American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Jul 2014
The Sepsis in Obstetrics Score: a model to identify risk of morbidity from sepsis in pregnancy.
We sought to design an emergency department sepsis scoring system to identify risk of intensive care unit (ICU) admission in pregnant and postpartum women. ⋯ A sepsis scoring system designed specifically for an obstetric population appears to reliably identify patients at high risk for admission to the ICU. Prospective validation is warranted.
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Am. J. Obstet. Gynecol. · Jul 2014
Maternal mortality in the United States: predictability and the impact of protocols on fatal postcesarean pulmonary embolism and hypertension-related intracranial hemorrhage.
The purpose of this study was to examine the efficacy of specific protocols that have been developed in response to a previous analysis of maternal deaths in a large hospital system. We also analyzed the theoretic impact of an ideal system of maternal triage and transport on maternal deaths and the relative performance of cause of death determination from chart review compared with a review of discharge coding data. ⋯ Disease-specific protocols are beneficial in the reduction of maternal death because of hypertensive disease and postoperative pulmonary embolism. From 2-6 women die annually in the United States because of cesarean delivery itself. A reduction in deaths from postpartum hemorrhage should be the priority for maternal death prevention efforts in coming years in the United States.
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Am. J. Obstet. Gynecol. · Jul 2014
Perinatal risk factors for severe injury in neonates treated with whole-body hypothermia for encephalopathy.
Our objective was to identify perinatal risk factors that are available within 1 hour of birth that are associated with severe brain injury after hypothermia treatment for suspected hypoxic-ischemic encephalopathy. ⋯ Worsening metabolic acidosis at birth, longer time to spontaneous respirations, and lack of exposure to oxytocin correlated with severe brain injury in neonates who were treated with whole-body hypothermia. These risk factors may help quickly identify neonatal candidates for time-sensitive investigational therapies for brain neuroprotection.
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Am. J. Obstet. Gynecol. · Jul 2014
Case ReportsActive sacral neuromodulator during pregnancy: a unique case report.
Sacral neuromodulation with an implanted device is used in patients who experience urinary retention and malfunctioning overactive bladder where conservative treatment is not sufficient. The knowledge of its effect on pregnancy is not known. ⋯ Full-term pregnancy was achieved, and a healthy child was delivered by cesarean section. Sacral neuromodulation during pregnancy appears to be safe and may be preferable to intermittent bladder catheterizations that increase the chance of urinary infections.