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Maternal medicine

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https://www.readbyqxmd.com/read/28535315/early-career-outcomes-of-family-medicine-residency-graduates-exposed-to-innovative-flexible-longitudinal-tracks
#1
Richard A Young, Dan Casey, Diana Singer, Elaine Waller, Patricia A Carney
BACKGROUND AND OBJECTIVES: The Preparing the Personal Physician for Practice (P4) project used a case series design to study innovations in the content, length, structure, and location of residency training in 14 geographically diverse family medicine programs between 2007 and 2012. We aimed to explore how offering flexible longitudinal tracks (FLT) affected graduates' scope of practice, particularly in maternal child health (MCH), which included at least 17 months of focused training that increased each year over 4 years...
May 2017: Family Medicine
https://www.readbyqxmd.com/read/28531885/fetal-treatment-2017-the-evolution-of-fetal-therapy-centers-a-joint-opinion-from-the-international-fetal-medicine-and-surgical-society-ifmss-and-the-north-american-fetal-therapy-network-naftnet
#2
Anita J Moon-Grady, Ahmet Baschat, Darrell Cass, Mahesh Choolani, Joshua A Copel, Timothy M Crombleholme, Jan Deprest, Stephen P Emery, Mark I Evans, Francois I Luks, Mary E Norton, Greg Ryan, Kuojen Tsao, Ross Welch, Michael Harrison
More than 3 decades ago, a small group of physicians and other practitioners active in what they called "fetal treatment" authored an opinion piece outlining the current status and future challenges anticipated in the field. Many advances in maternal, neonatal, and perinatal care and diagnostic and therapeutic modalities have been made in the intervening years, yet a thoughtful reassessment of the basic tenets put forth in 1982 has not been published. The present effort will aim to provide a framework for contemporary redefinition of the field of fetal treatment, with a brief discussion of the necessary minimum expertise and systems base for the provision of different types of interventions for both the mother and fetus...
May 23, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28526378/association-between-prepregnancy-obesity-and-metabolic-risk-in-chilean-premenopausal-women-10%C3%A2-y-postpartum
#3
Maria Luisa Garmendia, Carolina Zamudio, Marcela Araya, Juliana Kain
OBJECTIVES: One of every four pregnant women in Chile is obese. Gestational obesity is associated with maternal metabolic complications in pregnancy (e.g., gestational diabetes, preeclampsia), but to our knowledge, there is little evidence on relationships with future metabolic risk. The aim of this study was to evaluate the association between prepregnancy obesity (prepregnancy body mass index ≥30 kg/m(2)) or excessive gestational weight gain (GWG; according to the 2009 recommendations from the Institute of Medicine), and maternal metabolic complications 10 y postpartum in premenopausal Chilean women...
June 2017: Nutrition
https://www.readbyqxmd.com/read/28525293/where-do-women-get-advice-about-weight-eating-and-physical-activity-during-pregnancy
#4
Adrian Mercado, Becky Marquez, Barbara Abrams, Maureen G Phipps, Rena R Wing, Suzanne Phelan
BACKGROUND: Most women report not receiving information about gestational weight gain (GWG) from prenatal providers, but less is known about other sources of information and their potential impacts on GWG. The purpose of this study was to investigate sources of information about diet, physical activity, and weight control during pregnancy, and the impact of information sources on maternal GWG. MATERIALS AND METHODS: Participants were 183 women with normal weight and 172 women with overweight/obesity who had enrolled in a prenatal lifestyle intervention trial...
May 19, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28522319/association-between-gestational-weight-gain-and-perinatal-outcomes-in-women-with-chronic-hypertension
#5
Lynn M Yee, Aaron B Caughey, Yvonne W Cheng
BACKGROUND: Gestational weight gain above or below the 2009 Institute of Medicine guidelines has been associated with adverse maternal and neonatal outcomes. Although it has been well established that excess gestational weight gain is associated with the development of gestational hypertension and preeclampsia, the relationship between gestational weight gain and adverse perinatal outcomes among women with pregestational (chronic) hypertension is less clear. OBJECTIVE: The objective of this study was to examine the relationship between gestational weight gain above and below IOM guidelines and perinatal outcomes in a large, population-based cohort of women with chronic hypertension...
May 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28522317/the-association-between-cytochrome-p450-3a-progesterone-receptor-polymorphisms-plasma-17-ohpc-concentrations-and-spontaneous-preterm-birth
#6
Martha L Bustos, Steve N Caritis, Kathleen A Jablonski, Uma M Reddy, Yoram Sorokin, John M Thorp, Michael W Varner, Ronald J Wapner, Jay D Iams, Marshall W Carpenter, Alan M Peaceman, Brian M Mercer, Anthony Sciscione, Dwight J Rouse, Susan M Ramin
BACKGROUND: Infants born before 37 weeks' gestation are of public health concern since complications associated with preterm birth are the leading cause of mortality in children under 5 years of age and a major cause of morbidity and lifelong disability. The administration of 17-hydroxyprogesterone caproate (17-OHPC) reduces preterm birth by 33% in women with history spontaneous preterm birth (SPTB). We demonstrated previously that plasma concentrations of 17-OHPC vary widely among pregnant women and that women with 17-OHPC plasma concentrations in the lowest quartile had SPTB rates of 40% vs rates of 25% in those women with higher concentrations...
May 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28516087/dna-sequence-analysis-in-clinical-medicine-proceeding-cautiously
#7
REVIEW
Moyra Smith
Delineation of underlying genomic and genetic factors in a specific disease may be valuable in establishing a definitive diagnosis and may guide patient management and counseling. In addition, genetic information may be useful in identification of at risk family members. Gene mapping and initial genome sequencing data enabled the development of microarrays to analyze genomic variants. The goal of this review is to consider different generations of sequencing techniques and their application to exome sequencing and whole genome sequencing and their clinical applications...
2017: Frontiers in Molecular Biosciences
https://www.readbyqxmd.com/read/28509324/three-dimensional-neurosonography-a-novel-field-in-fetal-medicine
#8
Michał Lipa, Ritsuko Kimata Pooh, Mirosław Wielgoś
Neurosonography is a promising technique for prenatal diagnosis, combining features of ultrasound imaging with fetal neurology. The brain is a three-dimensional structure, therefore observing brain structure in the three basic planes (sagittal, coronal and axial) is mandatory. The anterior fontanelle and sagittal suture may serve as acoustic ultrasound windows in the transvaginal brain scan, allowing to obtain high-resolution neuroimages of the intracranial structures. Furthermore, three-dimensional (3D) ultrasound combined with the transvaginal brain approach provides detailed and sophisticated neuroimages...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28508731/submitting-medico-legal-intra-partum-ctg-i-p-ctg-monitoring-to-the-bolam-and-bolitho-principles
#9
George G Buttigieg
The article analyses some of the seeming weaknesses of the Bolam and Bolitho tests as applied to electronic foetal monitoring in labour, in the form of intra-partum CTG monitoring. Homing on to such aspects as confirmation of foetal hypoxia/acidosis, it evaluates the Bolam and Bolitho tests in the context of evidence-based medicine versus traditionally held views, which still hold their own in medical jurisprudence. Case law examples are quoted to illustrate various points. The discussion is of practical relevance both to the individual obstetrician as well as to national budgetary implications, bearing in mind, that, for example, in 2011, 'birth asphyxia' comprised 50% of the UK NHS litigation costs, and in the 2000-2010 decade, the same NHS forked out £3...
June 2017: Medico-legal Journal
https://www.readbyqxmd.com/read/28507351/practice-of-breastfeeding-and-immunisation-in-a-periurban-community-in-pakistan
#10
Haider Ghazanfar, Sualeha Saleem, Sajida Naseem, Ali Ghazanfar
OBJECTIVE: To assess the practice of breastfeeding and immunisation in a peri-urban community and correlate it with maternal care during pregnancy of the index child. METHODS: This community-based, cross-sectional survey was conducted at Shifa Tameer-e-Millat University and Shifa College of Medicine, Islamabad, Pakistan, from June 2014 to January 2016, using a self-generated questionnaire. Systemic random sampling method was used to collect data. SPSS 21 was used to analyse the data and to find associations between maternal care and practices of breastfeeding...
May 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28504476/thirty-years-of-interferon-tau-research-past-present-and-future-perspective
#11
REVIEW
Kazuhiko Imakawa, Rulan Bai, Keigo Nakamura, Kazuya Kusama
The year 2017 marks the 30th year since the discovery was made of amino acid and complementary DNA sequences of ovine trophoblast protein-1 (oTP-1), later renamed as interferon-tau (IFNτ). Ovine TP-1 was originally found as a secretory product of sheep conceptuses that rescues maternal corpus luteum (CL) and in fact, the uterine infusion of oTP-1 extended inter-estrous intervals. Finding this signaling molecule as an IFN-like sequence was surprising to the scientific community in reproduction because a homologous molecule in humans possesses anti-viral and anti-prolific activity and is often used in human medicines...
May 15, 2017: Animal Science Journal, Nihon Chikusan Gakkaihō
https://www.readbyqxmd.com/read/28502760/patterns-of-gestational-weight-gain-and-birthweight-outcomes-in-the-eunice-kennedy-shriver-national-institute-of-child-health-and-human-development-fetal-growth-studies-singletons-a-prospective-study
#12
Sarah J Pugh, Paul S Albert, Sungduk Kim, William Grobman, Stefanie N Hinkle, Roger B Newman, Deborah A Wing, Katherine L Grantz
BACKGROUND: Inadequate or excessive total gestational weight gain is associated with increased risks of small- and large-for-gestational-age births, respectively, but evidence is sparse regarding overall and trimester-specific patterns of gestational weight gain in relation to these risks. Characterizing the interrelationship between patterns of gestational weight gain across trimesters can reveal whether the trajectory of gestational weight gain in the first trimester sets the path for gestational weight gain in subsequent trimesters, thereby serving as an early marker for at-risk pregnancies...
May 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28501364/immune-modulation-treatments-where-is%C3%A2-the-evidence
#13
REVIEW
Malene Meisner Hviid, Nick Macklon
While advances in assisted reproductive techniques have been substantial, failure of the apparently viable embryo to implant remains a source of distress and frustration to patients and specialists alike. The unique maternal immunological response to the embryo and the notion that defects in early placentation underlie the great complications of pregnancy have focused attention on the therapeutic potential of peri-implantation immunomodulation. On the face of it, the rationale for this approach is very attractive...
May 10, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28491133/the-way-forward
#14
Sandra A Lowe
Improving maternal health and reducing maternal morbidity and mortality into the future will require a range of health-related and non-health-related strategies. The latter include education for women, better communication, access to transport and technology and cultural change. The role of obstetric medicine practice, research and education in achieving these objectives is discussed in this article. We need to recognise that it will require improvements in health provision and access to achieve our goal of safer childbirth for women and babies throughout the world...
March 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28491132/obstetric-medical-care-and-training-in-the-united-kingdom
#15
Adam D Jakes, Ingrid Watt-Coote, Matthew Coleman, Catherine Nelson-Piercy
The UK confidential enquiry into maternal deaths identified poor management of medical problems in pregnancy to be a contributory factor to a large proportion of indirect maternal deaths. Maternal (obstetric) medicine is an exciting subspecialty that encompasses caring for both women with pre-existing medical conditions who become pregnant, as well as those who develop medical conditions in pregnancy. Obstetrics and gynaecology trainees have some exposure to maternal medicine through their core curriculum and can then complete an advanced training skills module, subspecialise in maternal-fetal medicine or take time out to complete the Royal College of Physicians membership examination...
March 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28491126/developing-obstetric-medicine-training-in-latin-america
#16
José Rojas-Suarez, Niza Suarez, Oier Ateka-Barrutia
Maternal mortality is an important indicator of health in populations around the world. The distribution of maternal mortality ratio globally shows that middle- and low-income countries have ∼99% of the mortality burden. Most countries of Latin America are considered to be middle- or low-income countries, as well as areas of major inequities among the different social classes. Medical problems in pregnancy remain an important cause of morbidity and mortality in this region. Previous data indicate the need for a call to action for adequate diagnosis and care of medical diseases in obstetric care...
March 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28470035/health-effects-of-parental-deaths-among-adults-in-norway-purchases-of-prescription-medicine-before-and-after-bereavement
#17
Øystein Kravdal, Emily Grundy
We analyse effects of parental deaths on the health of women and men aged 18-59 in 2004-2008, indicated by purchases of prescription medicines. Register data covering the entire Norwegian population were used, and fixed-effects models were estimated to control for unobserved time-invariant individual factors. A parent's death seemed to have immediate adverse consequences in both main age groups considered (18-39, 40-59), although effects were lower in the older group. Some results suggested that this health disadvantage widened with increasing time since the parent's death...
December 2016: SSM—Population Health
https://www.readbyqxmd.com/read/28468112/-an-introduction-of-the-treatment-of-uterine-prolapse-and-urinary-fistula-from-1966-to-1976
#18
J Li
During the period 1966 to 1976, a large number of retained patients of uterine prolapse and urinary fistula became a problem around the maternal and child health aspects not to be ignored. All traditional Chinese and Western medical practitioners under difficult condition had been trying their best to continue to carry out the treatment. For uterine prolapse, Chinese medicine therapy included decoction therapy, acupuncture therapy, comprehensive therapy, para-uterine injection of traditional Chinese medicine preparations; whereas Western medicine treatment included hysterophore and surgery...
March 28, 2017: Zhonghua Yi Shi za Zhi, Chinese Journal of Medical History
https://www.readbyqxmd.com/read/28466568/physiological-and-pathological-angiogenesis-in-endometrium-at-the-time-of-embryo-implantation
#19
Xiaoyan Chen, Gene Chi Wai Man, Yingyu Liu, Fangrong Wu, Jin Huang, Tin Chiu Li, Chi Chiu Wang
Embryo establishes contact with the endometrium during implantation. Proper endometrial vascular development and maintenance at the time of embryo implantation is crucial for successful pregnancy. Vascular development at the maternal-embryo interface can be regulated by various cell types, of which uterine natural killer (uNK) cells play an important role. Abnormal angiogenesis and uNK cell number/function may lead to reproductive failure, particularly in women with recurrent miscarriage (RM) and women with recurrent implantation failure (RIF) after IVF-ET treatment, which are the important clinical hurdles in reproductive medicine to overcome...
May 3, 2017: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/28456509/effect-of-early-tranexamic-acid-administration-on-mortality-hysterectomy-and-other-morbidities-in-women-with-post-partum-haemorrhage-woman-an-international-randomised-double-blind-placebo-controlled-trial
#20
(no author information available yet)
BACKGROUND: Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. METHODS: In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries...
April 26, 2017: Lancet
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