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https://www.readbyqxmd.com/read/29791501/stillbirths-in-urban-guinea-bissau-a-hospital-and-community-based-study
#1
Morten Bjerregaard-Andersen, Najaaraq Lund, Anne Sofie Pinstrup Joergensen, Frida Starup Jepsen, Holger Werner Unger, Mama Mane, Amabelia Rodrigues, Staffan Bergström, Christine Stabell Benn
BACKGROUND: Stillbirth rates remain high in many low-income settings, with fresh (intrapartum) stillbirths accounting for a large part due to limited obstetrical care. We aimed to determine the stillbirth rate and identify potentially modifiable factors associated with stillbirth in urban Guinea-Bissau. METHODS: The study was carried out by the Bandim Health Project (BHP), a Health and Demographic Surveillance System site in the capital Bissau. We assessed stillbirth rates in a hospital cohort consisting of all deliveries at the maternity ward at the National Hospital Simão Mendes (HNSM), and in a community cohort, which only included women from the BHP area...
2018: PloS One
https://www.readbyqxmd.com/read/29788769/audit-of-intrapartum-care-based-on-the-national-guideline-for-midwifery-and-birth-services
#2
Sonia Minooee, Masoumeh Simbar, Zohreh Sheikhan, Hamid Alavi Majd
Providing high-quality maternity care is a worldwide health concern that necessitates regular assessment of intrapartum practice. In an observational study, we aimed to audit intrapartum care based on the National Guideline for Midwifery and Birth Services. Using quota sampling, a total of 200 pregnant women, admitted for normal vaginal delivery, were recruited from four educational hospitals in Tehran, Iran. An observational checklist was developed based on the national guideline to assess the quality of provided care...
January 1, 2018: Evaluation & the Health Professions
https://www.readbyqxmd.com/read/29777635/reducing-the-number-of-obstetrical-beds-by-challenging-traditions
#3
Camilla Dalby Salvig, Marie Højriis Storkholm, Jannie Dalby Salvig, Niels Uldbjerg
The aim of this commentary is to describe changes in women care at an obstetric department that made it possible to reduce the number of beds from 40 to 29. Patient pathways were reviewed and revised using lean methodology. The mean length of stay was reduced from 70 to 59 hours and the mean numbers of hospitalizations per woman from 1.26 to 1.20. At the organizational level, we introduced a Family Department, home management of newborns, home monitoring of the women with cardiotocography and blood samples, and intrapartum Group B Streptococcus-PCR...
May 19, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29760273/what-influences-success-in-family-medicine-maternity-care-education-programs-qualitative-exploration
#4
Anne Biringer, Milena Forte, Anastasia Tobin, Elizabeth Shaw, David Tannenbaum
OBJECTIVE: To ascertain how program leaders in family medicine characterize success in family medicine maternity care education and determine which factors influence the success of training programs. DESIGN: Qualitative research using semistructured telephone interviews. SETTING: Purposive sample of 6 family medicine programs from 5 Canadian provinces. PARTICIPANTS: Eighteen departmental leaders and program directors...
May 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29759976/missed-opportunities-for-prevention-of-vertical-hiv-transmission-in-canada-1997-2016-a-surveillance-study
#5
Ari Bitnun, Terry Lee, Jason Brophy, Lindy M Samson, Fatima Kakkar, Wendy Vaudry, Ben Tan, Deborah M Money, Joel Singer, Laura J Sauvé, Ariane Alimenti
BACKGROUND: Vertical HIV transmission has declined in Canada, but missed opportunities for prevention continue to occur. We sought to determine the adequacy, and changes over time in adequacy, of uptake of maternal and neonatal antiretroviral therapy for the prevention of vertical HIV transmission, and to determine the vertical transmission rate over time and according to adequacy of antenatal antiretroviral therapy during the combination antiretroviral therapy era in Canada. METHODS: The Canadian Perinatal HIV Surveillance Program collects data annually through retrospective chart review concerning HIV-infected women and their infants...
May 10, 2018: CMAJ Open
https://www.readbyqxmd.com/read/29750952/glucostabilizer%C3%A2-software-guided-insulin-dosing-improves-intrapartum-glycemic-management-in-women-with-diabetes
#6
Cheryl Dinglas, Jolene Muscat, Tracy Adams, Virginia Peragallo-Dittko, Anthony Vintzileos, Hye J Heo
BACKGROUND: During labor, maintenance of maternal euglycemia is critical to decrease the risk of neonatal hypoglycemia and associated morbidities. When continuous intravenous insulin infusion is needed, standardized insulin dosing charts have been used for titration of insulin to maintain glucose in target range. GlucoStabilizer™ is a software-guided insulin dosing system that calculates the dose of intravenous insulin needed based on metabolic parameters, target glucose concentration, and an individual's response to insulin...
May 8, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29731602/universal-rapid-human-immunodeficiency-virus-screening-at-delivery-a-cost-effectiveness-analysis
#7
Rachel K Scott, Stacia Crochet, Chun-Chih Huang
Objective: To determine the cost-effectiveness of universal maternal HIV screening at time of delivery to decrease mother-to-child transmission (MTCT), by comparing the cost and quality-adjusted life years (QALYs) of universal rapid HIV screening at time of delivery to two current standards of care for prenatal HIV screening in the United States. Study Design: We conducted a cost-effectiveness analysis to compare the cost and QALY of universal intrapartum rapid HIV screening with two current standards of care: (I) opt-out rapid HIV testing limited to patients without previous third-trimester screening and (II) opt-out rapid HIV testing limited to patients without any prenatal screening...
2018: Infectious Diseases in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29729217/improving-care-for-women-with-obstetric-fistula-new-who-recommendation-on-duration-of-bladder-catheterization-after-the-surgical-repair-of-a-simple-obstetric-urinary-fistula
#8
Mariana Widmer, Özge Tunçalp, Maria Regina Torloni, Olufemi T Oladapo, Maurice Bucagu, A Metin Gülmezoglu
Under the Sustainable Development Goals (SDGs) and universal health coverage, the "survive, thrive, transform" agenda moves beyond reducing mortality and focuses on the importance of maternal morbidity.(1 ) An obstetric fistula, one of the most devastating types of maternal morbidity, is usually caused by injury during childbirth from prolonged or obstructed labour. The prolonged compression of the fetal head against the pelvic bones can cause ischaemic necrosis of parts of the bladder, urethra or vagina, resulting in an abnormal opening between a woman's genital tract and her urinary tract that leads to the continuous flow of urine through the vagina...
May 5, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29728142/intermittent-fetal-heart-rate-monitoring-using-a-fetoscope-or-hand-held-doppler-in-rural-tanzania-a-randomized-controlled-trial
#9
Paschal Francis Mdoe, Hege L Ersdal, Estomih R Mduma, Jeffrey M Perlman, Robert Moshiro, Peter T Wangwe, Hussein Kidanto
BACKGROUND: Neonatal mortality is a global challenge, with an estimated 1.3 million intrapartum stillbirths in 2015. The majority of these were found in low resource settings with limited options to intrapartum fetal heart monitoring devices. This trial compared frequency of abnormal fetal heart rate (FHR) detection and adverse perinatal outcomes (i.e. fresh stillbirths, 24-h neonatal deaths, admission to neonatal care unit) among women intermittently assessed by Doppler or fetoscope in a rural low-resource setting...
May 4, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29724169/development-of-a-melting-curve-based-multiplex-real-time-pcr-assay-for-simultaneous-detection-of-streptococcus-agalactiae-and-genes-encoding-resistance-to-macrolides-and-lincosamides
#10
Eliane Saori Otaguiri, Ana Elisa Belotto Morguette, Alexandre Tadachi Morey, Eliandro Reis Tavares, Gilselena Kerbauy, Rosângela S L de Almeida Torres, Mauricio Chaves Júnior, Maria Cristina Bronharo Tognim, Viviane Monteiro Góes, Marco Aurélio Krieger, Marcia Regina Eches Perugini, Lucy Megumi Yamauchi, Sueli Fumie Yamada-Ogatta
BACKGROUND: Streptococcus agalactiae or Group B Streptococcus (GBS) remains the leading cause of infections in newborns worldwilde. Prenatal GBS screening of pregnant women for vaginal-rectal colonization is recommended in many countries to manage appropriate intrapartum antimicrobial prophylaxis for those identified as carriers. In this study, a novel melting-curve based multiplex real-time PCR assay for the simultaneous detection of GBS and macrolide and lincosamide resistance markers was developed...
May 3, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29720201/creating-a-positive-perception-of-childbirth-experience-systematic-review-and-meta-analysis-of-prenatal-and-intrapartum-interventions
#11
REVIEW
Mahshid Taheri, Amirhossien Takian, Ziba Taghizadeh, Nahid Jafari, Nasrin Sarafraz
BACKGROUND: A negative experience in childbirth is associated with chronic maternal morbidities. The aim of this systematic review and meta-analysis was to identify currently available successful interventions to create a positive perception of childbirth experience which can prevent psychological birth trauma. METHODS: Randomized controlled trials of interventions in pregnancy or labour which aimed to improve childbirth experience versus usual care were identified from 1994 to September 2016...
May 2, 2018: Reproductive Health
https://www.readbyqxmd.com/read/29710738/medico-legal-implications-of-hypothermic-neuroprotection-in-the-newborn
#12
S M Donn, J M Fanaroff
Hypoxic-ischemic encephalopathy (HIE) continues to be a significant source of long term neurological sequelae in infants born at or near term. In the past decade, selective head or whole body cooling has shown promising benefit in ameliorating some of the brain injury from intrapartum asphyxial insults and has become standard care in most developed countries. A decision to offer neuroprotective hypothermia (NPH) may engender subsequent litigation because it presupposes an acute intrapartum injury. Conversely, failing to offer cooling may be interpreted as a violation in the standard of care...
April 24, 2018: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/29709773/midwives-knowledge-attitudes-and-learning-needs-regarding-antenatal-vaccination
#13
Annette K Regan, Yvonne Hauck, Lisa Nicolaou, Danielle Engelbrecht, Janice Butt, Donna B Mak, Rikki Priest, Ronit Cukierman, Paul V Effler
OBJECTIVE: To determine the knowledge, attitudes and learning needs of midwives regarding antenatal vaccination. DESIGN AND SETTING: A cross-sectional, paper-based survey of midwives employed at the only public tertiary maternity hospital in the Australian state of Western Australia between November 2015 and July 2016. PARTICIPANTS: 252 midwives providing care in antepartum, intrapartum, and/or postpartum settings. MEASUREMENTS: Self-reported responses to a 41-item survey...
April 10, 2018: Midwifery
https://www.readbyqxmd.com/read/29680084/no-197b-fetal-health-surveillance-intrapartum-consensus-guideline
#14
Robert Liston, Diane Sawchuck, David Young
OBJECTIVE: This guideline provides new recommendations pertaining to the application and documentation of fetal surveillance in the intrapartum period that will decrease the incidence of birth asphyxia while maintaining the lowest possible rate of obstetrical intervention. Pregnancies with and without risk factors for adverse perinatal outcomes are considered. This guideline presents an alternative classification system for antenatal fetal non-stress testing and intrapartum electronic fetal surveillance to what has been used previously...
April 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29664907/what-matters-to-women-during-childbirth-a-systematic-qualitative-review
#15
Soo Downe, Kenneth Finlayson, Olufemi Oladapo, Mercedes Bonet, A Metin Gülmezoglu
INTRODUCTION: Design and provision of good quality maternity care should incorporate what matters to childbearing women. This qualitative systematic review was undertaken to inform WHO intrapartum guidelines. METHODS: Using a pre-determined search strategy, we searched Medline, CINAHL, PsycINFO, AMED, EMBASE, LILACS, AJOL, and reference lists of eligible studies published 1996-August 2016 (updated to January 2018), reporting qualitative data on womens' childbirth beliefs, expectations, and values...
2018: PloS One
https://www.readbyqxmd.com/read/29662280/effects-of-epidural-labour-analgesia-in-mother-and-foetus
#16
Varsha Laxmikant Deshmukh, Shaswatee S Ghosh, Kanan A Yelikar, Shreeniwas N Gadappa
Objective: Aim of study was to determine effect of epidural analgesia on progress of labour and mode of delivery, to find out its complications in labour and puerperium and to evaluate neonatal outcome in terms of APGAR score. Method: The present study was conducted in Department of Obstetrics and Gynaecology at Government Medical College Aurangabad over period of 2 years from June 2014 to June 2016 after taking approval from institutional ethical board. Hundred low-risk primigravidas were included in the study, 50 women received epidural analgesia for relief of labour pain at 3-4 cm and 50 women served as control...
April 2018: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/29661167/creating-an-optimality-index-netherlands-a-validation-study
#17
Suzanne M Thompson, Marianne J Nieuwenhuijze, Luc Budé, Raymond de Vries, Lisa Kane Low
BACKGROUND: At present, the maternity care system in the Netherlands is being reorganized into an integrated model of care, shifting the focus of midwives to include increasing numbers of births in hospital settings and clients with medium risk profiles. In light of these changes, it is useful for midwives to have a tool which may help them in reflecting upon care practices that promote physiological childbirth practices. The Optimality Index-US is an evidence based tool, designed to measure optimal perinatal care processes and outcomes...
April 16, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29655994/peripartum-anaesthetic-management-of-a-patient-with-brugada-syndrome-and-myoadenylate-deaminase-deficiency
#18
H Dawe, R Wendler, E Evans, S Hammond
Brugada syndrome is a rare electrophysiological cardiac disease which can result in serious arrhythmias and sudden cardiac death. Peripartum management is centred around avoiding arrhythmogenic drugs, including high doses of sodium channel blocking drugs such as bupivacaine. Myoadenylate deaminase deficiency, also known as adenosine monophosphate deaminase deficiency, is the commonest cause of myopathy in Caucasians. There is evidence that myoadenylate deaminase deficiency can predispose patients to developing malignant hyperthermia when exposed to specific anaesthetic agents...
March 2, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29655964/infant-outcome-after-complete-uterine-rupture
#19
Iqbal Al-Zirqi, Anne Kjersti Daltveit, Siri Vangen
BACKGROUND: Complete uterine rupture is a rare peripartum complication often associated with a catastrophic outcome for both mother and child. However, little has been written based on large data sets about maternal and infant outcome after complete ruptures. This is partly due to the rarity of the event and the serious maternal and infant outcome; it is also partly due to the use of international diagnostic codes that do not differentiate between the less catastrophic partial rupture and more catastrophic complete uterine rupture...
April 12, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29617838/improving-immediate-newborn-care-practices-in-philippine-hospitals-impact-of-a-national-quality-of-care-initiative-2008-2015
#20
Maria Asuncion A Silvestre, Priya Mannava, Marie Ann Corsino, Donna S Capili, Anthony P Calibo, Cynthia Fernandez Tan, John C S Murray, Jacqueline Kitong, Howard L Sobel
Objective: To determine whether intrapartum and newborn care practices improved in 11 large hospitals between 2008 and 2015. Design: Secondary data analysis of observational assessments conducted in 11 hospitals in 2008 and 2015. Setting: Eleven large government hospitals from five regions in the Philippines. Participants: One hundred and seven randomly sampled postpartum mother-baby pairs in 2008 and 106 randomly sampled postpartum mothers prior to discharge from hospitals after delivery...
March 31, 2018: International Journal for Quality in Health Care
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