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Low risk obstetrics

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https://www.readbyqxmd.com/read/28076828/perinatal-risk-factors-for-low-and-moderate-five-minute-apgar-scores-at-term
#1
Shimona Lai, Christopher Flatley, Sailesh Kumar
OBJECTIVE: To evaluate the specific maternal and perinatal variables associated with a low (≤3) or moderate (4-6) Apgar score, compared to a high (≥7) score. STUDY DESIGN: This was a retrospective, cohort study of 58429 term singleton babies born at the Mater Mother's Hospital in Brisbane, Australia in 2007-2013. Maternal demographics, socio-economic status using the Australian Socioeconomic Index for Areas (SEIFA) score, obstetric factors, and birth outcomes were compared for neonates grouped into three categories based on their five-minute Apgar: low (≤3), moderate (4-6) and high (≥7)...
January 6, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28070244/assessment-of-fetus-during-second-trimester-ultrasonography-using-hdlive-software-what-is-its-real-application-in-the-obstetrics-clinical-practice
#2
Gabriele Tonni, Gianpaolo Grisolia, Eduardo Félix Santana, Edward Araujo Júnior
AIM: To show imaging results from application of four-dimensional (4D) ultrasound lightening technique (HDlive™) in clinical obstetrics practice. METHODS: Normal and abnormal fetuses at second and third trimester of pregnancy undergoing routine scan with 4D HDlive™ (5DUS) in the rendering mode are described. Realistic features of fetal structures were provided by 5DUS in the rendering mode. Normal anatomy as well as pathology like cleft lip, hypoplastic face, micrognathia, low-set ears, corpus callosum, arthrogryposis, aortic arch, left congenital diaphragmatic hernia are highlighted in this study...
December 28, 2016: World Journal of Radiology
https://www.readbyqxmd.com/read/28068929/are-freestanding-midwifery-units-a-safe-alternative-to-obstetric-units-for-low-risk-primiparous-childbirth-an-analysis-of-effect-differences-by-parity-in-a-matched-cohort-study
#3
Louise Fischer Christensen, Charlotte Overgaard
BACKGROUND: Intrapartum complications and the use of obstetric interventions are more common in primiparous childbirth than in multiparous childbirth, leading to concern about out of hospital birth for primiparous women. The purpose of this study was to determine whether the effect of birthplace on perinatal and maternal morbidity and the use of obstetric interventions differed by parity among low-risk women intending to give birth in a freestanding midwifery unit or in an obstetric unit in the North Denmark Region...
January 9, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28057388/evaluation-of-focused-obstetric-ultrasound-examinations-by-health-care-personnel-in-the-democratic-republic-of-congo-guatemala-kenya-pakistan-and-zambia
#4
Robert O Nathan, Jonathan O Swanson, David L Swanson, Elizabeth M McClure, Victor Lokomba Bolamba, Adrien Lokangaka, Irma Sayury Pineda, Lester Figueroa, Walter López-Gomez, Ana Garces, David Muyodi, Fabian Esamai, Nancy Kanaiza, Waseem Mirza, Farnaz Naqvi, Sarah Saleem, Musaku Mwenechanya, Melody Chiwila, Dorothy Hamsumonde, Dennis D Wallace, Holly Franklin, Robert L Goldenberg
Prior studies have suggested that obstetrical (OB) ultrasound in low- and middle-income countries has aided in detection of high-risk conditions, which in turn could improve OB management. We are participating in a cluster-randomized clinical trial of OB ultrasound, which is designed to assess the effect of basic OB ultrasound on maternal mortality, fetal mortality, neonatal mortality, and maternal near-miss in 5 low-income countries. We designed a 2-week course in basic OB ultrasound, followed by 12 weeks of oversight, to train health care professionals with no prior ultrasound experience to perform basic OB ultrasound to screen for high-risk pregnancies...
November 10, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28054230/tumor-necrosis-factor-alpha-and-pregnancy-focus-on-biologics-an-updated-and-comprehensive-review
#5
REVIEW
Jaume Alijotas-Reig, Enrique Esteve-Valverde, Raquel Ferrer-Oliveras, Elisa Llurba, Josep Maria Gris
Tumor necrosis factor-α (TNF-α) is a central regulator of inflammation, and TNF-α antagonists may be effective in treating inflammatory disorders in which TNF-α plays a major pathogenic role. TNF-α has also been associated with inflammatory mechanisms related to implantation, placentation, and pregnancy outcome. TNF-α is secreted by immune cells and works by binding to TNFR1 and TNFR2 cell receptors. TNF-α is also related to JAK/STAT pathways, which opens up hypothetical new targets for modifying. The accurate balance between Th1 cytokines, mainly TNF-α, Th17, and Th2, particularly IL-10 is essential to achieve good obstetric outcomes...
January 4, 2017: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/28041927/achieving-higher-value-obstetrical-care
#6
REVIEW
Victoria G Woo, Tiffany Lundeen, Sierra Matula, Arnold Milstein
Obstetrical care in the United States is unnecessarily costly. Birth is one of the most common reasons for healthcare utilization in the US and one of the top expenditures for payers every year. However, compared to other Organization for Economic Cooperation and Development (OECD) countries, the US spends substantially more money per birth without better outcomes. Our team at the Clinical Excellence Research Center, a center focused on improving value in healthcare, spent a year studying ways in which obstetrical care in the US can deliver better outcomes at a lower cost...
December 29, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28040414/reproductive-outcomes-of-ivf-patients-with-unicornuate-uteri
#7
Kemal Ozgur, Hasan Bulut, Murat Berkkanoglu, Kevin Coetzee
In this retrospective observational study, the pregnancy, perinatal and obstetric outcomes of patients diagnosed with unicornuate uteri were compared with those of patients with normal uteri after undergoing intracytoplasmic sperm injection (ICSI) with fresh and cryopreserved embryo transfer. From a select population of 9676 infertile patients receiving IVF treatment, 75 (0.78%) were diagnosed with unicornuate uteri between January 2009 and December 2015. Fifty of them underwent ICSI treatment, with 90 fresh and cryopreserved embryo transfers...
December 23, 2016: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/28039875/first-trimester-isolated-maternal-hypothyroxinemia-adverse-maternal-metabolic-profile-and-impact-on-the-obstetrical-outcome
#8
Raluca Maria Furnica, Damien Gruson, John H Lazarus, Dominique Maiter, Pierre Bernard, Chantal Daumerie
BACKGROUND: Isolated maternal hypothyroxinemia (IH) is defined as low maternal FT4 (<5(th) percentile) and normal TSH. There is concern on its potential negative effects on the mother and offspring. OBJECTIVE: We aimed to evaluate the prevalence of IH and to assess the consequences of hypothyroxinemia on the maternal and foetal outcomes. SUBJECTS AND METHODS: From a total of 1300 consecutive pregnant women recruited during the prenatal screen (mean gestational age, 11...
December 31, 2016: Clinical Endocrinology
https://www.readbyqxmd.com/read/28034524/maternal-immunoglobulin-g-avidity-as-a-diagnostic-tool-to-identify-pregnant-women-at-risk-of-congenital-cytomegalovirus-infection
#9
Masatoki Kaneko, Masanao Ohhashi, Toshio Minematsu, Junsuke Muraoka, Kazumi Kusumoto, Hiroshi Sameshima
BACKGROUND: The immunoglobulin (Ig) G avidity index (AI) is useful to detect primary cytomegalovirus (CMV) infection. However, because IgG matures with time, this index is not useful to detect a primary infection, unless measured at an appropriate time. OBJECTIVES: We aimed to clarify the difference between using IgG AI and IgM positivity according to the stage of pregnancy to identify congenital CMV infection risk. STUDY DESIGN: We collected the serum samples from 1115 pregnant women who underwent maternal screening for primary infection (n = 956) and were referred to our hospital because of CMV IgM positivity (n = 155) or had abnormal fetal ultrasonography findings (n = 4)...
December 26, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28033694/risk-factors-and-consequent-outcomes-of-placenta-previa-report-from-a-referral-center
#10
Soraya Saleh Gargari, Zahra Seify, Ladan Haghighi, Maryam Khoshnood Shariati, Masoumeh Mirzamoradi
 Because of an unknown factor, the frequency of complicated pregnancy with placenta previa has been raised during past decade. This study was designed to deepen our understanding of risk factors and outcomes of placenta previa in our country. This study investigated 694 cases of placenta previa comparing with 600 healthy pregnant women with not overlie placenta in two referral and tertiary Obstetrics and Gynecological Hospital in Iran on the basis of the clinical and para-clinical analysis, in order to find the probable risk factors for occurrence of placenta previa and its effect on maternal and neonatal complications...
November 2016: Acta Medica Iranica
https://www.readbyqxmd.com/read/28029461/-prevention-of-preterm-birth-by-uterine-cervical-cerclage
#11
L Marcellin
OBJECTIVE: To review the scientific literature on cervical insufficiency and indications of cervical cerclage cervix. MATERIALS AND METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and international obstetrical societies between 1972 and June 2016 have been consulted. RESULTS: Cervical insufficiency is a pathophysiological concept and to date no consensual definition is available: the diagnosis is clinical and discussed retrospectively in case of patients with a history of late miscarriages and/or spontaneous preterm delivery, with asymptomatic dilatation of the cervix (professional consensus)...
October 29, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28029179/prenatal-diagnosis-of-congenital-heart-diseases-by-fetal-echocardiography-in-second-trimester-a-chinese-multicenter-study
#12
Chen Chu, Yingliu Yan, Yunyun Ren, Xiaotian Li, Yonghao Gui
INTRODUCTION: The objective of our study was to evaluate the performance of detailed fetal echocardiography by skilled obstetric physician sonologists in the diagnosis of congenital heart disease (CHD) in a Chinese population. MATERIAL AND METHODS: This investigation included a multicenter prospective cohort of 10,259 pregnant women attending ten regional tertiary hospitals in China. The inclusion criteria were singleton pregnancy and gestational age 18 ~ ≤28 weeks...
December 28, 2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28029178/exercise-during-pregnancy-and-risk-of-preterm-birth-in-overweight-and-obese-women-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#13
Elena Rita Magro-Malosso, Gabriele Saccone, Daniele Di Mascio, Mariarosaria Di Tommaso, Vincenzo Berghella
INTRODUCTION: The incidence of overweight and obesity in pregnancy has risen significantly in the last decades. Overweight and obesity have been shown to increase the risk for some adverse obstetric outcome. Lifestyle interventions, such as diet, physical activity and behavior changes, may reduce these risks promoting weight loss and/or preventing excessive weight gain. The possible impact of exercise on the risk of preterm birth (PTB) in overweight or obese women is controversial. Therefore, the aim of our study was to evaluate the effect of exercise on the risk of PTB in overweight or obese pregnant women...
December 28, 2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28019065/pregnancy-outcomes-in-women-with-mechanical-prosthetic-heart-valves-a-prospective-descriptive-population-based-study-using-the-united-kingdom-obstetric-surveillance-system-ukoss-data-collection-system
#14
S Vause, B Clarke, C L Tower, Crm Hay, M Knight
OBJECTIVE: To describe the incidence of mechanical prosthetic heart valves (MPHV) in pregnancy in the UK; rates of maternal and fetal complications in this group of women, and whether these vary with the anticoagulation used during pregnancy. DESIGN: Prospective descriptive population-based study. SETTING: All consultant-led maternity units in the UK. POPULATION: All women with an MPHV who were pregnant between 1 February 2013 and 31 January 2015...
December 26, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28013100/the-impact-of-highly-active-antiretroviral-therapy-on-obstetric-conditions-a-review
#15
REVIEW
Hannah M Sebitloane, Dhayendre Moodley
HIV is the leading cause of maternal and neonatal morbidity and mortality in resource constrained countries. Highly active antiretroviral treatment (HAART) initiated in pregnancy has now almost eliminated mother to child transmission of the virus, and is beginning to show the desired effect of reducing HIV related maternal mortality. By modulating host immunological responses HAART has the potential to alter infections during pregnancy, in addition to modifying clinical conditions such as preeclampsia. There is increasing evidence of the benefits of HAART given to pregnant women, however there is paucity of data that distinguishes HIV or HAART as the cause or exacerbation of pre-existing medical conditions or conditions specific to pregnancy...
December 9, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28009330/failure-to-initiate-breastfeeding-among-high-risk-obstetrical-patients-who-intended-to-breastfeed
#16
L Cordero, R Oza-Frank, M Moore-Clingenpeel, M B Landon, C A Nankervis
BACKGROUND: In the US, at the time of discharge from the hospital, 79% of women had initiated breastfeeding. Intention to breastfeed is a strong predictor of breastfeeding initiation; however, we reported initiation failure in 45% of women with pregestational diabetes who intended to breastfeed. Information regarding intention and initiation among women with other high risk obstetrical conditions (HROB) remains scarce. OBJECTIVE: To ascertain demographic and clinical factors associated with breastfeeding initiation failure among women with HROB conditions who intended to breastfeed...
2016: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28008325/lactobacilli-dominance-and-vaginal-ph-why-is-the-human-vaginal-microbiome-unique
#17
Elizabeth A Miller, DeAnna E Beasley, Robert R Dunn, Elizabeth A Archie
The human vaginal microbiome is dominated by bacteria from the genus Lactobacillus, which create an acidic environment thought to protect women against sexually transmitted pathogens and opportunistic infections. Strikingly, lactobacilli dominance appears to be unique to humans; while the relative abundance of lactobacilli in the human vagina is typically >70%, in other mammals lactobacilli rarely comprise more than 1% of vaginal microbiota. Several hypotheses have been proposed to explain humans' unique vaginal microbiota, including humans' distinct reproductive physiology, high risk of STDs, and high risk of microbial complications linked to pregnancy and birth...
2016: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28005272/prophylactic-versus-selective-blood-transfusion-for-sickle-cell-disease-in-pregnancy
#18
REVIEW
Babasola O Okusanya, Olufemi T Oladapo
BACKGROUND: Pregnant women with sickle cell disease (HbSS, HbSC and HbSβThal) may require blood transfusion to prevent severe anaemia or to manage potential medical complications. Preventive blood transfusion in the absence of complications starting from the early weeks of pregnancy or blood transfusion only for medical or obstetric indications have been used as management policies. There is currently no consensus on the blood transfusion policy that guarantees optimal clinical benefits with minimal risks for such women and their babies...
22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28002642/modification-of-obstetric-emergency-simulation-scenarios-for-realism-in-a-home-birth-setting
#19
Janelle Komorowski, Tia Andrighetti, Melissa Benton
INTRODUCTION: Clinical competency and clear communication are essential for intrapartum care providers who encounter high-stakes, low-frequency emergencies. The challenge for these providers is to maintain infrequently used skills. The challenge is even more significant for midwives who manage births at home and who, due to low practice volume and low-risk clientele, may rarely encounter an emergency. In addition, access to team simulation may be limited for home-birth midwives. This project modified existing validated obstetric simulation scenarios for a home-birth setting...
December 21, 2016: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28000639/relationship-between-gross-placental-characteristics-and-perinatal-outcome-of-low-risk-singleton-deliveries
#20
Kikelomo Temilola Adesina, Olumuyiwa O Ogunlaja, Abiodun P Aboyeji, Halimat J Akande, Abiodun S Adeniran, Adebunmi Olarinoye, Adegboyega A Fawole
BACKGROUND: Gross examination of the placenta may provide useful insight into the aetiology of newborn and maternal complications. A review of literature revealed only a few epidemiological studies that determined the relationships between placental abnormalities, gestational age and occurrence of adverse outcome in babies of healthy pregnant women in our region. PATIENTS AND METHODS: A prospective cross-sectional study was conducted at the Department of Obstetrics and Gynecology of University of Ilorin Teaching Hospital, between 1 st February and August 2013...
October 2016: Nigerian Postgraduate Medical Journal
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