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High risk obstetrics

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https://www.readbyqxmd.com/read/29045808/kaplan-meier-survival-analysis-overestimates-cumulative-incidence-of-health-related-events-in-the-presence-of-competing-risks-a-meta-analysis
#1
REVIEW
Sarah Lacny, Todd Wilson, Fiona Clement, Derek J Roberts, Peter Faris, William A Ghali, Deborah A Marshall
OBJECTIVE: Kaplan-Meier survival analysis may overestimate cumulative incidence in competing risks (CR) settings. The clinical significance of this overestimation has been questioned and CR methods are infrequently used. This meta-analysis compares the Kaplan-Meier method to the cumulative incidence function (CIF), a CR method. STUDY DESIGN AND SETTING: We searched MEDLINE, EMBASE, BIOSIS Previews, Web of Science (1992-2016), and article bibliographies for studies estimating cumulative incidence using the Kaplan-Meier method and CIF...
October 15, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29040531/survival-analysis-of-the-association-between-antenatal-care-attendance-and-neonatal-mortality-in-57-low-and-middle-income-countries
#2
David T Doku, Subas Neupane
Background: Neonatal mortality is unacceptably high in most low- and middle-income countries (LMICs). In these countries, where access to emergency obstetric services is limited, antenatal care (ANC) utilization offers improved maternal health and birth outcomes. However, evidence for this is scanty and mixed. We explored the association between attendance for ANC and survival of neonates in 57 LMICs. Methods: Employing standardized protocols to ensure comparison across countries, we used nationally representative cross-sectional data from 57 LMICs ( N  = 464 728) to investigate the association between ANC visits and neonatal mortality...
July 13, 2017: International Journal of Epidemiology
https://www.readbyqxmd.com/read/29039130/aspirin-for-prevention-of-preeclampsia
#3
A Atallah, E Lecarpentier, F Goffinet, M Doret-Dion, P Gaucherand, V Tsatsaris
Aspirin is currently the most widely prescribed treatment in the prevention of cardiovascular complications. The indications for the use of aspirin during pregnancy are, however, the subject of much controversy. Since the first evidence of the obstetric efficacy of aspirin in 1985, numerous studies have tried to determine the effect of low-dose aspirin on the incidence of preeclampsia, with very controversial results. Large meta-analyses including individual patient data have demonstrated that aspirin is effective in preventing preeclampsia in high-risk patients, mainly those with a history of preeclampsia...
October 16, 2017: Drugs
https://www.readbyqxmd.com/read/29034707/female-genital-mutilation-implications-for-clinical-practice
#4
Inez von Rège, Daniel Campion
Female genital mutilation (FGM) is an established cultural practice in over 30 countries. It has no health benefits, carries a high risk of physical and psychological harm, and is illegal in many countries including the UK. A sensitive approach is required, both in the management of complications and prevention of this practice. This article discusses the prevalence and classification of FGM, and offers practical advice to nurses and midwives involved in general and obstetric care. Legal aspects, including safeguarding responsibilities and the mandatory duty to report FGM in England and Wales, are outlined...
October 12, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29034449/nitrous-oxide-based-vs-nitrous-oxide-free-general-anaesthesia-and-accidental-awareness-in-surgical-patients-an-abridged-cochrane-systematic-review
#5
REVIEW
J Hounsome, J Greenhalgh, O J Schofield-Robinson, S R Lewis, T M Cook, A F Smith
Accidental awareness during general anaesthesia can arise from a failure to deliver sufficient anaesthetic agent, or from a patient's resistance to an expected sufficient dose of such an agent. Awareness is 'explicit' if the patient is subsequently able to recall the event. We conducted a systematic review into the effect of nitrous oxide used as part of a general anaesthetic on the risk of accidental awareness in people over the age of five years undergoing general anaesthesia for surgery. We included 15 randomised controlled trials, 14 of which, representing a total of 3439 participants, were included in our primary analysis of the frequency of accidental awareness events...
October 16, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29032705/a-mobile-application-for-monitoring-and-management-of-depressed-mood-in-a-vulnerable-pregnant-population
#6
Liisa Hantsoo, Stephanie Criniti, Annum Khan, Marian Moseley, Naomi Kincler, Laura J Faherty, C Neill Epperson, Ian M Bennett
OBJECTIVE: This study tested whether a mood tracking and alert (MTA) mobile application (app) improved mental health care delivery in a high-risk obstetric population. METHODS: Pregnant women with depressive symptomatology at <32 weeks gestation were followed for eight weeks after randomization to a control patient portal (PP) app alone or with the MTA app. The MTA app monitored activity, assessed mood, and alerted obstetric providers of signs of worsening mood...
October 16, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29028970/poor-obstetric-and-infant-outcomes-in-hiv-infected-pregnant-women-with-tuberculosis-in-south-africa-the-tshepiso-study
#7
Nicole Salazar-Austin, Jennifer Hoffmann, Silvia Cohn, Fildah Mashabela, Ziyaad Waja, Sanjay Lala, Christopher Hoffmann, Kelly E Dooley, Richard E Chaisson, Neil Martinson
Background: Prior to the wide availability of antiretroviral therapy, tuberculosis (TB) and HIV disease among pregnant women resulted in poor maternal and neonatal outcomes including high rates of mother-to-child transmission of both HIV and TB. We aimed to describe the impact of TB among HIV-infected mothers on obstetric and infant outcomes in a population with access to antiretroviral therapy. Methods: In this prospective cohort study, we followed HIV-infected pregnant women with and without TB disease from January 2011 through January 2014 in Soweto, South Africa...
September 26, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29027394/assessing-the-effect-of-guideline-introduction-on-clinical-practice-and-outcome-in-patients-with-endometrial-cancer-in-japan-a-project-of-the-japan-society-of-gynecologic-oncology-jsgo-guideline-evaluation-committee
#8
Shogo Shigeta, Satoru Nagase, Mikio Mikami, Masae Ikeda, Masako Shida, Isao Sakaguchi, Norichika Ushioda, Fumiaki Takahashi, Wataru Yamagami, Nobuo Yaegashi, Yasuhiro Udagawa, Hidetaka Katabuchi
OBJECTIVE: The Japan Society of Gynecologic Oncology (JSGO) published the first practice guideline for endometrial cancer in 2006. The JSGO guideline evaluation committee assessed the effect of this guideline introduction on clinical practice and patient outcome using data provided by the Japan Society of Obstetrics and Gynecology (JSOG) cancer registration system. METHODS: Data of patients with endometrial cancer registered between 2000 and 2012 were analyzed, and epidemiological and clinical trends were assessed...
November 2017: Journal of Gynecologic Oncology
https://www.readbyqxmd.com/read/29027393/down-regulated-serum-microrna-101-is-associated-with-aggressive-progression-and-poor-prognosis-of-cervical-cancer
#9
Wei Jiang, Jia Jia Pan, Ying Hui Deng, Mei Rong Liang, Li Hua Yao
OBJECTIVE: MicroRNAs (miRNAs) play a vital role in pathogenesis and progression of many cancers, including cervical cancer. However, importance of serum level of miR-101 in cervical cancer has rarely been studied. In the present study, clinical significance and prognostic value of serum miR-101 for cervical cancer was investigated. METHODS: Association between miR-101 level in cervical cancer tissues and prognosis of patients was analyzed by using data retrieved from The Cancer Genome Atlas (TCGA) database, which was followed with our clinical study in which miR-101 serum level comparison between cervical cancer patients and healthy controls was conducted by real-time quantitative polymerase chain reaction (PCR)...
November 2017: Journal of Gynecologic Oncology
https://www.readbyqxmd.com/read/29025450/an-increase-in-rates-of-obstetric-haemorrhage-in-a-setting-of-high-hiv-seroprevalence
#10
E Shabalala, Hannah M Sebitloane
BACKGROUND: Obstetric haemorrhage (OH) is the leading cause of maternal mortality worldwide, although, indirectly, HIV is also a leading cause of maternal mortality in some settings with a high HIV seroprevalence. OBJECTIVE: To determine the possible association between increasing rates of OH and HIV or its treatment. METHODS: We conducted a retrospective chart review of women with OH at King Edward VIII Hospital, Durban, South Africa, over a 3-year period (2009 - 2011), during which the drug regimen for the prevention of mother-to-child transmission was evolving from single-dose nevirapine to antenatal zidovudine combined with intrapartum nevirapine (also referred to as dual therapy), and finally to a combination or highly active antiretroviral therapy (cART or HAART)...
June 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29024912/how-important-is-aspirin-adherence-when-evaluating-effectiveness-of-low-dose-aspirin
#11
REVIEW
Kate Navaratnam, Zarko Alfirevic, Munir Pirmohamed, Ana Alfirevic
Low-dose aspirin (LDA) is advocated for women at high-risk of pre-eclampsia, providing a modest, 10%, reduction in risk. Cardiology meta-analyses demonstrate 18% reduction in serious vascular events with LDA. Non-responsiveness to aspirin (sometimes termed aspirin resistance) and variable clinical effectiveness are often attributed to suboptimal adherence. The aim of this review was to identify the scope of adherence assessments in RCTs evaluating aspirin effectiveness in cardiology and obstetrics and discuss the quality of information provided by current methods...
October 3, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29020782/-external-cephalic-version-after-36th-week-of-gestationanalysis-of-women%C3%A2-s-perspective
#12
K Wágnerová, L Hruban, P Janků
OBJECTIVE: Evaluation of opinions and subjective feelings of patients who have undergone an external cephalic version of a fetus in breech presentation after the 36th week of pregnancy. DESIGN: Observational analytic cohort study. SETTING: Department of Obstetrics and Gynecology, Masaryk University, University Hospital Brno. MATERIALS AND METHODS: We collected opinions and subjective evaluation from pregnant women who underwent an attempt of external cephalic version at the department of Gynecology and Obstetrics, Masaryk University in Brno in the period from 1st January 2015 to 31st December 2016 through a questionnaire...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/29016589/risk-factors-associated-with-low-birth-weight-among-deliveries-at-bharatpur-hospital
#13
Kamal Prasad Kandel, Sindhu Kafle
BACKGROUND: Babies with a birth weight of less than 2500 grams, irrespective of the period of their gestation are termed as Low Birth Weight (LBW) babies. Despite consistent efforts to improve the quality of maternal and child health, more than twenty million low birth-weight (LBW) babies are born every year throughout the world. Though, the health situation of Nepal has improved substantially over the years, the low birth-weight (LBW) rate is still high. The objective of this study was to assess the proportion of low birth weight and identify the associated factors for low birth weight in a live born infant among the institutionally delivered newborns...
September 8, 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28990811/evaluation-of-hospitalization-costs-and-associated-factors-among-maternity-stays-involving-low-risk-and-moderate-to-high-risk-childbirths-in-the-united-states
#14
Amy Law, Justin Yu, Wenlong Lin, Richard Lynen, Jay Lin
OBJECTIVES: This study aimed to assess the costs of childbirth and to identify factors associated with such hospital costs for low- and moderate/high-risk childbirth groups. METHODS: All hospitalizations for childbirth between 2010-2014 in the Premier Perspective Hospital Database were identified. Risk category for each birth was defined by the age of the subject and/or presence of specific maternal comorbidities and obstetric risk factors. Hospital childbirth costs were determined and stratified by risk groups...
October 9, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28986185/fertility-sparing-management-using-progestin-for-young-women-with-endometrial-cancer-from-a-population-based-study
#15
Soyoun Rachel Kim, Carlijn van der Zanden, Habibe Ikiz, Boris Kuzelijevic, Jon Havelock, Janice S Kwon
OBJECTIVE: For young women with complex atypical endometrial hyperplasia (CAH) and endometrial cancer (EC) who choose to preserve fertility, progestin therapy is the mainstay of treatment. The objective of this study was to evaluate oncologic and reproductive outcomes associated with progestin therapy among these women from a population-based cancer registry. METHODS: This was a retrospective population-based cohort study of women under age 45 in British Columbia from 2003 to 2015 with CAH or grade I endometrioid EC who used progestins as initial management...
October 3, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28983443/rowers-self-reported-behaviors-attitudes-and-safety-concerns-related-to-exercise-training-and-competition-during-pregnancy
#16
Ashley Franklin, Joanna Mishtal, Teresa Johnson, Judith Simms-Cendan
Background The American College of Obstetrics and Gynecology notes that pregnant athletes require more supervision due to their involvement in strenuous training schedules throughout pregnancy. Currently, rowing is not mentioned in the guidelines despite its increasing popularity, high cardiovascular demands, and risk for abdominal trauma. Methods This study aimed to elicit information from competitive female rowers regarding exercise, training, and competition during pregnancy. We administered a survey consisting of 122 items to female Masters rowers in the United States, aged 21 to 49 years, from June to December 2013...
August 1, 2017: Curēus
https://www.readbyqxmd.com/read/28980069/evaluation-of-the-value-of-plasma-concentration-of-copeptin-in-the-first-prenatal-visit-to-diagnose-gestational-diabetes-mellitus
#17
He-Hong Ma, Shuang-Yan Yang, Pei Wang, Jun-Feng Zhang
AIMS: Gestational diabetes mellitus (GDM) is increasing worldwide. The aim of this study was to investigate whether copeptin concentrations, measured at the first prenatal visit, are associated with risk of GDM. METHODS: From July 2015 to June 2016, consecutive women who admitted to the obstetrics center of our hospital were included. Data for fasting plasma glucose and copeptin concentrations at the first prenatal visit and one-step GDM screening with 75-g oral glucose tolerance test performed between 24 and 28 weeks of gestation were collected and analyzed...
October 4, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/28979649/-role-of-abortion-and-ectopic-pregnancies-in-maternal-mortality-rate-at-three-university-hospitals-in-yaound%C3%A3
#18
Danielle Victoire Tiako Kamga, Philip Njotang Nana, Florent Ymele Fouelifack, Jeanne Hortence Fouedjio
INTRODUCTION: The World Health Organization (WHO) estimates that 585.000 women die every year in the world as a result of complications related to pregnancy, delivery, postpartum period and abortion (the latter contributing to 13% of maternal deaths). Ectopic pregnancies are responsible for 10% of maternal mortality in the first quarter of pregnancy. Maternal mortality rate is high in Cameroon, estimated at 782 per 100.000 live births according to EDS-MICS 2011. AS the role of these two conditions in maternal mortality is little documented in our country, we conducted this study to assess the role of abortions and ectopic pregnancies in maternal mortality rate in Cameroon...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28976885/the-examination-of-work-related-musculoskeletal-discomforts-and-risk-factors-in-veterinarians
#19
Mesut Ergan, Ferdi Başkurt, Zeliha Başkurt
This study aimed to determine the frequency of work-related musculoskeletal discomforts (WMSDs) observed in veterinarians and the risk factors that may bring about these. Two hundred and seven veterinarians working in three provinces in south west Turkey were included in the study. The demographic and occupational information on the participants was recorded. The Modified Nordic Musculoskeletal Questionnaire was used to evaluate the musculoskeletal problems of different body parts, which cause difficulties at work and result in staying away from work...
September 26, 2017: Arhiv za Higijenu Rada i Toksikologiju
https://www.readbyqxmd.com/read/28973345/third-trimester-estrogens-and-maternal-breast-cancer-prospective-evidence
#20
Barbara A Cohn, Piera M Cirillo, Bill R Hopper, Pentti K Siiteri
Context: Full-term pregnancy is associated both with a transient increase and life-time decrease in maternal breast cancer risk. Estrone (E1), estradiol (E2) and estriol (E3) are estrogens found in high concentrations during the third trimester. E1 and E2 metabolism produces carcinogenic intermediaries, while E3 metabolism does not. Objective: We tested the hypothesis that higher estriol (E3) in pregnancy is protective, while higher estrone (E1) + estradiol (E2) increases risk...
July 28, 2017: Journal of Clinical Endocrinology and Metabolism
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