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Emergency Obstetric Care

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https://www.readbyqxmd.com/read/28211102/effectiveness-of-vaginal-breech-birth-training-strategies-an-integrative-review-of-the-literature
#1
REVIEW
Shawn Walker, Eamonn Breslin, Mandie Scamell, Pam Parker
BACKGROUND: The safety of vaginal breech birth depends on the skill of the attendant. The objective of this review was to identify, synthesize, and report the findings of evaluated breech birth training strategies. METHODS: A systematic search of the following on-line databases: Medline, CINAHL Plus, PsychINFO, EBM Reviews/Cochrane Library, EMBASE, Maternity and Infant Care, and Pubmed, using a structured search strategy. Studies were included in the review if they evaluated the efficacy of a breech birth training program or particular strategies, including obstetric emergency training evaluations that reported differentiated outcomes for breech...
February 17, 2017: Birth
https://www.readbyqxmd.com/read/28187838/pharmacologic-treatment-of-opioid-addiction-during-pregnancy
#2
REVIEW
Lori Keough, Heidi Collins Fantasia
Opioid addiction during pregnancy presents a treatment challenge to clinicians and women alike. Untreated addiction can lead to poor maternal and fetal health outcomes. Medication-assisted treatment is the standard of care, and methadone is the current drug of choice for treatment. Emerging evidence also supports the use of buprenorphine during pregnancy. Both methadone and buprenorphine have risks and benefits that should be explored before initiating treatment. Clinicians who work in obstetrics and in addiction treatment can collaborate and coordinate treatment to ensure optimal maternal and fetal outcomes...
February 2017: Nursing for Women's Health
https://www.readbyqxmd.com/read/28179699/referral-pattern-of-emergencies-in-obstetrics-implications-for-defining-scope-of-services-and-policy
#3
Rahat Najam Qureshi, Rozina Sikandar, Zahra Hoodbhoy, Raffat Bano, Nigar Jabeen
OBJECTIVE: To analyse referral pattern of high-risk obstetric cases from secondary to tertiary care hospitals and to assess their maternal and neonatal outcomes. METHODS: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised all referred obstetric cases from secondary-level hospitals to tertiary-level care within and outside the Hospital between January 2011 and December 2014. Day and time of referral, reason for referral as well as maternal and neonatal outcomes were collected...
December 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28178918/global-health-training-among-u-s-residency-specialties-a-systematic-literature-review
#4
Duncan K Hau, Luke R Smart, Jennifer I DiPace, Robert N Peck
BACKGROUND: Interest in global health training during residency is increasing. Global health knowledge is also becoming essential for health-care delivery today. Many U.S. residency programs have been incorporating global health training opportunities for their residents. We performed a systematic literature review to evaluate global health training opportunities and challenges among U.S. residency specialties. METHODS: We searched PubMed from its earliest dates until October 2015...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28170398/emergency-obstetric-care-in-a-rural-district-of-burundi-what-are-the-surgical-needs
#5
E De Plecker, R Zachariah, A M V Kumar, M Trelles, S Caluwaerts, W van den Boogaard, J Manirampa, K Tayler-Smith, M Manzi, K Nanan-N'zeth, B Duchenne, B Ndelema, W Etienne, P Alders, R Veerman, R Van den Bergh
OBJECTIVES: In a rural district hospital in Burundi offering Emergency Obstetric care-(EmOC), we assessed the a) characteristics of women at risk of, or with an obstetric complication and their types b) the number and type of obstetric surgical procedures and anaesthesia performed c) human resource cadres who performed surgery and anaesthesia and d) hospital exit outcomes. METHODS: A retrospective analysis of EmOC data (2011 and 2012). RESULTS: A total of 6084 women were referred for EmOC of whom 2534(42%) underwent a major surgical procedure while 1345(22%) required a minor procedure (36% women did not require any surgical procedure)...
2017: PloS One
https://www.readbyqxmd.com/read/28164320/perception-of-point-of-care-ultrasound-performed-by-emergency-medicine-physicians
#6
Whitney Hansen, Carl E Mitchell, Bikash Bhattarai, Napatkamon Ayutyanont, Jeffrey R Stowell
PURPOSE: Point-of-care ultrasound (POCUS) is integral to the practice of emergency medicine (EM). Furthermore, EM-performed POCUS (EM-POCUS) offers consultants the opportunity to avoid delays in care due to wait times for confirmatory imaging studies. This study is the first to describe the perception of POCUS to consulting services at a single institution where EM-POCUS is routinely performed. METHODS: This study was conducted as a survey distributed to residents from consultant specialties (internal medicine [IM], general surgery [GS], and obstetrics and gynecology [OB-GYN])...
February 6, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28154999/the-spiritual-and-theological-challenges-of-stillbirth-for-bereaved-parents
#7
Daniel Nuzum, Sarah Meaney, Keelin O'Donoghue
Stillbirth is recognized as one of the most challenging experiences of bereavement raising significant spiritual and theological questions. Semi-structured qualitative interviews were conducted with bereaved parents cared for in a tertiary maternity hospital to explore the spiritual impact of stillbirth. Data were analysed using interpretative phenomenological analysis. Stillbirth was identified as an immensely challenging spiritual and personal experience with enduring impact for parents. The superordinate themes to emerge were searching for meaning, maintaining hope and questioning core beliefs...
February 2, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/28146046/brazilian-specialists-perspectives-on-the-patient-referral-process
#8
Carmen Juliani, Maura MacPhee, Wilza Spiri
Since 1988, healthcare has been considered a citizen's right in Brazil. The Sistema Único de Saúde (SUS), has undergone development and expansion to ensure universal health coverage for the Brazilian public, the world's fifth largest population. The coordination of effective communications between primary care physicians, specialists and patients is a significant challenge, particularly the referral process. Our study objective was to understand the facilitators and barriers associated with referral process communications between primary care physicians and regional university hospital specialists in the State of Sao Paulo...
January 29, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28139878/assisted-vaginal-delivery-in-low-and-middle-income-countries-an-overview
#9
P E Bailey, J van Roosmalen, G Mola, C Evans, L de Bernis, B Dao
OBJECTIVE: To assess the use of assisted vaginal delivery (AVD) in low- and middle-income countries (LMICs), highlighting what level of care procedures were performed and identifying systemic barriers to its use. DESIGN: Cross-sectional health facility assessments. SETTING: Up to 40 countries in Latin America, sub-Saharan Africa and Asia. POPULATION: Assessments tended to be national in scope and included all hospitals and samples of midlevel facilities in public and private sectors...
January 31, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28132168/delivery-and-payment-redesign-to-reduce-disparities-in-high-risk-postpartum-care
#10
Elizabeth A Howell, Norma A Padrón, Susan J Beane, Joanne Stone, Virginia Walther, Amy Balbierz, Rashi Kumar, José A Pagán
Purpose This paper describes the implementation of an innovative program that aims to improve postpartum care through a set of coordinated delivery and payment system changes designed to use postpartum care as an opportunity to impact the current and future health of vulnerable women and reduce disparities in health outcomes among minority women. Description A large health care system, a Medicaid managed care organization, and a multidisciplinary team of experts in obstetrics, health economics, and health disparities designed an intervention to improve postpartum care for women identified as high-risk...
January 28, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28125540/use-of-obstetric-practice-web-sites-to-distribute-zika-virus-information-to-pregnant-women-during-a-zika-virus-outbreak
#11
Jonathan D Lehnert, Mallory K Ellingson, Grace W Goryoka, Raghuraj Kasturi, Emily Maier, Allison T Chamberlain
OBJECTIVE: To describe the current use of obstetric practice Web sites to disseminate Zika virus information to patients. DESIGN: Review of 913 randomly selected practice Web sites and associated social media accounts in January and August 2016. SETTING: Obstetric practice Web sites and associated social media accounts, United States of America. PARTICIPANTS: N/A. MAIN OUTCOME MEASURES: Proportion of obstetric practice Web sites and linked social media accounts providing Zika virus information...
January 25, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28116114/introducing-ehealth-strategies-to-enhance-maternal-and-perinatal-health-care-in-rural-tanzania
#12
Angelo Nyamtema, Nguke Mwakatundu, Sunday Dominico, Mkambu Kasanga, Fadhili Jamadini, Kelvin Maokola, Donald Mawala, Zabron Abel, Richard Rumanyika, Calist Nzabuhakwa, Jos van Roosmalen
BACKGROUND: Globally, eHealth has attracted considerable attention as a means of supporting maternal and perinatal health care. This article describes best practices, gains and challenges of implementing eHealth for maternal and perinatal health care in extremely remote and rural Tanzania. METHODS: Teleconsultation for obstetric emergency care, audio teleconferences and online eLearning systems were installed in ten upgraded rural health centres, four rural district hospitals and one regional hospital in Tanzania...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28114984/professionalism-professionalization-expertise-and-compassion-a-qualitative-study-of-medical-residents
#13
Susan P Phillips, Nancy Dalgarno
BACKGROUND: Formal and informal medical curricula convey expectations about professionalization, that is, the development of physician identity, and also about professionalism. This study examined whether, in general, junior residents experienced any dissonance between these roles and focused particularly on how they negotiated conflicts between compassion, self-care, duty and medical expertise. METHODS: In 2015, purposive sampling was used to select 21 first-year residents at a Canadian medical school...
January 23, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28103836/rapid-reduction-of-maternal-mortality-in-uganda-and-zambia-through-the-saving-mothers-giving-life-initiative-results-of-year-1-evaluation
#14
Florina Serbanescu, Howard I Goldberg, Isabella Danel, Tadesse Wuhib, Lawrence Marum, Walter Obiero, James McAuley, Jane Aceng, Ewlyn Chomba, Paul W Stupp, Claudia Morrissey Conlon
BACKGROUND: Achieving maternal mortality reduction as a development goal remains a major challenge in most low-resource countries. Saving Mothers, Giving Life (SMGL) is a multi-partner initiative designed to reduce maternal mortality rapidly in high mortality settings through community and facility evidence-based interventions and district-wide health systems strengthening that could reduce delays to appropriate obstetric care. METHODS: An evaluation employing multiple studies and data collection methods was used to compare baseline maternal outcomes to those during Year 1 in SMGL pilot districts in Uganda and Zambia...
January 19, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28103822/emergency-obstetric-and-neonatal-care-availability-use-and-quality-a-cross-sectional-study-in-the-city-of-lubumbashi-democratic-republic-of-the-congo-2011
#15
Abel Mukengeshayi Ntambue, Françoise Kaj Malonga, Karen D Cowgill, Michèle Dramaix-Wilmet, Philippe Donnen
BACKGROUND: While emergency obstetric and neonatal care (EmONC) is a proxy indicator for monitoring maternal and perinatal mortalities, in Democratic Republic of the Congo (DRC), data on this care is rarely available. In the city of Lubumbashi, the second largest in DRC with an estimated population of 1.5 million, the availability, use and quality of EmONC are not known. This study aimed to assess these elements in Lubumbashi. METHODS: This cross-sectional survey was conducted in April and May 2011...
January 19, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28100383/-hiv-antibody-detection-results-in-patients-seeking-medical-care-in-peking-union-medical-college-hospital-2003-2014
#16
X J Song, Z F Qiu, W Cao, J Xie, Z J Zhang, S X Xu, T S Li
Objective: To better understand the infection status of HIV in the patients seeking medical care in Peking Union Medical College Hospital. Methods: The HIV detection data of the patients in the hospital from 2003-2014 were collected for a statistical analysis with software SPSS 19.0. Results: A total of 715 421 patients were screened, and 1 012 (0.14%) patients were HIV positive, and HIV infection were confirmed in 776 (0.11%) patients by Western Blot testing. The detection rate of HIV infection increased from 0...
January 10, 2017: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
https://www.readbyqxmd.com/read/28099701/a-systematic-review-of-implementation-strategies-to-deliver-guidelines-on-obstetric-care-practice-in-low-and-middle-income-countries
#17
REVIEW
Mari Imamura, Lovney Kanguru, Suzanne Penfold, Tim Stokes, Janette Camosso-Stefinovic, Beth Shaw, Julia Hussein
BACKGROUND: Healthcare measures to prevent maternal deaths are well known. However, effective implementation of this knowledge to change practice remains a challenge. OBJECTIVES: To assess whether strategies to promote the use of guidelines can improve obstetric practices in low- and middle-income countries (LMICs). SEARCH STRATEGY: Electronic databases were searched up to February 7, 2014, using relevant terms for implementation strategies (e...
January 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28092247/-emergency-obstetric-causes-and-immediate-response-team-in-a-secondary-hospital
#18
Luis Rafael López-Ocaña, Norma Angélica Hernández-Pineda, Polita Rocío Cruz-Cruz, Manuel Ramiro-H, Víctor Octavio Pérez Del Valle-Ibarra
BACKGROUND: The aim of this work is to describe the causes of the obstetric emergency, which motivates the activation of the Immediate Response Team at a second level hospital of the Instituto Mexicano del Seguro Social, which has not an Intensive Care Unit for Adult Patients. METHODS: Retrospective observational study of the causes of obstetric emergency that occurred in the domains of Admission, Hospitalization, Labor, Delivery Room, Operating Room and Recovery of the Hospital General de Zona 53 of the IMSS, during the years 2014 and 2015...
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28078809/three-year-analysis-of-repeated-laboratory-tests-for-the-markers-total-cholesterol-ferritin-vitamin-d-vitamin-b12-and-folate-in-a-large-research-and-teaching-hospital-in-italy
#19
Monica Lanzoni, Marco Fornili, Irene Felicetta, Rita Maiavacca, Elia Biganzoli, Silvana Castaldi
RATIONALE, AIMS AND OBJECTIVES: The increasing number of diagnostic tests requests all over the world is a problem that can partially be explained by inappropriate testing. Impact on the total costs of health systems becomes relevant when tests are performed in a large amount. In this paper, retesting of total cholesterol, ferritin, vitamin B12 , vitamin D, and folate is assessed. METHODS: The Quality Unit of Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano (Fondazione) decided to perform a first assessment of the appropriate use of the laboratory tests cholesterol, ferritin, vitamin B12 , vitamin D, and folate focusing on the retesting interval for the same patient in the time period January 1, 2012, to December 31, 2014, in every care setting...
January 12, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28076828/perinatal-risk-factors-for-low-and-moderate-five-minute-apgar-scores-at-term
#20
Shimona Lai, Christopher Flatley, Sailesh Kumar
OBJECTIVE: To evaluate the specific maternal and perinatal variables associated with a low (≤3) or moderate (4-6) Apgar score, compared to a high (≥7) score. STUDY DESIGN: This was a retrospective, cohort study of 58429 term singleton babies born at the Mater Mother's Hospital in Brisbane, Australia in 2007-2013. Maternal demographics, socio-economic status using the Australian Socioeconomic Index for Areas (SEIFA) score, obstetric factors, and birth outcomes were compared for neonates grouped into three categories based on their five-minute Apgar: low (≤3), moderate (4-6) and high (≥7)...
January 6, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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