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Obstetrics emergency

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https://www.readbyqxmd.com/read/29454125/management-of-skull-base-tumors-in-the-obstetric-population-a-case-series
#1
Blake H Priddy, Bradley A Otto, Ricardo L Carrau, Daniel M Prevedello
BACKGROUND: Neoplasms rarely present during pregnancy. However, increase in plasma volume, hormone release induced growth, and tumor hypervascularity, can cause rapid symptoms. These range from not requiring intervention to necessitating emergent operations. OBJECTIVE: We describe an algorithm for the management of symptomatic neoplasm in the obstetric population, and provide recommendations regarding surgical indications and timing. METHODS: Patients who presented to a skull base clinic from 2010-2016 at large tertiary care hospital were reviewed to identify patients who presented with a skull base tumor during pregnancy...
February 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29450864/real-world-evaluation-of-direct-and-indirect-economic-burden-among-endometriosis-patients-in-the-united-states
#2
Ahmed M Soliman, Eric Surrey, Machaon Bonafede, James K Nelson, Jane Castelli-Haley
INTRODUCTION: The prevalence of endometriosis and the need for treatment in the USA has led to the need to explore the contemporary cost burden associated with the disease. This retrospective cohort study compared direct and indirect healthcare costs in patients with endometriosis to a control group without endometriosis. METHODS: Women aged 18-49 years with endometriosis (date of initial diagnosis = index date) were identified in the Truven Health MarketScan ® Commercial database between 2010 and 2014 and female control patients without endometriosis were matched by age and index year...
February 15, 2018: Advances in Therapy
https://www.readbyqxmd.com/read/29447043/re-engineering-the-interpretation-of-electronic-fetal-monitoring-to-identify-reversible-risk-for-cerebral-palsy-a-case-control-series
#3
Mark I Evans, Robert D Eden, David W Britt, Shara M Evans, Barry S Schifrin
BACKGROUND: Even Key Opinion leaders now concede that electronic fetal monitoring (EFM) cannot reliably identify fetal acidemia which many vouch as the only labor mediated pathophysiologic precursor for cerebral palsy (CP). We have developed the "Fetal Reserve Index" - an algorithm combining five dynamic components of EFM (1. Rate, 2. Variability, 3. Accelerations, 4. Decelerations, and 5. Excessive uterine activity) considered individually that are combined with the presence of: 6...
February 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29444779/estimating-the-met-need-for-emergency-obstetric-care-emoc-services-in-three-payams-of-torit-county-south-sudan-a-facility-based-retrospective-cross-sectional-study
#4
Pontius Bayo, Imose Itua, Suzie Paul Francis, Kofi Boateng, Elijo Omoro Tahir, Abdulmumini Usman
OBJECTIVE: To determine the met need for emergency obstetric care (EmOC) services in three Payams of Torit County, South Sudan in 2015 and to determine the frequency of each major obstetric complication. DESIGN: This was a retrospective cross-sectional study. SETTING: Four primary healthcare centres (PHCCs) and one state hospital in three payams (administrative areas that form a county) in Torit County, South Sudan. PARTICIPANTS: All admissions in the obstetrics and gynaecology wards (a total of 2466 patient admission files) in 2015 in all the facilities designated to conduct deliveries in the study area were reviewed to identify obstetric complications...
February 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29440934/prevalence-and-risk-factors-for-maternal-mortality-in-referral-hospitals-in-nigeria-a-multicenter-study
#5
Lorretta F Ntoimo, Friday E Okonofua, Rosemary N Ogu, Hadiza S Galadanci, Mohammed Gana, Ola N Okike, Kingsley N Agholor, Rukiyat A Abdus-Salam, Adetoye Durodola, Eghe Abe, Abdullahi J Randawa
Introduction: While reports from individual hospitals have helped to provide insights into the causes of maternal mortality in low-income countries, they are often limited for policymaking at national and subnational levels. This multisite study was designed to determine maternal mortality ratios (MMRs) and identify the risk factors for maternal deaths in referral health facilities in Nigeria. Methods: A pretested study protocol was used over a 6-month period (January 1-June 30, 2014) to obtain clinical data on pregnancies, births, and maternal deaths in eight referral hospitals across eight states and four geopolitical zones of Nigeria...
2018: International Journal of Women's Health
https://www.readbyqxmd.com/read/29439891/resuscitative-endovascular-balloon-occlusion-of-the-aorta-using-a-low-profile-device-is-easy-and-safe-for-emergency-physicians-in-cases-of-life-threatening-hemorrhage
#6
Takahiro Shoji, Takehiko Tarui, Takashi Igarashi, Yuki Mochida, Hiroyuki Morinaga, Yasuhiko Miyakuni, Yoshitaka Inoue, Yasuhiko Kaita, Hiroshi Miyauchi, Yoshihiro Yamaguchi
BACKGROUND: Bleeding from hemorrhagic shock can be immediately controlled by blocking the proximal part of the hemorrhagic point using either resuscitative thoracotomy for aortic cross-clamping or insertion of a large-caliber (10-14Fr) resuscitative endovascular balloon occlusion of the aorta (REBOA) device via the femoral artery. However, such methods are very invasive and have various complications. With recent progress in endovascular treatment, a low-profile REBOA device (7Fr) has been developed...
February 10, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29427974/time-of-day-is-not-associated-with-increased-rates-of-mortality-in-emergency-surgery-an-analysis-of-49-196-surgical-procedures
#7
Rodney A Gabriel, Alison M A'Court, Ulrich H Schmidt, Richard P Dutton, Richard D Urman
STUDY OBJECTIVE: There is a lack of large, multi-institutional studies analyzing the association of timing of emergency surgery with death occurring either intraoperatively or in the recovery room setting. The primary objective of this study was to determine if time of day for emergency surgeries was associated with mortality. DESIGN: Retrospective analysis. SETTING: U.S. healthcare facilities. PATIENTS: Adult patients undergoing emergency surgery and general anesthesia...
February 7, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29423186/assessment-of-health-facility-capacity-to-provide-newborn-care-in-bangladesh-haiti-malawi-senegal-and-tanzania
#8
Rebecca Winter, Jennifer Yourkavitch, Wenjuan Wang, Lindsay Mallick
Background: Despite the importance of health facility capacity to provide comprehensive care, the most widely used indicators for global monitoring of maternal and child health remain contact measures which assess women's use of services only and not the capacity of health facilities to provide those services; there is a gap in monitoring health facilities' capacity to provide newborn care services in low and middle income countries. Methods: In this study we demonstrate a measurable framework for assessing health facility capacity to provide newborn care using open access, nationally-representative Service Provision Assessment (SPA) data from the Demographic Health Surveys Program...
December 2017: Journal of Global Health
https://www.readbyqxmd.com/read/29423184/postnatal-care-for-newborns-in-bangladesh-the-importance-of-health-related-factors-and-location
#9
Kavita Singh, Paul Brodish, Mahbub Elahi Chowdhury, Taposh Kumar Biswas, Eunsoo Timothy Kim, Christine Godwin, Allisyn Moran
Background: Bangladesh achieved Millennium Development Goal 4, a two thirds reduction in under-five mortality from 1990 to 2015. However neonatal mortality remains high, and neonatal deaths now account for 62% of under-five deaths in Bangladesh. The objective of this paper is to understand which newborns in Bangladesh are receiving postnatal care (PNC), a set of interventions with the potential to reduce neonatal mortality. Methods: Using data from the Bangladesh Maternal Mortality Survey (BMMS) 2010 we conducted logistic regression analysis to understand what socio-economic and health-related factors were associated with early postnatal care (PNC) by day 2 and PNC by day 7...
December 2017: Journal of Global Health
https://www.readbyqxmd.com/read/29422727/pattern-and-outcome-of-obstetric-admissions-into-the-intensive-care-unit-of-a-southeast-nigerian-hospital
#10
Benjamin Chukwuma Ozumba, Leonard Ogbonna Ajah, Vitus Okwuchukwu Obi, Uche Anthony Umeh, Joseph Tochukwu Enebe, Kingsley Chukwu Obioha
Background and Aims: Although pregnancy and labor are considered physiological processes, the potential for catastrophic complications is constant and may develop rapidly. There is growing evidence that admission of high-risk patients into the Intensive Care Unit (ICU) is associated with a reduction in maternal mortality. This study was aimed at reviewing all obstetric patients admitted into the ICU. Materials and Methods: This was a retrospective study of all obstetric patients who were admitted into the ICU between January 1, 2012, and December 31, 2013...
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29420697/environmental-influences-on-infant-cortical-thickness-and-surface-area
#11
Shaili C Jha, Kai Xia, Mihye Ahn, Jessica B Girault, Gang Li, Li Wang, Dinggang Shen, Fei Zou, Hongtu Zhu, Martin Styner, John H Gilmore, Rebecca C Knickmeyer
Cortical thickness (CT) and surface area (SA) vary widely between individuals and are associated with intellectual ability and risk for various psychiatric and neurodevelopmental conditions. Factors influencing this variability remain poorly understood, but the radial unit hypothesis, as well as the more recent supragranular cortex expansion hypothesis, suggests that prenatal and perinatal influences may be particularly important. In this report, we examine the impact of 17 major demographic and obstetric history variables on interindividual variation in CT and SA in a unique sample of 805 neonates who received MRI scans of the brain around 2 weeks of age...
February 6, 2018: Cerebral Cortex
https://www.readbyqxmd.com/read/29419927/prevalence-of-prolonged-latent-phase-and-labor-outcomes-review-of-birth-records-in-a-swedish-population
#12
Karin Ängeby, Bodil Wilde-Larsson, Ingegerd Hildingsson, Ann-Kristin Sandin-Bojö
INTRODUCTION: The prevalence of a prolonged latent phase of labor has been described as ranging from 5% to 6.5% in previous research. The aim of this study was to describe the prevalence of the prolonged latent phase of 18 hours or more, based on women's report, in women intending vaginal birth and who had spontaneous onset of labor. An additional aim was to compare the incidence of obstetric interventions, and the labor and neonatal outcomes in women with and without a prolonged latent phase...
January 2018: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29408749/comparison-of-maternal-and-neonatal-outcomes-for-patients-with-placenta-accreta-spectrum-between-online-to-offline-management-model-with-standard-care-model
#13
Wen Sun, Lin Yu, Shiliang Liu, Yanhong Chen, Juanjuan Chen, Shi Wu Wen, Dunjin Chen
OBJECTIVE: Online-to-offline is a new model for emergent medical service with the ability to connect care providers with patients on instant basis. This study aims to evaluate maternal and neonatal outcomes in patients with placenta accreta spectrum managed by an online-to-offline care model. METHODS: Starting from January 1, 2015, management of patients with placenta accreta spectrum was changed from standard care model into an online-to-offline care model through "Wechat" in Guangzhou Medical Centre for Critical Obstetrical Care...
February 2, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29406472/novel-approach-to-emergency-departments-pediatric-readiness-across-a-health-system
#14
Isabel A Barata, Joriane M Stadnyck, Meredith Akerman, Kate OʼNeill, Jill Castaneda, Anupama Subramony, Paula Fessler, Charles Schleien, John DʼAngelo
STUDY OBJECTIVE: A gap analysis of emergency departments' (EDs') pediatric readiness across a health system was performed after the appointment of a service line health system pediatric emergency medicine (PEM) quality director. METHODS: A 55-question survey was completed by each eligible ED to generate a weighted pediatric readiness score (WPRS). The survey included questions regarding volume, ED configuration, presence of a pediatric emergency care coordinator (PECC), quality initiatives, policies and procedures, and equipment...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29406317/electrohysterography-in-the-diagnosis-of-preterm-birth-a-review
#15
Javier Garcia-Casado, Yiyao Ye-Lin, Gema Prats-Boluda, Javier Mas-Cabo, José Alberola-Rubio, Alfredo Perales
Preterm birth (PTB) is one of the most common and serious complications in pregnancy. About 15 million preterm neonates are born every year, with ratios of 10-15% of total births. In industrialized countries, preterm delivery is responsible for 70% of mortality and 75% of morbidity in the neonatal period. Diagnostic means for its timely risk assessment are lacking and the underlying physiological mechanisms are unclear. Surface recording of the uterine myoelectrical activity (electrohysterogram, EHG) has emerged as a better uterine dynamics monitoring technique than traditional surface pressure recordings and provides information on the condition of uterine muscle in different obstetrical scenarios with the emphasis on predicting preterm deliveries...
February 6, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29397441/evaluation-of-cesarean-scar-after-single-and-double-layer-hysterotomy-closure-a-prospective-cross-sectional-study
#16
Nur Betül Tekiner, Berna Aslan Çetin, Lale Susan Türkgeldi, Gökçe Yılmaz, İbrahim Polat, Ali Gedikbaşı
BACKGROUND: We aimed to determine if there is a difference in the size of the cesarean scar defect using saline infusion sonography (SIS) performed on the postoperative third month in patients who underwent single- or double-layered unlocked closure of their uterine incision during their first cesarean delivery. METHODS: This study was conducted as a prospective cross-sectional study between February 2015 and January 2016 in patients admitted to the labour ward of the Kanuni Sultan Suleyman Training and Research Hospital who subsequently underwent their first delivery by cesarean section...
February 3, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29397439/emergency-department-use-during-pregnancy-a-prospective-observational-study-in-a-single-center-institution
#17
Fabinshy Thangarajah, Christina Baur, Stefanie Hamacher, Peter Mallmann, Verena Kirn
PURPOSE: Gynecologists working in emergency department services in hospitals lately have the impression that the number of pregnant women who present themselves because of anxiety or uncertainty is increasing. Hence, the aim of this study was to assess reasons of pregnant women for presenting themselves to an emergency department. Of special interest was how far a diagnosis could be confirmed for the symptoms pregnant women complained about. METHODS: This is a prospective questionnaire-based study conducted between April 2015 and April 2016 in the Department of Gynecology and Obstetrics of the University Hospital of Cologne...
February 3, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29394423/assessing-correlation-of-residency-applicants-interview-dates-with-likelihood-of-matching
#18
Sameer Avasarala, Elizabeth Thompson, Sarah Whitehouse, Sean Drake
OBJECTIVES: This study aimed to determine whether the timing of an interview relative to the recruitment season was associated with being ranked or matched at an academic medical center. METHODS: Eleven specialties (anesthesiology, diagnostic radiology, emergency medicine, family medicine, general surgery, internal medicine, neurology, neurosurgery, obstetrics-gynecology, orthopedic surgery, and psychiatry) that participated in the National Resident Matching Program were included in the study...
February 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29391671/decision-delivery-interval-in-emergency-and-urgent-caesarean-sections-need-to-reconsider-the-recommendations
#19
Nalini Mishra, Ruchi Gupta, Nomita Singh
Introduction: The timeline between a decision made and delivery of the baby is termed decision delivery interval (DDI). According to current recommendations, an emergency caesarean section must be performed within 30 min of the decision. The present study was conducted with an objective to assess DDI in a busy obstetric unit in India and its impact on obstetric outcome. Material and Method: A total of 480 women with indications of category I (emergency): Immediate threat to life of woman or foetus (n = 66), and category II (urgent): Maternal or foetal compromise but not immediately life-threatening (n = 414), were studied in the context of DDI and composite adverse perinatal outcomes including fresh stillbirth, 5-min Apgar score <7 and NICU admission...
February 2018: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/29388408/-delivery-site-for-f%C3%A5-tus-with-congenital-heart-disease-chu-of-li%C3%A3-ge-experience-and-international-recommandations
#20
C Van Linthout, C Brulmans, X Capelle, F Kridelka, M C Seghaye
Optimal choice of delivery site after a diagnosis of congenital heart disease (CHD) improves neonatal mortality and morbidity. We report the CHU of Liège experience and review the international recommendations. Between 2011 and 2016, 54 fetuses were diagnosed with CHD in our service. Retrospectively we estimated the appropriateness of the site of delivery considering the postnatal outcome. We confronted our experience with the recent international recommendations for in utero transfer to a tertiary center...
January 2018: Revue Médicale de Liège
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