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 1,225 records · Page 68Linked to original sources
PubMed1992

[Obstetrical prognosis of gestational pemphigoid. Study of a series of 13 cases and review of the literature].

Pemphigoid gestationis (PG) Herpes Gestationis (HG) is an auto-immune bullous dermatosis which usually occurs in pregnancy. We have studied the maternal and fetal prognosis of this pathological condition. Thirteen cases were reported at the same time by the departments of dermatology and obstetrics of the Charles-Nicolle Hospital between 1980 and 1990. Two women were not followed up. In the remaining eleven there was one intrauterine fetal death and one intrauterine fetal growth retardation (IUGR). One case was delivered prematurely because of obstetric indications. Four infants were delivered by Caesarean section on purely obstetrical indications. The other cases were delivered normally. There were no dermatological lesions or other malformations in the infants. Immediately after delivery ten women showed exacerbation of the skin lesions and most of these were treated by general corticotherapy. Our results were compared with those found in the literature. The prognosis differs according to different authors but in order to avoid any risks the condition must be followed carefully by obstetricians and dermatologists and laboratories working together.

Adult↗
PubMed1992

Improving obstetric outcomes in ethnic minorities: an evaluation of health advocacy in Hackney.

Ethnic differences in birthweight, perinatal mortality and other obstetric outcomes are now well known. In some districts with a significant ethnic minority population, services are provided for non-English-speaking women using maternity units. Various models have developed, including translators, interpreters, Linkworkers, the Department of Health funded Asian Mother and Baby Campaign and health advocates. This paper describes the evaluation of a health advocacy programme in Hackney, East London. The advocates do more than simply interpret language. Anecdotal examples of how this approach changes clinical practice encouraged the project steering group to commission a study to test the hypothesis that health advocacy could improve obstetric outcomes in non-English-speaking women. A retrospective study was carried out comparing 1000 non-English-speaking women delivering at the Mothers' Hospital, Hackney, in 1986 who had been accompanied by an advocate with women delivering at the same hospital in 1979 and at a reference hospital, Whipps Cross. The study found significant differences between the groups in three outcomes: antenatal length of stay, induction and mode of delivery. The changes in Caesarean section were of particular note. The rates rose from 11 to 17 per cent at the reference hospital, whereas they fell from 10.8 to 8.5 per cent at the Mothers' Hospital. This is highly statistically significant. Although these changes cannot be directly attributed to health advocacy, it was considered reasonable to deduce that improved communication could have influenced clinical practice. These findings suggest that health advocacy may offer a mechanism to address some of the adverse obstetric outcomes observed in ethnic minorities.

Adult↗
PubMed2005

Family medicine obstetrics. Collaborative interdisciplinary program for a declining resource.

PROBLEM BEING ADDRESSED: A continuing decline in the number of family physicians in Canada providing obstetric, and particularly intrapartum, care. OBJECTIVE OF PROGRAM: The Maternity Centre of Hamilton in Ontario was a pilot project initiated to help family physicians provide full obstetric care through a collaborative interdisciplinary model and shared call. PROGRAM DESCRIPTION: Eleven family physicians provided care in collaboration with a nurse practitioner and other health professionals. Women came from the Maternity Centre's own practices, community physicians, or agencies, or through self-referral. More than a quarter of the women were considered psychosocially high-risk patients. Key features of the program included interdisciplinary collaboration and information technology that supported prenatal and birth documentation. CONCLUSION: The program has helped family physicians, and even recruited some, to practise full obstetric care and has provided high-quality, accessible services to pregnant women. Physicians experienced increased jab and personal satisfaction, and patients were highly satisfied with the service.

Cooperative Behavior↗
PubMed2005

Physicians' liability in obstetric and gynecology practice.

PURPOSE: Litigation in obstetric and gynecologic practice has arisen as an important issue. This article aims to highlight issues related to malpractice in obstetrics and gynecology in order to point out several important aspects of medical practice, which may offer adequate professional protection. METHODS AND MATERIAL: Search of the current relevant literature. RESULTS: The four most common clinical causes of medical litigation in obstetrics and gynecology are cases involving fetal distress, uterine rupture after a vaginal birth in a woman with a previous Cesarean section, shoulder dystocia, and misdiagnosis of breast cancer. Litigation raised in most of the cases is driven by bad outcomes and not by malpractice. Additionally, both juries and the public often expect perfection as the natural result of pregnancy and any deviation from this expectation has to be the result of someone's negligence. For this reason it has become mandatory for doctors in hospitals and private practices to acquire a sufficient knowledge relating to modem management, to document carefully in writing their procedural and management plans and to become familiar with the legal aspects of medical practice. Adequate communication and a written patient's consent form are of paramount importance. CONCLUSION: Maintenance of high standards in daily practice with continuous training, clear communication and a signed Patient's Informed Consent Form along with the appropriate documentation of any procedure carried out may provide professional safety to practicing obstetricians and gynecologists in case of medical litigation.

Europe↗
PubMed2005

[Obstetric analgesia in Norwegian hospitals].

BACKGROUND: Experience from our hospital has shown a significant increase in the use of epidural analgesia during labour. We wanted to see if this was a general trend in Norway, and wanted to find out for what kind of labour analgesia was offered in the different labour wards. MATERIAL AND METHOD: A questionnaire concerning obstetric analgesia and anaesthetic methods for caesarean section was sent to chief anaesthetists and head midwives in Norwegian hospitals. The information was compared to an identical questionnaire from 1996. In addition, data concerning obstetric analgesia was collected from the Norwegian Medical Birth Register. 77% of the anaesthetic departments and 88% of the labour wards responded to the questionnaire. RESULTS: The use of epidural analgesia was on an average 20.6% (range 0-40.5%), which is twice as much as in 1996. 75% answered that the parturients' wish for epidural analgesia was reason enough to give an epidural. 84% of caesarean sections were performed in regional anaesthesia and 16% were done in general anaesthesia. This represents a significant reduction in the use of general anaesthesia. 85% of the labour wards offered acupuncture, which is a tremendous increase compared to 1996. Systemic opioids are still widely used, and pethidine is still the most frequently used opioid. Pethidine's negative side effect profile has been widely focused on during the past decade. The hospital's information on the various analgesic methods available for labour analgesi, is clearly improved since 1996. CONCLUSION: Obstetric analgesia in Norwegian hospitals has improved substantially since the last survey.

Acupuncture Analgesia↗
PubMed2005

Antenatal care: a comparison of demographic and obstetric characteristics of early and late attenders in the Niger Delta, Nigeria.

BACKGROUND: The utilization of modern antenatal care is poor in most parts of Nigeria and studies indicate that the majority of those who present for antenatal care do so late. MATERIAL/METHODS: This was a retrospective study involving 303 consecutively booked pregnant women over a 6-month period (March 1 to August 31, 2004) in a suburban tertiary hospital practice. The objectives were to determine the incidence of late booking for antenatal care and to compare the demographic and obstetric characteristics of women who booked late with those who booked early for antenatal care. The Fisher's exact test, odds ratio, and the 95% confidence interval were used for statistical analysis. RESULTS: Most (79.9%) of the women booked late for antenatal care. It was found that age, parity, level of education, social class, previous fetal loss, and previous obstetric complications did not differ significantly between women who booked early and those who booked late. CONCLUSIONS: The majority of the study population booked late for antenatal care. Socio-demographic and obstetric factors do not appear to be responsible for late utilization of antenatal care in the Niger Delta, Nigeria. Further studies are needed to explore the contribution of cultural factors to late presentation for antenatal care. Community-based health education programs on the importance of early presentation for antenatal care need to be put in place to address the anomaly of late utilization of antenatal care in Nigerian women.

Adolescent↗
PubMed2005

Patients' quality assessment of ambulatory obstetric and gynaecological services.

PURPOSE: The quality could be assessed from two perspectives: internal and external. From the internal perspective the quality means being consistent with particular conditions and standards. The external perspective is based on relative assessment of the product made by a client who is also aware of other competitors' offer. Despite the professional assessment which is focused on providing health services according to medical and managerial correctness, patient's assessment is also relevant. Measuring patient's satisfaction is additional method of health services quality assessment. The aim of the study was to estimate patients' opinion on quality of ambulatory obstetric and gynaecological services. MATERIAL AND METHODS: The study was conducted in 11 obstetric and gynaecological out-patient clinics of Lublin in September and October 2003. The study tool was an author's questionnaire. Patients were asked to assess such areas as registration before visit, their relationship with nurses and gynaecologists and other aspects of services provision like intimacy assurance and respecting Patient's Rights. The collected data was statistically analysed. RESULTS: 635 patients took part in the study. The biggest groups in the studied population were women at the age of 20-30 years, married, living in cities and secondary educated. It was found that around half of the population is satisfied and 2.2% of them are unsatisfied with the fact that they have chosen particular out-patient clinic. More than 70% of women had positive opinion of following aspects influencing general opinion about service quality: politness of reception desk staff, opening hours, the length of time before a patient is seen by the specialist, intimacy assurance and respect for Patient's Rights in the practice. 80% of patients were satisfied with the relationship with nurses and 3.3% were unsatisfied with it. Eight patients out of ten were satisfied with gynaecological care, less than 2% were unsatisfied. The studied women had also high opinion of the course of visit. More than 90% of studied patients trust their gynaecologists. CONCLUSIONS: More satisfied with the services provided by the obstetric and gynaecological out-patient clinics were women living in cities than in villages and those visiting nonpublic than public practices.

Adult↗
PubMedDate not supplied

[Organization of obstetrical teaching and practice in our regions before 1815 (first part)].

As elsewhere in Europe, the origins of Belgian obstetrics are related to the double rivalry between medical doctors and surgeons on the one hand and between surgeons and midwives on the other hand. Extension of obstetrical teaching in our regions has been hampered because of political turmoil resulting from the successive territorial dominations by Spain, Austria, France and Holland. In this evolution, the organisational sanitary model emerging from the French revolution exerted a prominent influence namely through creation of the subordinate grade of "Health Officer" and the suppression of local medical colleges as well as of the sole existing university faculty of medicine. These factors explain the poor quality of obstetrics which has prevailed on our soil until 1815.

Belgium↗
PubMed2006

Mental health of residents during Obstetrics and Gynecology training in Thailand.

OBJECTIVE: To evaluate mental health of residents during Obstetrics and Gynecology training and identify the factors that affect mental health problems. MATERIAL AND METHOD: During January-April 2004, one hundred and sixty Obstetrics and Gynecology residents (62% of 259) had completed a self-administered questionnaire composed of demographic data, workload, self-report of life stressors, and the Thai Mental Health Questionnaire (TMHQ-70). RESULTS: The prevalence of mental health problems was 29% (46/160). Somatization and social function were found in the first and second rank (18.1% and 11.9%), respectively. A resident who was younger than 25 years old, was married, cared for more than 20 patients per 8 hours in the labor room, performed more than 10 academic activities per year, or attended more than 5 examinations per year was at risk to develop social function problems. CONCLUSION: About one-third of residents training in Obstetrics and Gynecology have faced mental health problems--somatization, social function, depression and anxiety. The significant risk factors associated with social function problems were younger age, marriage and excessive workload

Adult↗
PubMed2006

[Prescription and drug expenditure in gynecology and obstetrics in Northwest medical units from IMSS].

BACKGROUND: Drug prescription is the most frequent medical intervention in Gynecology and Obstetrics; however, studies of prescription profile are limited. In this study, we analyzed differences of expense by drug prescription for gynecologic and obstetrics health problems. PATIENTS AND METHOD: It was performed a cross sectional study for one year analysis in each medical area that shape IMSS western district. We calculated spending and consumption coefficients for each drug and therapeutic groups. User coefficients were ordered to compare consumption differences. Besides the statistical ratio of consumption between drugs groups, we described the differences found and analyzed the prescription profile among medical regions. RESULTS: Data related to the expenses in each one of the regions show important differences in each one of the drugs and therapeutic groups. The most common expense for drugs is related to the treatment of osteoporosis, menopause and fertility problems. We also found differences in prescription drug preferences in each therapeutic subgroup. DISCUSSION: Drug prescription studies are useful as a basis for further specific studies in each pharmacologic subgroup. There are few studies that analyze the drug prescription profile on Gynecology and Obstetrics. In this study it is possible to suppose that medical prescription was not based on known medical evidences; therefore, we must reconsider the need of a permanent actualization and systematic medical evaluation.

Cross-Sectional Studies↗
PubMed2006

Educational needs of Australian rural and remote doctors for intermediate obstetric ultrasound and emergency medicine ultrasound.

INTRODUCTION: The aim of this research was to determine the educational needs of Australian rural and remote doctors for intermediate obstetric ultrasound and emergency medicine ultrasound. The main research questions were: what educational topics would rural and remote doctors prefer to learn about in intermediate obstetric ultrasound and emergency medicine ultrasound, and what were those doctors' preferred methods of delivery for an ultrasound education program. METHOD: A self-administered postal questionnaire containing a pre-paid return envelope was mailed to 344 Australian rural and remote doctors in December 2003. RESULTS: 107 completed questionnaires were returned, giving a response rate of 32.7%. This was after the denominator was adjusted for the 17 doctors whose letters were returned to sender. The respondents included 23 (21.5%) female and 84 (78.5%) male doctors. Eighty doctors (74.8%) stated that they used ultrasound, and 27 (25.2%) said they did not. Seventy-seven (72%) indicated they had previously participated in some ultrasound education and training. The respondents stated that their main areas of educational need in intermediate obstetric ultrasound were ectopic pregnancy (76.6%), miscarriage (72%), intrauterine growth restriction (65.4%), transvaginal scanning (47.7%), detecting fetal abnormalities (47.7%) and morphology scanning at 18-20 weeks (41.1%). The main areas of educational need in emergency medicine ultrasound were focused abdominal sonography in trauma (63.5%), detecting foreign bodies (40.2%), gynecological ultrasound (39.2%), gall bladder and biliary tract (37.4%), abdominal aortic aneurysm (32.7%) and trauma bleeding (31.7%). CONCLUSION: Australian rural and remote doctors are using ultrasound technology to improve the clinical investigation and diagnosis of a large variety of clinical conditions in their family medical practices. This paper describes the results of research into the educational needs of this target group of doctors.

Australia↗
PubMed1991

An integrated, hospital information system based obstetrical medical record and database.

Described in this paper is the implementation and integration of an obstetrical medical record and database into an existing hospital information system. A unique feature of this system was the integration of existing data captured by the established hospital information systems with the newly implemented obstetrical database to form a complete patient data profile. This complete database integrated data from hospital functions such as demographic data obtained at patient registration, outpatient visits and tests, inpatient admission historical data, tests and procedures, newborn data and miscellaneous data required for birth registration. An important second feature was the utilization of physicians and nurses to enter the obstetrical data. This permitted immediate access to patient data from any hospital information system terminal, immediate retrieval for generating reports, and subsequently, ad hoc queries, statistical analysis and the electronic transfer of birth registration data to the State Vital Statistics Registry.

Academic Medical Centers↗
PubMed1991

[Padding of the uterine wall in severe obstetrical hemorrhage].

Severe obstetrical hemorrhage demand an emergency treatment, and hysterectomy is not always adequate. We report our technique of uterine wall padding (UWP), as performed on five women who underwent surgery with UWP for an obstetrical hemorrhage that was severe either at the onset (n = 3) or after transfer to our department (n = 2). The technique consists of padding the uterine walls with X stitches of slowly resorbable thread. The reasons for the operation were: uterine muscle atonia in 2 cases and vaginal laceration, placenta preavia and placenta accreta in 1 case each. The UWP technique was carried out during or after subtotal hysterectomy for hemorrhage in 4 patients, and with preservation of the uterus in one patient. No secondary operation was required after UWP. Less blood products were transfused in women who had immediate UWP than in those for whom UWP was a second-line operation. UWP was more efficient when performed at an early stage. In the woman with placenta accreta the uterus could be salvaged by UWP. This simple technique contributes to the reduction of blood transfusions in severe obstetrical hemorrhage.

Blood Transfusion↗
PubMed1991

[Carl Wilhelm Mayer (1795-1868)--founder of the Berlin Society of Obstetrics].

115 years ago the society of gynaecology and obstetrics in Berlin was found. Already in 1844 the Berlin physician and obstetrician Carl Wilhelm Mayer (1795-1868) has initiated the foundation of a society of obstetrics. This was the first medical-scientific society of the world. We want to demonstrate the biography of C. W. Mayer and also his importance in the creation of a modern medical association. In the second part of present paper, the situation of foundation and the first years of the Berlin society of obstetrics were described.

Berlin↗
PubMed1991

Urological injuries during obstetric and gynaecological surgical procedures.

Urological injuries during obstetric and gynaecological operations carried out between Jan. '88 to Dec. '88, at a hospital involved in resident teaching programmes were analysed retrospectively. Each case was reviewed for predisposing factors, location and type of injury, time and method of recognition and management. Fifteen injuries were documented in 892 gynaecological procedures and 296 obstetric procedures. Twelve injuries occurred during gynaecological operations whereas 3 occurred during obstetric operations. Thirteen were bladder injuries and two were ureteric injuries. Infiltrating carcinoma of cervix, pelvic adhesions, adhesions because of previous operations and distorted anatomy, were the important risk factors.

Female↗
PubMed1990

Postgraduate internship in gynecology and obstetrics for physician assistants: a 4-year experience.

Changes in the Hospital Code (405 Regulations) to limit the number of hours worked by residents have been implemented in New York state and may soon become a nation-wide policy. Although their goal is to guarantee quality of patient care and assure education for residents, the limitation of hours worked has increased manpower shortages, some of which could be resolved by using physician assistants with specialty training. To provide this training, a Postgraduate Internship in Gynecology and Obstetrics for Physician Assistants has been developed at the North Central Bronx Hospital and the Montefiore Medical Center. It is the first program of its kind at the postgraduate level to educate physician assistants specifically for practice in obstetrics and gynecology. The program consists of 3 months of didactic lectures to review and update knowledge on topics in medicine, surgery, gynecology, preoperative and postoperative care, cardiac and trauma life support, and critical care, followed by a clinical year similar to that of a rotating physician intern. We believe that such postgraduate educational opportunities in gynecology and obstetrics benefit both the individual physician assistant's growth and development and the level of care delivered, and may be an answer to staffing needs.

Curriculum↗
PubMed1990

Obstetric care of a Southeast Asian refugee population in a midwestern community.

The obstetric records of 430 Hmong and other Southeast Asian refugee women were retrospectively reviewed from January 1, 1977 to July 1, 1988. All patients gave birth in two hospitals in a midwestern community, La Crosse, Wisconsin. Lack of medical care for early pregnancy complications, late onset of obstetric care, anemia, and high rates of parasites and hepatitis occurred frequently in pregnancy. Admission in advanced labor, a low operative delivery rate (6%), and a higher prematurity rate characterized intrapartum care. Birthweight data revealed statistically significantly smaller infants after 38 weeks' gestation. Postpartum febrile morbidity and neonatal complications were rare. Cultural differences and their effects on obstetric care are discussed.

Abortion, Spontaneous↗
PubMed1990

Primary care obstetrics in rural western New York. A multi-center case review.

Obstetric care in rural communities is in crisis due to the shortage of practitioners and the pressures of regulatory agencies on small obstetric units. We reviewed the records of 297 pregnant women presenting to the offices of 12 family physicians in rural areas of Western New York State. Local deliveries were done in rural hospitals that reported fewer than 500 deliveries per year. Family physicians obtained consultation in 36% of the pregnancies. Of these, care responsibility was transferred to an obstetrician 50% of the time (18% of all pregnancies). Two percent of the cases were transferred to a regional referral center. There was one perinatal death and one intrauterine fetal death in this series. Of the 222 deliveries by family physicians, oxytocin was used in 23%, narcotic analgesia was used in 15.3%, and outlet assist in 8.1%. Labors were somewhat longer than standard labor curves, and the overall cesarean section rate was 13.5%. We conclude that obstetric care by rural family physicians utilizing small rural Western New York hospitals is consistent with standards of care elsewhere when practiced in the context of an organized referral network.

Family Practice↗