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adverse obstetric outcome

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https://www.readbyqxmd.com/read/28319128/serious-adverse-neonatal-outcomes-such-as-5-minute-apgar-score-of-zero-and-seizures-or-severe-neurologic-dysfunction-are-increased-in-planned-home-births-after-cesarean-delivery
#1
Amos Grünebaum, Laurence B McCullough, Birgit Arabin, Frank A Chervenak
The United States is with 37,451 home births in 2014 the country with the largest absolute number of home births among all developed countries. The purpose of this study was to examine the occurrence and risks of a 5-minute Apgar score of zero and neonatal seizures or serious neurologic dysfunction in women with a history of prior cesarean delivery for planned home vaginal birth after cesarean (VBAC), compared to hospital VBAC and hospital birth cesarean deliveries for term normal weight infants in the United States from 2007-2014...
2017: PloS One
https://www.readbyqxmd.com/read/28306682/training-future-anesthesiologists-in-obstetric-care
#2
Mauricio Vasco Ramírez
PURPOSE OF REVIEW: In order for the obstetric anesthesiologist to become a true perioperative / peripartum physician, a change in formative programs and certification process in anesthesia are needed. RECENT FINDINGS: Anesthesia training programs are migrating to competency based medical education (CBME) worldwide. The traditional model of attending lectures, grand rounds, reading textbooks and journal papers should be complemented by virtual modalities such as massive open online courses or online teaching tools...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28297592/a-systematized-review-of-atypical-antipsychotics-in-pregnant-women-balancing-between-risks-of-untreated-illness-and-risks-of-drug-related-adverse-effects
#3
Sarah Tosato, Umberto Albert, Simona Tomassi, Felice Iasevoli, Claudia Carmassi, Silvia Ferrari, Maria Giulia Nanni, Alessandra Nivoli, Umberto Volpe, Anna Rita Atti, Andrea Fiorillo
OBJECTIVE: To summarize risks related to (1) illness and (2) second-generation antipsychotic (SGA) treatment in pregnant women and their offspring. Concerning illness-related risks, we focused on bipolar disorder and schizophrenia, psychiatric disorders for which SGAs are preferentially prescribed. DATA SOURCES: PubMed, Ovid, Scopus, PsycINFO, and Cochrane Library were searched from the date of the first available article to October 2015 using the following key terms: pregnancy OR gestation OR bipolar disorder OR schizophrenia...
March 14, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28295207/human-gestation-associated-tissues-express-functional-cytosolic-nucleic-acid-sensing-pattern-recognition-receptors
#4
Aled H Bryant, Georgina E Menzies, Louis M Scott, Samantha Spencer-Harty, Lleucu B Davies, Rachel A Smith, Ruth H Jones, Catherine A Thornton
The role of viral infections in adverse pregnancy outcomes has gained interest in recent years. Innate immune pattern recognition receptors (PRRs) and their signalling pathways that yield a cytokine output in response to pathogenic stimuli have been postulated to link infection at the maternal-fetal interface and adverse pregnancy outcomes. The objective of this study was to investigate the expression and functional response of nucleic acid ligand responsive Toll-like receptors (TLR3, 7, 8 and 9), and retinoic acid-inducible gene 1 (RIG-I)-like receptors (RIG-I, MDA5 and LGP2) in human term gestation-associated tissues (placenta, choriodecidua and amnion) using an explant model...
March 13, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28286688/beneficial-effects-on-pregnancy-outcomes-of-thyroid-hormone-replacement-for-subclinical-hypothyroidism
#5
Norman J Blumenthal, Creswell J Eastman
Background. Hypothyroidism and raised thyroid antibody levels have been associated with adverse obstetrical outcomes. Several studies have investigated causal associations, but results have been inconsistent and few studies have reported the effects of thyroxine replacement therapy on pregnancy outcomes in hypothyroid patients. Objective. The primary study objective was to determine the outcome of pregnancies in women diagnosed with overt and subclinical hypothyroidism (SCH) (serum TSH > 2.5 mIU/L) and those with elevated circulating thyroid autoantibody levels in the first trimester of pregnancy and after the institution of appropriate thyroxine replacement therapy to maintain the serum TSH ≤ 2...
2017: Journal of Thyroid Research
https://www.readbyqxmd.com/read/28286050/the-role-of-maternal-age-in-twin-pregnancy-outcomes
#6
Amelia S McLennan, Cynthia Gyamfi-Bannerman, Cande V Ananth, Jason D Wright, Zainab Siddiq, Mary E D'Alton, Alexander M Friedman
BACKGROUND: There is limited data on how maternal age is related to twin pregnancy outcomes. OBJECTIVE: To assess the relationship between maternal age and risk for preterm birth, fetal death, and neonatal death in the setting of twin pregnancy. STUDY DESIGN: This population-based study of US birth, fetal death, and period linked birth-infant death files from 2007-2013 evaluated neonatal outcomes for twin pregnancies. Maternal age was categorized as 15 to 17, 18 to 24, 25 to 29, 30 to 34, 35 to 39, and ≥40 years of age...
March 9, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28286001/understanding-high-utilization-of-unscheduled-care-in-pregnant-women-of-low-socioeconomic-status
#7
Pooja K Mehta, Tamala Carter, Cjloe Vinoya, Shreya Kangovi, Sindhu K Srinivas
BACKGROUND: Pregnant high utilizers of unscheduled care may be at particular risk for poor perinatal outcomes, but the drivers of this association have not been explored from the patient perspective. PURPOSE: We sought to understand maternal preference for unscheduled hospital-based obstetric care to inform interventions and improve value of publicly funded care during pregnancy. METHODS: We conducted a comparative qualitative analysis of in-depth semistructured interviews...
March 9, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28283105/perinatal-characteristics-and-obstetric-complications-in-mothers-with-multiple-sclerosis-record-linkage-study
#8
Alexander Goldacre, Julia Pakpoor, Michael Goldacre
BACKGROUND: Multiple sclerosis (MS) predominantly onsets in women of reproductive age. The possibility of adverse obstetric and perinatal outcomes is a likely source of concern to pregnant women with MS and their clinicians. We aimed to compare the characteristics of the pregnancies of mothers with or without MS. METHODS: The historical Oxford Record Linkage Study specialised maternity dataset (850,000 people, 1970-1989), with record-linkage between mother and baby, was analysed...
February 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28279637/a-qualitative-exploration-of-how-midwives-and-obstetricians-perception-of-risk-affects-care-practices-for-low-risk-women-and-normal-birth
#9
Sandra Healy, Eileen Humphreys, Catriona Kennedy
BACKGROUND: Maternity care is facing increasing intervention and iatrogenic morbidity rates. This can be attributed, in part, to higher-risk maternity populations, but also to a risk culture in which birth is increasingly seen as abnormal. Technology and intervention are used to prevent perceived implication in adverse outcomes and litigation. QUESTION: Does midwives' and obstetricians' perception of risk affect care practices for normal birth and low-risk women in labour, taking into account different settings? METHODS: The research methods are developed within a qualitative framework...
March 6, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/28277599/pregnancy-complications-after-hysteroscopic-metroplasty-a-ten-year-case-control-study
#10
Alessandro Loddo, Maurizio Nicola D'Alterio, Manuela Neri, Francesca Masala, Fiorenza Lo Cane, Gian Benedetto Melis
INTRODUCTION: Septate uterus is one of the most common congenital uterine anomalies and it may effect female reproductive health causing different obstetric complications, in particular miscarriages and reduction of fertility. MATERIALS AND METHODS: We conducted a retrospective case-control (1:4) comparative study (Canadian Task Force Classification II-2) with the purpose to evaluate pregnancy complications (abnormal fetal presentations, preterm deliveries, and caesarean sections) and reproductive outcome after hysteroscopic metroplasty...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28277382/current-applications-of-big-data-in-obstetric-anesthesiology
#11
Thomas T Klumpner, Melissa E Bauer, Sachin Kheterpal
PURPOSE OF REVIEW: The narrative review aims to highlight several recently published 'big data' studies pertinent to the field of obstetric anesthesiology. RECENT FINDINGS: Big data has been used to study rare outcomes, to identify trends within the healthcare system, to identify variations in practice patterns, and to highlight potential inequalities in obstetric anesthesia care. Big data studies have helped define the risk of rare complications of obstetric anesthesia, such as the risk of neuraxial hematoma in thrombocytopenic parturients...
March 8, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28274149/may-intraperitoneal-irrigation-with-betadine-improve-cesarean-delivery-outcomes-results-of-a-6-years-single-centre-experience
#12
Riccardo Marino, Stella Capriglione, Giulia Morosetti, Silvia Di Angelo Antonio, Andrea Miranda, Marta Pazzola, Salvatore Lopez, Lodovico Patrizi, Roberto Angioli, Paolo Stella
PURPOSE: Cesarean presents increased risk of adverse outcomes, such as endometritis, bacteremia, peritonitis, and maternal fever. This retrospective study aims to evaluate, for the first time in Literature, the effects Betadine washing versus normal saline washing after uterine closure in women undergoing cesarean delivery (CD) at ≥36 gestational weeks. METHODS: Of the 2080 patients identified retrospectively for the analysis at Department of Obstetrics and Gynecology of San Camillo Hospital of Rome, 1042 were assigned to "Betadine group" and 1038 to "No Betadine group"...
March 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28270323/toxicity-and-early-clinical-outcomes-in-cervical-cancer-following-extended-field-helical-tomotherapy-to-para-aortic-lymph-nodes
#13
E Jouglar, L Thomas, A de la Rochefordière, G Noël, M Le Blanc-Onfroy, G Delpon, L Campion, M-A Mahé
PURPOSE: To evaluate toxicity and early disease outcome among patients treated for cervical cancer with extended-field helical tomotherapy to the para-aortic nodes. PATIENTS AND METHODS: Thirty-eight patients (International Federation of Gynecology and Obstetrics [FIGO] stage IB2-IVA) from four institutions received extended-field helical tomotherapy and were retrospectively evaluated. All had nodal disease. Para-aortic lymph nodes were involved in 31 patients. Patients were assessed for toxicity using version 4 of the National Cancer Institute's common terminology criteria for adverse events...
December 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28266776/gestational-age-at-diagnosis-of-early-onset-fetal-growth-restriction-and-impact-on-management-and-survival-a-population-based-cohort-study
#14
I Monier, P-Y Ancel, A Ego, I Guellec, P-H Jarreau, M Kaminski, F Goffinet, J Zeitlin
OBJECTIVE: To investigate the impact of gestational age (GA) at diagnosis of fetal growth restriction (FGR) on obstetric management and rates of live birth and survival for very preterm infants with early-onset FGR. DESIGN: Population-based cohort study. SETTING: All maternity units in 25 French regions in 2011. POPULATION: Fetuses diagnosed with FGR before 28 weeks of gestation among singleton births between 22 and 31 weeks of gestation without severe congenital anomalies...
March 7, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28264638/to-ignore-or-not-to-ignore-placental-calcifications-on-prenatal-ultrasound-a-systematic-review-and-meta-analysis
#15
Fadi G Mirza, Labib M Ghulmiyyah, Hani Tamim, Maha Makki, Dima Jeha, Anwar Nassar
OBJECTIVE: The human placenta is known to calcify with advancing gestational age, and, in fact, the presence of significant calcifications is one of the components of grade III placenta, typical of late gestation. As such, the presence of significant placental calcifications often prompts obstetric providers to expedite delivery. This practice has been attributed, in part, to the presumed association between grade III placenta and adverse pregnancy outcomes. Such approach, however, can be the source of major anxiety and may lead to unnecessary induction of labor, with its associated predisposition to cesarean delivery as well as a myriad of maternal and neonatal morbidities...
March 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28262436/gene-environment-interaction-as-a-predictor-of-early-adjustment-in-first-episode-psychosis
#16
David Fraguas, Covadonga M Díaz-Caneja, Iluminada Corripio, Ana González-Pinto, Antonio Lobo, Miquel Bioque, Manuel J Cuesta, Julio Sanjuán, Elisa Rodríguez-Toscano, Bárbara Arias, Salvador Sarró, Bibiana Cabrera, Antoni Bulbena, Eduard Vieta, Josefina Castro-Fornieles, Celso Arango, Miquel Bernardo, Mara Parellada
BACKGROUND: This study aims to explore the gene-environment interaction hypothesis applied to pre-symptomatic neurodevelopmental phenotypes of first episode psychosis (FEP), that is, genetic factors might increase vulnerability to the effects of environmental adverse conditions occurring at later stages of development. METHODS: We constructed a schematic 'two-hit' model, with Val/Val homozygosity for the catechol-O-methyltransferase (COMT) Val158Met polymorphism as the 'first hit' and history of obstetric complications and parental socioeconomic status as 'second hits'...
March 2, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28255522/opportunities-to-foster-efficient-communication-in-labor-and-delivery-using-simulation
#17
Kay Daniels, Colleen Hamilton, Susan Crowe, Steven S Lipman, Louis P Halamek, Henry C Lee
Introduction Communication errors are an important contributing factor in adverse outcomes in labor and delivery (L&D) units. The objective of this study was to identify common lapses in verbal communication using simulated obstetrical scenarios and propose alternative formats for communication. Methods Health care professionals in L&D participated in three simulated clinical scenarios. Scenarios were recorded and reviewed to identify questions repeated within and across scenarios. Questions that were repeated more than once due to ineffective communication were identified...
January 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28255302/urinary-tract-infections-among-hiv-positive-pregnant-women-in-mwanza-city-tanzania-are-high-and-predicted-by-low-cd4-count
#18
Tito Chaula, Jeremiah Seni, Nhandi Ng'walida, Alphaxaid Kajura, Mariam M Mirambo, Rebekah DeVinney, Stephen E Mshana
Introduction. Urinary tract infection (UTI) among pregnant women can lead to adverse maternal and foetal outcomes. UTI has been widely studied in the general obstetric population in Tanzania; the present study evaluated the magnitude, antimicrobial resistance, and predictors of UTI among HIV-positive pregnant women. Methods. Between March and May 2016 midstream urine samples from 234 women attending prevention of mother to child transmission of HIV (PMTCT) clinics were analyzed using standard methods. Data was analyzed by STATA version 11...
2017: International Journal of Microbiology
https://www.readbyqxmd.com/read/28253893/effect-of-suppressive-acyclovir-administered-to-hsv-2-positive-mothers-from-week-28-to-36%C3%A2-weeks-of-pregnancy-on-adverse-obstetric-outcomes-a-double-blind-randomised-placebo-controlled-trial
#19
Sarah Nakubulwa, Dan K Kaye, Freddie Bwanga, Nazarius Mbona Tumwesigye, Edith Nakku-Joloba, Florence Mirembe
BACKGROUND: Acyclovir (ACV) given to HSV-2 positive women after 36 weeks reduces adverse outcomes but its benefit at lower gestation was undocumented. We determined the effect of oral acyclovir administered from 28 to 36 weeks on premature rupture of membranes (PROM) primarily and preterm delivery risk. METHODS: This was a randomized, double-blind placebo-controlled trial among 200 HSV-2 positive pregnant women at 28 weeks of gestation at Mulago Hospital, Uganda...
March 3, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28252306/-pregnancy-outcomes-in-women-with-gestational-diabetes-specific-subgroups-might-require-increased-attention
#20
V Bartáková, V Ťápalová, K Wágnerová, P Janků, J Bělobrádková, K Kaňková
OBJECTIVES: To compare peri-partal parameters between two groups of pregnant women - with and without gestational diabetes mellitus (GDM), to correlate degree of glucose abnormality with incidence of peri-partal morbidity and, finally, to analyse the potential effect of comorbidities (i.e. obesity, hypertension, thyreopathy, polycystic ovary syndrome, trombophylia, anemia, allergy, smoking) on pregnancy outcomes. DESIGN: Epidemiological observational "case-control" study...
2017: Ceská Gynekologie
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