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Emergency Obstetric Care

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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
#1
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
#2
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
https://www.readbyqxmd.com/read/28056865/why-women-do-not-ask-for-information-on-preconception-health-a-qualitative-study
#3
Renata Bortolus, Nadia C Oprandi, Francesca Rech Morassutti, Luca Marchetto, Francesca Filippini, Eleonora Agricola, Alberto E Tozzi, Carlo Castellani, Faustina Lalatta, Bruno Rusticali, Pierpaolo Mastroiacovo
BACKGROUND: Preconception care involves health promotion to reduce risk factors that might affect women and couples of childbearing age. The risk factors of adverse reproductive outcomes include recognized genetic diseases in the family or the individual, previous congenital diseases, miscarriage, prematurity, fetal growth restriction, infertility, chronic maternal diseases, lifestyle, and occupational or environmental factors. Effective preconception care involves a range of preventive, therapeutic and behavioural interventions...
January 5, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28046036/reducing-maternal-deaths-in-ethiopia-results-of-an-intervention-programme-in-southwest-ethiopia
#4
Bernt Lindtjørn, Demissew Mitiku, Zillo Zidda, Yaliso Yaya
BACKGROUND: In a large population in Southwest Ethiopia (population 700,000), we carried out a complex set of interventions with the aim of reducing maternal mortality. This study evaluated the effects of several coordinated interventions to help improve effective coverage and reduce maternal deaths. Together with the Ministry of Health in Ethiopia, we designed a project to strengthen the health-care system. A particular emphasis was given to upgrade existing institutions so that they could carry out Basic (BEmOC) and Comprehensive Emergency Obstetric Care (CEmOC)...
2017: PloS One
https://www.readbyqxmd.com/read/28005984/knowledge-and-skills-of-healthcare-providers-in-sub-saharan-africa-and-asia-before-and-after-competency-based-training-in-emergency-obstetric-and-early-newborn-care
#5
Charles A Ameh, Robert Kerr, Barbara Madaj, Mselenge Mdegela, Terry Kana, Susan Jones, Jaki Lambert, Fiona Dickinson, Sarah White, Nynke van den Broek
BACKGROUND: Healthcare provider training in Emergency Obstetric and Newborn Care (EmOC&NC) is a component of 65% of intervention programs aimed at reducing maternal and newborn mortality and morbidity. It is important to evaluate the effectiveness of this. METHODS: We evaluated knowledge and skills among 5,939 healthcare providers before and after 3-5 days 'skills and drills' training in emergency obstetric and newborn care (EmOC&NC) conducted in 7 sub-Saharan Africa countries (Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Zimbabwe) and 2 Asian countries (Bangladesh, Pakistan)...
2016: PloS One
https://www.readbyqxmd.com/read/28005272/prophylactic-versus-selective-blood-transfusion-for-sickle-cell-disease-in-pregnancy
#6
REVIEW
Babasola O Okusanya, Olufemi T Oladapo
BACKGROUND: Pregnant women with sickle cell disease (HbSS, HbSC and HbSβThal) may require blood transfusion to prevent severe anaemia or to manage potential medical complications. Preventive blood transfusion in the absence of complications starting from the early weeks of pregnancy or blood transfusion only for medical or obstetric indications have been used as management policies. There is currently no consensus on the blood transfusion policy that guarantees optimal clinical benefits with minimal risks for such women and their babies...
22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28003676/a-case-of-refractory-systemic-capillary-leak-syndrome-clarkson-s-disease-during-pregnancy
#7
Yukiko Hikasa, Masao Hayashi, Satoshi Suzuki, Hiroshi Morimatsu
A 32-year-old woman, pregnant with twins, presented with a chief complaint of general fatigue. Her general condition had rapidly deteriorated since her last visit to the primary obstetrician; the patient was then referred to our hospital because of suspected fetal death. She underwent emergency cesarean section because fetal death had indeed occurred, and she was then admitted to the intensive care unit (ICU). On ICU admission, she was found to be in shock. Laboratory analysis revealed extreme hemoconcentration and a low albumin level, and initially, septic shock with obstetric complications was suspected...
December 2016: Acta Medica Okayama
https://www.readbyqxmd.com/read/28003175/design-of-a-serious-game-for-handling-obstetrical-emergencies
#8
Estelle Jean Dit Gautier, Virginie Bot-Robin, Aurélien Libessart, Guillaume Doucède, Michel Cosson, Chrystèle Rubod
BACKGROUND: The emergence of new technologies in the obstetrical field should lead to the development of learning applications, specifically for obstetrical emergencies. Many childbirth simulations have been recently developed. However, to date none of them have been integrated into a serious game. OBJECTIVE: Our objective was to design a new type of immersive serious game, using virtual glasses to facilitate the learning of pregnancy and childbirth pathologies...
December 21, 2016: JMIR Serious Games
https://www.readbyqxmd.com/read/28002642/modification-of-obstetric-emergency-simulation-scenarios-for-realism-in-a-home-birth-setting
#9
Janelle Komorowski, Tia Andrighetti, Melissa Benton
INTRODUCTION: Clinical competency and clear communication are essential for intrapartum care providers who encounter high-stakes, low-frequency emergencies. The challenge for these providers is to maintain infrequently used skills. The challenge is even more significant for midwives who manage births at home and who, due to low practice volume and low-risk clientele, may rarely encounter an emergency. In addition, access to team simulation may be limited for home-birth midwives. This project modified existing validated obstetric simulation scenarios for a home-birth setting...
December 21, 2016: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/27998636/use-of-point-of-care-ultrasound-for-the-diagnosis-of-ovarian-hyperstimulation-syndrome
#10
Sowdhamani Bellapu, Joshua Guttman
BACKGROUND: Ovarian hyperstimulation syndrome (OHSS) occurs when ovaries are overstimulated and enlarged due to fertility treatments resulting in a shift of serum from the intravascular space to the third space, mainly the abdominal cavity. It is the most serious complication of ovarian hyperstimulation for assisted reproduction. CASE REPORT: We present the case of a 40-year-old woman who presented with abdominal bloating and nausea 2 weeks after undergoing in vitro fertilization (IVF); she was diagnosed by an outside radiology ultrasound as having a ruptured ovarian cyst...
December 17, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27998318/management-of-severe-dengue-hemorrhagic-fever-and-bleeding-complications-in-a-primigravida%C3%A2-patient-a-case-report
#11
Hori Hariyanto, Corry Quando Yahya, Primartanto Wibowo, Oloan E Tampubolon
BACKGROUND: The incidence of dengue hemorrhagic fever is increasing among the adult population living in endemic areas. The disease carries a 0.73% fatality rate for the general population, but what happens when the disease strikes a special subpopulation group, the obstetrics? Perhaps the important question specific to this special subpopulation revolves around the right time and mode of delivery under severe coagulopathy and plasma leakage in conditions of imminent delivery. CASE PRESENTATION: A 24-year-old primigravid Sundanese woman presented to our intensive care unit due to acute pulmonary edema secondary to massive plasma leakage caused by severe dengue...
December 20, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27997480/health-care-provider-knowledge-and-attitudes-regarding-reporting-diseases-and-events-to-public-health-authorities-in-tennessee
#12
Mary-Margaret A Fill, Rendi Murphree, April C Pettit
CONTEXT: In the United States, state laws require health care providers to report specific diseases and events to public health authorities, a fundamental facet of disease surveillance. However, reporting by providers is often inconsistent, infrequent, and delayed. OBJECTIVE: To examine knowledge, attitudes, and practices regarding provider disease reporting and to understand current barriers to provider disease reporting. DESIGN: A cross-sectional study was conducted via an anonymous, standardized electronic survey...
December 16, 2016: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/27993924/limited-effectiveness-of-a-skills-and-drills-intervention-to-improve-emergency-obstetric-and-newborn-care-in-karnataka-india-a-proof-of-concept-study
#13
Beena Varghese, Jayanna Krishnamurthy, Blaze Correia, Ruchika Panigrahi, Maryann Washington, Vinotha Ponnuswamy, Prem Mony
OBJECTIVE: The majority of the maternal and perinatal deaths are preventable through improved emergency obstetric and newborn care at facilities. However, the quality of such care in India has significant gaps in terms of provider skills and in their preparedness to handle emergencies. We tested the feasibility, acceptability, and effectiveness of a "skills and drills" intervention, implemented between July 2013 and September 2014, to improve emergency obstetric and newborn care in the state of Karnataka, India...
December 23, 2016: Global Health, Science and Practice
https://www.readbyqxmd.com/read/27974170/getting-it-right-the-first-time-defining-regionally-relevant-training-curricula-and-provider-core-competencies-for-point-of-care-ultrasound-education-on-the-african-continent
#14
Margaret Salmon, Megan Landes, Cheryl Hunchak, Justin Paluku, Luc Malemo Kalisya, Christian Salmon, Mundenga Mutendi Muller, Benjamin Wachira, James Mangan, Kajal Chhaganlal, Joseph Kalanzi, Aklilu Azazh, Sara Berman, El-Sayed Zied, Hein Lamprecht
Significant evidence identifies point-of-care ultrasound (PoCUS) as an important diagnostic and therapeutic tool in resource-limited settings. Despite this evidence, local health care providers on the African continent continue to have limited access to and use of ultrasound, even in potentially high-impact fields such as obstetrics and trauma. Dedicated postgraduate emergency medicine residency training programs now exist in 8 countries, yet no current consensus exists in regard to core PoCUS competencies...
December 11, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27942344/acute-care-trauma-surgeon-s-role-in-obstetrical-gynecologic-emergencies-the-obcat-alert
#15
Seong K Lee, Eddy H Carrillo, Andrew Rosenthal, Rafael Sanchez, Chauniqua Kiffin, Dafney L Davare
BACKGROUND: Overwhelming hemorrhage or other intra-abdominal complications may be associated with obstetrical or gynecologic (OB/GYN) procedures and may require the surgical training of an Acute Care/Trauma Surgeon. The OB Critical Assessment Team (OBCAT Alert) was developed at our institution to facilitate a multidisciplinary response to complex OB/GYN cases. We sought to review and characterize the Acute Care/Trauma Surgeon's role in these cases. METHODS: We conducted a retrospective review of all emergency consults during an OB/GYN case at our institution from 2008 to 2015...
2016: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27920246/beyond-utilization-measuring-effective-coverage-of-obstetric-care-along-the-quality-cascade
#16
Elysia Larson, Daniel Vail, Godfrey M Mbaruku, Redempta Mbatia, Margaret E Kruk
OBJECTIVE: To determine the effective coverage of obstetric care in a rural Tanzanian region and to assess differences in effective coverage by wealth. DESIGN: Cross-sectional structured interviews. SETTING: Pwani Region, Tanzania. PARTICIPANTS: The study includes 24 rural, government-managed, primary healthcare clinics and their catchment populations. From January-April 2016, we conducted a household survey of a census of women with recent deliveries, health worker knowledge surveys and facility audits...
December 4, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27916235/the-rohingya-people-of-myanmar-health-human-rights-and-identity
#17
REVIEW
Syed S Mahmood, Emily Wroe, Arlan Fuller, Jennifer Leaning
The Rohingya people of Myanmar (known as Burma before 1989) were stripped of citizenship in 1982, because they could not meet the requirement of proving their forefathers settled in Burma before 1823, and now account for one in seven of the global population of stateless people. Of the total 1·5 million Rohingya people living in Myanmar and across southeast Asia, only 82 000 have any legal protection obtained through UN-designated refugee status. Since 2012, more than 159 000 people, most of whom are Rohingya, have fled Myanmar in poorly constructed boats for journeys lasting several weeks to neighbouring nations, causing hundreds of deaths...
December 2, 2016: Lancet
https://www.readbyqxmd.com/read/27911959/barriers-to-timely-and-safe-blood-transfusion-for-pph-patients-evidence-from-a-qualitative-study-in-dhaka-bangladesh
#18
Sadika Akhter, Iqbal Anwar, Rashida Akter, Feroza Akhter Kumkum, Monjura Khatun Nisha, Fatema Ashraf, Ferdousi Islam, Nazneen Begum, Mahbub Elahi Chowdhury, Anne Austin, Syed Shariful Islam, Aminur Rahman
BACKGROUND AND OBJECTIVES: In Bangladesh, postpartum hemorrhage (PPH) is the leading cause of maternal mortality accounting for 31% of all blood transfusions in the country. Although safe blood transfusion is one of the 8 signal functions of Comprehensive Emergency Obstetric Care (CEmOC) strategy, most of the designated public sector CEmOC facilities do not have on-site blood storage system. Emergent blood is mainly available from external blood banks. As a result, emergent patients are to rely on an unregulated network of brokers for blood which may raise question about blood safety...
2016: PloS One
https://www.readbyqxmd.com/read/27895842/postoperative-outcome-of-caesarean-sections-and-other-major-emergency-obstetric-surgery-by-clinical-officers-and-medical-officers-in-malawi
#19
Garvey Chilopora, Caetano Pereira, Francis Kamwendo, Agnes Chimbiri, Eddie Malunga, Staffan Bergström
BACKGROUND: Clinical officers perform much of major emergency surgery in Malawi, in the absence of medical officers. The aim of this study was to validate the advantages and disadvantages of delegation of major obstetric surgery to non-doctors. METHODS: During a three month period, data from 2131 consecutive obstetric surgeries in 38 district hospitals in Malawi were collected prospectively. The interventions included caesarean sections alone and those that were combined with other interventions such as subtotal and total hysterectomy repair of uterine rupture and tubal ligation...
September 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/27886436/factors-that-hinder-or-enable-maternal-health-strategies-to-reduce-delays-in-rural-and-pastoralist-areas-in-ethiopia
#20
Ruth Jackson, Fisaha Haile Tesfay, Tesfay Gebregzabher Gebrehiwot, Hagos Godefay
OBJECTIVES: To document factors that hinder or enable strategies to reduce the first and second delays of the Three Delays in rural and pastoralist areas in Ethiopia. METHODS: A key informant study was conducted with 44 Health Extension Workers in Afar Region, Kafa Zone (Southern Nation, Nationalities and Peoples' Region), and Adwa Woreda (Tigray Region). Health Extension Workers were trained to interview women and ask for stories about their recent experiences of birth...
November 25, 2016: Tropical Medicine & International Health: TM & IH
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