Obstetrics and gynecology clinics of North America
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Obstet. Gynecol. Clin. North Am. · Sep 2020
ReviewPostpartum Depression: Identification and Treatment in the Clinic Setting.
Perinatal care, including the management of mental health issues, often falls under the auspices of primary care providers. Postpartum depression (PPD) is a common problem that affects up to 15% of women. ⋯ Fortunately, there have been a variety of treatment studies using antidepressants, nonpharmacologic interactions, and most recently, allopregnanolone (Brexanolone) infusion that have shown benefits. The most commonly used screening scale, Edinburgh Postnatal Depression Scale, a 10-item self-rated scale, has been translated into a variety of languages.
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Obstet. Gynecol. Clin. North Am. · Mar 2020
ReviewWhat Obstetricians Need to Know About Placental Pathology.
The placenta can serve as a valuable source of information about maternal and fetal conditions during the pregnancy; however, the abilities to perform a preliminary gross examination and interpret a placental pathology report are variable among obstetricians. This article discusses the indications for placental submission to pathology; the essentials of gross examination, including elements that should be performed in the delivery suite; and the most common and clinically relevant histologic findings that may be encountered in the report.
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Obstet. Gynecol. Clin. North Am. · Jun 2019
ReviewObstetric Anesthesia: Leading the Way in Patient Safety.
The subspecialty of obstetric anesthesiology has embraced patient safety research, which has led to a reduction in obstetric anesthesia-related morbidity and mortality. Although there are innumerable individual improvements, this article highlights the following innovations: safer and more effective labor analgesia, safer treatments for hypotension associated with neuraxial blockade, advances in spinal and epidural techniques for operative deliveries, lower incidence of postdural puncture headache through improved technology, safer parental agents for labor analgesia, improved safety of general anesthesia in obstetrics, improved education and the use of simulation including team training, and reductions in operating room-related infections.
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Obstet. Gynecol. Clin. North Am. · Jun 2019
ReviewCreating Change at Scale: Quality Improvement Strategies used by the California Maternal Quality Care Collaborative.
Creating change at scale within a short time frame poses multiple challenges. Using the experience of the California Maternal Quality Care Collaborative, the authors illustrate how state perinatal quality collaboratives have been able to achieve this goal using a series of key steps: engage as many disciplines and partner organizations as possible; mobilize low-burden data to create a rapid-cycle data center to support the quality improvement efforts; provide up-to-date guidance for implementation using safety bundles and tool kits; and make available coaching and peer learning to support implementation through multihospital quality collaboratives. There are now multiple national resources available to support these efforts.
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Obstet. Gynecol. Clin. North Am. · Jun 2019
ReviewApplying Patient Safety to Reduce Maternal Mortality.
Maternal morbidity and mortality is on the rise in the United States. Several local, state, and nationwide organizations have worked toward reducing maternal mortality by improving patient safety. ⋯ Patient care bundles, supported by the American College of Obstetricians and Gynecologists, as well as The Council on Patient Safety, provide a standardized approach to obstetric care. Monitoring outcomes through root cause analysis is key to improving patient safety and outcomes.