The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
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J. Matern. Fetal. Neonatal. Med. · Sep 2021
Randomized Controlled TrialRespiratory outcomes after neonatal prone versus supine positioning following scheduled cesarean delivery: a randomized trial.
Prone positioning is a common practice after vaginal birth promoting skin to skin contact and has been associated with improved oxygenation in mechanically ventilated neonates in the recent analysis. Neonates of women not in labor delivered via C-section are at increased risk of respiratory distress; it is unclear whether vigorous neonates without a need of resuscitation would benefit from prone positioning immediately after birth. ⋯ Prone or supine positioning of term neonates after scheduled cesarean delivery resulted in comparable respiratory outcomes including the need for resuscitation in the first minutes of life.
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J. Matern. Fetal. Neonatal. Med. · Aug 2021
A standardized post-cesarean analgesia regimen reduces postpartum opioid use.
Optimal post-cesarean pain control is important. With the rising opioid epidemic it is imperative to maximize non-opioid based primary approaches to post-cesarean pain control. In 2018, we implemented a standardized post-cesarean analgesia regimen. ⋯ Scheduled administration of acetaminophen and NSAIDs following cesarean birth significantly decreased the cumulative dose of opioids used in the first 72 h postoperatively.
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J. Matern. Fetal. Neonatal. Med. · Aug 2021
Utility of fiberoptic bronchoscopy for difficult airway in neonates.
Newborns diagnosed with craniofacial malformations or laryngeal and tracheal alterations may often need advanced airway-management for airway stabilization. Although fiberoptic bronchoscopy (FB) is currently the gold standard for difficult airway management, there is a scarcity of published data on the application of FB in newborns for intubation and controlled extubation (CE). ⋯ Fiberoptic bronchoscopy is an essential tool to avoid the risk of a failed extubation in neonates with difficult airway.
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J. Matern. Fetal. Neonatal. Med. · Aug 2021
An analysis of the high cesarean section rates in Turkey by Robson classification.
Cesarean deliveries outnumbered vaginal deliveries in Turkey. The aim of this study is to analyze the CS rates, sizes of the groups and their contribution to CS in the Robson10-Group Classification to address the main drivers that are associated with an increase in CS rates in Turkey by comparing with the customized benchmark, World Health Organization (WHO) Multi-country Survey Reference (MCS) population. We also evaluate the existence of the Pareto principle that states that for many phenomena, about the 80% of the consequences (increase in CS rate) are produced by 20% of the causes. ⋯ Robson classification in Pareto diagrams for each sector identified the main contributors to the CS rate as Groups 5, 3, 2, 1, 4 and 10 not only to target groups that may benefit from implementations or interventions but also guide public policies and investments for reducing CS rates in Turkey. Consequences of the commercialization on the health care system is apparent. Policies should be directed at the private sector, where 44.7% of the deliveries occur and where CS indication seems not to be driven by medical reasons completely.
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J. Matern. Fetal. Neonatal. Med. · Aug 2021
Identifying strategies to reduce cesarean section rates by using Robson ten-group classification.
To assess the cesarean section (CS) rates using Robson ten-group classification system (RTGCS) and the interventions combined with RTGCS which may reduce the CS rates. ⋯ To the best of our knowledge, this study is the first that gives the birth data from Turkey using RTGCS and showed that some interventions combined with RTGCS to reduce CS rates should be properly used.