6,133 results match your criteria obstetric emergency


Pilot investigation shows high sensitivity and specificity using an Abridged Subjective Global Assessment without physical examination in a tertiary hospital; pertinence for use amongst those without COVID-19 when physical distancing required during the pandemic.

Authors:
Angela Vivanti

Clin Nutr ESPEN 2021 Aug 9;44:463-465. Epub 2021 Jun 9.

Princess Alexandra Hospital, Brisbane, Qld 4102, Australia; School of Human Movement and Nutrition Studies, University of Queensland, Qld 4072, Australia. Electronic address:

Background: Completing malnutrition assessments when physically distant has been an immediate challenge during the COVID-19 pandemic. Even during periods of physical distancing, continuing nutrition assessments amongst those without COVID-19 is vital given that high malnutrition prevalence exists in clinical settings. The investigation aim was to assess the reliability of utilising the validated Subjective Global Assessment (SGA) tool, without compared to with physical examination. Read More

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Delays during emergency obstetric care and their determinants among mothers who gave birth in South Gondar zone hospitals, Ethiopia. A cross-sectional study design.

Glob Health Action 2021 Jan;14(1):1953242

Department of Midwifery, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

Background: The majority of maternal deaths occur during delivery and the immediate postnatal period as a result of delays in seeking care, failure to reach health institutions, and receiving inappropriate health care. In developing countries, delayed access to timely healthcare contributes to high maternal mortality and morbidity.

Objective: This study aimed to assess the delays during emergency obstetric care and associated factors with delays during emergency obstetric care. Read More

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January 2021

Correction to: How to specify healthcare process improvements collaboratively using rapid, remote consensus-building: a frame work and a case study of its application.

BMC Med Res Methodol 2021 Jul 29;21(1):156. Epub 2021 Jul 29.

THIS Institute (The Healthcare Improvement Studies Institute), Departmentof Public Health and Primary Care, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH, UK.

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Spontaneous uterine rupture during the first trimester of a partial molar pregnancy in a scar uterus: A rare case report.

Int J Surg Case Rep 2021 Jul 22;85:106229. Epub 2021 Jul 22.

Obstetrics and Gynecology Department, University Hospital Center Ibn Rochd, Casablanca 20100, Morocco; Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.

Introduction: Spontaneous uterine rupture in the first trimester is a redoubtable obstetric emergency that carries a high risk for both mother and fetus.

Cases Presentation: We present the case of a spontaneous uterine rupture in a patient with a scarred uterus at 9 weeks' gestation treated by laparotomy in emergency obstetrical department of Ibn Rochd University Hospital of Casablanca; whose histological examination of the removed material found a partial mole.

Clinical Discussion: Spontaneous uterine rupture in the first trimester is rare and usually occurs in a scarred or malformed uterus. Read More

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An international multidisciplinary peer-driven consensus on the optimal use of hemostatic powders in surgical practice.

Updates Surg 2021 Jul 28. Epub 2021 Jul 28.

Department of General Surgery, S. Eugenio Hospital, Piazzale dell'Umanesimo, 10, 00144, Rome, Italy.

Bleeding is a consequence of insufficient hemostasis and excessive bleeding at a surgical site is associated with an increased risk of post-operative infection, transfusion and re-operation, in addition to increased hospital length of stay and costs. Surgeons employ a range of methods to achieve hemostasis, including topical hemostatic agents of differing composition and properties. Hemostatic powders are a sub-group of topical hemostats, which can be used in helping as adjuncts to manage troublesome bleeding in a variety of situations. Read More

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Central Placenta Previa With Coexisting Central Cervical Fibroid in Pregnancy: An Obstetrician's Nightmare.

Cureus 2021 Jun 24;13(6):e15910. Epub 2021 Jun 24.

Obstetrics and Gynecology, Tata Main Hospital, Jamshedpur, IND.

Pregnancy with central placenta praevia and a coexistent cervical fibroid is infrequently encountered in clinical practice. A patient with this unusual combination is a nightmare for any clinician, especially if she presents with obstetric emergencies. In this scenario, there is a high chance of catastrophic obstetric hemorrhage during the peripartum period leading to a fatal outcome. Read More

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Operational Barriers in Providing Comprehensive Emergency Obstetric Care by Task Shifting of Medical Officers in Selected States of India.

Indian J Community Med 2021 Apr-Jun;46(2):252-257. Epub 2021 May 29.

Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India.

Background: A network of first referral unit (FRU) is set up to improve the availability and accessibility of comprehensive emergency obstetric care (CEmOC) services. To fill the gap of the scarcity of obstetricians and anesthetists at FRU, two short-term trainings in CEmOC and anesthesia were started for in-service medical officers.

Objective: This study aimed to assess the operational status of FRU in providing CEmOC services by task shifting of trained medical officers in selected states of India. Read More

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Health facility capacity to provide postabortion care in Afghanistan: a cross-sectional study.

Reprod Health 2021 Jul 28;18(1):160. Epub 2021 Jul 28.

Athena Institute, Vrije Universitate, Amsterdam, The Netherlands.

Background: Afghanistan has one of the highest burdens of maternal mortality in the world, estimated at 638 deaths per 100,000 live births in 2017. Infections, obstetric hemorrhage, and unsafe abortion are the three leading causes of maternal death. Contraceptive prevalence rate has fluctuated between 10 and 20% since 2006. Read More

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Motivation to participate and experiences of the informed consent process for randomized clinical trials in emergency obstetric care in Uganda.

Authors:
Dan Kabonge Kaye

BMC Med Ethics 2021 Jul 28;22(1):104. Epub 2021 Jul 28.

College of Health Sciences, Department of Obstetrics and Gynecology, Makerere University, P.O. Box 7072, Kampala, Uganda.

Background: Informed consent, whose goal is to assure that participants enter research voluntarily after disclosure of potential risks and benefits, may be impossible or impractical in emergency research. In low resource settings, there is limited information on the experiences of the informed consent process for randomized clinical trials in the emergency care context. The objective of this study was to explore the experiences of the informed consent process and factors that motivated participation in two obstetrics and newborn care randomized clinical trials (RCTs). Read More

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Unusual umbilical Doppler waveform and fetal distress likely due to hypercoiled cord.

Minerva Obstet Gynecol 2021 Aug;73(4):506-508

Obstetric Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.

Both reduced and increased umbilical cord coiling patterns have been associated with fetal distress and adverse perinatal outcomes, including fetal death. Prenatal diagnosis of cord coiling anomalies is challenging but potentially very useful for identifying those that may benefit from a more intensive monitoring. Nevertheless, there is no standardized approach for this potentially lethal complication when suspected. Read More

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Exchange Transfusion for Hyperbilirubinemia among Term and Near Term in NICU of a Tertiary Care Hospital of Bangladesh: Findings from a Prospective Study.

Euroasian J Hepatogastroenterol 2021 Jan-Jun;11(1):21-26

Department of Neonatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.

Background: Exchange transfusion in newborns is recommended as emergency management of hyperbilirubinemia to prevent bilirubin encephalopathy and kernicterus.

Aim: This study aimed to determine the frequency and document common side effects of exchange transfusion and outcomes of newborns requiring exchange transfusion.

Materials And Methods: This prospective study was done in the Neonatal Intensive Care Unit (NICU) of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh, from January 2016 to December 2019. Read More

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Proportion, Characteristics and Maternal Outcome of women referred for childbirth to a tertiary hospital in northern Tanzania - A descriptive retrospective study based on a hospital birth registry.

Sex Reprod Healthc 2021 Jul 10;29:100646. Epub 2021 Jul 10.

Kilimanjaro Christian Medical University College, Moshi, Tanzania; Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical Centre, Moshi Tanzania.

Objective: Timely identification of danger signs and prompt referral to higher level may prevent complication associated with childbirth. With a high MMR in Tanzania, there is need to highlight the information on the proportion of women referred to tertiary healthcare, their basic characteristics and outcomes. This study aimed to determine the proportion, basic characteristics and outcomes among women referred while in labour, from lower health facilities to a tertiary hospital in northern Tanzania. Read More

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Non-haemorrhagic uterine rupture at 28 weeks of pregnancy following previous caesarean section: a case report.

BMC Pregnancy Childbirth 2021 Jul 24;21(1):529. Epub 2021 Jul 24.

Kitovu Hospital, Masaka, Uganda.

Background: There is need to put forward more symptoms and signs that could suggest a diagnosis of uterine rupture so that clinicians' suspicion is increased; there is also need to put forward uncommon intraoperative findings in patients with uterine rupture to correlate with the signs and symptoms of patients.

Case Presentation: A 33 year old Gravida 5 Para 4 + 0 with 2 previous caesarean section scars at 28 weeks of amenorrhoea, presented to hospital complaining of lower abdominal pain for 11 h. She had no vaginal bleeding or vaginal discharge or pain on passing urine. Read More

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Basic emergency obstetric and newborn care service availability and readiness in Nepal: Analysis of the 2015 Nepal Health Facility Survey.

PLoS One 2021 21;16(7):e0254561. Epub 2021 Jul 21.

School of Public Health and Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal.

Background: Achieving maternal and newborn related Sustainable Development Goals targets is challenging for Nepal, mainly due to poor quality of maternity services. In this context, we aim to assess the Basic Emergency Obstetric and Newborn Care (BEmONC) service availability and readiness in health facilities in Nepal by analyzing data from Nepal Health Facility Survey (NHFS), 2015.

Methods: We utilized cross-sectional data from the nationally representative NHFS, 2015. Read More

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Problem-solving with MRI in acute abdominopelvic conditions, part 2: gynecological, obstetric, vascular, and renal diseases.

Emerg Radiol 2021 Jul 21. Epub 2021 Jul 21.

Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.

The purpose of this article is to illustrate the benefits of magnetic resonance imaging (MRI) in the setting of abdominopelvic emergencies. Owing to intrinsically high soft-tissue contrast resolution, and ability to resolve different soft tissue, MRI holds notable advantages over other imaging modalities and can be used as a problem-solving tool. Additional advantages of MRI include lack of radiation-related risks to children and pregnant women, and the ability to acquire detailed diagnostic information even without intravenous contrast which can be beneficial in patients with contrast allergy and end-stage renal disease. Read More

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Preterm Labor Using Tocolysis as a Possible Risk Factor for Postpartum Depression: A 14-Year Population-Based Study in Taiwan.

Int J Environ Res Public Health 2021 07 5;18(13). Epub 2021 Jul 5.

Department of Obstetrics & Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.

Postpartum depression (PPD) is associated with negative physical and mental health outcomes for the mother and infant. Women often experience elevated symptoms of PPD, and the incidence of PPD has increased in recent years. There were lack of studies to investigate the effects of medications during pregnancy. Read More

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Accuracy of cricothyroid membrane identification using ultrasound and palpation techniques in obese obstetric patients: an observational study.

Int J Obstet Anesth 2021 Jun 30;48:103205. Epub 2021 Jun 30.

Department of Anaesthesia, University Hospital Limerick, Ireland.

Background: During performance of emergency front of neck access, the final step in management algorithms for the 'can't intubate, can't oxygenate' scenario, accurate identification of the cricothyroid membrane, is crucial. Accurate identification using palpation techniques is low, with highest failure rates occurring in obese females.

Methods: This prospective observational study recruited 28 obese obstetric patients. Read More

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Inequity in uptake of hospital-based childbirth care in rural Tanzania: analysis of the 2015-16 Tanzania Demographic and Health Survey.

Health Policy Plan 2021 Jul 19. Epub 2021 Jul 19.

Athena Institute, VU Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.

Proportions of facility births are increasing throughout sub-Saharan Africa, but obstetric services vary within the health system. In Tanzania, advanced management of childbirth complications (comprehensive emergency obstetric care) is offered in hospitals, while in frontline, primary health care (PHC) facilities (health centres and dispensaries) mostly only routine childbirth care is available. With over half (54%) of rural births in facilities, we hypothesized the presence of socio-economic inequity in hospital-based childbirth uptake in rural Tanzania and explored whether this relationship was modified by parity. Read More

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Prenatal and Obstetric Parameters of Late Terminations: A Retrospective Analysis.

Geburtshilfe Frauenheilkd 2021 Jul 13;81(7):807-818. Epub 2021 Jul 13.

Universitätsklinikum Leipzig, Abteilung für Geburtsmedizin, Leipzig, Germany.

In Germany, the highly sensitive issue of late terminations of pregnancy and feticide is regulated in Sec. 218a para. 2 of the German Penal Code (medical indication). Read More

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Maternal, pregnancy and neonatal outcomes of twin gestations in women with rheumatic diseases: A single-center, case-control study.

Eur J Obstet Gynecol Reprod Biol 2021 Jun 29;264:49-55. Epub 2021 Jun 29.

Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Department of Obstetrics and Gynecology, ASST Spedali Civili, Brescia, Italy. Electronic address:

Objective: To assess maternal, pregnancy and neonatal outcomes of twin pregnancy (TP) in women with rheumatic diseases (RD) (Group A) as compared to those of singleton pregnancy (SP) in women with RD (Group B) and TP in the general obstetric population (GOP) (Group C).

Methods: Case-control study including TP in RD during the period 2009-2020 at single institution. Women in Group A were matched with women of the same age at conception and affected by the same RD (Group B). Read More

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Association of ABO and Rh blood groups with obstetric outcomes in SARS-CoV-2 infected pregnancies: A prospective study with a multivariate analysis.

Eur J Obstet Gynecol Reprod Biol 2021 Jul 7;264:41-48. Epub 2021 Jul 7.

Obstetrics and Gynaecology Department, Puerta de Hierro University Hospital of Majadahonda. Majadahonda, Madrid, Spain; Autónoma University of Madrid, Spain. Electronic address:

Objective: To evaluate the influence of ABO and Rh blood groups on morbidity among SARS-CoV-2 infected pregnancies.

Design: Prospective observational study.

Setting: 78 centers of the Spanish Obstetric Emergency Group. Read More

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A whole blood based resuscitation strategy in civilian medical services: Experience from a Norwegian hospital in the period 2017-2020.

Transfusion 2021 07;61 Suppl 1:S22-S31

Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.

Background: Civilian and military guidelines recommend early balanced transfusion to patients with life-threatening bleeding. Low titer group O whole blood was introduced as the primary blood product for resuscitation of massive hemorrhage at Haukeland University Hospital, Bergen, Norway, in December 2017. In this report, we describe the whole blood program and present results from the first years of routine use. Read More

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911 EMS Activations by Pregnant Patients in Maryland (USA) during the COVID-19 Pandemic.

Prehosp Disaster Med 2021 Jul 14:1-6. Epub 2021 Jul 14.

Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MarylandUSA.

Introduction: In the early phase of the coronavirus disease 2019 (COVID-19) pandemic, United States Emergency Medical Services (EMS) experienced a decrease in calls, and at the same time, an increase in out-of-hospital deaths. This finding led to a concern for the implications of potential delays in care for the obstetric population.

Hypothesis/problem: This study examines the impact of the pandemic on prehospital care amongst pregnant women. Read More

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Changes in obstetric interventions and preterm birth during COVID-19: A nationwide study from Iceland.

Acta Obstet Gynecol Scand 2021 Jul 13. Epub 2021 Jul 13.

Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland.

Introduction: Previous evidence has been conflicting regarding the effect of coronavirus disease 2019 (COVID-19) pandemic lockdowns on obstetric intervention and preterm birth rates. The literature to date suggests potentially differential underlying mechanisms based on country economic setting. We aimed to study these outcomes in an Icelandic population where uniform lockdown measures were implemented across the country. Read More

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Cesarean Scar Ectopic Pregnancy: A Case Report.

J Emerg Nurs 2021 Jul 6. Epub 2021 Jul 6.

Background: A cesarean scar pregnancy is a rare, life-threatening obstetric emergency. Early recognition and prompt treatment of cesarean scar pregnancy is essential because of the risk for long-term reproductive complications associated with this condition.

Case Presentation: A 33-year-old gravida 6 para 5 female presented to the emergency department with pain to the suprapubic area. Read More

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Top 10 Pearls for the Recognition, Evaluation, and Management of Maternal Sepsis.

Obstet Gynecol 2021 Aug;138(2):289-304

Department of Obstetrics and Gynecology, University of Connecticut, Farmington, Connecticut; the Department of Obstetrics and Gynecology, Eglin Air Force Base, Eglin, Florida; and the Department of Gynecology and Obstetrics, Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland.

Maternal sepsis is an obstetric emergency and a leading cause of maternal morbidity and mortality. Early recognition in a pregnant or postpartum patient can be a challenge as the normal physiologic changes of pregnancy may mask the signs and symptoms of sepsis. Bedside assessment tools may aid in the detection of maternal sepsis. Read More

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Health and Social Inequalities in Women Living in Disadvantaged Conditions: A Focus on Gynecologic and Obstetric Health and Intimate Partner Violence.

Health Equity 2021 15;5(1):408-413. Epub 2021 Jun 15.

Primary Care Services, Eleemosynaria Apostolica, Vatican City State, Vatican City.

Gynecologic and obstetric health and intimate partner violence are particularly influenced by social determinants of health, such as poverty, low education, and poor nutritional status, and by ethnic and racial factors. In this study, we evaluated health and social inequalities of women living in disadvantaged neighborhoods in the city of Rome, Italy. The study included 128 women living in socioeconomically disadvantaged neighborhoods. Read More

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Reliability of last menstrual period recall, an early ultrasound and a Smartphone App in predicting date of delivery and classification of preterm and post-term births.

BMC Pregnancy Childbirth 2021 Jul 7;21(1):493. Epub 2021 Jul 7.

Department of Obstetrics and Gynaecology, School of Clinical Medicine, University of KwaZulu-Natal, 719 Umbilo Road, Congella, 4013, South Africa.

Background: A reliable expected date of delivery (EDD) is important for pregnant women in planning for a safe delivery and critical for management of obstetric emergencies. We compared the accuracy of LMP recall, an early ultrasound (EUS) and a Smartphone App in predicting the EDD in South African pregnant women. We further evaluated the rates of preterm and post-term births based on using the different measures. Read More

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Adenomyosis: Impact on Fertility and Obstetric Outcomes.

Reprod Sci 2021 Jul 6. Epub 2021 Jul 6.

Gynecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda, 12, 20122, Milan, Italy.

In this commentary, we discuss the associations between adenomyosis, fertility, and obstetric outcomes. A recent meta-analysis on the impact of adenomyosis on reproductive outcomes found a 43% reduction in the odds ratio (OR) for clinical pregnancy and a threefold increase in the risk of miscarriage in women with adenomyosis compared with controls. Moreover, adenomyosis seems to be strongly associated with pre-eclampsia with an OR of almost 8. Read More

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Feasibility of task-sharing with community health workers for the identification, emergency management and referral of women with pre-eclampsia, in Mozambique.

Reprod Health 2021 Jul 6;18(1):145. Epub 2021 Jul 6.

Maternal Health Unit, Centro de Investigação em Saúde da Manhiça (CISM), Manhiça, Mozambique.

Background: Maternal mortality is an important public health problem in low-income countries. Delays in reaching health facilities and insufficient health care professionals call for innovative community-level solutions. There is limited evidence on the role of community health workers in the management of pregnancy complications. Read More

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