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Maternal Health, Neonatology and Perinatology

Hellen Namusoke, Maria Musoke Nannyonga, Robert Ssebunya, Victoria Kirabira Nakibuuka, Edison Mworozi
Background: Hypoxic Ischemic Encephalopathy carries high case fatality rates ranging between 10-60%, with 25% of survivors have an adverse long-term neurodevelopment outcome. Despite the above, there is paucity of data regarding its magnitude and short term outcomes in a low resource setting like Uganda. Therefore we set out to determine the incidence and short term outcomes of Newborns with Hypoxic Ischemic Encephalopathy at St.Francis Hospital, Nsambya. Methods: This was a Prospective Cohort study conducted between October 2015 and January 2016 at St...
2018: Maternal Health, Neonatology and Perinatology
Ebenezer Owusu Darkwa, Robert Djagbletey, Daniel Sottie, Christian Owoo, Naa Martekuor Vanderpuye, Raymond Essuman, George Aryee
Background: Pregnancy is associated with significant changes in maternal cardiovascular system which regulates oxygen and nutrient supply to the growing foetus. Nitric oxide, a physiologic vascular smooth muscle relaxant regulates blood flow and therefore may play a role in the cardiovascular changes in pregnancy. The study aimed to determine the levels and changes in maternal serum nitric oxide levels during healthy pregnancy. Methods: A case-control study was conducted among 32 healthy non-pregnant women as controls and 100 healthy pregnant women (consisting of 33 first trimester, 37 s trimester, and 30 third trimester) as cases...
2018: Maternal Health, Neonatology and Perinatology
Kotomi Yamaguchi, Kazutomo Ohashi
Background: Per the 2014 Japanese Midwives Association (JMA) guidelines, midwives were allowed to manage the deliveries for group B streptococcus (GBS)-positive pregnant women in labour at maternity homes without the supervision of a medical doctor if they complied with the guidelines of the Japan Society of Obstetrics and Gynecology (JSOG), wherein midwives working for maternity homes are expected to cooperate with commissioned obstetricians and paediatricians in cooperative medical facilities...
2018: Maternal Health, Neonatology and Perinatology
Fortress Yayra Aku, Patricia Akweongo, Kofi Nyarko, Samuel Sackey, Fredrick Wurapa, Edwin Andrew Afari, Donne Kofi Ameme, Ernest Kenu
Background: Globally, 4 million neonates die annually, with one-third of such deaths occurring as a result of infections. In 2011, there were 7.2million deaths in children below 5 years globally, and a proportion of 40% of these deaths occurred in neonates. Sepsis was reported to account for one-third of these deaths. Presently, multidrug antibiotic resistance is rapidly increasing in Neonatal Intensive Care Units (NICUs), particularly in developing countries and poses a threat to public health...
2018: Maternal Health, Neonatology and Perinatology
Gwendoline Lilly Tanyaradzwa Chimhini, Simbarashe Chimhuya, Vasco Chikwasha
Background: Acute Bilirubin Encephalopathy in the neonatal period is a major cause of permanent disability. Effective screening and surveillance are essential in the newborn period to enable timely management. Noninvasive transcutaneous bilirubin devices have been successfully used for screening in many settings. We evaluated the accuracy of the Draeger JM 103 (Medical Systems, USA) for estimating serum bilirubin in Zimbabwean newborns. Methods: Paired transcutaneous (forehead and sternum) and serum bilirubin measurements were compared on 283 infants consecutively recruited between 01 August and 30 November 2015 at Harare Hospital Neonatal Unit...
2018: Maternal Health, Neonatology and Perinatology
Margo S Harrison, Robert L Goldenberg
Globally, data show that many women of reproductive age desire to use modern family planning methods. Many of these women do not have access to modern contraceptives, which is termed their 'unmet need' for contraception. In low- and middle-income countries where total fertility rates can be high and many women have undesired fertility, or wish to increase their inter-pregnancy intervals, access to modern contraceptives is often inadequate. The puerperium is a unique time for interventions to offer modern contraceptive methods...
2017: Maternal Health, Neonatology and Perinatology
Sheila M Gephart, Corrine Hanson, Christine M Wetzel, Michelle Fleiner, Erin Umberger, Laura Martin, Suma Rao, Amit Agrawal, Terri Marin, Khaver Kirmani, Megan Quinn, Jenny Quinn, Katherine M Dudding, Tanya Clay, Jason Sauberan, Yael Eskenazi, Caroline Porter, Amy L Msowoya, Christina Wyles, Melissa Avenado-Ruiz, Shayla Vo, Kristina M Reber, Jennifer Duchon
Background: Although decades have focused on unraveling its etiology, necrotizing enterocolitis (NEC) remains a chief threat to the health of premature infants. Both modifiable and non-modifiable risk factors contribute to varying rates of disease across neonatal intensive care units (NICUs). Purpose: The purpose of this paper is to present a scoping review with two new meta-analyses, clinical recommendations, and implementation strategies to prevent and foster timely recognition of NEC...
2017: Maternal Health, Neonatology and Perinatology
Paul Nkemtendong Tolefac, Gregory Edie Halle-Ekane, Valirie Ndip Agbor, Carlson Barbila Sama, Calypse Ngwasiri, Pierre Marie Tebeu
Background: Early initiation of antenatal care visits is an essential component of services to improving maternal and new born health. The Cameroonian Demographic and Health Survey conducted in 2011 indicated that only 34% of pregnant women start antenatal care in the first trimester. However, detailed study to identify factors associated with late initiation of care has not been conducted in Cameroon. The aim of this study was to assess the prevalence of late booking first ANC visit amongst attendance of first ANC and the determinants of late first ANC in Douala general hospital...
2017: Maternal Health, Neonatology and Perinatology
Stephanie L Smith, Christopher A Rouse
Docosahexaenoic acid (DHA) is a long chain poly-unsaturated fatty acid (LCPUFA) that has a role in the cognitive and visual development, as well as in the immune function of newborns. Premature infants are typically deficient in DHA for several reasons, to include fetal accretion of DHA that typically occurs during the third trimester. These premature infants are reliant on enteral sources of DHA, most commonly through breast milk. The DHA content in breast milk varies in direct correlation with maternal DHA intake and mothers consuming a Western diet typically have lower levels of DHA in their breast milk...
2017: Maternal Health, Neonatology and Perinatology
Morarji Peesay
Nuchal cord occurs when the umbilical cord becomes wrapped around the fetal neck 360 degrees. Nuchal cords occur in about 10-29% of fetuses and the incidence increases with advancing gestation age. Most are not associated with perinatal morbidity and mortality, but a few studies have shown that nuchal cord can affect the outcome of delivery with possible long-term effects on the infants. Nuchal cords are more likely to cause problems when the cord is tightly wrapped around the neck, with effects of a tight nuchal cord conceptually similar to strangulation...
2017: Maternal Health, Neonatology and Perinatology
Manal E Sharif, Ahmed Mohamedain, AbdelBagi A Ahmed, Abubakr M Nasr, Ishag Adam
Background: Preterm birth (PTB) is the major health problem world-wide; there are few published studies on PTB and folic acid. Methods: The study was conducted to assess the serum level of folic acid in PTB. A case-control study was conducted at Saad Abualila maternity hospital (Khartoum, Sudan) during the period of March through December 2015. Women who delivered live singleton babies were dived in two groups; the cases were women who had PTB "delivery before completed 37weeks but after 24 weeks of pregnancy" and the controls were women who delivered at term (37-42 weeks)...
2017: Maternal Health, Neonatology and Perinatology
Lisa M Tussing-Humphreys, Jessica L Thomson, Nefertiti OjiNjideka Hemphill, Melissa H Goodman, Alicia S Landry
Background: Excessive postnatal weight retention may pose a threat to a woman's health and future pregnancies. Women in the Lower Mississippi Delta (LMD) region of Mississippi suffer from among the highest rates of obesity in the U.S. and are more likely to gain an excessive amount of weight during pregnancy. The aim of this study was to determine if LMD women who received a lifestyle enhanced maternal, infant, and early childhood home visiting (MIECHV) curriculum had more favorable weight outcomes through 12-months postpartum compared to women who received a standard MIECHV curriculum...
2017: Maternal Health, Neonatology and Perinatology
Satyan Lakshminrusimha, Martin Keszler, Haresh Kirpalani, Krisa Van Meurs, Patricia Chess, Namasivayam Ambalavanan, Bradley Yoder, Maria V Fraga, Holly Hedrick, Kevin P Lally, Leif Nelin, Michael Cotten, Jonathan Klein, Stephanie Guilford, Ashley Williams, Aasma Chaudhary, Marie Gantz, Jenna Gabrio, Dhuly Chowdhury, Kristin Zaterka-Baxter, Abhik Das, Rosemary D Higgins
Background: Congenital diaphragmatic hernia (CDH) is commonly associated with pulmonary hypoplasia and pulmonary hypertension (PH). PH associated with CDH (CDH-PH) is frequently resistant to conventional pulmonary vasodilator therapy including inhaled nitric oxide (iNO) possibly due to right and left ventricular dysfunction. Milrinone is an intravenous inotrope and lusitrope with pulmonary vasodilator properties and has been shown anecdotally to improve oxygenation in PH. We developed this pilot study to determine if milrinone infusion would improve oxygenation in neonates ≥36 weeks postmenstrual age (PMA) with CDH...
2017: Maternal Health, Neonatology and Perinatology
Thomas P Sartwelle, James C Johnston, Berna Arda
Bioethics abolished the prevailing Hippocratic tenet instructing physicians to make treatment decisions, replacing it with autonomy through informed consent. Informed consent allows the patient to choose treatment after options are explained by the physician. The appearance of bioethics in 1970 coincided with the introduction of electronic fetal monitoring (EFM), which evolved to become the fetal surveillance modality of choice for virtually all women in labor. Autonomy rapidly pervaded all medical procedures, but there was a clear exemption for EFM...
2017: Maternal Health, Neonatology and Perinatology
Adidja Amani, Jobert Richie Nansseu, Evelyn M Mah, Clemence Meguejio Vougmo, Seidou Moluh Moluh, Robinson Mbu
Background: Perinatal networks have yielded substantial contribution in decreasing the neonatal mortality rate. We present here the process of implementation of a perinatal network in Yaoundé (Cameroon) based on the WhatsApp messenger application as well as some preliminary results and achievements. Methods: In December 2016, the Yaoundé Perinatal Network was launched, regrouping a multidisciplinary team of health professionals dealing with perinatal care in Yaoundé, Cameroon...
2017: Maternal Health, Neonatology and Perinatology
Tadele Girum, Abebaw Wasie
Background: Maternal mortality is a major public health issue in developing countries due to its shocking magnitude and lower declining pattern. With appropriate strategy and intensive implementation programs, some countries have made remarkable progress, however in developing countries where 99% of maternal death is occurring; little or no progress has been made. Identifying determinants and designing intervention will have important role to overcome the problem. Therefore this study aimed to identify correlates of maternal mortality in developing countries...
2017: Maternal Health, Neonatology and Perinatology
Christopher J D McKinlay, J Geoffrey Chase, Jennifer Dickson, Deborah L Harris, Jane M Alsweiler, Jane E Harding
Continuous glucose monitoring (CGM) is well established in the management of diabetes mellitus, but its role in neonatal glycaemic control is less clear. CGM has provided important insights about neonatal glucose metabolism, and there is increasing interest in its clinical use, particularly in preterm neonates and in those in whom glucose control is difficult. Neonatal glucose instability, including hypoglycaemia and hyperglycaemia, has been associated with poorer neurodevelopment, and CGM offers the possibility of adjusting treatment in real time to account for individual metabolic requirements while reducing the number of blood tests required, potentially improving long-term outcomes...
2017: Maternal Health, Neonatology and Perinatology
Penélope Saldanha Marinho, Antonio José Cunha, Joffre Amim Junior, Arnaldo Prata-Barbosa
Arboviruses are emerging infectious diseases with the ability to expand geographically and rapidly affect large populations. The recent epidemic caused by the Zika virus in the Americas and congenital Zika syndrome associated with maternal infection has called out attention to the importance of studying arboviruses during pregnancy. This is a review on selected arboviruses infections during gestation, including Zika, Chikungunya, Dengue and Yellow Fever viruses. Issues such as historical overview, pathogenesis, transmission, clinical conditions, diagnosis, treatment and prevention are addressed...
2017: Maternal Health, Neonatology and Perinatology
Deepak Sharma
"Golden Hour" of neonatal life is defined as the first hour of post-natal life in both preterm and term neonates. This concept in neonatology has been adopted from adult trauma where the initial first hour of trauma management is considered as golden hour. The "Golden hour" concept includes practicing all the evidence based intervention for term and preterm neonates, in the initial sixty minutes of postnatal life for better long-term outcome. Although the current evidence supports the concept of golden hour in preterm and still there is no evidence seeking the benefit of golden hour approach in term neonates, but neonatologist around the globe feel the importance of golden hour concept equally in both preterm and term neonates...
2017: Maternal Health, Neonatology and Perinatology
Calum T Roberts, Kate A Hodgson
Nasal High Flow (HF) is a mode of 'non-invasive' respiratory support for preterm infants, with several potential modes of action, including generation of distending airway pressure, washout of the nasopharyngeal dead space, reduction of work of breathing, and heating and humidification of inspired gas. HF has several potential advantages over continuous positive airway pressure (CPAP), the most commonly applied form of non-invasive support, such as reduced nasal trauma, ease of use, and infant comfort, which has led to its rapid adoption into neonatal care...
2017: Maternal Health, Neonatology and Perinatology
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