Obstetrics and gynecology
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Obstetrics and gynecology · May 2010
ReviewMultidisciplinary team training in a simulation setting for acute obstetric emergencies: a systematic review.
To perform a systematic review of the literature on the effectiveness of multidisciplinary teamwork training in a simulation setting for the reduction of medical adverse outcomes in obstetric emergency situations. ⋯ Introduction of multidisciplinary teamwork training with integrated acute obstetric training interventions in a simulation setting is potentially effective in the prevention of errors, thus improving patient safety in acute obstetric emergencies. Studies on its effectiveness and cost-effectiveness are needed before team training can be implemented on broad scale.
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Obstetrics and gynecology · May 2010
Evaluating risk-adjusted cesarean delivery rate as a measure of obstetric quality.
To validate the risk-adjusted cesarean delivery rate as a measure of obstetric quality through its association with maternal and neonatal outcomes for all pregnancies (model 1) and in primiparous patients with singleton pregnancies (model 2). ⋯ Lower-than-expected risk-adjusted cesarean delivery rates in all patients or when restricted to a more homogeneous group of primiparous patients with term singleton pregnancies are associated with higher-than-expected adverse maternal or neonatal outcomes. Higher-than-expected risk-adjusted cesarean delivery rates do not result in improved outcomes.
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Obstetrics and gynecology · May 2010
Case ReportsThe effects of respiratory failure on delivery in pregnant patients with H1N1 2009 influenza.
The majority of hospitalizations for H1N1 complications have been in people with high-risk comorbidities, including pregnancy. Here we describe the obstetric and critical care treatment of three patients with confirmed H1N1 influenza virus infection complicated by acute respiratory failure. ⋯ These three cases illustrate that a high index of suspicion, prompt treatment, timing and mode of delivery considerations, and interdisciplinary treatment are integral to the care of pregnant patients with H1N1 influenza infections complicated by acute respiratory failure.
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To estimate the incidence of amniotic-fluid embolism and to describe risk factors, management, and outcomes. ⋯ High-quality supportive care can result in good maternal outcomes after amniotic-fluid embolism. Clinicians should consider both the risks and benefits of induction and cesarean delivery because more restricted use may result in a decrease in the number of women suffering a potentially fatal amniotic-fluid embolism. The observed increased risk of fatality in ethnic-minority women may be associated with differences in underlying medical conditions or access to care, and clinicians should that ensure appropriate services are provided to minimize this risk.
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Obstetrics and gynecology · May 2010
First-trimester vaginal bleeding and complications later in pregnancy.
To evaluate the association of first-trimester bleeding without miscarriage and complications later in the first pregnancy as well as in the next pregnancy. ⋯ Women with first-trimester bleeding in the first pregnancy have an increased risk of complications later in the first pregnancy and of recurrence of first-trimester bleeding and other complications in the second pregnancy.