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https://www.readbyqxmd.com/read/28938748/random-start-ovarian-stimulation-for-fertility-preservation-appears-unlikely-to-delay-initiation-of-neoadjuvant-chemotherapy-for-breast-cancer
#1
Joseph M Letourneau, Nikita Sinha, Kaitlyn Wald, Eve Harris, Molly Quinn, Tal Imbar, Evelyn Mok-Lin, A Jo Chien, Mitchell Rosen
STUDY QUESTION: Is random start ovarian stimulation associated with delays in initiation of neoadjuvant chemotherapy for breast cancer? SUMMARY ANSWER: Among women who complete fertility preservation (FP) consultation, random start ovarian stimulation is unlikely to delay time to initiation of neoadjuvant chemotherapy start. WHAT IS KNOWN ALREADY: Neoadjuvant chemotherapy is now a widely accepted treatment modality for operable breast cancer and random start ovarian stimulation is an increasingly-utilized modality for FP...
October 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28938429/effect-of-preconception-impaired-glucose-tolerance-on-pregnancy-outcomes-in-women-with-polycystic-ovary-syndrome
#2
Daimin Wei, Bo Zhang, Yuhua Shi, Lin Zhang, Shigang Zhao, Yanzhi Du, Lizhen Xu, Richard S Legro, Heping Zhang, Zi-Jiang Chen
Context: Women with polycystic ovary syndrome (PCOS) commonly have intrinsic insulin resistance and are recommended to undergo an oral glucose tolerance test (OGTT) for diabetes screening. However, the effect of preconception impaired glucose tolerance (IGT) on pregnancy is still unclear. Objective: To prospectively assess the effect of preconception IGT on pregnancy outcomes. Design, Setting, Patients, Intervention(s) and Main Outcome Measure(s): This was a secondary analysis of a multicenter randomized trial in 1508 women with PCOS comparing live birth and obstetric complications between fresh and frozen embryo transfer...
August 14, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28938298/safety-and-efficacy-of-epidural-analgesia
#3
Elke M E Bos, Markus W Hollmann, Philipp Lirk
PURPOSE OF REVIEW: Epidural analgesia remains a widely used analgesic technique. This article aims to assess the safety of epidural analgesia by balancing efficacy and complications, of epidural analgesia for acute, labor and chronic pain. RECENT FINDINGS: Main indications for epidural analgesia include major open abdominal surgery, thoracotomy and labor analgesia. Past and current literature show that epidural analgesia leads to statistically significant, but possibly clinically less meaningful, reductions in pain scores compared with intravenous analgesia...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28938062/news-from-the-editors-roberto-romero-editor-of-ultrasound-in-obstetrics-and-gynecology-from-2003-to-2017-steps-down
#4
Stuart Campbell
No abstract text is available yet for this article.
September 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28938051/pregnancy-disorders-in-africa-and-the-obstetric-dilemma
#5
Annettee Nakimuli, Ashley Moffett
The high neonatal and maternal morbidity and mortality associated with the extremes of birth weight is referred to as the obstetric dilemma. Pre-eclampsia and other conditions that lead to low birth weight are considered as the Great Obstetrical Syndromes (GOS). At the other extreme is high birth weight resulting in obstructed labour. Fetal weight largely depends on placental function and defective placentation is a common feature of the GOS. There is evidence that the local uterine immune system (KIR and HLA-C) regulates placentation, with racial differences noted...
December 1, 2016: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28937572/obstetric-care-consensus-no-6-periviable-birth
#6
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937571/practice-bulletin-no-183-postpartum-hemorrhage
#7
(no author information available yet)
Maternal hemorrhage, defined as a cumulative blood loss of greater than or equal to 1,000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after the birth process, remains the leading cause of maternal mortality worldwide (1). Additional important secondary sequelae from hemorrhage exist and include adult respiratory distress syndrome, shock, disseminated intravascular coagulation, acute renal failure, loss of fertility, and pituitary necrosis (Sheehan syndrome).Hemorrhage that leads to blood transfusion is the leading cause of severe maternal morbidity in the United States closely followed by disseminated intravascular coagulation (2)...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937567/obstetric-care-consensus-no-6-summary-periviable-birth
#8
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937566/practice-bulletin-no-183-summary-postpartum-hemorrhage
#9
(no author information available yet)
Maternal hemorrhage, defined as a cumulative blood loss of greater than or equal to 1,000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after the birth process, remains the leading cause of maternal mortality worldwide (1). Additional important secondary sequelae from hemorrhage exist and include adult respiratory distress syndrome, shock, disseminated intravascular coagulation, acute renal failure, loss of fertility, and pituitary necrosis (Sheehan syndrome).Hemorrhage that leads to blood transfusion is the leading cause of severe maternal morbidity in the United States closely followed by disseminated intravascular coagulation (2)...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937537/a-comparison-of-biologic-screening-and-diagnostic-indicators-to-detect-in-utero-opiate-and-cocaine-exposure-among-mother-infant-dyads
#10
Meagan Stabler, Peter Giacobbi, Ilana Chertok, Leann Long, Lesley Cottrell, Panitan Yossuck
BACKGROUND: Opioid and cocaine antenatal substance use can result in significant obstetric and pediatric health implications. Accurate detection of in utero exposed neonates can improve patient care and health outcomes. Therefore, the effectiveness of mother-infant biological and diagnostic indicators collected at labor and delivery to provide accurate detection of in utero opiate and cocaine exposure was assessed. METHODS: A retrospective medical chart review included 335 mother-infant dyads exposed to antenatal substances who were delivered between January 2009 and March 2014...
September 19, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28937514/surgical-skills-feedback-and-mytipreport-is-there-construct-validity
#11
AnnaMarie Connolly, Anita Blanchard, Alice Goepfert, Nicole Donnellan, Elizabeth Buys, Richard Uribe, Kimberly Kenton
OBJECTIVE: To initiate construct validity testing of myTIPreport for procedural skill assessment in a prospective multicenter evaluation study. METHODS: Teachers and learners from a convenience-based site selection of obstetrics and gynecology (OBGYN) and female pelvic medicine and reconstructive surgery (FPMRS) training programs performed procedural assessments in myTIPreport. The specifically defined 5-point Dreyfus rating scale describing ability levels from novice to expert was used...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937513/entrustment-evidence-used-by-expert-gynecologic-surgical-teachers-to-determine-residents-autonomy
#12
Xiaodong Phoenix Chen, Amy M Sullivan, Joan M Bengtson, John L Dalrymple
OBJECTIVE: To identify entrustment evidence used by expert gynecologic surgical teachers to determine obstetrics and gynecology residents' level of autonomy in the operating room. METHODS: A qualitative interview study was undertaken from March to November 2016. Four selection criteria were used to define and purposefully sample expert gynecologic surgical teachers across the United States to represent all four geographic regions. All interviews were audio-recorded and transcribed...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937512/obstetricians-and-gynecologists-of-the-future-a-survey-of-medical-students-applying-to-residency
#13
Meredith J Alston, Amy Meg Autry, Sarah A Wagner, Abigail Winkel, Amanda A Allshouse, Alyssa Stephenson-Famy
OBJECTIVE: To understand the characteristics and career goals of medical students selecting a career in obstetrics and gynecology. METHODS: In 2015-2016, medical students invited for interviews for obstetrics and gynecology residency at the University of Colorado, University of Washington, University of California San Francisco, Loyola University, and New York University received a voluntary 20-item electronic survey regarding factors influencing their choice of medical specialty...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937446/costs-of-robotic-assisted-versus-traditional-laparoscopy-in-endometrial-cancer
#14
Riikka-Liisa K Vuorinen, Minna M Mäenpää, Kari Nieminen, Eija I Tomás, Tiina H Luukkaala, Anssi Auvinen, Johanna U Mäenpää
OBJECTIVES: The purpose of this study was to compare the costs of traditional laparoscopy and robotic-assisted laparoscopy in the treatment of endometrial cancer. METHODS AND MATERIALS: A total of 101 patients with endometrial cancer were randomized to the study and operated on starting from 2010 until 2013, at the Department of Obstetrics and Gynecology of Tampere University Hospital, Tampere, Finland. Costs were calculated based on internal accounting, hospital database, and purchase prices and were compared using intention-to-treat analysis...
October 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28936111/agile-development-of-a-smartphone-app-for-perinatal-monitoring-in-a-resource-constrained-setting
#15
Boris Martinez, Rachel Hall-Clifford, Enma Coyote, Lisa Stroux, Camilo E Valderrama, Christopher Aaron, Aaron Francis, Cate Hendren, Peter Rohloff, Gari D Clifford
Technology provides the potential to empower frontline healthcare workers with low levels of training and literacy, particularly in low- and middle-income countries. An obvious platform for achieving this aim is the smartphone, a low cost, almost ubiquitous device with good supply chain infrastructure and a general cultural acceptance for its use. In particular, the smartphone offers the opportunity to provide augmented or procedural information through active audiovisual aids to illiterate or untrained users, as described in this article...
2017: Journal of Health Informatics in Developing Countries
https://www.readbyqxmd.com/read/28935263/predicting-preterm-birth-cervical-length-and-fetal-fibronectin
#16
REVIEW
Moeun Son, Emily S Miller
Spontaneous preterm birth remains the leading cause of neonatal morbidity and mortality worldwide, and accounts for a significant global health burden. Several obstetric strategies to screen for spontaneous preterm delivery, such as cervical length and fetal fibronectin measurement, have emerged. However, the effectiveness of these strategies relies on their ability to accurately predict those pregnancies at increased risk for spontaneous preterm birth (SPTB). Transvaginal cervical shortening is predictive of preterm birth and when coupled with appropriate preterm birth prevention strategies, has been associated with reductions in SPTB in asymptomatic women with a singleton gestation...
September 18, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28934941/folic-acid-usage-and-associated-factors-in-the-prevention-of-neural-tube-defects-among-pregnant-women-in-ethiopia-cross-sectional-study
#17
Meselech Ambaw Dessie, Ejigu Gebeye Zeleke, Shimelash Bitew Workie, Ayanaw Worku Berihun
BACKGROUND: Neural tube defects are among the most common birth defects, contributing to miscarriage, infant mortality, severe congenital abnormalities and serious disabilities. It is burdensome to patients, caregivers, healthcare systems and society. It could be reduced if women consume a folic acid supplement before and during the early weeks of pregnancy. This study assesses folic acid usage and associated factors for the prevention of neural tube defects among pregnant women in Ethiopia...
September 21, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28934836/pregnancy-in-women-with-hypertrophic-cardiomyopathy-data-from-the-european-society-of-cardiology-initiated-registry-of-pregnancy-and-cardiac-disease-ropac
#18
S Goland, I M van Hagen, G Elbaz-Greener, U Elkayam, A Shotan, W M Merz, S C Enar, I R Gaisin, P G Pieper, M R Johnson, R Hall, A Blatt, J W Roos-Hesselink
Aims: We report the maternal and foetal outcomes at birth and after 6 months in a cohort of pregnant women with hypertrophic cardiomyopathy (HCM). Although most women with HCM tolerate pregnancy well, there is an increased risk of obstetric and cardiovascular complications. Methods and results: All pregnant women with HCM entered into the prospective worldwide Registry of Pregnancy and Cardiac disease (ROPAC) were included in this analysis. The primary endpoint was a major adverse cardiovascular event (MACE), which included death, heart failure (HF), thrombo-embolic event, and arrhythmia...
September 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28934320/household-costs-and-time-to-seek-care-for-pregnancy-related-complications-the-role-of-results-based-financing
#19
Jobiba Chinkhumba, Manuela De Allegri, Jacob Mazalale, Stephan Brenner, Don Mathanga, Adamson S Muula, Bjarne Robberstad
Results-based financing (RBF) schemes-including performance based financing (PBF) and conditional cash transfers (CCT)-are increasingly being used to encourage use and improve quality of institutional health care for pregnant women in order to reduce maternal and neonatal mortality in low-income countries. While there is emerging evidence that RBF can increase service use and quality, little is known on the impact of RBF on costs and time to seek care for obstetric complications, although the two represent important dimensions of access...
2017: PloS One
https://www.readbyqxmd.com/read/28934086/towards-ontology-based-decision-support-systems-for-complex-ultrasound-diagnosis-in-obstetrics-and-gynecology
#20
P Maurice, F Dhombres, E Blondiaux, S Friszer, L Guilbaud, N Lelong, B Khoshnood, J Charlet, N Perrot, E Jauniaux, D Jurkovic, J-M Jouannic
INTRODUCTION: We have developed a new knowledge base intelligent system for obstetrics and gynecology ultrasound imaging, based on an ontology and a reference image collection. This study evaluates the new system to support accurate annotations of ultrasound images. We have used the early ultrasound diagnosis of ectopic pregnancies as a model clinical issue. MATERIAL AND METHODS: The ectopic pregnancy ontology was derived from medical texts (4260 ultrasound reports of ectopic pregnancy from a specialist center in the UK and 2795 Pubmed abstracts indexed with the MeSH term "Pregnancy, Ectopic") and the reference image collection was built on a selection from 106 publications...
May 2017: Journal of gynecology obstetrics and human reproduction
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