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[PMID]:29187935
[Au] Autor:Ennaqui K; Makayssi A; Boufettal H; Samouh N
[Ad] Endereço:Centre Hospitalier Universitaire Ibn Rochd, Faculty of Medecine and Pharmacy, Hassan II University of Casablanca, Morocco.
[Ti] Título:[Haemorrhagic stroke of the brainstem secondary to postpartum eclampsia: about a case and literature review].
[Ti] Título:Accident vasculaire cérébral hémorragique du tronc cérébral suite à une éclampsie du post partum: à propos d'un cas et revue de la littérature..
[So] Source:Pan Afr Med J;27:266, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:fre
[Ab] Resumo:Strokes are rare but severe accidents during pregnancy and post-partum period. They are responsible for high mortality and morbidity rates. Pre-eclampsia, eclampsia, and strokes are significantly related. Endothelial dysfunction, alteration of brain self-regulation and severe hypertension are, probably, the cause of many strokes in pregnant women and during postpartum period. We report a case of hemorrhagic stroke of the brainstem in a nonmonitored 21-year old patient at 38 weeks pregnant admitted with severe preeclampsia complicated by eclampsia and then by haemorrhagic stroke of the brainstem on the second post-operative day after cesarean section performed due to suspicion of retroplacental haematoma arisen since her admission. Intracerebral hemorrhage is a rare but severe complication in post-partum women. Several studies are underway to fill the gaps of knowledge involved in the management of pre-eclamptic patients with neurological complications.
[Mh] Termos MeSH primário: Eclampsia/fisiopatologia
Hemorragias Intracranianas/etiologia
Transtornos Puerperais/fisiopatologia
Acidente Vascular Cerebral/etiologia
[Mh] Termos MeSH secundário: Tronco Encefálico/patologia
Cesárea
Feminino
Seres Humanos
Período Pós-Parto
Pré-Eclâmpsia/fisiopatologia
Gravidez
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171219
[Lr] Data última revisão:
171219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.266.12288


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[PMID]:28797767
[Au] Autor:Dong XY; Bai CB; Nao JF
[Ad] Endereço:Department of Neurology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, China.
[Ti] Título:Clinical and radiological features of posterior reversible encephalopathy syndrome in patients with pre-eclampsia and eclampsia.
[So] Source:Clin Radiol;72(10):887-895, 2017 Oct.
[Is] ISSN:1365-229X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIM: To analyse and summarise clinical and radiological features among patients with posterior reversible encephalopathy syndrome (PRES), to assess related factors with eclampsia and pre-eclampsia, and to compare the different factors between cytotoxic and vasogenic oedema among PRES patients. MATERIALS AND METHODS: The clinical and radiological findings of 237 pre-eclamptic or eclamptic patients with neurological symptoms were evaluated retrospectively. Multiple logistic regression analyses were performed to compare the differences among these parameters. RESULTS: Seventy-six patients (32.07%) were diagnosed with PRES. Multiple logistic regression indicated that seizure (odds ratio [OR], 2.760; 95% confidence interval [CI]: 1.087-7.011; p=0.033), visual disturbances (OR=2.062 95%CI, 1.033-4.115; p=0.004), multiple production history (OR=3.637; 95% CI: 1.068-8.228; p=0.002) were independent risk factors for PRES. PRES+ (OR=3.217; 95%CI, 1.346-7.686; p=0.009), Visual disturbances (OR=4.283; 95% CI: 1.843-9.953; p=0.001) had strong association with eclampsia. Visual disturbances (OR=7.200; 95% CI: 2.116-24.496; p=0.002) had strong correlation with eclampsia among PRES+ patients. Visual disturbances (OR=2.947; 95% CI: 1.135-7.648; p=0.026) were independently related to cytotoxic oedema. CONCLUSIONS: Nearly one-third of pre-eclampsia or eclampsia patients with neurological symptoms have PRES. Visual disturbances, seizure, multiple production history are independent risk factors for PRES. Visual disturbances have a strong association with eclampsia whether patients have PRES or not. Visual disturbances are independently related to cytotoxic oedema among PRES+ patients.
[Mh] Termos MeSH primário: Eclampsia/diagnóstico
Imagem por Ressonância Magnética
Síndrome da Leucoencefalopatia Posterior/diagnóstico por imagem
Pré-Eclâmpsia/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Anticonvulsivantes/uso terapêutico
Anti-Hipertensivos/uso terapêutico
Encéfalo/diagnóstico por imagem
Diazepam/uso terapêutico
Eclampsia/terapia
Feminino
Seres Humanos
Labetalol/uso terapêutico
Sulfato de Magnésio/uso terapêutico
Neuroimagem/métodos
Fenitoína/uso terapêutico
Síndrome da Leucoencefalopatia Posterior/diagnóstico
Síndrome da Leucoencefalopatia Posterior/tratamento farmacológico
Pré-Eclâmpsia/terapia
Gravidez
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticonvulsants); 0 (Antihypertensive Agents); 6158TKW0C5 (Phenytoin); 7487-88-9 (Magnesium Sulfate); Q3JTX2Q7TU (Diazepam); R5H8897N95 (Labetalol)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170812
[St] Status:MEDLINE


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[PMID]:28797036
[Au] Autor:Kharkova OA; Grjibovski AM; Krettek A; Nieboer E; Odland JØ
[Ad] Endereço:Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
[Ti] Título:First-trimester smoking cessation in pregnancy did not increase the risk of preeclampsia/eclampsia: A Murmansk County Birth Registry study.
[So] Source:PLoS One;12(8):e0179354, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although prior studies have shown that smoking reduces preeclampsia/eclampsia risk, the consequence of giving up this habit during pregnancy should be assessed. The aims of the current study were threefold: (i) describe maternal characteristics of women with preeclampsia/eclampsia; (ii) examine a possible association between the number of cigarettes smoked daily during pregnancy and the development of this affliction; and (iii) determine if first-trimester discontinuation of smoking during pregnancy influences the risk. METHODS: A registry-based study was conducted using data from the Murmansk County Birth Registry (MCBR). It included women without pre-existing hypertension, who delivered a singleton infant during 2006-2011 and had attended the first antenatal visit before 12 week of gestation. We adjusted for potential confounders using logistic regression. RESULTS: The prevalence of preeclampsia/eclampsia was 8.3% (95%CI: 8.0-8.6). Preeclampsia/eclampsia associated with maternal age, education, marital status, parity, excessive weight gain and body mass index at the first antenatal visit. There was a dose-response relationship between the number of smoked cigarettes per day during pregnancy and the risk of preeclampsia/eclampsia (adjusted OR1-5 cig/day = 0.69 with 95%CI: 0.56-0.87; OR6-10 cig/day = 0.65 with 95%CI: 0.51-0.82; and OR≥11 cig/day = 0.49 with 95%CI: 0.30-0.81). There was no difference in this risk among women who smoked before and during pregnancy and those who did so before but not during pregnancy (adjusted OR = 1.10 with 95%CI: 0.91-1.32). CONCLUSIONS: Preeclampsia/eclampsia was associated with maternal age, education, marital status, parity, excessive weight gain, and body mass index at the first antenatal visit. There was a negative dose-response relationship between the number of smoked cigarettes per day during pregnancy and the odds of preeclampsia/eclampsia. However, women who gave up smoking during the first trimester of gestation had the same risk of preeclampsia/eclampsia as those who smoked while pregnant. Consequently, antenatal clinic specialists are advised to take these various observations into account when counselling women on smoking cessation during pregnancy.
[Mh] Termos MeSH primário: Eclampsia/epidemiologia
Pré-Eclâmpsia/epidemiologia
Fumar/efeitos adversos
Abandono do Uso de Tabaco
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Gravidez
Primeiro Trimestre da Gravidez
Fatores de Risco
Federação Russa/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170811
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0179354


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[PMID]:28704570
[Au] Autor:Bellizzi S; Sobel HL; Ali MM
[Ad] Endereço:UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
[Ti] Título:Signs of eclampsia during singleton deliveries and early neonatal mortality in low- and middle-income countries from three WHO regions.
[So] Source:Int J Gynaecol Obstet;139(1):50-54, 2017 Oct.
[Is] ISSN:1879-3479
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine the prevalence of eclampsia symptoms and to explore associations between eclampsia and early neonatal mortality. METHODS: The present secondary analysis included Demographic and Health Surveys data from 2005 to 2012; details of signs related to severe obstetric adverse events of singleton deliveries during interviewees' most recent delivery in the preceding 5 years were included. Data and delivery history were merged for pooled analyses. Convulsions-used as an indicator for having experienced eclampsia-and early neonatal mortality rates were compared, and a generalized random effect model, adjusted for heterogeneity between and within countries, was used to investigate the impact of presumed eclampsia on early neonatal mortality. RESULTS: The merged dataset included data from six surveys and 55 384 live deliveries that occurred in Colombia, Bangladesh, Indonesia, Mali, Niger, and Peru. Indications of eclampsia were recorded for 1.2% (95% confidence interval [CI] 1.0-1.3), 1.7% (95% CI 1.5-2.1), and 1.7% (95% CI 1.5-2.1) of deliveries reported from the American, South East Asian, and African regions, respectively. Pooled analyses demonstrated that eclampsia was associated with increased risk of early neonatal mortality (adjusted risk ratio 2.1 95% CI 1.4-3.2). CONCLUSION: Increased risk of early neonatal mortality indicates a need for strategies targeting the early detection of eclampsia and early interventions.
[Mh] Termos MeSH primário: Eclampsia/epidemiologia
Cuidado Pré-Natal/normas
[Mh] Termos MeSH secundário: Adolescente
Adulto
Estudos Transversais
Países em Desenvolvimento
Eclampsia/etiologia
Eclampsia/mortalidade
Feminino
Necessidades e Demandas de Serviços de Saúde
Inquéritos Epidemiológicos
Seres Humanos
Lactente
Mortalidade Infantil
Recém-Nascido
Serviços de Saúde Materno-Infantil
Área Carente de Assistência Médica
Meia-Idade
Gravidez
Resultado da Gravidez
Fatores Socioeconômicos
Organização Mundial da Saúde
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170714
[St] Status:MEDLINE
[do] DOI:10.1002/ijgo.12262


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[PMID]:28697093
[Au] Autor:Bernstein PS; Martin JN; Barton JR; Shields LE; Druzin ML; Scavone BM; Frost J; Morton CH; Ruhl C; Slager J; Tsigas EZ; Jaffer S; Menard MK
[Ad] Endereço:Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York; University of Mississippi, Jackson, Mississippi; Baptist Healthcare Lexington, Lexington, Kentucky; Marian Regional Medical Center, Santa Maria, California; Dignity Health, San Francisco, California; Stanford University, Stanford, California; the Society for Obstetric Anesthesia and Perinatology, Milwaukee, Wisconsin; the University of Chicago, Chicago, Illinois; the American Academy of Family Physicians, Leawood, Kansas; the California Maternal Quality Care Collaborative, Stanford, California; the Association of Women's Health, Obstetric and Neonatal Nurses, Washington, DC; the American College of Nurse-Midwives, Silver Spring, Maryland; Frontier Nursing University, Hyden, Kentucky; the Preeclampsia Foundation, Melbourne, Florida; the American College of Obstetricians and Gynecologists, Washington, DC; the Society for Maternal-Fetal Medicine; Washington, DC; and the University of North Carolina, Chapel Hill, North Carolina.
[Ti] Título:National Partnership for Maternal Safety: Consensus Bundle on Severe Hypertension During Pregnancy and the Postpartum Period.
[So] Source:Obstet Gynecol;130(2):347-357, 2017 Aug.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Complications arising from hypertensive disorders of pregnancy are among the leading causes of preventable severe maternal morbidity and mortality. Timely and appropriate treatment has the potential to significantly reduce hypertension-related complications. To assist health care providers in achieving this goal, this patient safety bundle provides guidance to coordinate and standardize the care provided to women with severe hypertension during pregnancy and the postpartum period. This is one of several patient safety bundles developed by multidisciplinary work groups of the National Partnership for Maternal Safety under the guidance of the Council on Patient Safety in Women's Health Care. These safety bundles outline critical clinical practices that should be implemented in every maternity care setting. Similar to other bundles that have been developed and promoted by the Partnership, the hypertension safety bundle is organized into four domains: Readiness, Recognition and Prevention, Response, and Reporting and Systems Learning. Although the bundle components may be adapted to meet the resources available in individual facilities, standardization within an institution is strongly encouraged. This commentary provides information to assist with bundle implementation.
[Mh] Termos MeSH primário: Consenso
Hipertensão Induzida pela Gravidez/terapia
Hipertensão/terapia
Obstetrícia/métodos
Complicações Cardiovasculares na Gravidez/terapia
Transtornos Puerperais/terapia
[Mh] Termos MeSH secundário: Anti-Hipertensivos/uso terapêutico
Eclampsia/diagnóstico
Eclampsia/terapia
Medicina Baseada em Evidências
Feminino
Seres Humanos
Hipertensão/prevenção & controle
Hipertensão Induzida pela Gravidez/diagnóstico
Hipertensão Induzida pela Gravidez/prevenção & controle
Obstetrícia/educação
Educação de Pacientes como Assunto
Pré-Eclâmpsia/diagnóstico
Pré-Eclâmpsia/terapia
Gravidez
Transtornos Puerperais/diagnóstico
Transtornos Puerperais/prevenção & controle
Triagem/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antihypertensive Agents)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170712
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002115


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[PMID]:28696959
[Au] Autor:Bernstein PS; Martin JN; Barton JR; Shields LE; Druzin ML; Scavone BM; Frost J; Morton CH; Ruhl C; Slager J; Tsigas EZ; Jaffer S; Menard MK
[Ad] Endereço:From the *Division of Maternal Fetal Medicine, †Department of Obstetrics and Gynecology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York; ‡University of Mississippi, Jackson, Mississippi; §Maternal-Fetal Medicine, Baptist Healthcare Lexington, Lexington, Kentucky; ‖Maternal Fetal Medicine, Marian Regional Medical Center, Santa Maria, California; ¶Perinatal Safety for Dignity Health, San Francisco, California; #Department of Obstetrics and Gynecology, Stanford University, Stanford, California; **Department of Anesthesia & Critical Care, ††Department of Obstetrics & Gynecology, University of Chicago, Chicago, Illinois; ‡‡Health of the Public and Science Division, American Academy of Family Physicians, Leawood, Kansas; §§California Maternal Quality Care Collaborative, Stanford, California; ‖‖Women's Health Programs, Association of Women's Health, Obstetric and Neonatal Nurses, Washington, DC; ¶¶American College of Nurse-Midwives, Silver Spring, Maryland; ##Frontier Nursing University, Hyden, Kentucky; ***Preeclampsia Foundation, Melbourne, Florida; †††American College of Obstetricians and Gynecologists, Washington, DC; ‡‡‡Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.
[Ti] Título:National Partnership for Maternal Safety: Consensus Bundle on Severe Hypertension During Pregnancy and the Postpartum Period.
[So] Source:Anesth Analg;125(2):540-547, 2017 Aug.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Complications arising from hypertensive disorders of pregnancy are among the leading causes of preventable severe maternal morbidity and mortality. Timely and appropriate treatment has the potential to significantly reduce hypertension-related complications. To assist health care providers in achieving this goal, this patient safety bundle provides guidance to coordinate and standardize the care provided to women with severe hypertension during pregnancy and the postpartum period. This is one of several patient safety bundles developed by multidisciplinary work groups of the National Partnership for Maternal Safety under the guidance of the Council on Patient Safety in Women's Health Care. These safety bundles outline critical clinical practices that should be implemented in every maternity care setting. Similar to other bundles that have been developed and promoted by the Partnership, the hypertension safety bundle is organized into four domains: Readiness, Recognition and Prevention, Response, and Reporting and Systems Learning. Although the bundle components may be adapted to meet the resources available in individual facilities, standardization within an institution is strongly encouraged. This commentary provides information to assist with bundle implementation.
[Mh] Termos MeSH primário: Eclampsia/diagnóstico
Obstetrícia/normas
Segurança do Paciente/normas
Hemorragia Pós-Parto/terapia
Período Pós-Parto
Pré-Eclâmpsia/diagnóstico
[Mh] Termos MeSH secundário: Medicina de Emergência
Medicina Baseada em Evidências
Feminino
Guias como Assunto
Pesquisa sobre Serviços de Saúde
Seres Humanos
Hipertensão/terapia
Obstetrícia/organização & administração
Pacientes Ambulatoriais
Hemorragia Pós-Parto/epidemiologia
Gravidez
Medição de Risco
Triagem
Estados Unidos
Saúde da Mulher
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170712
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002304


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[PMID]:28522319
[Au] Autor:Yee LM; Caughey AB; Cheng YW
[Ad] Endereço:Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL. Electronic address: lynn.yee@northwestern.edu.
[Ti] Título:Association between gestational weight gain and perinatal outcomes in women with chronic hypertension.
[So] Source:Am J Obstet Gynecol;217(3):348.e1-348.e9, 2017 Sep.
[Is] ISSN:1097-6868
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Gestational weight gain above or below the 2009 National Academy of Medicine guidelines has been associated with adverse maternal and neonatal outcomes. Although it has been well established that excess gestational weight gain is associated with the development of gestational hypertension and preeclampsia, the relationship between gestational weight gain and adverse perinatal outcomes among women with pregestational (chronic) hypertension is less clear. OBJECTIVE: The objective of this study was to examine the relationship between gestational weight gain above and below National Academy of Medicine guidelines and perinatal outcomes in a large, population-based cohort of women with chronic hypertension. STUDY DESIGN: This is a population-based retrospective cohort study of women with chronic hypertension who had term, singleton, vertex births in the United States from 2012 through 2014. Prepregnancy body mass index was calculated using self-reported prepregnancy weight and height. Women were categorized into 4 groups based on gestational weight gain and prepregnancy body mass index: (1) weight gain less than, (2) weight gain within, (3) weight gain 1-19 lb in excess of, and (4) weight gain ≥20 lb in excess of the National Academy of Medicine guidelines. The χ tests and multivariable logistic regression analysis were used for statistical comparisons. Stratified analyses by body mass index category were additionally performed. RESULTS: In this large birth cohort, 101,259 women met criteria for inclusion. Compared to hypertensive women who had gestational weight gain within guidelines, hypertensive women with weight gain ≥20 lb over National Academy of Medicine guidelines were more likely to have eclampsia (adjusted odds ratio, 1.93; 95% confidence interval, 1.54-2.42) and cesarean delivery (adjusted odds ratio, 1.60; 95% confidence interval, 1.50-1.70). Excess weight gain ≥20 lb over National Academy of Medicine guidelines was also associated with increased odds of 5-minute Apgar <7 (adjusted odds ratio, 1.29; 95% confidence interval, 1.13-1.47), neonatal intensive care unit admission (adjusted odds ratio, 1.23; 95% confidence interval, 1.14-1.33), and large-for-gestational-age neonates (adjusted odds ratio, 2.41; 95% confidence interval, 2.27-2.56) as well as decreased odds of small-for-gestational-age status (adjusted odds ratio, 0.52; 95% confidence interval, 0.46-0.58). Weight gain 1-19 lb over guidelines was associated with similar fetal growth outcomes although with a smaller effect size. In contrast, weight gain less than National Academy of Medicine guidelines was not associated with adverse maternal outcomes but was associated with increased odds of small for gestational age (adjusted odds ratio, 1.31; 95% confidence interval, 1.21-1.52) and decreased odds of large-for-gestational-age status (adjusted odds ratio, 0.86; 95% confidence interval, 0.81-0.92). Analysis of maternal and neonatal outcomes stratified by body mass index demonstrated similar findings. CONCLUSION: Women with chronic hypertension who gain less weight than National Academy of Medicine guidelines experience increased odds of small-for-gestational-age neonates, whereas excess weight gain ≥20 lb over National Academy of Medicine guidelines is associated with cesarean delivery, eclampsia, 5-minute Apgar <7, neonatal intensive care unit admission, and large-for-gestational-age neonates.
[Mh] Termos MeSH primário: Hipertensão/epidemiologia
Ganho de Peso
[Mh] Termos MeSH secundário: Adulto
Índice de Apgar
Peso ao Nascer
Cesárea/estatística & dados numéricos
Estudos de Coortes
Eclampsia/epidemiologia
Feminino
Seres Humanos
Recém-Nascido
Recém-Nascido Pequeno para a Idade Gestacional
Unidades de Terapia Intensiva
Unidades de Terapia Intensiva Neonatal
Admissão do Paciente/estatística & dados numéricos
Guias de Prática Clínica como Assunto
Gravidez
Estudos Retrospectivos
Estados Unidos/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170520
[St] Status:MEDLINE


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[PMID]:28302085
[Au] Autor:Bracco F; Masini M; De Tonetti G; Brogioni F; Amidani A; Monichino S; Maltoni A; Dato A; Grattarola C; Cordone M; Torre G; Launo C; Chiorri C; Celleno D
[Ad] Endereço:Department of Educational Sciences, University of Genoa, Corso A. Podestà, 2, 16128, Genoa, Italy. fabrizio.bracco@unige.it.
[Ti] Título:Adaptation of non-technical skills behavioural markers for delivery room simulation.
[So] Source:BMC Pregnancy Childbirth;17(1):89, 2017 Mar 17.
[Is] ISSN:1471-2393
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Simulation in healthcare has proved to be a useful method in improving skills and increasing the safety of clinical operations. The debriefing session, after the simulated scenario, is the core of the simulation, since it allows participants to integrate the experience with the theoretical frameworks and the procedural guidelines. There is consistent evidence for the relevance of non-technical skills (NTS) for the safe and efficient accomplishment of operations. However, the observation, assessment and feedback on these skills is particularly complex, because the process needs expert observers and the feedback is often provided in judgmental and ineffective ways. The aim of this study was therefore to develop and test a set of observation and rating forms for the NTS behavioural markers of multi-professional teams involved in delivery room emergency simulations (MINTS-DR, Multi-professional Inventory for Non-Technical Skills in the Delivery Room). METHODS: The MINTS-DR was developed by adapting the existing tools and, when needed, by designing new tools according to the literature. We followed a bottom-up process accompanied by interviews and co-design between practitioners and psychology experts. The forms were specific for anaesthetists, gynaecologists, nurses/midwives, assistants, plus a global team assessment tool. We administered the tools in five editions of a simulation training course that involved 48 practitioners. Ratings on usability and usefulness were collected. RESULTS: The mean ratings of the usability and usefulness of the tools were not statistically different to or higher than 4 on a 5-point rating scale. In either case no significant differences were found across professional categories. CONCLUSION: The MINTS-DR is quick and easy to administer. It is judged to be a useful asset in maximising the learning experience that is provided by the simulation.
[Mh] Termos MeSH primário: Competência Clínica
Eclampsia/terapia
Emergências
Equipe de Assistência ao Paciente
Hemorragia Pós-Parto/terapia
Convulsões/terapia
Treinamento por Simulação
Inércia Uterina/terapia
[Mh] Termos MeSH secundário: Adulto
Anestesiologia/educação
Cognição
Comunicação
Salas de Parto
Feminino
Feedback Formativo
Seres Humanos
Relações Interprofissionais
Masculino
Enfermagem Materno-Infantil/educação
Meia-Idade
Tocologia/educação
Obstetrícia/educação
Hemorragia Pós-Parto/etiologia
Gravidez
Convulsões/etiologia
Habilidades Sociais
Hemorragia Uterina/terapia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170318
[St] Status:MEDLINE
[do] DOI:10.1186/s12884-017-1274-z


  9 / 3033 MEDLINE  
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Cecatti, José Guilherme
Texto completo
[PMID]:28301493
[Au] Autor:Lotufo FA; Parpinelli MA; Osis MJ; Surita FG; Costa ML; Cecatti JG
[Ad] Endereço:Department of Obstetrics and Gynecology, School of Medical Sciences of the University of Campinas, Campinas, State of São Paulo, Brazil.
[Ti] Título:Obstetrician's risk perception on the prescription of magnesium sulfate in severe preeclampsia and eclampsia: A qualitative study in Brazil.
[So] Source:PLoS One;12(3):e0172602, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Magnesium sulfate (MgSO4) is the drug of choice for the prevention and control of seizures in the management of severe preeclampsia/eclampsia. Several barriers have been identified in the use of MgSO4, especially in low and middle-income settings. OBJECTIVE: To describe the obstetrician's perception on possible reasons for underutilizing magnesium sulfate to treat preeclampsia/eclampsia. METHOD: A qualitative clinical study, based on phenomenological reference by semi-structured interviews and open-ended discussions with obstetricians of the public healthcare system in primary care units (PCU) and referral maternity hospitals (RMH), in a southeastern Brazilian city. RESULTS: Fear of drug toxicity was the major cause for not prescribing the medication in PCU. Fear was justified by insufficient technical, structural and organizational resources of healthcare facilities and by a shortage of physicians properly trained for adequate drug use. CONCLUSION: Fear of toxicity of magnesium sulfate was the main barrier towards timely and proper drug use. Periodic skill development and training of obstetricians, along with integration of the medical team in the work environment may contribute to decrease fear, ensuring safety of drug prescription and thus possibly reducing adverse outcomes related to PE.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Eclampsia/tratamento farmacológico
Sulfato de Magnésio/uso terapêutico
Obstetrícia/recursos humanos
Pré-Eclâmpsia/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Brasil
Feminino
Seres Humanos
Masculino
Meia-Idade
Gravidez
Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
7487-88-9 (Magnesium Sulfate)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170317
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0172602


  10 / 3033 MEDLINE  
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[PMID]:28288576
[Au] Autor:Gudu W
[Ad] Endereço:Department of Obstetrics & Gynecology, Karamara General Hospital/Jigjiga University, P.O.Box: 238, Jigjiga, Somali Regional State, Ethiopia. wondgu@yahoo.com.
[Ti] Título:Prodromal symptoms, health care seeking in response to symptoms and associated factors in eclamptic patients.
[So] Source:BMC Pregnancy Childbirth;17(1):87, 2017 Mar 14.
[Is] ISSN:1471-2393
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Eclampsia is one of the leading causes of maternal death worldwide. Maternal catastrophe is made worse in developing countries by the high incidence coupled with delayed presentation of patients and health facility constraints in effective management of eclampsia and its complications. METHODS: A prospective study of all 93 eclamptic women admitted to a general hospital in Somali regional state, Ethiopia was conducted between May 1, 2014 and April 30, 2015 using a structured questionnaire which included socio-demographic data, antenatal visit status, distance of nearest maternal health facility, timing of convulsions, questions related to symptoms preceding seizures; health care seeking for the symptoms and time interval from prodromal symptoms to the diagnosis of eclampsia. Descriptive statistics and multivariable logistic regression analyses were conducted. Statistical tests were done at a level of significance of P < 0.05. RESULTS: There were 93 cases of eclampsia among 3500 deliveries with an incidence of 2.7%. The timing of Eclampsia was antepartum in 57 (61.3%); intrapartum in 26 (28.0%) and postpartum in 10 (10.7%). Most (63%) were not having any antenatal care (ANC) follow up. Precedent symptoms were reported in 73 (79.0%) of the mothers with severe head ache in 70 (75.0%); visual disturbance in 44 (47%) and epigastric pain in 17 (18.0%). The frequency of symptoms was not influenced by the timing of eclampsia and degree of hypertension and prodromal symptoms were reported in 80% of the patients with severe hypertension. The mean duration of prodromal symptoms before patients were diagnosed with eclampsia was 5.5 days. Only 19/73 (26.0%) of the patients with prodromal symptoms visited a health facility for their complaints prior to developing eclampsia. The diagnosis of hypertensive disorder of pregnancy was made in 8 (42.0%) of these patients. Independent predictors of failure to seek health care in response to preceding symptoms were: rural residence (p-value < 0.001) and distance of maternal health facility of > 5km (p-value < 0.01). CONCLUSIONS: Precedent symptoms were reported in most women. But many patients present late in response to these warning signs of eclampsia. Improving awareness of prodromal symptoms of eclampsia and timely health care seeking; providing ANC advises on danger signs of eclampsia in the socio-cultural context of the community; ensuring access to ANC services for rural mothers, and administration of anticonvulsants for all women with prodromal symptoms are recommended.
[Mh] Termos MeSH primário: Eclampsia/diagnóstico
Comportamentos Relacionados com a Saúde
Acesso aos Serviços de Saúde
Aceitação pelo Paciente de Cuidados de Saúde
Sintomas Prodrômicos
[Mh] Termos MeSH secundário: Dor Abdominal/etiologia
Dor Abdominal/fisiopatologia
Adulto
Estudos Transversais
Eclampsia/epidemiologia
Eclampsia/fisiopatologia
Etiópia/epidemiologia
Feminino
Cefaleia/etiologia
Cefaleia/fisiopatologia
Seres Humanos
Incidência
Modelos Logísticos
Análise Multivariada
Gravidez
Cuidado Pré-Natal/utilização
Estudos Prospectivos
População Rural/estatística & dados numéricos
Convulsões/etiologia
Convulsões/fisiopatologia
Inquéritos e Questionários
Fatores de Tempo
Transtornos da Visão/etiologia
Transtornos da Visão/fisiopatologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170315
[St] Status:MEDLINE
[do] DOI:10.1186/s12884-017-1272-1



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