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Low risk obstetrics

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https://www.readbyqxmd.com/read/28432736/severe-primary-autoimmune-thrombocytopenia-itp-in-pregnancy-a-national-cohort-study
#1
A Care, S Pavord, M Knight, Z Alfirevic
OBJECTIVE: To quantify UK incidence of severe ITP in pregnancy, determine current treatment strategies and establish maternal and neonatal morbidity and mortality associated with severe ITP in pregnancy. DESIGN: A prospective national cohort study SETTING: United Kingdom POPULATION: Women with severe ITP; defined as platelets <50 x 10(9) /l in pregnancy or antenatal treatment of isolated low platelets. METHODS: Data collected via United Kingdom Obstetric Surveillance System (UKOSS) between 1(st) June 2013-31(st) January 2015 from all UK Consultant led obstetric units...
April 22, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28426160/assessment-and-support-during-early-labour-for-improving-birth-outcomes
#2
REVIEW
Shinobu Kobayashi, Nobutsugu Hanada, Masayo Matsuzaki, Kenji Takehara, Erika Ota, Hatoko Sasaki, Chie Nagata, Rintaro Mori
BACKGROUND: The progress of labour in the early or latent phase is usually slow and may include painful uterine contractions. Women may feel distressed and lose their confidence during this phase. Support and assessment interventions have been assessed in two previous Cochrane Reviews. This review updates and replaces these two reviews, which have become out of date. OBJECTIVES: To investigate the effectiveness of assessment and support interventions for women during early labour...
April 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28420558/maternal-medical-complexity-impact-on-prenatal-health-care-spending-among-women-at-low-risk-for-cesarean-section
#3
Shayna D Cunningham, Carolina Herrera, Ifeyinwa E Udo, Katy B Kozhimannil, Eric Barrette, Urania Magriples, Jeannette R Ickovics
BACKGROUND: Obstetric procedures are among the most expensive health care services, yet relatively little is known about health care spending among pregnant women, particularly the commercially-insured. OBJECTIVE: The objective of this study was to examine the association between maternal medical complexity, as a result of having one or more comorbid conditions, and health care spending during the prenatal period among a national sample of 95,663 commercially-insured women at low risk for cesarean delivery...
April 15, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28420507/asymptomatic-pyuria-in-pregnant-women-during-the-first-trimester-is-associated-with-an-increased-risk-of-adverse-obstetrical-outcomes
#4
Yun-Ju Lai, Te-Yao Hsu, Kuo-Chung Lan, Hao Lin, Chia-Yu Ou, Hung-Chun Fu, Ching-Chang Tsai
OBJECTIVE: Urinalysis is included in the prenatal examination in the first trimester in Taiwan, in contrast to Western countries. We aimed to investigate whether asymptomatic pyuria as detected by urinalysis was associated with adverse perinatal outcomes. MATERIALS AND METHODS: A total of 1187 singleton pregnant women who received prenatal care at Kaohsiung Chang Gung Memorial Hospital between January 2012 and December 2013 were included for retrospective analysis...
April 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28419213/risks-factors-for-congenital-cmv-infection-following-primary-and-non-primary-maternal-infection-a-prospective-neonatal-screening-study-using-pcr-in-saliva
#5
Marianne Leruez-Ville, Jean-François Magny, Sophie Couderc, Christine Pichon, Marine Parodi, Laurence Bussières, Tiffany Guilleminot, Idir Ghout, Yves Ville
Background: The design of diagnostic and preventive strategies have been prevented by gaps in knowledge of the epidemiology of congenital CMV (cCMV) with the type of maternal infection as well as the lack of large-scale neonatal screening tools. Methods: 11,715 consecutive newborns were screened for cCMV by PCR in saliva. Prevalence, type of maternal infection, socio-demographic, obstetrical and serological data were analyzed. Results: Positive predictive value of CMV PCR in saliva was 59%, false positive results were associated with lower viral loads (p<0...
April 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28416029/the-health-outcomes-of-human-offspring-conceived-by-assisted-reproductive-technologies-art
#6
M Chen, L K Heilbronn
Concerns have been raised about the health and development of children conceived by assisted reproductive technologies (ART) since 1978. Controversially, ART has been linked with adverse obstetric and perinatal outcomes, an increased risk of birth defects, cancers, and growth and development disorders. Emerging evidence suggests that ART treatment may also predispose individuals to an increased risk of chronic ageing related diseases such as obesity, type 2 diabetes and cardiovascular disease. This review will summarize the available evidence on the short-term and long-term health outcomes of ART singletons, as multiple pregnancies after multiple embryos transfer, are associated with low birth weight and preterm delivery, which can separately increase risk of adverse postnatal outcomes, and impact long-term health...
April 18, 2017: Journal of Developmental Origins of Health and Disease
https://www.readbyqxmd.com/read/28412995/development-and-validation-of-prediction-models-for-risks-of-complications-in-early-onset-pre-eclampsia-prep-a-prospective-cohort-study
#7
Shakila Thangaratinam, John Allotey, Nadine Marlin, Ben W Mol, Peter Von Dadelszen, Wessel Ganzevoort, Joost Akkermans, Asif Ahmed, Jane Daniels, Jon Deeks, Khaled Ismail, Ann Marie Barnard, Julie Dodds, Sally Kerry, Carl Moons, Richard D Riley, Khalid S Khan
BACKGROUND: The prognosis of early-onset pre-eclampsia (before 34 weeks' gestation) is variable. Accurate prediction of complications is required to plan appropriate management in high-risk women. OBJECTIVE: To develop and validate prediction models for outcomes in early-onset pre-eclampsia. DESIGN: Prospective cohort for model development, with validation in two external data sets. SETTING: Model development: 53 obstetric units in the UK...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28409671/the-mediating-role-of-placenta-in-the-relationship-between-maternal-exercise-during-pregnancy-and-full-term-low-birth-weight
#8
Lihua Huang, Lijun Fan, Peng Ding, Yan-Hui He, Chuanbo Xie, Zhongzheng Niu, Fu-Ying Tian, Shixin Yuan, Deqin Jia, Wei-Qing Chen
OBJECTIVE: To explore the association of maternal exercise during pregnancy with full-term low birth weight (FT-LBW) and whether placenta mediates their association. STUDY DESIGN: We investigated 326 pregnant women delivering FT-LBW weight newborns (cases) and 1644 delivering full-term normal birth weight newborns (controls) in this case-control study. Information concerning maternal exercise during pregnancy, socio-demographics and obstetric characteristics were collected at Women and Children's Hospitals of Shenzhen and Foshan in Guangdong, China...
April 14, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28406844/the-role-of-he4-a-novel-biomarker-in-predicting-optimal-cytoreduction-after-neoadjuvant-chemotherapy-in-advanced-ovarian-cancer
#9
Francesco Plotti, Giuseppe Scaletta, Stella Capriglione, Roberto Montera, Daniela Luvero, Salvatore Lopez, Alessandra Gatti, Carlo De Cicco Nardone, Corrado Terranova, Roberto Angioli
OBJECTIVES: This study aimed to evaluate serum human epididymis protein 4 (HE4) changes during neoadjuvant chemotherapy (NACT) to establish HE4 predebulking surgery cutoff values and to demonstrate that CA125, HE4, and computed tomography (CT) taken together are better able to predict complete cytoreduction after NACT in advanced ovarian cancer patients. METHODS: From January 2006 to November 2015, patients affected by epithelial advanced ovarian cancer (International Federation of Gynecology and Obstetrics stage III-IV), considered not optimally resectable, were included in this prospective study...
April 13, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28403957/effectiveness-of-elective-cervical-cerclage-according-to-obstetric-history
#10
D Korb, P Marzouk, J Deu, J-F Oury, O Sibony
OBJECTIVE: To assess the effectiveness of elective history-indicated cervical cerclage according to obstetrical history. STUDY DESIGN: We analyzed pregnancy outcome of a retrospective cohort of women who have had history-indicated McDonald's cerclage. Principal outcome was gestational age (GA) at delivery. RESULT: Between January 2003 and December 2013, 205 women were included. We analyzed population in two risk groups: 1- Low-risk (≤2 prior preterm birth (PTB)/second trimester loss (STL), or prior success of cerclage), 2- High risk (≥3 prior PTB/STL, or prior failure of cerclage)...
January 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28403891/foley-catheter-for-cervical-priming-in-induction-of-labour-at-university-obstetrics-unit-colombo-sri-lanka-a-clinical-audit-with-a-patient-satisfaction-survey
#11
M Patabendige, A Jayawardane
BACKGROUND: Intracervical insertion of a Foley catheter (FC) has shown to be a safe, effective and relatively feasible mechanical method of cervical priming in induction of labour (IOL). We evaluated indications, effectiveness, patient acceptability and outcomes of FC use in IOL adhering to the ward protocol in our unit. METHODS: A clinical audit with a patient satisfaction survey conducted between July and September 2013 in University Obstetric Unit, Colombo, Sri Lanka...
April 12, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28403049/clinical-and-microbiologic-characteristics-of-early-onset-sepsis-among-very-low-birth-weight-infants-opportunities-for-antibiotic-stewardship
#12
Sagori Mukhopadhyay, Karen M Puopolo
BACKGROUND: Most very low birth weight (VLBW, birth weight <1500 g) infants receive empiric antibiotics for risk of early-onset sepsis (EOS). The objective of this study was to determine the characteristics of VLBW infants with culture-confirmed EOS at a single center during 25 years and to identify opportunities for antibiotic stewardship. METHODS: Retrospective cohort study includes VLBW infants admitted from 1990 to 2015. EOS was defined as isolation of a pathogen in blood or cerebrospinal fluid culture obtained at <72 hours of age...
May 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28391748/small-for-gestational-age-babies-of-low-risk-term-pregnancies-does-antenatal-detection-matter
#13
Catarina Policiano, Andreia Fonseca, Jorge M Mendes, Nuno Clode, Luís M Graça
OBJECTIVES: To compare delivery route and admission rate to neonatal intensive care unit between small- and appropriate-for-gestational-age babies among low-risk term pregnancies. METHODS: A retrospective study was conducted using the database of deliveries in 2014 at a tertiary hospital. Babies delivered at ≥37 weeks with birthweight <10th centile were considered small-for-gestational-age (SGA) and >90th centile were considered large-for-gestational-age...
April 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28390672/increased-risk-of-peripartum-perinatal-mortality-in-unplanned-births-outside-institution-a-retrospective-population-based-study
#14
Hilde M Engjom, Nils-Halvdan Morken, Even Høydahl, Ole F Norheim, Kari Klungsøyr
BACKGROUND: Births in midwife-led institutions may reduce the frequency of medical interventions and provide cost-effective care, while larger institutions offer medically and technically advanced obstetric care. Unplanned births outside institution and intrapartum stillbirths have frequently been excluded in previous studies on adverse outcomes by place of birth OBJECTIVE: To assess peripartum mortality by place of birth and travel time to obstetric institutions, with the hypothesis that centralization reduces institution availability but improves mortality...
April 6, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28368791/-fertility-sparing-management-of-endometrial-cancer-and-atypical-hyperplasia
#15
C Gonthier, A Trefoux-Bourdet, D Luton, M Koskas
The fertility sparing management of endometrial cancer and atypical hyperplasia concern women in childbearing age with stage 1, grade 1, endometrioid adenocarcinoma confined to endometrium or atypical hyperplasia (simple or complex). These pathologies affecting more frequently postmenopausal women, the number of people involved is relatively low. The main risk factor is hyperestrogenism and these patients often present a history of infertility with a desire for pregnancy. The recommendations for this conservative management are scarce and unclear...
February 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/28367647/risk-for-postpartum-hemorrhage-transfusion-and-hemorrhage-related-morbidity-at-low-moderate-and-high-volume-hospitals
#16
Audrey A Merriam, Jason D Wright, Zainab Siddiq, Mary E D'Alton, Alexander M Friedman, Cande V Ananth, Brian T Bateman
OBJECTIVE: The objective of this study was to characterize risk for and temporal trends in postpartum hemorrhage across hospitals with different delivery volumes. STUDY DESIGN: This study used the Nationwide Inpatient Sample (NIS) to characterize risk for postpartum hemorrhage from 1998 to 2011. Hospitals were classified as having either low, moderate or high delivery volume (≤1000, 1001 to 2000, >2000 deliveries per year, respectively). The primary outcomes included postpartum hemorrhage, transfusion, and related severe maternal morbidity...
April 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28363606/observational-study-of-neonatal-safety-for-outpatient-labour-induction-priming-with-dinoprostone-vaginal-insert
#17
Geoffrey W Cundiff, Mary Lynn Simpson, Nicole Koenig, Terry Lee
OBJECTIVES: To evaluate the safety of outpatient induction with dinoprostone insert in low-risk labour inductions for premature rupture of membranes or postdates gestation. METHODS: This retrospective cohort study compared outpatient labour induction priming with inpatient induction in terms of neonatal safety, mode of delivery, and obstetrical parameters. The sample included all inductions for premature rupture of membranes or postdate gestation. The analysis used logistic regression...
March 28, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28360907/aspirin-the-mechanism-of-action-revisited-in-the-context-of-pregnancy-complications
#18
REVIEW
Angela P Cadavid
Aspirin is one of the most frequently used and cheapest drugs in medicine. It belongs to the non-steroidal anti-inflammatory drugs with a wide range of pharmacological activities, including analgesic, antipyretic, and antiplatelet properties. Currently, it is accepted to prescribe a low dose of aspirin to pregnant women who are at high risk of preeclampsia (PE) because it reduces the onset of this complication. Another pregnancy alteration in which a low dose of aspirin is recommended is the obstetric antiphospholipid syndrome (APS)...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28359258/what-influences-birth-place-preferences-choices-and-decision-making-amongst-healthy-women-with-straightforward-pregnancies-in-the-uk-a-qualitative-evidence-synthesis-using-a-best-fit-framework-approach
#19
Kirstie Coxon, Alison Chisholm, Reem Malouf, Rachel Rowe, Jennifer Hollowell
BACKGROUND: English maternity care policy has supported offering women choice of birth setting for over twenty years, but only 13% of women in England currently give birth in settings other than obstetric units (OUs). It is unclear why uptake of non-OU settings for birth remains relatively low. This paper presents a synthesis of qualitative evidence which explores influences on women's experiences of birth place choice, preference and decision-making from the perspectives of women using maternity services...
March 31, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28355302/prevalence-of-caesarean-sections-in-enugu-southeast-nigeria-analysis-of-data-from-the-healthy-beginning-initiative
#20
Jayleen K L Gunn, John E Ehiri, Elizabeth T Jacobs, Kacey C Ernst, Sydney Pettygrove, Katherine E Center, Alice Osuji, Amaka G Ogidi, Nnabundo Musei, Michael C Obiefune, Chinenye O Ezeanolue, Echezona E Ezeanolue
BACKGROUND: In order to meet the Sustainable Development Goal to decrease maternal mortality, increased access to obstetric interventions such as Caesarean sections (CS) is of critical importance. As a result of women's limited access to routine and emergency obstetric services in Nigeria, the country is a major contributor to the global burden of maternal mortality. In this analysis, we aim to establish rates of CS and determine socioeconomic or medical risk factors associated with having a CS in Enugu, southeast Nigeria...
2017: PloS One
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