A Standardized Postpartum Oxytocin Protocol to Reduce Hemorrhage Treatment: Outcomes by Delivery Mode.

Background: Postpartum hemorrhage prophylaxis guidelines lack consensus and do not address the major factor of delivery mode. This creates quality and safety concerns. The objective of this study was to evaluate the effect of implementing a standardized prophylaxis protocol on postpartum hemorrhage treatment by delivery mode.

A Standardized Oxytocin Administration Protocol After Delivery to Reduce the Treatment of Postpartum Hemorrhage.

Background: Postpartum hemorrhage (PPH) is a leading cause of maternal death, and its rate and severity have been increasing. Oxytocin is widely recommended for PPH prophylaxis, but consensus is lacking on the dose or duration, leading to disparate and subjective practices. In this study, clinical outcomes were compared before and after introduction of a quality measure: a standardized oxytocin protocol for PPH prophylaxis.

Placental Alpha Microglobulin-1 Compared With Fetal Fibronectin to Predict Preterm Delivery in Symptomatic Women.

Objective: To compare the rapid bedside test for placental α microglobulin-1 with the instrumented fetal fibronectin test for prediction of imminent spontaneous preterm delivery among women with symptoms of preterm labor.

Methods: We conducted a prospective observational study on pregnant women with signs or symptoms suggestive of preterm labor between 24 and 35 weeks of gestation with intact membranes and cervical dilatation less than 3 cm. Participants were prospectively enrolled at 15 U.

Bedside Safety Huddles to Manage a Complex Obstetric Case.

Multidisciplinary communication is essential to safety in health care. Safety huddles offer an opportunity to develop and implement a standardized care plan to improve outcomes. This is especially true for complex obstetric cases.

Management of Maternal Cardiac Arrest in the Third Trimester of Pregnancy: A Simulation-Based Pilot Study.

Objective. To evaluate confidence, knowledge, and competence after a simulation-based curriculum on maternal cardiac arrest in an Obstetrics & Gynecologic (OBGYN) residency program. Methods.

Preterm labor: role of the nurse practitioner.

The nurse practitioner may play a pivotal role in diagnosing preterm labor through risk assessment and physical exam. While treatment and management of preterm labor are usually beyond the nurse practitioner's scope of practice, they can play an important role in preventing preterm birth through assessment, action, or advocacy.

Changes in the indications for scheduled births to reduce nonmedically indicated deliveries occurring before 39 weeks of gestation.

Objective: To estimate the change in indications for scheduled deliveries during the Ohio Perinatal Quality Collaborative's initiative to decrease scheduled deliveries for nonmedical indications before 39 weeks of gestation.

Methods: Documented indications for scheduled deliveries between 36 0/7 and 38 6/7 weeks were categorized as: strong medically accepted reasons for delivery; intermediate acceptability; and unnecessary before 39 weeks. We describe each of these indication categories as a proportion of all deliveries in the participating hospitals between October 2008 and December 2009.

Hyperosmolar hyperglycemic state of pregnancy with intrauterine fetal demise and preeclampsia.

Hyperosmolar hyperglycemic state (HHS) is a serious complication of uncontrolled hyperglycemia. Paralleling the obesity epidemic, the incidence of type 2 diabetes is increasing in a younger population. Therefore, obstetricians must be prepared to deal with the complications of this disease.

Congenital pulmonary lymphangiectasis sequence: a rare, heterogeneous, and lethal etiology for prenatal pleural effusion.

Objective: Case report and literature review for congenital pulmonary lymphangiectasis (CPL) CASE REPORT: Male fetus with bilateral pleural effusion, thoracoamniotic shunt, preterm delivery, and prolonged neonatal course with neonatal death at 3 months. Autopsy-identified CPL.

Discussion: Review of pathology, clinical course, and genetics of CPL.