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Obstetrics critical care

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https://www.readbyqxmd.com/read/29454125/management-of-skull-base-tumors-in-the-obstetric-population-a-case-series
#1
Blake H Priddy, Bradley A Otto, Ricardo L Carrau, Daniel M Prevedello
BACKGROUND: Neoplasms rarely present during pregnancy. However, increase in plasma volume, hormone release induced growth, and tumor hypervascularity, can cause rapid symptoms. These range from not requiring intervention to necessitating emergent operations. OBJECTIVE: We describe an algorithm for the management of symptomatic neoplasm in the obstetric population, and provide recommendations regarding surgical indications and timing. METHODS: Patients who presented to a skull base clinic from 2010-2016 at large tertiary care hospital were reviewed to identify patients who presented with a skull base tumor during pregnancy...
February 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29422727/pattern-and-outcome-of-obstetric-admissions-into-the-intensive-care-unit-of-a-southeast-nigerian-hospital
#2
Benjamin Chukwuma Ozumba, Leonard Ogbonna Ajah, Vitus Okwuchukwu Obi, Uche Anthony Umeh, Joseph Tochukwu Enebe, Kingsley Chukwu Obioha
Background and Aims: Although pregnancy and labor are considered physiological processes, the potential for catastrophic complications is constant and may develop rapidly. There is growing evidence that admission of high-risk patients into the Intensive Care Unit (ICU) is associated with a reduction in maternal mortality. This study was aimed at reviewing all obstetric patients admitted into the ICU. Materials and Methods: This was a retrospective study of all obstetric patients who were admitted into the ICU between January 1, 2012, and December 31, 2013...
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29422404/new-challenges-for-a-core-procedure-development-of-a-faculty-workshop-for-skills-maintenance-for-abdominal-hysterectomy
#3
Lori R Berkowitz, Kaitlyn James, Emil Petrusa, Carey York-Best, Anjali J Kaimal
OBJECTIVE: To describe the development of a low-cost educational module for OB/GYN faculty skills maintenance for total abdominal hysterectomy (TAH), a low frequency core procedure in obstetrics and gynecology. DESIGN: After review of existing educational tools and utilization of a modified Delphi method to establish consensus regarding key procedural components for skills maintenance, a 2-hour workshop was developed to review knowledge and participate in a simulation focused on the critical steps in performing TAH...
February 5, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29422154/audit-for-quality-of-care-and-fate-of-maternal-critical-cases-at-women-s-health-hospital
#4
Howieda Fouly, Fayza Ahmed Abdou, Ahmed M Abbas, Ayat Masoud Omar
Maternal deaths remain high, numbers at the facility level are relatively low. AIM: To evaluate effect of management guidelines on occurrence of maternal near miss in Women's Health Hospital. DESIGN: A cross-sectional study. SETTING: ICU of Women's Health Hospital's at Assiut Main University Hospital and Al-fayoum University Hospital. SUBJECTS: Convenient sample of 93 maternal near-miss cases including (Pregnancy or postpartum complications)...
February 2018: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/29415634/too-long-to-wait-obstetric-fistula-and-the-sociopolitical-dynamics-of-the-fourth-delay-in-soroti-uganda
#5
Bonnie Ruder, Melissa Cheyney, Alice Aturo Emasu
Uganda has one of the highest obstetric fistula rates in the world with approximately 200,000 women currently suffering. Surgical closure successfully treats fistula in the majority of cases, yet there is a severe shortage of facilities and trained surgeons in low-resource countries. The purpose of this study was to examine Ugandan women's experiences of obstetric fistula with the aim of adding narrative depth to the clinical literature on this devastating birth injury. Data were collected through semistructured interviews, focus groups, and participant observation...
February 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29408749/comparison-of-maternal-and-neonatal-outcomes-for-patients-with-placenta-accreta-spectrum-between-online-to-offline-management-model-with-standard-care-model
#6
Wen Sun, Lin Yu, Shiliang Liu, Yanhong Chen, Juanjuan Chen, Shi Wu Wen, Dunjin Chen
OBJECTIVE: Online-to-offline is a new model for emergent medical service with the ability to connect care providers with patients on instant basis. This study aims to evaluate maternal and neonatal outcomes in patients with placenta accreta spectrum managed by an online-to-offline care model. METHODS: Starting from January 1, 2015, management of patients with placenta accreta spectrum was changed from standard care model into an online-to-offline care model through "Wechat" in Guangzhou Medical Centre for Critical Obstetrical Care...
February 2, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29366711/screening-for-recommended-antenatal-risk-factors-how-long-does-it-take
#7
Amy Waller, Jamie Bryant, Emilie Cameron, Mohamed Galal, Ian Symonds, Rob Sanson-Fisher
BACKGROUND: Detection and management of antenatal risk factors is critical for quality care. AIMS: To determine (1) women's views about when they should be asked about antenatal health factors as recommended in the Australian antenatal guidelines; and (2) the time required to provide recommended care using a clinical scenario. METHODS: In Phase 1, pregnant women attending an outpatient obstetrics clinic at a public hospital were surveyed about preferred screening for antenatal risk factors during visit(s)...
January 20, 2018: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/29324608/quality-assurance-practices-in-obstetric-care-a-survey-of-hospitals-in-california
#8
Lisbet S Lundsberg, Henry C Lee, Grace Villarin Dueñas, Kimberly D Gregory, Holly K Grossetta Nardini, Christian M Pettker, Jessica L Illuzzi, Xiao Xu
OBJECTIVE: To assess hospital practices in obstetric quality management activities and identify institutional characteristics associated with utilization of evidence-supported practices. METHODS: Data for this study came from a statewide survey of obstetric hospitals in California regarding their organization and delivery of perinatal care. We analyzed responses from 185 hospitals that completed quality assurance sections of the survey to assess their practices in a broad spectrum of quality enhancement activities...
February 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29320998/the-perceptions-and-experiences-of-women-who-achieved-and-did-not-achieve-a-waterbirth
#9
Lucy Lewis, Yvonne L Hauck, Caroline Crichton, Courtney Barnes, Corrinne Poletti, Helen Overing, Louise Keyes, Brooke Thomson
BACKGROUND: There is a gap in knowledge and understanding relating to the experiences of women exposed to the opportunity of waterbirth. Our aim was to explore the perceptions and experiences of women who achieved or did not achieve their planned waterbirth. METHODS: An exploratory design using critical incident techniques was conducted between December 2015 and July 2016, in the birth centre of the tertiary public maternity hospital in Western Australia. Women were telephoned 6 weeks post birth...
January 10, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29319760/acute-kidney-injury-in-critically-ill-obstetric-patients-a-cross-sectional-study-in-an-intensive-care-unit-in-northeast-brazil
#10
Geraldo Bezerra da Silva Junior, Suzanne Vieira Saintrain, Gabriel de Castro Castelo, Vanessa Ribeiro de Vasconcelos, Juliana Gomes Ramalho de Oliveira, Amanda Maria Timbó Rocha, Adolfo Gomes Vasconcelos Júnior, Maria Vieira de Lima Saintrain, Elizabeth De Francesco Daher
INTRODUCTION: Acute kidney injury (AKI) is a complication still poorly studied in the setting of obstetric patients, which is associated with increased mortality. Objective: The aim of this study was to investigate the frequency and risk factors of AKI among critically ill obstetric patients. METHODS: A cross-sectional study was conducted with all patients admitted to an intensive care unit (ICU) due to obstetric complications, in Fortaleza, Brazil, in the period between January 2012 and December 2014...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29310986/multidisciplinary-obstetric-critical-care-delivery-the-concept-of-the-virtual-intensive-care-unit
#11
REVIEW
Michael P Leovic, Hailey N Robbins, Roman S Starikov, Michael R Foley
With an increasing prevalence of chronic medical conditions and the associated potential for decompensation to critical illness among modern day parturients, we present here the concept of the "virtual" intensive care unit. We challenge the traditional association of the word "unit" to extend beyond a fixed physical setting to portray an individualized, predetermined patient care team capable of managing these complex patients in a variety of settings. In this model, obstetric critical care is provided through a multidisciplinary patient care team, with emphasis on early identification of complicated pregnancies, detailed antepartum planning, anticipation of complications, and retrospective review of clinical outcomes aimed at continued quality improvement...
January 5, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29212509/incremental-cost-and-cost-effectiveness-of-low-dose-high-frequency-training-in-basic-emergency-obstetric-and-newborn-care-as-compared-to-status-quo-part-of-a-cluster-randomized-training-intervention-evaluation-in-ghana
#12
Michelle Willcox, Heather Harrison, Amos Asiedu, Allyson Nelson, Patricia Gomez, Amnesty LeFevre
BACKGROUND: Low-dose, high-frequency (LDHF) training is a new approach best practices to improve clinical knowledge, build and retain competency, and transfer skills into practice after training. LDHF training in Ghana is an opportunity to build health workforce capacity in critical areas of maternal and newborn health and translate improved capacity into better health outcomes. METHODS: This study examined the costs of an LDHF training approach for basic emergency obstetric and newborn care and calculates the incremental cost-effectiveness of the LDHF training program for health outcomes of newborn survival, compared to the status quo alternative of no training...
December 6, 2017: Globalization and Health
https://www.readbyqxmd.com/read/29202731/economic-evaluation-of-emergency-obstetric-care-training-a-systematic-review
#13
Aduragbemi Banke-Thomas, Megan Wilson-Jones, Barbara Madaj, Nynke van den Broek
BACKGROUND: Training healthcare providers in Emergency Obstetric Care (EmOC) has been shown to be effective in improving their capacity to provide this critical care package for mothers and babies. However, little is known about the costs and cost-effectiveness of such training. Understanding costs and cost-effectiveness is essential in guaranteeing value-for-money in healthcare spending. This study systematically reviewed the available literature on cost and cost-effectiveness of EmOC trainings...
December 4, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29181330/evaluation-of-admission-indications-clinical-characteristics-and-outcomes-of-obstetric-patients-admitted-to-the-intensive-care-unit-of-a-teaching-hospital-center-a-five-year-retrospective-review
#14
Farnoush Farzi, Ali Mirmansouri, Zahra Atrkar Roshan, Bahram Naderi Nabi, Gelareh Biazar, Shima Yazdipaz
Background: Care of obstetric patients has always been a challenge for critical care physicians, because in addition to their complex pregnancy-related disease, fetal viability is considered. Objectives: The aim of this study was to review the admission indications, clinical characteristics and outcomes of obstetric patients, admitted to the intensive care unit of Alzzahra teaching hospital affiliated to Guilan University of Medical Sciences, Rasht, Iran. Methods: This retrospective cohort study was conducted on pregnant /post-partum (up to 6 weeks) patients admitted to the ICU over a 5-year period from April 2009 to April, 2014...
June 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29179955/the-utility-of-bedside-simulation-for-training-in-critical-care-obstetrics
#15
REVIEW
Jean-Ju Sheen, Colleen Lee, Dena Goffman
Over the last 2 decades, the maternal mortality ratio in the United States has doubled from 7.4/100,000 live births in 1986 to 14.5/100,000 today. Despite great advances in health care, increasing rates of maternal morbidity and mortality in the United States have prompted calls to action to reverse this disturbing trend. Assisted reproductive technology has allowed women to delay childbearing to more advanced ages, resulting in a greater number of pregnancies complicated by one or more of the diseases associated with aging, such as cardiovascular disease, cancer, type 2 diabetes, and hypertension...
November 24, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/29156486/-update-in-obstetric-anesthesia-tried-and-trusted-methods-controversies-and-new-perspectives
#16
Peter Kranke, Thorsten Annecke, Dorothee H Bremerich, Daniel Chappell, Thierry Girard, Wiebke Gogarten, Robert Hanß, Lutz Kaufner, Sophie Neuhaus, Tobias Ninke, Thomas Standl, Stefan Weber, Yvonne Jelting, Thomas Volk
Since 1975, a plethora of lectures within the context of annual meetings relevant for the clinical care has been summarized in "what's new in obstetric anesthesia" by the society for Obstetric anesthesia and Perinatology which can be recommended to everyone interested in anaesthesiology in the delivery room. After the death of Gerard W. Ostheimer, Professor of Anaesthesiology at Brigham and Women's Hospital in Boston, Massachusetts, it became renamed the Gerard W. Ostheimer "what's new in obstetric anesthesia" lecture to honor his contributions to regional anesthesia and obstetric anaesthesia...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#17
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29143614/composite-measures-of-women-s-empowerment-and-their-association-with-maternal-mortality-in-low-income-countries
#18
Chiao-Wen Lan, Paula Tavrow
BACKGROUND: Maternal mortality has declined significantly since 1990. While better access to emergency obstetrical care is partially responsible, women's empowerment might also be a contributing factor. Gender equality composite measures generally include various dimensions of women's advancement, including educational parity, formal employment, and political participation. In this paper, we compare several composite measures to assess which, if any, are associated with maternal mortality ratios (MMRs) in low-income countries, after controlling for other macro-level and direct determinants...
November 8, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29141482/obstetric-practice-guidelines-labor-s-love-lost
#19
Wayne R Cohen, Emanuel A Friedman
Implementation of clinical practice guidelines may moderate health care costs, improve care, reduce medicolegal liability, and provide a uniformity in care allowing meaningful investigation of treatments and outcomes. However, new guidelines are often uncritically embraced by clinicians, risk management organizations, insurance companies, and the courts as the standard of care. Adoption of incompletely vetted recommendations can lead to patient harm. Recent recommendations made by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine for assessment and management of labor provide an example of well-intended guidelines adopted uncritically...
November 15, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29122228/-depressive-symptoms-and-psychosocial-risk-factors-in-high-complexity-obstetric-patients-admitted-to-a-critical-care-obstetric-unit-in-cali-colombia
#20
Ana María Guerra, Diana María Dávalos Pérez, Alejandro Castillo Martínez
Depression is the main cause of years lossed due to disability in the world, and it affects 50% more women 50% than men. Perinatal depression has been linked with more anxiety, a chronic course, and disability than depression in other life stages. In spite of its high prevalence and serious health effects on both mother and foetus, it is frequently under-diagnosed. This study was performed on all high risk obstetric patients admitted to a critical care obstetric unit in Cali, Colombia, from January to June, 2014...
October 2017: Revista Colombiana de Psiquiatría
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