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https://www.readbyqxmd.com/read/28937572/obstetric-care-consensus-no-6-periviable-birth
#1
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937567/obstetric-care-consensus-no-6-summary-periviable-birth
#2
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28927395/detection-and-risk-stratification-of-women-at-high-risk-of-preterm-birth-in-rural-communities-near-nagpur-india
#3
Archana Patel, Amber Abhijeet Prakash, Yamini V Pusdekar, Hemant Kulkarni, Patricia Hibberd
BACKGROUND: Presently, preterm birth is globally the leading cause of neonatal mortality. Prompt community based identification of women at high risk for preterm births (HRPB) can either help to avert preterm births or avail effective interventions to reduce neonatal mortality due to preterm births. We evaluated the performance of a package to train community workers to detect the presence of signs or symptoms of HRPB. METHODS: Pregnant women enrolled in the intervention arm of a cluster randomized trial of Antenatal Corticosteroids (ACT Trial) conducted at Nagpur, India were informed about 4 directly observable signs and symptoms of preterm labor...
September 19, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28903611/maternal-leukocytosis-after-antenatal-corticosteroid-administration-a-systematic-review-and-meta-analysis
#4
Melissa E Bauer, Laura K Price, Mark P MacEachern, Michelle Housey, Elizabeth S Langen, Samuel T Bauer
Although it is known that corticosteroid administration causes leukocytosis, the magnitude and length of time this leukocytosis persists is unknown during pregnancy. This study aimed to establish the expected range of maternal leukocytosis in healthy pregnant women at risk for preterm delivery after antenatal corticosteroid administration. PubMed, Embase and ClinicalTrials.gov were searched to identify the studies in healthy women at risk for preterm delivery without signs of clinical infection that reported white blood cell values preceding and after antenatal corticosteroid administration...
September 14, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28875885/a-review-of-antenatal-corticosteroid-use-in-premature-neonates-in-a-middle-income-country
#5
A Laher, D E Ballot, T Ramdin, T Chirwa
BACKGROUND: Antenatal corticosteroid (ANS) use in premature neonates has become a standard of practice. However, there is low ANS coverage in low- to middle-income countries (LMICs). Recent studies have questioned the efficacy of ANSs in such countries. OBJECTIVE: To review the use of ANSs in preterm neonates at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), South Africa. METHODS: This was a retrospective observational study of all neonates with a birth weight of 500 - 1 800 g born at CMJAH between 1 January 2013 and 30 June 2016...
August 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28862773/trends-in-outcomes-of-very-preterm-infants-in-romania-a-tale-of-three-cities
#6
Laura Mihaela Suciu, Lucian Puscasiu, Manuela Cucerea, Bela Szabo, Maria Livia Ognean, Olimpia Petrescu, Dan Ștefan Sîmpălean, Edward F Bell
BACKGROUND: Although survival of preterm infants has improved, prematurity remains the second-leading cause of death before 5 years of age in Romania. Data on the changing mortality of Romanian preterm infants born before 29 weeks of gestation have not been available. METHODS: We performed the present study to compare outcomes of infants of gestational age 25-28 weeks born in 2007-2010 (n=247) with those born in 2011-2014 (n=235). Data were analyzed from 3 tertiary neonatal intensive care centers...
September 1, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28859764/no-347-obstetric-management-at-borderline-viability
#7
Noor Niyar N Ladhani, Radha S Chari, Michael S Dunn, Griffith Jones, Prakesh Shah, Jon F R Barrett
OBJECTIVE: The primary objective of this guideline was to develop consensus statements to guide clinical practice and recommendations for obstetric management of a pregnancy at borderline viability, currently defined as prior to 25+6 weeks. INTENDED USERS: Clinicians involved in the obstetric management of women whose fetus is at the borderline of viability. TARGET POPULATION: Women presenting for possible birth at borderline viability. EVIDENCE: This document presents a summary of the literature and a general consensus on the management of pregnancies at borderline viability, including maternal transfer and consultation, administration of antenatal corticosteroids and magnesium sulfate, fetal heart rate monitoring, and considerations in mode of delivery...
September 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28858117/exacerbation-of-primary-intestinal-lymphangiectasia-during-late-pregnancy-and-recovery-after-delivery-a-case-report-and-literature-review
#8
REVIEW
Jianyang Lu, Hongbo Zhai
RATIONALE: Primary intestinal lymphangiectasia (PIL) is a rare disease characterized by dilated intestinal lacteals resulting in lymph leakage into the small bowel lumen. Main clinical features include intermittent diarrhea, hypoproteinemia. Scattered case reports suggested that PIL is compatible to pregnancy, but with increased complications. PATIENT CONCERNS: A 34-year-old woman with endoscopically diagnosed PIL presented to antenatal our clinic at 10 weeks into gestation...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28856015/antenatal-corticosteroid-treatment-for-the-prevention-of-peri-intraventricular-haemorrhage-in-preterm-newborns-a-retrospective-cohort-study-using-transfontanelle-ultrasonography
#9
Bianca A Almeida, Livia T Rios, Edward Araujo Júnior, Luciano M Nardozza, Antonio F Moron, Marília G Martins
OBJECTIVE: The objective of this study was to assess the correlation between antenatal corticosteroids and peri-intraventricular haemorrhage (PIVH) using transfontanelle ultrasonography, as well as to evaluate the risk factors for its incidence. METHODS: We performed a retrospective cohort study using medical records of preterm newborns. The protocol for maternal corticoid administration for foetal lung maturation included dexamethasone 4 mg (intramuscular) 8/8 hours per 48 hours, with one cycle per week...
June 2017: Journal of Ultrasonography
https://www.readbyqxmd.com/read/28822438/-effect-of-antenatal-corticosteroids-therapy-on-the-mortality-and-morbidity-of-small-for-gestational-age-infants-born-at-24-34-completed-weeks-a-retrospective-multicenter-study
#10
(no author information available yet)
Objective: To assess the impact of antenatal corticosteroids (ACS) therapy on mortality and morbidities in small for gestational age (SGA) preterm infants. Method: A retrospective database analysis was performed. Preterm infants born at 24-34 completed weeks who were diagnosed as SGA in 14 hospitals in China between 2013 and 2014 were evaluated for mortality and major morbidities including respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), necrotising enterocolitis (NEC), retinopathy of prematurity (ROP), patent ductus arteriosus (PDA) and sepsis...
August 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28796691/neonatal-outcomes-of-low-risk-late-preterm-twins-compared-with-late-preterm-singletons
#11
COMPARATIVE STUDY
Shimrit Yaniv Salem, Mia Kibel, Elizabeth Asztalos, Arthur Zaltz, Jon Barrett, Nir Melamed
OBJECTIVE: To test the hypothesis that the risk of neonatal morbidity among late-preterm twins is similar to that of late-preterm singletons. METHODS: We conducted a retrospective cohort study of all women with twin or singleton pregnancy who gave birth during the late-preterm period in a single tertiary center between 2008 and 2015. Neonatal outcomes of low-risk, late-preterm twins were compared with those of low-risk, late-preterm singletons. The primary outcome was the same primary composite respiratory morbidity variable that was used in the randomized controlled trial of Gyamfi-Bannerman et al on the administration of antenatal corticosteroids during the late-preterm period...
September 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28782409/association-between-antenatal-corticosteroids-and-neonatal-hypoglycemia-in-indicated-early-preterm-births
#12
Spencer G Kuper, Sima H Baalbaki, Melissa M Parrish, Victoria C Jauk, Alan T Tita, Lorie M Harper
PURPOSE: We sought to determine if administration of antenatal corticosteroids in early preterm births (<34 weeks) is associated with an increased risk of developing neonatal hypoglycemia (<40 mg/dL) within the first 48 h of neonatal life. MATERIALS AND METHODS: Retrospective cohort of all indicated singleton preterm births (23-34 weeks) in a single tertiary center from 2011 to 2014. The primary outcome was neonatal hypoglycemia (<40 mg/dL) within the first 48 h of life...
August 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28771408/promoting-early-child-development-with-interventions-in-health-and-nutrition-a-systematic-review
#13
REVIEW
Tyler Vaivada, Michelle F Gaffey, Zulfiqar A Bhutta
CONTEXT: Although effective health and nutrition interventions for reducing child mortality and morbidity exist, direct evidence of effects on cognitive, motor, and psychosocial development is lacking. OBJECTIVE: To review existing evidence for health and nutrition interventions affecting direct measures of (and pathways to) early child development. DATA SOURCES: Reviews and recent overviews of interventions across the continuum of care and component studies...
August 2017: Pediatrics
https://www.readbyqxmd.com/read/28767132/antenatal-corticosteroid-prophylaxis-in-singleton-and-multiple-pregnancies
#14
Luigi Gagliardi, Renato Lucchini, Roberto Bellù, Rinaldo Zanini
BACKGROUND: The effects of antenatal corticosteroids (ANS) in multiple pregnancies are disputed. In this article, we examined whether estimated effects differ in singletons and multiples and in small for gestational age (SGA) preterm infants. METHODS: We studied 17 073 singletons (81% treated with ANS) and 8274 multiples (86% treated) born at 24-33 weeks from the Italian Neonatal Network (2005-2013). We used Poisson regression models with robust variance to estimate adjusted risk ratios (RR) of in-hospital death, severe intraventricular haemorrhage (IVH), periventricular leukomalacia (PVL), and the composite outcome of severe IVH and death...
August 2, 2017: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/28746032/early-mortality-and-morbidity-in-infants-with-birth-weight-of-500-grams-or-less-in-japan
#15
Hirosuke Inoue, Masayuki Ochiai, Kazuaki Yasuoka, Koichi Tanaka, Hiroaki Kurata, Junko Fujiyoshi, Yuki Matsushita, Shutaro Suga, Kazuaki Nonaka, Tomoaki Taguchi, Kiyoko Kato, Shouichi Ohga
OBJECTIVE: To assess the short-term prognosis of Japanese infants with a birth weight (BW) of ?500?g. STUDY DESIGN: Demographic and clinical data were reviewed for 1473 live born infants with a BW ?500?g at gestational age ?22 weeks who were treated in the 204 affiliated hospitals of the Neonatal Research Network of Japan between 2003 and 2012. RESULTS: Survival to hospital discharge occurred in 811 of 1473 infants (55%; 95% CI 53%-58%). The survival rates of BW ?300?g, 301-400?g, and 401-500?g were 18% (95% CI 10%-31%), 41% (95% CI 36%-47%), and 60% (95% CI 57%-63%), respectively...
June 1, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28742678/committee-opinion-no-713-antenatal-corticosteroid-therapy-for-fetal-maturation
#16
(no author information available yet)
Corticosteroid administration before anticipated preterm birth is one of the most important antenatal therapies available to improve newborn outcomes. A single course of corticosteroids is recommended for pregnant women between 24 0/7 weeks and 33 6/7 weeks of gestation who are at risk of preterm delivery within 7 days, including for those with ruptured membranes and multiple gestations. It also may be considered for pregnant women starting at 23 0/7 weeks of gestation who are at risk of preterm delivery within 7 days, based on a family's decision regarding resuscitation, irrespective of membrane rupture status and regardless of fetal number...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742672/committee-opinion-no-713-summary-antenatal-corticosteroid-therapy-for-fetal-maturation
#17
(no author information available yet)
Corticosteroid administration before anticipated preterm birth is one of the most important antenatal therapies available to improve newborn outcomes. A single course of corticosteroids is recommended for pregnant women between 24 0/7 weeks and 33 6/7 weeks of gestation who are at risk of preterm delivery within 7 days, including for those with ruptured membranes and multiple gestations. It also may be considered for pregnant women starting at 23 0/7 weeks of gestation who are at risk of preterm delivery within 7 days, based on a family's decision regarding resuscitation, irrespective of membrane rupture status and regardless of fetal number...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28716807/antenatal-corticosteroid-administration-between-24-hours-and-7-days-before-extremely-preterm-delivery-is-associated-with-the-lowest-rate-of-mortality
#18
Colm P Travers, Waldemar A Carlo
No abstract text is available yet for this article.
July 17, 2017: Evidence-based Medicine
https://www.readbyqxmd.com/read/28714111/room-for-improvement-in-breast-milk-feeding-after-very-preterm-birth-in-europe-results-from-the-epice-cohort
#19
Emilija Wilson, Anna-Karin Edstedt Bonamy, Mercedes Bonet, Liis Toome, Carina Rodrigues, Elizabeth A Howell, Marina Cuttini, Jennifer Zeitlin
Breast milk feeding (BMF) is associated with lower neonatal morbidity in the very preterm infant (<32 weeks gestation) and breastfeeding is beneficial for maternal health. Previous studies show large variations in BMF after very preterm birth and recognize the need for targeted breastfeeding support in the neonatal intensive care units (NICU). In a European collaboration project about evidence-based practices after very preterm birth, we examined the association between maternal, obstetric, and infant clinical factors; neonatal and maternal care unit policies; and BMF at discharge from the NICU...
July 17, 2017: Maternal & Child Nutrition
https://www.readbyqxmd.com/read/28693356/contemporary-practice-patterns-in-the-use-of-amniocentesis-for-fetal-lung-maturity
#20
Kevin C Visconti, Emily DeFranco, Beena D Kamath-Rayne
PURPOSE: Fetal lung maturity (FLM) testing has been performed to help direct delivery timing in complex obstetrical conditions. We explored current practice patterns of FLM testing attempting to identify factors affecting its use. MATERIALS AND METHODS: We distributed a 31-question survey to obstetricians and perinatologists that examined practice characteristics potentially affecting FLM usage. Logistic regression measured associations between these factors and test utilization...
July 25, 2017: Journal of Maternal-fetal & Neonatal Medicine
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