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Maternal Health, Neonatology and Perinatology

Kidanemariam Alem Berhie, Habtamu Gebremariam Gebresilassie
BACKGROUND: Stillbirth is often defined as fetal death after 24 weeks of gestation, but a fetus greater than any combination of 16, 20, 22, 24, or 28 weeks gestational age and 350 g, 400 g, 500 g, or 1000 g birth weight may be considered stillborn depending on local law. Once the fetus has died, the mother may or may not have contractions and undergo childbirth or in some cases, a Caesarean section. Most stillbirths occur in full-term pregnancies. METHODS: This study has intended to model determinants of experiencing stillbirth among women in child bearing age group of Ethiopia using the Ethiopian demographic and health Survey data (EDHS, 2011)...
2016: Maternal Health, Neonatology and Perinatology
Habiba Kapaya, Fiona Broughton Pipkin, Barrie Hayes-Gill, Pamela V Loughna
BACKGROUND: Previous researchers have studied circadian changes in the fetal heart rate (FHR) on small sample sizes and in a strictly controlled environment. This study was undertaken to investigate these changes during the late second and third trimesters, using a portable fetal electrocardiogram recording device (Monica AN24) in pregnant women in home and hospital environments with unrestricted mobility. METHODS: This was a prospective cohort study of 54 pregnant women with uncomplicated singleton pregnancies between 25 and 40 weeks gestation...
2016: Maternal Health, Neonatology and Perinatology
Lisa M Tussing-Humphreys, Jessica L Thomson, Melissa H Goodman, Sarah Olender
BACKGROUND: A woman's diet while pregnant can play an important role in her reproductive health as well as the health of her unborn child. Diet quality and nutrient intake amongst pregnant women residing in the rural Lower Mississippi Delta (LMD) region of the United States is inadequate. The Delta Healthy Sprouts Project was designed to test the comparative impact of two home visiting programs on weight status, dietary intake, and health behaviors of women and their infants residing in the LMD region...
2016: Maternal Health, Neonatology and Perinatology
Nega Assefa, Yihune Lakew, Betelhem Belay, Haji Kedir, Desalew Zelalem, Negga Baraki, Melake Damena, Lemessa Oljira, Wondimye Ashenafi, Melkamu Dedefo
BACKGROUND: In the world, Neonatal mortality accounts for 40 % of death of children under the age of 5 years. Majority of neonatal deaths occur in developing countries outside of formal health system, among which death in the first hour of first day of their life constitute the huge bulk. This analysis is intended to estimate neonatal mortality rates and identify the leading causes of death based on the surveillance data over 6 years period in Kersa health and demographic surveillance system (Kersa HDSS) site, Eastern Ethiopia...
2016: Maternal Health, Neonatology and Perinatology
Margo S Harrison, Robert L Goldenberg
Cesarean section is an essential maternal healthcare service. Its role in labor and delivery care in low- and middle-income countries is complex; in many low-resource settings it is underutilized in the most needy of populations and overused by the less needy, without clear methods to ensure that universal access is available. Additionally, even if universal access were available, it is not evident that these countries would have the capacity or the finances to appropriate meet demand for the procedure, or that patients would want to utilize the care...
2016: Maternal Health, Neonatology and Perinatology
David Hutchon, Nick Bettles
The rationale for keeping the mother and her newborn together even when neonatal resuscitation is required is presented. The development of a customised mobile resuscitation trolley is detailed explaining how the resuscitation team can be provided with all the facilities of a standard resuscitation trolley to resuscitate the neonate at the mother's side with an intact cord. Alternative low tech solutions which may be appropriate in low resource setting and with a low risk population are also described.
2016: Maternal Health, Neonatology and Perinatology
Stuart B Hooper, Corinna Binder-Heschl, Graeme R Polglase, Andrew W Gill, Martin Kluckow, Euan M Wallace, Douglas Blank, Arjan B Te Pas
While it is now recognized that umbilical cord clamping (UCC) at birth is not necessarily an innocuous act, there is still much confusion concerning the potential benefits and harms of this common procedure. It is most commonly assumed that delaying UCC will automatically result in a time-dependent net placental-to-infant blood transfusion, irrespective of the infant's physiological state. Whether or not this occurs, will likely depend on the infant's physiological state and not on the amount of time that has elapsed between birth and umbilical cord clamping (UCC)...
2016: Maternal Health, Neonatology and Perinatology
Paul J Rozance, William W Hay
Despite being a very common problem after birth, consensus on how to manage low glucose concentrations in the first 48 h of life has been difficult to establish and remains a debated issue. One of the reasons for this is that few studies have provided the type of data needed to establish a definitive approach agreed upon by all. However, some recent publications have provided much needed primary data to inform this debate. These publications have focused on aspects of managing low blood glucose concentrations in the patients most at-risk for asymptomatic hypoglycemia-those born late-preterm, large for gestational age, small for gestational age, or growth restricted, and those born following a pregnancy complicated by diabetes mellitus...
2016: Maternal Health, Neonatology and Perinatology
Kennedy Diema Konlan, Joseph M Kombat, Mary Gifty Wuffele, Milicent Aarah-Bapuah
BACKGROUND: The partogram is the most effective tool to use to monitor the progress of labour and complications associated with labour. The main objective of this study was to assess the knowledge level of midwives on the effective use of the partogram in monitoring the progress of labour in the Tamale Metropolis of Ghana. METHODS: This study was a cross-sectional descriptive study conducted on 140 midwives selected using random sampling technique from March to July, 2011...
2016: Maternal Health, Neonatology and Perinatology
Tonse Nk Raju
The editor of Maternal Health, Neonatology, and Perinatology would like to thank all of the reviewers who have contributed to the journal in Volume 1 (2015).
2016: Maternal Health, Neonatology and Perinatology
Sandra E Juul, Dennis E Mayock, Bryan A Comstock, Patrick J Heagerty
BACKGROUND: In 2013, nearly four million babies were born in the U.S., among whom 447,875 were born preterm. Approximately 30,000 of these infants were born before 28 weeks of gestation. These infants, termed Extremely Low Gestational Age Neonates (ELGANs), experience high morbidity and mortality despite modern therapies: approximately 20 % of ELGANs admitted to an NICU die before discharge, 20 % of survivors have severe, and 20 % moderate neurodevelopmental impairment (NDI). New approaches are needed to improve neonatal outcomes...
2015: Maternal Health, Neonatology and Perinatology
Sina Haeri
Fetal lower urinary tract obstruction (LUTO) is a serious condition, which commonly results in marked perinatal morbidity and mortality. The characteristic prenatal presentation of LUTO includes an enlarged bladder with bilateral obstructive uropathy. While mild forms of the disease result in minimal clinical sequelae, the more severe forms commonly lead to oligohydramnios, dysplastic changes in the fetal kidneys, and ultimately result in secondary pulmonary hypoplasia. The aim of this review is to provide practitioners with a practical and concise overview of the presentation, evaluation, and treatment of LUTO...
2015: Maternal Health, Neonatology and Perinatology
Enrico Valerio, Margherita Fantinato, Irene Alba Beatrice Giovannini, Eugenio Baraldi, Lino Chiandetti
BACKGROUND: Pre-delivery maternal electrolyte derangements may reflect themselves in the newborn, since placental homeostasis determines electrolyte equilibrium between mother and fetus. CASE PRESENTATION: A term newborn, transferred to our Neonatal Intensive Care Unit 1 h after birth for an apnoea episode, presented with initially left-sided, and subsequently generalized tonic-clonic seizures due to severe hyponatremia (119 mmol/L). Seizures rapidly ceased after electrolyte correction plus a phenobarbital bolus...
2015: Maternal Health, Neonatology and Perinatology
Alice Gong, Yvette R Johnson, Judith Livingston, Kathleen Matula, Andrea F Duncan
BACKGROUND: Neonatal intensive care is a remarkable success story with dramatic improvements in survival rates for preterm newborns. Significant efforts and resources are invested to improve mortality and morbidity but much remains to be learned about the short and long-term effects of neonatal intensive care unit (NICU) interventions. Published guidelines recommend that infants discharged from the NICU be in an organized follow-up program that tracks medical and neurodevelopmental outcomes...
2015: Maternal Health, Neonatology and Perinatology
Margaret Atuahene, David Mensah, Martin Adjuik
BACKGROUND: Birth weight is a major determinant of infant morbidity and mortality. Fetal undernourishment means an increased risk of dying during a baby's early months and years. Birth weight has emerged as the leading indicator of infant health and welfare and the central focus of infant health policy. The issues have not been comprehensively evaluated in part due to lack of or limited empirical data. To this end, this study is aimed to evaluate the effects of maternal determinants on the birth weights of neonates in two major hospitals...
2015: Maternal Health, Neonatology and Perinatology
G Arnolda, H M Nwe, D Trevisanuto, A A Thin, A A Thein, T Defechereux, D Kumara, L Moccia
BACKGROUND: Jaundice is the commonest neonatal ailment requiring treatment. Untreated, it can lead to acute bilirubin encephalopathy (ABE), chronic bilirubin encephalopathy (CBE) or death. ABE and CBE have been largely eliminated in industrialised countries, but remain a problem of largely undocumented scale in low resource settings. As part of a quality-improvement intervention in the Neonatal Care Units of two paediatric referral hospitals in Myanmar, hospitals collected de-identified data on each neonate treated on new phototherapy machines over 13-20 months...
2015: Maternal Health, Neonatology and Perinatology
Susan Niermeyer
BACKGROUND: Recent experimental physiology data and a large, population-based observational study have changed umbilical cord clamping from a strictly time-based construct to a more complex equilibrium involving circulatory changes and the onset of respirations in the newly born infant. However, available evidence is not yet sufficient to optimize the management of umbilical cord clamping. FINDINGS: Current guidelines vary in their recommendations and lack advice for clinicians who face practical dilemmas in the delivery room...
2015: Maternal Health, Neonatology and Perinatology
Margo S Harrison, Hillary Mabeya, Robert L Goldenberg, Elizabeth M McClure
BACKGROUND: While obstetric fistula has been recognized as a major maternal morbidity since the 1980s, it has become an indicator of access to and quality of women' s health care. FINDINGS: Obstetric fistula still exists in low-income countries (LIC) because health care systems fail to provide adequate family planning, skilled birth attendance, basic and emergency obstetric care, and affordable treatment of fistula, while concurrently lacking social networks to serve as safety nets for affected girls and women [WHO, 2007]...
2015: Maternal Health, Neonatology and Perinatology
Oded Langer
BACKGROUND: Glyburide has replaced insulin as the first line of therapy in the treatment of gestational diabetes in the United States. Glyburide and metformin therapies were reported to be comparable to insulin yet also cost-effective, patient-friendly, and potentially compliance-enhancing. Recently, the efficacy of the use of these oral hypoglycemic drugs has been questioned. In this review, the questionable concerns will be addressed: Which diabetic drug(s) cross the placenta? What is the quality of evidence and the data source validity? Which treatment modalities are most effective in reducing the primary outcome in GDM? Which drug is most effective in improving secondary outcomes? FINDINGS: This review documents the methodological issues in study design that have impacted the results for the provision of health care interventions in GDM...
2015: Maternal Health, Neonatology and Perinatology
Archana B Patel, Sreelatha Meleth, Omrana Pasha, Shivaprasad S Goudar, Fabian Esamai, Ana L Garces, Elwyn Chomba, Elizabeth M McClure, Linda L Wright, Marion Koso-Thomas, Janet L Moore, Sarah Saleem, Edward A Liechty, Robert L Goldenberg, Richard J Derman, K Michael Hambidge, Waldemar A Carlo, Patricia L Hibberd
BACKGROUND: Consequences of exposure to household air pollution (HAP) from biomass fuels used for cooking on neonatal deaths and stillbirths is poorly understood. In a large multi-country observational study, we examined whether exposure to HAP was associated with perinatal mortality (stillbirths from gestation week 20 and deaths through day 7 of life) as well as when the deaths occurred (macerated, non-macerated stillbirths, very early neonatal mortality (day 0-2) and later neonatal mortality (day 3-28)...
2015: Maternal Health, Neonatology and Perinatology
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