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Society of Maternal Fetal Medicine

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https://www.readbyqxmd.com/read/28236651/intravenous-fluid-rate-for-reduction-of-cesarean-delivery-rate-in-nulliparous-women-a-systematic-review-and-meta-analysis
#1
Robert M Ehsanipoor, Gabriele Saccone, Neil S Seligman, Rebecca Pierce-Williams, Andrea Ciardulli, Vincenzo Berghella
The National Institute of Child Health and Human Development, American College of Obstetricians and Gynecologists, and Society for Maternal-Fetal Medicine have emphasized the need to promote vaginal delivery and have offered recommendations to safely prevent primary cesarean delivery. However, there has been limited discussion regarding management of intravenous fluids and other aspects of labor management that may influence labor. Therefore the aim of our study was to determine if an intravenous fluid rate of 250 vs 125 mL/hour is associated with a difference in cesarean delivery rate MATERIAL AND METHODS: Searches were performed in Medline, OVID, Scopus, ClinicalTrials...
February 25, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28198038/likelihood-of-cesarean-delivery-after-applying-leading-active-labor-diagnostic-guidelines
#2
Jeremy L Neal, Nancy K Lowe, Julia C Phillippi, Sharon L Ryan, Amy M Knupp, Mary S Dietrich, Stephen F Thung
BACKGROUND: Friedman, the United Kingdom's National Institute for Health and Care Excellence (NICE), and the American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine (ACOG/SMFM) support different active labor diagnostic guidelines. Our aims were to compare likelihoods for cesarean delivery among women admitted before vs in active labor by diagnostic guideline (within-guideline comparisons) and between women admitted in active labor per one or more of the guidelines (between-guideline comparisons)...
February 15, 2017: Birth
https://www.readbyqxmd.com/read/28188771/twin-vaginal-delivery-innovate-or-abdicate
#3
Sarah Rae Easter, Laura Taouk, Jay Schulkin, Julian N Robinson
Neonatal safety data along with national guidelines have prompted renewed interest in vaginal delivery of twins, particularly in the case of the noncephalic second twin. Yet, the rising rate of twin cesarean deliveries, coupled with the national decline in operative obstetrics, raises concerns about the availability of providers who are skilled in twin vaginal birth. Providers are key stakeholders for increasing rates of twin vaginal delivery. We surveyed a group of practicing obstetricians to explore potential barriers to the vaginal birth of twins with a focus on delivery of the noncephalic second twin...
February 7, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28164084/comparison-of-phenylephrine-and-ephedrine-in-treatment-of-spinal-induced-hypotension-in-high-risk-pregnancies-a-narrative-review
#4
REVIEW
Sasima Dusitkasem, Blair H Herndon, Monsicha Somjit, David L Stahl, Emily Bitticker, John C Coffman
PURPOSE: To compare maternal and fetal effects of intravenous phenylephrine and ephedrine administration during spinal anesthesia for cesarean delivery in high-risk pregnancies. SOURCE: An extensive literature search was conducted using the US National Library of Medicine, MEDLINE search engine, Cochrane review, and Google Scholar using search terms "ephedrine and phenylephrine," "preterm and term and spinal hypotension," "preeclampsia and healthy parturients," or "multiple and singleton gestation and vasopressor...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28142152/improving-safe-and-effective-use-of-drugs-in-pregnancy-and-lactation-workshop-summary
#5
Laura E Riley, Alison G Cahill, Richard Beigi, Renate Savich, George Saade
In February 2015, given high rates of use of medications by pregnant women and the relative lack of data on safety and efficacy of many drugs utilized in pregnancy, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the Society for Maternal-Fetal Medicine (SMFM), the American College of Obstetricians and Gynecologists (ACOG), and the American Academy of Pediatrics (AAP) convened a group of experts to review the "current" state of the clinical care and science regarding medication use during the perinatal period...
January 31, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28108156/the-role-of-ultrasound-in-women-who-undergo-cell-free-dna-screening
#6
Mary E Norton, Joseph R Biggio, Jeffrey A Kuller, Sean C Blackwell
The introduction of cell-free DNA screening for aneuploidy into obstetric practice in 2011 revolutionized the strategies utilized for prenatal testing. The purpose of this document is to review the current data on the role of ultrasound in women who have undergone or are considering cell-free DNA screening. The following are Society for Maternal-Fetal Medicine recommendations: (1) in women who have already received a negative cell-free DNA screening screen, ultrasound at 11-14 weeks of gestation solely for the purpose of nuchal translucency measurement (Current Procedural Terminology code 76813) is not recommended (grade 1B); (2) we recommend that diagnostic testing should not be recommended to patients solely for the indication of an isolated soft marker in the setting of a negative cell-free DNA screen (grade 2B); (3) in women with an isolated soft marker without other clinical implications (ie, choroid plexus cyst or echogenic intracardiac focus) and a negative cell-free DNA screen, we recommend describing the finding as not clinically significant or as a normal variant (grade 2B); (4) in women with an isolated soft marker that has no other clinical implication (ie, choroid plexus cyst or echogenic intracardiac focus) and a negative first- or second-trimester screening result, we recommend describing the finding as not clinically significant or as a normal variant (grade 2B); (5) we recommend that all women in whom a structural abnormality is identified by ultrasound should be offered diagnostic testing with chromosomal microarray (grade 1A); and (6) we recommend against routine screening for microdeletions with cell-free DNA screening (grade 1B)...
January 17, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28062023/we-should-proceed-with-caution-when-it-comes-to-antenatal-corticosteroids-after-34-weeks
#7
Christina M Nowik, Gregory A L Davies, Graeme N Smith
The Society for Maternal-Fetal Medicine recently released a statement supporting the use of antenatal corticosteroids for women at high risk of late preterm birth. This followed a trend of increasing use of antenatal corticosteroids after 34 weeks' gestation, based on evidence for decreased respiratory morbidity. The absolute benefits, however, are relatively small. We should balance this against the possible long-term harms of corticosteroids after 34 weeks before expanding the indications for their antenatal use...
January 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27819164/current-trends-in-the-diagnosis-and-management-of-gestational-diabetes-mellitus-in-the-united-states
#8
Brianne E Bimson, Barak M Rosenn, Sara A Morris, Elizabeth B Sasso, Rachelle A Schwartz, Lois E Brustman
OBJECTIVE: To assess current practice patterns among members of the Society for Maternal-Fetal Medicine (SMFM) with respect to the diagnosis and management of gestational diabetes mellitus (GDM). METHODS: A 38 question survey on GDM diagnosis and management was distributed to SMFM members. RESULTS: 2330 SMFM members were surveyed with a 40% response rate. Overall, 90.6% of respondents recommend a 2-step (versus a 1-step) diagnostic test. Cutoff values for the 1-h-50 g glucose challenge test vary from 130-140 mg/dL, but the majority (83%) adopts Carpenter Coustan criteria for the 3-h-100 g oral glucose tolerance test...
November 24, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27689239/treatment-options-for-hypertension-in-pregnancy-and-puerperium
#9
REVIEW
Farah H Amro, Hind N Moussa, Olaide A Ashimi, Baha M Sibai
Hypertensive disorders have become increasingly prevalent and complicate an increasing number of pregnancies. Therefore it is essential that the medications used to treat these disorders be well understood. Furthermore the management is complicated by special consideration needed for the physiologic changes of pregnancy as well as the consideration for possible adverse fetal effects. Areas covered: We performed a review of the scientific literature of medications used to treat hypertensive disorders in pregnancy...
December 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27662643/prenatal-screening-for-microcephaly-an-update-after-three-decades
#10
Shari E Gelber, Amos Grünebaum, Frank A Chervenak
BACKGROUND: Due to the recent outbreak of Zika virus, there has been a newfound interest in fetal and neonatal microcephaly. In 1984, Chervenak et al. proposed criteria for the prenatal ultrasound diagnosis of microcephaly as ≤3 standard deviations (SD) from the mean. Despite improvements in medicine these criteria have not been reevaluated in 30 years. OBJECTIVE: To examine how the original 1984 Chervenak et al. criteria for the diagnosis of fetal microcephaly apply to a current population utilizing modern ultrasound equipment and techniques...
February 1, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/27638987/joint-sogc-ccmg-opinion-for-reproductive-genetic-carrier-screening-an-update-for-all-canadian-providers-of-maternity-and-reproductive-healthcare-in-the-era-of-direct-to-consumer-testing
#11
R Douglas Wilson, Isabelle De Bie, Christine M Armour, Richard N Brown, Carla Campagnolo, June C Carroll, Nan Okun, Tanya Nelson, Rhonda Zwingerman, Francois Audibert, Jo-Ann Brock, Richard N Brown, Carla Campagnolo, June C Carroll, Isabelle De Bie, Jo-Ann Johnson, Nan Okun, Melanie Pastruck, Karine Vallée-Pouliot, R Douglas Wilson, Rhonda Zwingerman, Christine Armour, David Chitayat, Isabelle De Bie, Sara Fernandez, Raymond Kim, Josee Lavoie, Norma Leonard, Tanya Nelson, Sherry Taylor, Margot Van Allen, Clara Van Karnebeek
OBJECTIVE: This guideline was written to update Canadian maternity care and reproductive healthcare providers on pre- and postconceptional reproductive carrier screening for women or couples who may be at risk of being carriers for autosomal recessive (AR), autosomal dominant (AD), or X-linked (XL) conditions, with risk of transmission to the fetus. Four previous SOGC- Canadian College of Medical Geneticists (CCMG) guidelines are updated and merged into the current document. INTENDED USERS: All maternity care (most responsible health provider [MRHP]) and paediatric providers; maternity nursing; nurse practitioner; provincial maternity care administrator; medical student; and postgraduate resident year 1-7...
August 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27560600/severe-maternal-morbidity-screening-and%C3%A2-review
#12
Sarah K Kilpatrick, Jeffrey L Ecker
This document builds upon recommendations from peer organizations and outlines a process for identifying maternal cases that should be reviewed. Severe maternal morbidity is associated with a high rate of preventability, similar to that of maternal mortality. It also can be considered a near miss for maternal mortality because without identification and treatment, in some cases, these conditions would lead to maternal death. Identifying severe morbidity is, therefore, important for preventing such injuries that lead to mortality and for highlighting opportunities to avoid repeat injuries...
September 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27530804/first-stage-of-labour-management-practices-a-survey-of-australian-obstetric-providers
#13
Louise White, Nigel Lee, Michael Beckmann
AIMS: To report on the opinions and reported practices of Australian obstetricians and general practice (GP) obstetricians, in the definition and management of spontaneous first stage of labour, in low-risk nulliparous women. MATERIALS AND METHODS: Cross-sectional survey sent electronically to all Australian Specialist obstetricians (FRANZCOG) and Diplomates. Respondents answered questions regarding care of nulliparous women in spontaneous labour at term across three domains: (i) practitioners' characteristics; (ii) current practice; (iii) opinion regarding joint statement by ACOG/SMFM (Society of Maternal Fetal Medicine) 'Safe prevention of primary caesarean section'...
August 17, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27434693/when-to-deliver-women-with-diabetes-in-pregnancy
#14
Aaron B Caughey, Amy M Valent
The prevalence of pregestational diabetes and the incidence of gestational diabetes have both increased over recent years. One component of the management of diabetes in pregnancy is the timing of delivery in the late-preterm, early-term, or full-term periods. Recent guidance from the National Institute for Child Health and Human Development, Society for Maternal-Fetal Medicine, and American College of Obstetricians and Gynecologists has lacked specificity, for example, recommending delivery for women with pregestational diabetes with poorly controlled glucose levels to be from 34 to 39 weeks' gestation...
November 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27427470/the-use-of-chromosomal-microarray-for%C3%A2-prenatal%C3%A2-diagnosis
#15
Lorraine Dugoff, Mary E Norton, Jeffrey A Kuller
Chromosomal microarray analysis is a high-resolution, whole-genome technique used to identify chromosomal abnormalities, including those detected by conventional cytogenetic techniques, as well as small submicroscopic deletions and duplications referred to as copy number variants. Because chromosomal microarray analysis has a greater resolution than conventional karyotyping, it can detect deletions and duplications down to a 50- to 100-kb level. The purpose of this document is to discuss the technique, advantages, and disadvantages of chromosomal microarray analysis and its indications and limitations...
October 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27418448/society-for-maternal-fetal-medicine-smfm-special-report-current-approaches-to-measuring-quality-of-care-in-obstetrics
#16
Jennifer L Bailit, Kimberly D Gregory, Sindhu Srinivas, Thomas Westover, William A Grobman, George R Saade
Heath care measurement and evaluation is an integral piece of the health care system. The creation and assessment of care performance metrics are important and relevant for the obstetric community including both clinicians and patients. Careful deliberation is required to create a measurement system that results in optimal care for women and families. This article reviews the current approaches to measuring quality in obstetrics.
September 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27372270/proposed-diagnostic-criteria-for-the-case-definition-of-amniotic-fluid-embolism-in-research-studies
#17
Steven L Clark, Roberto Romero, Gary A Dildy, William M Callaghan, Richard M Smiley, Arthur W Bracey, Gary D Hankins, Mary E D'Alton, Mike Foley, Luis D Pacheco, Rakesh B Vadhera, J Patrick Herlihy, Richard L Berkowitz, Michael A Belfort
Amniotic fluid embolism is a leading cause of maternal mortality in developed countries. Our understanding of risk factors, diagnosis, treatment, and prognosis is hampered by a lack of uniform clinical case definition; neither histologic nor laboratory findings have been identified unique to this condition. Amniotic fluid embolism is often overdiagnosed in critically ill peripartum women, particularly when an element of coagulopathy is involved. Previously proposed case definitions for amniotic fluid embolism are nonspecific, and when viewed through the eyes of individuals with experience in critical care obstetrics, would include women with a number of medical conditions much more common than amniotic fluid embolism...
October 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27197937/obstetric-hemorrhage-survey-attitudes-and-practices-of-maternal-fetal-medicine-fellows
#18
H K Ahmadzia, S M Thomas, A P Murtha, R P Heine, L R Brancazio
OBJECTIVE: To evaluate experiences related to obstetric hemorrhage and suspected abnormal placentation among first year maternal-fetal medicine fellows. STUDY DESIGN: A cross-sectional anonymous survey was administered at the Society for Maternal-Fetal Medicine fellow retreat in March 2013. Fellows were asked about management strategies that reflected both their individual and institutional practices. RESULTS: There was a 56% response rate (55/98)...
May 17, 2016: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/27187010/menopausal-women-requesting-egg-embryo-donation-examining-health-screening-guidelines-for-assisted-reproductive-technology
#19
Taleen MacArthur, Gloria Bachmann, Charletta Ayers
OBJECTIVE: As more postreproductive women opt to pursue pregnancy with advanced assisted reproductive technologies (ART), the menopausal practitioner will become more involved in counseling, screening, and referral of premenopausal, perimenopausal, and postmenopausal women for these services. This review was conducted with the aim of (1) evaluating ART screening practices as they pertain to postreproductive women, and (2) reviewing the outcomes of ART using oocyte donation in postreproductive women...
July 2016: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/27133011/the-role-of-routine-cervical-length-screening-in-selected-high-and-low-risk-women-for-preterm-birth-prevention
#20
Jennifer McIntosh, Helen Feltovich, Vincenzo Berghella, Tracy Manuck
Preterm birth remains a major cause of neonatal death and short and long-term disability in the US and across the world. The majority of preterm births are spontaneous and cervical length screening is one tool that can be utilized to identify women at increased risk who may be candidates for preventive interventions. The purpose of this document is to review the indications and rationale for CL screening to prevent preterm birth in various clinical scenarios. The Society for Maternal-Fetal Medicine recommends (1) routine transvaginal cervical length screening for women with singleton pregnancy and history of prior spontaneous preterm birth (grade 1A); (2) routine transvaginal cervical length screening not be performed for women with cervical cerclage, multiple gestation, preterm premature rupture of membranes, or placenta previa (grade 2B); (3) practitioners who decide to implement universal cervical length screening follow strict guidelines (grade 2B); (4) sonographers and/or practitioners receive specific training in the acquisition and interpretation of cervical imaging during pregnancy (grade 2B)...
September 2016: American Journal of Obstetrics and Gynecology
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