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High Risk Pregnancy. Obstetric Emergencies.

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https://www.readbyqxmd.com/read/30074551/headache-in-pregnancy
#1
Matthew S Robbins
PURPOSE OF REVIEW: Headache disorders are extraordinarily common and disproportionately impact women of childbearing age. This article reviews the importance of proper diagnosis, natural history, and management of headache disorders in pregnant and postpartum women. RECENT FINDINGS: Red flags for secondary headache specifically among pregnant women include elevated blood pressure and lack of a previous headache history, as well as a prolonged duration of the headache attack in those with a prior history of migraine...
August 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/30016929/bleeding-complications-and-antithrombotic-treatment-in-264-pregnancies-in-antiphospholipid-syndrome
#2
C M Yelnik, M Lambert, E Drumez, V Le Guern, J-L Bacri, M M Guerra, C A Laskin, D W Branch, L R Sammaritano, N Morel, G Guettrot-Imbert, D Launay, E Hachulla, P-Y Hatron, J E Salmon, N Costedoat-Chalumeau
Purpose The purpose of this study was to evaluate the safety of antithrombotic treatments prescribed during pregnancy in patients with antiphospholipid syndrome (APS). Methods This international, multicenter study included two cohorts of patients: a retrospective French cohort and a prospective US cohort (PROMISSE study). Inclusion criteria were (1) APS (Sydney criteria), (2) live pregnancy at 12 weeks of gestation (WG) with (3) follow-up data until six weeks post-partum. According to APS standard of care, patients were treated with aspirin and/or low-molecular weight heparin (LMWH) at prophylactic (pure obstetric APS) or therapeutic doses (history of thrombosis)...
September 2018: Lupus
https://www.readbyqxmd.com/read/29914780/understanding-the-experiences-of-east-african-immigrant-women-with-gestational-diabetes-mellitus
#3
Fartoon M Siad, Xiao Yang Fang, Maria J Santana, Sonia Butalia, Marilynne A Hebert, Doreen M Rabi
OBJECTIVES: East African (EA) women are a subpopulation who are at very high risk for gestational diabetes (GDM) and poor obstetric outcomes, but little is known about the care experiences of this understudied group. The objective of this study was to document the impact of a diagnosis of GDM and the perceptions of diabetes care among EA immigrant women. METHODS: Semistructured in-depth interviews were conducted with 10 EA immigrant women diagnosed with GDM in Calgary; they were recruited from community and tertiary care settings...
February 2, 2018: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/29862717/-design-and-application-of-high-risk-pregnancy-monitoring-warning-internet-platform-based-on-internet-of-things
#4
Heqing Lu, Xiaofeng Zhang, Bin Li
Through illustrating the designing of high-risk pregnancy maternal-fetal monitoring system based on the internet of things, this paper introduced the specific application of using wearable medical devices to provide maternal-fetal mobile medical services. With the help of big data and cloud obstetrics platform, the monitoring and warning network was further improved, the level-to-level administration of high-risk pregnancy was realized, the level of perinatal health care was enhanced and the risk of critical emergency of pregnancy decreased...
September 30, 2017: Zhongguo Yi Liao Qi Xie za Zhi, Chinese Journal of Medical Instrumentation
https://www.readbyqxmd.com/read/29847607/reducing-stillbirths-in-ethiopia-results-of-an-intervention-programme
#5
Bernt Lindtjørn, Demissew Mitike, Zillo Zidda, Yaliso Yaya
Previous studies from South Ethiopia have shown that interventions that focus on intrapartum care substantially reduce maternal mortality and there is a need to operationalize health packages that could reduce stillbirths. The aim of this paper is to evaluate if a programme that aimed to improve maternal health, and mainly focusing on strengthening intrapartum care, also would reduce the number of stillbirths, and to estimate if there are other indicators that explains high stillbirth rates. Our study used a "continuum of care" approach and focussed on providing essential antenatal and obstetric services in communities through health extension workers, at antenatal and health facility services...
2018: PloS One
https://www.readbyqxmd.com/read/29770322/sociodemographic-and-medical-risk-factors-associated-with-antepartum-depression
#6
Giridhara R Babu, G V S Murthy, Neeru Singh, Anita Nath, Mohanbabu Rathnaiah, Nolita Saldanha, R Deepa, Sanjay Kinra
Background: The increasing recognition of antenatal depression is an emerging area of concern in developing countries. We conducted a study to estimate the prevalence of antenatal mental distress and its relation with sociodemographic factors, obstetric factors, and physiological wellbeing in pregnant women attending public health facilities in Bengaluru, South India. Methods: Nested within a cohort study, we assessed the mental status in 823 pregnant women in two public referral hospitals...
2018: Frontiers in Public Health
https://www.readbyqxmd.com/read/29736276/pregnant-women-who-requested-a-108-ambulance-in-two-states-of-india
#7
Samiksha Singh, Pat Doyle, Oona Maeve Renee Campbell, Govindaraju Venkata Ramana Rao, Gudlavalleti V S Murthy
We studied the pregnant women, who requested a '108' ambulance in two Indian states (Andhra Pradesh (AP) and Himachal Pradesh (HP)). We conducted a cross-sectional telephone survey to study the characteristics and outcomes of those who (1) were transported using '108' ambulance, (2) were sent '108' ambulance but did not use it and (3) were not assigned a '108' ambulance. We conducted interviews within 24 hours of clients' call and followed them up at 48 hours, on the 7th and 28th day. 90% of pregnant women callers in AP and only 16% in HP were from poorer socioeconomic circumstances...
2018: BMJ Global Health
https://www.readbyqxmd.com/read/29621911/incidence-and-natural-history-of-preeclampsia-eclampsia-at-the-university-maternity-of-antananarivo-madagascar-high-prevalence-of-the-early-onset-condition
#8
Andriamanetsiarivo Tanjona Ratsiatosika, Eric Razafimanantsoa, Valéry Bruno Andriantoky, Noël Ravoavison, Rakotovao Andrianampanalinarivo Hery, Malik Boukerrou, Silvia Iacobelli, Pierre-Yves Robillard
OBJECTIVES: To investigate the incidence of early - (delivery <34 weeks) (EOP) versus late-onset (delivery ≥34 weeks) (LOP) in Madagascar. STUDY DESIGN: Eight months observational study of all preeclamptic/eclamptic women delivering at the maternity of the University Hospital of Befelatanana, Antananarivo, Madagascar. Sociodemographical and obstetrical risk factors are analyzed. RESULTS: Over the study period, we found 142 combined preeclampsia/eclampsia among 4316 births (incidence 3...
April 22, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29573218/understanding-environmental-contributions-to-autism-causal-concepts-and-the-state-of-science
#9
REVIEW
Irva Hertz-Picciotto, Rebecca J Schmidt, Paula Krakowiak
The complexity of neurodevelopment, the rapidity of early neurogenesis, and over 100 years of research identifying environmental influences on neurodevelopment serve as backdrop to understanding factors that influence risk and severity of autism spectrum disorder (ASD). This Keynote Lecture, delivered at the May 2016 annual meeting of the International Society for Autism Research, describes concepts of causation, outlines the trajectory of research on nongenetic factors beginning in the 1960s, and briefly reviews the current state of this science...
April 2018: Autism Research: Official Journal of the International Society for Autism Research
https://www.readbyqxmd.com/read/29519718/local-anesthetic-induced-methemoglobinemia-during-pregnancy-a-case-report-and-evaluation-of-treatment-options
#10
Andrew C Faust, Emily Guy, Nidhu Baby, Anthony Ortegon
BACKGROUND: Methemoglobinemia is a well-recognized adverse drug reaction related to the use of certain local anesthetic agents. The mainstay of treatment for methemoglobinemia is i.v. methylene blue, along with provision of supplemental oxygen; however, methylene blue is listed as a category X teratogen. This poses an issue should methemoglobinemia develop during pregnancy. CASE REPORT: A 35-year-old, 20-week and 5-day gravid female was transferred from an outpatient oral surgeon's office for hypoxia...
May 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29455616/is-the-fetal-cerebroplacental-ratio-better-that-the-estimated-fetal-weight-in-predicting-adverse-perinatal-outcomes-in-a-low-risk-cohort
#11
Christopher Flatley, Sailesh Kumar
OBJECTIVE: In high-risk pregnancies combining the cerebro-placental ratio (CPR) with the estimated fetal weight (EFW) improves the identification of vulnerable fetuses. The purpose of this study was to assess the CPR and EFW's ability to predict adverse obstetric and perinatal outcomes in a low-risk pregnancy, when measured late in gestation. METHODS: This was a retrospective study of women who birthed at Mater Mothers Hospitals, Brisbane, Australia between 2010 and 2015...
February 18, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29455380/clinical-features-and-peripartum-outcomes-in-pregnant-women-with-cardiac-disease-a-nationwide-retrospective-cohort-study-in-japan
#12
Toshiaki Isogai, Hiroki Matsui, Hiroyuki Tanaka, Akira Kohyama, Kiyohide Fushimi, Hideo Yasunaga
Although the number of pregnancies in women with cardiac disease is increasing worldwide, there are few data concerning their clinical characteristics and peripartum outcomes. Using the Diagnosis Procedure Combination database between 2008 and 2014 in Japan, we retrospectively identified pregnant women who underwent high-risk delivery due to obstetric or non-obstetric comorbidities. We classified eligible women into those with pre-existing cardiac disease (cardiac disease group) and those with non-cardiac comorbidities (non-cardiac disease group) and compared their characteristics and peripartum outcomes...
August 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29440934/prevalence-and-risk-factors-for-maternal-mortality-in-referral-hospitals-in-nigeria-a-multicenter-study
#13
Lorretta F Ntoimo, Friday E Okonofua, Rosemary N Ogu, Hadiza S Galadanci, Mohammed Gana, Ola N Okike, Kingsley N Agholor, Rukiyat A Abdus-Salam, Adetoye Durodola, Eghe Abe, Abdullahi J Randawa
Introduction: While reports from individual hospitals have helped to provide insights into the causes of maternal mortality in low-income countries, they are often limited for policymaking at national and subnational levels. This multisite study was designed to determine maternal mortality ratios (MMRs) and identify the risk factors for maternal deaths in referral health facilities in Nigeria. Methods: A pretested study protocol was used over a 6-month period (January 1-June 30, 2014) to obtain clinical data on pregnancies, births, and maternal deaths in eight referral hospitals across eight states and four geopolitical zones of Nigeria...
2018: International Journal of Women's Health
https://www.readbyqxmd.com/read/29422727/pattern-and-outcome-of-obstetric-admissions-into-the-intensive-care-unit-of-a-southeast-nigerian-hospital
#14
Benjamin Chukwuma Ozumba, Leonard Ogbonna Ajah, Vitus Okwuchukwu Obi, Uche Anthony Umeh, Joseph Tochukwu Enebe, Kingsley Chukwu Obioha
Background and Aims: Although pregnancy and labor are considered physiological processes, the potential for catastrophic complications is constant and may develop rapidly. There is growing evidence that admission of high-risk patients into the Intensive Care Unit (ICU) is associated with a reduction in maternal mortality. This study was aimed at reviewing all obstetric patients admitted into the ICU. Materials and Methods: This was a retrospective study of all obstetric patients who were admitted into the ICU between January 1, 2012, and December 31, 2013...
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29272998/risk-factors-and-outcome-of-patients-with-eclampsia-at-a-tertiary-hospital-in-egypt
#15
Ahmad Mahran, Hashem Fares, Reham Elkhateeb, Mahmoud Ibrahim, Haitham Bahaa, Ahmad Sanad, Alaa Gamal, Mohamed Zeeneldin, Eissa Khalifa, Ahmed Abdelghany
BACKGROUND: Eclampsia is a major cause of maternal and neonatal morbidity and mortality in low and middle income countries. The aim of this study was to assess the risk factors and maternal and perinatal outcome in patients with eclampsia in order to get reliable data that helps in reducing the incidence and improving the outcome in an area with high incidence of eclampsia. METHODS: Retrospective study including 250 patients diagnosed with eclampsia at Minia Maternity University Hopsital, Minia, Egypt in the period between January 2013 and December 2014...
December 22, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29189694/committee-opinion-no-726-hospital-disaster-preparedness-for-obstetricians-and-facilities-providing-maternity-care
#16
(no author information available yet)
Large-scale catastrophic events and infectious disease outbreaks highlight the need for disaster planning at all community levels. Features unique to the obstetric population (including antepartum, intrapartum, postpartum and neonatal care) warrant special consideration in the event of a disaster. Pregnancy increases the risks of untoward outcomes from various infectious diseases. Trauma during pregnancy presents anatomic and physiologic considerations that often can require increased use of resources such as higher rates of cesarean delivery...
December 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29189692/committee-opinion-no-726-summary-hospital-disaster-preparedness-for-obstetricians-and-facilities-providing-maternity-care
#17
(no author information available yet)
Large-scale catastrophic events and infectious disease outbreaks highlight the need for disaster planning at all community levels. Features unique to the obstetric population (including antepartum, intrapartum, postpartum and neonatal care) warrant special consideration in the event of a disaster. Pregnancy increases the risks of untoward outcomes from various infectious diseases. Trauma during pregnancy presents anatomic and physiologic considerations that often can require increased use of resources such as higher rates of cesarean delivery...
December 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29164597/maternal-body-mass-index-as-a-predictor-for-delivery-method
#18
Anita Pettersen-Dahl, Gulim Murzakanova, Leiv Sandvik, Katariina Laine
INTRODUCTION: High maternal body mass index (BMI) is associated with complications during pregnancy and delivery such as gestational diabetes, hypertensive disorders, perineal injuries and macrosomia. The aim of this study was to assess the association between maternal BMI and delivery method in non-breech, singleton deliveries, after 36 weeks of gestation, in women with no more than one previous cesarean section, in Oslo University Hospital, Ullevål. MATERIAL AND METHODS: This retrospective register study used data from the hospital obstetrical database in 2011-2012, forming a cohort of 8821 women...
February 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29122802/emergency-obstetric-care-provision-in-southern-ethiopia-a-facility-based-survey
#19
MULTICENTER STUDY
Mitchell Windsma, Tienke Vermeiden, Floris Braat, Andualem Mengistu Tsegaye, Asheber Gaym, Thomas van den Akker, Jelle Stekelenburg
OBJECTIVES: To assess the provision of basic emergency obstetric and newborn care (BEmONC), knowledge of high-risk pregnancies and referral capacity at health centres in Southern Ethiopia. DESIGN: A facility-based survey, using an abbreviated version of the Averting Maternal Death and Disability needs assessment tool for emergency obstetric and newborn care. Modules included infrastructure, staffing, number of deliveries, maternal and perinatal mortality, BEmONC signal functions, referral capacity and knowledge of risk factors in pregnancy...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29070512/identifying-and-treating-subclinical-thyroid-dysfunction-in-pregnancy-emerging-controversies
#20
REVIEW
Inés Velasco, Peter Taylor
Thyroid hormones are essential for an adequate growth and development of the fetus. In addition to the classical association between maternal hypothyroidism and neurological impairment in the progeny, other adverse reproductive events have been associated with maternal thyroid dysfunction including infertility, miscarriage and preterm delivery. Although all scientific societies endorse the treatment of overt hypothyroidism; the management and/or treatment of subclinical hypothyroidism, hypothyroxinemia or antithyroid antibody-positive women should be considered with caution...
January 2018: European Journal of Endocrinology
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