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Maternal fetal medicine

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https://www.readbyqxmd.com/read/29240547/implementing-cdc-s-level-of-care-assessment-tool-locate-a-national-collaboration-to-improve-maternal-and-child-health
#1
Andrea Catalano, Amanda Bennett, Ashley Busacker, Alethia Carr, David Goodman, Charlan Kroelinger, Ekwutosi Okoroh, Mary Brantley, Wanda Barfield
Perinatal regionalization, or risk-appropriate care, is an approach that classifies facilities based on capabilities to ensure women and infants receive care at a facility that aligns with their risk. The CDC designed the Levels of Care Assessment Tool (LOCATe) to assist jurisdictions working in risk-appropriate care in assessing a facility's level of maternal and neonatal care aligned with the most current American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine (ACOG/SMFM) and American Academy of Pediatrics (AAP) guidelines...
December 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/29215645/cherchez-la-femme-maternal-incidental-findings-can-explain-discordant-prenatal-cell-free-dna-sequencing-results
#2
REVIEW
Diana W Bianchi
Circulating DNA fragments in a pregnant woman's plasma derive from three sources: placenta, maternal bone marrow, and fetus. Prenatal sequencing to noninvasively screen for fetal chromosome abnormalities is performed on this mixed sample; results can therefore reflect the maternal as well as the fetoplacental DNA. Although it is recommended that pretest counseling include the possibility of detecting maternal genomic imbalance, this seldom occurs. Maternal abnormalities that can affect a prenatal screening test result include disorders that affect the size and metabolism of DNA, such as B12 deficiency, autoimmune disease, and intrahepatic cholestasis of pregnancy...
December 7, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29193867/improved-safety-margin-for-embryotoxicity-in-rats-for-the-new-endoperoxide-artefenomel-oz439-as-compared-to-artesunate
#3
Robert L Clark, Tammye L Edwards, Monica Longo, Joseph Kinney, Don K Walker, Jon Rhodes, Sally A Clode, Thomas Rückle, Timothy Wells, Nicole Andenmatten, Anna Christine Huber
BACKGROUND: Combination medicines including an artemisinin are the mainstay of antimalarial therapy. Artemisinins are potent embryotoxicants in animal species due to their trioxane moiety. METHODS: As part of its development, the new synthetic trioxolane antimalarial artefenomel (OZ439) was tested in rat whole embryo culture and in rat embryo-fetal toxicity studies with dosing throughout organogenesis or with a single dose on Gestational Day (GD) 12. The single-dose studies included groups treated with artesunate to allow a direct comparison of the embryotoxicity of the two antimalarials and included toxicokinetics hematology and histological examination of embryos...
November 28, 2017: Birth Defects Research
https://www.readbyqxmd.com/read/29193244/an-efficient-sequence-for-fetal-brain-imaging-at-3t-with-enhanced-t1-contrast-and-motion-robustness
#4
Giulio Ferrazzi, Anthony N Price, Rui Pedro A G Teixeira, Lucilio Cordero-Grande, Jana Hutter, Ana Gomes, Francesco Padormo, Emer Hughes, Torben Schneider, Mary Rutherford, Maria Kuklisova Murgasova, Joseph V Hajnal
PURPOSE: Ultrafast single-shot T2 -weighted images are common practice in fetal MR exams. However, there is limited experience with fetal T1 -weighted acquisitions. This study aims at establishing a robust framework that allows fetal T1 -weighted scans to be routinely acquired in utero at 3T. METHODS: A 2D gradient echo sequence with an adiabatic inversion was optimized to be robust to fetal motion and maternal breathing optimizing grey/white matter contrast at the same time...
November 28, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/29191448/adverse-perinatal-outcomes-associated-with-crown-rump-length-discrepancy-in-in%C3%A2-vitro-fertilization-pregnancies
#5
Kristy Cho, Caitlin Dunne, Arianne Y K Albert, Jon C Havelock
OBJECTIVE(S): To determine whether an association exists between small crown-rump length (CRL) and adverse obstetrical outcomes in pregnancies conceived by IVF and to compare a CRL reference based on IVF pregnancies to a reference based on spontaneous pregnancies. DESIGN: Retrospective cohort study. CRL was classified as small by comparing it with the local university hospital maternal fetal medicine standard and the Monash IVF reference chart. SETTING: University-affiliated fertility center...
November 28, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29190847/adverse-maternal-and-neonatal-outcomes-in-indicated-compared-with-spontaneous-preterm-birth-in-healthy-nulliparas-a-secondary-analysis-of-a-randomized-trial
#6
Alan T Tita, Lindsay Doherty, Jim M Roberts, Leslie Myatt, Kenneth J Leveno, Michael W Varner, Ronald J Wapner, John M Thorp, Brian M Mercer, Alan Peaceman, Susan M Ramin, Marshall W Carpenter, Jay Iams, Anthony Sciscione, Margaret Harper, Jorge E Tolosa, George R Saade, Yoram Sorokin
No abstract text is available yet for this article.
November 30, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/29183819/smfm-special-report-reducing-racial-and-ethnic-disparities-in-maternal-morbidity-and-mortality-a-call-to-action
#7
Joses A Jain, Lorene A Temming, Mary E D'Alton, Cynthia Gyamfi-Bannerman, Methodius Tuuli, Judette M Louis, Sindhu K Srinivas, Aaron B Caughey, William A Grobman, Mark Hehir, Elizabeth Howell, George R Saade, Alan T N Tita, Laura E Riley
Racial and ethnic disparities in maternal morbidity and mortality are an important public health problem in the United States. As racial and ethnic minorities are expected to comprise over one half of the U.S. population by 2050, this issue that must be urgently addressed. Research suggests that the drivers of health disparities occur at three levels: patient, provider, and system. Although we have recognized this issue and identified elements that contribute to it, knowledge must be converted into action to address it...
November 25, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29155504/cervical-funneling-or-intra-amniotic-debris-and-preterm-birth-among-nulliparous-women-with-a-midtrimester-cervical-length-less-than-30-mm
#8
George R Saade, Elizabeth A Thom, William A Grobman, Jay D Iams, Brian M Mercer, Uma M Reddy, Alan T N Tita, Dwight J Rouse, Yoram Sorokin, Ronald J Wapner, Kenneth J Leveno, Sean C Blackwell, M Sean Esplin, Jorge E Tolosa, John M Thorp, Steve N Caritis, J Peter VanDorsten
OBJECTIVE: To evaluate whether the presence of cervical funneling or intra-amniotic debris identified in the second trimester is associated with higher rates of preterm birth (PTB) in asymptomatic nulliparous women with a midtrimester cervical length (CL) less than 30 mm (i.e., less than the 10(th) percentile). METHODS: A secondary cohort analysis of a multicenter trial of women between 16 and 22 weeks with a singleton gestation and a CL less than 30 mm by transvaginal ultrasound randomized to either 17-alpha hydroxyprogesterone caproate or placebo...
November 20, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29142784/the-value-of-implementing-multidisciplinary-perinatal-care-conference-in-the-private-practice-setting
#9
Robert C Johnston, Sina Haeri, Richard T Hale, William Lindsley, Annette McCormick, Eric Su
Objective  The objective of this study was to estimate the impact of multidisciplinary (Multi-D) perinatal care conference (PCC) implementation in the private practice setting. Methods  After the initial 12-month period following implementation of the monthly PCC by private maternal-fetal medicine and neonatology practitioners, conference attendees were asked to completed a modified version of the Attitudes Toward Health Care Teams Scale, involving 19 questions assessing their attitudes and opinions toward Multi-D team care on a five-point Likert's scale...
October 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29141482/obstetric-practice-guidelines-labor-s-love-lost
#10
Wayne R Cohen, Emanuel A Friedman
Implementation of clinical practice guidelines may moderate health care costs, improve care, reduce medicolegal liability, and provide a uniformity in care allowing meaningful investigation of treatments and outcomes. However, new guidelines are often uncritically embraced by clinicians, risk management organizations, insurance companies, and the courts as the standard of care. Adoption of incompletely vetted recommendations can lead to patient harm. Recent recommendations made by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine for assessment and management of labor provide an example of well-intended guidelines adopted uncritically...
November 15, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29138035/defining-failed-induction-of-labor
#11
William A Grobman, Jennifer Bailit, Yinglei Lai, Uma M Reddy, Ronald J Wapner, Michael W Varner, John M Thorp, Kenneth J Leveno, Steve N Caritis, Mona Prasad, Alan T N Tita, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
BACKGROUND: While there are well-accepted standards for the diagnosis of arrested active-phase labor, the definition of a "failed" induction of labor remains less certain. One approach to diagnosing a failed induction is based on the duration of the latent phase. However, a standard for the minimum duration that the latent phase of a labor induction should continue, absent acute maternal or fetal indications for cesarean delivery, remains lacking. OBJECTIVE: The objective of this study was to determine the frequency of adverse maternal and perinatal outcomes as a function of the duration of the latent phase among nulliparous women undergoing labor induction...
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29129033/infant-safe-sleep-a-survey-of-the-knowledge-attitudes-and-behaviors-of-obstetric-physicians
#12
Nichole L Hodges, Sarah E Anderson, Lara B McKenzie, Mira L Katz
Obstetricians may be a pregnant woman's primary professional source of information about her infant prior to the birth, but infant safe sleep knowledge, attitudes and behaviors of this population are unknown. This study explores obstetric physicians' knowledge, attitudes, and behaviors related to Sudden Infant Death Syndrome and infant safe sleep and identifies barriers as well as enabling and/or reinforcing factors associated with providing infant safe sleep education in the prenatal environment. A cross-sectional survey was conducted with obstetric physicians who provide prenatal healthcare to women in Ohio...
November 11, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/29120459/informative-priors-on-fetal-fraction-increase-power-of-the-noninvasive-prenatal-screen
#13
Hanli Xu, Shaowei Wang, Lin-Lin Ma, Shuai Huang, Lin Liang, Qian Liu, Yang-Yang Liu, Ke-Di Liu, Ze-Min Tan, Hao Ban, Yongtao Guan, Zuhong Lu
PurposeNoninvasive prenatal screening (NIPS) sequences a mixture of the maternal and fetal cell-free DNA. Fetal trisomy can be detected by examining chromosomal dosages estimated from sequencing reads. The traditional method uses the Z-test, which compares a subject against a set of euploid controls, where the information of fetal fraction is not fully utilized. Here we present a Bayesian method that leverages informative priors on the fetal fraction.MethodOur Bayesian method combines the Z-test likelihood and informative priors of the fetal fraction, which are learned from the sex chromosomes, to compute Bayes factors...
November 9, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29120454/hospital-volume-and-cesarean-delivery-among-low-risk-women-in-a-nationwide-sample
#14
M A Clapp, K E James, A Melamed, J L Ecker, A J Kaimal
OBJECTIVE: We sought to determine if hospital delivery volume was associated with a patient's risk for cesarean delivery in low-risk women. STUDY DESIGN: This study retrospectively examines a cohort of 1 657 495 deliveries identified in the 2013 Nationwide Readmissions Database. Hospitals were stratified by delivery volume quartiles. Low-risk patients were identified using the Society for Maternal-Fetal Medicine definition (n=845 056). A multivariable logistic regression accounting for hospital-level clustering was constructed to assess the factors affecting a patient's odds for cesarean delivery...
November 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29115686/inner-volume-echo-volumar-imaging-ivevi-for-robust-fetal-brain-imaging
#15
Rita G Nunes, Giulio Ferrazzi, Anthony N Price, Jana Hutter, Andreia S Gaspar, Mary A Rutherford, Joseph V Hajnal
PURPOSE: Fetal functional MRI studies using conventional 2-dimensional single-shot echo-planar imaging sequences may require discarding a large data fraction as a result of fetal and maternal motion. Increasing the temporal resolution using echo volumar imaging (EVI) could provide an effective alternative strategy. Echo volumar imaging was combined with inner volume (IV) imaging (IVEVI) to locally excite the fetal brain and acquire full 3-dimensional images, fast enough to freeze most fetal head motion...
November 8, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/29112649/racial-and-ethnic-differences-in-utilization-of-labor-management-strategies-intended-to-reduce-cesarean-delivery-rates
#16
Lynn M Yee, Maged M Costantine, Madeline Murguia Rice, Jennifer Bailit, Uma M Reddy, Ronald J Wapner, Michael W Varner, John M Thorp, Steve N Caritis, Mona Prasad, Alan T N Tita, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
OBJECTIVE: To examine whether racial and ethnic differences exist in the frequency of and indications for cesarean delivery and to assess whether application of labor management strategies intended to reduce cesarean delivery rates is associated with patient's race and ethnicity. METHODS: This is a secondary analysis of a multicenter observational obstetric cohort. Trained research personnel abstracted maternal and neonatal records of greater than 115,000 pregnant women from 25 hospitals (2008-2011)...
November 3, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29107981/prevalence-and-risk-factors-of-monochorionic-diamniotic-twinning-after-assisted-reproduction-a-six-year-experience-base-on-a-large-cohort-of-pregnancies
#17
Bing Song, Zhao-Lian Wei, Xiao-Feng Xu, Xue Wang, Xiao-Jin He, Huan Wu, Ping Zhou, Yun-Xia Cao
OBJECTIVE: To characterize the incidence and risk factors for monochorionic diamniotic(MC-DA) twinning after assisted reproductive technologies (ART). DESIGN: Retrospective population-based study. SETTING: The study was conducted in China; Department of Reproductive Medicine Center at The First Affiliated Hospital of Anhui Medical University. POPULATION: A cohort of 8860 clinical pregnancies after embryo transfer (ET) carried out in our center between 2011 and 2016 were retrospectively analyzed for the incidence of MC-DA twinning...
2017: PloS One
https://www.readbyqxmd.com/read/29102503/maternal-hemodynamics-a-method-to-classify-hypertensive-disorders-of-pregnancy
#18
Enrico Ferrazzi, Tamara Stampalija, Lorenzo Monasta, Daniela Di Martino, Sharona Vonck, Wilfried Gyselaers
BACKGROUND: The classification of hypertensive disorders of pregnancy is based on the time at the onset of hypertension, proteinuria, and other associated complications. Maternal hemodynamic interrogation in hypertensive disorders of pregnancy considers not only the peripheral blood pressure but also the entire cardiovascular system, and it might help to classify the different clinical phenotypes of this syndrome. OBJECTIVE: This study aimed to examine cardiovascular parameters in a cohort of patients affected by hypertensive disorders of pregnancy according to the clinical phenotypes that prioritize fetoplacental characteristics and not the time at onset of hypertensive disorders of pregnancy...
November 2, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29101225/weighing-the-social-and-ethical-considerations-of-maternal-fetal-surgery
#19
Ryan M Antiel, Alan W Flake, Christopher A Collura, Mark P Johnson, Natalie E Rintoul, John D Lantos, Farr A Curlin, Jon C Tilburt, Stephen D Brown, Chris Feudtner
OBJECTIVES: The ethics of maternal-fetal surgery involves weighing the importance of potential benefits, risks, and other consequences involving the pregnant woman, fetus, and other family members. We assessed clinicians' ratings of the importance of 9 considerations relevant to maternal-fetal surgery. METHODS: This study was a discrete choice experiment contained within a 2015 national mail-based survey of 1200 neonatologists, pediatric surgeons, and maternal-fetal medicine physicians, with latent class analysis subsequently used to identify groups of physicians with similar ratings...
November 3, 2017: Pediatrics
https://www.readbyqxmd.com/read/29100260/a-comparison-of-the-nulliparous-term-singleton-vertex-and-society-of-maternal-fetal-medicine-cesarean-birth-metrics-based-on-hospital-size
#20
Laurence E Shields, Suzan Walker, Herman L Hedriana, Suzanne Wiesner, Barbara Pelletreau, Jane Hitti, Thomas J Benedetti
No abstract text is available yet for this article.
November 3, 2017: American Journal of Perinatology
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