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Emergency Obstetric Care

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https://www.readbyqxmd.com/read/29049412/measuring-facility-capability-to-provide-routine-and-emergency-childbirth-care-to-mothers-and-newborns-an-appeal-to-adjust-for-delivery-caseload-of-facilities
#1
Stephanie M Allen, Charles Opondo, Oona M R Campbell
BACKGROUND: Measurement of Emergency Obstetric Care capability is common, and measurement of newborn and overall routine childbirth care has begun in recent years. These assessments of facility capabilities can be used to identify geographic inequalities in access to functional health services and to monitor improvements over time. This paper develops an approach for monitoring the childbirth environment that accounts for the delivery caseload of the facility. METHODS: We used data from the Kenya Service Provision Assessment to examine facility capability to provide quality childbirth care, including infrastructure, routine maternal and newborn care, and emergency obstetric and newborn care...
2017: PloS One
https://www.readbyqxmd.com/read/29046769/factors-that-affect-the-onset-of-action-of-non-depolarizing-neuromuscular-blocking-agents
#2
REVIEW
Yong Byum Kim, Tae-Yun Sung, Hong Seuk Yang
Neuromuscular blockade plays an important role in the safe management of patient airways, surgical field improvement, and respiratory care. Rapid-sequence induction of anesthesia is indispensable to emergency surgery and obstetric anesthesia, and its purpose is to obtain a stable airway, adequate depth of anesthesia, and appropriate respiration within a short period of time without causing irritation or damage to the patient. There has been a continued search for new neuromuscular blocking drugs (NMBDs) with a rapid onset of action...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29040531/survival-analysis-of-the-association-between-antenatal-care-attendance-and-neonatal-mortality-in-57-low-and-middle-income-countries
#3
David T Doku, Subas Neupane
Background: Neonatal mortality is unacceptably high in most low- and middle-income countries (LMICs). In these countries, where access to emergency obstetric services is limited, antenatal care (ANC) utilization offers improved maternal health and birth outcomes. However, evidence for this is scanty and mixed. We explored the association between attendance for ANC and survival of neonates in 57 LMICs. Methods: Employing standardized protocols to ensure comparison across countries, we used nationally representative cross-sectional data from 57 LMICs ( N  = 464 728) to investigate the association between ANC visits and neonatal mortality...
July 13, 2017: International Journal of Epidemiology
https://www.readbyqxmd.com/read/29040509/a-new-use-for-an-old-tool-maternity-waiting-homes-to-improve-equity-in-rural-childbirth-care-results-from-a-cross-sectional-hospital-and-community-survey-in-tanzania
#4
Piera Fogliati, Manuela Straneo, Sabina Mangi, Gaetano Azzimonti, Firma Kisika, Giovanni Putoto
Limited quality of childbirth care in sub-Saharan Africa primarily affects the poor. Greater quality is available in facilities providing advanced management of childbirth complications. We aimed to determine whether Maternity Waiting Homes (MWHs) may be a tool to improve access of lower socio-economic women to such facilities. Secondary analysis of a cross-sectional hospital survey from Iringa District, Tanzania was carried out. Women who delivered between October 2011 and May 2012 in the only District facility providing comprehensive Emergency Obstetric Care were interviewed...
October 10, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29040316/rising-trends-and-inequalities-in-cesarean-section-rates-in-pakistan-evidence-from-pakistan-demographic-and-health-surveys-1990-2013
#5
Sarwat Mumtaz, Jinwook Bahk, Young-Ho Khang
Despite global efforts to improve maternal health, many developing countries including Pakistan have failed to achieve the target of a 75% reduction in maternal deaths by 2015. Addressing socioeconomic inequalities in access to emergency obstetric care is crucial for reducing the maternal mortality rate. This study was done to examine the time trends and socioeconomic inequalities in the utilization of cesarean section (C-section) in Pakistan during 1990-2013. We used data from the Pakistan Demographic and Health Surveys (PDHS) conducted during 1990 to 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28994352/the-impact-of-a-multi-level-maternal-health-programme-on-facility-delivery-and-capacity-for-emergency-obstetric-care-in-zambia
#6
Elizabeth G Henry, Donald M Thea, Davidson H Hamer, William DeJong, Kebby Musokotwane, Kenneth Chibwe, Godfrey Biemba, Katherine Semrau
In 2012, Saving Mothers, Giving Life (SMGL), a multi-level health systems initiative, launched in Kalomo District, Zambia, to address persistent challenges in reducing maternal mortality. We assessed the impact of the programme from 2012 to 2013 using a quasi-experimental study with both household- and health facility-level data collected before and after implementation in both intervention and comparison areas. A total of 21,680 women and 75 non-hospital health centres were included in the study. Using the difference-in-differences method, multivariate logistic regression, and run charts, rates of facility-based birth (FBB) and delivery with a skilled birth provider were compared between intervention and comparison sites...
October 10, 2017: Global Public Health
https://www.readbyqxmd.com/read/28983910/-your-lack-of-planning-does-not-constitute-my-emergency-caring-for-obstetric-patients-with-mental-illness
#7
EDITORIAL
K McCombe
No abstract text is available yet for this article.
October 5, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28979638/-fight-against-maternal-mortality-in-rural-areas-decentralization-of-emergency-obstetric-cares-in-burkina-faso
#8
Souleymane Kaboré, Clément Ziemlé Méda, Issiaka Sombié, Léon Blaise Savadogo, Robert Karama, Koabié Bakouan, Djénéba Sanon Ouédraogo, Norbert Coulibaly, Robert Lucien Kargougou, Emanuel Lankoandé, Ramatou Windsouri Sawadogo, Karen Gosch
INTRODUCTION: In order to cover the shortage of midwives (MWs) in the health district of Tougan, Burkina Faso, a strategy for the decentralization of emergency obstetric cares, based on ad hoc interventions undertaken by MW to manage obstetric complications in health centers (HCs), has been developed in rural areas. This study aimed to describe this experience and to analyze the achieved results. METHODS: We conducted a cross-sectional, analytical, intervention study based on a review of routine data from all the parturients treated from 2013 to 2015...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28967511/does-surgical-site-infection-after-caesarean-section-in-polish-hospitals-reflect-high-quality-patient-care-or-poor-postdischarge-surveillance-results-from-a-3-year-multicenter-study
#9
Anna Różańska, Andrzej Jarynowski, Katarzyna Kopeć-Godlewska, Jadwiga Wójkowska-Mach, Agnieszka Misiewska-Kaczur, Marzena Lech, Małgorzata Rozwadowska, Marlena Karwacka, Joanna Liberda, Joanna Domańska
BACKGROUND: Caesarean sections (CSs) are associated with a high infection risk. Surgical site infection (SSI) incidence is among the markers of effectiveness of infection prevention efforts. The aim of this study was to analyze risk factors for SSI, incidence, and microbiology in patients who underwent CS. METHODS: The study was conducted during 2013-2015 using active infection surveillance in 5 Polish hospitals according to the European Centre for Disease Prevention and Control surveillance network known as HAI-Net...
September 26, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28962566/-i-stayed-with-my-illness-a-grounded-theory-study-of-health-seeking-behaviour-and-treatment-pathways-of-patients-with-obstetric-fistula-in-kenya
#10
Anne M Khisa, Grace M Omoni, Isaac K Nyamongo, Rachel F Spitzer
BACKGROUND: Obstetric fistula classic symptoms of faecal and urinary incontinence cause women to live with social stigma, isolation, psychological trauma and lose their source of livelihoods. There is a paucity of studies on the health seeking behaviour trajectories of women with fistula illness although women live with the illness for decades before surgery. We set out to establish the complete picture of women's health seeking behaviour using qualitative research. We sought to answer the question: what patterns of health seeking do women with obstetric fistula display in their quest for healing? METHODS: We used grounded theory methodology to analyse data from narratives of women during inpatient stay after fistula surgery in 3 hospitals in Kenya...
September 29, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28950830/a-survey-based-study-of-zika-virus-communication-preferences-among-pregnant-women-in-georgia-united-states
#11
Mallory K Ellingson, Catherine M Bonk, Allison T Chamberlain
BACKGROUND: Because of the particularly severe perinatal outcomes associated with antenatal Zika virus infection, it is important for prenatal care providers to communicate Zika virus risks and strategies for prevention to their patients. Although face-to-face communication is ideal, clinic visits may not allow for in-depth discussion of all concerns. While previous studies have shown prenatal providers to be pregnant women's most trusted sources of health information, there is little knowledge on what secondary communication modalities pregnant women prefer for receiving information from their providers about an evolving public health emergency...
September 26, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28946844/woman-centred-care-during-pregnancy-and-birth-in-ireland-thematic-analysis-of-women-s-and-clinicians-experiences
#12
Andrew Hunter, Declan Devane, Catherine Houghton, Annmarie Grealish, Agnes Tully, Valerie Smith
BACKGROUND: Recent policy and service provision recommends a woman-centred approach to maternity care. Midwife-led models of care are seen as one important strategy for enhancing women's choice; a core element of woman-centred care. In the Republic of Ireland, an obstetric consultant-led, midwife-managed service model currently predominates and there is limited exploration of the concept of women centred care from the perspectives of those directly involved; that is, women, midwives, general practitioners and obstetricians...
September 25, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28945616/new-models-of-care
#13
Hal C Lawrence
The practice of obstetrics and gynecology continues to evolve. Changes in the obstetrician-gynecologists workforce, reimbursement, governmental regulations, and technology all drive new models of care. The advent of the obstetric hospitalist is one new model, and the development of team-based care is another. Increasingly, obstetrician-gynecologists are becoming employees of health care delivery systems, and others are focusing the scope of their practices to subspecialites. As new practice models emerge, the specialty of obstetrics and gynecology will continue to change to meet the health care needs of women...
December 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28934836/pregnancy-in-women-with-hypertrophic-cardiomyopathy-data-from-the-european-society-of-cardiology-initiated-registry-of-pregnancy-and-cardiac-disease-ropac
#14
S Goland, I M van Hagen, G Elbaz-Greener, U Elkayam, A Shotan, W M Merz, S C Enar, I R Gaisin, P G Pieper, M R Johnson, R Hall, A Blatt, J W Roos-Hesselink
Aims: We report the maternal and foetal outcomes at birth and after 6 months in a cohort of pregnant women with hypertrophic cardiomyopathy (HCM). Although most women with HCM tolerate pregnancy well, there is an increased risk of obstetric and cardiovascular complications. Methods and results: All pregnant women with HCM entered into the prospective worldwide Registry of Pregnancy and Cardiac disease (ROPAC) were included in this analysis. The primary endpoint was a major adverse cardiovascular event (MACE), which included death, heart failure (HF), thrombo-embolic event, and arrhythmia...
September 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28934320/household-costs-and-time-to-seek-care-for-pregnancy-related-complications-the-role-of-results-based-financing
#15
Jobiba Chinkhumba, Manuela De Allegri, Jacob Mazalale, Stephan Brenner, Don Mathanga, Adamson S Muula, Bjarne Robberstad
Results-based financing (RBF) schemes-including performance based financing (PBF) and conditional cash transfers (CCT)-are increasingly being used to encourage use and improve quality of institutional health care for pregnant women in order to reduce maternal and neonatal mortality in low-income countries. While there is emerging evidence that RBF can increase service use and quality, little is known on the impact of RBF on costs and time to seek care for obstetric complications, although the two represent important dimensions of access...
2017: PloS One
https://www.readbyqxmd.com/read/28930786/the-relationship-between-2009-pandemic-h1n1-influenza-during-pregnancy-and-preterm-birth-a-population-based-cohort-study
#16
Deshayne B Fell, Robert W Platt, Olga Basso, Kumanan Wilson, Jay S Kaufman, David L Buckeridge, Jeffrey C Kwong
BACKGROUND: Previous studies of maternal influenza illness and preterm birth have yielded inconsistent results. Our objective was to assess the association between 2009 pandemic H1N1 (pH1N1) influenza during pregnancy and preterm birth in a large obstetrical population. METHODS: We linked a province-wide birth registry with health administrative databases to identify influenza-coded hospitalizations, emergency department visits, or physician visits among pregnant women during the 2009 H1N1 pandemic (our proxy for clinical pH1N1 influenza illness)...
September 19, 2017: Epidemiology
https://www.readbyqxmd.com/read/28929879/safer-muslim-motherhood-social-conditions-and-maternal-mortality-in-the-muslim-world
#17
Kylea Laina Liese, Angela B Maeder
The greatest variation in maternal mortality is among poor countries and wealthy countries that rely on emergency obstetric technology to save a woman's life during childbirth. However, substantial variation in maternal mortality ratios (MMRs) exists within and among poor countries with uneven access to advanced obstetric services. This article examines MMRs across the Muslim world and compares the impact of national wealth, female education, and skilled birth attendants on maternal mortality. Understanding how poor countries have lowered MMRs without access to expensive obstetric technologies suggests that certain social variables may act protectively to reduce the maternal risk for life-threatening obstetric complications that would require emergency obstetric care...
September 20, 2017: Global Public Health
https://www.readbyqxmd.com/read/28928575/referrral-systems-development-and-survey-of-perioperative-and-critical-care-referral-to-anesthetists
#18
P L Narendra, Harihar V Hegde, Maroof Ahmad Khan, Dayanand G Talikoti, Samson Nallamilli
INTRODUCTION: Anesthetists come in contact with more than two-third of hospital patients. Timely referral to anesthetists is vital in perioperative and remote site settings. Delayed referrals, improper referrals, and referrals at inappropriate levels can result in inadequate preparation, perioperative complications, and poor outcome. METHODS: The self administered paper survey to delegates attending anesthesia conferences. Questions were asked on how high-risk, emergency surgical cases remote site and critical care patients were referred to anesthetists and presence of rapid response teams...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28919603/current-trends-of-using-antimicrobials-at-obstetrics-and-gynaecology-department-in-a-tertiary-care-hospital
#19
M M Islam, S K Saha, S Saha, U A Wahid, R R Gomes, K S Ahmed, A N Naushad, S E Suchi, C Saha, D Mondal
This cross-sectional descriptive study was done to analyse the current trends of using antimicrobials in various surgical procedures at Obstetrics and Gynaecology department in Mymensingh Medical College Hospital, Mymensingh from July 2014 to June 2015. Among 300 postoperative obstetrics and gynaecological surgery cases, samples were selected as non-random purposive selection method where pattern of using antimicrobials were analysed by SPSS method 20.1 versions. The incidence of antimicrobial resistance is on continued rise with a threat to return to the pre-antibiotic era...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28904676/-gestational-diabetes-revealed-by-inaugural-diabetic-ketoacidosis-about-a-case
#20
Serge Irie Bi Gohi, Pete Yaich, Koffi N'guessan, Bernard Ogondon, Yapo Brouh
Ketoacidosis complicating gestational diabetes is rare and responsible for severe maternal-fetal mortality. It is an acute metabolic emergency whose management is multidisciplinary. Early diagnosis and treatment affect the vital prognosis of both the mother and the fetus. We report the case of a 27-year old pregnant woman at term, with a family history of diabetes, admitted to the emergency obstetric care with alertness problems associated with dyspnoea. The diagnosis of inaugural ketoacidosis decompensated due to severe malaria associated with gestational diabetes was retained on the basis of patient's medical history, of clinical examination and paraclinical assessment...
2017: Pan African Medical Journal
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