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Trial obstetrics

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https://www.readbyqxmd.com/read/28319128/serious-adverse-neonatal-outcomes-such-as-5-minute-apgar-score-of-zero-and-seizures-or-severe-neurologic-dysfunction-are-increased-in-planned-home-births-after-cesarean-delivery
#1
Amos Grünebaum, Laurence B McCullough, Birgit Arabin, Frank A Chervenak
The United States is with 37,451 home births in 2014 the country with the largest absolute number of home births among all developed countries. The purpose of this study was to examine the occurrence and risks of a 5-minute Apgar score of zero and neonatal seizures or serious neurologic dysfunction in women with a history of prior cesarean delivery for planned home vaginal birth after cesarean (VBAC), compared to hospital VBAC and hospital birth cesarean deliveries for term normal weight infants in the United States from 2007-2014...
2017: PloS One
https://www.readbyqxmd.com/read/28319122/can-a-simulation-based-training-program-impact-the-use-of-evidence-based-routine-practices-at-birth-results-of-a-hospital-based-cluster-randomized-trial-in-mexico
#2
Jimena Fritz, Dilys M Walker, Susanna Cohen, Gustavo Angeles, Hector Lamadrid-Figueroa
BACKGROUND: In Mexico, although the majority of births are attended in hospitals, reports have emerged of obstetric violence, use of unsafe practices, and failure to employ evidence-based practices (EBP). Recent attention has refocused global efforts towards provision of quality care that is both patient-centered and evidence-based. Scaling up of local interventions should rely on strong evidence of effectiveness. OBJECTIVE: To perform a secondary analysis to evaluate the impact of a simulation and team-training program (PRONTO) on the performance of EBP in normal births...
2017: PloS One
https://www.readbyqxmd.com/read/28318187/timing-of-umbilical-cord-clamping-of-term-infants
#3
REVIEW
José María Ceriani Cernadas
For at least over 200 years, multiple controversies have arisen around the timing of umbilical cord clamping. In the past decades, early cord clamping (within the first 15 seconds) had markedly prevailed. Only in the 21st century, randomized controlled trials have demonstrated the benefits of delayed cord clamping (at 2-3 minutes). Delayed cord clamping has been practiced in obstetrics based on the recommendations made by scientific societies and in systematic reviews, which have provided solid evidence to support this practice in term infants...
April 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28292361/effectiveness-of-per-rectal-misoprostol-versus-intramuscular-oxytocin-for-prevention-of-primary-postpartum-haemorrhage
#4
Raheela Asmat, Tasneem Ashraf, Fazila Asmat, Shakila Asmat, Nagina Asmat
OBJECTIVE: To compare the effectiveness of per rectal misoprostol over oxytocin in primary postpartum haemorrhage (PPH). STUDY DESIGN: Randomised controlled trial study. PLACE AND DURATION OF STUDY: Gynaecology and Obstetrics Department, Unit IV, Bolan Medical Complex Hospital, Quetta, from September 2013 to February 2014. METHODOLOGY: Emergency obstetric patients receiving per rectal misoprostol (800 µgm) were named as group 'A' and those receiving 10 units oxytocin intramuscularly were labelled as group 'B'...
January 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28291725/in-situ-operating-room-based-simulation-a-review
#5
Lily Owei, Christopher J Neylan, Raghavendra Rao, Robert C Caskey, Jon B Morris, Richard Sensenig, Ari D Brooks, Daniel T Dempsey, Noel N Williams, Joshua H Atkins, Dimitry Y Baranov, Kristoffel R Dumon
OBJECTIVE: To systematically review the literature surrounding operating room-based in situ training in surgery. METHODS: A systematic review was conducted of MEDLINE. The review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, and employed the Population, Intervention, Comparator, Outcome (PICO) structure to define inclusion/exclusion criteria. The Kirkpatrick model was used to further classify the outcome of in situ training when possible...
March 10, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28291126/strategies-to-reduce-blood-product-utilization-in-obstetric-practice
#6
Holger Neb, Kai Zacharowski, Patrick Meybohm
PURPOSE OF REVIEW: Patient blood management (PBM) aims to improve patient outcome and safety by reducing the number of unnecessary RBC transfusions and vitalizing patient-specific anemia reserves. Although PBM is increasingly recognized as best clinical practice in elective surgery, implementation of PBM is restrained in the setting of obstetrics. This review summarizes recent findings to reduce blood product utilization in obstetric practice. RECENT FINDINGS: PBM-related evidence-based benefits should be urgently adopted in the field of obstetric medicine...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28286688/beneficial-effects-on-pregnancy-outcomes-of-thyroid-hormone-replacement-for-subclinical-hypothyroidism
#7
Norman J Blumenthal, Creswell J Eastman
Background. Hypothyroidism and raised thyroid antibody levels have been associated with adverse obstetrical outcomes. Several studies have investigated causal associations, but results have been inconsistent and few studies have reported the effects of thyroxine replacement therapy on pregnancy outcomes in hypothyroid patients. Objective. The primary study objective was to determine the outcome of pregnancies in women diagnosed with overt and subclinical hypothyroidism (SCH) (serum TSH > 2.5 mIU/L) and those with elevated circulating thyroid autoantibody levels in the first trimester of pregnancy and after the institution of appropriate thyroxine replacement therapy to maintain the serum TSH ≤ 2...
2017: Journal of Thyroid Research
https://www.readbyqxmd.com/read/28284515/hepatitis-b-and-pregnancy
#8
Eliana Castillo, Kellie Murphy, Julie van Schalkwyk
OBJECTIVE: To review the epidemiology, natural history, evaluation, and treatment of hepatitis B virus (HBV) infection during pregnancy. This will aid obstetric care providers in counseling their patients regarding perinatal risks and management options available to pregnant women with hepatitis B. OUTCOMES: Outcomes evaluated include thresholds for HBV anti-viral treatment for prevention of perinatal transmission and for invasive procedures during pregnancy for women with hepatitis B infection...
March 8, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28274337/catatonia-among-women-with-postpartum-psychosis-in-a-mother-baby-inpatient-psychiatry-unit
#9
Abhinav Nahar, Nithin Kondapuram, Geetha Desai, Prabha S Chandra
OBJECTIVE: The aims of the present study were to determine the prevalence of catatonia in women with postpartum psychosis, describe its socio demographic, clinical and obstetric correlates and identify predictors of treatment response. METHODS: Data was extracted from clinical charts of 200 women with postpartum psychosis admitted to an inpatient mother baby unit (MBU) in India over a 3year period. RESULTS: Of the 200 patients, 20% (n=40) had symptoms of catatonia...
March 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28270884/critical-imperative-for-the-reform-of-british-interpretation-of-fetal-heart-rate-decelerations-analysis-of-figo-and-nice-guidelines-post-truth-foundations-cognitive-fallacies-myths-and-occam-s-razor
#10
REVIEW
Shashikant L Sholapurkar
Cardiotocography (CTG) has disappointingly failed to show good predictability for fetal acidemia or neonatal outcomes in several large studies. A complete rethink of CTG interpretation will not be out of place. Fetal heart rate (FHR) decelerations are the most common deviations, benign as well as manifestation of impending fetal hypoxemia/acidemia, much more commonly than FHR baseline or variability. Their specific nomenclature is important (center-stage) because it provides the basic concepts and framework on which the complex "pattern recognition" of CTG interpretation by clinicians depends...
April 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28264595/uterine-rupture-after-previous-low-segment-transverse-cesarean-is-rarely-catastrophic
#11
Sofia Soltsman, Yuri Perlitz, Moshe Ben Ami, Izhar Ben Shlomo
OBJECTIVE: The cornerstone of concerns over trial of labor after cesarean (TOLAC) is the risk of uterine rupture. The purpose of this study was to document the rate of uterine rupture during TOLAC and to delineate its severity and consequences. MATERIALS AND METHODS: We retrospectively collected the data on vaginal and cesarean deliveries after a previous cesarean section with specific emphasis on uterine rupture and dehiscence in our center from 2006 through 2013...
March 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28255987/a-randomised-double-blind-trial-of-phenylephrine-and-metaraminol-infusions-for-prevention-of-hypotension-during-spinal-and-combined-spinal-epidural-anaesthesia-for-elective-caesarean-section
#12
N J McDonnell, M J Paech, N A Muchatuta, S Hillyard, E A Nathan
Prophylactic vasopressor administration is commonly recommended to reduce maternal hypotension during spinal anaesthesia for caesarean section. Metaraminol has undergone limited investigation in obstetric anaesthesia for this purpose, particularly in comparison with phenylephrine. In this multicentre, randomised, double-blind, non-inferiority study, we compared prophylactic phenylephrine or metaraminol infusions, started immediately after spinal anaesthesia, in 185 women who underwent elective caesarean section...
March 3, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28253893/effect-of-suppressive-acyclovir-administered-to-hsv-2-positive-mothers-from-week-28-to-36%C3%A2-weeks-of-pregnancy-on-adverse-obstetric-outcomes-a-double-blind-randomised-placebo-controlled-trial
#13
Sarah Nakubulwa, Dan K Kaye, Freddie Bwanga, Nazarius Mbona Tumwesigye, Edith Nakku-Joloba, Florence Mirembe
BACKGROUND: Acyclovir (ACV) given to HSV-2 positive women after 36 weeks reduces adverse outcomes but its benefit at lower gestation was undocumented. We determined the effect of oral acyclovir administered from 28 to 36 weeks on premature rupture of membranes (PROM) primarily and preterm delivery risk. METHODS: This was a randomized, double-blind placebo-controlled trial among 200 HSV-2 positive pregnant women at 28 weeks of gestation at Mulago Hospital, Uganda...
March 3, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28241927/no-341-diagnosis-and-management-of-adnexal-torsion-in-children-adolescents-and-adults
#14
Sari Kives, Suzy Gascon, Élise Dubuc, Nancy Van Eyk
OBJECTIVE: To review the evidence and provide recommendations on the diagnosis and management of adnexal torsion in children, adolescents, and women. OUTCOMES: Elements evaluated include the risk factors, diagnostic accuracy, management options, and outcomes of adnexal torsion. EVIDENCE: Published literature was retrieved through searches of MEDLINE, Embase, CINAHL, and the Cochrane Library using appropriate controlled vocabulary and key words ("adnexal torsion," "ovarian torsion")...
February 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28239452/intervening-with-healthcare-workers-hand-hygiene-compliance-knowledge-and-perception-in-a-limited-resource-hospital-in-indonesia-a-randomized-controlled-trial-study
#15
Dewi Santosaningsih, Dewi Erikawati, Sanarto Santoso, Noorhamdani Noorhamdani, Irene Ratridewi, Didi Candradikusuma, Iin N Chozin, Thomas E C J Huwae, Gwen van der Donk, Eva van Boven, Anne F Voor In 't Holt, Henri A Verbrugh, Juliëtte A Severin
BACKGROUND: Hand hygiene is recognized as an important measure to prevent healthcare-associated infections. Hand hygiene adherence among healthcare workers is associated with their knowledge and perception. This study aimed to evaluate the effect of three different educational programs on improving hand hygiene compliance, knowledge, and perception among healthcare workers in a tertiary care hospital in Indonesia. METHODS: The study was performed from May to October 2014 and divided into a pre-intervention, intervention, and post-intervention phase...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28235522/preprocedural-ultrasound-assessment-does-not-improve-trainee-performance-of-spinal-anesthesia-for-obstetrical-patients-a-randomized-controlled-trial
#16
Timothy P Turkstra, Kristine L Marmai, Kevin P Armstrong, Kamal Kumar, S Indu Singh
STUDY OBJECTIVE: This randomized controlled trial was designed to evaluate the efficacy of additional information from preprocedure ultrasound examination to aid anesthesiology trainees performing spinal anesthesia for obstetric patients. DESIGN: Trainee residents were randomly allocated to landmark technique and anatomy demonstration via ultrasound examination or landmark technique only for spinal anesthetic placement. SETTING: Obstetric delivery suite...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28231274/early-skin-to-skin-contact-after-cesarean-section-a-randomized-clinical-pilot-study
#17
Martina Kollmann, Lisa Aldrian, Anna Scheuchenegger, Eva Mautner, Sereina A Herzog, Berndt Urlesberger, Reinhard B Raggam, Uwe Lang, Barbara Obermayer-Pietsch, Philipp Klaritsch
OBJECTIVE: Early bonding by skin-to-skin contact (SSC) has been demonstrated to be beneficial for mothers and newborns following vaginal delivery. The aim of this study was to investigate the impact of intraoperative bonding (early SSC) after cesarean section on neonatal adaptation, maternal pain and stress response. STUDY DESIGN: This prospective, randomized-controlled pilot study was performed at a single academic tertiary hospital (Department of Obstetrics and Gynecology, Medical University of Graz, Austria) between September 2013 and January 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28222999/effect-of-stepwise-perinatal-immunization-education-a-cluster-randomized-controlled-trial
#18
Aya Saitoh, Akihiko Saitoh, Isamu Sato, Tomohiro Shinozaki, Hajime Kamiya, Satoko Nagata
BACKGROUND: Perinatal immunization education is important for improving the immunization outcomes of infants; however, the content of educational materials used at each perinatal period has not been carefully evaluated. We hypothesized that stepwise education offered at different perinatal periods would improve infant immunization status and enhance maternal immunization knowledge. METHODS: In this cluster-randomized controlled trial, pregnant women were recruited from nine obstetric sites in Niigata, Japan...
February 17, 2017: Vaccine
https://www.readbyqxmd.com/read/28220604/a-mobile-health-intervention-promoting-healthy-gestational-weight-gain-for-women-entering-pregnancy-at-a-high-body-mass-index-the-txt4two-pilot-randomised-controlled-trial
#19
J C Willcox, S A Wilkinson, M Lappas, K Ball, D Crawford, E A McCarthy, B Fjeldsoe, R Whittaker, R Maddison, K J Campbell
OBJECTIVE: To determine the feasibility and effectiveness of an mHealth intervention promoting healthy diet, physical activity and gestational weight gain in pregnant women. DESIGN: Randomised controlled trial (RCT). SETTING: Australian tertiary obstetric hospital. POPULATION: One hundred pregnant women who were overweight or obese prior to pregnancy. METHODS: Women recruited at the first antenatal clinic visit were randomised to either an intervention or a control group...
February 20, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28220582/kinesio-taping-for-pain-control-during-labor-protocol-of-a-randomized-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
Maria Amelia Miquelutti, José Guilherme Cecatti
This study protocol will evaluate the effectiveness and safety during labor and delivery of the Kinesio Taping bandage for pain sensation, satisfaction of patients, and obstetric and neonatal outcomes. A randomized controlled trial with 60 participants divided into two groups will be conducted. The intervention group will receive bandage application on the vertebral regions corresponding to uterine dermatomes - from T10 to L1 and from S2 to S4. The control group will receive bandage application away from uterine dermatomes, from T1 to T4...
March 2017: Nursing & Health Sciences
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