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Best Practice & Research. Clinical Obstetrics & Gynaecology

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https://www.readbyqxmd.com/read/30007778/genetic-studies-of-gestational-duration-and-preterm-birth
#1
REVIEW
Ge Zhang, Amit Srivastava, Jonas Bacelis, Julius Juodakis, Bo Jacobsson, Louis J Muglia
The fine control of birth timing is important to human survival and evolution. A key challenge in studying the mechanisms underlying the regulation of human birth timing is that human parturition is a unique to human event - animal models provide only limited information. The duration of gestation or the risk of preterm birth is a complex human trait under genetic control from both maternal and fetal genomes. Genomic discoveries through genome-wide association (GWA) studies would implicate relevant genes and pathways...
June 15, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29935891/preface-volume-50
#2
EDITORIAL
Thomas M D'Hooghe
No abstract text is available yet for this article.
May 16, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29866432/the-uterine-pacemaker-of-labor
#3
REVIEW
Roger Charles Young
The laboring uterus is generally thought to initiate contractions much similar to the heart, with a single, dedicated pacemaker. Research on human and animal models over decades has failed to identify such pacemaker. On the contrary, data indicate that instead of being fixed at a site similar to the sinoatrial node of the heart, the initiation site for each uterine contraction changes during time, often with each contraction. The enigmatic uterine "pacemaker" does not seem to fit the standard definition of what a pacemaker should be...
April 26, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29779863/the-global-epidemiology-of-preterm-birth
#4
REVIEW
Joshua P Vogel, Saifon Chawanpaiboon, Ann-Beth Moller, Kanokwaroon Watananirun, Mercedes Bonet, Pisake Lumbiganon
This article is a part of a series that focuses on the current state of evidence and practice related to preterm birth prevention. We provide an overview of current knowledge (and limitations) on the global epidemiology of preterm birth, particularly around how preterm birth is defined, measured, and classified, and what is known regarding its risk factors, causes, and outcomes. Despite the reported associations between preterm birth and a wide range of socio-demographic, medical, obstetric, fetal, and environmental factors, approximately two-thirds of preterm births occur without an evident risk factor...
April 26, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29759932/examining-the-link-between-placental-pathology-growth-restriction-and-stillbirth
#5
REVIEW
Robert M Silver
Stillbirth, often defined as death of a fetus ≥20 weeks of gestation, is emotionally devastating for families and caregivers. It is often associated with fetal growth restriction (FGR). Indeed, FGR or small-for-gestational age fetus (SGA) is a major risk factor for stillbirth. In rare cases, this is due to genetic abnormalities or infections. However, in most cases, it is linked to placental insufficiency. This may be due to abnormal placental development or placental damage, thereby resulting in decreased blood flow, oxygen, and nutrients to the fetus...
May 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29753694/physiological-adaptation-of-the-growth-restricted-fetus
#6
REVIEW
Karel Maršál
The growth-restricted fetus in utero is exposed to a hostile environment and suffers undernutrition and hypoxia. To cope with the stress, the fetus changes its physiological functions. These adaptive changes aid intrauterine survival; however, they can lead to permanent functional and structural changes that can contribute to the development of serious chronic diseases later in life. Epigenetic mechanisms are an important part of the pathophysiological processes behind this "developmental origin of adult diseases...
May 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29661565/fetal-growth-restriction-in-twins
#7
REVIEW
R Townsend, A Khalil
Twin pregnancies are more likely to be affected by fetal growth restriction (FGR), preterm birth and perinatal loss. The management of fetal growth restriction in multiple pregnancy, particularly where only one fetus is affected is complicated by the need to consider the interests of both twins. Selective growth restriction in monochorionic (MC) twins is a pathophysiological process distinct from FGR in dichorionic (DC) pregnancies and management demands an understanding of the monochorionic placental structure and interdependent fetal circulations...
May 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29656984/corrigendum-to-benign-and-malignant-pathology-of-the-uterus-best-pract-res-clin-obstet-gynaecol-46-2018-12-30
#8
V Tanos, K E Berry
No abstract text is available yet for this article.
May 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29656983/prophylaxis-and-treatment-of-foetal-growth-restriction
#9
REVIEW
Aamod Nawathe, Anna L David
Foetal growth restriction (FGR) and associated placental pathologies such as pre-eclampsia and stillbirth arise in early pregnancy when inadequate remodelling of maternal spiral arteries leads to persistent high-resistance low-flow uteroplacental circulation. Current interventions concentrate on targeting the placental ischaemia-reperfusion injury and oxidative stress associated with an imbalance in angiogenic/anti-angiogenic factors. Recent meta-analyses confirm that aspirin modestly reduces the risk for small-for-gestational-age pregnancy in high-risk women...
May 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29606482/planning-management-and-delivery-of-the-growth-restricted-fetus
#10
REVIEW
Ahmet A Baschat
A uniform approach to management of fetal growth restriction (FGR) improves outcome, prevents stillbirth, and allows appropriately timed delivery. An estimated fetal weight below the tenth percentile with coexisting abnormal umbilical artery (UA), middle cerebral artery (MCA), or cerebroplacental ratio Doppler index best identifies the small fetus requiring surveillance. Placental perfusion defects are more common earlier in gestation; accordingly, early-onset (≤32 weeks of gestation) and late-onset (>32 weeks) FGR differ in clinical phenotype...
May 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29605157/fetal-biometry-to-assess-the-size-and-growth-of-the-fetus
#11
REVIEW
Neil O'Gorman, Laurent J Salomon
Ultrasound assessment of fetal size is central to modern practice of prenatal care. It facilitates accurate pregnancy dating and screening for fetal growth disorders. This article discusses evidence-based recommended methods for pregnancy dating and biometric measurements. We address some confusing terms such as fetal growth "standards" and fetal growth "references" along with explaining the differences between prescriptive and descriptive charts and between growth charts based on estimated fetal weight vs those based on birth weight...
May 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29576470/building-consensus-and-standards-in-fetal-growth-restriction-studies
#12
REVIEW
Sanne Jehanne Gordijn, Irene Maria Beune, Wessel Ganzevoort
Fetal growth restriction is a pathologic condition in which the fetus fails to reach its biologically based growth potential. There is inconsistency in terminology, definition, monitoring, and management, both in clinical practice and in the existing literature. This hampers interpretation and comparison of cohorts and studies. Standardization is essential. With the lack of a golden standard, or the opportunity to come to empirical evidence, consensus procedures can help to establish standardization. Consensus procedures provide no new information but formulate an agreement (as second best in the absence of robust evidence) for clinical and/or research practice on the basis of existing data...
May 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29571821/care-of-the-growth-restricted-newborn
#13
REVIEW
Bianca Carducci, Zulfiqar A Bhutta
With the first 1,000 days of life proving to be a critical window of opportunity for physical and cognitive growth and development, an optimal intrauterine environment is vital. If fetus needs are compromised prenatally, there is an increased risk of intrauterine growth restriction (IUGR), and infants being born premature, low birth weight (LBW), or small-for-gestational age (SGA). Specialized care of these high-risk infants is necessary in terms of preconception interventions, resuscitation, thermoregulation, nutritional support and kangaroo mother care...
May 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29571820/universal-screening-for-foetal-growth-restriction
#14
REVIEW
Gordon C S Smith
Foetal growth restriction (FGR) is a major cause of morbidity and mortality. Clinical methods for identifying women whose pregnancies are affected by FGR do not perform well. Despite this, the current approach to screening includes the clinical assessment of risk and targeted use of ultrasound. Universal screening of women using ultrasound has not been shown to improve outcomes in randomised controlled trials and, when implemented nationally in France, appeared mostly to change outcomes for the worse through the effect of iatrogenic prematurity on false positives...
May 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29550180/monitoring-fetal-growth-in-settings-with-limited-ultrasound-access
#15
REVIEW
Sikolia Z Wanyonyi, Steve K Mutiso
Abnormal fetal growth significantly increases neonatal mortality and the risk of stillbirth. This creates the need for accurately monitoring fetal growth in all pregnancies regardless of the risk status. Several methods used in clinical practice include abdominal palpation, symphysio-fundal height measurements, and obstetric ultrasound. Of these, obstetric ultrasound remains the most reliable and objective way to monitor fetal growth. However, in most low-resource areas, access to obstetric ultrasound remains poor and this leaves the two as the only options available...
May 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29778458/noninvasive-diagnosis-of-endometriosis-review-of-current-peripheral-blood-and-endometrial-biomarkers
#16
REVIEW
Dorien F O, Idhaliz Flores, Etienne Waelkens, Thomas D'Hooghe
A noninvasive biomarker-based test could help shorten the diagnostic delay for endometriosis. The most investigated biomarker sources are peripheral blood and endometrium. Discovery of endometriosis biomarkers is often hypothesis-driven, i.e. when one or a few biomarkers are investigated based on their role in the disease pathogenesis. Alternatively, a hypothesis-generating approach has been followed using the "omics" technologies. A variety of biomarkers for endometriosis have been investigated, but no biomarker has been validated for clinical use...
April 13, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29724667/preventing-preterm-birth-new-approaches-to-labour-therapeutics-using-nanoparticles
#17
REVIEW
Jonathan W Paul, Roger Smith
Preterm birth remains a major obstetric problem with ramifications that extend beyond immediate health and safety concerns for the newborn to include massive societal and economic burden. Although three quarters of preterm birth-related deaths could be prevented with cost-effective interventions, there has been little progress towards achieving sustained tocolysis that translates into improved outcomes for the newborn. With private enterprise reluctant to venture into the sphere of tocolysis, due to potential litigation, advances in the field may fall to new approaches using existing tocolytic resources more effectively...
April 13, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29724668/rationale-for-current-and-future-progestin-based-therapies-to-prevent-preterm-birth
#18
REVIEW
Megan Weatherborn, Sam Mesiano
Preterm birth (PTB) is the leading cause of neonatal morbidity and mortality worldwide. The only medicinal therapy currently recommended to prevent PTB is prophylactic progestin therapy in the form of micronized progesterone (P4) administered daily via vaginal suppository from the 24th to the 34th week of gestation or 17α-hydroxyprogesterone caproate in oil administered weekly from the 16th to the 36th week of gestation via an intramuscular injection. These therapies decrease the risk of PTB in women with an elevated risk of PTB indicated by a history of PTB or by a short cervix measured by sonography at mid-gestation...
April 11, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29753695/the-microbiome-in-preterm-birth
#19
REVIEW
Derrick M Chu, Maxim Seferovic, Ryan M Pace, Kjersti M Aagaard
The microbiome is thought to play a role in the maintenance of a healthy pregnancy and thus may either contribute to or protect from preterm birth. Study of the human microbiome has been aided by metagenomic sequencing approaches, providing greater insight into the commensal bacteria that coexist in and on our bodies. The vaginal microbiome has been the most widely studied, though there have been recent efforts to explore the gut, cervical-vaginal, placental and oral microbiomes in the further search of etiologies of preterm birth...
April 9, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29503125/disorders-of-sex-development
#20
REVIEW
Selma Feldman Witchel
Normal sex development depends on the precise spatio-temporal sequence and coordination of mutually antagonistic activating and repressing factors. These factors regulate the commitment of the unipotential gonad into the binary pathways governing normal sex development. Typically, the presence of the SRY gene on the Y chromosome triggers the cascade of molecular events that lead to male sex development. Disorders of sex development comprise a heterogeneous group of congenital conditions associated with atypical development of internal and external genitalia...
April 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
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