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Maternal morbidity

Joseph Ting, Ashley Roberts, Anne Synnes, Roderick Canning, Jaya Bodani, Luis Monterossa, Prakesh S Shah
BACKGROUND: Neonatal fungaemia is associated with adverse neonatal outcomes and higher overall healthcare expenditure. Our objective is to review the epidemiology of invasive fungal infections (IFIs) in neonates in Canada. METHODS: A retrospective cohort study using data collected by the Canadian Neonatal Network (CNN) was conducted. Using a nested matched cohort study design, risk factors and outcomes of neonates born <33 weeks gestation (n=39,305) during 2003-2013 were compared between neonates diagnosed with an IFI during their stay to infection-free controls...
March 15, 2018: Pediatric Infectious Disease Journal
Raghad Mubarak Aljuhaysh, Nagah Mohamed Abo El-Fetoh, Malak Ibrahim Alanazi, Afaf Shuaib Albaqawi, Wafa Mohammed Alanazi, Najah Salah Alanazi, Reham Muqbil Alanazi, Atheer Mutab Alanazi, Eiman Mohammad Alnemer, Rahma Abdulhadi Alenezi, Tasleem Khoudier Alabdullatif, Rehab Abdallah Alanazi, Samiyah Sarhan Alanazi, Kawthar Saeed Alsultan, Ibtisam Matan Alanazi, Duaa Sami Alsunayni
Background and aim: Rh isoimmunization still contributes to the neonatal morbidity and mortality due to non-immunization, under-immunization, and in rare cases, false Rh typing. The main objective of this study was to determine the prevalence of Rh incompatibility, mothers' knowledge about Rh incompatibility, mothers' knowledge about anti-D immunoglobulin and to show the pregnancy outcome of Rh negative mothers. Methods: A cross-sectional study was carried out at the Maternity and Children Hospital in Arar city from November 2016 to May 2017...
December 2017: Electronic Physician
Flor M Munoz
Maternal immunization has the potential to significantly improve maternal and child health worldwide by reducing maternal and infant morbidity and mortality associated with disease caused by pathogens that are particularly relevant in the perinatal period and in early life, and for which no alternative effective preventive strategies exist. Research on all aspects related to vaccines for administration during pregnancy is ongoing with support of multiple stakeholders and global participation. Substantial progress has been made, and the availability of new vaccines licensed exclusively for use in pregnant women to protect their infants has become an achievable goal...
2018: Frontiers in Immunology
Berna Aslan Cetin, Begum Aydogan Mathyk, Alev Atis Aydin, Nadiye Koroglu, Pinar Yalcin Bahat, Ilkbal Temel Yuksel, Elif Goknur Topcu, Ismail Ozdemir
BACKGROUND: Postpartum hemorrhage (PPH) is one of the leading causes of maternal morbidity and mortality around the world. Medical treatments and uterus-sparing interventions including balloon tamponades and compression sutures are the first line options before the decision is made to perform a hysterectomy. Our aim is to compare the success rates of the Hayman compression suture and the Bakri balloon tamponade in patients with PPH. METHODS: We enrolled 82 patients who were diagnosed with uterine atony during their cesarean sections and failed to respond to uterotonic agents...
March 20, 2018: Journal of Maternal-fetal & Neonatal Medicine
Junko Yasuoka, Keiko Nanishi, Kimiyo Kikuchi, Sumihiro Suzuki, Po Ly, Boukheng Thavrin, Tsutomu Omatsu, Tetsuya Mizutani
BACKGROUND: Maternal morbidity and mortality is still a major public health issue in low- and middle-income countries such as Cambodia. Improving access to antenatal care (ANC) services for pregnant women has been widely recognized as one of the most effective means of reducing maternal mortality and morbidity. As such, this study examined the barriers for pregnant women living in rural, agricultural villages to accessing ANC based on data collected in the Ratanakiri province, one of the least developed provinces in Cambodia, using a combination of a community-based cross-sectional survey and a geographic information system (GIS)...
2018: PloS One
Olivia Falconer, Marie-Louise Newell, Christine E Jones
The success of prevention of mother to child transmission programs over the last two decades has led to an increasing number of infants who are exposed to human immunodeficiency virus (HIV), but who are not themselves infected (HIV-exposed, uninfected infants). Although the morbidity and mortality among HIV-exposed, uninfected infants is considerably lower than that among HIV-infected infants, they may remain at increased risk of infections in the first 2 years of life compared with their HIV-unexposed peers, especially in the absence of breastfeeding...
2018: Frontiers in Immunology
M Migda, M S Migda, B Migda, E Wender-Ozegowska
Metabolic syndrome (MS) and obesity is an important risk factor for fetal complications like excessive fetal growth manifested by large for gestational age (LGA) and macrosomia, which is a consequence of metabolic disturbances present in the first trimester of pregnancy. The aim of this prospective observational study is to analyze the relationship between the first trimester biochemical and anthropometric parameters of fetuses with the incidence of their macrosomia and LGA so to early predict such complications in women with symptoms of MS...
December 2017: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
Minerva Kyei-Onanjiri, Mary Carolan-Olah, John Koku Awoonor-Williams, Terence V McCann
BACKGROUND: Maternal morbidity and mortality is most prevalent in resource-poor settings such as sub-Saharan Africa and southern Asia. In sub-Saharan Africa, Ghana is one of the countries still facing particular challenges in reducing its maternal morbidity and mortality. Access to emergency obstetric care (EmOC) interventions has been identified as a means of improving maternal health outcomes. Assessing the range of interventions provided in health facilities is, therefore, important in determining capacity to treat obstetric emergencies...
March 15, 2018: BMC Health Services Research
Sophie Vincent, Nicholas Czuzoj-Shulman, Andrea R Spence, Haim A Abenhaim
OBJECTIVE: To examine the association between pre-pregnancy body mass index (BMI) and neonatal respiratory-related outcomes among women who underwent an elective cesarean section (CS). METHODS: A retrospective cohort study was conducted using the Centers for Disease Control and Prevention (CDC)'s 2009-2013 period linked birth/infant death dataset. Women who had elective CSs at term were categorized by their pre-pregnancy BMI as normal, overweight, obese or morbidly obese...
March 15, 2018: Journal of Perinatal Medicine
Gabriella Bröms, Ann Haerskjold, Fredrik Granath, Helle Kieler, Lars Pedersen, Ingegärd A Berglind
Studies on pregnancy and birth outcomes in women with psoriasis are scarce and the findings inconsistent. The effect of maternal psoriasis and its severity on the risk of adverse pregnancy and birth outcomes was examined. A cross-national population-based cohort study was performed using prospectively collected data from Denmark and Sweden. Singleton births in women with psoriasis were identified in the national health registers between April 2007 and December 2012 and classified according to disease severity...
March 15, 2018: Acta Dermato-venereologica
Marcelo R Luizon, Daniela A Pereira, Valeria C Sandrim
Hypertension is a leading cause of cardiovascular mortality, but only about half of patients on antihypertensive therapy achieve blood pressure control. Preeclampsia is defined as pregnancy-induced hypertension and proteinuria, and is associated with increased maternal and perinatal mortality and morbidity. Similarly, a large number of patients with preeclampsia are non-responsive to antihypertensive therapy. Pharmacogenomics may help to guide the personalized treatment for non-responsive hypertensive patients...
2018: Frontiers in Pharmacology
Dilek Uysal, Hakan Cokmez, Cetin Aydin, Tolga Ciftpinar
Postpartum haemorrhage is the most important cause of maternal morbidity and mortality, especially when all conservative measures, including syntometrine oxytocin and Bakri balloons have failed to accomplish haemostasis and expeditious surgical procedures, such as uterine artery ligation and emergency peripartum hysterectomy (EPH) are required. This retrospective study analysed 31 cases of EPH performed between January 2007 and January 2016 in the Department of Gynecology and Obstetrics of Izmir Ataturk Teaching and Research Hospital...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Beatriz Paulina Ayala Quintanilla, Wendy E Pollock, Susan J McDonald, Angela J Taft
INTRODUCTION: Preventing and reducing violence against women (VAW) and maternal mortality are Sustainable Development Goals. Worldwide, the maternal mortality ratio has fallen about 44% in the last 25 years, and for one maternal death there are many women affected by severe acute maternal morbidity (SAMM) requiring management in the intensive care unit (ICU). These women represent the most critically ill obstetric patients of the maternal morbidity spectrum and should be studied to complement the review of maternal mortality...
March 14, 2018: BMJ Open
Shefaly Shorey, Cornelia Chee, Yap-Seng Chong, Esperanza Debby Ng, Ying Lau, Cindy-Lee Dennis
BACKGROUND: Multiple international agencies, including the World Health Organization and the International Monetary Fund, have emphasized the importance of maternal mental health for optimal child health and development. Adequate social support is vital for the most vulnerable to postpartum mood disorders. Hence, an urgent need for sustainable social support programs to aid mothers ease into their new parenting role exists. OBJECTIVE: This study protocol aims to examine the effectiveness of a technology-based peer support intervention program among mothers at risk for postnatal depression in the early postpartum period...
March 14, 2018: JMIR Research Protocols
Silvia de Souza Campos Fernandes, Dirceu Solé, Paulo Camargos, Cláudia Ribeiro de Andrade, Cássio da Cunha Ibiapina
OBJECTIVE: To evaluate risk factors associated with asthma symptoms in adolescents in the 13- to 14-year age bracket. METHODS: This was a cross-sectional study involving adolescents enrolled in randomly selected public schools in the city of Belo Horizonte, Brazil, and conducted with the use of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and its supplementary module for risk factor assessment. The ISAAC questionnaire was completed by the students themselves, whereas the supplementary questionnaire was completed by their parents or legal guardians...
January 2018: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
Vanessa Bueno-Lopez, Carmen Fuentelsaz-Gallego, Manel Casellas-Caro, Ana Maria Falgueras-Serrano, Silvia Crespo-Berros, Ana Maria Silvano-Cocinero, Carolina Alcaine-Guisado, Manuela Zamoro Fuentes, Elena Carreras, Carmen Terré-Rull
BACKGROUND: Fetal occiput posterior position in labor is associated with more painful and prolonged labor, and an increase in both maternal and fetal morbidity. The aim of this study is to assess whether the modified Sims position on the side of the fetal spine increases the rotation to occiput anterior position in women with epidural analgesia and a fetus in persistent occiput posterior (POP) position. METHODS: This is an open, randomized controlled, clinical trial...
March 14, 2018: Birth
Semih Zeki Uludag, Mehmet Serdar Kutuk, Mehmet Dolanbay, Mahmut Tuncay Ozgun, Gunel Eliyeva, Ozguc Altun
The aim of this study was to compare the effect of local intracavitary methotrexate (MTX) injection and laparoscopic (L/S) cornuostomy in the treatment of interstitial pregnancy (IP) in terms of clinical and reproductive outcome. The data of patients with IP (n:10) who were treated between September 2011 and December 2016 with either an intra-amniotic MTX injection (n:7) or L/S cornuostomy (n:3) were retrospectively evaluated. All cases (7/7) in the local injection group and two (2/3) in the L/S group were successfully treated with the initial treatment...
March 14, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Eva Nüsken, Jörg Dötsch, Lutz T Weber, Kai-Dietrich Nüsken
Chronic kidney disease affects more than 10% of the population. Programming studies have examined the interrelationship between environmental factors in early life and differences in morbidity and mortality between individuals. A number of important principles has been identified, namely permanent structural modifications of organs and cells, long-lasting adjustments of endocrine regulatory circuits, as well as altered gene transcription. Risk factors include intrauterine deficiencies by disturbed placental function or maternal malnutrition, prematurity, intrauterine and postnatal stress, intrauterine and postnatal overnutrition, as well as dietary dysbalances in postnatal life...
2018: Frontiers in Pediatrics
Ross W McQuivey, Jon E Block, Robert A Massaro
As a leading cause of maternal death, postpartum hemorrhage (PPH) remains a worldwide obstetrical problem. However, in most cases, mortality and morbidity can be averted if efforts are immediately undertaken to achieve hemostasis. Uterine balloon tamponade has been shown to provide effective control of PPH and avoid more invasive surgical procedures and even the emergency peripartum hysterectomy. Recent clinical recommendation suggests that balloon tamponade should be considered earlier in the treatment cascade in conjunction with uterotonic agents to ensure hemostasis in the most timely fashion and maximize clinical outcomes...
2018: Medical Devices: Evidence and Research
Efrain Riveros-Perez, Amy C Hermesch, Linda A Barbour, Joy L Hawkins
Aplastic anemia is a hematologic condition occasionally presenting during pregnancy. This pathological process is associated with significant maternal and neonatal morbidity and mortality. Obstetric and anesthetic management is challenging, and treatment requires a coordinated effort by an interdisciplinary team, in order to provide safe care to these patients. In this review, we describe the current state of the literature as it applies to the complexity of aplastic anemia in pregnancy, focusing on pathophysiologic aspects of the disease in pregnancy, as well as relevant obstetric and anesthetic considerations necessary to treat this challenging problem...
2018: International Journal of Women's Health
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