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https://www.readbyqxmd.com/read/28632951/improving-the-quality-of-maternity-services-in-uganda-through-accelerated-implementation-of-essential-interventions-by-healthcare-professional-associations
#1
Cintia Spira, Amata Kwizera, Sue Jacob, Dinah Amogin, Joseph Ngonzi, Charles P Namisi, Romano Byaruhanga, Hamid Rushwan, Peter Cooper, Frances Day-Stirk, Mabel Berrueta, Ezequiel García-Elorrio, José M Belizán
OBJECTIVE: To assess whether the implementation of a package of activities through the joint action of the three international healthcare professionals associations (HCPAs) increased the use of intrapartum and postnatal essential interventions (EIs) in two hospitals in Uganda. METHODS: A non-controlled before-and-after study was undertaken to evaluate the effect of a package of activities designed to change practice relating to nine EIs among providers. Coverage of the EIs was measured in a 3-month pre-implementation period and a 3-month post-implementation period in 2014...
June 20, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28629247/obstetric-practice-patterns-in-pregnancies-complicated-by-fetal-trisomy-13-or-18
#2
Sarah K Dotters-Katz, Marcela C Smid, Cora Mcelwain, Jeffrey A Kuller, Jay Schulkin
PURPOSE: Describe practice patterns among obstetrician/gynecologists (OB/GYNs) when caring for women with pregnancy complicated by fetal trisomy 13(T13) or 18(T18), and compare these between maternal-fetal-medicine (MFM) and non-MFM providers. MATERIALS AND METHODS: We conducted an electronic survey using the American College of Obstetricians and Gynecologists database. Using simple statistics, we describe demographics and practice patterns among respondents, and compare those of MFM practitioners with non-MFM providers...
June 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28628578/neuraxial-anesthesia-in-obstetric-patients-receiving-thromboprophylaxis-with-unfractionated-or-low-molecular-weight-heparin-a-systematic-review-of-spinal-epidural-hematoma
#3
Lisa R Leffert, Heloise M Dubois, Alexander J Butwick, Brendan Carvalho, Timothy T Houle, Ruth Landau
Venous thromboembolism remains a major source of morbidity and mortality in obstetrics with an incidence of 29.8/100,000 vaginal delivery hospitalizations; cesarean delivery confers a 4-fold increased risk of thromboembolism when compared with vaginal delivery. Revised national guidelines now stipulate that the majority of women delivering via cesarean and women at risk for ante- or postpartum venous thromboembolism receive mechanical or pharmacological thromboprophylaxis. This practice change has important implications for obstetric anesthesiologists concerned about the risk of spinal epidural hematoma (SEH) among anticoagulated women receiving neuraxial anesthesia...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28607675/improving-coverage-measurement-for-reproductive-maternal-neonatal-and-child-health-gaps-and-opportunities
#4
Melinda K Munos, Cynthia K Stanton, Jennifer Bryce
BACKGROUND: Regular monitoring of coverage for reproductive, maternal, neonatal, and child health (RMNCH) is central to assessing progress toward health goals. The objectives of this review were to describe the current state of coverage measurement for RMNCH, assess the extent to which current approaches to coverage measurement cover the spectrum of RMNCH interventions, and prioritize interventions for a novel approach to coverage measurement linking household surveys with provider assessments...
June 2017: Journal of Global Health
https://www.readbyqxmd.com/read/28595604/functionality-and-acceptability-of-a-wireless-fetal-heart-rate-monitoring-device-in-term-pregnant-women-in-rural-southwestern-uganda
#5
Godfrey R Mugyenyi, Esther C Atukunda, Joseph Ngonzi, Adeline Boatin, Blair J Wylie, Jessica E Haberer
BACKGROUND: Over 3 million stillbirths occur annually in sub Saharan Africa; most occur intrapartum and are largely preventable. The standard of care for fetal heart rate (FHR) assessment in most sub-Saharan African settings is a Pinard Stethoscope, limiting observation to one person, at one point in time. We aimed to test the functionality and acceptability of a wireless FHR monitor that could allow for expanded monitoring capacity in rural Southwestern Uganda. METHODS: In a mixed method prospective study, we enrolled 1) non-laboring healthy term pregnant women to wear the device for 30 min and 2) non-study clinicians to observe its use...
June 8, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28595580/planned-home-compared-with-planned-hospital-births-mode-of-delivery-and-perinatal-mortality-rates-an-observational-study
#6
Jacoba van der Kooy, Erwin Birnie, Semiha Denktas, Eric A P Steegers, Gouke J Bonsel
BACKGROUND: To compare the mode of delivery between planned home versus planned hospital births and to determine if differences in intervention rates could be interpreted as over- or undertreatment. METHODS: Intervention and perinatal mortality rates were obtained for 679,952 low-risk women from the Dutch Perinatal Registry (2000-2007). Intervention was defined as operative vaginal delivery and/or caesarean section. Perinatal mortality was defined as the intrapartum and early neonatal mortality rate up to 7 days postpartum...
June 8, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28594099/cerebroplacental-ratio-thresholds-measured-within-two-weeks-of-birth-and-the-risk-of-cesarean-section-for-intrapartum-fetal-compromise-and-adverse-neonatal-outcome
#7
Larissa N Bligh, Amal A Alsolai, Ristan M Greer, Sailesh Kumar
OBJECTIVES: Prediction of intrapartum fetal compromise in uncomplicated, term pregnancies is a global obstetric challenge. Currently, no widely accepted screening test for this condition exists, although the cerebroplacental ratio (CPR) shows promise. We aimed to prospectively evaluate the screening performance of the CPR 10(th) centile for detection of Cesarean section for intrapartum fetal compromise (IFC) and composite adverse neonatal outcome (ANO) in low-risk women from 36 weeks and to determine the best CPR threshold from three previously described in the literature...
June 8, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28594070/labor-delivery-and-anesthesia-experiences-of-women-with-physical-disability
#8
Suzanne C Smeltzer, Amy J Wint, Jeffrey L Ecker, Lisa I Iezzoni
BACKGROUND: Although many women with physical disabilities report poor quality reproductive health care, little research has addressed labor, delivery, and anesthesia experiences of these women. This study was conducted to explore these experiences in women with significant mobility disabilities. METHODS: A qualitative descriptive study was conducted with 22 women from the United States who had delivered newborns within the prior 10 years. All had significant mobility disabilities...
June 8, 2017: Birth
https://www.readbyqxmd.com/read/28592237/labour-management-guidelines-for-a-tanzanian-referral-hospital-the-participatory-development-process-and-birth-attendants-perceptions
#9
Nanna Maaløe, Natasha Housseine, Jos van Roosmalen, Ib Christian Bygbjerg, Britt Pinkowski Tersbøl, Rashid Saleh Khamis, Birgitte Bruun Nielsen, Tarek Meguid
BACKGROUND: While international guidelines for intrapartum care appear to have increased rapidly since 2000, literature suggests that it has only in few instances been matched with reviews of local modifications, use, and impact at the targeted low resource facilities. At a Tanzanian referral hospital, this paper describes the development process of locally achievable, partograph-associated, and peer-reviewed labour management guidelines, and it presents an assessment of professional birth attendants' perceptions...
June 7, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28583154/a-cohort-analysis-of-neonatal-hospital-mortality-rate-and-predictors-of-neonatal-mortality-in-a-sub-urban-hospital-of-cameroon
#10
Paul Koki Ndombo, Quinta Mua Ekei, Joel Noutakdie Tochie, Mazou Ngou Temgoua, Francky Teddy Endomba Angong, Ferdinand Ndom Ntock, Lawrence Mbuagbaw
BACKGROUND: In Cameroon, sustainable effort needs to be done to reduce the current neonatal mortality rate from 21 deaths per 1000 live births to the global target of fewer than ten deaths per 1000 live births by 2035. We aimed to determine the neonatal hospital mortality rate and predictors of neonatal hospital mortality (NHM) in a major referral sub-urban hospital of Cameroon in a bit to formulate interventions to curb this burden. METHODS: This was a prospective cohort study consecutively enrolling all neonates admitted into the neonatology unit of the Bamenda Regional Hospital (BRH) from November 2015 to February 2016...
June 5, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28552091/quality-assessment-of-home-births-in-denmark
#11
Sabrina Jensen, Lotte B Colmorn, Anne-Mette Schroll, Lone Krebs
INTRODUCTION: The safety of home births has been widely debated. Observational studies examining maternal and neonatal outcomes of home births have become more frequent, and the quality of these studies has improved. The aim of the present study was to describe neonatal outcomes of home births compared with hospital births and to discuss which data are needed to evaluate the safety of home births. METHODS: This was a register-based cohort study. Data on all births in Denmark (2003-2013) were collected from the Danish Medical Birth Registry (DMBR)...
May 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28537203/data-accuracy-in-the-victorian-perinatal-data-collection
#12
Margaret M Flood, Susan J McDonald, Wendy E Pollock, Mary-Ann Davey
OBJECTIVE: Public health data sets such as the Victorian Perinatal Data Collection (VPDC) provide an important source for health planning, monitoring, policy, research and reporting purposes. Data quality is paramount, requiring periodic assessment of data accuracy. This article describes the conduct and findings of a validation study of data on births in 2011 extracted from the VPDC. METHOD: Data from a random sample of one percent of births in Victoria in 2011 were extracted from original medical records at the birth hospital and compared with data held in the VPDC...
January 1, 2017: HIM Journal
https://www.readbyqxmd.com/read/28520771/quality-of-maternity-care-and-its-determinants-along-the-continuum-in-kenya-a-structural-equation-modeling-analysis
#13
Patrick Opiyo Owili, Miriam Adoyo Muga, Bomar Rojas Mendez, Bradley Chen
BACKGROUND: Improving access to delivery services does not guarantee access to quality obstetric care and better survival, and therefore, concerns for quality of maternal and newborn care in low- and middle-income countries have been raised. Our study explored characteristics associated with the quality of initial assessment, intrapartum, and immediate postpartum and newborn care, and further assessed the relationships along the continuum of care. METHODS: The 2010 Service Provision Assessment data of Kenya for 627 routine deliveries of women aged 15-49 were used...
2017: PloS One
https://www.readbyqxmd.com/read/28520654/systematic-review-of-hydrotherapy-research-does-a-warm-bath-in-labor-promote-normal-physiologic-childbirth
#14
Jenna Shaw-Battista
Health sciences research was systematically reviewed to assess randomized controlled trials of standard care versus immersion hydrotherapy in labor before conventional childbirth. Seven studies of 2615 women were included. Six trials examined hydrotherapy in midwifery care and found an effect of pain relief; of these, 2 examined analgesia and found reduced use among women who bathed in labor. One study each found that hydrotherapy reduced maternal anxiety and fetal malpresentation, increased maternal satisfaction with movement and privacy, and resulted in cervical dilation progress equivalent to standard labor augmentation practices...
May 17, 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28491126/developing-obstetric-medicine-training-in-latin-america
#15
José Rojas-Suarez, Niza Suarez, Oier Ateka-Barrutia
Maternal mortality is an important indicator of health in populations around the world. The distribution of maternal mortality ratio globally shows that middle- and low-income countries have ∼99% of the mortality burden. Most countries of Latin America are considered to be middle- or low-income countries, as well as areas of major inequities among the different social classes. Medical problems in pregnancy remain an important cause of morbidity and mortality in this region. Previous data indicate the need for a call to action for adequate diagnosis and care of medical diseases in obstetric care...
March 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28486858/ante-and-intrapartum-risk-factors-for-neonatal-hypoxic-ischemic-encephalopathy
#16
Cecilia Lundgren, Lars Brudin, Anna-Stina Wanby, Marie Blomberg
PURPOSE: To identify obstetrical risk factors for the diagnosis of neonatal hypoxic ischemic encephalopathy (HIE). A secondary aim was to determine the incidence of HIE. MATERIALS AND METHODS: A retrospective cohort study including 36,086 women with singleton term pregnancies giving live births in Sweden between 2009 and 2013. Cases of HIE were identified from three different sources. Risk factors for HIE were evaluated using univariate and multivariate analyses...
May 9, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28483254/teratoma-of-the-neonatal-head-and-neck-a-41-year-experience
#17
Jacob R Brodsky, Alexandria L Irace, Amanda Didas, Karen Watters, Judy A Estroff, Carol E Barnewolt, Antonio Perez-Atayde, Reza Rahbar
OBJECTIVE: To review our institution's experience with the presentation, evaluation, and management of teratoma of the head and neck in the neonatal population. DESIGN: Retrospective case series (November 1970 through September 2011). SETTING: Tertiary care children's hospital. PATIENTS: 14 patients (12 boys and 2 girls). INTERVENTION: Detailed review of presentation, diagnostic approaches, surgical management, and outcomes...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28458123/the-motivation-and-capacity-to-go-above-and-beyond-qualitative-analysis-of-free-text-survey-responses-in-the-m-ngo-randomised-controlled-trial-of-caseload-midwifery
#18
Jyai Allen, Sue Kildea, Donna L Hartz, Mark Tracy, Sally Tracy
OBJECTIVE: to explore whether women allocated to caseload care characterise their midwife differently to those allocated to standard care. DESIGN: multi-site unblinded, randomised, controlled, parallel-group trial. SETTING: the study was conducted in two metropolitan teaching hospitals across two Australian cities. POPULATION: women of all obstetric risk were eligible to participate. Inclusion criteria were: 18 years or older, less than 24 week's gestation with a singleton pregnancy...
March 29, 2017: Midwifery
https://www.readbyqxmd.com/read/28437302/pain-management-in-the-opioid-dependent-pregnant-woman
#19
Rebecca R Safley, Jamie Swietlikowski
Opioid dependence is an epidemic in the United States, and the percentage of pregnant women who are opioid dependent has increased dramatically in the last decade. Pain management, already a concern for intrapartum and postpartum care, is complicated in the context of opioid dependence. This clinical review surveys the literature on pain management in opioid-dependent pregnant women to summarize current consensus and evidence to guide clinical practice. Points of consensus for pain management in opioid-dependent pregnant women include continual opioid maintenance therapy throughout the pregnancy and the postpartum period; adequate management of acute pain; the contraindication of opioid agonist-antagonists for pain management; and the need for interdisciplinary teams using a multimodal approach to provide optimal care to opioid-dependent pregnant women...
April 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28426597/accommodating-immigrant-women-s-preferences-for-female-health-care-providers
#20
Christa Aubrey, Zubia Mumtaz, Patrick B Patterson, Radha Chari, B F Peter Mitchell
OBJECTIVE: To investigate obstetricians' perspectives of the importance, effect, and challenges of providing intrapartum care to immigrant women who request a female obstetrician. METHODS: A focused ethnography was conducted at a large teaching hospital, which serves a high proportion of immigrant clientele (predominantly North or East African, Middle Eastern, and South Asian) in Edmonton, Alberta, Canada. Data collection comprised single, semistructured interviews with a purposive sample of 20 obstetric health care providers (10 resident and 10 staff obstetricians)...
May 2017: Obstetrics and Gynecology
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