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Maternal Health, Neonatology and Perinatology

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https://www.readbyqxmd.com/read/28932408/golden-hour-of-neonatal-life-need-of-the-hour
#1
REVIEW
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
https://www.readbyqxmd.com/read/28904810/nasal-high-flow-treatment-in-preterm-infants
#2
REVIEW
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
https://www.readbyqxmd.com/read/28794892/the-use-of-non-invasive-fetal-electrocardiography-in-diagnosing-second-degree-fetal-atrioventricular-block
#3
Igor Lakhno, Joachim A Behar, Julien Oster, Vyacheslav Shulgin, Oleksii Ostras, Fernando Andreotti
BACKGROUND: Complete atrioventricular block in fetuses is known to be mostly associated with autoimmune disease and can be irreversible if no steroids treatment is provided. Conventional methods used in clinical practice for diagnosing fetal arrhythmia are limited since they do not reflect the primary electrophysiological conduction processes that take place in the myocardium. The non-invasive fetal electrocardiogram has the potential to better support fetal arrhythmias diagnosis through the continuous analysis of the beat to beat variation of the fetal heart rate and morphological analysis of the PQRST complex...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28706729/a-retrospective-review-of-the-pediatric-development-clinic-implementation-a-model-to-improve-medical-nutritional-and-developmental-outcomes-of-at-risk-under-five-children-in-rural-rwanda
#4
Eric Ngabireyimana, Christine Mutaganzwa, Catherine M Kirk, Ann C Miller, Kim Wilson, Evodia Dushimimana, Olivier Bigirumwami, Evelyne S Mukakabano, Fulgence Nkikabahizi, Hema Magge
BACKGROUND: As more high-risk newborns survive the neonatal period, they remain at significant medical, nutritional, and developmental risk. However, no follow-up system for early intervention exists in most developing countries. In 2014, a novel Pediatric Development Clinic (PDC) was implemented to provide comprehensive follow-up to at-risk under-five children, led by nurses and social workers in a district hospital and surrounding health centers in rural Rwanda. METHODS: At each PDC visit, children undergo clinical/nutritional assessment and caregivers participate in counseling sessions...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28690864/surgical-site-infections-after-cesarean-delivery-epidemiology-prevention-and-treatment
#5
REVIEW
Tetsuya Kawakita, Helain J Landy
Cesarean delivery (CD) is one of the most common procedures performed in the United States, accounting for 32% of all deliveries. Postpartum surgical site infection (SSI), wound infection and endometritis is a major cause of prolonged hospital stay and poses a burden to the health care system. SSIs complicate a significant number of patients who undergo CD - 2-7% will experience sound infections and 2-16% will develop endometritis. Many risk factors for SSI have been described. These include maternal factors (such as tobacco use; limited prenatal care; obesity; corticosteroid use; nulliparity; twin gestations; and previous CD), intrapartum and operative factors (such as chorioamnionitis; premature rupture of membranes; prolonged rupture of membranes; prolonged labor, particularly prolonged second stage; large incision length; subcutaneous tissue thickness > 3 cm; subcutaneous hematoma; lack of antibiotic prophylaxis; emergency delivery; and excessive blood loss), and obstetrical care on the teaching service of an academic institution...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28630744/maternal-predictors-of-neonatal-outcomes-after-emergency-cesarean-section-a-retrospective-study-in-three-rural-district-hospitals-in-rwanda
#6
Naome Nyirahabimana, Christine Minani Ufashingabire, Yihan Lin, Bethany Hedt-Gauthier, Robert Riviello, Jackline Odhiambo, Joel Mubiligi, Martin Macharia, Stephen Rulisa, Illuminee Uwicyeza, Patient Ngamije, Fulgence Nkikabahizi, Theoneste Nkurunziza
BACKGROUND: In sub-Saharan Africa, neonatal mortality post-cesarean delivery is higher than the global average. In this region, most emergency cesarean sections are performed at district hospitals. This study assesses maternal predictors for poor neonatal outcomes post-emergency cesarean delivery in three rural district hospitals in Rwanda. METHODS: This retrospective study includes a random sample of 441 neonates from Butaro, Kirehe and Rwinkwavu District Hospitals, born between 01 January and 31 December 2015...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28593052/scaling-up-contraceptives-use-in-the-division-with-lowest-contraceptives-use-in-bangladesh-sources-methods-and-determinants
#7
Gulam Muhammed Al Kibria, Vanessa Burrowes, Sharmin Majumder, Atia Sharmeen, Rifath Ara Alam Barsha, Shakir Hossen
BACKGROUND: Total fertility rate (TFR) is high and at a static level for the last two decades in Bangladesh. Reduction of fertility by increasing contraceptives use could reduce maternal and neonatal mortality. To achieve the targeted contraceptive prevalence rate (CPR) of Family Planning 2020 (FP2020) Initiative, it is important to increase CPR in all regions of the country. However, it is lower in Sylhet Division compared to other divisions in Bangladesh. This study looked into the methods, source and determinants of contraceptives use in this division...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28560046/a-review-of-delivery-room-resuscitation-in-very-low-birth-weight-infants-in-a-middle-income-country
#8
Daynia E Ballot, Faustine Agaba, Peter A Cooper, Victor A Davies, Tanusha Ramdin, Lea Chirwa, David Rakotsoane, Lethile Madzudzo
BACKGROUND: Advanced levels of delivery room resuscitation in very low birth weight infants are reported to be associated with death and complications of prematurity. In resource limited settings, the need for delivery room resuscitation is often used as a reason to limit care in these infants. METHODS: This was a review of delivery room resuscitation in very low birth weight infants born in a tertiary hospital in South Africa between 01 January 2013 and 30 June 2016...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28439421/factors-associated-with-cesarean-delivery-rates-a-single-institution-experience
#9
Spencer McClelland, Naomi Gorfinkle, Alan A Arslan, Maria Teresa Benedetto-Anzai, Teresa Cheon, Yuzuru Anzai
BACKGROUND: The aim of this study was to identify factors associated with variability in Cesarean delivery (CD) rates amongst providers at a single institution. METHODS: A retrospective cohort analysis was carried out on all births at NYU Langone Medical Center from 2005-2013. Data was collected for subjects and linked to diagnosis codes for singleton and twin deliveries. Descriptive characteristics were generated for all deliveries, and inferential analysis was performed including multiple covariates for singleton deliveries in the 2010-2013 cohort, including both univariate and multivariate regression analyses to identify factors associated with higher CD rates...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28331630/factors-affecting-deliveries-attended-by-skilled-birth-attendants-in-bangladesh
#10
Gulam Muhammed Al Kibria, Swagata Ghosh, Shakir Hossen, Rifath Ara Alam Barsha, Atia Sharmeen, S M Iftekhar Uddin
BACKGROUND: The presence of skilled birth attendants (SBAs) is crucial in childbirth to reduce the maternal mortality ratio (MMR) and to achieve the maternal mortality target of the United Nations' Sustainable Development Goals (SDGs). The aim of this study was to investigate the factors related to childbirths attended by SBAs in Bangladesh. METHODS: Data from the Bangladesh Demographic and Health Survey (2014 BDHS) were analyzed. Logistic regression was applied to calculate crude odds ratios (CORs), adjusted odds ratios (AORs), 95% confidence intervals (CIs), and p-values...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28331629/congenital-diaphragmatic-hernia-a-review
#11
REVIEW
Praveen Kumar Chandrasekharan, Munmun Rawat, Rajeshwari Madappa, David H Rothstein, Satyan Lakshminrusimha
Congenital Diaphragmatic hernia (CDH) is a condition characterized by a defect in the diaphragm leading to protrusion of abdominal contents into the thoracic cavity interfering with normal development of the lungs. The defect may range from a small aperture in the posterior muscle rim to complete absence of diaphragm. The pathophysiology of CDH is a combination of lung hypoplasia and immaturity associated with persistent pulmonary hypertension of newborn (PPHN) and cardiac dysfunction. Prenatal assessment of lung to head ratio (LHR) and position of the liver by ultrasound are used to diagnose and predict outcomes...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28228969/prevention-and-treatment-of-neonatal-nosocomial-infections
#12
REVIEW
Jayashree Ramasethu
Nosocomial or hospital acquired infections threaten the survival and neurodevelopmental outcomes of infants admitted to the neonatal intensive care unit, and increase cost of care. Premature infants are particularly vulnerable since they often undergo invasive procedures and are dependent on central catheters to deliver nutrition and on ventilators for respiratory support. Prevention of nosocomial infection is a critical patient safety imperative, and invariably requires a multidisciplinary approach. There are no short cuts...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28203387/an-overview-of-available-drugs-for-management-of-opioid-abuse-during-pregnancy
#13
REVIEW
Jillian Laslo, Jon-Michael Brunner, Daniel Burns, Emily Butler, Autumn Cunningham, Ryan Killpack, Courtney Pyeritz, Kimberly Rinard, Jennifer Childers, Joseph Horzempa
The prevalence of opioid abuse in the United States has been steadily increasing over the last several years among many major demographics, including pregnant women. Rise in prenatal opioid abuse has resulted in subsequent escalation of neonatal abstinence syndrome incidence, prompting the US Congress to pass the Protecting Our Infants Act of 2015. This act specifically calls for a critical review of current treatment options for prenatal opioid abuse which may ultimately lead to the development of better therapies and a decreased incidence of neonatal abstinence syndrome...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28116114/introducing-ehealth-strategies-to-enhance-maternal-and-perinatal-health-care-in-rural-tanzania
#14
Angelo Nyamtema, Nguke Mwakatundu, Sunday Dominico, Mkambu Kasanga, Fadhili Jamadini, Kelvin Maokola, Donald Mawala, Zabron Abel, Richard Rumanyika, Calist Nzabuhakwa, Jos van Roosmalen
BACKGROUND: Globally, eHealth has attracted considerable attention as a means of supporting maternal and perinatal health care. This article describes best practices, gains and challenges of implementing eHealth for maternal and perinatal health care in extremely remote and rural Tanzania. METHODS: Teleconsultation for obstetric emergency care, audio teleconferences and online eLearning systems were installed in ten upgraded rural health centres, four rural district hospitals and one regional hospital in Tanzania...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28116113/early-onset-fetal-growth-restriction
#15
REVIEW
Andrea Dall'Asta, Valentina Brunelli, Federico Prefumo, Tiziana Frusca, Christoph C Lees
Fetal growth restriction (FGR) diagnosed before 32 weeks is identified by fetal smallness associated with Doppler abnormalities and is associated with significant perinatal morbidity and mortality and maternal complications. Recent studies have provided new insights into pathophysiology, management options and postnatal outcomes of FGR. In this paper we review the available evidence regarding diagnosis, management and prognosis of fetuses diagnosed with FGR before 32 weeks of gestation.
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28101373/optimizing-maternal-and-neonatal-outcomes-with-postpartum-contraception-impact-on-breastfeeding-and-birth-spacing
#16
REVIEW
Aparna Sridhar, Jennifer Salcedo
Postpartum contraception is important to prevent unintended pregnancies. Assisting women in achieving recommended inter-pregnancy intervals is a significant maternal-child health concern. Short inter-pregnancy intervals are associated with negative perinatal, neonatal, infant, and maternal health outcomes. More than 30% of women experience inter-pregnancy intervals of less than 18 months in the United States. Provision of any contraceptive method after giving birth is associated with improved inter-pregnancy intervals...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/27795833/timing-and-cause-of-perinatal-mortality-for-small-for-gestational-age-babies-in-south-africa-critical-periods-and-challenges-with-detection
#17
Tina Lavin, David B Preen, Robert Pattinson
BACKGROUND: Little information exists on timing and cause of death for small-for-gestational-age (SGA) babies in low-and-middle-income-countries (LMICs), despite evidence from high-income countries suggesting critical periods for SGA babies. This study explored the timing and cause of stillbirth and early neonatal mortality (END, <7 days) by small-for-gestational age in three provinces in South Africa. In South Africa, the largest category of perinatal deaths is unexplained stillbirth, of which up to one-quarter have intra-uterine growth restriction...
2016: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/27660718/logistic-regression-analysis-on-the-determinants-of-stillbirth-in-ethiopia
#18
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
https://www.readbyqxmd.com/read/27595008/circadian-changes-and-sex-related-differences-in-fetal-heart-rate-parameters
#19
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
https://www.readbyqxmd.com/read/27536380/maternal-diet-quality-and-nutrient-intake-in-the-gestational-period-results-from-the-delta-healthy-sprouts-comparative-impact-trial
#20
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
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