- Is Previous Periacetabular Osteotomy Associated with Pregnancy, Delivery, and Peripartum Complications? [Journal Article]Clin Orthop Relat Res 2019CO
- CONCLUSIONS: In this small survey study, we found no differences in terms of complications, preterm delivery or low birth weight infants between patients who had a history of periacetabular osteotomy and normative national data regarding complications of pregnancy and delivery. However, we did note that patients with a history of periacetabular osteotomy were more likely to deliver future children by cesarean section, which could be attributable to obstetrician preference as most obstetricians in another small survey study have expressed concern about patients with a history of periacetabular osteotomy. Future studies should aim to increase the knowledge of the association of periacetabular osteotomy and delivery method, specifically with transition to cesarean for failure to progress during labor. Future consideration of using the Academic Network of Conservational Hip Outcomes Research repository to develop National Surgical Quality Improvement Program data may help to elucidate this relationship more clearly and help guide appropriate indications for scheduled cesarean sections in the setting of prior pelvic osteotomy.
- The Ob/Gyn and the transgender patient. [Journal Article]Curr Opin Obstet Gynecol 2019CO
- CONCLUSIONS: Given their surgical expertise and experience with hormone management, obstetrician-gynecologists are in a unique position to provide quality healthcare in this population.
- Common Reasons for Malpractice Lawsuits Involving Pulmonary Embolism and Deep Vein Thrombosis. [Journal Article]J Surg Res 2019; 245:212-216JS
- CONCLUSIONS: The most frequently cited negligent act was the failure to give prophylactic anticoagulation, even after discharge. The trends noted in this study may potentially be addressed and therefore prevented by systems-based practice changes. The most common allegation, "failure to diagnose and treat," suggests that first-contact doctors such as emergency physicians and primary care practitioners must maintain a high index of suspicion for deep vein thrombosis/pulmonary embolism.
- The effectiveness and safety of introducing condom-catheter uterine balloon tamponade for postpartum hemorrhage at secondary level hospitals in Uganda, Egypt and Senegal: a stepped wedge, cluster-randomized trial. [Journal Article]BJOG 2019BJOG
- CONCLUSIONS: Introduction of condom-catheter UBT in these settings did not improve maternal outcomes and was associated with an increase in the combined incidence of PPH-related surgery and maternal death. The lack of demonstrated benefit of UBT introduction with respect to severe outcomes warrants reflection of its role. This article is protected by copyright. All rights reserved.
- Vaginal Birth after Cesarean Section in Taiwan: A Population-Based Study. [Journal Article]J Clin Med 2019; 8(8)JC
- The rate of vaginal birth after cesarean section (VBAC) is extremely low in Taiwan probably due to the high perceived risk of trial of labor after a cesarean (TOLAC). To promote the benefits associated with vaginal birth, this study provides evidence to potentially assist relevant public authorities adopt appropriate guidelines or optimize health insurance reimbursement policies to achieve a high…
The rate of vaginal birth after cesarean section (VBAC) is extremely low in Taiwan probably due to the high perceived risk of trial of labor after a cesarean (TOLAC). To promote the benefits associated with vaginal birth, this study provides evidence to potentially assist relevant public authorities adopt appropriate guidelines or optimize health insurance reimbursement policies to achieve a higher VBAC rate. Employing the National Health Insurance (NHI) Claim Data, this study analyzes women's adoptions of birth-giving methods for those who had previous cesarean section (CS) experiences. Empirical methods include logit, probit, and hierarchical regression models controlling women's demographics, incentive indicators, as well as hospital and obstetrician characteristics. Taiwan continues to have a decreasing trend in VBAC rate even with an increase in NHI payment for vaginal birth delivery in 2005, which stimulated a surge in VBAC rate only temporarily. Factors that significantly influence women's adoption of VBAC include institution-specific random effects, weekend admission, comorbidities during pregnancy, and income and fertility of women. Change in service payment from National Health Insurance (NHI) to healthcare providers constitutes an effective policy in directing clinical practices in the short term. Constant and systematic policy review should be undertaken to promote safe and beneficial medical practices. The results of the study suggest that women's adoption of birth-giving method is dominated by non-medical considerations. Significant institution-specific effects imply that women might not be well-informed regarding their optimal birth-giving choice. Health education and training programs for hospital personnel should be kept up to date to better serve society.
- Women's health in Northwestern Syria: Findings from Healthy-Syria 2017 study. [Journal Article]Avicenna J Med 2019 Jul-Sep; 9(3):94-106AJ
- CONCLUSIONS: We found a huge deficiency in ANC and PNC visits, a high adolescent birth rate, and a higher cesarean-to-vaginal delivery ratio than what is recommended by the WHO. We also found a severe shortage in the number of obstetrician-gynecologists serving this population.
- Intimate Partner Violence and Women's Health. [Journal Article]Obstet Gynecol 2019; 134(3):470-480OG
- Intimate partner violence affects 15-71% of women over their lifetime, resulting in significant stress, negative health effects, and negative economic effects. Features include physical and sexual abuse as well as psychological abuse and controlling behaviors such as reproductive coercion or stalking. Intimate partner violence can occur in both heterosexual and same-sex relationships, though the …
Intimate partner violence affects 15-71% of women over their lifetime, resulting in significant stress, negative health effects, and negative economic effects. Features include physical and sexual abuse as well as psychological abuse and controlling behaviors such as reproductive coercion or stalking. Intimate partner violence can occur in both heterosexual and same-sex relationships, though the risk may be higher in lesbian, gay, bisexual, transgender, queer, or questioning couples. Pregnancy remains an especially risky time for escalating abuse and also provides a window of opportunity for screening and intervention. Victims experience many consequences of abuse, including physical injuries, traumatic brain injury, and chronic conditions such as headaches, insomnia, pelvic pain, depression, anxiety, and posttraumatic stress disorder. Homicide is an especially devastating consequence, with 40-45% of female victims killed by an intimate partner, and homicide remains an important cause of pregnancy-related death. Routine screening is recommended by the American College of Obstetricians and Gynecologists and the U.S. Preventive Services Task Force, and obstetrician-gynecologists (ob-gyns) should remain vigilant for signs of abuse in their patients. Often the cycle of abuse makes it difficult for women to break free, and ob-gyns should continue to provide supportive care regardless of a woman's readiness to leave an abusive relationship.
- Survivor Guilt of a Pregnant Obstetrician. [Journal Article]Obstet Gynecol 2019OG
- Health Care Provider Adherence to Surgical Guidelines for Risk-Reducing Salpingo-Oophorectomy. [Journal Article]Obstet Gynecol 2019OG
- CONCLUSIONS: Despite clear surgical guidelines, only two thirds of all health care providers were fully adherent to guidelines. Gynecologic oncologists were more likely to follow surgical guidelines compared with general ob-gyns and more likely to diagnose occult neoplasia despite similar patient populations. Rates of risk-reducing surgery will likely continue to increase as genetic testing becomes more widespread, highlighting the importance of health care provider education for this procedure. Centralized care or referral to subspecialists for risk-reducing salpingo-oophorectomy may be warranted.
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- Is it the decision of women to choose a cesarean section as the mode of birth? A review of literature on the views of stakeholders. [Journal Article]BMC Pregnancy Childbirth 2019; 19(1):286BP
- CONCLUSIONS: This review provided a debate on the choice of pregnant women in uncomplicated pregnancies on the mode of birth from various stakeholders. Further research is required to explore what the meanings of autonomy of pregnant women to choose the mode of birth, and the process that they go through when making this decision.