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Pesquisa : E07.858.700.650 [Categoria DeCS]
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  1 / 1341 MEDLINE  
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[PMID]:29084763
[Au] Autor:Muraca GM; Skoll A; Lisonkova S; Sabr Y; Brant R; Cundiff GW; Joseph KS
[Ad] Endereço:School of Population and Public Health, Department of Obstetrics & Gynaecology, The University of British Columbia, Vancouver, BC.
[Ti] Título:Response to "Data limitations may affect conclusions in study of vaginal delivery at midpelvic station".
[So] Source:CMAJ;189(43):E1344-E1345, 2017 10 30.
[Is] ISSN:1488-2329
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Parto Obstétrico
Forceps Obstétrico
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Gravidez
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171101
[St] Status:MEDLINE
[do] DOI:10.1503/cmaj.733350


  2 / 1341 MEDLINE  
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[PMID]:29084762
[Au] Autor:Wood SL
[Ad] Endereço:Associate Professor, Departments of Obstetrics and Gynecology, Cummings School of Medicine, University of Calgary, Calgary, Alta.
[Ti] Título:Data limitations may affect conclusions in study of vaginal delivery at midpelvic station.
[So] Source:CMAJ;189(43):E1343, 2017 10 30.
[Is] ISSN:1488-2329
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Parto Obstétrico
Forceps Obstétrico
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Gravidez
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171101
[St] Status:MEDLINE
[do] DOI:10.1503/cmaj.733316


  3 / 1341 MEDLINE  
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[PMID]:28847784
[Au] Autor:Muraca GM; Lisonkova S; Joseph KS; Skoll A; Cundiff GW; Brant R; Sabr Y
[Ad] Endereço:School of Population and Public Health, and Department of Obstetrics & Gynaecology, The University of British Columbia, Vancouver, BC.
[Ti] Título:The authors reply to "The end of forceps deliveries?" and "Beware selection bias".
[So] Source:CMAJ;189(34):E1098, 2017 08 28.
[Is] ISSN:1488-2329
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Forceps Obstétrico
Viés de Seleção
[Mh] Termos MeSH secundário: Parto Obstétrico
Extração Obstétrica
Feminino
Seres Humanos
Gravidez
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170830
[St] Status:MEDLINE
[do] DOI:10.1503/cmaj.733285


  4 / 1341 MEDLINE  
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[PMID]:28847783
[Au] Autor:Pairaudeau N
[Ad] Endereço:Consultant Obstetrician and Gynecologist, University of Toronto, Toronto, Ont.
[Ti] Título:The end of forceps deliveries?
[So] Source:CMAJ;189(34):E1097, 2017 08 28.
[Is] ISSN:1488-2329
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Extração Obstétrica
Forceps Obstétrico
[Mh] Termos MeSH secundário: Parto Obstétrico
Feminino
Seres Humanos
Gravidez
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170830
[St] Status:MEDLINE
[do] DOI:10.1503/cmaj.733247


  5 / 1341 MEDLINE  
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[PMID]:28779515
[Au] Autor:Liabsuetrakul T; Choobun T; Peeyananjarassri K; Islam QM
[Ad] Endereço:Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand, 90110.
[Ti] Título:Antibiotic prophylaxis for operative vaginal delivery.
[So] Source:Cochrane Database Syst Rev;8:CD004455, 2017 08 05.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Vacuum and forceps assisted vaginal deliveries are reported to increase the incidence of postpartum infections and maternal readmission to hospital compared to spontaneous vaginal delivery. Prophylactic antibiotics may be prescribed to prevent these infections. However, the benefit of antibiotic prophylaxis for operative vaginal deliveries is still unclear. OBJECTIVES: To assess the effectiveness and safety of antibiotic prophylaxis in reducing infectious puerperal morbidities in women undergoing operative vaginal deliveries including vacuum or forceps deliveries, or both. SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register (12 July 2017), ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (12 July 2017) and reference lists of retrieved studies. SELECTION CRITERIA: All randomised trials comparing any prophylactic antibiotic regimens with placebo or no treatment in women undergoing vacuum or forceps deliveries were eligible. Participants were all pregnant women without evidence of infections or other indications for antibiotics of any gestational age undergoing vacuum or forceps delivery for any indications. Interventions were any antibiotic prophylaxis (any dosage regimen, any route of administration or at any time during delivery or the puerperium) compared with either placebo or no treatment. DATA COLLECTION AND ANALYSIS: Two review authors assessed trial eligibility and methodological quality. Two review authors extracted the data independently using prepared data extraction forms. Any discrepancies were resolved by discussion and a consensus reached through discussion with all review authors. We assessed methodological quality of the one included trial using the GRADE approach. MAIN RESULTS: One trial, involving 393 women undergoing either vacuum or forceps deliveries, was included. The trial compared the antibiotic intravenous cefotetan after cord clamping compared with no treatment. This trial reported only two out of the nine outcomes specified in this review. Seven women in the group given no antibiotics had endomyometritis and none in prophylactic antibiotic group, the risk reduction was 93% (risk ratio (RR) 0.07; 95% confidence interval (CI) 0.00 to 1.21; low-quality evidence). There was no difference in the length of hospital stay between the two groups (mean difference (MD) 0.09 days; 95% CI -0.23 to 0.41; low-quality evidence). Overall, the risk of bias was judged to be unclear. The quality of the evidence using GRADE was low for both endometritis and maternal length of stay. AUTHORS' CONCLUSIONS: One small trial was identified reporting only two outcomes. Evidence from this single trial suggests that antibiotic prophylaxis may lead to little or no difference in endometritis or maternal length of stay. There were no data on any other outcomes to evaluate the impact of antibiotic prophylaxis after operative vaginal delivery. Future research on antibiotic prophylaxis for operative vaginal delivery is needed to conclude whether it is useful for reducing postpartum morbidity.
[Mh] Termos MeSH primário: Antibioticoprofilaxia
Extração Obstétrica/efeitos adversos
Infecção Puerperal/prevenção & controle
Doenças Vaginais/prevenção & controle
[Mh] Termos MeSH secundário: Endometrite/prevenção & controle
Feminino
Seres Humanos
Forceps Obstétrico
Gravidez
Ensaios Clínicos Controlados Aleatórios como Assunto
Vácuo-Extração/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170920
[Lr] Data última revisão:
170920
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170806
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD004455.pub4


  6 / 1341 MEDLINE  
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[PMID]:28594775
[Au] Autor:Skinner S; Davies-Tuck M; Wallace E; Hodges R
[Ad] Endereço:Ritchie Centre, Department of Obstetrics and Gynecology, Hudson Institute, Monash University, and Perinatal Services Monash Health, Monash Medical Centre, Clayton, Victoria, Australia.
[Ti] Título:Perinatal and Maternal Outcomes After Training Residents in Forceps Before Vacuum Instrumental Birth.
[So] Source:Obstet Gynecol;130(1):151-158, 2017 Jul.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare the rates of attempted and successful instrumental births, intrapartum cesarean delivery, and subsequent perinatal and maternal morbidity before and after implementing a training intervention to arrest the decline in forceps competency among resident obstetricians. METHODS: This retrospective cohort study examined all attempted instrumental births at Monash Health from 2005 to 2014. We performed an interrupted time-series analysis to compare outcomes of attempted instrumental births in 2005-2009 with those in 2010-2014. RESULTS: There were 72,490 births from 2005 to 2014 at Monash Health, of which 8,789 (12%) were attempted instrumental vaginal births. After the intervention, rates of forceps births increased [autoregressive integrated moving average coefficient (ß) 1.5, 95% confidence interval (CI) 1.03-1.96; P<.001], and vacuum births decreased (ß -1.43, 95% CI -2.5 to -0.37; P<.01). Rates of postpartum hemorrhage decreased (ß -1.3, 95% CI -2.07 to -0.49; P=.002) and epidural use increased (ß 0.03, 95% CI 0.02-0.05; P<.001). There was no change in rates of unsuccessful instrumental births (ß -0.39, 95% CI -3.03 to 2.43; P=.83), intrapartum cesarean delivery (ß -0.29, 95% CI -0.55 to 0.14; P=.24), third- and fourth-degree tears (ß -1.04, 95% CI -3.1 to 1.00; P=.32), or composite neonatal morbidity (ß -0.18, 95% CI -0.38 to 0.02, P=.08). Unsuccessful instrumental births were more likely to be in nulliparous women (P<.001), less likely to have a senior obstetrician present (P<.001), be at later gestation (P<.001), and involved larger birth weight neonates (P<.001). CONCLUSION: A policy of ensuring obstetric forceps competency before beginning vacuum training results in more forceps births, fewer postpartum hemorrhages, and no increase in third- and fourth-degree perineal injuries or episiotomies.
[Mh] Termos MeSH primário: Competência Clínica
Forceps Obstétrico/efeitos adversos
Avaliação de Resultados (Cuidados de Saúde)
Vácuo-Extração/educação
[Mh] Termos MeSH secundário: Adulto
Traumatismos do Nascimento/etiologia
Parto Obstétrico/educação
Feminino
Seres Humanos
Internato e Residência
Serviços de Saúde Materno-Infantil
Períneo/lesões
Gravidez
Resultado da Gravidez
Vácuo-Extração/efeitos adversos
Vitória
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170731
[Lr] Data última revisão:
170731
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170609
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002097


  7 / 1341 MEDLINE  
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[PMID]:28584040
[Au] Autor:Muraca GM; Sabr Y; Lisonkova S; Skoll A; Brant R; Cundiff GW; Joseph KS
[Ad] Endereço:School of Population and Public Health (Muraca, Lisonkova, Joseph); Department of Obstetrics & Gynaecology (Muraca, Sabr, Lisonkova, Skoll, Cundiff, Joseph); Department of Statistics (Brant), The University of British Columbia, Vancouver, BC; Department of Obstetrics and Gynaecology (Sabr), King
[Ti] Título:Perinatal and maternal morbidity and mortality after attempted operative vaginal delivery at midpelvic station.
[So] Source:CMAJ;189(22):E764-E772, 2017 Jun 05.
[Is] ISSN:1488-2329
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Increased use of operative vaginal delivery (i.e., forceps or vacuum application), of which 20% occurs at midpelvic station, has been advocated to reduce the rate of cesarean delivery. We aimed to quantify severe perinatal and maternal morbidity and mortality associated with attempted midpelvic operative vaginal delivery. METHODS: We studied all term singleton deliveries in Canada between 2003 and 2013, by attempted midpelvic operative vaginal or cesarean delivery with labour (with and without prolonged second stage). The primary outcomes were composite severe perinatal morbidity and mortality (e.g., convulsions, assisted ventilation, severe birth trauma and perinatal death), and composite severe maternal morbidity and mortality (e.g., severe postpartum hemorrhage, shock, sepsis, cardiac complications, acute renal failure and death). RESULTS: The study population included 187 234 deliveries. Among women with dystocia and prolonged second stage of labour, midpelvic operative vaginal delivery was associated with higher rates of severe perinatal morbidity and mortality compared with cesarean delivery (forceps, adjusted odds ratio [AOR] 1.81, 95% confidence interval [CI] 1.24 to 2.64; vacuum, AOR 1.81, 95% CI 1.17 to 2.80; sequential instruments, AOR 3.19, 95% CI 1.73 to 5.88), especially with higher rates of severe birth trauma. Rates of severe maternal morbidity and mortality were not significantly different after operative vaginal delivery, although rates of obstetric trauma were higher (forceps, AOR 4.51, 95% CI 4.04 to 5.02; vacuum, AOR 2.70, 95% CI 2.35 to 3.09; sequential instruments, AOR 4.24, 95% CI 3.46 to 5.19). Among women with fetal distress, similar associations were seen for severe birth trauma and obstetric trauma, although vacuum was associated with lower rates of severe maternal morbidity and mortality (AOR 0.52, 95% CI 0.33 to 0.80). Associations tended to be stronger among women without a prolonged second stage. INTERPRETATION: Midpelvic operative vaginal delivery is associated with higher rates of severe birth trauma and obstetric trauma, whereas overall rates of severe perinatal and maternal morbidity and mortality vary by indication and operative instrument.
[Mh] Termos MeSH primário: Traumatismos do Nascimento/epidemiologia
Cesárea/efeitos adversos
Distocia/epidemiologia
Complicações do Trabalho de Parto/epidemiologia
Forceps Obstétrico/efeitos adversos
Hemorragia Pós-Parto/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Canadá
Bases de Dados Factuais
Feminino
Seres Humanos
Recém-Nascido
Modelos Logísticos
Mortalidade Materna
Análise Multivariada
Razão de Chances
Mortalidade Perinatal
Gravidez
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:171110
[Lr] Data última revisão:
171110
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170607
[St] Status:MEDLINE
[do] DOI:10.1503/cmaj.161156


  8 / 1341 MEDLINE  
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[PMID]:28279445
[Au] Autor:Han B; Xu M
[Ad] Endereço:Department of Anesthesiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
[Ti] Título:A comprehensive analysis of continuous epidural analgesia's effect on labor and neonates in maternal hypertensive disorder patients.
[So] Source:Pregnancy Hypertens;7:33-38, 2017 Jan.
[Is] ISSN:2210-7797
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Maternal hypertensive disorder is one of the most common and severe medical complications during pregnancy. Epidural analgesia administration is widely used during labor process. AIM: To evaluate the potential advantage or disadvantage of continuous epidural analgesia's on labor and neonates for maternal hypertensive disorder patients comprehensively. METHODS: We have retrospectively analyzed 232 patients who diagnosed as maternal hypertensive disorder in our hospital since 2015. Among which, 126 patients including 28 cases of severe preeclampsia were administrated with continuous epidural analgesia (Analgesia group), the other 106 patients were untreated (Control group). We have compared the maternal age, body weight, gestational weeks, period for the first and second labor stage; the incidence of eclampsia, natural labor, cesarean section, forceps delivery and postpartum hemorrhage between these two groups respectively; furthermore, we recorded patients who received oxytocin and antihypertensive treatment during the delivery progress as well as evaluated the neonate body weight, Apgar score and performed umbilical cord blood gas analysis. RESULTS: Continuous epidural analgesia does not affect the first and second labor stage period (p=0.36), However, there is a significantly higher demand for oxytocin treatment (36.5% Vs 19.8%, p<0.01) and a significantly lower requirement for antihypertensive treatment (22.2% Vs 81.1%, p<0.001) in analgesia group compared to control group. We also notice that the natural delivery ratio in analgesia group is higher than control group and most importantly, continuous epidural analgesia can increase 1min Apgar score and has no other effect on neonates' body weight, umbilical cord blood gas parameters, 5min and 10min Apgar score. CONCLUSIONS: Our result based on a large cohort comprehensive analysis indicates that continuous epidural analgesia can benefit both maternal hypertensive disorder patients and neonates without any side effect.
[Mh] Termos MeSH primário: Analgesia Epidural/efeitos adversos
Analgesia Obstétrica/efeitos adversos
Hipertensão Induzida pela Gravidez/fisiopatologia
Trabalho de Parto
[Mh] Termos MeSH secundário: Analgesia Epidural/métodos
Analgesia Obstétrica/métodos
Anti-Hipertensivos/administração & dosagem
Índice de Apgar
Peso ao Nascer
Peso Corporal
Cesárea/estatística & dados numéricos
Eclampsia/epidemiologia
Feminino
Sangue Fetal/química
Idade Gestacional
Seres Humanos
Recém-Nascido
Idade Materna
Forceps Obstétrico
Ocitocina/administração & dosagem
Hemorragia Pós-Parto/epidemiologia
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antihypertensive Agents); 50-56-6 (Oxytocin)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170717
[Lr] Data última revisão:
170717
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170311
[St] Status:MEDLINE


  9 / 1341 MEDLINE  
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[PMID]:28224270
[Au] Autor:Huebner M; Brucker SY; Tunn R; Naumann G; Reisenauer C; Abele H
[Ad] Endereço:Department of Obstetrics and Gynecology, University Hospital of Tuebingen, Tuebingen, Germany. markus.huebner@med.uni-tuebingen.de.
[Ti] Título:Intrapartal pelvic floor protection: a pragmatic and interdisciplinary approach between obstetrics and urogynecology.
[So] Source:Arch Gynecol Obstet;295(4):795-798, 2017 Apr.
[Is] ISSN:1432-0711
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Pelvic floor protection is an issue of increasing relevance. This article sought to summarize the session at last year's annual meeting of the German Society of Gynecology and Obstetrics (DGGG) in Stuttgart (10/2016) called "Urogynecology 2020-what is the optimal rate of cesarean section-does urogynecology have to deal with Obstetrics?". The main focus was set on the two important anatomical structures, the levator ani muscle and the anal sphincters. Operative vaginal delivery, epidural anesthesia, and episiotomy are subject to discussion.
[Mh] Termos MeSH primário: Complicações do Trabalho de Parto/patologia
Distúrbios do Assoalho Pélvico/prevenção & controle
[Mh] Termos MeSH secundário: Canal Anal/lesões
Canal Anal/fisiopatologia
Anestesia Epidural/efeitos adversos
Cesárea/efeitos adversos
Parto Obstétrico/efeitos adversos
Episiotomia/efeitos adversos
Feminino
Seres Humanos
Complicações do Trabalho de Parto/prevenção & controle
Forceps Obstétrico/efeitos adversos
Obstetrícia/métodos
Diafragma da Pelve/anatomia & histologia
Diafragma da Pelve/lesões
Diafragma da Pelve/fisiopatologia
Distúrbios do Assoalho Pélvico/etiologia
Distúrbios do Assoalho Pélvico/patologia
Gravidez
Vácuo-Extração/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE
[do] DOI:10.1007/s00404-017-4316-x


  10 / 1341 MEDLINE  
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[PMID]:28153664
[Au] Autor:Kasbaoui S; Séverac F; Aïssi G; Gaudineau A; Lecointre L; Akladios C; Favre R; Langer B; Sananès N
[Ad] Endereço:Department of Obstetrics and Gynecology, Strasbourg University Hospital, Strasbourg, France.
[Ti] Título:Predicting the difficulty of operative vaginal delivery by ultrasound measurement of fetal head station.
[So] Source:Am J Obstet Gynecol;216(5):507.e1-507.e9, 2017 May.
[Is] ISSN:1097-6868
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Clinical assessment of fetal head station is difficult and subjective; it is mandatory before attempting operative vaginal delivery. OBJECTIVE: The principal objective of our study was to assess whether measurement of the perineum-to-skull ultrasound distance was predictive of a difficult operative vaginal delivery. Secondary objectives included evaluation of the interobserver reproducibility of perineum-to-skull ultrasound distance and comparison of this measurement and digital examination in predicting a difficult operative delivery. STUDY DESIGN: This was a prospective cohort study including all cases of operative vaginal deliveries in singleton pregnancies in cephalic presentation >34 weeks' gestation, from 2012 through 2015. All data were entered prospectively in a medical record system specially devised to meet the requirements of this study. RESULTS: Of the 659 patients in whom perineum-to-skull ultrasound distance was measured prior to operative vaginal delivery, 120 (18%) met the composite criterion for a difficult extraction. Perineum-to-skull ultrasound distance measurement of ≥40 mm was significantly associated with the occurrence of a difficult extraction based on the composite criterion, after adjustment for parity, presentation type, and fetal macrosomia (odds ratio, 2.38; 95% confidence interval, 1.51-3.74; P = .0002). The intraclass correlation coefficient between the perineum-to-skull ultrasound distance measured by the first operator and that measured by the second operator was 0.96 (95% confidence interval, 0.95-0.97; P < .0001). Based on the receiver operating characteristic curve analyses, perineum-to-skull ultrasound distance was a more accurate predictor of difficult operative delivery than digital vaginal examination (P = .036). CONCLUSION: Measurement of the perineum-fetal skull ultrasound distance is a reproducible and predictive index of the difficulty of instrumental extraction. Ultrasound is a useful supplementary tool to the usual clinical findings.
[Mh] Termos MeSH primário: Cabeça/diagnóstico por imagem
Forceps Obstétrico
Períneo/diagnóstico por imagem
Ultrassonografia Pré-Natal
Vácuo-Extração
[Mh] Termos MeSH secundário: Adulto
Peso ao Nascer
Estudos de Coortes
Feminino
Feto
Seres Humanos
Apresentação no Trabalho de Parto
Funções Verossimilhança
Paridade
Valor Preditivo dos Testes
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170731
[Lr] Data última revisão:
170731
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170204
[St] Status:MEDLINE



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