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Seminars in Perinatology

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https://www.readbyqxmd.com/read/29033106/current-options-for-mechanical-prevention-of-preterm-birth
#1
REVIEW
Rupsa C Boelig, Vincenzo Berghella
Cervical insufficiency can be defined by a combination of obstetric history, cervical dilation on exam, and/or short cervical length in women with prior preterm birth. Options for mechanical intervention include cerclage and pessary. There is evidence to support the benefit of a cervical cerclage in women with singleton gestations who have a diagnosis of cervical insufficiency either based on second trimester painless cervical dilatation leading to recurrent early preterm births, or a history of early spontaneous preterm birth and a second trimester transvaginal ultrasound short cervical length or cervical dilation on exam...
October 12, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28988725/prevention-of-preterm-birth-novel-interventions-for-the-cervix
#2
REVIEW
Bouchra Koullali, Andrea R Westervelt, Kristin M Myers, Michael D House
Preterm birth is the leading cause of neonatal mortality and morbidity worldwide. Spontaneous preterm birth is a complex, multifactorial condition in which cervical dysfunction plays an important role in some women. Current treatment options for cervical dysfunction include cerclage and supplemental progesterone. In addition, cervical pessary is being studied in research protocols. However, cerclage, supplemental progesterone and cervical pessary have well known limitations and there is a strong need for alternate treatment options...
October 5, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28958628/computer-modeling-tools-to-understand-the-causes-of-preterm-birth
#3
REVIEW
Andrea R Westervelt, Kristin M Myers
The mechanical integrity of the soft tissue structures supporting the fetus may play a role in maintaining a healthy pregnancy and triggering the onset of labor. Currently, the level of mechanical loading on the uterus, cervix, and fetal membranes during pregnancy is unknown, and it is hypothesized that the over-stretch of these tissues contributes to the premature onset of contractility, tissue remodeling, and membrane rupture, leading to preterm birth. The purpose of this review article is to introduce and discuss engineering analysis tools to evaluate and predict the mechanical loads on the uterus, cervix, and fetal membranes...
September 25, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28947068/17-alpha-hydroxyprogesterone-caproate-for-preterm-birth-prevention-where-have-we-been-how-did-we-get-here-and-where-are-we-going
#4
REVIEW
Tracy A Manuck
Prematurity is a major public health problem in the United States and worldwide. Women with a history of a previous preterm birth are at high risk for recurrence. Progesterone is a key hormone involved in pregnancy maintenance. In general, progesterone is thought to maintain pregnancy through several closely linked mechanisms: (1) promotion of uterine quiescence, (2) inhibition of pro-inflammatory cells, and (3) immunosuppressive action. 17-Alpha hydroxyprogesterone caproate is currently the only medication approved to prevent recurrent preterm birth...
September 22, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28943054/maintaining-and-repeating-tocolysis-a-reflection-on-evidence
#5
REVIEW
Isabelle Dehaene, Lina Bergman, Paula Turtiainen, Alexandra Ridout, Ben Willem Mol, Elsa Lorthe
It is inherent to human logic that both doctors and patients want to suppress uterine contractions when a woman presents in threatened preterm labor. Tocolysis is widely applied in women with threatened preterm labor with a variety of drugs. According to literature, tocolysis is indicated to enable transfer to a tertiary center as well as to ensure the administration of corticosteroids for fetal maturation. There is international discrepancy in the content and the implementation of guidelines on preterm labor...
September 21, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28941962/racial-and-ethnic-differences-in-preterm-birth-a-complex-multifactorial-problem
#6
REVIEW
Tracy A Manuck
Preterm birth remains the leading cause of morbidity and mortality among nonanomalous neonates, and is a major public health problem. Non-Hispanic black women have a 2-fold greater risk for preterm birth compared with non-Hispanic white race. The reasons for this disparity are poorly understood and cannot be explained solely by sociodemographic factors. Underlying factors including a complex interaction between maternal, paternal, and fetal genetics, epigenetics, the microbiome, and these sociodemographic risk factors likely underlies the differences between racial groups, but these relationships are currently poorly understood...
September 20, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28935263/predicting-preterm-birth-cervical-length-and-fetal-fibronectin
#7
REVIEW
Moeun Son, Emily S Miller
Spontaneous preterm birth remains the leading cause of neonatal morbidity and mortality worldwide, and accounts for a significant global health burden. Several obstetric strategies to screen for spontaneous preterm delivery, such as cervical length and fetal fibronectin measurement, have emerged. However, the effectiveness of these strategies relies on their ability to accurately predict those pregnancies at increased risk for spontaneous preterm birth (SPTB). Transvaginal cervical shortening is predictive of preterm birth and when coupled with appropriate preterm birth prevention strategies, has been associated with reductions in SPTB in asymptomatic women with a singleton gestation...
September 18, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/29074002/novel-thoughts-on-preterm-birth-research-proceedings-of-the-13th-annual-preterm-birth-international-collaborative-prebic-meeting
#8
REVIEW
Cynthia Gyamfi-Bannerman, Ramkumar Menon, Elizabeth A Bonney, Siobhan M Dolan, Mark Johnson, Ronald F Lamont, Sam Mesiano, Amy P Murtha, Leslie Myatt, Indira Mysorekar, Scott M Williams, Nanbert Zhong, Hanns Helmer
No abstract text is available yet for this article.
November 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28889957/pathophysiology-of-preterm-labor-with-intact-membranes
#9
REVIEW
Asha N Talati, David N Hackney, Sam Mesiano
Preterm labor with intact membranes is a major cause of spontaneous preterm birth (sPTB). To prevent sPTB a clear understanding is needed of the hormonal interactions that initiate labor. The steroid hormone progesterone acting via its nuclear progesterone receptors (PRs) in uterine cells is essential for the establishment and maintenance of pregnancy and disruption of PR signaling (i.e., functional progesterone/PR withdrawal) is key trigger for labor. The process of parturition is also associated with inflammation within the uterine tissues and it is now generally accepted that inflammatory stimuli from multiple extrinsic and intrinsic sources induce labor...
November 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28886866/genetics-hormonal-influences-and-preterm-birth
#10
REVIEW
Kara M Rood, Catalin S Buhimschi
Prematurity is a devastating disease with high neonatal morbidity and mortality based on gestational age at birth. Genetic and hormonal signals impact directly on the maternal predisposition to preterm birth or sudden onset of myometrial contractility. Candidate gene or genome-wide approaches are beginning to identify potential variants for women at risk for premature delivery or increased responsiveness to hormonal signals including progesterone. However, a majority of these studies have not yielded definitive results to allow for at this stage for development of personalized therapy...
November 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28865982/epidemiology-of-preterm-birth
#11
REVIEW
Stephanie E Purisch, Cynthia Gyamfi-Bannerman
Preterm birth is a worldwide epidemic with a global incidence of 15 million per year. Though rates of preterm birth in the United States have declined over the last decade, nearly 1 in 10 babies is still born preterm. The incidence, gestational age, and underlying etiology of preterm birth is highly variable across different racial and ethnic groups and geographic boundaries. In this article, we review the epidemiology of preterm birth in the United States and globally, with a focus on temporal trends and racial, ethnic, and geographic disparities...
November 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28826790/the-pathophysiology-of-human-premature-cervical-remodeling-resulting-in-spontaneous-preterm-birth-where-are-we-now
#12
REVIEW
Joy Vink, Mirella Mourad
Approximately one in ten (approximately 500,000) pregnancies results in preterm birth (PTB) annually in the United States. Although we have seen a slight decrease in the U.S. PTB rate between 2007 and 2014, data from 2014 to 2015 shows the preterm birth rate has slightly increased. It is even more intriguing to note that the rate of PTB has not significantly decreased since the 1980s. In order to decrease the rate of spontaneous preterm birth (sPTB), it is imperative that we improve our understanding of normal and abnormal reproductive tissue structure and function and how these tissues interact with each other at a cellular and biochemical level...
November 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28823578/maternal-microbiomes-in-preterm-birth-recent-progress-and-analytical-pipelines
#13
REVIEW
Lindsay A Parnell, Catherine M Briggs, Indira U Mysorekar
Worldwide, 10% of babies are born preterm, defined as birth before 37 weeks' gestation. We have had little success in developing strategies to prevent preterm births, the majority of which are due to infection or are idiopathic. An emerging hypothesis is that the maternal microbiome-the bacteria that inhabit the mother's body and play vital functions in normal health-contributes to the etiology of preterm birth. Here, we highlight the latest data revealing correlations between preterm birth and maternal intestinal, vaginal, cervical, and placental microbiomes...
November 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28818299/current-preterm-birth-prevention-strategies
#14
EDITORIAL
Joy Vink, Cynthia Gyamfi-Bannerman
No abstract text is available yet for this article.
November 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28807394/preterm-prelabor-rupture-of-the-membranes-a-disease-of-the-fetal-membranes
#15
Ramkumar Menon, Lauren S Richardson
Preterm prelabor rupture of the membranes (pPROM) remains a significant obstetric problem that affects 3-4% of all pregnancies and precedes 40-50% of all preterm births. pPROM arises from complex, multifaceted pathways. In this review, we summarize some old concepts and introduce some novel theories related to pPROM pathophysiology. Specifically, we introduce the concept that pPROM is a disease of the fetal membranes where inflammation-oxidative stress axis plays a major role in producing pathways that can lead to membrane weakening through a variety of processes...
November 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/29037343/the-prevalence-of-selected-major-birth-defects-in-the-united-states
#16
REVIEW
Russell S Kirby
Although collectively they are fairly common, birth defects receive limited attention as a group of outcomes either clinically or from a public health perspective. This article provides an overview of the prevalence, trends and selected socio-demographic risk factors for several major birth defects, including neural tube defects, cranio-facial anomalies, congenital heart defects, trisomies 13, 18, and 21, and gastroschisis and omphalocele. Attention should focus on strengthening existing registries, creating birth defects surveillance programs in states that do not have them, and standardizing registry methods so that broadly national data to monitor these trends are available...
October 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28889958/maternity-care-access-quality-and-outcomes-a-systems-level-perspective-on-research-clinical-and-policy-needs
#17
REVIEW
Katy B Kozhimannil, Rachel R Hardeman, Carrie Henning-Smith
The quality of maternity care in the United States is variable, and access to care is tenuous for rural residents, low-income individuals, and people of color. Without accessible, timely, and high-quality care, certain clinical and sociodemographic characteristics of individuals may render them more vulnerable to poor birth outcomes. However, risk factors for poor birth outcomes do not occur in a vaccum; rather, health care financing, delivery, and organization as well as the policy environment shape the context in which patients seek and receive maternity care...
October 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28864275/racial-disparity-in-infant-mortality
#18
Nana Matoba, James W Collins
In the United States, African-American infants have significantly higher mortality than white infants. Previous work has identified associations between individual socioeconomic factors and select community-level factors. In this review, the authors look beyond traditional risk factors for infant mortality and examine the social context of race in this country, in an effort to understand African-American women's long-standing birth outcome disadvantage. In the process, recent insights are highlighted concerning neighborhood-level factors such as crime, segregation, built environment, and institutional racism, other likely causes for the poor outcomes of African-American infants in this country compared with infants in most other industrialized nations...
October 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28860024/perinatal-legislative-policies-and-health-outcomes
#19
REVIEW
Scott A Lorch
Perinatal epidemiology examines the variation and determinants of pregnancy outcomes from a maternal and neonatal perspective. However, improving public and population health also requires the translation of this evidence base into substantive public policies. Assessing the impact of such public policies requires sufficient data to include potential confounding factors in the analysis, such as coexisting medical conditions and socioeconomic status, and appropriate statistical and epidemiological techniques...
October 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28860023/understanding-pregnancy-outcomes-using-epidemiology-and-health-services-research
#20
EDITORIAL
Scott A Lorch
No abstract text is available yet for this article.
October 2017: Seminars in Perinatology
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