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defination of adverse obstetric outcome

María Carolina Silva, Alvaro Sepúlveda-Martínez, Rodolfo Guíñez, María Teresa Haye, Mauro Parra-Cordero
BACKGROUNDS/AIMS: To assess the perinatal outcome of pregnancies with chorionic bump detected at the first trimester of pregnancy. METHODS: This was a nested case-control study of pregnancies with chorionic bump identified at the first trimester ultrasound that was performed from October 2014 and October 2016. The control group consisted of the following 5 unaffected pregnancies after each case. From the first trimester ultrasound, maternal and perinatal characteristics were obtained and stored in a dedicated database...
November 2, 2018: Gynecologic and Obstetric Investigation
Beth A Payne, Helen Ryan, Jeffrey Bone, Laura A Magee, Alice B Aarvold, J Mark Ansermino, Zulfiqar A Bhutta, Mary Bowen, J Guilherme Cecatti, Cynthia Chazotte, Tim Crozier, Anne-Cornélie J M de Pont, Oktay Demirkiran, Tao Duan, Marlot Kallen, Wessel Ganzevoort, Michael Geary, Dena Goffman, Jennifer A Hutcheon, K S Joseph, Stephen E Lapinsky, Isam Lataifeh, Jing Li, Sarka Liskonova, Emily M Hamel, Fionnuala M McAuliffe, Colm O'Herlihy, Ben W J Mol, P Gareth R Seaward, Ramzy Tadros, Turkan Togal, Rahat Qureshi, U Vivian Ukah, Daniela Vasquez, Euan Wallace, Paul Yong, Vivian Zhou, Keith R Walley, Peter von Dadelszen
BACKGROUND: Intensive care unit (ICU) outcome prediction models, such as Acute Physiology And Chronic Health Evaluation (APACHE), were designed in general critical care populations and their use in obstetric populations is contentious. The aim of the CIPHER (Collaborative Integrated Pregnancy High-dependency Estimate of Risk) study was to develop and internally validate a multivariable prognostic model calibrated specifically for pregnant or recently delivered women admitted for critical care...
October 30, 2018: Critical Care: the Official Journal of the Critical Care Forum
Aleksandra Antovic, Maria Sennström, Katarina Bremme, Elisabet Svenungsson
The present clinical and laboratory classification criteria for antiphospholipid syndrome (APS) were established in Sydney, Australia, in 2006. In this review, we focus on the obstetric subset of APS (OAPS), defined by persistent positivity for antiphospholipid antibodies together with either early recurrent pregnancy loss, early fetal death, stillbirth or premature birth <34 gestational weeks due to pre-eclampsia, eclampsia and placental insufficiency. It is important to diagnose these cases since most women suffering from OAPS can, when given appropriate treatment, have successful pregnancies...
2018: Lupus Science & Medicine
M T Ferguson, A T Dennis
Peri-operative anaemia is a significant risk factor for morbidity and mortality. Anaemia during pregnancy is associated with adverse maternal and neonatal outcomes, and postpartum haemorrhage remains a leading cause of maternal mortality worldwide. Caesarean section is an operation incurring moderate risk of bleeding, and rates are rising globally. Recent international consensus guidelines recommend targeting a pre-operative haemoglobin > 130 g.l-1 for all patients having surgery with moderate-to-high risk of bleeding, regardless of sex...
October 16, 2018: Anaesthesia
Jeanette M Olsen
OBJECTIVE: To identify pregnancy risk factors and outcomes associated with a woman's history of adverse childhood experiences (ACEs) and summarize what is known about routine screening for ACEs as part of prenatal care. DATA SOURCES: The Academic Search Premier, Academic Search Complete, CINAHL, Health Source: Nursing Academic Edition, MEDLINE, PsychINFO, and PubMed databases were searched. The terms adverse childhood experiences or ACEs, trauma informed care, and childhood trauma were each paired individually with the terms pregnancy or pregnant or prenatal or antenatal or perinatal or maternal; obstetrics; and maternal-child health...
November 2018: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
Benjamin A Kamala, Hege L Ersdal, Ingvild Dalen, Muzdalifat S Abeid, Matilda M Ngarina, Jeffrey M Perlman, Hussein L Kidanto
BACKGROUND: Intrapartum Fetal Heart Rate (FHR) monitoring is crucial for the early detection of abnormal FHR, facilitating timely obstetric interventions and thus the potential reduction of adverse perinatal outcomes. We explored midwifery practices of intrapartum FHR monitoring pre and post implementation of a novel continuous automatic Doppler device (the Moyo). METHODOLOGY: A pre/post observational study among low-risk pregnancies at a tertiary hospital was conducted from March to December 2016...
2018: PloS One
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
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
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
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
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 (BP) 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 (BP 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 (BW). METHODS: Databases (PubMed, Embase, and Cochrane Library) were searched for cohort studies with data on prehypertension in pregnancy and adverse obstetrical outcomes, including SGA and/or BW...
September 25, 2018: Journal of Maternal-fetal & Neonatal Medicine
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
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
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
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
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
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
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
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
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
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