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Intrapartum

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https://www.readbyqxmd.com/read/29792103/prolonged-use-of-antibiotics-after-birth-is-associated-with-increased-morbidity-in-preterm-infants-with-negative-cultures
#1
C Fajardo, B Alshaikh, A Harabor
BACKGROUND: Most preterm infants are exposed to a variable duration of antibiotic therapy after birth despite negative cultures. Data is emerging about the risks of prolonged antibiotics. We sought to assess the association between length of initial antibiotic course and neonatal outcomes in a cohort from a single large perinatal centre. METHODS: Retrospective cohort study of prospectively collected data on all infants with a birth weight of less than 1250 g hospitalized in our NICU in a 4-year window and who had negative blood and CSF cultures in the first 2 days of life...
May 23, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29791501/stillbirths-in-urban-guinea-bissau-a-hospital-and-community-based-study
#2
Morten Bjerregaard-Andersen, Najaaraq Lund, Anne Sofie Pinstrup Joergensen, Frida Starup Jepsen, Holger Werner Unger, Mama Mane, Amabelia Rodrigues, Staffan Bergström, Christine Stabell Benn
BACKGROUND: Stillbirth rates remain high in many low-income settings, with fresh (intrapartum) stillbirths accounting for a large part due to limited obstetrical care. We aimed to determine the stillbirth rate and identify potentially modifiable factors associated with stillbirth in urban Guinea-Bissau. METHODS: The study was carried out by the Bandim Health Project (BHP), a Health and Demographic Surveillance System site in the capital Bissau. We assessed stillbirth rates in a hospital cohort consisting of all deliveries at the maternity ward at the National Hospital Simão Mendes (HNSM), and in a community cohort, which only included women from the BHP area...
2018: PloS One
https://www.readbyqxmd.com/read/29788769/audit-of-intrapartum-care-based-on-the-national-guideline-for-midwifery-and-birth-services
#3
Sonia Minooee, Masoumeh Simbar, Zohreh Sheikhan, Hamid Alavi Majd
Providing high-quality maternity care is a worldwide health concern that necessitates regular assessment of intrapartum practice. In an observational study, we aimed to audit intrapartum care based on the National Guideline for Midwifery and Birth Services. Using quota sampling, a total of 200 pregnant women, admitted for normal vaginal delivery, were recruited from four educational hospitals in Tehran, Iran. An observational checklist was developed based on the national guideline to assess the quality of provided care...
January 1, 2018: Evaluation & the Health Professions
https://www.readbyqxmd.com/read/29786834/assessment-of-lactate-production-as-a-response-to-sustained-intrapartum-hypoxia-in-large-for-gestational-age-newborns
#4
Mehreen Zaigham, Karin Källén, Per Olofsson
INTRODUCTION: Lactate concentration in umbilical cord blood is an important measure of intrapartum anaerobic metabolism. The aim of the study was to compare lactate production of large-for-gestational-age (LGA) fetuses against appropriate-for-gestational-age (AGA) fetuses during hypoxia, in diabetic and non-diabetic mothers. MATERIAL AND METHODS: 17 358 validated paired arterial and venous umbilical cord blood samples taken at birth with a full panel of pH, glucose and lactate were analyzed relative to LGA (n=2789) and AGA (n=14 569)...
May 22, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29780807/a-critical-review-of-the-bacterial-baptism-hypothesis-and-the-impact-of-cesarean-delivery-on-the-infant-microbiome
#5
REVIEW
Lisa F Stinson, Matthew S Payne, Jeffrey A Keelan
Numerous studies suggest that infants delivered by cesarean section are at a greater risk of non-communicable diseases than their vaginal counterparts. In particular, epidemiological studies have linked Cesarean delivery with increased rates of asthma, allergies, autoimmune disorders, and obesity. Mode of delivery has also been associated with differences in the infant microbiome. It has been suggested that these differences are attributable to the "bacterial baptism" of vaginal birth, which is bypassed in cesarean deliveries, and that the abnormal establishment of the early-life microbiome is the mediator of later-life adverse outcomes observed in cesarean delivered infants...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29780786/-ex-utero-intrapartum-treatment-procedure-in-two-fetuses-with-airway-obstruction
#6
Joohee Lee, Mi-Young Lee, Yeni Kim, Jae-Yoon Shim, Hye-Sung Won, Euiseok Jeong, Byong Sop Lee, Ki-Soo Kim, Woo-Jong Choi, Yoon Se Lee
The ex utero intrapartum treatment (EXIT) procedure was introduced to reduce fetal hypoxic damage while establishing an airway in fetuses with upper and lower airway obstruction. Delivery of the fetal head and shoulders while maintaining the uteroplacental circulation offers time to secure the fetal airway. Here, we report two cases of EXIT procedure for fetal airway obstruction, which were successfully managed with extensive preoperative planning by a professional multidisciplinary team.
May 2018: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/29777635/reducing-the-number-of-obstetrical-beds-by-challenging-traditions
#7
Camilla Dalby Salvig, Marie Højriis Storkholm, Jannie Dalby Salvig, Niels Uldbjerg
The aim of this commentary is to describe changes in women care at an obstetric department that made it possible to reduce the number of beds from 40 to 29. Patient pathways were reviewed and revised using lean methodology. The mean length of stay was reduced from 70 to 59 hours and the mean numbers of hospitalizations per woman from 1.26 to 1.20. At the organizational level, we introduced a Family Department, home management of newborns, home monitoring of the women with cardiotocography and blood samples, and intrapartum Group B Streptococcus-PCR...
May 19, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29772076/victims-and-victimisation
#8
Matthew Cauldwell, Susan Bewley
We congratulate McNamara et al. on their work examining the impact that intrapartum stillbirth has on obstetricians (1). The findings from their qualitative study highlight and reinforce themes others have identified. We conducted a similar study interviewing maternity staff (consultant obstetricians, trainees and midwives) about the impact of their involvement in rarer maternal death cases (2). We reported similar themes particularly around the fear of blame. This was perceived as coming not only from the media but also from professional colleagues...
May 17, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29772053/delivery-outcome-after-trial-of-labor-in-nulliparous-women-over-40-years-of-age-a-population-based-study
#9
Victoria Ankarcrona, Daniel Altman, Anna-Karin Wikström, Bo Jacobsson, Sophia Brismar Wendel
INTRODUCTION: An increasing proportion of nulliparous women are over 40 years and labor is more often induced. The aim of this study was to assess delivery outcome in women over 40 years, accounting for the interaction between age and induction. MATERIAL AND METHODS: Population-based study of 1 644 598 nulliparous women with live singleton cephalic term deliveries 1992 to 2011. Risks of intrapartum cesarean section, operative vaginal delivery, obstetric anal sphincter injury (OASIS), and 5-minutes Apgar score <7 were calculated in women ≥40 years with induced or spontaneous labor, and women <40 years with induced labor by unconditional logistic regression, and presented with crude and adjusted odds ratios (aOR) with 95% confidence intervals (95%CI)...
May 17, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29768660/validation-of-a-computerized-algorithm-to-quantify-fetal-heart-rate-deceleration-area
#10
Erika Gyllencreutz, Ke Lu, Kaj Lindecrantz, Pelle G Lindqvist, Lennart Nordstrom, Malin Holzmann, Farhad Abtahi
INTRODUCTION: Reliability in visual cardiotocography interpretation is unsatisfying, which has led to development of computerized cardiotocography. Computerized analysis is well established for antenatal fetal surveillance, but has yet not performed sufficiently during labor. We aimed to investigate the capacity of a new computerized algorithm compared to visual assessment in identifying intrapartum fetal heart rate baseline and decelerations. MATERIAL AND METHODS: Three-hundred-and-twelve intrapartum cardiotocography tracings with variable decelerations were analysed by the computerized algorithm and visually examined by two observers, blinded to each other and the computer analysis...
May 16, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29761674/screening-arab-israeli-pregnant-women-for-group-b-streptococcus-by-the-amplivue-gbs-assay-are-the-rates-higher-than-the-national-average
#11
Marwan Hakim, Adel Jabour, Miriam Anton, Meggie Hakim, Sahar Kheirallah
BACKGROUND: The recommendation of the U.S. Centers for Disease Control and Prevention regarding universal screening for Group B Streptococcus (GBS) at 35-37 weeks gestational age in pregnancy is not accepted in Israel. The National Council for Obstetrics, Neonatology and Genetics recommends intrapartum prophylaxis, mainly based on risk factors, to prevent early neonatal GBS infection. This policy is based on past studies demonstrating low colonization rates of the bacteria in Israeli pregnant women and very low neonatal sepsis rates...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29760273/what-influences-success-in-family-medicine-maternity-care-education-programs-qualitative-exploration
#12
Anne Biringer, Milena Forte, Anastasia Tobin, Elizabeth Shaw, David Tannenbaum
OBJECTIVE: To ascertain how program leaders in family medicine characterize success in family medicine maternity care education and determine which factors influence the success of training programs. DESIGN: Qualitative research using semistructured telephone interviews. SETTING: Purposive sample of 6 family medicine programs from 5 Canadian provinces. PARTICIPANTS: Eighteen departmental leaders and program directors...
May 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29759976/missed-opportunities-for-prevention-of-vertical-hiv-transmission-in-canada-1997-2016-a-surveillance-study
#13
Ari Bitnun, Terry Lee, Jason Brophy, Lindy M Samson, Fatima Kakkar, Wendy Vaudry, Ben Tan, Deborah M Money, Joel Singer, Laura J Sauvé, Ariane Alimenti
BACKGROUND: Vertical HIV transmission has declined in Canada, but missed opportunities for prevention continue to occur. We sought to determine the adequacy, and changes over time in adequacy, of uptake of maternal and neonatal antiretroviral therapy for the prevention of vertical HIV transmission, and to determine the vertical transmission rate over time and according to adequacy of antenatal antiretroviral therapy during the combination antiretroviral therapy era in Canada. METHODS: The Canadian Perinatal HIV Surveillance Program collects data annually through retrospective chart review concerning HIV-infected women and their infants...
May 10, 2018: CMAJ Open
https://www.readbyqxmd.com/read/29754970/cessation-of-breastfeeding-in-association-with-oxytocin-administration-and-type-of-birth-a-prospective-cohort-study
#14
Aurora Fernández-Cañadas Morillo, Modesto Durán Duque, Ana B Hernández López, Cristina Muriel Miguel, Pilar Pérez Riveiro, Angel Salcedo Mariña, Ana Royuela Vicente, María L Casillas Santana, Miguel A Marín Gabriel
BACKGROUND: Some studies have suggested an association between synthetic oxytocin administration and type of birth with the initiation and consolidation of breastfeeding. AIM: This study aimed to test whether oxytocin administration and type of birth are associated with cessation of exclusive breastfeeding at different periods. A second objective was to investigate whether the administered oxytocin dose is associated with cessation of exclusive breastfeeding. METHODS: We conducted a prospective cohort study (n=529) in a tertiary hospital...
May 10, 2018: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/29752923/video-compared-to-conversational-contraceptive-counseling-during-labor-and-maternity-hospitalization-in-colombia-a-randomized-trial
#15
Alyssa R Hersh, Luisa F Muñoz, Mónica Rincón, Carolina Alvarez, Jorge E Tolosa, Diva J Moreno, Martha Rubio, Juan C Vargas, Francisco Edna, Nelson Taborda, Maureen K Baldwin
OBJECTIVE: Assess if video-based contraceptive education could be an efficient adjunct to contraceptive counseling and attain the same contraceptive knowledge acquisition as conversation-based counseling. STUDY DESIGN: This was a multi-center randomized, controlled trial examining contraceptive counseling during labor and maternity hospitalization regarding the options of immediate postpartum contraception. At two urban public hospitals, we randomized participants to a structured conversation with a trained counselor or a 14-min video providing the same information...
May 9, 2018: Contraception
https://www.readbyqxmd.com/read/29752892/high-vertical-hiv-transmission-rate-in-the-midwest-region-of-brazil
#16
Vanessa Terezinha Gubert de Matos, Fabiani de Morais Batista, Naiara Valera Versage, Clarice Souza Pinto, Vanessa Marcon de Oliveira, Érica Freire de Vasconcelos Pereira, Roberta Barbeta Dos Rios de Matos, Márcia Maria Ferrairo Janini Dal Fabbro, Ana Lúcia Lyrio de Oliveira
OBJECTIVES: To estimate vertical HIV transmission rate in a capital city of the Midwest region of Brazil and describe the factors related to transmission. METHODS: A descriptive epidemiological study based on the analysis of secondary data from the Notifiable Diseases Information System (SINAN). The analysis considered all HIV-infected pregnant women with delivery in Campo Grande-MS in the years 2007-2013 and their HIV-exposed infants. RESULTS: A total of 218 births of 176 HIV-infected pregnant women were identified during the study period, of which 187 infants were exposed and uninfected, 19 seroconverted, and 12 were still inconclusive in July 2015...
May 9, 2018: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29750952/glucostabilizer%C3%A2-software-guided-insulin-dosing-improves-intrapartum-glycemic-management-in-women-with-diabetes
#17
Cheryl Dinglas, Jolene Muscat, Tracy Adams, Virginia Peragallo-Dittko, Anthony Vintzileos, Hye J Heo
BACKGROUND: During labor, maintenance of maternal euglycemia is critical to decrease the risk of neonatal hypoglycemia and associated morbidities. When continuous intravenous insulin infusion is needed, standardized insulin dosing charts have been used for titration of insulin to maintain glucose in target range. GlucoStabilizer™ is a software-guided insulin dosing system that calculates the dose of intravenous insulin needed based on metabolic parameters, target glucose concentration, and an individual's response to insulin...
May 8, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29750801/streptococcus-agalactiae-carriage-among-pregnant-women-living-in-rio-de-janeiro-brazil-over-a-period-of-eight-years
#18
Ana Caroline N Botelho, Juliana G Oliveira, Andreia P Damasco, Késia T B Santos, Ana Flávia M Ferreira, Gabriel T Rocha, Penélope S Marinho, Rita B G Bornia, Tatiana C A Pinto, Marco A Américo, Sergio E L Fracalanzza, Lúcia M Teixeira
Group B Streptococcus (GBS) carriage by pregnant women is the primary risk factor for early-onset GBS neonatal sepsis. Intrapartum antibiotic prophylaxis (IAP) can prevent this transmission route, and two main approaches are recommended to base the selection of pregnant women to be submitted to IAP: the risk-based and the culture-based strategies. In Brazil, compliance to such recommendations is poor, and not much is known about GBS carriage. In the present study, 3,647 pregnant women living in Rio de Janeiro State, Brazil, were screened for GBS anogenital colonization, over a period of 8 years (2008-2015)...
2018: PloS One
https://www.readbyqxmd.com/read/29750766/infectious-morbidity-mortality-and-nutrition-in-hiv-exposed-uninfected-formula-fed-infants-results-from-the-hptn-040-pactg-1043-trial
#19
Nava Yeganeh, D Heather Watts, Jiahong Xu, Tara Kerin, Esau C Joao, Jose Henrique Pilotto, Gerhard Theron, Glenda Gray, Breno Santos, Rosana Fonseca, Regis Kreitchmann, Jorge Pinto, Marisa M Mussi-Pinhata, Valdilea Veloso, Margaret Camarca, Lynne Mofenson, Jack Moye, Karin Nielsen-Saines
BACKGROUND: HIV exposed uninfected (HEU) infants are a growing population with potentially poor health outcomes. We evaluated morbidity and mortality in HEU formula-fed infants enrolled in the NICHD HPTN 040/PACTG 1043 trial. METHODS: Infectious morbidity, mortality, and undernutrition were evaluated within a cohort of 1,000 HEU infants enrolled between 4/2004 and 4/2010 in Brazil (N=766) and South Africa (N=234) as part of the NICHD/HPTN 040 trial of three different antiretroviral regimens to decrease intrapartum HIV vertical transmission...
May 10, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29742660/management-of-labor-and-delivery-after-fetoscopic-repair-of-an-open-neural-tube-defect
#20
Jaden R Kohn, Vibha Rao, Allison A Sellner, Dina Sharhan, Jimmy Espinoza, Alireza A Shamshirsaz, William E Whitehead, Michael A Belfort, Magdalena Sanz Cortes
OBJECTIVE: To report labor, delivery, and neonatal outcomes in a cohort of women delivering neonates who had undergone fetoscopic neural tube defect repair. METHODS: We conducted a retrospective cohort study from April 2014 to January 2018. All patients met Management of Myelomeningocele Study eligibility criteria. We included patients with completed second-trimester fetoscopic neural tube defect repair (laparotomy, uterine exteriorization, and minimally invasive access through two or three uterine ports) followed by standardized management of labor and delivery at our institution...
May 7, 2018: Obstetrics and Gynecology
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