood Action groups (SMAGs), have potential to lead to desired health behavioural change and favourable health outcomes. SMAGs are community-based volunteer groups that aim to reduce critical delays that occur at household level with regard to decision-making about seeking life-saving maternal care at health facilities. The aim of this study was to explore perspectives, roles, achievements and challenges of the SMAG programme in Kalomo, Zambia...
July 10, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28693518/the-third-delay-understanding-waiting-time-for-obstetric-referrals-at-a-large-regional-hospital-in-ghana
#4
David M Goodman, Emmanuel K Srofenyoh, Adeyemi J Olufolabi, Sung Min Kim, Medge D Owen
BACKGROUND: Delay in receiving care significantly contributes to maternal morbidity and mortality. Much has been studied about reducing delays prior to arrival to referral facilities, but the delays incurred upon arrival to the hospital have not been described in many low- and middle-income countries. METHODS: We report on the obstetric referral process at Ridge Regional Hospital, Accra, Ghana, the largest referral hospital in the Ghana Health System. This study uses data from a prospectively-collected cohort of 1082 women presenting with pregnancy complications over a 10-week period...
July 11, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28692347/prevalence-of-difficult-intubation-and-failed-intubation-in-a-diverse-obstetric-community-based-population
#5
Richard Pollard, Matthew Wagner, Katherine Grichnik, Brittany C Clyne, Ashraf S Habib
Objective To describe the incidence of difficult and failed intubations in obstetric patients during a 6-year period monitored by a quality assurance program together with American Society of Anesthesiologists Physical Status (ASA PS) scores, and obesity (Body mass index > 30 kg/m(2)). Methods Following Institutional Review Board approval, data about obstetric patients who experienced unanticipated difficult or failed intubations from 2010-2015 were obtained from the quality assurance database of a large, community-based anesthesiology group practice...
July 10, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28691865/postpartum-emergency-department-visits-and-inpatient-readmissions-in-a-medicaid-population-of-mothers
#6
Deborah B Ehrenthal, Katie Gelinas, David A Paul, Abiy Agiro, Cynthia Denemark, Anthony J Brazen, Michael Pollack, Matthew K Hoffman
BACKGROUND: Little comprehensive literature exists to broadly examine risk factors for emergency department (ED) utilization or inpatient admission after obstetrical delivery. MATERIALS AND METHODS: We conducted a retrospective cohort study of Medicaid-insured women from 2009 to 2012 who delivered at a regional perinatal center in the Mid-Atlantic. Women were included if Medicaid was the primary payer of record for the delivery and there was continuous 9-month predelivery Medicaid eligibility...
July 10, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28691348/rare-complication-of-fibroids-in-pregnancy-spontaneous-fibroid-rupture
#7
Alim Swarray-Deen, Shirley A Mensah-Brown, Jerry Coleman
Uterine fibroids in pregnancy present with numerous complications. However, spontaneous rupture is a rare and potentially life-threatening event. We report a case of a 43-year-old multiparous woman who presented with hypovolemic shock secondary to a ruptured uterine fibroid 2 days after a spontaneous vaginal delivery. Emergency laparotomy confirmed massive intra-abdominal hemorrhage from the ruptured capsule of a 10-cm subserosal fibroid. A myomectomy was performed. Her postoperative recovery period was uneventful...
July 10, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28690864/surgical-site-infections-after-cesarean-delivery-epidemiology-prevention-and-treatment
#8
REVIEW
Tetsuya Kawakita, Helain J Landy
Cesarean delivery (CD) is one of the most common procedures performed in the United States, accounting for 32% of all deliveries. Postpartum surgical site infection (SSI), wound infection and endometritis is a major cause of prolonged hospital stay and poses a burden to the health care system. SSIs complicate a significant number of patients who undergo CD - 2-7% will experience sound infections and 2-16% will develop endometritis. Many risk factors for SSI have been described. These include maternal factors (such as tobacco use; limited prenatal care; obesity; corticosteroid use; nulliparity; twin gestations; and previous CD), intrapartum and operative factors (such as chorioamnionitis; premature rupture of membranes; prolonged rupture of membranes; prolonged labor, particularly prolonged second stage; large incision length; subcutaneous tissue thickness > 3 cm; subcutaneous hematoma; lack of antibiotic prophylaxis; emergency delivery; and excessive blood loss), and obstetrical care on the teaching service of an academic institution...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28688814/proceedings-beyond-ultrasound-first-forum-on-improving-the-quality-of-ultrasound-imaging-in-obstetrics-and-gynecology
#9
Beryl R Benacerraf, Katherine K Minton, Carol B Benson, Bryann S Bromley, Brian D Coley, Peter M Doubilet, Wesley Lee, Samuel H Maslak, John S Pellerito, James J Perez, Eric Savitsky, Norman A Scarborough, Joseph Wax, Alfred Z Abuhamad
The Beyond Ultrasound First Forum was conceived to increase awareness that the quality of obstetric and gynecologic ultrasound can be improved, and is inconsistent throughout the country, likely due to multiple factors, including the lack of a standardized curriculum and competency assessment in ultrasound teaching. The Forum brought together representatives from many professional associations, the imaging community including radiology, obstetrics and gynecology, emergency medicine among others, in addition to government agencies, insurers, industry and others with common interest in obstetric and gynecologic ultrasound...
July 5, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28688109/root-causes-and-social-consequences-of-birth-injuries-in-western-uganda
#10
Jennifer N Angell, Priscilla Busingye, Gabriel Y-K Ganyaglo, Cheryl A Moyer
Incontinence-inducing delivery injuries, such as obstetric fistula and anal-sphincter tears, are devastating sequelae of prolonged and obstructed labor, and can only be repaired through surgery. Such injuries are most prevalent in settings where delays and limitations in accessing emergency obstetric services are common [1, 2]. The 2011 Demographic and Health Survey of Uganda [3] estimated that 2% of Ugandan women have experienced obstetric fistula and resulting trans-vaginal urine or fecal incontinence. This article is protected by copyright...
July 8, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28685041/comprehensive-review-of-the-evidence-regarding-the-effectiveness-of-community-based-primary-health-care-in-improving-maternal-neonatal-and-child-health-3-neonatal-health-findings
#11
Emma Sacks, Paul A Freeman, Kwame Sakyi, Mary Carol Jennings, Bahie M Rassekh, Sundeep Gupta, Henry B Perry
BACKGROUND: As the number of deaths among children younger than 5 years of age continues to decline globally through programs to address the health of older infants, neonatal mortality is becoming an increasingly large proportion of under-5 deaths. Lack of access to safe delivery care, emergency obstetric care and postnatal care continue to be challenges for reducing neonatal mortality. This article reviews the available evidence regarding the effectiveness of community-based primary health care (CBPHC) and common components of programs aiming to improve health during the first 28 days of life...
June 2017: Journal of Global Health
https://www.readbyqxmd.com/read/28681538/prenatal-maternal-stress-events-and-phenotypic-outcomes-in-autism-spectrum-disorder
#12
Kandice J Varcin, Gail A Alvares, Mirko Uljarević, Andrew J O Whitehouse
There is significant heterogeneity amongst individuals with Autism Spectrum Disorder (ASD) in symptom presentation and severity. An understanding of the factors that contribute to and modulate symptom severity are critical to informing prognosis, stratification, and treatment decisions. Maternal prenatal stress exposure is a nonspecific risk factor for a wide array of neurodevelopmental outcomes in subsequent offspring. Emerging evidence suggests that prenatal maternal stress may increase ASD risk and contribute to variability in autism-like traits in the general population...
July 6, 2017: Autism Research: Official Journal of the International Society for Autism Research
https://www.readbyqxmd.com/read/28681107/comparison-of-maternal-and-fetal-complications-in-elective-and-emergency-cesarean-section-a-systematic-review-and-meta-analysis
#13
Xiao-Jing Yang, Shan-Shan Sun
BACKGROUND: Though the same types of complication were found in both elective cesarean section (ElCS) and emergence cesarean section (EmCS), the aim of this study is to compare the rates of maternal and fetal morbidity and mortality between ElCS and EmCS. METHODS: Full-text articles involved in the maternal and fetal complications and outcomes of ElCS and EmCS were searched in multiple database. Review Manager 5.0 was adopted for meta-analysis, sensitivity analysis, and bias analysis...
July 5, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28675781/telling-the-whole-story-about-simulation-based-education
#14
Jeffrey H Barsuk, William C McGaghie, Diane B Wayne
The work of Draycott et al. using simulators to train professionals on obstetric emergencies clearly shows that rigorous simulation-based education improves perinatal outcomes, safety attitudes, and teamwork climate (1). We read "The cost of local, multi-professional obstetric emergencies training" (2) with great interest. In their study, the authors report an annual cost for the obstetric training intervention of up to €148,000. Although this is important information, we are concerned that telling only half the story about simulation-based education may have a paradoxical effect...
July 4, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28672754/postpartum-infection-in-relation-to-maternal-characteristics-obstetric-interventions-and-complications
#15
Daniel Axelsson, Jan Brynhildsen, Marie Blomberg
The purpose was to evaluate the association between maternal characteristics, obstetrical interventions/complications and postpartum wound infections (WI), urinary tract infection (UTI) and endometritis. Furthermore, this study aimed to determine the time from delivery to onset of infections after discharge from the hospital. Three large Swedish Medical Health Registers were scrutinized for the period 2005-2012. A total of 582,576 women had 795,072 deliveries. Women with diagnosis codes for WIs, UTIs or endometritis, from delivery to 8 weeks postpartum, were compared to non-infected women...
June 26, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28668157/mr-imaging-of-pelvic-emergencies-in-women
#16
REVIEW
Ursula S Knoepp, Michael B Mazza, Suzanne T Chong, Ashish P Wasnik
MR imaging is a useful adjunct imaging modality for evaluating women presenting with acute lower abdominal/pelvic pain who have negative or inconclusive sonographic findings. In pregnant women, although obstetric complications are of prime concern, gastrointestinal pathologies also warrant careful attention, and MR imaging is often useful in refining the diagnosis. In nonpregnant women, gynecologic pathologies and gastrointestinal pathologies are of major concern, and may necessitate evaluation with MR imaging...
August 2017: Magnetic Resonance Imaging Clinics of North America
https://www.readbyqxmd.com/read/28666306/-simulation-training-in-obstetrics-survey-of-participants-in-a-low-fidelity-training
#17
Almut Störr, Martina König-Bachmann, Christiane Schwarz
Background Childbirth is a physiological process. However a normal delivery may suddenly turn into a life-threatening emergency. In this case, maternal and infant health depends largely on appropriate and timely interventions, and effective teamwork of all professionals. In order to meet the complex requirements, different concepts for interdisciplinary simulation training in obstetric emergencies have been developed and evaluated mainly in Scandinavian and English-speaking countries. In this context, both high-fidelity and low-fidelity trainings have been found to be effective...
June 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28663682/hepatitis-e-virus-induced-acute-liver-failure-with-scrub-typhus-coinfection-in-a-pregnant-woman
#18
Nipun Verma, Megha Sharma, Manisha Biswal, Sunil Taneja, Nitya Batra, Abhay Kumar, Radha K Dhiman
Coinfections contribute significantly to diagnostic challenges of acute febrile illnesses, especially in endemic areas. The confusion caused by overlapping clinical features impedes timely management. Herein, we report an unusual, previously unreported case of a pregnant woman suffering from a coinfection of scrub typhus and hepatitis E virus. A 25-year-old, 31-week pregnant woman presented with jaundice for 5 days and altered sensorium for 2 days. She had features of both viral acute liver failure (ALF) and tropical infections mimicking ALF, including hyperbilirubinemia, coagulopathy, anemia, thrombocytopenia, intravascular hemolysis, and hepatosplenomegaly...
June 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28657992/ready-or-not-obstetrics-and-gynecology-resident-preparedness-for-female-pelvic-medicine-and-reconstructive-surgery-training
#19
Tanaka J Dune, Robert H Blackwell, Arianna Griffin, Susanne Taege, Juliana Sung, Elizabeth R Mueller, Linda Brubaker
OBJECTIVE: The aim of this study was to assess the perception of female pelvic medicine and reconstructive surgery (FPMRS) program directors (PDs) and obstetrics and gynecology (OG) FMPRS fellows regarding the adequacy of OG residency as preparation for FPMRS fellowship. METHODS: Electronic invitations to complete a modified version of a validated survey were extended to FPMRS PDs and their second- and third-year OG FPMRS fellows who had just completed their first or second year of FPMRS fellowship, respectively...
June 27, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28655668/simulation-training-for-emergency-obstetric-and-neonatal-care-in-senegal-preliminary-results
#20
M Gueye, P M Moreira, M E Faye-Dieme, M D Ndiaye-Gueye, O Gassama, S M Kane-Gueye, A A Diouf, M M Niang, M Diadhiou, M Diallo, Y D Dieng, O Ndiaye, A Diouf, J C Moreau
To describe a new training approach for emergency obstetric and neonatal care (EmONC) introduced in Senegal to strengthen the skills of healthcare providers. The approach was based on skills training according to the so-called "humanist" method and on "lifesaving skills". Simulated practice took place in the classroom through 13 clinical stations summarizing the clinical skills needed for EmONC. Evaluation took place in all phases, and the results were recorded in a database to document the progress of each learner...
June 1, 2017: Médecine et Santé Tropicales
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