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defination of adverse obstetric outcome

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https://www.readbyqxmd.com/read/29986620/effects-of-antenatal-indomethacin-on-ductus-arteriosus-early-closure-and-on-adverse-outcomes-in-preterm-neonates
#1
Daniela Doni, Giuseppe Paterlini, Anna Locatelli, Sara Arnoldi, Maria Chiara Magri, Davide Bernasconi, Maria Grazia Valsecchi, Paolo Emilio Tagliabue
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. Indomethacin is also used in the postnatal age for pharmacologic treatment of patent ductus arteriosus (PDA), but no data concerning the effects of antenatal exposure on postnatal ductal patency are available...
July 9, 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
#2
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
#3
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
#4
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
#5
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
#6
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/society-for-maternal-fetal-medicine-smfm-consult-series-45-mild-fetal-ventriculomegaly-diagnosis-evaluation-and-management
#7
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 (CMA), and a workup for fetal infection...
April 26, 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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/29518643/duration-of-spontaneous-labour-in-low-risk-women-with-normal-perinatal-outcomes-a-systematic-review
#11
REVIEW
Edgardo Abalos, Olufemi T Oladapo, Mónica Chamillard, Virginia Díaz, Julia Pasquale, Mercedes Bonet, Joao Paulo Souza, A Metin Gülmezoglu
BACKGROUND: Despite decades of research, the concept of normality in labour in terms of its progression and duration is not universal or standardized. However, in clinical practice, it is important to define the boundaries that distinguish what is normal from what is abnormal to enable women and care providers have a shared understanding of what to expect and when labour interventions are justified. OBJECTIVES: To synthesise available evidence on the duration of latent and active first stage and the second stage of spontaneous labour in women at low risk of complications with 'normal' perinatal outcomes...
April 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29462628/term-small-for-gestational-age-infants-from-low-risk-women-are-at-significantly-greater-risk-of-adverse-neonatal-outcomes
#12
Jessie V Madden, Christopher J Flatley, Sailesh Kumar
BACKGROUND: Small-for-gestational-age infants (birthweight <0th centile) are at increased risk of perinatal complications but are frequently not identified antenatally, particularly in low-risk women delivering at term (≥37 weeks gestation). This is compounded by the fact that late pregnancy ultrasound is not the norm in many jurisdictions for this cohort of women. We thus investigated the relationship between birthweight <10th centile and serious neonatal outcomes in low-risk women at term...
May 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29455616/is-the-fetal-cerebroplacental-ratio-better-that-the-estimated-fetal-weight-in-predicting-adverse-perinatal-outcomes-in-a-low-risk-cohort
#13
Christopher Flatley, Sailesh Kumar
OBJECTIVE: In high-risk pregnancies combining the cerebro-placental ratio (CPR) with the estimated fetal weight (EFW) improves the identification of vulnerable fetuses. The purpose of this study was to assess the CPR and EFW's ability to predict adverse obstetric and perinatal outcomes in a low-risk pregnancy, when measured late in gestation. METHODS: This was a retrospective study of women who birthed at Mater Mothers Hospitals, Brisbane, Australia between 2010 and 2015...
February 18, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29447091/obesity-in-pregnancy-a-comparison-of-four-national-guidelines
#14
Dana Vitner, Kristin Harris, Cynthia Maxwell, Dan Farine
BACKGROUND: Obesity in pregnancy has become one of the most important challenges in obstetrical care given its prevalence and potential adverse impact on both mother and fetus. The primary objective of this descriptive review is to identify common themes and distinctions within the current recommendations for maternal obesity in the most updated version of four published national guidelines. METHODS: We reviewed the following guidelines for obesity in pregnancy: American College of Obstetricians and Gynecologists (ACOG) 2015, Royal Australian and New Zealand College of Obstetricians and Gynecologists (RANZCOG) 2013, Royal College of Obstetrics and Gynecology (RCOG) 2010, and Society of Obstetrics and Gynecologists of Canada (SOGC) 2010...
February 26, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29447043/re-engineering-the-interpretation-of-electronic-fetal-monitoring-to-identify-reversible-risk-for-cerebral-palsy-a-case-control-series
#15
Mark I Evans, Robert D Eden, David W Britt, Shara M Evans, Barry S Schifrin
BACKGROUND: Even key opinion leaders now concede that electronic fetal monitoring (EFM) cannot reliably identify fetal acidemia which many vouch as the only labor mediated pathophysiologic precursor for cerebral palsy (CP). We have developed the "Fetal Reserve Index" - an algorithm combining five dynamic components of EFM (1. Rate, 2. Variability, 3. Accelerations, 4. Decelerations, and 5. Excessive uterine activity) considered individually that are combined with the presence of: 6...
February 28, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29404743/no-evidence-of-obstetrical-adverse-events-after-hyperimmune-globulin-application-for-primary-cytomegalovirus-infection-in-pregnancy-experience-from-a-single-centre
#16
Loredana Delle Chiaie, Patrick Neuberger, Matthias Vochem, Angela Lihs, Ulrich Karck, Martin Enders
PURPOSE: To determine the frequency of obstetrical adverse events and clinical outcome in infants following antenatal hyperimmune globulin (HIG) treatment for primary cytomegalovirus (CMV) infection in pregnancy. METHODS: Data from 50 women including three twin pregnancies were retrospectively evaluated. Primary infection was defined by seroconversion or the presence of CMV-specific IgM and low IgG avidity. All women received two or more infusions of HIG (200 U/kg)...
June 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29323608/the-association-between-low-50-g-glucose-challenge-test-values-and-adverse-pregnancy-outcomes
#17
Hayan Kwon, Joonho Lee, Byung-Wan Lee, Ja-Young Kwon, Young-Han Kim
BACKGROUND: The implications of low values on the 50 g glucose challenge test (GCT) in pregnancy are not clearly defined. Few studies have evaluated the influence of maternal low GCT values on obstetrical outcomes. This study aimed to compare pregnancy outcomes between women with low 50 g GCT values and those with normal values. MATERIALS AND METHODS: Women undergoing gestational diabetes mellitus screening at 24-28 weeks of gestational age between January 2010 and December 2016 were retrospectively evaluated...
January 11, 2018: Journal of Women's Health
https://www.readbyqxmd.com/read/29291413/impact-of-recommended-changes-in-labor-management-for-prevention-of-the-primary-cesarean-delivery
#18
Claire Thuillier, Sophie Roy, Violaine Peyronnet, Thibaud Quibel, Aurélie Nlandu, Patrick Rozenberg
BACKGROUND: The dramatic rise in cesarean delivery rates worldwide in recent decades, without evidence of a concomitant decrease in cerebral palsy rates, has raised concerns about its potential negative consequences for maternal and infant health. In 2014, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine jointly published an Obstetric Care Consensus for safe prevention of the primary cesarean delivery. OBJECTIVE: We sought to assess whether modification of our protocol to implement these recommendations helped to decrease our primary cesarean delivery rate safely...
March 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29286910/selective-iugr-in-dichorionic-twins-what-can-doppler-assessment-and-growth-discordancy-say-about-neonatal-outcomes
#19
Paola Algeri, Matteo Frigerio, Maria Lamanna, Petya Vitanova Petrova, Sabrina Cozzolino, Maddalena Incerti, Salvatore Andrea Mastrolia, Nadia Roncaglia, Patrizia Vergani
OBJECTIVE: The aim of the present study was to assess, in a population of dichorionic twin pregnancies with selective growth restriction, the effect of inter-twin differences by use of Doppler velocimetry and fetal growth discordancy on perinatal outcomes. METHODS: This was a retrospective study including dichorionic twin pregnancies from January 2008 to December 2015 at the Department of Obstetrics and Gynecology of Fondazione MBBM. Only dichorionic twin pregnancies affected by selective intrauterine growth restriction (IUGR) delivering at ≥24 weeks were included in the study...
December 29, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29277275/towards-standardized-criteria-for-diagnosing-chronic-intervillositis-of-unknown-etiology-a-systematic-review
#20
REVIEW
M Bos, P G J Nikkels, D Cohen, J W Schoones, K W M Bloemenkamp, J A Bruijn, H J Baelde, M L P van der Hoorn, R J Turner
Chronic intervillositis of unknown etiology (CIUE) is a poorly understood, relatively rare condition characterized histologically by the intervillous infiltration of mononuclear cells in the placenta. Clinically, CIUE is associated with poor pregnancy outcome (e.g., impaired fetal growth, preterm birth, fetal death) and high risk of recurrence in subsequent pregnancies. Because CIUE is not defined consistently, it is essential to clearly define this condition. We therefore review the published definitions of CIUE...
January 2018: Placenta
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