ABSTRACT
Extrasystoles particularly premature atrial contractions noted during labour on the fetal heart rate monitoring strip are usually thought to be benign. In pregnancies complicated by fetal infection and/or the fetal inflammatory response syndrome, there are some data that extrasystoles noted during the intrapartum period may be related to neonatal sepsis and eventual poor neonatal outcome including death or neonatal encephalopathy. Additional observations are needed to substantiate this hypothesis.
Subject(s)
Cardiac Complexes, Premature/diagnosis , Fetal Distress/diagnosis , Fetal Monitoring , Heart Rate, Fetal/physiology , Adolescent , Adult , Cardiac Complexes, Premature/complications , Fatal Outcome , Female , Humans , Pregnancy , Pregnancy Outcome , Prenatal Care , Sepsis/etiology , Systemic Inflammatory Response Syndrome/etiologyABSTRACT
OBJECTIVE: The purpose of this study was to determine whether risk-adjusted hospital primary cesarean delivery rates are associated with poor neonatal outcomes. STUDY DESIGN: The Washington State Birth Events Records for 1995 and 1996 were used. Predicted primary cesarean delivery rates were calculated for each hospital. Women were divided by whether the hospital had an actual primary cesarean delivery rate below, within, or greater than the predicted CI. Asphyxia (a lack of oxygen that leads to organ damage) was used as a marker of poor neonatal outcome. Risk of neonatal asphyxia was compared for each of the 3 cesarean rating groups. RESULTS: The risk for asphyxia among infants who were born to women who delivered at hospitals that had more, within, or fewer cesarean deliveries than predicted were 0.58%, 0.17%, and 0.33%, respectively (P <.0001). CONCLUSION: Infants born to women who delivered at hospitals that had more than or fewer than the predicted number of primary cesarean deliveries experienced a greater risk of neonatal asphyxia.
Subject(s)
Asphyxia Neonatorum/etiology , Cesarean Section/statistics & numerical data , Adolescent , Adult , Child , Female , Humans , Infant, Newborn , Middle Aged , Pregnancy , Risk , Risk AdjustmentABSTRACT
Transition to retirement is a necessary step for all physicians because of the physical and emotional changes that occur with the aging process, the physician's ethical responsibilities to patients, and at times, because there is a desire to pursue different goals. It is important to begin to plan for this transition early in one's career so that some planning for postretirement vocation and avocation can be made and financial concerns can be addressed. A recent ACOG survey of 1000 Fellows ages 40-60 demonstrates that this planning is not occurring universally and the assistance of Fellows in preparation for this transition is now becoming an ACOG initiative.
