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Antepartum

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https://www.readbyqxmd.com/read/29351151/hepatitis-c-in-pregnancy-in-the-era-of-direct-acting-antiviral-treatment-potential-benefits-of-universal-screening-and-antepartum-therapy
#1
Helene B Bernstein, Jeffrey C Dunkelberg, Kimberly K Leslie
Hepatitis C in pregnancy is on the rise, and new direct-acting antiviral agents are available that cure the disease. Published recommendations need to be reviewed and clinically evaluated for the care of pregnant women who are at risk for or have chronic hepatitis C. Available evidence and some of the medical and ethical reasons to consider universal screening and antepartum therapy for hepatitis C during pregnancy are presented. Universal screening and proactive treatment during pregnancy is on the horizon, and these measures should be quickly evaluated for safety and implemented if appropriate...
March 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29342157/timing-of-maternal-death-levels-trends-and-ecological-correlates-using-sibling-data-from-34-sub-saharan-african-countries
#2
Leena Merdad, Mohamed M Ali
Millennium Development Goal 5 has not been universally achieved, particularly in sub-Saharan Africa. Understanding whether maternal deaths occur during pregnancy, childbirth, or puerperium is important to effectively plan maternal health programs and allocate resources. Our main research objectives are to (1) describe the proportions and rates of mortality for the antepartum, intrapartum, and postpartum periods; (2) document how these trends vary by sub-region; and (3) investigate ecological correlations between these rates and maternal care interventions...
2018: PloS One
https://www.readbyqxmd.com/read/29335023/early-neonatal-glutaric-aciduria-type-i-hidden-by-perinatal-asphyxia-a-case-report
#3
Giacomo Biasucci, Nicola Morelli, Federica Natacci, Massimo Mastrangelo
BACKGROUND: Perinatal asphyxia (PA) occurs in about 2 to 10 per 1000 live full-term births. Although neonatal epileptic seizures are observed in up to 60% of cases, PA may mimic or subtend other conditions. Hypoxia related brain injury is particularly relevant, as it may have permanent effects on neuropsychomotor development. Antepartum obstetric conditions, may, in turn, lead to hypoxic-ischemic damage to the fetus and the newborn, often underlying PA. Herein, a case of PA that hid and triggered signs and symptoms of Glutaric Aciduria type I (GA-I), is reported...
January 15, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29330153/heart-failure-in-pregnant-women-a-concern-across-the-pregnancy-continuum
#4
Mulubrhan F Mogos, Mariann R Piano, Barbara L McFarlin, Jason L Salemi, Kylea L Liese, Joan E Briller
BACKGROUND: Heart failure (HF) is a leading cause of maternal morbidity and mortality in the United States, but prevalence, correlates, and outcomes of HF-related hospitalization during antepartum, delivery, and postpartum periods remain unknown. The objective was to examine HF prevalence, correlates, and outcomes among pregnancy-related hospitalizations among women 13 to 49 years of age. METHODS AND RESULTS: We used the 2001 to 2011 Nationwide Inpatient Sample...
January 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29324621/immediate-delivery-compared-with-expectant-management-in-late-preterm-prelabor-rupture-of-membranes-an-individual-participant-data-meta-analysis
#5
Johanna Quist-Nelson, Annemijn A de Ruigh, Anna Lene Seidler, David P van der Ham, Christine Willekes, Vincenzo Berghella, Eva Pajkrt, Jillian Patterson, David Espinoza, Jonathan Morris, Ben Mol, Lisa Askie
OBJECTIVE: To compare the effects of immediate delivery an expectant management among women whose pregnancies were complicated by preterm prelabor rupture of membranes (PROM) in the late preterm period (from 34 0/7 weeks until 36 6/7 weeks of gestation). DATA SOURCES: PubMed, Scopus, ClinicalTrials.gov, EMBASE, and the Cochrane Central Register of Controlled Trials were searched from inception until December 2016. METHODS OF STUDY SELECTION: We included all randomized controlled trials with individual participant data reporting on late preterm PROM with randomization to immediate delivery or expectant management...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29324610/risk-factors-for-the-development-of-obstetric-anal-sphincter-injuries-in-modern-obstetric-practice
#6
Olga Ramm, Victoria G Woo, Yun-Yi Hung, Hsuan-Chih Chen, Miranda L Ritterman Weintraub
OBJECTIVE: To characterize the rate of obstetric anal sphincter injuries and identify key risk factors of obstetric anal sphincter injuries, including duration of the second stage of labor. METHODS: This retrospective cohort study included all singleton, term, cephalic vaginal deliveries within Kaiser Permanente Northern California between January 2013 and December 2014 (N=22,741). Incidence of obstetric anal sphincter injuries, defined as third- or fourth-degree perineal lacerations, was the primary outcome...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29319590/ultrasound-findings-associated-with-antepartum-viral-infection
#7
Jude P Crino, Rita W Driggers
This article reviews the sonographic manifestations of fetal infection and the role of ultrasound in the evaluation of the fetus at risk for congenital infection. Several ultrasound findings have been associated with in utero fetal infections. For the patient with a known or suspected fetal infection, sonographic identification of characteristic abnormalities can provide useful information for counseling and perinatal management. Demonstration of such findings in the low-risk patient may serve to identify the fetus with a previously unsuspected infection...
March 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29310986/multidisciplinary-obstetric-critical-care-delivery-the-concept-of-the-virtual-intensive-care-unit
#8
REVIEW
Michael P Leovic, Hailey N Robbins, Roman S Starikov, Michael R Foley
With an increasing prevalence of chronic medical conditions and the associated potential for decompensation to critical illness among modern day parturients, we present here the concept of the "virtual" intensive care unit. We challenge the traditional association of the word "unit" to extend beyond a fixed physical setting to portray an individualized, predetermined patient care team capable of managing these complex patients in a variety of settings. In this model, obstetric critical care is provided through a multidisciplinary patient care team, with emphasis on early identification of complicated pregnancies, detailed antepartum planning, anticipation of complications, and retrospective review of clinical outcomes aimed at continued quality improvement...
January 5, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29309283/hiv-infection-antepartum-treatment-and-management
#9
Helene B Bernstein, Adam D Wegman
Human immunodeficiency virus (HIV) is a retrovirus which became pandemic in the early 1980s. Since its initial characterization, advancements in diagnosis and management have transformed HIV infection from a terminal diagnosis to a chronic, manageable condition. Effective antiretroviral therapy, acting at multiple steps in the viral lifecycle, durably suppresses viral replication, preserves maternal health and prevents mother to child HIV transmission. Here, we review the salient clinical and ethical considerations of managing HIV infection during pregnancy and delivery...
March 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29306559/differential-associations-of-adverse-childhood-experience-on-maternal-health
#10
Nicole M Racine, Sheri L Madigan, Andre R Plamondon, Sheila W McDonald, Suzanne C Tough
INTRODUCTION: The current study examined whether three distinct antecedent factors related to maternal adverse childhood experiences were differentially associated with maternal health and psychosocial outcomes in the antepartum period. It was hypothesized that all three adverse childhood experience factors would be positively associated with poor health prior to pregnancy, poor reproductive health history, and health complications and psychosocial difficulties during pregnancy. METHODS: Data from 1,994 women (mean age=30...
January 3, 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29306493/delivery-room-resuscitation-and-short-term-outcomes-in-moderately-preterm-infants
#11
Monika Bajaj, Girija Natarajan, Seetha Shankaran, Myra Wyckoff, Abbot R Laptook, Edward F Bell, Barbara J Stoll, Waldemar A Carlo, Betty R Vohr, Shampa Saha, Krisa P Van Meurs, Pablo J Sanchez, Carl T D'Angio, Rosemary D Higgins, Abhik Das, Nancy Newman, Michele C Walsh
OBJECTIVES: To describe the frequency and extent of delivery room resuscitation and evaluate the association of delivery room resuscitation with neonatal outcomes in moderately preterm (MPT) infants. STUDY DESIGN: This was an observational cohort study of MPT infants delivered at 290/7 to 336/7 weeks' gestational age (GA) enrolled in the Neonatal Research Network MPT registry. Infants were categorized into 5 groups based on the highest level of delivery room intervention: routine care, oxygen and/or continuous positive airway pressure, bag and mask ventilation, endotracheal intubation, and cardiopulmonary resuscitation including chest compressions and/or epinephrine use...
January 3, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29305829/meta-analysis-on-the-effect-of-aspirin-use-for-prevention-of-preeclampsia-on-placental-abruption-and-antepartum-hemorrhage
#12
REVIEW
Stephanie Roberge, Emmanuel Bujold, Kypros H Nicolaides
BACKGROUND: Impaired placentation in the first 16 weeks of pregnancy is associated with increased risk of subsequent development of preeclampsia, birth of small for gestational age neonates and placental abruption. Previous studies reported that prophylactic use of aspirin reduces the risk of preeclampsia and small for gestational age neonates with no significant effect on placental abruption. However, meta-analyses of randomized controlled trials examining the effect of aspirin in relation to gestational age at onset of therapy and dose of the drug reported that significant reduction in the risk of preeclampsia and small for gestational age neonates is achieved only if the onset of treatment is at ≤16 weeks of gestation and the daily dose of the drug is ≥100 mg...
January 3, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29289025/impact-of-misclassification-error-in-the-estimation-of-maternal-major-depression-disorder-prevalence-in-home-visitation-programs
#13
Arthur H Owora, Hélène Carabin
The objective of this study was to measure the bias introduced by misclassification error when estimating the prevalence of MDD among mothers in two community-based studies. Baseline data were collected from mothers participating in two home visitation study sites in South Central United States between 2010 and 2014. The operational definition of MDD was a Center of Epidemiological Studies-Depression - Short Form (CESD-SF) score of 10 or higher. Misclassification error was adjusted for using CESD-SF sensitivity and specificity priors that were either antepartum or postpartum specific or non-specific...
December 20, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/29288737/robotic-assisted-laparoscopic-abdominal-cerclage-placement-during-pregnancy
#14
S Kyle Gonzales, C David Adair, Carlos Torres, Eliezer D Rodriguez, Shanti Mohling, Rayan Elkattah, Stephen DePasquale
STUDY OBJECTIVE: The objective of this study is to report our center's series of Robotic-Assisted Laparoscopic Abdominal Cerclage (RALAC) placement during pregnancy. DESIGN: Descriptive study. Canadian Task Force Classification III SETTING: Single academic institution PATIENTS: Patients undergoing Robotic-Assisted Laparoscopic Abdominal Cerclage placement during pregnancy. INTERVENTIONS: Robotic-Assisted Laparoscopic Abdominal Cerclage (RALAC) MEASUREMENTS AND MAIN RESULTS: 11 patients underwent RALAC...
December 27, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29283902/herpesviridae-infection-prevention-screening-and-management
#15
Akila Subramaniam, William J Britt
Bacterial, viral, and parasitic pathogens add significant morbidity and even mortality to pregnancy-with adverse effects extending to both the gravida and the newborn. Three herpesviruses deserve considerable attention given the effects of perinatal infection on obstetric outcomes, specifically maternal and neonatal morbidity. In the following review, we will provide a description of cytomegalovirus, herpes simplex virus, and varicella zoster virus. For each viral pathogen, we will describe the epidemiology, natural history, screening and diagnosis modalities, treatments, and implications for antepartum care...
March 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29280473/the-safety-of-low-molecular-weight-heparin-during-and-after-pregnancy
#16
Eric Lu, Joseph J Shatzel, Jennifer Salati, Thomas G DeLoughery
Importance: In industrialized countries, venous thromboembolism remains a leading cause of mortality in pregnant women. Low-molecular-weight heparin (LMWH) is the most commonly recommended anticoagulant in pregnancy, having been proven effective and safe in multiple prospective clinical trials. Objective: The aim of this article is to outline existing recommendations for proper use of LMWH in pregnancy and data on risks of LMWH. Evidence Acquisition: Wereviewed guidelines froma number of professional societies...
December 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/29279951/hip-osteonecrosis-and-pregnancy-in-healthy-women
#17
Philippe Hernigou, Sibylle Jammal, Jacques Pariat, Charles Henri Flouzat-Lachaniette, Arnaud Dubory
PURPOSE: Osteonecrosis has been reported to be associated with pregnancy in the absence of other known risk factors for the disease. Few population-based data exist to support an association since the association is rare. We investigated the association of the femoral head and pregnancy to define if pregnancy was a risk factor and to define the risk period. METHODS: Using a case-crossover method design among 652 patients who were healthy (without any known cause of osteonecrosis) during or after pregnancy, we defined the periods of risk based on the timing of reported osteonecrosis and pregnancy...
December 26, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29248212/influence-of-conjugated-linoleic-acids-and-vitamin-e-on-biochemical-hematological-and-immunological-variables-of-dairy-cows-during-the-transition-period
#18
S Schäfers, D von Soosten, U Meyer, C Drong, J Frahm, A Tröscher, W Pelletier, H Sauerwein, S Dänicke
The objective of this experiment was to determine the effects of conjugated linoleic acid (CLA) and vitamin E as well as their interaction on biochemical and hematological variables and on leukocyte populations and their functionality. We assigned 59 German Holstein cows between the 2nd and 9th lactation to 4 dietary groups in a 2 × 2 factorial design with the factors CLA and vitamin E. Six weeks before calving the cows had a BCS of 3.7 to provoke a higher risk of developing ketosis, which might impair their immune function...
December 13, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/29232667/correlation-between-subpubic-arch-angle-and-mode-of-delivery-in-large-for-gestational-age-fetuses
#19
Tullio Ghi, Andrea Dall'Asta, Alice Suprani, Elisa Aiello, Andrea Musarò, Costanza Bosi, Giuseppe Pedrazzi, Ariane Kiener, Domenico Arduini, Tiziana Frusca, Giuseppe Rizzo
OBJECTIVES: A narrow subpubic arch angle (SPA) has been associated with a higher risk of operative delivery and prolonged labor. The aim of this study was to evaluate the correlation between SPA and labor outcome in a cohort of women delivering a large-for-gestational-age (LGA) fetus. METHODS: An observational study involving two Italian tertiary centers (Parma and Rome) was carried out. Nulliparous women referred to the antepartum clinic between 35 and 39 weeks due to an increased risk of having an LGA fetus at birth were prospectively selected for the study purpose...
December 13, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29228911/intrapartum-factors-associated-with-neonatal-hypoxic-ischemic-encephalopathy-a-case-controlled-study
#20
Vanessa E Torbenson, Mary Catherine Tolcher, Kate M Nesbitt, Christopher E Colby, Sherif A El-Nashar, Bobbie S Gostout, Amy L Weaver, Michaela E Mc Gree, Abimbola O Famuyide
BACKGROUND: Neonatal encephalopathy (NE) affects 2-4/1000 live births with outcomes ranging from negligible neurological deficits to severe neuromuscular dysfunction, cerebral palsy and death. Hypoxic ischemic encephalopathy (HIE) is the sub cohort of NE that appears to be driven by intrapartum events. Our objective was to identify antepartum and intrapartum factors associated with the development of neonatal HIE. METHODS: Hospital databases were searched using relevant diagnosis codes to identify infants with neonatal encephalopathy...
December 11, 2017: BMC Pregnancy and Childbirth
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