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https://www.readbyqxmd.com/read/29870394/abnormally-invasive-placenta-aip-pre-cesarean-amnion-drainage-to-facilitate-exteriorization-of-the-gravid-uterus-through-a-transverse-skin-incision
#1
Thorsten Braun, Katharina Weizsäcker, Mustafa Zelal Muallem, Janina Tillinger, Larry Hinkson, Frederic Chantraine, Wolfgang Henrich
The number of pregnant women with abnormally invasive placenta (AIP) including clinical relevant placenta increta and percreta has markedly increased with a reported incidence of as high as one in 731, By 2020 in the United States, there will be an estimated 4504 new cases of AIP and 130 AIP-associated maternal deaths annually. The preoperative diagnosis and operative management of AIP is challenging. In a planned cesarean delivery, a vertical lower abdominal skin incision is widely used in order to have enough space to perform a hysterotomy above the cranial edge of the placenta to avoid significant fetal and/or maternal hemorrhage...
June 5, 2018: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29866484/neonatal-echocardiogram-in-duodenal-obstruction-is-unnecessary-after-normal-fetal-cardiac-imaging
#2
Caroline Q Stephens, Stephanie Dukhovny, Kathryn J Rowland, Nicholas A Hamilton
BACKGROUND: Duodenal obstruction (DO) is associated with congenital cardiac anomalies that may complicate the delivery of anesthesia during surgical repair. As most infants undergo fetal ultrasounds that identify cardiac anomalies, our aim was to determine the utility of obtaining preoperative neonatal echocardiograms in all DO patients. METHODS: We conducted a retrospective cohort study of all DO patients treated at two tertiary care children's hospitals between January 2005 and February 2016...
May 6, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29842812/management-of-chaos-by-intact-cord-resuscitation-case-report-and-literature-review
#3
Manisha Kumar, Amit Gupta, Vijay Kumar, Anu Handa, Mayura Balliyan, Jyoti Meena, Shubhasis Roychoudhary
BACKGROUND: Congenital high airway obstruction syndrome (CHAOS) is a near fatal condition, except when the ex-utero intrapartum treatment (EXIT) procedure is performed as rescue. After antenatal diagnosis of the condition counseling regarding prognosis and outcome needs to be provided Case: We describe here a case with CHAOS due to isolated fetal laryngeal atresia, presented at our center at 33-week gestation. After counseling regarding the uncertain outcome, consent for elective caesarean was not given...
May 29, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29791204/role-of-adenosine-signaling-in-coordinating-cardiomyocyte-function-and-coronary-vascular-growth-in-chronic-fetal-anemia
#4
Lowell Davis, James Musso, Divya Soman, Samantha Louey, Jonathan William Nelson, Sonnet S Jonker
Fetal anemia causes rapid and profound changes in cardiac structure and function, stimulating proliferation of the cardiac myocytes, expansion of the coronary vascular tree, and impairing early contraction and relaxation. While HIF-1α is sure to play a role, adenosine, a metabolic byproduct that increases coronary flow and growth, is implicated as a major stimulus for these adaptations. We hypothesized that genes involved in myocardial adenosine signaling would be up-regulated in chronically anemic fetuses, and that calcium handling genes would be down-regulated...
May 23, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29768964/effects-of-combined-spinal-epidural-analgesia-on-first-stage-of-labor-a-cohort-study
#5
Silvia Poma, Luigia Scudeller, Chiara Verga, Giorgio Mirabile, Barbara Gardella, Federica Broglia, Maria Ciceri, Marinella Fuardo, Simona Pellicori, Maddalena Gerletti, Silvia Zizzi, Elena Masserini, Maria Paola Delmonte, Giorgio Antonio Iotti
BACKGROUND: Neuraxial anesthesia is considered as the gold standard in the control labor of pain. Its variants are epidural analgesia and combined spinal-epidural analgesia. Few studies, as yet, have investigated the duration of labor as a primary outcome. Some authors have suggested that combined spinal-epidural analgesia may reduce labor duration but at the moment the benefit of shortening labor is uncertain. The main aim of this study was to compare combined spinal-epidural with epidural analgesia in terms of their effect on duration of stage I labor, maternal, and neonatal outcomes...
May 17, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29732167/bugs-in-the-program-can-pregnancy-drugs-and-smoking-disturb-molecular-reprogramming-of-the-fetal-germline-increasing-heritable-risk-for-autism-and-neurodevelopmental-disorders
#6
Jill Escher
In a seeming paradox, the prevalence of autism spectrum disorder (ASD) has surged, while at the same time research has pointed to the strong heritability of this neurodevelopmental pathology. Here an autism research philanthropist suggests a biological phenomenon of exogenously induced 'gamete disruption' that could reconcile these seemingly contradictory observations. Mining information from her own family history and that of her fellow autism parents, while also engaging with the scientific community, she proposes that a subset of the autisms may be rooted in a variety of molecular glitches in parental gametes induced by certain acute exposures during the parents' own fetal or neonatal development...
April 2018: Environmental Epigenetics
https://www.readbyqxmd.com/read/29716181/the-impact-of-fetal-load-of-hirudo-verbana-saline-extract-antigens-on-morphometrical-hematological-and-immunological-parameters-of-rats-in-the-early-stages-of-post-embryonic-development
#7
Ruslan F Aminov, Aleksandr K Frolov
The aim of the study was to determine the immunostimulatory effect of antigens from saline extract of the medicinal leech on the morphometric parameters of the body and major immunogenic organs of rats. Wild-type female rats were administered medicinal leech saline extract antigens intraperitoneally two weeks before and two weeks after mating (in total four injections). The offspring were examined, as were the mothers after feeding the offspring, at 1, 15, 30, 60 days after birth. The morphometric parameters of the animals were recorded...
2018: Annals of Parasitology
https://www.readbyqxmd.com/read/29672287/early-administration-of-magnesium-sulfate-during-open-fetal-myelomeningocele-repair-reduces-the-dose-of-inhalational-anesthesia
#8
Roopali Donepudi, Melissa Huynh, Kenneth J Moise, Ramesha Papanna, Anthony Johnson, Mary Austin, KuoJen Tsao, Ranu Jain
INTRODUCTION: Optimal uterine relaxation is achieved through higher minimum alveolar concentration (MAC) of inhalational anesthetics, increasing risks to mother and fetus. Our objective was to determine if earlier administration of magnesium sulfate would reduce the requirement of inhalational anesthetics in fetal myelomeningocele repair. MATERIALS AND METHODS: Prospective observational study of fetal myelomeningocele repair was performed from September 2011 to August 2017...
April 19, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29664053/labor-onset-oxytocin-use-and-epidural-anesthesia-for-vaginal-birth-after-cesarean-section-and-associated-effects-on-maternal-and-neonatal-outcomes-in-a-tertiary-hospital-in-china-a-retrospective-study
#9
Shao-Wen Wu, He Dian, Wei-Yuan Zhang
Background: In the mainland of China, the trial of labor after cesarean section is still a relatively new technique. In this study, we aimed to investigate the effects of labor onset, oxytocin use, and epidural anesthesia on maternal and neonatal outcomes for vaginal birth after cesarean section (VBAC) in a tertiary hospital in China. Methods: This was a retrospective study carried out on 212 VBAC cases between January 2015 and June 2017 in Beijing Obstetrics and Gynecology Hospital, Capital Medical University...
April 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29628561/norepinephrine-versus-ephedrine-to-maintain-arterial-blood-pressure-during-spinal-anesthesia-for-cesarean-delivery-a-prospective-double-blinded-trial
#10
Ali Mohamed Ali Elnabtity, Mohamed Foad Selim
Background: Ephedrine was conventionally regarded as the first-choice drug to maintain maternal blood pressure during spinal anesthesia for cesarean delivery, due to its stimulant activity on α- and β-adrenergic receptors. Norepinephrine is a weak β-adrenergic and potent α-adrenergic receptor agonist. Therefore, it may be suitable for maintaining blood pressure with less chronotropic effects compared to ephedrine. Patients and Methods: One hundred and forty healthy patients having cesarean delivery under spinal anesthesia were randomized to Group N ( n = 61) who received a prophylactic bolus of norepinephrine 5 μg intravenous (i...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29608321/management-of-pregnancy-sensitized-with-anti-inb-with-monocyte-monolayer-assay-and-maternal-blood-donation
#11
Raj Shree, Kimberly K Ma, Lay S Er, Meghan Delaney
Maternal red blood cell (RBC) alloantibodies can cause hemolytic disease of the fetus and newborn (HDFN). Although much is described about common antibodies associated with HDFN, management of a pregnancy complicated by a maternal rare antibody presents several challenges related to assessment of fetal anemia risk, availability of blood for transfusion to the mother and/or the fetus or newborn if needed, and planning for delivery in the case of maternal hemorrhage. Here we report the laboratory medicine workup of a patient who presented for obstetrical care in the United States in the third trimester and had a rare antibody (anti-Inb)...
January 2018: Immunohematology
https://www.readbyqxmd.com/read/29604954/an-intramural-uterine-fibroid-became-submucosal-in-the-puerperium-proposed-probable-mechanism-a-case-report
#12
Elie Nkwabong
BACKGROUND: Vaginal prolapse of a large uterine fibroid is a rare phenomenon in a woman who delivered vaginally recently, given that this fibroid might have obstructed labor. The author presents a case report of a vaginally prolapsed large pedunculated submucosal uterine myoma in a woman with a recent uncomplicated vaginal delivery. CASE PRESENTATION: A 25-year-old black African woman had four intramural uterine fibroids of diameters 62 to 94 mm diagnosed in April 2013 with standard ultrasound scan...
April 1, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29601303/the-opioid-epidemic-and-pregnancy-implications-for-anesthetic-care
#13
Britany L Raymond, Bradley T Kook, Michael G Richardson
PURPOSE OF REVIEW: This review summarizes evolving knowledge regarding adverse maternal, fetal, and neonatal effects of opioid exposure during pregnancy, and current treatment options for opioid use disorder (OUD). Maternal and fetal implications of maternal opioid maintenance with methadone and buprenorphine are described. Finally, acute and chronic pain management strategies in opioid-tolerant parturients are reviewed. RECENT FINDINGS: Opioid use among parturients has risen dramatically, with opioid use during pregnancy as high as 20%...
June 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29595529/ec50-of-epidural-ropivacaine-combined-with-dexmedetomidine-for-labor-analgesia
#14
Wp Zhang, Cuiling Li
BACKGROUND: It was reported that the optimal concentration of epidural dexmedetomidine for labor analgesia was 0.5▒ug/mL when combined with 0.1% ropivacaine. This study investigated the median effective concentration (EC50) of epidural ropivacaine for labor analgesia when combined with 0.5▒ug/mL dexmedetomidine. METHODS: Sixty full-term primiparas were enrolled and divided into two groups in this prospective study. Group D received 10▒mL solution (ropivacaine + 0...
March 27, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29594083/large-parotid-gland-lipoblastoma-in-a-teenager
#15
Danny Jandali, Ashley Heilingoetter, Ritu Ghai, Jill Jeffe, Samer Al-Khudari
Background: Lipoblastomas are rare benign neoplasms that arise from fetal white fat cells. They are typically found in children under the age of 3 and have been reported in the mediastinum, extremities, and infrequently in the head and neck. We present a rare case of a lipoblastoma arising from the parotid gland and the first known report of a parotid lipoblastoma in a teenager. Case presentation: A 15-year-old male presented with a painless, slowly enlarging parotid mass and left facial swelling...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29593226/caffeine-augments-anesthesia-neurotoxicity-in-the-fetal-macaque-brain
#16
Kevin K Noguchi, Stephen A Johnson, Francesca M Manzella, Kobe L Masuoka, Sasha L Williams, Lauren D Martin, Gregory A Dissen, Chrysanthy Ikonomidou, Katie J Schenning, John W Olney, Ansgar M Brambrink
Caffeine is the most frequently used medication in premature infants. It is the respiratory stimulant of choice for apnea associated with prematurity and has been called the silver bullet in neonatology because of many proven benefits and few known risks. Research has revealed that sedative/anesthetic drugs trigger apoptotic death of neurons and oligodendrocytes in developing mammalian brains. Here we evaluated the influence of caffeine on the neurotoxicity of anesthesia in developing nonhuman primate brains...
March 28, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29548042/maternal-fetal-medicine-workforce-survey-are-we-ready-for-regionalized-levels-of-maternal-care
#17
Katharine D Wenstrom, Mary E D'Alton, Daniel F O'Keefe
OBJECTIVE:  To conduct a survey of the members of the Society for Maternal-Fetal Medicine (SMFM) to determine the practice patterns of maternal-fetal medicine (MFM) subspecialists in the United States and to estimate the likelihood that our work force is sufficient to support the proposed MFM staffing requirements for level III and IV maternity centers. STUDY DESIGN:  All regular SMFM members in the United States were invited to answer a 26 question survey by email...
March 16, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29527296/management-of-eight-labor-and-delivery-patients-dependent-on-buprenorphine-subutex%C3%A2-a-retrospective-chart-review
#18
Solina Tith, Garinder Bining, Laurent Bollag
Background : Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by "The American College of Obstetrics and Gynecology" as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists' unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia...
2018: F1000Research
https://www.readbyqxmd.com/read/29506860/-anesthesia-for-cesarean-delivery-in-a-patient-with-klippel-trenaunay-syndrome
#19
Clara Elisa Frare de Avelar Teixeira, Angélica de Fátima de Assunção Braga, Franklin Sarmento da Silva Braga, Vanessa Henriques Carvalho, Rafael Miranda da Costa, Giselle Ioná Teixeira Brighenti
INTRODUCTION: Klippel-Trenaunay syndrome is a rare congenital vascular disease characterized by cutaneous hemangiomas, varicosities, and limb asymmetry, which may evolve with coagulation disorders and hemorrhage as more frequent complications in pregnant patients. Pregnancy is not advised in women with this syndrome due to increased obstetric risk. CASE REPORT: Female patient, 29 years old, 99kg, 167cm, BMI 35.4kg.m-2 , physical status ASA III, with 27 weeks of gestational age and diagnosis of Klippel-Trenaunay syndrome...
March 2, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29502065/-application-of-sevoflurane-and-laryngeal-mask-in-cesarean-section-in-women-with-heart-disease
#20
Zhi-Peng Wang, Jue Ma, Sheng Wang, Li-Na Yu, Jin-Feng Wei, Jin-Dong Xu
OBJECTIVE: To compare the safety of sevoflurane anesthesia with laryngeal mask and tracheal intubation in cesarean section in women with heart disease. METHODS: Fifty-two pregnant women with heart diseases undergoing cesarean section were randomized into laryngeal mask (LAM) group and tracheal intubation group. In LAM group, 6% sevoflurane was given at the rate of 6 L/min for induction with a maintenance sevoflurane concentration of 3%. In the intubation group, 1...
February 20, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
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