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https://www.readbyqxmd.com/read/28446203/clinicians-views-and-experiences-of-offering-two-alternative-consent-pathways-for-participation-in-a-preterm-intrapartum-trial-a-qualitative-study
#1
Celine Y Chhoa, Alexandra Sawyer, Susan Ayers, Angela Pushpa-Rajah, Lelia Duley
BACKGROUND: The Cord Pilot Trial compared alternative policies for timing of cord clamping at very preterm birth at eight UK hospitals. Preterm birth can be rapid and unexpected, allowing little time for the usual consent process. Therefore, in addition to the usual procedure for written consent, a two-stage pathway for consent for use when birth was imminent was developed. The aims of this study were to explore clinicians' views and experiences of offering two consent pathways for recruitment to a randomised trial of timing of cord clamping at very preterm birth...
April 26, 2017: Trials
https://www.readbyqxmd.com/read/28443284/fecal-short-chain-fatty-acid-variations-by-breastfeeding-status-in-infants-at-4%C3%A2-months-differences-in-relative-versus-absolute-concentrations
#2
Sarah L Bridgman, Meghan B Azad, Catherine J Field, Andrea M Haqq, Allan B Becker, Piushkumar J Mandhane, Padmaja Subbarao, Stuart E Turvey, Malcolm R Sears, James A Scott, David S Wishart, Anita L Kozyrskyj
Our gut microbiota provide a number of important functions, one of which is the metabolism of dietary fiber and other macronutrients that are undigested by the host. The main products of this fermentation process are short-chain fatty acids (SCFAs) and other intermediate metabolites including lactate and succinate. Production of these metabolites is dependent on diet and gut microbiota composition. There is increasing evidence for the role of SCFAs in host physiology and metabolic processes as well as chronic inflammatory conditions such as allergic disease and obesity...
2017: Frontiers in Nutrition
https://www.readbyqxmd.com/read/28439022/structure-of-a-protective-epitope-of-group-b-streptococcus-type-iii-capsular-polysaccharide
#3
Filippo Carboni, Roberto Adamo, Monica Fabbrini, Riccardo De Ricco, Vittorio Cattaneo, Barbara Brogioni, Daniele Veggi, Vittoria Pinto, Irene Passalacqua, Davide Oldrini, Rino Rappuoli, Enrico Malito, Immaculada Y Ros Margarit, Francesco Berti
Despite substantial progress in the prevention of group B Streptococcus (GBS) disease with the introduction of intrapartum antibiotic prophylaxis, this pathogen remains a leading cause of neonatal infection. Capsular polysaccharide conjugate vaccines have been tested in phase I/II clinical studies, showing promise for further development. Mapping of epitopes recognized by protective antibodies is crucial for understanding the mechanism of action of vaccines and for enabling antigen design. In this study, we report the structure of the epitope recognized by a monoclonal antibody with opsonophagocytic activity and representative of the protective response against type III GBS polysaccharide...
April 24, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28437302/pain-management-in-the-opioid-dependent-pregnant-woman
#4
Rebecca R Safley, Jamie Swietlikowski
Opioid dependence is an epidemic in the United States, and the percentage of pregnant women who are opioid dependent has increased dramatically in the last decade. Pain management, already a concern for intrapartum and postpartum care, is complicated in the context of opioid dependence. This clinical review surveys the literature on pain management in opioid-dependent pregnant women to summarize current consensus and evidence to guide clinical practice. Points of consensus for pain management in opioid-dependent pregnant women include continual opioid maintenance therapy throughout the pregnancy and the postpartum period; adequate management of acute pain; the contraindication of opioid agonist-antagonists for pain management; and the need for interdisciplinary teams using a multimodal approach to provide optimal care to opioid-dependent pregnant women...
April 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28428183/risk-and-burden-of-adverse-intrapartum-related-outcomes-associated-with-non-cephalic-and-multiple-birth-in-rural-nepal-a-prospective-cohort-study
#5
Naoko Kozuki, Joanne Katz, Subarna K Khatry, James M Tielsch, Steven C LeClerq, Luke C Mullany
OBJECTIVES: Intrapartum-related complications are the second leading cause of neonatal death worldwide. We estimate the community-level risk and burden of intrapartum-related fetal/neonatal mortality and morbidity associated with non-cephalic and multiple birth in rural Sarlahi District, Nepal. DESIGN: Community-based prospective cohort study. SETTING: Rural Sarlahi District, Nepal. PARTICIPANTS: Pregnant women residing in the study area...
April 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28426597/accommodating-immigrant-women-s-preferences-for-female-health-care-providers
#6
Christa Aubrey, Zubia Mumtaz, Patrick B Patterson, Radha Chari, B F Peter Mitchell
OBJECTIVE: To investigate obstetricians' perspectives of the importance, effect, and challenges of providing intrapartum care to immigrant women who request a female obstetrician. METHODS: A focused ethnography was conducted at a large teaching hospital, which serves a high proportion of immigrant clientele (predominantly North or East African, Middle Eastern, and South Asian) in Edmonton, Alberta, Canada. Data collection comprised single, semistructured interviews with a purposive sample of 20 obstetric health care providers (10 resident and 10 staff obstetricians)...
May 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28422358/is-mean-platelet-volume-a-better-biomarker-in-pre-eclampsia
#7
Gustavo Vilchez, Moraima Lagos, Komal Kumar, Pedro Argoti
AIM: Platelet activation and destruction is a well recognized feature of pre-eclampsia, but the current literature is contradictory regarding the role of mean platelet volume (MPV) in the diagnosis of this condition. We investigated whether MPV, compared with other routine laboratory markers such as platelet count, is a more significant biomarker of pre-eclampsia, giving special attention to the intrapartum period. METHODS: Biochemical and hematological markers along pregnancy including MPV were compared retrospectively between pre-eclampsia and matched controls...
April 19, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28420662/outcome-of-a-screening-programme-for-the-prevention-of-neonatal-invasive-early-onset-group-b-streptococcus-infection-in-a-uk-maternity-unit-an-observational-study
#8
G Gopal Rao, G Nartey, T McAree, A O'Reilly, S Hiles, T Lee, S Wallace, R Batura, P Khanna, H Abbas, C Tilsed, R Nicholl, T Lamagni, P Bassett
BACKGROUND: Against a background of failure to prevent neonatal invasive early-onset group B Streptococcus infections (GBS) in our maternity unit using risk-based approach for intrapartum antibiotic prophylaxis, we introduced an antenatal GBS carriage screening programme to identify additional women to target for prophylaxis. OBJECTIVES: To describe the implementation and outcome of an antepartum screening programme for prevention of invasive early-onset GBS infection in a UK maternity unit...
April 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28420339/protocol-for-the-development-of-a-salutogenic-intrapartum-core-outcome-set-sipcos
#9
Valerie Smith, Deirdre Daly, Ingela Lundgren, Tine Eri, Cecily Begley, Mechthild M Gross, Soo Downe, Zarko Alfirevic, Declan Devane
BACKGROUND: Maternity intrapartum care research and clinical care more often focus on outcomes that minimise or prevent adverse health rather than on what constitutes positive health and wellbeing (salutogenesis). This was highlighted recently in a systematic review of reviews of intrapartum reported outcomes where only 8% of 1648 individual outcomes, from 102 systematic reviews, were agreed as being salutogenically-focused. Added to this is variation in the outcomes measured in individual studies rendering it very difficult for researchers to synthesise, fully, the evidence from studies on a particular topic...
April 19, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28419084/neonatal-resuscitation-in-global-health-settings-an-examination-of-the-past-to-prepare-for-the-future
#10
REVIEW
Beena D Kamath-Rayne, Sara K Berkelhamer, K C Ashish, Hege L Ersdal, Susan Niermeyer
BACKGROUND: As rates of childhood mortality decline, neonatal deaths account for nearly half of under-5 deaths worldwide. Intrapartum-related events (birth asphyxia) contribute to approximately one-quarter of neonatal deaths, many of which can be prevented by simple resuscitation and newborn care interventions. METHODS: This paper reviews various lines of research that have influenced the global neonatal resuscitation landscape. A brief situational analysis of asphyxia-related newborn mortality in low-resource settings is linked to renewed efforts to reduce neonatal mortality in the Every Newborn Action Plan...
April 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28418986/performance-of-virological-testing-for-early-infant-diagnosis-a-systematic-review
#11
Divya Mallampati, Nathan Ford, Alisse Hanaford, Nandita Sugandhi, Martina Penazzato
BACKGROUND: Improved access to both maternal antiretroviral therapy (ART) and infant prophylaxis may have an impact on the performance of virological assays for diagnosis of HIV infection in infants. This systematic review was performed to assess the diagnostic accuracy of virological testing at birth as well as the performance of virological testing on dried-blood spots at 6-weeks amongst HIV- and ARV-exposed infants. METHODS: A systematic review was performed for studies published between January 1, 2009 and January 30, 2015...
April 7, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28411530/the-influence-of-intrapartum-opioid-use-on-breastfeeding-experience-at-6-weeks-post-partum-a-secondary-analysis
#12
Julie-Anne Fleet, Meril Jones, Ingrid Belan
OBJECTIVE: To examine breastfeeding experiences up to 6 weeks postpartum for mothers administered intranasal fentanyl, subcutaneous fentanyl or intramuscular pethidine for intrapartum analgesia. DESIGN: A secondary analysis was undertaken using the per-protocol dataset to examine the third phase of a larger randomised controlled trial. This phase of the study examined breastfeeding intention and experience from the first hour of birth to 6 weeks postpartum. Medical records were audited and women were contacted at 6 weeks postpartum to complete a telephone questionnaire...
April 3, 2017: Midwifery
https://www.readbyqxmd.com/read/28410276/hiv-transmission-to-premature-very-low-birth-weight-infants
#13
Candyce Levin, David Le Roux, Michael Harrison, Lloyd Tooke
There is sparse literature about HIV transmission in preterm infants. 82 HIV exposed preterm infants received birth PCRs. Five (6.1%) were HIV positive with all 5 mothers receiving inadequate antiretrovirals. Of the PCR negative infants, 9 died and 87% of the survivors received further PCR testing which remained negative. With correct care, intrapartum transmission of HIV can virtually be eliminated.
April 13, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28409757/confirmation-of-posterior-uterine-rupture-in%C3%A2-the-second-trimester-by-magnetic-resonance-imaging
#14
P G Sharma, D A Rajderkar
Intrapartum uterine rupture is a life-threating and rare complication of pregnancy which seldom occurs in the second trimester. Typically, the diagnosis is made using ultrasound; however, magnetic resonance imaging can provide certain advantages in the emergent setting. We present a unique case of a posterior uterine rupture confirmed by magnetic resonance imaging to be involving the unscarred posterior uterine wall in a 20- year- old gravid female with two previous cesarean-sections.
April 8, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28406484/induction-of-labor-by-foley-catheter-compared-with-spontaneous-onset-of-labor-after-previous-cesarean-section-a-cohort-study
#15
H Kruit, H Wilkman, A Tekay, L Rahkonen
OBJECTIVE: To evaluate the safety of induction of labor (IOL) with Foley catheter (FC) in women with a history of previous cesarean section (CS) and to assess risk factors for repeat CS and adverse maternal outcomes. STUDY DESIGN: Cohort study of 1559 women with a history of previous CS in Helsinki University Hospital, Finland between 2013 and 2014. RESULTS: Three hundred and sixty-one women (23.2%) underwent IOL by FC and 1198 (76.8%) had spontaneous onset of labor...
April 13, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28403965/understanding-fetal-physiology-and-second-line-monitoring-during-labor
#16
REVIEW
C Garabedian, J De Jonckheere, L Butruille, P Deruelle, L Storme, V Houfflin-Debarge
Cardiotocography (CTG) is a technique used to monitor intrapartum fetal condition and is one of the most common obstetric procedures. Second line methods of fetal monitoring have been developed in an attempt to reduce unnecessary interventions due to continuous cardiotocography and to better identify fetuses at risk of intrapartum asphyxia. The acid-base balance of the fetus is evaluated by fetal blood scalp samples, the modification of the myocardial oxygenation by the fetal ECG ST-segment analysis (STAN) and the autonomic nervous system by the power spectral analysis of the fetal heart variability...
February 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28399847/evaluation-of-helping-babies-breathe-quality-improvement-cycle-hbb-qic-on-retention-of-neonatal-resuscitation-skills-six-months-after-training-in-nepal
#17
Ashish Kc, Johan Wrammert, Viktoria Nelin, Robert B Clark, Uwe Ewald, Stefan Peterson, Mats Målqvist
BACKGROUND: Each year 700,000 infants die due to intrapartum-related complications. Implementation of Helping Babies Breathe (HBB)-a simplified neonatal resuscitation protocol in low-resource clinical settings has shown to reduce intrapartum stillbirths and first-day neonatal mortality. However, there is a lack of evidence on the effect of different HBB implementation strategies to improve and sustain the clinical competency of health workers on bag-and-mask ventilation. This study was conducted to evaluate the impact of multi-faceted implementation strategy for HBB, as a quality improvement cycle (HBB-QIC), on the retention of neonatal resuscitation skills in a tertiary hospital of Nepal...
April 11, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28399531/intrapartum-ultrasound-to-differentiate-flexion-and-deflexion-in-occipitoposterior-rotation
#18
Federica Bellussi, Tullio Ghi, Aly Youssef, Ilaria Cataneo, Ginevra Salsi, Giuliana Simonazzi, Gianluigi Pilu
OBJECTIVE: To evaluate the ability of intrapartum ultrasound to differentiate occipitoposterior (OP) rotation with normal flexion of the head from deflexion, to compare the accuracy of ultrasound with the digital examination, and to assess the outcome of labor according to the type of presentation. PATIENTS AND METHODS: A retrospective study of patients with abnormal labor because of either prolongation and/or abnormal cardiotocography and OP rotation who underwent intrapartum sonography...
April 12, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28398680/cytomegalovirus-infection-in-pregnancy
#19
REVIEW
Nicole L Davis, Caroline C King, Athena P Kourtis
Cytomegalovirus (CMV) is a DNA herpesvirus that is common worldwide. The two known main sources of primary CMV infection during pregnancy are through sexual activity and contact with young children. Primary infection occurs in approximately 1 to 4% of pregnancies, and is mostly asymptomatic in immunocompetent adults. However, primary infection may manifest as a mild mononucleosis or flu-like syndrome with persistent fever and fatigue. CMV can be transmitted from mother-to-child in utero, intrapartum, or during breastfeeding...
March 15, 2017: Birth Defects Res
https://www.readbyqxmd.com/read/28397976/resident-consultant-cover-may-become-part-of-21st-century-maternity-care-but-it-is-not-a-panacea
#20
Matt Prior, Tim Draycott, Christy Burden
Resident consultant cover has long been proposed as a solution to a wide variety of current intrapartum issues: poor clinical outcomes; high intervention rates, particularly increasing rates of caesarean section; middle grade rota gaps, and decreased training opportunities. However, as for many previous well-intentioned, apparently simple and plausible interventions introduced into maternity care, there may be little or no benefit when robustly tested. This article is protected by copyright. All rights reserved...
April 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
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