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Guideline in obstetrics

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https://www.readbyqxmd.com/read/28643664/intervention-of-the-obstetrician-during-childbirth-in-a-supposedly-low-risk-population-and-influence-of-parity
#1
J Huet, G Beucher, L Geoffroy, R Morello, G Benoist, M Dreyfus
OBJECTIVE: Compare obstetrician intervention and calling rates during labour and delivery between low-risk and high-risk women and study the influence of parity on these rates. MATERIAL AND METHODS: Descriptive retrospective study conducted on 227 patients in a university maternity unit (level 3 university hospital maternity unit) between 1st and 30th January 2014. The low- and high-risk populations were characterised according to the French National Authority for Health (HAS) and NICE guidelines...
April 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28637428/quality-of-care-provided-in-two-scottish-rural-community-maternity-units-a-retrospective-case-review
#2
Sara Denham, Tracy Humphrey, Ruth Taylor
BACKGROUND: Women in Scotland with uncomplicated pregnancies are encouraged by professional bodies and national guidelines to access community based models of midwife-led care for their labour and birth. The evidence base for these guidelines relates to comparisons of predominantly urban birth settings in England. There appears to be little evidence available about the quality of the care during the antenatal, birth and post birth periods available for women within the Scottish Community Maternity Unit (CMU) model...
June 21, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28632532/postpartum-tubal-sterilization-making-the-case-for-urgency
#3
Michael G Richardson, Sarah J Hall, Lisa C Zuckerwise
The parturient who requests postpartum sterilization has given consideration to and has made decisions regarding this aspect of her medical care long before her delivery. She arrives at parturition expecting the postpartum procedure to be performed as intended. The American Congress of Obstetricians and Gynecologists has reaffirmed its opinion that postpartum sterilization is an urgent procedure, owing to the safety and superior effectiveness of tubal sterilization via minilaparotomy in the immediate postpartum period, and the adverse consequences for mothers, babies, and society when the procedure is not actualized as desired and intended...
June 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28628578/neuraxial-anesthesia-in-obstetric-patients-receiving-thromboprophylaxis-with-unfractionated-or-low-molecular-weight-heparin-a-systematic-review-of-spinal-epidural-hematoma
#4
Lisa R Leffert, Heloise M Dubois, Alexander J Butwick, Brendan Carvalho, Timothy T Houle, Ruth Landau
Venous thromboembolism remains a major source of morbidity and mortality in obstetrics with an incidence of 29.8/100,000 vaginal delivery hospitalizations; cesarean delivery confers a 4-fold increased risk of thromboembolism when compared with vaginal delivery. Revised national guidelines now stipulate that the majority of women delivering via cesarean and women at risk for ante- or postpartum venous thromboembolism receive mechanical or pharmacological thromboprophylaxis. This practice change has important implications for obstetric anesthesiologists concerned about the risk of spinal epidural hematoma (SEH) among anticoagulated women receiving neuraxial anesthesia...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28626823/a-survey-of-ophthalmologists-and-gynecologists-regarding-termination-of-pregnancy-and-choice-of-delivery-mode-in-the-presence-of-eye-diseases
#5
Seyed-Farzad Mohammadi, Mojgan Letafat-Nejad, Elham Ashrafi, Hanieh Delshad-Aghdam
PURPOSE: To evaluate and compare the attitudes of ophthalmologists and gynecologists in suggesting appropriate approach to pregnancy in different ocular conditions. METHODS: Specialty-specific questionnaires on delivery mode and abortion indications for ophthalmic patients (refractive, vascular, oncologic, retinal, glaucoma, postoperation, posttrauma, and infectious) were designed and distributed among physician staff of Farabi Eye Hospital and Yas Women Hospital in Tehran...
June 2017: Journal of Current Ophthalmology
https://www.readbyqxmd.com/read/28625292/no-185-hiv-screening-in-pregnancy
#6
Lisa Keenan-Lindsay, Mark H Yudin
OBJECTIVE: The purpose of this guideline is to provide recommendations to obstetric health care providers and to minimize practice variations for HIV screening, while taking provincial and territorial recommendations into account. OUTCOMES: The risk of transmission of HIV from mother to fetus is significant if the mother is not treated. The primary outcome of screening for and treating HIV in pregnancy is a marked decrease in the rate of vertical transmission of HIV from mother to fetus...
July 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28625288/no-96-the-reproductive-care-of-women-living-with-hepatitis-c-infection
#7
Marc Boucher, Andrée Gruslin
OBJECTIVE: hepatitis C virus (HCV) is an increasingly important public health problem worldwide. Health care workers providing care to women of childbearing age are uniquely placed in their practices to identify a significant proportion of at-risk patients and to provide appropriate screening and counselling. The primary objective of this guideline is to provide accurate, current information to those offering reproductive care to women living with HCV. This document is also intended to raise awareness of HCV in both the medical and general populations...
July 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28606654/management-of-marfan-syndrome-during-pregnancy-a-real-world-experience-from-a-joint-cardiac-obstetric-service
#8
Joanna C E-S Lim, Matthew Cauldwell, Roshni R Patel, Anselm Uebing, Ruth A Curry, Mark R Johnson, Michael A Gatzoulis, Lorna Swan
BACKGROUND: Pregnancy in Marfan Syndrome (MFS) is associated with increased maternal risk of cardiovascular events. Given the maternal and genetic risks, pre-conception counselling is essential to facilitate informed choices. Multidisciplinary antenatal care with regular imaging is mandatory and best delivered through a Joint Cardiac Obstetric Service (JCOS). The aim of this study was to compare the care delivered in a JCOS against recognised international standards (European Society of Cardiology (ESC))...
May 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28604452/utility-and-actual-use-of-european-and-spanish-guidelines-on-the-management-of-endometrial-cancer-among-gynecologic-oncologists-in-spain
#9
Ignacio Zapardiel, Claudia Blancafort, David Cibula, Ibon Jaunarena, Mikel Gorostidi, Antonio Gil-Moreno, Javier De Santiago
OBJECTIVE: The aim of the study was to analyze the current management of endometrial cancer across Spain and to evaluate the use and applicability of the national and international guidelines. MATERIALS AND METHODS: An electronic 30-question survey was distributed among all Spanish Society of Obstetrics and Gynecology-registered specialists dedicated to gynecologic oncology in Spain by e-mail. Data were collected anonymously and analyzed using SPSS program. RESULTS: One hundred forty-five (17...
June 10, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28600890/pilot-study-of-a-software-supported-protocol-for-second-trimester-ultrasound-screening
#10
Thierry Bultez, Jean-Pierre Bernard, Ulrike Metzger, Yves Ville, Laurent Julien Salomon
OBJECTIVES: To evaluate the feasibility and impact of using a software-supported protocol for routine second-trimester ultrasound scanning. METHODS: We conducted a comparative observational study of 2 sets of 25 randomly selected normal routine second-trimester examinations performed by the same expert sonographer before and 1 year after the introduction of a software-supported protocol. The scanning protocol was identical during both periods and conformed to International Society of Ultrasound in Obstetrics and Gynecology guidelines...
June 10, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28592237/labour-management-guidelines-for-a-tanzanian-referral-hospital-the-participatory-development-process-and-birth-attendants-perceptions
#11
Nanna Maaløe, Natasha Housseine, Jos van Roosmalen, Ib Christian Bygbjerg, Britt Pinkowski Tersbøl, Rashid Saleh Khamis, Birgitte Bruun Nielsen, Tarek Meguid
BACKGROUND: While international guidelines for intrapartum care appear to have increased rapidly since 2000, literature suggests that it has only in few instances been matched with reviews of local modifications, use, and impact at the targeted low resource facilities. At a Tanzanian referral hospital, this paper describes the development process of locally achievable, partograph-associated, and peer-reviewed labour management guidelines, and it presents an assessment of professional birth attendants' perceptions...
June 7, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28591333/-regionalization-of-perinatal-health-care-in-the-province-of-santa-fe-argentina
#12
Alberto Tomás Simioni, Oraldo Llanos, Mariana Romero, Silvina Ramos, Vanessa Brizuela, Edgardo Abalos
Objective: Improve the performance of the regionalization policy in the province of Santa Fe, Argentina, as a strategy to improve perinatal health care by analyzing implementation processes and building consensus among decision makers and stakeholders around an action plan. Methods: Implementation research was conducted using mixed methodology. A needs assessment established tracer indicators to measure adherence to the components of the policy. Actors were studied to identify the barriers and facilitators of implementation...
May 25, 2017: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28585458/safety-of-cesarean-myomectomy-in-women-with-single-anterior-wall-and-lower-uterine-segment-myomas
#13
Radmila Sparić, Antonio Malvasi, Saša Kadija, Aleksandar Stefanović, Svetlana Spremović Radjenović, Jela Popović, Aleksandra Pavić, Andrea Tinelli
OBJECTIVE: Cesarean myomectomy (CM) is a safe procedure in selected cases. Nevertheless, literature lacks clear guidelines on patient selection. We aimed to evaluate CM safety in patients with single anterior wall and lower uterine segment (LUS) myomas. METHODS: The authors selected pregnants at term, scheduled for CSs, with single anterior wall or LUS myomas. All their clinical, demographic, obstetric, and surgical parameters were recorded. RESULTS: Thirty-six women had a CM (study group), and 17 had a CS without myoma removal (control group)...
June 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28583106/prescription-drug-use-during-pregnancy-in-southern-tigray-region-north-ethiopia
#14
Fantahun Molla, Admassu Assen, Solomon Abrha, Birhanetensay Masresha, Arega Gashaw, Abrham Wondimu, Yared Belete, Wondim Melkam
BACKGROUND: Judicious utilization of drugs rescues the fetus from the harmful effects while treating the health problems of the pregnant women. This study aimed at evaluating drug utilization pattern and its associated factors among pregnant women in Southern Tigray, Ethiopia. METHOD: Institution based cross-sectional study was conducted among 647 pregnant women who had been attending obstetrics-gynecology and antenatal care units in different health facilities of Southern Tigray region...
June 5, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28579865/adaptation-of-maternal-fetal-physiology-to-exercise-in-pregnancy-the-basis-of-guidelines-for-physical-activity-in-pregnancy
#15
REVIEW
Edward R Newton, Linda May
Only 50 years ago obstetric care providers and women had many concerns regarding whether exercise during pregnancy created a harmful competition for substrate resources between the fetus and the mother. Animal and human research in the past 50 years, which includes acute and chronic aerobic exercise during pregnancy, has a reassuring margin of safety throughout gestation in women. Maternal physiology adapts to pregnancy changes involving the cardiorespiratory and glucometabolic alterations. Due to these changes, pregnant women have slight differences in response to acute exercise sessions...
2017: Clinical Medicine Insights. Women's Health
https://www.readbyqxmd.com/read/28579623/reference-curve-for-the-mean-uterine-artery-pulsatility-index-in-singleton-pregnancies
#16
Alexander Weichert, Andreas Hagen, Michael Tchirikov, Ilka B Fuchs, Wolfgang Henrich, Michael Entezami
INTRODUCTION: Doppler sonography of the uterine artery (UA) is done to monitor pregnancies, because the detected flow patterns are useful to draw inferences about possible disorders of trophoblast invasion. Increased resistance in the UA is associated with an increased risk of preeclampsia and/or intrauterine growth restriction (IUGR) and perinatal mortality. In the absence of standardized figures, the normal ranges of the various available reference curves sometimes differ quite substantially from one another...
May 2017: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/28576354/does-the-addition-of-active-body-warming-to-in-line-intravenous-fluid-warming-prevent-maternal-hypothermia-during-elective-caesarean-section-a-randomised-controlled-trial
#17
R Chebbout, R S Newton, M Walters, I J Wrench, M Woolnough
INTRODUCTION: Inadvertent perioperative hypothermia occurs frequently during elective caesarean section but perioperative active body warming is not widely used. There is a paucity of evidence of its use in the obstetric population, and no applicable guidelines. We set out to identify a superior active warming method for preventing inadvertent perioperative hypothermia. METHODS: Following ethical approval, 132 women presenting for uncomplicated elective caesarean section with spinal anaesthesia were recruited...
April 27, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28567280/solar-powered-oxygen-systems-in-remote-health-centers-in-papua-new-guinea-a-large-scale-implementation-effectiveness-trial
#18
Trevor Duke, Ilomo Hwaihwanje, Magdalynn Kaupa, Jonah Karubi, Doreen Panauwe, Martin Sa'avu, Francis Pulsan, Peter Prasad, Freddy Maru, Henry Tenambo, Ambrose Kwaramb, Eleanor Neal, Hamish Graham, Rasa Izadnegahdar
BACKGROUND: Pneumonia is the largest cause of child deaths in Papua New Guinea (PNG), and hypoxaemia is the major complication causing death in childhood pneumonia, and hypoxaemia is a major factor in deaths from many other common conditions, including bronchiolitis, asthma, sepsis, malaria, trauma, perinatal problems, and obstetric emergencies. A reliable source of oxygen therapy can reduce mortality from pneumonia by up to 35%. However, in low and middle income countries throughout the world, improved oxygen systems have not been implemented at large scale in remote, difficult to access health care settings, and oxygen is often unavailable at smaller rural hospitals or district health centers which serve as the first point of referral for childhood illnesses...
June 2017: Journal of Global Health
https://www.readbyqxmd.com/read/28544433/gynecological-challenges-in-the-diagnosis-and-care-of-patients-with-dsd-the-role-of-the-obstetrician-gynecologist-in-the-multidisciplinary-approach-to-the-patient
#19
Veronica Gomez-Lobo, Anne-Marie Amies Oelschlager
Disorders (differences) of sex development (DSD) are identified when there is atypical chromosomal, gonadal, or anatomic sex. Given the complexity of DSD conditions, the consensus guidelines recommend that affected individuals be evaluated and cared for by teams with expertise in DSD conditions. Obstetrician gynecologists are experts in genital and reproductive anatomy, hormonal function, fertility, sexuality, and obstetrics, allowing them to provide a unique and essential function within the DSD team. Furthermore, obstetrician gynecologists with expertise in Pediatric and Adolescent Gynecology may follow individuals from birth into adulthood and provide reproductive health care for all ages, allowing these patients to "grow up" with them...
May 25, 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/28529087/a-critical-analysis-of-australian-policies-and-guidelines-for-water-immersion-during-labour-and-birth
#20
Megan Cooper, Helen McCutcheon, Jane Warland
BACKGROUND: Accessibility of water immersion for labour and/or birth is often dependent on the care provider and also the policies/guidelines that underpin practice. With little high quality research about the safety and practicality of water immersion, particularly for birth, policies/guidelines informing the practice may lack the evidence necessary to ensure practitioner confidence surrounding the option thereby limiting accessibility and women's autonomy. AIM: The aims of the study were to determine how water immersion policies and/or guidelines are informed, who interprets the evidence to inform policies/guidelines and to what extent the policy/guideline facilitates the option for labour and birth...
May 18, 2017: Women and Birth: Journal of the Australian College of Midwives
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