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Low risk obstetrics

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https://www.readbyqxmd.com/read/29155965/is-frozen-embryo-transfer-better-for-mothers-and-babies-can-cumulative-meta-analysis-provide-a-definitive-answer
#1
Abha Maheshwari, Shilpi Pandey, Edwin Amalraj Raja, Ashalatha Shetty, Mark Hamilton, Siladitya Bhattacharya
BACKGROUND: Initial observational studies and a systematic review published 5 years ago have suggested that obstetric and perinatal outcomes are better in offspring conceived following frozen rather than fresh embryo transfers, with reduced risks of preterm birth, small for gestational age, low birth weight and pre-eclampsia. More recent primary studies are beginning to challenge some of these findings. We therefore conducted an updated systematic review and cumulative meta-analysis to examine if these results have remained consistent over time...
November 13, 2017: Human Reproduction Update
https://www.readbyqxmd.com/read/29155474/visual-biofeedback-using-trans-perineal-ultrasound-during-the-second-stage-of-labor
#2
Yinon Gilboa, Tahl I Frenkel, Yael Schlesinger, Sofie Rousseau, Daniel Hamiel, Reuven Achiron, Sharon Perlman
OBJECTIVES: to assess the obstetrical and psychological effect of visual biofeedback using trans-perineal ultrasound (TPU) during the second stage of labor. METHODS: Visual biofeedback using TPU was performed prospectively during the second stage of labor in twenty-six low risk nulliparous women. Pushing efficacy was assessed by the angle of progression at rest and during pushing efforts before and after observing the ultrasound screen. Obstetrical outcomes included level of perineal tearing, mode of delivery and length of the second stage...
November 20, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29145897/it-does-matter-where-you-come-from-mothers-experiences-of-childbirth-in-midwife-obstetric-units-tshwane-south-africa
#3
Sarie J Oosthuizen, Anne-Marie Bergh, Robert C Pattinson, Jackie Grimbeek
BACKGROUND: Health professionals are striving to improve respectful care for women, but they fall short in the domains of effective communication, respectful and dignified care and emotional support during labour. This study aimed to determine women's experiences of childbirth with a view to improving respectful clinical care practices in low-risk, midwife-led obstetric units in the Tshwane District Health District, South Africa. METHODS: A survey covering all midwife-led units in the district was conducted among 653 new mothers...
November 16, 2017: Reproductive Health
https://www.readbyqxmd.com/read/29144586/relationship-between-hospital-level-percentage-of-midwife-attended-births-and-obstetric-procedure-utilization
#4
Laura Attanasio, Katy B Kozhimannil
INTRODUCTION: Research has shown good outcomes among individual low-risk women who receive perinatal care from midwives, yet little is known about how hospital-level variation in midwifery care relates to procedure use and maternal health. This study aimed to document the association between the hospital-level proportion of midwife-attended births and obstetric procedure utilization. METHODS: This analysis used 2 data sources: Healthcare Cost and Utilization Project State Inpatient Database data for New York in 2014, and New York State Department of Health data on the percentage of midwife-attended births at hospitals in the state in 2014...
November 16, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29137550/reengineering-electronic-fetal-monitoring-interpretation-using-the-fetal-reserve-index-to-anticipate-the-need-for-emergent-operative-delivery
#5
Robert D Eden, Mark I Evans, Shara M Evans, Barry S Schifrin
OBJECTIVE: The near-ubiquitous use of electronic fetal monitoring has failed to lower the rates of both cerebral palsy and emergency operative deliveries (EODs). Its performance metrics have low sensitivity, specificity, and predictive values for both. There are many EODs, but the vast majority have normal outcomes. The EODs, however, cause serious disruption in the delivery suite routine with increased complications, anxiety, and concern for all. METHODS: We developed the fetal reserve index (FRI) as multicomponent algorithm including 4 FHR components (analyzed individually), uterine activity, and maternal, obstetrical, and fetal risk factors to assess risk of cerebral palsy and EOD...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/29135051/low-molecular-weight-heparin-and-aspirin-exacerbate-human-endometrial-endothelial-cell-responses-to-antiphospholipid-antibodies
#6
Zola Chihombori Quao, Mancy Tong, Elena Bryce, Seth Guller, Lawrence W Chamley, Vikki M Abrahams
PROBLEM: Women with antiphospholipid antibodies (aPL) are at risk for pregnancy complications despite treatment with low molecular weight heparin (LMWH) or aspirin (ASA). aPL recognizing beta2 glycoprotein I can target the uterine endothelium, however, little is known about its response to aPL. This study characterized the effect of aPL on human endometrial endothelial cells (HEECs), and the influence of LMWH and ASA. METHOD OF STUDY: HEECs were exposed to aPL or control IgG, with or without low-dose LMWH and ASA, alone or in combination...
November 14, 2017: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/29132771/-neonatal-herpes-epidemiology-clinical-manifestations-and-management-guidelines-for-clinical-practice-from-the-french-college-of-gynecologists-and-obstetricians-cngof
#7
L Renesme
OBJECTIVES: To describe the epidemiology of neonatal herpes and its risk factors, clinical and paraclinic manifestations, propose guidelines for a newborn at risk of neonatal herpes, describe treatment modalities, describe post-natal transmission and its prevention. METHODS: Bibliographic search from Medline, Cochrane Library databases and research of international clinical practice guidelines. RESULTS: Neonatal herpes is rare (about 20 cases per year in France) and mainly due to HSV 1 (level of evidence LE3)...
November 10, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29131457/neurodevelopmental-outcome-of-hiv-exposed-but-uninfected-infants-in-the-mother-and-infants-health-study-cape-town-south-africa
#8
Priscilla E Springer, Amy L Slogrove, Barbara Laughton, Julie A Bettinger, Henriëtte H Saunders, Christopher D Molteno, Mariana Kruger
OBJECTIVES: To compare neurodevelopmental outcomes of HIV-exposed uninfected (HEU) and HIV-unexposed uninfected (HUU) infants in a peri-urban South African population. HEU infants living in Africa face unique biological and environmental risks but uncertainty remains regarding their neurodevelopmen-tal outcome. This is partly due to lack of well-matched HUU comparison groups needed to adjust for confounding factors. METHODS: This was a prospective cohort study of infants enrolled at birth from a low- risk midwife obstetric facility...
November 13, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/29131385/rural-community-birth-maternal-and-neonatal-outcomes-for-planned-community-births-among-rural-women-in-the-united-states-2004-2009
#9
Elizabeth Nethery, Wendy Gordon, Marit L Bovbjerg, Melissa Cheyney
BACKGROUND: Approximately 22% of women in the United States live in rural areas with limited access to obstetric care. Despite declines in hospital-based obstetric services in many rural communities, midwifery care at home and in free standing birth centers is available in many rural communities. This study examines maternal and neonatal outcomes among planned home and birth center births attended by midwives, comparing outcomes for rural and nonrural women. METHODS: Using the Midwives Alliance of North America Statistics Project 2...
November 13, 2017: Birth
https://www.readbyqxmd.com/read/29130708/-association-between-birth-weight-and-cardiometabolic-risk-factors-in-children-of-bucaramanga-colombia
#10
Edna Magaly Gamboa Delgado, Yully Andrea Rangel-Díaz, Yareni Yunuen Gutiérrez-Gómez
BACKGROUND: Birth weight could be a medium-term risk factor in the development of overweight and obesity and a long-term risk factor of cardio-metabolic diseases. OBJECTIVE: To evaluate the association between birth weight and cardio-metabolic risk factors in children from Bucaramanga, Colombia. METHODS: This cross-sectional study included 1,282 children between five and eleven years of age in Bucaramanga. Dependent variables: arterial hypertension, arterial prehypertension, overweight/obesity, glucose intolerance, insulin resistance, dyslipidemia...
October 24, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29125378/type-of-obstetric-anesthesia-administered-and-complications-in-women-with-preeclampsia-in-low-and-middle-income-countries-a-systematic-review
#11
Soha Sobhy, Kuhan Dharmarajah, David Arroyo-Manzano, Ramesan Navanatnarajah, James Noblet, Javier Zamora, Shakila Thangaratinam
BACKGROUND: Delivery is often expedited with cesarean section, necessitating anesthesia, to prevent complications in women with preeclampsia. Anesthesia-associated risks in these women from low- and middle-income countries (LMICs) are not known. METHODS: We searched major databases (until February 2017) for studies on general vs. regional anesthesia in women with preeclampsia. We summarized the association between outcomes and type of anesthesia using a random effects model and reported as odds ratio (OR) with 95% confidence intervals (95% CIs)...
November 2017: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/29124067/labor-induction-with-orally-administrated-misoprostol-a-retrospective-cohort-study
#12
Tove Wallstrom, Hans Jarnbert-Pettersson, David Stenson, Helena Akerud, Elisabeth Darj, Kristina Gemzell-Danielsson, Eva Wiberg-Itzel
Introduction: One great challenge in obstetric care is labor inductions. Misoprostol has advantages in being cheap and stable at room temperature and available in resource-poor settings. Material and Methods: Retrospective cohort study of 4002 singleton pregnancies with a gestational age ≥34 w at Sodersjukhuset, Stockholm, during 2009-2010 and 2012-2013. Previously used methods of labor induction were compared with misoprostol given as a solution to drink, every second hour...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29112646/transfusion-preparedness-strategies-for-obstetric-hemorrhage-a-cost-effectiveness-analysis
#13
Brett D Einerson, Zuzana Stehlikova, Richard E Nelson, Brandon K Bellows, Kensaku Kawamoto, Erin A S Clark
OBJECTIVE: To evaluate the cost-effectiveness of common obstetric transfusion preparedness strategies to prevent emergency-release transfusions. METHODS: A decision analytic model compared five commonly used transfusion preparedness strategies in a general obstetric population. Patients were classified as being at low, moderate, or high risk for transfusion. The most prepared strategy used a policy of universal type and screen plus crossmatch for high-risk patients...
November 3, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29108444/outcomes-after-periviable-ultrasound-indicated-cerclage
#14
Daphnie Drassinower, Elizabeth Coviello, Helain J Landy, Cynthia Gyamfi-Bannerman, Annette Perez-Delboy, Alexander M Friedman
BACKGROUND: Cerclage placed for a sonographically short cervix has been shown to reduce the risk of preterm delivery in women with a history of prior preterm birth. While short cervix is traditionally placed before viability, the threshold gestational age at which viability is achieved continues to decrease, and, as a result, a larger subset of women may be ineligible to receive this potentially beneficial procedure. OBJECTIVE: To evaluate the association between obstetric outcomes and perioperative complications after placement of an ultrasound-indicated cerclage at periviability compared to placement in the previable period...
November 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29102365/pregnancy-in-women-with-a-cardiomyopathy-outcomes-and-predictors-from-a-retrospective-cohort
#15
Gilles Billebeau, Martin Etienne, Riadh Cheikh-Khelifa, Daniele Vauthier-Brouzes, Estelle Gandjbakhch, Richard Isnard, Jacky Nizard, Michel Komajda, Marc Dommergues, Philippe Charron
BACKGROUND: Pregnancies in women with pre-existing cardiomyopathies are considered at high risk for complications. However, few data are available to characterize their natural history and predict the outcome. AIMS: Our aim was to evaluate the prevalence and predictors of acute cardiac and obstetric events in women with a cardiomyopathy during pregnancy, excluding peripartum cardiomyopathy. METHODS: In this retrospective study in a referral centre for cardiomyopathies, we included 43 consecutive pregnancies in 36 women with dilated, hypertrophic, arrhythmogenic right ventricular or tachycardia-induced cardiomyopathy, or left ventricular non-compaction...
October 25, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29097614/two-year-neurodevelopmental-outcome-of-an-infant-born-at-21-weeks-4-days-gestation
#16
Kaashif A Ahmad, Charlotte S Frey, Mario A Fierro, Alexander B Kenton, Frank X Placencia
Recent literature confirms that, at the lower limit of extrauterine survival, substantial intercenter variability exists in resuscitation practice. The reasons for this variability are unclear, but may be related to disagreement on how to apply the best interests standard to extremely premature infants. Currently, both obstetric and pediatric societies recommend against assessing for viability or attempting resuscitation before 22 weeks' gestation. In this context, we report the unimpaired 2-year outcome of a female infant resuscitated after delivery at 21 weeks' 4 days' gestation and 410 g birth weight...
November 2, 2017: Pediatrics
https://www.readbyqxmd.com/read/29096053/antibiotic-prophylaxis-for-episiotomy-repair-following-vaginal-birth
#17
REVIEW
Mercedes Bonet, Erika Ota, Chioma E Chibueze, Olufemi T Oladapo
BACKGROUND: Bacterial infections occurring during labour, childbirth, and the puerperium may be associated with considerable maternal and perinatal morbidity and mortality. Antibiotic prophylaxis might reduce wound infection incidence after an episiotomy, particularly in situations associated with a higher risk of postpartum perineal infection, such as midline episiotomy, extension of the incision, or in settings where the baseline risk of infection after vaginal birth is high. However, available evidence is unclear concerning the role of prophylactic antibiotics in preventing infections after an episiotomy...
November 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29095502/obstetric-outcomes-after-conservative-treatment-for-cervical-intraepithelial-lesions-and-early-invasive-disease
#18
REVIEW
Maria Kyrgiou, Antonios Athanasiou, Ilkka E J Kalliala, Maria Paraskevaidi, Anita Mitra, Pierre Pl Martin-Hirsch, Marc Arbyn, Phillip Bennett, Evangelos Paraskevaidis
BACKGROUND: The mean age of women undergoing local treatment for pre-invasive cervical disease (cervical intra-epithelial neoplasia; CIN) or early cervical cancer (stage IA1) is around their 30s and similar to the age of women having their first child. Local cervical treatment has been correlated to adverse reproductive morbidity in a subsequent pregnancy, however, published studies and meta-analyses have reached contradictory conclusions. OBJECTIVES: To assess the effect of local cervical treatment for CIN and early cervical cancer on obstetric outcomes (after 24 weeks of gestation) and to correlate these to the cone depth and comparison group used...
November 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29082792/evaluation-of-late-adolescent-pregnancies-is-late-adolescence-a-risk-factor-for-preterm-labor
#19
Sunullah Soysal, Abdullah Sarioz, Gokce Anik Ilhan, Ali Kocagoz, Aylin Dizi, Ilhan Gursoy, Ipek Celik, Damla Ozmen
STUDY OBJECTIVE: We evaluated effect of late adolescence during pregnancy and its confounding factors on neonatal and maternal results. OBJECTIVE: The aim of the present study is to evaluate the effect of late adolescence on maternal, perinatal outcomes and preterm labor. METHODS: This retrospective study was carried out on 172 late adolescents and 160 adult women who delivered in a tertiary center. The demographic features, obstetrical and neonatal properties of the patients were analyzed...
October 29, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29079078/maternal-characteristics-for-the-prediction-of-preeclampsia-in-nulliparous-women-the-great-obstetrical-syndromes-gos-study
#20
Amélie Boutin, Cédric Gasse, Suzanne Demers, Yves Giguère, Amélie Tétu, Emmanuel Bujold
OBJECTIVE: Low-dose aspirin started in early pregnancy significantly reduces the risk of preeclampsia (PE) in high-risk women, especially preterm PE. This study aimed to evaluate the influence of maternal characteristics on the risk of PE in nulliparous women. METHODS: The Great Obstetrical Syndromes (GOS) study recruited nulliparous women with singleton pregnancies at 11 to 13 weeks. The following maternal characteristics were collected: age, BMI, ethnicity, chronic diseases, smoking, and assisted reproductive technologies...
October 24, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
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