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https://www.readbyqxmd.com/read/28351027/re-thinking-elective-single-embryo-transfer-increased-risk-of-monochorionic-twinning-a-systematic-review
#1
Margaret Dziadosz, Mark I Evans
BACKGROUND/OBJECTIVES: Multiple pregnancies have tripled in the United States over the past 3 decades. Attributed to increasing maternal age at delivery but more so assisted reproductive technological advances, an effort has been made to decrease twinning through elective single embryo transfer. We sought to review and evaluate risks of monochorionic twinning as a predictable consequence of increasing utilization of elective single embryo transfer on perinatal outcomes. Primary outcomes included twinning rates, fetal anomalies, growth, preterm birth, and mortality...
March 29, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28350838/function-and-failure-of-the-fetal-membrane-modelling-the-mechanics-of-the-chorion-and-amnion
#2
Stefaan W Verbruggen, Michelle L Oyen, Andrew T M Phillips, Niamh C Nowlan
The fetal membrane surrounds the fetus during pregnancy and is a thin tissue composed of two layers, the chorion and the amnion. While rupture of this membrane normally occurs at term, preterm rupture can result in increased risk of fetal mortality and morbidity, as well as danger of infection in the mother. Although structural changes have been observed in the membrane in such cases, the mechanical behaviour of the human fetal membrane in vivo remains poorly understood and is challenging to investigate experimentally...
2017: PloS One
https://www.readbyqxmd.com/read/28346925/microbiota-and-necrotizing-enterocolitis
#3
Sanjay Patole
Necrotizing enterocolitis (NEC) is an acquired gastrointestinal inflammatory condition with significant mortality and morbidity in preterm very low birth weight infants. The interplay between toll-like receptors, bacterial endotoxins, developmentally regulated excessive proinflammatory responses of the immature innate immune system, hypoxia, ischemia, reperfusion, free radicals, and the presence of substrates and bacterial endotoxins is thought to play an important role in the pathogenesis of NEC. The association (cause?) of various microbes (bacteria, viruses, and fungi) with NEC has intrigued researchers for many years...
2017: Nestlé Nutrition Institute Workshop Series
https://www.readbyqxmd.com/read/28343600/comparison-of-late-mortality-among-twins-versus-singletons-with-congenital-heart-defects
#4
Anne Maria Herskind, Lisbeth Aagaard Larsen, Dorthe Almind Pedersen, Kaare Christensen
In 2014, in the United States, nearly 7% of newborns were twins. Congenital heart defects (CHDs) are more frequent in both monozygotic and dizygotic twins than in singletons. Still, the longer-term prognosis for CHD twins is unknown. Here we assess the mortality pattern for CHD twins up to age 36 years and compare it with that for non-CHD twins, non-CHD co-twins, and CHD singletons. We identified all twins and a 5% random sample of all singletons born in Denmark from 1977 to 2009 by linking Danish national population and health registers...
March 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28343557/infants-born-to-opioid-dependent-women-in-ontario-2002-2014
#5
Susan B Brogly, Suzanne Turner, Katherine Lajkosz, Greg Davies, Adam Newman, Ana Johnson, Kimberly Dow
BACKGROUND: There is a paucity of data characterizing mother-infant pairs with prenatal opioid dependence in Canada. We therefore conducted a study of relevant births in Ontario from 2002 to 2014. METHODS: We used data from the Institute for Clinical Evaluative Sciences, the linked databases of coded population-based Ontario health services records. Differences in characteristics of opioid-dependent mother-neonate pairs and infant hospital costs by year were assessed using linear regression, and we calculated rates of preterm birth, low birth weight, birth defects, mortality, and neonatal abstinence syndrome...
March 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28341800/variability-in-very-preterm-stillbirth-and-in-hospital-mortality-across-europe
#6
Elizabeth S Draper, Bradley N Manktelow, Marina Cuttini, Rolf F Maier, Alan C Fenton, Patrick Van Reempts, Anna-Karin Bonamy, Jan Mazela, Klaus Bᴓrch, Corinne Koopman-Esseboom, Heili Varendi, Henrique Barros, Jennifer J Zeitlin
BACKGROUND AND OBJECTIVE: Stillbirth and in-hospital mortality rates associated with very preterm births (VPT) vary widely across Europe. International comparisons are complicated by a lack of standardized data collection and differences in definitions, registration, and reporting. This study aims to determine what proportion of the variation in stillbirth and in-hospital VPT mortality rates persists after adjusting for population demographics, case-mix, and timing of death. METHODS: Standardized data collection for a geographically defined prospective cohort of VPTs (22(+0)-31(+6) weeks gestation) across 16 regions in Europe...
March 24, 2017: Pediatrics
https://www.readbyqxmd.com/read/28333939/maintenance-nifedipine-therapy-for-preterm-symptomatic-placenta-previa-a-randomized-multicenter-double-blind-placebo-controlled-trial
#7
Eric Verspyck, Claire de Vienne, Charles Muszynski, Michael Bubenheim, Isabella Chanavaz-Lacheray, Michel Dreyfus, Philippe Deruelle, Jacques Benichou
OBJECTIVE: To assess the impact of maintenance nifedipine therapy on pregnancy duration in women with preterm placenta previa bleeding. METHODS: PPADAL was a randomized, double-blind, placebo-controlled trial conducted between 05/2008 and 05/2012 in five French hospitals. The trial included 109 women, aged ≥ 18 years, with at least one episode of placenta previa bleeding, intact membranes and no other pregnancy complication, at gestational age 24 to 34 weeks and after 48 hours of complete acute tocolysis...
2017: PloS One
https://www.readbyqxmd.com/read/28332298/impact-of-maternal-obesity-on-very-preterm-infants
#8
Rubia Khalak, Asha Rijhsinghani, Sarah E McCallum
OBJECTIVE: Infants born at less than  34 weeks' gestational age are at higher risk for morbidity and mortality. Data are limited on the impact of maternal obesity on the very preterm infant. This study reviewed whether maternal obesity further increases the intensive care needs of very preterm infants of less than 34 weeks' gestation. METHODS: Maternal and neonatal data for live-born singleton births of 23 0/7 to 33 6/7 weeks' gestation delivering in upstate New York were reviewed...
March 22, 2017: Obesity
https://www.readbyqxmd.com/read/28329897/maternal-labor-delivery-and-perinatal-outcomes-associated-with-placental-abruption-a-systematic-review
#9
Katheryne L Downes, Katherine L Grantz, Edmond D Shenassa
Objective Risk factors for placental abruption have changed, but there has not been an updated systematic review investigating outcomes. Methods We searched PubMed, EMBASE, Web of Science, SCOPUS, and CINAHL for publications from January 1, 2005 through December 31, 2016. We reviewed English-language publications reporting estimated incidence and/or risk factors for maternal, labor, delivery, and perinatal outcomes associated with abruption. We excluded case studies, conference abstracts, and studies that lacked a referent/comparison group or did not clearly characterize placental abruption...
March 22, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28325581/prenatal-prediction-of-pulmonary-hypoplasia
#10
REVIEW
Jourdan E Triebwasser, Marjorie C Treadwell
Pulmonary hypoplasia, although rare, is associated with significant neonatal morbidity and mortality. Conditions associated with pulmonary hypoplasia include those which limit normal thoracic capacity or movement, including skeletal dysplasias and abdominal wall defects; those with mass effect, including congenital diaphragmatic hernia and pleural effusions; and those with decreased amniotic fluid, including preterm, premature rupture of membranes, and genitourinary anomalies. The ability to predict severe pulmonary hypoplasia prenatally aids in family counseling, as well as obstetric and neonatal management...
March 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28321847/antenatal-corticosteroids-for-accelerating-fetal-lung-maturation-for-women-at-risk-of-preterm-birth
#11
REVIEW
Devender Roberts, Julie Brown, Nancy Medley, Stuart R Dalziel
BACKGROUND: Respiratory morbidity including respiratory distress syndrome (RDS) is a serious complication of preterm birth and the primary cause of early neonatal mortality and disability. While researching the effects of the steroid dexamethasone on premature parturition in fetal sheep in 1969, Liggins found that there was some inflation of the lungs of lambs born at gestations at which the lungs would be expected to be airless. Liggins and Howie published the first randomised controlled trial in humans in 1972 and many others followed...
March 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28318214/preterm-labor-prevention-and-management
#12
Kristen Rundell, Bethany Panchal
In the United States, preterm delivery is the leading cause of neonatal morbidity and is the most common reason for hospitalization during pregnancy. The rate of preterm delivery (before 37 weeks' gestation) has been declining since 2007. Clinical diagnosis of preterm labor is made if there are regular contractions and concomitant cervical change. Less than 10% of women with a clinical diagnosis of preterm labor will deliver within seven days of initial presentation. Women with a history of spontaneous preterm delivery are 1...
March 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28316639/feature-extraction-and-classification-of-ehg-between-pregnancy-and-labour-group-using-hilbert-huang-transform-and-extreme-learning-machine
#13
Lili Chen, Yaru Hao
Preterm birth (PTB) is the leading cause of perinatal mortality and long-term morbidity, which results in significant health and economic problems. The early detection of PTB has great significance for its prevention. The electrohysterogram (EHG) related to uterine contraction is a noninvasive, real-time, and automatic novel technology which can be used to detect, diagnose, or predict PTB. This paper presents a method for feature extraction and classification of EHG between pregnancy and labour group, based on Hilbert-Huang transform (HHT) and extreme learning machine (ELM)...
2017: Computational and Mathematical Methods in Medicine
https://www.readbyqxmd.com/read/28316097/improved-postnatal-care-is-needed-to-maintain-gains-in-neonatal-survival-after-the-implementation-of-the-helping-babies-breathe-initiative
#14
J Wrammert, A Kc, U Ewald, M Målqvist
AIM: Helping Babies Breathe (HBB) is a neonatal resuscitation protocol proven to reduce intrapartum-related mortality in low-income settings. The aim of this study was to describe the timing and causes of neonatal in-hospital deaths before and after HBB training at a maternity health facility in Nepal. METHODS: A prospective cohort study was conducted at the facility between July 2012 and September 2013. All 137 staff, including medical doctors and midwives, were trained in January 2013...
March 17, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28303276/a-parameterized-ultrasound-based-finite-element-analysis-of-the-mechanical-environment-of-pregnancy
#15
Andrea R Westervelt, Michael Fernandez, Michael House, Joy Vink, Chia-Ling Nhan-Chang, Ronald Wapner, Kristin M Myers
Preterm birth is the leading cause of childhood mortality, and can lead to health risks in survivors. The mechanical function of the uterus, fetal membranes, and cervix have dynamic roles to protect the fetus during gestation. To understand their mechanical function and relation to preterm birth, we built a 3-dimensional parameterized finite element model of pregnancy. This model is generated by an automated procedure that is informed by maternal ultrasound measurements. A baseline model at 25 weeks of gestation was characterized, and to visualize the impact of cervical structural parameters on tissue stretch we evaluated the model sensitivity to: (1) anterior uterocervical angle, (2) cervical length, (3) posterior cervical offset, and (4) cervical stiffness...
March 17, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28294506/changes-in-management-policies-for-extremely-preterm-births-and-neonatal-outcomes-from-2003-to-2012-two-population-based-studies-in-10-european-regions
#16
M Bonet, M Cuttini, A Piedvache, E M Boyle, P H Jarreau, L Kollée, R F Maier, D W A Milligan, P Van Reempts, T Weber, H Barros, J Gadzinowki, E S Draper, J Zeitlin
OBJECTIVE: to investigate changes in maternity and neonatal unit policies towards extremely preterm infants (EPTI) between 2003 and 2012 and concurrent trends in their mortality and morbidity in ten European regions. DESIGN: population-based cohort studies in 2003 (MOSAIC study) and 2011/12 (EPICE study) and questionnaires from hospitals. SETTING: 70 hospitals in ten European regions. POPULATION: infants born at <27 weeks of gestational age (GA) in hospitals participating in both the MOSAIC and EPICE studies (1240 in 2003, 1293 in 2011/2012)...
March 14, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28293548/age-appropriate-functions-and-dysfunctions-of-the-neonatal-neutrophil
#17
REVIEW
Shelley Melissa Lawrence, Ross Corriden, Victor Nizet
Neonatal and adult neutrophils are distinctly different from one another due to well-defined and documented deficiencies in neonatal cells, including impaired functions, reduced concentrations of microbicidal proteins and enzymes necessary for pathogen destruction, and variances in cell surface receptors. Neutrophil maturation is clearly demonstrated throughout pregnancy from the earliest hematopoietic precursors in the yolk sac to the well-developed myeloid progenitor cells in the bone marrow around the seventh month of gestation...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28292463/key-players-of-the-necroptosis-pathway-ripk1-and-sirt2-are-altered-in-placenta-from-preeclampsia-and-fetal-growth-restriction
#18
Natalie J Hannan, Sally Beard, Natalie K Binder, Kenji Onda, Tu'uhevaha J Kaitu'u-Lino, Qi Chen, Laura Tuohey, Manarangi De Silva, Stephen Tong
INTRODUCTION: Preeclampsia (PE) and fetal growth restriction (FGR) are among the leading causes of perinatal morbidity and mortality. Placental insufficiency is central to these conditions. The mechanisms underlying placental insufficiency are poorly understood. Apoptosis has long been considered the only form of regulated cell death, recent research has identified an alternate process of programmed cell death known as necroptosis [1]. Necroptosis is distinct from apoptosis, relying on the deacetylase sirtuin-2 [2], receptor interacting kinases RIPK1 and 3, and the pseudokinase MLKL [3]...
March 2017: Placenta
https://www.readbyqxmd.com/read/28291893/predictive-accuracy-of-serial-transvaginal-cervical-lengths-and-quantitative-vaginal-fetal-fibronectin-levels-for-spontaneous-preterm-birth-among-nulliparous-women
#19
M Sean Esplin, Michal A Elovitz, Jay D Iams, Corette B Parker, Ronald J Wapner, William A Grobman, Hyagriv N Simhan, Deborah A Wing, David M Haas, Robert M Silver, Matthew K Hoffman, Alan M Peaceman, Steve N Caritis, Samuel Parry, Pathik Wadhwa, Tatiana Foroud, Brian M Mercer, Shannon M Hunter, George R Saade, Uma M Reddy
Importance: Spontaneous preterm birth is a leading cause of infant mortality. Prediction, largely based on prior pregnancy outcomes, is not possible in women pregnant for the first time. Objective: To assess the accuracy of universal screening to predict spontaneous preterm birth in nulliparous women using serial measurements of vaginal fetal fibronectin levels and cervical length. Design, Settings, and Participants: A prospective observational cohort study of nulliparous women with singleton pregnancies, from 8 clinical sites across the United States between October 2010 and May 2014...
March 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28291053/safety-of-tenofovir-disoproxil-fumarate-based-antiretroviral-therapy-regimens-in-pregnancy-for-hiv-infected-women-and-their-infants-a-systematic-review-and-meta-analysis
#20
Jean B Nachega, Olalekan A Uthman, Lynne M Mofenson, Jean R Anderson, Steve Kanters, Francoise Renaud, Nathan Ford, Shaffiq Essajee, Meg C Doherty, Edward J Mills
BACKGROUND: There are limited data on adverse effects of tenofovir disoproxil fumarate (TDF)-based antiretroviral therapy (ART) on pregnant women and their infants. METHODS: We conducted a systematic review of studies published between January 1980 and January 2017 that compared adverse outcomes in HIV-infected women receiving TDF- vs. non-TDF-based ART during pregnancy. The relative risk for associations was pooled using a fixed-effects model. RESULTS: Sixteen studies met study inclusion criteria...
March 10, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
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