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Obstetrics critical care

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https://www.readbyqxmd.com/read/28545473/defining-disrespect-and-abuse-of-newborns-a-review-of-the-evidence-and-an-expanded-typology-of-respectful-maternity-care
#1
REVIEW
Emma Sacks
Amid increased attention to quality of obstetric care and respectful maternity care globally, insufficient focus has been given to quality of care and respectful care for newborns in the postnatal period. Especially in low and middle income countries, where low utilisation of obstetric and neonatal services is of concern, it is plausible that poor quality of care or mistreatment of newborns or stillborn infants will influence future care seeking, both for the health care needs of the growing infant and for subsequent pregnancies...
May 25, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28529087/a-critical-analysis-of-australian-policies-and-guidelines-for-water-immersion-during-labour-and-birth
#2
Megan Cooper, Helen McCutcheon, Jane Warland
BACKGROUND: Accessibility of water immersion for labour and/or birth is often dependent on the care provider and also the policies/guidelines that underpin practice. With little high quality research about the safety and practicality of water immersion, particularly for birth, policies/guidelines informing the practice may lack the evidence necessary to ensure practitioner confidence surrounding the option thereby limiting accessibility and women's autonomy. AIM: The aims of the study were to determine how water immersion policies and/or guidelines are informed, who interprets the evidence to inform policies/guidelines and to what extent the policy/guideline facilitates the option for labour and birth...
May 18, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/28515515/the-parturient-in-the-interventional-radiology-suite-new-frontier-in-obstetric-anaesthesia
#3
REVIEW
Tasneem Dhansura, Nabila Shaikh
The anaesthesiologist's presence during interventional radiology (IR) is increasing due to increasingly ill patients and intricate procedures. The management of a parturient in IR suite is complex in terms of logistics of an unfamiliar procedure in an unfamiliar area. The literature available is largely written by radiologists with little attention paid to anaesthetic details and considerations. In the Indian scenario, in the absence of hybrid operating rooms (ORs), logistics involve transport of a parturient back and forth between the IR suite and the OR...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28506952/retrospective-evaluation-of-pregnant-women-with-celiac-disease
#4
Kemal Beksaç, Gökçen Örgül, Murat Çağan, Ergun Karaağaoğlu, Serap Arslan, Mehmet Sinan Beksaç
OBJECTIVE: To show celiac disease (CD) and its poor pregnancy outcome relationship, and to demonstrate the importance of a gluten-free diet together with low-dose low-molecular-weight heparin (LMWH) and low-dose corticosteroid (LDC) in the management of pregnancies with CD. MATERIAL AND METHODS: This study consisted of 2 groups of patients. Six patients with CD (control group) on a gluten-free diet were monitored during their first pregnancies within the framework of antenatal care program and their pregnancy outcomes were compared with eight poorly-treated pregnant patients with CD (study group) who were referred from other medical institutions...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28426506/applications-of-noninvasive-hemodynamic-monitoring-in-obstetric-management
#5
John T Sullivan
Clinicians managing obstetric patients are dependent on valid hemodynamic measurements to guide care. Heart rate and noninvasive blood pressure guide most current care. New hemodynamic monitors are being used to report research findings and are being investigated by clinicians for their value to supplement standard monitoring. These include arterial pulse contour analysis, Doppler velocimetry, and bioimpedance among others. This chapter serves to present these new devices with a critical review of their advantages and limitations, and most importantly the validity of their measurements...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28421900/the-magnitude-and-factors-related-to-facility-based-maternal-mortality-in-mozambique
#6
Leonardo Chavane, Martinho Dgedge, Olivier Degomme, Osvaldo Loquiha, Marc Aerts, Marleen Temmerman
Facility-based maternal mortality remains an important public health problem in Mozambique. A number of factors associated with health system functioning can be described behind the occurrence of these deaths. This paper aimed to evaluate the magnitude of the health facility-based maternal mortality, its geographical distribution and to assess the health facility factors implicated in the occurrence of these deaths. A secondary analysis was done on data from the survey on maternal health needs performed by the Ministry of Health of Mozambique in 2008...
May 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28416176/maternal-early-warning-systems-towards-reducing-preventable-maternal-mortality-and-severe-maternal-morbidity-through-improved-clinical-surveillance-and-responsiveness
#7
Lisa C Zuckerwise, Heather S Lipkind
Despite increasing awareness of obstetric safety initiatives, maternal mortality and severe maternal morbidity in the United States have continued to increase over the past 20 years. Since results from large-scale surveillance programs suggest that up to 50% of maternal deaths may be preventable, new efforts are focused on developing and testing early warning systems for the obstetric population. Early warning systems are a set of specific clinical signs or symptoms that trigger the awareness of risk and an urgent patient evaluation, with the goal of reducing severe morbidity and mortality through timely diagnosis and treatment...
April 14, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28412917/is-there-a-teratogenicity-risk-associated-with-cannabis-and-synthetic-cannabimimetics-spice-intake
#8
Laura Orsolini, Duccio Papanti, John Corkery, Maria Antonietta De Luca, Cristina Cadoni, Gaetano Di Chiara, Fabrizio Schifano
BACKGROUND: Substance use, including cannabis, has been documented amongst women both in the pre-conception period and during pregnancy, particularly during the 1st trimester, which is clearly the most critical period in the organogenesis. The recent emergence on the drug market of synthetic cannabimimetics/SC ('spice') may represent a new challenge for clinicians. OBJECTIVE: A literature overview on the teratogenicity profile of both cannabis and synthetic cannabimimetics was here carried out...
April 13, 2017: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/28390255/exploring-the-needs-and-challenges-of-women-reintegrating-after-obstetric-fistula-repair-in-northern-ghana
#9
Kimberly Jarvis, Solina Richter, Helen Vallianatos
OBJECTIVE: to explore the cultural, social and economic needs and challenges of women in northern Ghana as they resume their day-to-day lives post obstetric fistula repair. DESIGN: a critical ethnographic approach. SETTING: a state run fistula treatment center in Tamale, northern Ghana, and 24 rural communities in northern Ghana. PARTICIPANTS: ninety-nine (N=99) participants were recruited using purposive, convenience and snowball sampling...
March 27, 2017: Midwifery
https://www.readbyqxmd.com/read/28355302/prevalence-of-caesarean-sections-in-enugu-southeast-nigeria-analysis-of-data-from-the-healthy-beginning-initiative
#10
Jayleen K L Gunn, John E Ehiri, Elizabeth T Jacobs, Kacey C Ernst, Sydney Pettygrove, Katherine E Center, Alice Osuji, Amaka G Ogidi, Nnabundo Musei, Michael C Obiefune, Chinenye O Ezeanolue, Echezona E Ezeanolue
BACKGROUND: In order to meet the Sustainable Development Goal to decrease maternal mortality, increased access to obstetric interventions such as Caesarean sections (CS) is of critical importance. As a result of women's limited access to routine and emergency obstetric services in Nigeria, the country is a major contributor to the global burden of maternal mortality. In this analysis, we aim to establish rates of CS and determine socioeconomic or medical risk factors associated with having a CS in Enugu, southeast Nigeria...
2017: PloS One
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#11
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323672/safety-interventions-on-the-labor-and-delivery-unit
#12
Rachel M Kacmar
PURPOSE OF REVIEW: The present review highlights recent advances in efforts to improve patient safety on labor and delivery units and well tolerated care for pregnant patients in general. RECENT FINDINGS: Recent studies in obstetric patient safety have a broad focus but repetitive themes for interdisciplinary training include: simulating critical events, having open multidisciplinary communication, frequent reviews of cases of maternal morbidity, and implementing maternal early warning systems...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#13
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28277367/executive-summary-of-the-revitalize-initiative-standardizing-gynecologic-data-definitions
#14
Howard T Sharp, Julia V Johnson, Lauren A Lemieux, Sean M Currigan
Effective care coordination across the women's health continuum is critically important. Unlike obstetric care, which tends to be more episodic and limited to pregnant and postpartum women, women receive health care, whether around pregnancy or for nonobstetric issues, in a variety of care settings by members of multiple health disciplines. Having access to standardized clinical data is imperative to providing optimal patient care. The reVITALize Gynecology Data Definitions Initiative leads a national multidisciplinary movement to offer standard gynecologic data definitions for use in written and verbal clinical communication, electronic health record data capture, quality improvement, and clinical research...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28277357/in-pursuit-of-progress-toward-effective-preterm-birth-reduction
#15
James N Martin, Mary DʼAlton, Bo Jacobsson, Jane E Norman
Recently the March of Dimes and the International Federation of Gynecology and Obstetrics Working Group on Preterm Birth released its findings from an extensive cross-country individual patient data analysis of 4.1 million singleton births in five high-income, very high human development index countries. The specific contributions of 21 risk factors for both spontaneous and health care provider-initiated preterm birth were assessed to better understand how these vary among the countries selected for intensive study...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28270884/critical-imperative-for-the-reform-of-british-interpretation-of-fetal-heart-rate-decelerations-analysis-of-figo-and-nice-guidelines-post-truth-foundations-cognitive-fallacies-myths-and-occam-s-razor
#16
REVIEW
Shashikant L Sholapurkar
Cardiotocography (CTG) has disappointingly failed to show good predictability for fetal acidemia or neonatal outcomes in several large studies. A complete rethink of CTG interpretation will not be out of place. Fetal heart rate (FHR) decelerations are the most common deviations, benign as well as manifestation of impending fetal hypoxemia/acidemia, much more commonly than FHR baseline or variability. Their specific nomenclature is important (center-stage) because it provides the basic concepts and framework on which the complex "pattern recognition" of CTG interpretation by clinicians depends...
April 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28244641/resident-consultant-obstetrician-presence-on-the-labour-ward-versus-other-models-of-consultant-cover-a-systematic-review-of-intrapartum-outcomes
#17
REVIEW
J Henderson, J J Kurinczuk, M Knight
BACKGROUND: Several key policy documents have advocated 24-hour consultant obstetrician presence on the labour ward as a means of improving the safety of birth. However, it is unclear what published evidence exists comparing the outcomes of intrapartum care with 24-hour consultant labour ward presence and other models of consultant cover. OBJECTIVES: To collate and critically appraise evidence of the effect of continuous resident consultant obstetrician cover on the labour ward on outcomes of intrapartum care compared with other models of consultant cover...
February 28, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28225422/clinical-updates-in-women-s-health-care-summary-structural-heart-disease-primary-and-preventive-care-review
#18
Tiberio Frisoli, Michele Doughty Voeltz
Reproductive-aged women with structural heart disease who become pregnant as well as postreproductive-aged women with this condition represent a significant proportion of patients seen by obstetrician- gynecologists. Usually, their conditions are complex, and a basic knowledge of the anatomy and physiology of the heart is required. Additionally, understanding the effect of pregnancy on women with structural heart disease is critically important to optimizing maternal and fetal outcomes. This monograph addresses the pathophysiology, signs and symptoms, screening and diagnosis, basic management, and suggested counseling for an obstetric-gynecologic patient with structural heart disease...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28219965/a-public-health-response-to-opioid-use-in-pregnancy
#19
Stephen W Patrick, Davida M Schiff
The use of opioids during pregnancy has grown rapidly in the past decade. As opioid use during pregnancy increased, so did complications from their use, including neonatal abstinence syndrome. Several state governments responded to this increase by prosecuting and incarcerating pregnant women with substance use disorders; however, this approach has no proven benefits for maternal or infant health and may lead to avoidance of prenatal care and a decreased willingness to engage in substance use disorder treatment programs...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28214925/missed-opportunities-in-neonatal-deaths-in-rwanda-applying-the-three-delays-model-in-a-cross-sectional-analysis-of-neonatal-death
#20
Efua Wilmot, Marcel Yotebieng, Alison Norris, Fidele Ngabo
Objective Administered in a timely manner, current evidence-based interventions could reduce neonatal deaths from infections, intrapartum injuries and complications due to prematurity. The three delays model (delay in seeking care, in arriving at a health facility, and in receiving adequate care), which has been applied to understanding maternal deaths, may be useful for understanding neonatal deaths. We assess the main causes of neonatal deaths in Rwanda and their associated delays. Methods Using a cross-sectional study design, we evaluated data from 2012 from 40 facilities in which babies were delivered...
February 18, 2017: Maternal and Child Health Journal
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