Adding “pregnancy” to the Centor score, aim to reduce maternal death

Trauma related injury is the leading cause of non-obstetric maternal death. The gravid uterus is at risk for injury, particularly during motor vehicle accidents. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a means of controlling pelvic hemorrhage in the setting of trauma. We report the use of REBOA in a hemodynamically unstable, multiply-injured young woman with viable intrauterine pregnancy.

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TO EVALUATE THE EFFECTIVENESS OF CONDOM BALLOON CATHETER IN TREATING INTRACTABLE POSTPARTUM HEMORRHAGE AT KONTUM PROVINCIAL HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.6.24 ◽

2018 ◽

Vol 8 (6) ◽

pp. 178-183

Author(s):

Dinh Nguyen Gia ◽

Thanh Cao Ngoc

Keyword(s):

Maternal Death ◽

Postpartum Hemorrhage ◽

Medical Management ◽

Balloon Catheter ◽

Uterine Atony ◽

Cross Sectional ◽

Common Cause ◽

Provincial Hospital ◽

Balloon Tamponade ◽

Condom Catheter

Background: Postpartum hemorrhage (PPH) remains a significant contributor to maternal morbility and mortality and accounts for 31% of maternal death in Vietnam. The most common cause of PPH is uterine atony. Recently, uterine tamponade using intrauterine condom appears to be an effective tool in the management of intractable PPH. Objectives: To evaluate the success of condom as a tamponade to arrest intractable PPH due to uterine atony in patients not responding to medical management. Materials and Methods: The study was designed as a cross-sectional and descriptive, included 32 patients who underwent condom balloon tamponade at Kontum Provincial Hospital from 1/2012 to 8/2016. Results: 32 women (mean age 25.71 ± 6.45 years range, 16 - 39) underwent condom balloon tamponade for PPH controls. 29 patients (90.62%) successfully responded the tamponade therapy by the use of condom catheter. Three patients (9.37%) required hysterectomy. Conclusions: Condom catheter balloon effectively controls the intractable PPH due to uterine atony. Key words: PPH (Pospartum hemorrhage), Tamponade, Condom catheter balloon, Uterine atony

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Maternal Death Rate in Glasgow

BMJ ◽

10.1136/bmj.1.3977.684-c ◽

1937 ◽

Vol 1 (3977) ◽

pp. 684-684

Author(s):

D. M. Blair

Keyword(s):

Maternal Death ◽

Death Rate

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Positive Rate of Tests for Group a Streptococcus and Viral Features in Children with Acute Pharyngitis

Children ◽

10.3390/children8070599 ◽

2021 ◽

Vol 8 (7) ◽

pp. 599

Author(s):

Dasom Wi ◽

Soo-Han Choi

Keyword(s):

Laboratory Testing ◽

Older Patients ◽

Group A Streptococcus ◽

Throat Culture ◽

Acute Pharyngitis ◽

Rapid Antigen Detection Test ◽

Positive Rate ◽

Group A ◽

Centor Score ◽

Low Prevalence

Group A streptococcus (GAS) is an important cause of acute pharyngitis. We investigated the positive rate of GAS tests and clinical viral features in children with acute pharyngitis. A retrospective review was conducted for patients <15 years old with both rapid antigen detection test (RADT) and throat culture results. Patients were excluded if they were diagnosed with influenza or had received antibiotics within two weeks before these tests. A total of 377 patients were eligible. The median age of patients was 3.5 years, and 45.4% of total patients were <3 years old. Among all patients, 68.7% had at least one viral feature, and 39% had more than two. The overall positiv rate for GAS was 11.4%. The GAS positive rate was significantly lower in patients <3 years old than in older patients (1.8% vs. 19.4%, p < 0.0001). The overall sensitivity and specificity of RADT were 75.0% (95% CI: 57.8–87.9) and 97.9% (95% CI: 95.8–99.2), respectively. The GAS positive rate was not significantly different between patients with and without viral features (12.4% vs. 9.3%, p = 0.4854). In patients aged 3–14 years, the GAS positive rate was not associated with the modified Centor score or the frequency of clinical viral features. Despite a low prevalence of GAS pharyngitis, testing for GAS was frequently performed in children <3 years old in this study. Appropriate use of laboratory testing for GAS pharyngitis and judicious prescription of antibiotics were imperative.

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The reliability of maternal audit instruments to assign cause of death in maternal deaths review process: a systematic review and meta-analysis

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03840-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ratnasari D. Cahyanti ◽

Widyawati Widyawati ◽

Mohammad Hakimi

Keyword(s):

Systematic Review ◽

Maternal Death ◽

Meta Analysis ◽

Diagnostic Reliability ◽

Maternal Deaths ◽

Measurement Tools ◽

Study Population ◽

Underlying Causes ◽

Meta Regression Analysis

Abstract Background Maternal Death Reviews (MDR) can assist in formulating prevention strategies to reduce maternal mortality. To support MDR, an adequate MDR instrument is required to accurately identify the underlying causes of maternal deaths. We conducted a systematic review and meta-analysis to determine the reliability of maternal death instruments for conducting the MDR process. Method Three databases: PubMed, ProQuest and EBSCO were systematically searched to identify related research articles published between January 2004 and July 2019. The review and meta-analysis involved identification of measurement tools to conduct MDR in all or part of maternal audit. Eligibiliy and quality of studies were evaluated using the Modified Quality Appraisal of Diagnostic Reliability (QAREL) Checklist: Reliability Studies. Results Overall, 242 articles were identified. Six articles examining the instrument used for MDR in 4 countries (4 articles on verbal autopsy (VA) and 2 articles on facility-based MDR) were included. None of studies identified reliability in evaluation instruments assessing maternal audit cycle as a comprehensive approach. The pooled kappa for the MDR instruments was 0.72 (95%CI:0.43–0.99; p < 0.001) with considerable heterogeneity (I2 = 96.19%; p < 0.001). Subgroup analysis of MDR instruments showed pooled kappa in VA of 0.89 (95%CI:0.52–1.25) and facility-based MDR of 0.48 (95%CI:0.15–0.82). Meta-regression analysis tended to show the high heterogeneity was likely associated with sample sizes, regions, and year of publications. Conclusions The MDR instruments appear feasible. Variation of the instruments suggest the need for judicious selection of MDR instruments by considering the study population and assessment during the target periods.

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