RESUMEN
OBJECTIVES: To compare pregnancy outcomes after transabdominal chorionic villus sampling using biopsy forceps or needle. MATERIALS AND METHODS: Retrospective bicentric study including all women who had a transabdominal chorionic villus sampling between 2005 and 2009 (172 using biopsy forceps and 160 using needle). The primary endpoint was the rate of fetal loss, after excluding medical abortion due to the result of the biopsy. The secondary endpoint was the rate of premature rupture of the membrane. All cases were reviewed to try to determine the responsibility of the biopsy. RESULTS: The pregnancy outcomes were not different between the two groups: 4 (4.4%) fetal losses in the biopsy forceps group and 6 (7.4%) in the needle group (P=0.52). Only one case (1.2%) of fetal loss can be attributed to the biopsy, using a needle, and none (0%) following a forceps biospy (P=0.29). The rate of premature rupture of the membrane was comparable in the two groups. CONCLUSION: The pregnancy outcomes following chorionic villus sampling using a biopsy forceps or a needle seem comparable.
Asunto(s)
Biopsia/instrumentación , Muestra de la Vellosidad Coriónica/métodos , Resultado del Embarazo/epidemiología , Biopsia con Aguja , Muestra de la Vellosidad Coriónica/efectos adversos , Femenino , Muerte Fetal , Rotura Prematura de Membranas Fetales/epidemiología , Rotura Prematura de Membranas Fetales/etiología , Humanos , Embarazo , Estudios Retrospectivos , Instrumentos QuirúrgicosRESUMEN
Integrated delivery systems continue to form through hospital mergers. The basis for the mergers and systems development as presented to hospital boards and the community is to lower health care costs, and improve quality and access.
Asunto(s)
Prestación Integrada de Atención de Salud/organización & administración , Instituciones Asociadas de Salud , Toma de Decisiones en la Organización , Consejo Directivo , Michigan , Modelos Organizacionales , Responsabilidad Social , Valores Sociales , Integración de SistemasAsunto(s)
Servicio de Cardiología en Hospital/organización & administración , Cardiología/organización & administración , Enfermedades Cardiovasculares/terapia , Comercialización de los Servicios de Salud/organización & administración , Presupuestos , Cardiología/economía , Servicio de Cardiología en Hospital/economía , Conducta Cooperativa , Necesidades y Demandas de Servicios de Salud , Humanos , Comercialización de los Servicios de Salud/economía , Comercialización de los Servicios de Salud/normas , Modelos Organizacionales , Técnicas de Planificación , Administración de la Práctica Médica , Estados UnidosRESUMEN
Financial managers faced with the task of recommending whether diversified services should be dissolved or continued need a logical means of analysis. Their evaluations should consider not only the venture's financial results but concerns specific to the hospital and its market, as well as related social and legal issues. Failure analysis, a function of business portfolio management, helps put these variables in perspective and provides a framework for decision making.