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1.
Anesth Analg ; 123(4): 942-9, 2016 10.
Artículo en Inglés | MEDLINE | ID: mdl-27636577

RESUMEN

Obstetric venous thromboembolism is a leading cause of severe maternal morbidity and mortality. Maternal death from thromboembolism is amenable to prevention, and thromboprophylaxis is the most readily implementable means of systematically reducing the maternal death rate. Observational data support the benefit of risk-factor-based prophylaxis in reducing obstetric thromboembolism. This bundle, developed by a multidisciplinary working group and published by the National Partnership for Maternal Safety under the guidance of the Council on Patient Safety in Women's Health Care, supports routine thromboembolism risk assessment for obstetric patients, with appropriate use of pharmacologic and mechanical thromboprophylaxis. Safety bundles outline critical clinical practices that should be implemented in every maternity unit. The safety bundle is organized into four domains: Readiness, Recognition, Response, and Reporting and Systems Learning. Although the bundle components may be adapted to meet the resources available in individual facilities, standardization within an institution is strongly encouraged.


Asunto(s)
Muerte Materna/prevención & control , Seguridad del Paciente , Complicaciones del Embarazo/epidemiología , Complicaciones del Embarazo/prevención & control , Tromboembolia Venosa/epidemiología , Tromboembolia Venosa/prevención & control , Parto Obstétrico/efectos adversos , Parto Obstétrico/métodos , Parto Obstétrico/normas , Femenino , Humanos , Mortalidad Materna/tendencias , Seguridad del Paciente/normas , Hemorragia Posparto/diagnóstico , Hemorragia Posparto/epidemiología , Hemorragia Posparto/prevención & control , Embarazo , Complicaciones del Embarazo/diagnóstico , Factores de Riesgo , Estados Unidos/epidemiología , Tromboembolia Venosa/diagnóstico
2.
J Obstet Gynecol Neonatal Nurs ; 50(1): 88-101, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33220179

RESUMEN

Supporting women, families, and clinicians with information, emotional support, and health care resources should be part of an institutional response after a severe maternal event. A multidisciplinary approach is needed for an effective response during and after the event. As a member of the maternity care team, the nurse's role includes coordination, documentation, and ensuring patient safety in emergency situations. The National Partnership for Maternal Safety, under the guidance of the Council on Patient Safety in Women's Health Care, has developed interprofessional work groups to develop safety bundles on diverse topics. This article provides the rationale and supporting evidence for the support after a severe maternal event bundle, which includes structure- and evidence-based resources for women, families, and maternity care providers. The bundle is organized into four domains: Readiness, Recognition, Response, and Reporting and Systems Learning, and it may be adapted by nurses and multidisciplinary leaders in birthing facilities for implementation as a standardized approach to providing support for everyone involved in a severe maternal event.


Asunto(s)
Servicios de Salud Materna , Obstetricia , Consenso , Femenino , Humanos , Seguridad del Paciente , Embarazo , Salud de la Mujer
3.
J Obstet Gynecol Neonatal Nurs ; 45(5): 706-17, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27619099

RESUMEN

Obstetric venous thromboembolism is a leading cause of severe maternal morbidity and mortality. Maternal death from thromboembolism is amenable to prevention, and thromboprophylaxis is the most readily implementable means of systematically reducing the maternal death rate. Observational data support the benefit of risk-factor-based prophylaxis in reducing obstetric thromboembolism. This bundle, developed by a multidisciplinary working group and published by the National Partnership for Maternal Safety under the guidance of the Council on Patient Safety in Women's Health Care, supports routine thromboembolism risk assessment for obstetric patients, with appropriate use of pharmacologic and mechanical thromboprophylaxis. Safety bundles outline critical clinical practices that should be implemented in every maternity unit. The safety bundle is organized into four domains: Readiness, Recognition, Response, and Reporting and Systems Learning. Although the bundle components may be adapted to meet the resources available in individual facilities, standardization within an institution is strongly encouraged.


Asunto(s)
Mortalidad Materna , Tromboembolia Venosa , Consenso , Femenino , Humanos , Muerte Materna , Guías de Práctica Clínica como Asunto , Embarazo , Factores de Riesgo
4.
J Midwifery Womens Health ; 61(5): 649-657, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-29473681

RESUMEN

Obstetric venous thromboembolism is a leading cause of severe maternal morbidity and mortality. Maternal death from thromboembolism is amenable to prevention, and thromboprophylaxis is the most readily implementable means of systematically reducing the maternal death rate. Observational data support the benefit of risk-factor-based prophylaxis in reducing obstetric thromboembolism. This bundle, developed by a multidisciplinary working group and published by the National Partnership for Maternal Safety under the guidance of the Council on Patient Safety in Women's Health Care, supports routine thromboembolism risk assessment for obstetric patients, with appropriate use of pharmacologic and mechanical thromboprophylaxis. Safety bundles outline critical clinical practices that should be implemented in every maternity unit. The safety bundle is organized into 4 domains: Readiness, Recognition, Response, and Reporting and Systems Learning. Although the bundle components may be adapted to meet the resources available in individual facilities, standardization within an institution is strongly encouraged.


Asunto(s)
Muerte Materna , Complicaciones del Embarazo/prevención & control , Tromboembolia Venosa/prevención & control , Consenso , Femenino , Humanos , Mortalidad Materna , Seguridad del Paciente , Embarazo , Complicaciones del Embarazo/etiología , Factores de Riesgo , Tromboembolia Venosa/etiología
5.
Obstet Gynecol ; 128(4): 688-98, 2016 10.
Artículo en Inglés | MEDLINE | ID: mdl-27607857

RESUMEN

Obstetric venous thromboembolism is a leading cause of severe maternal morbidity and mortality. Maternal death from thromboembolism is amenable to prevention, and thromboprophylaxis is the most readily implementable means of systematically reducing the maternal death rate. Observational data support the benefit of risk-factor-based prophylaxis in reducing obstetric thromboembolism. This bundle, developed by a multidisciplinary working group and published by the National Partnership for Maternal Safety under the guidance of the Council on Patient Safety in Women's Health Care, supports routine thromboembolism risk assessment for obstetric patients, with appropriate use of pharmacologic and mechanical thromboprophylaxis. Safety bundles outline critical clinical practices that should be implemented in every maternity unit. The safety bundle is organized into four domains: Readiness, Recognition, Response, and Reporting and Systems Learning. Although the bundle components may be adapted to meet the resources available in individual facilities, standardization within an institution is strongly encouraged.


Asunto(s)
Anticoagulantes/administración & dosificación , Heparina de Bajo-Peso-Molecular/administración & dosificación , Complicaciones Cardiovasculares del Embarazo/prevención & control , Tromboembolia Venosa/prevención & control , Anticoagulantes/efectos adversos , Cesárea , Consenso , Femenino , Heparina de Bajo-Peso-Molecular/efectos adversos , Humanos , Parto , Periodo Periparto , Guías de Práctica Clínica como Asunto , Embarazo , Complicaciones Cardiovasculares del Embarazo/epidemiología , Medición de Riesgo , Trombocitopenia/inducido químicamente , Trombocitopenia/diagnóstico , Factores de Tiempo , Tromboembolia Venosa/epidemiología
6.
J Midwifery Womens Health ; 58(6): 632-42, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24406036

RESUMEN

Puerperal genital tract infections, although less common in the 21st century, continue to affect maternal mortality and morbidity rates in the United States. Puerperal genital tract infections include endometritis as well as abdominal and perineal wound infections. These infections interrupt postpartum restoration, increase the potential for readmission to a health care facility, and can interfere with maternal-infant bonding. In addition, unrecognized or improperly treated genital tract infection could extend to other sites via venous circulation or the lymphatic system and increase the risk of severe complications or sepsis. Midwives are leaders in education, low rates of intervention, and prompt recognition of deviation from normal. Because puerperal genital tract infection usually begins after discharge, detailed education for women will encourage preventative health care, prompt recognition, and treatment.


Asunto(s)
Infección Puerperal/diagnóstico , Infección Puerperal/tratamiento farmacológico , Infección de la Herida Quirúrgica/diagnóstico , Infección de la Herida Quirúrgica/tratamiento farmacológico , Antibacterianos/uso terapéutico , Cesárea/efectos adversos , Endometritis/complicaciones , Endometritis/diagnóstico , Endometritis/tratamiento farmacológico , Femenino , Humanos , Control de Infecciones/métodos , Embarazo , Infección Puerperal/prevención & control , Factores de Riesgo , Sepsis/diagnóstico , Sepsis/tratamiento farmacológico , Infección de la Herida Quirúrgica/prevención & control
7.
J Midwifery Womens Health ; 56(3): 266-81, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21535374

RESUMEN

Nearly 30% of women experience an anxiety disorder at some time during their lives, and there is increasing evidence that anxiety disorders are associated with adverse pregnancy outcomes. Despite increased media coverage regarding anxiety disorders, women are reluctant to discuss signs and symptoms of anxiety with family or health care providers. Additionally, despite ongoing research and improved educational curricula, primary care and women's health care providers find diagnosis and treatment of mental health disorders challenging. This article reviews the diagnostic features and pharmacologic treatment options for the most common anxiety disorders including generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, and posttraumatic stress disorder. The impact of anxiety disorders on pregnancy and guidelines for management are presented.


Asunto(s)
Antidepresivos/uso terapéutico , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/tratamiento farmacológico , Benzodiazepinas/uso terapéutico , Antidepresivos/efectos adversos , Antidepresivos de Segunda Generación/efectos adversos , Antidepresivos de Segunda Generación/uso terapéutico , Benzodiazepinas/efectos adversos , Femenino , Humanos , Embarazo , Complicaciones del Embarazo/tratamiento farmacológico , Complicaciones del Embarazo/psicología , Escalas de Valoración Psiquiátrica , Factores de Riesgo
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