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https://www.readbyqxmd.com/read/28937572/obstetric-care-consensus-no-6-periviable-birth
#1
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937567/obstetric-care-consensus-no-6-summary-periviable-birth
#2
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28935064/no-231-guidelines-for-the-management-of-vasa-previa
#3
Robert Gagnon
OBJECTIVES: To describe the etiology of vasa previa and the risk factors and associated condition, to identify the various clinical presentations of vasa previa, to describe the ultrasound tools used in its diagnosis, and to describe the management of vasa previa. OUTCOMES: Reduction of perinatal mortality, short-term neonatal morbidity, long-term infant morbidity, and short-term and long-term maternal morbidity and mortality. EVIDENCE: Published literature on randomized trials, prospective cohort studies, and selected retrospective cohort studies was retrieved through searches of PubMed or Medline, CINAHL, and the Cochrane Library, using appropriate controlled vocabulary (e...
October 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28931404/a-cluster-randomized-trial-to-reduce-major-perinatal-morbidity-among-women-with-one-prior-cesarean-delivery-in-qu%C3%A3-bec-prisma-trial-study-protocol-for-a-randomized-controlled-trial
#4
N Chaillet, E Bujold, B Masse, W A Grobman, P Rozenberg, J C Pasquier, A Shorten, M Johri, F Beaudoin, H Abenhaim, S Demers, W Fraser, M Dugas, S Blouin, E Dubé, R Gauthier
BACKGROUND: Rates of cesarean delivery are continuously increasing in industrialized countries, with repeated cesarean accounting for about a third of all cesareans. Women who have undergone a first cesarean are facing a difficult choice for their next pregnancy, i.e.: (1) to plan for a second cesarean delivery, associated with higher risk of maternal complications than vaginal delivery; or (b) to have a trial of labor (TOL) with the aim to achieve a vaginal birth after cesarean (VBAC) and to accept a significant, but rare, risk of uterine rupture and its related maternal and neonatal complications...
September 20, 2017: Trials
https://www.readbyqxmd.com/read/28922987/admissions-for-hypoglycaemia-after-35%C3%A2-weeks-of-gestation-perinatal-predictors-of-cost-of-stay
#5
Theodore Dassios, Anne Greenough, Stamatina Leontiadi, Ann Hickey, Nick Kametas
BACKGROUND: Hypoglycaemia accounts for approximately one tenth of term admissions to neonatal units, can cause long-term neurodevelopmental impairment and is associated with significant burden to the affected infants, families and the health system. OBJECTIVE: To define the prevalence, length and cost of admissions for hypoglycaemia in infants born at greater than 35 weeks gestation and to identify antenatal and perinatal predictors of those outcomes. MATERIAL AND METHODS: This was a retrospective audit of infants admitted for hypoglycaemia between 1/1/2012 and 31/12/2015, in a level three neonatal intensive care unit at King's College Hospital NHS Foundation Trust, London...
September 18, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28917139/a-good-abortion-experience-a-qualitative-exploration-of-women-s-needs-and-preferences-in-clinical-care
#6
Anna L Altshuler, Alison Ojanen-Goldsmith, Paul D Blumenthal, Lori R Freedman
What do women ending their pregnancies want and need to have a good clinical abortion experience? Since birth experiences are better studied, birth stories are more readily shared and many women who have had an abortion have also given birth, we sought to compare women's needs and preferences in abortion to those in birth. We conducted semi-structured intensive interviews with women who had both experiences in the United States and analyzed their intrapartum and abortion care narratives using grounded theory, identifying needs and preferences in abortion that were distinct from birth...
September 8, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28913129/evaluating-the-content-and-quality-of-intrapartum-care-in-vaginal-births-an-example-of-a-state-hospital
#7
Zekiye Karaçam, Döndü Arslan Kurnaz, Gizem Güneş
OBJECTIVE: The purpose of the research was to assess the content and quality of the intrapartum care offered in vaginal births in Turkey, based on the example of a state hospital. MATERIALS AND METHODS: This cross-sectional study was conducted between January 1(st), 2013 and December 31(st), 2014 at Aydın Maternity and Children's Hospital. The study sample consisted of 303 women giving vaginal birth, who were recruited into the study using the method of convenience sampling...
March 2017: Turk J Obstet Gynecol
https://www.readbyqxmd.com/read/28892306/effect-of-locally-tailored-labour-management-guidelines-on-intrahospital-stillbirths-and-birth-asphyxia-at-the-referral-hospital-of-zanzibar-a-quasi-experimental-pre-post-study-the-partoma-study
#8
Nanna Maaløe, Natasha Housseine, Tarek Meguid, Birgitte Bruun Nielsen, Aksel Karl Georg Jensen, Rashid Saleh Khamis, Ali Gharib Mohamed, Mbweni Makame Ali, Said Mzee Said, Jos van Roosmalen, Ib Christian Bygbjerg
OBJECTIVE: To evaluate effect of locally-tailored labour management guidelines (PartoMa guidelines) on intrahospital stillbirths and birth asphyxia. DESIGN: Quasi-experimental pre-post-study investigating the causal pathway through changes in clinical practice. SETTING: Tanzanian low-resource referral hospital, Mnazi Mmoja Hospital. POPULATION: Facility deliveries during baseline (1(st) October 2014 till 31(st) January 2015) and the ninth till twelfth intervention month (1(st) October 2015 till 31(st) January 2016)...
September 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28882116/thistle-trial-of-hands-on-interprofessional-simulation-training-for-local-emergencies-a-research-protocol-for-a-stepped-wedge-clustered-randomised-controlled-trial
#9
Erik Lenguerrand, Catherine Winter, Karen Innes, Graeme MacLennan, Dimitrios Siassakos, Pauline Lynch, Alan Cameron, Joanna Crofts, Alison McDonald, Kirsty McCormack, Mark Forrest, John Norrie, Siladitya Bhattacharya, Tim Draycott
BACKGROUND: Many adverse pregnancy outcomes in the UK could be prevented with better intrapartum care. Training for intrapartum emergencies has been widely recommended but there are conflicting data about their effectiveness. Observational studies have shown sustained local improvements in perinatal outcomes associated with the use of the PRactical Obstetric Multi-Professional Training - (PROMPT) training package. However this effect needs to be investigated in the context of randomised study design in settings other than enthusiastic early adopter single-centres...
September 7, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28867889/massive-maternal-haemorrhage-a-rare-case-of-ruptured-uterine-varix
#10
Shikha Sharma, Pankaj Yadav, Anshuja Singla
Haemoperitoneum anytime during pregnancy is a rare but catastrophic event. With advancement in antenatal and intrapartum care, the maternal survival has improved manyfold. Management involves immediate resuscitation with volume correction followed by surgery, mostly laparotomy. This case is of a booked primigravida, with otherwise uneventful pregnancy, who suffered a massive haemoperitoneum. On laparotomy, the only cause found was a small uterine varix on the posterior uterine surface. The patient survived after multiple transfusions, but it led to a fresh stillborn baby...
October 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28835213/evaluation-of-the-mobile-nurse-training-mnt-intervention-a-step-towards-improvement-in-intrapartum-practices-in-bihar-india
#11
Aritra Das, Dipty Nawal, Manoj Kumar Singh, Morchan Karthick, Parika Pahwa, Malay Bharat Shah, Tanmay Mahapatra, Kunal Ranjan, Indrajit Chaudhuri
BACKGROUND: Evidence shows that improving the quality of intrapartum care is critical for maternal survival. However, a significant rise in the proportion of facility-based births over the last decade in India - attributable to a cash transfer program - has not resulted in a corresponding reduction in maternal mortality, thanks, in part, to low-skilled care at facilities. The current study evaluated a mobile knowledge-based intervention aimed at improving quality of care by mentoring in-service staff nurses at public obstetric facilities...
August 23, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28833512/intrapartum-obstetric-care-in-the-united-states-military-comparison-of-military-and-civilian-care-systems-within-tricare
#12
Anju Ranjit, Wei Jiang, Tiannan Zhan, Linda Kimsey, Bart Staat, Catherine T Witkop, Sarah E Little, Adil H Haider, Julian N Robinson
BACKGROUND: Expectant mothers who are beneficiaries of TRICARE (universal insurance to United States Armed Services members and their dependents) can choose to receive care within direct (salary-based) or purchased (fee-for-service) care systems. We sought to compare frequency of intrapartum obstetric procedures and outcomes such as severe acute maternal morbidity (SAMM) and common postpartum complications between direct and purchased care systems within TRICARE. METHODS: TRICARE (2006-2010) claims data were used to identify deliveries...
August 22, 2017: Birth
https://www.readbyqxmd.com/read/28828876/development-spots-in-communication-during-the-management-of-the-intrapartum-period-an-interpretive-multiple-case-study-in-a-developing-context
#13
Doreen K M M'Rithaa, Susan R Fawcus, Margaretha De la Harpe, Mikko Korpela
BACKGROUND: Health care activities are influenced by information communication between women during pregnancy, birth and motherhood and skilled birth attendants (SBAs) and further, between the health care workers during the continuum of care. Therefore, effective information communication processes (ICP) within and between health care facilities are a requirement for appropriate management of patients or clients. The management of the intrapartum period requires swift responses while managing critical information required for further referral and management processes...
July 31, 2017: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/28822629/acute-intrapartum-rupture-of-the-pubic-symphysis-requiring-resuscitation-and-surgical-intervention-a-case-report
#14
Marie Buitendyk, Barbara Brennan, Parag Vora, Patricia Smith, Stephanie Winsor
BACKGROUND: Pubic symphysis rupture significant enough to cause serious complications or require surgical intervention is exceedingly rare. Here we review the literature and examine the details of a unique presentation. CASE: A 27-year-old woman presented in labour at 34+6 weeks gestation after an uncomplicated monochorionic-diamniotic twin pregnancy. After vaginal delivery, she developed a substantial labial hematoma. Hours later, she became hemodynamically unstable...
August 16, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28814285/quality-of-midwife-provided-intrapartum-care-in-amhara-regional-state-ethiopia
#15
Tegbar Yigzaw, Fantu Abebe, Lalem Belay, Yewulsew Assaye, Equlinet Misganaw, Ashebir Kidane, Desalegn Ademie, Jos van Roosmalen, Jelle Stekelenburg, Young-Mi Kim
BACKGROUND: Despite much progress recently, Ethiopia remains one of the largest contributors to the global burden of maternal and newborn deaths and stillbirths. Ethiopia's plan to meet the sustainable development goals for maternal and child health includes unprecedented emphasis on improving quality of care. The purpose of this study was to assess the quality of midwifery care during labor, delivery and immediate postpartum period. METHODS: A cross-sectional study using multiple data collection methods and a 2-stage cluster sampling technique was conducted from January 25 to February 14, 2015 in government health facilities of the Amhara National Regional State of Ethiopia...
August 16, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28812454/risk-factors-for-intrapartum-acidemia-a-cohort-study
#16
Stina Wretler, Lennart Nordström, Sophie Graner, Malin Holzmann
PURPOSE: Birth acidemia is associated with short- and long-term morbidity in the child. Optimal intrapartum surveillance and timely interventions may reduce the incidence of these outcomes. Knowledge about conditions which increase the risks might be beneficial for optimal care. The aim with this study was to identify factors which increased the risk for lactacidemia in fetal scalp blood. MATERIALS AND METHODS: A secondary analysis of a cohort study performed at Karolinska University Hospital Stockholm Sweden between February 2009 and February 2011...
August 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28807974/exploring-family-physicians-reasons-to-continue-or-discontinue-providing-intrapartum-care-qualitative-descriptive-study
#17
Marion Dove, Maman Joyce Dogba, Charo Rodríguez
OBJECTIVE: To examine the reasons why family physicians continue or discontinue providing intrapartum care in their clinical practice. DESIGN: Qualitative descriptive study. SETTING: Two hospitals located in a multicultural area of Montreal, Que, in November 2011 to June 2012. PARTICIPANTS: Sixteen family physicians who were current or former providers of obstetric care. METHODS: Data were collected using semistructured qualitative interviews...
August 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28800671/-outcomes-of-planned-out-of-hospital-and-low-risk-hospital-births-in-lower-saxony
#18
Antje Petersen, Lea-Marie Köhler, Christiane Schwarz, Bernhard Vaske, Mechthild M Gross
Introduction Internationally, there is debate on the safety of different birth settings inside and outside of hospitals. Low-risk women in Germany can choose where they give birth, and out-of-hospital births are especially necessary in regions lacking infrastructure. To date, national studies are required. Materials and Methods We investigated planned out-of-hospital (OH) and hospital births in Lower Saxony, Germany, in 2005. Women with a singleton fetus in the vertex position were included once they reached 34+0 gestational weeks...
August 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28799705/the-process-of-intrapartum-care-among-skilled-birth-attendants-in-the-dominican-republic-and-maternal-perceptions-of-care-during-labor-and-birth-a-case-report
#19
Peter Schindler, Rosa Burgos, Kimberly Vuong, Hilary Aviela Lerner, Elsa Evangelista, Flor Josefina Rodriguez, Lourdes Peralta Polanco, Jennifer Foster
INTRODUCTION: The World Health Organization calls for situation analyses of maternity settings globally to improve maternal-newborn health. This study evaluated the care processes of skilled birth attendants and women's satisfaction with the care in a public hospital in the Dominican Republic. The purpose of the assessment was to establish a baseline to build quality improvements. METHODS: A cross-sectional, mixed-methods, observational study was conducted by an international team...
August 11, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28799193/an-analysis-of-the-effects-of-intrapartum-factors-neonatal-characteristics-and-skin-to-skin-contact-on-early-breastfeeding-initiation
#20
Ying Lau, Pyai Htun Tha, Sarah Su Tin Ho-Lim, Lai Ying Wong, Peng Im Lim, Binte Zaini Mattar Citra Nurfarah, Shefaly Shorey
This study aims to determine relationships between intrapartum factors, neonatal characteristics, skin-to-skin contact (SSC), and early breastfeeding initiation after spontaneous vaginal and Caesarean section or operative vaginal birth. A total of 915 mother-newborn dyads were considered in a hypothetical model based on integrated concepts of breastfeeding initiation model, infant learning framework, and attachment theory. Multiple-group path analysis was used to determine whether differences exist between effects of immediate SSC (≤30 min) on early breastfeeding initiation in different modes of birth...
August 10, 2017: Maternal & Child Nutrition
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