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American Journal of Perinatology Reports

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https://www.readbyqxmd.com/read/28078172/gastric-rupture-in-pregnancy-case-series-from-a-tertiary-institution-in-rwanda-and-review-of-the-literature
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/27924247/could-high-volume-of-physical-activities-in-early-pregnancy-interfere-with-deep-placentation
#7
Chantale Vachon-Marceau, Mario Girard, Michèle Bisson, Suzanne Demers, Isabelle Marc, Emmanuel Bujold
Background The impact of physical activity (PA) during pregnancy on obstetrical outcomes remains controversial. We followed pregnant women who reported more than 3 hours of sustained PA per week during the first trimester of pregnancy. Cases Total five eligible women were followed. We observed small placenta from the first trimester (median: 0.68; interquartile [IQ]: 0.62-0.97 multiples of median [MoM]) to delivery (median: 0.82; IQ: 0.71-0.94 MoM), high uterine artery pulsatility index in the first (median: 1...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27924246/adenovirus-and-culture-negative-sepsis-in-a-preterm-neonate
#8
Mohannad Moallem, Eunkyung Song, Preeti Jaggi, Miriam R Conces, Adriana E Kajon, Pablo J Sánchez
Background Respiratory viral infections remain an underrecognized cause of morbidity and mortality among preterm infants in the neonatal intensive care unit (NICU). Case Report An eight day old, 650 gram birth weight, 23 weeks' gestational age female developed "culture-negative" sepsis manifested by respiratory deterioration, hypoxia, leukocytosis, and thrombocytopenia. She was diagnosed with pneumonia and hepatitis due to adenovirus HAdV-D (H29F9) by polymerase chain reaction (PCR) testing, but died at the age of 18 days despite treatment with cidofovir and immune globulin intravenous...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27917307/clinical-and-cost-impact-analysis-of-a-novel-prognostic-test-for-early-detection-of-preterm-birth
#9
Aaron B Caughey, John A F Zupancic, James M Greenberg, Susan S Garfield, Stephen F Thung, Jay D Iams
Objective The objective of this study was to evaluate the potential impact to the U.S. health care system by adopting a novel test that identifies women at risk for spontaneous preterm birth. Methods A decision-analytic model was developed to assess clinical and cost outcomes over a 1-year period. The use of a prognostic test to predict spontaneous preterm birth in a hypothetical population of women reflective of the U.S. population (predictive arm) was compared with the current baseline rate of spontaneous preterm birth and associated infant morbidity and mortality (baseline care arm)...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27900229/patient-perception-of-negative-noninvasive-prenatal-testing-results
#10
A Theresa Wittman, S Shahrukh Hashmi, Hector Mendez-Figueroa, Salma Nassef, Blair Stevens, Claire N Singletary
Objective To determine patient perception of residual risk after receiving a negative non-invasive prenatal testing result. Introduction Recent technological advances have yielded a new method of prenatal screening, non-invasive prenatal testing (NIPT), which uses cell-free fetal DNA from the mother's blood to assess for aneuploidy. NIPT has much higher detection rates and positive predictive values than previous methods however, NIPT is not diagnostic. Past studies have demonstrated that patients may underestimate the limitations of prenatal screening; however, patient perception of NIPT has not yet been assessed...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27896019/naloxone-and-metabolites-quantification-in-cord-blood-of-prenatally-exposed-newborns-and-correlations-with-maternal-concentrations
#11
Samantha L Wiegand, Madeleine J Swortwood, Marilyn A Huestis, John Thorp, Hendreé E Jones, Neeta L Vora
Objective To quantify naloxone and metabolite concentrations in newborns prenatally exposed to sublingual buprenorphine/naloxone and to correlate neonatal and maternal metabolite concentrations. Methods This is a prospective observational cohort study. Eleven pregnant women treated for opioid use disorder with sublingual buprenorphine/naloxone were enrolled. Maternal and newborn blood was collected and analyzed for naloxone, buprenorphine, and metabolites via liquid chromatography tandem mass spectrometry...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27822433/erratum-pregnancy-complicated-by-gorham-stout-disease-and-refractory-chylothorax
#12
Jessica Hellyer, Hunter Oliver-Allen, Majid Shafiq, Alisha Tolani, Maurice Druzin, Michael Jeng, Stanley Rockson, Robert Lowsky
[This corrects the article DOI: 10.1055/s-0036-1593443.].
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27822432/standard-external-doppler-fetal-heart-tracings-versus-external-fetal-electrocardiogram-in-very-preterm-gestation-a-pilot-study
#13
Gary Fruhman, Jeffrey A Gavard, Kristina McCormick, Judy Wilson-Griffin, Erol Amon, Gilad A Gross
Introduction Very preterm babies can be difficult to monitor using standard external Doppler fetal heart tracings (eFHR). External fetal electrocardiogram (fECG) is a potential alternative. Methods This was a prospective observational pilot study of hospitalized patients at 24 to 28 weeks' gestation. A total of 30 women were traced for up to 2 hours using eFHR followed by up to 2 hours using fECG. The percentage of time the fetal heart rate was traced during the 2-hour window for each modality was calculated...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27822431/development-implementation-and-assessment-of-a-genetics-curriculum-across-institutions
#14
Sarah Dotters-Katz, Ginger Hocutt, C Michael Osborne, Emily E Hardisty, Laurie Demmer, Neeta Vora
Objective Many residency programs offer limited exposure and minimal didactic time genetics, despite its frequent use in obstetrics and gynecology. The objective of this study was to develop, pilot, and assess a three-module women's health genetics curriculum for residents that was easily transferable between institutions. Methods An interactive three-module genetics curriculum covering basic principles, prenatal screening/diagnosis, and cancer genetics was developed. A pre- and posttests were used to assess improvement in knowledge...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27738550/propofol-related-infusion-syndrome-in-the-peripartum-period
#15
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
https://www.readbyqxmd.com/read/27730006/erratum-clinical-findings-and-autopsy-of-a-preterm-infant-with-breast-milk-acquired-cytomegalovirus-infection
#16
Anne-Aurélie Lopes, Souad Belhabri, Leila Karaoui
[This corrects the article DOI: 10.1055/s-0035-1566249.].
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27722031/categorizing-fetal-heart-rate-variability-with-and-without-visual-aids
#17
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
https://www.readbyqxmd.com/read/27708981/pregnancy-complicated-by-gorham-stout-disease-and-refractory-chylothorax
#18
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
https://www.readbyqxmd.com/read/28078171/could-revision-of-the-embryology-influence-our-cesarean-delivery-technique-towards-an-optimized-cesarean-delivery-for-universal-use
#19
Michael Stark, Ospan Mynbaev, Yuri Vassilevski, Patrick Rozenberg
Until today, there is no standardized Cesarean Section method and many variations exist. The main variations concern the type of abdominal incision, usage of abdominal packs, suturing the uterus in one or two layers, and suturing the peritoneal layers or leaving them open. One of the questions is the optimal location of opening the uterus. Recently, omission of the bladder flap was recommended. The anatomy and histology as results from the embryological knowledge might help to solve this question. The working thesis is that the higher the incision is done, the more damage to muscle tissue can take place contrary to incision in the lower segment, where fibrous tissue prevails...
July 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27695644/neonatal-enterovirus-infection-case-series-of-clinical-sepsis-and-positive-cerebrospinal-fluid-polymerase-chain-reaction-test-with-myocarditis-and-cerebral-white-matter-injury-complications
#20
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
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