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https://www.readbyqxmd.com/read/29622577/analysis-of-caesarean-sections-using-robson-10-group-classification-system-in-a-university-hospital-in-eastern-ethiopia-a-cross-sectional-study
#1
Abera Kenay Tura, Olga Pijpers, Myrna de Man, Myrthe Cleveringa, Ingeborg Koopmans, Tadesse Gure, Jelle Stekelenburg
OBJECTIVE: To analyse caesarean section (CS) using Robson 10-group classification system in an Ethiopian university hospital. DESIGN: Cross-sectional study. SETTING: A university hospital in eastern, Ethiopia. PARTICIPANTS: 980 women who underwent CS from January 2016 to April 2017. MAIN OUTCOME: Robson groups (1-10-based on gestational age, fetal presentation, number of fetus, onset of labour and history of CS) and indications for CS...
April 4, 2018: BMJ Open
https://www.readbyqxmd.com/read/29606355/fetal-neuropathology-in-zika-virus-infected-pregnant-female-rhesus-monkeys
#2
Amanda J Martinot, Peter Abbink, Onur Afacan, Anna K Prohl, Roderick Bronson, Jonathan L Hecht, Erica N Borducchi, Rafael A Larocca, Rebecca L Peterson, William Rinaldi, Melissa Ferguson, Peter J Didier, Deborah Weiss, Mark G Lewis, Rafael A De La Barrera, Edward Yang, Simon K Warfield, Dan H Barouch
The development of interventions to prevent congenital Zika syndrome (CZS) has been limited by the lack of an established nonhuman primate model. Here we show that infection of female rhesus monkeys early in pregnancy with Zika virus (ZIKV) recapitulates many features of CZS in humans. We infected 9 pregnant monkeys with ZIKV, 6 early in pregnancy (weeks 6-7 of gestation) and 3 later in pregnancy (weeks 12-14 of gestation), and compared findings with uninfected controls. 100% (6 of 6) of monkeys infected early in pregnancy exhibited prolonged maternal viremia and fetal neuropathology, including fetal loss, smaller brain size, and histopathologic brain lesions, including microcalcifications, hemorrhage, necrosis, vasculitis, gliosis, and apoptosis of neuroprogenitor cells...
March 28, 2018: Cell
https://www.readbyqxmd.com/read/29604064/altered-autonomic-control-of-heart-rate-variability-in-the-chronically-hypoxic-fetus
#3
C J Shaw, B J Allison, N Itani, K J Botting, Y Niu, C C Lees, D A Giussani
Although fetal heart rate variability (FHRV) has long been recognised as a powerful predictor of fetal wellbeing, the mechanisms by which it is reduced in the chronically hypoxic fetus have yet to be established. In particular, the physiological mechanism underlying the reduction of short term variation (STV) in fetal compromise remains unclear. In this study, we present a longitudinal study of the development of autonomic control of FHRV, assessed by indirect indices, time domain (SDNN, RMSSD) and power spectral analysis (LF, HF, LF/HF), in normoxic and chronically hypoxic, chronically catheterised, singleton fetal sheep over the last third of gestation...
March 31, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29593991/uterine-rupture-in-a-primigravid-patient-with-an-unscarred-bicornuate-uterus-at-term
#4
Brad Nitzsche, Maggie Dwiggins, Susan Catt
Background: Uterine rupture of an unscarred primigravid uterus is an exceedingly rare event. Cases of spontaneous rupture of an unscarred bicornuate uterus have been reported, but typically occur in the first or second trimester. Case: A 28-year-old primigravida at 37 weeks gestation with a known bicornuate uterus and no prior surgery underwent an emergent cesarean section after presenting with severe abdominal pain and signs of fetal compromise. She was found to have a uterine rupture with the fetus free in the abdomen accompanied by a large hemoperitoneum...
July 2017: Case Reports in Women's Health
https://www.readbyqxmd.com/read/29566610/histologic-changes-associated-with-placental-separation-in-gilts-infected-with-porcine-reproductive-and-respiratory-syndrome-virus
#5
Predrag Novakovic, Susan E Detmer, Muhammad Suleman, Carol M Malgarin, Daniel J MacPhee, John C S Harding
The placenta is a vital organ providing the developing fetus with nutrient and gas exchange, thermoregulation, and waste elimination necessary for fetal development, as well as producing hormones to maintain pregnancy. It is hypothesized that fetal pig death in porcine reproductive and respiratory syndrome may be attributed to pathology of the maternal-fetal interface leading to premature placental separation. This study was designed to evaluate the chronologic progression of porcine reproductive and respiratory syndrome virus (PRRSV)-induced lesions at the maternal-fetal interface, with particular focus on placental separation in experimentally challenged third-trimester gilts...
January 1, 2018: Veterinary Pathology
https://www.readbyqxmd.com/read/29530740/ductus-arteriosus-and-fetal-echocardiography-implications-for-practice
#6
REVIEW
Silvia G V Alvarez, Angela McBrien
The ductus arteriosus (DA) is a crucial part of the fetal circulation, both in the normal fetus and in critical congenital heart disease (CHD). It allows shunting between the pulmonary and systemic circulations. In physiological prenatal conditions, the DA lets the majority of right ventricular output bypass the fluid-filled, high-resistance lungs. The DA can cause hemodynamic compromise in the fetus and neonate when constricted or absent (in isolation or in patients with CHD) and may lead to pre- or postnatal sequelae within other systems when forming part of a vascular ring...
March 7, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29523603/resolution-of-severe-fetal-distress-following-treatment-of-maternal-diabetic-ketoacidosis
#7
Yang Huang Grace Ng, Tat Xin Ee, Devendra Kanagalingam, Hak Koon Tan
Diabetic ketoacidosis (DKA) during pregnancy is a serious metabolic complication of diabetes with high mortality and morbidity if not detected and treated immediately. We report a case of a woman with type 1 diabetes mellitus who had poorly controlled diabetes in the first half of pregnancy and developed DKA at 29 weeks gestation. At presentation, she had a pathological fetal heart tracing but delivery was delayed for maternal stabilisation and reversal of acidosis. Once hyperglycaemia, acidosis and maternal stabilisation were achieved, fetal compromise resolved and delivery was no longer indicated...
March 9, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29520867/randomised-double-blind-comparison-of-bolus-phenylephrine-or-ephedrine-for-treatment-of-hypotension-in-women-with-pre-eclampsia-undergoing-caesarean-section
#8
M Mohta, S Duggal, G T Chilkoti
Treatment of post-spinal hypotension during caesarean section assumes special concern in pre-eclamptic patients due to a compromised fetoplacental circulation and increased risk of placental hypoperfusion. Phenylephrine and ephedrine are the most commonly used vasopressors, although the best choice is still not clear. We studied 80 pre-eclamptic women with a singleton pregnancy who underwent caesarean section with spinal anaesthesia, and who developed hypotension defined as a decrease in systolic arterial pressure ≥ 20% from baseline or absolute value < 100 mmHg...
March 9, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29516615/home-blood-pressure-monitoring-in-a-hypertensive-pregnant-population-cost-minimisation-study
#9
G Xydopoulos, H Perry, E Sheehan, B Thilaganathan, R Fordham, A Khalil
BACKGROUND: Traditional monitoring of blood pressure in hypertensive pregnant women requires frequent visits to the maternity outpatient services. Home blood-pressure monitoring (HBPM) could offer a cost-saving alternative that is acceptable to patients. The main objective of this study was to undertake a health economic analysis of HBPM compared with traditional monitoring in hypertensive pregnant women. METHODS: This was a case-control study. Cases were pregnant women with hypertension who had HBPM with or without the adjunct of a smartphone app, via a specially designed pathway...
March 8, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29514530/accuracy-of-the-fetal-cerebroplacental-ratio-for-the-detection-of-intrapartum-compromise-in-nonsmall-fetuses
#10
José Morales-Roselló, Asma Khalil, Victoria Fornés-Ferrer, Alfredo Perales-Marín
OBJECTIVE: To study the accuracy of the cerebroplacental ratio (CPR) for the detection of intrapartum fetal compromise (IFC) in fetuses growing over the 10th centile. METHODS: This was a prospective study of 569 nonsmall fetuses attending the day hospital unit of a tertiary hospital that underwent an ultrasound examination at 36-40 weeks, and were delivered within 4 weeks of examination. IFC was defined as a composite of: abnormal intrapartum fetal heart rate or intrapartum fetal scalp pH < 7...
March 7, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29511418/obstetrics-at-decisive-crossroads-regarding-pattern-recognition-of-fetal-heart-rate-decelerations-scientific-principles-and-lessons-from-memetics
#11
REVIEW
Shashikant L Sholapurkar
The survival of cardiotocography (CTG) as a tool for intrapartum fetal monitoring seems threatened somewhat unjustifiably and unwittingly despite the absence of better alternatives. Fetal heart rate (FHR) decelerations are center-stage (most important) in the interpretation of CTG with maximum impact on three-tier classification. The pattern-discrimination of FHR decelerations is inexorably linked to their nomenclature. Unscientific or flawed nomenclature of decelerations can explain the dysfunctional CTG interpretation leading to errors in detection of acidemic fetuses...
April 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29505797/changes-in-gene-expression-following-long-term-in-vitro-exposure-of-macaca-mulatta-trophoblast-stem-cells-to-biologically-relevant-levels-of-endocrine-disruptors
#12
Uros Midic, Benjamin Goheen, Kailey A Vincent, Catherine A VandeVoort, Keith E Latham
Trophoblast stem cells (TSCs) are crucial for embryo implantation and placentation. Environmental toxicants that compromise TSC function could impact fetal viability, pregnancy, and progeny health. Understanding the effects of low, chronic EDC exposures on TSCs and pregnancy is a priority in developmental toxicology. Differences in early implantation between primates and other mammals make a nonhuman primate model ideal. We examined effects of chronic low-level exposure to atrazine, tributyltin, bisphenol A, bis(2-ethylhexyl) phthalate, and perfluorooctanoic acid on rhesus monkey TSCs in vitro by RNA sequencing...
March 2, 2018: Reproductive Toxicology
https://www.readbyqxmd.com/read/29473646/research-review-intergenerational-transmission-of-disadvantage-epigenetics-and-parents-childhoods-as-the-first-exposure
#13
Pamela Scorza, Cristiane S Duarte, Alison E Hipwell, Jonathan Posner, Ana Ortin, Glorisa Canino, Catherine Monk
BACKGROUND: For decades, economists and sociologists have documented intergenerational transmission of socioeconomic disadvantage, demonstrating that economic, political, and social factors contribute to 'inherited hardship'. Drawing on biological factors, the developmental origins of adult health and disease model posits that fetal exposure to maternal prenatal distress associated with socioeconomic disadvantage compromises offspring's neurodevelopment, affecting short- and long-term physical and mental health, and thereby psychosocial standing and resources...
February 23, 2018: Journal of Child Psychology and Psychiatry, and Allied Disciplines
https://www.readbyqxmd.com/read/29468771/home-blood-pressure-monitoring-in-a-hypertensive-pregnant-population
#14
H Perry, E Sheehan, B Thilaganathan, A Khalil
OBJECTIVE: The majority of patients with chronic or gestational hypertension do not develop pre-eclampsia. Home blood-pressure monitoring (HBPM) has the potential to offer a more accurate and acceptable means of monitoring hypertensive patients during pregnancy compared with traditional pathways of frequent outpatient monitoring. The aim of this study was to determine whether HBPM reduces visits to antenatal services and is safe in pregnancy. METHODS: This was a case-control study of 166 hypertensive pregnant women, which took place at St George's Hospital, University of London...
February 22, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29460382/an-algorithm-for-predicting-robin-sequence-from-fetal-mri
#15
Cory M Resnick, Tessa D Kooiman, Carly E Calabrese, David Zurakowski, Bonnie L Padwa, Maarten J Koudstaal, Judy A Estroff
BACKGROUND: Infants with Robin sequence (RS) may present with airway compromise at delivery. Prenatal diagnosis would improve preparation and postnatal care. The purpose of this study was to devise a predictive algorithm for RS based on fetal magnetic resonance imaging (MRI). METHODS: Retrospective case-control study including fetal MRIs from 2002-2017. Inclusion criteria were: (1) MRI of adequate quality, (2) live-born infant, and (3) postnatal evaluation. Subjects were grouped based on postnatal diagnosis: (1) RS (micrognathia, glossoptosis, airway obstruction), (2) micrognathia without airway obstruction ("micrognathia"), (3) cleft lip and palate ("CLP"), and (4) gestational-age-matched controls...
February 19, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29456901/awake-craniotomy-for-the-treatment-of-a-cortical-pseudoaneurysm-in-a-pregnant-patient
#16
Hirad Hedayat, Daniel R Felbaum, John E Reynolds, Rashid M Janjua
Neurosurgical pathologies presenting during pregnancy are uncommon. If present, the situation creates a unique diagnostic, observational, and therapeutic challenge as both lives are placed at potential risk. Surgical procedures during pregnancy are approached carefully as physiological stressors associated with surgery and anesthesia may cause fetal or maternal compromise. We present the only known case of a pseudoaneurysm treated with an awake craniotomy, allowing us to abate the risks associated with general anesthesia in pregnancy...
December 7, 2017: Curēus
https://www.readbyqxmd.com/read/29453123/an-experiential-model-of-education-introduced-to-improve-the-confidence-of-student-midwives-in-undertaking-second-stage-management-of-the-perineum-ssmp
#17
Teresa Arias, Kirstie Coxon
BACKGROUND AND OBJECTIVE: the limited availability of high quality evidence related to second stage management of the perineum (SSMP) combined with a perceived shift in UK practice towards a 'hands off' the perineum/fetal head approach are likely to have impacted significantly on student midwives' understanding of SSMP. This paper presents a classroom based educational session using low fidelity simulation, which was designed in response to student feedback and aimed to improve confidence in this skill...
February 13, 2018: Midwifery
https://www.readbyqxmd.com/read/29437032/computerised-interpretation-of-the-fetal-heart-rate-during-labour-a-randomised-controlled-trial-infant
#18
Peter Brocklehurst, David Field, Keith Greene, Edmund Juszczak, Sara Kenyon, Louise Linsell, Chris Mabey, Mary Newburn, Rachel Plachcinski, Maria Quigley, Philip Steer, Liz Schroeder, Oliver Rivero-Arias
BACKGROUND: Continuous electronic fetal monitoring (EFM) in labour is widely used and computerised interpretation has the potential to increase its utility. OBJECTIVES: This trial aimed to find out whether or not the addition of decision support software to assist in the interpretation of the cardiotocograph (CTG) reduced the number of poor neonatal outcomes, and whether or not it was cost-effective. DESIGN: Two-arm individually randomised controlled trial...
February 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29406989/excessive-fetal-movements-are-a-sign-of-fetal-compromise-which-merits-further-examination
#19
Alexander E P Heazell, Tomasina Stacey, Louise M O'Brien, Edwin A Mitchell, Jane Warland
Changes in fetal movement are associated with increased risk of stillbirth after 28 weeks of pregnancy. The majority of studies have focussed on maternal perception of reduced fetal movements, which is associated with stillbirth via placental dysfunction. Recent studies have also described an association between a single episode of excessive fetal movements and late stillbirth. We present a hypothesis that a sudden episode of excessive fetal activity indicates fetal compromise relating to underlying disturbance of the in utero environment, which if it persists can lead to fetal death...
February 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29405479/persistent-extreme-hyperextension-of-the-fetal-neck-clinical-and-neuroimaging-findings
#20
Shai Shrot, Clark T Johnson, W Christopher Golden, Ahmet A Baschat, Janine E Bullard, Aylin Tekes, Andrea Poretti, Emily Dunn, Thierry A G M Huisman
BACKGROUND AND PURPOSE: Persistent hyperextension of the fetal craniocervical junction or neck is one of several fetal positions commonly observed on prenatal imaging. Underlying fetal structural etiologies such as fetal neck masses and iniencephaly can be detected as causes of hyperextension. Caesarean delivery is considered in cases of vaginal delivery or obstructed labor for fear of cervical spinal cord injury. In this case series, we describe the prenatal magnetic resonance imaging (MRI) findings and their potential role in obstetric management and discuss postnatal outcomes in fetuses demonstrating prenatal imaging findings of persistent extreme hyperextension of the neck...
February 5, 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
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