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Early pregnancy management

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https://www.readbyqxmd.com/read/28207161/prenatal-diagnosis-of-congenital-cytomegalovirus-infection-in-115-cases-a-5%C3%A2-years-single-centre-experience
#1
M Enders, A Daiminger, S Exler, K Ertan, G Enders, R Bald
OBJECTIVE: To investigate the diagnostic value of invasive prenatal diagnosis (PD) of congenital CMV infection from amniotic fluid (AF) and fetal blood (FB) METHODS: Retrospective study on 115 pregnancies with CMV primary infection. A total of 111 AF and 106 FB samples were investigated for various virological and non-virological markers. Detailed ultrasound examinations were performed at time of PD. RESULTS: Overall sensitivity of CMV PCR in FB (75.6%; 95%CI 60-87) and AF (72...
February 16, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28203028/-unerupted-first-deciduous-molar-located-higher-to-the-first-premolar-a-case-report
#2
Y Zhan, H Liu
Tooth eruption is defined as the movement of a tooth from its site of development within the alveolar process to its functional position in the oral cavity. The process of tooth eruption can be divided into different phases: pre-eruptive bone stage, alveolar bone stage, mucosal stage, preocclusal stage, occlusal stage and maturation stage. Any disturbance in these phases can lead to eruptive anomalies. The incidence of unerupted teeth is usually higher among permanent teeth than among deciduous ones. Of the primary teeth reported as unerupted, second deciduous molars are the teeth most frequently involved, followed by primary central incisors...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28197344/from-bad-to-worse-paraganglioma-diagnosis-during-induction-of-labor-for-coexisting-preeclampsia
#3
Sasima Dusitkasem, Blair H Herndon, Dalton Paluzzi, Joseph Kuhn, Robert H Small, John C Coffman
Pheochromocytomas and extra-adrenal paragangliomas are catecholamine-secreting tumors that rarely occur in pregnancy. The diagnosis of these tumors in pregnancy can be challenging given that many of the signs and symptoms are commonly attributed to preeclampsia or other more common diagnoses. Early diagnosis and appropriate management are essential in optimizing maternal and fetal outcomes. We report a rare case of a catecholamine-secreting tumor in which diagnosis occurring at the time labor was being induced for concomitant preeclampsia with severe features...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28191905/st-elevation-acute-myocardial-infarction-in-pregnancy-2016-update
#4
REVIEW
Sahar Ismail, Cynthia Wong, Priya Rajan, Mladen I Vidovich
Acute myocardial infarction (AMI) during pregnancy or the early postpartum period is rare, but can be devastating for both the mother and the fetus. There have been major advances in the diagnosis and treatment of acute coronary syndromes in the general population, but there is little consensus on the approach to diagnosis and treatment of pregnant women. This article reviews the literature relating to the pathophysiology of AMI in pregnant patients and the challenges in diagnosis and treatment of ST-elevation myocardial infarction (STEMI) in this unique population...
February 13, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28182335/how-to-monitor-pregnancies-complicated-by-fetal-growth-restriction-and-delivery-below-32-weeks
#5
W Ganzevoort, N Mensing van Charante, B Thilaganathan, F Prefumo, B Arabin, C M Bilardo, C Brezinka, J B Derks, A Diemert, J J Duvekot, E Ferrazzi, T Frusca, K Hecher, N Marlow, P Martinelli, E Ostermayer, A T Papageorghiou, D Schlembach, Ktm Schneider, T Todros, A Valcamonico, Gha Visser, A van Wassenaer-Leemhuis, C C Lees, H Wolf
OBJECTIVES: In the recent TRUFFLE study it appeared that, in pregnancies complicated by fetal growth restriction (FGR) between 26 and 32 weeks, monitoring of the ductus venosus (DV) combined with computerised cardiotocography (cCTG) as a trigger for delivery, increased the chance of infant survival without neurological impairment. However, concerns in interpretation were raised as DV monitoring appeared associated with a non-significant increase in fetal death, and part of the infants were delivered after 32 weeks, after which the study protocol was no longer applied...
February 9, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28181214/aspirin-single-dose-for-perineal-pain-in-the-early-postpartum-period
#6
REVIEW
Sujana Molakatalla, Emily Shepherd, Rosalie M Grivell
BACKGROUND: Perineal trauma (due to spontaneous tears, surgical incision (episiotomy) or in association with operative vaginal birth) is common after vaginal birth, and is often associated with postpartum perineal pain. Birth over an intact perineum may also lead to perineal pain. There are adverse health consequences associated with perineal pain for the women and their babies in the short- and long-term, and the pain may interfere with newborn care and the establishment of breastfeeding...
February 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28180962/cardiotocography-and-the-evolution-into-computerised-cardiotocography-in-the-management-of-intrauterine-growth-restriction
#7
REVIEW
Christina Kouskouti, Kerstin Regner, Julia Knabl, Franz Kainer
Timely recognition and appropriate management of high-risk pregnancies, such as intrauterine growth restriction (IUGR), are of paramount importance for every obstetrician. After the initial screening of IUGR fetuses through sonographic fetometry and Doppler, the focus is shifted to the appropriate monitoring and timing of delivery. This can, especially in cases of early IUGR, become a very difficult task. At this point, cardiotocography (CTG) is introduced as a major tool in the day-to-day monitoring of the antenatal well-being of the IUGR fetus...
February 8, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28180146/-i-think-we-ve-got-too-many-tests-prenatal-providers-reflections-on-ethical-and-clinical-challenges-in-the-practice-integration-of-cell-free-dna-screening
#8
B L Gammon, S A Kraft, M Michie, M Allyse
BACKGROUND: The recent introduction of cell-free DNA-based non-invasive prenatal screening (cfDNA screening) into clinical practice was expected to revolutionize prenatal testing. cfDNA screening for fetal aneuploidy has demonstrated higher test sensitivity and specificity for some conditions than conventional serum screening and can be conducted early in the pregnancy. However, it is not clear whether and how clinical practices are assimilating this new type of testing into their informed consent and counselling processes...
July 2016: Ethics, Medicine, and Public Health
https://www.readbyqxmd.com/read/28179198/cesarean-scar-ectopic-pregnancy-laparoscopic-resection-and-total-scar-dehiscence-repair-a-case-report
#9
Sara Mahgoub, Victor Gabriele, Emilie Faller, Bruno Langer, Arnaud Wattiez, Lise Lecointre, Cherif Akladios
STUDY OBJECTIVE: Illustrate laparoscopic technique for resection of cesarean scar ectopic pregnancy, associated with isthmocele repair. DESIGN: Case report SETTING: Tertiary referral centre in Strasbourg, France. The study was approved by the local IRB. BACKGROUND: Cesarean scar pregnancy is a rare form of ectopic pregnancy. The major risk of this type of pregnancy is the early uterine rupture with massive bleeding and maternal life-threatening...
February 4, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28174626/maternal-undernutrition-and-excessive-body-weight-and-risk-of-birth-and-health-outcomes
#10
Md Nuruzzaman Khan, Md Mizanur Rahman, Asma Ahmad Shariff, Md Mostafizur Rahman, Md Shafiur Rahman, Md Aminur Rahman
BACKGROUND: Overweight and obesity are increasing in low- and middle-income countries, while underweight remains a significant health problems. However, the association between double burden of nutrition and risk of adverse birth and health outcomes is still unclear in Bangladesh. The aim of this study was to determine the effect of maternal undernutrition and excessive body weight on a range of maternal and child health outcomes. METHODS: In this study, we used Bangladesh Demographic and Health Survey (BDHS) 2011 and 2014 data sets to cover the maternal, child and non-communicable diseases related health outcomes...
2017: Archives of Public Health, Archives Belges de Santé Publique
https://www.readbyqxmd.com/read/28168434/fetal-alcohol-spectrum-disorders-characteristics-complications-and-treatment
#11
Lauren F Wilhoit, David A Scott, Brooke A Simecka
Fetal Alcohol Spectrum Disorders (FASD) includes a continuum of disorders that occur in children as a result of their mothers' consumption of alcohol during pregnancy. The most severe of these disorders is Fetal Alcohol Syndrome (FAS). FASD presents differently in every child, but all children with FASD have intellectual and/or behavioral impairments. There is no cure for FASD, but research shows that early intervention and life-long support help those born with FASD to manage the difficulties that come with it...
February 6, 2017: Community Mental Health Journal
https://www.readbyqxmd.com/read/28166576/the-effects-of-abortion-training-on-family-medicine-residents-clinical-experience
#12
Aleza K Summit, Marji Gold
BACKGROUND AND OBJECTIVES: RHEDI, Reproductive Health Education in Family Medicine, offers technical assistance and funding to family medicine residency programs to support integrated opt-out abortion and reproductive health training for residents. This study assessed the impact of this enhanced training on residents' reproductive health experience. METHODS: Investigator-developed pre- and post-surveys were administered online to 214 residents at 12 family medicine residency programs before and after their RHEDI training experience...
January 2017: Family Medicine
https://www.readbyqxmd.com/read/28160896/patient-centered-care-to-address-barriers-for-pregnant-women-with-opioid-dependence
#13
REVIEW
Mary Beth Sutter, Sarah Gopman, Lawrence Leeman
Pregnant women affected by substance use often encounter barriers to treatment, including housing insecurity, poverty, mental health issues, social stigma, and access to health care. Providers may lack the resources needed to provide quality care. Clinicians offering prenatal care to women with substance use disorder are encouraged to support family-centered, multidisciplinary care to women and their infants, focusing on harm reduction. Collaboration between providers of maternity care, substance abuse treatment, case management, family primary care, and pediatric developmental care can improve outcomes during pregnancy and through the early years of parenting...
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28159390/sickle-cell-disease
#14
REVIEW
Russell E Ware, Mariane de Montalembert, Léon Tshilolo, Miguel R Abboud
Sickle cell disease is a common and life-threatening haematological disorder that affects millions of people worldwide. Abnormal sickle-shaped erythrocytes disrupt blood flow in small vessels, and this vaso-occlusion leads to distal tissue ischaemia and inflammation, with symptoms defining the acute painful sickle-cell crisis. Repeated sickling and ongoing haemolytic anaemia, even when subclinical, lead to parenchymal injury and chronic organ damage, causing substantial morbidity and early mortality. Currently available treatments are limited to transfusions and hydroxycarbamide, although stem cell transplantation might be a potentially curative therapy...
January 31, 2017: Lancet
https://www.readbyqxmd.com/read/28157751/inherited-and-uncommon-causes-of-stroke
#15
Jennifer Juhl Majersik
PURPOSE OF REVIEW: This article is a practical guide to identifying uncommon causes of stroke and offers guidance for evaluation and management, even when large controlled trials are lacking in these rarer forms of stroke. RECENT FINDINGS: Fabry disease causes early-onset stroke, particularly of the vertebrobasilar system; enzyme replacement therapy should be considered in affected patients. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), often misdiagnosed as multiple sclerosis, causes migraines, early-onset lacunar strokes, and dementia...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157643/ratios-of-biochemical-markers-in-peritoneal-fluid-to-those-in-venous-blood-for-the-diagnosis-of-ruptured-tubal-pregnancy-a-prospective-study
#16
Xiao-Lu Zhu, Zhuo-Wei Xue, Yan-Li Xu, Juan Wang, Zhi-Hong Ai, Yin-Cheng Teng
OBJECTIVES: Ectopic pregnancies are among the leading causes of maternal morbidity and mortality in both developed and emerging nations, but tests for early, accurate, and convenient detection are lacking. STUDY DESIGN: Between January 2013 and February 2015, 504 women with tubal pregnancy were prospectively recruited, and their clinical characteristics were recorded. Samples of peritoneal fluid were collected by culdocentesis, and venous blood was drawn from the antecubital vein...
January 18, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28155021/anti-angiogenesis-and-preeclampsia-in-2016
#17
REVIEW
Susanne Schrey-Petersen, Holger Stepan
PURPOSE OF REVIEW: Preeclampsia remains one of the most important complications in pregnancy worldwide. With this review, we aim to give an overview on important research findings over the last years and their effects on current clinical management. RECENT FINDINGS: The association between preeclampsia and altered angiogenesis is nowadays widely accepted. Only during the last years, assessment of angiogenic factors such as the soluble fms-like tyrosine kinase-1-to-placental growth factor (sFlt-1/PlGF) ratio has become available to everyday clinical practice with commercially available automated measurements...
January 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28144773/lumbar-disk-herniation-during-pregnancy-a-review-on-general-management-and-timing-of-surgery
#18
REVIEW
Hugo Ardaillon, Yosef Laviv, Jeffrey E Arle, Ekkehard M Kasper
STUDY DESIGN: Narrative review with case illustration. OBJECTIVE: Provide an overview of existing management strategies to suggest a guideline for surgical management of lumbar disk herniation in pregnant women based on time of presentation. METHODS: We performed a narrative review on the topic using the PubMed database. A total of 63 relevant articles published after 1992 were identified, of which 17 fulfilled selection criteria. RESULTS: A total of 22 published cases of spine surgery for disk herniation during pregnancy were found in 17 studies on the topic...
January 31, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28141956/bell-s-facial-nerve-palsy-in-pregnancy-a-clinical-review
#19
Ahsen Hussain, Charles Nduka, Philippa Moth, Raman Malhotra
Bell's facial nerve palsy (FNP) during pregnancy and the puerperium can present significant challenges for the patient and clinician. Presentation and prognosis can be worse in this group of patients. This article reviews the background, manifestation and management options of FNP. In particular, it focuses on the controversies that exist regarding corticosteroid use during pregnancy and outlines approaches to diagnosis and treatment. Based on this review, we recommend an early evidence-based approach using guidelines derived from non-pregnant populations...
January 31, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28139508/antiphospholipid-antibody-titers-and-clinical-outcomes-in-patients-with-recurrent-miscarriage-and-antiphospholipid-antibody-syndrome-a-prospective-study
#20
Yu Song, Hai-Yan Wang, Jie Qiao, Ping Liu, Hong-Bin Chi
BACKGROUND: The management of patients with recurrent miscarriage (RM) and antiphospholipid antibody syndrome (APS) includes prolonged treatment with heparin and aspirin, starting from the confirmation of pregnancy and continuing until 6 weeks after birth. This study was conducted to determine the relationship between changes in antiphospholipid antibody titers and clinical outcomes. The effect of a shortened treatment regimen was also evaluated. METHODS: A prospective study of 123 patients with RM and APS between March 2012 and May 2014 was conducted...
2017: Chinese Medical Journal
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