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Emergency obstetric

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https://www.readbyqxmd.com/read/28930786/the-relationship-between-2009-pandemic-h1n1-influenza-during-pregnancy-and-preterm-birth-a-population-based-cohort-study
#1
Deshayne B Fell, Robert W Platt, Olga Basso, Kumanan Wilson, Jay S Kaufman, David L Buckeridge, Jeffrey C Kwong
BACKGROUND: Previous studies of maternal influenza illness and preterm birth have yielded inconsistent results. Our objective was to assess the association between 2009 pandemic H1N1 (pH1N1) influenza during pregnancy and preterm birth in a large obstetrical population. METHODS: We linked a province-wide birth registry with health administrative databases to identify influenza-coded hospitalizations, emergency department visits, or physician visits among pregnant women during the 2009 H1N1 pandemic (our proxy for clinical pH1N1 influenza illness)...
September 19, 2017: Epidemiology
https://www.readbyqxmd.com/read/28929879/safer-muslim-motherhood-social-conditions-and-maternal-mortality-in-the-muslim-world
#2
Kylea Laina Liese, Angela B Maeder
The greatest variation in maternal mortality is among poor countries and wealthy countries that rely on emergency obstetric technology to save a woman's life during childbirth. However, substantial variation in maternal mortality ratios (MMRs) exists within and among poor countries with uneven access to advanced obstetric services. This article examines MMRs across the Muslim world and compares the impact of national wealth, female education, and skilled birth attendants on maternal mortality. Understanding how poor countries have lowered MMRs without access to expensive obstetric technologies suggests that certain social variables may act protectively to reduce the maternal risk for life-threatening obstetric complications that would require emergency obstetric care...
September 20, 2017: Global Public Health
https://www.readbyqxmd.com/read/28928575/referrral-systems-development-and-survey-of-perioperative-and-critical-care-referral-to-anesthetists
#3
P L Narendra, Harihar V Hegde, Maroof Ahmad Khan, Dayanand G Talikoti, Samson Nallamilli
INTRODUCTION: Anesthetists come in contact with more than two-third of hospital patients. Timely referral to anesthetists is vital in perioperative and remote site settings. Delayed referrals, improper referrals, and referrals at inappropriate levels can result in inadequate preparation, perioperative complications, and poor outcome. METHODS: The self administered paper survey to delegates attending anesthesia conferences. Questions were asked on how high-risk, emergency surgical cases remote site and critical care patients were referred to anesthetists and presence of rapid response teams...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28927497/decision-to-delivery-time-and-perinatal-complications-in-emergency-cesarean-section
#4
Günther Heller, Erik Bauer, Stefanie Schill, Teresa Thomas, Frank Louwen, Friedrich Wolff, Björn Misselwitz, Stephan Schmidt, Christof Veit
BACKGROUND: A decision-to-delivery interval (DDI) of no more than 20 minutes has long been considered a requirement for cesarean sections, even though there have hardly been any studies on this topic. We retrospectively investigated data relevant to DDI for emergency cesarean sections performed for the most common indications, namely, suspected and documented fetal asphyxia. METHODS: We analyzed data on emergency in-hospital cesarean sections in the period 2008-2015...
September 4, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28919603/current-trends-of-using-antimicrobials-at-obstetrics-and-gynaecology-department-in-a-tertiary-care-hospital
#5
M M Islam, S K Saha, S Saha, U A Wahid, R R Gomes, K S Ahmed, A N Naushad, S E Suchi, C Saha, D Mondal
This cross-sectional descriptive study was done to analyse the current trends of using antimicrobials in various surgical procedures at Obstetrics and Gynaecology department in Mymensingh Medical College Hospital, Mymensingh from July 2014 to June 2015. Among 300 postoperative obstetrics and gynaecological surgery cases, samples were selected as non-random purposive selection method where pattern of using antimicrobials were analysed by SPSS method 20.1 versions. The incidence of antimicrobial resistance is on continued rise with a threat to return to the pre-antibiotic era...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28919404/emergency-in-the-clinic-a-simulation-curriculum-to-improve-outpatient-safety
#6
Eve Espey, Gillian Baty, John Rask, Michelle Chungtuyco, Brenda Pereda, Lawrence Leeman
BACKGROUND: Emergency response skills are essential when events such as seizure, anaphylaxis or hemorrhage occur in the outpatient setting. As services and procedures increasingly move outside the hospital, training to manage complications may improve outcomes. OBJECTIVE: The objective of this study was to evaluate a simulation-based curriculum in outpatient emergency management skills with the outcome measures of graded objective performance and learner self-efficacy...
September 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28913496/anaesthesiologists-simulation-training-during-emergencies-in-obstetrics
#7
Volodymyr V Artyomenko, Volodymyr M Nosenko
BACKGROUND AND AIMS: Methods of simulation training and quality assessment during obstetric emergencies are still ambiguous. The aim of this study was to evaluate the effectiveness of anaesthesiologists' simulation training for emergency situations in obstetrics. METHODS: We conducted a prospective, descriptive, and comparative study to evaluate the anaesthesiologists' simulation training effectiveness during obstetrical emergencies. Data of 109 obstetrical anaesthesiologists trained over two years for invasive procedures and cardiopulmonary resuscitation, high-fidelity scenarios and medical personnel teamwork included were analyzed...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28913126/angular-pregnancy
#8
İbrahim Alanbay, Mustafa Öztürk, Kazım Emre Karaşahin, Müfit Cemal Yenen
Angular pregnancy is a rare condition in which the embryo is implanted in the lateral angle of the uterine cavity, medial to the uterotubal junction and round ligament, and causes life-threatening obstetric complications. It is important to differentiate this condition from interstitial and cornual pregnancy because they all result in emergency conditions. Although angular pregnancy can progress to term pregnancy, it may be associated with major obstetric complications such as uterine rupture, placental retention, postpartum hemorrhage, or may need further surgery and hysterectomy...
December 2016: Turk J Obstet Gynecol
https://www.readbyqxmd.com/read/28905356/impact-of-shoulder-dystocia-stratified-by-type-of-manoeuvre-on-severe-neonatal-outcome-and-maternal-morbidity
#9
Flurina Michelotti, Christopher Flatley, Sailesh Kumar
BACKGROUND: Shoulder dystocia is an uncommon and unpredictable obstetric emergency. It is associated with significant neonatal, maternal and medico-legal consequences. AIM: To ascertain the impact shoulder dystocia has on severe neonatal and maternal outcomes specific to the type of manoeuvre. MATERIALS AND METHODS: This was a retrospective study of 48 021 term singleton vaginal deliveries the Mater Mothers' Hospital in Brisbane between 2007 and 2015...
September 14, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28904676/-gestational-diabetes-revealed-by-inaugural-diabetic-ketoacidosis-about-a-case
#10
Serge Irie Bi Gohi, Pete Yaich, Koffi N'guessan, Bernard Ogondon, Yapo Brouh
Ketoacidosis complicating gestational diabetes is rare and responsible for severe maternal-fetal mortality. It is an acute metabolic emergency whose management is multidisciplinary. Early diagnosis and treatment affect the vital prognosis of both the mother and the fetus. We report the case of a 27-year old pregnant woman at term, with a family history of diabetes, admitted to the emergency obstetric care with alertness problems associated with dyspnoea. The diagnosis of inaugural ketoacidosis decompensated due to severe malaria associated with gestational diabetes was retained on the basis of patient's medical history, of clinical examination and paraclinical assessment...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28901005/delivery-arrangements-for-health-systems-in-low-income-countries-an-overview-of-systematic-reviews
#11
REVIEW
Agustín Ciapponi, Simon Lewin, Cristian A Herrera, Newton Opiyo, Tomas Pantoja, Elizabeth Paulsen, Gabriel Rada, Charles S Wiysonge, Gabriel Bastías, Lilian Dudley, Signe Flottorp, Marie-Pierre Gagnon, Sebastian Garcia Marti, Claire Glenton, Charles I Okwundu, Blanca Peñaloza, Fatima Suleman, Andrew D Oxman
BACKGROUND: Delivery arrangements include changes in who receives care and when, who provides care, the working conditions of those who provide care, coordination of care amongst different providers, where care is provided, the use of information and communication technology to deliver care, and quality and safety systems. How services are delivered can have impacts on the effectiveness, efficiency and equity of health systems. This broad overview of the findings of systematic reviews can help policymakers and other stakeholders identify strategies for addressing problems and improve the delivery of services...
September 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28898688/improving-non-technical-skills-teamwork-in-post-partum-haemorrhage-a-grouped-randomised-trial
#12
Pippa M Letchworth, Shane P Duffy, Dan Phillips
OBJECTIVE: To determine the effect of a decision support technology on teamwork and associated non-technical (NTS) and technical skills when teams manage post-partum haemorrhage (PPH) in the simulated environment. METHODS: Multidisciplinary (MDT) maternity teams were taught how to manage post partum haemorrhage. They were randomised to the intervention: using a decision support mobile digital platform or a control group. Each team managed a post-partum simulation, which was recorded and reviewed by assessors...
August 26, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28885400/internal-validation-of-the-sepsis-in-obstetrics-score-to-identify-risk-of-morbidity-from-sepsis-in-pregnancy
#13
Catherine M Albright, Phinnara Has, Dwight J Rouse, Brenna L Hughes
OBJECTIVE: To prospectively validate the Sepsis in Obstetrics Score, a pregnancy-specific sepsis scoring system, to identify risk for intensive care unit (ICU) admission for sepsis in pregnancy. METHODS: This is a prospective validation study of the Sepsis in Obstetrics Score. The primary outcome was admission to the ICU for sepsis. Secondary outcomes included admission to a telemetry unit and time to administration of antibiotic therapy. We evaluated test characteristics of a predetermined score of 6 or greater...
September 5, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28882128/institutional-maternal-and-perinatal-deaths-a-review-of-40-low-and-middle-income-countries
#14
Patricia E Bailey, Wasihun Andualem, Michel Brun, Lynn Freedman, Sourou Gbangbade, Malick Kante, Emily Keyes, Edwin Libamba, Allisyn C Moran, Halima Mouniri, Dahada Ould El Joud, Kavita Singh
BACKGROUND: Understanding the magnitude and clinical causes of maternal and perinatal mortality are basic requirements for positive change. Facility-based information offers a contextualized resource for clinical and organizational quality improvement. We describe the magnitude of institutional maternal mortality, causes of death and cause-specific case fatality rates, as well as stillbirth and pre-discharge neonatal death rates. METHODS: This paper draws on secondary data from 40 low and middle income countries that conducted emergency obstetric and newborn care assessments over the last 10 years...
September 7, 2017: BMC Pregnancy and Childbirth
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
#15
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/28877675/signal-functions-for-emergency-obstetric-care-as-an-intervention-for-reducing-maternal-mortality-a-survey-of-public-and-private-health-facilities-in-lusaka-district-zambia
#16
Tannia Tembo, Gershom Chongwe, Bellington Vwalika, Lungowe Sitali
BACKGROUND: Zambia's maternal mortality ratio was estimated at 398/100,000 live births in 2014. Successful aversion of deaths is dependent on availability and usability of signal functions for emergency obstetric and neonatal care. Evidence of availability, usability and quality of signal functions in urban settings in Zambia is minimal as previous research has evaluated their distribution in rural settings. This survey evaluated the availability and usability of signal functions in private and public health facilities in Lusaka District of Zambia...
September 6, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28874936/factors-influencing-participation-in-clinical-trials-emergency-medicine-vs-other-specialties
#17
Anita Kurt, Hope M Kincaid, Charity Curtis, Lauren Semler, Matthew Meyers, Melanie Johnson, Beth A Careyva, Brian Stello, Timothy J Friel, Mark C Knouse, John C Smulian, Jeanne L Jacoby
INTRODUCTION: This study investigated factors that influence emergency medicine (EM) patients' decisions to participate in clinical trials and whether the impact of these factors differs from those of other medical specialties. METHODS: A survey was distributed in EM, family medicine (FM), infectious disease (ID), and obstetrics/gynecology (OB/GYN) outpatient waiting areas. Eligibility criteria included those who were 18 years of age or older, active patients on the day of the survey, and able to complete the survey without assistance...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28873334/pregnancy-outcome-in-women-with-congenital-heart-disease-a-single-center-experience
#18
Despina Ntiloudi, Thomas Zegkos, Maria Anna Βazmpani, Despoina Parcharidou, Theofilos Panagiotidis, Stavros Hadjimiltiades, Haralambos Karvounis, George Giannakoulas
BACKGROUND: Pregnancies in patients with adult congenital heart disease (ACHD) are often complicated. We aimed to highlight the nature and the rate of these complications in a single center patient population. METHODS: We studied retrospectively all the pregnancies of women who presented on an outpatient basis and all pregnancies were reviewed for maternal and fetal outcomes. RESULTS: Of 117 pregnancies from 52 ACHD patients (age at pregnancy 28...
September 2, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28867883/examining-the-use-of-magnesium-sulfate-to-treat-pregnant-women-with-preeclampsia-and-eclampsia-results-of-a-program-assessment-of-emergency-obstetric-care-emoc-training-in-india
#19
Henna Budhwani, Poonam Shivkumar, Chittaranjan Narhari Purandare, Nicholas A Cataldo, Sadhana Desai, Prakash Bhatt, Dinesh Baswal, Ajey Bhardwaj
BACKGROUND: The aim of this study is to examine rates of magnesium sulfate utilization by emergency obstetric care trainees to treat preeclampsia-eclampsia in India. Secondarily, structural barriers are identified which limit the use of magnesium sulfate, highlighting limitations of emergency obstetric care training, which is a commonly implemented intervention in resource-poor settings. METHODS: Trainees' curriculum specified magnesium sulfate treatment for eclampsia and severe preeclampsia...
October 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28864269/uses-of-chitosan-for-treating-different-forms-of-serious-obstetrics-hemorrhages
#20
G Carles, C Dabiri, A Mchirgui, E O Saoudi, N Hcini, K Pouget, B Seve, B de Matteis
Postpartum hemorrhage is a major cause of maternal death worldwide. Many therapeutic strategies have been developed to reduce maternal morbidity and mortality like oxytocin, prostaglandin, and uterine balloons. A new member of the therapeutic arsenal has recently emerged, the chitosan (Celox(®)), used since several years by military doctors to stop bleeding of combat wounds. In 2012, a first study was reported with the successful use of chitosan-coated gauze to treat severe postpartum hemorrhage. We report here four cases of the use of chitosan to treat life-threatening obstetric bleeding...
August 31, 2017: Journal of gynecology obstetrics and human reproduction
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