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https://www.readbyqxmd.com/read/28086822/assessment-of-quality-of-care-among-in-patients-with-postpartum-haemorrhage-and-severe-pre-eclampsia-at-st-francis-hospital-nsambya-a-criteria-based-audit
#1
Alfred Lumala, Peter Sekweyama, Andrew Abaasa, Humphrey Lwanga, Romano Byaruhanga
BACKGROUND: The maternal mortality ratio of Uganda is still high and the leading causes of maternal mortality are postpartum haemorrhage (PPH), severe pre-eclampsia and eclampsia. Criteria-based audit (CBA) is a way of improving quality of care that has not been commonly used in low income countries. This study aimed at finding out the quality of care provided to patients with these conditions and to find out if the implementation of recommendations from the audit cycle resulted in improvement in quality of care...
January 13, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28068990/risk-factors-for-severe-postpartum-hemorrhage-a-case-control-study
#2
Lill Trine Nyfløt, Irene Sandven, Babill Stray-Pedersen, Silje Pettersen, Iqbal Al-Zirqi, Margit Rosenberg, Anne Flem Jacobsen, Siri Vangen
BACKGROUND: In high-income countries, the incidence of severe postpartum hemorrhage (PPH) has increased. This has important public health relevance because severe PPH is a leading cause of major maternal morbidity. However, few studies have identified risk factors for severe PPH within a contemporary obstetric cohort. METHODS: We performed a case-control study to identify risk factors for severe PPH among a cohort of women who delivered at one of three hospitals in Norway between 2008 and 2011...
January 10, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28067621/cohort-profile-the-finnish-genetics-of-pre-eclampsia-consortium-finnpec
#3
Tiina Jääskeläinen, Seppo Heinonen, Eero Kajantie, Juha Kere, Katja Kivinen, Anneli Pouta, Hannele Laivuori
PURPOSE: The Finnish Genetics of Pre-eclampsia Consortium (FINNPEC) Study was established to set up a nationwide clinical and DNA database on women with and without pre-eclampsia (PE), including their partners and infants, in order to identify genetic risk factors for PE. PARTICIPANTS: FINNPEC is a cross-sectional case-control cohort collected from 5 university hospitals in Finland during 2008-2011. A total of 1450 patients with PE and 1065 pregnant control women without PE (aged 18-47 years) were recruited...
November 10, 2016: BMJ Open
https://www.readbyqxmd.com/read/28067011/accuracy-of-competing-risks-model-in-screening-for-pre-eclampsia-by-maternal-factors-and-biomarkers-at-11-13-weeks-gestation
#4
Neil O'Gorman, David Wright, Liona C Poon, Daniel L Rolnik, Argyro Syngelaki, Alan Wright, Ranjit Akolekar, Simona Cicero, Deepa Janga, Jacques Jani, Francisca S Molina, Catalina de Paco Matallana, Nikos Papantoniou, Nicola Persico, Walter Plasencia, Mandeep Singh, Kypros H Nicolaides
OBJECTIVE: To examine the diagnostic accuracy of a previously developed model for prediction of preeclampsia (PE) by a combination of maternal factors and biomarkers at 11-13 weeks' gestation. METHODS: This was a prospective first-trimester multicenter study of screening for PE in 8,775 singleton pregnancies. A previously published algorithm was used for the calculation of patient-specific risk of PE in each patient. The detection rates (DR) and false positive rates (FPR) for delivery with PE at <32, <37 and ≥37 weeks were estimated and compared to those in the dataset used for development of the algorithm...
January 9, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28065256/a-newborn-infant-with-oxygen-desaturation-during-sleep
#5
Ashley Deschamp, Ameet Daftary
The patient is a 1-week-old boy born at 37+2 weeks' gestational age through spontaneous vaginal delivery. The pregnancy was complicated by maternal gestational diabetes mellitus and pre-eclampsia. The Apgar score was 9 at both 1 minute and 5 minutes after birth. Because of hypoglycemia at delivery that required IV dextrose, he was admitted to the local neonatal intensive care unit. His blood glucose levels quickly stabilized, dextrose administration was discontinued, and the patient began breast-feeding. On day 2 of life, the patient began having intermittent oxygen desaturation, with oxygen saturation as measured by pulse oximetry down to 70% while sleeping; he was transferred to a tertiary-care NICU for further management...
January 2017: Chest
https://www.readbyqxmd.com/read/28058791/re-pre-eclampsia-an-important-risk-factor-for-asymptomatic-heart-failure-c-ghossein-doha-j-van-neer-b-wissink-n-breetveld-l-j-de-windt-a-p-j-van-dijk-m-j-van-der-vlugt-m-c-h-janssen-w-m-heidema-r-r-scholten-and-m-e-a-spaanderman-ultrasound-obstet-gynecol-2017
#6
https://www.readbyqxmd.com/read/28058790/re-endothelial-dysfunction-and-vascular-stiffness-in-women-with-previous-pregnancy-complicated-by-early-or-late-pre-eclampsia-r-orabona-e-sciatti-e-vizzardi-i-bonadei-and-a-valcamonico-ultrasound-obstet-gynecol-2017-49-116-123
#7
https://www.readbyqxmd.com/read/28058788/re-lung-and-cardiac-ultrasound-for-hemodynamic-monitoring-of-patients-with-severe-pre-eclampsia-j-ambrozic-g-brzan-simenc-k-prokselj-n-tulz-m-cvijic-and-m-lucovnik-ultrasound-obstet-gynecol-2017-49-104-109
#8
https://www.readbyqxmd.com/read/28056406/the-impact-of-maternal-factors-on-the-association-between-temperature-and-preterm-delivery
#9
Rupa Basu, Hong Chen, De-Kun Li, Lyndsay A Avalos
BACKGROUND: Few studies have examined maternal modifiers of temperature and adverse birth outcomes because of lack of data. We assessed the relationship between apparent temperature, preterm delivery (PTD) and maternal demographics, medical and mental health conditions, and behaviors. METHODS: A time-stratified case-crossover analysis was conducted using 14,466 women who had a PTD (20 to less than 37 gestational weeks) from 1995 to 2009 using medical records from a large health maintenance organization in Northern California...
January 2, 2017: Environmental Research
https://www.readbyqxmd.com/read/28054230/tumor-necrosis-factor-alpha-and-pregnancy-focus-on-biologics-an-updated-and-comprehensive-review
#10
REVIEW
Jaume Alijotas-Reig, Enrique Esteve-Valverde, Raquel Ferrer-Oliveras, Elisa Llurba, Josep Maria Gris
Tumor necrosis factor-α (TNF-α) is a central regulator of inflammation, and TNF-α antagonists may be effective in treating inflammatory disorders in which TNF-α plays a major pathogenic role. TNF-α has also been associated with inflammatory mechanisms related to implantation, placentation, and pregnancy outcome. TNF-α is secreted by immune cells and works by binding to TNFR1 and TNFR2 cell receptors. TNF-α is also related to JAK/STAT pathways, which opens up hypothetical new targets for modifying. The accurate balance between Th1 cytokines, mainly TNF-α, Th17, and Th2, particularly IL-10 is essential to achieve good obstetric outcomes...
January 4, 2017: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/28054130/posterior-reversible-encephalopathy-syndrome
#11
REVIEW
Marlene Fischer, Erich Schmutzhard
The posterior reversible encephalopathy syndrome (PRES) is a neurological disorder of (sub)acute onset characterized by varied neurological symptoms, which may include headache, impaired visual acuity or visual field deficits, disorders of consciousness, confusion, seizures, and focal neurological deficits. In a majority of patients the clinical presentation includes elevated arterial blood pressure up to hypertensive emergencies. Neuroimaging, in particular magnetic resonance imaging, frequently shows a distinctive parieto-occipital pattern with a symmetric distribution of changes reflecting vasogenic edema...
January 4, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28046205/dietary-advice-interventions-in-pregnancy-for-preventing-gestational-diabetes-mellitus
#12
REVIEW
Joanna Tieu, Emily Shepherd, Philippa Middleton, Caroline A Crowther
BACKGROUND: Gestational diabetes mellitus (GDM) is a form of diabetes occurring during pregnancy which can result in short- and long-term adverse outcomes for women and babies. With an increasing prevalence worldwide, there is a need to assess strategies, including dietary advice interventions, that might prevent GDM. OBJECTIVES: To assess the effects of dietary advice interventions for preventing GDM and associated adverse health outcomes for women and their babies...
January 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28030762/placental-proteomics-provides-insights-into-pathophysiology-of-pre-eclampsia-and-predicts-possible-markers-in-plasma
#13
Sheon Mary, Mahesh J Kulkarni, Dipankar Malakar, Sadhana R Joshi, Savita S Mehendale, Ashok P Giri
Pre-eclampsia is a hypertensive disorder characterized by the new onset of hypertension >140/90 mmHg and proteinuria after the 20th week of gestation. The disorder is multi-factorial and originates with abnormal placentation. Comparison of the placental proteome of normotensive (n=25) and pre-eclamptic (n=25) patients by gel-free proteomic techniques, identified a total of 2145 proteins in the placenta of which 180 were differentially expressed (>1.3 fold, p<0.05). Gene ontology enrichment analysis of biological process suggested that the differentially expressed proteins belonged to various physiological processes such as angiogenesis, apoptosis, oxidative stress, hypoxia, placental development, which are implicated in the pathophysiology of pre-eclampsia...
December 28, 2016: Journal of Proteome Research
https://www.readbyqxmd.com/read/28029224/preterm-prelabour-rupture-of-membranes-a-retrospective-cohort-study-of-association-with-adverse-outcome-in-subsequent-pregnancy
#14
I M Aris, S Logan, C Lim, M Choolani, A Biswas, S Bhattacharya
OBJECTIVE: To assess the association of first pregnancy preterm prelabour rupture of membranes (PPROM) with adverse maternal and perinatal outcomes in the next pregnancy. DESIGN: Retrospective cohort study. SETTING: Grampian, Scotland, UK. POPULATION: Women with first deliveries recorded in the Aberdeen Maternity Neonatal Databank, 1986-2005. METHODS: Women identified from the AMND database (n = 37 776) were classified into exposed (PPROM in first pregnancy; n = 1979) and unexposed (no PPROM in first pregnancy; n = 35 797) cohorts...
December 28, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28029221/the-antepartum-stillbirth-syndrome-risk-factors-and-pregnancy-conditions-identified-from-the-intergrowth-21-st-project
#15
J E Hirst, J Villar, C G Victora, A T Papageorghiou, D Finkton, F C Barros, M G Gravett, F Giuliani, M Purwar, I O Frederick, R Pang, L Cheikh Ismail, A Lambert, W Stones, Y A Jaffer, D G Altman, J A Noble, E O Ohuma, S H Kennedy, Z A Bhutta
OBJECTIVES: To identify risk factors for antepartum stillbirth, including fetal growth restriction, among women with well-dated pregnancies and access to antenatal care. DESIGN: Population-based, prospective, observational study. SETTING: Eight international urban populations. POPULATION: Pregnant women and their babies enrolled in the Newborn Cross-Sectional Study of the INTERGROWTH-21(st) Project. METHODS: Cox proportional hazard models were used to compare risks among antepartum stillborn and liveborn babies...
December 28, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28027946/how-serpins-transport-hormones-and-regulate-their-release
#16
REVIEW
Robin W Carrell, Randy J Read
The adaptation of the serpin framework and its mechanism to perform diverse functions is epitomised in the hormone carriers of the blood. Thyroxine and the corticosteroids are transported bound in a 1:1 ratio on almost identical sites in the two homologous binding-globulins, TBG and CBG. Recent structural findings show an equilibrated, rather than on-and-off, release of the hormones from the carriers, reflecting small reversible movements of the hinge region of the reactive loop that modify the conformational flexibility of the underlying hormone-binding site...
December 24, 2016: Seminars in Cell & Developmental Biology
https://www.readbyqxmd.com/read/28026897/pregnancy-outcome-of-gestational-diabetes-mellitus-using-a-structured-model-of-care-wings-project-wings-10
#17
Ram Uma, Balaji Bhavadharini, Harish Ranjani, Manni Mohanraj Mahalakshmi, Ranjit Mohan Anjana, Ranjit Unnikrishnan, Arivudainambi Kayal, Belma Malanda, Anne Belton, Viswanathan Mohan
AIM: To evaluate the impact of a structured model of care (MOC) prepared for resource-constrained settings, on the pregnancy outcomes of Asian Indian women with gestational diabetes mellitus (GDM). METHODS: Pregnant women were screened under the Women in India with GDM Strategy (WINGS) MOC for GDM using the International Association of Diabetes and Pregnancy Study Groups criteria. Women with GDM went through a structured MOC that included medical nutrition therapy (MNT), regular physical activity (PA); and insulin when indicated...
December 27, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28012449/placental-maternal-vascular-malperfusion-and-adverse-pregnancy-outcomes-in-gestational-diabetes-mellitus
#18
Christina M Scifres, W Tony Parks, Maisa Feghali, Steve N Caritis, Janet M Catov
INTRODUCTION: Maternal vascular malperfusion (MVM) lesions represent hypoxic-ischemic damage to the placenta, and they are associated with adverse pregnancy outcomes. Women with gestational diabetes (GDM) are at increased risk for pregnancy complications, so we set out to characterize the prevalence and clinical correlates of MVM lesions in this cohort. METHODS: This was a retrospective cohort study of 1187/1374 (86.4%) women with GDM delivered between 2009 and 2012 who had placental pathology available...
January 2017: Placenta
https://www.readbyqxmd.com/read/28012202/association-of-serum-papp-a-levels-in-first-trimester-with-small-for-gestational-age-and-adverse-pregnancy-outcomes-systematic-review-and-meta-analysis
#19
R Katie Morris, Ashwini Bilagi, Pooja Devani, Mark D Kilby
OBJECTIVES: To determine association, and predictive ability, of first trimester maternal serum pregnancy associated plasma protein A (PAPP-A) with adverse pregnancy outcomes. METHOD: Searches of Medline, Embase and CINAHL (inception-September 2015) for studies including pregnant women with first trimester PAPP-A and assessment of pregnancy outcomes.Study characteristics, quality and results extracted. Meta-analysis of odds ratios (OR), and likelihood ratios (LR) and 95% confidence intervals (CI)...
December 23, 2016: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28003872/a-reversible-posterior-leucoencephalopathy-syndrome-including-blindness-caused-by-preeclampsia
#20
G Vandenbossche, J Maquet, P Vroonen, G Lambert, M Nisolle, F Kridelka, E Emonts
Complications of (pre)eclampsia may involve multiple systems and organs. Neurological symptoms may occur. Visual symptoms concern up to 25% the of patients with severe preeclampsia and 50% of the patients with eclampsia. An uncommon effect of severe preeclampsia is sudden blindness. Blindness may be part of a clinical and radiological presentation named Posterior Reversible Encephalopathy Syndrome (PRES). PRES may lead to permanent neurological deficit, recurrences or death. We report the case of a 24-year-old Caucasian patient, gravida 5 para 2 who developed preeclampsia and PRES complicated with blindness at 32 weeks of gestation...
September 2016: Facts, Views & Vision in ObGyn
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