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antenatal corticosteroids

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https://www.readbyqxmd.com/read/29766152/undesired-effect-of-excessive-betamethasone-administration-during-pregnancy-a-rare-case
#1
Alireza Mirzaei, Solmaz Piri, Kaveh Gharanizadeh, Mozhdeh Zabihiyeganeh
Background: Postpartum bilateral femoral neck fracture (BFNF) is a rare condition. We here report a case of BFNF due to excessive corticosteroid consumption, twin pregnancy, immobility, and vitamin D deficiency. Case: This is a report of a 32-yr-old woman with bilateral femoral insufficiency fracture five days after emergency cesarean section due to preterm labor, twin pregnancy, and the history of a previous cesarean section at 33 wk. Antenatal repeated courses of betamethasone injections for fetal lung maturity, daily oral use of prednisolone for the history of miscarriage, immobilization, and vitamin D deficiency were the important contributing factors in her past medical history and lab investigations...
March 2018: International Journal of Reproductive Biomedicine (Yazd, Iran)
https://www.readbyqxmd.com/read/29758177/the-efficacy-of-antenatal-steroid-therapy-is-dependent-on-the-duration-of-low-concentration-fetal-exposure-evidence-from-a-sheep-model-of-pregnancy
#2
Matthew W Kemp, Masatoshi Saito, Haruo Usuda, Shimpei Watanabe, Shinichi Sato, Takushi Hanita, Yusaku Kumagai, Timothy J Molloy, Michael Clarke, Peter J Eddershaw, Gabrielle C Musk, Augusto Schmidt, Demelza Ireland, Lucy Furfaro, Matthew S Payne, John P Newnham, Alan H Jobe
OBJECTIVE: Antenatal corticosteroids (ANS) are among the most important and widely used interventions to improve outcomes for preterm infants. ANS dosing regimens remain un-optimized and without maternal weight-adjusted dosing. We, and others, have hypothesised that once a low concentration of materno-fetal steroid exposure is achieved and maintained, the duration of the steroid exposure determines treatment efficacy. Using a sheep model of pregnancy, we tested the relationship between steroid dose, and duration of exposure, and treatment efficacy...
May 9, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29747882/antenatal-corticosteroids-who-should-we-be-treating
#3
REVIEW
Whitney A Booker, Cynthia Gyamfi-Bannerman
Antenatal corticosteroids remain one of the crucial interventions in those at risk for imminent preterm birth. Therapeutic benefits include reducing major complications of prematurity such as respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis, as well as an overall decrease in neonatal deaths. Optimal reductions in neonatal morbidity and mortality require a thoughtful review of the timing of administration. In addition, a thorough understanding is required of which patients maximally benefit from this intervention in the management and counseling of those at risk for preterm birth...
June 2018: Clinics in Perinatology
https://www.readbyqxmd.com/read/29720513/glucocorticoids-antenatal-corticosteroid-therapy-and-fetal-heart-maturation
#4
Emma Agnew, Jessica Ivy, Sarah Stock, Karen Chapman
Glucocorticoids are essential in mammals to mature fetal organs and tissues in order to survive after birth. Hence, antenatal glucocorticoid treatment (termed antenatal corticosteroid therapy) can be life-saving in preterm babies and is commonly used in women at risk of preterm birth. Whilst the effects of glucocorticoids on lung maturation have been well described, the effects on the fetal heart remain less clear. Experiments in mice have shown that endogenous glucocorticoid action is required to mature the fetal heart...
May 2, 2018: Journal of Molecular Endocrinology
https://www.readbyqxmd.com/read/29702710/neonatal-morbidities-among-moderately-preterm-infants-with-and-without-exposure-to-antenatal-corticosteroids
#5
Sanjay Chawla, Girija Natarajan, Dhuly Chowdhury, Abhik Das, Michele Walsh, Edward F Bell, Abbot R Laptook, Krisa Van Meurs, Carl T D'Angio, Barbara J Stoll, Sara B DeMauro, Seetha Shankaran
OBJECTIVE:  We aimed to compare the rates of "surfactant treated respiratory disease" and other neonatal morbidities among moderately preterm (MPT) infants exposed to no, partial, or a complete course of antenatal corticosteroids (ANS). STUDY DESIGN:  This observational cohort study evaluated MPT infants (290/7 -336/7 weeks' gestational age), born between January 2012 and November 2013 and enrolled in the "MPT Registry" of the National Institute of Child Health and Human Development Neonatal Research Network...
April 27, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29702709/neonatal-outcomes-based-on-duration-of-exposure-to-antenatal-corticosteroids-in-indicated-preterm-deliveries
#6
Chase R Cawyer, Spencer G Kuper, Lisa A Dimperio, Alan T Tita, Joseph R Biggio, Lorie M Harper
OBJECTIVE:  To evaluate how duration of exposure to antenatal corticosteroids (ACSs) prior to delivery affects neonatal outcomes in indicated preterm deliveries. STUDY DESIGN:  This is a retrospective cohort of all indicated singleton preterm deliveries (23-34 weeks) in a single tertiary center from 2011 to 2014 comparing those who received ACS 2 to 7 days versus >7 days prior to delivery. The primary neonatal outcome was a composite of arterial cord pH < 7 or base excess ≤ 12, 5-minute Apgar ≤ 3, cardiopulmonary resuscitation, culture-proven neonatal sepsis, intraventricular hemorrhage grade III/IV, necrotizing enterocolitis, and neonatal death...
April 27, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29681180/amniocentesis-compared-with-antenatal-corticosteroids-prior-to-early-term-scheduled-cesarean-delivery
#7
Kelly B Zafman, Nathan S Fox
OBJECTIVE: There are a variety of maternal or fetal conditions that require late preterm or early term delivery. In cases where early delivery is indicated, optimal management is not always clear. Historically, obstetricians used amniocentesis to document fetal lung maturity, but recently, many have transitioned to administration of antenatal corticosteroids (ACS). The objective of this study was to compare neonatal outcomes between women undergoing amniocentesis or receiving ACS prior to scheduled cesarean delivery (CD) less than 39 weeks...
April 22, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29679046/impact-of-antenatal-corticosteroids-in-preterm-neonates-based-on-maternal-body-mass-index
#8
Maheer Faden, Sarah D McDonald, Prakeshkumar S Shah, Amit Mukerji
OBJECTIVE: Impact of antenatal corticosteroid (ACS) in context of maternal body mass index (BMI) as it relates to neonatal outcomes remains unclear. We sought to evaluate effects of ACS on clinical outcomes of preterm infants based on maternal BMI. METHODS: We performed a retrospective cohort study among neonates 23-33 weeks' GA at a tertiary neonatal intensive care unit from 2011 to 2015. Outcomes of neonates exposed to any ACS and pre-pregnancy maternal BMI ≥ 25 (N = 491) were compared with maternal BMI < 25 (N = 484)...
April 20, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29674201/placental-histopathological-lesions-in-correlation-with-neonatal-outcome-in-preeclampsia-with-and-without-severe-features
#9
Eran Weiner, Ohad Feldstein, Liliya Tamayev, Ehud Grinstein, Elad Barber, Jacob Bar, Letizia Schreiber, Michal Kovo
OBJECTIVE: We aimed to compare pregnancy outcome and placental histopathology in women with preeclampsia (PE) with and without severe features. METHODS: The medical records and placental pathology reports of all pregnancies complicated by PE during 2008-2016, were reviewed. Results were compared between those with and without severe features (severe PE vs. mild PE groups), according to current ACOG guidelines. Placental lesions were classified to maternal/fetal vascular supply lesions, and maternal/fetal inflammatory responses...
February 7, 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29669335/antenatal-corticosteroid-exposure-disrupts-myelination-in-the-auditory-nerve-of-preterm-sheep
#10
Judith Rittenschober-Böhm, Jennifer Rodger, Alan H Jobe, Suhas G Kallapur, Dorota A Doherty, Boris W Kramer, Matthew S Payne, Michael Archer, Christian Rittenschober, John P Newnham, Yuichiro Miura, Angelika Berger, Stephen G Matthews, Matthew W Kemp
BACKGROUND: Antenatal corticosteroids (ACS) improve preterm neonatal outcomes. However, uncertainty remains regarding the safety of ACS exposure for the developing fetus, particularly its neurosensory development. OBJECTIVES: We investigated the effect of single and multiple ACS exposures on auditory nerve development in an ovine model of pregnancy. METHODS: Ewes with a single fetus (gestational age [GA] 100 days) received an intramuscular injection of 150 mg medroxyprogesterone-acetate, followed by intramuscular (i) betamethasone (0...
April 17, 2018: Neonatology
https://www.readbyqxmd.com/read/29590200/retrospective-harm-benefit-analysis-of-pre-clinical-animal-research-for-six-treatment-interventions
#11
Pandora Pound, Christine J Nicol
BACKGROUND: The harm benefit analysis (HBA) is the cornerstone of animal research regulation and is considered to be a key ethical safeguard for animals. The HBA involves weighing the anticipated benefits of animal research against its predicted harms to animals but there are doubts about how objective and accountable this process is. OBJECTIVES: i. To explore the harms to animals involved in pre-clinical animal studies and to assess these against the benefits for humans accruing from these studies; ii...
2018: PloS One
https://www.readbyqxmd.com/read/29542436/balancing-demand-for-universally-improved-health-outcomes-with-need-for-a-local-standard-of-care
#12
Christina Krudy, Kavita Shah Arora
The United States, along with other resource-rich countries, leads global health care by advancing medical care through randomized controlled trials (RCTs). While most medical research is conducted in these resource-rich areas, RCTs, including replications of previous trials, are additionally carried out in low- and middle-income countries. On the basis of positive findings from several RCTs conducted in high-income countries, the Antenatal Corticosteroids Trial (ACT) evaluated the effectiveness of antenatal corticosteroids in reducing neonatal mortality in low- and middle-income countries...
March 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29514604/efficacy-of-serum-procalcitonin-to-predict-spontaneous-preterm-birth-in-women-with-threatened-preterm-labour-a-prospective-observational-study
#13
Guillaume Ducarme, François Desroys du Roure, Aurélie Le Thuaut, Joséphine Grange, Mathilde Vital, Jérôme Dimet
BACKGROUND: A hypothesis of preterm parturition is that the pathogenesis of spontaneous preterm birth (sPTB) may be associated with an inflammatory process. Based on this theory, we have hypothesized that an inflammatory biomarker, procalcitonin (PCT), may be a good predictive marker of sPTB at the admission for threatened preterm labour (TPL). The present study was aimed to investigate the association between serum PCT and sPTB in women with TPL and to evaluate whether PCT levels may predict sPTB in women with TPL within 7 or 14 days...
March 7, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29513706/a-care-bundle-including-antenatal-corticosteroids-reduces-preterm-infant-mortality-in-tanzania-a-low-resource-country
#14
Augustine Massawe, Hussein L Kidanto, Robert Moshiro, Edna Majaliwa, Flora Chacha, Aisa Shayo, Paschal Mdoe, Prisca Ringia, Mary Azayo, Georgina Msemo, Estomih Mduma, Hege L Ersdal, Jeffrey M Perlman
BACKGROUND: Preterm neonatal mortality (NM) has remained high and unchanged for many years in Tanzania, a resource-limited country. Major causes of mortality include birth asphyxia, respiratory insufficiency and infections. Antenatal corticosteroids (ACS) have been shown to significantly reduce mortality in developed countries. There is inconsistent use of ACS in Tanzania. OBJECTIVE: To determine whether implementation of a care bundle that includes ACS, maternal antibiotics (MA), neonatal antibiotics (NA) and avoidance of moderate hypothermia (temperature < 36°C) targeting infants of estimated gestational age (EGA) 28 to 34 6/7 weeks would reduce NM (< 7 days) by 35%...
2018: PloS One
https://www.readbyqxmd.com/read/29496431/-in-the-case-of-premature-live-birth-is-very-early-rupture-of-the-membranes-an-additional-risk-factor-for-morbidity-and-mortality
#15
T Isnard, A Vincent-Rohfritsch, C Le Ray, F Goffinet, J Patkai, J Sibiude
OBJECTIVE: To describe survival rate after preterm premature rupture of membranes (PPROM) before 25 weeks of gestation and compare neonatal morbidity and mortality among those born alive with a control group of infants born at a similar gestational age without premature rupture of membranes. METHODS: We conducted a retrospective single-centre study at Port-Royal maternity, from 2007 to 2015, comparing neonatal outcomes between liveborninfants exposed to PPROM prior to 25 weeks of gestation (WG) and a control group not exposed to premature rupture of the membranes...
April 2018: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29492065/comparing-neonatal-respiratory-morbidity-in-neonates-delivered-after-34-weeks-of-gestation-with-and-without-antenatal-corticosteroid
#16
Burcu Kisa Karakaya, Yasemin Tasci, Ozlem Yoruk, Hatice Kansu-Celik, Fuat Emre Canpolat
Objective: To investigate the effect of antenatal corticosteroid prophylaxis on neonatal respiratory morbidity between 34 and 37 weeks of gestation. Methods: This retrospective study evaluated the neonatal respiratory complications of 683 low risk singleton pregnancies delivered at 34-37 weeks of gestation in a tertiary care center between Jan 2012 and Sept 2015. Group-I (n=294) comprised data of woman who did not receive betamethasone and Group-II(n=396) comprised those who received betamethasone after 34 weeks of gestation for cases at risk of preterm birth...
November 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29485138/counselling-and-management-for-anticipated-extremely-preterm-birth
#17
COMMENT
Brigitte Lemyre, Gregory Moore
Counselling couples facing the birth of an extremely preterm infant is a complex and delicate task, entailing both challenges and opportunities. This revised position statement proposes using a prognosis-based approach that takes the best estimate of gestational age into account, along with additional factors, including estimated fetal weight, receipt of antenatal corticosteroids, singleton versus multiple pregnancy, fetal status and anomalies on ultrasound and place of birth. This statement updates data on survival in Canada, long-term neurodevelopmental disability at school age and quality of life, with focus on strategies to communicate effectively with parents...
September 2017: Paediatrics & Child Health
https://www.readbyqxmd.com/read/29459939/cognitive-outcomes-of-children-born-extremely-or-very-preterm-since-the-1990s-and-associated-risk-factors-a-meta-analysis-and-meta-regression
#18
E Sabrina Twilhaar, Rebecca M Wade, Jorrit F de Kieviet, Johannes B van Goudoever, Ruurd M van Elburg, Jaap Oosterlaan
Importance: Despite apparent progress in perinatal care, children born extremely or very preterm (EP/VP) remain at high risk for cognitive deficits. Insight into factors contributing to cognitive outcome is key to improve outcomes after EP/VP birth. Objective: To examine the cognitive abilities of children of EP/VP birth (EP/VP children) and the role of perinatal and demographic risk factors. Data Sources: PubMed, Web of Science, and PsycINFO were searched without language restriction (last search March 2, 2017)...
April 1, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/29398054/severe-neurodevelopmental-impairment-in-neonates-born-preterm-impact-of-varying-definitions-in-a-canadian-cohort
#19
Matthew D Haslam, Sarka Lisonkova, Dianne Creighton, Paige Church, Junmin Yang, Prakesh S Shah, K S Joseph, Anne Synnes
OBJECTIVE: To assess the impact of variations in the definition of severe neurodevelopmental impairment (NDI) on the incidence of severe NDI and the association with risk factors using the Canadian Neonatal Follow-Up Network cohort. STUDY DESIGN: Literature review of severe NDI definitions and application of these definitions were performed in this database cohort study. Infants born at 23-28 completed weeks of gestation between 2009 and 2011 (n = 2187) admitted to a Canadian Neonatal Network neonatal intensive care unit and assessed at 21 months' corrected age were included...
February 2, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29372144/antenatal-corticosteroids-and-outcomes-of-preterm-small-for-gestational-age-neonates-in-a-single-medical-center
#20
Woo Jeng Kim, Young Sin Han, Hyun Sun Ko, In Yang Park, Jong Chul Shin, Jeong Ha Wie
Objective: This study investigated the effect of an antenatal corticosteroid (ACS) in preterm small-for-gestational-age (SGA) neonate. Methods: This study was a retrospective cohort study. We compared women who received ACS with unexposed controls and evaluated neonatal complications among those having a singleton SGA neonate born between 29 and 34 complete gestational weeks. The neonates born after 32 weeks of gestation were divided into subgroups. Multivariable logistic regression analysis was performed...
January 2018: Obstetrics & Gynecology Science
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