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severe maternal morbidity

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https://www.readbyqxmd.com/read/29334493/understanding-severe-maternal-morbidity-hospital-based-review
#1
Sarah J Kilpatrick
Cases of severe maternal morbidity (SMM) share similarities to maternal deaths, including increasing in frequency and having similar rates of preventability. This article will review steps to organizing and implementing standard reviews of all cases of SMM. These steps include create multidisciplinary SMM review committee; identify potential SMM cases and confirm true SMM; identify the morbidity; abstract and summarize data; present case to review committee for discussion; determine events leading to morbidity; determine opportunities to improve outcome; assess provider, system and patient factors in cases with opportunities to improve outcome; make recommendations; and effect change and evaluate improvement...
January 12, 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29327608/pregnancy-outcomes-of-women-with-spina-bifida
#2
Nathalie Auger, Laura Arbour, Mireille E Schnitzer, Jessica Healy-Profitós, Geneviève Nadeau, William D Fraser
PURPOSE: To assess the pregnancy outcomes of women with spina bifida. MATERIALS AND METHODS: We analyzed a population-based cohort of 397 pregnant women with spina bifida and 1,083,211 without spina bifida who delivered infants in hospitals in Quebec, Canada, 1989-2013. Outcomes included maternal and infant morbidity and mortality at delivery. We used log-binomial regression models to estimate prevalence ratios (PR) and 95% confidence intervals (CI) for the association of maternal spina bifida with pregnancy outcomes, accounting for maternal characteristics...
January 12, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29325069/effect-of-healthcare-spending-on-the-relationship-between-the-human-development-index-and-maternal-and-neonatal-mortality
#3
Kaamel M Nuhu, Justin T McDaniel, Genevieve A Alorbi, Juan I Ruiz
Background: Several factors affect morbidity and mortality the world over. Previous research shows mortality rates are higher among individuals of lower socio-economic status. We investigated the trajectory of neonatal (NM) and maternal (MM) mortality between 2010 and 2014 and the effect of healthcare spending on the relationship between the Human Development Index (HDI) and NM and MM. Methods: Data were obtained from the United Nations Development Program and World Bank...
January 9, 2018: International Health
https://www.readbyqxmd.com/read/29324605/estimating-the-hospital-delivery-costs-associated-with-severe-maternal-morbidity-in-new-york-city-2008-2012
#4
Renata E Howland, Meghan Angley, Sang Hee Won, Wendy Wilcox, Hannah Searing, Tsu-Yu Tsao
OBJECTIVE: To quantify the average and total hospital delivery costs associated with severe maternal morbidity in excess of nonsevere maternal morbidity deliveries over a 5-year period in New York City adjusting for other sociodemographic and clinical factors. METHODS: We conducted a population-based cross-sectional study using linked birth certificates and hospital discharge data for New York City deliveries from 2008 to 2012. Severe maternal morbidity was defined using a published algorithm of International Classification of Diseases, 9 Revision, Clinical Modification disease and procedure codes...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29319586/the-role-of-the-anesthesiologist-in-preventing-severe-maternal-morbidity-and-mortality
#5
Emily McQuaid, Lisa R Leffert, Brian T Bateman
Anesthesiologists are responsible for the safe and effective provision of analgesia for labor and anesthesia for cesarean delivery and other obstetric procedures. In addition, obstetric anesthesiologists often have a unique role as the intensivists of the obstetric suite. The anesthesiologist is frequently the clinician with the greatest experience in the acute bedside management of a hemodynamically unstable patient and expertise in life-saving interventions. This review will discuss (1) risks associated with neuraxial and general anesthesia for labor and delivery, and (2) clinical scenarios in which the obstetric anesthesiologist is commonly called upon to function as a "peridelivery intensivist...
January 9, 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29317701/a-genome-wide-association-study-identifies-only-two-ancestry-specific-variants-associated-with-spontaneous-preterm-birth
#6
Nadav Rappoport, Jonathan Toung, Dexter Hadley, Ronald J Wong, Kazumichi Fujioka, Jason Reuter, Charles W Abbott, Sam Oh, Donglei Hu, Celeste Eng, Scott Huntsman, Dale L Bodian, John E Niederhuber, Xiumei Hong, Ge Zhang, Weronika Sikora-Wohfeld, Christopher R Gignoux, Hui Wang, John Oehlert, Laura L Jelliffe-Pawlowski, Jeffrey B Gould, Gary L Darmstadt, Xiaobin Wang, Carlos D Bustamante, Michael P Snyder, Elad Ziv, Nikolaos A Patsopoulos, Louis J Muglia, Esteban Burchard, Gary M Shaw, Hugh M O'Brodovich, David K Stevenson, Atul J Butte, Marina Sirota
Preterm birth (PTB), or the delivery prior to 37 weeks of gestation, is a significant cause of infant morbidity and mortality. Although twin studies estimate that maternal genetic contributions account for approximately 30% of the incidence of PTB, and other studies reported fetal gene polymorphism association, to date no consistent associations have been identified. In this study, we performed the largest reported genome-wide association study analysis on 1,349 cases of PTB and 12,595 ancestry-matched controls from the focusing on genomic fetal signals...
January 9, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29310901/why-do-we-not-want-to-recommend-influenza-vaccination-to-young-children-a-qualitative-study-of-australian-parents-and-primary-care-providers
#7
Ruby Biezen, Danilla Grando, Danielle Mazza, Bianca Brijnath
INTRODUCTION: Influenza vaccination has been shown to be safe and effective against influenza and in the prevention of complicating secondary respiratory illnesses. However, its uptake in young children remains low. This study explored the views, attitudes and practices of parents and primary care providers (PCPs) on their knowledge and acceptance of influenza vaccination in children under 5. METHODS: Using a cross-sectional qualitative research design, we conducted 30 in-depth interviews with PCPs (i...
January 5, 2018: Vaccine
https://www.readbyqxmd.com/read/29310615/avoiding-late-preterm-deliveries-to-reduce-neonatal-complications-an-11-year-cohort-study
#8
Noémie Bouchet, Angèle Gayet-Ageron, Marina Lumbreras Areta, Riccardo Erennio Pfister, Begoña Martinez de Tejada
BACKGROUND: Late preterm (LPT) newborns, defined as those born between 34 0/7 and 36 6/7 gestational weeks, have higher short- and long-term morbidity and mortality than term infants (≥37 weeks). A categorization to justify a non-spontaneous LPT delivery has been proposed to distinguish evidence-based from non-evidence-based criteria. This study aims to describe rates and temporal trends of non-spontaneous LPT neonates delivered according to evidence-based or non-evidence-based criteria and to evaluate the number of avoidable LPT deliveries, including severe neonatal morbidity rates and associated risk factors...
January 8, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29308448/trends-in-obstetric-intervention-and-pregnancy-outcomes-of-canadian-women-with-diabetes-in-pregnancy-from-2004-to-2015
#9
Amy Metcalfe, Yasser Sabr, Jennifer A Hutcheon, Lois Donovan, Janet Lyons, Jason Burrows, K S Joseph
Context: Multiple consensus statements decree that women with diabetes mellitus should have comparable birth outcomes to women without diabetes mellitus; however, there is a scarcity of contemporary population-based studies on this issue. Objective: To examine temporal trends in obstetric interventions and perinatal outcomes in a population-based cohort of women with type 1, type 2, or gestational diabetes mellitus compared with a control population. Design: Cross-sectional study...
December 1, 2017: Journal of the Endocrine Society
https://www.readbyqxmd.com/read/29298686/a-single-center-experience-with-12-consecutive-cases-of-pregnancy-among-patients-with-membranous-ventricular-septal-aneurysm
#10
Kana Wang, Xiaodong Wang, Haiyan Yu, Xinghui Liu, Aiyun Xing, Yong You
BACKGROUND: Membranous ventricular septal aneurysm (MVSA) is a rare cardiac anomaly that can occur as an isolated entity or being associated with other cardiac malformations. Complications of MVSA include thromboembolism, arrhythmia, rupture, bacterial endocarditis, right ventricular outflow tract obstruction, and atrioventricular valve diseases.The success rate of pregnancy and delivery in patients with MVSA has not been reported in the literature. This study was to assess the clinical implications of this condition from our center's experience...
January 3, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29298455/preterm-preeclampsia-with-severe-features-composite-maternal-and-neonatal-morbidities-associated-with-fetal-growth-restriction
#11
Olaide Ashimi Balogun, Raminder K Khanagura, Heather R Kregel, Farah H Amro, Baha M Sibai, Suneet P Chauhan
OBJECTIVE:  The objective of this study was to compare adverse pregnancy outcomes between fetuses with estimated fetal weight (EFW) < 10 to > 10% in women with preterm preeclampsia (PE) with severe features. MATERIALS AND METHODS:  All women with preterm PE with severe features and nonanomalous singletons with EFW were identified at a tertiary center. Women with oligohydramnios or absent/reversed umbilical Doppler velocimetry were excluded. Using multivariable analysis, we compared the composite maternal and neonatal morbidities (CMM and CNM) between those with appropriate for gestational age (AGA) fetal growth, defined as EFW at 10 to 90th versus those with fetal growth restriction (FGR), defined as EFW < 10th percentile for gestational age (GA)...
January 3, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29297413/care-seeking-behaviors-for-maternal-and-newborn-illnesses-among-self-help-group-households-in-uttar-pradesh-india
#12
Kumudha Aruldas, Aastha Kant, P S Mohanan
BACKGROUND: India has made large strides in reducing maternal mortality ratio and neonatal mortality rate, yet care-seeking behavior for appropriate care is still a challenge. We conducted a qualitative study to understand the process of recognition and care-seeking for maternal and newborn illnesses in rural India where a health intervention through women's self-help groups (SHG) to improve maternal and newborn health behaviors is implemented by a non-governmental organization, the Rajiv Gandhi Mahila Vikas Pariyojana...
December 21, 2017: Journal of Health, Population, and Nutrition
https://www.readbyqxmd.com/read/29285088/vascular-corrosion-casting-of-normal-and-pre-eclamptic-placentas
#13
Geping Yin, Ming Chen, Juan Li, Xiaoli Zhao, Shujun Yang, Xiuyun Li, Zheng Yuan, Aifang Wu
Pre-eclampsia is an important cause of maternal and fetal morbidity and mortality that is associated with decreased placental perfusion. In the present study, vascular corrosion casting was used to investigate the differences in structural changes of the fetoplacental vasculature between normal and pre-eclamptic placentas. An improved epoxy resin vascular casting technique was used in the present study. Casting media were infused into 40 normal and 40 pre-eclamptic placentas through umbilical arteries and veins in order to construct three dimensional fetoplacental vasculatures...
December 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29284032/prevalence-of-anemia-and-associated-factors-among-school-children-in-gondar-town-public-primary-schools-northwest-ethiopia-a-school-based-cross-sectional-study
#14
Zegeye Getaneh, Bamlaku Enawgaw, Getabalew Engidaye, Masresha Seyoum, Muruts Berhane, Zegeye Abebe, Fikir Asrie, Mulugeta Melku
BACKGROUND: Anemia is a global public health problem affecting 305 million school children (SC) worldwide. It has deleterious effects in SC, including lower school achievement due to impaired cognitive development and physical growth, fatigue and poor attention span, and increased morbidity because of reduced resistance to infection. Hence, the aim of this study was to assess the prevalence and associated factors of anemia among SC attending public primary schools in Gondar town, northwest Ethiopia...
2017: PloS One
https://www.readbyqxmd.com/read/29282009/strider-sildenafil-therapy-in-dismal-prognosis-early-onset-fetal-growth-restriction-an-international-consortium-of-randomised-placebo-controlled-trials
#15
A Pels, L C Kenny, Z Alfirevic, P N Baker, Peter von Dadelszen, C Gluud, C T Kariya, B W Mol, A T Papageorghiou, A G van Wassenaer-Leemhuis, W Ganzevoort, K M Groom
BACKGROUND: Severe, early-onset fetal growth restriction due to placental insufficiency is associated with a high risk of perinatal mortality and morbidity with long-lasting sequelae. Placental insufficiency is the result of abnormal formation and function of the placenta with inadequate remodelling of the maternal spiral arteries. There is currently no effective therapy available. Some evidence suggests sildenafil citrate may improve uteroplacental blood flow, fetal growth, and meaningful infant outcomes...
December 28, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29281659/immunogenicity-of-rotavirus-vaccine-rotarixtm-in-infants-with-environmental-enteric-dysfunction
#16
Innocent Mwape, Samuel Bosomprah, John Mwaba, Katayi Mwila-Kazimbaya, Natasha Makabilo Laban, Caroline Cleopatra Chisenga, Gibson Sijumbila, Michelo Simuyandi, Roma Chilengi
INTRODUCTION: Deployment of rotavirus vaccines has contributed to significant declines in diarrheal morbidity and mortality globally. Unfortunately, vaccine performance in low-middle income countries (LMICs) is generally lower than in developed countries. The cause for this has been associated with several host and maternal factors including poor water sanitation and hygiene (WASH) status, which are predominant in LMICs. More recently, environmental enteric dysfunction (EED) has specifically been hypothesized to contribute to poor vaccine uptake and response...
2017: PloS One
https://www.readbyqxmd.com/read/29280474/anemia-in-pregnancy-a-pragmatic-approach
#17
Dongmei Sun, Anne McLeod, Shital Gandhi, Ann Kinga Malinowski, Nadine Shehata
Importance: Anemia is common in pregnancy, ranging from 5.4% in developed countries to more than 80% in developing countries. Anemia in pregnancy has been associated with prematurity, low birth weight, and adverse pregnancy outcomes. Objective: This review uses clinical vignettes to illustrate the clinical presentations, approach to diagnosis, maternal and fetal implications, and treatment for the common etiologies of anemia in pregnancy. Evidence Acquisition: Literature review...
December 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/29273378/safety-and-efficacy-of-preoperative-abdominal-aortic-balloon-occlusion-in-placenta-increta-and-or-percreta
#18
Wenjuan Sun, Shuhong Duan, Gang Xin, Juan Xiao, Fanzhen Hong, Haijie Hong, Yuange Wu, Yongping Xu
BACKGROUND: With the increase of cesarean deliveries globally, the incidence of placenta adhesive disorder has been on the rise greatly which is associated closely with maternal and infant morbidity and mortality. We sought to investigate the safety and efficacy of preoperative transfemoral balloon occlusion of abdominal aorta in cesarean section of women with placenta increta or percreta. METHODS: We conducted a retrospective study of 31 patients with placenta increta or percreta diagnosed by ultrasound and/or magnetic resonance imaging...
February 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29241615/provision-of-medical-supply-kits-to-improve-quality-of-antenatal-care-in-mozambique-a-stepped-wedge-cluster-randomised-trial
#19
Ana Pilar Betrán, Eduardo Bergel, Sally Griffin, Armando Melo, My Huong Nguyen, Alicia Carbonell, Santos Mondlane, Mario Merialdi, Marleen Temmerman, A Metin Gülmezoglu
BACKGROUND: High levels of maternal and newborn mortality and morbidity remain a daunting reality in many low-income countries. Several interventions delivered during antenatal care have been shown to improve maternal and newborn outcomes, but stockouts of medical supplies at point of care can prevent implementation of these services. We aimed to evaluate whether a supply chain strategy based on the provision of kits could improve quality of care. METHODS: We did a pragmatic, stepped-wedge, cluster-randomised controlled trial at ten antenatal care clinics in Mozambique...
January 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29237307/oligohydramnios-is-an-independent-risk-factor-for-perinatal-morbidity-among-women-with-preeclampsia-who-delivered-preterm
#20
Alex Rabinovich, Keren Holtzman, Ilana Shoham-Vardi, Moshe Mazor, Offer Erez
PURPOSE: Determine the relationship between oligohydramnios and adverse maternal and neonatal outcomes in a unique cohort of preterm preeclamptic patients. MATERIALS AND METHODS: A retrospective matched case control study comparing 81 preterm parturients (28 0/7 and 36 6/7 weeks) with preeclampsia and oligohydramnios to 81 preterm preeclamptic patients with a normal amniotic fluid index (AFI). RESULTS: 4.8 percent of all our preterm preeclamptic patients had oligohydramnios...
December 13, 2017: Journal of Maternal-fetal & Neonatal Medicine
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