scholarly journals Vaginal Delivery: A Day-Care Procedure with the use of Day-Care Delivery Protocol

2013 ◽  
Vol 5 (3) ◽  
pp. 158-160
Author(s):  
Shruti Malvi ◽  
Savita Mishra
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
South Asian ◽  
Day Care ◽  
Perinatal Outcome ◽  
Care Delivery ◽  
Close Monitoring ◽  
Care Procedure ◽  
Delivery Protocol

ABSTRACT Objectives To know the feasibility of safe activation and augmentation of labor with close monitoring leading to favorable fetomaternal outcome, as a day-care procedure using the daycare delivery (DCD) protocol. Materials and methods Inclusion of a select subset of 304 primi women at term was done for labor activation and augmentation, in a closely monitored fashion, followed by assessment of outcomes and follow-up. Results Almost 70% of the selected primi women delivered vaginally within the stipulated time of 12 to 15 hours and only 18% needed cesarean section. No perinatal mortality was observed. Conclusion Day-care delivery may prove to be a suitable option to the parturient and her obstetrician ensuring quality labor and optimal perinatal outcome. How to cite this article Malvi S, Mishra S. Vaginal Delivery: A Day-Care Procedure with the use of Day-Care Delivery Protocol. J South Asian Feder Obst Gynae 2013;5(3):158-160.

scholarly journals Adverse Neonatal Outcome are More Common among Babies Born by Cesarean Section than Naturally Born Babies at Public Hospitals in Eastern Ethiopia: A Comparative Prospective Follow-Up Study at Eastern Ethiopia

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110183
Author(s):  
Maleda Tefera ◽  
Nega Assefa ◽  
Kedir Teji Roba ◽  
Letta Gedefa
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Neonatal Outcome ◽  
Birth Asphyxia ◽  
Public Hospitals ◽  
Obstructed Labor ◽  
Eastern Ethiopia ◽  
Adverse Neonatal Outcome ◽  
Follow Up Study

The adverse neonatal outcome is defined as the presence of birth asphyxia, respiratory distress, birth trauma, hypothermia, meconium aspiration syndrome, neonatal intensive care admission, and neonatal death. It is a major concern in developing countries, including Ethiopia. This study tried to identify predictors of adverse neonatal outcomes at selected public hospitals in Eastern Ethiopia. A hospital-based prospective follow-up study was conducted in three public hospitals in Eastern Ethiopia from June to October 2020. A total of 2,246 laboring women and neonates born at the hospitals were enrolled in the study. Data were collected through interviews, observation checklists, and clinical chart review. Reports were presented in relative risks with 95% CIs. The overall magnitude of adverse neonatal outcome was 20.97% (95% CI: 19.33- 22.71%). It was 24.3% for babies born through cesarean section (95% CI: 21.3%, 27.5). The presence of meconium in the amniotic fluid increased the risk for neonates delivered via cesarean section (ARR, 1.52 95% CI; 1.04, 2.22). Among neonates born via vaginal delivery, the risk of adverse neonatal outcome was higher among nullipara women (ARR, 1.42 95% CI; 1.02, 1.99) and among women diagnosed with abnormal labor or pregnancy such as APH, pre-eclampsia, obstructed labor, fetal distress, and mal-presentation at admission (ARR, 1.30 95%CI; 1.01, 1.67). The risk of adverse neonatal outcome was higher among babies born through the cesarian section than those born via vaginal delivery. Abnormal labor or pregnancy and being primiparous increased the risk of adverse neonatal outcome in vaginal delivery.

scholarly journals Umbilical artery thrombosis diagnosed at different gestational ages and fetal outcomes: a case series

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing Wei ◽  
Qiaoyun Li ◽  
Hongbo Zhai
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Close Monitoring ◽  
Ultrasound Scan ◽  
Umbilical Blood ◽  
Artery Thrombosis

Abstract Background Umbilical artery thrombosis is a rare complication of pregnancy strongly associated with poor fetal and perinatal outcomes, such as intrauterine asphyxia, fetal growth restriction, and stillbirth. Its pathogenesis remains unclear, and there is the added challenge of selecting an appropriate delivery time to achieve excellent neonatal outcomes. Methods Our Hospital is a critical maternal rescue center with approximately 7000 births annually. We present a series of 8 cases of umbilical artery thrombosis diagnosed at the hospital between Apr 1, 2018, and Jan 31, 2020. We identified the cases through a keyword search of the maternity and pathology information management systems. Results Three patients were diagnosed with a transabdominal ultrasound scan and hypoxia on fetal heart monitoring. All three patients had emergency cesarean section delivery. Four patients were observed closely for 5 to 13 weeks from initial detection by an ultrasound scan to delivery. Only one patient was diagnosed after vaginal delivery by Hematoxylin-eosin staining of umbilical cord sections. Seven patients had deliveries by cesarean section, and one patient had a vaginal delivery. All infants were born alive. Conclusions Umbilical artery thrombosis is a challenging and rare condition that can occur at different gestational ages, especially when diagnosed in the third trimester and accompanied by fetal growth restriction. Consequently, these patients require close monitoring of umbilical blood flow and fetal growth and intervention at the appropriate time to achieve an optimal outcome.

Abstract 057: Beyond Convenience: Video Visits Can Increase The Efficiency Of Preventive Care Delivery

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Neil M Kalwani ◽  
Katherine M Wang ◽  
Jahnavi Deb ◽  
Thomas Gold ◽  
Akhil Maddukuri ◽  
...  
Keyword(s):  
South Asian ◽  
Cardiometabolic Risk ◽  
Care Delivery ◽  
Preventive Cardiology ◽  
Level Data ◽  
Cardiology Clinic ◽  
Care Practices ◽  
Time Required ◽  
Operational Impacts

Introduction: In response to the COVID-19 pandemic, medical practices have expanded utilization of telehealth. Little is known about the operational impacts of transitioning from in-person to video visits in specialty clinics. In 2018, the Stanford South Asian Translational Heart Initiative (SSATHI), a preventive cardiology clinic focused on high-risk South Asian adults, introduced CardioClick, a program replacing in-person follow-up visits with video visits. Hypothesis: We hypothesized that implementation of video visits increased the efficiency of clinic operations. Methods: We extracted visit-level data from the EHR for 134 patients enrolled in CardioClick with video follow-up visits from June 14, 2018 to April 21, 2020 and a cohort of 276 patients enrolled in the in-person SSATHI prevention program with follow-up visits from September 11, 2014 to March 6, 2020. Results: Patients in CardioClick and the in-person cohort were similar in terms of age (mean 45 years), gender balance (23 vs 21% female), and cardiometabolic risk profiles. There were 181 video and 637 in-person follow-up visits. Video visits were shorter than in-person visits, both in terms of total clinic time [median 22 min (IQR 16, 29) vs 67 min (48, 100)] and provider time required [median 22 min (IQR 16, 29) vs 30 min (12, 58)]. Video visits were more likely to end on time (71 vs 11%, p<0.001). The median video visit ended on time while the median in-person visit ended 32 min late (13, 70) (see Figure). Providers were also more likely to complete video visit documentation the same day (56 vs 42%, p=0.001). Conclusions: In a preventive cardiology clinic, video follow-up visits required less clinic and provider time than in-person visits, were more likely to end on time, and were associated with increased same-day provider documentation completion. In conclusion, video visits offer benefits beyond their convenience and may increase the operational efficiency of specialty care practices focused on disease prevention, improving value in care delivery.

scholarly journals Pregnancy outcome during the bombing of Yugoslavia from Mart 24 to June 9, 1999

2006 ◽  
Vol 63 (4) ◽  
pp. 377-382 ◽  
Author(s):  
Dragan Krstic ◽  
Darko Marinkovic ◽  
Ljiljana Mirkovic ◽  
Jelena Krstic
Keyword(s):  
Cesarean Section ◽  
Pregnancy Outcome ◽  
Vaginal Delivery ◽  
Spontaneous Abortion ◽  
Perinatal Outcome ◽  
Lower Percentage ◽  
Previous Cesarean Section ◽  
Term Delivery ◽  
Duration Of Pregnancy ◽  
Previous Cesarean

Background/Aim. The aim of this study was to evaluate pregnancy outcome during the bombing of Yugoslavia in the period from March 24 to June 9, 1999. Methods. A retrospective study included a total of 81spontaneous abortion following XII gestation week, and 1448 deliveries, hospitalized in the regional hospital. The analyzed were: the incidence of spontaneous abortion, Cesarean section, post-term delivery, vaginal delivery following the previous Cesarean section within the period from March 24 to June 9, 1999, and compared to the same periods in 1998 and 2000 by the use of ?? and Kolgomorov-Smirnov tests. Results. Under the conditions of a three-month stress imposed by the bombing, significantly increased were the incidence of spontaneous abortion and vaginal delivery following the previous Cesarean section, while the incidence of Cesarean section and post-term delivery were decreased, but the incidence of perinatal outcome was paradoxically improved. The analysis of findings on admittance revealed that iterative Cesarean section was performed electively, close to the expected term of delivery, and vaginal delivery following the previous Cesarean section mainly two weeks before that term with the admittance finding confirming a high active stage pregnancy. Conclusions. Within the bombing, statistically significantly was increased the percentage of abortions after XII gestation week, and the biological duration of pregnancy was reduced. The reduced duration of pregnancy complete with the accelerated fetal mutation (also caused by the stress) resulted in better perinatal outcome, and statistically significantly lower percentage of Cesarean section.

scholarly journals Comparison of Perinatal Outcome of Breech Presentation between Vaginal Delivery and Cesarean Section

2016 ◽  
Vol 4 (1) ◽  
pp. 4 ◽  
Author(s):  
Buddhi Kumar Shrestha ◽  
Subha Shrestha
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Perinatal Outcome ◽  
College Teaching ◽  
Breech Presentation ◽  
Morbidity And Mortality ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Vaginal Deliveries ◽  
Significant Difference

Introduction: Many times, parturient opt for labour and vaginal breech delivery even after informing increased perinatal risks. Vaginal breech deliveries are undertaken with the reasons like avoidance of cesarean section in next pregnancy, null risk of operative and anesthetic hazards, ability to resume early all household works after vaginal birth, etc. The purpose of this study is to compare the perinatal outcome of breech deliveries in singleton breech presentation between vaginal breech delivery and cesarean section.   Methods: A retrospective study was done in Lumbini Medical College Teaching Hospital for the duration of one year (December 2014 to November 2015). Data of perinatal outcome of breech deliveries were collected from the hospital records. The records of neonatal examination were also collected. The primary outcomes included were neonatal morbidity and mortality.   Results: Out of 80 selected women with breech presentation, 42 of them had vaginal deliveries and 38 women had undergone caesarean section. The perinatal mortality was 4.8% and morbidity was 2% in vaginal breech deliveries. There was no significant difference of APGAR score in the two groups at any time. Similarly, there was no significant difference in perinatal morbidity and mortality in the two groups. Nulliparous women were more likely to deliver by Cesarean section.   Conclusion:  In places where planned vaginal delivery is a common practice and when strict criteria are met before and during labour, planned vaginal breech delivery of singleton fetus in breech presentation remains a safe option that can be offered to women.

Gamma Knife surgery for low-flow cavernous sinus dural arteriovenous fistulas

2010 ◽  
Vol 113 (Special_Supplement) ◽  
pp. 21-27 ◽  
Author(s):  
Hyun Ho Jung ◽  
Jong Hee Chang ◽  
Kum Whang ◽  
Jin Soo Pyen ◽  
Jin Woo Chang ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Cavernous Sinus ◽  
Transarterial Embolization ◽  
Gamma Knife Surgery ◽  
Low Flow ◽  
Close Monitoring ◽  
Arteriovenous Fistulas ◽  
Ocular Symptoms ◽  
Dural Arteriovenous Fistulas

Object The purpose of this study was to assess the efficacy of Gamma Knife surgery (GKS) for treating cavernous sinus dural arteriovenous fistulas (CSDAVFs). Methods Of the 4123 GKSs performed between May 1992 and March 2009, 890 procedures were undertaken to treat vascular lesions. In 24 cases, the vascular lesion that was treated was a dural arteriovenous fistula, and in 6 of these cases, the lesion involved the cavernous sinus. One of these 6 cases was lost to follow-up, leaving the other 5 cases (4 women and 1 man) to comprise the subjects of this study. All 5 patients had more than 1 ocular symptom, such as ptosis, chemosis, proptosis, and extraocular movement palsy. In all patients, CSDAVF was confirmed by conventional angiography. Three patients were treated by GKS alone and 2 patients were treated by GKS combined with transarterial embolization. The median follow-up period after GKS in these 5 cases was 30 months (range 9–59 months). Results All patients experienced clinical improvement, and their improvement in ocular symptoms was noticed at a mean of 17.6 weeks after GKS (range 4–24 weeks). Two patients received embolization prior to GKS but did not display improvement in ocular symptoms. An average of 20 weeks (range 12–24 weeks) was needed for complete improvement in clinical symptoms. There were no treatment-related complications during the follow-up period. Conclusions Gamma Knife surgery should be considered as a primary, combined, or additional treatment option for CSDAVF in selected cases, such as when the lesion is a low-flow shunt without cortical venous drainage. For those selected cases, GKS alone may suffice as the primary treatment method when combined with close monitoring of ocular symptoms and intraocular pressure.

scholarly journals Neurological Evaluation of Patients with Newly Diagnosed Coeliac Disease Presenting to Gastroenterologists: A 7-Year Follow-Up Study

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1846
Author(s):  
Marios Hadjivassiliou ◽  
Iain D. Croall ◽  
Richard A. Grünewald ◽  
Nick Trott ◽  
David S. Sanders ◽  
...  
Keyword(s):  
Coeliac Disease ◽  
Brain Imaging ◽  
Cerebellar Atrophy ◽  
Neurological Dysfunction ◽  
Close Monitoring ◽  
Newly Diagnosed ◽  
Positive Serology ◽  
Original Cohort ◽  
Follow Up Study

We have previously shown that 67% of patients with newly diagnosed coeliac disease (CD) presenting to gastroenterologists have evidence of neurological dysfunction. This manifested with headache and loss of co-ordination. Furthermore 60% of these patients had abnormal brain imaging. In this follow-up study, we re-examined and re-scanned 30 patients from the original cohort of 100, seven years later. There was significant reduction in the prevalence of headaches (47% to 20%) but an increase in the prevalence of incoordination (27% to 47%). Although those patients with coordination problems at baseline reported improvement on the gluten free diet (GFD), there were 7 patients reporting incoordination not present at baseline. All 7 patients had positive serology for one or more gluten-sensitivity related antibodies at follow-up. In total, 50% of the whole follow-up cohort were positive for one or more gluten-related antibodies. A comparison between the baseline and follow-up brain imaging showed a greater rate of cerebellar grey matter atrophy in the antibody positive group compared to the antibody negative group. Patients with CD who do not adhere to a strict GFD and are serological positive are at risk of developing ataxia, and have a significantly higher rate of cerebellar atrophy when compared to patients with negative serology. This highlights the importance of regular review and close monitoring.

OP270 Why The Haute Autorité de Santé Rejects the Widespread Use Of “Mini-Bypass”/One Anastomosis Gastric Bypass For Obesity In France

2020 ◽  
Vol 36 (S1) ◽  
pp. 4-4
Author(s):  
Jean-Charles Lafarge ◽  
Denis-Jean David ◽  
Cédric Carbonneil
Keyword(s):  
Esophageal Cancer ◽  
Gastric Bypass ◽  
Adverse Events ◽  
Severe Obesity ◽  
One Anastomosis Gastric Bypass ◽  
Close Monitoring ◽  
Efficacy And Safety ◽  
Multicenter Rct ◽  
Nutritional Complications

IntroductionOne anastomosis gastric bypass (OAGB) has become a widespread technique over the last few years in France, without any prior assessment and despite existing controversies among bariatric surgeons. An older bypass technique for treating obesity, the Roux-en-Y gastric bypass (RYGB), is available and reimbursed, having been assessed and approved for use in 2005. In 2019, the French Haute Autorité de Santé (HAS) assessed OAGB for the treatment of severe and massive obesity. This assessment, the first in the world, was undertaken for OAGBs carried out with a 200- or 150-centimeter biliopancreatic-limb (BP-limb) length.MethodsA systematic review (SR) of the literature and consultation of a working group consisting of both healthcare professionals (clinician and surgeons) and patients were carried out. The primary aim of our assessment was to determine whether the OAGB technique can replace RYGB. The efficacy and safety profile of OAGB was compared with RYGB in adult patients with massive, severe obesity. Complications and postoperative follow up specific to OAGB were identified.ResultsThe three selected randomized controlled trials (RCTs) could not confirm the superiority or the non-inferiority of OAGB, compared with RYGB, on the selected efficacy endpoints of weight loss, resolution of comorbidities, and quality of life. Adverse events reported for OAGB included severe nutritional complications and bile reflux that could potentially lead to lower esophageal cancer. In one RCT, the frequency of serious adverse events in the OAGB group was almost two times higher than in the RYGB group.ConclusionsHAS considered that OAGB carried out with a longer (200 centimeter) BP-limb is not a validated technique for the surgical treatment of massive, severe obesity. Thus, it cannot be considered an alternative to RYGB. There were insufficient data available on OAGB performed with a 150-centimeter BP-limb. Thus, HAS recommended undertaking a multicenter RCT to assess the efficacy and safety of OAGB. Patients who have already undergone OAGB should receive the same follow up as patients who have received RYGB, including close monitoring for nutritional complications and lower esophageal cancer and an endoscopic examination five years after surgery.

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