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Low risk obstetrics

Karin Hammarberg, Rebecca Zosel, Caroline Comoy, Sarah Robertson, Carol Holden, Mandy Deeks, Louise Johnson
Some potentially modifiable factors adversely affect fertility and pregnancy health. To inform a fertility health promotion programme, this study investigated fertility knowledge and information-seeking behaviour among people of reproductive age. This was a qualitative study involving six focus group discussions with women and men who intended to have children in the future and eight paired interviews with couples who were actively trying to conceive. Participants (n = 74) themselves generally claimed 'low' to 'average' levels of knowledge about fertility...
October 25, 2016: Human Fertility: Journal of the British Fertility Society
Yeshwondm Mamuye, Balkachew Nigatu, Delayehu Bekele, Mekonen Getahun
BACKGROUND: Maternal cytomegalovirus (CMV) and Rubella infections result in adverse neonatal outcomes. Both CMV and Rubella are more widespread in developing countries and in communities with lower socioeconomic status. Thus, the aim of this study was to determine IgM specific to CMV and Rubella among newborns and Maternal CMV-seroprevalence and to identify risk factors. METHOD AND FINDING: Using cross sectional study design a total of 312 (156 newborns and 156 mothers) study participants were recruited by simple random sampling technique from gynecology outpatient department (OPD) and ward, starting from April 1, 2015 to June 30, 2015...
October 21, 2016: BMC Research Notes
Sonia Duarte de Azevedo Bittencourt, Rosa Maria Soares Madeira Domingues, Lenice Gnocchi da Costa Reis, Márcia Melo Ramos, Maria do Carmo Leal
BACKGROUND: In Brazil, hospital childbirth care is available to all, but differences in access and quality of care result in inequalities of maternal health. The objective of this study is to assess the infrastructure and staffing of publicly financed labor and birth care in Brazil and its adequacy according to clinical and obstetric conditions potentially associated with obstetric emergencies. METHODS: Nationwide cross-sectional hospital-based study "Birth in Brazil: national survey into labor and birth" conducted in 2011-2012...
October 17, 2016: Reproductive Health
Annah Lane, Ling Lee, Donna Traves, Andreas Lee
INTRODUCTION: The antenatal diagnosis of open spina bifida (OSB), a neural tube defect, is predominantly made at the second trimester morphology scan by ultrasound detection of structural abnormalities resulting from the associated Chiari II malformation. Evidence has emerged suggesting that these structural abnormalities can be detected earlier, by examination of the posterior fossa as part of the first trimester nuchal translucency scan. In particular, absence of the intra-cranial translucency (IT) of the fourth ventricle has shown promise as a diagnostic marker of OSB, although the sensitivity and specificity of this finding varies widely in the literature...
October 21, 2016: Journal of Medical Imaging and Radiation Oncology
Hannah H Leslie, Günther Fink, Humphreys Nsona, Margaret E Kruk
BACKGROUND: Ending preventable newborn deaths is a global health priority, but efforts to improve coverage of maternal and newborn care have not yielded expected gains in infant survival in many settings. One possible explanation is poor quality of clinical care. We assess facility quality and estimate the association of facility quality with neonatal mortality in Malawi. METHODS AND FINDINGS: Data on facility infrastructure as well as processes of routine and basic emergency obstetric care for all facilities in the country were obtained from 2013 Malawi Service Provision Assessment...
October 2016: PLoS Medicine
Rebecca S Usadi, Kathryn S Merriam
The incidence of subclinical hypothyroidism (SCH) in pregnancy was classically thought to be low; however, with new definition of normal TSH range in pregnancy, there has been an increase in the percentage of women who meet classification for SCH. The diagnosis of SCH is important not only for monitoring for maternal conversion to overt hypothyroidism, but also for identifying obstetric and neonatal outcomes related to SCH. Although there have been proven associations between maternal overt hypothyroidism and adverse obstetric and neonatal outcomes, there has been conflicting data on the correlation between SCH and these outcomes...
October 17, 2016: Seminars in Reproductive Medicine
Wen Tang, Yi Mu, Xiaohong Li, Yanping Wang, Zheng Liu, Qi Li, Mingrong Li, Robert Scherpbier, Sufang Guo, Xiaona Huang, Leni Kang, Jun Zhu, Juan Liang
OBJECTIVE: This study aimed to identify new evidence about the burden and risk factors of low birthweight (LBW) in China using national facility-based data. METHODS: The association between sociodemographic and obstetric characteristics and LBW was examined using a multilevel model, taking into account the clustering of livebirths within hospitals and multiple gestations per woman. RESULTS: There were 3 915 965 deliveries and 235 247 cases born with LBW, producing a LBW rate of 5...
October 16, 2016: Journal of Maternal-fetal & Neonatal Medicine
Chandni Prakash, Susan Hatters-Friedman, Charmian Moller-Olsen, Abigail North
INTRODUCTION: Pregnancy is a vulnerable period for recurrence of bipolar disorder. Discontinuation of mood stabilisers during pregnancy and the postpartum period can significantly increase the risk of recurrence of bipolar disorder. Lamotrigine is an anti-epileptic drug that has been approved for the maintenance treatment of bipolar disorder. Epilepsy literature has indicated that lamotrigine has a reassuring safety profile in pregnancy but there is little information on its effectiveness and safety in pregnant women with mental disorders...
August 15, 2016: Psychopharmacology Bulletin
Amy O'Donnell, Catherine McParlin, Stephen C Robson, Fiona Beyer, Eoin Moloney, Andrew Bryant, Jennifer Bradley, Colin Muirhead, Catherine Nelson-Piercy, Dorothy Newbury-Birch, Justine Norman, Emma Simpson, Brian Swallow, Laura Yates, Luke Vale
BACKGROUND: Nausea and vomiting in pregnancy (NVP) affects up to 85% of all women during pregnancy, but for the majority self-management suffices. For the remainder, symptoms are more severe and the most severe form of NVP - hyperemesis gravidarum (HG) - affects 0.3-1.0% of pregnant women. There is no widely accepted point at which NVP becomes HG. OBJECTIVES: This study aimed to determine the relative clinical effectiveness and cost-effectiveness of treatments for NVP and HG...
October 2016: Health Technology Assessment: HTA
O M Shaaban, A M Abbas, H A Abdel Hafiz, A S Abdelrahman, M Rashwan, E R Othman
BACKGROUND: Pregnancy during lactation is common in Egypt and is often unplanned. Overlap between pregnancy and lactation could be associated with an increased risk for the pregnant mother, her fetus as well as her nursing child. AIM OF THE STUDY: The current study aims to compare the maternal and perinatal outcome of pregnancies occurred during lactation with those occurred after weaning in women with substandard nutrition. MATERIALS AND METHODS: A prospective-cohort study was carried out in six Maternal and Child Health Centers in Assiut-Egypt...
December 28, 2015: Facts, Views & Vision in ObGyn
R S Monteiro, D P Dob, M R Cauldwell, M A Gatzoulis
Women with a single ventricle circulation palliated with the Fontan operation require specialist multidisciplinary management. We report 14 such cases with successful pregnancies and detail the pathophysiology encountered. A combined obstetric and cardiac service between Chelsea and Westminster Hospital and Royal Brompton Hospital provides care for women with heart disease, and maintains a prospective database of referred women. We searched this database for women with a known Fontan circulation and reviewed the case notes and electronic patient records between January 1994 and December 2015...
September 7, 2016: International Journal of Obstetric Anesthesia
Alexandre Delamou, Therese Delvaux, Abdoul Habib Beavogui, Alain Levêque, Wei-Hong Zhang, Vincent De Brouwere
BACKGROUND: Obstetric fistula is a serious medical condition which affects women in low income countries. Despite the progress of research on fistula, there is little data on long term follow-up after surgical repair. The objective of this study is to analyse the factors associated with the recurrence of fistula and the outcomes of pregnancy following fistula repair in Guinea. METHODS: A descriptive longitudinal study design will be used. The study will include women who underwent fistula repair between 2012 and 2015 at 3 fistula repair sites supported by the Fistula Care Project in Guinea (Kissidougou Prefectoral Hospital, Labé Regional Hospital and Jean Paul II Hospital of Conakry)...
October 10, 2016: BMC Pregnancy and Childbirth
Helen M Ryan, Sumedha Sharma, Laura A Magee, J Mark Ansermino, Karen MacDonell, Beth A Payne, Keith R Walley, Peter von Dadelszen
OBJECTIVE: To assess the performance of the Acute Physiology and Chronic Health Evaluation II (APACHE II) mortality prediction model in pregnant and recently pregnant women receiving critical care in low-, middle-, and high-income countries during the study period (1985-2015), using a structured literature review. DATA SOURCES: Ovid MEDLINE, Embase, Web of Science, and Evidence-Based Medicine Reviews, searched for articles published between 1985 and 2015. STUDY SELECTION: Twenty-five studies (24 publications), of which two were prospective, were included in the analyses...
October 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Péter Mihalicza, György Csákány, Miklós Szabó
INTRODUCTION: Care provision for very low birth weight and very low gestational age newborns requires high level clinical preparedness. Appropriate care and care management reduce mortality. AIM: To present Hungarian and international outcomes and local regional differences characterizing neonatal care in 2006-2008, based on the results of the EuroHOPE study. METHOD: Hungarian data were created by linking the obstetrics registry with the financing database of the Health Insurance Fund...
October 2016: Orvosi Hetilap
Laura Oakley, Nicole Penn, Maria Pipi, Eugene Oteng-Ntim, Pat Doyle
OBJECTIVE: The objective of this study was to investigate whether moderately increased maternal age is associated with obstetric and neonatal outcome in a contemporary population, and to consider the possible role of co-morbidities in explaining any increased risk. STUDY DESIGN: Secondary analysis of routinely collected data from a large maternity unit in London, UK. Data were available on 51,225 singleton deliveries (≥22 weeks) occurring to women aged ≥20 between 2004 and 2012...
2016: PloS One
Louise T Day, Daniel Hruschka, Felicity Mussell, Eva Jeffers, Stacy L Saha, Shafiul Alam
BACKGROUND: Prior studies have shown that using uterotonics to augment or induce labor before arrival at comprehensive Emergency Obstetric and Neonatal Care (CEmONC) settings (henceforth, "outside uterotonics") may contribute to perinatal mortality in low- and middle-income countries. We estimate its effect on perinatal mortality in rural Bangladesh. METHODS: Using hospital records (23986 singleton term births, Jan 1, 2009-Dec 31, 2015) from rural Bangladesh, we use a logistic regression model to estimate the increased risk of perinatal death from uterotonics administered outside a CEmONC facility...
October 6, 2016: Reproductive Health
Rohan D'Souza, Candice K Silversides, Claire McLintock
The prothrombotic state of pregnancy increases the risk of thromboembolic complications and death in women with mechanical heart valves (MHVs). Although it is accepted that these women must be on therapeutic anticoagulation throughout pregnancy, competing maternal and fetal risks, as well as the lack of high-quality data from prospective studies, make the choice of the optimal method of anticoagulation challenging. Vitamin K antagonists (VKAs) are associated with fewer maternal complications, but conversely also the lowest live birth rates as well as warfarin-related embryopathy and fetopathy...
October 5, 2016: Seminars in Thrombosis and Hemostasis
L Hawke, J Grabell, W Sim, L Thibeault, E Muir, W Hopman, G Smith, P James
INTRODUCTION: Women with inherited bleeding disorders are at increased risk for bleeding complications during pregnancy and the postpartum period, particularly postpartum haemorrhage (PPH). AIM: This retrospective study evaluates pregnancy management through the Inherited Bleeding Disorders Clinic of Southeastern Ontario, the clinical factors associated with pregnancy-related abnormal bleeding and assesses tranexamic acid use in the postpartum treatment of bleeding disorder patients...
October 5, 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
Katherine Rhoades, Sarah Telliard, Tiffany Stanfill Thomas, Jennifer L Barkin
OBJECTIVE: We examined 1) women's perceptions regarding self-care, 2) applications of self-care, and 3) barriers to practicing effective self-care. METHODS: Four focus groups were conducted in a low-income, pregnant population. Focus group recruitment and discussions took place at a large medical center in a medically underserved area of central Georgia. Thirty-two adult pregnant women attending a high-risk obstetric clinic were included. Data related to holistic self-care were identified and grouped into one of three categories: women's valuations of self-care, applications of self-care, and barriers to self-care...
September 30, 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Jesús Zacarías Villarreal Pérez, José Manuel Ramírez Aranda, Manuel de la O Cavazos, Michelle de J Zamudio Osuna, José Perales Dávila, María Romelia Ballesteros Elizondo, Marco Vinicio Gómez Meza, Francisco Javier García Elizondo, Azucena M Rodríguez González
Immunization with the tetanus, diphtheria, and pertussis (Tdap) vaccine raises controversies on immunogenicity and possible antibody interference. We performed an experimental, double-blind, parallel group controlled clinical trial to evaluate the safety and immunogenicity of the Tdap vaccine in 204 pregnant women and their children and to determine its interference in antibody production. Pregnant women 18 to 38 years of age with 12 to 24 weeks gestation, a low obstetric risk, and without serious disease were randomly selected...
September 29, 2016: Human Vaccines & Immunotherapeutics
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