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Focused antenatal care and fetal outcome

Ruchi Amin, Aaron Domack, Joseph Bartoletti, Erika Peterson, Britton Rink, Jennifer Bruggink, Melissa Christensen, Anthony Johnson, William Polzin, Amy J Wagner
BACKGROUND: Gastroschisis is an abdominal wall defect with increasing incidence. Given the lack of surveillance guidelines among maternal-fetal medicine (MFM) specialists, this study describes current practices in gastroschisis management. MATERIALS AND METHODS: An online survey was administered to MFM specialists from institutions affiliated with the North American Fetal Therapy Network (NAFTNet). Questions focused on surveillance timing, testing, findings that changed clinical management, and delivery plan...
May 23, 2018: Fetal Diagnosis and Therapy
Jacqueline Lagendijk, Amber A Vos, Loes C M Bertens, Semiha Denktas, Gouke J Bonsel, Ewout W Steyerberg, Jasper V Been, Eric A P Steegers
Social deprivation negatively affects health outcomes but receives little attention in obstetric risk selection. We investigated whether a combination of (1) risk assessment focused on non-medical risk factors, lifestyle factors, and medical risk factors, with (2) subsequent institution of risk-specific care pathways, and (3) multidisciplinary consultation between care providers from the curative and the public health sector reduced adverse pregnancy outcomes among women in selected urban areas in the Netherlands...
June 2018: European Journal of Epidemiology
Rosalind Haddrill, Georgina L Jones, Dilly Anumba, Caroline Mitchell
BACKGROUND: Delayed access to antenatal care in high income countries is associated with poor maternal, fetal and neonatal outcomes. The aim was to synthesise the diverse body of evidence around women's views of early antenatal care and barriers to attendance in such countries. Critical Interpretive Synthesis integrates the process of systematic review with the qualitative methods of meta-ethnography and grounded theory, with a focus on theory generation to inform policy, practice and future research...
June 2018: Women and Birth: Journal of the Australian College of Midwives
Deborah Almond, Mwayi Madanitsa, Victor Mwapasa, Linda Kalilani-Phiri, Jayne Webster, Feiko Ter Kuile, Lucy Paintain
BACKGROUND: Malaria in pregnancy is a major cause of adverse maternal and fetal outcomes. Intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) is one of the control strategies promoted by WHO. In response to mounting resistance to SP, intermittent screening and treatment (ISTp) has been proposed as an alternative. The objective of this study was to explore the acceptability of ISTp for health workers and pregnant women. METHODS: Semi-structured interviews of ten health workers and five focus group discussions of 38 women enrolled in an ongoing trial comparing IPTp-SP and ISTp with dihydroartemisinin-piperaquine (DP) were conducted at two antenatal clinics in rural Malawi...
November 28, 2016: Malaria Journal
Mwayiwawo Madanitsa, Linda Kalilani, Victor Mwapasa, Anna M van Eijk, Carole Khairallah, Doreen Ali, Cheryl Pace, James Smedley, Kyaw-Lay Thwai, Brandt Levitt, Duolao Wang, Arthur Kang'ombe, Brian Faragher, Steve M Taylor, Steve Meshnick, Feiko O Ter Kuile
BACKGROUND: In Africa, most plasmodium infections during pregnancy remain asymptomatic, yet are associated with maternal anemia and low birthweight. WHO recommends intermittent preventive therapy in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP). However, sulfadoxine-pyrimethamine (SP) efficacy is threatened by high-level parasite resistance. We conducted a trial to evaluate the efficacy and safety of scheduled intermittent screening with malaria rapid diagnostic tests (RDTs) and treatment of RDT-positive women with dihydroartemisinin-piperaquine (DP) as an alternative strategy to IPTp-SP...
September 2016: PLoS Medicine
Özlem Aşcı, Gülay Rathfisch
BACKGROUND: Although it is known that lifestyle behaviors of pregnant women are closely related to maternal and fetal health, number of data concerning efficacy of intervention on lifestyle during pregnancy is limited. The purpose of this study is to determine the effect of lifestyle interventions on improving dietary habits and lifestyle behaviors, ensuring gestational weight gain (GWG) within recommended levels and limiting postpartum weight retention (PWR). METHODS: The study was conducted as a randomized controlled trial in a family health center located in Istanbul, Turkey, between June 2011 and July 2012...
February 24, 2016: Journal of Health, Population, and Nutrition
Katherine C Teela, Dane A De Silva, Katie Chapman, Anne R Synnes, Diane Sawchuck, Melanie Basso, Robert M Liston, Peter von Dadelszen, Laura A Magee
BACKGROUND: Administration of magnesium sulphate (MgSO4) to women with imminent preterm birth at <34 weeks is an evidence-based antenatal neuroprotective strategy to prevent cerebral palsy. Although a Society of Obstetricians and Gynaecologists of Canada (SOGC) national guideline with practice recommendations based on relevant clinical evidence exists, ongoing controversies about aspects of this treatment remain. Given this, we anticipated managed knowledge translation (KT) would be needed to facilitate uptake of the guidelines into practice...
December 22, 2015: BMC Pregnancy and Childbirth
Jennifer L Ridgeway, Annie LeBlanc, Megan Branda, Roger W Harms, Megan A Morris, Kate Nesbitt, Bobbie S Gostout, Lenae M Barkey, Susan M Sobolewski, Ellen Brodrick, Jonathan Inselman, Anne Baron, Angela Sivly, Misty Baker, Dawn Finnie, Rajeev Chaudhry, Abimbola O Famuyide
BACKGROUND: Most low-risk pregnant women receive the standard model of prenatal care with frequent office visits. Research suggests that a reduced schedule of visits among low-risk women could be implemented without increasing adverse maternal or fetal outcomes, but patient satisfaction with these models varies. We aim to determine the effectiveness and feasibility of a new prenatal care model (OB Nest) that enhances a reduced visit model by adding virtual connections that improve continuity of care and patient-directed access to care...
December 2, 2015: BMC Pregnancy and Childbirth
Batool A Haider, Zulfiqar A Bhutta
BACKGROUND: Multiple-micronutrient (MMN) deficiencies often coexist among women of reproductive age in low- to middle-income countries. They are exacerbated in pregnancy due to the increased demands, leading to potentially adverse effects on the mother and developing fetus. Though supplementation with MMNs has been recommended earlier because of the evidence of impact on pregnancy outcomes, a consensus is yet to be reached regarding the replacement of iron and folic acid supplementation with MMNs...
November 1, 2015: Cochrane Database of Systematic Reviews
Nathalie Fleming, Teresa O'Driscoll, Gisela Becker, Rachel F Spitzer
OBJECTIVE: To describe the needs and evidence-based practice specific to care of the pregnant adolescent in Canada, including special populations. OUTCOMES: Healthy pregnancies for adolescent women in Canada, with culturally sensitive and age-appropriate care to ensure the best possible outcomes for these young women and their infants and young families, and to reduce repeat pregnancy rates. EVIDENCE: Published literature was retrieved through searches of PubMed and The Cochrane Library on May 23, 2012 using appropriate controlled vocabulary (e...
August 2015: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Nousheen Aziz, Sajida Yousfani
OBJECTIVE: To determine the risk factors, management modalities, fetomaternal outcome of uterine rupture cases at University teaching hospital in Pakistan. METHODS: This retrospective descriptive study was conducted at the Department of Gynaecology and Obstetrics Liaquat University of Medical and Health Sciences (LUMHS) for a period of one year from January 1st to December 31st 2012. Main outcome measures were frequency, age, parity, booking status, risk factors, management modalities, fetal and maternal mortality associated with uterine rupture...
July 2015: Pakistan Journal of Medical Sciences Quarterly
Rosalie M Grivell, Zarko Alfirevic, Gillian M L Gyte, Declan Devane
BACKGROUND: Cardiotocography (CTG) is a continuous recording of the fetal heart rate obtained via an ultrasound transducer placed on the mother's abdomen. CTG is widely used in pregnancy as a method of assessing fetal well-being, predominantly in pregnancies with increased risk of complications. OBJECTIVES: To assess the effectiveness of antenatal CTG (both traditional and computerised assessments) in improving outcomes for mothers and babies during and after pregnancy...
September 12, 2015: Cochrane Database of Systematic Reviews
Neeta K Makhija, Ashlie A Tronnes, Benjamin S Dunlap, Jay Schulkin, Sophia M Lannon
BACKGROUND: Antenatal corticosteroid administration is a critical fetal intervention, and the use of a rescue protocol is now standard practice. Rescue antenatal corticosteroid may improve overall accuracy of antenatal corticosteroid administration timing, but this observation and its effect on the initial course is unknown. OBJECTIVE: We sought to compare the accuracy of antenatal corticosteroid administration before and after the implementation of a rescue antenatal corticosteroid protocol...
January 2016: American Journal of Obstetrics and Gynecology
Chung-Wei Chang, Tien-Yan Ma, Mei-San Choi, Yu-Yun Hsu, Yi-Jing Tsai, Ting-Wei Hou
This study develops an antenatal care information system to assist women during pregnancy. We designed and implemented the system as both a web-based service and a multi-platform application for smartphones and tablets. The proposed system has three novel features: (1) web-based maternity records, which contains concise explanations of various antenatal screening and diagnostic tests; (2) self-care journals, which allow pregnant women to keep track of their gestational weight gains, blood pressure, fetal movements, and contractions; and (3) health education, which automatically presents detailed information on antenatal care and other pregnancy-related knowledge according to the women's gestational age...
August 2015: Computer Methods and Programs in Biomedicine
Zarko Alfirevic, Tamara Stampalija, Nancy Medley
BACKGROUND: One of the main aims of routine antenatal care is to identify the 'at risk' fetus in order to apply clinical interventions which could result in reduced perinatal morbidity and mortality. Doppler ultrasound study of umbilical artery waveforms helps to identify the compromised fetus in 'high-risk' pregnancies and, therefore, deserves assessment as a screening test in 'low-risk' pregnancies. OBJECTIVES: To assess the effects on obstetric practice and pregnancy outcome of routine fetal and umbilical Doppler ultrasound in unselected and low-risk pregnancies...
April 15, 2015: Cochrane Database of Systematic Reviews
Matthew Benage, P Gregg Greenough, Patrick Vinck, Nada Omeira, Phuong Pham
BACKGROUND: After more than three years of violence in Syria, Lebanon hosts over one million Syrian refugees creating significant public health concerns. Antenatal care delivery to tens of thousands of pregnant Syrian refugee women is critical to preventing maternal and fetal mortality but is not well characterized given the multiple factors obtaining health data in a displaced population. This study describes antenatal care access, the scope of existing antenatal care, and antenatal and family planning behaviors and practice among pregnant Syrian refugees in various living conditions and multiple geographic areas of Lebanon...
2015: Conflict and Health
Ellen A Boamah, Kp Asante, Ka Ae-Ngibise, Patrick L Kinney, Darby W Jack, Grace Manu, Irene T Azindow, Seth Owusu-Agyei, Blair J Wylie
BACKGROUND: Four million premature deaths occur yearly as a result of smoke from cooking fires. The Ghana Randomized Air Pollution and Health Study (GRAPHS) is underway in the Kintampo North municipality and South district of rural Ghana to evaluate the impact of improved cook stoves introduced during pregnancy on birth weight and childhood pneumonia. These hypotheses are being tested in a cluster-randomized intervention trial among 1415 maternal-infant pairs within 35 communities assigned to a control arm (traditional cooking) or one of two intervention arms (cooking with an improved biomass stove; cooking with liquefied petroleum gas stoves)...
December 18, 2014: JMIR Research Protocols
Vicki Flenady, Aleena M Wojcieszek, Dimitri N M Papatsonis, Owen M Stock, Linda Murray, Luke A Jardine, Bruno Carbonne
BACKGROUND: Preterm birth is a major contributor to perinatal mortality and morbidity, affecting around 9% of births in high-income countries and an estimated 13% of births in low- and middle-income countries. Tocolytics are drugs used to suppress uterine contractions for women in preterm labour. The most widely used tocolytic are the betamimetics, however, these are associated with a high frequency of unpleasant and sometimes severe maternal side effects. Calcium channel blockers (CCBs) (such as nifedipine) may have similar tocolytic efficacy with less side effects than betamimetics...
June 5, 2014: Cochrane Database of Systematic Reviews
Barthélémy Tosello, Lionel Dany, Catherine Gire, Pierre Bétrémieux, Marie-Emilie Vriet-Ndour, Pierre Le Coz, Claude D'Ercole, Umberto Siméoni, Marie-Ange Einaudi
BACKGROUND: After prenatal diagnosis of lethal fetal abnormality (LFA), some couples choose to continue the pregnancy rather than opt for termination of the pregnancy. This may result in the requirement for neonatal palliative care, which in France is prescribed by the Leonetti Law. These rare situations raise various questions about when and how palliative care is provided in cases of LFA. OBJECTIVE: The main goal of the study was to clarify the place given to the concept of perinatal palliative care within the antenatal information provided by perinatal professionals...
August 2014: Journal of Palliative Medicine
Elizabeth Mason, Lori McDougall, Joy E Lawn, Anuradha Gupta, Mariam Claeson, Yogan Pillay, Carole Presern, Martina Baye Lukong, Gillian Mann, Marijke Wijnroks, Kishwar Azad, Katherine Taylor, Allison Beattie, Zulfiqar A Bhutta, Mickey Chopra
Remarkable progress has been made towards halving of maternal deaths and deaths of children aged 1-59 months, although the task is incomplete. Newborn deaths and stillbirths were largely invisible in the Millennium Development Goals, and have continued to fall between maternal and child health efforts, with much slower reduction. This Series and the Every Newborn Action Plan outline mortality goals for newborn babies (ten or fewer per 1000 livebirths) and stillbirths (ten or fewer per 1000 total births) by 2035, aligning with A Promise Renewed target for children and the vision of Every Woman Every Child...
August 2, 2014: Lancet
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