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Low risk obstetrics

Sikolia Z Wanyonyi, Steve K Mutiso
Abnormal fetal growth significantly increases neonatal mortality and the risk of stillbirth. This creates the need for accurately monitoring fetal growth in all pregnancies regardless of the risk status. Several methods used in clinical practice include abdominal palpation, symphysio-fundal height measurements, and obstetric ultrasound. Of these, obstetric ultrasound remains the most reliable and objective way to monitor fetal growth. However, in most low-resource areas, access to obstetric ultrasound remains poor and this leaves the two as the only options available...
March 14, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
Aisha Mansoor Ali, Abdulaziz Alobaid, Tasnim Nidal Malhis, Ahmad Fawzi Khattab
BACKGROUND: Vitamin D plays pivotal role in decidualization and implantation of the placenta. Recent researches have shown that low level of vitamin D3 "25-hydroxyvitamin D (25[OH]D)" in serum is a risk factor for pre-eclampsia. Latest evidence supports role of vitamin D3 deficiency treatment in reducing the risk of pre-eclampsia. The aim of this study is to determine the effect of antenatal supplementation of vitamin D3 on the risk of pre-eclampsia and to explore the dose effect in attaining the vitamin D3 normal level...
March 2, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Marnie J Meylor de Mooij, Rachael L Hodny, Daniel A O'Neil, Matthew R Gardner, Mekayla Beaver, Andrea T Brown, Barbara A Barry, Lorna M Ross, Amy J Jasik, Katharine M Nesbitt, Susan M Sobolewski, Susan M Skinner, Rajeev Chaudhry, Brian C Brost, Bobbie S Gostout, Roger W Harms
Using a human-centered design method, our team sought to envision a new model of care for women experiencing low-risk pregnancy. This model, called OB Nest, aimed to demedicalize the experience of pregnancy by providing a supportive and empowering experience that fits within patients' daily lives. To explore this topic, we invited women to use self-monitoring tools, a text-based smartphone application to communicate with their care team, and moderated online communities to connect with other pregnant women...
March 9, 2018: Mayo Clinic Proceedings
E Gandjbakhch, E Varlet, G Duthoit, V Fressart, P Charron, C Himbert, C Maupain, C Bordet, F Hidden-Lucet, J Nizard
INTRODUCTION: The prognosis of pregnancy in patients with Arrhythmogenic Right Ventricular Cardiomyopathy/dysplasia (ARVC/D) is poorly documented. The aim of this study is to assess the cardiac risks during pregnancy and the impact of ARVC/D on fetuses/neonates/children. METHODS: We included all ARVC/D women with a history of pregnancy from the ARVC/D Pitié-Salpêtrière registry. Cardiac and obstetrical events having occurred during pregnancy/delivery/post-partum periods and neonatal data/follow-up were collected...
May 1, 2018: International Journal of Cardiology
Alexandros Laios, Jenneke Kasius, Anastasios Tranoulis, Alexandros Gryparis, Thomas Ind
OBJECTIVE: It is difficult to critically outline the optimal treatment for women with early-stage cervical cancer (eCC) wishing fertility preservation. Neoadjuvant chemotherapy (NAC) to downstage "bulky" eCC could potentially lead to fertility-sparing surgery (FSS) in a wider patient population. The rationale is to provide oncological safety balanced with maximal fertility effort. We aimed to obtain the most accurate fertility outcomes for eCC women treated with NAC followed by FSS and identify potential factors favoring fertility...
March 14, 2018: International Journal of Gynecological Cancer
M Y Tan, D Wright, A Syngelaki, R Akolekar, S Cicero, D Janga, M Singh, E Greco, A Wright, K Maclagan, L C Poon, K H Nicolaides
OBJECTIVE: To test the hypothesis that the performance of first-trimester screening for pre-eclampsia (PE) by a method that uses Bayes' theorem to combine maternal factors with biomarkers is superior to that defined by current National Institute for Health and Care Excellence (NICE) guidelines. METHODS: This was a prospective multicenter study (screening program for pre-eclampsia (SPREE)) in seven National Health Service maternity hospitals in England, of women recruited between April and December 2016...
March 14, 2018: Ultrasound in Obstetrics & Gynecology
Emily Aherne, Katie Beauchamp, Niamh Maher, Thomas Walsh, William Boyd, Maeve Eogan, Leo Lawler
A 32-year-old primiparous woman presented with severe abdominal pain at 21 weeks' gestation. Background history of laparoscopy for chronic pelvic pain and a spontaneous miscarriage was noted. On examination, she was peritonitic and tachycardic with low grade fever and anemia. MRI abdomen demonstrated a uterine rupture with a large cap of clotted blood overlying the uterine fundus with the appearance of a "shower cap" and large volume haemoperitoneum, the presumptive diagnosis was uterine rupture with placental extrusion...
May 2017: Ulster Medical Journal
Panpan Li, Hexuan Yin, Fanling Meng, Shuang Liu, Haixia Liu, Rong Ma
BACKGROUND: Tripartite motif-containing protein 44 (TRIM44) has been recently identified as a novel oncogene that is overexpressed in several types of human cancers; however, its role in endometrial cancer (EC) remains unknown. The purpose of the current study was to investigate the TRIM44 protein expression and clinicopathological significance of TRIM44 in EC. METHODS: Paraffin-embedded surgical specimens were collected from 143 patients with EC for the immunohistochemical analysis of TRIM44 expression...
March 6, 2018: Pathology, Research and Practice
Edgardo Abalos, Olufemi T Oladapo, Mónica Chamillard, Virginia Díaz, Julia Pasquale, Mercedes Bonet, Joao Paulo Souza, A Metin Gülmezoglu
BACKGROUND: Despite decades of research, the concept of normality in labour in terms of its progression and duration is not universal or standardized. However, in clinical practice, it is important to define the boundaries that distinguish what is normal from what is abnormal to enable women and care providers have a shared understanding of what to expect and when labour interventions are justified. OBJECTIVES: To synthesise available evidence on the duration of latent and active first stage and the second stage of spontaneous labour in women at low risk of complications with 'normal' perinatal outcomes...
February 27, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Laura Schummers, Jennifer A Hutcheon, Michele R Hacker, Tyler J VanderWeele, Paige L Williams, Thomas A McElrath, Sonia Hernandez-Diaz
BACKGROUND: First deliveries in women older than 35, 40, or 45 are at increased risk for adverse pregnancy outcomes compared with those in younger women. However, specific relationships between each additional year of maternal age and pregnancy risks remain unclear, and absolute risks at each maternal age are not known. METHODS: Using a population-based cohort of nulliparous women in British Columbia, Canada, from 2004-2014 (n=203,414), We examined relationships between maternal age (modeled flexibly to allow curvilinear shapes) and pregnancy outcomes using logistic regression...
March 6, 2018: Epidemiology
Catarina Canário, Bárbara Figueiredo
AIMS: The aims of this study were to analyse the changes in anxiety and depression symptoms from early pregnancy to 30 months postpartum according to gender and parity. METHOD: 129 couples (N = 258) recruited from an obstetrics unit completed self-report measures of anxiety and depression at each pregnancy trimester, childbirth, 3 and 30 months postpartum. Using multilevel modelling, piecewise dyadic growth curve models were performed, assessing time, gender and parity as predictors of anxiety and depression symptoms...
November 2017: Journal of Reproductive and Infant Psychology
Małgorzata Mizgier, Kinga Mruczyk, Grazyna Jarząbek-Bielecka, Jan Jeszka
OBJECTIVES: The goal of the paper was to compare weight gain in pregnant women in relation to the week of gestation at birth, the delivery method, and the occurrence of macrosomia and low birth weights for patients with different durations of physical activity during pregnancy. MATERIALS AND METHODS: The full course of study was completed by 57 pregnant women enrolled in an 18-week physical activity programme during their second and third trimesters. The actual duration of their physical activity was monitored with the ActiGraph GT3X monitor...
2018: Ginekologia Polska
Fatma Beyazit, Fatma Sılan, Meryem Gencer, Buket Aydin, Barış Paksoy, Mesut A Unsal, Ozturk Ozdemir
OBJECTIVES: Cervical cancer is the second most common type of cancer for women worldwide with a great proportion proved to be related to human papillomavirus (HPV) infection. As infection with HPV is the strongest risk factor for cervical neoplasia, detection of HPV genotypes in cervical and vaginal specimens of women with normal and abnormal cytology seems to be of paramount importance in cervical cancer screening. The objective of the study is to evaluate the prevalence and HPV genotypes among women with normal or abnormal Pap smear tests...
2018: Ginekologia Polska
A Kotaska
Based on prediction models and expert opinion, most obstetric venous thromboembolism guidelines recommend low-molecular-weight heparin for many postpartum women, including most delivering by caesarean. Scrutiny reveals major oversights: prediction models are based on studies that report asymptomatic deep vein thrombosis; risk estimates are not adjusted for time exposure; and harm caused by heparin has been overlooked. The benefits of heparin are exaggerated and its harms are under-appreciated. Estimates of the numbers-needed-to-treat and harm are universally lacking...
March 7, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
M Nováčková, Z Pastor, J Matěcha, M Čekal, J Froněk, R Chmel
OBJECTIVE: Evaluation of pregnancies and deliveries in women after solid organ transplantations with respect to the maternal and fetal risks. DESIGN: Overview article. SETTING: Department of Obstetrics and Gynaecology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague. METHODS: Literature search using the Web of Science, Ovid, Cochrane, Google Scholar and Medline databases with keywords (transplantation, pregnancy, immunosuppression) and analysis of articles published in impact and reviewed journals from 1958 to 2017...
2018: Ceská Gynekologie
V Balaya, H Bonsang-Kitzis, C Ngo, M Delomenie, M Gosset, M Mimouni, C Nos, P M David, A S Bats, F Lecuru
Pregnancy-associated breast cancer is rare, but this clinical situation arises in 1/10,000 to 1/3,000 pregnancies. In patients presenting an early-stage breast tumor devoid of clinically pathological lymph node, sentinel lymph node (SLN) biopsy has not yet been validated as a routine procedure for pregnant women due to the lack of data in the literature. The blue dye injection is not recommended because of 2% theoretical risk of anaphylactic shock. Several studies have shown that Tc99m injection at conventional dose between 12...
March 3, 2018: Journal of Gynecology Obstetrics and Human Reproduction
Weina Guo, Jing Cai, Min Li, Hongbo Wang, Yi Shen
BACKGROUND: Despite that pelvic and para-aortic lymphadenectomy (PPaLND) is recommended as part of accurate surgical staging by International Federation of Gynecology and Obstetrics (FIGO) in endometrial cancer, the impact of para-aortic lymphadenectomy on survival remains controversial. The aim of this work is to evaluate the survival benefits or risks in endometrial cancer patients who underwent surgical staging with or without para-aortic lymphadenectomy using meta-analysis. METHODS: Literature search was undertaken using PubMed, Embase, and Cochrane Library databases for relevant articles published between January 1, 1990, and January 1, 2017, without language restriction...
January 2018: Medicine (Baltimore)
N Levy, O Goren, A Cattan, C F Weiniger, I Matot
BACKGROUND: Laboring women with low platelet counts may be denied neuraxial block due to concerns about causing a spinal-epidural hematoma. AIMS: To assess the anesthetic management, complications and outcome variables of women with low platelet counts, and to expand the existing data regarding the safety of neuraxial blocks in this patient population. METHODS: This is a retrospective analysis of anesthetic and obstetric data from women with platelet counts <100 000/μL, who were admitted to a single referral center during 2011-2014...
January 31, 2018: International Journal of Obstetric Anesthesia
Geoffroy Canlorbe, Cyril Touboul, Cyrus Chargari, Enrica Bentivegna, Amandine Maulard, Patricia Pautier, Catherine Genestie, Philippe Morice, Sébastien Gouy
AIM: To evaluate the influence on relapse-free survival (RFS) and overall survival (OS) of a transitory protective stoma (TPS) at the time of complete cytoreductive surgery for advanced-stage ovarian cancer. PATIENTS AND METHODS: From our Institution, we retrospectively selected patients from 2006 to 2011 with ovarian cancer with the following criteria: stage IIIB to IVA (pleural effusion) according to the International Federation of Gynaecology and Obstetrics classification; complete cytoreductive surgery (CC0 according to Sugarbaker's classification); and a low anterior resection...
March 2018: Anticancer Research
Matthias David, Katrin Alexandra Scherer, Wolfgang Henrich, Jürgen Breckenkamp
Objectives: Does the incidence and/or indication(s) for emergency cesarean section differ if the pregnant woman has an immigrant background (IB)? Does a lack of language proficiency (communication problems) and a low acculturation level result in a longer decision-to-delivery interval (D-D interval)? Are neonates born to women with IB by emergency cesarean section in a poorer condition post delivery? Patient cohorts and method: Standardized interviews were carried out before or immediately after delivery in three Berlin obstetric hospitals...
February 2018: Geburtshilfe und Frauenheilkunde
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