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https://www.readbyqxmd.com/read/28098575/obstetric-anesthesia-liability-concerns
#1
Joanna M Davies, Linda S Stephens
Obstetric practice carries a high risk of medical liability and involves both obstetricians and anesthesiologists. Analysis of data from the Anesthesia Closed Claims Project database shows an increase in the proportion of anesthesia claims for maternal death and brain damage between the 1990s and 2000 and later, primarily due to hemorrhage. The proportion of claims for newborn brain damage remained unchanged while those for maternal nerve injury and minor injuries decreased. Use of massive transfusion protocols and clinical drills have been shown to improve outcomes from hemorrhage...
January 16, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28098573/managing-maternal-sepsis-early-warning-criteria-to-ecmo
#2
Cesar Padilla, Arvind Palanisamy
Maternal sepsis is now a leading cause of direct maternal death during pregnancy. This review addresses the latest advances in the identification and management of critically ill parturients. Specifically, this review will focus on the vulnerability of pregnant women to sepsis, the utility of early warning criteria in the identification of the septic parturient, emphasize the immediate antibiotic management of suspected sepsis, and elaborate upon the latest understanding in the ventilatory management of parturients with sepsis...
January 16, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28097431/placental-dapk1-and-autophagy-marker-lc3b-ii-are-dysregulated-by-tnf-%C3%AE-in-a-gestational-age-dependent-manner
#3
Andreas Prokesch, Astrid Blaschitz, Tamara Bauer, Gerit Moser, Ursula Hiden, Julianna Zadora, Ralf Dechend, Florian Herse, Martin Gauster
Autophagy, a cell-survival process responsible for degradation of protein aggregates and damaged organelles, is increasingly recognized as another mechanism essential for human placentation. A substantial body of experiments suggests inflammation and oxidative stress as the underlying stimuli for altered placental autophagy, giving rise to placenta dysfunction and pregnancy pathologies. Here, the hypothesis is tested whether or not pro-inflammatory cytokines interleukin (IL)-6 and tumor necrosis factor (TNF)-α are able to influence the expression profile of autophagy genes in human first-trimester villous placenta...
January 17, 2017: Histochemistry and Cell Biology
https://www.readbyqxmd.com/read/28096390/modification-of-host-dendritic-cells-by-microchimerism-derived-extracellular-vesicles-generates-split-tolerance
#4
William Bracamonte-Baran, Jonathan Florentin, Ying Zhou, Ewa Jankowska-Gan, W John Haynes, Weixiong Zhong, Todd V Brennan, Partha Dutta, Frans H J Claas, Jon J van Rood, William J Burlingham
Maternal microchimerism (MMc) has been associated with development of allospecific transplant tolerance, antitumor immunity, and cross-generational reproductive fitness, but its mode of action is unknown. We found in a murine model that MMc caused exposure to the noninherited maternal antigens in all offspring, but in some, MMc magnitude was enough to cause membrane alloantigen acquisition (mAAQ; "cross-dressing") of host dendritic cells (DCs). Extracellular vesicle (EV)-enriched serum fractions from mAAQ(+), but not from non-mAAQ, mice reproduced the DC cross-dressing phenomenon in vitro...
January 17, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28095917/social-and-traditional-practices-and-their-implications-for-family-planning-a-participatory-ethnographic-study-in-renk-south-sudan
#5
Khalifa Elmusharaf, Elaine Byrne, Diarmuid O'Donovan
BACKGROUND: Understanding what determines family size is crucial for programmes that aim to provide family planning services during and after conflicts. Recent research found that development agents in post conflict settings do not necessarily take time to understand the context adequately, translate their context understanding into programming, or adjust programming in the light of changes. South Sudan, a country that has been suffering from war for almost 50 years, has one of the highest maternal death rates and the lowest contraceptive utilization rates in the world...
January 17, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28095812/maternal-sepsis-complicating-arabin-cervical-pessary-placement-for-the-prevention-of-preterm-birth-a-case-report
#6
Begoña Martinez de Tejada
BACKGROUND: Preterm delivery is a major health problem and contributes to more than 50% of all neonatal and infant deaths. Recently, there has been a renewed interest in the use of cervical pessaries as a safe and effective intervention with few maternal side-effects for the prevention of preterm birth in both single and twin pregnancies. CASE PRESENTATION: A 43-year-old gravida 5, para 1 (previous preterm birth at 24 weeks) patient with an in vitro fertilization twin pregnancy had an Arabin cervical pessary placed at 19 weeks of pregnancy due to the presence of cervical funneling identified by ultrasound screening...
January 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28095802/a-case-control-study-investigating-factors-associated-with-high-infant-death-in-saiha-district-of-mizoram-india-bordering-myanmar
#7
Alok K Deb, Shanta Dutta, Chhaihlo Hnichho, Mary Vanlalpeki, Hli Thapi Phosa, Khaila Rakhu, Samuel Lalfakawma Fanai, Manoj Chakrabarti, Samiran Panda
BACKGROUND: Infant mortality has dropped considerably in India over the last 5 years. A sharp contrast to this decline in national average of infant mortality is the rate recorded during 2014-2015 from the southernmost district of Saiha, Mizoram having a common international border with Myanmar. As this district specific rate (113 per 1000 live births) is 3 times higher compared to the national and state average, the present investigation was carried out to identify associated factors...
January 17, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28092344/choriocapillaris-signal-voids-in-maternally-inherited-diabetes-and-deafness-and-in-pseudoxanthoma-elasticum
#8
Richard F Spaide
PURPOSE: To evaluate the pattern of choriocapillaris signal voids in maternally inherited diabetes and deafness and in pseudoxanthoma elasticum in eyes before the development of any geographic atrophy. METHODS: The choriocapillaris under the central macula was imaged with the Optovue RTVue XR Avanti using a 10 μm slab thickness. Automatic local thresholding of the resultant raw data extracted areas of absent flow signal, called signal voids, and these were counted and logarithmically binned...
January 13, 2017: Retina
https://www.readbyqxmd.com/read/28092247/-emergency-obstetric-causes-and-immediate-response-team-in-a-secondary-hospital
#9
Luis Rafael López-Ocaña, Norma Angélica Hernández-Pineda, Polita Rocío Cruz-Cruz, Manuel Ramiro-H, Víctor Octavio Pérez Del Valle-Ibarra
BACKGROUND: The aim of this work is to describe the causes of the obstetric emergency, which motivates the activation of the Immediate Response Team at a second level hospital of the Instituto Mexicano del Seguro Social, which has not an Intensive Care Unit for Adult Patients. METHODS: Retrospective observational study of the causes of obstetric emergency that occurred in the domains of Admission, Hospitalization, Labor, Delivery Room, Operating Room and Recovery of the Hospital General de Zona 53 of the IMSS, during the years 2014 and 2015...
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28091425/a-10-years-autopsy-based-study-of-maternal-mortality-in-lagos-state-university-teaching-hospital-lagos-nigeria
#10
F A Faduyile, S S Soyemi, F E Emiogun, J O Obafunwa
BACKGROUND: Maternal mortality is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy. Nigeria is among the six countries that record over 50% of all maternal deaths in the world. There are few papers on autopsy based causes of maternal mortality. This paper is to present the causes of maternal mortality that had postmortem done in our center. MATERIALS AND METHODS: This is a 10-year retrospective study of all maternal deaths seen in our center from January 01, 2005 to December 31, 2014...
February 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28090594/effects-of-tranexamic-acid-on-platelet-function-and-thrombin-generation-etaplat-woman-trial-sub-study
#11
Kastriot Dallaku, Haleema Shakur, Ian Roberts, Phil Edwards, Danielle Beaumont, Maria Delius, Braun Siegmund, Orion Gliozheni, Ilir Tasha, Saimir Cenameri, Ulrich Mansmann
Background. Postpartum haemorrhage (PPH) is a leading cause of maternal death. Tranexamic acid (TXA) has the potential to reduce bleeding and a large randomized placebo controlled trial of its effect in women with PPH (The WOMAN trial) is underway. TXA might also affect coagulation factors and platelets.  Objectives. To examine the effect of TXA on thrombin generation, platelet function, fibrinogen, D-dimer and coagulation factors in women with PPH.  Methods. We will conduct a sub-study within the WOMAN trial...
December 15, 2016: Wellcome Open Res
https://www.readbyqxmd.com/read/28090477/the-economic-cost-of-implementing-maternal-and-neonatal-death-review-in-a-district-of-bangladesh
#12
Animesh Biswas, Abdul Halim, Fazlur Rahman, Charli Eriksson, Koustuv Dalal
INTRODUCTION: Maternal and neonatal death review (MNDR) introduced in Bangladesh and initially piloted in a district during 2010. MNDR is able to capture each of the maternal, neonatal deaths and stillbirths from the community and government facilities (hospitals). This study aimed to estimate the cost required to implement MNDR in a district of Bangladesh during 2010-2012. MATERIALS AND METHODS: MNDR was implemented in Thakurgaon district in 2010 and later gradually extended until 2015...
December 9, 2016: Journal of Public Health Research
https://www.readbyqxmd.com/read/28088552/antipredator-tactics-are-largely-maternally-controlled-in-goitered-gazelle-a-hider-ungulate
#13
David Blank
Predation is usually the primary cause of infant death among ungulate species, with the annual variation in the survival of neonates over their first summer a major factor in the population dynamics of many ungulates. Consequently, the maternal rearing strategy of a species is crucial for its reproductive success. Since the roles mothers and fawns play in the implementation of antipredator strategies in hider species have been poorly understood until now, this paper considers this behavior in the goitered gazelle, which is a typical hider species...
January 11, 2017: Behavioural Processes
https://www.readbyqxmd.com/read/28087902/a-review-of-the-preventability-of-maternal-mortality-in-one-hospital-system-in-louisiana-usa
#14
James J Morong, Jane K Martin, Robert S Ware, Alfred G Robichaux
OBJECTIVE: To determine preventability of in-hospital maternal mortality in the Ochsner Health System (OHS) in the US state of Louisiana. METHODS: A retrospective study was undertaken of all known cases of in-hospital maternal death (during pregnancy or within 42 days of termination) that occurred within OHS facilities in 1995-2013. Associations between characteristics and mortality and preventability were investigated. Incidence rate ratios (IRRs) were calculated in view of varying reference values...
December 9, 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28081048/a-prospective-cohort-study-of-common-childhood-infections-in-south-african-hiv-exposed-uninfected-and-hiv-unexposed-infants
#15
Amy L Slogrove, Monika M Esser, Mark F Cotton, David P Speert, Tobias R Kollmann, Joel Singer, Julie A Bettinger
BACKGROUND: Much evidence of HIV-exposed uninfected (HEU) infant infectious morbidity predates availability of maternal combination antiretroviral therapy and does not control for universal risk factors (preterm birth, low birth weight, suboptimal breastfeeding and poverty). METHODS: This prospective cohort study identified HIV-infected and HIV-uninfected mothers and their newborns from South African community midwife unit. The primary outcome, infectious cause hospitalization or death before 6 months of age, was compared between HEU and HIV-unexposed (HU) infants and classified for type and severity using validated study-specific case definitions...
February 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28079778/association-of-intended-route-of-delivery-and-maternal-morbidity-in-twin-pregnancy
#16
Sarah Rae Easter, Julian N Robinson, Ellice Lieberman, Daniela Carusi
OBJECTIVE: To evaluate maternal morbidity in twin pregnancies according to intended mode of delivery. METHODS: We assembled a 7-year retrospective cohort (2007-2014) of women delivering viable, vertex-presenting twins beyond 32 weeks of gestation without contraindication to labor or uterine scar. We classified women as undergoing a trial of labor to attempt vaginal birth or choosing an elective cesarean delivery. Our primary outcome was a measure of composite maternal morbidity including death, postpartum hemorrhage, infection, major procedure, readmission for infection or reoperation, need for dilation and evacuation for hemorrhage or infection, venous thromboembolism, small bowel obstruction or ileus, or intensive care unit admission...
January 9, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28077095/geographic-information-system-for-improving-maternal-and-newborn-health-recommendations-for-policy-and-programs
#17
Yordanos B Molla, Barbara Rawlins, Prestige Tatenda Makanga, Marc Cunningham, Juan Eugenio Hernández Ávila, Corrine Warren Ruktanonchai, Kavita Singh, Sylvia Alford, Mira Thompson, Vikas Dwivedi, Allisyn C Moran, Zoe Matthews
This correspondence argues and offers recommendations for how Geographic Information System (GIS) applied to maternal and newborn health data could potentially be used as part of the broader efforts for ending preventable maternal and newborn mortality. These recommendations were generated from a technical consultation on reporting and mapping maternal deaths that was held in Washington, DC from January 12 to 13, 2015 and hosted by the United States Agency for International Development's (USAID) global Maternal and Child Survival Program (MCSP)...
January 11, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28074548/annual-report-of-the-perinatology-committee-japan-society-of-obstetrics-and-gynecology-2015-proposal-of-urgent-measures-to-reduce-maternal-deaths
#18
Satoru Takeda, Jun Takeda, Keisuke Murakami, Takahiko Kubo, Hiromi Hamada, Maki Murakami, Shintaro Makino, Hiroaki Itoh, Takashi Ohba, Katsuhiko Naruse, Hiroaki Tanaka, Naohiro Kanayama, Shigeki Matsubara, Hiroshi Sameshima, Tomoaki Ikeda
Perinatal care in Japan has progressed rapidly in recent decades, remarkably reducing maternal, perinatal and neonatal mortality rates. This is attributable not only to the sustained efforts and dedication of past obstetricians and midwives, but also to the collective results achieved by the Japan Society of Obstetrics and Gynecology and healthcare administration, including research on advanced medical care, education, medical care improvements and establishing perinatal care centers. Although the maternal mortality rate was in steady decline until 2007 (3...
January 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28074311/improving-maternal-and-infant-child-health-outcomes-with-community-based-pregnancy-support-groups-outcomes-from-moms2b-ohio
#19
Patricia Temple Gabbe, Rebecca Reno, Carmen Clutter, T F Schottke, Tanikka Price, Katherine Calhoun, Jamie Sager, Courtney D Lynch
Objectives To describe temporal changes in maternal and child health outcomes in an impoverished urban community after the implementation of an innovative community-based pregnancy support program, named Moms2B. Methods Beginning in 2011, pregnant women in an urban impoverished community were recruited for participation in a community-based pregnancy support program focused on improving nutrition coupled with increasing social and medical support. The comprehensive program targeting pregnancy through the infants' first year of life was developed and staffed by a multidisciplinary team from an academic health system...
January 10, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28074213/-intrahepatic-cholestasis-of-pregnancy-rare-but-important
#20
REVIEW
A E Kremer, K Wolf, S Ständer
Intrahepatic cholestasis of pregnancy (ICP) is a liver-specific disorder occurring in approximately 0.5-2.0% of all pregnancies with a considerable variation in certain ethnic groups. ICP usually runs a benign course for the mother and is characterized by maternal pruritus mainly in the third trimester, elevated transaminases and fasting total serum bile salts and increased fetal adverse events. The etiology of ICP is only partially understood but seems to be multifactorial. Cholestasis-inducing effects of certain female sex hormones and their metabolites play an important role in genetically susceptible women...
January 10, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
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