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https://www.readbyqxmd.com/read/29661165/midwives-perceptions-on-using-a-fetoscope-and-doppler-for-fetal-heart-rate-assessments-during-labor-a-qualitative-study-in-rural-tanzania
#1
Paschal Francis Mdoe, Hege Langli Ersdal, Estomih Mduma, Robert Moshiro, Hussein Kidanto, Columba Mbekenga
BACKGROUND: The Doppler is thought to be more comfortable and effective compared to the fetoscope for assessing the fetal heart rate (FHR) during labor. However, in a rural Tanzanian hospital, midwives who had easy access to both devices mostly used fetoscope. This study explored midwives' perception of factors influencing their preference for using either a Pinard fetoscope or a FreePlay wind-up Doppler for intermittent FHR monitoring. METHODS: Midwives who had worked for at least 6 months in the labor ward were recruited...
April 16, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29657082/horner-s-syndrome-following-obstetric-neuraxial-blockade-a-systematic-review-of-the-literature
#2
D J Chambers, K Bhatia
Horner's syndrome is a rarely reported complication of neuraxial blockade. In obstetric practice, the neurological signs of Horner's syndrome may cause anxiety amongst patients and healthcare staff, but more importantly may herald the onset of maternal hypotension. Medline, CINAHL, and EMBASE databases were searched to identify cases of Horner's syndrome following obstetric neuraxial blockade. Anaesthetic technique, clinical features, anaesthetic management of the Horner's syndrome and time to resolution were assessed...
March 17, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29643618/a-randomized-clinical-trial-of-intrathecal-magnesium-sulfate-versus-midazolam-with-epidural-administration-of-0-75-ropivacaine-for-patients-with-preeclampsia-scheduled-for-elective-cesarean-section
#3
Sophia Paleti, P Krishna Prasad, B Sowbhagya Lakshmi
Background and Aims: Magnesium sulfate and midazolam have been used as adjuvants to local anesthetics via intrathecal and epidural routes to augment the quality of block and prolong postoperative analgesia. This study compares addition of intrathecal magnesium sulfate versus intrathecal midazolam to epidurally administered isobaric ropivacaine as a part of combined spinal epidural technique in pre-eclamptic parturients undergoing elective cesarean section. Material and Methods: After institutional ethics committee approval and written informed consent, 50 pre-eclamptic parturients were randomly allocated to one of the two groups of 25 each to either receive intrathecal magnesium sulfate (50 mg) or intrathecal midazolam (1 mg) in combination with epidural ropivacaine (0...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29621826/cognitive-functions-of-the-fetus
#4
Aida Salihagic Kadic, Asim Kurjak
The human brain is intricately designed to execute cognitive functions, such as perception, attention, action, memory and learning. The complete nervous system is active during prenatal development and the aim of this review is to present data on fetal cognitive functions. The fetus processes sensory stimuli at a cortical level, including painful stimulus, from about 25 weeks of gestation onwards. At gestational week 34, the fetus is able not only to perceive complex acoustic external sounds but also to discriminate between different sounds...
April 2018: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/29614629/genetic-modifiers-of-severity-in-sickle-cell-disease
#5
Alicia K Chang, Carly C Ginter Summarell, Parendi T Birdie, Vivien A Sheehan
Sickle cell disease (SCD) is one of the most common single disease disorders world-wide. It is remarkable for its clinical heterogeneity, even among individuals with identical genotypes. Some individuals experience morbidity and mortality in early childhood, while others have a relatively mild course, and normal or near normal life expectancy. Many clinical complications are associated with SCD; most notably frequent pain episodes, stroke, acute chest syndrome, avascular necrosis, nephropathy, retinopathy and pulmonary hypertension...
2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29601303/the-opioid-epidemic-and-pregnancy-implications-for-anesthetic-care
#6
Britany L Raymond, Bradley T Kook, Michael G Richardson
PURPOSE OF REVIEW: This review summarizes evolving knowledge regarding adverse maternal, fetal, and neonatal effects of opioid exposure during pregnancy, and current treatment options for opioid use disorder (OUD). Maternal and fetal implications of maternal opioid maintenance with methadone and buprenorphine are described. Finally, acute and chronic pain management strategies in opioid-tolerant parturients are reviewed. RECENT FINDINGS: Opioid use among parturients has risen dramatically, with opioid use during pregnancy as high as 20%...
March 29, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29595529/ec50-of-epidural-ropivacaine-combined-with-dexmedetomidine-for-labor-analgesia
#7
Wp Zhang, Cuiling Li
BACKGROUND: It was reported that the optimal concentration of epidural dexmedetomidine for labor analgesia was 0.5▒ug/mL when combined with 0.1% ropivacaine. This study investigated the median effective concentration (EC50) of epidural ropivacaine for labor analgesia when combined with 0.5▒ug/mL dexmedetomidine. METHODS: Sixty full-term primiparas were enrolled and divided into two groups in this prospective study. Group D received 10▒mL solution (ropivacaine + 0...
March 27, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29594003/snake-bite-in-third-trimester-of-pregnancy-with-systemic-envenomation-and-delivery-of-a-live-baby-in-a-low-resource-setting-a-case-report
#8
Adebayo A Adewole, Osadolor A Ugiagbe, Temitope G Onile, Gabriel A Joseph, Oluwamayowa D Kassim, Patricia F Medupin, Abiodun S Adeniran
Background: Snake bite in the third trimester of pregnancy with late presentation, systemic envenomation; disseminated intravascular coagulopathy and delivery of a live neonate is uncommon in a low resource setting. Case: We present a 22 year old unbooked Gravida 3 Para 1+ 1 1alive lentiviral positive woman at 32 weeks gestation with snake bite, leg swelling, vaginal bleeding and labour pains. At presentation, there were anemia, tachycardia, hypotension; a gravid uterus with a single fetus in longitudinal lie, cephalic presentation, regular fetal heart rate and cervical dilatation of 3 cm...
October 2017: Case Reports in Women's Health
https://www.readbyqxmd.com/read/29593991/uterine-rupture-in-a-primigravid-patient-with-an-unscarred-bicornuate-uterus-at-term
#9
Brad Nitzsche, Maggie Dwiggins, Susan Catt
Background: Uterine rupture of an unscarred primigravid uterus is an exceedingly rare event. Cases of spontaneous rupture of an unscarred bicornuate uterus have been reported, but typically occur in the first or second trimester. Case: A 28-year-old primigravida at 37 weeks gestation with a known bicornuate uterus and no prior surgery underwent an emergent cesarean section after presenting with severe abdominal pain and signs of fetal compromise. She was found to have a uterine rupture with the fetus free in the abdomen accompanied by a large hemoperitoneum...
July 2017: Case Reports in Women's Health
https://www.readbyqxmd.com/read/29587658/de-medicalization-of-birth-by-reducing-the-use-of-oxytocin-for-augmentation-among-first-time-mothers-a-prospective-intervention-study
#10
L C Gaudernack, K F Frøslie, T M Michelsen, N Voldner, M Lukasse
BACKGROUND: The use of synthetic oxytocin for augmentation of labor is rapidly increasing worldwide. Hyper-stimulation is the most significant side effect, which may cause fetal distress and operative delivery. We performed an intervention consisting of an educational program and modified guidelines to achieve a more appropriate use of oxytocin. METHODS: This prospective intervention study included 431 first-time mothers at term with spontaneous onset of labor before (October 2012 to May 2013), and 664 after the intervention (April 2014 to April 2015)...
March 27, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29582422/the-effect-of-spinal-hyperbaric-bupivacaine-fentanyl-or-hyperbaric-bupivacaine-on-uterine-tone-and-fetal-heart-rate-in-labouring-women-a-randomised-controlled-study
#11
A Kuberan, K Jain, R Bagga, J K Makkar
The mechanism for fetal heart rate abnormalities following spinal opioids remains controversial. We evaluated uterine tone, using an intra-uterine pressure catheter, and fetal heart rate abnormalities in 30 women in spontaneous labour with cervical dilation of 3-5 cm having combined spinal-epidural analgesia. Women were randomly assigned to receive a spinal with 2.0 mg hyperbaric bupivacaine plus 15 μg fentanyl, or 2.5 mg hyperbaric bupivacaine. The primary outcome measure was an increase > 10 mmHg in baseline uterine tone in the 30-min period following spinal injection...
March 26, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29560295/a-case-of-sciatica-during-labor-due-to-an-occiput-posterior-fetus
#12
Cassandra Wasson, Telianne Chon
A 28-year-old term G3P0020 received an epidural with complete pain relief. Approximately 19 hours after the epidural placement, the pain increased. Sensory levels were rechecked and were bilateral and adequate at T8. Further discussion revealed that the pain was unrelated to her contractions; it was in her buttocks and radiating down the leg. The possibility of the fetus being positioned occiput posterior (OP) was discussed. The patient was placed into knee-chest position with instantaneous relief of her pain...
January 17, 2018: Curēus
https://www.readbyqxmd.com/read/29553965/efficacy-of-an-ergonomic-ankle-support-aid-for-squatting-position-in-improving-pushing-skills-and-birth-outcomes-during-the-second-stage-of-labor-a-randomized-controlled-trial
#13
Yu-Ching Lin, Meei-Ling Gau, Ghi-Hwei Kao, Hung-Chang Lee
BACKGROUND: The physical positions that are adopted by women during childbirth significantly impact their childbirth outcomes and experiences. Literature studies have associated using a squatting position with reduced childbirth pain and increased comfort and pushing efficiency. However, the major disadvantage of the squatting position is that women may lack the muscular fitness and stamina necessary to sustain this position for a long period. PURPOSE: The aim of this study was to compare the pushing experiences and birth outcomes of three different pushing positions during the second stage of labor...
March 16, 2018: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29537658/efficiency-of-the-modified-sims-maternal-position-in-the-rotation-of-persistent-occiput-posterior-position-during-labor-a-randomized-clinical-trial
#14
Vanessa Bueno-Lopez, Carmen Fuentelsaz-Gallego, Manel Casellas-Caro, Ana Maria Falgueras-Serrano, Silvia Crespo-Berros, Ana Maria Silvano-Cocinero, Carolina Alcaine-Guisado, Manuela Zamoro Fuentes, Elena Carreras, Carmen Terré-Rull
BACKGROUND: Fetal occiput posterior position in labor is associated with more painful and prolonged labor, and an increase in both maternal and fetal morbidity. The aim of this study is to assess whether the modified Sims position on the side of the fetal spine increases the rotation to occiput anterior position in women with epidural analgesia and a fetus in persistent occiput posterior (POP) position. METHODS: This is an open, randomized controlled, clinical trial...
March 14, 2018: Birth
https://www.readbyqxmd.com/read/29527296/management-of-eight-labor-and-delivery-patients-dependent-on-buprenorphine-subutex%C3%A2-a-retrospective-chart-review
#15
Solina Tith, Garinder Bining, Laurent Bollag
Background : Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by "The American College of Obstetrics and Gynecology" as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists' unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia...
2018: F1000Research
https://www.readbyqxmd.com/read/29510639/-non-hodgkin%C3%A2-s-b-lymphoma-of-the-ovaries-with-an-unfavourable-prognosis-incidental-finding-during-caesarean-section
#16
M Kopáčková, P Beránek, I Bydžovská, R Pytlík, J Soukup, M Mrhalová
OBJECTIVE: Presentation of a rare finding non-Hodgkin´s B-lymphoma of the ovary in a patient during caesarean section. DESIGN: Case report. SETTINGS: Department of Obstetrics and Gynaecology, Regional Hospital Liberec, a.s.; First Internal Clinic - Clinic of Hematology, First Faculty of Medicine and General University Hospital, Charles University in Prague; Department of Pathology and Molecular Medicine, Second Faculty of Medicine, Charles University in Praque and Motol University Hospital...
2018: Ceská Gynekologie
https://www.readbyqxmd.com/read/29500650/mimics-of-malrotation-on-pediatric-upper-gastrointestinal-series-a-pictorial-review
#17
REVIEW
Anilawan Smitthimedhin, Angela Suarez, Ryan L Webb, Hansel J Otero
Intestinal malrotation is a continuum of congenital anomalies due to lack of rotation or incomplete rotation of the fetal intestine around the superior mesenteric artery axis. The abnormal bowel fixation (by mesenteric bands) or absence of fixation of portions of the bowel increases the risk of bowel obstruction, acute or chronic volvulus, and bowel necrosis. The clinical presentation of patients with malrotation without, with intermittent, or with chronic volvulus can be problematic, with an important minority presenting late or having atypical or chronic symptoms, such as intermittent vomiting, abdominal pain, duodenal obstruction, or failure to thrive...
March 3, 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29500216/negotiating-acceptable-termination-of-pregnancy-for-non-lethal-fetal-anomaly-a-qualitative-study-of-professional-perspectives
#18
Lisa Crowe, Ruth H Graham, Stephen C Robson, Judith Rankin
OBJECTIVE: This study aims to explore the perspectives of professionals around the issue of termination of pregnancy for non-lethal fetal anomaly (TOPFA). METHODS: Semi-structured interviews were undertaken with medical professionals (14 consultants in fetal medicine, obstetrics, neonatology and paediatrics) and social care professionals (nine individuals with roles supporting people living with impairment) from the Northeast of England. Analysis adopted an inductive thematic approach facilitated by NVivo...
March 1, 2018: BMJ Open
https://www.readbyqxmd.com/read/29495906/safety-of-a-physical-therapy-protocol-for-women-with-preeclampsia-a-randomized-controlled-feasibility-trial
#19
Tawana Vicente Bertagnolli, Michelle de Souza Rangel Machado, Cristine Jorge Homsi Ferreira, Jackeline de Souza Rangel Machado, Geraldo Duarte, Ricardo Carvalho Cavalli
OBJECTIVE: To assess the feasibility and safety of a physiotherapy protocol applied to pregnant women with preeclampsia. METHODS: Randomized, controlled, single-blind feasibility study, with 24 hospitalized pregnant women with preeclampsia. The intervention group received one session of the physiotherapy. The control group remained under the routine care of the hospital. The primary outcomes were Doppler velocimetry, cardiotocography, and maternal-fetal hemodynamics...
March 1, 2018: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/29479676/experiences-of-living-with-fetal-alcohol-spectrum-disorders-a-systematic-review-and-synthesis-of-qualitative-data
#20
REVIEW
Helena Domeij, Gunilla Fahlström, Göran Bertilsson, Monica Hultcrantz, Heather Munthe-Kaas, Christina Nehlin Gordh, Gert Helgesson
AIM: To identify and assess available evidence from qualitative studies exploring experiences of individuals living with fetal alcohol spectrum disorders (FASD) or those living with a child with FASD, as well as experiences of interventions aimed at supporting individuals with FASD and their families. METHOD: A systematic literature search was conducted in six electronic databases: PubMed, Embase, Cochrane Library, CINAHL, PsycINFO, and Scopus. Included studies were analysed using manifest content analysis...
February 26, 2018: Developmental Medicine and Child Neurology
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