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Emergency Obstetric Care

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https://www.readbyqxmd.com/read/29454125/management-of-skull-base-tumors-in-the-obstetric-population-a-case-series
#1
Blake H Priddy, Bradley A Otto, Ricardo L Carrau, Daniel M Prevedello
BACKGROUND: Neoplasms rarely present during pregnancy. However, increase in plasma volume, hormone release induced growth, and tumor hypervascularity, can cause rapid symptoms. These range from not requiring intervention to necessitating emergent operations. OBJECTIVE: We describe an algorithm for the management of symptomatic neoplasm in the obstetric population, and provide recommendations regarding surgical indications and timing. METHODS: Patients who presented to a skull base clinic from 2010-2016 at large tertiary care hospital were reviewed to identify patients who presented with a skull base tumor during pregnancy...
February 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29444779/estimating-the-met-need-for-emergency-obstetric-care-emoc-services-in-three-payams-of-torit-county-south-sudan-a-facility-based-retrospective-cross-sectional-study
#2
Pontius Bayo, Imose Itua, Suzie Paul Francis, Kofi Boateng, Elijo Omoro Tahir, Abdulmumini Usman
OBJECTIVE: To determine the met need for emergency obstetric care (EmOC) services in three Payams of Torit County, South Sudan in 2015 and to determine the frequency of each major obstetric complication. DESIGN: This was a retrospective cross-sectional study. SETTING: Four primary healthcare centres (PHCCs) and one state hospital in three payams (administrative areas that form a county) in Torit County, South Sudan. PARTICIPANTS: All admissions in the obstetrics and gynaecology wards (a total of 2466 patient admission files) in 2015 in all the facilities designated to conduct deliveries in the study area were reviewed to identify obstetric complications...
February 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29440934/prevalence-and-risk-factors-for-maternal-mortality-in-referral-hospitals-in-nigeria-a-multicenter-study
#3
Lorretta F Ntoimo, Friday E Okonofua, Rosemary N Ogu, Hadiza S Galadanci, Mohammed Gana, Ola N Okike, Kingsley N Agholor, Rukiyat A Abdus-Salam, Adetoye Durodola, Eghe Abe, Abdullahi J Randawa
Introduction: While reports from individual hospitals have helped to provide insights into the causes of maternal mortality in low-income countries, they are often limited for policymaking at national and subnational levels. This multisite study was designed to determine maternal mortality ratios (MMRs) and identify the risk factors for maternal deaths in referral health facilities in Nigeria. Methods: A pretested study protocol was used over a 6-month period (January 1-June 30, 2014) to obtain clinical data on pregnancies, births, and maternal deaths in eight referral hospitals across eight states and four geopolitical zones of Nigeria...
2018: International Journal of Women's Health
https://www.readbyqxmd.com/read/29427974/time-of-day-is-not-associated-with-increased-rates-of-mortality-in-emergency-surgery-an-analysis-of-49-196-surgical-procedures
#4
Rodney A Gabriel, Alison M A'Court, Ulrich H Schmidt, Richard P Dutton, Richard D Urman
STUDY OBJECTIVE: There is a lack of large, multi-institutional studies analyzing the association of timing of emergency surgery with death occurring either intraoperatively or in the recovery room setting. The primary objective of this study was to determine if time of day for emergency surgeries was associated with mortality. DESIGN: Retrospective analysis. SETTING: U.S. healthcare facilities. PATIENTS: Adult patients undergoing emergency surgery and general anesthesia...
February 7, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29423186/assessment-of-health-facility-capacity-to-provide-newborn-care-in-bangladesh-haiti-malawi-senegal-and-tanzania
#5
Rebecca Winter, Jennifer Yourkavitch, Wenjuan Wang, Lindsay Mallick
Background: Despite the importance of health facility capacity to provide comprehensive care, the most widely used indicators for global monitoring of maternal and child health remain contact measures which assess women's use of services only and not the capacity of health facilities to provide those services; there is a gap in monitoring health facilities' capacity to provide newborn care services in low and middle income countries. Methods: In this study we demonstrate a measurable framework for assessing health facility capacity to provide newborn care using open access, nationally-representative Service Provision Assessment (SPA) data from the Demographic Health Surveys Program...
December 2017: Journal of Global Health
https://www.readbyqxmd.com/read/29423184/postnatal-care-for-newborns-in-bangladesh-the-importance-of-health-related-factors-and-location
#6
Kavita Singh, Paul Brodish, Mahbub Elahi Chowdhury, Taposh Kumar Biswas, Eunsoo Timothy Kim, Christine Godwin, Allisyn Moran
Background: Bangladesh achieved Millennium Development Goal 4, a two thirds reduction in under-five mortality from 1990 to 2015. However neonatal mortality remains high, and neonatal deaths now account for 62% of under-five deaths in Bangladesh. The objective of this paper is to understand which newborns in Bangladesh are receiving postnatal care (PNC), a set of interventions with the potential to reduce neonatal mortality. Methods: Using data from the Bangladesh Maternal Mortality Survey (BMMS) 2010 we conducted logistic regression analysis to understand what socio-economic and health-related factors were associated with early postnatal care (PNC) by day 2 and PNC by day 7...
December 2017: Journal of Global Health
https://www.readbyqxmd.com/read/29422727/pattern-and-outcome-of-obstetric-admissions-into-the-intensive-care-unit-of-a-southeast-nigerian-hospital
#7
Benjamin Chukwuma Ozumba, Leonard Ogbonna Ajah, Vitus Okwuchukwu Obi, Uche Anthony Umeh, Joseph Tochukwu Enebe, Kingsley Chukwu Obioha
Background and Aims: Although pregnancy and labor are considered physiological processes, the potential for catastrophic complications is constant and may develop rapidly. There is growing evidence that admission of high-risk patients into the Intensive Care Unit (ICU) is associated with a reduction in maternal mortality. This study was aimed at reviewing all obstetric patients admitted into the ICU. Materials and Methods: This was a retrospective study of all obstetric patients who were admitted into the ICU between January 1, 2012, and December 31, 2013...
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29408749/comparison-of-maternal-and-neonatal-outcomes-for-patients-with-placenta-accreta-spectrum-between-online-to-offline-management-model-with-standard-care-model
#8
Wen Sun, Lin Yu, Shiliang Liu, Yanhong Chen, Juanjuan Chen, Shi Wu Wen, Dunjin Chen
OBJECTIVE: Online-to-offline is a new model for emergent medical service with the ability to connect care providers with patients on instant basis. This study aims to evaluate maternal and neonatal outcomes in patients with placenta accreta spectrum managed by an online-to-offline care model. METHODS: Starting from January 1, 2015, management of patients with placenta accreta spectrum was changed from standard care model into an online-to-offline care model through "Wechat" in Guangzhou Medical Centre for Critical Obstetrical Care...
February 2, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29406472/novel-approach-to-emergency-departments-pediatric-readiness-across-a-health-system
#9
Isabel A Barata, Joriane M Stadnyck, Meredith Akerman, Kate OʼNeill, Jill Castaneda, Anupama Subramony, Paula Fessler, Charles Schleien, John DʼAngelo
STUDY OBJECTIVE: A gap analysis of emergency departments' (EDs') pediatric readiness across a health system was performed after the appointment of a service line health system pediatric emergency medicine (PEM) quality director. METHODS: A 55-question survey was completed by each eligible ED to generate a weighted pediatric readiness score (WPRS). The survey included questions regarding volume, ED configuration, presence of a pediatric emergency care coordinator (PECC), quality initiatives, policies and procedures, and equipment...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29387145/provision-of-emergency-obstetric-care-at-secondary-level-in-a-conflict-setting-in-a-rural-area-of-afghanistan-is-the-hospital-fulfilling-its-role
#10
Daphne Lagrou, Rony Zachariah, Karen Bissell, Catherine Van Overloop, Masood Nasim, Hamsaya Nikyar Wagma, Shafiqa Kakar, Séverine Caluwaerts, Eva De Plecker, Renzo Fricke, Rafael Van den Bergh
Background: Provision of Emergency Obstetric and Neonatal Care (EmONC) reduces maternal mortality and should include three components: Basic Emergency Obstetric and Neonatal Care (BEmONC) offered at primary care level, Comprehensive EmONC (CEmONC) at secondary level and a good referral system in-between. In a conflict-affected province of Afghanistan (Khost), we assessed the performance of an Médecins Sans Frontières (MSF) run CEmONC hospital without a primary care and referral system...
2018: Conflict and Health
https://www.readbyqxmd.com/read/29385135/bypassing-health-facilities-for-childbirth-in-the-context-of-the-jsy-cash-transfer-program-to-promote-institutional-birth-a-cross-sectional-study-from-madhya-pradesh-india
#11
Yogesh Sabde, Sarika Chaturvedi, Bharat Randive, Kristi Sidney, Mariano Salazar, Ayesha De Costa, Vishal Diwan
Bypassing health facilities for childbirth can be costly both for women and health systems. There have been some reports on this from Sub-Saharan African and from Nepal but none from India. India has implemented the Janani Suraksha Yojana (JSY), a large national conditional cash transfer program which has successfully increased the number of institutional births in India. This paper aims to study the extent of bypassing the nearest health facility offering intrapartum care in three districts of Madhya Pradesh, India, and to identify individual and facility determinants of bypassing in the context of the JSY program...
2018: PloS One
https://www.readbyqxmd.com/read/29370798/barriers-and-prospects-of-india-s-conditional-cash-transfer-program-to-promote-institutional-delivery-care-a-qualitative-analysis-of-the-supply-side-perspectives
#12
Adyya Gupta, Jasmine Fledderjohann, Hanimi Reddy, V R Raman, David Stuckler, Sukumar Vellakkal
BACKGROUND: Under the National Health Mission (NHM) of India, Janani Suraksha Yojana (JSY) offers conditional cash transfer and support services to pregnant women to use institutional delivery care facilities. This study aims to understand community health workers' (ASHAs) and program officials' perceptions regarding barriers to and prospects for the uptake of facilities offered under the JSY. METHODS: Fifty in-depth interviews of a purposively selected sample of ASHAs (n = 12), members of Village Health and Sanitation Committees (n = 11), and officials at different tiers of healthcare facilities (n = 27) were conducted in three Indian states...
January 25, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29367432/within-country-inequalities-in-caesarean-section-rates-observational-study-of-72-low-and-middle-income-countries
#13
Adeline Adwoa Boatin, Anne Schlotheuber, Ana Pilar Betran, Ann-Beth Moller, Aluisio J D Barros, Ties Boerma, Maria Regina Torloni, Cesar G Victora, Ahmad Reza Hosseinpoor
OBJECTIVE: To provide an update on economic related inequalities in caesarean section rates within countries. DESIGN: Secondary analysis of demographic and health surveys and multiple indicator cluster surveys. SETTING: 72 low and middle income countries with a survey conducted between 2010 and 2014 for analysis of the latest situation of inequality, and 28 countries with a survey also conducted between 2000 and 2004 for analysis of the change in inequality over time...
January 24, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29365196/effect-of-antenatal-steroids-on-respiratory-morbidity-of-late-preterm-newborns-a-randomized-controlled-trial
#14
Vijaya Ontela, Gowri Dorairajan, Vishnu B Bhat, Palanivel Chinnakali
Objective: The objective of this article was to study the effect of antenatal dexamethasone on the respiratory morbidity of late preterm newborns. Study design: A randomized controlled trial, conducted in Obstetrics and Gynecology Department in collaboration with Neonatology department at JIPMER, India. In total, 155 women were studied in each group. Intention to treat analysis and per protocol analysis were done. Results: Overall 31 (10%) newborns were admitted to intensive care unit...
January 22, 2018: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/29351152/ebola-infection-in-pregnancy-a-global-perspective-and-lessons-learned
#15
Lisa B Haddad, John Horton, Bruce S Ribner, Denise J Jamieson
The 2014 to 2016 Ebola outbreak, primarily based in 3 West African countries, had far-reaching global effects. Importantly, the crisis highlighted large gaps in reproductive health services in affected countries and inadequate health care system preparedness for obstetrical patients in the setting of highly contagious infectious diseases. We aim to review Ebola virus effects with a focus on the obstetrical implications in the context of this recent Ebola outbreak, discuss the lessons learned following this outbreak and propose current measures specific to obstetrics that should be considered in preparation for the next concerning emergent infectious disease...
March 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29347926/handheld-ultrasound-to-avert-maternal-and-neonatal-deaths-in-2-regions-of-the-philippines-an-ibuntis%C3%A2-intervention-study
#16
Godofreda V Dalmacion, Ramon T Reyles, Antonia E Habana, Lalaine Mae V Cruz, Maricelle C Chua, Analyn T Ngo, Milagros J Tia-Jocson, Emmanuel S Baja
BACKGROUND: The major causes of maternal and neonatal mortality in the Philippines are hemorrhages and obstructed labor due to placental implantation abnormalities (PIAs), twin pregnancies and fetal malpresentations. All of which are all easily detected by ultrasound. However, women in rural areas and low-income groups do not have access to ultrasound during their prenatal care. We aimed to provide additional evidence on the benefits of handheld ultrasound (HU) for screening pregnancy related abnormalities in order to avert maternal and neonatal deaths...
January 18, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29340508/-space-time-and-power-in-hospital-health-care-contributions-based-on-the-ethnography-of-an-obstetric-center
#17
María Guadalupe García, María Laura Recoder, Susana Margulies
This paper presents the results of an ethnographic study of an obstetric center within a hospital of Greater Buenos Aires and an analysis of the spatio-temporal dimension of hospital care. The fieldwork, carried out between 2007 and 2011, followed the everyday dynamics of the hospital and included observation in the obstetrics unit (waiting areas, the obstetric center where births and emergencies receive care, and the ambulatory care, ultrasound, and hospitalization rooms, among others) as well as spaces such as the appointments and statistics offices, the office of social services, the central hall, the pharmacy, and hallway waiting areas...
July 2017: Salud Colectiva
https://www.readbyqxmd.com/read/29323605/outcomes-for-gestational-carriers-versus-traditional-surrogates-in-the-united-states
#18
Erika L Fuchs, Abbey B Berenson
BACKGROUND: Little is known about the obstetric and procedural outcomes of traditional surrogates and gestational carriers. MATERIALS AND METHODS: Participants included 222 women living in the United States who completed a brief online survey between November 2015 and February 2016. Differences between gestational carriers (n = 204) and traditional surrogates (n = 18) in demographic characteristics, pregnancy outcomes, and procedural outcomes were examined using chi-squared tests, Fisher's exact tests, and t-tests...
January 11, 2018: Journal of Women's Health
https://www.readbyqxmd.com/read/29322220/diabetes-and-pregnancy-national-trends-over-a-15%C3%A2-year-period
#19
Sharon T Mackin, Scott M Nelson, Joannes J Kerssens, Rachael Wood, Sarah Wild, Helen M Colhoun, Graham P Leese, Sam Philip, Robert S Lindsay
AIMS/HYPOTHESIS: We aimed to examine time trends in national perinatal outcomes in pregnancies complicated by pre-existing type 1 or type 2 diabetes. METHODS: We analysed episode-level data on all obstetric inpatient delivery events (live or stillbirth) between 1 April 1998 and 31 March 2013 (n = 813,921) using the Scottish Morbidity Record (SMR02). Pregnancies to mothers with type 1 (n = 3229) and type 2 (n = 1452) diabetes were identified from the national diabetes database (Scottish Care Information-Diabetes), and perinatal outcomes were compared among women with type 1 diabetes, type 2 diabetes and those without diabetes...
January 11, 2018: Diabetologia
https://www.readbyqxmd.com/read/29318985/a-randomised-controlled-trial-and-economic-evaluation-of-intraoperative-cell-salvage-during-caesarean-section-in-women-at-risk-of-haemorrhage-the-salvo-cell-salvage-in-obstetrics-trial
#20
Khalid S Khan, Philip Moore, Matthew Wilson, Richard Hooper, Shubha Allard, Ian Wrench, Tracy Roberts, Carol McLoughlin, Lee Beresford, James Geoghegan, Jane Daniels, Sue Catling, Vicki A Clark, Paul Ayuk, Stephen Robson, Fang Gao-Smith, Matthew Hogg, Louise Jackson, Doris Lanz, Julie Dodds
BACKGROUND: Caesarean section is associated with blood loss and maternal morbidity. Excessive blood loss requires transfusion of donor (allogeneic) blood, which is a finite resource. Cell salvage returns blood lost during surgery to the mother. It may avoid the need for donor blood transfusion, but reliable evidence of its effects is lacking. OBJECTIVES: To determine if routine use of cell salvage during caesarean section in mothers at risk of haemorrhage reduces the rates of blood transfusion and postpartum maternal morbidity, and is cost-effective, in comparison with standard practice without routine salvage use...
January 2018: Health Technology Assessment: HTA
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