bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of Subsequent Pregnancies in Women With Complete Uterine Rupture: A Population-based Case-control Study
Authors: Thisted D. , Rasmussen S. , Krebs L. 
Published: February 2023

(Acta Obstet Gynecol Scand. 2022;101:506–513)
Complete uterine rupture or the rupture of the myometrium occurs in 0.5% of trial of labor after cesarean delivery (TOLAC) births and is related to several adverse events. Few studies regarding the impact of uterine rupture on future delivery have been conducted and have small population sizes. This study aimed to identify later pregnancy outcomes after uterine rupture, identify complications related to the delivery, and compare early pregnancy complications with a control group.
Neonatal Resuscitation in 22-Week Pregnancies
Authors: Lee C.D. , Nelin L. , Foglia E.E. 
Published: February 2023

(N Engl J Med. 2022;386:391–393)
A case vignette is presented to highlight contrasting approaches to the imminent delivery of a 22-week neonate. A 20-year-old, gravida 2 pregnant woman presented at the emergency department with symptoms of premature labor. Her first child was born at 34 weeks by spontaneous vaginal delivery and is a healthy 2-year-old. This parturient has no chronic medical conditions and is receiving routine prenatal care. Her prenatal ultrasonography showed no fetal or placental irregularities. Her vital signs were normal and physical exam is notable only for her active pregnancy. On cervical exam, 3 cm dilation, 40% effacement, and a −2 fetal station. Clinicians are invited to reflect on 2 scenarios regarding whether (1) resuscitation should be recommended for all 22-week neonates; or (2) resuscitation should be offered selectively for 22-week neonates, with opinions offered by experts in favor of positions assigned by the editor.
Fetal Reduction From Twin to Singleton Gestation: A Meta-analysis
Authors: Bardin R. , Gupta M. , Greenberg G. , Nandrajog A. , Tenenbaum-Gavish K. , Gupta N. , Perlman S. , Shmueli A. , Hadar E. 
Published: February 2023

(Int J Gynaecol Obstet. 2022;158:260–269)
Fetal reduction may be requested by parents in a multiparous pregnancy with normally developing fetuses in favor of supporting maternal medical conditions, psychological factors, poorly resourced socioeconomic status, or to improve projected pregnancy outcome. This is in contrast to selective termination where there is an abnormal fetus in a multiparous pregnancy. Twin pregnancies carry 2 to 3.5 times increased risk of maternal hypertensive and hyperglycemic complications, and 2 to 3 times increased risk of perinatal and infant mortality. Approximately 50% of twin pregnancies result in preterm birth (PTB), and further early PTB occurs in 14%. The benefits and drawbacks of multifetal reduction in triplets and quadruplets has been studied, but maternal, perinatal, and neonatal results for twins are inconsistent. This meta-analysis helps to clarify issues around fetal reduction compared to ongoing twin pregnancies.
No Pain Management for Labor: Individual and Organizational Determinants: A Secondary Analysis of the 2016 French National Perinatal Survey
Authors: Merrer J. , Chantry A.A. , Blondel B. , Le Ray C. , Bonnet M.P. 
Published: February 2023

(Eur J Anaesthesiol. 2022;39:489–497)
Pain management during labor and delivery is a fundamental right for patients in labor. Disparities in women’s access to analgesia in childbirth requires further research. Using national data, this study aims to determine the proportion of women who receive no labor pain management, and its individual and organizational factors.
A Survey of Labor Epidural Practices at Obstetric Anesthesia Fellowship Programs in the United States
Authors: Callahan E. , Yeh P. , Carvalho B. , George R.B. 
Published: February 2023

(Can J Anaesth. 2022;69:591–596)
Methods of delivery for labor epidural analgesia (LEA) are varied and numerous, with areas of consensus and departure in the consideration of best practices among anesthesia providers. With variations in placement technique, choosing to use a combined spinal epidural (CSE) with the additional delivery of intrathecal (IT) medication, opting for an initial bolus delivery, and the multiplying variables of analgesic selection in the epidural or IT space, practice heterogeneity may become a norm that is worth reconsidering in favor of an evidence-based consensus. Contemporary LEA practices were surveyed in American Council for Graduate Medical Education (ACGME)-accredited obstetric anesthesiology fellowship training programs to estimate the current thought on optimal LEA care.
Prevention and Management of Intraoperative Pain During Cesarean Section Under Neuraxial Anesthesia: A Technical and Interpersonal Approach
Authors: Plaat F. , Stanford S. , Lucas D. , Andrade J. , Careless J. , Russell R. , Bishop D. , Lo Q. , Bogod D. 
Published: February 2023

(Anaesthesia. 2022;77:588–597)
The term failure in literature has several different meanings including no blockage, partial blockage, or the need for general anesthesia. In an effort to support clinicians and patients during anesthesia, this article outlines eleven recommendations created by the Obstetric Anaesthetists’ Association working group and the Obstetric Anaesthetists' Association Executive Committee that are designed to improve care and provide minimum standards for consent, assessment of pain, management of intraoperative pain, follow-up communication, and communication as a whole. A group of varied anesthetists and a psychologist formed these recommendations based on 44 studies and literature published in Medline, Embase, CINAHL, and PubMed through the years of 1980 and 2020.
Comparison of Equipotent Doses of Intrathecal Hyperbaric Prilocaine 2% and Hyperbaric Bupivacaine 0.5% for Elective Caesarean Section: A Prospective, Randomized, Controlled, 2-Center Clinical Trial
Authors: Goffard P. , Leloup R. , Vercruysse Y. , Fils J.F. , Gautier P.E. , Kapessidou Y. 
Published: February 2023

(Eur J Anaesthesiol. 2022;39:227–235)
Spinal anesthesia is the most common anesthetic for elective cesarean delivery (CD), usually with a long-acting local anesthesia like bupivacaine combined with opioids. While providing many benefits, bupivacaine also comes with risks. Hyperbaric prilocaine, an intermediate-acting local anesthetic, thus may have some advantages. Intrathecal (IT) 2% prilocaine provides rapid onset of sensory and motor block without significant side effects, however, has not been widely studied for CD. This study compared IT hyperbaric prilocaine 2% and hyperbaric bupivacaine 0.5% during elective CD.
Spinal Versus General Anesthesia for Cesarean Delivery in Pregnant Women With Moyamoya Disease: A Retrospective Observational Study
Authors: Kim H.J. , Choi S.H. , Kwon H. , Park E.K. , Kwon J.Y. , Yang H. , Kim S.H. 
Published: February 2023

(Anesth Analg. 2022;135:617–624)
Moyamoya disease (MMD), a rare cerebrovascular disease causing the vascular network at the brain’s base to be fragile, requiring careful blood pressure control and proactive medical treatment to prevent life-threatening hemorrhage and/or ischemic events. The exact risks pregnancy, labor, and delivery for MMD patients is unknown. The aim of this study was to determine if the choice of spinal anesthesia versus general anesthesia would have a significant effect on the intraoperative mean arterial pressure in MMP patients undergoing cesarean section.
Frequency and Risk Factors for Difficult Intubation in Women Undergoing General Anesthesia for Cesarean Delivery: A Multicenter Retrospective Cohort Analysis
Authors: Reale S.C. , Bauer M.E. , Klumpner T.T. , Aziz M.F. , Fields K.G. , Hurwitz R. , Saad M. , Kheterpal S. , Bateman B.T. 
Published: February 2023

(Anesthesiology. 2022;136:697–708)
Elucidating the contemporary rate of difficult or failed intubation in women undergoing general anesthesia for cesarean delivery is confounded in the literature by small sample size, and the unaccounted-for increased use of neuraxial anesthesia and video laryngoscope, all amounting to generally outdated information available for this question. As the mother and neonate are at high risk for adverse outcome with difficult intubation, it is important to understand characteristics that may increase the likelihood of this complication, as to initiate pertinent preparation and early neuraxial anesthesia. The aim of this study was to determine an updated frequency of difficult and failed intubation in the obstetric setting and identify risk factors of such that may be particular to women receiving general anesthesia for cesarean delivery.
Transversus Abdominis Plane Block Versus Local Anesthetic Wound Infiltration for Analgesia After Cesarean Section: A Systematic Review and Meta-analysis With Trial Sequential Analysis
Authors: Grape S. , Kirkham K.R. , Albrecht E. 
Published: February 2023

(Eur J Anaesthesiol. 2022;39:244–251)
Cesarean delivery (CD) rates have been increasing, and regional anesthesia has been shown to mitigate negative postoperative maternal outcomes. When intrathecal opioid is absent, experts suggest fascial plane blocks, such as a transversus abdominis plane (TAP) block, or local anesthetic wound infiltration for analgesia following CD. This study aims to review TAP block and wound infiltration analgesic techniques and outcomes to determine which is better for CD.
Predictors of Patient Postdischarge Opioid Use After Cesarean Delivery: A Prospective Study
Authors: Cohen A. , Xie X. , Zeuner R. , Galperin S. , Brunei T. 
Published: February 2023

(Int J Obstet Anesth. 2022;50:103249)
Many consider the United States’ opioid crisis a public health emergency. Therefore, all available avenues to discourage opioid use after medical intervention is necessary. Opioids are frequently prescribed after cesarean delivery (CD) but use is inconsistent. This study assessed post-CD opioid use and identified demographic characteristics that correspond with additional opioid use.
Pregnancy and Labor Epidural Effects on Gastric Emptying: A Prospective Comparative Study
Authors: Bouvet L. , Schulz T. , Piana F. , Desgranges F.-P. , Chassard D. 
Published: February 2023

(Anesthesiology. 2022;136:542–550)
Strict fasting during labor has been practiced for more than 70 years in the United States. During that time, the incidence of peripartum aspiration pneumonia has significantly decreased, in part due to advances in anesthesia. Some European guidelines allow patients to consume low-residue food during labor, while US guidelines only allow for clear fluids. There is a lack of strong data concerning gastric emptying in labor. This study compared gastric emptying after a light meal in laboring patients with epidural analgesia, laboring patients without epidural analgesia, pregnant nonlaboring women, and nonpregnant women.
V-Y Flap Over Moberg’s Flap to Cover the Thumb’s Fingertip Injury: Technique and Cases
Authors: Díaz Luis Carlos , Vergara-Amador Enrique , Camacho Castro Felipe 
Published: February 2023

The Moberg flap has been used to achieve coverage of amputations of the thumb’s fingertip. However, it has been associated with flexion contractures of the interphalangeal (IP) joint of the thumb. A modification of the surgical technique is presented, adding a distal V-Y flap to allow greater advancement, and avoiding IP joint contractures. The proposed surgical technique is presented, and a case series of patients treated with this modification is introduced. A total of 5 patients underwent this surgical technique. All the flaps healed without complications. No patient presented stiffness or flexion contracture of the thumb´s IP joint. There were no cases of neuropathic pain and the 2-point discrimination over the flap was 6.8 mm on average. In conclusion, the proposed variation to the Moberg’s flap allows adequate coverage of injuries to the thumb’s fingertip with a low rate of complications, adequate sensitivity of the reconstructed digit and avoiding flexion contractures of the IP joint.
Mortality and Sequential Organ Failure Assessment Score in Patients With Suspected Sepsis: The Impact of Acute and Preexisting Organ Failures and Infection Likelihood
Authors: Christensen Erik E. , Prebensen Christian H. , Martinsen Anders B. , Stiff Elisabeth T. , Hoff Rune , Kvale Dag , Holten Aleksander R. 
Published: February 2023

IMPORTANCE:
The Sequential Organ Failure Assessment (SOFA) was chosen in the definition of sepsis due to superior validity in predicting mortality. However, few studies have assessed the contributions of acute versus chronic organ failures to SOFA for mortality prediction.

OBJECTIVES:
The main objective in this study was to assess the relative importance of chronic and acute organ failures in mortality prediction in patients with suspected sepsis at hospital admission. We also evaluated how the presence of infection influenced the ability of SOFA to predict 30-day mortality.

DESIGN, SETTING, AND PARTICIPANTS:
Single-center prospective cohort study including 1,313 adult patients with suspected sepsis in rapid response teams in the emergency department.

MAIN OUTCOMES AND MEASURES:
The main outcome was 30-day mortality. We measured the maximum total SOFA score during admission (SOFATotal), whereas preexisting chronic organ failure SOFA (SOFAChronic) score was assessed by chart review, allowing calculation of the corresponding acute SOFA (SOFAAcute) score. Likelihood of infection was determined post hoc as “No infection” or “Infection.”

RESULTS:
SOFAAcute and SOFAChronic were both associated with 30-day mortality, adjusted for age and sex (adjusted odds ratios [AORs], 1.3; 95% CI, 1.3–14 and 1.3; 1.2–1.7), respectively. Presence of infection was associated with lower 30-day mortality (AOR, 0.4; 95% CI, 0.2–0.6), even when corrected for SOFA. In “No infection” patients, SOFAAcute was not associated with mortality (AOR, 1.1; 95% CI, 1.0–1.2), and in this subgroup, neither SOFAAcute greater than or equal to 2 (relative risk [RR], 1.1; 95% CI, 0.6–1.8) nor SOFATotal greater than or equal to 2 (RR, 3.6; 95% CI, 0.9–14.1) was associated with higher mortality.

CONCLUSIONS AND RELEVANCE:
Chronic and acute organ failures were equally associated with 30-day mortality in suspected sepsis. A substantial part of the total SOFA score was due to chronic organ failure, calling for caution when using total SOFA in defining sepsis and as an outcome in intervention studies. SOFA’s mortality prediction ability was highly dependent on actual presence of infection.
An Adapted Self-screening Tool for Peripartum Cardiomyopathy in Haiti
Authors: Rene Cassandra , Faustin Mikerlyne , Bonhomme Jerry , Deschamps Marie-Marcelle , Jean-Gilles Michele , Rosenberg Rhonda , Ibrahim Michel , McNairy Margaret , Pape Jean W. , Devieux Jessy G. 
Published: February 2023

Background:
Peripartum cardiomyopathy (PPCM) is considered rare in the United States; however, the literature notes that the disease has a higher prevalence in developing countries such as Haiti. Dr. James D. Fett, a US cardiologist, developed and validated a self-assessment measure for PPCM in the United States to aid women to easily differentiate the signs and symptoms of heart failure from those related to a normal pregnancy. Although this instrument was validated, it lacks the adaptation necessary to account for the language, culture, and education of the Haitian population.

Objective:
The aim of this study was to translate and culturally adapt the Fett PPCM self-assessment measure for use among a Haitian Creole speaking population.

Methods:
A preliminary Haitian Creole direct translation was developed from the original English Fett self-test. A total of four focus groups with medical professionals and 16 cognitive interviews with members of a community advisory board were conducted to refine the preliminary Haitian Creole translation and adaptation.

Results:
The adaptation focused on incorporating cues that would be tangible and connected to the reality of the Haitian population while maintaining the intended meaning of the original Fett measure.

Conclusions:
The final adaptation provides an instrument suitable for administration by auxiliary health providers and community health workers to help patients distinguish symptoms of heart failure from symptoms related to normal pregnancy and further quantify the severity of signs and symptoms that might be indicative of heart failure.
A Pilot Study on Standardized In-hospital Education About Heart Failure Conducted During the First Days After Decompensation
Authors: Siennicka Agnieszka , Biegus Jan , Gajewski Piotr , Młynarska Katarzyna , Sokolski Mateusz , Siwołowski Paweł , Zymliński Robert , Jedynak Kamila , Ponikowska Beata , Urban Szymon 
Published: February 2023

Introduction:
Education addressed to heart failure (HF) patients constitutes an important element of modern comprehensive treatment programs. The present article demonstrates a novel method of standardized in-hospital education addressed to patients admitted due to decompensation in HF.

Methods:
This pilot study was conducted among 20 patients [19 men, age 63 ± 16 years, NYHA (Classification according to New York Heart Association) on admission (II/III/IV): 5/25/70%]. Five-day education was based on individual sessions conducted using colorful boards demonstrating selected, highly practical elements of the knowledge about HF management, prepared by experts in HF management (medical doctors, a psychologist, and a dietician). The level of knowledge about HF was measured before and after education, based on a questionnaire prepared by the authors of the boards.

Results:
All patients experienced an improvement of their clinical status (confirmed by reduced New York Heart Association class and body mass, both P < 0.05). Mini Mental State Exam (MMSE) confirmed that no one demonstrated cognitive impairment. The score reflecting the level of knowledge about HF improved significantly after 5 days of in-hospital treatment accompanied by education (P = 0.0001).

Conclusions:
We showed that the proposed model of education addressed to patients with decompensated HF, conducted using colorful boards demonstrating selected, highly practical elements of the knowledge about HF management, prepared by experts in HF management lead to significant increase of HF-related knowledge.
The Effects of Exercise Training on Low Back/Pelvic Girdle Pain During Pregnancy: A Systematic Review
Authors: McCarthy Traci A. , Reddy Pranav S. , Simonds Adrienne H. , Spaeth Andrea M. 
Published: February 2023

Background:
Forty-five percent of pregnant women report moderate to severe low back and/or pelvic girdle pain (LBP/PGP) during pregnancy. Exercise, specifically muscular fitness training, is effective for the prevention and treatment of LBP/PGP in the general population. However, its efficacy during pregnancy is unknown.

Objectives:
The goal of this review is to examine the evidence supporting muscular fitness training for prevention and treatment of LBP/PGP during pregnancy.

Study Design:
A systematic review.

Methods:
A systematic review was conducted from February 2021 to June 2022 using online databases and hand searching. Randomized control trials were included if the population was pregnant women, the intervention was exercise training, the comparison was a nonexercise control group, and the outcome was LBP/PGP. A risk of bias analysis using the Cochran Risk of Bias (RoB) tool and quality assessment were performed using the GRADE method. The included articles were compiled into exercise types for comparison.

Results:
Of the 1707 articles found, 26 (n = 3946 pregnant women) were included in the final analysis after removing duplicates, articles that did not meet inclusion criteria, and articles unavailable in English. Seventeen out of 26 articles found that exercise during pregnancy had a positive effect on pain, but the quality of the studies ranged from very low to moderate. None of the included articles utilized strength training for muscular fitness, 2 used hypertrophy training, and the remaining articles utilized muscular endurance programs for muscular fitness.

Conclusion:
Strength and hypertrophy training for LBP/PGP during pregnancy is largely unknown and understudied; however, many other modes of exercise for muscular endurance improved pain. More research is warranted to determine the benefits of traditional strength and hypertrophy training for LBP/PGP management during pregnancy.
Oral Chemotherapeutic Ingestions Reported to a Poison Control Center Treated in a Health Care Facility
Authors: Ontiveros Sam , Hogue Brenna , Kreshak Allyson , Coyne Christopher , Cantrell Lee , Minns Alicia 
Published: February 2023

Background:
The approach to cancer chemotherapy has changed in recent years, and there are several new oral chemotherapeutics that offer convenience to patients. These medications have toxicity, which may be particularly amplified in an overdose.

Study Design:
This was a retrospective review of all oral chemotherapy overdoses reported to the California Poison Control System between January 2009 and December 2019. Inclusion criteria were all ingestions coded as “antineoplastic, monoclonal antibody, or thalidomide” that were evaluated at a health care facility. We evaluated outcomes per AAPCC criteria (stratified as death, major, moderate, mild, or no effect) as well as symptoms and interventions.

Results:
There were 314 total cases reported; 169 single-substance ingestions (54%) and 145 cases with coingestant(s) (46%). One hundred eighty cases were female (57%) and 134 male (43%). Age ranges were as follows: ages 1–10 years old (87 cases); ages 11–19 years old (26 cases); 20–59 years old (103 cases); ages 60 and older (98 cases). The majority of cases were unintentional ingestions (199, 63%). The most common medication reported was methotrexate with 140 cases (45%), followed by anastrozole (32 cases) and azathioprine (25 cases). One hundred thirty-eight cases were admitted to the hospital for further care (ICU 63 cases; non-ICU 75 cases). Eighty-four of the methotrexate cases received the antidote leucovorin (60%). Five of the capecitabine ingestions received uridine (36%). Outcomes included 124 cases with no effect, 87 cases with minor effect, 73 case with moderate effect, 26 cases with major effect, and 4 deaths.

Conclusion:
Although methotrexate is the most common oral chemotherapeutic agent involved in overdoses reported to the California Poison Control System, there are many other oral chemotherapeutics from various drug classes, which can lead to toxicity. Although deaths are rare, further studies are needed to determine if particular drugs or drug classes warrant more scrutiny.