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Preterm management

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https://www.readbyqxmd.com/read/28538238/current-research-on-the-epidemiology-pathogenesis-and-management-of-necrotizing-enterocolitis
#1
Simon Eaton, Clare M Rees, Nigel J Hall
Despite decades of research on necrotizing enterocolitis, we still do not fully understand the pathogenesis of the disease, or how to prevent or how to treat it. However, as a result of recent significant advances in the microbiology, molecular biology, and cell biology of the intestine of preterm infants and infants with necrotizing enterocolitis, there is some hope that research into this devastating disease will yield some important translation into effective prevention, more rapid diagnosis, and novel therapies...
2017: Neonatology
https://www.readbyqxmd.com/read/28538235/what-should-we-do-about-low-blood-pressure-in-preterm-infants
#2
Eugene M Dempsey
The management of preterm infants with low blood pressure soon after birth remains unresolved. The definition of what constitutes low blood pressure is uncertain. At birth, mean blood pressure appears to be gestation specific and increases in the first few days of life. Antenatal steroids, delayed cord clamping, and the avoidance of mechanical ventilation are all associated with higher mean blood pressure and less hypotension after birth. Rates of hypotension of 15-50% have been reported in various studies of extremely preterm infants...
2017: Neonatology
https://www.readbyqxmd.com/read/28532678/selective-intrauterine-growth-restriction-in-monochorionic-diamniotic-twin-pregnancies
#3
REVIEW
Mar Bennasar, Elisenda Eixarch, Josep Maria Martinez, Eduard Gratacós
Selective intrauterine growth restriction (sIUGR) affects 10-15% of all monochorionic pregnancies. Early severe forms are associated with intrauterine demise or neurological adverse outcome for both twins. The characteristics of umbilical artery (UA) Doppler in the IUGR fetus determine three clinical types: (I) normal UA Doppler and associated with good prognosis; (II) persistently absent/reverse UA end-diastolic flow and associated with early deterioration of the IUGR twin and very preterm delivery; (III) intermittently absent/reverse end-diastolic flow in the UA, and associated with unexpected fetal demise or neurological injury in one or both twins...
May 19, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28532255/outpatient-vs-inpatient-management-for-superimposed-preeclampsia-without-severe-features-a-retrospective-multicenter-study
#4
Corina N Schoen, Sindy C Moreno, Gabriele Saccone, Nora M Graham, Lauren C Hand, Giuseppe M Maruotti, Pasquale Martinelli, Vincenzo Berghella, Amanda Roman
PURPOSE: To determine if women with preterm superimposed preeclampsia without severe features can be successfully and safely triaged to outpatient management. MATERIALS AND METHODS: This was a multicenter, retrospective, cohort study of singleton pregnancies with superimposed preeclampsia without severe features diagnosed before 37 weeks managed outpatient versus inpatient at Thomas Jefferson University (Philadelphia, USA) and at University of Naples (Naples, Italy) from January 2008 to July 2015...
May 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28532196/fetal-and-neonatal-involvement-in-maternal-rheumatologic-disease
#5
Shigeo Iijima
A pregnancy complicated with rheumatologic diseases can have various influences on the fetus and/or neonate. Maternal systemic lupus erythematosus (SLE) may cause preterm and/or small for gestational age (SGA) delivery and neonatal lupus (NL). Some neonates with NL have congenital heart block (CHB) with increased morbidity and mortality, even requiring pacemakers. Antiphospholipid syndrome may occur with SLE and affect fetal and/or neonatal outcomes. Pregnancy involving primary Sjögren syndrome (pSS) tends to result in preterm delivery and low birthweight infants...
May 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28526449/predictors-of-vaginal-delivery-in-medically-indicated-early-preterm-induction-of-labor
#6
Rachel A Sievert, Spencer G Kuper, Victoria C Jauk, Melissa Parrish, Joseph R Biggio, Lorie M Harper
BACKGROUND: When delivery is indicated prior to 34 weeks, many providers perform a cesarean delivery (CD) rather than induce labor based on perceptions of a high failure rate. Given the morbidity of CD, an accurate estimate of the success rate and factors associated with success in preterm induction of labor (IOL) is important in management decisions. OBJECTIVE: We sought to develop a prediction model for successful induction of labor in preterm patients using factors known at the time the decision is made to deliver...
May 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28523894/primary-cutaneous-mucormycosis-in-an-extremely-preterm-infant-successfully-treated-with-liposomal-amphotericin-b
#7
Christopher D Lowe, Rebecca J Sainato, David R Stagliano, Maribel M Morgan, Brian P Green
Cutaneous mucormycosis is a rare but often fatal invasive fungal infection that occurs most commonly in patients with diabetes, malignancy, and other immunocompromising conditions. We report an extremely preterm (<28 weeks) baby boy who developed polymicrobial sepsis and primary cutaneous mucormycosis within his first 10 days of life. He was successfully treated with medical management alone since he was not a candidate for surgery. Successful treatment of cutaneous mucormycosis without surgical debridement has been reported on only two other occasions...
May 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28522651/pregnancy-and-glomerular-disease-a-systematic-review-of-the-literature-with-management-guidelines
#8
Kimberly Blom, Ayodele Odutayo, Kate Bramham, Michelle A Hladunewich
During pregnancy, CKD increases both maternal and fetal risk. Adverse maternal outcomes include progression of underlying renal dysfunction, worsening of urine protein, and hypertension, whereas adverse fetal outcomes include fetal loss, intrauterine growth restriction, and preterm delivery. As such, pregnancy in young women with CKD is anxiety provoking for both the patient and the clinician providing care, and because the heterogeneous group of glomerular diseases often affects young women, this is an area of heightened concern...
May 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28508672/assessing-infant-oriented-care-with-developmental-support-approach-in-iranian-nicus
#9
Mostajab Razavi Nejad, Zahra Eskandary, Mohammad Heidarzadeh, Abolfazl Afjeh, Amir Almasi-Hashiani, Forouzan Akrami
INTRODUCTION: Developmental care program is a comprehensive program to reduce secondary effects of NICU and special care on brain development in premature infants. This study aimed to assess neonatal care situation in Iranian NICUs based on developmental approach to design and provide clinical guidelines for daily care for the care givers and the infant's family. METHODS: This was a cross-sectional study conducted in NICUS in Iran. A total of 23 NICUs of 9 Universities of Medical Sciences were investigated...
May 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28508414/cervical-cerclage-placed-before-14%C3%A2-weeks-gestation-in-women-with-one-previous-midtrimester-loss-a-population-based-cohort-study
#10
Margaret E Harpham, Charles S Algert, Christine L Roberts, Jane B Ford, Antonia W Shand
BACKGROUND: Cervical cerclage is used in an attempt to reduce recurrence risk of preterm birth, but evidence for use is limited. AIMS: To compare pregnancy outcomes among women with a single previous midtrimester delivery when managed with or without a cervical cerclage. MATERIALS AND METHODS: Population-based cohort study of all women in New South Wales, Australia with a singleton pregnancy ending in birth/miscarriage ≥14 and <28 weeks, between 2003 and 2011...
May 16, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28506952/retrospective-evaluation-of-pregnant-women-with-celiac-disease
#11
Kemal Beksaç, Gökçen Örgül, Murat Çağan, Ergun Karaağaoğlu, Serap Arslan, Mehmet Sinan Beksaç
OBJECTIVE: To show celiac disease (CD) and its poor pregnancy outcome relationship, and to demonstrate the importance of a gluten-free diet together with low-dose low-molecular-weight heparin (LMWH) and low-dose corticosteroid (LDC) in the management of pregnancies with CD. MATERIAL AND METHODS: This study consisted of 2 groups of patients. Six patients with CD (control group) on a gluten-free diet were monitored during their first pregnancies within the framework of antenatal care program and their pregnancy outcomes were compared with eight poorly-treated pregnant patients with CD (study group) who were referred from other medical institutions...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28502874/aerobic-vaginitis-no-longer-a-stranger
#12
Gilbert G G Donders, Gert Bellen, Svitrigaile Grinceviciene, Kateryna Ruban, Pedro Vieira-Baptista
Aerobic vaginitis (AV) is the name given in 2002 to a vaginal infectious entity which was not recognized as such before. It is characterized by abnormal (dysbiotic) vaginal microflora containing aerobic, enteric bacteria, variable levels of vaginal inflammation and deficient epithelial maturation. Although AV and bacterial vaginosis (BV) share some characteristics, such as a diminished number or absence of lactobacilli, increased discharge (fishy smelling in BV, while in severe forms of AV, a foul, rather rotten smell may be present) and increased pH (often more pronounced in AV), there are also striking differences between the two...
May 11, 2017: Research in Microbiology
https://www.readbyqxmd.com/read/28502186/efectiveness-of-dydrogesterone-17-oh-progesterone-and-micronized-progesterone-in-prevention-of-preterm-birth-in-women-with-a-short-cervix
#13
Olga Anatolievna Pustotina
OBJECTIVE: to compare the efficacy of dydrogesterone, 17-OH progesterone (17OHP) and oral or vaginal micronized progesterone with cerclage for the prevention of preterm birth in women with a short cervix. METHODS: The study included 95 women with singleton gestation and cervical length (CL)≤ 25 mm. Among these, 35 women were asymptomatic at 15-24 weeks and 60 had symptoms of threatened late miscarriage (LM) or preterm delivery (PD). Patients were randomized to receive dydrogesterone, 17OHP or oral/vaginal micronized progesterone; after one week of therapy 15 women underwent cerclage...
May 14, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28490415/maternal-and-perinatal-characteristics-of-small-for-gestational-age-newborns-ten-year-experience-of-a-single-center
#14
Nihal Şahin Uysal, Çağrı Gülümser, Filiz Bilgin Yanık
OBJECTIVE: The aim of this study was to analyze the maternal and perinatal characteristics of small for gestational age (SGA) newborns compared to appropriate for gestational age (AGA) newborns in singleton pregnancies managed at our hospital between January 2006 and December 2015. MATERIAL AND METHODS: The study (n=456) and control (n=4925) groups included pregnancies resulting in SGA and AGA newborns, respectively. Additionally, two SGA subgroups were defined according to abnormal (n=34) and normal (n=57) Doppler findings...
May 11, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28489765/anesthetic-management-of-cesarean-delivery-in-parturients-with-ruptured-sinus-of-valsalva-aneurysm-care-compliant-2-case-reports-and-literature-review
#15
Gang Fang, Man Li, Jian Li, Li Lin, Wei Mei
RATIONALE: Ruptured sinus of Valsalva aneurysm is rare and dangerous in parturients. Few cases of ruptured SVA in pregnancy are reported, and the anesthetic management for cesarean delivery has scarcely been described. PATIENT CONCERNS: A parturient at 37-week gestation complained of a sore throat and cough that started 3 days before admission, followed 1 day later by fever, dizziness, breathlessness, and palpitation on exertion. Case two at 36-week gestation complained of a 1-day history of bloating in the lower abdomen...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28486979/mediation-of-the-effect-of-malaria-in-pregnancy-on-stillbirth-and-neonatal-death-in-an-area-of-low-transmission-observational-data-analysis
#16
Kerryn A Moore, Freya J I Fowkes, Jacher Wiladphaingern, Nan San Wai, Moo Kho Paw, Mupawjay Pimanpanarak, Verena I Carrara, Jathee Raksuansak, Julie A Simpson, Nicholas J White, François Nosten, Rose McGready
BACKGROUND: Malaria in pregnancy is preventable and contributes significantly to the estimated 5.5 million stillbirths and neonatal deaths that occur annually. The contribution of malaria in pregnancy in areas of low transmission has not been quantified, and the roles of maternal anaemia, small-for-gestational-age status, and preterm birth in mediating the effect of malaria in pregnancy on stillbirth and neonatal death are poorly elucidated. METHODS: We analysed observational data routinely collected at antenatal clinics on the Thai-Myanmar border (1986-2015)...
May 10, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28482713/preterm-labor-and-birth-management-recommendations-from-the-european-association-of-perinatal-medicine
#17
G C Di Renzo, L Cabero Roura, F Facchinetti, H Helmer, C Hubinont, B Jacobsson, J S Jørgensen, R F Lamont, A Mikhailov, N Papantoniou, V Radzinsky, A Shennan, Y Ville, Gha Visser, M Wielgos
No abstract text is available yet for this article.
May 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28481445/optimising-fertility-outcomes-for-women-with-early-stage-cervical-cancer-when-less-is-more
#18
Efterpi Tingi, Emma J Crosbie, Gemma Owens
Radical hysterectomy and pelvic lymphadenectomy is standard management for early-stage cervical cancer. Radical trachelectomy achieves equivalent oncological outcomes to hysterectomy thus providing an alternative for women who wish to preserve their fertility (Xu et al. Acta Obstet Gynecol Scand 2011; 90: 1200-09). Trachelectomy offers the potential for pregnancy but poor obstetric sequelae, including second trimester miscarriage, preterm premature rupture of membranes (PPROM) and preterm delivery are common, likely due to reduced mechanical support from a shortened cervix and ascending infection...
May 8, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28471443/the-role-of-near-infrared-spectroscopy-monitoring-in-preterm-infants
#19
P Korček, Z Straňák, J Širc, G Naulaers
Neurological morbidities such as peri/intraventricular hemorrhage and periventricular leukomalacia largely determine the neurodevelopmental outcome of vulnerable preterm infants and our aim should be to minimize their occurrence or severity. Bed-side neuromonitoring could provide valuable pieces of information about possible hemodynamic disturbances that are significantly associated with neurological morbidities and increased mortality. Near-infrared spectroscopy offers evaluation of regional cerebral oxygenation, which in conjunction with other non-invasive methods may give us a more complete picture about end-organ perfusion...
May 4, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28471441/how-to-assess-hemodynamic-status-in-very-preterm-newborns-in-the-first-week-of-life
#20
G Escourrou, L Renesme, E Zana, A Rideau, M O Marcoux, E Lopez, G Gascoin, P Kuhn, P Tourneux, I Guellec, C Flamant
BACKGROUND: Assessing hemodynamic status in preterm newborns is an essential task, as many studies have shown increased morbidity when hemodynamic parameters are abnormal. Although oscillometric monitoring of arterial blood pressure (BP) is widely used due to its simplicity and lack of side effects, these values are not always correlated with microcirculation and oxygen delivery. OBJECTIVES: This review focuses on different tools for the assessment of hemodynamic status in preterm newborns...
May 4, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
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