bluuebunny/crossref_metadata_2025_split huggingface dataset:
The International Network of Obstetric Survey Systems Study of Uterine Rupture: A Descriptive Multicountry Population-based Study
Authors: Vandenberghe G. , Bloemenkamp K. , Berlage S. , Colmorn L. , Deneux-Tharaux C. , Gissler M. , Knight M. , Langhoff-Roos J. , Lindqvist P.G. , Oberaigner W. , Van Roosmalen J. , Zwart J. , Roelens K. 
Published: November 2019

(BJOG. 2019;126(3):370–381)
Complete uterine rupture is a rare delivery complication, and is connected with emergency interventions during delivery as well as potentially detrimental outcomes for both mother and child. There is an increasing occurrence of complete uterine rupture, and this trend can be attributed to an increase in trial of labor after cesarean section (TOLAC). TOLAC generally has been accepted as a clinically safe method to reduce the rate of cesarean sections (CSs) and reduce maternal morbidity associated with multiple CSs; however, care providers may be reluctant to offer TOLAC to their patients because of the uterine rupture risk. This population-based study aimed to assess the prevalence of uterine rupture in relationship to CS and TOLAC rates in 9 countries from the International Network of Obstetric Survey Systems (INOSS).
Blood Transfusion Following Intended Vaginal Birth After Cesarean Versus Elective Repeat Cesarean Section in Women With a Prior Primary Cesarean: A Population‐based Record Linkage Study
Authors: Pont S. , Austin K. , Ibiebele I. , Torvaldsen S. , Patterson J. , Ford J. 
Published: November 2019

(Acta Obstet Gynecol Scand. 2019;98:382–389)
For parturients with a previous cesarean delivery, counseling and decision-making needs to be made regarding whether to attempt a vaginal birth after cesarean (VBAC) or undergo elective repeat cesarean section (ERCS). Many factors should be considered during the decision-making process including the likelihood of requiring blood transfusion due to postpartum hemorrhage (PPH). This is an important factor because blood transfusions after PPH have been associated with longer hospital stay, and increased risk of infection, morbidity, and mortality. This study was undertaken to ascertain blood transfusion and PPH rates related to chosen delivery method (VBAC or ERCS) for women with a prior cesarean delivery, as well as to determine the effect of the number of prior cesarean deliveries on transfusion rates.
Lower Uterine Segment Placental Thickness in Women With Abnormally Invasive Placenta
Authors: Bhide A. , Laoreti A. , Agten A.K. , Papageorghiou A. , Khalil A. , Uprichard J. , Thilaganathan B. , Chandraharan E. 
Published: November 2019

(Acta Obstet Gynecol Scand. 2019;98:95–100)
Although uncommon, abnormally invasive placentation (AIP) is associated with adverse maternal outcomes, including maternal mortality, and appears to be increasing in frequency. Maternal morbidity from AIP can be reduced when the diagnosis is known prenatally. Thus, more objective markers of AIP would be useful in establishing the diagnosis. This study aimed to determine whether increased placental thickness in the lower uterine segment could be an indicator of the presence of AIP in women with a low-lying placenta.
The Effectiveness of Applying Soft Tissue Bonding Adhesive Composed of 2-Ethyl Cyanoacrylate to Epidural Catheter Fixations Using Film Dressings: An Open-Label, Randomized, Parallel-Group Comparative Study
Authors: Tadokoro T. , Kakinohana M. , Navarro M. , Goya M. , Odo Y. 
Published: November 2019

(Anesth Analg. 2019;129(1):149–154)
During a cesarean section, epidural catheters that are not adequately fixed can migrate or even fail; this failure can result in insufficient anesthesia for the patient. Although there are various fixation methods for epidural catheters, there is currently no commonly agreed upon technique. These authors conducted their study in patients having a cesarean delivery to determine if a film dressing used in combination with a surgical adhesive (Aron Alpha A) would provide superior fixation in comparison to a film dressing used independently.
Elevated Fibrinogen, von Willebrand Factor, and Factor VIII Confer Resistance to Dilutional Coagulopathy and Activated Protein C in Normal Pregnant Women
Authors: Tanaka K.A. , Bharadwaj S. , Hasan S. , Judd M. , Abuelkasem E. , Henderson R.A. , Chow J.H. , Williams B. , Mazzeffi M.A. , Crimmins S.D. , Malinow A.M. 
Published: November 2019

(Br J Anaesth. 2019;122(6):751–759)
Gestational alterations to coagulation factor concentrations include elevated levels of factor (F) VII, FVIII, and von Willebrand factor (vWF) in comparison to the blood of nonpregnant (NP) reference patients. These elevated factors serve as an advantage in regards to prevention of postpartum hemorrhage. Standard treatment of obstetrical hemorrhage includes fluid replacement, transfusion, vasoactive therapy, and surgical intervention. This treatment can lead to hemodilution after hemorrhage, and consequently progressive coagulopathy, but unfortunately optimal hemostatic intervention(s) and coagulation monitoring are not yet standardized.
Optimising the Management of Late Term Pregnancies: Inconclusive Evidence and High Induction Rates Affect Quality of Care for Women
Authors: Kenyon S. , Skrybant M. , Johnston T. 
Published: November 2019

(BMJ. 2019;364:1681)
Most pregnant women want clear and accurate evidence-based information to help them make decisions about their labor and delivery experience. When confronted with a “postterm” pregnancy, which poses increased risks for women and their babies, this information is especially important. A recent Cochrane systematic review reported that induction at or beyond the due date was associated with fewer perinatal deaths, neonatal admissions to intensive care, and cesarean sections but more operative vaginal births when compared with expectant management. This editorial discussed previous studies and the current study by Keulen and colleagues.
A Randomized Trial of Progesterone in Women With Bleeding in Early Pregnancy
Authors: Coomarasamy A. , Devall A.J. , Cheed V. , Harb H. , Middleton L.J. , Gallos I.D. , Williams H. , Eapen A.K. , Roberts T. , Ogwulu C.C. , Goranitis I. , Daniels J.P. , Ahmed A. , Bender-Atik R. , Bhatia K. , Bottomley C. , Brewin J. , Choudhary M. , Crosfill F. , Deb S. , Duncan W.C. , Ewer A. , Hinshaw K. , Holland T. , Izzat F. , Johns J. , Kriedt K. , Lumsden M.A. , Manda P. , Norman J.E. , Nunes N. , Overton C.E. , Quenby S. , Rao S. , Ross J. , Shahid A. , Underwood M. , Vaithilingam N. , Watkins L. , Wykes C. , Horne A. , Jurkovic D. 
Published: November 2019

(N Engl J Med. 2019;380(19):1815–1824)
This study aimed to determine whether the controversial use of progesterone therapy in women with early bleeding in pregnancy could result in a higher incidence of live births than use of a placebo. It was a multicenter, randomized, double-blind, placebo-controlled trial to evaluate progesterone, as compared with placebo, in women with vaginal bleeding in early pregnancy. Women received vaginal suppositories of progesterone, or a placebo, from presentation of bleeding to 16 weeks to determine if progesterone therapy helps improve pregnancy outcomes for women with vaginal bleeding in early pregnancy.
Reproduction, Fear of Childbirth and Obstetric Outcomes in Women Treated for Fear of Childbirth in Their First Pregnancy: A Historical Cohort
Authors: Möller L. , Josefsson A. , Lilliecreutz C. , Gunnervik C. , Bladh M. , Sydsjö G. 
Published: November 2019

(Acta Obstet Gynecol Scand. 2019;98:374–381)
Fear of childbirth (FOC) affects between 7% and 20% of all pregnant women, and about 8% of pregnant women in Sweden receive counseling for FOC during their pregnancy. FOC is associated with a higher rate of cesarean section on maternal request. Previous data suggest that some FOC treatment methods may be inadequate for eliminating the fear, which may lead women to have negative birth experiences and potentially consider not having additional children. This study aimed to compare the long-term reproductive and obstetric outcomes in women treated for FOC during their first pregnancy with women who did not experience FOC with their first pregnancy.
Photoplethysmographic Evaluation of Sympathectomy During Lumbar Epidural Analgesia: A Randomized Comparison of 0.125% Ropivacaine and 0.125% Levobupivacaine
Authors: Reiner K. , Lukic A. , Martinus M. , Cacic M. , Mihaljevic S. 
Published: November 2019

(Acta Anaesthesiol Scand. 2019;63(6):775–780)
The method of photoplethysmography measures blood flow in the skin through the use of infrared light to gage nervous system activity during both peripheral and central anesthesia blocks. Experts today believe that ropivacaine and levobupivacaine carry varying levels of cardiovascular safety, with ropivacaine being less dangerous, despite a lack of data supporting this opinion. These investigators hypothesized that these 2 local anesthetics actually carry the same cardiovascular safety risk, and aimed to measure the effects of both ropivacaine and levobupivacaine using photoplethysmography.
Ultrasound-Assisted Technology Versus the Conventional Landmark Location Method in Spinal Anesthesia for Cesarean Delivery in Obese Parturients: A Randomized Controlled Trial
Authors: Li M. , Ni X. , Xu Z. , Shen F. , Song Y. , Li Q. , Liu Z. 
Published: November 2019

(Anesth Analg. 2019;129(1):155–161)
For cesarean deliveries, spinal anesthesia is typically performed with the use of manual palpation. However, some patients present challenges to this method, particularly patients with imperceptible surface landmarks or those who are obese. Because spinal anesthesia placement may be more difficult in these patients, there is an increased likelihood of postdural puncture headache, paresthesia, or spinal hematoma. It has been proposed that preprocedure ultrasound scanning can assist care providers with spinal anesthesia placement, but not much research has been done on this subject. These investigators conducted their study to determine whether lateral-positioned ultrasound scanning would result in more precise needle insertions than a blind manual palpation technique for obese patients.
Author-reported affiliations on abstracts accepted for the Pediatric Orthopaedic Society of North America (POSNA) Annual Meeting: A retrospective review
Authors: Murphy Robert F. , Barfield William R. , Offerle Thomas , Osborne Davis , Mooney James F. 
Published: November 2019

Professional education at academic medical meetings is under increasing scrutiny. No data have been published regarding the academic or institutional affiliations of authors who submit abstracts as part of the Pediatric Orthopaedic Society of North America (POSNA) Annual Meeting. We sought to study the self-reported institutional affiliations and other factors over a 6-year period. The POSNA annual meeting programs 2011-2016 were reviewed. The number of abstracts, including those for main program podium presentations, posters, e-posters, and subspecialty day were queried. The number of authors on each submission, presenting author’s reported institutional affiliation, and involvement of a study group or database were documented. Over the 5-year study period the abstract number increased (188 abstracts in 2011 and 294 in 2016, abstracts or a 56% increase). The mean number of authors listed per abstract was five (range, 4.9 to 5.4). Nineteen percent of abstracts were affiliated with three institutions: Texas Scottish Rite Hospital (103), Boston Children’s Hospital (95) and Rady Children’s Hospital (84). Boston Children’s Hospital and Texas Scottish Rite Hospital were most frequent in the main program. These two institutions accounted for 16% to 25% of main program podium abstracts across all years. The total number of abstracts with a study group affiliation increased over the evaluated period (five abstracts in 2011, 18 abstracts in 2016, a 4.5-fold increase). The abstract number at the POSNA annual meeting has increased substantially recently. Although the average number of authors listed on the abstract remained consistent over the review period, study groups/databases were reported as an author/source more frequently. Two academic pediatric orthopaedic centers were affiliated with approximately 20% of the main program abstracts each year.

Level of Evidence:
Level IV.
Development of a Risk Prediction Model With Improved Clinical Utility in Elective Cervical and Lumbar Spine Surgery
Authors: Broda Andrew , Sanford Zachary , Turcotte Justin , Patton Chad 
Published: November 2019

Study Design.
Retrospective cohort.

Objective.
We present a universal model of risk prediction for patients undergoing elective cervical and lumbar spine surgery.

Summary of Background Data.
Previous studies illustrate predictive risk models as possible tools to identify individuals at increased risk for postoperative complications and high resource utilization following spine surgery. Many are specific to one condition or procedure, cumbersome to calculate, or include subjective variables limiting applicability and utility.

Methods.
A retrospective cohort of 177,928 spine surgeries (lumbar (L) Ln = 129,800; cervical (C) Cn = 48,128) was constructed from the 2012 to 2016 American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database. Cases were identified by Current Procedural Terminology (CPT) codes for cervical fusion, lumbar fusion, and lumbar decompression laminectomy. Significant preoperative risk factors for postoperative complications were identified and included in logistic regression. Sum of odds ratios from each factor was used to develop the Universal Spine Surgery (USS) score. Model performance was assessed using receiver-operating characteristic (ROC) curves and tested on 20% of the total sample.

Results.
Eighteen risk factors were identified, including sixteen found to be significant outcomes predictors. At least one complication was present among 11.1% of patients, the most common of which included bleeding requiring transfusion (4.86%), surgical site infection (1.54%), and urinary tract infection (1.08%). Complication rate increased as a function of the model score and ROC area under the curve analyses demonstrated fair predictive accuracy (lumbar = 0.741; cervical = 0.776). There were no significant deviations between score development and testing datasets.

Conclusion.
We present the Universal Spine Surgery score as a robust, easily administered, and cross-validated instrument to quickly identify spine surgery candidates at increased risk for postoperative complications and high resource utilization without need for algorithmic software. This may serve as a useful adjunct in preoperative patient counseling and perioperative resource allocation.

Level of Evidence: 3
Half of Unplanned Readmissions Following One or Two-Level Anterior Cervical Decompression and Fusion Are Unrelated to Surgical Site
Authors: Sing David C. , Vora Molly , Yue John K. , Silveira Luke , Tannoury Chadi 
Published: November 2019

Mini
In this study we analyze rates of readmission, and the timing and reasons for readmission after one to two level anterior cervical decompression and fusion. Among 18,833 patients who underwent anterior cervical decompression and fusion, 3% were readmitted to the hospital within 30 days. 39.5% of readmissions were for reasons related to surgical site.

Study Design.
Retrospective review of a national database.

Objective.
In this study we analyze rates of readmission, and the timing and reasons for readmission after one to two level anterior cervical decompression and fusion (ACDF).

Summary of Background Data.
The safety profile of ACDF has been previously described with readmission rates typically between 2% and 4%. However no studies have investigated the primary diagnoses driving readmission, and whether these diagnoses are related to the surgical site.

Methods.
Demographics, comorbidities, and procedural characteristics were collected for all patients undergoing one or two-level ACDF for degenerative indications identified by Current Procedural Terminology (CPT) coding in the National Surgical Quality Improvement Program (NSQIP) database. The incidence of 30-day complications and readmissions was calculated, and the reasons for readmission as well as the timing of readmission were reviewed. Multivariate logistic regression analyses were performed to identify risk factors associated with complications or readmissions within 30 days of surgery.

Results.
Eighteen thousand eight hundred thirty three patients underwent ACDF (15,464 single-level and 3369 two-level, mean age 53.7 yrs, standard deviation [SD]: 11.6; 50% male). Postoperative complication rate of was 4.3% in two-level fusions and 3.5% in single-level fusion (P = 0.027). Five hundred sixty nine unplanned readmissions were identified (3.0%), of which 39.5% were related to the surgical site and 49.7% were unrelated to the surgical site (10.5% unknown cause of readmission). The most frequent reason for 30-day readmission was pneumonia (9.3%, mean time to readmission of 11.3 d) followed by dysphagia (7.4%, 6.3 d), and acute postoperative pain (7.2%, 11.4 d).

Conclusion.
In this nationwide analysis of 18,833 ACDF cases, 3.0% of patients were readmitted within 30 days, of which at least 49.7% were for reasons unrelated to the surgical site.

Level of Evidence: 3
Effect of Tracheal Intubation Mode on Cuff Pressure During Retractor Splay and Dysphonia Recovery After Anterior Cervical Spine Surgery
Authors: Huang Wen-Cheng , Tan Elise Chia-Hui , Chang Chih-Chang , Kuo Yi-Hsuan , Hsu Xavier T. J. , Chang Wen-Kuei , Huang Shiang-Suo , Chen Pin-Tarng , Chu Ya-Chun 
Published: November 2019

Mini
This randomized clinical trial showed different intubation mode in anesthesia did not affect the increase of endotracheal cuff pressure caused by the retractor splay in anterior cervical spine surgery. However, nasotracheal intubation improved postoperative dysphonia recovery after anterior cervical spine surgery.

Study Design.
Prospective, randomized, double-blinded trial.

Objective.
The aim of this study was to investigate whether the mode of tracheal intubation affects intraoperative endotracheal tube cuff pressure on retractor splay and post-anterior cervical spine surgery (ACSS) voice outcome.

Summary of Background Data.
The combination of endotracheal tube (ETT) and cervical retractors has been implicated in recurrent laryngeal nerve compression and neuropraxia after ACSS. The asymmetric position of the oroETT within the larynx, as being fixed distally by the cuff and proximally by taping on one side of the mouth, may contribute to unilateral vocal palsy.

Methods.
Adult patients undergoing ACSS were randomized to receive either nasotracheal or orotracheal intubation under anesthesia. The primary endpoint was the maximal endotracheal tube cuff pressure (ETCP) when the retractors were set up. After the maximal ETCPs were recorded, then ETCPs were controlled to less than 25 mmHg. Secondary endpoints were self-assessed hoarseness, pitch, and loudness of voice on postoperative days (PODs) 1, 2, 7, and 30.

Results.
We equally allocated 110 patients to nasotracheal and orotracheal intubation. The maximal ETCP during retractor splay did not differ for both the means and distributions of pressure range. After the surgery, more patients in the nasotracheal intubation group reported none or mild change of voice than did the orotracheal intubation group on PODs 1 and 2, in terms of hoarseness, pitch, and loudness (P = 0.001, 0.001, and 0.005, respectively, on POD 1; P = 0.002, 0.003, and 0.011, respectively, on POD 2). Mixed model analysis demonstrated that patients with nasotracheal intubation had significantly lower dysphonia scores after surgery (estimate treatment effect: −1.62, P < 0.0001). Statistics was adjusted to exclude interaction with ETT sizes.

Conclusion.
The tracheal intubation modes did not affect ETCP during retractor splay. However, nasotracheal intubation had a beneficial effect on dysphonia recovery after ACSS.

Level of Evidence: 2
Timing of Tracheostomy in Pediatric Patients: A Systematic Review and Meta-Analysis*
Authors: Abdelaal Ahmed Mahmoud M. Alkhatip Ahmed , Younis Mohamed , Jamshidi Negar , Hussein Hazem A , Farag Ehab , Hamza Mohamed K. , Bahr Mahmoud H. , Goda Ahmed Ahmed , Sallam Amr M. , Mohamed Hassan , Elayashy Mohamed , Hosny Hisham , Yassin Hany M. , Abdelhaq Mohamed , Elramely Mohamed A. , Reeves David , Mills Kerry E. , Kamal Ahmed M. , Zakaria Dina 
Published: November 2019

Objectives:
Tracheostomy is a very common clinical intervention in critically ill adult patients. The indications for tracheostomy procedures in pediatric patients with complex conditions have increased dramatically in recent years, but there are currently no guidelines on the optimal timing of tracheostomy in pediatric patients undergoing prolonged ventilation.

Data Sources:
We performed a systematic search of the existing literature in MEDLINE via PubMed and Embase databases and the Cochrane Library to identify clinical trials, observational studies, and cohort studies that compare early and late tracheostomy in children. The date of the last search was August 27, 2018. Included articles were subjected to manual searching.

Study Selection:
Studies in mechanically ventilated children that compared early with late tracheostomy were included.

Data Extraction:
Data were extracted into a spreadsheet and copied into Review Manager 5.3 (The Cochrane Collaboration, Copenhagen, Denmark).

Data Synthesis:
Data were meta-analyzed using an inverse variance, random effects model. Continuous outcomes were calculated as mean differences with 95% CIs, and dichotomous outcomes were calculated as Mantel-Haenszel risk ratios with 95% CIs. We included eight studies (10 study arms). These studies were all retrospective cohort studies. Early tracheostomy was associated with significant reductions in mortality, days on mechanical ventilation, and length of intensive care and total hospital stay, although the lack of randomized, controlled trials limits the validity of these findings. Although variance was imputed for some studies, these conclusions did not change after removing these studies from the analysis.

Conclusions:
In children on mechanical ventilation, early tracheostomy may improve important medical outcomes. However, our data demonstrate the urgent need for high-quality, randomized controlled trials in the pediatric population.