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Early pregnancy management

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https://www.readbyqxmd.com/read/29334711/-serologic-surveillance-indicators-analysis-among-syphilis-infected-pregnant-women-in-east-china
#1
L X Dou, Q Wang, X Y Wang, Y P Qiao, M Su, X Jin, A L Wang
Objective: To analyze serologic surveillance indicators during pregnancy among syphilis-infected women who delivered in 2013 in East China. Methods: Data were from national 'Information System of Prevention of Mother-to-child Transmission of HIV, syphilis and HBV Management' and in total 5 206 syphilis-infected pregnant women who delivered in 2013 and in East China were involved in the analysis. Information on demographic characters, laboratory tests, and treatment regimens were collected. The maternal non-treponemal testing surveillance and titer distribution were described and compare the proportions between pregnant women receiving standard testing and non-standard testing, taking baseline testing and testing before delivery or at the third trimester...
January 6, 2018: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
https://www.readbyqxmd.com/read/29328940/first-trimester-serum-biomarkers-to-predict-gestational-diabetes-in-a-high-risk-cohort-striving-for-clinically-useful-thresholds
#2
Siobhan M Corcoran, Natalie Achamallah, John O' Loughlin, Philip Stafford, Pat Dicker, Fergal D Malone, Fionnuala Breathnach
OBJECTIVES: Screening and diagnosis of gestational diabetes (GDM) has been a source of controversy. The prevalence has increased in line with an obesity epidemic and a trend towards delayed child-bearing. Treatment of even modest glycaemic impairment in pregnancy has been shown to be beneficial in preventing its clinical sequalae. However the cumbersome nature and timing of the oral glucose tolerance test coupled with debate around universal versus risk factor based screening have been problematic...
January 1, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29327350/adopting-innovation-in-gynaecology-the-introduction-of-e-consult
#3
Rebecca Mann, Peter H M van de Weijer
OBJECTIVE: To describe the development of an e-consultation service as part of the triaging and grading process of referrals and to report on the efficacy and safety of such a service. METHODS: All gynaecology e-consults in the study period June 2015 to March 2016 were retrospectively reviewed. The outcomes of interest were the initial reduction in first face-to-face hospital visits, and the rate of re-referrals. Acute admission for the same reason, a subsequent diagnosis of underlying (pre)-malignancy, or patient death from the condition related to the index referral were selected as measures for patient safety...
January 12, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29325265/-clinical-analysis-of-105-intrauterine-fetal-deaths-in-17-years
#4
S Wang, H X Yang
Objective: To study the cause of intrauterine fetal death (IUFD) in 17 years. Methods: From June 1(st), 2000 to May 31(st), 2017, 65 621 women delivered in Peking University First Hospital. Clinical data of 105 cases of IUFD (including 82 singleton pregnancies and 23 twin pregnancies) during the 17 years were analyzed retrospectively. Results: (1) In singleton pregnancies, the leading cause of IUFD was maternal complications, including severe pre-eclampsia (36/82, 43.9%) and diabetes mellitus (6/82, 7.3%). The second reason was umbilical cord factors (13/82, 15...
December 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/29325264/-high-risk-factors-analysis-of-stillbirth
#5
Y Xiong, H X Xia, Y S Wang, X L Lin, T T Zhu, Y Zhao, X T Li
Objective: To explore the high risk factors of stillbirth. Methods: 176 cases of stillbirth were collected in the Obstetrics and Gynecology Hospital of Fudan University from January 1(st), 2010 to December 31(st), 2016. All cases were analyzed retrospectively, including general profile, high risk factors of stillbirth in different years and pregnancy periods. Results: (1) The incidence of stillbirth was 0.178%(176/98 785). Stillbirth occured mostly at 28-28(+6) gestational weeks (10.8%,19/176), and the second peak was 29-29(+6) weeks(10...
December 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/29322346/study-on-the-incidence-and-influences-on-heterotopic-pregnancy-from-embryo-transfer-of-fresh-cycles-and-frozen-thawed-cycles
#6
Shan Xiao, Meilan Mo, Xiaodong Hu, Hongzhan Zhang, Shiru Xu, Zhuran Wang, Yong Zeng
PURPOSE: The purpose of this study was to determine the heterotopic pregnancy rate using fresh versus frozen-thawed embryo transfers and factors associated with heterotopic pregnancy (HP). Management and clinical outcomes after heterotopic pregnancy were also evaluated. METHODS: In this retrospective cohort study, we included 12,484 women who had clinical pregnancies after in vitro fertilization treatment at our fertility center between 2012 and 2017. Patients received fresh day 3 embryos (F-D3 group), fresh day 5 blastocysts (F-D5 group), frozen-thawed day 3 embryos (T-D3 group), or frozen-thawed day 5 or 6 blastocysts (T-D5/6 groups) transfers...
January 11, 2018: Journal of Assisted Reproduction and Genetics
https://www.readbyqxmd.com/read/29319359/secondary-and-tertiary-preventions-of-thyroid-disease
#7
Fereidoun Azizi, Ladan Mehran, Farhad Hosseinpanah, Hossein Delshad, Atieh Amouzegar
INTRODUCTION: Secondary and tertiary preventions are concerned with the recognition of the disease process in a very early stage and delay in progression to complete disease and minimization of complications and the impact of illness. METHODS: All articles related to secondary and tertiary prevention of thyroid diseases were reviewed. Using related key words, articles published between 2001 and 2015 were evaluated, categorized, and analyzed. RESULTS: In secondary prevention, congenital hypothyroidism and subclinical hypo and hyperthyroidism are equally important...
January 10, 2018: Endocrine Research
https://www.readbyqxmd.com/read/29310986/multidisciplinary-obstetric-critical-care-delivery-the-concept-of-the-virtual-intensive-care-unit
#8
REVIEW
Michael P Leovic, Hailey N Robbins, Roman S Starikov, Michael R Foley
With an increasing prevalence of chronic medical conditions and the associated potential for decompensation to critical illness among modern day parturients, we present here the concept of the "virtual" intensive care unit. We challenge the traditional association of the word "unit" to extend beyond a fixed physical setting to portray an individualized, predetermined patient care team capable of managing these complex patients in a variety of settings. In this model, obstetric critical care is provided through a multidisciplinary patient care team, with emphasis on early identification of complicated pregnancies, detailed antepartum planning, anticipation of complications, and retrospective review of clinical outcomes aimed at continued quality improvement...
January 5, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29309283/hiv-infection-antepartum-treatment-and-management
#9
Helene B Bernstein, Adam D Wegman
Human immunodeficiency virus (HIV) is a retrovirus which became pandemic in the early 1980s. Since its initial characterization, advancements in diagnosis and management have transformed HIV infection from a terminal diagnosis to a chronic, manageable condition. Effective antiretroviral therapy, acting at multiple steps in the viral lifecycle, durably suppresses viral replication, preserves maternal health and prevents mother to child HIV transmission. Here, we review the salient clinical and ethical considerations of managing HIV infection during pregnancy and delivery...
January 5, 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29305253/chronic-hypertension-first-trimester-blood-pressure-control-and-likelihood-of-severe-hypertension-preeclampsia-and-small-for-gestational-age
#10
Diane Nzelu, Dan Dumitrascu-Biris, Kypros H Nicolaides, Nikos A Kametas
BACKGROUND: There is extensive evidence that pre-pregnancy chronic hypertension is associated with high risk of development of severe hypertension and preeclampsia and birth of small for gestational age neonates. However, previous studies have not reported whether anti-hypertensive use, blood pressure control or normalization of blood pressure during early pregnancy influence the rates of these pregnancy complications. OBJECTIVE: To stratify women with pre-pregnancy chronic hypertension according to the use of antihypertensive medications and level of blood pressure control at the first hospital visit during the first-trimester of pregnancy and examine the rates of severe hypertension, preeclampsia and birth of small for gestational age neonates according to such stratification...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29298715/the-potential-of-task-shifting-selected-maternal-interventions-to-auxiliary-midwives-in-myanmar-a-mixed-method-study
#11
Kyu Kyu Than, Khaing Nwe Tin, Thazin La, Kyaw Soe Thant, Theingi Myint, James G Beeson, Stanley Luchters, Alison Morgan
BACKGROUND: An estimated 282 women die for every 100,000 live births in Myanmar, most due to preventable causes. Auxiliary Midwives (AMWs) in Myanmar are responsible for providing a package of care during pregnancy and childbirth to women in rural hard to reach areas where skilled birth attendants (Midwives) are not accessible. This study aims to examine the role of AMWs in Myanmar and to assess the current practices of three proposed essential maternal interventions (oral supplement distribution to pregnant women; administration of misoprostol to prevent postpartum haemorrhage; management of puerperal sepsis with oral antibiotics) in order to facilitate a formal integration of these tasks to AMWs in Myanmar...
January 3, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29290922/gestational-diabetes-from-a-to-z
#12
REVIEW
AbdelHameed Mirghani Dirar, John Doupis
Gestational diabetes mellitus (GDM) is defined as any degree of hyperglycaemia that is recognized for the first time during pregnancy. This definition includes cases of undiagnosed type 2 diabetes mellitus (T2DM) identified early in pregnancy and true GDM which develops later. GDM constitutes a greater impact on diabetes epidemic as it carries a major risk of developing T2DM to the mother and foetus later in life. In addition, GDM has also been linked with cardiometabolic risk factors such as lipid abnormalities, hypertensive disorders and hyperinsulinemia...
December 15, 2017: World Journal of Diabetes
https://www.readbyqxmd.com/read/29277273/identification-of-potential-early-biomarkers-of-preeclampsia
#13
Angelika V Timofeeva, Vladyslava A Gusar, Nataliya E Kan, Kseniya N Prozorovskaya, Anna O Karapetyan, Oleg R Bayev, Vitaliy V Chagovets, Sergei F Kliver, Daria Yu Iakovishina, Vladimir E Frankevich, Gennadiy T Sukhikh
INTRODUCTION: It is thought that poor placental perfusion caused by inadequate remodelling of the maternal spiral arteries leads to preeclampsia (PE). To identify novel signalling pathways that contribute to PE pathogenesis and to create prerequisites for the non-invasive diagnosis of PE before clinical manifestations of the disease, this study aimed to evaluate miRNA expression levels in the placenta and blood plasma of pregnant women. METHODS: miRNA deep sequencing followed by real-time quantitative RT-PCR was applied to compare miRNA expression profiles in the placenta and blood plasma from women with early- and late-onset PE relative to the control group...
January 2018: Placenta
https://www.readbyqxmd.com/read/29275238/simultaneous-pregnancy-in-each-uterine-cavity-of-a-double-uterus-in-a-young-nigerian-multipara-who-presented-with-a-retained-second-twin-following-an-unsupervised-preterm-labor-at-home-case-report
#14
Emmanuel Oluchikwu Ani, Emmanuel Ajuluchukwu Ugwa, Aminu Bashir Taiye, Iwasam Elemi Agbor, Ibrahim Shaaibu Suleiman
INTRODUCTION: Simultaneous pregnancy in each uterine cavity of a double uterus is unusual but is a recognized risk factor for preterm labour and other poor obstetrics outcomes. The work has been reported in line with the SCARE criteria. PRESENTATION OF CASE: We report an unusual case of simultaneous pregnancy in each uterine cavity of a double uterus in a young African grand multipara who presented with a retained second twin following a preterm labour at home. DISCUSSION: A double or didelphys uterus as reported in the literatures is still uncommon even in Africa...
December 13, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29250791/successful-management-of-severe-red-blood-cell-alloimmunization-in-pregnancy-with-a-combination-of-therapeutic-plasma-exchange-intravenous-immune-globulin-and-intrauterine-transfusion
#15
Laura C Nwogu, Kenneth J Moise, Kimberly L Klein, Hlaing Tint, Brian Castillo, Yu Bai
BACKGROUND: Antibodies to Rhesus and Kell antigens have been associated with severe hemolytic disease of the fetus and newborn (HDFN) necessitating intrauterine transfusion (IUT) of red blood cells (RBCs). We report a case series of five women with severe HDFN secondary to maternal RBC alloimmunization who were successfully managed with therapeutic plasma exchange (TPE), intravenous immune globulin (IVIG), and IUT. STUDY DESIGN AND METHODS: This is a retrospective case series of five women with severe HDFN who underwent a total of three TPE procedures during Weeks 10 to 13 of pregnancy, followed by weekly IVIG infusions...
December 17, 2017: Transfusion
https://www.readbyqxmd.com/read/29246235/comparative-satisfaction-of-receiving-medical-abortion-service-from-nurses-and-auxiliary-nurse-midwives-or-doctors-in-nepal-results-of-a-randomized-trial
#16
Anand Tamang, Iqbal H Shah, Pragya Shrestha, I K Warriner, Duolao Wang, Kusum Thapa, N T My Huong, Olav Meirik
BACKGROUND: Early first-trimester medical abortion (MA) service (≤ 63 days) has been provided by doctors and nurses under doctors' supervision since 2009 in Nepal. This paper assesses whether MA services provided by specifically trained and certified nurses and auxiliary nurse-midwives independently from doctors' supervision, is considered as satisfactory by women as those provided by doctors. METHODS: The data come from a multi-center, randomized, controlled equivalence trial conducted between April 2009 and March 2010 in five district hospitals in Nepal...
December 16, 2017: Reproductive Health
https://www.readbyqxmd.com/read/29237320/clinical-management-of-women-with-listeriosis-risk-during-pregnancy-a-review-of-national-guidelines
#17
Lisa Pucci, Mario Massacesi, Giuseppina Liuzzi
INTRODUCTION: Listeriosis is an uncommon foodborne infection that may cause moderate maternal illness, but can be extremely serious for the fetus and the newborn. Several guidelines have been elaborated in order to help clinicians on the care of pregnant women with known or suspected exposure to Listeria monocytogenes. The aim of this review is to collect, assess and summarize them, in order to provide a comprehensive overlook and to highlight the grey areas in the guidance that could result in failure to detect some infected but asymptomatic women...
December 13, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/29236714/non-invasive-identification-of-protein-biomarkers-for-early-pregnancy-diagnosis-in-the-cheetah-acinonyx-jubatus
#18
Diana C Koester, David E Wildt, Morgan Maly, Pierre Comizzoli, Adrienne E Crosier
Approximately 80% of cheetahs living in typical zoological collections never reproduce. In more than 60% of breedings, the female is confirmed to ovulate, but parturition fails to occur. It is unknown if these non-pregnant intervals of elevated progesterone (deemed luteal phases) are conception failures or a pregnancy terminating in embryonic/fetal loss. There have been recent advances in metabolic profiling and proteome analyses in many species with mass spectrometry used to identify 'biomarkers' and mechanisms indicative of specific physiological states (including pregnancy)...
2017: PloS One
https://www.readbyqxmd.com/read/29232273/practice-bulletin-no-191-tubal-ectopic-pregnancy
#19
(no author information available yet)
Ectopic pregnancy is defined as a pregnancy that occurs outside of the uterine cavity. The most common extrauterine site of ectopic pregnancy is the fallopian tube. Most cases of tubal ectopic pregnancy that are detected early can be treated successfully either with minimally invasive surgery or with medical management using methotrexate. However, tubal ectopic pregnancy in an unstable patient is a medical emergency that requires prompt surgical intervention. The purpose of this document is to review information on the current understanding of tubal ectopic pregnancy and to provide guidelines for timely diagnosis and management that are consistent with the best available scientific evidence...
December 5, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29230832/management-of-chronic-myeloid-leukemia-in-the-setting-of-pregnancy-when-is-leukocytapheresis-appropriate-a-case-report-and-review-of-the-literature
#20
Elizabeth M Staley, Sierra C Simmons, Alexander Z Feldman, Robin G Lorenz, Marisa B Marques, Lance A Williams, X Long Zheng, Huy P Pham
BACKGROUND: Chronic myeloid leukemia (CML) is a common hematologic malignancy; however, its occurrence during pregnancy is unusual due to its low prevalence in females of childbearing age. There are conflicting reports of how to best manage CML in pregnancy, particularly in the setting of leukocytosis. CASE REPORT: A 30-year-old female was diagnosed with CML at 18 weeks' estimated gestational age. On initial presentation she reported fatigue, night sweats, and early satiety, and was found to have a white blood cell (WBC) count of 69...
December 11, 2017: Transfusion
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