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defination of adverse obstetric outcome

Sara Tavares, João Cavaco-Gomes, Marina Moucho, Milton Severo, Mário Mateus, Carla Ramalho, Gerard H A Visser, Nuno Montenegro
Objective The objective of this study was to assess possible day-night differences in perinatal and maternal labor outcomes in a hospital setting with no day-night differences in the presence of experienced medical staff. Design This was a retrospective study conducted over 5 years between 2008 and 2012. Setting This study was set at the obstetric delivery unit in a tertiary hospital. Population A total of 9,143 singleton deliveries were assessed after 34 weeks of gestation and after exclusion of major congenital malformations, inductions of labor, and elective cesarean sections...
October 27, 2016: American Journal of Perinatology
Eran Weiner, Letizia Schreiber, Ehud Grinstein, Ohad Feldstein, Noa Rymer-Haskel, Jacob Bar, Michal Kovo
OBJECTIVE: We aimed to compare obstetric outcome and placental-histopathology in pregnancies complicated by preeclampsia with severe features with and without HELLP syndrome. METHODS: Labor, maternal characteristics, neonatal outcome and placental histopathology of pregnancies complicated with severe preeclampsia during 2008-2015 were reviewed. Results were compared between those without signs of HELLP syndrome (severe preeclampsia group) and those with concomitant HELLP syndrome (HELLP group)...
November 2016: Placenta
Lynn M Yee, Grecio Sandoval, Jennifer Bailit, Uma M Reddy, Ronald J Wapner, Michael W Varner, Steve N Caritis, Mona Prasad, Alan T N Tita, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
OBJECTIVE: To describe factors associated with delayed pushing and evaluate the relationship between delayed pushing and perinatal outcomes in nulliparous women with singleton term gestations. METHODS: This was a secondary analysis of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Assessment of Perinatal Excellence cohort of 115,502 women and their neonates born in 25 U.S. hospitals from 2008 to 2011. Nulliparous women with singleton, cephalic, nonanomalous term births who achieved 10-cm cervical dilation were included...
November 2016: Obstetrics and Gynecology
Azeez Butali, Chinyere Ezeaka, Osayame Ekhaguere, Nancy Weathers, Jenna Ladd, Iretiola Fajolu, Christopher Esezobor, Christian Makwe, Bukola Odusanya, Rose Anorlu, Wasiu Adeyemo, Edna Iroha, Mathias Egri-Okwaji, Prisca Adejumo, Lawal Oyeneyin, Moses Abiodun, Bolaji Badejoko, Kelli Ryckman
INTRODUCTION: Preterm birth is a dire complication of pregnancy that poses huge long-term medical and financial burdens for affected children, their families, and the health care system. The aim of the present study was to identify characteristics associated with preterm births at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria from 2011 to 2013. METHODS: We obtained Information from 5,561 maternal, fetal/neonatal and obstetric records from the labor ward...
2016: Pan African Medical Journal
G Ducellier, P Moussy, L Sahmoune, S Bonneau, E Alanio, J-P Bory
OBJECTIVE: Prenatal diagnosis of complex laparoschisis is difficult and yet it is associated with a significantly increased morbidity and mortality. The aim of the study was to define ultrasonographic factor and obstetrical criteria to predicting adverse neonatal outcome. METHODS: Retrospective cohort study over 10 years, of 35 gastroschisis cases in CHU of Reims (France). The primary outcome was the neonatal death due to gastroschisis. The sonographic markers was bowel dilatation intra- or extra-abdominale, amniotic fluid, intra-uterin growth...
September 2016: Gynécologie, Obstétrique & Fertilité
Louise E Glover, Blair Fennimore, Mary Wingfield
The incidence and prevalence of inflammatory bowel disease (IBD) continues to rise with time, signifying its emergence as a global disease. Clinical onset of IBD, comprising Crohn's disease and ulcerative colitis, typically occurs before or at peak reproductive age. Although active disease in female patients is associated with reduced fertility and adverse obstetric outcomes in pregnancy, the molecular mechanisms underlying this altered reproductive course, and its impact on IBD transmission to offspring, remain poorly understood...
November 2016: Inflammatory Bowel Diseases
Nynke de Groot, Angélica A Venekamp, Hanneke W Torij, Mijke P Lambregtse-Van den Berg, Gouke J Bonsel
INTRODUCTION: pregnancy care for vulnerable women is often perceived as a burden by caregivers as vulnerable clients require complex case management, additional time, and more often show adverse perinatal outcomes. Vulnerable clients bring about additional work strain for the caregiver, especially when the workload is high. We define client vulnerability as coexistence of psychopathology, psychosocial problems or substance use, together with features of deprivation. We investigated, as part of a national programme, whether the subjective caregiver's perception of workload and the objective registry-based caseload of vulnerable clients are in agreement, and whether a structured organisation of antenatal risk management reduces the burden associated with the perceived workload, in particular if the objective caseload is high...
September 2016: Midwifery
Eric Barbarite, Shahrose Hussain, Anna Dellarole, Mohamed Samy Elhammady, Eric Peterson
Hemodynamic changes during pregnancy may favor the formation and rupture of intracranial aneurysms. Despite this risk, guidelines for managing intracranial aneurysms during pregnancy have not been clearly defined. The objective of this review is to describe the treatment options for pregnant women with intracranial aneurysms, and to report the maternal and fetal outcomes associated with different treatment strategies. A search of the literature was conducted using the PubMed database for the period January 1991 through June 2015...
2016: Turkish Neurosurgery
Supuni Kapurubandara, Sarah Melov, Evangeline Shalou, Indika Alahakoon
BACKGROUND: Consanguinity defined as the sexual union between two related individuals has been previously an infrequent practice in Australia, but recently there has been migration from countries with widespread practice of consanguinity. There is limited and conflicting evidence in the literature that suggests consanguinity to be associated with adverse obstetric outcomes. AIM: To assess the effect of consanguinity on perinatal outcomes. MATERIALS AND METHODS: A retrospective analysis of singleton births over a ten-year period at an Australian tertiary hospital...
December 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Simeon-Pierre Choukem, Tsi Njim, Julius Atashili, Julian P Hamilton-Shield, Robinson Mbu
BACKGROUND AND AIMS: High birth weight (HBW) increases the risk of maternal and fetal morbidity and mortality. Its prevalence and adverse outcomes may be reduced if risk factors are identified and managed during pregnancy. The cut-off value for HBW remains debatable. The objectives of this study were to identify the optimal cut-off value and determine the prevalence, predictors and adverse outcomes of HBW in a suburban area of Cameroon. DESIGN: A 6-year retrospective register analysis and a 3-month prospective phase...
2016: BMJ Open
Andrea Busnelli, Alessio Paffoni, Luigi Fedele, Edgardo Somigliana
BACKGROUND: Thyroid autoimmunity (TAI) is the most frequent autoimmune condition and the first cause of thyroid dysfunction among women of reproductive age. Notably, it has been associated with adverse obstetric outcomes during all trimesters of pregnancy. Furthermore, since most studies show an increased prevalence of TAI among women attending infertility clinics, a detrimental impact of this condition on natural fertility and on the rate of success of assisted reproductive techniques has been suggested...
June 20, 2016: Human Reproduction Update
Oya Demirci, Ertuğrul Yılmaz, Özgür Tosun, Pınar Kumru, Arzu Arınkan, Didar Mahmutoğlu, Selçuk Selçuk, Zehra Nihal Dolgun, Resul Arısoy, Emre Erdoğdu, Nazan Tarhan
BACKGROUND: Young maternal age is variously defined in studies of its effect on obstetrics and perinatal outcomes. Also, pregnancy has been reported as the leading cause of death in adolescent girls in low- and middle-income countries. AIMS: The aim of the study was to evaluate whether young maternal age was associated with an increased risk of obstetrics and perinatal adverse outcomes. STUDY DESIGN: Case-control study. METHODS: This case-control study was derived from a database of the medical records between January 2008 and December 2012...
May 2016: Balkan Medical Journal
Elizabeth M McClure, Robert L Goldenberg, Alan H Jobe, Menachem Miodovnik, Marion Koso-Thomas, Pierre Buekens, Jose Belizan, Fernando Althabe
The Global Network's Antenatal Corticosteroids Trial (ACT), was a multi-country, cluster-randomized trial to improve appropriate use of antenatal corticosteroids (ACS) in low-resource settings in low-middle income countries (LMIC). ACT substantially increased ACS use in the intervention clusters, but the intervention failed to show benefit in the targeted < 5th percentile birth weight infants and was associated with increased neonatal mortality and stillbirth in the overall population. In this issue are six papers which are secondary analyses related to ACT that explore potential reasons for the increase in adverse outcomes overall, as well as site differences in outcomes...
2016: Reproductive Health
Ahmed M Soliman, Machaon Bonafede, Amanda M Farr, Jane Castelli-Haley, Craig Winkel
BACKGROUND: Endometriosis affects over 10 million women in the United States. Depot leuprolide acetate (LA), a gonadotropin-releasing hormone agonist, has been used extensively for the treatment of women with endometriosis but is associated with hypoestrogenic symptoms and bone mineral density loss. The concomitant use of add-back therapies, specifically norethindrone acetate (NETA), can alleviate these adverse effects. OBJECTIVE: To compare adherence to and persistence with LA treatment and time to endometriosis-related surgery among women treated with NETA and women treated with LA plus other add-back therapies or LA only...
May 2016: Journal of Managed Care & Specialty Pharmacy
Justin S Brandt, Jamie A Bastek, Eileen Wang, Stephanie Purisch, Nadav Schwartz
OBJECTIVES: Previous studies have demonstrated an association between adverse obstetric outcomes, such as preterm birth, and in utero inflammation. The fetal thymus, which can be visualized in the anterior mediastinum on obstetric sonography, may involute in response to such inflammation and thus may identify pregnancies at increased risk for these outcomes. We therefore sought to determine whether second-trimester fetal thymus measurements are associated with preterm birth. METHODS: Transabdominal fetal thymus measurements were prospectively obtained in singleton pregnancies at gestational ages of 18 weeks to 23 weeks 6 days during a 5-month period...
May 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Ping Ling Yeoh, Klaus Hornetz, Maznah Dahlui
BACKGROUND: The purpose of antenatal care is to monitor and improve the wellbeing of the mother and foetus. The World Health Organization recommends risk-oriented strategy that includes: (i) routine care to all women, (ii) additional care for women with moderately severe diseases and complications, (iii) specialised obstetrical and neonatal care for women with severe diseases and complications. Antenatal care is concerned with adequate care in order to be effective. Measurement for adequacy of antenatal care often applies indexes that assess initiation of care and number of visits...
2016: PloS One
William A Grobman, Jennifer Bailit, Yinglei Lai, Uma M Reddy, Ronald J Wapner, Michael W Varner, Steve N Caritis, Mona Prasad, Alan T N Tita, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
OBJECTIVE: To estimate the associations between the duration of active pushing during the second stage of labor and maternal and neonatal outcomes. METHODS: We performed an observational study in which data were obtained by trained abstractors from maternal and neonatal charts of deliveries at 25 hospitals over a 3-year period. In this secondary analysis, women with no prior cesarean delivery who had a term, singleton, cephalic gestation and reached complete dilation were analyzed...
April 2016: Obstetrics and Gynecology
Thomas von Hösslin, Paul Imboden, Andreas Lüthi, Marta J Rozanski, Thomas W Schnider, Miodrag Filipovic
BACKGROUND: Thoracic epidural analgesia is a well established technique for postoperative pain relief after major abdominal and thoracic surgery. Safety remains a major concern because of serious adverse events including epidural haematoma, abscess and permanent neurological deficit. OBJECTIVE: The aim of this study was to evaluate the incidence and the long-term outcome of serious adverse events associated with thoracic epidural analgesia. DESIGN: Retrospective cohort study...
October 2016: European Journal of Anaesthesiology
Jane Elizabeth Norman, Neil Marlow, Claudia-Martina Messow, Andrew Shennan, Phillip R Bennett, Steven Thornton, Stephen C Robson, Alex McConnachie, Stavros Petrou, Neil J Sebire, Tina Lavender, Sonia Whyte, John Norrie
BACKGROUND: Progesterone administration has been shown to reduce the risk of preterm birth and neonatal morbidity in women at high risk, but there is uncertainty about longer term effects on the child. METHODS: We did a double-blind, randomised, placebo-controlled trial of vaginal progesterone, 200 mg daily taken from 22-24 to 34 weeks of gestation, on pregnancy and infant outcomes in women at risk of preterm birth (because of previous spontaneous birth at ≤34 weeks and 0 days of gestation, or a cervical length ≤25 mm, or because of a positive fetal fibronectin test combined with other clinical risk factors for preterm birth [any one of a history in a previous pregnancy of preterm birth, second trimester loss, preterm premature fetal membrane rupture, or a history of a cervical procedure to treat abnormal smears])...
May 21, 2016: Lancet
Michael Tien, Dionne F Peacher, Amber M Franz, Shawn Y Jia, Ashraf S Habib
Objective To report on the failure rate of spinal catheters placed following inadvertent dural puncture (IDP) compared with re-sited epidural catheters in the obstetric population. Research design and methods Patients who experienced IDP during epidural or combined spinal epidural placement with 17 or 18 gauge Tuohy needles for labor analgesia between 2003 and 2014 were identified using our post-dural puncture headache (PDPH) database. Patients were categorized into two groups: those who had spinal catheters inserted and those who had epidural catheters re-sited...
May 2016: Current Medical Research and Opinion
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