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Update on obstetric

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https://www.readbyqxmd.com/read/28332182/status-update-on-women-s-reproductive-health-care-and-obstetrics-gynecology-postgraduate-training-in-post-ebola-sierra-leone
#1
Rachel Chan Seay, A P Koroma, Jenell Coleman, Clark T Johnson, Emmanuel A Ugwa, Jean Anderson
Academic partnerships can help to expand the women's reproductive healthcare workforce and improve maternal mortality.(1) In-country postgraduate and continuing medical education opportunities are key to training and retaining specialized physicians. The present report describes a developing academic partnership to build capacity in Sierra Leone following the Ebola virus disease epidemic. This article is protected by copyright. All rights reserved.
March 23, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28326198/could-perinatal-asphyxia-induce-a-synaptopathy-new-highlights-from-an-experimental-model
#2
REVIEW
María Inés Herrera, Matilde Otero-Losada, Lucas Daniel Udovin, Carlos Kusnier, Rodolfo Kölliker-Frers, Wanderley de Souza, Francisco Capani
Birth asphyxia also termed perinatal asphyxia is an obstetric complication that strongly affects brain structure and function. Central nervous system is highly susceptible to oxidative damage caused by perinatal asphyxia while activation and maturity of the proper pathways are relevant to avoiding abnormal neural development. Perinatal asphyxia is associated with high morbimortality in term and preterm neonates. Although several studies have demonstrated a variety of biochemical and molecular pathways involved in perinatal asphyxia physiopathology, little is known about the synaptic alterations induced by perinatal asphyxia...
2017: Neural Plasticity
https://www.readbyqxmd.com/read/28321847/antenatal-corticosteroids-for-accelerating-fetal-lung-maturation-for-women-at-risk-of-preterm-birth
#3
REVIEW
Devender Roberts, Julie Brown, Nancy Medley, Stuart R Dalziel
BACKGROUND: Respiratory morbidity including respiratory distress syndrome (RDS) is a serious complication of preterm birth and the primary cause of early neonatal mortality and disability. While researching the effects of the steroid dexamethasone on premature parturition in fetal sheep in 1969, Liggins found that there was some inflation of the lungs of lambs born at gestations at which the lungs would be expected to be airless. Liggins and Howie published the first randomised controlled trial in humans in 1972 and many others followed...
March 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28291236/acute-fatty-liver-disease-of-pregnancy-updates-in-pathogenesis-diagnosis-and-management
#4
REVIEW
Joy Liu, Tara T Ghaziani, Jacqueline L Wolf
Acute fatty liver of pregnancy (AFLP) is an obstetric emergency characterized by maternal liver failure and may have complications for the mother and fetus, including death. This review examines recent literature on the epidemiology, pathogenesis, diagnosis, and treatment of acute fatty liver of pregnancy. Pathogenesis of this disease has been linked to defects in fatty acid metabolism during pregnancy, especially in the setting of fetal genetic defects in fatty acid oxidation. The value of screening all patients for these genetic defects remains to be determined...
March 14, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28284515/hepatitis-b-and-pregnancy
#5
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/28241927/no-341-diagnosis-and-management-of-adnexal-torsion-in-children-adolescents-and-adults
#6
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/28225422/clinical-updates-in-women-s-health-care-summary-structural-heart-disease-primary-and-preventive-care-review
#7
Tiberio Frisoli, Michele Doughty Voeltz
Reproductive-aged women with structural heart disease who become pregnant as well as postreproductive-aged women with this condition represent a significant proportion of patients seen by obstetrician- gynecologists. Usually, their conditions are complex, and a basic knowledge of the anatomy and physiology of the heart is required. Additionally, understanding the effect of pregnancy on women with structural heart disease is critically important to optimizing maternal and fetal outcomes. This monograph addresses the pathophysiology, signs and symptoms, screening and diagnosis, basic management, and suggested counseling for an obstetric-gynecologic patient with structural heart disease...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28062025/amniotic-fluid-technical-update-on-physiology-and-measurement
#8
Kenneth I Lim, Kimberly Butt, Kentia Naud, Mila Smithies
OBJECTIVE: OUTCOMES: EVIDENCE: A MEDLINE and KFINDER search was used to identify relevant articles, with review of bibliography identified article including Cochrane reviews and recent review articles. VALUES: The evidence collected was reviewed by the Diagnostic Imaging Committee of the Society of Obstetricians and Gynecologists of Canada. The recommendations were made according to the guidelines developed by The Canadian Task Force on Preventative Health Care (Table 1)...
January 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28054230/tumor-necrosis-factor-alpha-and-pregnancy-focus-on-biologics-an-updated-and-comprehensive-review
#9
REVIEW
Jaume Alijotas-Reig, Enrique Esteve-Valverde, Raquel Ferrer-Oliveras, Elisa Llurba, Josep Maria Gris
Tumor necrosis factor-α (TNF-α) is a central regulator of inflammation, and TNF-α antagonists may be effective in treating inflammatory disorders in which TNF-α plays a major pathogenic role. TNF-α has also been associated with inflammatory mechanisms related to implantation, placentation, and pregnancy outcome. TNF-α is secreted by immune cells and works by binding to TNFR1 and TNFR2 cell receptors. TNF-α is also related to JAK/STAT pathways, which opens up hypothetical new targets for modifying. The accurate balance between Th1 cytokines, mainly TNF-α, Th17, and Th2, particularly IL-10 is essential to achieve good obstetric outcomes...
January 4, 2017: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/28008286/pregnancy-after-bariatric-surgery-improving-outcomes-for-mother-and-child
#10
REVIEW
Irene González, Albert Lecube, Miguel Ángel Rubio, Pedro Pablo García-Luna
The significant increase in the prevalence of obesity has led to an increase in the number of obese women who become pregnant. In this setting, in recent years, there has been an exponential rise in the number of bariatric procedures, with approximately half of them performed in women of childbearing age, and a remarkable surge in the number of women who become pregnant after having undergone bariatric surgery (BS). These procedures entail the risk of nutritional deficiencies, and nutrition is a crucial aspect during pregnancy...
2016: International Journal of Women's Health
https://www.readbyqxmd.com/read/28005272/prophylactic-versus-selective-blood-transfusion-for-sickle-cell-disease-in-pregnancy
#11
REVIEW
Babasola O Okusanya, Olufemi T Oladapo
BACKGROUND: Pregnant women with sickle cell disease (HbSS, HbSC and HbSβThal) may require blood transfusion to prevent severe anaemia or to manage potential medical complications. Preventive blood transfusion in the absence of complications starting from the early weeks of pregnancy or blood transfusion only for medical or obstetric indications have been used as management policies. There is currently no consensus on the blood transfusion policy that guarantees optimal clinical benefits with minimal risks for such women and their babies...
December 22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27932010/bottleneck-analysis-approach-to-accelerate-newborn-care-services-in-two-regions-in-ghana-implications-for-national-newborn-care
#12
A E Yawson, J K Awoonor-Williams, I Sagoe-Moses, P K Aboagye, A O Yawson, L K Senaya, G Bonsu, J B Eleeza, E E A Agongo, H K Banskota
OBJECTIVE: The aim of this work is to describe application of a data-driven approach (bottleneck analysis [BNA] approach process) to accelerate newborn care services in two regions and what effect it had on national-level newborn care interventions in Ghana. STUDY DESIGN: A mixed-method approach was used for the study. The BNA tool generated quantitative data and group discussions provided phenomenological explanations to identified service gaps. METHODS: Regional newborn care health service assessments were conducted in November 2013 through desk reviews, field and health facility visits and coaching/mentorship...
December 2016: Public Health
https://www.readbyqxmd.com/read/27924688/susceptibility-to-vaccine-preventable-diseases-and-vaccination-adherence-among-healthcare-workers-in-italy-a-cross-sectional-survey-at-a-regional-acute-care-university-hospital-and-a-systematic-review
#13
Umberto Leone Roberti Maggiore, Carolina Scala, Alessandra Toletone, Nicoletta Debarbieri, Mauro Perria, Beatrice D'Amico, Alfredo Montecucco, Mariano Martini, Guglielmo Dini, Paolo Durando
Healthcare Workers (HCWs) have an increased risk both to acquire and to spread vaccine preventable diseases (VPDs) both to their colleagues and, especially, to vulnerable patients. The prevention of occupational hazards among HCWs is based on proper adoption of the standard and additional precautions, immunizations, and secondary preventive measures, such as post-exposure prophylaxis. Moreover, HCWs are often referred to as the most trusted source of vaccine-related information for their patients. In the present article, we report the findings of a cross-sectional study investigating the compliance to vaccinations among HCWs employed at the Obstetric Unit of a regional acute-care University Hospital in Northern Italy...
February 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/27914244/surgical-treatment-and-histopathological-assessment-of-advanced-cervicovaginal-carcinoma-a-prospective-study-and-retrospective-analysis
#14
Michael Höckel, Benjamin Wolf, Bettina Hentschel, Lars-Christian Horn
BACKGROUND: Standard treatment of advanced cervicovaginal cancer [international federation of gynecology and obstetrics (FIGO) stages II(B), III(A, B), IVA] is (chemo-)radiation excluding the possibility of systematic histopathological assessment of locoregional tumour spread. Laterally extended endopelvic resection (LEER) and therapeutic lymph node dissection (tLND) are novel surgical treatment options for advanced cervicovaginal cancer. METHODS: The therapeutic efficacy of LEER for locally advanced primary and recurrent cervicovaginal cancer was reassessed by an update of the prospective observational trial at the University of Leipzig...
January 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/27765958/diagnosis-therapy-and-follow-up-care-of-vulvar-cancer-and-its-precursors-guideline-of-the-dggg-and-dkg-s2k-level-awmf-registry-number-015-059-november-2015
#15
H G Schnürch, S Ackermann, C D Alt, J Barinoff, C Böing, C Dannecker, F Gieseking, A Günthert, P Hantschmann, L C Horn, R Kürzl, P Mallmann, S Marnitz, G Mehlhorn, C C Hack, M C Koch, U Torsten, W Weikel, L Wölber, M Hampl
Purpose: This is an official guideline, published and coordinated by the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO, Study Group for Gynecologic Oncology) of the Deutsche Krebsgesellschaft (DKG, German Cancer Society) and the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG, German Society for Gynecology and Obstetrics). The number of cases with vulvar cancer is on the rise, but because of the former rarity of this condition and the resulting lack of literature with a high level of evidence, in many areas knowledge of the optimal clinical management still lags behind what would be required...
October 2016: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/27737492/laparoscopy-versus-laparotomy-for-figo-stage-i-ovarian-cancer
#16
REVIEW
Frederico S Falcetta, Theresa A Lawrie, Lídia Rf Medeiros, Maria Ines da Rosa, Maria I Edelweiss, Airton T Stein, Alice Zelmanowicz, Anaelena B Moraes, Roselaine R Zanini, Daniela D Rosa
BACKGROUND: This is an updated version of the original review that was first published in the Cochrane Database of Systematic Reviews 2008, Issue 4. Laparoscopy has become an increasingly common approach to surgical staging of apparent early-stage ovarian tumours. This review was undertaken to assess the available evidence on the benefits and risks of laparoscopy compared with laparotomy for the management of International Federation of Gynaecology and Obstetrics (FIGO) stage I ovarian cancer...
October 13, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27720516/-pregnancy-in-women-with-spinal-cord-injuries-state-of-knowledge
#17
B Boisseau, B Perrouin-Verbe, N Le Guillanton, I Derrendinger, A-S Riteau, B Idiard-Chamois, N Winer
OBJECTIVES: Updating knowledge of health professionals about pregnant women with spinal cord injuries. Development of maternity hospitals to make them accessible to spinal cord injured pregnant women to improve their care in pre-, per- and post-partum. METHODS: Cross-sectional declarative study based on a questionnaire distributed to health professionals in the maternity hospital of the University Hospital of Nantes and liberal midwives of Nantes conurbation, based on their knowledge, their difficulties and their expectations for obstetrical care for spinal cord injured women...
November 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27681692/an-update-on-the-acute-management-of-shoulder-dystocia
#18
Marisa Gilstrop, Matthew K Hoffman
Shoulder dystocia continues to challenge obstetrical providers and therefore the management must evolve. The available literature demonstrates clear value in both simulation training and having a clear algorithmic approach. Similarly, the available literature suggests that delivery of the posterior arm should be prioritized. Several new techniques such as the Menticoglou maneuver, Gaskin's maneuver, and the posterior axilla sling traction technique offer obstetrical choices after more traditional techniques have failed...
December 2016: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27670710/management-of-spontaneous-labour-at-term%C3%A2-in-healthy-women
#19
Lily Lee, Jessica Dy, Hussam Azzam
OBJECTIVE: The purpose of this guideline is to provide guidance for the intrapartum management of spontaneous labour, whether normal or abnormal, in term, healthy women, and to provide guidance in the management of first and second stage dystocia to increase the likelihood of a vaginal birth and optimize birth outcomes. EVIDENCE: Published literature was retrieved through searches of PubMed and the Cochrane Library in October 2011 using appropriate, controlled vocabulary (e...
September 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27649091/european-consensus-guidelines-on-the-management-of-respiratory-distress-syndrome-2016-update
#20
David G Sweet, Virgilio Carnielli, Gorm Greisen, Mikko Hallman, Eren Ozek, Richard Plavka, Ola Didrik Saugstad, Umberto Simeoni, Christian P Speer, Máximo Vento, Gerard H A Visser, Henry L Halliday
Advances in the management of respiratory distress syndrome (RDS) ensure that clinicians must continue to revise current practice. We report the third update of the European Guidelines for the Management of RDS by a European panel of expert neonatologists including input from an expert perinatal obstetrician based on available literature up to the beginning of 2016. Optimizing the outcome for babies with RDS includes consideration of when to use antenatal steroids, and good obstetric practice includes methods of predicting the risk of preterm delivery and also consideration of whether transfer to a perinatal centre is necessary and safe...
2017: Neonatology
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