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Medical disorders in pregnancy

Evangelia Elenis, Gunilla Sydsjö, Alkistis Skalkidou, Claudia Lampic, Agneta Skoog Svanberg
BACKGROUND: Pregnancies resulting through oocyte donation have been associated with increased risk for adverse outcomes for the mother, such as gestational hypertensive disorders. However, little is known about possible neonatal complications of such pregnancies. The purpose of this study was to evaluate the neonatal health outcomes among singleton pregnancies in a population of relatively young and healthy oocyte recipients in Sweden, taking into account the medical indication leading to treatment...
October 21, 2016: BMC Pediatrics
Marina Parca Cavelagna Teixeira, Tatiana Peloso Reis Queiroga, Maria Dos Anjos Mesquita
Objective: To determine the frequency and risk factors of small-for-gestational-age newborns in a high-risk maternity. Methods: This is an observational, cross-sectional, and case-control study, conducted in a public tertiary care maternity hospital. Data from 998 newborns and their mothers were collected through interviews and review of medical records and prenatal care cards. Some placentas underwent histopathological analysis. The variables of small-for-gestational-age and non-small-for-gestational-age newborns and of their mothers were statistically compared by means of Student's t test, Fisher's exact test, and odds ratio...
July 2016: Einstein
A M Kurmanova, G M Kurmanova, V N Lokshin
The viral hepatitis abnormalities in the female reproductive system are due to hepatic and extrahepatic damage. On the background of HBV- and HCV-infections, menstrual disorders prevail in the structure of reproductive system pathology; disorders of reproductive function in the form of pregnancy loss and infertility are detected in each second case. Depression of T-cell immunity in the immune status is observed in the patients with intact reproductive function. When miscarriage was in past medical history then divergent changes subpopulations of lymphocytes are found...
October 2016: Gynecological Endocrinology
Annamagreth M Mukwenda, Columba K Mbekenga, Andrea B Pembe, Pia Olsson
BACKGROUND: Eclampsia is a major cause of maternal and perinatal mortality that requires advanced care and long hospital stays with uncertain outcomes for mother and baby. Care of eclamptic women is particularly challenging in low-income settings. Standards for medical care for eclampsia are established but the psychosocial needs of women are under-researched. AIM: To explore and describe women's experiences of having had, and recovered from, eclampsia at a tertiary hospital in Tanzania...
October 14, 2016: Women and Birth: Journal of the Australian College of Midwives
Xiang Kong, Yan Kong, Fangyuan Zhang, Tingting Wang, Jin Yan
BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is a specific pregnancy-related disorder without standard medical therapies. Ursodeoxycholic acid (UDCA) is the most used medicine, but the efficacy and safety of UDCA remain uncertain. Several meta-analyses had been made to assess the effects of UDCA in ICP. However, the samples were not large enough to convince obstetricians to use UDCA. We conducted a meta-analysis to evaluate the effects and safety of UDCA in patients with ICP, which included only randomized controlled trials (RCTs)...
October 2016: Medicine (Baltimore)
Heléne E K Sundelin, Olof Stephansson, Kari Johansson, Jonas F Ludvigsson
INTRODUCTION: An increased risk of preterm birth in women with Joint Hypermobility Syndrome (JHS) or Ehlers-Danlos Syndrome (EDS) is suspected. MATERIAL AND METHODS: In this nationwide cohort study from 1997 through 2011, women with either JHS or EDS or both disorders were identified through the Swedish Patient Register, and linked to the Medical Birth Register. Thereby 314 singleton births to women with JHS/EDS before delivery were identified. These births were compared with 1,247,864 singleton births to women without a diagnosis of JHS/EDS...
October 14, 2016: Acta Obstetricia et Gynecologica Scandinavica
Kozeta Miliku, Nienke E Bergen, Hanneke Bakker, Albert Hofman, Eric A P Steegers, Romy Gaillard, Vincent W V Jaddoe
BACKGROUND: Hypertensive disorders in pregnancy may affect the cardiovascular risk of offspring. We examined the associations of maternal blood pressure throughout pregnancy and hypertensive disorders in pregnancy with childhood blood pressure of offspring. Specific focus was on the comparison with paternal blood pressure effects, the identification of critical periods, and the role of birth outcomes and childhood body mass index in the observed associations. METHODS AND RESULTS: This study was embedded in a population-based prospective cohort study among 5310 mothers and fathers and their children...
October 14, 2016: Journal of the American Heart Association
Veronica Gomez-Lobo, Anne-Marie Amies Oelschlager
Disorders (differences) of sexual development encompass a variety of conditions with atypical development of chromosomal, gonadal, or anatomic sex. Three of the most common differences of sex development conditions include congenital adrenal hyperplasia, complete androgen insensitivity, and Turner syndrome. Obstetrician-gynecologists who care for affected individuals in their practice must be familiar with the genetic, endocrine, and anatomic considerations of the most common conditions to provide optimal care...
October 6, 2016: Obstetrics and Gynecology
Chandni Prakash, Susan Hatters-Friedman, Charmian Moller-Olsen, Abigail North
INTRODUCTION: Pregnancy is a vulnerable period for recurrence of bipolar disorder. Discontinuation of mood stabilisers during pregnancy and the postpartum period can significantly increase the risk of recurrence of bipolar disorder. Lamotrigine is an anti-epileptic drug that has been approved for the maintenance treatment of bipolar disorder. Epilepsy literature has indicated that lamotrigine has a reassuring safety profile in pregnancy but there is little information on its effectiveness and safety in pregnant women with mental disorders...
August 15, 2016: Psychopharmacology Bulletin
Orkun Cetin, Erbil Karaman, Harun Arslan, Ali Kolusarı, Recep Yıldızhan, Mesut Ozgokce, Abdussamet Batur, Ibrahim Akbudak
PURPOSE: To compare maternal liver elasticity scores by Acoustic Radiation Force Impulse (ARFI) elastosonography in healthy and preeclamptic pregnancies and its association with the severity of the disease. MATERIALS AND METHODS: Forty-two healthy, 33 mild, 33 severe preeclamptic and 28 pregnant women with Hemolysis, Elevated Liver enzymes, and Low Platelets (HELLP) syndrome were included into the study. Maternal liver elasticity was measured by ARFI elastosonography at the first day of puerperium...
October 13, 2016: Journal of Maternal-fetal & Neonatal Medicine
John J Mccarthy, Martin H Leamon, Loretta P Finnegan, Catherine Fassbender
Increase in the number of opioid dependent pregnant women delivering babies at risk for neonatal abstinence syndrome (NAS) prompted a General Accountability Office (GAO) report documenting deficits in research and provider knowledge about care of the maternal/fetal unit and the neonate. There are three general sources of dependence: untreated opioid use disorder (OUD), pain management, and medication assisted treatment with methadone or buprenorphine. A survey of methadone patients' experiences when telling a physician of their pregnancy and opioid dependence demonstrated physician confusion about proper care, frequent negative interactions with the mother, and failures to provide appropriate referral...
October 8, 2016: American Journal of Obstetrics and Gynecology
Umesh Ramadurg, Marianne Vidler, Umesh Charanthimath, Geetanjali Katageri, Mrutyunjaya Bellad, Ashalata Mallapur, Shivaprasad Goudar, Shashidhar Bannale, Chandrashekhar Karadiguddi, Diane Sawchuck, Rahat Qureshi, Peter von Dadelszen, Richard Derman
BACKGROUND: In India, the hypertensive disorders of pregnancy and postpartum haemorrhage are responsible for nearly 40 % of all maternal deaths. Most of these deaths occur in primary health settings which frequently lack essential equipment and medication, are understaffed, and have limited or no access to specialist care. Community health care workers are regarded as essential providers of basic maternity care; and the quality of care they provide is dependent on the level of knowledge and skills they possess...
September 30, 2016: Reproductive Health
Gustaf Brander, Mina Rydell, Ralf Kuja-Halkola, Lorena Fernández de la Cruz, Paul Lichtenstein, Eva Serlachius, Christian Rück, Catarina Almqvist, Brian M D'Onofrio, Henrik Larsson, David Mataix-Cols
Importance: Perinatal complications may increase the risk of obsessive-compulsive disorder (OCD). Previous reports were based on small, retrospective, specialist clinic-based studies that were unable to rigorously control for unmeasured environmental and genetic confounding. Objective: To prospectively investigate a wide range of potential perinatal risk factors for OCD, controlling for unmeasured factors shared between siblings in the analyses. Design, Setting, and Participants: This population-based birth cohort study included all 2 421 284 children from singleton births in Sweden from January 1, 1973, to December 31, 1996, who were followed up through December 31, 2013...
October 5, 2016: JAMA Psychiatry
Farah H Amro, Hind N Moussa, Olaide A Ashimi, Baha M Sibai
Hypertensive disorders have become increasingly prevalent and complicate an increasing number of pregnancies. Therefore it is essential that the medications used to treat these disorders be well understood. Furthermore the management is complicated by special consideration needed for the physiologic changes of pregnancy as well as the consideration for possible adverse fetal effects. Areas covered: We performed a review of the scientific literature of medications used to treat hypertensive disorders in pregnancy...
October 11, 2016: Expert Opinion on Drug Safety
D Vinayagam, Elena Mantovani, B Thilaganthan, A Khalil
BACKGROUND: Hypertensive disorders in pregnancy (HDP) are associated with altered maternal haemodynamics, which can be investigated using non-invasive methodologies. OBJECTIVE: To assess maternal haemodynamics using USCOM 1A® in patients presenting with non-medicated, hypertensive disorders of pregnancy and normotensive controls. METHODS: A prospective, nested case-control study in 65 patients presenting with unmedicated hypertension. The control population consisted of 400 subjects who did not have a history of hypertensive disorders...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
D Lanssens, A Van Moerebeke, A van den Hoogen, N Geusens, L Grieten, W Gyselaers
BACKGROUND: Gestational hypertensive disorders (GHD) are major contributors to maternal mortality worldwide. In Ziekenhuis Oost- Limburg (Genk, Belgium), a remote monitoring (RM) program for pregnant women at risk for developing GHD was initiated in January 2015 to evaluate the relevance of a RM program. RM is a relatively new approach that broadly can be defined as the application of telecommunication technologies in interchanging medical data, information and services between healthcare providers and patients...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
I Behrens, S Basit, M Melbye, J A Lykke, J Wohlfahrt, H Bundgaard, B Thilaganathan, H A Boyd
BACKGROUND: Women with a history of hypertensive disorders of pregnancy (HDP) are known to have an increased risk of hypertension years after their pregnancy. However, how soon after an affected pregnancy the risk of hypertension increases and how/whether this risk evolves over time, is unclear. METHOD: Using national health register data, we identified all women giving birth in Denmark from 1978 to 2011. Cox regression analysis was used to compare the rates of incident post-pregnancy hypertension requiring treatment with medication after pregnancy in women with and without a history of HDP, by the number of years since pregnancy...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Baharak Amir, Victoria M Allen, Susan Kirkland, Kathleen MacPherson, Scott Farrell
OBJECTIVE: To estimate the influence of labour and pregnancy factors on long-term pelvic floor health outcomes. METHODS: This population-based cohort study was conducted using linkage between the Nova Scotia Atlee Perinatal Database, the Medical Services Insurance Database, and the Canadian Institute for Health Information's Discharge Abstract Database from 1988 to 2006; this allowed for the evaluation of patient utilization of care providers for pelvic floor disorders and captured conservative and surgical interventions...
September 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
D Healy, J Le Noury, D Mangin
OBJECTIVE: To investigate possible linkages between neurodevelopmental delay and neurodevelopmental spectrum disorders and exposure to medication with effects on serotonin reuptake inhibition during pregnancy. METHODS: We systematically reviewed the epidemiological literature for studies bearing on this relationship in children born with neurodevelopmental spectrum disorder and related conditions, as well as animal studies giving serotonin reuptake inhibitors to pregnant animals and in addition reviewed the literature for proposals as to possible mechanisms that might link effects on serotonin reuptake with cognitive changes post-partum...
September 17, 2016: International Journal of Risk & Safety in Medicine
Vijaya Subramanian, Janani Venkat, Mohana Dhanapal
AIM AND OBJECTIVES: To analyze which is superior, Doppler velocimetry or non-stress test or both by means of categorization into four groups and comparing the prediction of perinatal outcome in high-risk pregnancies like anemia, hypertensive disorders of pregnancies. MATERIALS AND METHODS: This was a prospective study conducted at the Department of Obstetrics and Gynaecology, ISO KGH, Madras Medical College, Chennai, in the year 2014. Two hundred high-risk pregnancies like anemia, hypertensive disorders of pregnancy were included in the study...
October 2016: Journal of Obstetrics and Gynaecology of India
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