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https://www.readbyqxmd.com/read/28762570/streptococcal-toxic-shock-syndrome-occurring-in-the-third-trimester-of-pregnancy-a-case-report
#1
Mohamad Irani, Rodney McLaren, Richard H Savel, Oksana Bogatyryova, Fady Khoury-Collado
Group A streptococcal (GAS) toxic shock syndrome (TSS) is a rare life-threatening illness. Most reported cases have occurred in the post-partum period. Here, we report a rare case of a primigravid who developed GAS TSS in the third trimester. We also review the potential preventive measures and treatment modalities for this syndrome. A 29-year-old primigravid presented at 36 weeks' gestation with diarrhea, abdominal pain, fever, and fetal bradycardia. She underwent an emergency cesarean section and was subsequently diagnosed with GAS TSS...
August 1, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28754057/risk-assessments-of-epidural-analgesia-during-labor-and-delivery
#2
Antonio Herrera-Gómez, Elvira De Luna-Bertos, Javier Ramos-Torrecillas, Francisco M Ocaña-Peinado, Concepción Ruiz, Olga García-Martínez
Epidural analgesia (EA) is one of the methods of choice for labor pain relief, but its adverse effects on the mother and child remain controversial. The objective of this study was to determine whether there is an association between the use of EA and different aspects of labor. The author(s) analyzed the effect of EA on different aspects of labor in a retrospective cohort observational study of deliveries in a public Spanish hospital during a 3-year period. Women with EA administration were found to increase the risk of stimulated labor, reduce the percentage of spontaneous deliveries, increase the risk of instrumental labor due to stalled labor or loss of fetal well-being, and increase the percentage of episiotomies...
July 1, 2017: Clinical Nursing Research
https://www.readbyqxmd.com/read/28753654/medical-treatment-of-second-trimester-fetal-miscarriage-a-retrospective-analysis
#3
Maarit Niinimäki, Maarit Mentula, Reetta Jahangiri, Jaana Männistö, Annina Haverinen, Oskari Heikinheimo
OBJECTIVES: Research on the treatment of second-trimester miscarriages is scarce. We studied the outcomes, and the factors associated with adverse events and need for hospital resources in the medical treatment of second-trimester miscarriage. MATERIALS AND METHODS: In these retrospective analyses we studied women treated for spontaneous fetal miscarriage with misoprostol-only (n = 24) or mifepristone and misoprostol (n = 177) in duration of gestation 12+1-21+6...
2017: PloS One
https://www.readbyqxmd.com/read/28753044/severe-bark-scorpion-envenomation-in-adults
#4
Ayrn D O'Connor, Angela Padilla-Jones, Anne-Michelle Ruha
INTRODUCTION: The preponderance of medical literature regarding severe bark scorpion envenomation describes pediatric patients; however, the majority (>66%) of annual poison center calls pertain to adults. This retrospective review sought to evaluate the clinical manifestations of adults with severe Centruroides sculpturatus envenomation and determine if significant morbidity occurred. METHODS: This is a retrospective review of adults presenting to a single tertiary referral center with Grade-III or Grade-IV scorpion envenomation from 1 January 2007 to 3 March 2013...
July 28, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28747162/advanced-abdominal-pregnancy-with-live-fetus-and-severe-preeclampsia-case-report
#5
Fekade Getachew Hailu, Getnet Tesfaye Yihunie, Ahmed Amdihun Essa, Walelign Kindie Tsega
BACKGROUND: Abdominal pregnancy may account for up to 1.4% of all ectopic pregnancies. The incidence of abdominal pregnancy differs in various literatures and ranges between 1:10,000 pregnancies to 1:30, 000 pregnancies. The clinical symptoms of an uncomplicated abdominal pregnancy are unspecific. There are reports of maternal and fetal survival from advanced abdominal pregnancies. CASE PRESENTATION: Our case was a 26 years old gravida 4, para 3 (2 alive, one early neonatal death) woman...
July 26, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28734732/perinatal-and-neonatal-use-of-sedation-and-analgesia
#6
REVIEW
Christopher McPherson, Terrie Inder
Optimal obstetric and neonatal care requires the provision of adequate analgesia for painful procedures. However, anesthetic and analgesic agents have the potential to adversely impact the developing fetal/neonatal brain. In this setting, clinicians must assess the risks and benefits of pharmacologic anesthesia and analgesia for specific indications in this population. General anesthesia is required for non-obstetric surgery and cesarean section in the absence of neuraxial anesthesia for the health of the mother and fetus...
July 19, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28715964/uterine-and-abdominal-muscle-electromyographic-activities-in-control-and-pcea-treated-nulliparous-women-during-the-second-stage-of-labor
#7
Xueya Qian, Pin Li, Shao-Qing Shi, Robert E Garfield, Huishu Liu
OBJECTIVE: Patient-controlled epidural analgesia (PCEA), used to relieve pain during delivery, delays labor but the mechanism is unknown. The aim was to investigate the effects of PCEA on uterine and abdominal muscles electromyographic (EMG) activity during the second stage of labor. METHODS: This study included 45 nulliparous pregnant women without PCEA, 42 women with standard PCEA treatment given during the first stage of labor and stopped near the end of the first stage, and 22 women with standard PCEA treatment with continued use throughout the first and second stages of labor...
August 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/28684143/what-s-new-in-clinical-obstetric-anesthesia-in-2015
#8
REVIEW
P E Hess
Each calendar year the Society for Obstetric Anesthesia and Perinatology invites an individual to conduct a review of the medical literature, identifying clinically relevant publications of interest to the obstetric anesthesia provider. This report of that effort covers the publications from 2015 and includes the categories of anesthesia and analgesia, complications of neuraxial procedures, and the effects of anesthesia on the fetus. Neuraxial procedures represent the foundation of obstetric anesthesia; advances in anesthesia and analgesia include novel modes of administration, and refinements in care of the medically complex patient...
March 18, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28663623/comparison-of-epidural-butorphanol-with-neostigmine-and-epidural-sufentanyl-with-neostigmine-for-first-stage-of-labor-analgesia-a-randomized-controlled-trial
#9
Manoj Chaurasia, Ashok Kumar Saxena, Geetanjali T Chilkoti
BACKGROUND: Epidural administration of neostigmine appears to be safe in the obstetric population. Recently, few studies have concluded 10 μg sufentanil to be an effective adjuvant with epidural neostigmine in providing labor analgesia. However, no study has evaluated the analgesic effect of epidural butorphanol with neostigmine for the same. MATERIALS AND METHODS: The parturients were randomly allocated to one of the three study groups - Group A (n = 30) received butorphanol 1 mg and neostigmine 7 μg/kg...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28661021/outcome-of-cesarean-scar-pregnancy-a-systematic-review-and-meta-analysis
#10
REVIEW
Giuseppe Calì, Ilan E Timor-Trisch, Josè Palacios-Jaraquemada, Ana Monteaugudo, Danilo Buca, Francesco Forlani, Alessandra Familiari, Giovanni Scambia, Ganesh Acharya, Francesco D'Antonio
OBJECTIVE: To explore the outcome of women managed expectantly following a diagnosis of caesarean scar pregnancy (CSP). METHODS: The outcomes observed were: severe first trimester vaginal bleeding, clinical symptoms (abdominal pain, vaginal bleeding) requiring treatment, uncomplicated miscarriage, complicated miscarriage requiring intervention, first or second trimester uterine rupture, first or second trimester hysterectomy, third trimester bleeding, third trimester uterine rupture, third trimester hysterectomy, maternal death, occurrence of abnormally invasive placenta (AIP), prevalence of placenta percreta, ultrasound signs suggestive of AIP, liveborn fetuses...
June 29, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28656055/optimal-dose-of-epidural-dexmedetomidine-added-to-ropivacaine-for-epidural-labor-analgesia-a-pilot-study
#11
Zhang Wangping, Ren Ming
BACKGROUND: Dexmedetomidine combined with local anesthetics can decrease the concentration of epidural ropivacaine. However, the optimal dose of epidural dexmedetomidine combined with ropivacaine for labor analgesia is still uncertain. This study investigated the effect of adding different dose of epidural dexmedetomidine to ropivacaine during epidural labor analgesia. METHODS: One hundred women were randomly assigned to one of the four groups (Groups A, B, C, and D received 0...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28645454/uterine-diverticulum-with-fetal-leg-entrapment-a-case-report
#12
Nirmala Chandrasekaran, Mark H Yudin, Howard Berger
BACKGROUND: Uterine anomalies causing fetal complications are very rarely encountered in obstetric practice and thus pose a diagnostic dilemma. CASE: A multigravid patient attended the clinic for an ultrasound examination in the third trimester following a recent hospital admission for abdominal pain. Ultrasound imaging revealed a large uterine diverticulum in the right cornu of the uterus with evidence of fetal leg entrapment. Because of concerns of increased soft tissue edema in the entrapped leg, the patient was delivered at 35 weeks' gestation by elective CS...
June 20, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28629246/clinical-significance-of-primary-symptoms-in-women-with-placental-abruption
#13
Youwen Mei, Yonghong Lin
BACKGROUND: To evaluate the clinical significance of primary symptoms in women with placental abruption. METHODS: A retrospective study of 273 cases of placental abruption was performed. The subjects were classified into two groups according to primary symptoms: 210 cases of the vaginal bleeding group and 63 cases of the abdominal pain group. The clinical features, maternal and neonatal outcomes were compared between two groups. RESULTS: The incidence of preeclampsia and preterm birth in the vaginal bleeding group was significantly lower than abdominal pain group, while the incidence of premature rupture of membrane (PROM) in the former group was higher than that in the latter group...
July 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28625307/postcesarean-delivery-analgesia
#14
REVIEW
Brendan Carvalho, Alexander J Butwick
Effective pain management should be a key priority in women undergoing cesarean delivery. Suboptimal perioperative pain management is associated with chronic pain, greater opioid use, delayed functional recovery, impaired maternal-fetal bonding, and increased postpartum depression. Severe acute postoperative pain is also strongly associated with persistent pain after cesarean delivery. Multimodal analgesia is the core principle for cesarean delivery pain management. The use of neuraxial morphine and opioid-sparing adjuncts such as scheduled nonsteroidal anti-inflammatory medications and acetaminophen is recommended for all women undergoing cesarean delivery with neuraxial anesthesia unless contraindicated...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28593773/-hellp-syndrome-requiring-therapeutic-plasma-exchange-due-to-progression-to-multiple-organ-dysfunction-syndrome-with-predominant-encephalopathy-respiratory-and-renal-insufficiency
#15
M Trávniková, J Gumulec, Z Kořístek, M Navrátil, M Janáč, J Pelková, P Šuráň, E Doležálková, O Šimetka
OBJECTIVE: Case report of woman with twin pregnancy complicated by HELLP syndrome which progressed to multiple organ dysfunction syndrome with predominant encephalopathy, renal and respiratory insufficiency with the need to perform repeated therapeutic plasma exchange. DESIGN: Case report. SETTING: Department of gynecology and obstetrics, University Hospital in Ostrava; Departmet of hematooncology, University Hospital in Ostrava; Department of gynecology and obstetrics, Vsetín hospital; Department of hematology and transfusion, Vsetín Hospital...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28591209/sexual-function-and-postpartum-depression-6-months-after-attempted-operative-vaginal-delivery-according-to-fetal-head-station-a-prospective-population-based-cohort-study
#16
Guillaume Ducarme, Jean-François Hamel, Stéphanie Brun, Hugo Madar, Benjamin Merlot, Loïc Sentilhes
OBJECTIVE: To evaluate the effect of the fetal head station at attempted operative vaginal delivery (aOVD), and specifically midpelvic or low aOVD, on female and male sexual function and symptoms of postpartum depression (PPD) at 6 months. DESIGN: Prospective population-based cohort study. SETTING: 1,941 women with singleton term fetuses in vertex presentation with midpelvic or low aOVD between 2008 and 2013 in a tertiary care university hospital...
2017: PloS One
https://www.readbyqxmd.com/read/28573877/activity-restriction-and-risk-of-preterm-delivery
#17
Heather I Levin, Anthony Sciscione, Cande V Ananth, Daphnie Drassinower, Sarah G Obican, Ronald J Wapner
PURPOSE: We sought to determine if activity restriction (AR) in a cohort of women at high risk for preterm delivery is associated with the risk of preterm delivery. MATERIALS AND METHODS: This is a secondary analysis of the MFMU's Preterm Prediction Study; a multicenter prospective cohort study designed to identify risk factors of preterm birth. The study group consisted of women with a singleton gestation that at their first study visit (23-24 weeks) had at least one of the following criteria: patient reported contractions, severe back pain, a cervical length <15 mm, spotting, protruding membranes, or positive fetal fibronectin...
June 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28555553/efficacy-and-safety-of-foley-catheter-balloon-for-cervix-priming-in-term-pregnancy
#18
Catarina Policiano, Mariana Pimenta, Diana Martins, Nuno Clode
INTRODUCTION: Foley catheter promotes cervix priming by a direct mechanical effect of distension. MATERIAL AND METHODS: A prospective observational study was conducted at a tertiary hospital, including all cases of induction of labor with Foley catheter between September 1, 2013 and November 30, 2015. Women were eligible if they had a singleton pregnancy with a Bishop score < 6 and a gestational age ≥ 41 weeks or a medical indication for induction of labor...
April 28, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28551104/-what-measures-of-perineal-protection-at-birth-are-consensual-in-france-results-of-a-delphi-survey
#19
R de Tayrac, L Carligny, R Zimmerman, S Huberlant, V Letouzey
OBJECTIVE: To evaluate expert's opinion in order to obtain a consensus on the different measures of perineal protection at the time of vaginal delivery. METHODS: A survey using the Delphi method was carried out with a panel of French obstetricians, urogynecologists and midwives. The questionnaire included 22 questions grouped into four groups: expulsive efforts, indications of episiotomy, episiotomy repair and other forms of perineal protection. The experts had to answer on a 9-point scale, both on the validity and the clarity of each proposal...
May 24, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28545266/-analysis-of-misssed-diagnosis-and-misdiagnosis-of-1-212-cases-with-placental-abruption
#20
D Xu, C Liang, J W Xu, J He
Objective: To investigate the risk factors and clinical manifestations of placental abruption, and to analyze the causes of missed diagnosis and misdiagnosis. Methods: A retrospective analysis was conducted in 135 584 women who delivered in Women's Hospital, School of Medicine, Zhejiang University from January 2005 to December 2015. The diagnosis of placental abruption was made in 1 212 cases. According to the consistency of prenatal and postnatal diagnosis, they were divided into 3 groups. (1) The diagnosis was consistent prenatally and postnatally in 715 cases(58...
May 25, 2017: Zhonghua Fu Chan Ke za Zhi
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