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Obstetrics400 papers

Airway morbidity

Last edited: 4/13/2026

Overview

Airway morbidity encompasses a range of complications affecting the airway, often seen in critical obstetric scenarios, pediatric emergencies, and geriatric care, impacting morbidity and mortality rates significantly. 172232

Diagnosis

  • Clinical Presentation: Dyspnea, stridor, cyanosis, and altered mental status.
  • Diagnostic Tests: Flexible laryngoscopy, imaging (CT/MRI), arterial blood gas analysis.
  • Grading Systems: Utilization of scoring systems like the Modified Obstetric Early Warning Score for risk stratification. 9

    • Management

  • Airway Management: Rapid sequence intubation, use of supraglottic airways, and surgical airway interventions as needed.
  • Supportive Care: Mechanical ventilation, oxygen therapy, and hemodynamic stabilization.
  • Specific Interventions: Transillumination-assisted technique for intubation in novices 37.

    • Special Populations

  • Pregnancy: Focus on obstetric emergencies requiring immediate airway intervention; risk of severe maternal morbidity increased 6811.
  • Pediatrics: Unique airway anatomy necessitates specialized techniques and equipment; frequent pediatric ICU admissions for airway anomalies 17.
  • Elderly: Increased risk of multi-morbidity and polypharmacy complicating airway management; careful consideration of pharmacological interactions 182434.

    • Key Recommendations

  • Implement multidisciplinary training programs for obstetric life support to improve recognition and treatment of maternal emergencies, enhancing airway management skills 1. (Evidence: Moderate)
  • Utilize early warning systems tailored for obstetric patients to predict and manage critical illness proactively 9. (Evidence: Moderate)
  • Enhance quality and equity in hospital practices through organizational factors and policies that reduce severe maternal morbidity rates 13. (Evidence: Moderate)
  • Optimize medication management in elderly patients with multi-morbidity to prevent adverse drug reactions impacting airway stability 1925. (Evidence: Weak)
  • Conduct thorough local reviews of severe maternal events with external validation to improve care quality and reduce failure to rescue 36. (Evidence: Moderate)

    • References

    1 Cunningham SD, Carandang RR, Wood LS, Barry M, Baker P, Murphy M et al.. Evaluating a train-the-trainer approach for implementing obstetric life support in diverse healthcare contexts throughout Arizona: a mixed methods protocol. BMC health services research 2025. link 2 Giouleka S, Tsakiridis I, Chalkia-Prapa EM, Katzi F, Liberis A, Michos G et al.. Antibiotic Prophylaxis in Obstetrics and Gynecology: A Comparative Review of Guidelines. Obstetrical & gynecological survey 2025. link 3 Zainab U, Abbas M, Urooj A, Rabia M, Sun H, Ahmed Shehzad M. Undesired nexus poor health status of child under-five: A case study of Pakistan. PloS one 2025. link 4 Nishimura HM, Snguon S, Moen M, Dean LT. Guaranteed income and health in the United States and Canada: a scoping review. Epidemiologic reviews 2025. link 5 Burkey BB. The Role of Faith in Wellness (for Otolaryngologists). Otolaryngologic clinics of North America 2025. link 6 Damtew BS, Hailu AM, Fente BM, Workneh TW, Abdi HB. Determinant of adverse early neonatal outcomes following emergency cesarean section in North West, Ethiopia: institutional-based case-control study. BMC pregnancy and childbirth 2024. link 7 Boulet SL, Stanhope KK, Platner M, Costley LK, Jamieson DJ. Postpartum healthcare expenditures for commercially insured deliveries with and without severe maternal morbidity. American journal of obstetrics & gynecology MFM 2024. link 8 Brunton JS, Torbenson VE. Can Obstetrics and Gynecology Hospitalists Reduce Severe Maternal Morbidity?. Obstetrics and gynecology clinics of North America 2024. link 9 Xu Y, Zhu S, Song H, Lian X, Zeng M, He J et al.. Comparison of the efficacy for early warning systems in predicting obstetric critical illness. European journal of obstetrics, gynecology, and reproductive biology 2024. link 10 Davidson M, Kielar A, Tonseth RP, Seland K, Harvie S, Hanneman K. The Landscape of Rural and Remote Radiology in Canada: Opportunities and Challenges. Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes 2024. link 11 Ukah UV, Platt RW, Auger N, Lisonkova S, Ray JG, Malhamé I et al.. Risk of recurrent severe maternal morbidity: a population-based study. American journal of obstetrics and gynecology 2023. link 12 O'Regan A, Glynn L, Niranjamn V, O'Connor R, Hannigan A. How often do patients attend general practice, how often are they referred to hospital, and how do multi-morbidity and polypharmacy affect general practice attendance and referral rates?. Rural and remote health 2023. link 13 Howell EA, Sofaer S, Balbierz A, Kheyfets A, Glazer KB, Zeitlin J. Distinguishing High-Performing From Low-Performing Hospitals for Severe Maternal Morbidity: A Focus on Quality and Equity. Obstetrics and gynecology 2022. link 14 Jennings ELM, O'Mahony D, Gallagher PF. Medication-related quality of life (MRQoL) in ambulatory older adults with multi-morbidity and polypharmacy. European geriatric medicine 2022. link 15 Morton CH, Hall MF, Shaefer SJM, Karsnitz D, Pratt SD, Klassen M et al.. National Partnership for Maternal Safety: Consensus Bundle on Support After a Severe Maternal Event. Journal of obstetric, gynecologic, and neonatal nursing : JOGNN 2021. link 16 Chun JY, Bharadwaz A, Kyaw Tun J, Bilhim T, Gonzalez-Junyent C, Kawa B. CIRSE Standards of Practice on Conducting Meetings on Morbidity and Mortality. Cardiovascular and interventional radiology 2021. link 17 Thom CS, Deshmukh H, Soorikian L, Jacobs I, Fiadjoe JE, Lioy J. Airway emergency management in a pediatric hospital before and during the COVID-19 pandemic. International journal of pediatric otorhinolaryngology 2020. link 18 Błeszyńska E, Wierucki Ł, Zdrojewski T, Renke M. Pharmacological Interactions in the Elderly. Medicina (Kaunas, Lithuania) 2020. link 19 O'Mahony D, Gudmundsson A, Soiza RL, Petrovic M, Cruz-Jentoft AJ, Cherubini A et al.. Prevention of adverse drug reactions in hospitalized older patients with multi-morbidity and polypharmacy: the SENATOR randomized controlled clinical trial. Age and ageing* 2020. link 20 Crowley EK, Sallevelt BTGM, Huibers CJA, Murphy KD, Spruit M, Shen Z et al.. Intervention protocol: OPtimising thERapy to prevent avoidable hospital Admission in the Multi-morbid elderly (OPERAM): a structured medication review with support of a computerised decision support system. BMC health services research 2020. link 21 Nwadiugwu MC. Multi-Morbidity in the Older Person: An Examination of Polypharmacy and Socioeconomic Status. Frontiers in public health 2020. link 22 Lyndon A. Failure to Rescue, Communication, and Safety Culture. Clinical obstetrics and gynecology 2019. link 23 D'Alton ME, Friedman AM, Bernstein PS, Brown HL, Callaghan WM, Clark SL et al.. Putting the "M" back in maternal-fetal medicine: A 5-year report card on a collaborative effort to address maternal morbidity and mortality in the United States. American journal of obstetrics and gynecology 2019. link 24 Welch C, Bangash A, Wears R, Rice D, Aziz V. Geriatric medicine and old age psychiatry joint training pre-feasibility pilot study: an innovative approach to collaborative postgraduate training. BMC medical education 2019. link 25 Jennings E, Gallagher P, O'Mahony D. Detection and prevention of adverse drug reactions in multi-morbid older patients. Age and ageing 2019. link 26 Witteveen T, Kallianidis A, Zwart JJ, Bloemenkamp KW, van Roosmalen J, van den Akker T. Laparotomy in women with severe acute maternal morbidity: secondary analysis of a nationwide cohort study. BMC pregnancy and childbirth 2018. link 27 Jain JA, Temming LA, D'Alton ME, Gyamfi-Bannerman C, Tuuli M, Louis JM et al.. SMFM Special Report: Putting the "M" back in MFM: Reducing racial and ethnic disparities in maternal morbidity and mortality: A call to action. American journal of obstetrics and gynecology 2018. link 28 Oliveira Neto AF, Parpinelli MA, Costa ML, Souza RT, Ribeiro do Valle C, Cecatti JG. Exploring Epidemiological Aspects, Distribution of WHO Maternal Near Miss Criteria, and Organ Dysfunction Defined by SOFA in Cases of Severe Maternal Outcome Admitted to Obstetric ICU: A Cross-Sectional Study. BioMed research international 2018. link 29 Kyei-Onanjiri M, Carolan-Olah M, Awoonor-Williams JK, McCann TV. Review of emergency obstetric care interventions in health facilities in the Upper East Region of Ghana: a questionnaire survey. BMC health services research 2018. link 30 Howell EA. Reducing Disparities in Severe Maternal Morbidity and Mortality. Clinical obstetrics and gynecology 2018. link 31 Bintabara D, Kibusi SM. Intimate partner violence victimization increases the risk of under-five morbidity: A stratified multilevel analysis of pooled Tanzania Demographic Health Surveys, 2010-2016. PloS one 2018. link 32 Skalska A, Składzień J. Challenges of modern medicine - geriatric otolaryngology or the advantages of cooperation between an otolaryngologist and a geriatrician. Otolaryngologia polska = The Polish otolaryngology 2018. link 33 Humphreys J, Jameson K, Cooper C, Dennison E. Early-life predictors of future multi-morbidity: results from the Hertfordshire Cohort. Age and ageing 2018. link 34 Teh RO, Menzies OH, Connolly MJ, Doughty RN, Wilkinson TJ, Pillai A et al.. Patterns of multi-morbidity and prediction of hospitalisation and all-cause mortality in advanced age. Age and ageing 2018. link 35 Dupont C, Winer N, Rabilloud M, Touzet S, Branger B, Lansac J et al.. Multifaceted intervention to improve obstetric practices: The OPERA cluster-randomized controlled trial. European journal of obstetrics, gynecology, and reproductive biology 2017. link 36 Shah A, Kemp B, Sellers S, Hinton L, O'Connor M, Brocklehurst P et al.. Towards optimising local reviews of severe incidents in maternity care: messages from a comparison of local and external reviews. BMJ quality & safety 2017. link 37 Wang J, Yuan L, Fu G, Tang W, Yu G, Guo F et al.. A comparison of the transillumination-assisted technique versus midline approach technique in novices: a prospective randomized controlled trial about the Bonfils intubation fiberscope. BMC anesthesiology 2017. link 38 Molokhia M, Majeed A. Current and future perspectives on the management of polypharmacy. BMC family practice 2017. link 39 Arora KS, Shields LE, Grobman WA, D'Alton ME, Lappen JR, Mercer BM. Triggers, bundles, protocols, and checklists--what every maternal care provider needs to know. American journal of obstetrics and gynecology 2016. link 40 Van Leer PE, Lavine EK, Rabrich JS, Wiener DE, Clark MA, Wong TY. Resident Supervision and Patient Safety: Do Different Levels of Resident Supervision Affect the Rate of Morbidity and Mortality Cases?. The Journal of emergency medicine 2015. link 41 Cecatti JG, Silveira C, Souza RT, Fernandes KG, Surita FG. EXPERIENCE WITH THE BRAZILIAN NETWORK FOR STUDIES IN REPRODUCTIVE AND PERINATAL HEALTH: THE POWER OF COLLABORATION IN POSTGRADUATE PROGRAMS. Revista do Colegio Brasileiro de Cirurgioes 2015. link 42 Friedman AM. Maternal early warning systems. Obstetrics and gynecology clinics of North America 2015. link 43 Chang A, Fernandez H, Cayea D, Chheda S, Paniagua M, Eckstrom E et al.. Complexity in graduate medical education: a collaborative education agenda for internal medicine and geriatric medicine. Journal of general internal medicine 2014. link 44 D'Alton ME, Bonanno CA, Berkowitz RL, Brown HL, Copel JA, Cunningham FG et al.. Putting the "M" back in maternal-fetal medicine. American journal of obstetrics and gynecology 2013. link 45 Oliveira-Neto A, Parpinelli MA, Cecatti JG, Souza JP, Sousa MH. Sequential organ failure assessment score for evaluating organ failure and outcome of severe maternal morbidity in obstetric intensive care. TheScientificWorldJournal 2012. link 46 Cecatti JG, Souza JP, Oliveira Neto AF, Parpinelli MA, Sousa MH, Say L et al.. Pre-validation of the WHO organ dysfunction based criteria for identification of maternal near miss. Reproductive health 2011. link 47 Gogia S, Sachdev HS. Maternal postpartum vitamin A supplementation for the prevention of mortality and morbidity in infancy: a systematic review of randomized controlled trials. International journal of epidemiology 2010. link 48 Oliveira Neto AF, Parpinelli MA, Cecatti JG, Souza JP, Sousa MH. Factors associated with maternal death in women admitted to an intensive care unit with severe maternal morbidity. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2009. link 49 Cuthill JA, Fitzpatrick K, Glen J. Anaesthesia--a sedentary specialty? Accelerometer assessment of the activity level of anaesthetists while at work. Anaesthesia 2008. link 50 Parshuram CS. Pharmacotherapeutic friendly fire in the intensive care unit: high stakes seeking high calibre. Critical care (London, England) 2008. link 51 Christian P, Darmstadt GL, Wu L, Khatry SK, Leclerq SC, Katz J et al.. The effect of maternal micronutrient supplementation on early neonatal morbidity in rural Nepal: a randomised, controlled, community trial. Archives of disease in childhood 2008. link 52 Islam MT, Hossain MM, Islam MA, Haque YA. Improvement of coverage and utilization of EmOC services in southwestern Bangladesh. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2005. link 53 Hepler CD. Regulating for outcomes as a systems response to the problem of drug-related morbidity. Journal of the American Pharmaceutical Association (Washington, D.C. : 1996) 2001. link31211-6) 54 Fafowora OF, Ajibode HA, Fadamiro CO, Ajewole AA, Ogundipe OO, Osuntokun OO. Ocular morbidity survey in an opthalmically underserved rural area of Nigeria. African journal of medicine and medical sciences 1998. link 55 Moore AA, Siu AL. Screening for common problems in ambulatory elderly: clinical confirmation of a screening instrument. The American journal of medicine 1996. link89520-4) 56 Boult C, Pacala JT, Boult LB. Targeting elders for geriatric evaluation and management: reliability, validity, and practicality of a questionnaire. Aging (Milan, Italy) 1995. link 57 Popplewell PY, Henschke PJ. What is the value of a Geriatric Assessment Unit in a teaching hospital? A comparative study of the management of elderly inpatients. Australian health review : a publication of the Australian Hospital Association 1983. link

    Original source

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      Evaluating a train-the-trainer approach for implementing obstetric life support in diverse healthcare contexts throughout Arizona: a mixed methods protocol. — Cunningham SD, Carandang RR, Wood LS, Barry M, Baker P, Murphy M et al. BMC health services research (2025)
    2. [2]
      Antibiotic Prophylaxis in Obstetrics and Gynecology: A Comparative Review of Guidelines. — Giouleka S, Tsakiridis I, Chalkia-Prapa EM, Katzi F, Liberis A, Michos G et al. Obstetrical & gynecological survey (2025)
    3. [3]
      Undesired nexus poor health status of child under-five: A case study of Pakistan. — Zainab U, Abbas M, Urooj A, Rabia M, Sun H, Ahmed Shehzad M PloS one (2025)
    4. [4]
      Guaranteed income and health in the United States and Canada: a scoping review. — Nishimura HM, Snguon S, Moen M, Dean LT Epidemiologic reviews (2025)
    5. [5]
      The Role of Faith in Wellness (for Otolaryngologists). — Burkey BB Otolaryngologic clinics of North America (2025)
    6. [6]
      Determinant of adverse early neonatal outcomes following emergency cesarean section in North West, Ethiopia: institutional-based case-control study. — Damtew BS, Hailu AM, Fente BM, Workneh TW, Abdi HB BMC pregnancy and childbirth (2024)
    7. [7]
      Postpartum healthcare expenditures for commercially insured deliveries with and without severe maternal morbidity. — Boulet SL, Stanhope KK, Platner M, Costley LK, Jamieson DJ American journal of obstetrics & gynecology MFM (2024)
    8. [8]
      Can Obstetrics and Gynecology Hospitalists Reduce Severe Maternal Morbidity? — Brunton JS, Torbenson VE Obstetrics and gynecology clinics of North America (2024)
    9. [9]
      Comparison of the efficacy for early warning systems in predicting obstetric critical illness. — Xu Y, Zhu S, Song H, Lian X, Zeng M, He J et al. European journal of obstetrics, gynecology, and reproductive biology (2024)
    10. [10]
      The Landscape of Rural and Remote Radiology in Canada: Opportunities and Challenges. — Davidson M, Kielar A, Tonseth RP, Seland K, Harvie S, Hanneman K Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes (2024)
    11. [11]
      Risk of recurrent severe maternal morbidity: a population-based study. — Ukah UV, Platt RW, Auger N, Lisonkova S, Ray JG, Malhamé I et al. American journal of obstetrics and gynecology (2023)
    12. [12]
      How often do patients attend general practice, how often are they referred to hospital, and how do multi-morbidity and polypharmacy affect general practice attendance and referral rates? — O'Regan A, Glynn L, Niranjamn V, O'Connor R, Hannigan A Rural and remote health (2023)
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      Distinguishing High-Performing From Low-Performing Hospitals for Severe Maternal Morbidity: A Focus on Quality and Equity. — Howell EA, Sofaer S, Balbierz A, Kheyfets A, Glazer KB, Zeitlin J Obstetrics and gynecology (2022)
    14. [14]
      Medication-related quality of life (MRQoL) in ambulatory older adults with multi-morbidity and polypharmacy. — Jennings ELM, O'Mahony D, Gallagher PF European geriatric medicine (2022)
    15. [15]
      National Partnership for Maternal Safety: Consensus Bundle on Support After a Severe Maternal Event. — Morton CH, Hall MF, Shaefer SJM, Karsnitz D, Pratt SD, Klassen M et al. Journal of obstetric, gynecologic, and neonatal nursing : JOGNN (2021)
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      CIRSE Standards of Practice on Conducting Meetings on Morbidity and Mortality. — Chun JY, Bharadwaz A, Kyaw Tun J, Bilhim T, Gonzalez-Junyent C, Kawa B Cardiovascular and interventional radiology (2021)
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      Pharmacological Interactions in the Elderly. — Błeszyńska E, Wierucki Ł, Zdrojewski T, Renke M Medicina (Kaunas, Lithuania) (2020)
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      Prevention of adverse drug reactions in hospitalized older patients with multi-morbidity and polypharmacy: the SENATOR* randomized controlled clinical trial. — O'Mahony D, Gudmundsson A, Soiza RL, Petrovic M, Cruz-Jentoft AJ, Cherubini A et al. Age and ageing (2020)
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      Intervention protocol: OPtimising thERapy to prevent avoidable hospital Admission in the Multi-morbid elderly (OPERAM): a structured medication review with support of a computerised decision support system. — Crowley EK, Sallevelt BTGM, Huibers CJA, Murphy KD, Spruit M, Shen Z et al. BMC health services research (2020)
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      Multi-Morbidity in the Older Person: An Examination of Polypharmacy and Socioeconomic Status. — Nwadiugwu MC Frontiers in public health (2020)
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      Failure to Rescue, Communication, and Safety Culture. — Lyndon A Clinical obstetrics and gynecology (2019)
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      Putting the "M" back in maternal-fetal medicine: A 5-year report card on a collaborative effort to address maternal morbidity and mortality in the United States. — D'Alton ME, Friedman AM, Bernstein PS, Brown HL, Callaghan WM, Clark SL et al. American journal of obstetrics and gynecology (2019)
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      Geriatric medicine and old age psychiatry joint training pre-feasibility pilot study: an innovative approach to collaborative postgraduate training. — Welch C, Bangash A, Wears R, Rice D, Aziz V BMC medical education (2019)
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      Detection and prevention of adverse drug reactions in multi-morbid older patients. — Jennings E, Gallagher P, O'Mahony D Age and ageing (2019)
    26. [26]
      Laparotomy in women with severe acute maternal morbidity: secondary analysis of a nationwide cohort study. — Witteveen T, Kallianidis A, Zwart JJ, Bloemenkamp KW, van Roosmalen J, van den Akker T BMC pregnancy and childbirth (2018)
    27. [27]
      SMFM Special Report: Putting the "M" back in MFM: Reducing racial and ethnic disparities in maternal morbidity and mortality: A call to action. — Jain JA, Temming LA, D'Alton ME, Gyamfi-Bannerman C, Tuuli M, Louis JM et al. American journal of obstetrics and gynecology (2018)
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      Exploring Epidemiological Aspects, Distribution of WHO Maternal Near Miss Criteria, and Organ Dysfunction Defined by SOFA in Cases of Severe Maternal Outcome Admitted to Obstetric ICU: A Cross-Sectional Study. — Oliveira Neto AF, Parpinelli MA, Costa ML, Souza RT, Ribeiro do Valle C, Cecatti JG BioMed research international (2018)
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      Review of emergency obstetric care interventions in health facilities in the Upper East Region of Ghana: a questionnaire survey. — Kyei-Onanjiri M, Carolan-Olah M, Awoonor-Williams JK, McCann TV BMC health services research (2018)
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      Reducing Disparities in Severe Maternal Morbidity and Mortality. — Howell EA Clinical obstetrics and gynecology (2018)
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      Intimate partner violence victimization increases the risk of under-five morbidity: A stratified multilevel analysis of pooled Tanzania Demographic Health Surveys, 2010-2016. — Bintabara D, Kibusi SM PloS one (2018)
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      Challenges of modern medicine - geriatric otolaryngology or the advantages of cooperation between an otolaryngologist and a geriatrician. — Skalska A, Składzień J Otolaryngologia polska = The Polish otolaryngology (2018)
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      Towards optimising local reviews of severe incidents in maternity care: messages from a comparison of local and external reviews. — Shah A, Kemp B, Sellers S, Hinton L, O'Connor M, Brocklehurst P et al. BMJ quality & safety (2017)
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      Sequential organ failure assessment score for evaluating organ failure and outcome of severe maternal morbidity in obstetric intensive care. — Oliveira-Neto A, Parpinelli MA, Cecatti JG, Souza JP, Sousa MH TheScientificWorldJournal (2012)
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      Pre-validation of the WHO organ dysfunction based criteria for identification of maternal near miss. — Cecatti JG, Souza JP, Oliveira Neto AF, Parpinelli MA, Sousa MH, Say L et al. Reproductive health (2011)
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      Maternal postpartum vitamin A supplementation for the prevention of mortality and morbidity in infancy: a systematic review of randomized controlled trials. — Gogia S, Sachdev HS International journal of epidemiology (2010)
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      Factors associated with maternal death in women admitted to an intensive care unit with severe maternal morbidity. — Oliveira Neto AF, Parpinelli MA, Cecatti JG, Souza JP, Sousa MH International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (2009)
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      The effect of maternal micronutrient supplementation on early neonatal morbidity in rural Nepal: a randomised, controlled, community trial. — Christian P, Darmstadt GL, Wu L, Khatry SK, Leclerq SC, Katz J et al. Archives of disease in childhood (2008)
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      Improvement of coverage and utilization of EmOC services in southwestern Bangladesh. — Islam MT, Hossain MM, Islam MA, Haque YA International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (2005)
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      Ocular morbidity survey in an opthalmically underserved rural area of Nigeria. — Fafowora OF, Ajibode HA, Fadamiro CO, Ajewole AA, Ogundipe OO, Osuntokun OO African journal of medicine and medical sciences (1998)
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      Screening for common problems in ambulatory elderly: clinical confirmation of a screening instrument. — Moore AA, Siu AL The American journal of medicine (1996)
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      Targeting elders for geriatric evaluation and management: reliability, validity, and practicality of a questionnaire. — Boult C, Pacala JT, Boult LB Aging (Milan, Italy) (1995)
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      What is the value of a Geriatric Assessment Unit in a teaching hospital? A comparative study of the management of elderly inpatients. — Popplewell PY, Henschke PJ Australian health review : a publication of the Australian Hospital Association (1983)
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