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American Journal of Perinatology Reports

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https://www.readbyqxmd.com/read/29765789/pharmacokinetics-of-hydroxyprogesterone-caproate-and-its-primary-metabolites-during-pregnancy
#1
Kim A Boggess, Jeffrey B Baker, Amy P Murtha, Alan M Peaceman, Dinesh M Shah, Sylvia L Siegfried, Robert Birch
Objective  To measure pharmacokinetics of hydroxyprogesterone caproate (OHPC) and its major metabolites throughout pregnancy. Study Design  Thirty women were prescribed OHPC for recurrent preterm birth prevention. Three cohorts of subjects had blood drawn for 7 consecutive days at one of three times: cohort 1 ( n  = 6) after the first dose (weeks 16-20), cohort 2 ( n  = 8) between weeks 24 and 28, and cohort 3 ( n  = 16) between weeks 32 and 36. We measured serum trough levels after week 1 in cohort 1 or after two consecutive weekly doses in cohorts 2 and 3...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29765788/early-pulmonary-interstitial-emphysema-in-preterm-neonates-respiratory-management-and-case-report-in-nonventilated-very-low-birth-weight-twins
#2
Judith Gronbach, Harald Ehrhardt, Klaus-Peter Zimmer, Markus Waitz
Early pulmonary interstitial emphysema in extreme preterm neonates is closely linked with respiratory distress syndrome and exposure to mechanical ventilation. In severe cases, maintaining adequate gas exchange aiming to avoid further lung damage and other neonatal morbidities associated with systemic/pulmonary hypoperfusion, prolonged hypoxia, and respiratory acidosis can be challenging and requires in-depth knowledge into the pathophysiology of the disease. Herein, we report on very low birth weight twins who developed early pulmonary interstitial emphysema during noninvasive respiratory support...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29765787/liver-failure-and-conjugated-hyperbilirubinemia-in-a-preterm-neonate-role-of-early-ivig-and-exchange-transfusion
#3
Jayasree Nair, Vasantha H S Kumar
Neonatal liver failure (NLF) is a rare diagnosis but carries with it significant risks of mortality and morbidity. Common etiologies for NLF include metabolic causes, gestational alloimmune liver disease (GALD or neonatal hemochromatosis), and viral infections. We report a case of liver failure in a premature infant with abnormal iron profile within 48 hours of birth. Lack of accepted guidelines for the initial management of severe jaundice with a high direct component in the first week after birth made treatment challenging...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29755833/risk-factors-for-umbilical-cord-prolapse-at-the-time-of-artificial-rupture-of-membranes
#4
Tetsuya Kawakita, Chun-Chih Huang, Helain J Landy
Objective  The aim of the study was to examine the association between cervical exam at the time of artificial rupture of membranes (AROM) and cord prolapse. Study Design  We conducted a retrospective cohort study using the data from the Consortium on Safe Labor. We included women with cephalic presentation and singleton pregnancies at ≥ 23 weeks' gestation who underwent AROM during the course of labor. Multivariable logistic regression was used to calculate the adjusted odds ratio (aOR) with 95% confidence interval (95% CI), controlling for prespecified covariates...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29736321/neonatal-thyrotoxicosis-with-tricuspid-valve-regurgitation-and-hydrops-in-a-preterm-infant-born-to-a-mother-with-graves-disease
#5
Stefani Doucette, Anne Tierney, Anne Roggensack, Kamran Yusuf
Neonatal hyperthyroidism is rare disorder due to the passage of thyroid receptor antibodies (TRBs) from the mother to the fetus. Neonatal thyrotoxicosis can present in several ways and if unrecognized, can be fatal. We present a preterm neonate who developed fetal hydrops and tricuspid regurgitation in utero. The mother had a history of treated Grave's disease. The infant responded to maternal treatment antenatally and postnatal anti-thyroid treatment, with resolution of both the tricuspid regurgitation and hydrops...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29686937/implementing-obstetric-early-warning-systems
#6
EDITORIAL
Alexander M Friedman, Mary L Campbell, Carolyn R Kline, Suzanne Wiesner, Mary E D'Alton, Laurence E Shields
Severe maternal morbidity and mortality are often preventable and obstetric early warning systems that alert care providers of potential impending critical illness may improve maternal safety. While literature on outcomes and test characteristics of maternal early warning systems is evolving, there is limited guidance on implementation. Given current interest in early warning systems and their potential role in care, the 2017 Society for Maternal-Fetal Medicine (SMFM) Annual Meeting dedicated a session to exploring early warning implementation across a wide range of hospital settings...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29686936/complete-placenta-previa-ultrasound-biometry-and-surgical-outcomes
#7
Alison C Wortman, Stephanie L Schaefer, Donald D McIntire, Jeanne S Sheffield, Diane M Twickler
Objective  To evaluate the relationship between surgical outcomes and ultrasound measurement of placental extension beyond the cervical os in women with placenta previa. Study Design  This is a retrospective cohort study of singleton pregnancies with placenta previa undergoing third-trimester ultrasound and delivering at our institution from 2002 through 2011. For study purposes, an investigator measured placental extension, defined as the placental distance from the internal os across the placenta continuing out to the lowest placental edge...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29670815/transatlantic-air-travel-in-the-third-trimester-of-pregnancy-does-it-affect-the-fetus
#8
B Petrikovsky, M Terrani, L Sichinava
Most commercial airlines allow pregnant women to fly up to 36 weeks of gestation. Available information suggests that noise, vibration, and cosmic radiation present a small risk for the pregnant air traveler. The goal of the study was to assess the possible effect of transatlantic flights on the condition of the third-trimester fetus. In total, 112 patients were recruited into the study between January 2005 and June 2016. All underwent a transatlantic flight in the third trimester of pregnancy. All underwent nonstress test before and within 12 hours after the transatlantic flight, and 24 hours later...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29657898/slow-elevation-in-protein-c-activity-without-a-proc-mutation-in-a-neonate-with-intracranial-hemorrhage
#9
Erika Uehara, Hiro Nakao, Yusuke Tsumura, Hisaya Nakadate, Shoichiro Amari, Hideshi Fujinaga, Yoshiyuki Tsutsumi, Dongchon Kang, Shouichi Ohga, Akira Ishiguro
Severe protein C (PC) deficiency leads to purpura fulminans and stroke in newborns. However, the clinical impact of plasma PC activity on the development of neonatal cerebral disease remains elusive. We report a case of hemorrhagic stroke associated with neonatal asphyxia and severe PC deficiency. Plasma PC and protein S activity 7 days after birth was 12% and 43%, respectively. No PROC mutation was found. PC levels did not exceed 20% until 2 months of age, even in the absence of consumption coagulopathy or vitamin K deficiency...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29651359/preclinical-labor-and-delivery-shadowing-the-impact-on-medical-students-perceptions-of-obstetrics-and-gynecology
#10
Sarah Dotters-Katz, Alexis Panzer, Matthew Givens, Marcela Smid, Alice Chuang
Objective  We sought to determine the impact of preclinical exposure (shadowing) to labor and delivery (L&D) on medical students' perceptions of obstetrics and gynecology (OB/GYN). Study Design  We administered a written survey to rising third-year medical students at a single center prior to any clerkship. We described motivation/deterrents for shadowing among students, and experiences/perceptions of those students who shadowed. Results  In total, 119/136 (86%) students completed the survey. Of those, 29% participated in shadowing on L&D...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29651358/pilot-study-of-intra-aortic-balloon-occlusion-to-limit-morbidity-in-patients-with-adherent-placentation-undergoing-cesarean-hysterectomy
#11
Elizabeth Blumenthal, Rashmi Rao, Aisling Murphy, Jeffrey Gornbein, Richard Hong, John M Moriarty, Daniel A Kahn, Carla Janzen
Objective  We study whether using an intra-aortic balloon (IAB) during cesarean hysterectomy decreases delivery morbidity in patients with suspected morbidly adherent placentation. Study Design  This is a retrospective cohort study of deliveries complicated by suspected abnormal placentation between 2009 and 2016 comparing maternal and neonatal outcomes with an IAB placed prior to cesarean hysterectomy versus no IAB. The primary outcome included quantified blood loss (QBL). Results  Thirty-five cases were reviewed, 16 with IAB and 19 without IAB...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29637011/neurocysticercosis-in-pregnancy
#12
Camille Webb, Mauricio La Rosa, Gayle Olson, Miguel Cabada
The normal physiologic changes during pregnancy contribute to nutritional, metabolic, and immunologic adjustments, which can have an impact on the presentation of several diseases. New onset seizures during pregnancy and the postpartum can be attributed to several etiologies. Patient demographic data as well as personal and social histories are key in determining the etiology of new onset seizures. Neurocysticercosis (NCC), a commonly overlooked etiology, must be included in the differential diagnosis of patients with new onset seizures coming from NCC endemic areas...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29560285/mid-trimester-cervical-consistency-index-and-cervical-length-to-predict-spontaneous-preterm-birth-in-a-high-risk-population
#13
Núria Baños, Carla Julià, Núria Lorente, Silvia Ferrero, Teresa Cobo, Eduard Gratacos, Montse Palacio
Background  Short cervical length (CL) has not been shown to be adequate as a single predictor of spontaneous preterm birth (sPTB) in high-risk pregnancies. Objective  The objective of this study was to evaluate the performance of the mid-trimester cervical consistency index (CCI) to predict sPTB in a cohort of high-risk pregnancies and to compare the results with those obtained with the CL. Study Design  Prospective cohort study including high-risk singleton pregnancies between 19 +0 and 24 +6 weeks...
January 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29527407/transient-neonatal-diabetes-mellitus-in-a-very-preterm-infant-due-to-abcc8-mutation
#14
Barbara Piccini, Caterina Coviello, Livia Drovandi, Artuso Rosangela, Francesca Monzali, Emilio Casalini, Sabrina Giglio, Sonia Toni, Carlo Dani
Neonatal diabetes mellitus (NDM) is a monogenic form of diabetes occurring within 6 months from birth. NDM can be permanent or transient (TNDM). We report the case of a preterm infant with TNDM due to an ABCC8 mutation identified by next-generation sequencing. The pancreatic adenosine triphosphate (ATP)-sensitive K+ (K-ATP) channel is a key regulator of insulin secretion. Gain-of-function mutations in the genes encoding the Kir6.2 (KCNJ11) and SUR1 (ABCC8) subunits of the channel cause neonatal diabetes. The patient was successfully managed with insulin lispro at a 1:100 dilution, drawn up in an insulin pen injector with a 4-mm needle...
January 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29527406/a-retrospective-database-analysis-of-neonatal-morbidities-to-evaluate-a-composite-endpoint-for-use-in-preterm-labor-clinical-trials
#15
Jeanne M Pimenta, Myla Ebeling, Timothy H Montague, Kathleen J Beach, Jill Abell, Michael T O'Shea, Marcy Powell, Thomas C Hulsey
Objective  To propose and assess a composite endpoint (CE) of neonatal benefit based on neonatal mortality and morbidities by gestational age (GA) for use in preterm labor clinical trials. Study Design  A descriptive, retrospective analysis of the Medical University of South Carolina Perinatal Information System database was conducted. Neonatal morbidities were assessed for inclusion in the CE based on clinical significance/risk of childhood neurodevelopmental impairment, frequency, and association with GA in a mother-neonate linked cohort, comprising women with uncomplicated singleton pregnancies delivered at ≥24 weeks' GA...
January 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29497573/nonoperative-treatment-of-appendicitis-during-pregnancy-in-a-remote-area
#16
Anne-Kathrine Carstens, Lise Fensby, Luit Penninga
Appendicitis is the most common nonobstetric surgical disease during pregnancy. Appendicitis during pregnancy is associated with an increased risk of morbidity and perforation compared with the general population. Furthermore, it may cause preterm birth and fetal loss, and quick surgical intervention is the established treatment option in pregnant women with appendicitis. In Greenland, geographical distances are very large, and weather conditions can be extreme, and surgical care is not always immediately available...
January 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29492329/intrauterine-herpes-simplex-virus-infection-presenting-as-a-zosteriform-eruption-in-a-newborn
#17
Caitlin M Drumm, Maura C Caufield, Cynthia M DeKlotz, Helena B Pasieka, Kabir M Abubakar
There is significant morbidity and mortality associated with the transmission of herpes simplex virus (HSV) from pregnant women to their fetus or newborn. Although most commonly transmitted in the peripartum period, in rare cases HSV can lead to intrauterine infection. Cutaneous lesions are the most common manifestation of intrauterine HSV, and have a wide spectrum of presentation. We present a rare case of intrauterine HSV-2 infection presenting with a zosteriform eruption mimicking congenital varicella syndrome in a newborn...
January 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29472990/differential-methylation-of-syncytin-1-and-2-distinguishes-fetal-growth-restriction-from-physiologic-small-for-gestational-age
#18
Sami P Makaroun, Katherine P Himes
Objective  The retroviral genes encoding Syncytin-1 ( SYN1 ) and Syncytin-2 ( SYN2 ) are epigenetically regulated, uniquely expressed in the placenta and critical to placental function. We sought to determine if placental expression and methylation patterns of SYN1 and SYN2 from pregnancies complicated by fetal growth restriction (FGR) differed from physiologic small for gestational age (SGA) and appropriate for gestational age (AGA) controls. Study Design  Placental biopsies were obtained from AGA, SGA and FGR neonates delivered at >36 weeks gestation...
January 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29423334/pre-pregnancy-body-mass-index-and-third-trimester-depressive-symptoms-in-a-healthy-privately-insured-sample
#19
Stephanie A Schuette, Michelle A Kominiarek, Katherine L Wisner, Suena H Massey
Objectives  While being overweight (body mass index [BMI] >25) prior to pregnancy is linked to antenatal depression, whether weight is confounded by socioeconomic and/or medical risks is unclear. Study Design  We assessed 66 healthy privately insured pregnant women at M = 35.0 ± 3.3 weeks for symptoms of depression (Inventory for Depressive Symptoms-Self-Report (IDS-SR 30), lifetime history of depression and other psychiatric conditions (Mini International Neuropsychiatric Interview), and pre-pregnancy BMI derived from pre-pregnancy weight (by recall) and directly measured height...
January 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29362688/pregnant-women-s-knowledge-and-beliefs-about-the-safety-and-outcomes-of-delivery-at-various-gestational-ages
#20
Melody A Baldwin, Geeta K Swamy, Sarahn M Wheeler
Objectives  Despite the morbidity associated with late preterm and early-term births, there is limited data on pregnant women's perception of neonatal risk based on gestational age (GA). Therefore, our objective was to determine pregnant women's perception of neonatal risks at varying GAs. Method  Through an anonymous 24-question survey, pregnant women were asked to designate the GA at delivery that is desirable, safe, and defined as full term. Responses were compared based on race, history of preterm birth, and medical comorbidities...
January 2018: American Journal of Perinatology Reports
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