Artykuły w czasopismach: „Obstetric intervention”

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Singh, Saddam, Ashish Pratap Singh, Anil Chouhan i Ajay Patidar. "Prevalence of operative complications in obstetric and gynecological surgeries requiring interventions by a general surgeon and their associated risk factors: A retrospective study in a tertiary care hospital in Vindhya region". Asian Journal of Medical Sciences 13, nr 9 (1.09.2022): 178–82. http://dx.doi.org/10.3126/ajms.v13i9.44060.

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Background: Surgical complications can occur in any surgery despite the best possible efforts, thereby affecting the prognosis. Gynecological and obstetric surgeries also result in some complications which require interventions by a general surgeon. These complications can be either causing hemodynamic instability, urinary tract injury, gastrointestinal tract injury, or infections. Aims and Objectives: The present study designed to identify and classify the various complication in obstetric and gynecological surgeries requiring interventions by a general surgeon and to correlate the various risk factors that predispose to these complications. Materials and Methods: The present retrospective study was conducted in the Department of Obstetrics and Gynecology and Department of Surgery, Shyam Shah Medical College and associated hospitals, Rewa, M.P., for 6 months from January 2021 to June 2021. Gynecological and obstetric surgeries resulting in complications requiring surgical intervention were identified and classified based on patients’ demographic characteristics, comorbidities, and type of complications. Results: A total of 1356 cases undergoing an obstetrical or gynecological procedure in the department of obstetrics and gynecology were studied. About 2.14% of the patients had some kind of intraoperative or post-operative complications, which required intervention by a general surgeon. The mean age of females having complications was 37.17±3.71 years. Overall the most common complication was surgical site infection with 48% of the total cases. Conclusion: In this present study, the incidence of surgical complications in obstetrical and gynecological surgeries, which is associated with higher morbidity postoperatively. These complications can be prevented by proper vigilance and surgical technique in high-risk patients.

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Fox, Haylee, Emily Callander, Daniel Lindsay i Stephanie M. Topp. "Is there unwarranted variation in obstetric practice in Australia? Obstetric intervention trends in Queensland hospitals". Australian Health Review 45, nr 2 (2021): 157. http://dx.doi.org/10.1071/ah20014.

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ObjectiveThe aim of this study was to report on the rates of obstetric interventions within each hospital jurisdiction in the state of Queensland, Australia. MethodsThis project used a whole-of-population linked dataset that included the health and cost data of all mothers who gave birth in Queensland, Australia, between 2012 and 2015 (n=186789), plus their babies (n=189909). Adjusted and unadjusted rates of obstetric interventions and non-instrumental vaginal delivery were reported within each hospital jurisdiction in Queensland. ResultsHigh rates of obstetric intervention exist in both the private and public sectors, with higher rates demonstrated in the private than public sector. Within the public sector, there is substantial variation in rates of intervention between hospital and health service jurisdictions after adjusting for confounding variables that influence the need for obstetric intervention. ConclusionsDue to the high rates of obstetric interventions statewide, a deeper understanding is needed of what factors may be driving these high rates at the health service level, with a focus on the clinical necessity of the provision of Caesarean sections. What is known about the topic?Variation in clinical practice exists in many health disciplines, including obstetric care. Variation in obstetric practice exists between subpopulation groups and between states and territories in Australia. What does this paper add?What we know from this microlevel analysis of obstetric intervention provision within the Australian population is that the provision of obstetric intervention varies substantially between public sector hospital and health services and that this variation is not wholly attributable to clinical or demographic factors of mothers. What are the implications for practitioners?Individual health service providers need to examine the factors that may be driving high rates of Caesarean sections within their institution, with a focus on the clinical necessity of Caesarean section.

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Saha, R., i P. Gautam. "Obstetric Emergencies: Feto-maternal Outcome at a Teaching Hospital". Nepal Journal of Obstetrics and Gynaecology 9, nr 1 (28.09.2014): 37–40. http://dx.doi.org/10.3126/njog.v9i1.11186.

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Aims: This study was done to know the pattern of obstetric emergencies and its influence on maternal and fetal outcome. Methods: A descriptive study was carried out in the department of obstetrics and gynecology at Kathmandu Medical College Teaching Hospital from 1st June 2013 to 31st May 2014. Cases were categorized as early pregnancy emergencies (ruptured ectopic pregnancy, complications of abortion), ante-partum emergencies and intra-partum emergencies (antepartum haemorrhage, preeclampsia, eclampsia, preterm prelabor rupture of membranes, rupture uterus), post-partum emergencies (postpartum haemorrhage, retained placenta, placenta accreta, uterine inversion), puerperal emergencies (postpartum sepsis), fetal emergencies (cord prolapse, shoulder dystocia). Outcome noted were type of emergency, obstetric intervention done, maternal and perinatal morbidity and mortality. Results: A total of 80 (4.45%) obstetric emergencies occurred among 1796 deliveries .The most common obstetric emergencies were obstetric hemorrhage (62.5%), severe preeclampsia (23.5%) and preterm prelabor rupture of membranes (10%). The obstetric interventions done were cesarean section (43.75%), exploratory laparotomy (33.75%) and blood transfusion (40%). Obstetric emergencies were responsible for 66.6% of total maternal death and 24.56% of total perinatal death. Conclusions: In spite of best efforts, some obstetric emergencies do occur. Obstetric hemorrhage and severe preeclampsia are the frequent obstetric emergencies. Cesarean section, exploratory laparotomy and blood transfusion were the commonly performed interventions. A better outcome can be achieved by national policy of promoting utilization of antenatal care, institutional deliveries, skilled birth attendance at delivery, liberal blood transfusion and regular training of doctors and nurses. DOI: http://dx.doi.org/10.3126/njog.v9i1.11186 NJOG 2014 Jan-Jun; 2(1):37-40

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Rawal, S., i A. Rana. "Second Intervention in Obstetric Hemorrhage". Journal of Institute of Medicine Nepal 34, nr 1 (9.11.2013): 18–24. http://dx.doi.org/10.3126/jiom.v34i1.9118.

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Introduction: Obstetric hemorrhage is still one of the dreaded complications that contribute to a maximum number of maternal morbidity and mortality till date. The management of obstetric hemorrhage involves early recognition, assessment and resuscitation. Though dealt with appropriate use of oxytocic agents, it may seldom require surgical techniques, including uterine tamponade, major vessel ligation, compression sutures, and even hysterectomy. Method: Prospective study of 20 cases of laparotomy for obstetrical hemorrhage carried out at Tribhuvan University Teaching Hospital, Kathmandu, Nepal, between Jan 2003 to Nov 2011. Results: Out of 20 cases, massive hemoperitoneum (more than a liter) was noted in 9 and associated risk factors in 10. Source of bleeding in 20 cases were from extensive hematoma (retroperitoneal and broad ligament) in 5, including a rectus sheath hematoma and with colporrhexis, oozing inverted T incision repaired in a single layer (1), placental bed (3) and 1 was from vessels in LUS. There was bleeding from uterine angle (4) and incision (1). Bleeding from tear at various sites were 3, from uterovesicle fold of peritoneum 1 and from the ruptured uterus following vacuum delivery in a case of VBAC (1). Uterine packing was done in 1, B-Lynch in 3 and 1 failed needing the uterine packing; uterine artery ligation in 2 including ovarian vessel ligation in 1, repair of ruptured uterus in 1 and subtotal hysterectomy in 5 cases. There were 3 mortalities due to DIC, pulmonary edema and ARF and rest were discharged in good health. Conclusion: Choosing of the right technique, complete hemostasis and meticulous closure of all surgical incisions will prevent the need for laparotomy following LSCS. Vigilant monitoring of all the post operative patients will lead to early diagnosis of intraperitoneal / pervaginal bleeding and its management, thus preventing morbidity and mortality owing to late diagnosis. DOI: http://dx.doi.org/10.3126/joim.v34i1.9118 Journal of Institute of Medicine, April, 2012; 34:1 18-24

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Malla, D. S. "EPISIOTOMY : A CHALLENGING OBSTETRIC INTERVENTION". Journal of Nepal Medical Association 42, nr 145 (1.01.2003): 54–58. http://dx.doi.org/10.31729/jnma.791.

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ABSTRACTThe professional literatures on the development of widely practiced procedure, episiotomy through theyears from the first publication in 1742 are reviewed. It reveals the change in number of publication as wellas the contributors to the development of perception about episiotomy. So it consisted expression of opinionof doctors initially then the co-workers like nurses and researchers and clients or consumers themselvestoo. It concludes that episiotomies prevent anterior perineal tear but fails to accomplish other benefitstraditionally ascribed to pelvic floor damage and relaxation including its sequel and also protection ofnewboin from intracranial haemorrhage and intrapartum asphyxia. Episiotomy substantially increasematernal blood loss during delivery and risk of anal sphincter damage with their long term morbidity.There is an urgent need to restrict the use of episiotomy in vaginal delivery.Key Words: Episiotomy, Perineal tear, anal sphincter damage.

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Swahnberg, Katarina, Anke Zbikowski, Kumudu Wijewardene, Agneta Josephson, Prembarsha Khadka, Dinesh Jeyakumaran, Udari Mambulage i Jennifer J. Infanti. "Can Forum Play Contribute to Counteracting Abuse in Health Care? A Pilot Intervention Study in Sri Lanka". International Journal of Environmental Research and Public Health 16, nr 9 (8.05.2019): 1616. http://dx.doi.org/10.3390/ijerph16091616.

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Obstetric violence refers to the mistreatment of women in pregnancy and childbirth care by their health providers. It is linked to poor quality of care, lack of trust in health systems, and adverse maternal and neonatal outcomes. Evidence of interventions to reduce and prevent obstetric violence is limited. We developed a training intervention using a participatory theatre technique called Forum Play inspired by the Theatre of the Oppressed for health providers in Sri Lanka. This paper assesses the potential of the training method to increase staff awareness of obstetric violence and promote taking action to reduce or prevent it. We conducted four workshops with 20 physicians and 30 nurses working in three hospitals in Colombo, Sri Lanka. Participants completed a questionnaire before and three-to-four months after the intervention. At follow-up, participants more often reported that they had been involved in situations of obstetric violence, indicating new knowledge of the phenomenon and/or an increase in their ability to conceptualise it. The intervention appears promising for improving the abilities of health care providers to recognise obstetric violence, the first step in counteracting it. The study demonstrates the value of developing further studies to assess the longitudinal impacts of theatre-based training interventions to reduce obstetric violence and, ultimately, improve patient care.

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Santana, Ariane Teixeira de, Ridalva Dias Martins Felzemburgh, Telmara Menezes Couto i Lívia Pinheiro Pereira. "Performance of resident nurses in obstetrics on childbirth care". Revista Brasileira de Saúde Materno Infantil 19, nr 1 (marzec 2019): 135–44. http://dx.doi.org/10.1590/1806-93042019000100008.

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Abstract Objectives: to describe good practices on childbirth care and obstetric interventions performed by resident nurses in obstetrics during the obstetric childbirth risk at a public maternity hospital in Salvador. Methods: a descriptive cross-sectional study with a quantitative approach, based on the of 102 parturients, between February and April 2016. The data collection was performed through the collection of information on clinical files for analysis by using descriptive statistics with absolute and relative frequencies for the evaluated categorical variables. Results: it was observed that 100.0% of the women used some kind of non-pharmacological method for pain relief, although the method of choice was to take a hot bath; 99.0% of the women drank liquids; 94.0% had the presence of a companion of free choice; 99.0% walked during labor; 100.0% had the freedom to choose a position during childbirth. It is noteworthy that no woman in this study was submitted to episiotomy, and more than 70.0% were not submitted to any obstetric intervention. Conclusions: the Programa de Residência em Enfermagem (Residency Nursing Program) an important point in the childbirth humanization process is directly associated to the increase in the normal childbirth rates, the highest use on good practices in childbirth care, and the reduction on obstetric interventions.

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Prasad, Dipali, Huma Nishat, Bhawana Tiwary, Swet Nisha, Archana Sinha i Neeru Goel. "Review of obstetrical emergencies and fetal out come in a tertiary care centre". International Journal of Research in Medical Sciences 6, nr 5 (25.04.2018): 1554. http://dx.doi.org/10.18203/2320-6012.ijrms20181467.

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Background: Obstetric emergencies can occur suddenly and unexpectedly. Obstetrics is unique in that there are two patients to consider and care for, a mother and a baby or fetus. Identification and referral of high risk pregnancies are an integral part of maternal and child health services. Timeliness and appropriateness can reduce the incidence of obstetric emergencies. Present study was carried out to know the incidence, nature and outcome of obstetric emergencies.Methods: Retrospective study of obstetric emergencies admitted to Obstetrics and Gynaecology department of Indira Gandhi Institute of Medical science, Patna from March 2015 to September 2017.Results: The common clinical presentation was Ectopic Pregnancy (19.64%), Heart Disease (16.64%), Abortion (13.69%), Severe Anaemia (16.66%), Purpureal Sepsis (9.52%), Sever pregnancy induced hypertension (3.57%), Eclampsia/ HELLP Syndrome (2.38%), Multiple Pregnancy (1.19%) Malignancy Disorder with Pregnancy (2.97%) and HIV in pregnancy (0.59%). Intervention done include Dilation and evacuation (13.69%), Caesarean section (28.57%), Vaginal delivery (22.62%), Caesarean Hysterectomy (2.38%), Exploratory Laparotomy (20.83%) and conservative management in (11.90%) of patients. Maternal outcome include shock due to rupture ectopic and post-partum (16.68%), Blood Transfusion done in (27.99%), Septicaemia (15.48%), ICU admission (8.92%), HDU (12.5%), Pulmonary oedema (6.54%), DIC (4.16%), CCF (3.57%), Ventilatory Support (1.78%) and Maternal Mortality (2.38%). Fatal outcome includes live birth (58.8%), NICU Admission (27.45%), Ventilatory Support (7.84%) and Neonatal mortality (5.88%).Conclusions: High risk pregnancy identification and proper antenatal, intranatal and postnatal care will reduce the incidence of obstetrical emergencies. Peripheral health care system need to be strengthen and early referral need to be implemented for better maternal and fetal outcome.

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Dodd, Jodie, i Jeffrey Robinson. "Commentary: public and private intervention rates in obstetric practice". Australian Health Review 27, nr 2 (2004): 9. http://dx.doi.org/10.1071/ah042720009.

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Dr Jodie Dodd is a maternal fetal medicine fellow, and Professor Jeffrey Robinson is head of Department of Obstetrics & Gynaecology, University of Adelaide.The paper by Shorten and Shorten published in the last edition of Australian Health Review highlights differences in intervention rates (induction of labour, caesarean section, use of epidural analgesia) between women receiving private obstetric care and those receiving public obstetric care (Shorten & Shorten 2004).Similarly, the authors highlight the more frequent occurrence of "less favourable birth outcomes such as emergency CS, instrumental birth, episiotomy and (perineal) tear requiring suturing" in women giving birth in private hospital settings. These differences persisted after controlling for the risk profile of the woman or development of complications during birth (Shorten & Shorten 2004). These findings are not new in Australia, having been reported previously by King (1993 and 2000), and Roberts and colleagues (2000 and 2002). However, Shorten and Shorten's link to subsidies for private insurance raises a new concern.The global interest in obstetric intervention rates and in particular rates of caesarean section has been underpinned by the assumption that there is in fact an "ideal" rate of intervention, where benefits outweigh risks. Much of this discussion developed after the World Health Organization published a statement to the effect that a caesarean section rate of 15% was appropriate (WHO 1985). However there has been little critique of the derivation of this figure and there is a lack of evidence in the scientific literature supporting it. The rate of any particular intervention should not be considered in isolation - what is important is how the intervention relates to increasing or decreasing maternal and infant mortality and morbidity.

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Pinto, Keli Regiane Tomeleri da Fonseca, Adriana Valongo Zani, Cátia Campaner Ferrari Bernardy, Mariana Angela Rossaneis, Renne Rodrigues i Cristina Maria Garcia de Lima Parada. "Factors associated with obstetric interventions in public maternity hospitals". Revista Brasileira de Saúde Materno Infantil 20, nr 4 (grudzień 2020): 1081–90. http://dx.doi.org/10.1590/1806-93042020000400009.

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Abstract Objectives: to identify the prevalence and factors associated with obstetric interventions in parturients assisted in public maternity hospitals. Methods: a cross-sectional study with 344 puerperal women, from two public maternity hospitals, referring to childbirth by Sistema Único de Saúde (SUS) (Public Health Service System) in Londrina City, Paraná, Brazil, between January and June 2017. The medical records were the data source. The following obstetric interventions were considered: oxytocin use, artificial rupture of the membranes, instrumental childbirth and episiotomy. Multivariate Poisson regression was used to analyze associated factors, with p<5% being significant. Results: the prevalence of obstetric intervention was 55.5%, the maximum number of interventions in the same parturient woman was three. The most frequent interventions were the use of oxytocin (50.0%) and artificial rupture of membranes (29.7%). The variables associated on maternal disease (p=0.005) and intrapartum meconium (p=0.022) independently increased, the risk of obstetric intervention, while dilation was equal to or greater than 5 cm at admission, there was a protective factor against this outcome (p=0.030). Conclusion: the prevalence of obstetric interventions was high. In the case of maternal disease and intrapartum meconium, special attention should be given to the parturient woman, in order to avoid unnecessary interventions. Thus, the maternity hospitals need to review their protocols, seeking good practices in childbirth care.

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Barreiros, Michele de Pinho, Hanna Ariane Monteiro Carrera, Elisângela da Silva Ferreira, Maria Elizabete de Castro Rassy, Regina Racquel dos Santos Jacinto, Carla Monique Lavareda Costa, Luiza Karla Alves de Paula i in. "The use of technology in the classification of obstetric risk: An integrative literature review". International Journal of Advanced Engineering Research and Science 9, nr 9 (2022): 230–36. http://dx.doi.org/10.22161/ijaers.99.22.

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Objective: To analyze from scientific productions how technology with the insertion of Modified Obstetric Alert Scores (MEOWS) can support the health professional responsible for carrying out the reception and risk classification in obstetrics in maternity hospitals. Method: This is an integrative literature review that selected 20 articles in the MEDLINE, LILACS, SciELO and PUBMED databases, which were analyzed and the inclusion criteria applied: articles available in full, published in Portuguese, English and Spanish, that answered the research question. Results: The selected articles were grouped into thematic categories, 1) Nurse's role in welcoming with Obstetric Risk Classification; 2) Insertion of the Modified Obstetric Warning Scoring System (MEOWS) in the Obstetric Urgency and Emergency Unit; 3) Technology and its contribution to Nursing Care. Final considerations: The technology offers a better guarantee for patient safety, as it allows intervention and quick access to the obstetric care needed in the face of the evidenced risk.

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King, James F. "Obstetric intervention and the economic imperative". BJOG: An International Journal of Obstetrics & Gynaecology 100, nr 4 (kwiecień 1993): 303–4. http://dx.doi.org/10.1111/j.1471-0528.1993.tb12967.x.

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Ramsden, Gordon. "Obstetric intervention and the economic imperative". BJOG: An International Journal of Obstetrics and Gynaecology 100, nr 11 (listopad 1993): 1063. http://dx.doi.org/10.1111/j.1471-0528.1993.tb15155.x.

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Rajasekar, Dhanasekaran, i Marion Hall. "Urinary tract injuries during obstetric intervention". BJOG: An International Journal of Obstetrics and Gynaecology 104, nr 6 (czerwiec 1997): 731–34. http://dx.doi.org/10.1111/j.1471-0528.1997.tb11986.x.

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Foote, Andrew J., i Warwick B. Giles. "Review of Obstetric Operative Intervention Rates". Journal of Obstetrics and Gynaecology Research 18, nr 3 (wrzesień 1992): 195–98. http://dx.doi.org/10.1111/j.1447-0756.1992.tb00002.x.

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Joseph, K. S., Kitaw Demissie i Michael S. Kramer. "Obstetric intervention, stillbirth, and preterm birth". Seminars in Perinatology 26, nr 4 (sierpień 2002): 250–59. http://dx.doi.org/10.1053/sper.2002.34769.

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MacDorman, Marian F., Marie Thoma, Eugene Declercq i Elizabeth A. Howell. "The relationship between obstetrical interventions and the increase in U.S. preterm births, 2014-2019". PLOS ONE 17, nr 3 (30.03.2022): e0265146. http://dx.doi.org/10.1371/journal.pone.0265146.

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We examined the relationship between obstetrical intervention and preterm birth in the United States between 2014 and 2019. This observational study analyzed 2014–2019 US birth data to assess changes in preterm birth, cesarean delivery, induction of labor, and associated risks. Logistic regression modeled the odds of preterm obstetrical intervention (no labor cesarean or induction) after risk adjustment. The percentage of singleton preterm births in the United States increased by 9.4% from 2014–2019. The percent of singleton, preterm births delivered by cesarean increased by 6.0%, while the percent with induction of labor increased by 39.1%. The percentage of singleton preterm births where obstetrical intervention (no labor cesarean or induction) potentially impacted the gestational age at delivery increased from 47.6% in 2014 to 54.9% in 2019. Preterm interventions were 13% more likely overall in 2019 compared to 2014 and 17% more likely among late preterm births, after controlling for demographic and medical risk factors. Compared to non-Hispanic White women, Non-Hispanic Black women had a higher risk of preterm obstetric interventions. Preterm infants have higher morbidity and mortality rates than term infants, thus any increase in the preterm birth rate is concerning. A renewed effort to understand the trends in preterm interventions is needed to ensure that obstetrical interventions are evidence-based and are limited to those cases where they optimize outcomes for both mothers and babies.

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Narang, Ridhi, Gurpreet K. Nandmer i Rekha Sapkal. "Factors affecting post-operative wound gaping and their outcome in obstetrical and gynecological abdominal surgeries". International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, nr 4 (30.03.2017): 1530. http://dx.doi.org/10.18203/2320-1770.ijrcog20171422.

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Background: Postoperative wound gaping is a very traumatic event both for patient and treating doctor as it adds economical and psychological burden to the patient and the family. This study was conducted with the aim to find out the various factors affecting postoperative wound gaping and their outcome in obstetrical and gynecological abdominal surgeries.Methods: This Retrospective observational study was carried out in the Department of Obstetrics and Gynecology at Peoples College of medical sciences and research Centre, Bhopal, India from 1st May 2014 to 31st October 2015.Results: A total of 1310 patients underwent major obstetrical and gynecological abdominal surgeries, out of which 29 cases developed postoperative wound gaping with the percentage being 2.2%. The rate was found to be higher among the emergency obstetric case (51.7%). Associated risk factors being anemia (72%), obesity (65%), hypoproteinemia (62%) and diabetes (52%) among gynecological surgeries and prolonged rupture of membranes (53%), emergency LSCS and previous LSCS (47%) among the obstetric cases. The common causative organism was found to be E. coli (28.5%) followed by acinetobacter and pseudomonas.Conclusions: Anemia, obesity, hypoproteinemia, diabetes, history of previous surgeries, emergency operations are the high risk factors for wound gaping in both obstetrics and gynecology surgeries. Correction of anemia, diabetes preoperatively, high protein diet and prevention of other risk factors like avoiding prolonged labor, use potent antibiotics in cases of rupture of membrane, timely intervention, provide well equipped wards with clean environment would be rewarding for better outcome of the surgery.

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Stumbar, Sarah E., Suzanne Minor i Marquita Samuels. "A Prenatal Standardized Patient Experience for Medical Students on Their Family Medicine Clerkship". Family Medicine 50, nr 5 (2.05.2018): 376–79. http://dx.doi.org/10.22454/fammed.2018.826159.

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Background and Objectives: Students on their family medicine clerkship at Herbert Wertheim College of Medicine get little clinical exposure to obstetric care, which is not commonly provided by family physicians in urban settings. To address this, we added to our clerkship didactic curriculum a 2-hour session involving a standardized patient (SP). The SP is collectively interviewed by the student group during four simulated prenatal visits, each of which present a different complication of pregnancy. The goal of this study was to evaluate the students’ perception of this session’s utility, the session’s ability to increase student self-confidence regarding obstetric issues, and perceived relevance of obstetrics to family medicine. Methods: During the 2016-2017 academic year, we evaluated this educational intervention using anonymous, immediate postsession surveys containing both Likert scale and open-ended questions. Qualitative answers were analyzed using a thematic analysis approach, with development of a codebook by consensus. Results: Students overwhelmingly found this session to be pertinent to their learning needs and reported an increase in their self-confidence level regarding obstetrical care. Continuity of care, comprehensive care, and an emphasis on health prevention were identified themes relating how obstetrics embodies the principles of family medicine. Conclusions: We developed this prenatal standardized patient experience to expose our clerkship students to full-spectrum family medicine, including primary care obstetrics. Our data suggests that this session increased students’ self-confidence with obstetrics management, filled in gaps in their clinical exposure to full-spectrum family medicine, and addressed a perceived learning need.

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Pesce, Andrew F. "Private obstetric intervention: good, bad or whatever?" Medical Journal of Australia 190, nr 9 (maj 2009): 467–68. http://dx.doi.org/10.5694/j.1326-5377.2009.tb02518.x.

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Barik, Sukumar, Michael H. Jones i Godwin I. Meniru. "Obstetric intervention and the economic imperative [Commentary]". BJOG: An International Journal of Obstetrics and Gynaecology 101, nr 1 (styczeń 1994): 88. http://dx.doi.org/10.1111/j.1471-0528.1994.tb13029.x.

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Cohen-Kerem, Raanan, Craig Railton, Dana Oren, Michael Lishner i Gideon Koren. "Pregnancy outcome following non-obstetric surgical intervention". American Journal of Surgery 190, nr 3 (wrzesień 2005): 467–73. http://dx.doi.org/10.1016/j.amjsurg.2005.03.033.

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Amoakoh-Coleman, Mary, Evelyn Ansah, Kerstin Klipstein-Grobusch i Daniel Arhinful. "Completeness of obstetric referral letters/notes from subdistrict to district level in three rural districts in Greater Accra region of Ghana: an implementation research using mixed methods". BMJ Open 9, nr 9 (wrzesień 2019): e029785. http://dx.doi.org/10.1136/bmjopen-2019-029785.

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ObjectiveTo assess the completeness of obstetric referral letters/notes at the district level of healthcare.DesignAn implementation research within three districts in Greater Accra region using mixed methods. During baseline and intervention phases, referral processes for all obstetric referrals from lower level facilities seen at the district hospitals were documented including indications for referrals, availability and completeness of referral notes/forms. An assessment of before and after intervention availability and completeness of referral forms was carried out. Focus group discussions, non-participant observations and in-depth interviews with health workers and pregnant women were conducted for qualitative data.SettingThree (3) districts in the Greater Accra region of Ghana.ParticipantsPregnant women referred from lower levels of care to and seen at the district hospital, health workers within the three districts and pregnant women attending antenatal clinic in the district and their family members or spouses.InterventionAn enhanced interfacility referral communication system consisting of training, provision of communication tools for facilities, formation of hospital referral teams and strengthening feedback mechanisms.OutcomeCompleteness of obstetric referral letters/notes.ResultsProportion of obstetric referrals with referral notes improved from 27.2% to 44.3% from the baseline to intervention period. Mean completeness (95% CI) of all forms was 71.3% (64.1% to 78.5%) for the study period, improving from 70.7% (60.4% to 80.9%) to 71.9% (61.1% to 82.7%) from baseline to intervention periods. Health workers reported they do not always provide referral notes and that most referral notes are not completely filled due to various reasons.ConclusionsMost obstetric referrals did not have referral notes. The few notes provided were not completely filled. Interventions such as training of health workers, regular review of referral processes and use of electronic records can help improve both the provision of and completeness of the referral notes.

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Barbosa, Andreia Mendes, Erika Pereira Machado, Ana Paula Felix Arantes i Renato Canevari Dutra da Silva. "Early intervention in obstetric brachial palsy: a review/ Intervenção precoce na paralisia braquial obstetrica: uma revisão". Brazilian Journal of Development 7, nr 8 (23.08.2021): 83605–16. http://dx.doi.org/10.34117/bjdv7n8-528.

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Obstetric brachial paralysis is the end of an injury to the nerve fibers of the brachial plexus during obstetric maneuvers during childbirth. The injury has a great impact on the functionality of the injured upper limb of the newborn. The signs and symptoms vary, depending on the location of the lesion. The early intervention of the physiotherapist in the rehabilitation process is essential to prevent complications and improve motor function. Physiotherapeutic treatment has a very important contribution to the rehabilitation of children with obstetric brachial palsy, however, it is important to respect the neuropsychomotor development process normal child. The physiotherapy objectives basically consists on avoiding contractures and adhesions; promoting motor and sensory stimulation; maintaining range of motion and functional training. Among the techniques that these professionals have, we can highlight passive and active kinesiotherapy, electrostimulation, proprioceptive stimulation, hydrotherapy and Movement Induction and Containment Therapy (MICT), always creating the best possible conditions for the recovery of this individual's functional capacity.

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Raine-Fenning, Nicholas, i Mark Kilby. "Obstetric cholestasis". Fetal and Maternal Medicine Review 9, nr 1 (luty 1997): 1–17. http://dx.doi.org/10.1017/s0965539597000016.

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Obstetric cholestasis (OC) is associated with significant perinatal mortality and maternal morbidity. Fetal outcome may be improved with increased antenatal surveillance and timely intervention. Frequently attributed to the Scandinavian authors Alvar Svanborg and Leif Thorling, the first case report was by Ahlfeld in 1883 who elegantly described recurrent jaundice in a pregnant patient that remitted with delivery. During the 1950's various terminologies originated describing some of the characteristic features of the disease: icterus gravidarum, cholestatic hepatosis and recurrent jaundice during pregnancy, all synonymous with ‘obstetric cholestasis.’ Ahlfeld's original patient did not complain of itching but over the recent years pruritis has become the commonest manifestation. Obstetric cholestasis is the most common disorder of liver function unique to pregnancy and second only to acute viral hepatitis as a cause of jaundice in the third trimester.

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Ochejele, Silas. "Review Article on Emergency Obstetric Care". Journal of BioMedical Research and Clinical Practice 1, nr 1 (20.04.2018): 1–8. http://dx.doi.org/10.46912/jbrcp.27.

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Maternal death was once a common occurrence worldwide but today, 99% of maternal deaths occur in low income countries. Most of the maternal deaths are due to direct obstetric complications. Emergency obstetric care is the intervention required to save the lives of these women. It is based on a tripod of signal functions, skilled birth attendants and a functional health system. The objective of this article was to discuss the role of Emergency obstetric care in maternal mortality reduction. A systematic review of available articles on Emergency obstetric care; and Emergency obstetric care training materials, experience and observations used/made between 2003 and 2017 in Nigeria was used for this work. Emergency obstetric care is the nucleus on which all other maternal mortality reduction activities are hinged. The paradigm evolvement of Emergency obstetric care offers the last hope for a woman with direct obstetric complication. However, the skilled birth attendant must have the right attitude in addition to her/his professional skills for effective implementation of these interventions. Women need access to and availability of Emergency obstetric care as well as a continuum of care that includes antenatal, intra-partum and postnatal care, newborn care and family planning services to reduce maternal mortality.

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Verma, Pallavi, Pavitra Manu Dogra, Shivendra Kumar Sinha, Ramesh Kaushik i Davinder Bhardwaj. "Neglected obstetric haemorrhage leading to acute kidney injury". International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, nr 11 (28.10.2017): 5177. http://dx.doi.org/10.18203/2320-1770.ijrcog20175051.

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Pregnancy related acute kidney injury takes substantial share of acute kidney injury (AKI) in India, with obstetrical haemorrhage having high morbidity and mortality. A young female had neglected obstetric haemorrhage (unrecognized intrauterine and massive intraperitoneal bleeding post caesarean, due to uterine trauma and atony) and dangerous intra-abdominal hypertension with exsanguination eventually leading to shock, multifactorial AKI, metabolic acidosis, and hyperkalemia. Intensive and aggressive management with subtotal hysterectomy, inotropes, fluid management, mechanical ventilation, tracheostomy, and hemodialysis changed the outcome. Despite odds against, neglected obstetric haemorrhage with complicated AKI, was managed successfully by emergency hysterectomy, aggressive intervention for AKI with intensive fluid, ventilatory management and daily hemodialysis. Timely identification and aggressive management of this condition and complications is pivotal in preventing complications, morbidity, and maternal mortality.

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O'Connell, M. P., i S. W. Lindow. "Trends in obstetric intervention in the United Kingdom". International Journal of Gynecology & Obstetrics 70 (2000): A64. http://dx.doi.org/10.1016/s0020-7292(00)82685-5.

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Chaudhary, Shrawan K. "Scaling up safe motherhood program at Dang district: Impact of programmatic intervention". Nepal Journal of Obstetrics and Gynaecology 3, nr 2 (29.07.2014): 21–25. http://dx.doi.org/10.3126/njog.v3i2.10827.

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Introduction: Safe motherhood has been a national priority programme and this article highlights the impact of a good programmatic approach to improve safe motherhood services in a district of mid west region of Nepal. Method: Interventions included strengthening of program- Emergency Obstetric Care Services (EmOC) at district hospital and Primary Health Care Center level (basic and comprehensive), Skilled Birth Attendance (SBA) at Health Post level and Community Based Safe Motherhood interventions at community level. In addition, improved family/community practices for birth preparedness and referral of mothers through building the capacity of individuals and families to demand and utilize health services were also implemented. Results: Met need of Emergency Obstetric Care increased from 2% in 2000 to 27.58 % in 2005/06. Number of births increased in hospital from 1078 (2003/2004) to 1753 (2005/2006). Number of caesarean sections was 10 in 2003/04 whereas it has risen to 174 in 2005/06. Similar trends were noticed in other obstetric procedures such as instrumental deliveries and manual removal of placenta. There has also been a significant increase in utilization of EmOC services among the poorest castes- Dalits and Janjatis (from 6.3% in 2000/01 to 12.7% in 2003/04). Twenty four hours blood transfusion services are made available at district hospital. EmOC fund has saved the life of 676 women who utilized EmOC fund and watch group has referred total 559 women to health facilities. Conclusion: Data from Dang district suggests that if interventions are delivered simultaneously and effectively at community level and health facility level, there is definite impact on various indicators of safe motherhood program. However, frequent turnover of staff, vacant post, lack of provision of 24 hours SBA services, limited budget for construction, training and equipment supports, lack of transportation and communication in remote Village Development Committees are barriers of effective safe motherhood program. DOI: http://dx.doi.org/10.3126/njog.v3i2.10827 Nepal Journal of Obstetrics and Gynaecology Vol.3(2) 2008; 21-25

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Akbar, Hajira, Mohammad Amir Nawaid, Tabassum Muzaffar, Sana Imtiaz i Asma Ansari. "Spectrum of Grown up Congenital Heart (GUCH) at Armed Forces Institute of Cardiology/ National Institute of Heart Diease: 10 years Experience". Pakistan Armed Forces Medical Journal 72, SUPPL-3 (23.11.2022): S623–27. http://dx.doi.org/10.51253/pafmj.v72isuppl-3.9565.

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Objective: To determine the spectrum of Grown up Congenital Heart (GUCH) at Armed Forces Institute of Cardiology/National Institute of Heart Dieases. Study Design: Descriptive cross sectional study. Place and Duration of Study: Paediatric Cardiac Surgery and Obstetric department of Armed Force Institute of Cardiology/National Institute of Heart Diease, Rawalpindi Pakistan, from 2011 to 2021. Methodology: It was a descriptive cross sectional study conducted at Paediatric Cardiology, Paediatric Cardiac Surgery and Obstetric department of AFIC/NIHD. After taking informed consent, a total of 1344 patients fulfilling inclusion and exclusion criteria with non probability consecutive sampling were enrolled in study from 2011 to 2021. Diagnosis, transthoracic echocardiography findings, procedural details (cardiac catheterization/cardiac surgery/obstetrical intervention) and outcome of all patients were noted. Results: Out of 1344 patients, 700 patients had cardiac catheterization. Among patients who underwent cardiac cath, 304(43%)were males and 396(56.6%) were females. 279(39%) diagnostic and 421(61%) cardiac interventional procedures were done.Most common procedure done was ASD device closure in 227(32%) patients. Complications were seen in 29(4%) patients and mortality in 3(0.4%) patients. There were a total of 188 patients who underwent congenital cardiac surgery. Out of patients who underwent congenital cardiac surgery procedures, 96(51%) were male and 92(49%) were female patients. Major complications were observed in 51(25%) patients and the mortality was 11(5%).There were total of 456 patients in obstetrics department. Out of 456 patients, 54(11%) were with congenital cardiac lesions .The most common defect was VSD 27(6%)patients and dilated cardiomyopathy (DCM) 27(6%) patients followed by ASD and TOF. The maternal and fetal mortality was12(2.7%) and 22(5.5%) respectively. Conclusion:With immense advancement in diagnosis and management of congenital cardiac diseases, a significant number of patients remain undiagnosed and untreated till the time they present as GUCH. Most common presentation is ASD which is mostly manageable by transcatheter intervention, however late presentation carries a risk of complications like pulmonary hypertension.

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Kaza, Leon, Senad Halluni, Rustem Celami i Zef Delia. "Cezarean Hysterectomy, A lifesaving Procedure that Albanian Obstetricans Must Be Familiar With". Albanian Journal of Trauma and Emergency Surgery 2, nr 1 (20.01.2018): 57–60. http://dx.doi.org/10.32391/ajtes.v2i1.158.

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Cesarean Hysterectomy refers to emergency peripartum hysterectomy - EPH, which is performed as a life-saving procedure in cases of continual obstetric hemorrhage secondary to uterine atony, uterine rupture, placental disorders, fibroids, and lacerations during cesarean section - CS or vaginal parturition. Emergency peripartum hysterectomy - EPH, although rare in modern obstetrics, remains a life- saving procedure in cases of severe hemorrhage. In contemporary obstetrics, the overall incidence of severe postpartum hemorrhage was reported to occur in 6.7/1,000 deliveries worldwide. It is one of the leading causes of maternal mortality and morbidity and represents the most challenging complication that an obstetrician will face. The incidence of peripartum hysterectomy in the literature is reported as 0.24, 0.77, 2.3, and 5.09 per 1,000 deliveries by many authors mentioning a few; Sakse et al., White- man et al., Bai et al., and Zeteroglu et al., respectively. Nevertheless, there is a lack of Albanian data on EPH. To our knowledge, there is no Portuguese information on postpartum hemorrhage and EPH, which does not mean that we do not have such obstetrical complications and therefore such emergency intervention. This paper’s intention is to bring awareness of such catastrophic obstetrical complications especially in young primigravida and primipara women.

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Hoque, Monjurul. "Incidence of Obstetric and Foetal Complications during Labor and Delivery at a Community Health Centre, Midwives Obstetric Unit of Durban, South Africa". ISRN Obstetrics and Gynecology 2011 (31.07.2011): 1–6. http://dx.doi.org/10.5402/2011/259308.

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The objectives of this retrospective cohort study were to estimate the incidence of obstetric complications during labor and delivery and their demographic predictors. A total of 2706 pregnant women were consecutively admitted to a midwife obstetric unit with labor pain between January and December 2007 constituted the sample. Among them 16% were diagnosed with obstetrical and foetal complications. The most frequently observed foetal and obstetric complications were foetal distress (35.5/1000) and poor progress of labor (28.3/1000), respectively. Primigravid and grandmultiparity women were 12 (OR = 11.89) and 5 (OR = 4.575) times, respectively, more likely to have complications during labor and delivery. Women without antenatal care had doubled (OR = 1.815, 95% CI, 1.310; 2.515) the chance of having complications. Mothers age <20 years was protective (OR = 0.579, 95% CI, 0.348; 0.963) of complications during delivery compared to women who were ≥35 years. National and local policies and intervention programmes must address the need of the risk groups of pregnant women during labor and delivery.

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Abd Elmoniem, Somaya O., Elham A. Ramadan i Ahlam E. M. Sarhan. "Effect of Health Educational Program on Knowledge, Attitude, and Reaction of Pregnant Women Regarding Obstetric and Newborn Danger Signs". Evidence-Based Nursing Research 2, nr 4 (12.11.2020): 14. http://dx.doi.org/10.47104/ebnrojs3.v2i4.170.

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Context: Globally, every minute, at least one pregnant woman dies from obstetric complications. Also, the majority of neonatal deaths occur during the first week of life. These mortality rates can be reduced by increased knowledge, positive attitude, and appropriate reaction regarding obstetric and newborn danger signs. Aim: of the study was to examine the effect of health education program on knowledge, attitude, and the reaction of pregnant women regarding obstetric and newborn danger signs. Methods: A quasi-experimental research (pre/post-intervention) design was utilized to achieve this study's aim. A purposive sample of 70 pregnant women was recruited according to inclusion criteria. This research was conducted in the Antenatal Outpatient Clinic at Benha University Hospital. Two tools were used for data collection. They were a Structured Interviewing Questionnaire and a Modified Likert Scale to assess women's attitude. Results: 77.1% had poor knowledge pre educational program compared by 92.9% post educational program intervention. Regarding attitude, 52.9% had a negative attitude preprogram compared to 87.1% had a positive attitude post-program with a statistically significant difference between the two phases regarding all knowledge elements. The majority of them (83.3%) had an appropriate reaction (seeking medical help) after the educational program than a few of them pre educational program. Conclusion: The implementation educational program significantly improved pregnant women’s knowledge, attitude, and reaction regarding obstetrics and newborn danger signs. The study recommended developing antenatal classes for all pregnant women about key danger signs, appropriate decisions, and reactions in obstetric and newborn danger signs. Further research regarding replicating this study on a large representative probability sample is highly recommended to achieve more generalization of the results.

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Rosenblatt, Roger A., Gregory R. Saunders, Carolyn J. Tressler, Eric H. Larson, Thomas S. Nesbitt i L. Gary Hart. "The Diffusion of Obstetric Technology into Rural U.S. Hospitals". International Journal of Technology Assessment in Health Care 10, nr 3 (1994): 479–89. http://dx.doi.org/10.1017/s0266462300006693.

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AbstractWe determined the distribution and sophistication of obstetric technologies in all 80 maternity hospitals in the state of Washington and examined the effect of rural or urban location, birth volume, and physician staffing on technological intensity. Although smaller and more rural hospitals refer most premature and low-birth-weight infants to regional referral centers, sophisticated prenatal and intrapartum technologies are available in the majority of even the smallest and most remote rural units. Rural hospitals have slightly lower obstetrical intervention rates than do their urban counterparts, but the differences are not great.

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Ragea, Carina, Anca Marina Ciobanu, Corina Gica, Mihaela Demetrian, Brindusa Ana Cimpoca-Raptis, Gheorghe Peltecu, Radu Botezatu, Nicolae Gica i Anca Maria Panaitescu. "Adnexal torsion in pregnancy". Romanian Medical Journal 69, S2 (31.01.2022): 54–58. http://dx.doi.org/10.37897/rmj.2022.s2.12.

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This review has the purpose to evaluate and report clinical characteristics, treatment, and obstetric outcomes of adnexal torsion in pregnant women in order to raise awareness of the need for prompt diagnosis and surgical intervention. Adnexal torsion (AT) in pregnancy is a rare event but is a surgical emergency that needs prompt intervention. Misdiagnosis or delay in treatment can lead to loss of ovarian function with an effect on future fertility and loss of the pregnancy. The use of assisted reproductive technology is associated with an increased risk of AT. Diagnosis of AT is very challenging due to its nonspecific signs and symptoms such as abdominal pain, nausea, vomiting, and abdominal tenderness. Furthermore, pregnant women with AT present with specific characteristics, and these common signs and symptoms may be caused by other obstetric and non-obstetric conditions. Ultrasound examination may not be as valuable as in non-pregnant women. MRI can assist in making the diagnosis in pregnant women. Clinical suspicion of AT should not delay treatment if the imaging evaluation is not clarifying. In standard practice, the surgical treatment of AT is performed by laparoscopy which is safe for pregnant patients regardless of the trimester. The treatment is based on a conservative approach by preserving the adnexa although initially, the ovary may seem necrotic. During the intervention the adnexa is de-twisted, and cystectomy or cyst aspiration is performed, if any adnexal mass is present, to reduce the recurrence risk. Surgery during pregnancy for suspected AT does not lead to adverse obstetrical outcomes. Given the difficulties of the diagnosis of AT in pregnancy, it is of great importance that clinicians are familiar with this complication in pregnancy and are aware of the need for prompt intervention.

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Amarin, V. N., i H. F. Akasheh. "Advanced maternal age and pregnancy outcome". Eastern Mediterranean Health Journal 7, nr 4-5 (15.09.2001): 646–51. http://dx.doi.org/10.26719/2001.7.4-5.646.

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To assess the effect of maternal age on obstetric intervention and pregnancy outcome, a retrospective study compared obstetric intervention, pregnancy complications and outcome in 73 women of age > 35 years with 471 women of age 20-25 years attending Prince Ali Military Hospital, Jordan from June 1999 to May 2000. Older women were found to have significantly higher rates of medical complications such as hypertension and diabetes mellitus. Despite significantly increased frequency of large babies, trisomy 21, twin pregnancy and antepartum haemorrhage, overall outcome was satisfactory. We conclude that older women, managed by modern obstetric methods and delivered in a modern health-care centre, can expect good pregnancy outcomes.

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Faponle, AF, i AT Adenekan. "Obstetric Admissions into the Intensive Care Unit in a Sub-urban University Teaching Hospital". Nepal Journal of Obstetrics and Gynaecology 6, nr 2 (2.09.2012): 33–36. http://dx.doi.org/10.3126/njog.v6i2.6754.

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Aims: Intensive care medicine is relatively young in developing countries and there are few studies showing obstetric utilization of the facilities in Intensive Care Units (ICU) in many developing nations. We sought to determine the ICU utilization by obstetric patients in our hospital, assess the spectrum of diseases necessitating admissions, the intervention required and outcome of such admissions. Methods: A 5 year retrospective review of all obstetric admissions into the ICU from January 2003 to December 2007. Subjects were included if they were admitted during pregnancy up to 42 days post partum. Data obtained included demographics, obstetric history, pre-existing medical problems, admission diagnosis, indication for ICU admission, intervention in the ICU and outcome. Results: Obstetric cases accounted for 1.5 % of total admissions into the ICU. These also represented 0.2% of total hospital deliveries. All the patients were admitted post partum. Eclampsia was the commonest primary obstetric diagnosis (58.8%) with neurological dysfunction as the commonest indication for ICU admission. Mortality rate among admitted cases was 41.2%. Conclusions: Obstetric patients form a small population of a third world multi-disciplinary ICU but mortality among this group was high. It is recommended that large obstetric units should establish there own ICUs with standard facilities which will facilitate improved care of critically ill pregnant women and thereby improve the outcome. NJOG 2011 Nov-Dec; 6 (2): 33-36 DOI: http://dx.doi.org/10.3126/njog.v6i2.6754

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Turner, R. "Companion During Labor Lessens Women's Need of Obstetric Intervention". Family Planning Perspectives 23, nr 5 (wrzesień 1991): 238. http://dx.doi.org/10.2307/2135768.

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Bigwood, M., i A. Ling. "P.122 Improving follow up after obstetric anaesthetic intervention". International Journal of Obstetric Anesthesia 50 (maj 2022): 66. http://dx.doi.org/10.1016/j.ijoa.2022.103418.

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Shorten, Brett, i Allison Shorten. "Response: public and private intervention rates in obstetric practice". Australian Health Review 28, nr 1 (2004): 105. http://dx.doi.org/10.1071/ah040105.

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Papapetros, I. "Obstetric intervention among private and public patients in Australia". BMJ 322, nr 7283 (17.02.2001): 430. http://dx.doi.org/10.1136/bmj.322.7283.430.

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Clark, Steven L., Jonathan B. Perlin, Sarah Fraker, Jamee Bush, Janet A. Meyers, Donna R. Frye i Thomas L. Garthwaite. "Association of Obstetric Intervention With Temporal Patterns of Childbirth". Obstetrics & Gynecology 124, nr 5 (listopad 2014): 873–80. http://dx.doi.org/10.1097/aog.0000000000000485.

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Heres, M. H. B., M. Pel, P. M. Elferink-Stinkens, O. J. S. Van Hemel i P. E. Treffers. "The Dutch obstetric intervention study - variations in practice patterns". International Journal of Gynecology & Obstetrics 50, nr 2 (sierpień 1995): 145–50. http://dx.doi.org/10.1016/0020-7292(95)02424-b.

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Clark, S. L., J. B. Perlin, S. Fraker, J. Bush, J. A. Meyers, D. R. Frye i T. L. Garthwaite. "Association of Obstetric Intervention With Temporal Patterns of Childbirth". Obstetric Anesthesia Digest 35, nr 3 (wrzesień 2015): 140–41. http://dx.doi.org/10.1097/01.aoa.0000469476.49976.04.

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Pesch, Megan H., Carter Anderson i Erika Mowers. "Improving Obstetric Provider Congenital Cytomegalovirus Knowledge and Practices". Infectious Diseases in Obstetrics and Gynecology 2020 (8.11.2020): 1–4. http://dx.doi.org/10.1155/2020/8875494.

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Background. Congenital cytomegalovirus infection (cCMV) is the most common congenital infection. Antenatal education is proven to reduce cCMV risk. Little is known about obstetric provider knowledge and practice patterns around cCMV. Objectives. To evaluate obstetric provider knowledge and practice patterns regarding cCMV at baseline and again after a brief educational intervention. Methods. Obstetric providers ( N = 53 ) at a US academic community hospital were invited to complete a survey regarding their knowledge and practice patterns around cCMV. Providers attended a brief presentation about cCMV and later were invited to repeat the same survey. Univariate statistics were calculated for baseline data, and prepost intervention comparison analyses were conducted. Results. Baseline cCMV knowledge was low at 49% ( M = 17.54 out of a possible 36, SD 6.4), with most providers (51%) reporting never counseling pregnant patients about cCMV. Post intervention, overall cCMV knowledge increased to 80% ( M = 29.33 , SD 4.1, p < .001 ); provider intention to counsel about cCMV prevention increased to 100%. Conclusions. Obstetric provider knowledge about cCMV is low, which likely impacts their antenatal counseling. Educational initiatives to increase awareness about cCMV may increase antenatal education and thereby decrease the risk of cCMV.

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Simó González, Marta, Oriol Porta Roda, Josep Perelló Capó, Ignasi Gich Saladich i Joaquim Calaf Alsina. "Mode of Vaginal Delivery: A Modifiable Intrapartum Risk Factor for Obstetric Anal Sphincter Injury". Obstetrics and Gynecology International 2015 (2015): 1–5. http://dx.doi.org/10.1155/2015/679470.

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The aim of this study was to analyze the comparative risks of this anal sphincter injury in relation to the type of intervention in vaginal delivery. We performed an observational, retrospective study of all vaginal deliveries attended at a tertiary university hospital between January 2006 and December 2009. We analyzed the incidence of obstetric anal sphincter injury for each mode of vaginal delivery: spontaneous delivery, vacuum, Thierry spatulas, and forceps. We determined the proportional incidence between methods taking spontaneous delivery as the reference. Ninety-seven of 4526 (2.14%) women included in the study presented obstetric anal sphincter injury. Instrumental deliveries showed a significantly higher risk of anal sphincter injury (2.7 to 4.9%) than spontaneous deliveries (1.1%). The highest incidence was for Thierry spatulas (OR 4.804), followed by forceps (OR 4.089) and vacuum extraction (OR 2.509). The type of intervention in a vaginal delivery is a modifiable intrapartum risk factor for obstetric anal sphincter injury. Tearing can occur in any type of delivery but proportions vary significantly. All healthcare professionals attending childbirth should be aware of the risk for each type of intervention and consider these together with the obstetric factors in each case.

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Rasmussen, Ole, Annika Yding, Finn Lauszus, Charlotte Andersen, Jacob Anhøj i Jane Boris. "Importance of Individual Elements for Perineal Protection in Childbirth: An Interventional, Prospective Trial". American Journal of Perinatology Reports 08, nr 04 (październik 2018): e289-e294. http://dx.doi.org/10.1055/s-0038-1675352.

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Objective To analyze the association between each element of a hands-on intervention in childbirth and the incidence of obstetric anal sphincter injuries (OASIS). Study Design We conducted a prospective, interventional quality improvement project and implemented a care bundle with five elements at an obstetric department in Denmark with 3,000 deliveries annually. We aimed at reducing the incidence of OASIS. In the preintervention period, 355 vaginally delivering nulliparous women were included. Similarly, 1,622 nulliparous women were included in the intervention period. The association of each element with the outcome was estimated using a regression analysis. Results The incidence of OASIS went down from 7.0 to 3.4% among nulliparous women delivering vaginally (p = 0.003; relative risk = 0.48; 95% confidence interval [CI]: 0.30–0.76). Number needed to treat was 28. Logistic regression analysis showed that using hand on the head of the child significantly reduced the risk of OASIS (odds ratio = 0.28; 95% CI: 0.14–0.58). Conclusion Using a quality improvement framework, we documented the individual elements of the intervention. Hand on the infant's head reduced the risk of OASIS.

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Jindani, Shahna Anishbhai, Asha Bhagwatibhai Sailor, Dipti A. Modi, Somika Kaul i Bijal D. Rami. "A prospective study of obstetric and gynaecological emergencies in a tertiary care hospital". International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, nr 5 (28.04.2020): 1992. http://dx.doi.org/10.18203/2320-1770.ijrcog20201794.

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Background: The management of obstetrics and gynaecological emergency is directed at the preservation of life, health, sexual function and the perpetuation of fertility. The main aim of the study was to access the burden of surgical emergency and to study the course of management at a tertiary care hospital.Methods: This prospective study was carried out in the department of obstetrics and gynaecology, S. S. G. Hospital, Baroda for a period from January to December 2018.Results: A total of 73 patients presented to our emergency room who required urgent surgical intervention. All patients were resuscitated and surgery was done at earliest possible time. The age of patient ranged from 18 to 45 years. About 75.8% of female presented with the complaint of acute abdomen, followed by 32.9% with bleeding per vaginum. 16.4% had vomiting, 6.8% with fever and 4.1% with mass per abdomen. In majority of cases a diagnosis of ruptured ectopic pregnancy (34 patients) was made, followed by PPH in 14 patients and 12 cases of rupture uterus. Four cases of torsion of ovarian mass and 3 cases of septic peritonitis were operated. The most common surgery performed was salpingectomy followed by subtotal obstetric hysterectomy. A mortality rate of 8.2% was noted.Conclusions: This study emphasized the great role of timely surgical intervention as lifesaving procedures. Skilled clinicians and immediate intervention in a tertiary care is the main-stay of the emergency case management and are indispensable for decreasing mortality and morbidity.

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Viegas, O. A. C., W. P. Leong, S. Ahmed i S. S. Ratnam. "Obstetrical outcome with increasing maternal age". Journal of Biosocial Science 26, nr 2 (kwiecień 1994): 261–67. http://dx.doi.org/10.1017/s0021932000021283.

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SummaryA retrospective study of 21,442 Singaporean women who gave birth at the National University Hospital, Singapore, between January 1986 and November 1991 is used to assess the effects of increasing age on obstetric performance. The results show that reproduction after the age of 35 years in Singapore is associated with a higher incidence of antenatal complications such as hypertension and diabetes and a higher rate of obstetric intervention. However, given the current level of obstetric and neonatal care in Singapore, these adverse features do not prejudice the obstetric and neonatal outcomes.

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., Preetkamal, Ripan Bala, Simranjeet Kaur i Madhu Nagpal. "Obstetrics ICU admissions: learning objectives". International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, nr 4 (26.03.2019): 1294. http://dx.doi.org/10.18203/2320-1770.ijrcog20191019.

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Background: The management of critical illness in pregnancy requires intensive monitoring of obstetric patients in the intensive care unit. Systematic way of surveillance will allow the measurement of outcomes of interest and associated risk factors. Intensive care unit is highly specified and sophisticated area of hospital which is specifically designed, staffed, furnished and equipped, dedicated to the management of critically sick patients, injuries or complications. The aim of this study was to know the frequency of ICU admission in obstetrical patients, to analyse the medical or surgical comorbidity related to obstetrical problems, to segregate the cause of morbidity and to identify the risk reducing strategies.Methods: This observational study was conducted in 40 ICU patients in present institute from 1st December 2016 to 28th February 2019. The present study was divided into two groups in group I, intervention was done first followed by ICU intervention and in group II, ICU stabilization was done first followed by obstetrical intervention. The parameters noted were age, parity, gestation age, diagnosis on admission, associated medical and surgical comorbidity, reason for ICU admission, any surgical procedure performed, details of treatment given in ICU like ventilator support, blood transfusion, dialysis or ionotropic support. Patients outcome, review of mortality and area of improvement were also noted.Results: There were 17.5% mortalities observed in present study. The most common ICU intervention was blood transfusion (81.19%) followed by mechanical ventilation (37.8%). Commonest cause of mortality was multiorgan dysfunction (28.5%) followed by hypertensive disorder of pregnancy (14.3%), peripartum cardiomyopathy (14.3%), acute fatty liver of pregnancy (14.3%), septic shock (14.3%) and acute febrile illness (14.3%). Most of the patients were unbooked (74.3%), 47.2% cases did not receive antenatal care.Conclusions: There is need for antenatal registration of all pregnant women and institutional deliveries should be the aim. There should be antenatal detection and management of medical and surgical comorbidities. There is need for training in emergency obstetrics so that complication can be recognized and managed at an optimum time.

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