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American Journal of Perinatology Reports

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https://www.readbyqxmd.com/read/28428904/salvage-of-necrotic-appearing-limb-after-in-utero-endoscopic-lysis-of-constriction-bands
#1
M Abdel-Sattar, A Chon, B Chen, W Burkhalter, R H Chmait
We report a case of amniotic band syndrome complicated by constriction bands and marked distal swelling of both lower extremities. Color Doppler interrogation of the right lower extremity revealed complete lack of blood flow below the level of the constriction. Upon fetoscopic survey, the right lower extremity beyond the constriction band appeared dusky red and discolored with desquamation, consistent with a necrotic appearance. The constriction bands were cut in utero using endoshears, thereby allowing restoration of blood flow on postoperative day 1...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28413694/first-neonatal-demise-with-travel-associated-zika-virus-infection-in-the-united-states-of-america
#2
Nikolaos Zacharias, Janice Whitty, Sarah Noblin, Sophia Tsakiri, Jose Garcia, Michael Covinsky, Meenakshi Bhattacharjee, David Saulino, Nina Tatevian, Sean Blackwell
Zika virus is increasingly recognized as a fetal pathogen worldwide. We describe the first case of neonatal demise with travel-associated Zika virus infection in the United States of America, including a novel prenatal ultrasound finding. A young Latina presented to our health care system in Southeast Texas for prenatal care at 23 weeks of gestation. Fetal Dandy-Walker malformation, asymmetric cerebral ventriculomegaly, single umbilical artery, hypoechoic fetal knee, dorsal foot edema, and mild polyhydramnios were noted upon initial screening prenatal sonography at 26 weeks...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28405492/a-rare-complication-of-central-venous-catheter-extravasation-in-a-preterm-neonate-hemidiaphragmatic-paralysis
#3
C Hobson, D Dubillot, H Lardy, D Sirinelli, E Saliba, E Lopez
We report a case of a preterm neonate born at 26 weeks' of gestation diagnosed with unilateral diaphragmatic paralysis. This paralysis was a consequence of a phrenic nerve injury due to extravasation of hyperosmolar parenteral nutrition fluid in the upper thorax. Chest X-rays and ultrasonography confirmed the diagnosis. The neonate was treated with prolonged respiratory support and did not require surgical treatment. This report describes a case of hemidiaphragmatic paralysis as a complication of central venous catheter insertion...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28367358/perinatal-and-neonatal-outcomes-of-triplet-gestations-based-on-chorionicity
#4
Maureen Downing, Suela Sulo, Barbara V Parilla
Objective To compare perinatal and neonatal outcomes of dichorionic (DC) and monochorionic (MC) with trichorionic (TC) triplet gestations. Methods A retrospective cohort study of DC + MC versus TC triplet gestations delivered at a tertiary care hospital from 2009 to 2015. The results include 42 sets of triplets (TC, n = 26; DC + MC, n = 16). Maternal demographics and pregnancy data were compared. Neonatal outcomes were assessed using composite morbidity and mortality. Results Maternal baseline characteristics including age, mode of conception, race, parity, body mass index, and previous preterm delivery were statistically comparable...
January 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28367357/resuscitation-with-intact-placental-circulation-in-a-preterm-infant-with-hydrops-fetalis
#5
Simone Pratesi, Iuri Corsini, Caterina Coviello, Silvia Perugi, Carlo Dani
A preterm infant with prenatal diagnosis of hydrops fetalis was spontaneously delivered at 30 weeks of gestational age in a tertiary level hospital. Prenatal echography pointed out severe bilateral pleural effusions and diffused subcutaneous edema. A neonatologist team, alerted at the expulsion stage of labor, assisted the neonate immediately after birth and bilateral hydrothorax was drained with intact placental circulation to avoid a nonrespiratory period and its possible detrimental hemodynamic effects. The newborn was well stabilized in the delivery room before cutting the umbilical cord and starting mechanical ventilation...
January 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28348923/massive-urinary-protein-excretion-associated-with-greater-neonatal-risk-in-preeclampsia
#6
Julio Mateus, Roger Newman, Baha M Sibai, Qing Li, John R Barton, C Andrew Combs, Edwin Guzman, Kim A Boggess, Cynthia Gyamfi, Peter von Dadelszen, Doug Woelkers
Objective The objective of this study was to compare clinical outcomes of preeclamptic pregnancies according to the proteinuria level. Study Design Secondary analysis of a multicenter prospective cohort study of women with preeclampsia (PE) symptomatology. Nonproteinuria, mild-proteinuria, and massive-proteinuria PEs were defined as: < 165 mg in 12 hours or < 300 mg in 24 hours, 165 mg to 2.69 g in 12 hours or 300 mg to 4.99 g in 24 hours, and ≥ 2.7 g in 12 hours or ≥ 5...
January 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28255522/opportunities-to-foster-efficient-communication-in-labor-and-delivery-using-simulation
#7
Kay Daniels, Colleen Hamilton, Susan Crowe, Steven S Lipman, Louis P Halamek, Henry C Lee
Introduction Communication errors are an important contributing factor in adverse outcomes in labor and delivery (L&D) units. The objective of this study was to identify common lapses in verbal communication using simulated obstetrical scenarios and propose alternative formats for communication. Methods Health care professionals in L&D participated in three simulated clinical scenarios. Scenarios were recorded and reviewed to identify questions repeated within and across scenarios. Questions that were repeated more than once due to ineffective communication were identified...
January 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28255521/management-of-breast-cancer-during-pregnancy-are-we-compliant-with-current-guidelines
#8
Victoria Shlensky, Sigrun Hallmeyer, Lourdes Juarez, Barbara V Parilla
Introduction The purpose of this study was to evaluate the management of patients with breast cancer in pregnancy treated at the Advocate Health Care, to determine whether these patients were treated according to guidelines for pregnant patients, which aim to maximize both fetal and maternal outcomes. Methods A retrospective chart review was performed at the Advocate Lutheran General Hospital, Christ Medical Center, and Illinois Masonic Medical Center from 2002 to 2012 on patients diagnosed with breast cancer during pregnancy using ICD-9 (International Classification of Diseases - 9th version) codes...
January 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28255520/validation-of-a-prediction-model-for-vaginal-birth-after-cesarean-delivery-reveals-unexpected-success-in-a-diverse-american-population
#9
Melanie Mai Maykin, Amanda J Mularz, Lydia K Lee, Stephanie Gaw Valderramos
Objective To investigate the validity of a prediction model for success of vaginal birth after cesarean delivery (VBAC) in an ethnically diverse population. Methods We performed a retrospective cohort study of women admitted at a single academic institution for a trial of labor after cesarean from May 2007 to January 2015. Individual predicted success rates were calculated using the Maternal-Fetal Medicine Units Network prediction model. Participants were stratified into three probability-of-success groups: low (<35%), moderate (35-65%), and high (>65%)...
January 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28228977/transient-hemi-lower-limb-ischemia-in-the-newborn-arterial-thrombosis-or-persistent-sciatic-artery
#10
Makiko Kirino, Masayuki Ochiai, Masako Ichiyama, Hirosuke Inoue, Takeshi Kusuda, Tadamune Kinjo, Masataka Ishimura, Shouichi Ohga
Neonatal thromboembolism occurs with various predispositions and triggers. Early diagnosis of the thrombosis is challenging and essential for the therapeutic interventions. We herein report two newborns who presented with transient hemi-lower limb ischemia due to (1) arterial thrombosis or (2) a persistent sciatic artery (PSA). The patient with arterial thrombosis showed elevations of fibrin degradation product and D-dimer and received antithrombin and heparin intravenously. The patient with PSA was immediately assessed by a contrast-enhanced computed tomography because of a transient ischemic episode with no evidence of hypercoagulability...
January 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28210520/synchronous-aberrant-cerebellar-and-opercular-development-in-fetuses-and-neonates-with-congenital-heart-disease-correlation-with-early-communicative-neurodevelopmental-outcomes-initial-experience
#11
A Wong, T Chavez, S O'Neil, J Votava-Smith, D Miller, S delCastillo, A Panigrahy, L Paquette
Patients with congenital heart disease (CHD) demonstrate multidomain cognitive delays. Cingulo-opercular and cerebellar brain networks are critical to language functions. This is a description of our initial experience aiming to identify an anatomic correlate for CHD patients with expressive language delays. Fetal CHD patients, prospectively enrolled, underwent serial fetal (1.5T), postnatal pre- and postoperative (3T) MRI. Non-CHD patients were enrolled retrospectively from the same epoch. Comparable fetal and neonatal T2 contrast was used for manual linear cross-sectional measurement...
January 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28210519/achondroplasia-in-the-premature-infant-an-elusive-diagnosis-in-the-neonatal-intensive-care-unit
#12
Kimberly E Fagen, Anna R Blask, Eva I Rubio, Dorothy I Bulas
Achondroplasia is a difficult prenatal diagnosis to make before the late second and third trimester. We describe two cases where an infant was born prematurely with no overt signs of achondroplasia. Despite multiple chest and abdominal radiographs during the neonatal course, the diagnosis was not made until term equivalent age was reached. We retrospectively reviewed these two cases to highlight the elusive findings of achondroplasia in the premature infant.
January 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28210518/epstein-barr-virus-induced-mononucleosis-as-an-imitator-of-severe-preeclampsia
#13
S Allison Staley, Marcela C Smid, Sarah K Dotters-Katz, Elizabeth M Stringer
Background In pregnancy, conditions presenting with hematologic abnormalities, transaminitis, and proteinuria pose diagnostic challenges in pregnancy. Case We present the case of an 18-year-old woman, G1P0, at 33 weeks' gestation with fever of unknown cause, who developed progressively elevated liver enzymes, proteinuria, and thrombocytopenia, due to Epstein-Barr virus (EBV) infection. Conclusion Acute infection with EBV should be included in the differential diagnosis of preeclampsia with severe features, particularly in the setting of fever...
January 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28180030/serial-measurement-of-superior-vena-cava-flow-in-evaluation-of-the-clinical-severity-of-pial-arteriovenous-fistula-in-an-infant
#14
Mako Ago, Kenichi Masumoto, Atsushi Uchiyama, Yasuo Aihara, Yoshikazu Okada, Satoshi Kusuda
Background Pial arteriovenous fistula (AVF) is composed of one or more direct arterial feeding vessels with a single draining vein without nidus. A patient with the disease with high-flow AV shunting in the neonatal period not only suffers from high-output cardiac failure but also shows secondary neurological sequelae. In vein of Galen aneurysmal malformation, superior vena cava (SVC) flow measurements provide useful prognostic information. Case Presentation We measured serial SVC flow in a male infant with pial AVF...
January 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28078172/gastric-rupture-in-pregnancy-case-series-from-a-tertiary-institution-in-rwanda-and-review-of-the-literature
#15
David Ntirushwa, Stephen Rulisa, Febronie Muhorakeye, Lisa Bazzett-Matabele, Theogene Rurangwa, Maria Small
Background Gastric rupture is a rare, life-threatening condition during pregnancy. Case study We present three cases of gastric perforation during pregnancy and the puerperium. The first patient presented with gastric perforation 4 days following an uncomplicated cesarean delivery for obstetric indications. She initially complained of epigastric pain; however, those symptoms resolved. She later demonstrated worsening abdominal distension, intra-abdominal free fluid, and signs of peritonitis. At laparotomy, an ascariasis-associated gastric rupture was diagnosed...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28050333/placenta-percreta-and-incomplete-uterine-rupture-after-endometrial-ablation-and-tubal-occlusion
#16
Jaden R Kohn, Edwina Popek, Concepcion R Diaz-Arrastia, Xiaoming Guan, Alireza A Shamshirsaz, Michael A Belfort, Karin A Fox
Endometrial ablation offers symptomatic relief for menorrhagia. Pregnancy after ablation is rare but is often complicated due to pregnancy loss, growth restriction, preterm premature rupture of membranes, preterm delivery, and morbidly adherent placentation, a dangerous complication that can result in hemorrhage, intensive care unit admission, and cesarean hysterectomy. We report a case of pregnancy conceived contemporaneously with endometrial ablation and tubal occlusion. Diagnosis of pregnancy was delayed due to low suspicion...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28050332/secondary-postpartum-hemorrhage-due-to-spontaneous-uterine-artery-rupture-after-normal-vaginal-delivery-managed-by-selective-arterial-embolization
#17
Mili Thakur, Henry O Adekola, Radwan Asaad, Bernard Gonik
Secondary postpartum hemorrhage due to an intraperitoneal bleed following a vaginal delivery is extremely rare. We present a case of spontaneous rupture of the uterine artery following a normal vaginal delivery with a delayed presentation, which resulted in significant morbidity. This case discusses the presentation and management of this rare obstetrical emergency. The report also discusses the role of selective arterial embolization in management of secondary postpartum hemorrhage.
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28050331/placental-microrna-expression-is-not-altered-by-maternal-obesity-and-fetal-overgrowth
#18
Neda Ghaffari, Samuel Parry, Michal A Elovitz, Celeste P Durnwald
Objective The epigenetic mechanisms underlying fetal metabolic programming are poorly understood. We studied whether obesity is associated with alterations in placental miRNA expression. Study Design A cross-sectional study was performed, including (1) normal-weight women (BMI 20-24.9 kg/m(2)) and normal-birth-weight (BW) infants (2,700-3,500 g) (n = 20), (2) normal-weight and macrosomic infants (BW ≥ 4,000 g) (n = 10), (3) obese (BMI ≥ 35 kg/m(2)) and normal BW infants (n = 16), and (4) obese and macrosomic infants (n = 10)...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27994945/early-postnatal-seizures-in-a-neonate-with-wolf-hirschhorn-syndrome
#19
Hayato Go, Kentaro Haneda, Hajime Maeda, Kei Ogasawara, Takashi Imamura, Nobuo Momoi, Mitsuaki Hosoya
Background Wolf-Hirschhorn syndrome (WHS), which is characterized by a typical facial appearance, growth retardation, mental retardation, seizures, and congenital cardiac defects, has an estimated incidence of 1 per 50,000 births. Case We report a case of a low birth weight neonate with WHS and seizures, as well as persistent pulmonary hypertension in the early neonatal period. Apgar scores were 6 (1 minute) and 8 (5 minutes) with evident retraction. After admission to the neonatal intensive care unit, the patient had tonic-clonic seizures with epilepticus 30 minute after birth...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27994944/placental-abruption-revealed-by-hemoperitoneum-a-case-report
#20
C Bertholdt, A Vincent-Rohfritsch, V Tsatsaris, F Goffinet
Background Hemoperitoneum is a life-threatening surgical emergency. Diagnosis of the cause is often difficult, in particular, during pregnancy when it may be either obstetric or nonobstetric. Case We report the case of a hemoperitoneum caused by the backflow of blood through a uterine tube, due to placental abruption. Conclusion Hemoperitoneum in pregnant women with no other signs can reveal placental abruption. The difficulty in identifying the cause may delay appropriate management.
October 2016: American Journal of Perinatology Reports
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