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https://www.readbyqxmd.com/read/29774532/the-fetus-at-the-tipping-point-modifying-the-outcome-of-fetal-asphyxia
#1
Simerdeep K Dhillon, Christopher A Lear, Robert Galinsky, Guido Wassink, Joanne O Davidson, Sandra Juul, Nicola J Robertson, Alistair J Gunn, Laura Bennet
Brain injury around birth is associated with nearly half of all cases of cerebral palsy. Although brain injury is multifactorial, particularly after preterm birth, acute hypoxia-ischaemia is a major contributor to injury. It is now well established that the severity of injury after HI is determined by a dynamic balance between injurious and protective processes. In addition, mothers who are at risk of premature delivery have high rates of diabetes and antepartum infection/inflammation and are almost universally given treatments such as antenatal glucocorticoids and magnesium sulphate to reduce the risk of death and complications after preterm birth...
May 17, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29768662/immersion-in-water-during-labour-and-birth
#2
REVIEW
Elizabeth R Cluett, Ethel Burns, Anna Cuthbert
BACKGROUND: Water immersion during labour and birth is increasingly popular and is becoming widely accepted across many countries, and particularly in midwifery-led care settings. However, there are concerns around neonatal water inhalation, increased requirement for admission to neonatal intensive care unit (NICU), maternal and/or neonatal infection, and obstetric anal sphincter injuries (OASIS). This is an update of a review last published in 2011. OBJECTIVES: To assess the effects of water immersion during labour and/or birth (first, second and third stage of labour) on women and their infants...
May 16, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29757389/manual-handling-of-burdens-as-a-predictor-of-birth-outcome-a-finnish-birth-register-study
#3
Emma Kwegyir-Afful, Reeta Lamminpää, Tuomas Selander, Mika Gissler, Katri Vehviläinen-Julkunen, Seppo Heinonen, Markku Sallmen, Kimmo Räsänen
Background: Negative effects of manual handling of burdens on pregnancy outcomes are not elucidated in Finland. This study examines the association between perinatal outcomes and occupational exposure to manual handling of burdens. Methods: The study cohort was identified from the Finnish Medical Birth Register (MBR, 1997-2014) and information on exposure from the Finnish job-exposure matrix (FINJEM) 1997-2009. The cohort included all singleton births of mothers who were classified as 'service and care workers' representing the exposure group (n=74 286) and 'clerks' as the reference (n=13 873)...
May 10, 2018: European Journal of Public Health
https://www.readbyqxmd.com/read/29753526/prenatally-versus-postnatally-diagnosed-congenital-diaphragmatic-hernia-side-stage-and-outcome
#4
Carmen Mesas Burgos, Björn Frenckner, Matias Luco, Matthew T Harting, Pamela A Lally, Kevin P Lally
AIM: To compare outcomes between prenatally and postnatally diagnosed CDH in a large multicenter database of prospectively collected data and evaluate factors associated with poorer outcome for prenatally diagnosed CDH. MATERIAL AND METHODS: We used information from the multicenter, multinational CDH Study Group database on patients born between 2007 and 2015. We compared differences between prenatally and postnatally diagnosed CDH with respect to survival, side, size, ECMO needs, associated major cardiac malformations and liver position...
April 14, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29694344/elective-induction-of-labor-at-39-weeks-among-nulliparous-women-the-impact-on-maternal-and-neonatal-risk
#5
Rachel G Sinkey, Jasmin Lacevic, Tea Reljic, Iztok Hozo, Kelly S Gibson, Anthony O Odibo, Benjamin Djulbegovic, Charles J Lockwood
OBJECTIVE: Optimal management of pregnancies at 39 weeks gestational age is unknown. Therefore, we sought to perform a comparative effectiveness analysis of elective induction of labor (eIOL) at 39 weeks among nulliparous women with non-anomalous singleton, vertex fetuses as compared to expectant management (EM) which included IOL for medical or obstetric indications or at 41 weeks in undelivered mothers. MATERIALS AND METHODS: A Monte Carlo micro-simulation model was constructed modeling two mutually exclusive health states: eIOL at 39 weeks, or EM with IOL for standard medical or obstetrical indications or at 41 weeks if undelivered...
2018: PloS One
https://www.readbyqxmd.com/read/29686009/influence-of-gestational-age-at-initiation-of-antihypertensive-therapy-secondary-analysis-of-chips-trial-data-control-of-hypertension-in-pregnancy-study
#6
Anouk Pels, Ben Willem J Mol, Joel Singer, Terry Lee, Peter von Dadelszen, Wessel Ganzevoort, Elizabeth Asztalos, Laura A Magee
For hypertensive women in CHIPS (Control of Hypertension in Pregnancy Study), we assessed whether the maternal benefits of tight control could be achieved, while minimizing any potentially negative effect on fetal growth, by delaying initiation of antihypertensive therapy until later in pregnancy. For the 981 women with nonsevere, chronic or gestational hypertension randomized to less-tight (target diastolic blood pressure, 100 mm Hg), or tight (target, 85 mm Hg) control, we used mixed-effects logistic regression to examine whether the effect of less-tight (versus tight) control on major outcomes was dependent on gestational age at randomization, adjusting for baseline factors as in the primary analysis and including an interaction term between gestational age at randomization and treatment allocation...
April 23, 2018: Hypertension
https://www.readbyqxmd.com/read/29681506/the-effect-of-very-advanced-maternal-age-on-maternal-and-neonatal-outcomes-a-systematic-review
#7
Jordana Leader, Amrit Bajwa, Andrea Lanes, Xiaolin Hua, Ruth Rennicks White, Natalie Rybak, Mark Walker
OBJECTIVE: To summarize information on the maternal and perinatal outcomes among pregnant women with a maternal age greater or equal to 45 years old compared with women with a maternal age of less than 45. METHODS: A comprehensive systematic search of online databases from January 1946 through June 2015 was completed. The maternal outcomes were: fetal loss, preterm birth, full-term birth, complications of pregnancy, the type of delivery, and periconception hemorrhage...
April 19, 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29661217/barriers-to-access-and-utilization-of-emergency-obstetric-care-at-health-facilities-in-sub-saharan-africa-a-systematic-review-protocol
#8
Ayele Geleto, Catherine Chojenta, Abdulbasit Mussa, Deborah Loxton
BACKGROUND: Nearly 15% of all pregnancies end in fatal perinatal obstetric complications including bleeding, infections, hypertension, obstructed labor, and complications of abortion. Between 1990 and 2015, an estimated 10.7 million women died due to obstetric complications. Almost all of these deaths (99%) happened in developing countries, and 66% of maternal deaths were attributed to sub-Saharan Africa. The majority of cases of maternal mortalities can be prevented through provision of evidence-based potentially life-saving signal functions of emergency obstetric care...
April 16, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29627351/placental-growth-factor-informed-management-of-suspected-pre-eclampsia-or-fetal-growth-restriction-the-mapple-cohort-study
#9
Andrew Sharp, Lucy C Chappell, Gustaaf Dekker, Sanja Pelletier, Yves Garnier, Onur Zeren, Katharina M Hillerer, Thorsten Fischer, Paul T Seed, Mark Turner, Andrew H Shennan, Zarko Alfirevic
OBJECTIVES: Placental Growth Factor (PlGF) has been shown to be beneficial in diagnosing pre-eclampsia. We performed a prospective cohort study of revealed PlGF in standard clinical use in four teaching hospitals in UK, Germany, Austria and Australia. STUDY DESIGN: Clinical data from women with suspected pre-eclampsia or fetal growth restriction <35 weeks' gestation with revealed PlGF measurement were collected (MAPPLE study). MAIN OUTCOME MEASURES: Data were compared to the PELICAN study (PlGF concealed)...
March 26, 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29618484/evaluating-the-process-and-outcomes-of-child-death-review-in-the-solomon-islands
#10
Mathew Sandakabatu, Titus Nasi, Carol Titiulu, Trevor Duke
While maternal and perinatal mortality auditing has been strongly promoted by the World Health Organization (WHO), there has been very limited promotion or evaluation of child death auditing in low/middle-income settings. In 2017, a standardised child death review process was introduced in the paediatric department of the National Hospital in Honiara, Solomon Islands. We evaluated the process and outcomes of child death reviews. The child death auditing process was assessed through systematic observations made at each of the weekly meetings using the following standards for evaluation: (1) adapted WHO tools for paediatric auditing; (2) the five stages of the audit cycle; (3) published principles of paediatric audit; and (4) WHO and Solomon Islands national clinical standards of Hospital Care for Children...
April 4, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29609571/under-estimation-of-maternal-and-perinatal-mortality-revealed-by-an-enhanced-surveillance-system-enumerating-all-births-and-deaths-in-pakistan
#11
Jasim Anwar, Siranda Torvaldsen, Mohamud Sheikh, Richard Taylor
BACKGROUND: Reliable and timely data on maternal and neonatal mortality is required to implement health interventions, monitor progress, and evaluate health programs at national and sub-national levels. In most South Asian countries, including Pakistan, vital civil registration and health information systems are inadequate. The aim of this study is to determine accurate maternal and perinatal mortality through enhanced surveillance of births and deaths, compared with prior routinely collected data...
April 2, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29558463/causes-of-death-and-infant-mortality-rates-among-full-term-births-in-the-united-states-between-2010-and-2012-an-observational-study
#12
Neha Bairoliya, Günther Fink
BACKGROUND: While the high prevalence of preterm births and its impact on infant mortality in the US have been widely acknowledged, recent data suggest that even full-term births in the US face substantially higher mortality risks compared to European countries with low infant mortality rates. In this paper, we use the most recent birth records in the US to more closely analyze the primary causes underlying mortality rates among full-term births. METHODS AND FINDINGS: Linked birth and death records for the period 2010-2012 were used to identify the state- and cause-specific burden of infant mortality among full-term infants (born at 37-42 weeks of gestation)...
March 2018: PLoS Medicine
https://www.readbyqxmd.com/read/29474397/beyond-signal-functions-in-global-obstetric-care-using-a-clinical-cascade-to-measure-emergency-obstetric-readiness
#13
John N Cranmer, Julia Dettinger, Kimberly Calkins, Minnie Kibore, Onesmus Gachuno, Dilys Walker
BACKGROUND: Globally, the rate of reduction in delivery-associated maternal and perinatal mortality has been slow compared to improvements in post-delivery mortality in children under five. Improving clinical readiness for basic obstetric emergencies is crucial for reducing facility-based maternal deaths. Emergency readiness is commonly assessed using tracers derived from the maternal signal functions model. OBJECTIVE-METHOD: We compare emergency readiness using the signal functions model and a novel clinical cascade...
2018: PloS One
https://www.readbyqxmd.com/read/29427018/advancing-survival-in-nigeria-a-pre-post-evaluation-of-an-integrated-maternal-and-neonatal-health-program
#14
Nancy L Sloan, Andrew Storey, Olufunke Fasawe, Jamila Yakubu, Kelly McCrystal, Owens Wiwa, Lene Jeanette Lothe, Mari Grepstad
Introduction Nigeria contributes more obstetric, postpartum and neonatal deaths and stillbirths globally than any other country. The Clinton Health Access Initiative in partnership with the Nigerian Federal Ministry of Health and the state Governments of Kano, Katsina, and Kaduna implemented an integrated Maternal and Neonatal Health program from July 2014. Up to 90% women deliver at home in Northern Nigeria, where maternal mortality ratio and neonatal mortality rates (MMR and NMR) are high and severe challenges to improving survival exist...
February 9, 2018: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29412326/-hospitalizations-due-to-complications-of-pregnancy-and-maternal-and-perinatal-outcomes-in-a-cohort-of-pregnant-women-in-the-brazilian-unified-national-health-system-in-s%C3%A3-o-paulo-brazil
#15
Barbara Laisa Alves Moura, Gizelton Pereira Alencar, Zilda Pereira da Silva, Marcia Furquim de Almeida
Maternal morbidity, fetal mortality, and neonatal mortality are important indicators of maternal and child health. The study aimed to describe maternal and perinatal outcomes (low birth weight, prematurity, fetal and neonatal deaths, postpartum hospitalizations, and readmission of newborns) in a cohort of pregnant women whose deliveries were covered by the Brazilian Unified National Health System (SUS) in the city of São Paulo, Brazil, in the second semester of 2012. We obtained a retrospective cohort of 55,404 pregnant women with deterministic and probabilistic linkage of data from the Hospital Information System of the SUS (SIH/SUS), Information System on Live Births (SINASC), Mortality Information System (SIM), and National Registry of Health Establishments (CNES) databases...
February 5, 2018: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/29383582/trend-and-causes-of-neonatal-mortality-in-a-level-iii-children-s-hospital-in-shanghai-a-15-year-retrospective-study
#16
Xue-Lian Wang, Jin Wang, Lin Yuan, Wen-Jing Shi, Yun Cao, Chao Chen
BACKGROUND: To determine the trend and causes of neonatal mortality in a large level III neonatal intensive care unit in Shanghai during a 15-year period. METHODS: This is a retrospective, single-centered study. All neonates who died during the period from January 1, 1999 to December 31, 2013 at Children's Hospital of Fudan University were included. We extracted relevant clinical information from their medical records, analyzed neonatal mortality rate and the characteristics of these patients, and compared neonatal deaths between different periods and populations...
February 2018: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/29360829/long-term-risks-and-benefits-associated-with-cesarean-delivery-for-mother-baby-and-subsequent-pregnancies-systematic-review-and-meta-analysis
#17
Oonagh E Keag, Jane E Norman, Sarah J Stock
BACKGROUND: Cesarean birth rates continue to rise worldwide with recent (2016) reported rates of 24.5% in Western Europe, 32% in North America, and 41% in South America. The objective of this systematic review is to describe the long-term risks and benefits of cesarean delivery for mother, baby, and subsequent pregnancies. The primary maternal outcome was pelvic floor dysfunction, the primary baby outcome was asthma, and the primary subsequent pregnancy outcome was perinatal death. METHODS AND FINDINGS: Medline, Embase, Cochrane, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were systematically searched for published studies in human subjects (last search 25 May 2017), supplemented by manual searches...
January 2018: PLoS Medicine
https://www.readbyqxmd.com/read/29322220/diabetes-and-pregnancy-national-trends-over-a-15-year-period
#18
Sharon T Mackin, Scott M Nelson, Joannes J Kerssens, Rachael Wood, Sarah Wild, Helen M Colhoun, Graham P Leese, Sam Philip, Robert S Lindsay
AIMS/HYPOTHESIS: We aimed to examine time trends in national perinatal outcomes in pregnancies complicated by pre-existing type 1 or type 2 diabetes. METHODS: We analysed episode-level data on all obstetric inpatient delivery events (live or stillbirth) between 1 April 1998 and 31 March 2013 (n = 813,921) using the Scottish Morbidity Record (SMR02). Pregnancies to mothers with type 1 (n = 3229) and type 2 (n = 1452) diabetes were identified from the national diabetes database (Scottish Care Information-Diabetes), and perinatal outcomes were compared among women with type 1 diabetes, type 2 diabetes and those without diabetes...
May 2018: Diabetologia
https://www.readbyqxmd.com/read/29303230/planned-birth-at-or-near-term-for-improving-health-outcomes-for-pregnant-women-with-gestational-diabetes-and-their-infants
#19
REVIEW
Linda M Biesty, Aoife M Egan, Fidelma Dunne, Eugene Dempsey, Pauline Meskell, Valerie Smith, G Meabh Ni Bhuinneain, Declan Devane
BACKGROUND: Gestational diabetes is a type of diabetes that occurs during pregnancy. Women with gestational diabetes are more likely to experience adverse health outcomes such as pre-eclampsia or polyhydramnios (excess amniotic fluid). Their babies are also more likely to have health complications such as macrosomia (birthweight > 4000 g) and being large-for-gestational age (birthweight above the 90th percentile for gestational age). Current clinical guidelines support elective birth, at or near term in women with gestational diabetes to minimise perinatal complications, especially those related to macrosomia...
January 5, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29301489/intrapartum-fetal-deaths-and-unexpected-neonatal-deaths-in-the-republic-of-ireland-2011-2014-a-descriptive-study
#20
K McNamara, K O'Donoghue, R A Greene
BACKGROUND: Intrapartum fetal death, the death of a fetus during labour, is a tragic outcome of pregnancy. The intrapartum death rate of a country is reflective of the care received by mothers and babies in labour and it is through analysing these cases that good aspects of care, as well as areas for improvement can be identified. Investigating unexpected neonatal deaths that may be associated with an intrapartum event is also helpful to fully appraise intrapartum care. This is a descriptive study of intrapartum fetal deaths and unexpected neonatal deaths in Ireland from 2011 to 2014...
January 4, 2018: BMC Pregnancy and Childbirth
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