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https://www.readbyqxmd.com/read/28645121/effect-of-obesity-on-gestational-and-perinatal-outcomes
#1
Sônia Regina Cabral Madi, Rosa Maria Rahmi Garcia, Vandrea Carla de Souza, Renato Luís Rombaldi, Breno Fauth de Araújo, José Mauro Madi
Purpose To assess the impact of pre-pregnancy obesity (body mass index [BMI] ≥ 30 kg/m(2)) on the gestational and perinatal outcomes. Methods Retrospective cohort study of 731 pregnant women with a BMI ≥ 30 kg/m(2) at the first prenatal care visit, comparing them with 3,161 women with a BMI between 18.5 kg/m(2) and 24.9 kg/m(2). Maternal and neonatal variables were assessed. Statistical analyses reporting the demographic features of the pregnant women (obese and normal) were performed with descriptive statistics followed by two-sided independent Student's t tests for the continuous variables, and the chi-squared (χ(2)) test, or Fisher's exact test, for the categorical variables...
June 23, 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28644587/recent-trends-in-vaginal-birth-after-caesarean-section
#2
A Brick, R Layte, M Farren, R Mahony, M J Turner
In developed countries, caesarean section (CS) rates continue to escalate and in Ireland nearly one in three women are now delivered by CS. The purpose of this study was to compare the management of women after one previous CS in two large Dublin maternity hospitals with the management in two other well-resourced countries. Data were analysed for Dublin, Massachusetts in the United States, and Hesse in Germany. It was found that since 1990, the CS rate in Dublin has increased by much more than in the other areas...
December 12, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/28643667/can-we-perform-a-prenatal-diagnosis-of-vasa-previa-to-improve-its-obstetrical-and-neonatal-outcomes
#3
E Nohuz, E Boulay, D Gallot, D Lemery, F Vendittelli
INTRODUCTION: Vasa previa (VP) is defined as a condition in which the fetal blood vessels, unsupported by the placenta or the umbilical cord, run through the membranes of the lower uterine segment. It is associated with a high risk of stillbirth by exsanguination. This study aimed to assess the clinical context of diagnosis of VP in order to elaborate a strategy for its prenatal diagnosis and to improve its obstetrical and neonatal outcomes. MATERIAL AND METHODS: This historical cohort study covered the period from January 1, 2011 to December 31, 2015...
April 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28643664/intervention-of-the-obstetrician-during-childbirth-in-a-supposedly-low-risk-population-and-influence-of-parity
#4
J Huet, G Beucher, L Geoffroy, R Morello, G Benoist, M Dreyfus
OBJECTIVE: Compare obstetrician intervention and calling rates during labour and delivery between low-risk and high-risk women and study the influence of parity on these rates. MATERIAL AND METHODS: Descriptive retrospective study conducted on 227 patients in a university maternity unit (level 3 university hospital maternity unit) between 1st and 30th January 2014. The low- and high-risk populations were characterised according to the French National Authority for Health (HAS) and NICE guidelines...
April 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28640100/level-of-sensory-block-after-spinal-anesthesia-as-a-predictor-of-hypotension-in-parturient
#5
Ning Zhang, Liangliang He, Jia-Xiang Ni
When the sensory block level (SBL) is ≥T5 or T4, a high incidence of hypotension occurs in parturients after spinal anesthesia. A rapidly ascending SBL is another risk factor for spinal anesthesia-induced hypotension. However, the relationship between the ascension rate of the SBL and spinal anesthesia-induced hypotension remains unclear.After placement in the left lateral position, combined epidural-spinal anesthesia was performed on 140 parturients undergoing caesarean section using the following procedure: no volume preloading, injection site of L3-4 or L4-5, injection rate of 0...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639706/exercise-for-pregnant-women-with-gestational-diabetes-for-improving-maternal-and-fetal-outcomes
#6
REVIEW
Julie Brown, Gilles Ceysens, Michel Boulvain
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with both short- and long-term complications for the mother and her baby. Exercise interventions may be useful in helping with glycaemic control and improve maternal and infant outcomes.The original review on Exercise for diabetic pregnant women has been split into two new review titles reflecting the role of exercise for pregnant women with gestational diabetes and for pregnant women with pre-existing diabetes. Exercise for pregnant women with gestational diabetes for improving maternal and fetal outcomes (this review) Exercise for pregnant women with pre-existing diabetes for improving maternal and fetal outcomes OBJECTIVES: To evaluate the effects of exercise interventions for improving maternal and fetal outcomes in women with GDM...
June 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28638494/an-unusual-case-of-live-caesarean-scar-ectopic-pregnancy-a-common-entity-in-an-uncommon-location
#7
Sayali D Joshi, Shenaz A Momin, Dev Shetty
BACKGROUND: Scar pregnancy is an extremely rare type of ectopic pregnancy, where there is implantation of the gestational sac onto the anterior wall of the uterus at the site of previous LSCS scar in a multipara female. Due to a poor vascular supply to the lower uterine segment, caesarean scars may heal improperly predisposing it to be a site of improper implantation of the gestational sac. RESULTS: The characteristic features are empty uterus and cervix, gestational sac in the anterior part of lower uterine segment with a history of painless vaginal bleeding...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28637726/interventions-for-preventing-mother-to-child-hiv-transmission-protocol-of-an-overview-of-systematic-reviews
#8
Windy Mariane Virenia Wariki, Erika Ota, Rintaro Mori, Charles S Wiysonge, Hacsi Horvath, Jennifer S Read
INTRODUCTION: Various interventions to prevent mother-to-child-transmission (MTCT) of HIV have been investigated and implemented. A number of systematic reviews assessing the efficacy of interventions for the prevention of MTCT of HIV reported antiretroviral prophylaxis, caesarean section before labour and before ruptured membranes, and complete avoidance of breastfeeding were efficacious for preventing MTCT of HIV. Recent WHO guidelines recommend lifelong antiretroviral therapy for all pregnant women for treatment of the woman's own HIV infection and for prevention of MTCT of HIV...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28637644/does-attendance-at-a-specialist-antenatal-clinic-improve-clinical-outcomes-in-women-with-class-iii-obesity-compared-with-standard-care-a-retrospective-case-note-analysis
#9
Fiona C Denison, Heather MacGregor, Laura I Stirrat, Kerrie Stevenson, Jane E Norman, Rebecca M Reynolds
OBJECTIVES: To determine whether attendance at a specialised multidisciplinary antenatal clinic for women with class III obesity (BMI >40 kg/m(2)) is associated with improved clinical outcomes compared with standard antenatal care. DESIGN: Retrospective cohort study using routinely collected data from electronic patient record. SETTING: Community and hospital based antenatal care. PARTICIPANTS: Women with a singleton pregnancy with class III obesity booked for antenatal care and delivered in one of two hospitals in NHS Lothian, Scotland, UK between 2008 and 2014...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28635415/known-and-unknown-cerebral-arteriovenous-malformations-in-pregnancies-haemorrhage-risk-and-influence-on-obstetric-management
#10
Xianli Lv, Wei Li, Hongwei He, Chuhan Jiang, Youxiang Li
Objective The objective of this study was to evaluate the haemorrhage risk of known and unknown cerebral arteriovenous malformations and their obstetric management. Methods A retrospective review was performed and analysed 67 consecutive cases of arteriovenous malformation with pregnancy history. Results Sixty-seven cases of arteriovenous malformation with pregnancy histories were identified. In 14 cases (20.9%) of arteriovenous malformation diagnosed before pregnancy, 11 cases were treated (10 embolisation and one surgery), there was no haemorrhage in 14 pregnancies, 14 healthy babies were delivered by caesarean section in 12 pregnancies (85...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28635352/a-randomized-controlled-trial-comparing-two-types-of-retractors-at-caesarean-delivery
#11
Abbey J Hardy-Fairbanks, Todd Mackenzie, Martin McCarthy, Marlene B Goldman, Michele R Lauria
The aim of this study was to determine if the use of a self-retaining, symmetrical retractor (OB/Mobius(®)) during caesarean delivery is associated with differences in post-operative pain experience. Consenting women undergoing caesarean delivery were randomly assigned to OB/Mobius(®) versus conventional retraction instruments. Women were blinded to retractor type and filled out surgical pain surveys each post-operative day. Additional outcome variables were collected through a provider survey and chart review...
June 21, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28632072/maternal-obesity-obstetric-interventions-and-post-partum-anaemia-increase-the-risk-of-post-partum-sepsis-a-population-based-cohort-study-based-on-swedish-medical-health-registers
#12
Daniel Axelsson, Marie Blomberg
BACKGROUND: The objective was to estimate whether maternal obesity and/or obstetric interventions are associated with diagnosed maternal post-partum sepsis. METHODS: A retrospective observational cohort study including all deliveries in Sweden between 1997 and 2012 (N = 1,558,752). Cases of sepsis (n = 376) were identified by International Classification of Diseases, (ICD-10) codes A40, A41 and O 85 in the Medical Birth Register and the National Patient Register...
June 20, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28631522/evidence-based-management-of-non-tubal-ectopic-pregnancies
#13
Aderemi Olaoluwa Alalade, Fredrick John Ennis Smith, Charlotte Emma Kendall, Funlayo Odejinmi
Recent advances in ultrasonography and the use of other modalities including magnetic resonance imaging scans have led to the early and more accurate diagnosis of non-tubal ectopic pregnancies (NTE). As a result, the management of these pregnancies has evolved. This article addresses the management options currently available for NTE. While surgical management remains the mainstay of treatment for ovarian, abdominal and cornual ectopics, there is growing evidence that some of these can be managed medically...
June 20, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28631513/the-effect-of-labour-pain-in-caesarean-delivery-on-neonatal-and-maternal-outcomes-in-a-term-low-risk-obstetric-population
#14
Meryem Kurek Eken, Gülçin Şahin Ersoy, Sinem Çetinkaya, Çetin Çam, Ateş Karateke
Planned caesarean delivery (CD) frequency is increasing in many countries, and elective CD accounts for 50% of preventable causes of neonatal respiratory morbidity. The clearing of fluid in the lungs is important for the establishment of normal gas exchange with inspired air. A defect in this clearance can result in respiratory problems in neonate, but on the other hand patients waiting for the onset of spontaneous labour pain, the increase in emergency CD, together with severe mortality and morbidity are causes of concern and cause anxiety and distrust of obstetricians...
June 20, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28631256/vulnerability-to-a-metabolic-challenge-following-perinatal-asphyxia-evaluated-by-organotypic-cultures-neonatal-nicotinamide-treatment
#15
R Perez-Lobos, C Lespay-Rebolledo, A Tapia-Bustos, E Palacios, V Vío, D Bustamante, P Morales, M Herrera-Marschitz
The hypothesis of enhanced vulnerability following perinatal asphyxia was investigated with a protocol combining in vivo and in vitro experiments. Asphyxia-exposed (AS) (by 21 min water immersion of foetuses containing uterine horns) and caesarean-delivered control (CS) rat neonates were used at P2-3 for preparing triple organotypic cultures (substantia nigra, neostriatum and neocortex). At DIV 18, cultures were exposed to different concentrations of H2O2 (0.25-45 mM), added to the culture medium for 18 h...
June 19, 2017: Neurotoxicity Research
https://www.readbyqxmd.com/read/28629786/-pregnancy-and-delivery-for-women-with-congenital-spinal-cord-defects-and-neurogenic-bladder
#16
Q Manach, M Dommergues, P Denys, K Loiseau, B Idiard-Chamois, E Chartier-Kastler, V Phé
INTRODUCTION: Data are scarce regarding pregnancy and delivery among women with a neurogenic bladder due to congenital spinal cord defects. OBJECTIVE: To report the obstetrical and urological outcomes of women with congenital spinal cord defects and vesico-sphincteric disorders. METHODS: A retrospective multicentric study included all consecutive women with a neurogenic bladder due to congenital spinal defects, who delivered between January 2005 and December 2014...
June 16, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28629273/the-association-between-maternal-race-and-adverse-outcomes-in-twin-pregnancies-with-similar-healthcare-access
#17
Marti D Soffer, Mariam Naqvi, Stephanie Melka, Aren Gottlieb, Julie Romero, Nathan S Fox
OBJECTIVE: To compare twin pregnancy outcomes between white and nonwhite women with similar access to healthcare. METHODS: Retrospective cohort study of all twin pregnancies delivered by a single maternal-fetal medicine practice from 2005-2016. All patients had private health insurance and equal access to physician care. Outcomes were compared between white and nonwhite women using logistic regression to adjust for differences at baseline. RESULTS: Of the 858 women included, 730 (85...
June 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28629247/obstetric-practice-patterns-in-pregnancies-complicated-by-fetal-trisomy-13-or-18
#18
Sarah K Dotters-Katz, Marcela C Smid, Cora Mcelwain, Jeffrey A Kuller, Jay Schulkin
PURPOSE: Describe practice patterns among obstetrician/gynecologists (OB/GYNs) when caring for women with pregnancy complicated by fetal trisomy 13(T13) or 18(T18), and compare these between maternal-fetal-medicine (MFM) and non-MFM providers. MATERIALS AND METHODS: We conducted an electronic survey using the American College of Obstetricians and Gynecologists database. Using simple statistics, we describe demographics and practice patterns among respondents, and compare those of MFM practitioners with non-MFM providers...
June 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28629241/a-model-to-predict-risk-of-postpartum-infection-after-caesarean-delivery
#19
Laura J Moulton, J Eric Jelovsek, Mark Lachiewicz, Kevin Chagin, Oluwatosin Goje
PURPOSE: To build and validate a statistical model to predict infection after Caesarean delivery (CD). METHODS: Patient and surgical variables within 30 days of CD were collected on 2419 women. Postpartum infection included surgical site infection, urinary tract infection, endomyometritis and pneumonia. The data were split into model development and internal validation (1 Jan - 31 Aug; N=1641) and temporal validation subsets (1 Sept - 31 Dec; N=778). Logistic regression models were fit to the data with concordance index and calibration curves used to assess accuracy...
June 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28628636/weight-change-across-the-start-of-three-consecutive-pregnancies-and-the-risk-of-maternal-morbidity-and-sga-birth-at-the-second-and-third-pregnancy
#20
Jacqueline M Wallace, Sohinee Bhattacharya, Graham W Horgan
BACKGROUND: Weight-change across parities and/or current BMI may influence maternal and fetal morbidity and requires to be differentiated to better inform weight-management guidance. METHODS: Direction, pattern and magnitude of weight-change across three consecutive parities and thereby two inter-pregnancy periods was described in 5079 women. The association between inter-pregnancy weight-change versus current BMI and adverse maternal events, SGA-birth and preterm delivery at second and third pregnancy were investigated by logistic regression...
2017: PloS One
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