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defination of adverse obstetric outcome

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https://www.readbyqxmd.com/read/30209050/effect-of-high-dose-folic-acid-supplementation-in-pregnancy-on-pre-eclampsia-fact-double-blind-phase-iii-randomised-controlled-international-multicentre-trial
#1
Shi Wu Wen, Ruth Rennicks White, Natalie Rybak, Laura M Gaudet, Stephen Robson, William Hague, Donnette Simms-Stewart, Guillermo Carroli, Graeme Smith, William D Fraser, George Wells, Sandra T Davidge, John Kingdom, Doug Coyle, Dean Fergusson, Daniel J Corsi, Josee Champagne, Elham Sabri, Tim Ramsay, Ben Willem J Mol, Martijn A Oudijk, Mark C Walker
OBJECTIVE: To determine the efficacy of high dose folic acid supplementation for prevention of pre-eclampsia in women with at least one risk factor: pre-existing hypertension, prepregnancy diabetes (type 1 or 2), twin pregnancy, pre-eclampsia in a previous pregnancy, or body mass index ≥35. DESIGN: Randomised, phase III, double blinded international, multicentre clinical trial. SETTING: 70 obstetrical centres in five countries (Argentina, Australia, Canada, Jamaica, and UK)...
September 12, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/30184557/occult-placenta-accreta-risk-factors-adverse-obstetrical-outcomes-and-recurrence-in-subsequent-pregnancies
#2
Clodagh Mullen, Ashley N Battarbee, Linda M Ernst, Alan M Peaceman
OBJECTIVE:  To assess the risk factors, adverse obstetrical outcomes, and recurrence risk associated with pathologically diagnosed occult placenta accreta. METHODS:  This was a retrospective observational study of clinically adherent placentas requiring manual extraction that underwent pathological examination. Cases were defined as those with histological evidence of placenta accreta, and controls were defined as those without accreta. All subsequent pregnancies were evaluated to determine the recurrence risk of occult accreta in future pregnancies...
September 5, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/30177079/first-trimester-placental-vascularization-and-angiogenetic-factors-are-associated-with-adverse-pregnancy-outcome
#3
Johanna E W Leijnse, Roel de Heus, Wilco de Jager, Wendy Rodenburg, Louis L H Peeters, Arie Franx, Niels Eijkelkamp
BACKGROUND: Hypertensive disorders, fetal growth restriction and preterm birth are major obstetrical complications and are related to impaired placentation. Early identification of impaired placentation can advance clinical care by preventing or postpone adverse pregnancy outcome. OBJECTIVES: Determine whether sonographic assessed placental vascular development and concomitant changes in inflammation- and/or angiogenesis-related serumproteins differ in the first trimester between uncomplicated pregnancies and pregnancies with adverse outcome...
July 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/30176816/planned-private-homebirth-in-victoria-2000-2015-a-retrospective-cohort-study-of-victorian-perinatal-data
#4
Miranda L Davies-Tuck, Euan M Wallace, Mary-Ann Davey, Vickie Veitch, Jeremy Oats
BACKGROUND: The outcomes for planned homebirth in Victoria are unknown. We aimed to compare the rates of outcomes for high risk and low risk women who planned to birth at home compared to those who planned to birth in hospital. METHODS: We undertook a population based cohort study of all births in Victoria, Australia 2000-2015. Women were defined as being of low or high risk of adverse pregnancy outcomes according to the eligibility criteria for homebirth and either planning to birth at home or in a hospital setting at the at the onset of labour...
September 4, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/30173597/prehypertension-during-pregnancy-and-risk-of-small-for-gestational-age-a-systematic-review-and-meta-analysis
#5
Chunxia Cao, Wei Cai, Xiulong Niu, Jiaxi Fu, Jianmei Ni, Qiong Lei, Jianmin Niu, Xin Zhou, Yuming Li
OBJECTIVE: Emerging evidence shows that high blood pressure level even below 140/90 mmHg during pregnancy is associated with increased risk for maternal and infant complications. The meta-analysis evaluated the associations between prehypertension (blood pressure 120-139/80-89 mmHg) during pregnancy and the risk of small for gestational age (SGA), as well as the impact of prehypertension on birth weight. METHODS: Databases (PubMed, Embase and Cochrane Library) were searched for cohort studies with data on prehypertension in pregnancy and adverse obstetrical outcomes, including small for gestational age (SGA) and/or birth weight...
September 3, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/30152840/the-clinical-prognostic-significance-of-myocardial-performance-index-mpi-in-stable-placental-mediated-disease
#6
I Bhorat, M Pillay, T Reddy
AIM: To determine whether a single elevated myocardial performance index (MPI) value in the third trimester of pregnancy is a marker for later adverse obstetric outcomes in stable placental-mediated disease, defined as well-controlled pre-eclampsia (PE) on a single agent and/or uncompensated intra-uterine growth restriction (IUGR). METHODS: Fifty-five foetuses whose mothers had stable placental-mediated disease, either mild pre-eclampsia controlled on a single agent, and/or uncompensated IUGR in the third trimester, attending the Foetal Unit at Inkosi Albert Luthuli Hospital, Durban, South Africa were prospectively recruited with 55 matched controls...
August 15, 2018: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/30109788/achieving-the-recommended-gestational-weight-gain-in-high-risk-versus-low-risk-pregnancies
#7
Yeela Ben Naftali, Irit Chermesh, Ido Solt, Yolanda Friedrich, Lior Lowenstein
BACKGROUND: Abnormal gestational weight gain (GWG) has been associated with adverse outcomes for mothers and their offspring. OBJECTIVES: To compare the achievement of recommended GWG and lifestyle factors in women with high-risk versus normal-risk pregnancies. METHODS: Pregnant women hospitalized in a gynecological and obstetrics department and pregnant women who arrived at a community clinic for a routine checkup were interviewed and completed questionnaires relating to weight gain and lifestyle factors (e...
July 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/30102428/hospitalisation-in-short-stay-units-for-adults-with-internal-medicine-diseases-and-conditions
#8
REVIEW
Camilla Strøm, Jakob S Stefansson, Maria Louise Fabritius, Lars S Rasmussen, Thomas A Schmidt, Janus C Jakobsen
BACKGROUND: Short-stay units are hospital units that provide short-term care for selected patients. Studies have indicated that short-stay units might reduce admission rates, time of hospital stays, hospital readmissions and expenditure without compromising the quality of care. Short-stay units are often defined by a target patient category, a target function, and a target time frame. Hypothetically, short-stay units could be established as part of any department, but this review focuses on short-stay units that provide care for participants with internal medicine diseases and conditions...
August 13, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/30041771/-hydroxychloroquine-to-obtain-pregnancy-without-adverse-obstetrical-events-in-primary-antiphospholipid-syndrome-french-phase-ii-multicenter-randomized-trial-hydrosapl
#9
A Mekinian, E Vicaut, J Cohen, M Bornes, G Kayem, O Fain
Antiphospholipid syndrome is defined by the presence of thrombosis and/or obstetrical adverse events (≥3 recurrent early miscarriage or fetal death or a prematurity<34 weeks of gestation) associated with persistent antiphospholipid antibodies. The pregnancy outcome has been improved by the conventional treatment (aspirin 100mg/day with low molecular weight heparin [LMWH] from 30 to 75% of uncomplicated pregnancies. In PROMISSE study, 19% of pregnancies had at least one obstetrical adverse event despite treatment (maternal, fetal or neonatal complications) in relation with APS...
July 2018: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/30016929/bleeding-complications-and-antithrombotic-treatment-in-264-pregnancies-in-antiphospholipid-syndrome
#10
C M Yelnik, M Lambert, E Drumez, V Le Guern, J-L Bacri, M M Guerra, C A Laskin, D W Branch, L R Sammaritano, N Morel, G Guettrot-Imbert, D Launay, E Hachulla, P-Y Hatron, J E Salmon, N Costedoat-Chalumeau
Purpose The purpose of this study was to evaluate the safety of antithrombotic treatments prescribed during pregnancy in patients with antiphospholipid syndrome (APS). Methods This international, multicenter study included two cohorts of patients: a retrospective French cohort and a prospective US cohort (PROMISSE study). Inclusion criteria were (1) APS (Sydney criteria), (2) live pregnancy at 12 weeks of gestation (WG) with (3) follow-up data until six weeks post-partum. According to APS standard of care, patients were treated with aspirin and/or low-molecular weight heparin (LMWH) at prophylactic (pure obstetric APS) or therapeutic doses (history of thrombosis)...
September 2018: Lupus
https://www.readbyqxmd.com/read/29986620/effects-of-antenatal-indomethacin-on-ductus-arteriosus-early-closure-and-on-adverse-outcomes-in-preterm-neonates
#11
Daniela Doni, Giuseppe Paterlini, Anna Locatelli, Sara Arnoldi, Maria Chiara Magri, Davide Bernasconi, Maria Grazia Valsecchi, Paolo Emilio Tagliabue
INTRODUCTION: Premature birth is a leading cause of neonatal morbidity and mortality. Since gestational age at birth is the most important predictive factor of adverse neonatal outcomes, strategies to postpone premature labor are of major importance. Studies on tocolytic drugs show that COX inhibitors such as indomethacin are superior to others in terms of efficiency in delaying birth, but results concerning neonatal outcomes associated with prenatal exposure to these drugs show controversial results...
August 13, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29900608/early-labor-cerebroplacental-ratio-assessment-in-uncomplicated-term-pregnancies-and-prediction-of-adverse-perinatal-outcomes-a-prospective-multicentre-study
#12
Andrea Dall'Asta, Tullio Ghi, Giuseppe Rizzo, Annalisa Cancemi, Filomena Aloisio, Domenico Arduini, Giuseppe Pedrazzi, Francesc Figueras, Tiziana Frusca
INTRODUCTION: Doppler ultrasound has recently been suggested to identify subclinical placental functional impairment among normal sized term fetuses. The objective of this study was to evaluate the relationship between cerebroplacental ratio (CPR) measured in early labor and perinatal and delivery outcomes in a cohort of uncomplicated singleton term pregnancies. METHODS: This was a multicentre, prospective, observational study involving three Tertiary Centres. Low risk term pregnancies, as defined by the absence of any maternal morbidity and pregnancy complication and normal ultrasound and clinical screening of the fetal growth in the third trimester, with spontaneous onset of labor were included...
June 13, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29895995/importance-of-adopting-bmi-classifications-using-public-health-action-points-to-delineate-obstetric-risk-factors-resulting-in-worsening-obstetric-outcomes-among-asian-population
#13
Muniswaran Ganeshan, Mohamad Adam Bujang, Shahrul Aiman Soelar, Shamala Devi Karalasingam, Harris Suharjono, Ravichandran Jeganathan
Aims: The aim of this study is to compare obstetric outcomes between overweight and class 1 obesity among pregnant women in their first pregnancy based on WHO's BMI cut-offs and the potential public health action points identified by WHO expert consultations specific for high-risk population such as Asians. Methods: This is a retrospective cohort review of data obtained from the Malaysian National Obstetrics and Gynaecology Registry between the year 2010 and year 2012...
June 2018: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/29866999/kidney-diseases-and-pregnancy-a-multidisciplinary-approach-for-improving-care-by-involving-nephrology-obstetrics-neonatology-urology-diabetology-bioethics-and-internal-medicine
#14
EDITORIAL
Giorgina Barbara Piccoli, Rossella Attini, Gianfranca Cabiddu
This multidisciplinary series is aimed at offering readers many opportunities to appreciate how a clinical and ethical approach to pregnancy has changed in patients with kidney diseases and with related conditions, including diabetes, hypertension, and immunologic diseases. Furthermore, this series aims to focus on the fact that many issues remain unreslved, that there are enormous gaps in knowledge, and that the bioethical approach needs to integrated in the clinical practice, which would allow for a deeper appreciation of different cultural and religious backgrounds...
June 4, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29808136/clinical-report-of-probable-catastrophic-antiphospholipid-syndrome-in-pregnancy
#15
Eryk Hakman, Sasha Mikhael
Background: Catastrophic APS (CAPS) is a rare but life-threatening form of APS defined as multiorgan thrombosis affecting a minimum of three organs with confirmation by histopathology of small vessel occlusions in at least one organ or tissue. The development of CAPS in pregnancy poses many diagnostic challenges as a result of its broad range of clinical presentations and its overlap with other obstetric complications and microangiopathic diseases. Because of the high associated mortality rate, prompt recognition and treatment are paramount...
2018: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29737274/antiepileptic-drug-monitoring-in-pregnancy-empire-a-double-blind-randomised-trial-on-effectiveness-and-acceptability-of-monitoring-strategies
#16
Shakila Thangaratinam, Nadine Marlin, Sian Newton, Annalise Weckesser, Manny Bagary, Lynette Greenhill, Rachel Rikunenko, Maria D'Amico, Ewelina Rogozińska, Andrew Kelso, Kelly Hard, Jamie Coleman, Ngawai Moss, Tracy Roberts, Lee Middleton, Julie Dodds, Angela Pullen, Sandra Eldridge, Alexander Pirie, Elaine Denny, Doug McCorry, Khalid S Khan
BACKGROUND: Pregnant women with epilepsy on antiepileptic drugs (AEDs) may experience a reduction in serum AED levels. This has the potential to worsen seizure control. OBJECTIVE: To determine if, in pregnant women with epilepsy on AEDs, additional therapeutic drug monitoring reduces seizure deterioration compared with clinical features monitoring after a reduction in serum AED levels. DESIGN: A double-blind, randomised trial nested within a cohort study was conducted and a qualitative study of acceptability of the two strategies was undertaken...
May 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29705191/mild-fetal-ventriculomegaly-diagnosis-evaluation-and-management
#17
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, and a workup for fetal infection...
July 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29700098/high-prevalence-of-iodine-deficiency-in-pregnant-women-living-in-adequate-iodine-area
#18
Verônica Carneiro Borges Mioto, Ana Carolina de Castro Nassif Gomes Monteiro, Rosalinda Yossie Asato de Camargo, Andréia Rodrigues Borel, Regina Maria Catarino, Sergio Kobayashi, Maria Cristina Chammas, Suemi Marui
OBJECTIVES: Iodine deficiency during pregnancy is associated with obstetric and neonatal adverse outcomes. Serum thyroglobulin (sTg) and thyroid volume (TV) are optional tools to urinary iodine concentration (UIC) for defining iodine status. This cross-sectional study aims to evaluate the iodine status of pregnant women living in iodine-adequate area by spot UIC and correlation with sTg, TV and thyroid function. METHODS: Two hundred and seventy-three pregnant women were evaluated at three trimesters...
May 2018: Endocrine Connections
https://www.readbyqxmd.com/read/29672829/timing-of-diagnosis-of-gestational-diabetes-and-pregnancy-outcomes-a-retrospective-cohort
#19
Alexis Shub, Tess Chee, Alexandra Templeton, Deborah Boyce, Catharine McNamara, Christine Houlihan, Leonid Churilov, Elizabeth A McCarthy
BACKGROUND: Recent guidelines suggest screening high-risk women in early pregnancy for gestational diabetes (GDM); however, there is little evidence to support this. AIMS: To compare pregnancy outcomes associated with diabetes for women with risk factors for GDM according to gestation of diagnosis. Early GDM was defined as a positive test before 20 weeks gestation, late GDM as a positive test at 20 or more weeks and no GDM when both tests were negative. MATERIALS AND METHODS: Retrospective analysis in an Australian tertiary hospital of women who underwent a glucose tolerance test in pregnancy prior to 20 weeks gestation, and a repeat test after 20 weeks gestation if the initial test was negative...
April 19, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29666409/exposure-to-phthalate-an-endocrine-disrupting-chemical-alters-the-first-trimester-placental-methylome-and-transcriptome-in-women
#20
N M Grindler, L Vanderlinden, R Karthikraj, K Kannan, S Teal, A J Polotsky, T L Powell, I V Yang, T Jansson
Phthalates are known endocrine disruptors and associated with decreased fecundity, pregnancy loss, and adverse obstetrical outcomes, however the underlying mechanisms remain to be established. Environmental factors can influence gene expression and cell function by modifying epigenetic marks, impacting the developing embryo as well as future generations of offspring. The impact of phthalates on placental gene methylation and expression is largely unknown. We studied the effect of maternal phthalate exposure on the human placental DNA methylome and transcriptome...
April 17, 2018: Scientific Reports
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