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Maternal fetal medicine

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https://www.readbyqxmd.com/read/29890949/complexity-of-gastroschisis-predicts-outcome-epidemiology-and-experience-in-an-australian-tertiary-centre
#1
Sarah J Melov, Irene Tsang, Ralph Cohen, Nadia Badawi, Karen Walker, Soundappan S V Soundappan, Thushari I Alahakoon
BACKGROUND: Gastroschisis is a congenital anomaly of the fetal abdominal wall, usually to the right side of umbilical insertion. It is often detected by routine antenatal ultrasound. Significant maternal and pediatric resources are utilised in the care of women and infants with gastroschisis. Increasing rates of gastroschisis worldwide have led institutions to review local data and investigate outcomes. A collaborative project was developed to review local epidemiology and investigate antenatal and neonatal factors influencing hospital length of stay (LOS) and total parental nutrition (TPN) in infants born with gastroschisis...
June 11, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29889758/industry-payments-to-obstetricians-and-gynecologists-under-the-sunshine-act
#2
Tyler M Muffly, Whitney L Giamberardino, Joseph Guido, Robbie Weterings, Brittney Bastow, Jeanelle Sheeder
OBJECTIVE: To evaluate financial relationships between obstetrician-gynecologists (ob-gyns) and industry, including the prevalence, magnitude, and the nature of payments. METHODS: We conducted a cross-sectional study in which we obtained a list of industry contributions to U.S. obstetricians and gynecologists through the Centers for Medicare and Medicaid Services Open Payments Database from August 1, 2013, to December 31, 2015. These data were cross-referenced with the entire cohort of practicing obstetricians and gynecologists, who were identified using the National Provider Identification database, because not all practicing ob-gyns received payments...
June 6, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29889745/simulation-in-obstetrics
#3
Andrew J Satin
Simulation in obstetrics is a widely accepted and valuable tool that benefits all levels of learners from medical students to maternal-fetal medicine subspecialists. What began as an adjunct to medical education now has a rapidly expanding role in acquisition of new and innovative procedures, team and unit training, and safety and quality initiatives. The number of obstetric simulation peer-reviewed reports has increased exponentially in recent years, yet only a small percentage of reports primarily addresses clinical outcomes...
June 6, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29883985/mode-of-delivery-in-previable-births
#4
Robert M Rossi, Emily A DeFranco
OBJECTIVE:  Preterm birth before 23 weeks of gestation typically results in neonatal death (5% survival). Society for Maternal-Fetal Medicine and American College of Obstetricians and Gynecologists published consensus guidelines recommending cesarean delivery (CD) not be performed for fetal indications between 20 and 226/7 weeks given the lack of proven benefit. We sought to quantify the previable CD rate and identify characteristics associated with previable CD. METHODS:  We performed a population-based retrospective cohort study of all live births in Ohio (2006-2015)...
June 8, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29804417/-study-on-weight-gain-in-different-stages-of-pregnancy-and-pregnancy-outcomes
#5
X L Chen, Y Y Peng, X Q Xu
Objective: By investigating the relationship of pregestational body mass index(BMI), trimester-specific gestational weight gain (rate) during the first, second, third and total trimesters of pregnancy with adverse pregnant outcomes, to evaluate the effects of different pregestational BMI, trimester-specific gestational weight gain on pregnant outcomes, and to provide evidences for gestational weight control. Methods: From April 2015 to January 2016, 964 pregnant women in Zhejiang Taizhou First People's Hospital and Taizhou Huangyan Maternal & Child Care Service Center were enrolled in random for prospective study and were divided into groups according to the Institute of Medicine 2009 guidelines[IOM2009]...
May 22, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29803315/fetoscopic-therapy-for-severe-pulmonary-hypoplasia-in-congenital-diaphragmatic-hernia-a-first-in-prenatal-regenerative-medicine-at-mayo-clinic
#6
Rodrigo Ruano, Denise B Klinkner, Karthik Balakrishnan, Victoria A Novoa Y Novoa, Norman Davies, Dean D Potter, William A Carey, Christopher E Colby, Amy B Kolbe, Katherine W Arendt, Leal Segura, Hans P Sviggum, Maureen A Lemens, Abimbola Famuyide, Andre Terzic
OBJECTIVE: To introduce the prenatal regenerative medicine service at Mayo Clinic for fetal endoscopic tracheal occlusion (FETO) care for severe congenital diaphragmatic hernia (CDH). PATIENTS AND METHODS: Two cases of prenatal management of severe CDH with FETO between January and August 2017 are reported. Per protocol, FETO was offered for life-threatening severe CDH at between 26 and 29 weeks' gestation. Regenerative outcome end point was fetal lung growth. Gestational age at procedure and maternal and perinatal outcomes were additional monitored parameters...
May 15, 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29800541/neonatal-outcomes-of-elective-early-term-births-after-demonstrated-fetal-lung-maturity
#7
Alan T N Tita, Kathleen A Jablonski, Jennifer L Bailit, William A Grobman, Ronald J Wapner, Uma M Reddy, Michael W Varner, John M Thorp, Kenneth J Leveno, Steve N Caritis, Jay D Iams, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
BACKGROUND: Studies of early term birth after demonstrated fetal lung maturity show that respiratory and other outcomes are worse with early term birth (370 -386 ) even after demonstrated fetal lung maturity when compared with full term birth (390 -406 ). However these studies included medically indicated births and are therefore potentially limited by confounding by the indication for delivery. Thus the increase in adverse outcomes might be due to the indication for early term birth rather than the early term birth itself...
May 22, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29796968/recommendations-for-the-use-of-ect-in-pregnancy-literature-review-and-proposed-clinical-protocol
#8
Heather Burrell-Ward, John A Fromson, Joseph J Cooper, Gildasio De Oliveira, Marcela Almeida
Psychiatric disorders are common in pregnancy, affecting 15-29% of pregnant women. Untreated depression has negative health consequences for mother and fetus. Electroconvulsive therapy (ECT) is an effective option for the treatment of severe depression, high suicide risk, catatonia, medication-resistant illness, psychotic agitation, severe physical decline, and other life-threatening conditions. To our knowledge, however, there is no literature that consolidates all the evidence on maternal and fetal risks associated with untreated depression, medications, and ECT then translating it into one cohesive protocol that could serve as a management guide and a source of reassurance to health-care providers involved in such practice...
May 23, 2018: Archives of Women's Mental Health
https://www.readbyqxmd.com/read/29791899/national-practice-patterns-for-prenatal-monitoring-in-gastroschisis-gastroschisis-outcomes-of-delivery-good-provider-survey
#9
Ruchi Amin, Aaron Domack, Joseph Bartoletti, Erika Peterson, Britton Rink, Jennifer Bruggink, Melissa Christensen, Anthony Johnson, William Polzin, Amy J Wagner
BACKGROUND: Gastroschisis is an abdominal wall defect with increasing incidence. Given the lack of surveillance guidelines among maternal-fetal medicine (MFM) specialists, this study describes current practices in gastroschisis management. MATERIALS AND METHODS: An online survey was administered to MFM specialists from institutions affiliated with the North American Fetal Therapy Network (NAFTNet). Questions focused on surveillance timing, testing, findings that changed clinical management, and delivery plan...
May 23, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29791315/incidence-of-early-onset-sepsis-in-infants-born-to-women-with-clinical-chorioamnionitis
#10
Tara M Randis, Madeline Murguia Rice, Leslie Myatt, Alan T N Tita, Kenneth J Leveno, Uma M Reddy, Michael W Varner, John M Thorp, Brian M Mercer, Mara J Dinsmoor, Susan M Ramin, Marshall W Carpenter, Philip Samuels, Anthony Sciscione, Jorge E Tolosa, George Saade, Yoram Sorokin
OBJECTIVE: To determine the frequency of sepsis and other adverse neonatal outcomes in women with a clinical diagnosis of chorioamnionitis. METHODS: We performed a secondary analysis of a multi-center placebo-controlled trial of vitamins C/E to prevent preeclampsia in low risk nulliparous women. Clinical chorioamnionitis was defined as either the "clinical diagnosis" of chorioamnionitis or antibiotic administration during labor because of an elevated temperature or uterine tenderness in the absence of another cause...
May 23, 2018: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29789925/associations-of-polymorphisms-of-cyp2d6-and-cyp2c9-with-early-onset-severe-pre-eclampsia-and-response-to-labetalol-therapy
#11
Cheng-Juan Sun, Lin Li, Xue-Yan Li, Wei-Yuan Zhang, Xiao-Wei Liu
PURPOSE: Early onset preeclampsia (PPE) contributes to life-threatening maternal complications and fetal demise. Pharmacogenomics is a precision medicine, and metabolizing enzymes responsive to antihypertensive remains understudied. The aim of this study was to evaluate the associations of polymorphisms of cytochrome P450, family 2, subfamily D, polypeptide 6 (CYP2D6) and cytochrome P450, family 2, subfamily C, polypeptide 9 (CYP2C9) with PPE and the relationship among CYP2D6, CYP2C9 polymorphisms and response to labetalol therapy...
May 22, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29786509/-targeted-screening-for-pre-eclampsia-in-the-first-trimester-of-pregnancy-at-toulouse-university-hospital
#12
A Genoux, P Guerby, M Morin, B Perret, C Vayssière, S M Hamdi
GOALS: Preeclampsia (PE) is a leading cause of maternal and neonatal morbidity and mortality. Early treatment by aspirin has been shown to significantly reduce PE risk before 37weeks supporting the implementation of first-trimester screening. SUBJECTS AND METHODS: A targeted screening was recently implemented at Toulouse University Hospital for women in their first pregnancy or those with personal or familial history of PE. It uses Fetal Medicine Foundation (FMF) algorithm that combines maternal characteristics, clinical, biophysical and biochemical (PAPP-A, Pregnancy Associated Plasma Protein-A, and PlGF, Placental Growth Factor) data...
May 18, 2018: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29744013/pregnancy-in-women-with-cardiovascular-diseases
#13
REVIEW
Karolina Adam
Patients with cardiovascular disease represent a significant cohort at risk for complications during pregnancy. The normal physiologic changes of pregnancy could further compromise the hemodynamics of various cardiovascular conditions, resulting in clinical deterioration and even death. The fetus of a gravida with cardiovascular disease also has an increased risk of morbidity, including an increased risk of inherited cardiac genetic disorders, fetal growth restriction, and premature delivery. These complications also increase the risk for antenatal and perinatal mortality...
October 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29743807/self-medication-practice-and-associated-factors-among-pregnant-women-in-addis-ababa-ethiopia
#14
Kidanemariam G/Michael Beyene, Solomon Worku Beza
Background: Self-medication which is the act of obtaining and using one or more medicines without medical supervision is a common practice among pregnant women. Unless proper caution is taken, it may result in maternal and fetal adverse outcomes. In Ethiopia, information on self-medication practice during pregnancy is scanty. Hence, this study aimed to assess self-medication practice and associated factors among pregnant women in government health centers in Addis Ababa. Methods: An institution-based mixed study design using a sequential explanatory approach was employed among 617 pregnant women and nine key informants in Addis Ababa from May 8, 2017, to June 30, 2017...
2018: Tropical Medicine and Health
https://www.readbyqxmd.com/read/29742665/variation-in-the-nulliparous-term-singleton-vertex-cesarean-delivery-rate
#15
Daniel N Pasko, Paula McGee, William A Grobman, Jennifer L Bailit, Uma M Reddy, Ronald J Wapner, Michael W Varner, John M Thorp, Kenneth J Leveno, Steve N Caritis, Mona Prasad, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
OBJECTIVE: To estimate the contributions of patient and health care provider-hospital characteristics to the variation in the frequency of nulliparous, term, singleton, vertex cesarean delivery in a multi-institutional U.S. cohort. METHODS: We performed a secondary analysis of the multicenter Assessment of Perinatal Excellence cohort of 115,502 mother and neonatal pairs who were delivered at 25 hospitals between March 2008 and February 2011. Women met inclusion criteria if they were nulliparous and delivered a singleton in vertex presentation at term...
June 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29734453/female-physicians-in-maternal-fetal-medicine-a-32-year-perspective
#16
Jacquelyn Blackstone, Vanessa K Will, William F Rayburn
OBJECTIVE:  To examine trends of female physicians either pursuing fellowships or in active practice in maternal-fetal medicine (MFM). METHODS:  This observational study examined complete sets of MFM fellows and active members of the Society for Maternal-Fetal Medicine (SMFM) between 1985 and 2016. Databases from SMFM, American College of Obstetricians and Gynecologists (ACOG), and Accreditation Council for Graduate Medical Education were used. Analysis of covariance testing was used to assess interactions over time between groups...
May 7, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29712489/sensitivity-of-prenatal-ultrasound-for-detection-of-trisomy-18
#17
David A Becker, Ying Tang, Adam P Jacobs, Joseph R Biggio, Rodney K Edwards, Akila Subramaniam
OBJECTIVES: To evaluate the sensitivity of prenatal ultrasound (US) for trisomy (T18) diagnosis and describe US findings in a large tertiary care institution in the USA. MATERIALS AND METHODS: This was a retrospective cohort of all T18 cases diagnosed at our institution from October 2004 to October 2014 based on prenatal or postnatal genetic diagnostic testing. We included all women with a fetus affected by T18 who had a comprehensive US by a maternal-fetal medicine specialist performed at our institution...
May 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29709455/the-approach-to-peripartum-management-of-anticoagulation-a-multidisciplinary-survey
#18
Sagar Rohailla, Ann Kinga Malinowski, Shital Gandhi, Anne McLeod, Rosane Nisenbaum, Nadine Shehata
OBJECTIVE: This study sought to determine whether there is practice variation in the treatment and prevention of acute venous thromboembolism (VTE) in pregnant patients, potentially to prioritize future studies. BACKGROUND: The risk of VTE during pregnancy is five-fold that of the non-pregnant state. Guidance is often lacking for the treatment and prophylaxis of VTE because there are few RCTs. METHODS: The study used a cross-sectional study design using a self-administered electronic questionnaire consisting of 11 case scenarios that were sent to hematologists, maternal-fetal medicine specialists, obstetricians and gynaecologists, and internal medicine specialists across Canada...
July 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29705191/society-for-maternal-fetal-medicine-smfm-consult-series-45-mild-fetal-ventriculomegaly-diagnosis-evaluation-and-management
#19
Nathan S Fox, Ana Monteagudo, Jeffrey A Kuller, Sabrina Craigo, Mary E Norton
Ventriculomegaly is defined as dilation of the fetal cerebral ventricles and is a relatively common finding on prenatal ultrasound. The purpose of this document is to review the diagnosis, evaluation, and management of mild fetal ventriculomegaly. When enlargement of the lateral ventricles (≥10 mm) is identified, a thorough evaluation should be performed, including detailed sonographic evaluation of fetal anatomy, amniocentesis for karyotype and chromosomal microarray analysis (CMA), and a workup for fetal infection...
April 26, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29700870/the-cost-effectiveness-of-first-trimester-screening-and-early-preventative-use-of-aspirin-in-women-at-high-risk-of-early-onset-pre-eclampsia
#20
Dayne Ortved, T Lee-Ann Hawkins, Jo-Ann Johnson, Jon Hyett, Amy Metcalfe
OBJECTIVE: Pre-eclampsia (PE) remains a leading cause of maternal and fetal morbidity and mortality. A first trimester screening algorithm predicting the risk of early onset PE has been developed and validated. Early prediction coupled with initiation of aspirin at 11 to 13 weeks in women identified as high risk is effective at reducing the prevalence of early onset PE. The aim of this study is to evaluate the cost-effectiveness of this first trimester screening program coupled with early use of low-dose aspirin in women at high risk of developing early onset PE versus current practice...
April 27, 2018: Ultrasound in Obstetrics & Gynecology
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