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Emergency Obstetric Care

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https://www.readbyqxmd.com/read/29669527/-i-didn-t-think-you-were-allowed-that-they-didn-t-mention-that-a-qualitative-study-exploring-women-s-perceptions-of-home-birth
#1
Jo Naylor Smith, Beck Taylor, Karen Shaw, Alistair Hewison, Sara Kenyon
BACKGROUND: Evidence suggests that home birth is as safe as hospital birth for low risk multiparous women, and is associated with reduced intervention rates and increased rates of normal birth. However the home birth rate in the UK is low, and few women choose this option. The aims of this study were to identify what influences multiparous women's choice of birth place, and to explore their views of home birth. METHODS: Five focus groups were conducted with multiparous women (n = 28) attending mother and baby groups in a city in the UK with a diverse multi-ethnic population...
April 18, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29668651/examining-trends-in-obstetric-quality-measures-for-monitoring-health-care-disparities
#2
Teresa Janevic, Natalia N Egorova, Jennifer Zeitlin, Amy Balbierz, Paul L Hebert, Elizabeth A Howell
BACKGROUND: Elective delivery (ED) before 39 weeks, low-risk cesarean delivery, and episiotomy are routinely reported obstetric quality measures and have been the focus of quality improvement initiatives over the past decade. OBJECTIVE: To estimate trends and differences in obstetric quality measures by race/ethnicity. RESEARCH DESIGN: We used 2008-2014 linked birth certificate-hospital discharge data from New York City to measure ED before 39 gestational weeks (ED <39), low-risk cesarean, and episiotomy by race/ethnicity...
April 17, 2018: Medical Care
https://www.readbyqxmd.com/read/29664956/you-pray-to-your-god-a-qualitative-analysis-of-challenges-in-the-provision-of-safe-timely-and-affordable-surgical-care-in-uganda
#3
Katherine Albutt, Rachel R Yorlets, Maria Punchak, Peter Kayima, Didacus B Namanya, Geoffrey A Anderson, Mark G Shrime
BACKGROUND: Five billion people lack access to safe, affordable, and timely surgical and anesthesia care. Significant challenges remain in the provision of surgical care in low-resource settings. Uganda is no exception. METHODS: From September to November 2016, we conducted a mixed-methods countrywide surgical capacity assessment at 17 randomly selected public hospitals in Uganda. Researchers conducted 35 semi-structured interviews with key stakeholders to understand factors related to the provision of surgical care...
2018: PloS One
https://www.readbyqxmd.com/read/29661217/barriers-to-access-and-utilization-of-emergency-obstetric-care-at-health-facilities-in-sub-saharan-africa-a-systematic-review-protocol
#4
Ayele Geleto, Catherine Chojenta, Abdulbasit Mussa, Deborah Loxton
BACKGROUND: Nearly 15% of all pregnancies end in fatal perinatal obstetric complications including bleeding, infections, hypertension, obstructed labor, and complications of abortion. Between 1990 and 2015, an estimated 10.7 million women died due to obstetric complications. Almost all of these deaths (99%) happened in developing countries, and 66% of maternal deaths were attributed to sub-Saharan Africa. The majority of cases of maternal mortalities can be prevented through provision of evidence-based potentially life-saving signal functions of emergency obstetric care...
April 16, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29644153/acute-fatty-liver-of-pregnancy-a-thorough-examination-of-a-harmful-obstetrical-syndrome-and-its-counterparts
#5
Joshua Ronen, Shahzeb Shaheen, David Steinberg, Kevin R Justus
Diagnosed in one of every 20,000 deliveries, acute fatty liver of pregnancy (AFLP) was considered to be a deadly disease for many years. However, advancements in the clinical and surgical management of pregnant mothers have lead to a drastic decrease in maternal morbidity and mortality. The corresponding case recounts a 23-year-old gravida 2 para 1 (G2P1) at 38 weeks gestational age (GA) with no relevant past medical or family medical history that presented to the emergency department (ED) with a five-day history of nausea, protracted vomiting, hypertension, and new-onset headache...
February 6, 2018: Curēus
https://www.readbyqxmd.com/read/29628965/improving-and-expanding-the-quality-of-emergency-obstetric-and-newborn-care-services-in-rural-areas-of-cambodia
#6
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
No abstract text is available yet for this article.
March 2018: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/29627348/the-acute-treatment-of-methemoglobinemia-in-pregnancy
#7
Nels Grauman Neander, Carly A Loner, Jason M Rotoli
BACKGROUND: Methemoglobinemia can be a potentially lethal condition due to the hypoxic stress placed on the body. In pregnancy, the deleterious effects can be even more catastrophic. The benefits of treatment in all patients, especially in those who are pregnant, must outweigh the inherent risks of the therapies used to treat methemoglobinemia. CASE REPORT: We present a case of a 26-year-old Hispanic pregnant female at 30 weeks gestation presenting to the emergency department for chest pain, hypoxia, and cyanosis...
April 4, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29626722/a-qualitative-study-of-nulliparous-women-s-decision-making-on-mode-of-delivery-under-china-s-two-child-policy
#8
Chunyi Gu, Xinli Zhu, Yan Ding, Setterberg Simone, Xiaojiao Wang, Hua Tao, Yu Zhang
OBJECTIVE: To explore nulliparous women's perceptions of decision making regarding mode of delivery under China's two-child policy. DESIGN: Qualitative descriptive design with in-depth semi-structured interviews. SETTING: Postnatal wards at a tertiary specialized women's hospital in Shanghai, China. PARTICIPANTS: 21 nulliparous women 2-3 days postpartum were purposively sampled until data saturation. METHODS: In-depth semi-structured interviews were conducted between October 8th, 2015 and January 31st, 2016...
March 20, 2018: Midwifery
https://www.readbyqxmd.com/read/29616653/accessibility-of-cesarean-deliveries-in-benin
#9
V Mongbo, J Saïzonou, G Sopoh, C Sossa-Jérôme, E M Ouendo, I Godin
To be used effectively, emergency obstetric and neonatal care must be available and accessible. This study sought to measure the accessibility of cesarean deliveries in Benin. Cross-sectional study of randomly selected women in each of the 12 obstetrics departments in Benin. Geographical accessibility was measured by estimating the distance between the parturientes residence and the hospital. Financial accessibility was the average direct cost of the cesarean delivery -the sum of medical and non-medical costs...
February 1, 2018: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/29596431/measuring-the-preparedness-of-health-facilities-to-deliver-emergency-obstetric-care-in-a-south-african-district
#10
Siphiwe Bridget Pearl Thwala, Duane Blaauw, Freddie Ssengooba
BACKGROUND: Improving the delivery of emergency obstetric care (EmNOC) remains critical in addressing direct causes of maternal mortality. United Nations (UN) agencies have promoted standard methods for evaluating the availability of EmNOC facilities although modifications have been proposed by others. This study presents an assessment of the preparedness of public health facilities to provide EmNOC using these methods in one South African district with a persistently high maternal mortality ratio...
2018: PloS One
https://www.readbyqxmd.com/read/29593989/postoperative-care-of-symphysiotomy-performed-for-severe-shoulder-dystocia-with-fetal-demise
#11
Joy Anderson, R Moss Hampton, Jonathan Lugo
Background: Shoulder dystocia is an obstetric emergency which occurs in 0.2-3% of all births ACOG Committee on Practice Bulletins-Obstetrics and The American College of Obstetrician and Gynecologists (2002) . Symphysiotomy is a treatment option reserved primarily for developing countries where mortality rates of Cesarean delivery are 1-2% Monjok et al. (2013) . Case: A G3P2002 with a history of two prior vaginal deliveries had a term delivery complicated by a severe shoulder dystocia...
April 2017: Case Reports in Women's Health
https://www.readbyqxmd.com/read/29587875/evaluation-of-a-novel-device-for-the-management-of-high-blood-pressure-and-shock-in-pregnancy-in-low-resource-settings-study-protocol-for-a-stepped-wedge-cluster-randomised-controlled-trial-cradle-3-trial
#12
Hannah L Nathan, Kate Duhig, Nicola Vousden, Elodie Lawley, Paul T Seed, Jane Sandall, Mrutyunjaya B Bellad, Adrian C Brown, Lucy C Chappell, Shivaprasad S Goudar, Muchabayiwa F Gidiri, Andrew H Shennan
BACKGROUND: Obstetric haemorrhage, sepsis and pregnancy hypertension account for more than 50% of maternal deaths worldwide. Early detection and effective management of these conditions relies on vital signs. The Microlife® CRADLE Vital Sign Alert (VSA) is an easy-to-use, accurate device that measures blood pressure and pulse. It incorporates a traffic-light early warning system that alerts all levels of healthcare provider to the need for escalation of care in women with obstetric haemorrhage, sepsis or pregnancy hypertension, thereby aiding early recognition of haemodynamic instability and preventing maternal mortality and morbidity...
March 27, 2018: Trials
https://www.readbyqxmd.com/read/29587793/thriving-in-scrubs-a-qualitative-study-of-resident-resilience
#13
Abigail Ford Winkel, Anne West Honart, Annie Robinson, Aubrie-Ann Jones, Allison Squires
BACKGROUND: Physician well-being impacts both doctors and patients. In light of high rates of physician burnout, enhancing resilience is a priority. To inform effective interventions, educators need to understand how resilience develops during residency. METHODS: A qualitative study using grounded theory examined the lived experience of resilience in residents. A cohort of obstetrics and gynecology residents were selected as a purposive, intensity sample.. Eighteen residents in all years of training participated in semi-structured interviews...
March 27, 2018: Reproductive Health
https://www.readbyqxmd.com/read/29582008/patient-centered-obstetric-care-in-the-age-of-cell-free-fetal-dna-prenatal-screening
#14
Patricia K Agatisa, Mary Beth Mercer, Ariane Mitchum, Marissa B Coleridge, Ruth M Farrell
Purpose: The clinical introduction of innovative prenatal genetic technologies challenges patients and providers to find new ways of fostering informed decision-making in a setting characterized by complexity and uncertainty. As prenatal genetic technology advances, important questions remain about how to structure patient-centered conversations that effectively prepare pregnant patients to make informed choices about the different genetic conditions for which this new form screening may be used...
March 2018: Journal of Patient Experience
https://www.readbyqxmd.com/read/29580916/influences-on-intentions-to-place-long-acting-reversible-contraceptives-a-pilot-study-comparing-by-provider-specialty-in-ohio
#15
Charee Thompson, Jane Broecker, Maggie Dade, Kelly Nottingham
STUDY OBJECTIVE: According to the American Academy of Pediatrics (AAP), pediatricians are to counsel and provide LARCs as first-line-of-defense contraceptives because they are the most effective. We wanted to explore positive influences on LARC placement for pediatricians, particularly when compared to providers in other specialties who care for women. DESIGN: Survey methods with data analyzed using analyses of variance and general linear models in statistical software SPSS 24...
March 23, 2018: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/29566655/maternal-death-and-delays-in-accessing-emergency-obstetric-care-in-mozambique
#16
Leonardo Antonio Chavane, Patricia Bailey, Osvaldo Loquiha, Martinho Dgedge, Marc Aerts, Marleen Temmerman
BACKGROUND: Despite declining trends maternal mortality remains an important public health issue in Mozambique. The delays to reach an appropriate health facility and receive care faced by woman with pregnancy related complications play an important role in the occurrence of these deaths. This study aims to examine the contribution of the delays in relation to the causes of maternal death in facilities in Mozambique. METHODS: Secondary analysis was performed on data from a national assessment on maternal and neonatal health that included in-depth maternal death reviews, using patient files and facility records with the most comprehensive information available...
March 22, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29560809/mbrrace-in-simulation-an-evaluation-of-a-multi-disciplinary-simulation-training-for-medical-emergencies-in-obstetrics-memo
#17
Mary Lavelle, Jennifer Abthorpe, Thomas Simpson, Gabriel Reedy, Fiona Little, Anita Banerjee
The majority of maternal deaths in the UK are due to pre-existing or new-onset medical conditions, known as 'indirect deaths'. The MBRRACE report identified serious gaps in clinicians' human factors skills, including communication, leadership and teamwork, which contributed to maternal death. In response, we developed the first multi-disciplinary simulation-based training programme designed to address Medical Emergencies in Obstetrics (MEmO). Employing a mixed methods design, this study evaluated the educational impact of this training programme on the healthcare staff (n = 140), including the medical doctors (n = 91) and the midwives (n = 49)...
March 21, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29555794/effect-of-age-and-cone-dimensions-on-cervical-regeneration-an-italian-multicentric-prospective-observational-study
#18
Andrea Ciavattini, Giovanni Delli Carpini, Lorenzo Moriconi, Nicolò Clemente, Nina Montik, Rosa De Vincenzo, Anna Del Fabro, Monica Buttignol, Caterina Ricci, Francesca Moro, Francesco Sopracordevole
OBJECTIVES: To evaluate cervical regeneration at 6 months following excisional treatment for high-grade cervical intraepithelial neoplasia (CIN), and to investigate the effect of cone dimensions, age of patients and technique of excision on the efficacy of the regeneration process. DESIGN: Prospective observational multicentric study. SETTING: Three tertiary care and research centres. PARTICIPANTS: Among the 197 eligible women of childbearing age, older than 25 years of age, undergoing for the first time a loop electrosurgical excision procedure or carbon dioxide laser cervical excision for a high-grade CIN at the colposcopy-directed cervical punch biopsy, and with a final diagnosis of high-grade CIN, 165 completed the 6-month follow-up and were included in the analysis...
March 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29553986/a-systematic-review-of-integrated-care-interventions-addressing-perinatal-depression-care-in-ambulatory-obstetric-care-settings
#19
Tiffany A Moore Simas, Michael P Flynn, Aimee R Kroll-Desrosiers, Stephanie M Carvalho, Leonard L Levin, Kathleen Biebel, Nancy Byatt
This systematic review searched 4 databases (PubMed/MEDLINE, Scopus, CINAHL, and PsychINFO) and identified 21 articles eligible to evaluate the extent to which interventions that integrate depression care into outpatient obstetric practice are feasible, effective, acceptable, and sustainable. Despite limitations among the available studies including marked heterogeneity, there is evidence supporting feasibility, effectiveness, and acceptability. In general, this is an emerging field with promise that requires additional research...
March 16, 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29545410/the-paediatrician-and-the-management-of-common-gynaecological-conditions
#20
REVIEW
Joanne K Ritchie, Pallavi Latthe, Deepthi Jyothish, Joanne C Blair
Paediatric gynaecology is an emerging discipline. Since 2000, there has been an advanced training programme in paediatric gynaecology available for obstetric and gynaecology trainees; additionally, a set of clinical standards1 for the care of paediatric and adolescent patients has been developed by The British Society of Paediatric and Adolescent Gynaecology (BritSPAG). BritSPAG is a multidisciplinary group of professionals including gynaecologists, paediatricians, paediatric urologists and endocrinologists...
March 15, 2018: Archives of Disease in Childhood
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