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https://www.readbyqxmd.com/read/28532393/maternal-care-quality-in-near-miss-and-maternal-mortality-in-an-academic-public-tertiary-hospital-in-yogyakarta-indonesia-a-retrospective-cohort-study
#1
Yuli Mawarti, Adi Utarini, Mohammad Hakimi
BACKGROUND: Reducing maternal mortality remains a major challenge for health care systems worldwide. The factors related to maternal mortality were extensively researched, and maternal death clusters around labour, delivery and the immediate postpartum period. Studies on the quality of maternal care in academic medical centre settings in low income countries are uncommon. METHODS: A retrospective cohort study of maternal deaths was conducted in an academic public tertiary hospital in Yogyakarta, and maternal near misses were used as controls...
May 22, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28528578/a-cluster-randomized-trial-to-reduce-caesarean-delivery-rates-in-quebec-cost-effectiveness-analysis
#2
Mira Johri, Edmond S W Ng, Clara Bermudez-Tamayo, Jeffrey S Hoch, Thierry Ducruet, Nils Chaillet
BACKGROUND: Widespread increases in caesarean section (CS) rates have sparked concerns about risks to mothers and infants and rising healthcare costs. A multicentre, two-arm, cluster-randomized trial in Quebec, Canada assessed whether an audit and feedback intervention targeting health professionals would reduce CS rates for pregnant women compared to usual care, and concluded that it reduced CS rates without adverse effects on maternal or neonatal health. The effect was statistically significant but clinically small...
May 22, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28526169/the-second-victim-a-review
#3
REVIEW
B Coughlan, D Powell, M F Higgins
Amongst the lay and media population there is a perception that pregnancy, labour and delivery is always physiological, morbidity and mortality should be "never events" and that error is the only cause of adverse events. Those working in maternity care know that it is an imperfect art, where adverse outcomes and errors will occur. When errors do occur, there is a domino effect with three groups being involved - the patient (first victim), the staff (second victims) and the organization (third victims). If the perceived expectation of patients on all clinicians is that of perfection, then clinicians may suffer the consequences of adverse outcomes in isolation and silence...
June 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28516500/healthcare-utilisation-induced-labour-and-caesarean-section-in-the-pregnancy-after-stillbirth-a-prospective-study
#4
Ida Kathrine Gravensteen, Eva-Marie Jacobsen, Per Morten Sandset, Linda Björk Helgadottir, Ingela Rådestad, Leiv Sandvik, Øivind Ekeberg
OBJECTIVE: To investigate healthcare utilisation, induced labour and caesarean section (CS) in the pregnancy after stillbirth and assess anxiety and dread of childbirth as mediators for these outcomes. DESIGN: Population-based pregnancy cohort study. SETTING: The Norwegian Mother and Child Cohort Study. SAMPLE: 901 pregnant women; 174 pregnant after stillbirth, 362 pregnant after live birth and 365 previously nulliparous...
May 18, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28515516/changes-in-cardiac-index-during-labour-analgesia-a-double-blind-randomised-controlled-trial-of-epidural-versus-combined-spinal-epidural-analgesia-a-preliminary-study
#5
Stephanie Yacoubian, Corrina M Oxford, Bhavani Shankar Kodali
BACKGROUND AND AIMS: Combined spinal-epidural (CSE) analgesia for labour and delivery is occasionally associated with foetal bradycardia. Decreases in cardiac index (CI) and/or uterine hypertonia are implicated as possible aetiological factors. No study has evaluated CI changes following combined spinal analgesia for labour and delivery. This prospective, double-blind, randomised controlled trial evaluates haemodynamic trends during CSE and epidural analgesia for labour. METHODS: Twenty-six parturients at term requesting labour analgesia were randomised to receive either epidural (E) or CSE analgesia...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28514779/low-back-pain-in-pregnancy-investigations-management-and-role-of-neuraxial-analgesia-and-anaesthesia-a-systematic-review
#6
Herman Sehmbi, Rohan D'Souza, Anuj Bhatia
BACKGROUND: Low back pain (LBP) is commonly experienced during pregnancy and is often poorly managed. There is much ambiguity in diagnostic work-up, appropriate management and decision-making regarding the use of neuraxial analgesia and anaesthesia during labour and delivery in these patients. This systematic review summarises the evidence regarding investigations, management strategies and considerations around performing neuraxial blocks for pregnant women with LBP. METHODS: We searched 3 databases and reviewed literature concerning LBP in pregnancy with regards to diagnostic modalities, management strategies and use of neuraxial techniques for facilitating labour and delivery...
May 18, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28506815/postpartum-diabetes-testing-rates-after-gestational-diabetes-mellitus-in-canadian-women-a-population-based-study
#7
Sonia Butalia, Lois Donovan, Anamaria Savu, Jeffrey Johnson, Alun Edwards, Padma Kaul
OBJECTIVES: We assessed the rate and type of postpartum glycemic testing in women with impaired glucose tolerance of pregnancy (IGTp) and gestational diabetes mellitus (GDM). We examined whether the likelihood of testing was modulated by patients' characteristics and pregnancy outcomes. METHODS: Our population-level cohort study included data from 132,905 pregnancies between October 1, 2008, and December 31, 2011, in Alberta, Canada. Laboratory data within 270 days before and 1 year after delivery were used to identify pregnancies involving IGTp/GDM and postpartum glycemic testing, respectively...
May 12, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28505479/women-s-self-reported-experience-of-unplanned-caesarean-section-results-of-a-swedish-study
#8
Annika Karlström
BACKGROUND: women´s experience of emergency caesarean section is often described as less positive compared to a vaginal birth or a planned caesarean section. Midwifery care for women where deviations from a normal birth process are present is a challenge. The aim of study was to compare self-reported birth outcomes for women undergoing birth through spontaneous onset of labour between those who actually had a vaginal birth and those who eventually had an emergency caesarean section. DESIGN AND SETTING: the study was part of a prospective longitudinal cohort study of parents' experiences, attitudes, and beliefs related to childbirth...
April 27, 2017: Midwifery
https://www.readbyqxmd.com/read/28489924/neonatal-and-maternal-outcomes-of-successful-manual-rotation-to-correct-malposition-of-the-fetal-head-a-retrospective-and-prospective-observational-study
#9
Nicola Tempest, Naomi McGuinness, Steven Lane, Dharani K Hapangama
OBJECTIVE: To evaluate the neonatal and maternal outcomes associated with successful operative vaginal births assisted by manual rotation. DESIGN: Prospective and retrospective observational study. SETTING: Delivery suite in a tertiary referral teaching hospital in England. POPULATION: A cohort of 2,426 consecutive operative births, in the second stage of labour, complicated with malposition of the fetal head during 2006-2013...
2017: PloS One
https://www.readbyqxmd.com/read/28488965/mild-to-moderate-foeto-maternal-haemorrhage-in-the-third-trimester-and-at-term-of-pregnancy-quantitative-determination-and-clinical-diagnostic-evaluation
#10
Fausta Beneventi, Chiara Cavagnoli, Elena Locatelli, Silvia Bariselli, Margherita Simonetta, Gianluca Viarengo, Cesare Perotti, Arsenio Spinillo
BACKGROUND: Foeto-maternal haemorrhage (FMH), a gestational event that occurs before or during delivery, consists of a loss of foetal blood into the maternal circulation. FMH occurs more frequently during the third trimester or labour both in normal and complicated pregnancies. In the case of alloimmunisation, the maternal immunological response and the severity of the resulting foetal or neonatal disease depend on the amount of foetal blood that passes into the maternal circulation. The aim of this study was to determine FMH in the third trimester and at term of pregnancy and to evaluate the role of clinical and ultrasound markers in the prediction of FMH...
April 19, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28487040/immediate-postpartum-neurological-deficits-in-the-lower-extremity-a-prospective-observational-study
#11
A Richards, T McLaren, M J Paech, E A Nathan, E Beattie, N McDonnell
BACKGROUND: Neurological deficits noted immediately after childbirth are usually various obstetric neuropathies, but prospective studies are limited. The main study aim was to quantify and describe immediate postpartum neurological deficits of the lower extremity, including the buttocks. METHODS: A prospective observational study of postpartum women delivering in a single maternity hospital during three months of 2016. Among 1147 eligible women, 1019 were screened for symptoms of lower extremity numbness or weakness within eight to 32hours of delivery...
April 8, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28486980/task-shifting-of-triage-to-peer-expert-informal-care-providers-at-a-tertiary-referral-hiv-clinic-in-malawi-a-cross-sectional-operational-evaluation
#12
Megan Landes, Courtney Thompson, Edson Mwinjiwa, Edith Thaulo, Chrissie Gondwe, Harriet Akello, Adrienne K Chan
BACKGROUND: HIV treatment models in Africa are labour intensive and require a high number of skilled staff. In this context, task-shifting is considered a feasible alternative for ART service delivery. In 2006, a lay health cadre of expert patients (EPs) at a tertiary referral HIV clinic in Zomba, Malawi was capacitated. There are few evaluations of EP program efficacy in this setting. Triage is the process of prioritizing patients in terms of the severity of their condition and ensures that no harmful delays occur to treatment and care...
May 9, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28477261/barriers-to-collaborative-anesthetic-care-between-anesthesiologists-and-nurses-on-the-labour-and-delivery-unit-a-study-using-a-modified-delphi-technique
#13
Lillia Y Fung, Kristi Downey, Nancy Watts, Jose C A Carvalho
INTRODUCTION: The practice of obstetrical anesthesia relies on collaborative effort between anesthesiologists and nurses, but teamwork remains a challenge. We sought to identify a consensus on the perceived barriers to collaborative care between anesthesiologists and perinatal nurses in a Canadian tertiary labour and delivery (L&D) unit. METHODS: A cross-sectional consensus-building study was conducted using a modified Delphi technique. We aimed to reach consensus on the barriers to collaborative care as well as to identify the reasons behind the issues and possible interventions...
May 5, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28464006/antenatal-small-class-education-versus-auditorium-based-lectures-to-promote-positive-transitioning-to-parenthood-a-randomised-trial
#14
Vibeke Koushede, Carina Sjöberg Brixval, Lau Caspar Thygesen, Solveig Forberg Axelsen, Per Winkel, Jane Lindschou, Christian Gluud, Pernille Due
Prospective parents widely use education to gain information about, e.g., labour and parenting skills. It is unknown if antenatal education in small classes is more beneficial for parenting stress and parenting alliance compared with other types of antenatal education. In the present randomised trial, we examined the effect of antenatal education in small classes versus auditorium-based lectures on perceived stress, parenting stress, and parenting alliance. A total of 1,766 pregnant women were randomised to receive: antenatal education in small classes three times in pregnancy and one time after delivery, each session lasted 2...
2017: PloS One
https://www.readbyqxmd.com/read/28449356/fetal-head-circumference-and-subpubic-angle-are-independent-risk-factors-for-unplanned-cesarean-and-operative-delivery
#15
Giuseppe Rizzo, Elisa Aiello, Costanza Bosi, Francesco D' Antonio, Domenico Arduini
INTRODUCTION: To ascertain whether combined ultrasound assessment of fetal head circumference (HC) and maternal subpubic angle (SPA) prior to the onset of labour may predict the likelihood of an unplanned operative delivery (UOD) in nulliparous women at term. MATERIAL AND METHODS: Prospective cohort study of singleton pregnancies in cephalic presentation. Pregnancies experiencing UOD secondary to fetal distress were excluded. HC was assessed transabdominally while SPA values were obtained from a reconstructed coronal plane on three-dimensional(3D) ultrasound performed trans-labially at 36-38 weeks of gestation...
April 27, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28448546/opium-use-during-pregnancy-and-risk-of-preterm-delivery-a-population-based-cohort-study
#16
Siavash Maghsoudlou, Sven Cnattingius, Scott Montgomery, Mohsen Aarabi, Shahriar Semnani, Anna-Karin Wikström, Shahram Bahmanyar
BACKGROUND: Use of narcotic or "recreational" drugs has been associated with adverse pregnancy outcomes such as preterm delivery. However, the associations might be confounded by other factors related to high-risk behaviours. This is the first study to investigate the association between traditional opium use during pregnancy and risk of preterm delivery. METHOD AND FINDINGS: We performed a population-based cohort study in the rural areas of the Golestan province, Iran between 2008 and 2010...
2017: PloS One
https://www.readbyqxmd.com/read/28446853/the-role-of-health-extension-workers-in-linking-pregnant-women-with-health-facilities-for-delivery-in-rural-and-pastoralist-areas-of-ethiopia
#17
Ruth Jackson, Assefa Hailemariam
BACKGROUND: Women's preference to give birth at home is deeply embedded in Ethiopian culture. Many women only go to health facilities if they have complications during birth. Health Extension Workers (HEWs) have been deployed to improve the utilization of maternal health services by bridging the gap between communities and health facilities. This study examined the barriers and facilitators for HEWs as they refer women to mid-level health facilities for birth. METHODS: A qualitative study was conducted in three regions: Afar Region, Southern Nations Nationalities and People's Region and Tigray Region between March to December 2014...
September 2016: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/28443976/women-s-autonomy-in-the-process-of-labour-and-childbirth-integrative-literature-review
#18
Thamiza Laureany da Rosa Dos Reis, Stela Maris de Mello Padoin, Thayla Rafaella Pasa Toebe, Cristiane Cardoso de Paula, Jacqueline Silveira de Quadros
Objective: To identify the available evidence in scientific literature on healthcare practices that interfere with the autonomy of Brazilian women in the labour and delivery process. Method: The search for papers was conducted in the databases LILACS, Scopus and PubMed, between 1996 and 2015, according to a guiding question and exclusion criteria, resulting in the selection of 22 papers to compose the analytic body. Results: The main practices that favoured the exercise of women's autonomy were out-of-hospital care practices; care practices of support and comfort; and educational care practices...
April 20, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28436125/the-quipp-app-a-safe-alternative-to-a-treat-all-strategy-for-threatened-preterm-labour
#19
Helena A Watson, Jenny Carter, Paul T Seed, Rachel M Tribe, Andrew H Shennan
OBJECTIVES: To evaluate the impact of a treat-all policy (advocated by NICE) compared to the QUIPP app (predictive model combining history of spontaneous preterm birth gestation and quantitative fetal fibronectin) for women in threatened preterm labour at <30 weeks gestation. METHODS: We conducted a subanalysis of prospectively collected data of pregnant women presenting with symptoms of preterm labour from the EQUIPP (REC Ref. 10/H0806/68) and PETRA (REC Ref...
April 24, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28432967/friendliness-functionality-and-freedom-design-characteristics-that-support-midwifery-practice-in-the-hospital-setting
#20
Athena Hammond, Caroline S E Homer, Maralyn Foureur
OBJECTIVE: to identify and describe the design characteristics of hospital birth rooms that support midwives and their practice. DESIGN: this study used a qualitative exploratory descriptive methodology underpinned by the theoretical approach of critical realism. Data was collected through 21 in-depth, face-to-face photo-elicitation interviews and a thematic analysis guided by study objectives and the aims of exploratory research was undertaken. SETTING: the study was set at a recently renovated tertiary hospital in a large Australian city...
April 4, 2017: Midwifery
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