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https://www.readbyqxmd.com/read/29452244/does-saline-enema-during-the-first-stage-of-labour-reduce-the-incidence-of-clostridium-difficile-colonization-in-neonates-randomized-controlled-trial
#1
Adel M Nada, Reham A Mohsen, Yosra M Hassan, Amira Sabry, Noha S Soliman
BACKGROUND: Maternal rectal enemas may reduce neonatal bacterial exposure during labour; this may reduce the risk of neonatal colonization with Clostridium difficile. The aim of this study was to determine the effectiveness of a saline enema during the first stage of labour in reducing neonatal colonization with C. difficile. METHODS: The study was conducted in Cairo University Hospital from January 2016 to July 2016. Asymptomatic mothers with uncomplicated vaginal delivery and their neonates without diarrhea were included...
February 13, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29447711/no-355-physiologic-basis-of-pain-in-labour-and-delivery-an-evidence-based-approach-to-its-management
#2
Julie Bonapace, Guy-Paul Gagné, Nils Chaillet, Raymonde Gagnon, Emmanuelle Hébert, Sarah Buckley
OBJECTIVE: To review the evidence relating to nonpharmacological approaches in the management of pain during labour and delivery. To formulate recommendations for the usage of nonpharmacological approaches to pain management. OPTIONS: Nonpharmacological methods available for pain management during labour and delivery exist. These should be included in the counselling and care of women. EVIDENCE: PubMed and Medline were searched for articles in French and English on subjects related to "breastfeeding," "pain," "epidural," "anaesthesia," "analgesia," "labour," "labor," and combined with "gate control theory," "alternative therapies," "massage," "position," "mobility," "TENS," "bathing," "DNIC," "acupuncture," "acupressure," "sterile water injection," "higher center," "control mind," "cognitive structuring," "holistic health," "complementary therapy(ies)," "breathing," "relaxation," "mental imagery," "visualization," "mind focusing," "hypnosis," "auto-hypnosis," "sophrology," "mind and body interventions," "music," "odors," "biofeedback," "Lamaze," "Bonapace," "prenatal training," "gymnastic," "chanting," "haptonomy," "environment," "transcutaneous electrical stimulus-stimulation," "antenatal education," "support," "continuous support," "psychosocial support," "psychosomatic medicine," "supportive care," "companion," "intrapartum care," "nurse," "midwife(ves)," "father," "doula," "caregiver," " hormones," "oxytocin," "endorphin," "prolactin," "catecholamine," "adrenaline," and "noradrenaline" from 1990 to December 2015...
February 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29445511/management-of-group-b-streptococcus-positive-pregnant-women-at-maternity-homes-in-japan-a-questionnaire-survey-of-compliance-among-midwives
#3
Kotomi Yamaguchi, Kazutomo Ohashi
Background: Per the 2014 Japanese Midwives Association (JMA) guidelines, midwives were allowed to manage the deliveries for group B streptococcus (GBS)-positive pregnant women in labour at maternity homes without the supervision of a medical doctor if they complied with the guidelines of the Japan Society of Obstetrics and Gynecology (JSOG), wherein midwives working for maternity homes are expected to cooperate with commissioned obstetricians and paediatricians in cooperative medical facilities...
2018: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/29444799/salvage-from-cervical-dystocia-in-third-degree-uterovaginal-prolapse-duhrssen-s-incision
#4
Manju Lata Verma, Vartika Tripathi, Uma Singh, Zakia Rahman
We present a case of a 28-year-old woman second gravida with a full-term pregnancy who presented to us in active phase of labour with third degree uterovaginal prolapse complicated by entrapment of fetal head by dystocia of cervix and fetal distress. Patient was immediately shifted to the operation theatre and prompt delivery was conducted by giving Duhrssen's incision on the highly vascular, oedematous prolapsed cervix. The outcome was an alive and healthy male baby. Duhrssen's incision was stitched with minimal blood loss...
February 14, 2018: BMJ Case Reports
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
#5
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/29438070/successfully-reducing-newborn-asphyxia-in-the-labour-unit-in-a-large-academic-medical-centre-a-quality-improvement-project-using-statistical-process-control
#6
Rikke von Benzon Hollesen, Rie Laurine Rosenthal Johansen, Christina Rørbye, Louise Munk, Pierre Barker, Anette Kjaerbye-Thygesen
BACKGROUND: A safe delivery is part of a good start in life, and a continuous focus on preventing harm during delivery is crucial, even in settings with a good safety record. In January 2013, the labour unit at Copenhagen University Hospital, Hvidovre, undertook a quality improvement (QI) project to prevent asphyxia and reduced the percentage of newborns with asphyxia by 48%. METHODS: The change theory consisted of two primary elements: (1) the clinical content, including three clinical bundles of evidence-based care, a 'delivery bundle', an 'oxytocin bundle' and a 'vacuum extraction bundle'; (2) an implementation theory, including improving skills in interpretation of cardiotocography, use of QI methods and participation in a national learning network...
February 3, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29434064/cervical-length-measurement-in-nulliparous-women-at-term-by-ultrasound-its-relationship-to-spontaneous-onset-of-labour
#7
Joydev Mukherji, Avishek Bhadra, Suhas Kumar Ghosh, Avijit Hazra, Monika Anant, Subir Kumar Bhattacharya, Bibekananda Das, Shabnam Banu
Background & objectives: Data on serial cervical length (CL) measurements in pregnancy at term to predict spontaneous labour onset are scarce and conflicting. This study was conducted to observe CL changes preceding spontaneous onset of labour, by serial transvaginal sonography (TVS) and transabdominal sonography (TAS), in nulliparous Indian women near term. Methods: Only nulliparous women with a singleton foetus in cephalic presentation and who confirmed their gestational age were recruited...
October 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29429318/perineal-tears-a-review
#8
Ryan Goh, Daryl Goh, Hasthika Ellepola
BACKGROUND: The female perineum is the diamond-shaped inferior outlet of the pelvis. This structure is at risk of trauma during labour because of spontaneous perineal tears of varying degrees or iatrogenic episiotomies. These injuries can result in disabling immediate and long-term complications in the woman. OBJECTIVE: The aim of this article is to provide general practitioners (GPs) with a good understanding of perineal tears by discussing the different classifications, immediate and long-term management, and recommendations for future deliveries...
January 2018: Aust J Gen Pract
https://www.readbyqxmd.com/read/29427893/ghana-s-community-based-primary-health-care-why-women-and-children-are-disadvantaged-by-its-implementation
#9
Roger A Atinga, Irene Akua Agyepong, Reuben K Esena
Policy analysis on why women and children in low- and middle-income settings are still disadvantaged by access to appropriate care despite Primary Health Care (PHC) programmes implementation is limited. Drawing on the street-level bureaucracy theory, we explored how and why frontline providers (FLP) actions on their own and in interaction with health system factors shape Ghana's community-based PHC implementation to the disadvantage of women and children accessing and using health services. This was a qualitative study conducted in 4 communities drawn from rural and urban districts of the Upper West region...
February 5, 2018: Social Science & Medicine
https://www.readbyqxmd.com/read/29426270/evening-primrose-oil-and-labour-is-it-effective-a-randomised-clinical-trial
#10
Mahnaz Kalati, Maryam Kashanian, Fereshteh Jahdi, Mohsen Naseri, Hamid Haghani, Narges Sheikhansari
The purpose of the present study was to evaluate the effects of evening primrose oil (EvPO) on the duration of pregnancy and labour. The study was performed as a triple blind placebo controlled randomised clinical trial on nulliparous low-risk women with a certain gestational age of 40 weeks of pregnancy and a Bishop score of less than 4. In the case group (EvPO group), EvPO capsules were administered, 1000 mg, twice daily, for 7 days, and in the control group, placebo was administered similarly. The women of the two groups were followed up to delivery...
February 9, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29426269/identification-of-preterm-birth-in-women-with-threatened-preterm-labour-between-34-and-37-weeks-of-gestation
#11
Cenk Gezer, Atalay Ekin, Ulas Solmaz, Alkim Gulsah Sahingoz Yildirim, Askin Dogan, Mehmet Ozeren
The aim of this study was to assess whether serum markers would be useful as a new predictor of preterm birth in patients with spontaneous, late preterm labour. Patients diagnosed with late preterm labour were divided into preterm delivery (229 patients) and term delivery (178 patients) groups. The two groups were compared in terms of clinical characteristics and levels of serum markers (leukocyte subtypes, platelet, C-reactive protein [CRP], neutrophil to lymphocyte ratio [NLR] and platelet to lymphocyte ratio [PLR]), which were obtained at admission...
February 9, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29425107/screening-for-gestational-diabetes-in-low-risk-women-effect-of-maternal-age
#12
Aida Kalok, Pravin Peraba, Shamsul Azhar Shah, Zaleha Abdullah Mahdy, Mohamad Abdul Jamil, Nirmala Kampan, Suraya Sulaiman, Nor Azlin Mohamed Ismail
Background Gestational diabetes mellitus (GDM) is on the rise globally and there are various screening guidelines with regard to patients' criteria. Materials and methods We conducted a prospective cross-sectional study to determine the prevalence of GDM amongst low-risk pregnant women above the age of 25 years. A modified glucose tolerance test (MGTT) was performed between 24 and 36 weeks of gestation. Women with GDM were divided into two groups for analysis: age between 25 and 34 years (group A) and above 35 years (group B)...
February 9, 2018: Hormone Molecular Biology and Clinical Investigation
https://www.readbyqxmd.com/read/29397441/evaluation-of-cesarean-scar-after-single-and-double-layer-hysterotomy-closure-a-prospective-cross-sectional-study
#13
Nur Betül Tekiner, Berna Aslan Çetin, Lale Susan Türkgeldi, Gökçe Yılmaz, İbrahim Polat, Ali Gedikbaşı
BACKGROUND: We aimed to determine if there is a difference in the size of the cesarean scar defect using saline infusion sonography (SIS) performed on the postoperative third month in patients who underwent single- or double-layered unlocked closure of their uterine incision during their first cesarean delivery. METHODS: This study was conducted as a prospective cross-sectional study between February 2015 and January 2016 in patients admitted to the labour ward of the Kanuni Sultan Suleyman Training and Research Hospital who subsequently underwent their first delivery by cesarean section...
February 3, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29395272/status-and-drivers-of-maternal-newborn-child-and-adolescent-health-in-the-islamic-world-a-comparative-analysis
#14
Nadia Akseer, Mahdis Kamali, Nour Bakhache, Maaz Mirza, Seema Mehta, Sara Al-Gashm, Zulfiqar A Bhutta
BACKGROUND: The Millennium Development Goal (MDG) period saw dramatic gains in health goals MDG 4 and MDG 5 for improving child and maternal health. However, many Muslim countries in the south Asian, Middle Eastern, and African regions lagged behind. In this study, we aimed to evaluate the status of, progress in, and key determinants of reproductive, maternal, newborn, child, and adolescent health in Muslim majority countries (MMCs). The specific objectives were to understand the current status and progress in reproductive, maternal, newborn, child, and adolescent health in MMCs, and the determinants of child survival among the least developed countries among the MMCs; to explore differences in outcomes and the key contextual determinants of health between MMCs and non-MMCs; and to understand the health service coverage and contextual determinants that differ between best and poor or moderate performing MMCs...
January 30, 2018: Lancet
https://www.readbyqxmd.com/read/29391293/a-case-of-non-treated-trichomonas-vaginalis-infection-and-severe-preterm-labour-with-positive-obstetrical-outcome
#15
E Salakos, D Korb, C Morin, O Sibony
Trichomonas vaginalis is a very common, sexually transmitted, infection that may sometimes be asymptomatic or cause vaginitis and urethritis. Recently, it has been associated with adverse obstetric outcomes such as preterm delivery, low birth weight and premature rupture of membranes. Trichomonas vaginalis can be vertically transmitted at birth. It has been found in pharynx and low respiratory tract of neonates with respiratory disease. It has also been involved in some cases of intellectual disability. The recommended treatment is a 2g metronidazole oral single dose, even for asymptomatic patients...
January 29, 2018: Journal of Gynecology Obstetrics and Human Reproduction
https://www.readbyqxmd.com/read/29384054/toll-like-receptor-4-a-new-target-for-preterm-labour-pharmacotherapies
#16
Sarah A Robertson, Hanan H Wahid, Peck Yin Chin, Mark R Hutchinson, Lachlan M Moldenhauer, Jeffrey A Keelan
Inflammatory activation, a major driver of preterm birth and subsequent neonatal morbidity, is an attractive pharmacological target for new preterm birth therapeutics. Inflammation elicited by intraamniotic infection is causally associated with preterm birth, particularly in infants delivered ≤34 weeks' gestation. However, sterile triggers of PTB, including placental ischaemic injury, uterine distention, cervical disease, or imbalance in the immune response, also act through inflammatory mediators released in response to tissue damage...
January 30, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29375881/the-evolving-role-of-traditional-birth-attendants-in-maternal-health-in-post-conflict-africa-a-qualitative-study-of-burundi-and-northern-uganda
#17
Primus Che Chi, Henrik Urdal
Objectives: Many conflict-affected countries are faced with an acute shortage of health care providers, including skilled birth attendants. As such, during conflicts traditional birth attendants have become the first point of call for many pregnant women, assisting them during pregnancy, labour and birth, and in the postpartum period. This study seeks to explore how the role of traditional birth attendants in maternal health, especially childbirth, has evolved in two post-conflict settings in sub-Saharan Africa (Burundi and northern Uganda) spanning the period of active warfare to the post-conflict era...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29373966/microeconomic-institutions-and-personnel-economics-for-health-care-delivery-a-formal-exploration-of-what-matters-to-health-workers-in-rwanda
#18
Pieter Serneels, Tomas Lievens
BACKGROUND: Most developing countries face important challenges regarding the quality of health care, and there is a growing consensus that health workers play a key role in this process. Our understanding as to what are the key institutional challenges in human resources, and their underlying driving forces, is more limited. A conceptual framework that structures existing insights and provides concrete directions for policymaking is also missing. METHODS: To gain a bottom-up perspective, we gather qualitative data through semi-structured interviews with different levels of health workers and users of health services in rural and urban Rwanda...
January 26, 2018: Human Resources for Health
https://www.readbyqxmd.com/read/29372092/intravenous-remifentanil-analgaesia-for-an-obstetric-patient-with-type-i-neurofibromatosis-and-a-factor-v-leiden-mutation
#19
José L Gálvez, Carlos L Errando, Silvia Serrano, Marga Martín-Ayuso, José M Valverde-Mantecón
Type I neurofibromatosis is characterised by altered skin pigmentation and the growth of benign tumours, particularly along the peripheral nerves and central nervous system. We report a 36-year-old primigravida woman in labour who was admitted to the obstetric suite of the Hospital Sant Joan de Déu, Barcelona, Spain, in 2007 with hypothyroidism, type I neurofibromatosis and a factor V Leiden mutation. Due to a lack of cranial and spinal imaging data, an epidural was not indicated; instead, continuous intravenous remifentanil analgaesia was administered...
November 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29366610/-occiput-posterior-presentation-at-delivery-materno-foetal-outcomes-and-predictive-factors-of-rotation
#20
V Othenin-Girard, M Boulvain, M-J Guittier
OBJECTIVES: To describe the maternal and foetal outcomes of an occiput posterior foetal position at delivery; to evaluate predictive factors of anterior rotation during labour. METHODS: Descriptive retrospective analysis of a cohort of 439 women with foetuses in occiput posterior position during labour. Logistic regression analysis to quantify the effect of factors that may favour anterior rotation. RESULTS: Most of foetuses (64%) do an anterior rotation during labour and 13% during the expulsive phase...
January 20, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
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