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Perinatology

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https://www.readbyqxmd.com/read/29156486/-update-in-obstetric-anesthesia-tried-and-trusted-methods-controversies-and-new-perspectives
#1
Peter Kranke, Thorsten Annecke, Dorothee H Bremerich, Daniel Chappell, Thierry Girard, Wiebke Gogarten, Robert Hanß, Lutz Kaufner, Sophie Neuhaus, Tobias Ninke, Thomas Standl, Stefan Weber, Yvonne Jelting, Thomas Volk
Since 1975, a plethora of lectures within the context of annual meetings relevant for the clinical care has been summarized in "what's new in obstetric anesthesia" by the society for Obstetric anesthesia and Perinatology which can be recommended to everyone interested in anaesthesiology in the delivery room. After the death of Gerard W. Ostheimer, Professor of Anaesthesiology at Brigham and Women's Hospital in Boston, Massachusetts, it became renamed the Gerard W. Ostheimer "what's new in obstetric anesthesia" lecture to honor his contributions to regional anesthesia and obstetric anaesthesia...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29144490/neonatal-lung-ultrasound-exam-guidelines
#2
D Kurepa, N Zaghloul, L Watkins, J Liu
Point-of-care ultrasound (POC-US) is increasingly used especially in emergency and critical-care medicine. It is focused, quick and does not expose patients to ionizing radiation. It encompasses all organ systems and has well-defined indications. Lung ultrasound (LUS) represents one of the most exciting applications in the field of POC-US. It is particularly important to emphasize the role of LUS in neonatology due to the specific pathology inherent in lung immaturity as well as in the particular sensitivity of neonates to repeated radiation exposure...
November 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29135597/society-for-obstetric-anesthesia-and-perinatology-2017-meeting-report
#3
Anthony Chau
No abstract text is available yet for this article.
November 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29120457/management-of-neonatal-spontaneous-intestinal-perforation-by-peritoneal-needle-aspiration
#4
M Gébus, J-L Michel, S Samperiz, L Harper, J-L Alessandri, D Ramful
OBJECTIVE: To describe conservative management of spontaneous intestinal perforation (SIP) in preterm infants using peritoneal needle aspiration (PNA). STUDY DESIGN: Monocentric retrospective review of SIP cases treated primarily by PNA between 1999 and 2015 (n=31). RESULTS: Mean gestational age was 29.2±2.4 weeks and birthweight 1149±428 g. SIP occurred at 3.7±2.2 days of life. PNA achieved definitive treatment in 18 patients (60%) with a mean of 1...
November 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29120456/indicators-of-skin-barrier-integrity-among-newborns-massaged-with-mustard-oil-in-rural-nepal
#5
A Summers, M O Visscher, S K Khatry, J B Sherchand, S C LeClerq, J Katz, J M Tielsch, L C Mullany
OBJECTIVE: The objective of this study was to determine the skin barrier changes during postnatal month 1 among infants receiving routine mustard oil massage in the humid conditions of rural Nepal. STUDY DESIGN: This was an observational study among 500 live-born neonates receiving mustard oil massage. Skin integrity such as erythema, rash, dryness, skin pH, stratum corneum protein concentration and transepidermal water loss was measured on days 1, 3, 7, 14 and 28...
November 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29120455/manipulating-the-microbiome-evolution-of-a-strategy-to-prevent-s-aureus-disease-in-children
#6
D F Khamash, A Voskertchian, A M Milstone
Hospitalized infants have the highest rates of invasive Staphylococcus aureus disease of any population and infection control strategies such as decolonization have been insufficient. For decades, researchers began studying the microbiome in search of new prevention strategies. The resident microbiota was found to be closely associated with susceptibility and at times, resistance to S. aureus colonization. The evolution of nucleic acid based techniques has enhanced our understanding of the complex relationship between the nasal microbiota and S...
November 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29120454/hospital-volume-and-cesarean-delivery-among-low-risk-women-in-a-nationwide-sample
#7
M A Clapp, K E James, A Melamed, J L Ecker, A J Kaimal
OBJECTIVE: We sought to determine if hospital delivery volume was associated with a patient's risk for cesarean delivery in low-risk women. STUDY DESIGN: This study retrospectively examines a cohort of 1 657 495 deliveries identified in the 2013 Nationwide Readmissions Database. Hospitals were stratified by delivery volume quartiles. Low-risk patients were identified using the Society for Maternal-Fetal Medicine definition (n=845 056). A multivariable logistic regression accounting for hospital-level clustering was constructed to assess the factors affecting a patient's odds for cesarean delivery...
November 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29120453/out-of-hospital-births-in-california-1991-2011
#8
A I Girsen, J A Mayo, D J Lyell, Y J Blumenfeld, D K Stevenson, Y Y El-Sayed, G M Shaw, M L Druzin
OBJECTIVE: We investigated the frequencies and characteristics of out-of-hospital births in a 20-year period in California, where 1 of every 7 births in the United States occurs. STUDY DESIGN: Birth certificate records of deliveries in California between 1991 and 2011 were analyzed. Out-of-hospital births were assessed by year, parity, gestational age and maternal race/ethnicity. RESULTS: In the 20-year period there were 10 593,904 deliveries, of which 46 243 occurred out of hospital (0...
November 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29120452/vascular-aging-and-cardiac-maladaptation-in-growth-restricted-preterm-infants
#9
A Sehgal, B J Allison, S M Gwini, S Menahem, S L Miller, G R Polglase
OBJECTIVE: To assess arterial morphology and mechanics in preterm infants with fetal growth restriction (FGR) compared with those appropriate for gestational age (AGA) in the early neonatal period. STUDY DESIGN: This observational study involved 20 preterm FGR infants (28 to 32 weeks) of gestational age (GA) and birth weight (BW) <10th centile and 20 preterm AGA infants. Vascular ultrasound was performed to measure aortic properties. RESULTS: GA and BW of FGR and AGA infants were 29...
November 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29120451/effect-of-maternal-smoking-on-stress-physiology-in-healthy-neonates
#10
C Haslinger, H Bamert, M Rauh, T Burkhardt, L Schäffer
OBJECTIVE: To assess the impact of maternal smoking during pregnancy (MSDP) on the neonatal hypothalamic-pituitary-adrenal axis. STUDY DESIGN: In a prospective observational study, salivary cortisol and cortisone levels were measured at the fourth day of life during resting conditions and in response to a pain-induced stress event in healthy neonates whose mothers smoked cigarettes during each stage of pregnancy and compared with controls. RESULTS: Neonates in the control group (n=70) exhibited a physiologic stress response with a significant increase in cortisol (1...
November 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29120450/apnea-bradycardia-and-desaturation-spells-in-premature-infants-impact-of-a-protocol-for-the-duration-of-spell-free-observation-on-interprovider-variability-and-readmission-rates
#11
P Chandrasekharan, M Rawat, A M Reynolds, K Phillips, S Lakshminrusimha
OBJECTIVE: To study the impact of implementing a protocol to standardize the duration of observation in preterm infants with apnea/bradycardia/desaturation spells before hospital discharge on length of stay (LOS) and readmission rates. STUDY DESIGN: A protocol to standardize the duration of in-hospital observation for preterm infants with apnea, bradycardia and desaturation spells who were otherwise ready for discharge was implemented in December 2013. We evaluated the impact of this protocol on the LOS and readmission rates of very low birth weight infants (VLBW)...
November 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29114962/annual-report-of-the-perinatology-committee-japan-society-of-obstetrics-and-gynecology-2016-overall-report-on-a-comprehensive-retrospective-study-of-obstetric-management-of-preterm-labor-and-preterm-premature-rupture-of-the-membranes
#12
Hiroshi Sameshima, Shigeru Saito, Yoshio Matsuda, Masato Kamitomo, Shintaro Makino, Masanao Ohashi, Emi Kino, Naohiro Kanayama, Satoru Takeda
We conducted a questionnaire survey on the current obstetric management of preterm labor (PL) and preterm premature rupture of the membranes (pPROM). The questionnaire covered approximately a third of all preterm deliveries and nearly half of the preterm deliveries before 32 gestational weeks. The diagnostic criterion for PL was either painful uterine contractions or cervical dilatation. Tocolytic agents were primarily used as long-term maintenance therapy. Intrauterine infection was clinically diagnosed at most responding institutions...
November 8, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29099429/the-society-for-obstetric-anesthesia-and-perinatology-consensus-statement-on-the-anesthetic-management-of-pregnant-and-postpartum-women-receiving-thromboprophylaxis-or-higher-dose-anticoagulants
#13
Lisa Leffert, Alexander Butwick, Brendan Carvalho, Katherine Arendt, Shannon M Bates, Alex Friedman, Terese Horlocker, Timothy Houle, Ruth Landau, Heloise Dubois, Roshan Fernando, Tim Houle, Sandra Kopp, Douglas Montgomery, Joseph Pellegrini, Richard Smiley, Paloma Toledo
Venous thromboembolism is recognized as a leading cause of maternal death in the United States. Thromboprophylaxis has been highlighted as a key preventive measure to reduce venous thromboembolism-related maternal deaths. However, the expanded use of thromboprophylaxis in obstetrics will have a major impact on the use and timing of neuraxial analgesia and anesthesia for women undergoing vaginal or cesarean delivery and other obstetric surgeries. Experts from the Society of Obstetric Anesthesia and Perinatology, the American Society of Regional Anesthesia, and hematology have collaborated to develop this comprehensive, pregnancy-specific consensus statement on neuraxial procedures in obstetric patients receiving thromboprophylaxis or higher dose anticoagulants...
November 1, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29095433/prospective-research-on-infants-with-mild-encephalopathy-the-prime-study
#14
C Prempunpong, L F Chalak, J Garfinkle, B Shah, V Kalra, N Rollins, R Boyle, K-A Nguyen, I Mir, A Pappas, P Montaldo, S Thayyil, P J Sánchez, S Shankaran, A R Laptook, G Sant'Anna
OBJECTIVE: To determine short-term outcomes of infants with evidence of hypoxia-ischemia at birth and classified as mild neonatal encephalopathy (NE) at <6 h of age. STUDY DESIGN: Prospective multicenter study. Mild NE was defined as ⩾1 abnormal category in modified Sarnat score. Primary outcome was any abnormality on early amplitude integrated electroencephalogram (aEEG) or seizures, abnormal brain magnetic resonance imaging (MRI) or neurological exam at discharge...
November 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29095432/pregnancy-induced-hypertension-and-neonatal-outcomes-a-systematic-review-and-meta-analysis
#15
A Razak, A Florendo-Chin, L Banfield, M G Abdul Wahab, S McDonald, P S Shah, A Mukerji
OBJECTIVE: Pregnancy-induced hypertension (PIH) is associated with preterm delivery but its independent impact on neonatal outcomes remains unclear. We sought to systematically review and meta-analyze clinical outcomes of preterm infants <37 weeks' gestation born to mothers with and without PIH. STUDY DESIGN: Medline, Embase, PsychINFO and CINAHL were searched from January 2000 to October 2016. Studies with low-moderate risk of bias reporting neonatal outcomes based on PIH as primary exposure variable were included...
November 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29095431/double-versus-single-intensive-phototherapy-with-leds-in-treatment-of-neonatal-hyperbilirubinemia
#16
M L Donneborg, P K Vandborg, B M Hansen, M Rodrigo-Domingo, F Ebbesen
OBJECTIVE: We investigate whether double phototherapy reduces total serum bilirubin concentration faster than single light during intensive phototherapy with high levels of irradiance using light-emitting diodes. STUDY DESIGN: Eighty-three infants with gestational age ⩾33 weeks and uncomplicated hyperbilirubinemia were randomized to either double (n=41) or single phototherapy (n=42) for 24 h. The mean irradiance was 64.8 μW cm(-2) nm(-1) from above and 39 μW cm(-2) nm(-1) from below...
November 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29095430/excipient-exposure-in-very-low-birth-weight-preterm-neonates
#17
T O Akinmboni, N L Davis, A J Falck, C F Bearer, S M Mooney
OBJECTIVE: The excipients benzyl alcohol, propylene glycol and ethanol are present in medications used in the neonatal intensive care unit. Exposure to high levels can have adverse effects in a neonatal population. The objective was to quantify excipient exposure in very low birth weight (VLBW) neonates and identify risk factors associated with greater exposure. STUDY DESIGN: A retrospective record review of VLBW infants admitted over 1 year. Excipient exposures were calculated and multivariable regression analyses identified risk factors for increasing exposure...
November 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29095429/activation-of-toll-like-receptors-in-meconium-aspiration-syndrome
#18
V Anand, S Basu, S S Yadav, G Narayan, B D Bhatia, A Kumar
OBJECTIVE: Meconium aspiration syndrome (MAS) is a common cause of neonatal morbidity and mortality. Incomplete understanding of the pathogenesis of MAS has hindered the development of specific therapies. We hypothesized that activation of Toll-like receptors (TLRs) might play a role in the pathogenesis of MAS. The present study evaluated the expression of TLR 1, 4, 7, 8 and 9 in neonates with MAS. STUDY DESIGN: The study included 39 neonates with MAS and 17 healthy gestational age-matched neonates as controls...
November 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29072677/the-impact-of-neurally-adjusted-ventilatory-assist-mode-on-respiratory-severity-score-and-energy-expenditure-in-infants-a-randomized-crossover-trial
#19
J L Rosterman, E K Pallotto, W E Truog, H Escobar, K A Meinert, A Holmes, H Dai, W M Manimtim
OBJECTIVE: Examine respiratory severity scores (RSS) (mean airway pressure × fraction of inspired oxygen) and resting energy expenditure (REE) on neurally adjusted ventilatory assist (NAVA) compared with synchronized intermittent mandatory ventilation with pressure controlled and supported breath (SIMV (PC)PS). STUDY DESIGN: A randomized, crossover trial in a level IV neonatal intensive care unit. Twenty-four patients were ventilated with NAVA or SIMV (PC) PS for 12 h and then crossed over to the alternative mode for 12 h...
October 26, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29072676/comparison-of-sprinting-vs-non-sprinting-to-wean-nasal-continuous-positive-airway-pressure-off-in-very-preterm-infants
#20
N Eze, D Murphy, V Dhar, V K Rehan
OBJECTIVE: Though nasal continuous positive airway pressure (NCPAP) is commonly used for non-invasive neonatal respiratory support, the optimal method of weaning NCPAP is not established. In this prospective, two-center randomized control trial we hypothesize that gradually increasing spontaneous breathing time off NCPAP increases successful weaning from NCPAP in infants born <31 weeks gestational age. STUDY DESIGN: Infants were randomized to one of the two NCPAP weaning protocols, a sprinting, that is, gradually increasing spontaneous breathing time off CPAP, protocol vs a non-sprinting (weaning pressure down) protocol...
October 26, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
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