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severe maternal morbidity

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https://www.readbyqxmd.com/read/28937571/practice-bulletin-no-183-postpartum-hemorrhage
#1
(no author information available yet)
Maternal hemorrhage, defined as a cumulative blood loss of greater than or equal to 1,000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after the birth process, remains the leading cause of maternal mortality worldwide (1). Additional important secondary sequelae from hemorrhage exist and include adult respiratory distress syndrome, shock, disseminated intravascular coagulation, acute renal failure, loss of fertility, and pituitary necrosis (Sheehan syndrome).Hemorrhage that leads to blood transfusion is the leading cause of severe maternal morbidity in the United States closely followed by disseminated intravascular coagulation (2)...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937566/practice-bulletin-no-183-summary-postpartum-hemorrhage
#2
(no author information available yet)
Maternal hemorrhage, defined as a cumulative blood loss of greater than or equal to 1,000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after the birth process, remains the leading cause of maternal mortality worldwide (1). Additional important secondary sequelae from hemorrhage exist and include adult respiratory distress syndrome, shock, disseminated intravascular coagulation, acute renal failure, loss of fertility, and pituitary necrosis (Sheehan syndrome).Hemorrhage that leads to blood transfusion is the leading cause of severe maternal morbidity in the United States closely followed by disseminated intravascular coagulation (2)...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28920504/outpatient-cervical-ripening-in-a-district-general-hospital-a-five-year-retrospective-cohort-study
#3
Lauren Barnfield, Edmund Neale, Sarah Reynolds
The number of women undergoing induction of labour has risen steadily in recent years. Outpatient induction is becoming more common in the UK in response to the required increase in resources, although evidence supporting its safety is lacking. We reviewed the notes of low-risk women presenting for outpatient cervical ripening using prostaglandins over a five-year period, and compared our neonatal and maternal outcomes to local and national data. Of the 502 eligible women, 400 underwent outpatient treatment...
September 18, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28905356/impact-of-shoulder-dystocia-stratified-by-type-of-manoeuvre-on-severe-neonatal-outcome-and-maternal-morbidity
#4
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/28889774/vaginal-breech-delivery-at-term-and-neonatal-morbidity-and-mortality-a-population-based-cohort-study-in-sweden
#5
C Ekéus, M Norman, K Åberg, S Winberg, K Stolt, A Aronsson
INTRODUCTION: The routine to deliver almost all term breech cases by elective cesarean section (CS) has continued to be debated due to the risk of maternal and neonatal complications. The aims of the study were 1) to investigate if mode of delivery impacts on the risk of morbidity and mortality among term infants in breech presentation and 2) to compare the rates of severe neonatal complications and mortality in relation to presentation and mode of delivery. METHODS: This population-based cohort study used data from the Swedish Medical Birth Register...
September 10, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28888263/epidemiology-of-racial-ethnic-disparities-in-severe-maternal-morbidity-and-mortality
#6
Sarah J Holdt Somer, Rachel G Sinkey, Allison S Bryant
The literature abounds with examples of racial/ethnic disparities in both obstetric outcomes and care. Disparities in maternal mortality are well documented with non-Hispanic blacks carrying the burden of the highest maternal mortality rates. Maternal deaths likely represent only the "tip of the iceberg" with respect to pregnancy complications, leading many to explore risk factors and disparities in severe maternal morbidity, a more common precursor to maternal mortality. This review article explores commonly cited indicators of severe maternal morbidity and includes a review of the epidemiological literature supporting or refuting disparities among each indicator...
August 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28887883/early-screening-and-prevention-of-preterm-preeclampsia-with-aspirin-time-for-clinical-implementation
#7
EDITORIAL
Daniel L Rolnik, Neil O'Gorman, Stephanie Roberge, Emmanuel Bujold, Jonathan Hyett, Serge Uzan, Michel Beaufils, Fabricio da Silva Costa
Despite all the research published in the last three decades on screening and prevention of preeclampsia (PE), this condition remains one of the main causes of maternal and perinatal morbidity and mortality, both in low and high-income countries. It affects 2-8% of all pregnancies, being responsible for one out of five maternal deaths and 15% of all premature deliveries(1) . An ideal screening test requires identification of women at high-risk of developing severe and early-onset forms of the disease, a high detection rate (DR) with an acceptable false-positive rate (FPR), and the availability of an effective preventive measure(2) ...
September 9, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28885417/association-of-nonsteroidal-antiinflammatory-drugs-and-postpartum-hypertension-in-women-with-preeclampsia-with-severe-features
#8
Oscar A Viteri, Joey A England, Mesk A Alrais, Kayla A Lash, Maria I Villegas, Olaide A Ashimi Balogun, Suneet P Chauhan, Baha M Sibai
OBJECTIVE: To estimate whether nonsteroidal antiinflammatory drugs (NSAIDs) are associated with persistent postpartum hypertension in a cohort of women with preeclampsia and severe features. METHODS: We conducted a retrospective cohort study at a single, tertiary center from January 2013 to December 2015. All women diagnosed with severe preeclampsia who remained hypertensive for greater than 24 hours after delivery were included. The primary outcome was the rate of persistent postpartum hypertension, defined as systolic blood pressure 150 mm Hg or greater or diastolic 100 mm Hg or greater (or both), on two occasions, at least 4 hours apart...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28871576/first-trimester-combined-screening-for-preeclampsia-and-small-for-gestational-age-a-single-centre-experience-and-validation-of-the-fmf-screening-algorithm
#9
Beatrice Mosimann, Chantal Pfiffner, Sofia Amylidi-Mohr, Lorenz Risch, Daniel Surbek, Luigi Raio
AIM OF THE STUDY: Preeclampsia (PE) is associated with severe maternal and fetal morbidity in the acute presentation and there is increasing evidence that it is also an important risk factor for cardiovascular disease later in life. Therefore, preventive strategies are of utmost importance. The Fetal Medicine Foundation (FMF) London recently developed a first trimester screening algorithm for placenta-related pregnancy complications, in particular early onset preeclampsia (eoPE) requiring delivery before 34 weeks, and preterm small for gestational age (pSGA), with a birth weight <5th percentile and delivery before 37 weeks of gestation, based on maternal history and characteristics, and biochemical and biophysical parameters...
September 5, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28870155/pessary-or-progesterone-to-prevent-preterm-delivery-in-women-with-short-cervical-length-the-quadruple-p-randomised-controlled-trial
#10
Maud D van Zijl, Bouchra Koullali, Christiana A Naaktgeboren, Ewoud Schuit, Dick J Bekedam, Etelka Moll, Martijn A Oudijk, Wilhelmina M van Baal, Marjon A de Boer, Henricus Visser, Joris van Drongelen, Flip W van de Made, Karlijn C Vollebregt, Moira A Muller, Mireille N Bekker, Jozien T J Brons, Marieke Sueters, Josje Langenveld, Maureen T Franssen, Nico W Schuitemaker, Erik van Beek, Hubertina C J Scheepers, Karin de Boer, Eveline M Tepe, Anjoke J M Huisjes, Angelo B Hooker, Evelyn C J Verheijen, Dimitri N Papatsonis, Ben Willem J Mol, Brenda M Kazemier, Eva Pajkrt
BACKGROUND: Preterm birth is in quantity and in severity the most important topic in obstetric care in the developed world. Progestogens and cervical pessaries have been studied as potential preventive treatments with conflicting results. So far, no study has compared both treatments. METHODS/DESIGN: The Quadruple P study aims to compare the efficacy of vaginal progesterone and cervical pessary in the prevention of adverse perinatal outcome associated with preterm birth in asymptomatic women with a short cervix, in singleton and multiple pregnancies separately...
September 4, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28864930/contemporary-epidemiology-and-novel-predictors-of-uterine-rupture-a-nationwide-population-based-study
#11
Gustavo Vilchez, Sarah Nazeer, Komal Kumar, Morgan Warren, Jing Dai, Robert J Sokol
PURPOSE: In spite of several policies aiming to decrease cesarean rates and related complications such as uterine rupture, data show that uterine rupture and associated morbidity are increasing along the years. Whether previously unidentified risk factors are currently playing an important role on these trends is unknown. We analyze current risks of uterine rupture and main preceding factors from more recent years compared to former data. METHODS: All uterine rupture cases in the US from 2011-2012 were selected, with matched non-uterine rupture cases selected as controls...
September 1, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28864269/uses-of-chitosan-for-treating-different-forms-of-serious-obstetrics-hemorrhages
#12
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
https://www.readbyqxmd.com/read/28851782/evaluating-maternity-units-a-prospective-cohort-study-of-freestanding-midwife-led-primary-maternity-units-in-new-zealand-clinical-outcomes
#13
Celia P Grigg, Sally K Tracy, Mark Tracy, Rea Daellenbach, Mary Kensington, Amy Monk, Virginia Schmied
OBJECTIVE: To compare maternal and neonatal birth outcomes and morbidities associated with the intention to give birth in a freestanding primary level midwife-led maternity unit (PMU) or tertiary level obstetric-led maternity hospital (TMH) in Canterbury, Aotearoa/New Zealand. DESIGN: Prospective cohort study. PARTICIPANTS: 407 women who intended to give birth in a PMU and 285 women who intended to give birth at the TMH in 2010-2011. All of the women planning a TMH birth were 'low risk', and 29 of the PMU cohort had identified risk factors...
August 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28846061/obstetric-outcomes-in-women-with-nonalcoholic-fatty-liver-disease
#14
Yeon Woo Lee, Christina D Yarrington
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases in the Western world and yet there is little research into its impact on pregnancy. METHODS: A literature review was conducted in the database PubMed, with articles published between 1990 and 2017. The selected studies addressed features specifically attributed to NAFLD and associated obstetric and neonatal outcomes. Nine studies met criteria. Our aim was to consolidate the limited literature and identify trends...
August 28, 2017: Metabolic Syndrome and related Disorders
https://www.readbyqxmd.com/read/28844352/unmet-met-need-for-contraception-and-self-reported-abortion-in-ghana
#15
Joshua Amo-Adjei, Eugene K M Darteh
BACKGROUND: Unmet need for contraception in several sub-Saharan African countries, including Ghana, remains high, with implications for unintended pregnancies and unsafe abortion, associated maternal morbidity and mortality. In this paper, we analysed for any associations between unmet/met need for contraception and the prevalence of abortion. METHODS: The paper utilizes the 2014 Ghana Demographic Health Survey dataset. Applying descriptive statistics initially, and later, a binary logistic regression, we estimate two different models, taking into account, unmet/met need for contraception (Model 1) and a multivariable one comprising socioeconomic, spatial, cultural and demographic behaviour variables (Model 2) to test the associations between unmet/met need for contraception in Ghana...
October 2017: Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives
https://www.readbyqxmd.com/read/28841838/maternal-and-perinatal-outcome-after-previous-caesarean-section-in-rural-rwanda
#16
Richard Kalisa, Stephen Rulisa, Jos van Roosmalen, Thomas van den Akker
BACKGROUND: Offering a trial of labor (ToL) after previous caesarean section (CS) is an important strategy to reduce short- and long-term morbidity associated with repeated CS. We compared maternal and perinatal outcomes between ToL and elective repeat caesarean section (ERCS) at a district hospital in rural Rwanda. METHODS: Audit of women's records with one prior CS who delivered at Ruhengeri district hospital in Rwanda between June 2013 and December 2014. RESULTS: Out of 4131 women who came for delivery, 435 (11%) had scarred uteri...
August 25, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28833512/intrapartum-obstetric-care-in-the-united-states-military-comparison-of-military-and-civilian-care-systems-within-tricare
#17
Anju Ranjit, Wei Jiang, Tiannan Zhan, Linda Kimsey, Bart Staat, Catherine T Witkop, Sarah E Little, Adil H Haider, Julian N Robinson
BACKGROUND: Expectant mothers who are beneficiaries of TRICARE (universal insurance to United States Armed Services members and their dependents) can choose to receive care within direct (salary-based) or purchased (fee-for-service) care systems. We sought to compare frequency of intrapartum obstetric procedures and outcomes such as severe acute maternal morbidity (SAMM) and common postpartum complications between direct and purchased care systems within TRICARE. METHODS: TRICARE (2006-2010) claims data were used to identify deliveries...
August 22, 2017: Birth
https://www.readbyqxmd.com/read/28833082/use-of-bulldog-vascular-clamps-to-reduce-intraoperative-bleeding-during-cesarean-hysterectomy-for-placenta-percreta
#18
Polat Dursun
Postpartum hemorrhage causes 25% of all maternal deaths worldwide and is the leading cause of maternal morbidity and mortality following vaginal or caesarean delivery. Every year, postpartum hemorrhage is estimated to cause approximately 125 000 maternal deaths and is associated with morbidity among 20 million women. It is caused by several obstetric conditions, including uterine atony and placental problems such as placenta accreta spectrum disorders, trauma, and lacerations. Several techniques are known to prevent postpartum hemorrhage, including uterine cavity tamponade, uterine artery ligation, uterine artery embolization, pre-cesarean prophylactic balloon catheterization, uterine compression sutures, hypogastric artery ligation, and hysterectomy...
August 21, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28832843/air-pollution-and-low-birth-weight-in-an-industrialized-city-in-southeastern-brazil-2003-2006
#19
Marcelo Moreno Dos Reis, Mariana Tavares Guimarães, Alfésio Luís Ferreira Braga, Lourdes Conceição Martins, Luiz Alberto Amador Pereira
Introduction: Birth weight is an important indicator of several conditions that manifest earlier (as fetal and neonatal mortality and morbidity, inhibited growth and cognitive development) and later in life such as chronic diseases. Air pollution has been associated with adverse pregnancy outcomes. Objective: Retrospective cohort study investigated the association between low birth weight (LBW) and maternal exposure to air pollutants in Volta Redonda city, Rio de Janeiro, Brazil, from 2003 to 2006...
April 2017: Revista Brasileira de Epidemiologia, Brazilian Journal of Epidemiology
https://www.readbyqxmd.com/read/28832665/severe-maternal-morbidity-in-zanzibar-s-referral-hospital-measuring-the-impact-of-in-hospital-care
#20
Tanneke Herklots, Lieke van Acht, Tarek Meguid, Arie Franx, Benoit Jacod
OBJECTIVE: to analyse the impact of in-hospital care on severe maternal morbidity using WHO's near-miss approach in the low-resource, high mortality setting of Zanzibar's referral hospital. SETTING: Mnazi Mmoja Hospital, a tertiary care facility, in Zanzibar, Tanzania. METHODS: We identified all cases of morbidity and mortality in women admitted within 42 days after the end of pregnancy at Mnazi Mmoja Hospital in the period from April to October 2016...
2017: PloS One
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