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Intrapartum care

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https://www.readbyqxmd.com/read/28520771/quality-of-maternity-care-and-its-determinants-along-the-continuum-in-kenya-a-structural-equation-modeling-analysis
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/28420339/protocol-for-the-development-of-a-salutogenic-intrapartum-core-outcome-set-sipcos
#9
Valerie Smith, Deirdre Daly, Ingela Lundgren, Tine Eri, Cecily Begley, Mechthild M Gross, Soo Downe, Zarko Alfirevic, Declan Devane
BACKGROUND: Maternity intrapartum care research and clinical care more often focus on outcomes that minimise or prevent adverse health rather than on what constitutes positive health and wellbeing (salutogenesis). This was highlighted recently in a systematic review of reviews of intrapartum reported outcomes where only 8% of 1648 individual outcomes, from 102 systematic reviews, were agreed as being salutogenically-focused. Added to this is variation in the outcomes measured in individual studies rendering it very difficult for researchers to synthesise, fully, the evidence from studies on a particular topic...
April 19, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28419084/neonatal-resuscitation-in-global-health-settings-an-examination-of-the-past-to-prepare-for-the-future
#10
REVIEW
Beena D Kamath-Rayne, Sara K Berkelhamer, K C Ashish, Hege L Ersdal, Susan Niermeyer
BACKGROUND: As rates of childhood mortality decline, neonatal deaths account for nearly half of under-5 deaths worldwide. Intrapartum-related events (birth asphyxia) contribute to approximately one-quarter of neonatal deaths, many of which can be prevented by simple resuscitation and newborn care interventions. METHODS: This paper reviews various lines of research that have influenced the global neonatal resuscitation landscape. A brief situational analysis of asphyxia-related newborn mortality in low-resource settings is linked to renewed efforts to reduce neonatal mortality in the Every Newborn Action Plan...
April 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28410276/hiv-transmission-to-premature-very-low-birth-weight-infants
#11
Candyce Levin, David Le Roux, Michael Harrison, Lloyd Tooke
There is sparse literature about HIV transmission in preterm infants. 82 HIV exposed preterm infants received birth PCRs. Five (6.1%) were HIV positive with all 5 mothers receiving inadequate antiretrovirals. Of the PCR negative infants, 9 died and 87% of the survivors received further PCR testing which remained negative. With correct care, intrapartum transmission of HIV can virtually be eliminated.
April 13, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28399847/evaluation-of-helping-babies-breathe-quality-improvement-cycle-hbb-qic-on-retention-of-neonatal-resuscitation-skills-six-months-after-training-in-nepal
#12
Ashish Kc, Johan Wrammert, Viktoria Nelin, Robert B Clark, Uwe Ewald, Stefan Peterson, Mats Målqvist
BACKGROUND: Each year 700,000 infants die due to intrapartum-related complications. Implementation of Helping Babies Breathe (HBB)-a simplified neonatal resuscitation protocol in low-resource clinical settings has shown to reduce intrapartum stillbirths and first-day neonatal mortality. However, there is a lack of evidence on the effect of different HBB implementation strategies to improve and sustain the clinical competency of health workers on bag-and-mask ventilation. This study was conducted to evaluate the impact of multi-faceted implementation strategy for HBB, as a quality improvement cycle (HBB-QIC), on the retention of neonatal resuscitation skills in a tertiary hospital of Nepal...
April 11, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28398680/cytomegalovirus-infection-in-pregnancy
#13
REVIEW
Nicole L Davis, Caroline C King, Athena P Kourtis
Cytomegalovirus (CMV) is a DNA herpesvirus that is common worldwide. The two known main sources of primary CMV infection during pregnancy are through sexual activity and contact with young children. Primary infection occurs in approximately 1 to 4% of pregnancies, and is mostly asymptomatic in immunocompetent adults. However, primary infection may manifest as a mild mononucleosis or flu-like syndrome with persistent fever and fatigue. CMV can be transmitted from mother-to-child in utero, intrapartum, or during breastfeeding...
March 15, 2017: Birth Defects Res
https://www.readbyqxmd.com/read/28397976/resident-consultant-cover-may-become-part-of-21st-century-maternity-care-but-it-is-not-a-panacea
#14
Matt Prior, Tim Draycott, Christy Burden
Resident consultant cover has long been proposed as a solution to a wide variety of current intrapartum issues: poor clinical outcomes; high intervention rates, particularly increasing rates of caesarean section; middle grade rota gaps, and decreased training opportunities. However, as for many previous well-intentioned, apparently simple and plausible interventions introduced into maternity care, there may be little or no benefit when robustly tested. This article is protected by copyright. All rights reserved...
April 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28392223/obstetric-care-in-women-with-genetic-disorders
#15
REVIEW
Shilpa Chetty, Mary E Norton
The management of pregnant women who are themselves affected with genetic diseases is an increasingly relevant and important issue. Improvements in early diagnosis and management of genetic disease, as well as advances in assisted reproductive technology have impacted pregnancy rates in a cohort of women who may not have otherwise been able to conceive. A multidisciplinary approach is key to the management of pregnant women with complex health conditions, including genetic diseases. Pertinent issues should be addressed in the preconception, antepartum, intrapartum and postpartum periods to optimize maternal and fetal health...
March 18, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28390672/increased-risk-of-peripartum-perinatal-mortality-in-unplanned-births-outside-an-institution-a-retrospective-population-based-study
#16
Hilde M Engjom, Nils-Halvdan Morken, Even Høydahl, Ole F Norheim, Kari Klungsøyr
BACKGROUND: Births in midwife-led institutions may reduce the frequency of medical interventions and provide cost-effective care, while larger institutions offer medically and technically advanced obstetric care. Unplanned births outside an institution and intrapartum stillbirths have frequently been excluded in previous studies on adverse outcomes by place of birth. OBJECTIVE: The objective of the study was to assess peripartum mortality by place of birth and travel time to obstetric institutions, with the hypothesis that centralization reduces institution availability but improves mortality...
April 6, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28383381/accommodating-immigrant-women-s-preferences-for-female-health-care-providers
#17
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)...
April 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28374410/intrapartum-and-neonatal-outcomes-in-singleton-pregnancies-following-conception-by-assisted-reproduction-techniques
#18
Kellie M Rozdarz, Christopher J Flatley, Sailesh Kumar
BACKGROUND: To characterise maternal demographics and ascertain whether clinically important differences exist in the intrapartum and neonatal outcomes associated with assisted reproductive technology (ART). MATERIALS AND METHODS: A retrospective study was undertaken between January 2007 and December 2013 of all singleton pregnancies conceived via ART at a major tertiary unit in Brisbane, Australia. Intrapartum outcomes were mode of delivery and indication for emergency caesarean...
April 3, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28372476/the-introduction-of-umbilical-cord-lactate-measurement-and-associated-neonatal-outcomes-in-a-south-african-tertiary-hospital-labor-ward
#19
E R Allanson, R C Pattinson, E A Nathan, J E Dickinson
PURPOSE: To investigate the utility of umbilical artery (UA) lactate measurements in a South African hospital for assessing intrapartum care and predicting neonatal outcomes. MATERIALS AND METHODS: From 3 March-12 November 2014, we conducted a prospective cohort study of UA lactate levels at Kalafong Hospital, Pretoria, South Africa. Following birth, a UA blood sample (<0.5uL) was taken from a double-clamped segment of cord and the lactate measured. Maternal and neonatal characteristics and outcomes were recorded...
April 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28370230/interventions-to-reduce-neonatal-mortality-a-mathematical-model-to-evaluate-impact-of-interventions-in-sub-saharan-africa
#20
Jennifer B Griffin, Elizabeth M McClure, Beena D Kamath-Rayne, Bonnie M Hepler, Doris J Rouse, Alan H Jobe, Robert L Goldenberg
AIM: To determine which interventions would have the greatest impact on reducing neonatal mortality in sub-Saharan Africa in 2012. METHODS: We used MANDATE, a mathematical model, to evaluate scenarios for the impact of available interventions on neonatal deaths from primary causes, including: (i) for birth asphyxia - obstetric care preventing intrapartum asphyxia, newborn resuscitation and treatment of asphyxiated infants; (ii) for preterm birth - corticosteroids, oxygen, continuous positive air pressure and surfactant; and, (iii) for serious newborn infection - clean delivery, chlorhexidine cord care and antibiotics...
March 31, 2017: Acta Paediatrica
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