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Cesarean Without Labor Safest for Breech Delivery

A large, population-based study has shown fewer adverse outcomes with cesarean delivery vs either cesarean delivery during labor or vaginal delivery for breech presentation.  
medscape.com
over 5 years ago
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28

Perimortem Cesarean Section in the Emergency Department

Guest post by Greg Press   The second perimortem C-section of my career happened last week. The  
emupdates.com
over 5 years ago
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9

Active and passive smoking and risk of spontaneous abortion, stillbirth and tubal ectopic pregnancy

Stream Active and passive smoking and risk of spontaneous abortion, stillbirth and tubal ectopic pregnancy by BMJ talk medicine from desktop or your mobile device  
feeds.bmj.com
over 5 years ago
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21

Shoulder Dystocia

Deliveries in the ED are obviously a rare event, and dystocias are a rarity inside of this rarity (representing about 0.6% to 1.4% of deliveries), but they still happen, and you need to know what to do if you end up with the catcher's mitt.  
emcurious.com
over 5 years ago
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13

Diet and exercise in pregnancy for preventing gestational diabetes mellitus | Cochrane

Gestational diabetes mellitus (GDM) is high blood glucose (hyperglycaemia) first occurring or first recognised during pregnancy. Between 1% and 14% of pregnant women develop GDM, with some at a higher risk than others (for example, women who are overweight or obese, older, of particular ethnicities, have had GDM previously, or have a family history of type II diabetes). GDM can cause significant health problems for mothers and babies. The babies may grow very large and, as a result, be injured at birth, or cause injury to mothers during birth. Women with GDM have an increased risk of having an induced birth, of their babies being born by caesarean section, and of having a preterm birth (before 37 weeks of pregnancy). Additionally, there can be long-term health problems for mothers and babies, including an increased risk of type II diabetes. Some diets (for example, those with low fibre and high glycaemic load) and physical inactivity, are potentially modifiable risk factors for GDM. There is evidence that lifestyle interventions in the general population (promoting diet and exercise changes) can prevent type II diabetes, and it has been suggested that these interventions may help prevent GDM in pregnancy.  
cochrane.org
over 5 years ago
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12

Preparing the cervix with different ripening agents before operative hysteroscopy | Cochrane

Are cervical ripening agents effective for dilating the cervix before operative hysteroscopy and do they reduce the risk of complications during the surgery?  
cochrane.org
over 5 years ago
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14

Do vaginal packing, tranexamic acid, interventional radiology or other interventions control vaginal bleeding in women with advanced cervical cancer? | Cochrane

Background: Cervical cancer (cancer of the neck of the womb) is the second most common cancer among women throughout the world, accounting for about 500,000 new detected cases and 273,000 deaths every year. Women more commonly present with advanced disease in the developing world, where access to cervical screening programmes is limited. Advanced cancer of the cervix may not be curable and women often need treatment to control distressing symptoms (palliation), such as vaginal bleeding. Bleeding can be severe enough to be life threatening in women with advanced cervical cancer. Management of vaginal bleeding often poses a challenge, especially in the developing world, where access to radiotherapy is limited. Options for palliative treatment of severe vaginal bleeding include interventional radiology treatment (using x-rays to guide the insertion of 'plugs' into blood vessels supplying the cancer) or vaginal packing (where gauze is compacted into the vagina to absorb the blood and apply pressure directly to the cervix), although these are often only partly effective and may cause harm. Vaginal packs can be soaked with formalin, which is a preservative chemical. Other options for treating severe vaginal bleeding include tranexamic acid (a medicine that reduces bleeding that can be given by mouth or by injection) and radiotherapy (high-energy x-ray treatment).  
cochrane.org
over 5 years ago
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2

Science Talk: Survey Finds Miscarriage Widely Misunderstood

http://www.einstein.yu.edu - Results of a new survey of more than 1,000 U.S. adults has found that misperceptions about miscarriage and its causes are widesp...  
youtube.com
about 5 years ago
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7

Baby born from ovary frozen in mother's childhood - BBC News

A woman in Belgium is the first in the world to give birth to a baby using transplanted ovarian tissue frozen when she was still a child, doctors say.  
bbc.co.uk
about 5 years ago
Www.bmj
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4

Tests to predict imminent delivery in threatened preterm labour

Predictive bedside tests such as quantitative fetal fibronectin, PAM-G1 (placental α microglobulin 1), and phIGFBP-1 (phosphorylated insulin-like growth factor binding protein 1) can risk stratify symptomatic women. “Low or negative” results can provide reassurance to most women and may avoid inappropriate interventions  
feeds.bmj.com
about 5 years ago
Www.bmj
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5

Tests to predict imminent delivery in threatened preterm labour

Predictive bedside tests such as quantitative fetal fibronectin, PAM-G1 (placental α microglobulin 1), and phIGFBP-1 (phosphorylated insulin-like growth factor binding protein 1) can risk stratify symptomatic women. “Low or negative” results can provide reassurance to most women and may avoid inappropriate interventions  
feeds.bmj.com
about 5 years ago
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1

Tests to predict imminent delivery in threatened preterm labour

Predictive bedside tests such as quantitative fetal fibronectin, PAM-G1 (placental α microglobulin 1), and phIGFBP-1 (phosphorylated insulin-like growth factor binding protein 1) can risk stratify symptomatic women. “Low or negative” results can provide reassurance to most women and may avoid inappropriate interventions  
feeds.bmj.com
about 5 years ago
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9

Eclampsia with Apnea Secondary to Magnesium Sulfate Administration

This case was written by Dr. Kyla Caners from McMaster University. Dr. Caners is a PGY4 Emergency Medicine resident and one of the editors-in-chief at EMSimCases. Why It Matters This case highlights three important aspects of managing an eclamptic patient: Early administration of magnesium sulfate Adding an anti-hypertensive agent if the blood pressure remains elevated after…  
emsimcases.com
about 5 years ago
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4

Cyclo-oxygenase (COX) inhibitors for treating preterm labour | Cochrane

Not enough evidence on whether COX inhibitors administered to women in threatened premature labour may reduce the risk of babies being born too early.  
cochrane.org
about 5 years ago
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13

Endometriosis 'risks miscarriage' - BBC News

Women with endometriosis are more likely to have a risky pregnancy or miscarry, say fertility doctors.  
bbc.co.uk
about 5 years ago
Www.bmj
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3

Dilatation and curettage procedure raises risk of premature birth in subsequent pregnancies, study finds

Use of dilatation and curettage in cases of miscarriage or for termination increases the risk of preterm birth and very preterm birth (under 32 weeks) in a subsequent pregnancy, a large analysis has found. The study’s lead author has called for a more “restrained use” of the procedure in favour of medical interventions.  
feeds.bmj.com
about 5 years ago
Www.bmj
0
1

Dilatation and curettage procedure raises risk of premature birth in subsequent pregnancies, study finds

Use of dilatation and curettage in cases of miscarriage or for termination increases the risk of preterm birth and very preterm birth (under 32 weeks) in a subsequent pregnancy, a large analysis has found. The study’s lead author has called for a more “restrained use” of the procedure in favour of medical interventions.  
feeds.bmj.com
about 5 years ago
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5

Methods for assessing pre-induction cervical ripening, the ability of the cervix to open in response to spontaneous uterine contractions | Cochrane

In this review, researchers from The Cochrane Collaboration examined a comparison between the Bishop score and any other method for checking pre-induction cervical ripening in women admitted for induction of labour. The Bishop score is the traditional method of determining the readiness of the cervix to open (dilate) before labour induction. It also assesses the position, softening and shortening of the cervix, and the location of the presenting part of the baby. After searching for relevant trials up to 31 March 2015, we included two randomised controlled trials that recruited 234 pregnant women.  
cochrane.org
about 5 years ago
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12

Antibiotic prophylaxis during the second and third trimester in pregnancy to reduce adverse pregnancy outcomes and morbidity | Cochrane

Antibiotics are administered to pregnant women during the second and third trimester of pregnancy (before labour) to prevent bacteria in the vagina and cervix affecting the pregnancy. Infection by some infectious organisms in a woman’s genital tract can cause health problems for the mother and her baby, and has been associated with preterm births. This review of eight randomised trials involved approximately 4300 women in their second or third trimester. We found that antibiotics did not reduce the risk of preterm prelabour rupture of the membranes (one trial, low quality of evidence), or the risk of preterm birth (six trials, high quality of evidence). Preterm delivery was reduced in pregnant women who had a previous preterm birth and an imbalance of bacteria in the vagina (bacterial vaginosis) during the current pregnancy. There was no reduction in preterm delivery in pregnant women with previous preterm birth without a bacterial imbalance during the current pregnancy (two trials). Postpartum endometritis, or infection of the uterus following birth, was reduced overall (three trials, moderate quality of evidence), as well as in a trial of high-risk women who had a previous preterm birth (one trial, moderate quality of evidence). No reduction in neonatal illness was observed. Outcomes of interest were available in trials with high losses to follow-up. We could not estimate the side effects of antibiotics since side effects were rare; however, antibiotics may still have serious side effects on women and their babies.  
cochrane.org
about 5 years ago
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8

Repeat doses of prenatal corticosteroids for women at risk of preterm birth for preventing neonatal respiratory disease | Cochrane

This review shows that a repeat dose of prenatal corticosteroids given to women who remain at risk of an early birth after an initial course of prenatal corticosteroids helps the baby's lungs and reduces serious health problems in the first few weeks of life.  
cochrane.org
about 5 years ago