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[PMID]:29444394
[Ti] Título:Hearing loss after spinal anesthesia : A comparative prospective randomized cohort study.
[So] Source:Acta Anaesthesiol Belg;67(2):87-95, 2016.
[Is] ISSN:0001-5164
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: In this comparative randomized cohort study, we aimed at evaluating the occurrence of sensorineural hearing loss after general and spinal anesthesia using both subjective and objective tests. MATERIAL AND METHODS: Fifty patients scheduled for elective cesarean section were approached, of which 21 patients received spinal anesthesia (group S), and 16 patients received general anesthesia (group G). In group S, a 27 G pencil point spinal needle was used. Pure tone audiometry and Distortion Product OtoAcoustic Emissions (DPOAE) were performed before and 48 hours after surgery. RESULTS: No between-group significant difference in pre and postoperative audiometric hearing threshold and pure tone average value were noticed, as well as in pre and postoperative DPOAE amplitude and signal-to-noise ratio (SNR). CONCLUSION: In this study, we did not observe any hearing loss after cesarean section under general or spinal anesthesia. Using the non-traumatic 27 gauge pencil point needle for performing spinal anesthesia does not seem to be associated with a risk of hearing loss, similarly to general anesthesia.
[Mh] Termos MeSH primário: Anestesia Obstétrica/efeitos adversos
Raquianestesia/efeitos adversos
Perda Auditiva Neurossensorial/etiologia
[Mh] Termos MeSH secundário: Adulto
Anestesia Geral
Audiometria de Tons Puros
Cesárea
Feminino
Seres Humanos
Emissões Otoacústicas Espontâneas
Gravidez
Estudos Prospectivos
Razão Sinal-Ruído
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE


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[PMID]:29367432
[Au] Autor:Boatin AA; Schlotheuber A; Betran AP; Moller AB; Barros AJD; Boerma T; Torloni MR; Victora CG; Hosseinpoor AR
[Ad] Endereço:Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
[Ti] Título:Within country inequalities in caesarean section rates: observational study of 72 low and middle income countries.
[So] Source:BMJ;360:k55, 2018 01 24.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To provide an update on economic related inequalities in caesarean section rates within countries. DESIGN: Secondary analysis of demographic and health surveys and multiple indicator cluster surveys. SETTING: 72 low and middle income countries with a survey conducted between 2010 and 2014 for analysis of the latest situation of inequality, and 28 countries with a survey also conducted between 2000 and 2004 for analysis of the change in inequality over time. PARTICIPANTS: Women aged 15-49 years with a live birth during the two or three years preceding the survey. MAIN OUTCOME MEASURES: Data on caesarean section were disaggregated by asset based household wealth status and presented separately for five subgroups, ranging from the poorest to the richest fifth. Absolute and relative inequalities were measured using difference and ratio measures. The pace of change in the poorest and richest fifths was compared using a measure of excess change. RESULTS: National caesarean section rates ranged from 0.6% in South Sudan to 58.9% in the Dominican Republic. Within countries, caesarean section rates were lowest in the poorest fifth (median 3.7%) and highest in the richest fifth (median 18.4%). 18 out of 72 study countries reported a difference of 20 percentage points or higher between the richest and poorest fifth. The highest caesarean section rates and greatest levels of absolute inequality were observed in countries from the region of the Americas, whereas countries from the African region had low levels of caesarean use and comparatively lower levels of absolute inequality, although relative inequality was quite high in some countries. 26 out of 28 countries reported increases in caesarean section rates over time. Rates tended to increase faster in the richest fifth (median 0.9 percentage points per year) compared with the poorest fifth (median 0.2 percentage points per year), indicating an increase in inequality over time in most of these countries. CONCLUSIONS: Substantial within country economic inequalities in caesarean deliveries remain. These inequalities might be due to a combination of inadequate access to emergency obstetric care among the poorest subgroups and high levels of caesarean use without medical indication in the richest subgroups, especially in middle income countries. Country specific strategies should address these inequalities to improve maternal and newborn health.
[Mh] Termos MeSH primário: Cesárea/estatística & dados numéricos
Países em Desenvolvimento
Disparidades em Assistência à Saúde/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Seres Humanos
Meia-Idade
Fatores Socioeconômicos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k55


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[PMID]:29325263
[Au] Autor:Yu L; Tang M; Fan XH; Du HM; Tang H; Chen P; Xing SL; Su CH; Chen DJ
[Ad] Endereço:Department of Obstetrics, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China.
[Ti] Título:[Analysis of 2 204 stillbirths in 11 hospitals of Guangdong province].
[So] Source:Zhonghua Fu Chan Ke Za Zhi;52(12):805-810, 2017 Dec 25.
[Is] ISSN:0529-567X
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To analyze the incidence and causes of stillbirth in 11 hospitals of Guangdong province, and to explore the appropriate interventions. Clinical data of stillbirth in 11 hospitals of Guangdong province were collected from January 2014 to December 2016. The gestational weeks, causes, maternal conditions and other factors were analyzed. (1) From 2014 to 2016, 103 472 newborns were delivered in the 11 hospitals, and the number of stillbirth was 2 204, with the incidence of 2.13%. Among them, 0.71%(738/103 472) was therapeutic induction, 1.42%(1 066/103 472) was natural stillbirth. At different gestational age (<28 weeks, 28-<37 weeks and ≥37 weeks), the incidence of stillbirth was 55.63% (1 226/2 204), 28.45% (627/2 204) and 15.92% (351/2 204), respectively, with statistically significant difference ( 0.01). (2) For stillbirth<28 weeks, the first reason was therapeutic induction, accounting for 53.34% (654/1 226). For stillbirth during 28-37 weeks, pre-eclampsia was the major cause, accounting for 40.67% (255/627). And for full-term stillbirth, the causes were umbilical cord factors (19.37%, 68/351), abnormal labor (17.09%, 60/351). (3) In all the stillbirth cases, the incidence of fetal growth restriction (FGR) 28 weeks was significantly higher than that during 28-37 weeks [23.49% (288/1 226) vs 18.02% (113/627) , 0.01]. (4) The stillbirth rate during labor was significantly higher in women ≥35 years old than in younger women [63.88% (191/299) vs 36.12% (108/299) ; χ(2)=9.346, 0.000]. For the causes of stillbirth during labor, the incidence of severe maternal obstetrical complications [61.11% (33/54) vs 38.89% (21/54) ; χ(2)=3.323, 0.002], abnormal labor [65.82% (52/79) vs 34.18% (27/79) ; χ(2)=4.067, 0.001] and abnormal fetal position [66.63% (26/39) vs 33.37% (13/39) ; χ(2)=3.002, 0.013] were higher in women ≥35 years old than in younger women. (5) Cesarean section during labor accounted for 33.77% (101/299) of stillbirth, including 76 cases of emergency cesarean section or converted to cesarean section during labor. (1) The incidence of stillbirth in the 11 hospitals is high, and the causes are different at different gestational ages, therefore, different interventions are needed to reduce the incidence in different gestational weeks. Supervision of therapeutic induction should be strengthened <28 gestational weeks; standard management of pregnancy might decrease the occurrence of natural death ≥28 weeks. (2) Attention should be paid to fetal body weight during pregnancy, especially FGR. (3) The stillbirth rate is high in elderly pregnant women, so it is important to strengthen the management of the elderly pregnant women.
[Mh] Termos MeSH primário: Distocia/epidemiologia
Retardo do Crescimento Fetal/epidemiologia
Pré-Eclâmpsia/epidemiologia
Natimorto/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Cesárea
China/epidemiologia
Feminino
Retardo do Crescimento Fetal/etiologia
Idade Gestacional
Hospitais
Seres Humanos
Incidência
Recém-Nascido
Trabalho de Parto
Gravidez
Cuidado Pré-Natal
Natimorto/etnologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180112
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0529-567x.2017.12.003


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[PMID]:29215512
[Au] Autor:Gibbs Pickens CM; Kramer MR; Howards PP; Badell ML; Caughey AB; Hogue CJ
[Ad] Endereço:Department of Epidemiology, Rollins School of Public Health, and Laney Graduate School and the Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia; and the Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon.
[Ti] Título:Term Elective Induction of Labor and Pregnancy Outcomes Among Obese Women and Their Offspring.
[So] Source:Obstet Gynecol;131(1):12-22, 2018 Jan.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate whether elective induction of labor between 39 through 41 weeks of gestation, as compared with expectant management, is associated with reduced cesarean delivery and other adverse outcomes among obese women and their offspring. METHODS: We conducted a retrospective cohort study using the 2007-2011 California Linked Patient Discharge Data-Birth Cohort File of 165,975 singleton, cephalic, nonanomalous deliveries to obese women. For each gestational week (39-41), we used multivariable logistic regression models, stratified by parity, to assess whether elective induction of labor or expectant management was associated with lower odds of cesarean delivery and other adverse outcomes. RESULTS: At 39 and 40 weeks of gestation, cesarean delivery was less common in obese nulliparous women who were electively induced compared with those who were expectantly managed (at 39 weeks of gestation, frequencies were 35.9% vs 41.0%, respectively [P<.05]; adjusted odds ratio [OR] 0.82, 95% CI 0.77-0.88). Severe maternal morbidity was less frequent among electively induced obese nulliparous patients (at 39 weeks of gestation, 5.6% vs 7.6% [P<.05]; adjusted OR 0.75, 95% CI 0.65-0.87). Neonatal intensive care unit admission was less common among electively induced obese nulliparous women (at 39 weeks of gestation, 7.9% vs 10.1% [P<.05]; adjusted OR 0.79, 95% CI 0.70-0.89). Patterns were similar among obese parous women at 39 weeks of gestation (crude frequencies and adjusted ORs [95% CIs] were as follows: for cesarean delivery, 7.0% vs 8.7% [P<.05] and 0.79 [0.73-0.86]; for severe maternal morbidity, 3.3% vs 4.0% [P<.05] and 0.83 [0.74-0.94]; for neonatal intensive care unit admission: 5.3% vs 7.4% [P<.05] and 0.75 [0.68-0.82]). Similarly, elective induction at 40 weeks of gestation was associated with reduced odds of cesarean delivery, maternal morbidity, and neonatal intensive care unit admission among both obese nulliparous and parous patients. CONCLUSION: Elective labor induction after 39 weeks of gestation was associated with reduced maternal and neonatal morbidity among obese women. Further prospective investigation is necessary.
[Mh] Termos MeSH primário: Cesárea/estatística & dados numéricos
Procedimentos Cirúrgicos Eletivos
Saúde do Lactente
Trabalho de Parto Induzido/métodos
Obesidade/complicações
Resultado da Gravidez
[Mh] Termos MeSH secundário: Adulto
Índice de Massa Corporal
Estudos de Coortes
Feminino
Idade Gestacional
Seres Humanos
Recém-Nascido
Trabalho de Parto
Modelos Logísticos
Análise Multivariada
Obesidade/diagnóstico
Razão de Chances
Gravidez
Estudos Retrospectivos
Medição de Risco
Estados Unidos
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002408


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[PMID]:29208652
[Au] Autor:Mullins E; Lees C; Brocklehurst P
[Ad] Endereço:Imperial College London, London, UK.
[Ti] Título:Is continuous electronic fetal monitoring useful for all women in labour?
[So] Source:BMJ;359:j5423, 2017 12 05.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Cardiotocografia
Sofrimento Fetal/diagnóstico
Trabalho de Parto
[Mh] Termos MeSH secundário: Cesárea/efeitos adversos
Feminino
Seres Humanos
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5423


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[PMID]:29480840
[Au] Autor:De Nola R; Di Naro E; Schonauer LM; Lucarelli G; Battaglia M; Fiore MG; Mastrolia SA; Loverro G
[Ad] Endereço:Department of Biomedical Sciences and Human Oncology, Gynaecologic and Obstetrics Clinic.
[Ti] Título:Clinical management of a unique case of PNET of the uterus during pregnancy, and review of the literature.
[So] Source:Medicine (Baltimore);97(2):e9505, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: PNETs (primitive neuroectodermal tumors) are a family of highly malignant neoplasms characterized by small round cells of neuroepithelial origin. They usually involve bone and soft tissues, and have a higher incidence in childhood. PATIENT CONCERNS: In this case report, we describe the obstetric and oncological outcome of a huge mass diagnosed as a leiomyoma in a 39-year-old pregnant woman who complained of low back pain, dysuria, and urinary frequency at 22 weeks of gestation. DIAGNOSES: During the 25th week of pregnancy, the patient was referred to our hospital at night with severe anemia and suspected hemoperitoneum. She underwent an emergency caesarean section, delivering a female fetus weighing 400 g, with an Apgar score of 7 at 1 minute and 9 at 5 minutes. INTERVENTION: During surgery, we found a huge uterine sarcoma-like metastatic tumor, invading the pelvic peritoneum and parametria bilaterally; the adnexae seemed disease-free. We performed a type B radical hysterectomy, bilateral salpingo-oophorectomy, pelvic peritonectomy, omentectomy, appendectomy, and excision of a bulky lymph node. Seven days after delivery, staging computed tomography (CT) scan demonstrated a large lombo-aortic lymph node compressing the left renal vein and we completed debulking with a second surgery, including diaphragmatic peritonectomy and excision of a huge lymph node by lombo-aortic lymphadenectomy, requiring partial reconstruction of an infiltrated renal vein. OUTCOME: Ten days after the second surgery, echo-color Doppler showed a regular microcirculation in the left kidney. The patient was discharged after 10 days, and the baby after 1 month, both in good health.Histological examination revealed a uterine body cPNET (central primitive neuroectodermal tumor) orienting the clinical management toward chemotherapy with cisplatin and etoposide. LESSONS: PNETs are aggressive neoplasms, usually diagnosed at an advanced stage. Due to their low incidence, universally accepted guidelines are still unavailable. Radical surgery leaving no macroscopic residual disease is mandatory in advanced stages. A good fertility-sparing procedure can be performed only in young women at early stages of disease, when the wish for childbearing is not yet fulfilled.
[Mh] Termos MeSH primário: Tumores Neuroectodérmicos Primitivos/cirurgia
Complicações Neoplásicas na Gravidez/cirurgia
Neoplasias Uterinas/cirurgia
[Mh] Termos MeSH secundário: Adulto
Cesárea
Serviços Médicos de Emergência
Feminino
Seres Humanos
Recém-Nascido
Tumores Neuroectodérmicos Primitivos/diagnóstico por imagem
Tumores Neuroectodérmicos Primitivos/tratamento farmacológico
Tumores Neuroectodérmicos Primitivos/patologia
Gravidez
Complicações Neoplásicas na Gravidez/diagnóstico por imagem
Complicações Neoplásicas na Gravidez/tratamento farmacológico
Complicações Neoplásicas na Gravidez/patologia
Neoplasias Uterinas/diagnóstico por imagem
Neoplasias Uterinas/tratamento farmacológico
Neoplasias Uterinas/patologia
Útero/diagnóstico por imagem
Útero/patologia
Útero/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180227
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009505


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[PMID]:29326175
[Au] Autor:Norman JE; Stock SJ
[Ad] Endereço:Tommy's Centre for Maternal and Fetal Health, MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK jane.norman@ed.ac.uk.
[Ti] Título:Birth options after a caesarean section.
[So] Source:BMJ;360:j5737, 2018 01 11.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Cesárea/psicologia
Parto/psicologia
Nascimento Vaginal Após Cesárea/psicologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Gravidez
Prova de Trabalho de Parto
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5737


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[PMID]:29450525
[Au] Autor:Daw JR; Sommers BD
[Ad] Endereço:Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
[Ti] Título:Association of the Affordable Care Act Dependent Coverage Provision With Prenatal Care Use and Birth Outcomes.
[So] Source:JAMA;319(6):579-587, 2018 02 13.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: The effect of the Affordable Care Act (ACA) dependent coverage provision on pregnancy-related health care and health outcomes is unknown. Objective: To determine whether the dependent coverage provision was associated with changes in payment for birth, prenatal care, and birth outcomes. Design, Setting, and Participants: Retrospective cohort study, using a differences-in-differences analysis of individual-level birth certificate data comparing live births among US women aged 24 to 25 years (exposure group) and women aged 27 to 28 years (control group) before (2009) and after (2011-2013) enactment of the dependent coverage provision. Results were stratified by marital status. Main Exposures: The dependent coverage provision of the ACA, which allowed young adults to stay on their parent's health insurance until age 26 years. Main Outcomes and Measures: Primary outcomes were payment source for birth, early prenatal care (first visit in first trimester), and adequate prenatal care (a first trimester visit and 80% of expected visits). Secondary outcomes were cesarean delivery, premature birth, low birth weight, and infant neonatal intensive care unit (NICU) admission. Results: The study population included 1 379 005 births among women aged 24-25 years (exposure group; 299 024 in 2009; 1 079 981 in 2011-2013), and 1 551 192 births among women aged 27-28 years (control group; 325 564 in 2009; 1 225 628 in 2011-2013). From 2011-2013, compared with 2009, private insurance payment for births increased in the exposure group (36.9% to 35.9% [difference, -1.0%]) compared with the control group (52.4% to 51.1% [difference, -1.3%]), adjusted difference-in-differences, 1.9 percentage points (95% CI, 1.6 to 2.1). Medicaid payment decreased in the exposure group (51.6% to 53.6% [difference, 2.0%]) compared with the control group (37.4% to 39.4% [difference, 1.9%]), adjusted difference-in-differences, -1.4 percentage points (95% CI, -1.7 to -1.2). Self-payment for births decreased in the exposure group (5.2% to 4.3% [difference, -0.9%]) compared with the control group (4.9% to 4.3% [difference, -0.5%]), adjusted difference-in-differences, -0.3 percentage points (95% CI, -0.4 to -0.1). Early prenatal care increased from 70% to 71.6% (difference, 1.6%) in the exposure group and from 75.7% to 76.8% (difference, 0.6%) in the control group (adjusted difference-in-differences, 0.6 percentage points [95% CI, 0.3 to 0.8]). Adequate prenatal care increased from 73.5% to 74.8% (difference, 1.3%) in the exposure group and from 77.5% to 78.8% (difference, 1.3%) in the control group (adjusted difference-in-differences, 0.4 percentage points [95% CI, 0.2 to 0.6]). Preterm birth decreased from 9.4% to 9.1% in the exposure group (difference, -0.3%) and from 9.1% to 8.9% in the control group (difference, -0.2%) (adjusted difference-in-differences, -0.2 percentage points (95% CI, -0.3 to -0.03). Overall, there were no significant changes in low birth weight, NICU admission, or cesarean delivery. In stratified analyses, changes in payment for birth, prenatal care, and preterm birth were concentrated among unmarried women. Conclusions and Relevance: In this study of nearly 3 million births among women aged 24 to 25 years vs those aged 27 to 28 years, the Affordable Care Act dependent coverage provision was associated with increased private insurance payment for birth, increased use of prenatal care, and modest reduction in preterm births, but was not associated with changes in cesarean delivery rates, low birth weight, or NICU admission.
[Mh] Termos MeSH primário: Cobertura do Seguro
Reembolso de Seguro de Saúde/estatística & dados numéricos
Patient Protection and Affordable Care Act
Resultado da Gravidez
Cuidado Pré-Natal/utilização
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Cesárea/estatística & dados numéricos
Feminino
Seres Humanos
Recém-Nascido de Baixo Peso
Cobertura do Seguro/estatística & dados numéricos
Seguro Saúde
Unidades de Terapia Intensiva Neonatal
Modelos Lineares
Medicaid/estatística & dados numéricos
Gravidez
Nascimento Prematuro/epidemiologia
Cuidado Pré-Natal/economia
Estudos Retrospectivos
Estados Unidos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180217
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2018.0030


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[PMID]:29424513
[Au] Autor:Cardona-Osuna ME; Avila-Vergara MA; Peraza-Garay F; Meneses-Valderrama V; Flores-Pompa E; Corrales-López A
[Ti] Título:[Comparison of pregnancy outcomes Caesarean techniques: modified Misgav-Ladach, Pfannenstiel-Kerr and Kerr-half infraumbilical].
[Ti] Título:Comparación de resultados obstétricos de las técnicas de cesárea: Misgav-Ladach modificada, Pfannenstiel-Kerr y media infraumbilical-Kerr..
[So] Source:Ginecol Obstet Mex;84(8):514-22, 2016 08.
[Is] ISSN:0300-9041
[Cp] País de publicação:Mexico
[La] Idioma:spa
[Ab] Resumo:Background: In Mexico, the prevalence of caesarean section is 40.9% in the health sector, the techniques used are the traditional Pfannenstiel-Kerr and Kerr-half infraumbilical and little experience with this new technique Misgav-Ladach modified. Objetive: To compare pregnancy outcomes (surgical and fetal extraction time, bleeding, postoperative pain, surgical wound infection, maternal and fetal death) caesarean section techniques modified Misgav-Ladach, Pfannenstiel-Kerr and infraumbilical. Material and method: Clinical trial in primiparous women with term pregnancy treated at the Medical Unit of High Specialty 23 of the Mexican Social Security Institute, Monterrey, Nuevo Leon, Mexico. Misgav-Ladach caesarean Caesarean modified and Kerr, the latter subdivided into two groups: infraumbilical Pfannenstiel incision and incision half-Kerr two groups patients were randomized. Results: 137 gilts were studied, with term pregnancy and BMI between 19 and 24.9 kg / m2. Caesarean modified Misgav-Ladach 68 patients and 69 classical Kerr (35 Pfannenstiel-Kerr and 34 infraumbilical) was performed. The surgical time in minutes was lower with modified Misgav-Ladach: 27.8 ± 8.0, Pfannenstiel-Kerr recorded 51.7 ± 12.1 and 12.0 ± infraumbilical media48.3 (p = 0.000). The time in seconds fetal extraction was lower in modified Misgav-Ladach: 96.2 ± 68.3, 474.9 ± Pfannenstiel-Kerr 294.1 and 423.2 ± 398.6 infraumbilical (p = 0.000). The trasoperatory milliliters bleeding was lower with modified Misgav-Ladach: 298.5 ± 57.3, 354.3 ± Pfannenstiel-Kerr 98.0 and 355.9 ± 110.6 infraumbilical (p = 0.001). Postoperative pain assessed with the visual analog scale in the first 24 hours was lower with modified Misgav-Ladach: 4.4 ± 1.9, 5.7 ± Pfannenstiel-Kerr and IK 2.1 6.1 ± 2.0 (p = 0.000). The start of the oral route and ambulation Nwas soon comparing modified Misgav-Ladach against Pfannenstiel-Kerr and Kerr-infraumbilical (p = 0.000). The prevalence of fever was 5.9% with modified Misgav-Ladach, 5.9% Pfannenstiel-Kerr and 32.4% withinfraumbilical-Kerr (p = 001). The discharge in hours was modified Misgav-Ladach ± 45.8 to 12.1 h, Pfannenstiel-Kerr 49.3 ± 12.3 h and 58.5 infraumbilical-Kerr ± 21.5 h (p = .000). In this study no maternal or fetal deaths were observed. Conclusion: Surgical time, bleeding, postoperative pain, better postoperative recovery and shorter hospital stays and less infection were significantly lower than with conventional techniques of caesarean Nsection or infraumbilical-Kerr technique.
[Mh] Termos MeSH primário: Cesárea/métodos
Dor Pós-Operatória/epidemiologia
Resultado da Gravidez
Infecção da Ferida Cirúrgica/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Índice de Massa Corporal
Feminino
Seres Humanos
Tempo de Internação
México
Duração da Cirurgia
Medição da Dor
Gravidez
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180210
[St] Status:MEDLINE


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[PMID]:29424512
[Au] Autor:Navarro-Santana B; Duarez-Coronado M; Plaza-Arranz J
[Ti] Título:[External cephalic version].
[Ti] Título:Versión cefálica externa..
[So] Source:Ginecol Obstet Mex;84(8):507-13, 2016 08.
[Is] ISSN:0300-9041
[Cp] País de publicação:Mexico
[La] Idioma:spa
[Ab] Resumo:Objetives: To analyze the rate of successful external cephalic versions in our center and caesarean sections that would be avoided with the use of external cephalic versions. Material and methods: From January 2012 to March 2016 external cephalic versions carried out at our center, which were a total of 52. We collected data about female age, gestational age at the time of the external cephalic version, maternal body mass index (BMI), fetal variety and situation, fetal weight, parity, location of the placenta, amniotic fluid index (ILA), tocolysis, analgesia, and newborn weight at birth, minor adverse effects (dizziness, hypotension and maternal pain) and major adverse effects (tachycardia, bradycardia, decelerations and emergency cesarean section). Results: 45% of the versions were unsuccessful and 55% were successful. The percentage of successful vaginal delivery in versions was 84% (4% were instrumental) and 15% of caesarean sections. With respect to the variables studied, only significant differences in birth weight were found; suggesting that birth weight it is related to the outcome of external cephalic version. Probably we did not find significant differences due to the number of patients studied. Conclusion: For women with breech presentation, we recommend external cephalic version before the expectant management or performing a cesarean section. The external cephalic version increases the proportion of fetuses in cephalic presentation and also decreases the rate of caesarean sections.
[Mh] Termos MeSH primário: Apresentação Pélvica
Cesárea/estatística & dados numéricos
Versão Fetal/métodos
[Mh] Termos MeSH secundário: Adulto
Peso ao Nascer
Feminino
Seres Humanos
Gravidez
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180210
[St] Status:MEDLINE



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