Obstetrics and gynecology
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Obstetrics and gynecology · Oct 2017
Review Meta AnalysisEvidence-Based Bundles and Cesarean Delivery Surgical Site Infections: A Systematic Review and Meta-analysis.
To estimate the association of implementation of evidence-based bundles with surgical site infection rates after cesarean delivery. ⋯ Evidence-based bundles are associated with a significant reduction in surgical site infection after cesarean delivery.
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Obstetrics and gynecology · Oct 2017
Association of Nonsteroidal Antiinflammatory Drugs and Postpartum Hypertension in Women With Preeclampsia With Severe Features.
To estimate whether nonsteroidal antiinflammatory drugs (NSAIDs) are associated with persistent postpartum hypertension in a cohort of women with preeclampsia and severe features. ⋯ In this cohort of women with preeclampsia and severe features before delivery, NSAIDs were not associated with increased rates of persistent postpartum hypertension.
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Obstetrics and gynecology · Sep 2017
Comparative StudyNeonatal Outcomes of Low-Risk, Late-Preterm Twins Compared With Late-Preterm Singletons.
To test the hypothesis that the risk of neonatal morbidity among late-preterm twins is similar to that of late-preterm singletons. ⋯ The risk of respiratory morbidity among late-preterm twins is similar to that of late-preterm singletons. Still, the low absolute rates of the composite respiratory morbidity in our population suggest that administration of antenatal corticosteroids may be mostly justified among neonates born closer to 34 weeks of gestation.
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Rh immunoprophylaxis for Rh-negative women requires an understanding of terminology used for Rh blood typing laboratory reports. The pathophysiology of Rh hemolytic disease of the fetus and newborn was elucidated by studies in rhesus monkeys. Subsequent studies revealed that the human blood group antigen responsible for Rh hemolytic disease of the newborn (D antigen) is related to, but different from, the rhesus monkey antigen. ⋯ For more than five decades, the practice of Rh immunoprophylaxis has remained unchanged in terms of the dose of Rh immune globulin and timing of injections. In contrast, advances in the science of Rh blood typing have resulted in a continuously evolving terminology, obliging obstetricians to update their vocabulary to guide their practice. The following review and glossary provide guidance for current Rh terminology and the rationale for changes.
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Obstetrics and gynecology · Aug 2017
National Partnership for Maternal Safety: Consensus Bundle on Severe Hypertension During Pregnancy and the Postpartum Period.
Complications arising from hypertensive disorders of pregnancy are among the leading causes of preventable severe maternal morbidity and mortality. Timely and appropriate treatment has the potential to significantly reduce hypertension-related complications. To assist health care providers in achieving this goal, this patient safety bundle provides guidance to coordinate and standardize the care provided to women with severe hypertension during pregnancy and the postpartum period. ⋯ Similar to other bundles that have been developed and promoted by the Partnership, the hypertension safety bundle is organized into four domains: Readiness, Recognition and Prevention, Response, and Reporting and Systems Learning. Although the bundle components may be adapted to meet the resources available in individual facilities, standardization within an institution is strongly encouraged. This commentary provides information to assist with bundle implementation.