Measuring Childbirth Outcomes Using Administrative and Birth Certificate Data

Conclusions Maternal and newborn outcomes should be jointly reported because hospital rates of maternal morbidity and newborn morbidity are poorly correlated. This can be done using a childbirth composite measure alongside separate measures of maternal and newborn outcomes.
Source: Anesthesiology - Category: Anesthesiology Source Type: research

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Abstract Agreement between estimated fibrinogen concentration via thromboelastography and traditional assays is not established in the parturient. We therefore recruited 56 parturients and performed Clauss and functional fibrinogen level (FLEV) tests. Mean difference of measurements was 36.8 mg/dL (95% CI, 21.8-51.9) with a standard deviation of 52.8 mg/dL. Calculated limits of agreement were 140.2 mg/dL (95% CI, 166.3-114.6) and -66.6 mg/dL (95% CI, -40.8 to -92.5), within the maximum allowable difference of 165 mg/dL. We therefore conclude that while most measurements fell within the limits of agreement, more wo...
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
Publication date: Available online 21 August 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Harriet Lamb, Alexander HeazellAbstractPerinatal death or cerebral palsy are devastating events for families. In an attempt to prevent these pregnancy outcomes, fetal wellbeing is assessed during labour by a variety of means. In this review, the most common means to confirm fetal wellbeing, the rationale for their use and evidence of their efficacy are discussed. With respect to labour, the indications for continuous electronic fetal monitoring are presented, together with a guide to interpretation of cardiotocograph...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
Publication date: Available online 20 August 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Amanda Zacharzewski, Ross MacnabAbstractCardiac disease is a significant cause of maternal mortality. In the UK in the last maternal mortality report, it was the leading cause of indirect maternal deaths (2.39 deaths per 100,000 maternities). The overall rate of maternal mortality from cardiac disease has significantly increased over the last three decades, with this increase being mostly attributable to deaths from ischaemic heart disease, myocardial infarction and peripartum cardiomyopathy. Conditions such as pulmo...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
Publication date: Available online 20 August 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Sophie A. Kimber CraigAbstractRegional anaesthetic techniques are the most frequently used type of anaesthetic used for caesarean deliveries. They have a better safety profile than general anaesthesia in the pregnant woman. The choice of whether to use a spinal, epidural or combined spinal–epidural technique will depend on patient and surgical factors. Particular care is required in those receiving therapeutic anticoagulation or with clotting abnormalities. Women should be provided with information regarding th...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
This article summarizes current guidelines in relation to consent that have been updated to reflect recent case law.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
Publication date: Available online 19 August 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Emma Sharkey, Siân GriffithsAbstractAnaesthesia, surgery and ionizing radiation may all prove harmful to an undetected pregnancy. Elective procedures should be deferred at least until the second trimester to reduce the risk of teratogenicity or spontaneous abortion. If surgery cannot be delayed, anaesthetic or surgical techniques can be modified, and the use of intraoperative ionizing radiation avoided where possible. Determination of pregnancy status is mandated by current national guidelines prior to any proc...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
AbstractObjectivesFew studies have investigated the prophylactic efficacy of dexmedetomidine (DEX) in postpartum depressive symptoms (PDS). A randomized, double ‐blind, placebo‐controlled trial was conducted to investigate whether the administration of DEX, immediately after delivery and for patient controlled intravenous analgesia (PCIA), can attenuate PDS.MethodsSix hundred parturients scheduled for elective caesarean delivery under spinal anesthesia were randomly allocated into the Control group (infusion with 0.9%normal saline after delivery and PCIA with sufentanil) and the DEX group (DEX infusion 0.5ug.kg‐1 aft...
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - Category: Drugs & Pharmacology Authors: Tags: Original Research Article Source Type: research
Neuraxial anesthesia is the standard of care for cesarean delivery and labor analgesia in obstetric patients but can be technically challenging due to the anatomical changes of pregnancy.1 In our tertiary care academic obstetric unit, we have an Epidural Positioning Device (EPD ®, PHS Medical, Watertown, SD, USA), designed to facilitate the sitting flexed position in patients having neuraxial anesthesia. On the product information sheet, the manufacturer of the device claims that the “Epidural Positioning Device positions patients correctly and comfortably by encouragin g cervical, thoracic and lumbar flexion whi...
Source: International Journal of Obstetric Anesthesia - Category: Anesthesiology Authors: Tags: Original Article Source Type: research
Conditions:   Anesthesia, Spinal;   Pain;   Pregnancy;   Cesarean Section Interventions:   Drug: EMLA cream;   Drug: 2% lidocaine Sponsor:   Aga Khan University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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