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Obstetrics critical care

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https://www.readbyqxmd.com/read/27918157/necrotic-fasciitis-of-the-lateral-muscle-group-of-the-thigh-following-outside-in-transobturatory-tape-procedure
#1
O Dvořák, D Leško, J Kestřánek
OBJECTIVE: Sling procedures are the preferred surgical treatment of stress urinary incontinence (SUI) due to their high success rate and low risk of complications. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology, Medical Faculty of Charles University and Faculty Hospital Hradec Kralove. CASE REPORT: Necrotic fasciitis is a rare infectious complication, the mortality of which varies by age and can reach 73% if untreated...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27907898/obstetrical-and-perinatal-outcomes-following-blastocyst-transfer-compared-to-cleavage-transfer-a-systematic-review-and-meta-analysis
#2
W P Martins, C O Nastri, L Rienzi, S Z van der Poel, C R Gracia, C Racowsky
STUDY QUESTION: Is blastocyst transfer safe when compared to cleavage stage embryo transfer regarding obstetric and perinatal outcomes? SUMMARY ANSWER: The clinical equipoise between blastocyst and cleavage stage embryo transfer remains as the evidence associating blastocyst transfer with some adverse perinatal outcomes is of low/very low quality. WHAT IS KNOWN ALREADY: Extended embryo culture to the blastocyst stage provides some theoretical advantages and disadvantages...
November 2016: Human Reproduction
https://www.readbyqxmd.com/read/27895065/social-determinants-and-maternal-exposure-to-intimate-partner-violence-of-obstetric-patients-with-severe-maternal-morbidity-in-the-intensive-care-unit-a-systematic-review-protocol
#3
Beatriz Paulina Ayala Quintanilla, Angela Taft, Susan McDonald, Wendy Pollock, Joel Christian Roque Henriquez
INTRODUCTION: Maternal mortality is a potentially preventable public health issue. Maternal morbidity is increasingly of interest to aid the reduction of maternal mortality. Obstetric patients admitted to the intensive care unit (ICU) are an important part of the global burden of maternal morbidity. Social determinants influence health outcomes of pregnant women. Additionally, intimate partner violence has a great negative impact on women's health and pregnancy outcome. However, little is known about the contextual and social aspects of obstetric patients treated in the ICU...
November 28, 2016: BMJ Open
https://www.readbyqxmd.com/read/27842632/a-cross-sectional-study-of-peripartum-blood-transfusion-in-the-eastern-cape-south-africa
#4
K Van den Berg, E M Bloch, A S Aku, M Mabenge, D V Creel, G J Hofmeyr, E L Murphy
BACKGROUND: Obstetric haemorrhage (OH) remains a major contributor to maternal morbidity and mortality. Blood transfusion is critical in OH management; yet, data on peripartum transfusion are lacking. A pilot study reported high rates of peripartum transfusion in a sample of South African (SA) hospitals, which was independently associated with HIV status. OBJECTIVES: To assess the incidence of peripartum transfusion in a sample of Eastern Cape, SA hospitals to evaluate generalisability of preceding study findings...
November 2, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27826131/preconception-care-education-for-women-with-diabetes-a-systematic-review-of-conventional-and-digital-health-interventions
#5
REVIEW
Chidiebere Hope Nwolise, Nicola Carey, Jill Shawe
BACKGROUND: Worldwide, 199.5 million women have diabetes mellitus (DM). Preconception care (PCC) education starting from adolescence has been recommended as an effective strategy for safeguarding maternal and child health. However, traditional preconception care advice provided by health care professionals (HCPs) within clinic settings is hindered by inadequate resources, suboptimal coverage, and busy clinics. Electronic health (eHealth), which is instrumental in solving problems around scarce health resources, could be of value in overcoming these limitations and be used to improve preconception care and pregnancy outcomes for women with DM...
November 8, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27816155/respiratory-considerations-including-airway-and-ventilation-issues-in-critical-care-obstetric-patients
#6
REVIEW
Holly Ende, Dirk Varelmann
Critical care management of the obstetric patient can present unique challenges. Parturients who present with respiratory distress can suffer from a multitude of etiologies, and each diagnosis must be pursued as appropriate to the clinical picture. Normal physiologic changes of pregnancy may obscure the presentation and diagnosis, and irrelevant of the cause, pregnancy may complicate the management of hypoxic and hypercarbic respiratory failure in this patient population. In addition to these concerns, both anticipated and unanticipated difficult airway management, including difficulty ventilating and intubating, are more common during pregnancy and may be encountered during endotracheal tube placement...
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27816150/critical-care-for-the-obstetrician-and-gynecologist-obstetric-hemorrhage-and-disseminated-intravascular-coagulopathy
#7
REVIEW
Arthur Jason Vaught
Obstetric hemorrhage accounts for 5% all deliveries in the United States and accounts for high maternal morbidity and mortality. Many hemorrhages are secondary to uterine atony and are quickly ameliorated with appropriate uterotonic use. However, for a subset of cases, severe hemorrhage may require advanced resuscitative techniques, and innovative procedural and surgical techniques. This article guides a provider through such a resuscitation.
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27811594/effect-of-implementing-a-standardized-shoulder-dystocia-documentation-form-on-quality-of-delivery-notes
#8
Lisa C Zuckerwise, Madison M Hustedt, Heather S Lipkind, Edmund F Funai, Cheryl A Raab, Christian M Pettker
OBJECTIVES: Complete and accurate documentation by the delivering provider in cases of shoulder dystocia is critical for providing clinical information and care to the patient and protecting providers from litigation risks. Standardized forms improve inclusion of certain data elements in the medical record, but the impact on subsequent narrative notes is unknown. We aimed to determine if implementation of a standardized shoulder dystocia documentation form improves obstetric provider written narrative delivery notes...
November 2, 2016: Journal of Patient Safety
https://www.readbyqxmd.com/read/27789310/severe-maternal-morbidity-and-comorbid-risk-in-hospitals-performing-1000-deliveries-per-year
#9
Mark P Hehir, Cande V Ananth, Jason D Wright, Zainab Siddiq, Mary E D'Alton, Alexander M Friedman
BACKGROUND: While research has demonstrated increasing risk for severe maternal morbidity in the United States, risk at lower volume hospitals remains poorly characterized. More than half of all obstetric units in the United States perform less than 1000 deliveries per year and improving care at these hospitals may be critical to reducing risk nationwide. OBJECTIVE: We sought to characterize maternal risk profiles and severe maternal morbidity at low-volume hospitals in the US...
October 24, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27773712/perinatal-regionalization-a-geospatial-view-of-perinatal-critical-care-united-states-2010-2013
#10
Mary D Brantley, Nicole L Davis, David A Goodman, William M Callaghan, Wanda D Barfield
BACKGROUND: Perinatal services exist today as a dyad of maternal and neonatal care. When perinatal care is fragmented or unavailable, excess morbidity and mortality may occur in pregnant women and newborns. OBJECTIVE: The objective of the study was to describe spatial relationships between women of reproductive age, individual perinatal subspecialists (maternal-fetal medicine and neonatology), and obstetric and neonatal critical care facilities in the United States to identify gaps in health care access...
October 20, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27773531/recommendations-about-pregnancy-from-women-with-mobility-disability-to-their-peers
#11
Lisa I Iezzoni, Amy J Wint, Suzanne C Smeltzer, Jeffrey L Ecker
BACKGROUND: Although growing numbers of women with mobility disability are becoming pregnant and desiring motherhood, relatively little is known about their pregnancy experiences or what they might recommend to other women with mobility disability contemplating pregnancy. METHODS: Using a semistructured, open-ended interview protocol, we conducted 2-hour telephone interviews with 22 women who had a significant mobility disability before becoming pregnant and had delivered babies within the prior 10 years...
October 20, 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/27769193/maternal-near-miss-and-quality-of-care-in-a-rural-rwandan-hospital
#12
Richard Kalisa, Stephen Rulisa, Thomas van den Akker, Jos van Roosmalen
BACKGROUND: The WHO Maternal Near Miss (MNM) approach was developed to evaluate and improve quality of obstetric care worldwide. This study aimed to study the incidence of MNM and quality of care at a district hospital in rural Rwanda by applying this approach. METHODS: A facility based, prospective cohort study conducted at a district hospital in rural Rwanda between June 2013 and December 2014. Subjects were followed from time of admission to discharge or death...
October 21, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27762469/medical-emergency-team-may-reduce-obstetric-intensive-care-unit-admissions
#13
Moon Seong Baek, Jeongsuk Son, Jin Won Huh, Chae-Man Lim, Younsuck Koh, Hye-Sung Won, Jae-Yoon Shim, Sang-Bum Hong
AIM: Some recent studies have reported that early intervention by a medical emergency team (MET) for clinical deterioration before intensive care unit (ICU) admission was associated with a survival benefit in critically ill cancer patients. We hypothesized that early MET intervention for an obstetric crisis in the general wards would be related to favorable outcomes in critically ill obstetric patients. METHODS: Data of obstetric patients who were managed by a MET were collected retrospectively from 1 March 2008 to 30 April 2015...
October 20, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27759743/perioperative-and-periprocedural-airway-management-and-respiratory-safety-for-the-obese-patient-2016-siaarti-consensus
#14
Flavia Petrini, Ida Di Giacinto, Rita Cataldo, Clelia Esposito, Vittorio Pavoni, Paolo Donato, Antonella Trolio, Guido Merli, Massimiliano Sorbello, Paolo Pelosi
Proper management of obese patients requires a team vision and appropriate behaviors by all health care providers in hospital. Specialist competencies are fundamental, as are specific clinical pathways and good clinical practices designed to deal with patients whose body mass index is ≥30 kg/m2. Standards of care for bariatric and non-bariatric surgery and for the critical care management of this population exist but are not well defined nor clearly followed in every hospital. Thus every anesthesiologist is likely to deal with this challenging population...
October 19, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27751799/performance-of-the-obstetric-early-warning-score-in-critically-ill-patients-for-the-prediction-of-maternal-death
#15
Angel Paternina-Caicedo, Jezid Miranda, Ghada Bourjeily, Andrew Levinson, Carmelo Dueñas, Camilo Bello Muñoz, José A Rojas-Suarez
BACKGROUND: Every day, about 830 women die worldwide from preventable causes related to pregnancy and childbirth. Obstetric early-warning scores have been proposed as a potential tool to reduce maternal morbidity and mortality, based upon the identification of predetermined abnormal values in the vital signs or laboratory parameters, to generate a rapid and effective medical response. Several early-warning scores have been developed for obstetrical patients, but the majority are the result of a clinical consensus rather than statistical analyses of clinical outcome measures (i...
October 14, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27720089/the-usefulness-of-the-apache-ii-score-in-obstetric-critical-care-a-structured-review
#16
Helen M Ryan, Sumedha Sharma, Laura A Magee, J Mark Ansermino, Karen MacDonell, Beth A Payne, Keith R Walley, Peter von Dadelszen
OBJECTIVE: To assess the performance of the Acute Physiology and Chronic Health Evaluation II (APACHE II) mortality prediction model in pregnant and recently pregnant women receiving critical care in low-, middle-, and high-income countries during the study period (1985-2015), using a structured literature review. DATA SOURCES: Ovid MEDLINE, Embase, Web of Science, and Evidence-Based Medicine Reviews, searched for articles published between 1985 and 2015. STUDY SELECTION: Twenty-five studies (24 publications), of which two were prospective, were included in the analyses...
October 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27684414/prognostic-accuracy-of-antenatal-neonatology-consultation
#17
S Kukora, N Gollehon, G Weiner, N Laventhal
OBJECTIVE: Neonatologists provide antenatal counseling to support shared decision-making for complicated pregnancies. Poor or ambiguous prognostication can lead to inappropriate treatment and parental distress. We sought to evaluate the accuracy of antenatal prognosticaltion. STUDY DESIGN: A retrospective cohort was assembled from a prospectively populated database of all outpatient neonatology consultations. On the basis of the written consultation, fetuses were characterized by diagnosis groups (multiple anomalies or genetic disorders, single major anomaly and obstetric complications), assigned to five prognostic categories (I=survivable, IIA=uncertain but likely survivable, II=uncertain, IIB=uncertain but likely non-survivable, III non-survivable) and two final outcome categories (fetal demise/in-hospital neonatal death or survival to hospital discharge)...
September 29, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27680693/an-integrative-review-on-women-living-with-obstetric-fistula-and-after-treatment-experiences
#18
Hannah Mafo Degge, Mark Hayter, Mary Laurenson
AIM AND OBJECTIVES: To review literature on the experiences of women with obstetric fistula, their lived experiences after treatment; and to provide evidence for future research. BACKGROUND: Obstetric fistula is an injury most commonly resulting from a prolonged labour. Long eradicated in developed countries, obstetric fistula remains a public health issue in sub-Saharan Africa and Asia. This is a highly stigmatised health condition, and an understanding of the women's experience is required to inform holistic approaches for care and prevention...
September 29, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27661653/practice-bulletin-no-170-critical-care-in-pregnancy
#19
(no author information available yet)
Critical care in pregnancy is a field that remains unevenly researched. Although there is a body of evidence to guide many recommendations in critical care, limited research specifically addresses obstetric critical care. The purpose of this document is to review the available evidence, propose strategies for care, and highlight the need for additional research. Much of the review will, of necessity, focus on general principles of critical care, extrapolating where possible to obstetric critical care.
October 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27661645/practice-bulletin-no-170-summary-critical-care-in-pregnancy
#20
(no author information available yet)
Critical care in pregnancy is a field that remains unevenly researched. Although there is a body of evidence to guide many recommendations in critical care, limited research specifically addresses obstetric critical care. The purpose of this document is to review the available evidence, propose strategies for care, and highlight the need for additional research. Much of the review will, of necessity, focus on general principles of critical care, extrapolating where possible to obstetric critical care.
October 2016: Obstetrics and Gynecology
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