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Emergency obstetric

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https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#1
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29145815/illness-recognition-and-care-seeking-for-maternal-complications-of-pregnancy-and-birth-in-rural-amhara-and-oromia-regional-states-of-ethiopia
#2
Lynn Sibley, Yared Amare
BACKGROUND: Ethiopia has made steady progress in improving maternal health over the decade, yet mortality remains high. The Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) was a 3.5-year project aimed at developing a community-oriented model to improve maternal and newborn survival in rural Ethiopia. Two years after the project ended, we carried out a case study to explore illness recognition and care seeking for complications of pregnancy and childbirth in the project area...
November 16, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29145645/waddlia-chondrophila-a-chlamydia-related-bacterium-has-a-negative-impact-on-human-spermatozoa
#3
D Baud, N Vulliemoz, A Ammerdorffer, J Gyger, G Greub, V Castella, M Stojanov
STUDY QUESTION: What is the impact of Waddlia chondrophila, an emerging Chlamydia-related bacterium associated with miscarriage, on human spermatozoa? SUMMARY ANSWER: W. chondrophila had a negative impact on human spermatozoa (decrease in viability and mitochondrial membrane potential) and was not entirely removed from infected samples by density gradient centrifugation. WHAT IS KNOWN ALREADY: Bacterial infection or colonization might have a deleterious effect on male fertility...
November 14, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29143614/composite-measures-of-women-s-empowerment-and-their-association-with-maternal-mortality-in-low-income-countries
#4
Chiao-Wen Lan, Paula Tavrow
BACKGROUND: Maternal mortality has declined significantly since 1990. While better access to emergency obstetrical care is partially responsible, women's empowerment might also be a contributing factor. Gender equality composite measures generally include various dimensions of women's advancement, including educational parity, formal employment, and political participation. In this paper, we compare several composite measures to assess which, if any, are associated with maternal mortality ratios (MMRs) in low-income countries, after controlling for other macro-level and direct determinants...
November 8, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29137550/reengineering-electronic-fetal-monitoring-interpretation-using-the-fetal-reserve-index-to-anticipate-the-need-for-emergent-operative-delivery
#5
Robert D Eden, Mark I Evans, Shara M Evans, Barry S Schifrin
OBJECTIVE: The near-ubiquitous use of electronic fetal monitoring has failed to lower the rates of both cerebral palsy and emergency operative deliveries (EODs). Its performance metrics have low sensitivity, specificity, and predictive values for both. There are many EODs, but the vast majority have normal outcomes. The EODs, however, cause serious disruption in the delivery suite routine with increased complications, anxiety, and concern for all. METHODS: We developed the fetal reserve index (FRI) as multicomponent algorithm including 4 FHR components (analyzed individually), uterine activity, and maternal, obstetrical, and fetal risk factors to assess risk of cerebral palsy and EOD...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/29137506/measuring-the-impact-of-cash-transfers-and-behavioral-nudges-on-maternity-care-in-nairobi-kenya
#6
Jessica Cohen, Claire Rothschild, Ginger Golub, George N Omondi, Margaret E Kruk, Margaret McConnell
Many patients in low-income countries express preferences for high-quality health care but often end up with low-quality providers. We conducted a randomized controlled trial with pregnant women in Nairobi, Kenya, to analyze whether cash transfers, enhanced with behavioral "nudges," can help women deliver in facilities that are consistent with their preferences and are of higher quality. We tested two interventions. The first was a labeled cash transfer (LCT), which explained that the cash was to help women deliver where they wanted...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29137030/emergency-obstetric-hysterectomy-for-life-threatening-postpartum-hemorrhage-a-12-year-review
#7
Yulong Zhang, Jianying Yan, Qing Han, Tingting Yang, Lihong Cai, Yuelin Fu, Xiaolu Cai, Meimei Guo
The aim of the study was to review the operative experiences of emergency hysterectomy for life-threatening postpartum hemorrhage (PPH) performed over a 12-year period at Fujian Provincial Maternity and Children's Hospital; to examine the incidence and risk factors for emergency obstetric hysterectomy; and to evaluate the curative effectiveness and safety of subtotal hysterectomy for life-threatening PPH.The records of all cases of emergency obstetric hysterectomy performed at Fujian Maternity and Children Health Hospital between January 2004 and June 2016 were analyzed...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29130111/microrna-433-inhibits-cervical-cancer-progression-by-directly-targeting-metadherin-to-regulate-the-akt-and-%C3%AE-catenin-signalling-pathways
#8
Changyan Liang, Jie Ding, Yuebo Yang, Liuzhi Deng, Xiaomao Li
Cervical cancer is one of the most common female malignancies worldwide. Emerging data have shown that microRNAs (miRNAs) play significant roles in various human cancers, including cervical cancer. Aberrantly expressed miRNAs in cervical cancer contribute to tumour occurrence and development as either tumour suppressors or promoters. Research suggests that miRNA-433 (miR-433) possibly plays an important role in the development of various cancer types. However, no study has explored the expression patterns, roles and underlying mechanisms of miR-433 in cervical cancer...
December 2017: Oncology Reports
https://www.readbyqxmd.com/read/29128995/a-systematic-review-of-dietary-interventions-for-gestational-weight-gain-and-gestational-diabetes-in-overweight-and-obese-pregnant-women
#9
REVIEW
Reeta Lamminpää, Katri Vehviläinen-Julkunen, Ursula Schwab
PURPOSE: The number of overweight and obese women is increasing in the obstetric population. The aim of this study was to review studies that reported results related to the efficacy of dietary interventions on gestational weight gain (GWG) or the prevention of gestational diabetes (GDM) in overweight and obese women. METHODS: The search was performed using the CINAHL, PubMed, Scopus and Medic electronic databases and limited to the years between 2000 and March 2016...
November 11, 2017: European Journal of Nutrition
https://www.readbyqxmd.com/read/29128088/emergency-contraception
#10
(no author information available yet)
No abstract text is available yet for this article.
November 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/29123862/management-of-maternal-anaphylaxis-in-pregnancy-a-case-report
#11
Yasunobu Tsuzuki, Mitsuo Narita, Masayuki Nawa, Urara Nakagawa, Toshiaki Wakai
Case: A 26-year-old woman (gravida 2, para 1) at 25 weeks' gestation was brought to the emergency department because of anaphylactic symptoms. She reported eating Japanese soba and developed symptoms of dyspnea, generalized itchy rash, abdominal pain, and severe uterine contractions within 15-30 min of eating. She was immediately treated by normal saline infusion, two injections of epinephrine (intramuscularly), and a nebulized short-acting β2-receptor agonist, followed by H1-antihistamine and methylprednisolone...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29122802/emergency-obstetric-care-provision-in-southern-ethiopia-a-facility-based-survey
#12
Mitchell Windsma, Tienke Vermeiden, Floris Braat, Andualem Mengistu Tsegaye, Asheber Gaym, Thomas van den Akker, Jelle Stekelenburg
OBJECTIVES: To assess the provision of basic emergency obstetric and newborn care (BEmONC), knowledge of high-risk pregnancies and referral capacity at health centres in Southern Ethiopia. DESIGN: A facility-based survey, using an abbreviated version of the Averting Maternal Death and Disability needs assessment tool for emergency obstetric and newborn care. Modules included infrastructure, staffing, number of deliveries, maternal and perinatal mortality, BEmONC signal functions, referral capacity and knowledge of risk factors in pregnancy...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29122786/a-nationwide-population-based-cohort-study-of-peripartum-hysterectomy-and-arterial-embolisation-in-belgium-results-from-the-belgian-obstetric-surveillance-system
#13
Griet Vandenberghe, Marine Guisset, Iris Janssens, Virginie Van Leeuw, Kristien Roelens, Myriam Hanssens, Erika Russo, Joachim Van Keirsbilck, Yvon Englert, Hans Verstraelen
OBJECTIVES: To assess the prevalence of major obstetric haemorrhage managed with peripartum hysterectomy and/or interventional radiology (IR) in Belgium. To describe women characteristics, the circumstances in which the interventions took place, the management of the obstetric haemorrhage, the outcome and additional morbidity of these women. DESIGN: Nationwide population-based prospective cohort study. SETTING: Emergency obstetric care. Participation of 97% of maternities covering 98...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29117653/effect-of-delivery-and-episiotomy-on-the-emergence-of-urinary-incontinence-in-women-review-of-literature
#14
Krešimir Živković, Nikica Živković, Tomislav Župić, Damir Hodžić, Vjekoslav Mandić, Slavko Orešković
Episiotomy is obstetric procedure during which the incision extends the vestibule of the vagina during the second stage of labor. Episiotomy was extensively spread with gradual increase of rates in the first half of the 20th century and was performed medio-laterally in all nulliparous women with the idea to protect fetal head from trauma and pelvic floor from injuries. However, reports claiming that episiotomy had no such benefits were published. It was shown that routine medio-lateral episiotomy did not protect against the appearance of urinary incontinence after vaginal delivery, while the risk of anal incontinence could be increased...
December 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29115073/assessment-of-competence-in-emergency-medicine-among-healthcare-professionals-in-cameroon
#15
Sang Chul Kim, Young Sun Ro, Sang Do Shin, Dae Han Wi, Joongsik Jeong, Ju Ok Park, Kyong Min Sun, Kwangsoo Bae
Development of a competence-based curriculum is important. This study aimed to develop competence assessment tools in emergency medicine and use it to assess competence of Cameroonian healthcare professionals. This was a cross-sectional, descriptive study. Through literature review, expert survey, and discrimination tests, we developed a self-survey questionnaire and a scenario-based competence assessment tool for assessing clinical knowledge and self-confidence to perform clinical practices or procedures. The self-survey consisted of 23 domains and 94 questionnaires on a 5-point Likert scale...
December 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29112646/transfusion-preparedness-strategies-for-obstetric-hemorrhage-a-cost-effectiveness-analysis
#16
Brett D Einerson, Zuzana Stehlikova, Richard E Nelson, Brandon K Bellows, Kensaku Kawamoto, Erin A S Clark
OBJECTIVE: To evaluate the cost-effectiveness of common obstetric transfusion preparedness strategies to prevent emergency-release transfusions. METHODS: A decision analytic model compared five commonly used transfusion preparedness strategies in a general obstetric population. Patients were classified as being at low, moderate, or high risk for transfusion. The most prepared strategy used a policy of universal type and screen plus crossmatch for high-risk patients...
November 3, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29112028/implementation-of-an-electronic-checklist-to-improve-patient-handover-from-ward-to-operating-room
#17
Kristine H Münter, Thea P Møller, Doris Østergaard, Lone Fuhrmann
OBJECTIVE: Research has identified numerous safety risks in perioperative patient handover. In handover from ward to operating room (OR), patients are often transferred by a third person. This adds to the risk of loss of important information and of caregivers in the OR not identifying possible risk factors. The aim of this study was to describe the implementation process and completion rate of a new preoperative, ward-to-OR checklist. Our goal was a 90% fulfillment. METHOD: This study is a prospective, observational study in a Danish University Hospital including all patients undergoing surgery in 2013...
November 4, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/29108472/maternal-and-fetal-outcomes-of-emergency-obstetric-referrals-to-a-nigerian-teaching-hospital
#18
Godwin O Akaba, Bissallah A Ekele
Our study sought to determine the maternal and fetal outcomes of emergency obstetric referrals to a Nigerian teaching hospital as well as assess reasons for these referrals. We enrolled women referred or who presented themselves to the emergency obstetric unit for management of complications of pregnancy, labour, delivery or the puerperium. The majority presented late, their mean duration of stay at the referring facility being 22.25 h. Only nine (7.3%) were transported by ambulance. Severe pre-eclampsia and eclampsia (in 33, 26...
January 1, 2017: Tropical Doctor
https://www.readbyqxmd.com/read/29096592/-safe-yet-violent-women-s-experiences-with-obstetric-violence-during-hospital-births-in-rural-northeast-india
#19
Sreeparna Chattopadhyay, Arima Mishra, Suraj Jacob
The majority of maternal health interventions in India focus on increasing institutional deliveries to reduce maternal mortality, typically by incentivising village health workers to register births and making conditional cash transfers to mothers for hospital births. Based on over 15 months of ethnographically informed fieldwork conducted between 2015 and 2017 in rural Assam, the Indian state with the highest recorded rate of maternal deaths, we find that while there has been an expansion in institutional deliveries, the experience of childbirth in government facilities is characterised by obstetric violence...
November 3, 2017: Culture, Health & Sexuality
https://www.readbyqxmd.com/read/29092726/factors-associated-with-unplanned-readmissions-in-a-major-australian-health-service
#20
Julie Considine, Karen Fox, David Plunkett, Melissa Mecner, Mary O'Reilly, Peteris Darzins
Objective The aim of the present study was to gain an understanding of the factors associated with unplanned hospital readmission within 28 days of acute care discharge from a major Australian health service.Methods A retrospective study of 20575 acute care discharges from 1 August to 31 December 2015 was conducted using administrative databases. Patient, index admission and readmission characteristics were evaluated for their association with unplanned readmission in ≤28 days.Results The unplanned readmission rate was 7...
November 2, 2017: Australian Health Review: a Publication of the Australian Hospital Association
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