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Emergency Obstetric Care

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https://www.readbyqxmd.com/read/28320332/assessing-emergency-obstetric-and-newborn-care-can-performance-indicators-capture-health-system-weaknesses
#1
Andrea Solnes Miltenburg, Richard Forget Kiritta, Thabea Benedicto Bishanga, Jos van Roosmalen, Jelle Stekelenburg
BACKGROUND: Regular monitoring and assessment of performance indicators for emergency obstetric and newborn care can help to identify priorities to improve health services for women and newborns. The aim of this study was to perform a district wide assessment of emergency obstetric and newborn care performance and identify ways for improvement. METHODS: Facility assessment of 13 dispensaries, four health centers and one district hospital in a rural district in Tanzania was performed in two data collection periods in 2014...
March 20, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28319122/can-a-simulation-based-training-program-impact-the-use-of-evidence-based-routine-practices-at-birth-results-of-a-hospital-based-cluster-randomized-trial-in-mexico
#2
Jimena Fritz, Dilys M Walker, Susanna Cohen, Gustavo Angeles, Hector Lamadrid-Figueroa
BACKGROUND: In Mexico, although the majority of births are attended in hospitals, reports have emerged of obstetric violence, use of unsafe practices, and failure to employ evidence-based practices (EBP). Recent attention has refocused global efforts towards provision of quality care that is both patient-centered and evidence-based. Scaling up of local interventions should rely on strong evidence of effectiveness. OBJECTIVE: To perform a secondary analysis to evaluate the impact of a simulation and team-training program (PRONTO) on the performance of EBP in normal births...
2017: PloS One
https://www.readbyqxmd.com/read/28306583/successful-resuscitation-following-massive-obstetric-hemorrhage-in-a-patient-of-the-jehovah-s-witness-faith-a-case-report
#3
Richard M Hubbard, Jonathan H Waters, Mark H Yazer
Hemorrhage is a leading cause of maternal morbidity and mortality worldwide. It is especially difficult to treat in patients of the Jehovah's Witness faith because they refuse certain blood products. This case report describes the resuscitation of a parturient Jehovah's Witness whose postcesarean delivery course was complicated by massive hemorrhage from unrecognized arterial bleeding in the intensive care unit with significant hemodynamic instability that necessitated an emergency bedside laparotomy. Her hemoglobin nadir was 1...
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28301484/health-facility-service-availability-and-readiness-for-intrapartum-and-immediate-postpartum-care-in-malawi-a-cross-sectional-survey
#4
Naoko Kozuki, Lolade Oseni, Angella Mtimuni, Reena Sethi, Tambudzai Rashidi, Fannie Kachale, Barbara Rawlins, Shivam Gupta
This analysis seeks to identify strengths and gaps in the existing facility capacity for intrapartum and immediate postpartum fetal and neonatal care, using data collected as a part of Malawi's Helping Babies Breath program evaluation. From August to September 2012, the Maternal and Child Health Integrated Program (MCHIP) conducted a cross-sectional survey in 84 Malawian health facilities to capture current health facility service availability and readiness and health worker capacity and practice pertaining to labor, delivery, and immediate postpartum care...
2017: PloS One
https://www.readbyqxmd.com/read/28298198/maternal-and-neonatal-service-usage-and-determinants-in-fragile-and-conflict-affected-situations-a-systematic-review-of-asia-and-the-middle-east
#5
Saji S Gopalan, Ashis Das, Natasha Howard
BACKGROUND: Fragile and conflict-affected situations (FCS) in Asia and the Middle-East contribute significantly to global maternal and neonatal deaths. This systematic review explored maternal and neonatal health (MNH) services usage and determinants in FCS in Asia and the Middle-East to inform policy on health service provision in these challenging settings. METHODS: This systematic review was conducted using a standardised protocol. Pubmed, Embase, Web of Science, and selected development agency websites were searched for studies meeting inclusion criteria...
March 15, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28291128/the-use-of-ultrasound-in-obstetric-anesthesia
#6
Carolyn F Weiniger, Limor Sharoni
PURPOSE OF REVIEW: The current review considers an array of recent applications for point-of-care ultrasound in clinical practice including diagnostic and therapeutic procedures that may be relevant for the obstetric anesthesiologist. The rapid advancement of technology and clinical applications for bedside ultrasound in obstetric anesthesiology requires an appraisal of the limitations and uses. RECENT FINDINGS: The review presents the most recent literature describing ultrasound-guided airway assessments, airway management, cricothyroidotomy, transthoracic echocardiography, gastric volume assessments, point-of-care lung ultrasound diagnoses, intracranial pressure assessments, vascular access, neuraxial blocks, and transversus abdominis plane blocks...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#7
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28288565/healthcare-workers-behaviors-and-personal-determinants-associated-with-providing-adequate-sexual-and-reproductive-healthcare-services-in-sub-saharan-africa-a-systematic-review
#8
Kim Jonas, Rik Crutzen, Bart van den Borne, Priscilla Reddy
BACKGROUND: Healthcare workers may affect the utilization of sexual and reproductive healthcare (SRH) services, and quality of care thereof, for example by their behaviours or attitudes they hold. This can become a hindrance to accessing and utilizing SRH services, particularly by young people, and thus a better understanding of these behaviours and associated factors is needed to improve access to and utilization of SRH services. METHODS: A systematic review of literature was conducted to identify studies focusing on healthcare workers' behaviors and personal determinants associated with providing adequate SRH services in sub-Saharan Africa (January 1990 - October 2015)...
March 13, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28286810/epidemiology-and-related-risk-factors-of-preterm-labor-as-an-obstetrics-emergency
#9
Ali Asghar Halimi Asl, Saeed Safari, Mohsen Parvareshi Hamrah
INTRODUCTION: Preterm birth is still a major health problem throughout the world, which results in 75% of neonatal mortality. Preterm labor not only inflicts financial and emotional distress, it may also lead to permanent disability. The present study was conducted to determine the related risk factors and preventive measures of preterm labor. METHODS: This retrospective cross-sectional study assessed all preterm labors, as well as an equal number of term labors, during seven years, at an educational hospital...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28286699/rural-women-s-experience-of-living-and-giving-birth-in-relief-camps-in-pakistan
#10
Humaira Maheen, Elizabeth Hoban
BACKGROUND: Women are more vulnerable than men in the same natural disaster setting. Preexisting gender inequality, socio-cultural community dynamics and poverty puts women at significant risk of mortality. Pregnant women are particularly vulnerable because of their limited or no access to prenatal and obstetric care during any disaster or humanitarian emergency setting. METHODS: In-depth interviews were conducted with 15 women who gave birth during the 2011 floods in Sindh Province, Pakistan...
January 31, 2017: PLoS Currents
https://www.readbyqxmd.com/read/28286001/understanding-high-utilization-of-unscheduled-care-in-pregnant-women-of-low-socioeconomic-status
#11
Pooja K Mehta, Tamala Carter, Cjloe Vinoya, Shreya Kangovi, Sindhu K Srinivas
BACKGROUND: Pregnant high utilizers of unscheduled care may be at particular risk for poor perinatal outcomes, but the drivers of this association have not been explored from the patient perspective. PURPOSE: We sought to understand maternal preference for unscheduled hospital-based obstetric care to inform interventions and improve value of publicly funded care during pregnancy. METHODS: We conducted a comparative qualitative analysis of in-depth semistructured interviews...
March 9, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28284197/case-review-of-perinatal-deaths-at-hospitals-in-kigali-rwanda-perinatal-audit-with-application-of-a-three-delays-analysis
#12
Aimable Musafili, Lars-Åke Persson, Cyprien Baribwira, Jessica Påfs, Patrick Adam Mulindwa, Birgitta Essén
BACKGROUND: Perinatal audit and the three-delays model are increasingly being employed to analyse barriers to perinatal health, at both community and facility level. Using these approaches, our aim was to assess factors that could contribute to perinatal mortality and potentially avoidable deaths at Rwandan hospitals. METHODS: Perinatal audits were carried out at two main urban hospitals, one at district level and the other at tertiary level, in Kigali, Rwanda, from July 2012 to May 2013...
March 11, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28275833/survey-of-emergency-and-essential-surgical-obstetric-and-anaesthetic-services-available-in-bangladeshi-government-health-facilities
#13
Jonathan Loveday, Sonal P Sachdev, Meena N Cherian, Francisco Katayama, A K M Akhtaruzzaman, Joe Thomas, N Huda, E Brian Faragher, Walter D Johnson
OBJECTIVE: Evaluate the capacity of government-run hospitals in Bangladesh to provide emergency and essential surgical, obstetric and anaesthetic services. METHODS: Cross-sectional survey of 240 Bangladeshi Government healthcare facilities using the World Health Organisation Situational Analysis Tool to Assess Emergency and Essential Surgical Care (SAT). This tool evaluates the ability of a healthcare facility to provide basic surgical, obstetric and anaesthetic care based on 108 queries that detail the infrastructure and population demographics, human resources, surgical interventions and reason for referral, and available surgical equipment and supplies...
March 8, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28259150/impact-of-the-roll-out-of-comprehensive-emergency-obstetric-care-on-institutional-birth-rate-in-rural-nepal
#14
Sheela Maru, Alex Harsha Bangura, Pooja Mehta, Deepak Bista, Lynn Borgatta, Sami Pande, David Citrin, Sumesh Khanal, Amrit Banstola, Duncan Maru
BACKGROUND: Increasing institutional births rates and improving access to comprehensive emergency obstetric care are central strategies for reducing maternal and neonatal deaths globally. While some studies show women consider service availability when determining where to deliver, the dynamics of how and why institutional birth rates change as comprehensive emergency obstetric care availability increases are unclear. METHODS: In this pre-post intervention study, we surveyed two exhaustive samples of postpartum women before and after comprehensive emergency obstetric care implementation at a hospital in rural Nepal...
March 4, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28255522/opportunities-to-foster-efficient-communication-in-labor-and-delivery-using-simulation
#15
Kay Daniels, Colleen Hamilton, Susan Crowe, Steven S Lipman, Louis P Halamek, Henry C Lee
Introduction Communication errors are an important contributing factor in adverse outcomes in labor and delivery (L&D) units. The objective of this study was to identify common lapses in verbal communication using simulated obstetrical scenarios and propose alternative formats for communication. Methods Health care professionals in L&D participated in three simulated clinical scenarios. Scenarios were recorded and reviewed to identify questions repeated within and across scenarios. Questions that were repeated more than once due to ineffective communication were identified...
January 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28228178/the-state-of-emergency-medical-services-ems-systems-in-africa
#16
Nee-Kofi Mould-Millman, Julia M Dixon, Nana Sefa, Arthur Yancey, Bonaventure G Hollong, Mohamed Hagahmed, Adit A Ginde, Lee A Wallis
Introduction Little is known about the existence, distribution, and characteristics of Emergency Medical Services (EMS) systems in Africa, or the corresponding epidemiology of prehospital illness and injury. METHODS: A survey was conducted between 2013 and 2014 by distributing a detailed EMS system questionnaire to experts in paper and electronic versions. The questionnaire ascertained EMS systems' jurisdiction, operations, finance, clinical care, resources, and regulatory environment...
February 23, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28211102/effectiveness-of-vaginal-breech-birth-training-strategies-an-integrative-review-of-the-literature
#17
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
#18
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
#19
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
#20
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
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