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Maternal morbidity

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https://www.readbyqxmd.com/read/28434087/hepatitis-b-during-pregnancy-in-endemic-areas-screening-treatment-and-prevention-of-mother-to-child-transmission
#1
Naichaya Chamroonkul, Teerha Piratvisuth
The proper management of pregnant women infected with hepatitis B virus (HBV) is necessary to prevent maternal and fetal morbidity and mortality and to protect the baby from HBV infection. In the majority of cases, vertical transmission can be prevented with a universal screening program, HBV vaccine immunoprophylaxis, and administration of hepatitis B immunoglobulin (HBIg) for babies born to mothers with HBV. However, in mothers with a high viral load (>200,000 or >1,000,000 IU/ml, depending on the guideline), the chance of immunoprophylaxis failure remains high...
April 22, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28433732/the-clinical-significance-of-an-estimated-fetal-weight-below-the-10th-centile-a-comparison-of-outcomes-between-5th-versus-5th-9th-centile
#2
Malgorzata Mlynarczyk, Suneet P Chauhan, Hind A Baydoun, Catherine M Wilkes, Kimberly R Earhart, Yili Zhao, Christopher Goodier, Eugene Chang, Nicole M Lee Plenty, E Kaitlyn Mize, Michelle Owens, Shilpa Babbar, Dev Maulik, Emily DeFranco, David McKinney, Alfred Z Abuhamad
BACKGROUND: The association between small for gestational age (SGA; birth weight < 10(th) centile for gestational age) and neonatal morbidity is well established. Yet there is a paucity of data on the relationship between suspected SGA (sonographic estimated fetal weight <10(th) centile), at two thresholds and subsequent neonatal morbidity. OBJECTIVE: The objective of this study was to determine the relationship between sonographic estimated fetal weight (SEFW) < 5(th) centile versus 5-9(th) centile and neonatal morbidity...
April 19, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28433705/maternal-immunisation-collaborating-with-mother-nature
#3
REVIEW
Arnaud Marchant, Manish Sadarangani, Mathieu Garand, Nicolas Dauby, Valerie Verhasselt, Lenore Pereira, Gordean Bjornson, Christine E Jones, Scott A Halperin, Kathryn M Edwards, Paul Heath, Peter J Openshaw, David W Scheifele, Tobias R Kollmann
Maternal immunisation has the potential to substantially reduce morbidity and mortality from infectious diseases after birth. The success of tetanus, influenza, and pertussis immunisation during pregnancy has led to consideration of additional maternal immunisation strategies to prevent group B streptococcus and respiratory syncytial virus infections, among others. However, many gaps in knowledge regarding the immunobiology of maternal immunisation prevent the optimal design and application of this successful public health intervention...
April 19, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28433704/pertussis-and-influenza-immunisation-during-pregnancy-a-landscape-review
#4
REVIEW
Bahaa Abu Raya, Kathryn M Edwards, David W Scheifele, Scott A Halperin
Immunisation during pregnancy is a relatively new strategy, and is currently limited to tetanus, pertussis, and influenza vaccines. None of these vaccines were developed specifically for use in pregnancy, but they provide an effective method of protecting mothers and young infants. In response to increases in pertussis morbidity and mortality among young infants, several countries have recommended universal tetanus, diphtheria, and acellular pertussis immunisation during pregnancy. Similarly, many countries recommend influenza immunisation during pregnancy to reduce the risk of disease for mother and infant...
April 19, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28433702/group-b-streptococcus-and-respiratory-syncytial-virus-immunisation-during-pregnancy-a-landscape-analysis
#5
REVIEW
Paul T Heath, Fiona J Culley, Christine E Jones, Beate Kampmann, Kirsty Le Doare, Marta C Nunes, Manish Sadarangani, Zain Chaudhry, Carol J Baker, Peter J M Openshaw
Group B streptococcus and respiratory syncytial virus are leading causes of infant morbidity and mortality worldwide. No licensed vaccines are available for either disease, but vaccines for both are under development. Severe respiratory syncytial virus disease can be prevented by passively administered antibody. The presence of maternal IgG antibody specific to respiratory syncytial virus is associated with reduced prevalence and severity of respiratory syncytial virus disease in the first few weeks of life, whereas maternal serotype-specific anticapsular antibody is associated with protection against both early-onset and late-onset group B streptococcus disease...
April 19, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28432903/the-decidua-of-preeclamptic-like-bph-5-mice-exhibits-an-exaggerated-inflammatory-response-during-early-pregnancy
#6
C Y Heyward, J L Sones, H E Lob, L C Yuen, K E Abbott, W Huang, Z R Begun, S D Butler, A August, C A Leifer, R L Davisson
Preeclampsia is a devastating complication of pregnancy characterized by late-gestation hypertension and proteinuria. Because the only definitive treatment is delivery of the fetus and placenta, preeclampsia contributes to increased morbidity and mortality of both mother and fetus. The BPH/5 mouse model, which spontaneously develops a syndrome strikingly similar to preeclampsia, displays excessive inflammation and suppression of inflammation improves pregnancy outcomes. During early pregnancy, decidual macrophages play an important role in promoting maternal tolerance to fetal antigens and regulating tissue remodeling, two functions that are critical for normal placental development...
April 10, 2017: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/28432737/outcome-reporting-across-randomised-controlled-trials-evaluating-therapeutic-interventions-for-pre-eclampsia-a-systematic-review
#7
REVIEW
James M N Duffy, Martin Hirsch, Anusuya Kawsar, Chris Gale, Louise Pealing, Maria N Plana, Marian Showell, Paula R Williamson, Khalid S Khan, Sue Ziebland, Richard J McManus
BACKGROUND: Standardising outcome collection and reporting in pre-eclampsia trials requires an appraisal of current outcome reporting. OBJECTIVES: To map maternal and offspring outcome reporting across randomised trials evaluating therapeutic interventions for pre-eclampsia. SEARCH STRATEGY: Randomised trials were identified by searching bibliographical databases from inception to January 2016. SELECTION CRITERIA: Randomised controlled trials...
April 22, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28432736/severe-primary-autoimmune-thrombocytopenia-itp-in-pregnancy-a-national-cohort-study
#8
A Care, S Pavord, M Knight, Z Alfirevic
OBJECTIVE: To quantify UK incidence of severe ITP in pregnancy, determine current treatment strategies and establish maternal and neonatal morbidity and mortality associated with severe ITP in pregnancy. DESIGN: A prospective national cohort study SETTING: United Kingdom POPULATION: Women with severe ITP; defined as platelets <50 x 10(9) /l in pregnancy or antenatal treatment of isolated low platelets. METHODS: Data collected via United Kingdom Obstetric Surveillance System (UKOSS) between 1(st) June 2013-31(st) January 2015 from all UK Consultant led obstetric units...
April 22, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28431858/third-trimester-preterm-and-term-premature-rupture-of-membranes-is-there-any-difference-in-maternal-characteristics-and-pregnancy-outcomes
#9
Ivana Chandra, Lizhou Sun
BACKGROUND: The clinical significance and management of preterm premature rupture of membranes (PPROM) remains a topic of a controversy. Although PROM is associated with a low rate of complications, PPROM may lead to significant neonatal and maternal morbidity. METHODS: We performed a retrospective study of 714 women who presented to Jiangsu Province Hospital with third trimester PPROM or PROM between January and December 2015. The data were analyzed by SPSS; the significance of maternal characteristics, and maternal and neonatal outcomes were tested using Student's t test and the χ(2) test...
April 18, 2017: Journal of the Chinese Medical Association: JCMA
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
#10
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/28426160/assessment-and-support-during-early-labour-for-improving-birth-outcomes
#11
REVIEW
Shinobu Kobayashi, Nobutsugu Hanada, Masayo Matsuzaki, Kenji Takehara, Erika Ota, Hatoko Sasaki, Chie Nagata, Rintaro Mori
BACKGROUND: The progress of labour in the early or latent phase is usually slow and may include painful uterine contractions. Women may feel distressed and lose their confidence during this phase. Support and assessment interventions have been assessed in two previous Cochrane Reviews. This review updates and replaces these two reviews, which have become out of date. OBJECTIVES: To investigate the effectiveness of assessment and support interventions for women during early labour...
April 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28426127/postpartum-hypertension-etiology-diagnosis-and-management
#12
Kathryn J Sharma, Sarah J Kilpatrick
Importance: Postpartum hypertension complicates approximately 2% of pregnancies and, similar to antepartum severe hypertension, can have devastating consequences including maternal death. Objective: This review aims to increase the knowledge and skills of women's health care providers in understanding, diagnosing, and managing hypertension in the postpartum period. Results: Hypertension complicating pregnancy, including postpartum, is defined as systolic blood pressure 140 mm Hg or greater and/or diastolic blood pressure 90 mm Hg or greater on 2 or more occasions at least 4 hours apart...
April 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28425765/the-prevention-and-treatment-of-venous-thromboembolism-in-pregnancy
#13
Michela Villani, Walter Ageno, Elvira Grandone, Francesco Dentali
Venous thromboembolism (VTE) in pregnancy represents an important cause of maternal morbidity and mortality in developed countries, with an incidence of 0.5-2.2 per 1000 pregnancies. In addition to haemostatic occurring during normal pregnancy, several risk factors have been identified. Thus, a variety of clinical conditions as well as fetal and maternal risks linked to a possible anticoagulant therapy should be considered for the management of VTE during pregnancy. Unfortunately, there is a paucity of high-quality evidence from randomized trials in this field, and current recommendations are based on observational studies or evidence gathered from studies in the non-pregnant population...
April 20, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28425011/pregnancy-related-myocardial-infarction
#14
H Lameijer, M C Lont, H Buter, A J van Boven, P W Boonstra, P G Pieper
INTRODUCTION: The risk of acute myocardial infarction in young women is low, but increases during pregnancy due to the physiological changes in pregnancy, including hypercoagulability. Ischaemic heart disease during pregnancy is not only associated with increased maternal morbidity and mortality, but also with high neonatal complications. Advancing maternal age and other risk factors for cardiovascular diseases may further increase the risk of ischaemic heart disease in young women. METHODS: We searched the coronary angiography database of a Dutch teaching hospital to identify women with acute myocardial infarction who presented during pregnancy or postpartum between 2011 and 2013...
April 19, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28424444/a-successful-cesarean-delivery-without-fetal-or-maternal-morbidity-in-an-eisenmenger-patient-with-cor-triatriatum-sinistrum-double-orifice-mitral-valve-large-ventricular-septal-defect-and-single-ventricle-who-was-under-long-term-bosentan-treatment
#15
Hacer Ceren Tokgöz, Cihangir Kaymaz, Nertila Poci, Özgür Yaşar Akbal, Selçuk Öztürk
Presently described is successful cesarean delivery in a pregnancy superimposed on long-term bosentan treatment in an Eisenmenger syndrome patient with cor triatriatum sinistrum, double-orifice mitral valve, and large ventricular septal defect resulting in single functioning ventricle with double outlets. Cesarean delivery was performed at 27th week of gestation without maternal or fetal morbidity. The infant had no congenital cardiovascular abnormality or any probable teratogenic effect of bosentan treatment during pregnancy...
March 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28424287/protective-efficacy-of-formaldehyde-inactivated-whole-virus-vaccine-and-antivirals-in-a-murine-model-of-coxsackievirus-a10-infection
#16
Zhenjie Zhang, Zhaopeng Dong, Juan Li, Michael J Carr, Dongming Zhuang, Jianxing Wang, Yawei Zhang, Shujun Ding, Yigang Tong, Dong Li, Weifeng Shi
Coxsackievirus A10 (CVA10) is one of the major pathogens associated with hand, foot and mouth disease (HFMD). CVA10 infection can cause herpangina and viral pneumonia, which can be complicated by severe neurological sequelae. Morbidity and mortality of CVA10-associated HFMD has been increasing in recent years, particularly in the pan-Pacific region. There are limited studies however on the pathogenesis and immunology of CVA10-associated HFMD infections, and few antiviral drugs or vaccines have been reported...
April 19, 2017: Journal of Virology
https://www.readbyqxmd.com/read/28421146/breastfeeding-after-gestational-diabetes-does-perceived-benefits-mediate-the-relationship
#17
Jordyn T Wallenborn, Robert A Perera, Saba W Masho
Introduction. Breastfeeding is recognized as one of the best ways to decrease infant mortality and morbidity. However, women with gestational diabetes mellitus (GDM) may have breastfeeding barriers due to the increased risk of neonatal and pregnancy complications. While the prevalence of GDM is increasing worldwide, it is important to understand the full implications of GDM on breastfeeding outcomes. The current study aims to investigate the (1) direct effect of GDM on breastfeeding duration and (2) indirect effect of GDM on breastfeeding duration through perceived benefits of breastfeeding...
2017: Journal of Pregnancy
https://www.readbyqxmd.com/read/28421136/time-from-pre-eclampsia-diagnosis-to-delivery-affects-future-health-prospects-of-children
#18
Birgitte Hollegaard, Jacob A Lykke, Jacobus J Boomsma
Background and objectives: Pre-eclampsia often has detrimental health effects for pregnant women and their fetuses, but whether exposure in the womb has long-term health-consequences for children as they grow up remains poorly understood. We assessed overall morbidity of children following exposure to either mild or severe pre-eclampsia up to 30 years after birth and related disease risks to duration of exposure, i.e. the time from diagnosis to delivery. Methodology: We did a registry-based retrospective cohort study in Denmark covering the years 1979-2009, using the separate diagnoses of mild and severe pre-eclampsia and the duration of exposure as predictor variables for specific and overall risks of later disease...
2017: Evolution, Medicine, and Public Health
https://www.readbyqxmd.com/read/28419948/genetic-generalized-epilepsy-in-three-siblings-with-8q21-13-q22-2-duplication
#19
Arezoo Rezazadeh, Felippe Borlot, Hanna Faghfoury, Danielle M Andrade
PURPOSE: Duplication of chromosome region 8q21-q22 is a rare copy number variant that has been previously reported in a limited number of patients. Although some of these patients had seizures, their electroclinical syndrome has not been described in detail. The aim of this study was to provide further insight into the specific epilepsy syndrome associated with 8q21.13-q22.2 duplication. METHOD: We describe 3 siblings with trisomy of 8q21.13-q22.2 who exhibited intellectual disability, facial dysmorphism and seizures...
April 11, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28418067/a-case-series-of-vital-signs-controlled-patient-assisted-intravenous-analgesia-vpia-using-remifentanil-for-labour-and-delivery
#20
W L Leong, B L Sng, Q Zhang, N L R Han, R Sultana, A T H Sia
Intravenous remifentanil patient-controlled analgesia can be used during labour as an alternative to epidural analgesia. Adverse effects of opioids, including hypoxia and bradycardia, may lead to maternal morbidity and mortality. We devised an interactive feedback system based on a clinical proportional algorithm, to continuously monitor for adverse effects to enhance safety and better titrate analgesia. This vital signs-controlled, patient-assisted intravenous analgesia with remifentanil used a prototype delivery system linked to a pulse oximeter that evaluated maternal oxygen saturation and heart rate continuously...
April 18, 2017: Anaesthesia
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