Zeitschrift für Geburtshilfe und Neonatologie
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Z Geburtshilfe Neonatol · Apr 2021
Randomized Controlled TrialHydrosonographic Assessment of the Effect of Two Different Suture Materials on Healing of the Uterine Scar after Cesarean Delivery: A Prospective Randomized Controlled Trial.
This study aimed to compare the effects of two different suture materials, monofilament synthetic absorbable sutures versus multifilament synthetic absorbable sutures, on healing the uterine scar after a cesarean delivery. ⋯ No statistically significant differences were observed between the groups with regard to the preoperative hemoglobin concentrations, the change in the hemoglobin concentrations, operating time, and the number of intraoperative additional hemostatic uterine sutures. Mean thickness of the residual myometrium covering the defect was thicker in the monofilament suture group in comparison to the multifilament suture group (7.76±2.11 vs. 5.96±1.69, respectively; p<0.01). The mean healing ratio was significantly higher in the monofilament suture group in comparison to the multifilament suture group (0.76±0.13 vs. 0.60±0.12, respectively; p<0.01) CONCLUSION: Continuous double-layer unlocked closure of the uterine incision at cesarean delivery using monofilament synthetic absorbable sutures decreases the risk of CS scar defect.
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Z Geburtshilfe Neonatol · Aug 2020
[Update on Recommendations for SARS-CoV-2/COVID-19 During Pregnancy, Birth and Childbed].
With begin of the SARS-CoV-2 pandemic the german obstetric, peri-/neonatological and pediatric professional societies published recommendations for care of pregnant and newborn, as well as for necessary staff protection in March 2020 [1-3]. Because of the rapid emerging increase of knowledge an update is required. This work therefore perceives as prosecution of the existing recommendations [1-3]. ⋯ In methodological dependence this update of recommendations comments on key questions of pre-, peri- and postnatal care at SARS-CoV-2 and COVID-19, based on publications up to 30.05.2020. Statements represent a carefully concerned expert consensus and can change contemporary as new knowledge appears. The responsibility for concrete management remains at the local medical team, decisions should be supported by these recommendations.
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Z Geburtshilfe Neonatol · Aug 2018
Review Comparative Study[Maternal Deaths Worldwide Falling - But Commonly Preventable].
According to data from the WHO, maternal mortality ratio has dropped worldwide by 44% between 1990 and 2015, yet more than 300,000 mothers still die annually, about 99% of them in the developing countries. In some developed countries the incidence of maternal deaths has even increased during the past 2 decades. The leading causes of direct maternal deaths are haemorrhage (nearly 3-quarters from postpartum haemorrhage), pulmonary embolism including amniotic fluid embolism, and hypertensive disorders of pregnancy; the leading cause of indirect maternal deaths is cardiac disease of the mother. ⋯ The UK Confidential Enquiries into Maternal Deaths and Morbidity are internationally recognized as the 'gold standard' in maternal mortality surveillance. Considering the 11 studies from different developed countries, nearly 50% of direct maternal deaths (range: 26-75%) are potentially preventable, most often those due to postpartum haemorrhage and hypertensive disorders of pregnancy, and the fewest of all due to amniotic fluid embolisms. The crucial point is to learn from failures leading to maternal deaths: each obstetric unit should scrutinise if and where the need for improvement exists to prevent severe maternal morbidity and mortality.
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Z Geburtshilfe Neonatol · Aug 2016
Controlled Clinical TrialPostoperative Foot Massage for Patients after Caesarean Delivery.
Little evidence is available on complementary therapies for anxiety and pain relief after caesarean delivery. The purpose of this study was to evaluate the effects of foot massage post-operatively in patients after caesarean delivery. ⋯ Post-operative massage intervention can reduce anxiety and pain in patients after caesarean delivery.
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Z Geburtshilfe Neonatol · Jun 2016
Review Practice Guideline[Pharmacological Thromboprophylaxis during Pregnancy and the Puerperium: Recommendations from Current Guidelines and their Critical Comparison].
Venous thromboembolism (VTE) is one of the leading causes of maternal deaths worldwide. Due to the increasing number of pregnant women with risk factors, the incidence of VTE has risen over the past decades. Mortality and morbidity of VTE are potentially preventable, since more than two-thirds of these women have identifiable risk factors and may benefit from appropriate thromboprophylaxis. ⋯ At the onset of labour, in case of any vaginal bleeding, prior to scheduled labour induction or at least 12 h before an elective caesarean section, antenatal LMWH prophylaxis should be discontinued. LMWH prophylaxis can be continued 4-6 h after vaginal delivery and 6-12 h after caesarean delivery when women do not have an increased risk of haemorrhage. Current guidelines recommend weight-based LMWH.