2,705 results match your criteria Labor and Delivery in the Emergency Department


Time matters - a Swedish cohort study of labor duration and risk of uterine rupture.

Acta Obstet Gynecol Scand 2021 Jun 11. Epub 2021 Jun 11.

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Introduction: Uterine rupture is an obstetric emergency associated with maternal and neonatal morbidity. The main risk factor is a prior cesarean section, with rupture occurring in subsequent labor. The aim of this study was to assess the risk of uterine rupture by labor duration and labor management. Read More

View Article and Full-Text PDF

Single-center task analysis and user-centered assessment of physical space impacts on emergency Cesarean delivery.

PLoS One 2021 10;16(6):e0252888. Epub 2021 Jun 10.

The Safety Learning Laboratory for Neonatal and Maternal Care, Stanford University, Stanford, California, United States of America.

Objective: This study aimed to begin to address this gap using validated techniques in human factors to perform a participatory user-centered analysis of physical space during emergency Cesarean.

Methods: This study employed a mixed-methods design. Focus group interviews and surveys were administered to a convenience sample (n = 34) of multidisciplinary obstetric teams. Read More

View Article and Full-Text PDF

Peripartum anesthetic management of women with SARS-CoV-2 infection in eight medical centers across three European countries: prospective cohort observation study.

J Matern Fetal Neonatal Med 2021 Jun 9:1-8. Epub 2021 Jun 9.

Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel.

Objective: Several reports of obstetric anesthesia management have been published since the onset of the COVID-19 pandemic. We aimed to collect high-quality broad and detailed data from different university medical centers in several European Society of Anesthesiologist countries.

Methods: This prospective observational survey was performed in eight medical centers in Spain, Israel and Portugal from 1 April to 31 July 2020. Read More

View Article and Full-Text PDF

Veterans Health Administration's Whole Health System of Care: Supporting the Health, Well-Being, and Resiliency of Employees.

Glob Adv Health Med 2021 30;10:21649561211022698. Epub 2021 May 30.

Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.

The Veterans Health Administration (VHA) is implementing a Whole Health System (WHS) of care that empowers and equips Veterans to take charge of their health and well-being and live their lives to the fullest, and increasingly leaders recognize the need and value in implementing a similar approach to support the health and well-being of employees. The purpose of this paper is to do the following: 1) provide an overview of the WHS of care in VHA and applicability in addressing employee resiliency; 2) provide a brief history of employee well-being efforts in VHA to date; 3) share new priorities from VHA leadership as they relate to Employee Whole Health strategy and implementation; and 4) provide a summary of the impacts of WHS of care delivery on employees. The WHS of care utilizes all therapeutic, evidence-based approaches to support self-care goals and personal health planning. Read More

View Article and Full-Text PDF

Perinatal Outcome and its Prediction Using Longitudinal Feto-Maternal Doppler Follow-Up in Late Onset Small for Gestational Age Fetuses - A Prospective Cohort Study.

Ultraschall Med 2021 Jun 8. Epub 2021 Jun 8.

Department of Pediatric Cardiology and Congenital Heart Defects, German Heart Centre Munich, München, Germany.

Purpose:  To describe the perinatal outcome of a prospective cohort of late-onset small-for-gestational-age (SGA) fetuses and to test adverse perinatal outcome (APO) prediction using Doppler measurements.

Methods:  Singleton pregnancies from 32 weeks with suspicion of SGA (followed-up each 2 weeks) and randomly selected healthy controls at a university hospital were included. The whole SGA group was divided into the FGR subgroup or SGA percentile 3-10 subgroup. Read More

View Article and Full-Text PDF

Impact of the COVID-19 pandemic on interventional radiology services across the world.

Clin Radiol 2021 May 19. Epub 2021 May 19.

UK National Interventional Radiology Trainee Research (UNITE) Collaborative, St Thomas Hospital, SE1 7EH, UK; Alfa Institute of Biomedical Sciences, Neapoleos 9, Marousi, Athens, Greece; Radiology Department, University Hospital of Lewisham, London, SE13 6LH, UK; Department of Interventional Radiology, Guys & St Thomas NHS Foundation Trust, London, SE1 9RS, UK. Electronic address:

Aim: To review data on the impact of the COVID-19 pandemic on interventional radiology (IR) services.

Materials And Methods: A systematic review of the available studies was performed according to the PRISMA guidelines.

Results: A total of 14 studies met the inclusion criteria. Read More

View Article and Full-Text PDF

Prioritizing health care workers and first responders for access to the COVID19 vaccine is not unethical, but both fair and effective - an ethical analysis.

Scand J Trauma Resusc Emerg Med 2021 Jun 4;29(1):77. Epub 2021 Jun 4.

Department of Emergency Medicine, Mayo Clinic, Rochester, MN, 55905, USA.

The Nordic countries have differed in their approach as to how much priority for COVID19 vaccine access should be given to health care workers. Two countries decided not to give health care workers highest priority, raising some controversy. The rationale was that those at highest risk of dying needed to come first. Read More

View Article and Full-Text PDF

Planned early delivery for late preterm pre-eclampsia in a low- and middle-income setting: a feasibility study.

Reprod Health 2021 Jun 2;18(1):110. Epub 2021 Jun 2.

Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK.

Background: Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity globally. Planned delivery between 34 and 36 weeks may reduce adverse pregnancy outcomes but is yet to be evaluated in a low and middle-income setting. Prior to designing a randomised controlled trial to evaluate this in India and Zambia, we carried out a 6-month feasibility study in order to better understand the proposed trial environment and guide development of our intervention. Read More

View Article and Full-Text PDF

Perceived Causes of Obstetric Fistula and Predictors of Treatment Seeking among Ugandan Women: Insights from Qualitative Research.

Afr J Reprod Health 2020 Jun;24(2):129-140

Department of Obstetrics, Gynaecology and Reproductive Sciences, University of California, San Francisco, 550 16th Street, San Francisco, USA.

Many obstetric fistula patients remain untreated or present late to treatment despite increasing surgical availability in Uga nda. We explored women's perceptions of the cause of their obstetric fistula and their treatment seeking behaviours, including barriers and facilitators to timely care access. In-depth interviews and focus group discussions were conducted from June-August 2014 among 33 women treated for obstetric fistula at Mulago Hospital, Kampala. Read More

View Article and Full-Text PDF

In Silico Studies of Some Isoflavonoids as Potential Candidates against COVID-19 Targeting Human ACE2 (hACE2) and Viral Main Protease (M).

Molecules 2021 May 10;26(9). Epub 2021 May 10.

Department of Pharmacognosy and Medicinal Plants, Faculty of Pharmacy (Boys), Al-Azhar University, Cairo 11884, Egypt.

The Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the "COVID-19" disease that has been declared by WHO as a global emergency. The pandemic, which emerged in China and widespread all over the world, has no specific treatment till now. The reported antiviral activities of isoflavonoids encouraged us to find out its in silico anti-SARS-CoV-2 activity. Read More

View Article and Full-Text PDF

The Successful Use of Nitroglycerin for Uterine Hyperstimulation with Fetal Heart Rate Abnormality Caused by a Controlled-Release Dinoprostone Vaginal Delivery System (PROPESS): A Case Report.

Medicina (Kaunas) 2021 May 12;57(5). Epub 2021 May 12.

Department of Obstetrics and Gynecology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.

The PROPESS, a controlled-release dinoprostone vaginal delivery system, is a pharmacological cervical ripening intervention and promotes cervical change causing uterine contraction. During insertion of the PROPESS, uterine hyperstimulation could occur and result in fetal heart rate (FHR) abnormality. We report a case of uterine hyperstimulation accompanied with FHR abnormality caused by the PROPESS in a pregnant woman. Read More

View Article and Full-Text PDF

General Versus Regional Anesthesia for Emergency Cesarean Delivery in a High-volume High-resource Referral Center: A Retrospective Cohort Study.

Rom J Anaesth Intensive Care 2020 Dec 31;27(2):6-10. Epub 2020 Dec 31.

Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, affiliated with Hebrew University, Jerusalem, Israel.

Objective: The choice of anesthesia for emergency cesarean delivery (CD) is one of the most important choices to make in obstetric anesthesia. In this study, we examine which type of anesthesia was used for emergency CD in our hospital, and how the choice affected the time from entry to the operation room until incision (TTI), time until delivery (TTD), and maternal/neonatal outcomes.

Methods: Retrospectively, we examined all emergency CD's performed in Shaare Zedek Medical Center between January-December 2018. Read More

View Article and Full-Text PDF
December 2020

Ethyl cellulose coated sustained release aspirin spherules for treating COVID-19: DOE led rapid optimization using arbitrary interface; applicable for emergency situations.

Int J Biol Macromol 2021 May 26;182:1769-1784. Epub 2021 May 26.

Department of Pharmacy, Annamalai University, Annamalainagar, Tamil Nadu, India.

This work attempts to resolve one of the key issues related to the design and development of sustained-release spherule of aspirin for oral formulations, tailored to treat COVID-19. For that, in the Design of Experiments (DOE) an arbitrary interface, "coating efficiency" (CE) is introduced and scaled the cumulative percentage coating (CPC) to get predictable control over drug release (DR). Subsequently, the granules containing ASP are converted to spherules and then to Ethyl cellulose (EC) Coated spherules (CS) by a novel bed coating during the rolling (BCDR) process. Read More

View Article and Full-Text PDF

Identifying safe care processes when GPs work in or alongside emergency departments: realist evaluation.

Br J Gen Pract 2021 May 27. Epub 2021 May 27.

Cardiff University School of Medicine, Cardiff, United Kingdom.

Background: Increasing pressure on emergency services has led to the development of different models of care delivery including GPs working in or alongside emergency departments (EDs), but with a lack of evidence for patient safety outcomes.

Aim: We aimed to explore how care processes work and how patient safety incidents associated with GPs working in ED settings may be mitigated.

Design And Setting: We used realist methodology with a purposive sample of 13 EDs with different GP service models. Read More

View Article and Full-Text PDF

Usage of Digital Tools to Access Primary Care in Quebec: An Environmental Scan.

Stud Health Technol Inform 2021 May;281:689-693

School of Public Health of the University of Montreal, Montreal, Canada.

Timely access to care is a persistent challenge for health care systems. Providing the right care to the right patient at the right time is important to reduce inappropriate use and improve the performance of healthcare services. The complexity of accessing primary care contributes to the high usage of emergency rooms for not-urgent conditions. Read More

View Article and Full-Text PDF

Trends in medicare spending across strata of resource utilization among older individuals in the United States.

EClinicalMedicine 2021 Jun 24;36:100873. Epub 2021 May 24.

Chair, Department of Health Policy, Vanderbilt University School of Medicine, Nashville, TN, United States.

Background: Health care spending is an increasing proportion of government expenditures in most Western countries. How this growth is distributed between individuals with minimal compared to high health care utilization is unknown.

Methods: We examined total and per-capita government expenditure in an observational cohort of fee-for-service U. Read More

View Article and Full-Text PDF

A Review of Research Progress of Pregnancy with Twins with Preeclampsia.

Risk Manag Healthc Policy 2021 18;14:1999-2010. Epub 2021 May 18.

Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China.

Preeclampsia has a significant long-term effect on the health of both mothers and babies. Preeclampsia-related pregnancy complications increase the morbidity and mortality of pregnant women and their fetuses by 5-8%. The recent advancement of assisted reproductive technology, combined with a rise in the number of elderly pregnant women, has resulted in pregnancy incidence with twins. Read More

View Article and Full-Text PDF

The role of homelessness community based organizations during COVID-19.

J Community Psychol 2021 May 25. Epub 2021 May 25.

Department of Sociology & Criminal Justice, Southeastern Louisiana University, Hammond, Louisiana, USA.

People experiencing homelessness are vulnerable to disasters and hazards and are at risk for contracting COVID-19. In this study, we gathered data from 10 community-based organizations (CBO's) in the United States that work to provide services for people experiencing homelessness. The combined CBO's span across rural, urban, and a mixture of both settings. Read More

View Article and Full-Text PDF

Prevention of post-traumatic stress disorder: Lessons learned from a terminated RCT of prolonged exposure.

PLoS One 2021 24;16(5):e0251898. Epub 2021 May 24.

Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.

The main purpose of the current trial was to test if a brief trauma-focused cognitive-behaviour therapy protocol (prolonged exposure; PE) provided within 72 h after a traumatic event could be effective in decreasing the incidence of post-traumatic stress disorder (PTSD), thus replicating and extending the findings from an earlier trial. After a pilot study (N = 10), which indicated feasible and deliverable study procedures and interventions, we launched an RCT with a target sample size of 352 participants randomised to either three sessions of PE or non-directive support. Due to an unforeseen major reorganisation at the hospital, the RCT was discontinued after 32 included participants. Read More

View Article and Full-Text PDF

Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection at the time of birth in England: national cohort study.

Am J Obstet Gynecol 2021 May 20. Epub 2021 May 20.

Fetal Medicine Unit, St George's Hospital, Blackshaw Road London SW17 0QT, UK; Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London SW17 0RE, UK. Electronic address:

Objective: The aim of this study was to determine the association between SARS-CoV-2 infection at the time of birth and maternal and perinatal outcomes.

Methods: This is a population-based cohort study in England. The inclusion criteria were women with a recorded singleton birth between 29 May 2020 and 31 January 2021 in a national database of hospital admissions. Read More

View Article and Full-Text PDF

Future and Development Direction of Digital Healthcare.

Healthc Inform Res 2021 Apr 30;27(2):95-101. Epub 2021 Apr 30.

Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Korea.

Objectives: Digital healthcare is expected to play a pivotal role in patient-centered healthcare. It empowers patients by informing, communicating, and motivating them. However, a pragmatic evaluation of the present status of digital healthcare has not been presented; therefore, we aimed to examine the status of digital healthcare in Korea. Read More

View Article and Full-Text PDF

Acceptance of trial of labor after cesarean (Tolac) among obstetricians in the Western Region of Saudi Arabia: A cross-sectional study.

Saudi J Biol Sci 2021 May 16;28(5):2795-2801. Epub 2021 Feb 16.

Department of Internal Medicine, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.

Background: Babies to women eligible for trial of labor after a cesarean (TOLAC) are sometimes delivered by cesarean section (CS). To obtain clinicians' attitudes and beliefs about TOLAC, this study was designed to investigate the views of clinicians when advising TOLAC-eligible pregnant women about TOLAC, and to explore their reasons in favor of or against TOLAC.

Methods: Interviews were carried out individually (face-to-face) with clinicians using a specially designed questionnaire to collect data from obstetricians in the Western Region of Saudi. Read More

View Article and Full-Text PDF

Factors Associated with the Type of Cesarean Section in Greece and Their Correlation with International Guidelines.

Acta Inform Med 2021 Mar;29(1):38-44

Department of Midwifery, University of West Attica, Greece.

Background: Cesarean section (CS) rates have been increasing worldwide with different effects on maternal and neonatal health. Factors responsible for the growing trend of CSs, include maternal characteristics, medical insurance and convenient scheduling or financial incentives. Effective interventions and guidelines are required to reduce CS rates. Read More

View Article and Full-Text PDF

Hemorrhagic Shock after Neonatal Circumcision: Severe Congenital Factor XIII Deficiency.

Case Rep Pediatr 2021 3;2021:5550199. Epub 2021 May 3.

Department of Pediatrics, Section of Pediatric Hematology, Oncology, Stem Cell Transplant, Comer Children's Hospital, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.

A Caucasian male infant born full term via normal spontaneous vaginal delivery was given vitamin K after birth, circumcised on day of life (DOL) 1, and discharged from the nursery on DOL 2. At the time of circumcision, oozing from the surgical site was noted and initially resolved with silver nitrate. Over the next two days, he presented to local emergency rooms multiple times for recurrent bleeding, eventually developing hemorrhagic shock resulting in admission to the neonatal intensive care unit. Read More

View Article and Full-Text PDF

A Novel pH-Sensitive Multifunctional DNA Nanomedicine: An Enhanced and Harmless GD2 Aptamer-Mediated Strategy for Guiding Neuroblastoma Antitumor Therapy.

Int J Nanomedicine 2021 10;16:3217-3240. Epub 2021 May 10.

Department of Neonatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.

Background: GD2 is a mainstream biomarker for neuroblastoma (NB)-targeted therapy. Current anti-GD2 therapeutics exhibit several side effects since GD2 is also expressed at low levels on normal cells. Thus, current anti-GD2 therapeutics can be compromised by the coexistence of the target receptor on both cancer cells and normal cells. Read More

View Article and Full-Text PDF

Emerging from emergency pandemic pedagogy: A survey of anatomical educators in the United Kingdom and Ireland.

Clin Anat 2021 May 17. Epub 2021 May 17.

School of Medicine, University College Dublin, Dublin, Ireland.

It is critical that academic opinion of pandemic pedagogy is comprehensively quantified in order to inform future practices. Thus, this study examines how anatomists in the United Kingdom (UK) and Republic of Ireland (ROI) perceive the teaching adaptations made in response to COVID-19, and how these adaptations have impacted their experiences teaching, their online work environment and community. Data was collected via a questionnaire from 24 anatomists across 15 universities in the UK (11) and ROI (4). Read More

View Article and Full-Text PDF

Review of aerosol delivery in the emergency department.

Ann Transl Med 2021 Apr;9(7):591

Department of Emergency Medicine, Division of Pediatric Emergency Medicine, UT Health San Antonio, San Antonio, TX, USA.

Aerosol delivery is a vital therapeutic strategy for both adult and pediatric patients presenting to the emergency department with respiratory distress. Aerosolized bronchodilators are frequently used as rescue medications for patients with diagnoses of asthma, chronic obstructive pulmonary disease (COPD), or pneumonia. Historically, emergency department providers utilized jet nebulizers (JNs) for medication delivery, but were challenged by a need for increasingly higher bronchodilator doses to elicit the desired response. Read More

View Article and Full-Text PDF

The Impact of COVID-19 on Acute and Elective Corneal Surgery at Moorfields Eye Hospital London.

Clin Ophthalmol 2021 6;15:1639-1645. Epub 2021 May 6.

Cornea and External Eye Disease Service, Moorfields Eye Hospital, London, UK.

Purpose: Moorfields Eye Hospital sits as a major tertiary centre for ophthalmic care in the United Kingdom and became a central hub to provide safe and effective ophthalmic care across London and surrounding regions during the COVID-19 pandemic. We explore the impact on both the acute and elective corneal services during the first wave of this pandemic.

Methods: A retrospective review of the proportion of corneal transplants and anterior segment trauma repairs was performed during the period of March 23rd to July 1st 2020 compared with an identical period in 2019. Read More

View Article and Full-Text PDF