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https://www.readbyqxmd.com/read/28807713/opioid-drug-use-and-acute-cardiac-events-among-pregnant-women-in-the-united-states
#1
Hamisu M Salihu, Jason L Salemi, Anjali Aggarwal, Beverly F Steele, Ross C Pepper, Mulubrhan F Mogos, Muktar H Aliyu
BACKGROUND: Cardiovascular disease remains a leading cause of pregnancy-associated deaths in the United States (US). The extent to which increasing opioid use among pregnant women contributes to fatal cardiovascular events is unknown. We examine trends in opioid use among pregnant women over the previous decade, and the association between changes in temporal trends in opioid drug use and the incidence of acute cardiac events among mothers. METHODS: In this retrospective analysis of the Healthcare and Cost Utilization Project (HCUP), we utilized a two-stage stratified cluster sampling of all inpatient hospital discharges from non-federal hospitals between 01/01/2002 through 12/31/2014...
August 11, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28805341/treatment-options-for-severe-pulmonary-embolism-during-pregnancy-and-the-postpartum-period-a-systematic-review
#2
G Martillotti, F Boehlen, H Robert-Ebadi, N Jastrow, M Righini, M Blondon
BACKGROUND: Massive pulmonary embolism (PE) during pregnancy or the postpartum period is a rare but dramatic event. Our aim was to systematically review the evidence to guide its management. METHODS: We searched Pubmed, Embase, conference proceedings and the RIETE registry for published cases of severe (submassive/massive) PE treated with thrombolysis, percutaneous or surgical thrombectomy and/or with ECMO, occurring during pregnancy or within 6 weeks of delivery...
August 14, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28755459/defining-definitions-a-delphi-study-to-develop-a-core-outcome-set-for-conditions-of-severe-maternal-morbidity
#3
T Schaap, K Bloemenkamp, C Deneux-Tharaux, M Knight, J Langhoff-Roos, E Sullivan, T van den Akker
OBJECTIVE: Develop a core outcome set of international consensus definitions for severe maternal morbidities. DESIGN: Electronic Delphi study. SETTING: International. POPULATION: Eight expert panels. METHODS: All 13 high-income countries represented in the International Network of Obstetric Surveillance Systems (INOSS) nominated five experts per condition of morbidity, who submitted possible definitions...
July 29, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28745848/optimizing-survival-outcomes-for-adult-patients-with-nontraumatic-cardiac-arrest-digest
#4
Julianna Jung, Milana Zaurova
Patient survival after cardiac arrest can be improved significantly with prompt and effective resuscitative care. This systematic review analyzes the basic life support factors that improve survival outcome, including chest compression technique and rapid defibrillation of shockable rhythms. For patients who are successfully resuscitated, comprehensive postresuscitation care is essential. Targeted temperature management is recommended for all patients who remain comatose, in addition to careful monitoring of oxygenation, hemodynamics, and cardiac rhythm...
October 22, 2016: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28743074/coronary-perfusion-pressure-and-compression-quality-in-maternal-cardiopulmonary-resuscitation-in-supine-and-left-lateral-tilt-positions-a-prospective-crossover-study-using-mannequins-and-swine-models
#5
Satoshi Dohi, Kiyotake Ichizuka, Ryu Matsuoka, Kohei Seo, Masaaki Nagatsuka, Akihiko Sekizawa
OBJECTIVE: The risk of maternal and fetal mortality is high if cardiopulmonary arrest occurs during pregnancy. To assess the best position for maternal cardiopulmonary resuscitation (CPR), a prospective randomized crossover study was undertaken, involving basic life support mannequin-based simulation (BLS-MS) and a swine model of pulseless electrical activity (an unstable cardiac state) incorporating a fetal mannequin (PEA-FM). STUDY DESIGN: The BLS-MS (performed by certified rescuers) served to evaluate the quality of chest compressions in 30° left lateral tilt (LLT) and supine positions...
July 16, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28719429/maternal-salvage-with-extracorporeal-life-support-lessons-learned-in-a-single-center
#6
Philippe Biderman, Uri Carmi, Eric Setton, Michael Fainblut, Oren Bachar, Sharon Einav
The American Heart Association scientific statement on cardiac arrest in pregnancy did not endorse extracorporeal life support for lack of cohort data. We studied all pregnancy and peripartum cases of extracorporeal life support in 1 medical center (n = 11), including collapse due to infection (n = 6, 55%), thromboembolism (n = 3, 27%), and cardiac disease (n = 2, 18%). Half of the cases (n = 5, 45%) involved extracorporeal cardiopulmonary resuscitation. Most mothers survived (n = 7, 64% [95% confidence interval, 32%-88%])...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28552468/air-pollution-and-cardiovascular-events-at-labor-and-delivery-a-case-crossover-analysis
#7
Sandie Ha, Tuija Männistö, Danping Liu, Seth Sherman, Qi Ying, Pauline Mendola
PURPOSE: In this case-crossover study, we investigated the odds of having a labor/delivery with cardiovascular event (i.e., ischemic heart disease, stroke, heart failure, cardiac arrest/failure, and other or unspecified cardiovascular events) associated with acute exposure to common air pollutants. METHODS: We selected 680 women with singleton pregnancy and cardiovascular events at labor/delivery from 12 U.S. clinical sites (2002-2008). Exposures to six criteria air pollutants, six particulate constituents, and 26 air toxics were obtained using modified Community Multiscale Air Quality models...
June 2017: Annals of Epidemiology
https://www.readbyqxmd.com/read/28412993/paediatric-onset-coronary-artery-anomalies-in-pregnancy-a-single-centre-experience-and-systematic-literature-review
#8
Michelle Keir, Catriona Bhagra, Debra Vatenmakher, Francisca Arancibia-Galilea, Katrijn Jansen, Norihisa Toh, Candice K Silversides, Jack Colman, Samuel C Siu, Mathew Sermer, Andrew M Crean, Rachel M Wald
OBJECTIVES: Individuals with childhood-onset coronary artery anomalies are at increased risk of lifelong complications. Although pregnancy is thought to confer additional risk, a few data are available regarding outcomes in this group of women. We sought to define outcomes of pregnancy in this unique population. METHODS: We performed a retrospective survey of women with paediatric-onset coronary anomalies and pregnancy in our institution, combined with a systematic review of published cases...
April 17, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28393757/prehospital-randomised-assessment-of-a-mechanical-compression-device-in-out-of-hospital-cardiac-arrest-paramedic-a-pragmatic-cluster-randomised-trial-and-economic-evaluation
#9
Simon Gates, Ranjit Lall, Tom Quinn, Charles D Deakin, Matthew W Cooke, Jessica Horton, Sarah E Lamb, Anne-Marie Slowther, Malcolm Woollard, Andy Carson, Mike Smyth, Kate Wilson, Garry Parcell, Andrew Rosser, Richard Whitfield, Amanda Williams, Rebecca Jones, Helen Pocock, Nicola Brock, John Jm Black, John Wright, Kyee Han, Gary Shaw, Laura Blair, Joachim Marti, Claire Hulme, Christopher McCabe, Silviya Nikolova, Zenia Ferreira, Gavin D Perkins
BACKGROUND: Mechanical chest compression devices may help to maintain high-quality cardiopulmonary resuscitation (CPR), but little evidence exists for their effectiveness. We evaluated whether or not the introduction of Lund University Cardiopulmonary Assistance System-2 (LUCAS-2; Jolife AB, Lund, Sweden) mechanical CPR into front-line emergency response vehicles would improve survival from out-of-hospital cardiac arrest (OHCA). OBJECTIVE: Evaluation of the LUCAS-2 device as a routine ambulance service treatment for OHCA...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28270448/management-of-pregnancy-and-obstetric-complications-in-prehospital-trauma-care-prehospital-resuscitative-hysterotomy-perimortem-caesarean-section
#10
EDITORIAL
Emir Battaloglu, Keith Porter
The need for prehospital resuscitative hysterotomy/perimortem caesarean section is rare. The procedures can be daunting and clinically challenging for practitioners. Maternal death can be averted by swift and decisive action. This guideline serves to inform prehospital practitioners about conducting maternal resuscitation following cardiac arrest, provides an evidence-based framework to support decision making and highlights areas for improvement in prehospital care.
May 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28242631/nearly-one-in-four-cardiac-arrests-in-pregnancy-is-due-to-anaesthesia-study-finds
#11
Susan Mayor
No abstract text is available yet for this article.
February 26, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28231684/emergency-peripartum-hysterectomy-a-challenge-or-an-obstetrical-defeat
#12
Aneta Malinowska-Polubiec, Ewa Romejko-Wolniewicz, Julia Zareba-Szczudlik, Agnieszka Dobrowolska-Redo, Agnieszka Sotowska, Roman Smolarczyk, Jan Wilczynski, Krzysztof Czajkowski
OBJECTIVES: Peripartum hysterectomy remains an obstetric nightmare. Most obstetricians consider it a defeat. The aim of our study was to assess the prevalence, indications, procedures and complications of emergency peripartum hysterectomy (EPH) in the 2nd Department of Obstetrics & Gynecology, Medical University of Warsaw during a 7 year period (2007-2013). METHODS: A retrospective evaluation of 21,144 deliveries was performed. We analyzed all cases of EPH, including the maternal characteristics, obstetrical history, course of pregnancy and delivery, type of surgery and complications...
October 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/28151819/epidemiology-of-cardiac-arrest-during-hospitalization-for-delivery-in-canada-a-nationwide-study
#13
Mrinalini Balki, Shiliang Liu, Juan Andrés León, Leyla Baghirzada
BACKGROUND: Cardiac arrest in pregnancy is a rare and devastating condition with high mortality and morbidity. The objective of this study was to generate information about maternal cardiac arrest in Canada by examining the frequency, temporal incidence, associated conditions, potential etiologies, and survival rates. METHODS: This retrospective population-based study used hospitalization data from the discharge abstract database of the Canadian Institute for Health Information relating to obstetric deliveries in Canada from April 1, 2002, to March 31, 2015...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28109048/tipping-our-caps-to-the-ukoss-cardiac-arrest-in-pregnancy-study
#14
J M Mhyre, B T Bateman
No abstract text is available yet for this article.
January 21, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28079767/primary-gastric-choriocarcinoma-presenting-as-a-pregnancy-of-unknown-location
#15
Alyssa Larish, Amanika Kumar, Sarah Kerr, Carrie Langstraat
BACKGROUND: Pregnancy of unknown location presents a diagnostic challenge, in rare occasions leading to the diagnosis of malignancy. We describe a case of β-hCG-secreting nongestational primary gastric choriocarcinoma presenting as a pregnancy of unknown location. CASE: A 37-year-old woman, gravida 4 para 3013, presented with several days of vaginal bleeding and rising β-hCG level without ultrasound localization of pregnancy. The diagnosis of pregnancy of unknown location was made and methotrexate administered at a β-hCG level of 7,779 milli-international units/mL...
February 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28079556/cardiac-arrest-obstetric-cpr-acls
#16
Benjamin Cobb, Steven Lipman
In contrast with other high-resource countries, maternal mortality has seen an increase in the United States. Caring for pregnant women in cardiac arrest may prove uniquely challenging given the rarity of the event coupled by the physiological changes of pregnancy. Optimization of resuscitative efforts warrants special attention as described in the 2015 American Heart Association's "Scientific Statement on Maternal Cardiac Arrest." Current recommendations address a variety of topics ranging from the basic components of chest compressions and airway management to some of the logistical complexities and operational challenges involved in maternal cardiac arrest...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28017511/out-of-hospital-cardiac-arrest-in-pregnancy-with-good-neurological-outcome-for-mother-and-infant
#17
S Pecher, E Williams
Cardiac arrest in pregnancy is rare (about 1:30000 pregnancies) and out-of-hospital cardiac arrests are even less frequent. Resuscitation of the pregnant mother is challenging and requires attention to the altered physiology, specific pathologies and the presence and well-being of the fetus. Once circulation has been restored, the lack of high-grade evidence regarding delivery of the baby and post-resuscitation care makes decision making complex. We present a case of out-of-hospital maternal cardiac arrest with successful resuscitation and good neurological outcome for mother and infant...
February 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27933173/a-rare-case-of-gestational-thyrotoxicosis-as-a-cause-of-acute-myocardial-infarction
#18
Varalaxmi Bhavani Nannaka, Dmitry Lvovsky
Angina pectoris in pregnancy is unusual and Prinzmetal's angina is much rarer. It accounts for 2% of all cases of angina. It is caused by vasospasm, but the mechanism of spasm is unknown but has been linked with hyperthyroidism in some studies. Patients with thyrotoxicosis-induced acute myocardial infarction are unusual and almost all reported cases have been associated with Graves' disease. Human chorionic gonadotropin hormone-induced hyperthyroidism occurs in about 1.4% of pregnant women, mostly when hCG levels are above 70-80 000 IU/L...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27926646/treatment-of-a-pregnant-patient-in-a-persistent-vegetative-state
#19
Matthew P Romagano, William E Scorza, Stephen E Lammers, Carole Dorr, John C Smulian
BACKGROUND: Brain injury leading to a persistent vegetative state during pregnancy involves difficult medical and ethical decisions. CASE: A 21-year-old multigravid woman entered a persistent vegetative state at 20 1/7 weeks of gestation after cardiac arrest with postanoxic brain injury from a suspected drug overdose. The clinical disciplines responsible for her case formed a collaborative care plan involving ventilator, nutrition, and medication support of the mother and regular fetal monitoring and ultrasound testing...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27913770/cor-triatriatum-a-review
#20
Ajay Kumar Jha, Neeti Makhija
Cor triatriatum is a rare congenital cardiac anomaly defined by an abnormal septation within the atrium (left or right) leading to inflow obstruction to the respective ventricles. It exists either in isolated classical form or may be associated with simple to complex congenital cardiac anomalies. Several anatomical variants exist even in the classical form, and therefore, it may require multimodal diagnostic modalities to characterize and differentiate for better percutaneous interventional or surgical planning...
June 2017: Seminars in Cardiothoracic and Vascular Anesthesia
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