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https://www.readbyqxmd.com/read/27907899/reducing-the-number-of-fetuses-in-a-pregnancy-providers-and-patients-views-of-challenges
#1
Robert L Klitzman
STUDY QUESTION: How do patients and providers perceive and make decisions about possible reductions of multi-fetal pregnancies? SUMMARY ANSWER: Physicians may be transferring additional embryos, assuming that patients will later undergo reduction if need be; but decisions to reduce pregnancies are difficult for patients, who may agree to undergo the procedure in advance and later renege. WHAT IS ALREADY KNOWN: Implanting more than one embryo increases the likelihood that at least one embryo will successfully lead to a child but also that the patient may end up with twins or higher-order multiple births...
November 2016: Human Reproduction
https://www.readbyqxmd.com/read/27907898/obstetrical-and-perinatal-outcomes-following-blastocyst-transfer-compared-to-cleavage-transfer-a-systematic-review-and-meta-analysis
#2
W P Martins, C O Nastri, L Rienzi, S Z van der Poel, C R Gracia, C Racowsky
STUDY QUESTION: Is blastocyst transfer safe when compared to cleavage stage embryo transfer regarding obstetric and perinatal outcomes? SUMMARY ANSWER: The clinical equipoise between blastocyst and cleavage stage embryo transfer remains as the evidence associating blastocyst transfer with some adverse perinatal outcomes is of low/very low quality. WHAT IS KNOWN ALREADY: Extended embryo culture to the blastocyst stage provides some theoretical advantages and disadvantages...
November 2016: Human Reproduction
https://www.readbyqxmd.com/read/27907271/adult-attention-deficit-hyperactivity-disorder-diagnosis-management-and-treatment-in-the-dsm-5-era
#3
Joel L Young, David W Goodman
Objective: To increase awareness of adult attention-deficit/hyperactivity disorder (ADHD) in the primary care community and to provide guidance for the management of this condition. Despite its increasing prevalence, adult ADHD largely remains underdiagnosed and inappropriately treated in the United States. The publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), has provided more clear diagnostic criteria for adult ADHD, but a solid framework supporting the transition of ADHD management from pediatric to adult primary care is lacking...
November 17, 2016: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/27895065/social-determinants-and-maternal-exposure-to-intimate-partner-violence-of-obstetric-patients-with-severe-maternal-morbidity-in-the-intensive-care-unit-a-systematic-review-protocol
#4
Beatriz Paulina Ayala Quintanilla, Angela Taft, Susan McDonald, Wendy Pollock, Joel Christian Roque Henriquez
INTRODUCTION: Maternal mortality is a potentially preventable public health issue. Maternal morbidity is increasingly of interest to aid the reduction of maternal mortality. Obstetric patients admitted to the intensive care unit (ICU) are an important part of the global burden of maternal morbidity. Social determinants influence health outcomes of pregnant women. Additionally, intimate partner violence has a great negative impact on women's health and pregnancy outcome. However, little is known about the contextual and social aspects of obstetric patients treated in the ICU...
November 28, 2016: BMJ Open
https://www.readbyqxmd.com/read/27893488/pregnancy-and-hiv-disease-progression-in-an-early-infection-cohort-from-five-african-countries
#5
Kristin M Wall, Wasima Rida, Lisa Haddad, Anatoli Kamali, Etienne Karita, Shabir Lakhi, William Kilembe, Susan Allen, Mubiana Inambao, Annie H Yang, Mary H Latka, Omu Anzala, Eduard J Sanders, Linda-Gail Bekker, Vinodh A Edward, Matt A Price
BACKGROUND: Understanding associations between pregnancy and HIV disease progression is critical to providing appropriate counseling and care to HIV-positive women. METHODS: From 2006-2011, women under age 40 with incident HIV infection were enrolled in an early HIV infection cohort in Kenya, Rwanda, South Africa, Uganda, and Zambia. Time-dependent Cox models evaluated associations between pregnancy and HIV disease progression. Clinical progression was defined as a single CD4 measurement <200 cells/μL, percent CD4 <14%, or category C event, with censoring at antiretroviral (ART) initiation for reasons other than prevention of mother-to-child transmission (PMTCT)...
November 22, 2016: Epidemiology
https://www.readbyqxmd.com/read/27882865/community-perceptions-on-domestic-violence-against-pregnant-women-in-nepal-a-qualitative-study
#6
Kunta Devi Pun, Jennifer J Infanti, Rajendra Koju, Berit Schei, Elisabeth Darj
BACKGROUND: Globally, knowledge of health sector options to respond to domestic violence during pregnancy is increasing, but this topic is under-investigated in Nepal. This gap affects the provision of adequate antenatal care services and understanding of factors that influence women's willingness and ability to use available services. It is critical to know more about the social norms in a community that promote and prevent women experiencing domestic violence from seeking antenatal care...
2016: Global Health Action
https://www.readbyqxmd.com/read/27882655/situated-technology-in-reproductive-health-care-do-we-need-a-new-theory-of-the-subject-to-promote-person-centred-care
#7
Biljana Stankovic
Going through reproductive experiences (especially pregnancy and childbirth) in contemporary Western societies almost inevitably involves interaction with medical practitioners and various medical technologies in institutional context. This has important consequences for women as embodied subjects. A critical appraisal of these consequences-coming dominantly from feminist scholarship-relied on a problematic theory of both technology and the subject, which are in contemporary approaches no longer considered as given, coherent and well individualized wholes, but as complex constellations that are locally situated and that can only be described empirically...
November 23, 2016: Nursing Philosophy: An International Journal for Healthcare Professionals
https://www.readbyqxmd.com/read/27866601/assessment-of-state-perinatal-hepatitis-b-prevention-laws
#8
Lindsay A Culp, Lisa Caucci, Nancy E Fenlon, Megan C Lindley, Noele P Nelson, Trudy V Murphy
INTRODUCTION: Identifying pregnant women with hepatitis B virus (HBV) infection for post-exposure prophylaxis of their infants is critical to preventing mother-to-child transmission of HBV infection. HBV infection in infancy results in premature death from chronic liver disease or cancer in 25% of affected infants. Universal screening of pregnant women for HBV infection is the standard of care, and in many states is supported by laws for screening and reporting these infections to public health...
December 2016: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/27846406/encourages-and-guides-or-diagnoses-and-monitors-woman-centred-ness-in-the-discourse-of-professional-midwifery-bodies
#9
M P O'Malley-Keighran, G Lohan
OBJECTIVE: the purpose of this study was to conduct a preliminary exploration of the language used by midwifery professional bodies to define the scope of practice of midwives in relation to woman-centred care. DESIGN: this is a qualitative study in which Critical Discourse Analysis and Transitivity Analysis from the Systemic Functional Linguistics tradition were used. Data were sampled from nine international midwifery professional bodies. FINDINGS: three general types of definitions of scope of practice were identified; a formal type which focused on midwifery practice in which the midwife and woman were largely absent as agents, a second, less formal type which focused on the midwife as agent, from which the woman was largely absent as an active participant and one exception to the pattern which featured the woman as agent...
October 28, 2016: Midwifery
https://www.readbyqxmd.com/read/27843850/birth-preparedness-and-complication-readiness-among-women-of-bankura-district-west-bengal
#10
Dipta Kanti Mukhopadhyay, Sharmistha Bhattacherjee, Sujishnu Mukhopadhyay, Sarmila Malik, Susmita Nayak, Akhil Bandhu Biswas
BACKGROUND: Birth preparedness and complication readiness (BPCR) is the process of planning for normal birth and anticipating the actions needed in case of an emergency which is critical in averting maternal morbidity and mortality. OBJECTIVES: To find out awareness and practices regarding BPCR among pregnant and recently delivered women in Bankura, West Bengal. MATERIALS AND METHODS: A cross-sectional, community-based study was carried out among 120 pregnant women and 235 recently delivered women...
April 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/27828872/sexual-behavior-and-vaginal-practices-during-pregnancy-and-postpartum-implications-for-hiv-prevention-strategies
#11
John Kinuthia, Barbra A Richardson, Alison L Drake, Daniel Matemo, Jennifer A Unger, R Scott McClelland, Grace John-Stewart
BACKGROUND: Understanding sexual behaviors and vaginal practices of pregnant and breastfeeding women in sub-Saharan Africa is critical to inform HIV prevention strategies during these periods. METHODS: HIV-uninfected women presenting for antenatal care in western Kenya were enrolled and followed through 36 weeks postpartum. Sexual behavior and vaginal practices were ascertained by structured questionnaires. Logistic regression was used to assess correlates of unprotected sex, vaginal washing, and vaginal drying...
November 4, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27826131/preconception-care-education-for-women-with-diabetes-a-systematic-review-of-conventional-and-digital-health-interventions
#12
REVIEW
Chidiebere Hope Nwolise, Nicola Carey, Jill Shawe
BACKGROUND: Worldwide, 199.5 million women have diabetes mellitus (DM). Preconception care (PCC) education starting from adolescence has been recommended as an effective strategy for safeguarding maternal and child health. However, traditional preconception care advice provided by health care professionals (HCPs) within clinic settings is hindered by inadequate resources, suboptimal coverage, and busy clinics. Electronic health (eHealth), which is instrumental in solving problems around scarce health resources, could be of value in overcoming these limitations and be used to improve preconception care and pregnancy outcomes for women with DM...
November 8, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27816156/cardiac-lesions-in-the-critical-care-setting
#13
REVIEW
Manisha Gandhi, Amir A Shamshirsaz
The long-held belief that pregnancy is absolutely contraindicated in maternal cardiovascular disease is no longer justifiable using evidence-base medicine. There are some conditions in which pregnancy is contraindicated, and high maternal risk and poor fetal outcome can be predicted. However, in many women with heart disease, a more favorable maternal and fetal outcome is expected. This article focusses on the cardiac conditions that require more attention and have the potential to require observation in the intensive care unit setting...
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27816155/respiratory-considerations-including-airway-and-ventilation-issues-in-critical-care-obstetric-patients
#14
REVIEW
Holly Ende, Dirk Varelmann
Critical care management of the obstetric patient can present unique challenges. Parturients who present with respiratory distress can suffer from a multitude of etiologies, and each diagnosis must be pursued as appropriate to the clinical picture. Normal physiologic changes of pregnancy may obscure the presentation and diagnosis, and irrelevant of the cause, pregnancy may complicate the management of hypoxic and hypercarbic respiratory failure in this patient population. In addition to these concerns, both anticipated and unanticipated difficult airway management, including difficulty ventilating and intubating, are more common during pregnancy and may be encountered during endotracheal tube placement...
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27805934/straight-talk-about-birth-control-a-contraceptive-education-protocol-for-home-care
#15
Leslie Schoenberg
Home healthcare providers play a critical role in the prevention of unintended pregnancies by providing evidence-based contraception education during home visits. This article describes an innovative and comprehensive contraception protocol that was developed for Nurse-Family Partnership to improve contraception education for home healthcare patients. The protocol focused on increasing uptake of long-acting reversible contraception (LARC) for high-risk prenatal and postpartum home healthcare patients. The protocol was designed to reduce early subsequent pregnancies and thereby improve outcomes for mothers and their infants...
November 2016: Home Healthcare Now
https://www.readbyqxmd.com/read/27789310/severe-maternal-morbidity-and-comorbid-risk-in-hospitals-performing-1000-deliveries-per-year
#16
Mark P Hehir, Cande V Ananth, Jason D Wright, Zainab Siddiq, Mary E D'Alton, Alexander M Friedman
BACKGROUND: While research has demonstrated increasing risk for severe maternal morbidity in the United States, risk at lower volume hospitals remains poorly characterized. More than half of all obstetric units in the United States perform less than 1000 deliveries per year and improving care at these hospitals may be critical to reducing risk nationwide. OBJECTIVE: We sought to characterize maternal risk profiles and severe maternal morbidity at low-volume hospitals in the US...
October 24, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27777432/case-of-24-week-fetus-delivered-from-mother-on-life-support-with-brain-death-from-suicide-attempt-ethical-issues-associated-with-severe-complications
#17
Takeshi Nishimura, Keisuke Kohama, Takaaki Osako, Taihei Yamada, Hiroyuki Tanaka, Atsunori Nakao, Joji Kotani
Advances in critical care medicine have made it possible to sustain vital organ systems in brain-dead patients. One clinical scenario besides donor organ retrieval in which a benefit may be gained from continuing life support is pregnancy. A pregnant woman in her late 30's at 23 weeks gestation exhibiting worsening depression was referred to the Department of Psychiatry. One day after admission she attempted suicide by hanging and suffered a cardiopulmonary arrest. A fetal heart beat and fetal motion was confirmed immediately after resuscitation...
October 2016: Acta Medica Okayama
https://www.readbyqxmd.com/read/27773531/recommendations-about-pregnancy-from-women-with-mobility-disability-to-their-peers
#18
Lisa I Iezzoni, Amy J Wint, Suzanne C Smeltzer, Jeffrey L Ecker
BACKGROUND: Although growing numbers of women with mobility disability are becoming pregnant and desiring motherhood, relatively little is known about their pregnancy experiences or what they might recommend to other women with mobility disability contemplating pregnancy. METHODS: Using a semistructured, open-ended interview protocol, we conducted 2-hour telephone interviews with 22 women who had a significant mobility disability before becoming pregnant and had delivered babies within the prior 10 years...
October 20, 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/27751799/performance-of-the-obstetric-early-warning-score-in-critically-ill-patients-for-the-prediction-of-maternal-death
#19
Angel Paternina-Caicedo, Jezid Miranda, Ghada Bourjeily, Andrew Levinson, Carmelo Dueñas, Camilo Bello Muñoz, José A Rojas-Suarez
BACKGROUND: Every day, about 830 women die worldwide from preventable causes related to pregnancy and childbirth. Obstetric early-warning scores have been proposed as a potential tool to reduce maternal morbidity and mortality, based upon the identification of predetermined abnormal values in the vital signs or laboratory parameters, to generate a rapid and effective medical response. Several early-warning scores have been developed for obstetrical patients, but the majority are the result of a clinical consensus rather than statistical analyses of clinical outcome measures (i...
October 14, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27745839/structural-chromosomal-rearrangements-require-nucleotide-level-resolution-lessons-from-next-generation-sequencing-in-prenatal-diagnosis
#20
Zehra Ordulu, Tammy Kammin, Harrison Brand, Vamsee Pillalamarri, Claire E Redin, Ryan L Collins, Ian Blumenthal, Carrie Hanscom, Shahrin Pereira, India Bradley, Barbara F Crandall, Pamela Gerrol, Mark A Hayden, Naveed Hussain, Bibi Kanengisser-Pines, Sibel Kantarci, Brynn Levy, Michael J Macera, Fabiola Quintero-Rivera, Erica Spiegel, Blair Stevens, Janet E Ulm, Dorothy Warburton, Louise E Wilkins-Haug, Naomi Yachelevich, James F Gusella, Michael E Talkowski, Cynthia C Morton
In this exciting era of "next-gen cytogenetics," integrating genomic sequencing into the prenatal diagnostic setting is possible within an actionable time frame and can provide precise delineation of balanced chromosomal rearrangements at the nucleotide level. Given the increased risk of congenital abnormalities in newborns with de novo balanced chromosomal rearrangements, comprehensive interpretation of breakpoints could substantially improve prediction of phenotypic outcomes and support perinatal medical care...
November 3, 2016: American Journal of Human Genetics
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