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American Journal of Perinatology

Gustavo Marcondes Rocha, Filipa Flor de Lima, Ana Paula Machado, Hercília Areias Guimarães
INTRODUCTION:  It is not yet fully known whether hypertensive disorders (HTD) during pregnancy impose an increased risk of development of bronchopulmonary dysplasia (BPD) in preterm newborn infants. OBJECTIVE:  To test the hypothesis that preeclampsia and other HTD are associated with the development of BPD in preterm infants. MATERIALS AND METHODS:  Data on mothers and preterm infants with gestational age 24 to 30 weeks were prospectively analyzed in 11 Portuguese level III centers...
July 11, 2018: American Journal of Perinatology
Gabriella De Rosa, Maria Pia De Carolis, Alessia Tempera, Alessandro Pedicelli, Massimo Rollo, Tony Christian Morena, Ersilia Luca, Daniele De Luca, Giorgio Conti, Marco Piastra
BACKGROUND:  Neonatal presentation of vein of Galen aneurysmal malformations (VGAMs) complicated by cardiac failure and pulmonary hypertension is frequently associated with a poor prognosis. Interventional neuroradiology with embolization can offer a chance for survival, although neurological damage can represent a limitation. OBJECTIVE:  This article determines if aggressive intensive care and drug management of cardiac failure before urgent embolization can influence morbidity and mortality...
July 10, 2018: American Journal of Perinatology
Ilina Datkhaeva, Phinnara Has, Kelly Fitzgerald, Brenna L Hughes
OBJECTIVE:  The objective of this study was to evaluate the negative predictive value (NPV) of a rapid influenza diagnostic test (RIDT) compared with polymerase chain reaction (PCR) in pregnant women. STUDY DESIGN:  Retrospective cohort study of pregnant women with a negative RIDT followed by confirmatory PCR for influenza A, H1N1, and B during the influenza seasons from 2012 to 2015. RESULTS:  The NPV of the RIDT was 85.4% (211 of 247), 93...
July 9, 2018: American Journal of Perinatology
Khalil M Chahine, Baha M Sibai
Chronic hypertension in pregnancy is traditionally classified according to degree of blood pressure (BP) elevation. Alternatively, stratifying women as high or low risk based on the etiology of hypertension, baseline work-up, and comorbid medical conditions will better inform clinicians about thresholds to initiate antihypertensive therapy, target BPs, frequency of antepartum visits, and timing of delivery. Women classified as high-risk chronic hypertension as described here require stricter BP management and more frequent follow-up visits as their associated rates of adverse maternal and/or fetal/neonatal outcomes appear higher than women classified as low-risk chronic hypertension...
July 9, 2018: American Journal of Perinatology
Christina Paidas Teefey, Celeste P Durnwald, Sindhu K Srinivas, Lisa D Levine
OBJECTIVE:  This article evaluates the differences in adverse maternal outcomes related to severe preeclampsia in obese versus nonobese women. STUDY DESIGN:  Retrospective cohort study and planned secondary analysis of women with severe preeclampsia comparing a composite adverse maternal outcome related to preeclampsia among obese (body mass index [BMI] ≥ 30 kg/m2 ) and nonobese (BMI < 30 kg/m2 ) women. The composite outcome was defined as ≥ 1 of the following prior to discharge: renal failure, liver abnormality, thrombocytopenia, blood transfusion, pulmonary edema, disseminated intravascular coagulation, stroke, or eclampsia...
July 6, 2018: American Journal of Perinatology
Ashish Premkumar, Rebecca J Baer, Laura L Jelliffe-Pawlowski, Mary E Norton
OBJECTIVE:  The objective of this study was to investigate the role of gestational hypertension (gHTN) and chronic hypertension (cHTN) on rates of preterm birth (PTB) among black women. STUDY DESIGN:  Singleton live births between 20 and 44 weeks' gestation among black women in California from 2007 to 2012 were used for analysis. Risk of PTB by subtype and gestational age among women with cHTN or gHTN, including preeclampsia, was calculated via Poisson's logistic regression modeling...
July 6, 2018: American Journal of Perinatology
Reem S Abu-Rustum, M Fouad Ziade, Ibrahim Ghosn, Nabil Helou
OBJECTIVE:  The aim of this study is to assess the feasibility of visualizing the middle cerebral artery (MCA), establishing the normogram for MCA pulsatility index (PI) and peak systolic velocity (PSV), and calculating cerebroplacental ratio (CPR) at 12 to 14 weeks. STUDY DESIGN:  Prospective cross-sectional study on 186 gravidas presenting for nuchal translucency (NT) assessment. Maternal body mass index (BMI), fetal crown-rump length (CRL), biparietal diameter (BPD), and NT were obtained...
July 6, 2018: American Journal of Perinatology
Leeann Pavlek, Monica Kraft, Caitlyn Simmons, Mary Ryan, Pavel Prusakov, Amanda Campbell, Nicklaus Brandehoff, Patrick C Ng, Jason Russell, Steven L Ciciora, Omid Fathi
Here, we review the case of a 26 1/7 weeks' gestation premature female infant born to a mother who intentionally ingested a large quantity of Tylenol, aspirin, quetiapine, and prenatal vitamins. The neonate subsequently had markedly elevated levels of both Tylenol and aspirin when checked on the first day of life. While overall clinically stable, the neonate did demonstrate coagulopathy as evidenced by abnormal coagulation studies. Both poison control and a pediatric gastroenterologist/hepatologist were consulted...
June 26, 2018: American Journal of Perinatology
Helen McCord, Elise Fieldhouse, Walid El-Naggar
OBJECTIVE:  This article assesses the degree of variability in the current practice of skin antiseptics used in Canadian neonatal intensive care units (NICUs) and different experiences related to each antiseptic used. METHODS:  An anonymous survey was distributed to a clinical representative of each of the 124 Canadian level II and level III NICUs. RESULTS:  One hundred and two respondents (82.2%), representing all Canadian provinces, completed the survey...
June 26, 2018: American Journal of Perinatology
Elizabeth S Langen, Anita Sit, Katie Sherwin, Deirdre J Lyell, Yair J Blumenfeld, Yasser Y El-Sayed
No abstract text is available yet for this article.
June 20, 2018: American Journal of Perinatology
Narongsak Nakwan
Persistent pulmonary hypertension of the newborn (PPHN) is a complication of several respiratory diseases characterized by an elevation in pulmonary vascular resistance with resultant right-to-left shunting of blood and severe hypoxemia in the neonatal period. PPHN carries a high rate of morbidity and mortality, particularly in limited-resource settings (low-income and/or developing country). Echocardiography remains the gold standard for diagnosis of PPHN. Modern therapies such as inhaled nitric oxide, high-frequency oscillatory ventilation, extracorporeal membrane oxygenation, and/or other pulmonary vasodilators agents can reduce the mortality rate of PPHN...
June 19, 2018: American Journal of Perinatology
Heather R Masters, Emily Housley, James W Van Hook, Emily DeFranco
OBJECTIVE:  We aim to quantify the impact of obesity on maternal intensive care unit (ICU) admission. MATERIALS AND METHODS:  This is a population-based, retrospective cohort study of Ohio live births from 2006 to 2012. The primary outcome was maternal ICU admission. The primary exposure was maternal body mass index (BMI). Relative risk (RR) of ICU admission was calculated by BMI category. Multivariate logistic regression quantified the risk of obesity on ICU admission after adjustment for coexisting factors...
June 19, 2018: American Journal of Perinatology
Brittney E Mason, Melissa C Matulich, Kate Swanson, Erin A Irwin, Alfred W Rademaker, Alan M Peaceman, Dana R Gossett
OBJECTIVE:  Previous studies have shown that risk of cesarean section increases among multiparous women as interbirth interval increases. One possibility is that progress of labor may vary with interbirth interval, such that with longer intervals, labor curves of multiparas more closely resemble those of nulliparas. We sought to define labor curves among a cohort of multiparas with varying interbirth intervals. STUDY DESIGN:  This was a retrospective cohort study of term multiparas with known interval from last delivery and only vaginal deliveries...
June 19, 2018: American Journal of Perinatology
Mitchell Goldstein, Leonard R Krilov, Jaime Fergie, Kimmie K McLaurin, Sally W Wade, David Diakun, Gregory M Lenhart, Adam Bloomfield, Amanda M Kong
OBJECTIVE:  The objective of this study was to compare risk for respiratory syncytial virus (RSV) hospitalizations (RSVH) for preterm infants 29 to 34 weeks gestational age (wGA) versus term infants before and after 2014 guidance changes for immunoprophylaxis (IP), using data from the 2012 to 2016 RSV seasons. STUDY DESIGN:  Using commercial and Medicaid claims databases, infants born between July 1, 2011 and June 30, 2016 were categorized as preterm or term...
June 19, 2018: American Journal of Perinatology
Spencer G Kuper, Kristin N Dotson, Sarah B Anderson, Stacy L Harris, Lorie M Harper, Alan T Tita
OBJECTIVE:  We sought to validate the SunTech Medical Advantage Model 2 Series with firmware LX 3.40.8 algorithm noninvasive blood pressure module in a pregnant population, including those with preeclampsia. STUDY DESIGN:  Validation study of an oscillometric noninvasive blood pressure module using the ANSI/AAMI ISO 81060-2:2013 standard guidelines. Pregnant women were enrolled into three subgroups: normotensive, hypertensive without proteinuria, and preeclampsia (hypertensive with random protein-to-creatinine ratio ≥ 0...
June 15, 2018: American Journal of Perinatology
Jonathan P Mintzer, Boriana Parvez, Edmund F La Gamma
OBJECTIVE:  Anemia causes blood flow redistribution and altered tissue metabolic behavior to sustain homeostatic oxygen consumption. We hypothesized that anemia severity would correlate with increased regional fractional tissue oxygen extraction among premature neonates. STUDY DESIGN:  Regional oxygen extraction was calculated using pulse oximetry and near-infrared spectroscopy data among neonates <1,250 g during their first 10 postnatal days. Oxygen extraction was assessed for correlations with raw hematocrit levels and following grouping into hematocrit quartiles...
June 15, 2018: American Journal of Perinatology
Rachel G Greenberg, P Brian Smith, Carl Bose, Reese H Clark, C Michael Cotten, Chris DeRienzo
OBJECTIVE:  We conducted a detailed survey to identify medication safety practices among a large network of United States neonatal intensive care units (NICUs). METHODS:  We created a 53-question survey to assess 300 U.S. NICU's demographics, medication safety practices, adverse drug event (ADE) reporting, and ADE response plans. RESULTS:  Among the 164 (55%) NICUs that responded to the survey, more than 85% adhered to practices including use of electronic health records, computerized physician order entry, and clinical decision support; fewer reported adopting barcoding, formal safety surveys, and formal culture training; 137 of 164 (84%) developed at least one NICU-specific order-set with a median of 10 order-sets...
June 15, 2018: American Journal of Perinatology
Laurence E Shields, Suzanne Wiesner, Catherine Klein, Barbara Pelletreau, Herman L Hedriana
OBJECTIVE:  To determine if a standardized intervention process for Category II fetal heart rates (FHRs) with significant decels (SigDecels) would improve neonatal outcome and to determine the impact on mode of delivery rates. STUDY DESIGN:  Patients with Category II FHRs from six hospitals were prospectively managed using a standardized approach based on the presence of recurrent SigDecels. Maternal and neonatal outcomes were compared between pre- (6 months) and post-(11 months) implementation...
June 12, 2018: American Journal of Perinatology
Robert M Rossi, Emily A DeFranco
OBJECTIVE:  Preterm birth before 23 weeks of gestation typically results in neonatal death (5% survival). Society for Maternal-Fetal Medicine and American College of Obstetricians and Gynecologists published consensus guidelines recommending cesarean delivery (CD) not be performed for fetal indications between 20 and 226/7 weeks given the lack of proven benefit. We sought to quantify the previable CD rate and identify characteristics associated with previable CD. METHODS:  We performed a population-based retrospective cohort study of all live births in Ohio (2006-2015)...
June 8, 2018: American Journal of Perinatology
Mauricio La Rosa, Nicholas Spencer, Mahmoud Abdelwahab, Gabriela Zambrano, Fawzi Saoud, Katherine Jelliffe, Gayle Olson, Mary Munn, George R Saade, Maged Costantine
OBJECTIVE:  Wearing a white coat (WC) has been associated with risk of colonization and transmission of resistant pathogens. Also, studies have shown that physicians' attire in general affects patients' confidence in their physician and the patient-physician relationship. Our objective is to evaluate the hypothesis that not wearing a WC during physician postpartum rounds does not affect patient-physician communication scores. MATERIALS AND METHODS:  This is an unblinded, randomized, parallel arms, controlled trial of postpartum women at a single university hospital...
June 8, 2018: American Journal of Perinatology
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