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Perinatal protocols

Kylee Trevillion, Jill Domoney, Andrew Pickles, Debra Bick, Sarah Byford, Margaret Heslin, Jeannette Milgrom, Rachel Mycroft, Carmine Pariante, Elizabeth Ryan, Myra Hunter, Louise Michele Howard
BACKGROUND: Depression is a common antenatal mental disorder and is associated with an increased risk of adverse effects on the fetus and significant morbidity for the mother; if untreated it can also continue into the post-natal period and affect mother-infant interactions. There has been little research evaluating the effectiveness or cost-effectiveness of antenatal psychological interventions for antenatal depression, particularly for mild to moderate disorders. International guidelines recommend a stepped care approach starting with Guided Self Help, and the aim of this exploratory trial is to investigate Guided Self Help modified for pregnancy...
October 18, 2016: Trials
Courtney Stanley Sundin, Lauren Bradham Mazac
Amniotic fluid embolism (AFE) is a rare but serious and potentially deadly complication of pregnancy that is unpreventable and unpredictable. Most AFE events occur during labor; however, approximately one third happen during the immediate postpartum period. Presentation is abrupt and thought to be an abnormal response to fetal materials entering maternal circulation through the placental insertion site. Care providers must recognize the signs and symptoms of AFE and react quickly in effort to treat potential complications...
October 13, 2016: MCN. the American Journal of Maternal Child Nursing
Jens Henrichs, Viki Verfaille, Laura Viester, Myrte Westerneng, Bert Molewijk, Arie Franx, Henriette van der Horst, Judith E Bosmans, Ank de Jonge, Petra Jellema
BACKGROUND: Intrauterine growth retardation (IUGR) is a major risk factor for perinatal mortality and morbidity. Thus, there is a compelling need to introduce sensitive measures to detect IUGR fetuses. Routine third trimester ultrasonography is increasingly used to detect IUGR. However, we lack evidence for its clinical effectiveness and cost-effectiveness and information on ethical considerations of additional third trimester ultrasonography. This nationwide stepped wedge cluster-randomized trial examines the (cost-)effectiveness of routine third trimester ultrasonography in reducing severe adverse perinatal outcome through subsequent protocolized management...
October 13, 2016: BMC Pregnancy and Childbirth
C H Backes, E M Bonachea, B K Rivera, M M Reynolds, C E Kovalchin, K M Reber, M K Ball, R Sutsko, S R Guntupalli, C V Smith, J D Mahan, M M Carbajal
OBJECTIVE: To evaluate the preparedness of pediatric residents entering accredited neonatal-perinatal medicine (NPM) fellowships in the United States. STUDY DESIGN: A multi-domain, validated survey was distributed to Program Directors (PDs) of US NPM fellowship programs. The 47-item survey explored 5 domains: professionalism, independent practice, psychomotor ability, clinical evaluation, and academia. A systematic, qualitative analysis on free-text comments was also performed...
September 29, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
David G Sweet, Virgilio Carnielli, Gorm Greisen, Mikko Hallman, Eren Ozek, Richard Plavka, Ola Didrik Saugstad, Umberto Simeoni, Christian P Speer, Máximo Vento, Gerard H A Visser, Henry L Halliday
Advances in the management of respiratory distress syndrome (RDS) ensure that clinicians must continue to revise current practice. We report the third update of the European Guidelines for the Management of RDS by a European panel of expert neonatologists including input from an expert perinatal obstetrician based on available literature up to the beginning of 2016. Optimizing the outcome for babies with RDS includes consideration of when to use antenatal steroids, and good obstetric practice includes methods of predicting the risk of preterm delivery and also consideration of whether transfer to a perinatal centre is necessary and safe...
September 21, 2016: Neonatology
Orly Sarid, Julie Cwikel, Johanna Czamanski-Cohen, Ephrat Huss
This paper presents an overview of a combined, evaluated protocol, cognitive behavioural and art therapy treatment (CB-ART), for the treatment of women with perinatal mood and anxiety disorders (PMADs). The protocol integrates cognitive behavioural interventions and art therapy. CB-ART focuses on changing distressing image, symptom or memory (ISM) that interferes with functioning. The method directs clients to identify compositional elements that characterize their stressful ISM and to alter the element in their imagination, in bodily sensations and on the page...
September 19, 2016: Archives of Women's Mental Health
Masamitsu Nakamura, Junichi Hasegawa, Tatsuya Arakaki, Shoko Hamada, Hiroko Takita, Tomohiro Oba, Keiko Koide, Ryu Matsuoka, Akihiko Sekizawa
AIM: The aim of this study was to evaluate the effect of long-term use of tocolytic agents to prevent preterm delivery and improve perinatal outcome. METHODS: A historical cohort study was performed in a single perinatal center. The maternal characteristics, frequency of preterm labor and prescribed dose of tocolytic agents were compared before and after changing the management protocol for threatened premature delivery. RESULTS: A total of 1548 deliveries were carried out before changing the protocol for the use of tocolytic agents for threatened premature delivery and 1444 deliveries afterwards...
September 19, 2016: Journal of Obstetrics and Gynaecology Research
R Douglas Wilson, Isabelle De Bie, Christine M Armour, Richard N Brown, Carla Campagnolo, June C Carroll, Nan Okun, Tanya Nelson, Rhonda Zwingerman, Francois Audibert, Jo-Ann Brock, Richard N Brown, Carla Campagnolo, June C Carroll, Isabelle De Bie, Jo-Ann Johnson, Nan Okun, Melanie Pastruck, Karine Vallée-Pouliot, R Douglas Wilson, Rhonda Zwingerman, Christine Armour, David Chitayat, Isabelle De Bie, Sara Fernandez, Raymond Kim, Josee Lavoie, Norma Leonard, Tanya Nelson, Sherry Taylor, Margot Van Allen, Clara Van Karnebeek
OBJECTIVE: This guideline was written to update Canadian maternity care and reproductive healthcare providers on pre- and postconceptional reproductive carrier screening for women or couples who may be at risk of being carriers for autosomal recessive (AR), autosomal dominant (AD), or X-linked (XL) conditions, with risk of transmission to the fetus. Four previous SOGC- Canadian College of Medical Geneticists (CCMG) guidelines are updated and merged into the current document. INTENDED USERS: All maternity care (most responsible health provider [MRHP]) and paediatric providers; maternity nursing; nurse practitioner; provincial maternity care administrator; medical student; and postgraduate resident year 1-7...
August 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Elizabeth L Turner, Siham Sikander, Omer Bangash, Ahmed Zaidi, Lisa Bates, John Gallis, Nima Ganga, Karen O'Donnell, Atif Rahman, Joanna Maselko
BACKGROUND: The negative effects of perinatal depression on the mother and child start early and persist throughout the lifecourse (Lancet 369(9556):145-57, 2007; Am J Psychiatry 159(1):43-7, 2002; Arch Dis Child 77(2):99-101, 1997; J Pak Med Assoc 60(4):329; J Psychosoma Res 49(3):207-16, 2000; Clin Child Fam Psychol Rev 14(1):1-27, 2011). Given that 10-35 % of children worldwide are exposed to perinatal depression in their first year of life (Int Rev Psychiatry 8(1):37-54, 1996), mitigating this intergenerational risk is a global public health priority (Perspect Public Health 129(5):221-7, 2009; Trop Med Int Health 13(4):579-83, 2008; Br Med Bull 101(1):57-79, 2012)...
2016: Trials
Stephen A Spector, Sean S Brummel, Caroline M Nievergelt, Adam X Maihofer, Kumud K Singh, Murli U Purswani, Paige L Williams, Rohan Hazra, Russell Van Dyke, George R Seage
The Pediatric HIV/AIDS Cohort Study (PHACS), the largest ongoing longitudinal study of perinatal HIV-infected (PHIV) and HIV-exposed, uninfected (PHEU) children in the United States, comprises the Surveillance Monitoring of Antiretroviral Therapy [ART] Toxicities (SMARTT) Study in PHEU children and the Adolescent Master Protocol (AMP) that includes PHIV and PHEU children ≥7 years. Although race/ethnicity is often used to assess health outcomes, this approach remains controversial and may fail to accurately reflect the backgrounds of ancestry-diverse populations as represented in the PHACS participants...
September 2016: Medicine (Baltimore)
Clare Newton Dunn, Qianpian Zhang, Josh Tjunrong Sia, Pryseley Nkouibert Assam, Shephali Tagore, Ban Leong Sng
BACKGROUND AND AIMS: A decision-to-delivery interval (DDI) of 30 min for category-one caesarean section (CS) deliveries is the standard of practice recommended by clinical guidelines. Our institution established a protocol for category-one ('crash') CS to expedite deliveries. The aim of this study is to evaluate DDI, factors that affect DDI and the mode of anaesthesia for category-one CS. METHODS: This retrospective cohort study evaluated 390 women who underwent category-one CS in a tertiary obstetric centre...
August 2016: Indian Journal of Anaesthesia
Filipa de Castro, Jean Marie Place, Betania Allen-Leigh, Leonor Rivera-Rivera, Deborah Billings
OBJECTIVE: To provide evidence on perinatal mental healthcare in Mexico. MATERIALS AND METHODS: Descriptive and bivariate analyses of data from a cross-sectional probabilistic survey of 211 public obstetric units. RESULTS: Over half (64.0%) of units offer mental healthcare; fewer offer perinatal depression (PND) detection (37.1%) and care (40.3%). More units had protocols/guidelines for PND detection and for care, respectively, in Mexico City-Mexico state (76...
August 2016: Salud Pública de México
Rebecca McDonald, Ryan Hodges, Michelle Knight, Mark Teoh, Andrew Edwards, Peter Neil, Euan M Wallace, Philip DeKoninck
INTRODUCTION: Monochorionic-diamniotic (MCDA) twin pregnancies are high risk, due to twin-to-twin transfusion syndrome (TTTS), twin anaemia polycythaemia sequence (TAPS) and intrauterine growth restriction (IUGR). There is limited evidence to guide ultrasound surveillance protocols. Using a retrospective cohort, we aimed to provide insight into the optimal interval of ultrasound surveillance. METHODS: Retrospective cohort of women with MCDA pregnancies who received antenatal care at Monash Medical Centre (January 2011-October 2014)...
August 25, 2016: Fetal Diagnosis and Therapy
Chong Wang, Chuan Wang, Zhi-Fang Jia, Xing Wu, Si-Min Wen, Fei Kong, Ke-Qin Hu, Jie Li, Jing Jiang, Jun-Qi Niu
Although routine immunoprophylaxis has been known to reduce hepatitis B virus (HBV) transmission, immunoprophylaxis failure still occurs. The study aimed to investigate the protective efficacy of an improved immunoprophylaxis protocol to prevent mother-to-infant transmission of HBV and to explore the potential risk factors associated with immunoprophylaxis failure and low antibody response.A prospective observational cohort study was conducted from July 2012 to April 2015. A total of 863 HBsAg-positive mothers and their 871 infants (8 pairs of twins) were included in the study...
August 2016: Medicine (Baltimore)
G Justus Hofmeyr, Joseph A K Kiiza
BACKGROUND: Chorioamnionitis is a leading cause of perinatal morbidity and mortality. Amnioinfusion aims at reducing the adverse effects of chorioamnionitis by dilution of the infective organisms or by an anti-microbial effect of the fluid infused. OBJECTIVES: The objective of this review was to determine the effect of amnioinfusion on clinical and sub-clinical chorioamnionitis, fetal well-being, fetal heart rate characteristics and perinatal and maternal morbidity and mortality...
2016: Cochrane Database of Systematic Reviews
Larry Veltman
Unintentional nurse-attended deliveries occur on most labor and delivery units. Some precipitous deliveries are unavoidable, but others, occurring after admission with the expectation that the woman's designated provider would attend the delivery are, for a variety of reasons, still attended only by nursing staff. This study was undertaken to establish a benchmark for unintentional nurse-attended deliveries. Fifty perinatal units were studied with respect to their statistics regarding unintentional nurse-attended deliveries...
August 2016: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
Nikki Mulligan, Stein Schalkwijk, Brookie M Best, Angela Colbers, Jiajia Wang, Edmund V Capparelli, José Moltó, Alice M Stek, Graham Taylor, Elizabeth Smith, Carmen Hidalgo Tenorio, Nahida Chakhtoura, Marjo van Kasteren, Courtney V Fletcher, Mark Mirochnick, David Burger
BACKGROUND: The study goal was to describe etravirine pharmacokinetics during pregnancy and postpartum in HIV-infected women. METHODS: IMPAACT P1026s and PANNA are on-going, non-randomized, open-label, parallel-group, multi-center phase-IV prospective studies in HIV-infected pregnant women. Intensive steady-state 12-h pharmacokinetic profiles were performed from 2nd trimester through postpartum. Etravirine was measured at two labs using validated ultra performance liquid chromatography (detection limits: 0...
2016: Frontiers in Pharmacology
Araceli Espinosa-Jeffrey, Bruno Blanchi, Juan Carlos Biancotti, Shalini Kumar, Megumi Hirose, Berhan Mandefro, Dodanim Talavera-Adame, Nissim Benvenisty, Jean de Vellis
Here we document three highly reproducible protocols: (1) a culture system for the derivation of human oligodendrocytes (OLs) from human induced pluripotent stem cells (hiPS) and their further maturation-our protocol generates viral- and integration-free OLs that efficiently commit and move forward in the OL lineage, recapitulating all the steps known to occur during in vivo development; (2) a method for the isolation, propagation and maintenance of neural stem cells (NSCs); and (3) a protocol for the production, isolation, and maintenance of OLs from perinatal rodent and human brain-derived NSCs...
2016: Current Protocols in Stem Cell Biology
Daniel Sachse, Anne Lee Solevåg, Jens Petter Berg, Britt Nakstad
BACKGROUND: Optimizing resuscitation is important to prevent morbidity and mortality from perinatal asphyxia. The metabolism of cells and tissues is severely disturbed during asphyxia and resuscitation, and metabolomic analyses provide a snapshot of many small molecular weight metabolites in body fluids or tissues. In this study metabolomics profiles were studied in newborn pigs that were asphyxiated and resuscitated using different protocols to identify biomarkers for subject characterization, intervention effects and possibly prognosis...
2016: PloS One
Ashley E Van Avermaete, Phi T Trac, Theresa W Gauthier, My N Helms
At birth, the lung undergoes a profound phenotypic switch from secretion to absorption, which allows for adaptation to breathing independently. Promoting and sustaining this phenotype is critically important in normal alveolar growth and gas exchange throughout life. Several in vitro studies have characterized the role of key regulatory proteins, signaling molecules, and steroid hormones that can influence the rate of lung fluid clearance. However, in vivo examinations must be performed to evaluate whether these regulatory factors play important physiological roles in regulating perinatal lung liquid absorption...
2016: Journal of Visualized Experiments: JoVE
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