Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “OBSTETRICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,207 records · Page 67Linked to original sources
PubMed2000

Measuring self-efficacy in substance abuse intervention in obstetric practices.

BACKGROUND: This study presents findings on the effect of an office-based obstetrics training program (given the acronym OBIWOM) on substance use assessment, management, and referral self-efficacy among obstetricians and staff of private, community-based obstetric practices. METHODS: Participants were obstetricians and staff from 10 of 27 available community-based, private obstetric practices in the target areas, for a practice participation rate of 37%. This study used a delayed treatment design to compare self-efficacy between practice staff randomly assigned to an immediate or delayed intervention group. RESULTS: Self-efficacy increased significantly after intervention from baseline to first follow-up for the immediate group, while no change was shown for the delayed (control) group. The impact of the intervention on self-efficacy was replicated in the assessment construct only after the intervention for the delayed group. CONCLUSION: This research shows that education and training can effectively improve self-efficacy in obstetricians and their staff in the management of substance use and pregnancy.

Adult↗
PubMed2000

Criteria for clinical audit of the quality of hospital-based obstetric care in developing countries.

Improving the quality of obstetric care is an urgent priority in developing countries, where maternal mortality remains high. The feasibility of criterion-based clinical audit of the assessment and management of five major obstetric complications is being studied in Ghana and Jamaica. In order to establish case definitions and clinical audit criteria, a systematic review of the literature was followed by three expert panel meetings. A modified nominal group technique was used to develop consensus among experts on a final set of case definitions and criteria. Five main obstetric complications were selected and definitions were agreed. The literature review led to the identification of 67 criteria, and the panel meetings resulted in the modification and approval of 37 of these for the next stage of audit. Criterion-based audit, which has been devised and tested primarily in industrialized countries, can be adapted and applied where resources are poorer. The selection of audit criteria for such settings requires local expert opinion to be considered in addition to research evidence, so as to ensure that the criteria are realistic in relation to conditions in the field. Practical methods for achieving this are described in the present paper.

Developing Countries↗
PubMedDate not supplied

[Analysis of transfers in the Gynecology and Obstetrics Department of Bangui Hospital].

During a study carried out over twelve months in the National Reference Center for Gynecology and Obstetrics at Bangui Hospital, we recorded 1,369 cases of evacuation in a total 5,020 admissions to the department. This corresponds to a frequency of 27.3%. In 73.8% of cases, this intervention was performed for obstetric reasons. It was justified in 73.1% of cases, and 96.5% of the justified interventions were for obstetric reasons. The unjustified interventions led to a normal delivery in 97% of cases. Errors in diagnosis were detected in 16.5% of the cases. In terms of prognosis, we recorded 91 deaths in the perinatal period (96 per thousand live births) and 37 maternal deaths (of the 39 recorded in the department), accounting for 94.9% of all maternal deaths, with a mortality rate of 2.7% for women undergoing uterine evacuation. Infant mortality was higher in cases of late intervention. The most frequent causes of death of the mothers were hemorrhagia on delivery, severe infection, rupture of the uterus and the tearing of soft tissues.

Adolescent↗
PubMed2000

[Monitoring the quality of obstetric care].

The aim of this study was to analyse some aspects and methods use to evaluate the quality of obstetric care, and their implementation into obstetric practice. Assurance of proper quality of services in obstetrics becomes today a key -problem in Poland. The article describes the evaluation of structures, processes, and results as methods of quality assurance and control. Authors suggest that special attention should by paid to correct leader- ship, medical records analysis and later formulating constructive conclusions and quality improvement. Audit and quality improvement at the national level seems to be very important. Monitoring of quality is not only necessary, but also continuous management and improvement. It is also necessary to remember that the process of quality improvement once begun should be continued.

Leadership↗
PubMed1995

[History of modern obstetrics in western medicine in china].

This paper deals with the developmental history of western medicine in China. Due to the hindrance of feudal conception, modern obstetrics began rather late. The first Chinese obstetrical ward was established in Fujian Province in 1911. Before 1930, the Chinese maternal and neonatal mortality rates were 4-5 times higher than that of European and American countries. After 1930, "Education of Midwives" commenced, including the founding of midwifery school, antenatal care, pelvie measurements, improvements of the diagnosis for pathological pregnancy, management of complications during pregnancy. All these have improved modern obstetrics in China and laid down the foundation for its development after 1949.

China↗
PubMed2002

[Breech presentation at term: evolution of French practices and an analysis of neonatal results in regards to obstetrical management of breech presentation, from AUDIPOG Database].

OBJECTIVES: To describe the evolution of medical practices in breech presentation at term and to compare early neonatal complications according to initial obstetrical decision on the type of delivery. METHODS: 71919 pregnancies are included in the AUDIPOG Database from 1994 to 2000. Among this cohort, pregnant women with a singleton in breech, at term were selected which represented 2136 women after the exclusion of in utero deaths and medical abortions. The first outcome was global criteria of severe early neonatal complications ("death during per or immediate post partum or transfer of the newborns to an intensive care or surgery unit"). The size of the sample authorized a power of 90%. RESULTS: The rate of cesarean section before labor was 40%. We found 2.3% of early neonatal complications in the group in which labor was accepted vs. 1.9% in the group with cesarean section performed before labor (p>0.05). After having taken into account prognostic factors, we do not see a significant difference for the risk of neonatal complications between the two groups (OR=1.33; 95% CI: 0.63-2.80). CONCLUSION: The analysis of the AUDIPOG Database describes the French obstetrical practice in breech presentation at term. We do not find a different risk in morbi-mortality as regards to the initial obstetrical choice regarding the type of delivery, but the absence of randomization in our study does not authorize a strong medical evidence to guide national recommendations.

Adult↗
PubMed2002

Policy and management constraints on access to and use of life-saving emergency obstetric care in India.

Maternal mortality is still very high in India and the developing world. India's maternal mortality ratio is about 540 deaths per 100,000 live births. Poverty and lack of resources contribute to this, but the main reasons for such high maternal mortality are policy barriers and management problems that impede access to good-quality emergency obstetric care in rural areas. The government policy does not encourage training general practitioners to provide cesarean sections, even when there are very few specialists available in rural and remote areas. Nurses are also prohibited from providing such basic emergency care procedures as intravenous oxytocics, antibiotics, and anticonvulsants. The doctors, nurses, and other hospital staff in managerial positions are not trained in modern management skills, which contributes to poor-quality services. The situation can be improved by training existing medical staff to provide emergency obstetric services in rural areas and training hospital managers in management skills. International aid organizations and women doctors should lobby for such policy changes, which will help increase access and quality of emergency obstetric care.

Emergency Medical Services↗
PubMed2002

Self-health attitudes and practices of obstetrics and gynecology nurses in Israel.

OBJECTIVE: To assess the attitude of obstetrics and gynecology nurses towards their own health and their health-related behaviors. METHODS: Two hundred and ninety community obstetrics and gynecology nurses in Israel were asked to complete a questionnaire on attitude to self-health, way of life, smoking habits, and regular breast, blood and PAP smear examinations. RESULTS: The average body mass index of the responders was 25.2 kg/m2. However, more than half the nurses (163/287, 56.8%) considered themselves as being above-average in weight, and only 41.1% as being appropriate in weight; 55% were on weight-loss diets. Smoking was reported by 44.8%. Blood tests, PAP smears and breast evaluations were regularly done by 72.5%, 83.0% and 55.7%, respectively. CONCLUSION: Obstetrics and Gynecology nurses in Israel are aware of the importance of their own health and have good health habits, except for cigarette smoking, which remains a problem among this group.

Attitude of Health Personnel↗
PubMed1975

Fetal prognosis in obstetric hepatosis.

116 women with obstetric hepatosis gave birth in the years 1971-1972 at the First and Second Departments of Obstetrics and Gynaecology, University Central Hospital, Helsinki. This accounts for a 1.1% incidence of all deliveries at this hospital. During most of these pregnancies fetal well-being was monitored by amnioscopy, by the oxytocin challenge test, by maternal urinary oestriol determinations and by estimating the fetal biparietal diameter weekly. In 38% of these pregnancies, signs of fetal distress were found, mainly an abnormal heart rate, or heart rate pattern, and/or meconium-stained amniotic fluid. These led to increased frequencies of induction of labour and of Caesarean sections performed because of asphyxia or imminent asphyxia as compared with a control group with similar age and parity distribution. There was an increase in the occurrence of twin pregnancies in the hepatosis series (7.6%). There were 4 intrauterine and altogether 8 perinatal losses of 125 infants born to hepatosis mothers. These observations suppport the opinion that there are increased risks for the fetus in pregnancies complicated by obstetric hepatosis. Amnioscopy and fetal heart rate recording during the delivery and oxytocin challenge test were found to be valuable in monitoring the fetal condition. The use of oestriol determinations, at least by employing the method in general clinical practice, was found to be of limited value in the predictive assessment of fetal distress in hepatosis. This might be due to impurities disturbing the determinations or to changed oestrogen metabolism in cholestasis.

Adult↗
PubMed2002

[Antiphospholipid syndrome in obstetrics--a new version of criteria, pathomechanism and the prophylaxis].

The paper surveys literature referring to criteria of the antiphospholipid syndrome in obstetrics as well as to the pathomechanism and prophylactic treatment. Criteria of that syndrome were modified in 1999. Generally accepted are two clinical criteria--thromboembolic complications and recurrent pregnancy loss, as well as two laboratory criteria--presence of lupus anticoagulant and/or anticardiolipin antibodies in the medium or high titer. Thrombocytopenia is no longer treated as a criterion. Diagnosis is formulated on the basis of at least one clinical and one laboratory criterion. It is assumed that obstetric complications are the result of immunological reaction of antiphospholipid antibodies with antigen located in trophoblast or vascular endothelium of the spiral arteries. The elimination of the activity of placental anticoagulant--annexin V--is the main mechanism of local thrombosis and infractions in placenta. Improvement in the results of obstetrics care can be achieved through prophylactic treatment: from the beginning of pregnancy until delivery, acetylosalicylic acid (aspirin) is applied in low doses, i.e. 80 mg/24 h and low molecular weight heparin or standard heparin in low-doses. It is recommended that for 6 weeks after delivery oral anticoagulants should be used in prophylactic doses in cases of primary syndrome, and in the secondary syndrome even constant antithrombotic prophylaxis is advised.

Antiphospholipid Syndrome↗
PubMed2002

Litigation: a threat to obstetric practice?

Claims that the practice of obstetrics is in crisis appear regularly in the media, but evidence for the claims is scarce. This article examines a range of evidence from Australia and overseas and explores the relationship between obstetric practice and litigation. While anecdotal evidence abounds, there is no hard evidence to confirm that litigation is the threat to obstetric practice that many practitioners strongly believe it is. It is likely that such practitioners respond by practising defensive medicine but this is very difficult to measure.

Attitude of Health Personnel↗
PubMed2002

Non-evidence-based use of Rho(D) immune globulin for threatened abortion by family practice and obstetric faculty physicians.

OBJECTIVE: To examine the practice patterns and differences between faculty members in obstetrics and gynecology (OB/G) and family practice (FP) residency programs in administering Rho(D) immune globulin (RhIG) for threatened abortion. STUDY DESIGN: A questionnaire was mailed to 50% (222) of all FP residencies and 100% (267) of OB/G programs in the United States. The obstetric curriculum coordinator at each FP residency and the director of obstetrics or maternal-fetal medicine at each OB/G residency were asked to respond. A total of 156 (70%) FP questionnaires and 186 (70%) OB/G questionnaires were returned after two mailings. RESULTS: Seventy-six percent of FP faculty and 85% of OB/G faculty reported giving RhIG in threatened abortion. Physicians with advanced training were more likely to recommend giving RhIG. CONCLUSION: Most FP and OB/G residency faculty report using RhIG in threatened abortion. The practice has become part of the medical culture despite the lack of supporting evidence and should be revaluated in that light.

Abortion, Threatened↗
PubMed2000

[Reconstruction of the shoulder joint function in the older obstetrical palsy].

OBJECTIVE: To study the reconstructional method and effect of shoulder joint function in the older obstetrical palsy with medial rotation contracture deformity. METHODS: From April 1996 to July 1999, 7 patients of older obstetrical palsy were adopted in this study. Among them, there were 5 males and 2 females, aged from 13 to 21 years old. No previous operation history and the main deformity was medial rotation contracture of shoulder. During operation, these patients were treated with "Z"-shape elongation of the tendon of subscapular muscle, transfer of the tendons of latissimus dorsi and teres major muscle to the tendons of supraspinous and infraspinous muscles. RESULTS: Followed up for 6 to 44 months(averaged 19 months), the Gilbert grading and Mallet scoring were 1.57, 7.57 preoperatively versus 3.45, 10.86 postoperatively, the abduction and external rotation of the shoulder joints recovered obviously. CONCLUSION: It is an effective operation for the older obstetrical palsy with medial rotation contracture of shoulder.

Adolescent↗
PubMedDate not supplied

Shoulder deformities in obstetric brachial plexus paralysis: a computed tomography study.

Obstetric brachial plexus palsy invariably involves the upper roots. If left untreated, characteristic deformities of the shoulder are common sequelae. The most objective way to investigate these shoulder deformities is computed tomographic (CT) scanning of bilateral upper limbs. In this study, specific measurements on CT scans of bilateral upper extremities were performed in a population of patients with obstetric brachial plexus palsy before and after reconstruction (nerve repairs and secondary procedures). The measurements showed that the restoration of external rotation and the scapula stabilization procedure correct the inclination of the humeral head, improve the joint congruency significantly, and decrease the winging of the scapula, thus improving the kinetics of the shoulder. Periodic CT measurement is an objective method of measuring the changes at the shoulder joint that occur over time during the natural evolution of the obstetric brachial plexus palsy lesion and of documenting the benefits of microsurgical intervention.

Brachial Plexus↗
PubMed2003

Use of packing in obstetric hemorrhage of uterine origin.

OBJECTIVE: To determine the safety and effectiveness of uterine packing to stop hemorrhage in obstetric patients following delivery and pregnancy termination. STUDY DESIGN: A review of obstetric records at Children's Hospital of Buffalo in a 9-year period was undertaken. Patients with uterine packing were identified. Indications, additional medical and surgical procedures, estimated blood loss, postoperative complications and packing material used were reviewed. RESULTS: A total of 9 patients were identified among 34,071. Five patients had hemorrhage during cesarean section. Two patients had hemorrhage after vaginal delivery; 1 case of which had failure with packing and resulted in postpartum hysterectomy. The remaining 2 patients had hemorrhage after dilation and evacuation. Uterine atony unresponsive to oxytocics was the most common indication for uterine packing (44%). The average hematocrit decrease was 10.4% (average total blood loss, 2,200 mL), and all patients received transfusion except 1. The only immediate postoperative complications occurred in a patient with postpartum hysterectomy after failed packing; she developed a pelvic abscess but did well after drainage. CONCLUSION: Uterine packing may be a reasonable alternative to further surgical intervention in patients with intractable obstetric hemorrhage who wish to preserve fertility.

Adult↗
PubMed1992

Legal and professional issues in critical care obstetrics.

The practice of critical care obstetrics is a challenging specialty that presents unique problems and issues in providing perinatal care. With the emergence of critical care obstetrics comes increased accountability and expanded responsibilities. This article addresses the legal and professional issues related to critical care obstetrics.

Critical Care↗
PubMed1963

Gynecological aspects of obstetrical delivery.

Parturition should be looked upon as a physiological exercise, and ideally the multiparous state should be one of asymptomatic change associated with comfortable function. However, because obstetrics is a field in which serious complications may suddenly occur, the ideal is not always possible. Among the delayed effects of delivery is a group of gynecological complications which may affect the well-being of the woman so involved in later life. Such complications as uterine prolapse, cystocele, rectocele, enterocele, and genital fistula may be the grim aftermath of poor obstetric practice.The article reviews some of the advances in the prevention of maternal mortality and morbidity and emphasizes the important place of intelligent conservative obstetrics in the hands of both general physicians and specialists.

Cystocele↗
PubMed1992

The incidence of surgical glove perforation during obstetric and gynaecological surgical procedures.

The increasing prevalence of diseases such as AIDS and hepatitis B makes safe surgical techniques more important than ever before. Intact surgical gloves act as a barrier against these infections and a study was therefore done to determine the incidence of surgical glove perforation during obstetric and gynaecological surgical procedures. Surgical gloves were collected and tested for perforations following 353 consecutive obstetric and gynaecological operations. Forty pairs of new unused surgical gloves were tested for perforations in the same way. Whereas none of the 40 control pairs of gloves was found to be perforated, 22%-24% of used gloves were perforated. The experience of the surgeon had no influence on the incidence of glove perforation (P = 0.997; chi 2-test). Left-hand gloves were more frequently perforated than right-hand gloves, but this difference was not statistically significant (P = 0.075: chi 2-test). These findings must be a source of concern to all those practising obstetrics and gynaecology and measures are therefore suggested to decrease the risk of HIV or hepatitis B transmission during operations.

Equipment Failure↗