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https://www.readbyqxmd.com/read/27894129/isolated-fetal-ascites-neonatal-outcome-in-51-cases-observed-in-a-tertiary-referral-center
#1
Vincenzo Davide Catania, Alessia Muru, Marcella Pellegrino, Erika Adalgisa De Marco, Filomena Valentina Paradiso, Carlo Manzoni, Lorenzo Nanni, Lucia Masini
Introduction Prenatal detection of isolated ascites is a rare finding on ultrasound, usually suggestive of an underlying pathology that may negatively impact on the pregnancy and neonatal outcome. The purpose of the present study was to evaluate the outcome of primary isolated ascites in relation to gestational age (GA) at diagnosis. Materials and Methods Data were prospectively collected for fetuses with ascites that have been followed in our center of prenatal diagnosis and therapy from 2004 to 2014. Patients have been divided in group I when ascites was detected before the 24th week of GA and group II if it was noticed later...
November 28, 2016: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27864598/impact-of-fetal-counseling-on-outcome-of-antenatal-congenital-surgical-anomalies
#2
Shilpa Sharma, Ranjana Bhanot, Dipika Deka, Minu Bajpai, Devendra K Gupta
AIM: To analyze the impact of counseling on antenatal congenital surgical anomalies (ACSA). METHODS: Cases presenting with ACSA for fetal counseling and those presenting in post-natal period following diagnosis of ACSA (PACSA) for surgical opinion were analyzed for spectrum, presentation and outcome. RESULTS: 117 cases including ACSA(68);PACSA(49) were analyzed. Gestational age at diagnosis of ACSA;PACSA was 17-37;17-39 weeks (median 24;32 weeks)...
November 18, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27854384/short-term-outcome-of-periviable-small-for-gestational-age-babies-is-our-counseling-up-to-date
#3
A R Lawin-O'Brien, A Dall'Asta, C Knight, S Sankaran, C Scala, A Khalil, A Bhide, S Heggarty, A Rakow, D Pasupathy, A T Papageorghiou, C C Lees
OBJECTIVE: There are limited data for counseling on and management of periviable small-for-gestational-age (SGA) fetuses. We therefore aimed to investigate the short-term outcome of periviable SGA fetuses in relation to the likely underlying cause. METHODS: This was a retrospective study of data from three London tertiary fetal medicine centers obtained between 2000 and 2015. We included viable singleton pregnancies with a severely small fetus, defined as those with an abdominal circumference ≤ 3(rd) percentile, identified between 22 + 0 and 25 + 6 weeks' gestation...
November 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27847654/the-case-for-improved-interprofessional-care-fatal-analgesic-overdose-secondary-to-acute-dental-pain-during-pregnancy
#4
Sarah K Y Lee, Rocio B Quinonez, Alice Chuang, Stephanie M Munz, Darya Dabiri
Prenatal oral health extends beyond the oral cavity, impacting the general well-being of the pregnant patient and her fetus. This case report follows a 19-year-old pregnant female presenting with acute liver failure secondary to acetaminophen overdose for management of dental pain following extensive dental procedures. Through the course of her illness, the patient suffered adverse outcomes including fetal demise, acute kidney injury, spontaneous bacterial peritonitis, and septic shock before eventual death from multiple organ failure...
2016: Case Reports in Dentistry
https://www.readbyqxmd.com/read/27842993/diagnosis-and-clinical-management-of-embryonic-mosaicism
#5
REVIEW
Nidhee M Sachdev, Susan M Maxwell, Andria G Besser, James A Grifo
Embryonic mosaicism occurs when two or more cell populations with different genotypes are present within the same embryo. New diagnostic techniques for preimplantation genetic screening (PGS), such as next-generation sequencing, have led to increased reporting of mosaicism. The interpretation of mosaicism is complicated because the transfer of some mosaic embryos has resulted in live births. Mosaic embryos may represent a third category between normal (euploidy) and abnormal (aneuploidy). This category of mosaic embryos may be characterized by decreased implantation and pregnancy potential as well as increased risk of genetic abnormalities and adverse pregnancy outcomes...
November 11, 2016: Fertility and Sterility
https://www.readbyqxmd.com/read/27824749/treatment-decisions-at-the-time-of-miscarriage-diagnosis
#6
Courtney A Schreiber, Veronica Chavez, Paul G Whittaker, Sarah J Ratcliffe, Ebony Easley, Frances K Barg
OBJECTIVE: To describe the factors patients and physicians prioritize during first-trimester miscarriage management and assess what drives satisfaction with care. METHODS: We conducted a mixed-methods study of clinically stable women seeking surgical, medical, or expectant miscarriage treatment. Women with first-trimester fetal demise or anembryonic gestation (N=55) completed demographic and psychosocial surveys. Using purposive sampling, 45 (82%) completed in-depth interviews...
December 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27819333/novel-toll-like-receptor-4-antagonist-naloxone-protects-mice-from-inflammation-induced-preterm-birth
#7
Peck Yin Chin, Camilla L Dorian, Mark R Hutchinson, David M Olson, Kenner C Rice, Lachlan M Moldenhauer, Sarah A Robertson
Toll-like receptor 4 (TLR4) activation by bacterial infection, or by sterile inflammatory insult is a primary trigger of spontaneous preterm birth. Here we utilize mouse models to investigate the efficacy of a novel small molecule TLR4 antagonist, (+)-naloxone, the non-opioid isomer of the opioid receptor antagonist (-)-naloxone, in infection-associated preterm birth. Treatment with (+)-naloxone prevented preterm delivery and alleviated fetal demise in utero elicited by i.p. LPS administration in late gestation...
November 7, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27781319/stillbirth-and-intrauterine-fetal-death-role-of-routine-histopathological-placental-findings-to-determine-cause-of-death
#8
J Man, J C Hutchinson, A E Heazell, M Ashworth, I Jeffrey, N J Sebire
OBJECTIVES: Placental abnormalities are a common cause of death in stillbirth, ranking second only to unexplained deaths, though there is wide variation in the proportion attributed to placental disease. In clinical practice, interpretation of the significance of placental findings is difficult, since many placental features in stillbirths overlap with those in live births. Our aim was to examine objectively classified placental findings from a series of > 1000 autopsies following intrauterine death in order to evaluate the role of placental histological examination in determining the cause of death...
October 25, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27763485/wernicke-s-encephalopathy-due-to-hyperemesis-gravidarum-clinical-and-magnetic-resonance-imaging-characteristics
#9
V V Ashraf, J Prijesh, R Praveenkumar, K Saifudheen
Hyperemesis gravidarum-induced Wernicke's encephalopathy (WE) is an underestimated condition. The purpose of this study is to improve its awareness and early diagnosis. We report five cases of WE secondary to hyperemesis gravidarum. Classic triad of encephalopathy, ataxia, and ocular signs was seen in four out of five patients. Two unusual features noted in this series were papilledema in one patient and severe sensory-motor peripheral neuropathy in one patient. Magnetic resonance imaging (MRI) was abnormal in all the five patients, and high signal in medial thalamus and surrounding the aqueduct was the most common abnormality (5/5)...
October 2016: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/27760748/the-local-and-systemic-immune-response-to-intrauterine-lps-in-the-prepartum-mouse
#10
Lydia F Edey, Kieran P O'Dea, Bronwen R Herbert, Renyi Hua, Simon N Waddington, David A MacIntyre, Philip R Bennett, Masao Takata, Mark R Johnson
Inflammation plays a key role in human term and preterm labor (PTL). Intrauterine LPS has been widely used to model inflammation induced complications of pregnancy including PTL. It has been shown to induce an intense myometrial inflammatory cell infiltration, but the role of LPS-induced inflammatory cell activation in labor onset and fetal demise is unclear. We investigated this using a mouse model of PTL, where an intrauterine injection of 10 µg of LPS (serotype 0111:B4) was given at E16 of CD1 mouse pregnancy...
October 19, 2016: Biology of Reproduction
https://www.readbyqxmd.com/read/27760663/-the-prognosis-of-monochorionic-co-twin-after-single-intrauterine-fetal-demise
#11
Y Wang, Y Wei, P B Yuan, X J Wang, Y Y Zhao
Objective: To analyze the prognosis of surviving monochorionic co-twin after single intrauterine fetal demise (sIUFD). Methods: Retrospectively analyzed the twin pregnancy cases admitted in Peking University Third Hospital between Jan 2008 and Feb 2015. We recorded perinatal characteristics, neuroimage in co-twin, and followed up the neonatal outcome. Results: 47 cases were found, including 45 cases of monochorionic diamniotic (MCDA) and 2 cases of monochorionic monoamniotic (MCMA). Median gestational age at sIUFD was 27 weeks...
October 11, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27759174/estimated-combined-cardiac-output-and-laser-therapy-for-twin-twin-transfusion-syndrome
#12
Shiraz A Maskatia, Rodrigo Ruano, Alireza A Shamshirsaz, Pouya Javadian, Joshua A Kailin, Michael A Belfort, Carolyn A Altman, Nancy A Ayres
INTRODUCTION: Twin-twin transfusion syndrome (TTTS) is the major cause for fetal demise in monochorionic diamniotic pregnancies. Estimated combined cardiac output (CCO) has not been studied in this setting. The primary aims of this study were to compare CCO in twin donor and recipient fetuses and assess differences in CCO before and after laser coagulation therapy. A secondary aim was to evaluate the relationship of CCO with perinatal mortality, defined as intrauterine or neonatal mortality (≤30 days of age) in fetuses that underwent laser coagulation therapy...
October 2016: Echocardiography
https://www.readbyqxmd.com/read/27756175/pregnancies-complicated-by-both-preeclampsia-and-growth-restriction-between-34-and-37-weeks-gestation-are-associated-with-adverse-perinatal-outcomes
#13
Kathryn J Sharma, Tania F Esakoff, Alyson Guillet, Richard M Burwick, Aaron B Caughey
OBJECTIVE: To determine whether adverse outcomes were more common in late preterm pregnancies complicated by preeclampsia and growth restriction compared to those affected by preeclampsia alone. METHODS: This was a retrospective cohort study of 8,927 singleton pregnancies with preeclampsia. Pregnancies with small for gestational age (SGA) neonates (birthweight <10(th) percentile) were compared to those appropriate for gestational age (AGA) neonates. Maternal outcomes included cesarean delivery (CD) rate, CD for fetal heart rate (FHR) abnormalities, abruption, postpartum hemorrhage (PPH), maternal transfusion, acute renal failure, and peripartum cardiomyopathy...
October 19, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27753020/characterization-of-human-pregnancy-specific-glycoprotein-psg-gene-copy-number-variations-in-pre-eclampsia-patients
#14
Chia Lin Chang, Chia Yu Chang, Da Xian Lee, Po Jen Cheng
Pre-eclampsia is a pregnancy-specific hypertensive disorder that affects 2-8 % of pregnancies. This disorder can lead to seizure, multi-organ failure and maternal death. The best approach to prevent pre-eclampsia-associated adverse outcomes is to be able to prevent pre-eclampsia as early as possible. Unfortunately, current diagnostic methods are ineffective at predicting the risk of pre-eclampsia during early pregnancy. In humans, low levels of a group of placenta-derived Pregnancy Specific Glycoproteins (PSGs) have been associated with intrauterine growth retardation and pre-eclampsia and there is a significant enrichment of cases with deletions in the PSG gene locus in pre-eclampsia patients...
2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27739945/blunt-prenatal-trauma-resulting-in-fetal-epidural-or-subdural-hematoma-case-report-and-systematic-review-of-the-literature
#15
Jacob R Joseph, Brandon W Smith, Hugh J L Garton
Blunt prenatal trauma is known to have consequences to the developing brain, and can result in subdural hematoma (SDH) or epidural hematoma (EDH). The authors present a case of blunt prenatal trauma resulting in a fetal SDH, intraparenchymal hematoma, and intraventricular hemorrhage, and perform a systematic review of the literature. This systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Relevant studies (up to April 2016) that reported on cases of fetal SDH or EDH after blunt prenatal trauma were identified from the PubMed database...
October 14, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27684414/prognostic-accuracy-of-antenatal-neonatology-consultation
#16
S Kukora, N Gollehon, G Weiner, N Laventhal
OBJECTIVE: Neonatologists provide antenatal counseling to support shared decision-making for complicated pregnancies. Poor or ambiguous prognostication can lead to inappropriate treatment and parental distress. We sought to evaluate the accuracy of antenatal prognosticaltion. STUDY DESIGN: A retrospective cohort was assembled from a prospectively populated database of all outpatient neonatology consultations. On the basis of the written consultation, fetuses were characterized by diagnosis groups (multiple anomalies or genetic disorders, single major anomaly and obstetric complications), assigned to five prognostic categories (I=survivable, IIA=uncertain but likely survivable, II=uncertain, IIB=uncertain but likely non-survivable, III non-survivable) and two final outcome categories (fetal demise/in-hospital neonatal death or survival to hospital discharge)...
September 29, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27643761/persistence-of-villous-immaturity-in-term-deliveries-following-intrauterine-transfusion-for-parvovirus-b19-infection-and-rhd-associated-hemolytic-disease-of-the-fetus-and-newborn
#17
Whitney A McCarthy, Edwina J Popek
Fetal anemia and hydrops may be caused by parvovirus B19 infection and maternal alloimmunization to RhD with subsequent hemolytic disease of the fetus and newborn. The use of intrauterine transfusion over the last few decades has dramatically improved outcomes. Prior literature has extensively documented placental changes associated with untreated parvovirus infection and RhD HDFN in intrauterine fetal demises (IUFD) and pre-term births; however, histopathologic changes in term placentas from term infants treated with IUT have not been reported...
September 19, 2016: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/27640608/gastroschisis-a-review-of-management-and-outcomes
#18
Rachel V O'Connell, Sarah K Dotters-Katz, Jeffrey A Kuller, Robert A Strauss
We performed an evidence-based review of the obstetrical management of gastroschisis. Gastroschisis is an abdominal wall defect, which has increased in frequency in recent decades. There is variation of prevalence by ethnicity and several known maternal risk factors. Herniated intestinal loops lacking a covering membrane can be identified with prenatal ultrasonography, and maternal serum α-fetoprotein level is commonly elevated. Because of the increased risk for growth restriction, amniotic fluid abnormalities, and fetal demise, antenatal testing is generally recommended...
September 2016: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/27638112/antenatal-palliative-care-consultation-implications-for-decision-making-and-perinatal-outcomes-in-a-single-centre-experience
#19
Stephanie Kukora, Nathan Gollehon, Naomi Laventhal
BACKGROUND: Some pregnant patients with complex fetal anomalies meet with paediatric palliative care subspecialists prior to delivery, but referral to antenatal palliative care consultation (APCC) is not standard. Little is known about its role in perinatal decision-making. METHODS: A single-centre retrospective cohort study was undertaken for patients referred for outpatient antenatal counselling by a neonatologist over a two-and-half-year period. Patients also receiving APCC were compared with infants with similar prognoses who did not...
September 16, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27607863/spontaneous-twin-pregnancy-after-oophoropexy-and-pelvic-radiation-for-rectal-cancer
#20
Kaitlyn Wald, Tom Easterling, Elizabeth M Swisher
BACKGROUND: Pregnancy after adulthood pelvic radiation is rare. There is a paucity of literature to guide preconception counseling and pregnancy management for these patients. CASE: A 36-year-old woman, gravida 2 para 1001, was referred at 28 weeks of gestation with spontaneous twins, preterm premature rupture of membranes, and a history of rectal cancer that had been treated 3 years previously with oophoropexy, chemoradiation, and abdominal perineal resection. Delivery was complicated by difficult fetal extraction and resulted in the demise of twin A...
October 2016: Obstetrics and Gynecology
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