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Guideline in obstetrics

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https://www.readbyqxmd.com/read/28445174/obstetric-anesthesia-for-a-pregnant-woman-with-brainstem-cavernous-malformations-a-case-report
#1
Misuzu Hayashi, Manabu Kakinohana
There are no well-defined guidelines for obstetric and anesthetic management of pregnant patients with cerebral cavernous malformations (CMs). We need to pay careful attention to the attendant risks of both general and neuraxial anesthesia in this population. Here, we describe the anesthetic management of a pregnant woman with brainstem CMs who underwent cesarean delivery. We selected a general anesthetic technique because of concerns of undesirable effects of neuraxial anesthesia in the presence of cerebral CMs...
April 25, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28436133/population-trends-in-prenatal-detection-of-transposition-of-great-arteries-impact-of-obstetrical-screening-ultrasound-guidelines
#2
Ravi Prasad, Mills Lindsay, Fruitman Deborah, Savard Winnie, Colen Timothy, Khoo Nee, Serrano-Lomelin Jesus, Hornberger Lisa K
BACKGROUND: D-transposition of the great arteries (D-TGA) is one of the most common critical neonatal heart defects. Although there are clinical advantages to a prenatal diagnosis, D-TGA has had low prenatal detection internationally. Recent obstetrical ultrasound guidelines incorporating screening of cardiac outflows may improve prenatal detection of D-TGA. We sought to evaluate trends in the prenatal detection of D-TGA with/without ventricular septal defect (VSD) in Alberta over the past 13 years, examining the potential impact of enhanced ultrasound guidelines in 2009-2010 and 2013 and factors impacting detection...
April 24, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28435667/neuraxial-opioids-as-analgesia-in-labour-and-postoperative-after-caesarean-section-and-hysterectomy-a-questionnaire-survey-in-sweden
#3
Anette Hein, Caroline Gillis-Haegerstrand, Jan G Jakobsson
Background: Neuraxial opioids improve labour analgesia and analgesia after caesarean section (CS) and hysterectomy. Undesirable side effects and difficulties in arranging postoperative monitoring might influence the use of these opioids. The aim of the present survey was to assess the use of intrathecal and epidural morphine in gynaecology and obstetrics in Sweden. Methods: A questionnaire was sent to 47 anaesthesiologists at obstetric units in Sweden concerning the use and postoperative monitoring of morphine, sufentanil and fentanyl in spinal/epidural anaesthesia...
2017: F1000Research
https://www.readbyqxmd.com/read/28435289/long-noncoding-rna-nbat-1-suppresses-tumorigenesis-and-predicts-favorable-prognosis-in-ovarian-cancer
#4
Changsheng Yan, Yi Jiang, Yicong Wan, Lin Zhang, Jinhui Liu, Shulin Zhou, Wenjun Cheng
Long noncoding RNA (lncRNA) has been proven to be involved in many biological processes in ovarian cancer (OC). However, the mechanism still remains unknown. In this study, we screened significantly downregulated NBAT-1, which has been proven to play a significant role in breast cancer, clear cell renal cell carcinoma, and neuroblastoma, but not in OC, in two independent datasets with relatively more samples (GSE18520 and GSE38666) from Gene Expression Omnibus. We found that lncRNA NBAT-1 was obviously downregulated in OC tissue compared to normal ovarian tissue (P<0...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28434089/pregnancy-and-kidney-disease-from-medicine-based-on-exceptions-to-exceptional-medicine
#5
EDITORIAL
Giorgina Barbara Piccoli, Gianfranca Cabiddu
The Webster dictionary defines exception as an anomaly, a person or thing that does not follow a rule, while the adjective exceptional has a different nuance, and means "above average". These two words may describe how obstetric nephrology has shifted from the description of very rare cases, to the development of a complex new and fascinating branch of medicine, that counterbalances obstetricians' usually optimistic outlook by focusing on subtle challenges posed by chronic diseases, and mitigate the frequently grim approach of nephrologists, with a message of hope: women with kidney disease can have the same basic life goals as healthy women their age...
April 22, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28412101/genetics-of-recurrent-miscarriage-and-fetal-loss
#6
REVIEW
M H Tur-Torres, C Garrido-Gimenez, J Alijotas-Reig
Despite years of research, miscarriage, particularly when recurrent, continues to pose a medical challenge. An embryo chromosomal error is responsible for 50-60% of recurrent cases; however, up to 30-50% remains an enigma. Successful pregnancy involves different maternal physiologic changes and certain complex interactions between the fetus and the mother by cytokines, angiogenic mediators and hormones. To date, research lines have focused on genetic and epigenetic polymorphisms related mainly to immune response and inflammatory mediators, and have yielded a significant relationship between recurrent miscarriage and immune mechanisms...
March 27, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28403414/a-national-survey-of-videolaryngoscopy-in-the-united-kingdom
#7
T M Cook, F E Kelly
Background.: There are increasing numbers of videolaryngoscopes marketed and increasing interest in the technology. The Difficult Airway Society's 2015 guidelines recommend that videolaryngoscopes should be immediately available at all times and that all anaesthetists should be trained and skilled in their use. Methods.: An electronic survey was sent to all UK National Health Service hospitals to examine availability, use, and attitudes to videolaryngoscopy, and closed in January 2014...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28398913/sepsis-in-obstetrics-treatment-prognosis-and-prevention
#8
Sheryl E Parfitt, Mary L Bogat, Cheryl Roth
Sepsis during pregnancy is one of the five leading causes of maternal mortality worldwide. Early recognition and prompt treatment of maternal sepsis is necessary to improve patient outcomes. Patient education on practices that reduce infections may be helpful in decreasing rates of sepsis. Education of nurses about early signs and symptoms of sepsis in pregnancy and use of obstetric-specific tools can assist in timely identification and better outcomes. Although the Surviving Sepsis Campaign (SSC) criteria for diagnosis of sepsis in the general population are not pertinent for obstetric patients, their treatment bundles (guidelines) are applicable and can be used to guide care of obstetric patients who develop sepsis...
April 10, 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/28376904/academic-research-productivity-of-post-graduate-students-at-makerere-university-college-of-health-sciences-uganda-from-1996-to-2010-a-retrospective-review
#9
E A Obuku, J N Lavis, A Kinengyere, D K Mafigiri, F Sengooba, C Karamagi, N K Sewankambo
BACKGROUND: Research is a core business of universities globally, and is crucial in the scientific process as a precursor for knowledge uptake and use. We aimed to assess the academic productivity of post-graduate students in a university located in a low-income country. METHODS: This is an observational retrospective documentary analysis using hand searching archives, Google Scholar and PubMed electronic databases. The setting is Makerere University College of Health Sciences, Uganda...
April 4, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28371362/pregnancy-related-acute-aortic-dissection-in-marfan-syndrome-a-review-of-the-literature
#10
REVIEW
Katherine Smith, Bernard Gros
A well-established association exists between acute aortic dissection and pregnancy, particularly in women with Marfan syndrome. However, there is debate regarding appropriate management guidelines. In particular, there are differing opinions regarding when prophylactic aortic root repair should be recommended as well as the efficacy of beta blockers in this clinical scenario. The current study evaluated 10 years of published literature (2005-2015) in the PubMed/Medline database. Fifty articles, describing 72 cases of women who presented with aortic dissection in the antepartum or postpartum period were identified...
April 2, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28368950/cervical-cancer-screening-and-subsequent-procedures-in-women-under-the-age-of-25-years-between-2007-and-2013-in-france-a-nationwide-french-healthcare-database-study
#11
Géric Maura, Christophe Chaignot, Alain Weill, François Alla, Isabelle Heard
Cervical cancer screening in young women may lead to the detection of lesions with a high potential for spontaneous regression and no benefit of surgery. French guidelines recommend initiating cervical cancer screening by the Pap test from the age of 25 years. To date, no French nationwide study has assessed cervical cancer screening in young women and the related subsequent work-up and surgical procedures among screen-positive women. Using data from the French national healthcare databases (around 50 million beneficiaries), annual and 3-year Pap test screening rates were calculated among women aged 15-24 years between 2007 and 2013...
March 31, 2017: European Journal of Cancer Prevention
https://www.readbyqxmd.com/read/28367018/blood-transfusion-practices-in-a-tertiary-care-center-in-northern-india
#12
Sonam Kumari
BACKGROUND: Blood transfusion plays vital roles in the medical and surgical practice. To achieve optimum use of blood, transfusion has to be appropriate and judicious consuming minimal resources and manpower. OBJECTIVE: To evaluate the pattern of blood transfusion requests and utilization with the aim of determining transfusion practice. MATERIALS AND METHODS: Blood request forms and cross-match worksheets at the blood bank were analyzed over a 6-month period...
April 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28355654/experience-of-point-of-care-devices-in-obstetrical-care
#13
Ove Karlsson
During pregnancy and puerperium, there are pronounced hemostatic changes characterized by increased coagulability and decreased fibrinolysis. In addition, hemostasis can change dramatically during obstetric complications. Several reports have described substandard management of hemostatic defects in this setting and state the need for guidelines and better care. Point-of-care devices can assess hemostatic status and are especially suitable in perioperative settings. Using point-of-care devices, no time is required for transportation, allowing faster availability of results and providing potential for better care of the patient...
March 29, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28346664/a-cross-sectional-comparison-of-three-guidelines-for-intrapartum-cardiotocography
#14
Meena Bhatia, Kamal R Mahtani, David Nunan, Aparna Reddy
OBJECTIVE: To compare the cardiotocography classification systems outlined by the International Federation of Gynecology and Obstetrics (FIGO) in 2015 and the UK National Institute for Health and Care Excellence (NICE) in 2007 and 2014. METHODS: A cross-sectional observational study of cardiotocography practices at a UK hospital was conducted among labor ward staff (n=21) from November 1 to November 31, 2015. All observers classified ten cardiotocography traces according to the three guidelines using a bespoke form...
March 27, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28343177/gaps-in-obstetric-care-processes-we-can-only-improve-what-is-being-measured
#15
Charlotte Millde Luthander, Hans Järnbert Pettersson, Ulf Högberg, Sophie Berglund, Charlotta Grunewald
A multifaceted intervention at all six obstetric units in the Stockholm Health Region was performed in 2008-2011 in order to increase safety for the newborn infants. Case-controlled criterion-based reviews of care processes during labor and delivery have been used to assess factors associated with suboptimal care during labor and delivery. Categories of increased risk of adverse outcome during labor and delivery were defined. Cases with low Apgar scores and healthy controls were scrutinized and compared to data from a study with an identical design performed before the intervention...
March 27, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28335654/gestational-weight-gain-among-nutritionally-treated-gdm-patients
#16
Anat Shmueli, Adi Borovich, Riki Bergel, Tamar Ovadia, Liran Hiersch, Eran Ashwal, Yariv Yogev, Amir Aviram
OBJECTIVE: We aimed to evaluate pregnancy outcome in diet-treated GDM patients according to the 2009 IOM (Institute of Medicine) guidelines concerning gestational weight gain (GWG). DESIGN AND PATIENTS: This was a retrospective cohort study, limited to women with singleton pregnancies and diet-treated GDM. Women with pre-existing diabetes or women with pharmaceutical treatment were excluded. We compared patients with adequate GWG with patients with excess GWG according to the 2009 IOM guidelines...
March 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28331968/choice-of-mode-of-delivery-in-a-subsequent-pregnancy-after-oasi-a-survey-among-dutch-gynecologists
#17
Judith J A E Donners, Kirsten B Kluivers, Jan W de Leeuw, Jeroen van Dillen, Sander M J van Kuijk, Mirjam Weemhoff
INTRODUCTION AND HYPOTHESIS: National and international guidelines do not provide clear recommendations on the mode of delivery in a subsequent pregnancy after obstetric anal sphincter injury (OASI). The aim of this study was to investigate the opinion of gynecologists in The Netherlands on this choice and the extent to which this choice is affected by the gynecologist's characteristics. METHODS: Of 973 gynecologists sent a questionnaire seeking their opinion on the mode of delivery in 16 different case descriptions, 234 (24%) responded...
March 22, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28331607/-simplified-international-recommendations-for-the-implementation-of-patient-blood-management-sir4pbm
#18
Patrick Meybohm, Bernd Froessler, Lawrence T Goodnough, Andrew A Klein, Manuel Muñoz, Michael F Murphy, Toby Richards, Aryeh Shander, Donat R Spahn, Kai Zacharowski
BACKGROUND: More than 30% of the world's population are anemic with serious medical and economic consequences. Red blood cell transfusion is the mainstay to correct anemia, but it is also one of the top five overused procedures and carries its own risk and cost burden. Patient blood management (PBM) is a patient-centered and multidisciplinary approach to manage anemia, minimize iatrogenic blood loss, and harness tolerance to anemia in an effort to improve patient outcome. Despite resolution 63...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28326464/meningiomas-in-pregnancy-timing-of-surgery-and-clinical-outcomes-as-observed-in-104-cases-and-establishment-of-a-best-management-strategy
#19
REVIEW
Yosef Laviv, Ahmed Bayoumi, Anand Mahadevan, Brett Young, Myles Boone, Ekkehard M Kasper
BACKGROUND: There is a strong correlation between the level of circulating female sex hormones and the parturient growth of meningiomas. As a result, rapid changes in meningioma size occur during pregnancy, putting both the mother and fetus at risk. Large, symptomatic meningiomas require surgical resection, regardless of the status of pregnancy. However, the preferred timing of such complex intervention is a matter of debate. The rarity of this clinical scenario and the absence of prospective trials make it difficult to reach evidence-based conclusions...
March 22, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#20
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
March 18, 2017: Current Opinion in Anaesthesiology
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