K. Goueslard, F. Jollant, J. Cottenet, S. Bechraoui-Quantin, P. Rozenberg, E. Simon, C. Quantin
{"title":"Hospitalization for Nonlethal Self-Harm and Premature Mortality in the 3 Years Following Adolescent Pregnancy: Population-Based Nationwide Cohort Study","authors":"K. Goueslard, F. Jollant, J. Cottenet, S. Bechraoui-Quantin, P. Rozenberg, E. Simon, C. Quantin","doi":"10.1097/01.aoa.0001015960.60124.c0","DOIUrl":"https://doi.org/10.1097/01.aoa.0001015960.60124.c0","url":null,"abstract":"(BJOG. 2023;130(9):1016–1027)\u0000 Research proves a rising risk of suicidal ideation and acts in the year before and the year after giving birth. Suicide is 1 of the 2 main causes of mortality for mothers in France. There is not a solid correlation between nonlethal self-harm and suicide following childbirth, so it is difficult to predict and prevent. Adolescents are at higher risk of nonlethal self-harm, and suicide is the second cause of premature deaths in their age category. Adolescent pregnancy is tied to additional mental disorders, psychosocial problems, anxiety, depression, and eating disorders, which are all risk factors for suicidal actions. This retrospective cohort study was designed to primarily provide insights about nonlethal self-harm risks and mortality in adolescent pregnancies. Secondarily, the study aimed to evaluate the causes of deaths when possible.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"33 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141102616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L.D. Pacheco, R.G. Clifton, G. Saade, H. Simhan, G.A. Macones
{"title":"Tranexamic Acid to Prevent Obstetrical Hemorrhage After Cesarean Delivery","authors":"L.D. Pacheco, R.G. Clifton, G. Saade, H. Simhan, G.A. Macones","doi":"10.1097/01.aoa.0001015900.50238.ba","DOIUrl":"https://doi.org/10.1097/01.aoa.0001015900.50238.ba","url":null,"abstract":"(N Engl J Med 2023;388(15):1365–1375)\u0000 Postpartum hemorrhage is the second leading cause of pregnancy-related death in the United States, and accounts for up to 27.1% of global maternal deaths. Tranexamic acid has been previously associated with a reduction in overall mortality in several different settings, but majorly in obstetrical contexts. Research has not discovered, however, if the use of tranexamic acid is beneficial when it comes to its prophylactic use to prevent significant blood loss after birth or related other outcomes such as incidence of blood transfusion products or need for additional intervention to control bleeding. This study was a randomized trial to assess the effectiveness of tranexamic acid administered immediately after umbilical cord clamping in reducing the risk of maternal death or blood transfusion compared to placebo.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"6 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141100734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Shakur-Still, I. Roberts, S. Grassin-Delyle, R. Chaudhri, A. Geer, M. Arribas, E. Lamy, R. Mansukhani, M.K. Lubeya, K. Javaid, A. Kayani, N. Israr, S.B. Mazhar, S. Urien, N. Bouazza, F. Foissac, D. Prowse, L. Carrington, C. Barrow, J. Onandia, E. Balogun
{"title":"Alternative Routes for Tranexamic Acid Treatment in Obstetric Bleeding (WOMAN-PharmacoTXA Trial): A Randomized Trial and Pharmacological Study in Cesarean Section Births","authors":"H. Shakur-Still, I. Roberts, S. Grassin-Delyle, R. Chaudhri, A. Geer, M. Arribas, E. Lamy, R. Mansukhani, M.K. Lubeya, K. Javaid, A. Kayani, N. Israr, S.B. Mazhar, S. Urien, N. Bouazza, F. Foissac, D. Prowse, L. Carrington, C. Barrow, J. Onandia, E. Balogun","doi":"10.1097/01.aoa.0001016024.85550.bb","DOIUrl":"https://doi.org/10.1097/01.aoa.0001016024.85550.bb","url":null,"abstract":"(BJOG. 2023;130(10):1177–1186)\u0000 Many maternal deaths due to severe postpartum bleeding (PPH) occur in middle-income or low-income countries. A widely practiced method for reducing postpartum bleeding is administration of tranexamic acid (TXA); methods of administration vary, with the drug being available as an intravenous (IV) infusion, intramuscular (IM) injection, and oral solution. The previous WOMAN-PharmacoTXA trial showed that IV TXA administered within 3 hours of delivery reduced PPH deaths by one-third, but IV administration is a barrier for care in low-income and middle-income countries. Therefore, it is important that such other administration options for such an integral lifesaving medication be evaluated in settings where IV infusion is difficult or impossible. This study was designed to evaluate the population pharmacokinetics (PK) and pharmacodynamics (PD) of TXA administered by IV infusion, IM injection, and oral routes in women having cesarean delivery (CD). This included evaluation of safety, adverse events, the concentration of TXA that crosses the placenta and its clearance, and the effect of administration route on D-dimer concentration.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"57 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141102054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Misra, S. Singh, S. Sarkar, B.K. Behera, S.S. Jena
{"title":"The Effect of Prophylactic Steroids on Shivering in Adults Undergoing Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"S. Misra, S. Singh, S. Sarkar, B.K. Behera, S.S. Jena","doi":"10.1097/01.aoa.0001016000.14492.92","DOIUrl":"https://doi.org/10.1097/01.aoa.0001016000.14492.92","url":null,"abstract":"(Anesth Analg. 2023;137(2):332–344)\u0000 Shivering is a common side effect to numerous things, such as hypothermia and often anesthetic drugs. Shivering is often an involuntary contraction of the skeletal muscles. It is often unwarranted and during surgery or delivery a patient can shiver due to general anesthetic drugs. Up to 65% of patients shiver when given general anesthetics and up to 60% also have it with spinal anesthesia. Certain nonpharmacological interventions have been attempted to decrease shivering for patients. Corticosteroids and anti-inflammatories may be given to help constrict the shivering effect of an anesthetic. To assess patients and decrease the risk of shivering for those undergoing surgery, additional studies have been made in using these types of drugs and research in randomized trials in perioperative shivering.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"20 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141102655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. Brown, C. Messaoudi, E. Silvia, H. Bleau, A. Meskill, A. Flynn, A.C. Abel-Bey, T.J. Ball
{"title":"Postpartum Navigation Decreases Severe Maternal Morbidity Most Among Black Women","authors":"Z. Brown, C. Messaoudi, E. Silvia, H. Bleau, A. Meskill, A. Flynn, A.C. Abel-Bey, T.J. Ball","doi":"10.1097/01.aoa.0001016012.95407.df","DOIUrl":"https://doi.org/10.1097/01.aoa.0001016012.95407.df","url":null,"abstract":"(Am J Obstet Gynecol. 2023;229:160.e1–160.e8)\u0000 The United States has significant disparities across varying racial and ethnic groups for pregnancy-related deaths. Research shows that Black women and American Indian or Alaskan Native women have a 3 to 4 times higher risk of pregnancy-related death than White women do, regardless of education. Postpartum care can greatly affect how severe maternal morbidity (SMM) and maternal mortality conditions are addressed. The primary aim of this study was to determine if a postpartum navigation program lowered 30-day postpartum hospitalization admissions from all causes and hospitalization admissions from indicators of SMM. This was done using guidelines from the US Centers for Disease Control and Prevention (CDC). This study also analyzed if the effectiveness of this program transcended across patient demographics like ethnicity and race.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"91 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T.E.K. Cersonsky, N.K. Ayala, H. Pinar, D.J. Dudley, G.R. Saade, R.M. Silver, A.K. Lewkowitz
{"title":"Identifying Risk of Stillbirth Using Machine Learning","authors":"T.E.K. Cersonsky, N.K. Ayala, H. Pinar, D.J. Dudley, G.R. Saade, R.M. Silver, A.K. Lewkowitz","doi":"10.1097/01.aoa.0001015988.43986.ab","DOIUrl":"https://doi.org/10.1097/01.aoa.0001015988.43986.ab","url":null,"abstract":"(Am J Obstet Gynecol. 2023;229:327:e1–16)\u0000 A tool that could help identify women at risk for stillbirth would be a welcome addition to clinical practice. Machine learning models, which can look at relationships between variables in large data sets, was investigated in this article. This study’s aim was to refine a machine learning model to predict stillbirth using data available prior to the gestational age of viability (22 to 24 wk). The researchers performed a secondary analysis of data in the Stillbirth Collaborative Research Network (SCRN), a study database of 982 stillbirths and 3000 representative live births from 2006 to 2009. The study included patients who delivered a live or stillborn fetus at >18 weeks’ gestation from 59 hospitals in 5 states (Georgia, Massachusetts, Rhode Island, Texas, and Utah). The data set included 6000 measures collected from interviews with the mother, postmortem pathological exam, cause of death analysis, and medical record Abstractsion. Subsequently 101 risk factor variables were identified and used in the model. These included maternal and biological father demographics, family history, maternal health history, prenatal lab data, fetal genetics, second-trimester screen, prenatal care history, ultrasound, and social determinants of health.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Ackerman-Banks, H. Lipkind, K. Palmsten, K. Ahrens
{"title":"Association Between Hypertensive Disorders of Pregnancy and Cardiovascular Diseases Within 24 Months After Delivery","authors":"C. Ackerman-Banks, H. Lipkind, K. Palmsten, K. Ahrens","doi":"10.1097/01.aoa.0001015964.97203.7e","DOIUrl":"https://doi.org/10.1097/01.aoa.0001015964.97203.7e","url":null,"abstract":"(Am J Obstet Gynecol. 2023;229(1):65.e1–65.e15)\u0000 Cardiovascular disease (CVD) is the leading cause of death among women in the United States. The association between hypertensive diseases of pregnancy (HDP) and CVD are well known with an increased risk of long-term morbidity. For short-term CVD outcomes after HDP, most existing data are limited to the immediate postpartum period and the data are limited on which specific cardiovascular diagnoses have the greatest risk profiles during the first 24 months after delivery. This study aimed to assess the risk of various cardiovascular diagnoses in the initial 24 months postdelivery among individuals with HDP compared with those without.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"73 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Krámská, S. Slabá, L. Hrešková, A. Kajdy, D. Sys, L. Poon, P. Calda
{"title":"Anxiety and Depressive Symptoms in Pregnant Women During the COVID-19 Pandemic in the Czech Republic—Broader Sociodemographic Causes, Connections and Implications","authors":"L. Krámská, S. Slabá, L. Hrešková, A. Kajdy, D. Sys, L. Poon, P. Calda","doi":"10.1097/01.aoa.0001015972.29684.2b","DOIUrl":"https://doi.org/10.1097/01.aoa.0001015972.29684.2b","url":null,"abstract":"(Acta Obstet Gynecol Scand. 2023;102:1014–1025)\u0000 The COVID-19 pandemic has profoundly impacted various aspects of life, posing risks not only to physical health but also to mental well-being. Psychological effects such as stress, anxiety, and depression are prevalent, particularly among pregnant women, with potential repercussions for pregnancy outcomes. This study explored the sociodemographic and psychological factors during the COVID pandemic that affected the mood of pregnant Czech women. Conducted through the MindCOVID study, our survey included 1830 pregnant women, utilizing standardized instruments (GAD-7 and PHQ-9) to assess anxiety and depression. The study focused on culturally specific characteristics and risk factors for mental disorders, providing valuable insights for effective multidisciplinary health care planning.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"59 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141102312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Rosvig, E. Steffensen, L. Brogaard, L. Hvidman, O. Kierkegaard, A.C. Kjeldsen, K. Taastrøm, N. Uldbjerg, S. Lou
{"title":"Women and Partners’ Experience of Major Postpartum Hemorrhage: A Qualitative Study","authors":"L. Rosvig, E. Steffensen, L. Brogaard, L. Hvidman, O. Kierkegaard, A.C. Kjeldsen, K. Taastrøm, N. Uldbjerg, S. Lou","doi":"10.1097/01.aoa.0001016036.85902.38","DOIUrl":"https://doi.org/10.1097/01.aoa.0001016036.85902.38","url":null,"abstract":"(BJOG. 2023;130(9):1087–1095)\u0000 Major postpartum hemorrhage (PPH) is classified as losing more than or equal to 1 L of blood within 2 hours of vaginal birth. In Denmark, this occurs in 7.2% of vaginal deliveries, compared with an incidence of about 4% in the developed countries. Managing major PPH requires a quick and appropriate response from multiple clinical professionals and providing proper medicine. Women and their partners often have negative experiences of PPH, which may relate to deficiencies in communication.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"6 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J.L. Munoz, L.M. Blankenship, P.S. Ramsey, G.A. McCann
{"title":"Implementation and Outcomes of a Uterine Artery Embolization and Tranexamic Acid Protocol for Placenta Accreta Spectrum","authors":"J.L. Munoz, L.M. Blankenship, P.S. Ramsey, G.A. McCann","doi":"10.1097/01.aoa.0001016028.15303.42","DOIUrl":"https://doi.org/10.1097/01.aoa.0001016028.15303.42","url":null,"abstract":"(Am J Obstet Gynecol. 2023;229(1):61.e1–61.e7)\u0000 During pregnancy, complications may arise such as placenta accreta spectrum (PAS) disorders. PAS is a continuum of conditions characterized by abnormal placental invasion, posing intraoperative risks during delivery. Patients with PAS often face postpartum complications, typically necessitating scheduled cesarean deliveries (CD) between 34 and 36 weeks gestation, making the delivery high risk. High blood loss and post-CD complications are common in women with placenta accreta, prompting the implementation of specific observations and protocols in medical facilities.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}