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American Journal of Perinatology Reports

Akwugo A Eziefule, Solafa Elshatanoufy, Mili Thakur, Frederico G Rocha
Background Propofol is a widely known, commonly used drug. Complications can occur with the use of this drug, including propofol-related infusion syndrome (PRIS). PRIS, in the obstetric population, has not been documented; however, we report a case of a patient who developed PRIS after an emergent cesarean delivery of a preterm infant. Case Study A 35-year-old multigravida woman presented complaining of leakage of fluid and decreased fetal movement. Her pregnancy was complicated by methadone maintenance therapy due to a history of opioid abuse...
October 2016: American Journal of Perinatology Reports
Anne-Aurélie Lopes, Souad Belhabri, Leila Karaoui
[This corrects the article DOI: 10.1055/s-0035-1566249.].
October 2016: American Journal of Perinatology Reports
Amanda J Ashdown, Mark W Scerbo, Lee A Belfore, Stephen S Davis, Alfred Z Abuhamad
Objective This study examined the ability of clinicians to correctly categorize images of fetal heart rate (FHR) variability with and without the use of exemplars. Study Design A sample of 33 labor and delivery clinicians inspected static FHR images and categorized them into one of four categories defined by the National Institute of Child Health and Human Development (NICHD) based on the amount of variability within absent, minimal, moderate, or marked ranges. Participants took part in three conditions: two in which they used exemplars representing FHR variability near the center or near the boundaries of each range, and a third control condition with no exemplars...
October 2016: American Journal of Perinatology Reports
Jessica Hellyer, Hunter Oliver-Allen, Majid Shafiq, Alisha Tolani, Maurice Druzin, Michael Jeng, Stanley Rockson, Robert Lowsky
Introduction Gorham-Stout Disease (GSD) is a rare disorder of bony destruction due to lymphangiomatosis, and is often triggered by hormones. One complication of GSD is the development of chylothorax, which carries a high mortality rate. Very little experience has been published to guide management in GSD during pregnancy to optimize both fetal and maternal health. Case Study A 20-year-old woman with known GSD presented with shortness of breath at 18 weeks of pregnancy, due to bilateral chylothoraces which required daily drainage...
October 2016: American Journal of Perinatology Reports
Frank H Morriss, Julie B Lindower, Heather L Bartlett, Dianne L Atkins, Jean O Kim, Jonathan M Klein, Bradley A Ford
Objective We describe five neonates with enteroviral (EV) infection to demonstrate central nervous system (CNS) and cardiac complications and report successful treatment of myocarditis with immunoglobulin intravenous (IVIG) in two. Study Design Case series identified during three enteroviral seasons in one neonatal intensive care unit (NICU) by cerebral spinal fluid (CSF) reverse transcriptase polymerase chain reaction (PCR) testing for EV in neonates suspected to have sepsis, but with sterile bacterial cultures...
July 2016: American Journal of Perinatology Reports
Carolina Bibbo, Sarah E Little, Jad Bsat, Kris Ann Botka, Carol B Benson, Julian N Robinson
Objective This study aims to evaluate pregnancy outcomes in patients with spontaneous and iatrogenic chorioamniotic separation diagnosed by ultrasound after 17 weeks. Methods This is a retrospective cohort study of women with a singleton pregnancy who were diagnosed with chorioamniotic separation (n = 106) after 17 weeks' gestation from January 2000 to January 2013. Patients with chorioamniotic separation were compared with a group of patients who had obstetric ultrasounds without a diagnosis of chorioamniotic separation...
July 2016: American Journal of Perinatology Reports
Kelli K Ryckman, Brittney M Donovan, Diedre K Fleener, Bruce Bedell, Kristi S Borowski
Objective Our primary objective was to assess the difference in amino and fatty acid biomarkers throughout pregnancy in women with and without obesity. Interactions between biomarkers and obesity status for associations with maternal and fetal metabolic measures were secondarily analyzed. Methods Overall 39 women (15 cases, 24 controls) were enrolled in this study during their 15- to 20-weeks' visit at the University of Iowa Hospitals and Clinics. We analyzed 32 amino acid and acylcarnitine concentrations with tandem mass spectrometry for differences throughout pregnancy as well as among women with and without obesity (body mass index [BMI] ≥ 35, BMI < 25)...
July 2016: American Journal of Perinatology Reports
Jennifer Gibbs, Firas Bridges, Kiran Trivedi, John Vullo
BACKGROUND: Rectus sheath hematoma (RSH) represents a rare, but serious cause of abdominal pain. CASE: Here we discuss the case of a healthy multigravida female who presented at 28 weeks gestation with spontaneous RSH. Conservative management with multiple blood transfusions led to the development of transfusion related acute lung injury (TRALI) and intensive care unit admission. She was managed with noninvasive ventilatory support, gradually improved, and was weaned of ventilation...
July 2016: American Journal of Perinatology Reports
Priscila Pinheiro Ribeiro Lyra, Gúbio Soares Campos, Igor Dórea Bandeira, Silvia Ines Sardi, Lilian Ferreira de Moura Costa, Flávia Rocha Santos, Carlos Alexandre Santos Ribeiro, Alena Maria Barreto Jardim, Ana Cecília Travassos Santiago, Patrícia Ribeiro de Oliveira, Lícia Maria Oliveira Moreira
[This corrects the article DOI: 10.1055/s-0036-1587323.].
July 2016: American Journal of Perinatology Reports
Luchin F Wong, Jacob Wilkes, Kent Korgenski, Michael W Varner, Tracy A Manuck
OBJECTIVE: The objective of this study was to describe pregnancy outcomes, including cervical insufficiency and preterm birth, in the subsequent pregnancy following an intrapartum cervical laceration. STUDY DESIGN: Retrospective cohort of women with their first two consecutive singleton pregnancies carried to ≥ 20(0/7) weeks' gestation within a tertiary health care system from 2002 to 2012. Cervical laceration cases were identified by ICD9 codes and included if suture repair was required...
July 2016: American Journal of Perinatology Reports
Ramesha Papanna, Lovepreet K Mann, Saul Snowise, Yisel Morales, Sanjay P Prabhu, Scheffer C G Tseng, Raymond Grill, Stephen Fletcher, Kenneth J Moise
OBJECTIVES: The objective of our study was to test the hypothesis that in utero repair of surgically created spina bifida in a sheep model using cryopreserved human umbilical cord (HUC) patch improves neurological outcome. METHODS: Spina bifida with myelotomy was surgically created in timed pregnant ewes at gestational day (GD) 75. The fetuses were randomly assigned to unrepaired versus HUC and treated at GD 95 and then delivered at GD 140. Neurological evaluation was performed using the Texas Spinal Cord Injury Scale (TSCIS), bladder control using ultrasound, and the hindbrain herniation...
July 2016: American Journal of Perinatology Reports
Hassan M Harirah, J Michael Smith, C Luke Dixon, Gary D V Hankins
Advanced abdominal pregnancy is an extremely rare condition that poses diagnostic and management challenges. A high index of suspicion and careful assessment of the patient's symptoms, supplemented with obstetric ultrasound, and magnetic resonance imaging, are crucial for timely diagnosis and management to prevent life-threatening complications. The presence of periviable fetuses in advanced abdominal pregnancies increases the challenge to achieve a balance between maternal and fetal benefits and risks. Early diagnosis and management decisions via a multidisciplinary approach and planned delivery are of paramount importance to minimize complications and achieve favorable maternal and fetal outcomes...
July 2016: American Journal of Perinatology Reports
Priscila Pinheiro Ribeiro Lyra, Gúbio Soares Campos, Igor Dórea Bandeira, Silvia Ines Sardi, Lilian Ferreira de Moura Costa, Flávia Rocha Santos, Carlos Alexandre Santos Ribeiro, Alena Maria Barreto Jardim, Ana Cecília Travassos Santiago, Patrícia Maria Ribeiro de Oliveira, Lícia Maria Oliveira Moreira
There is little information about the congenital chikungunya virus (CHIKV) transmission. We describe two cases of well-documented congenital CHIKV infection in Salvador-Brazil, where CHIKV has been identified since 2014. The outbreak in the city led to the clinical CHIKV diagnoses of both pregnant women 2 days before delivery. Urine and blood samples from the mothers and newborns were collected and tested for reverse transcription-polymerase chain reaction (PCR) analysis for Zika, dengue, and CHIKV. Both neonates and mothers had positive urine and serum PCR results for CHIKV...
July 2016: American Journal of Perinatology Reports
Lakha Prasannan, Matthew J Blitz, Jill M Rabin
INTRODUCTION: Acute myocardial infarction (MI) in pregnancy is a rare event, usually occurring late in gestation, either in the third trimester or in the puerperium. It is associated with significant maternal and fetal morbidity and mortality. Although diagnosis and management of MI in pregnancy has been discussed in the literature, management of pregnancy following an early antepartum MI, which may have more consequences for the fetus, has not received as much attention. CASE: A 38-year-old great grand multiparous woman presented to the emergency department complaining of acute onset chest pain...
July 2016: American Journal of Perinatology Reports
Olivia Myrick, Sarah Dotters-Katz, Matthew Grace, Tracy Manuck, Kim Boggess, William Goodnight
OBJECTIVE: This study aims to determine if antibiotics given for latency to women with twins and previable preterm premature rupture of membranes (PPROM) affect the duration from membrane rupture to delivery. METHODS: A retrospective cohort study of twin pregnancies at a single center from 2000 to 2015 with previable (14 (0/7)-22 (6/7) weeks) PPROM was conducted. Women who were not candidates for expectant management or who elected for immediate delivery were excluded...
July 2016: American Journal of Perinatology Reports
Stephen Contag, Clayton Brown, Sarah Crimmins, Katherine Goetzinger
OBJECTIVE: The objective of this study was to determine the effect of birthweight on prospective stillbirth risk. METHODS: Cross-sectional study of singleton births in the United States from 2010 to 2012 from 32 through 42 weeks was conducted. Stillbirth risk was stratified by birthweight and gestational age adjusted for time from death to delivery. The primary outcome was the prospective stillbirth risk for each birthweight category. Student t-test was used for continuous data, chi-square to compare categorical data...
July 2016: American Journal of Perinatology Reports
Antonio F Saad, Luis Monsivais, Luis D Pacheco
BACKGROUND: Despite its seldom occurrence, fetal tachycardia can lead to poor fetal outcomes including hydrops and fetal death. Management can be challenging and result in maternal adverse effects secondary to high serum drug levels required to achieve effective transplacental antiarrhythmic drug therapy. CASE: A 33-year-old woman at 33 weeks of gestation with a diagnosis of a fetal sustained superior ventricular tachycardia developed chest pain, shortness of breath, and bigeminy on electrocardiogram secondary to digoxin toxicity despite subtherapeutic serum drug levels...
July 2016: American Journal of Perinatology Reports
Cristina Ramos-Navarro, Manuel Sanchez-Luna, Ester Sanz-López, Elena Maderuelo-Rodriguez, Elena Zamora-Flores
BACKGROUND: Noninvasive ventilation is being increasingly used on preterm infants to reduce ventilator lung injury and bronchopulmonary dysplasia. The aim of this study was to evaluate the effectiveness of synchronized nasal intermittent positive pressure ventilation (SNIPPV) to prevent intubation in premature infants. METHODS: Prospective observational study of SNIPPV use on preterm infants of less than 32 weeks' gestation. All patients were managed using a prospective protocol intended to reduce invasive mechanical ventilation (iMV) use...
July 2016: American Journal of Perinatology Reports
Trassanee Chatmethakul, Ramachandra Bhat, Maryam Alkaabi, Abdul Siddiqui, Keith Peevy, Michael Zayek
Multifocal and diffuse infantile hepatic hemangioendotheliomas commonly present with signs of high-output congestive heart failure. In addition, prolonged persistent pulmonary overcirculation eventually leads to the development of pulmonary hypertension at a later age. We report a 2-day old, full-term infant with multifocal, large infantile hepatic hemangioendothelioma, who presented with an early onset of pulmonary hypertension, managed successfully with supportive care and systemic therapy directed toward the involution of infantile hepatic hemangioendothelioma...
July 2016: American Journal of Perinatology Reports
Diana A Racusin, Kathleen M Antony, Jennifer Haase, Melissa Bondy, Kjersti M Aagaard
OBJECTIVE: Despite the current prevalence of preterm births, no clear guidelines exist on the optimal mode of delivery. Our objective was to investigate the effects of mode of delivery on neonatal outcomes among premature infants in a large cohort. STUDY DESIGN: We applied a retrospective cohort study design to a database of 6,408 births. Neonates were stratified by birth weight and a composite score was calculated to assess neonatal outcomes. The results were then further stratified by fetal exposure to antenatal steroids, birth weight, and mode of delivery...
July 2016: American Journal of Perinatology Reports
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