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https://www.readbyqxmd.com/read/28651296/early-discharge-hospital-at-home
#1
REVIEW
Daniela C Gonçalves-Bradley, Steve Iliffe, Helen A Doll, Joanna Broad, John Gladman, Peter Langhorne, Suzanne H Richards, Sasha Shepperd
BACKGROUND: Early discharge hospital at home is a service that provides active treatment by healthcare professionals in the patient's home for a condition that otherwise would require acute hospital inpatient care. This is an update of a Cochrane review. OBJECTIVES: To determine the effectiveness and cost of managing patients with early discharge hospital at home compared with inpatient hospital care. SEARCH METHODS: We searched the following databases to 9 January 2017: the Cochrane Effective Practice and Organisation of Care Group (EPOC) register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and EconLit...
June 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28649035/multifaceted-intervention-to-improve-obstetric-practices-the-opera-cluster-randomized-controlled-trial
#2
Corinne Dupont, Norbert Winer, Muriel Rabilloud, Sandrine Touzet, Bernard Branger, Jacques Lansac, Laurent Gaucher, Antoine Duclos, Cyril Huissoud, Florent Boutitie, René-Charles Rudigoz, Cyrille Colin
OBJECTIVE: Suboptimal care contributes to perinatal morbidity and mortality. We investigated the effects of a multifaceted program designed to improve obstetric practices and outcomes. STUDY DESIGN: A cluster-randomized trial was conducted from October 2008 to November 2010 in 95 French maternity units randomized either to receive an information intervention about published guidelines or left to apply them freely. The intervention combined an outreach visit with a morbidity/mortality conference (MMC) to review perinatal morbidity/mortality cases...
June 19, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28637734/pregnancy-specific-stress-fetoplacental-haemodynamics-and-neonatal-outcomes-in-women-with-small-for-gestational-age-pregnancies-a-secondary-analysis-of-the-multicentre-prospective-observational-trial-to-optimise-paediatric-health-in-intrauterine-growth-restriction
#3
Terri A Levine, Ruth E Grunau, Ricardo Segurado, Sean Daly, Michael P Geary, Mairead M Kennelly, Keelin O'Donoghue, Alyson Hunter, John J Morrison, Gerard Burke, Patrick Dicker, Elizabeth C Tully, Fergal D Malone, Fiona A Alderdice, Fionnuala M McAuliffe
OBJECTIVES: To examine associations between maternal pregnancy-specific stress and umbilical (UA PI) and middle cerebral artery pulsatility indices (MCA PI), cerebroplacental ratio, absent end diastolic flow (AEDF), birthweight, prematurity, neonatal intensive care unit admission and adverse obstetric outcomes in women with small for gestational age pregnancies. It was hypothesised that maternal pregnancy-specific stress would be associated with fetoplacental haemodynamics and neonatal outcomes...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28629468/improving-detection-and-initial-management-of-gestational-diabetes-through-the-primary-level-of-care-in-morocco-protocol-for-a-cluster-randomized-controlled-trial
#4
Bettina Utz, Bouchra Assarag, Amina Essolbi, Amina Barkat, Nawal El Ansari, Bouchra Fakhir, Alexandre Delamou, Vincent De Brouwere
BACKGROUND: Morocco is facing a growing prevalence of diabetes and according to latest figures of the World Health Organization, already 12.4% of the population are affected. A similar prevalence has been reported for gestational diabetes (GDM) and although it is not yet high on the national agenda, immediate and long-term complications threaten the health of mothers and future generations. A situational analysis on GDM conducted in 2015 revealed difficulties in access to screening and delays in receiving appropriate care...
June 19, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28619771/revealed-versus-concealed-criteria-for-placental-insufficiency-in-an-unselected-obstetric-population-in-late-pregnancy-ratio37-randomised-controlled-trial-study-protocol
#5
Francesc Figueras, Eduard Gratacos, Marta Rial, Ilan Gull, Ladislav Krofta, Marek Lubusky, Cruz-Martinez Rogelio, Cruz-Lemini Mónica, Martinez-Rodriguez Miguel, Pamela Socias, Cristina Aleuanlli, Mauro C Parra Cordero
INTRODUCTION: Fetal growth restriction (FGR) affects 5%-10% of all pregnancies, contributing to 30%-50% of stillbirths. Unfortunately, growth restriction often is not detected antenatally. The last weeks of pregnancy are critical for preventing stillbirth among babies with FGR because there is a pronounced increase in stillbirths among growth-restricted fetuses after 37 weeks of pregnancy. Here we present a protocol (V.1, 23 May 2016) for the RATIO37 trial, which evaluates an integrated strategy for accurately selecting at-risk fetuses for delivery at term...
June 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28619692/a-randomized-trial-of-motivational-interviewing-and-facilitated-contraceptive-access-to-prevent-rapid-repeat-pregnancy-among-adolescent-mothers
#6
Jack Stevens, Robyn Lutz, Ngozi Osuagwu, Dana Rotz, Brian Goesling
BACKGROUND: Most interventions designed to reduce teen pregnancy rates have not focused on pregnant and/or parenting adolescents. Therefore, a large randomized controlled trial was conducted regarding a motivational interviewing program entitled Teen Options to Prevent Pregnancy in a low income sample of adolescent mothers. This program recommended monthly sessions between a participant and a registered nurse over 18 months. This program also featured facilitated birth control access through transportation assistance and a part-time contraceptive clinic...
June 12, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28616417/the-comparison-the-effect-of-training-by-means-of-simulation-and-oral-method-on-midwives-skill-in-management-of-shoulder-dystocia
#7
Masoumeh Kordi, Fatemeh Erfanian, Farzaneh Rashidi Fakari, Fatemeh Dastfan, Keivan Shariati Nejad
INTRODUCTION: Shoulder dystocia is one of the obstetric emergencies that are accompanied to serious risks for mother and fetus. It necessitates making the method of training of shoulder dystocia management more efficient, i.e., better management and giving services with higher quality. Thus, this study was carried out to compare the impact of training by simulation and oral technique on the skill of the employed midwives in obstetric clinics at Mashhad city (Iran) in shoulder dystocia management during 2012...
2017: Journal of Education and Health Promotion
https://www.readbyqxmd.com/read/28613398/fetal-and-umbilical-doppler-ultrasound-in-high-risk-pregnancies
#8
REVIEW
Zarko Alfirevic, Tamara Stampalija, Therese Dowswell
BACKGROUND: Abnormal blood flow patterns in fetal circulation detected by Doppler ultrasound may indicate poor fetal prognosis. It is also possible that false positive Doppler ultrasound findings could lead to adverse outcomes from unnecessary interventions, including preterm delivery. OBJECTIVES: The objective of this review was to assess the effects of Doppler ultrasound used to assess fetal well-being in high-risk pregnancies on obstetric care and fetal outcomes...
June 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28612671/racial-ethnic-disparities-in-magnesium-sulphate-neuroprotection-a-subgroup-analysis-of-a-multicenter-randomized-controlled-trial
#9
Gustavo Vilchez, Jing Dai, Komal Kumar, David Mundy, Eftichia Kontopoulos, Robert J Sokol
OBJECTIVE: Despite known racial disparities in obstetrics, as well as differences in magnesium pharmacodynamics according to race, the effect of race/ethnicity in magnesium sulphate (MgSO4) use during pregnancy has not been studied. Whether some mothers are at increased risk of side effects, or infants at decreased neuroprotective effects is unknown. We analyze the effect of race/ethnicity in maternal/infant outcomes after MgSO4 neuroprotection. STUDY DESIGN: Subgroup analysis of a multicenter clinical trial (BEAM trial) where pregnant women at risk of preterm birth were randomized to either MgSO4 or placebo...
June 14, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28610569/a-novel-tamponade-agent-for-management-of-post-partum-hemorrhage-adaptation-of-the-xstat-mini-sponge-applicator-for-obstetric-use
#10
Maria I Rodriguez, Jeffrey T Jensen, Kenton Gregory, Mary Bullard, Paul Longo, Jerry Heidel, Alison Edelman
BACKGROUND: Although uterine tamponade is an effective treatment for postpartum hemorrhage (PPH), current methods have key limitations in their use, particularly in low resource settings. The XStat™ Mini Sponge Dressing (MSD) is approved for the management of non-compressible wounds in the battlefield/trauma setting. The MSD applies highly compressed medical sponges capable of stopping high-flow arterial bleeding within seconds. The objective of our study was to adopt the MSD for use in managing PPH...
June 13, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28605006/treating-periodontal-disease-for-preventing-adverse-birth-outcomes-in-pregnant-women
#11
REVIEW
Zipporah Iheozor-Ejiofor, Philippa Middleton, Marco Esposito, Anne-Marie Glenny
BACKGROUND: Periodontal disease has been linked with a number of conditions, such as cardiovascular disease, stroke, diabetes and adverse pregnancy outcomes, all likely through systemic inflammatory pathways. It is common in women of reproductive age and gum conditions tend to worsen during pregnancy. Some evidence from observational studies suggests that periodontal intervention may reduce adverse pregnancy outcomes. There is need for a comprehensive Cochrane review of randomised trials to assess the effect of periodontal treatment on perinatal and maternal health...
June 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28602042/clinical-indications-for-cesarean-delivery-among-women-living-with-female-genital-mutilation
#12
Maria I Rodriguez, Lale Say, Jasmine Abdulcadir, Michelle J Hindin
OBJECTIVE: To compare primary indications for cesarean delivery among patients with different female genital mutilation (FGM) status. METHODS: The present secondary analysis included data from women who underwent trial of labor resulting in cesarean delivery at 28 obstetric centers in six African countries between November 1, 2001, and March 31, 2003. Associations between cesarean delivery indications and FGM status were assessed using descriptive statistics and multivariable multinomial logistic regression...
June 11, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28592237/labour-management-guidelines-for-a-tanzanian-referral-hospital-the-participatory-development-process-and-birth-attendants-perceptions
#13
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/28591756/the-fetal-reserve-index-re-engineering-the-interpretation-and-responses-to-fetal-heart-rate-patterns
#14
Robert D Eden, Mark I Evans, Shara M Evans, Barry S Schifrin
OBJECTIVE: Electronic fetal monitoring (EFM) correlates poorly with neonatal outcome. We present a new metric: the "Fetal Reserve Index" (FRI), formally incorporating EFM with maternal, obstetrical, fetal risk factors, and excessive uterine activity for assessment of risk for cerebral palsy (CP). METHODS: We performed a retrospective, case-control series of 50 term CP cases with apparent intrapartum neurological injury and 200 controls. All were deemed neurologically normal on admission...
June 8, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28589894/advising-women-with-diabetes-in-pregnancy-to-express-breastmilk-in-late-pregnancy-diabetes-and-antenatal-milk-expressing-dame-a-multicentre-unblinded-randomised-controlled-trial
#15
Della A Forster, Anita M Moorhead, Susan E Jacobs, Peter G Davis, Susan P Walker, Kerri M McEgan, Gillian F Opie, Susan M Donath, Lisa Gold, Catharine McNamara, Amanda Aylward, Christine East, Rachael Ford, Lisa H Amir
BACKGROUND: Infants of women with diabetes in pregnancy are at increased risk of hypoglycaemia, admission to a neonatal intensive care unit (NICU), and not being exclusively breastfed. Many clinicians encourage women with diabetes in pregnancy to express and store breastmilk in late pregnancy, yet no evidence exists for this practice. We aimed to determine the safety and efficacy of antenatal expressing in women with diabetes in pregnancy. METHODS: We did a multicentre, two-group, unblinded, randomised controlled trial in six hospitals in Victoria, Australia...
June 3, 2017: Lancet
https://www.readbyqxmd.com/read/28588944/onsite-midwife-led-birth-units-ombus-for-care-around-the-time-of-childbirth-a-systematic-review
#16
Qian Long, Emma R Allanson, Jennifer Pontre, Özge Tunçalp, George Justus Hofmeyr, Ahmet Metin Gülmezoglu
INTRODUCTION: To ensure timely access to comprehensive emergency obstetric care in low- and middle-income countries, a number of interventions have been employed. This systematic review assesses the effects of onsite midwife-led birth units (OMBUs) embedded within hospitals which provide comprehensive emergency obstetric and newborn care. METHODS: Both interventional and observational studies that compared OMBUs with standard medical-led obstetric care were eligible for inclusion...
August 2016: BMJ Global Health
https://www.readbyqxmd.com/read/28586127/cervical-stitch-cerclage-for-preventing-preterm-birth-in-singleton-pregnancy
#17
REVIEW
Zarko Alfirevic, Tamara Stampalija, Nancy Medley
BACKGROUND: Cervical cerclage is a well-known surgical procedure carried out during pregnancy. It involves positioning of a suture (stitch) around the neck of the womb (cervix), aiming to give mechanical support to the cervix and thereby reduce risk of preterm birth. The effectiveness and safety of this procedure remains controversial. This is an update of a review last published in 2012. OBJECTIVES: To assess whether the use of cervical stitch in singleton pregnancy at high risk of pregnancy loss based on woman's history and/or ultrasound finding of 'short cervix' and/or physical exam improves subsequent obstetric care and fetal outcome...
June 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28577545/the-effect-of-a-prenatal-lifestyle-intervention-on-glucose-metabolism-results-of-the-norwegian-fit-for-delivery-randomized-controlled-trial
#18
Linda R Sagedal, Ingvild Vistad, Nina C Øverby, Elling Bere, Monica K Torstveit, Hilde Lohne-Seiler, Elisabet R Hillesund, Are Pripp, Tore Henriksen
BACKGROUND: The effectiveness of prenatal lifestyle intervention to prevent gestational diabetes and improve maternal glucose metabolism remains to be established. The Norwegian Fit for Delivery (NFFD) randomized, controlled trial studied the effect of a combined lifestyle intervention provided to a general population, and found significantly lower gestational weight gain among intervention participants but no improvement in obstetrical outcomes or the proportion of large infants. The aim of the present study is to examine the effect of the NFFD intervention on glucose metabolism, including an assessment of the subgroups of normal-weight and overweight/obese participants...
June 2, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28576354/does-the-addition-of-active-body-warming-to-in-line-intravenous-fluid-warming-prevent-maternal-hypothermia-during-elective-caesarean-section-a-randomised-controlled-trial
#19
R Chebbout, R S Newton, M Walters, I J Wrench, M Woolnough
INTRODUCTION: Inadvertent perioperative hypothermia occurs frequently during elective caesarean section but perioperative active body warming is not widely used. There is a paucity of evidence of its use in the obstetric population, and no applicable guidelines. We set out to identify a superior active warming method for preventing inadvertent perioperative hypothermia. METHODS: Following ethical approval, 132 women presenting for uncomplicated elective caesarean section with spinal anaesthesia were recruited...
April 27, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28574931/neoadjuvant-weekly-paclitaxel-carboplatin-is-effective-in-stage-i-ii-cervical-cancer
#20
Rawand Salihi, Karin Leunen, Philippe Moerman, Frédéric Amant, Patrick Neven, Ignace Vergote
OBJECTIVE: Neoadjuvant chemotherapy (NACT) followed by surgery in cervical cancer is widely studied with paclitaxel-ifosfamide-cisplatinum 3 weekly (TIP). Although the response rates with TIP are high, the toxicity is substantial. Therefore, this study evaluates dose-dense paclitaxel-carboplatin (TC) as an alternative. METHODS: In this prospective phase 2 study trial, we included 36 patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB1 to IIB cervical cancer, who received 9 weeks' NACT dose-dense TC (median weekly dose paclitaxel 60 mg/m, carboplatinum area under the curve 2...
June 1, 2017: International Journal of Gynecological Cancer
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