IATS Panel Abstracts
Prior to the 18th century, caring for pregnant women in Europe was confined exclusively to women, and rigorously excluded men. The expectant mother would invite close female friends and family members to her home to keep her company. The presence of physicians and surgeons was very rare and only occurred once a serious complication had taken place and the midwife had exhausted all measures to manage the complication. Calling a surgeon was very much a last resort and having men deliver women in this era whatsoever was seen as offending female modesty. However, the subject matter and interest in the female reproductive system and sexual practice can be traced back to Ancient Egypt  and Ancient Greece. Living in the late first century A. After the death of Soranus, techniques and works of gynecology declined but very little of his works were recorded and survived to the late 18th century when gynaecology and obstetrics reemerged. These advances in knowledge were mainly regarding the physiology of pregnancy and labour. By the end of the century, medical professionals began to understand the anatomy of the uterus and the physiological changes that take place during labour. The introduction of forceps in childbirth also took place during the 18th century.
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Obstetric dating accuracy of current cpr. The quality of these wheels varies, but in general, the larger wheels yield better. Emerging clinical nurse obstetrics-gynecology, you both weeks before the completeness. Ultrasound in obstetric decision making. The quality of these wheels varies, but in obstetric dating accuracy, the larger wheels yield better.
APHA Annual Meeting & Expo. Home Events & Meetings Annual Meeting Schedule & Program. Recorded Annual Meeting Presentations (RAMP) are now available for purchase. MPH, NRP, US Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response; Robert Cothren, PhD.
Obstetric Pregnancy Obstetric Pregnancy For all Obstetrics scans, no special preparation is needed, although it is best to wear loose clothing that can easily be lifted or removed in order to expose your abdomen. You will lie on your back on an examination couch and the transducer moved back and forth across your stomach in order to gain the best possible image of the fetus. Ultrasound imaging in pregnancy is widely used to evaluate the baby.
It can determine if a baby is present, the position of the fetus and if there is a multiple pregnancy. It can also help to diagnose abnormalities or problems, help determine the age of the pregnancy and subsequent due date as well as showing the position of the placenta in relation to the birth canal.
There is also then a routine scan at 20 weeks. Individual circumstances may dictate that more scans may be offered and a breakdown of what you could receive is detailed below. Early viability scan This usually takes place at 6 to 10 weeks of pregnancy. The scan can confirm the number of babies in the uterus, the embryo can be observed and measured by about five and a half weeks and a heartbeat usually detected by 6 weeks. Scans at this stage in pregnancy are reassuring for women experiencing bleeding, pain or who have had previous miscarriages.
Transvaginal scanning may also be used to obtain a better image of the womb.
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With over 1, ob-gyn related apps on the market, ACOG’s EDD Calculator is the only one that reconciles the discrepancy in due dates between the first ultrasound and the date of the last menstrual period. The EDD Calculator also recalculates the due date based on ultrasound or on assisted reproductive technology ART to assist health care providers with patients who undergo embryo transfer, or IVF, in adherence to the Committee Opinion. ACOG supports the use of the EDD Calculator and will transition away from the physical plastic wheel in favor of this modern reinvention.
That’s the highest score among all of the other pregnancy wheel apps that my colleagues and I previously evaluated in our study published in Obstetrics and Gynecology in June
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The Global Network was developed with a goal of building local maternal and child health research capacity in resource-poor settings. The objective of the network was to conduct research focused on several high-need areas, such as preventing life-threatening obstetric complications, improving birth weight and infant growth, and improving childbirth practices in order to reduce mortality.
Scientists from developing countries, together with peers in the USA, lead research teams that identify and address population needs through randomized clinical trials and other research studies. Global Network projects develop and test cost-effective, sustainable interventions for pregnant women and newborns and provide guidance for national policy and for the practice of evidence-based medicine.
Since , Global Network sites in six low and middle-income countries have collected information on antenatal care practices, which are important as indicators of care and have implications for programs to improve maternal and child health. MNHR data from these sites were prospectively collected from January 1,
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Stephen R Large Background After a severe shortage of brain-dead donors, the demand for heart transplantation has never been greater. In an attempt to increase organ supply, abdominal and lung transplant programs have turned to the donation after circulatory-determined death DCD donor. However, because heart function cannot be assessed after circulatory death, DCD heart transplantation was deemed high risk and never adopted routinely.
We report a novel method of functional assessment of the DCD heart resulting in a successful clinical program. Methods Normothermic regional perfusion NRP was used to restore function to the arrested DCD heart within the donor after exclusion of the cerebral circulation. After weaning from support, DCD hearts underwent functional assessment with cardiac-output studies, echocardiography, and pressure-volume loops. In the feasibility phase, hearts were transported perfused before evaluation of function in modified working mode extracorporeally.
Manual of Neonatal Care 7th ed.
A pulse oximeter can provide a continuous assessment of the pulse without interruption of other resuscitation measures, but the device takes 1 to 2 minutes to apply, and it may not function during states of very poor cardiac output or perfusion. Once positive pressure ventilation or supplementary oxygen administration is begun, assessment should consist of simultaneous evaluation of 3 vital characteristics: The most sensitive indicator of a successful response to each step is an increase in heart rate.
At every delivery there should be at least 1 person whose primary responsibility is the newly born. This person must be capable of initiating resuscitation, including administration of positive-pressure ventilation and chest compressions. Either that person or someone else who is promptly available should have the skills required to perform a complete resuscitation, including endotracheal intubation and administration of medications.
R. G. Axell of University College London Hospitals NHS Foundation Trust, London (uclh) with expertise in: Cardiothoracic Surgery, Cardiology and Biomedical Engineering. Read 73 publications, and.
It is usually part of an assessment called combined first trimester screening. Combined first trimester screening Combined first trimester screening assesses the risk for your baby having certain chromosomal abnormalities trisomy 13, 18 and This testing combines the nuchal translucency ultrasound with specific blood tests. Nuchal translucency ultrasound alone can also provide this risk assessment, but it is not as accurate as combined first trimester screening.
Combined first trimester screening is a non-invasive way of assessing your risk, which means it does not involve putting needles into the placenta or amniotic sac, as happens with CVS and amniocentesis. This means that combined first trimester screening simply tells us if your risk is low or high. For example, it tells us whether your baby has a low risk of having trisomy 13, 18 or 21, or whether your baby has a high risk of having trisomy 13, 18 or This test gives us an indication of whether we should worry about your baby based on these results.
This means that combined first trimester screening will not give us a definitive answer. Chorionic villus sampling and amniocentesis are invasive tests, involving putting needles into the placenta or amniotic sac, and they are associated with an increased risk of miscarriage.
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Second-trimester ultrasound screening for aneuploi- dies is based on looking for rating markers and some predefined structural abnormalities. Archived from on 13 May Music and discover the joys of life without him will be my heart as well. Ultrasound may also detect fetal organ anomaly. Performing an ultrasound at this early stage of pregnancy can more accurately confirm the timing of the pregnancy and can also assess for multiple fetuses and major congenital abnormalities at an earlier stage.
The bright white circle center-right is the head, which faces to the left.
accuracy. It’s a Fort Pierce dog’s life I just saw on a television news program, that Califor-nia has passed a law prohibiting dogs, from being tied up Comprehensive Obstetric & Gynecologic care including:: Low & High risk obstetrics Contraception Gentle well-woman exams, Pap smears.
The decision agreed before birth may need to be modified based on the condition of the baby after birth and the postnatal gestational age assessment. You are called to counsel the parents of a fetus who is believed to be at the lower limits of viability whose birth is imminent. What should you tell the parents when they ask you how decisions about resuscitation are made? It is worth obtaining up-to-date outcome data for your institution or region, or use the NRP website and National Institute of Child Health and Human Development estimator for national data.
A woman is admitted at 24 weeks gestation with rupture of membranes, maternal fever, and premature labor. The baby is likely to be born in the next few hours with an estimated weight of g.
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The timing of certain tests, the monitoring of the baby’s growth, and the correct diagnosis of premature labor, or being truly “overdue,” postdates , as well as many other situations that arise in the course of a typical pregnancy, all depend on a correct determination of the EDC for appropriate management. In the past, the EDC was calculated by using Naegele’s Rule, which determined the date by subtracting 3 months from the 1st day of the last period and then adding 7 days. In fact, when a woman who has very regular, “textbook” 28 day cycles presents for prenatal care, this often turns out to be the correct EDC more often than not.
Other information used to calculate the gestational age, or the number of weeks and days from the first day of the last menstrual period LMP , includes the size of the uterus on pelvic bimanual examination. However, it is extremely common to encounter patients who have irregular or infrequent menstrual cycles, or have fibroid tumors that cause their uterus to feel enlarged on pelvic exam, or who conceive shortly after a pregnancy ends without ever actually having had a period after the last pregnancy , or who got pregnant while taking birth control pills, and these situations often render the above methods useless and misleading when trying to figure out a reliable EDC.
This is where our wonderful ultrasound machines can make a crucial difference. With today’s modern equipment, we can obtain very reliable images and measurements of even very early pregnancies, sometimes even seeing a heartbeat as early as weeks!
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At the larger measurements 40 and 50 mm lateral and axial the errors are almost exclusively ascribed to differences in machine—probe combinations, while at 10 mm it is clear that the differences are attributable to both intraobserver and machine—probe factors. This is of potential importance, as the differences between machine—probe combinations would lead to clinically significant differences in pregnancy dating depending on gestational age at dating and which parameter is used, for example CRL or FL.
The data are likely to be robust, as in all cases a given machine—probe combination either over measured, or under measured, showing consistent errors in the measurement, whose magnitude depended on the size of target being measured in the phantom. These findings are likely to be true as one observer performed all the measurements, and intraobserver error was calculated in all cases.
The ultrasound phantom provides a consistent target that was devoid of physiological variability, whereas a fetus may be moving in the uterus, thereby creating additional errors between measurements. The phantom weighed exactly the same g as specified on the calibration certificate provided by the manufacturer, indicating that there had been no water loss from it, hence the distance between the caliper targets is as specified.
Even if there were slight differences in the true distance between the caliper targets within the phantom, this would only introduce a systematic error for all axial and lateral measurements taken using the different ultrasound scanners. This study was designed to make comparisons of the differences in measurement taken using the different scanners, rather than as an evaluation of the absolute measurement size in comparison with the specified caliper target size.
Recent guidance recommends that caliper measurements perform to an accuracy appropriate to meet the clinical requirement 8 , 9. This is at odds with what is expected clinically3: This does not take into account errors introduced using other machine—probe combinations. This is of course a far cry from what is expected in our routine clinical practice.
This is not surprising, as one would expect errors to increase in absolute terms, but reduce in relative terms as the measurement becomes larger.
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Their comparison is fruitful. Additional literary and cross-cultural references will be explored in this presentation. These painted panels yield concrete documentation of the mobile habitat of the btsan po and his entourage during the sPu rgyal dynasty. The study of the women and men portrayed on these panels — their activities, weapons, cooking utensils and drinking vessels, costumes, jewelry and face make-up, and the accoutrements of their habitat – yield clues to better understanding of daily life in ancient Tibet while simultaneously relating to customs prevailing in nomads of western Tibet during the 20th century.
In this paper I will suggest the outlines of a typology of the styles of writing current during the latter part of the Tibetan imperial period — the late 8th to the mid 9th centuries. This typology is based on the earliest sources for written Tibetan: Based on the study of hundreds of such exemplars, the typology represents a preliminary attempt to provide a framework for approaching Tibetan written sources from the imperial period.
The typology is based on a palaeographical analysis of key letter forms, showing how different writing styles usually express changes in the “ductus” — the order and direction of strokes. I will also address the social context of the manuscripts, and suggest how writing styles were closely linked to the social function of the scribe and the manuscript.
The question of the relevance of the sources from “marginal” areas to development in the “centre” of Tibetan polity during the empire will also be discussed. Towards the end of the paper, I will give a brief description of the rapid development of calligraphic writing styles after the fall of the Tibetan empire, and suggest how we might be able to date manuscripts to the imperial or post-imperial periods based on their palaeographical features.
I will discuss the question of two different approaches to palaeographical analysis — the analysis of styles and the identification of individual scribal handwritings — arguing that one cannot be present without the other. In conclusion I will suggest the ways that the typology presented here needs to be challenged, developed and refined in future palaeographical research.