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Patient Basics: Cesarean Section

...uired. This is sometimes used in an emergency situation as it may be slightly faster. After the abdomen is opened, the bladder is protected from injury, and the uterus is opened. The incision in the uterus is usually horizontal and low in the uterus. Or it may be vertical. A vertical incision is preferred when a larger uterine incision is needed, or if the lower part of the uterus has not developed or stretched enough to permit a low horizontal in...

Better pre-term outcomes after vaginal delivery

...eralizable. However, standard limitations of a retrospective design and analysis apply and the investigation of short-term morbidities precludes commentary on longer-term consequences associated with route of delivery. Prospective studies are merited to assess evaluate whether the observed association is causal. Click to read the study in Obstetrics & Gynecology Relevant Reading: Uptodate: Overview of preterm labor and birth Dr. Erika F. Werner, M...

The ORIP trial: n-3 polyunsaturated long chain fatty acid supplementation has no effect on...

...ar to control. Evidence Rating Level: 1 (Excellent) Study Rundown: Preterm delivery, delivery before 37 weeks of gestation, is associated with increased childhood morbidity and mortality. N-3 long-chain polyunsaturated fatty acids are known to play a role in modulating proinflammatory prostaglandins such as PGE2 and PGF2a that are associated with cervical ripening and uterine contractility. In this multicenter, double-blind randomized control tria...

Cervical length indicates risk of preterm delivery [Classics Series]

...o the greatest extent possible. Limitations included definition of preterm delivery as delivery at less than 35 weeks, which differs from the current definition of delivery at less than 37 weeks. Inclusion of women with a history of prior PTD, who comprised 16% of the sample, introduced the opportunity for nonrandom misclassification and confounding since women with a history of PTD are more likely to have a short cervix and to experience PTD. Fut...

[Physician Comment] Next-day discharge after planned Cesarean delivery results in equivalent patient satisfaction, no...

...h by the authors or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. Content is produced in accordance with fair use copyrights solely and strictly for the purpose of teaching, news and criticism. No benefit, monetary or otherwise, is realized by any participants or the owner of this domain....

Delivery room thermal care interventions for hypothermia associated with improved outcomes

...rm and/or low birth weight infants In-Depth [systematic review and meta-analysis]: This network meta-analysis screened 6,154 titles from MEDLINE, the Cochrane Central Register of Controlled Trials, Embase, and CINAHL databases from their inception to November 5, 2020. In total, the study used data from 34 randomized and quasi-randomized clinical trials that enrolled 3,688 neonates, comparing various thermal care interventions in the delivery room...

[Ann Emerg Med.] False-negative FAST examination: associations with patient outcomes

...pathological intra-abdominal fluid and found that 49% had a false negative FAST exam. Analysis revealed that while severe head injury was positively associated with a false negative FAST (odds ratio [OR] 4.9; 95% confidence interval [CI] 1.5 to 15.7), severe abdominal injury was negatively associated (OR 0.3; 95% CI 0.1 to 0.5).  ED vital signs, GCS score, hematocrit and fractures to specific sites (e.g. ribs, pelvis, and spine) were not associate...

Quick Take: Planned early delivery or expectant management for late preterm pre-eclampsia (PHOENIX)

...vention. Of the women randomized to expectant management, 54% had a medically indicated delivery before 37 weeks’ gestation, with only two women giving birth before 37 weeks’ gestation without an additional medical indication. Researchers found that the incidence of the co-primary maternal outcome was significantly reduced in the planned delivery group (65%) as compared to the expectant management group (75%) (RR 0.86, 95% CI 0.79 to 0.94, p=0.000...

Patients who utilize online health services make greater use of in-person services

...r patient groups who might benefit most from online services, such as rurally located and elderly patients, were not explicitly evaluated. Future research is needed on several fronts: (1) to optimize access to care and costs of care, (2) to develop communication strategies to explain how online health services may replace certain in-person services, and (3) to examine service usage by patients using other kinds of HCIT besides patient portals. Cli...

Physician recourse to online reviews may be futile

...either restrict a patient’s ability to post any review at all, or effectively make any online commentary intellectual property belonging to the physician. Thus, when a physician seeks to respond to negative reviews, they are able to employ the less burdensome claims of breach of contract or copyright infringement. However, the use of medical NDAs to bypass defamation laws and the CDA doesn’t work. NDAs may be deemed unconscionable, and thus unenfo...

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