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Journal of Perinatal Medicine

Michelle T Nguyen, Laurence B McCullough, Frank A Chervenak
In obstetric practice, each pregnant woman presents with a composite of maternal and fetal characteristics that can alter the risk of significant harm without cesarean intervention. The hospital's availability of resources and the obstetrician's training, experience, and skill level can also alter the risk of significant harm without cesarean intervention. This paper proposes a clinical ethical framework that takes these clinical and organizational factors into account, to promote a deliberative rather than simplistic approach to decision-making and counseling about cesarean delivery...
October 25, 2016: Journal of Perinatal Medicine
Winnie Huiyan Sim, Edward Araujo Júnior, Fabricio Da Silva Costa, Penelope Marie Sheehan
AIM: To assess the contemporary maternal and neonatal outcomes following expectant management of preterm premature rupture of membranes (PPROM) prior to 24 weeks' gestation and to identify prognostic indicators of this morbid presentation. METHODS: We performed a systematic review in the Pubmed and EMBASE databases to identify the primary (perinatal mortality, severe neonatal morbidity and serious maternal morbidity) and secondary (neonatal survival and morbidity) outcomes following expectant management of previable PPROM...
October 25, 2016: Journal of Perinatal Medicine
Karolina Bartkute, Dalia Balsyte, Josef Wisser, Juozas Kurmanavicius
AIM: The aim of this study was to evaluate the predictive value of α-fetoprotein in maternal serum (MS-AFP) as a marker for diverse pregnancy outcomes. METHODS: The study was based on pregnancy and delivery data from 5520 women between 1999 and 2014 at University Hospital of Zurich (UHZ). INCLUSION CRITERIA: both MS-AFP and pregnancy outcome were known for the same pregnancy. Pregnancy outcomes and characteristics such as fetal malformation, intrauterine fetal death (IUFD) and intrauterine growth retardation as well as maternal age, weight before pregnancy, gestational age (GA) at delivery, newborn weight, length and head circumference were analyzed with respect to the MS-AFP value...
October 24, 2016: Journal of Perinatal Medicine
Susanne Hesselman, Maria Jonsson, Eva-Britta Råssjö, Monika Windling, Ulf Högberg
OBJECTIVE: To investigate the maternal complications associated with cesarean section (CS) in the extremely preterm period according to the gestational week (GW) and to indication of delivery. STUDY DESIGN: This is a retrospective case-referent study with a review of medical records of women who delivered at 22-27 weeks of gestation (n=647) at two level III units in Sweden. For abdominal delivery, gestational length was stratified into 22-24 (n=105) and 25-27 (n=301) weeks...
October 21, 2016: Journal of Perinatal Medicine
Alicia Martinez-Varea, Roberto Romero, Yi Xu, Derek Miller, Ahmed I Ahmed, Piya Chaemsaithong, Noppadol Chaiyasit, Lami Yeo, Majid Shaman, Kia Lannaman, Benjamin Cher, Sonia S Hassan, Nardhy Gomez-Lopez
OBJECTIVES: 1) To characterize the cellular composition of the amniotic fluid of patients diagnosed with clinical chorioamnionitis at term, as a function of the presence or absence of microorganisms determined by cultivation techniques, and 2) to characterize the cytokine production by white blood cells present in the amniotic fluid using flow cytometry-based techniques. MATERIALS AND METHODS: Amniotic fluid samples from 20 women who had the diagnosis of clinical chorioamnionitis at term were analyzed using cultivation techniques (for aerobic and anaerobic bacteria as well as genital Mycoplasmas)...
October 20, 2016: Journal of Perinatal Medicine
Amos Grünebaum, Laurence B McCullough, Birgit Arabin, Joachim Dudenhausen, Brooke Orosz, Frank A Chervenak
INTRODUCTION: The objective of this study was to evaluate the underlying causes of neonatal mortality (NNM) in midwife-attended home births and compare them to hospital births attended by a midwife or a physician in the United States (US). METHODS: A retrospective cohort study of the Centers for Disease Control (CDC) linked birth/infant death data set (linked files) for 2008 through 2012 of singleton, term (≥37 weeks) births and normal newborn weights (≥2500 grams)...
October 18, 2016: Journal of Perinatal Medicine
Rebecca J Baer, Juan Yang, Christina D Chambers, Kelli K Ryckman, Audrey F Saftlas, Vincenzo Berghella, Chris Dunkel Schetter, Gary M Shaw, David K Stevenson, Laura L Jelliffe-Pawlowski
There is well-established literature indicating change in partner as a risk for preeclampsia, yet the research on the risk of preterm birth after a change in partners has been sparse and inconsistent. Using a population of California live born singletons, we aimed to determine the risk of preterm birth after a change in partner between the first and second pregnancies. The risk of preterm and early term delivery in the second pregnancy was calculated for mothers who did or did not change partners between births with the referent group as women who delivered both pregnancies at term and did not change partners...
October 8, 2016: Journal of Perinatal Medicine
Nada Aracic, Ivica Stipic, Ivana Jakus Alujevic, Petar Poljak, Mario Stipic
AIM: To evaluate the influence of cervical length (CL) and parity as prediction factors for assessment of cesarean section (CS) risk in women with premature rupture of membranes (PROM) at term and unfavorable cervix, undergoing induction of labor (IOL) with dinoprostone intracervical gel. METHODS: A prospective study involved 50 nulliparous and 51 multiparous women admitted for IOL. Pre-induction CL was measured and delivery outcomes were recorded. RESULTS: Nulliparous women were younger than the multiparous (26...
October 8, 2016: Journal of Perinatal Medicine
Jara Pascual Mancho, Sabina Marti Gamboa, Olga Redrado Gimenez, Raquel Crespo Esteras, Belen Rodriguez Solanilla, Sergio Castan Mateo
OBJECTIVE: To determine the diagnostic accuracy of fetal scalp lactate sampling (FSLS) and to establish an optimal cut-off value for intrapartum acidosis compared with fetal scalp pH. METHODS: A 20-month retrospective cohort study was conducted of all neonates delivered in our institution for whom fetal scalp blood sampling (FSBS) was performed, matching their intrapartum gasometry to their cord gasometry at delivery (n=243). The time taken from the performance of scalp blood sampling to arterial umbilical cord gas acquisition was 45 min at most...
October 8, 2016: Journal of Perinatal Medicine
Peymaneh Alizadeh Taheri, Negar Sajjadian, Marzieh Asgharyan Fargi, Mamak Shariat
OBJECTIVE: Breast feeding alone does not provide adequate nutrition for growth in preterm infants; therefore, fortifiers are added when over 70-80 cc/kg/day of breast milk is tolerated. As there are few studies comparing early and late breast milk fortification, the following study was conducted. STUDY DESIGN: This double-blind clinical trial was performed on 80 preterm infants (gestational age of 28-34 weeks, birth weight <2 kg). The newborns were randomly divided into two groups to receive either early or late fortification...
September 27, 2016: Journal of Perinatal Medicine
Xiaoyan Gu, Yihua He, Ye Zhang, Lin Sun, Ying Zhao, Jiancheng Han, Xiaowei Liu
OBJECTIVE: Global racial variability in human development can lead to differences in size of fetal cardiac structures during gestation. Our objective is to establish normal reference ranges of fetal cardiac dimensions between 20 and 34 weeks from fetal echocardiograms recorded at a single center in China. METHODS: A prospective cross-sectional study was undertaken on single pregnancies with normal fetuses of varying gestational ages (GAs). A total of 4396 normal fetuses were divided into 15 groups from 20 to 34 weeks according to the GA...
September 26, 2016: Journal of Perinatal Medicine
Shari E Gelber, Amos Grünebaum, Frank A Chervenak
BACKGROUND: Due to the recent outbreak of Zika virus, there has been a newfound interest in fetal and neonatal microcephaly. In 1984, Chervenak et al. proposed criteria for the prenatal ultrasound diagnosis of microcephaly as ≤3 standard deviations (SD) from the mean. Despite improvements in medicine these criteria have not been reevaluated in 30 years. OBJECTIVE: To examine how the original 1984 Chervenak et al. criteria for the diagnosis of fetal microcephaly apply to a current population utilizing modern ultrasound equipment and techniques...
September 23, 2016: Journal of Perinatal Medicine
Cecilia Stalberg, Nathalia Noda, Jossimara Polettini, Bo Jacobsson, Ramkumar Menon
OBJECTIVE: Elafin is a low molecular weight protein with antileukoproteinase, anti-inflammatory, antibacterial and immunomodulating properties. The profile of Elafin in fetal membranes is not well characterized. This study determined the changes in Elafin expression and concentration in human fetal membrane from patients with preterm prelabor rupture of membranes (PPROM) and in vitro in response to intra-amniotic polymicrobial pathogens. METHOD: Elafin messenger RNA (mRNA) expressions were studied in fetal membranes from PPROM, normal term as well as in normal term not in labor membranes in an organ explant system treated (24 h) with lipopolysaccharide (LPS), using quantitative reverse transcription-polymerase chain reaction (RT-PCR)...
August 31, 2016: Journal of Perinatal Medicine
Karin Pichler, Miriam Michel, Manuela Zlamy, Sabine Scholl-Buergi, Elisabeth Ralser, Monika Jörg-Streller, Daniela Karall
BACKGROUND: Published data on breast milk feeding in infants suffering from inherited metabolic disorders (IMDs) other than phenylketonuria (PKU) are limited and described outcome is variable. OBJECTIVE: We aimed to evaluate retrospectively whether breastfeeding and/or breast milk feeding are feasible in infants with IMDs including organic acidemias, fatty acid oxidation disorders, urea cycle disorders, aminoacidopathies or disorders of galactose metabolism. METHODS: Data on breastfeeding and breast milk feeding as well as monitoring and neurological outcome were collected retrospectively from our database of patients with the mentioned IMD, who were followed in our metabolic center within the last 10 years...
August 26, 2016: Journal of Perinatal Medicine
Anne Borja, Michael Moretti, Nisha Lakhi
OBJECTIVE: To determine if there is an increased maternal or neonatal morbidity in overweight and obese patients with a false positive glucose challenge test (GCT). METHODS: Patients with a body mass index (BMI) ≥25.0 at registration were included in this prospective 36-month study. The study cohort consisted of patients with a false positive (FP) GCT, with two comparison cohorts: those with a (1) screen negative (SN) GCT result and (2) true positive (TP) GCT result...
August 26, 2016: Journal of Perinatal Medicine
Fiona L R Williams, Jennifer Watson, Chris Day, Aung Soe, Sateesh K Somisetty, Lesley Jackson, Elena Velten, Anita Boelen
BACKGROUND: Infants <32 weeks' gestation should not be exposed to topical iodine and its avoidance is recommended during pregnancy and breast feeding. Exposure to contrast media and topical iodine is frequently used in many preterm neonates. AIM: To determine whether thyrotropin levels in preterm infants are affected by exposure to intrapartum/neonatal topical iodine and/or the use of iodinated contrast media. DESIGN: Infants <32 weeks' gestation were recruited...
August 26, 2016: Journal of Perinatal Medicine
Hernâni Gonçalves, Mariana Morais, Paula Pinto, Diogo Ayres-de-Campos, João Bernardes
OBJECTIVE: The aim of this study was to explore whether linear and non-linear analysis of uterine contraction (UC) signals obtained with external tocodynamometry can predict operative vaginal delivery (OVD). MATERIALS AND METHODS: The last 2 h before delivery (H1 and H2) of 55 UC recordings acquired with external tocodynamometry in the labour ward of a tertiary care hospital were analysed. Signal processing involved the quantification of UCs/segment (UCN), and the linear and non-linear indices: Sample Entropy (SampEn) measuring signal irregularity; interval index (II) measuring signal variability, both of which may be associated with uterine muscle fatigue, and high frequency (HF), associated with maternal breathing movements...
August 26, 2016: Journal of Perinatal Medicine
Amir Weissman, Arie Drugan
BACKGROUND: Data regarding the effects of multifetal pregnancy on the incidence of gestational diabetes mellitus (GDM) are inconsistent and even conflicting. Twin pregnancies have been associated with no increase, a marginal increase or a higher incidence of gestational diabetes. In triplet pregnancies, these effects have not been investigated yet. OBJECTIVES: To analyze the results of the glucose challenge and tolerance tests in singleton, twin and triplet pregnancies...
August 17, 2016: Journal of Perinatal Medicine
Jovana Lekovich, Joshua Stewart, Sarah Anderson, Erin Niemasik, Nigel Pereira, Stephen Chasen
OBJECTIVE: Müllerian anomalies are associated with increased risk of miscarriage, intrauterine growth restriction (IUGR) and preterm birth. While a commonly implicated cause is restricted expansion of endometrial cavity, alternatively it could be due to abnormal placentation. We sought to examine clinical and histopathologic factors associated with preterm delivery in women with Müllerian anomalies. STUDY DESIGN: One hundred and eleven singleton pregnancies in 85 women were analyzed retrospectively...
August 17, 2016: Journal of Perinatal Medicine
Michael Tchirikov, Zhaxybay Sh Zhumadilov, Gauri Bapayeva, Michael Bergner, Michael Entezami
OBJECTIVE: To determine if intrauterine intraumbilical supplementation with amino acids (AA) and glucose can improve neonatal outcome of severe growth restricted human fetuses (IUGR). METHODS: Prospective pilot study of intrauterine treatment of severe IUGR fetuses [n=14, 27 weeks of gestation (range 23-31)] with cerebroplacental ratio <1, with long-term intraumbilical AA and glucose supplementation (10% of feto-placental blood volume/day) using a perinatal port system alone (n=5) or combined with hyperbaric oxygenation (n=1, HBO) vs...
August 17, 2016: Journal of Perinatal Medicine
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