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Guideline in obstetrics

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https://www.readbyqxmd.com/read/29197487/no-352-technical-update-the-role-of-early-comprehensive-fetal-anatomy-ultrasound-examination
#1
Ori Nevo, Richard Brown, Phyllis Glanc, Ken Lim
OBJECTIVE: This guideline presents an evidence-based technical update and recommendations for the performance of early comprehensive fetal anatomic scanning (ECFAS) at 11 to 16 weeks' gestation. OPTIONS: Patients at high risk for fetal anomalies and in whom traditional mid-second trimester transabdominal imaging may be challenging or who may benefit from earlier identification of fetal anomalies may be suitable for early fetal anatomy scanning. OUTCOMES: This practice may result in earlier identification of fetal anomalies and provide earlier intervention options in high-risk populations and/or in populations where mid-second trimester transabdominal scanning is challenging...
December 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29194062/cost-effectiveness-analysis-of-intraoperative-cell-salvage-for-obstetric-hemorrhage
#2
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/29180591/developing-outcome-measures-assessing-wound-management-and-patient-experience-a-mixed-methods-study
#3
Daisy Elliott
OBJECTIVES: To develop outcome measures to assess practical management of primary surgical wounds and patient experience. DESIGN: Mixed methods, including qualitative interviews and data extraction from published randomised controlled trials (RCTs). SETTING: Two university-teaching NHS hospitals and three district NHS hospitals in the South West and Midlands regions of England. PARTICIPANTS: Sixty-four patients and 15 healthcare professionals from abdominal general surgical specialities and obstetrics (caesarean section)...
November 26, 2017: BMJ Open
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
#4
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
https://www.readbyqxmd.com/read/29178578/trends-in-maternal-deaths-in-hiv-infected-women-on-a-background-of-changing-hiv-management-guidelines-in-south-africa-1997-to-2015
#5
Coceka N Mnyani, Eckhart J Buchmann, Matthew F Chersich, Karlyn A Frank, James A McIntyre
INTRODUCTION: As work begins towards the Sustainable Development Goal target of reducing the global maternal mortality ratio (MMR) to less than 70 deaths per 100,000 live births by 2030, much needs to be done in ending preventable maternal deaths. After 1990, South Africa experienced a reversal of gains in decreasing maternal mortality, with an increase in HIV-related maternal deaths. In this study, we assessed trends in maternal mortality in HIV-infected women, on a background of an evolving HIV care programme...
November 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/29169099/exposure-to-arsenic-in-tap-water-and-gestational-diabetes-a-french-semi-ecological-study
#6
Cécile Marie, Stéphanie Léger, Aline Guttmann, Olivier Rivière, Nathalie Marchiset, Didier Lémery, Françoise Vendittelli, Marie-Pierre Sauvant-Rochat
INTRODUCTION: The increase in the prevalence of gestational diabetes mellitus (GDM) and its consequences for mother and children prompts research on their risk factors including environmental factors. Studies on exposure to arsenic (As) in tap water and the risk of GDM have not provided conclusive evidence, particularly when levels of exposure were low (from 10 to 50µg As/L). The main objective of this study was to assess the association between exposure to As in tap water and the risk of GDM...
November 20, 2017: Environmental Research
https://www.readbyqxmd.com/read/29166810/anesthetic-management-of-amniotic-fluid-embolism-a-multi-center-prospective-cohort-study
#7
Shiri Skolnik, Alexander Ioscovich, Leonid A Eidelman, Atara Davis, Anat Shmueli, Amir Aviram, Sharon Orbach-Zinger
INTRODUCTION: Amniotic fluid embolism (AFE) is a rare and potentially lethal obstetric complication, commonly occurring during labor, delivery, or immediately postpartum. There is a paucity of data regarding incidence, risk factors, and clinical management. Our primary objective in this study was to evaluate clinical presentation of AFE and delineate anesthesia management of these cases. METHODS: This 10 years retrospective multi-center cohort study was performed in five tertiary university-affiliated medical centers, between the years 2005 and 2015...
November 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29162475/-thyrotropin-reference-ranges-during-pregnancy-in-the-province-of-huelva-spain
#8
A Ortega Carpio, I Vázquez Rico, M A Castaño López, L Duarte González, M Montilla Álvaro, A Ruiz Reina
OBJECTIVE: The correct diagnosis of hypothyroidism during pregnancy requires knowledge of the local trimester-specific thyrotropin (TSH) reference ranges. When these are not available, the guidelines recommend upper limits of 2.5, 3.0, and 3.0μU/ml for the 1(st), 2(nd), and 3(rd) trimesters, respectively. The aim is to establish the reference range for our local population. MATERIAL AND METHODS: A population-based observational study was performed on healthy pregnant women from 11 healthcare centres in the province of Huelva...
November 18, 2017: Semergen
https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#9
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29149470/international-survey-of-practices-used-in-the-diagnosis-and-management-of-placenta-accreta-spectrum-disorders
#10
Margarida Cal, Diogo Ayres-de-Campos, Eric Jauniaux
OBJECTIVE: To identify geographic differences in diagnostic and treatment practices during the perinatal management of placenta accreta spectrum (PAS) disorders. METHODS: An online survey was conducted from May 1 to August 1, 2017. The 18-item questionnaire was emailed to all members of the expert panel for the 2018 International Federation of Gynecology and Obstetrics consensus guidelines on PAS (n=34), as well as international experts who had contributed to the content of these guidelines (n=16)...
November 17, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29146286/-genital-herpes-and-pregnancy-epidemiology-clinical-manifestations-prevention-and-screening-guidelines-for-clinical-practice-from-the-french-college-of-gynecologists-and-obstetrician-cngof
#11
O Picone
OBJECTIVES: To analyze the consequences of genital herpes infections in pregnant women. METHODS: The PubMed database and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: The symptomatology of herpes genital rash is often atypical (NP2) and not different during pregnancy (Professional consensus). It is most often due to HSV2 (NP2). Seventy percent of pregnant patients have a history of infection with Herpes simplex virus, without reference to genital or labial localization, and this is in most cases type 1 (NP2)...
November 13, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29141482/obstetric-practice-guidelines-labor-s-love-lost
#12
Wayne R Cohen, Emanuel A Friedman
Implementation of clinical practice guidelines may moderate health care costs, improve care, reduce medicolegal liability, and provide a uniformity in care allowing meaningful investigation of treatments and outcomes. However, new guidelines are often uncritically embraced by clinicians, risk management organizations, insurance companies, and the courts as the standard of care. Adoption of incompletely vetted recommendations can lead to patient harm. Recent recommendations made by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine for assessment and management of labor provide an example of well-intended guidelines adopted uncritically...
November 15, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29139040/recommendations-for-the-follow-up-care-of-female-breast-cancer-survivors-a-guideline-of-the-spanish-society-of-medical-oncology-seom-spanish-society-of-general-medicine-semergen-spanish-society-for-family-and-community-medicine-semfyc-spanish-society-for-general
#13
A Barnadas, M Algara, O Cordoba, A Casas, M Gonzalez, M Marzo, A Montero, M Muñoz, A Ruiz, F Santolaya, T Fernandez
The increased incidence and decreased mortality of breast cancer have produced an increased number of breast cancer survivors. The type of sequelae and comorbidities that these patients present call for a collaborative follow-up by hospital-based specialized care and primary care. In this document, we present a guideline drafted and agreed among scientific societies whose members care for breast cancer survivors. The purpose of this guideline is to achieve the shared and coordinated follow-up of these patients by specialized care and primary care professionals...
November 14, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29132771/-neonatal-herpes-epidemiology-clinical-manifestations-and-management-guidelines-for-clinical-practice-from-the-french-college-of-gynecologists-and-obstetricians-cngof
#14
L Renesme
OBJECTIVES: To describe the epidemiology of neonatal herpes and its risk factors, clinical and paraclinic manifestations, propose guidelines for a newborn at risk of neonatal herpes, describe treatment modalities, describe post-natal transmission and its prevention. METHODS: Bibliographic search from Medline, Cochrane Library databases and research of international clinical practice guidelines. RESULTS: Neonatal herpes is rare (about 20 cases per year in France) and mainly due to HSV 1 (level of evidence LE3)...
November 10, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29132336/study-protocol-the-labor-progression-study-laps-does-the-use-of-a-dynamic-progression-guideline-in-labor-reduce-the-rate-of-intrapartum-cesarean-sections-in-nulliparous-women-a-multicenter-cluster-randomized-trial-in-norway
#15
Stine Bernitz, Rebecka Dalbye, Pål Øian, Jun Zhang, Torbjørn Moe Eggebø, Ellen Blix
BACKGROUND: The increasing rate of intrapartum cesarean sections is subject of attention and concern as it is associated with adverse outcomes. Labor dystocia is one of the most frequent indications for cesarean sections even though there is no consensus on criteria for labor dystocia. Traditionally the progression of labor follows guidelines based on Friedman's curve from the mid 1950s. In 2010 Zhang presented a new labor curve and a dynamic guideline for labor progression based on contemporary research...
November 13, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29113721/prognostic-factors-and-optimal-therapy-for-stages-i-ii-neuroendocrine-carcinomas-of-the-uterine-cervix-a-multi-center-retrospective-study
#16
Mitsuya Ishikawa, Takahiro Kasamatsu, Hitoshi Tsuda, Masaharu Fukunaga, Atsuhiko Sakamoto, Tsunehisa Kaku, Toru Nakanishi, Yoko Hasumi, Takashi Iwata, Tsukasa Baba, Takayoshi Nogawa, Wataru Kudaka, Hiroshi Kaneda, Shigemitsu Ono, Fumitaka Saito, Yoshimi Taniguchi, Satoshi Okada, Mika Mizuno, Takashi Onda, Nobuo Yaegashi
PURPOSE: We aimed to determine appropriate treatment guidelines for patients with stages I-II high-grade neuroendocrine carcinomas (HGNEC) of the uterine cervix in a multicenter retrospective study. PATIENTS AND METHODS: We reviewed the clinicopathological features and prognoses of 93 patients with HGNEC of International Federation of Gynecology and Obstetrics (FIGO) stages I and II. All patients were diagnosed with HGNEC by central pathological review. RESULTS: The median overall survival (OS) and disease-free survival (DFS) were 111...
November 4, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/29113718/pregnancy-outcomes-in-women-with-previous-gestational-hypertension-a-cohort-study-to-guide-counselling-and-management
#17
Diane Nzelu, Dan Dumitrascu-Biris, Katharine F Hunt, Mark Cordina, Nikos A Kametas
OBJECTIVES: In pregnant women with previous gestational hypertension: to compare the prevalence of preeclampsia as defined by the 2001 versus the 2014 International Society for the Study of Hypertension in Pregnancy (ISSHP) criteria, to determine the rates of fetal growth restriction (FGR) as defined, not only by birthweight centile, but in combination with fetal ultrasound studies and, finally, to determine rates of other related outcomes such as gestational diabetes (GDM) and obstetric cholestasis (OC)...
November 4, 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29113524/how-does-preeclampsia-affect-neonates-highlights-in-the-disease-s-immunity
#18
Lina R Marins, Leonardo B Anizelli, Ana L Sarquis, Mariana D Romanowski
INTRODUCTION: Preeclampsia (PE) is the primary obstetrical cause in one to four perinatal deaths. Although the etiology and pathogenesis of preeclampsia is not fully known, a proinflammatory immune state prevails and can disrupt fetal hematopoiesis. Some of the effects on the newborn include neonatal thrombocytopenia, neutropenia, a reduction in T regulatory cells and an increased cytotoxic natural killer cell profile. METHOD: Electronic databases were searched, and defined criteria were applied to select articles for review...
November 7, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29108143/medical-malpractice-web-advertising-a-qualitative-cross-sectional-analysis-of-plaintiff-medical-malpractice-firms-in-suffolk-county-massachusetts
#19
Comeron W Ghobadi, Ofelya Gevorgyan, Caroline E Bednarski, Emily L Hayman, Jessica R Walter, Shuai Xu
Medical malpractice plaintiff firms play a central role in the prosecution of malpractice claims. There have been limited studies on the online advertising practices of plaintiff medical malpractice firms. The Martindale-Hubbell directory was used to identify all plaintiff medical malpractice firms in Suffolk County, Massachusetts. Each firm's website was individually mined for relevant data. Thirty-one unique medical malpractice law firms were identified. Seventy-seven percent of law firms advertised awards with the Martindale-Hubbell AV rating, AVVO, and Super Lawyer being the three most common...
2017: Issues in Law & Medicine
https://www.readbyqxmd.com/read/29108141/teaching-ob-gyn-residents-bioethics-within-a-catholic-healthcare-context
#20
Andrew Steele
Residents entering training in the specialty of Obstetrics and Gynecology (OB/GYN) often have misconceptions as to what medical interventions Roman Catholic healthcare institutions prohibit, and why certain restrictions are placed on the provision of reproductive health options that are otherwise legally available to women. The Ethical and Religious Directives for Catholic Healthcare Services, produced by the United States Conference of Catholic Bishops seeks to provide a stable framework upon which reproductive health decisions can be based...
2017: Issues in Law & Medicine
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