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https://www.readbyqxmd.com/read/28413279/comparing-slow-and-rapid-bolus-of-ephedrine-in-pregnant-patients-undergoing-planned-cesarean-section-under-spinal-anesthesia
#1
Prabu Gunasekaran, Lenin Babu Elakkumanan, Hemavathi Balachander, M V S Satyaprakash
BACKGROUND AND AIMS: While ephedrine was the preferred drug for treating spinal-induced hypotension in pregnancy, its use has declined because of resultant fetal acidosis. The objective of this randomized control trial was to compare the effects of a slow and rapid bolus of ephedrine on fetal acidosis, maternal blood pressure, and heart rate (HR) during cesarean section performed under spinal anesthesia. MATERIAL AND METHODS: Eighty full-term parturients scheduled for cesarean section under spinal anesthesia were randomly allocated into two groups...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28373627/effects-of-transplanted-human-cord-blood-mononuclear-cells-on-pulmonary-hypertension-in-immunodeficient-mice-and-their-distribution
#2
Mikio Sugano, Homare Yoshida, Hirotsugu Kurobe, Hiroki Arase, Hajime Kinoshita, Takashi Kitaichi, Noriko Sugasawa, Soichiro Nakayama, Kazuhisa Maeda, Minoru Irahara, Tetsuya Kitagawa
OBJECTIVES: To investigate the effects of human umbilical cord blood-derived mononuclear cell (hUCB-MNC) transplantation on pulmonary hypertension (PH) induced by monocrotaline (MCT) in immunodeficient mice and their distribution. METHODS: MCT was administered to BALB/c Slc-nu/nu mice, and PH was induced in mice 4 weeks later. Fresh hUCB-MNCs harvested from a human donor after her delivery were injected intravenously into those PH mice. The medial thickness of pulmonary arterioles, ratio of right ventricular to septum plus left ventricular weight (RV/S+LV), and ratio of acceleration time to ejection time of pulmonary blood flow waveform (AT/ET) were determined 4 weeks after hUCB-MNC transplantation...
2017: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/28372508/the-small-for-gestational-age-fetus-has-an-intact-ability-to-develop-lacticemia-when-exposed-to-hypoxia-a-retrospective-comparative-register-study
#3
Fernanda Åkerman, Parisa Mokarami, Karin Källén, Per Olofsson
OBJECTIVE: To investigate the ability of small-for-gestational-age (SGA) fetuses to develop lacticemia during hypoxia. METHODS: Umbilical cord arterial and venous pH, lactate and glucose concentrations were determined in 1777 SGA (<10th percentile) and 14,569 AGA newborns and related to acidemia (pH < mean -2SD). Non-parametric statistics with two-sided p < .05 were considered significant. RESULTS: Glucose and lactate were linearly related and both variables correlated negatively with pH...
April 21, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28351056/comparison-of-umbilical-serum-copeptin-relative-to-erythropoietin-and-s100b-as-asphyxia-biomarkers-at-birth
#4
Milla Summanen, Laura Seikku, Petri Rahkonen, Vedran Stefanovic, Kari Teramo, Sture Andersson, Kai Kaila, Leena Rahkonen
BACKGROUND: Birth asphyxia, estimated to account for a million neonatal deaths annually, can cause a wide variety of neurodevelopmental impairments. There is a need to develop new, swift methods to identify those neonates who would benefit from neuroprotective treatments such as hypothermia. OBJECTIVES: To examine the utility of cord serum copeptin, a stable byproduct of arginine vasopressin release, as a biomarker of birth asphyxia based on a comparison with 2 biomarkers of hypoxia and brain trauma: erythropoietin and S100B...
March 29, 2017: Neonatology
https://www.readbyqxmd.com/read/28349526/pushing-bearing-down-methods-for-the-second-stage-of-labour
#5
REVIEW
Andrea Lemos, Melania Mr Amorim, Armele Dornelas de Andrade, Ariani I de Souza, José Eulálio Cabral Filho, Jailson B Correia
BACKGROUND: Maternal pushing during the second stage of labour is an important and indispensable contributor to the involuntary expulsive force developed by uterine contraction. There is no consensus on an ideal strategy to facilitate these expulsive efforts and there are contradictory results about the influence on the mother and fetus. OBJECTIVES: To evaluate the benefits and possible disadvantages of different kinds of techniques regarding maternal pushing/breathing during the expulsive stage of labour on maternal and fetal outcomes...
March 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28343228/focal-brain-injury-associated-with-a-model-of-severe-hypoxic-ischemic-encephalopathy-in-nonhuman-primates
#6
Ryan M McAdams, Ronald J McPherson, Raj P Kapur, Sandra E Juul
Worldwide, hypoxic-ischemic encephalopathy (HIE) is a major cause of neonatal mortality and morbidity. To better understand the mechanisms contributing to brain injury and improve outcomes in neonates with HIE, better preclinical animal models that mimic the clinical situation following birth asphyxia in term newborns are needed. In an effort to achieve this goal, we modified our nonhuman primate model of HIE induced by in utero umbilical cord occlusion (UCO) to include postnatal hypoxic episodes, in order to simulate apneic events in human neonates with HIE...
March 25, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28327433/sonographic-prediction-of-outcome-of-vacuum-deliveries-a%C3%A2-multicenter-prospective-cohort-study
#7
Birgitte H Kahrs, Sana Usman, Tullio Ghi, Aly Youssef, Erik A Torkildsen, Elsa Lindtjørn, Tilde B Østborg, Sigurlaug Benediktsdottir, Lis Brooks, Lotte Harmsen, Pål R Romundstad, Kjell Å Salvesen, Christoph C Lees, Torbjørn M Eggebø
BACKGROUND: Safe management of the second stage of labor is of great importance. Unnecessary interventions should be avoided and correct timing of interventions should be focused. Ultrasound assessment of fetal position and station has a potential to improve the precision in diagnosing and managing prolonged or arrested labors. The decision to perform vacuum delivery is traditionally based on subjective assessment by digital vaginal examination and clinical expertise and there is currently no method of objectively quantifying the likelihood of successful delivery...
March 19, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28323759/hypercapnia-caused-by-a-therapeutic-dosage-of-pregabalin-in-a-tetraplegic-patient-with-cervical-spinal-cord-injury
#8
Kyung Hee Do, Eun Jung Choi, Min Cheol Chang, Hea-Eun Yang
Pregabalin is often used for the treatment of neuropathic pain in patients with spinal cord injury (SCI). We reported a patient with C5 [S(C5/C6)] ASIA Impairment Scale C SCI due to cervical myelopathy who presented CO2 retention when taking a therapeutic dosage of pregabalin. An 88-year-old patient with cervical SCI was transferred to the department of physical medicine and rehabilitation. When he had transferred, his neuropathic pain had been treated with 150-mg pregabalin per day (75 mg twice a day); however, he still exhibited severe neuropathic pain with a Numeric Pain Rating Scale score of 7 to 8...
March 20, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28301895/association-of-fetal-heart-rate-baseline-change-and-neonatal-outcomes
#9
Michael Yang, Molly J Stout, Julia D López, Ryan Colvin, George A Macones, Alison G Cahill
Objective The objective of this study was to describe the incidence of baseline change within normal range during labor and its prediction of neonatal outcomes. Materials and Methods This was a prospective cohort of singleton, nonanomalous, term neonates with continuous electronic fetal monitoring and normal baseline fetal heart rate throughout the last 2 hours of labor. We determined baseline in 10-minute segments using Eunice Kennedy Shriver National Institute of Child Health and Human Development criteria...
March 16, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28294442/prediction-of-adverse-perinatal-outcome-by-cerebroplacental-ratio-adjusted-for-estimated-fetal-weight
#10
Angelo Sirico, Anke Diemert, Peter Glosemeyer, Kurt Hecher
OBJECTIVES: The aim of our study was to evaluate the relationship between the cerebroplacental ratio (CPR) and estimated fetal weight (EFW). Furthermore, we evaluated the role of CPR in the prediction of adverse perinatal outcome and whether CPR measurements adjusted for EFW improve its predictive value. METHODS: This is a retrospective cohort study including pregnancies, where Doppler investigations of umbilical artery (UA) and middle cerebral artery (MCA) were performed after 30 weeks...
March 12, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28282782/preterm-meconium-stained-amniotic-fluid-is-an-ominous-sign-for-the-development-of-chorioamnionitis-and-for-in-utero-cord-compression
#11
Dana Brabbing-Goldstein, Dan Nir, Deborah Cohen, Ariel Many, Sharon Maslovitz
PURPOSE: Meconium-stained amniotic fluid (MSAF) is rarely observed in preterm pregnancies, and its clinical significance is undetermined. We evaluated the correlation between MSAF and obstetrical and perinatal complications prior to 34 weeks' gestation. MATERIALS AND METHODS: Pregnancies complicated with MSAF between 24 and 34 weeks of gestation were compared with same gestational age-matched controls. The variables measured were: obstetrical complications: clinical chorioamnionitis, Intrahepatic Cohlestasis of Pregnancy - ICP, Intra Uterine Growth Restriction - IUGR, preeclampsia, gestational diabetes; nonobstetrical complications; and perinatal complications: cord around neck/body, Apgar <7 at 5 min, cord pH, Neonatal Intensive Care Unit - NICU admission, complications during NICU hospitalization, and composite outcome...
February 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28277364/intrauterine-hyperoxemia-and-risk-of-neonatal-morbidity
#12
Nandini Raghuraman, Lorene A Temming, Molly J Stout, George A Macones, Alison G Cahill, Methodius G Tuuli
OBJECTIVE: To test the hypothesis that intrauterine hyperoxemia is associated with an increased risk of neonatal morbidity. METHODS: This was a secondary analysis of a prospective study of singleton, nonanomalous deliveries at or beyond 37 weeks of gestation at an institution with a universal umbilical cord gas policy from 2010 to 2014. The primary outcome was a composite of neonatal morbidity including neonatal death, meconium aspiration syndrome, intubation, mechanical ventilation, hypoxic-ischemic encephalopathy, and hypothermic therapy...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28274150/biochemical-and-clinical-predictors-of-hypoxic-ischemic-encephalopathy-after-perinatal-asphyxia
#13
Rebekka Jones, Axel Heep, David Odd
OBJECTIVE: To determine the usefulness of measures, available shortly after birth, as predictors of hypoxic-ischemic encephalopathy (HIE) following perinatal asphyxia. PATIENTS: All inborn patients at Southmead Hospital between January 2012 and March 2014 at ≥36 weeks gestation with a pH <7 or BE >16 on cord or baby's blood within one hour of birth or 10-minute Apgar score ≤5 or requiring intermittent positive pressure ventilation at 10 minutes were eligible for inclusion...
March 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28270765/cafedrine-theodrenaline-20-1-is-an-established-alternative-for-the-management-of-arterial-hypotension-in-germany-a-review-based-on-a-systematic-literature-search
#14
REVIEW
Berthold Bein, Torsten Christ, Leopold H J Eberhart
A 20:1 combination of cafedrine:theodrenaline (Akrinor®) is widely used in Germany for the treatment of hypotensive states during anesthesia and in emergency medicine. Although this drug formulation has been available since 1963, there are few studies relating to its use and many of the data are only available in German. In this article, we summarize the available data and propose mechanisms for the effects of cafedrine/theodrenaline on cardiac muscle cells and vascular smooth muscle cells. Cafedrine/theodrenaline leads to a rapid increase in mean arterial pressure that is characterized by increased cardiac preload, stroke volume, and cardiac output...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28267223/fundal-pressure-during-the-second-stage-of-labour
#15
REVIEW
G Justus Hofmeyr, Joshua P Vogel, Anna Cuthbert, Mandisa Singata
BACKGROUND: Fundal pressure during the second stage of labour (also known as the 'Kristeller manoeuvre') involves application of manual pressure to the uppermost part of the uterus directed towards the birth canal, in an attempt to assist spontaneous vaginal birth and avoid prolonged second stage or the need for operative birth. Fundal pressure has also been applied using an inflatable belt. Fundal pressure is widely used, however methods of its use vary widely. Despite strongly held opinions in favour of and against the use of fundal pressure, there is limited evidence regarding its maternal and neonatal benefits and harms...
March 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28247426/birth-asphyxia-measured-by-the-ph-value-of-the-umbilical-cord-blood-may-predict-an-increased-risk-of-attention-deficit-hyperactivity-disorder
#16
Susanne Hvolgaard Mikkelsen, Jørn Olsen, Bodil Hammer Bech, Chunsen Wu, Zeyan Liew, Mika Gissler, Carsten Obel, Onyebuchi Arah
AIM: Although birth asphyxia is a major risk factor for neonatal and childhood morbidity and mortality, it has not been investigated much in relation to attention deficit hyperactivity disorder (ADHD). We examined whether birth asphyxia measured by the pH of the blood in the umbilical artery cord was associated with childhood ADHD. METHOD: A population-based cohort of 295 687 children born in Finland between 1991 and 2002 was followed until December 31, 2007. ADHD was identified by the International Classification of Diseases, 10th edition, as a diagnosis of hyperkinetic disorder...
March 1, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28231607/position-in-the-second-stage-of-labour-for-women-with-epidural-anaesthesia
#17
REVIEW
Marion Kibuka, Jim G Thornton
BACKGROUND: Epidural analgesia for pain relief in labour prolongs the second stage of labour and results in more instrumental deliveries. It has been suggested that a more upright position of the mother during all or part of the second stage may counteract these adverse effects. This is an update of a Cochrane review first published in 2013. OBJECTIVES: To assess the effects of different birthing positions (upright and recumbent) during the second stage of labour, on important maternal and fetal outcomes for women with epidural analgesia...
February 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28224745/the-effect-of-maternal-low-flow-oxygen-administration-during-the-second-stage-of-labour-on-umbilical-cord-artery-ph-a-randomised-controlled-trial
#18
G Qian, X Xu, L Chen, S Xia, A Wang, Y Chuai, W Jiang
OBJECTIVE: To assess the effect of maternal low flow oxygen administration during the second stage of labour on umbilical cord artery pH. DESIGN: A randomised controlled trial. SETTING: A tertiary teaching hospital in China. POPULATION: Women in the second stage of labour with no complications. METHODS: About 443 women were randomly allocated to receive either supplemental oxygen at a flow rate of 2 l/min or a sham supplementation by nasal cannula...
March 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28222428/neonatal-and-maternal-short-term-outcome-parameters-in-instrument-assisted-vaginal-delivery-compared-to-second-stage-cesarean-section-in-labour-a-retrospective-11-year-analysis
#19
Moritz Polkowski, Elna Kuehnle, Cordula Schippert, Sudip Kundu, Peter Hillemanns, Ismini Staboulidou
BACKGROUND: This study is aimed at comparing the neonatal and maternal short-term outcomes after instrumental-assisted vaginal delivery and cesarean section (CS) in labour. METHODS: This retrospective study over a period of 11 years included singleton pregnancies above 34 + 0 gestational weeks, giving birth either by instrumental-assisted delivery or CS in labour. Maternal and neonatal outcome parameters were analysed using t test or linear regression. RESULTS: A total of 1,971/2,571 deliveries were included for analysis: 149 forceps-, 393 vacuum-assisted deliveries and 1,420 CS in labour...
February 22, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28220601/multiple-sclerosis-and-nephrolithiasis-a-matched-case-comparative-study
#20
Vishnu Ganesan, Wen Min Chen, Rajat Jain, Shubha De, Manoj Monga
OBJECTIVE: To compare stone composition and serum/urine biochemistries in stone formers with multiple sclerosis (MS) against stone formers without MS and to examine the association between mobility, methods of bladder emptying, and stone formation. MATERIALS AND METHODS: In this retrospective case-control study, we identified patients diagnosed with multiple sclerosis and kidney stone disease who were seen at our institution between 2001 and 2016. For the first part of the study, up to 2 controls (stone formers without a history of MS) were identified for each case and matched on age, body mass index (BMI), and sex...
February 20, 2017: BJU International
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