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https://www.readbyqxmd.com/read/27888446/cesarean-section-in-the-setting-of-severe-pulmonary-hypertension-requiring-extracorporeal-life-support
#1
Ryosuke Hara, Shuhei Hara, Chin Siang Ong, Gary Schwartz, Christopher Sciortino, Narutoshi Hibino
We describe the use of veno-arterial extracorporeal membrane oxygenation (ECMO) in a 35-year-old female with severe fixed pulmonary hypertension who went into cardiogenic shock during a Cesarean section. Pregnancy in the presence of severe pulmonary hypertension is typically contraindicated due to high maternal mortality rates. This patient visited our hospital at 37 weeks of gestation after experiencing dyspnea and chest pain. Clinical evaluation revealed severe fixed pulmonary hypertension. At the time of the planned delivery, femoral lines were placed; in case of emergency, ECMO became necessary during the delivery...
November 25, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27726918/anaesthetic-management-of-parturients-with-univentricular-congenital-heart-disease-and-the-fontan-operation
#2
R S Monteiro, D P Dob, M R Cauldwell, M A Gatzoulis
Women with a single ventricle circulation palliated with the Fontan operation require specialist multidisciplinary management. We report 14 such cases with successful pregnancies and detail the pathophysiology encountered. A combined obstetric and cardiac service between Chelsea and Westminster Hospital and Royal Brompton Hospital provides care for women with heart disease, and maintains a prospective database of referred women. We searched this database for women with a known Fontan circulation and reviewed the case notes and electronic patient records between January 1994 and December 2015...
December 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27697883/the-baby-moves-prospective-cohort-study-protocol-using-a-smartphone-application-with-the-general-movements-assessment-to-predict-neurodevelopmental-outcomes-at-age-2%C3%A2-years-for-extremely-preterm-or-extremely-low-birthweight-infants
#3
A J Spittle, J Olsen, A Kwong, L W Doyle, P B Marschik, C Einspieler, Jly Cheong
INTRODUCTION: Infants born extremely preterm (EP; <28 weeks' gestation) and/or with extremely low birth weight (ELBW; <1000 g birth weight) are at increased risk for adverse neurodevelopmental outcomes. However, it is challenging to predict those EP/ELBW infants destined to have long-term neurodevelopmental impairments in order to target early intervention to those in most need. The General Movements Assessment (GMA) in early infancy has high predictive validity for neurodevelopmental outcomes in preterm infants...
October 3, 2016: BMJ Open
https://www.readbyqxmd.com/read/27609826/maternal-prepregnancy-bmi-and-risk-of-cerebral-palsy-in-offspring
#4
Ingeborg Forthun, Allen J Wilcox, Katrine Strandberg-Larsen, Dag Moster, Ellen A Nohr, Rolv Terje Lie, Pål Surén, Mette C Tollånes
OBJECTIVES: To investigate the association between maternal pre-pregnancy BMI and risk of cerebral palsy (CP) in offspring. METHODS: The study population consisted of 188 788 children in the Mothers and Babies in Norway and Denmark CP study, using data from 2 population-based, prospective birth cohorts: the Norwegian Mother and Child Cohort Study and the Danish National Birth Cohort. Prepregnancy BMI was classified as underweight (BMI <18.5), lower normal weight (BMI 18...
September 8, 2016: Pediatrics
https://www.readbyqxmd.com/read/27604839/the-effect-of-a-multidisciplinary-obstetric-emergency-team-training-program-the-in-time-course-on-diagnosis-to-delivery-interval-following-umbilical-cord-prolapse-a-retrospective-cohort-study
#5
Sean Copson, Katrina Calvert, Puvaneswary Raman, Elizabeth Nathan, Mathias Epee
BACKGROUND: Cord prolapse is an uncommon obstetric emergency, with potentially fatal consequences for the baby if prompt action is not taken. Simulation training provides a means by which uncommon emergencies can be practised, with the aim of improving teamwork and clinical outcomes. AIMS: This study aimed to determine if the introduction of a simulation-based training course was associated with an improvement in the management of cord prolapse, in particular the diagnosis to delivery interval...
September 7, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27591025/cohort-profile-cerebral-palsy-in-the-norwegian-and-danish-birth-cohorts-moband-cp
#6
Mette C Tollånes, Katrine Strandberg-Larsen, Ingeborg Forthun, Tanja Gram Petersen, Dag Moster, Anne-Marie Nybo Andersen, Camilla Stoltenberg, Jørn Olsen, Allen J Wilcox
PURPOSE: The purpose of MOthers and BAbies in Norway and Denmark cerebral palsy (MOBAND-CP) was to study CP aetiology in a prospective design. PARTICIPANTS: MOBAND-CP is a cohort of more than 210 000 children, created as a collaboration between the world's two largest pregnancy cohorts-the Norwegian Mother and Child Cohort study (MoBa) and the Danish National Birth Cohort. MOBAND-CP includes maternal interview/questionnaire data collected during pregnancy and follow-up, plus linked information from national health registries...
2016: BMJ Open
https://www.readbyqxmd.com/read/27445252/neurological-fallacies-leading-to-malpractice-a-case-studies-approach
#7
REVIEW
James C Johnston, Knut Wester, Thomas P Sartwelle
A young woman presents with an intracranial arachnoid cyst. Another is diagnosed with migraine headache. An elderly man awakens with a stroke. And a baby delivered vaginally after 2 hours of questionable electronic fetal monitoring patterns grows up to have cerebral palsy. These seemingly disparate cases share a common underlying theme: medical myths. Myths that may lead not only to misdiagnosis and treatment harms but to seemingly never-ending medical malpractice lawsuits, potentially culminating in a settlement or judgment against an unsuspecting neurologist...
August 2016: Neurologic Clinics
https://www.readbyqxmd.com/read/27404120/immediate-versus-deferred-delivery-of-the-preterm-baby-with-suspected-fetal-compromise-for-improving-outcomes
#8
REVIEW
Sarah J Stock, Leanne Bricker, Jane E Norman, Helen M West
BACKGROUND: Immediate delivery of the preterm fetus with suspected compromise may decrease the risk of damage due to intrauterine hypoxia. However, it may also increase the risks of prematurity. OBJECTIVES: To assess the effects of immediate versus deferred delivery of preterm babies with suspected fetal compromise on neonatal, maternal and long-term outcomes. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 April 2016) and reference lists of retrieved studies...
2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27254046/neurodevelopmental-outcome-of-extremely-low-birth-weight-children-at-corrected-age-of-two-years
#9
Kanya Mukhopadhyay, Rama Mahajan, Prahbhjot Malhi, Ashok Kumar
OBJECTIVE: To assess the neurodevelopmental, cognitive and behavioral function of extremely low birth weight babies (ELBW) till corrected age of two years. METHODS: 79 ELBW babies were enrolled and followed at 1 year (n=50), 18 months (n=47) and 2 years (n=36). Adverse composite outcome was defined as death or moderate-to-severe neurodevelopmental impairment (defined as either cerebral palsy or DQ score <70 or deafness or blindness). RESULTS: At 1 year, 24% were neurologically abnormal...
May 8, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27199883/rodent-hypoxia-ischemia-models-for-cerebral-palsy-research-a-systematic-review
#10
REVIEW
Prakasham Rumajogee, Tatiana Bregman, Steven P Miller, Jerome Y Yager, Michael G Fehlings
Cerebral palsy (CP) is a complex multifactorial disorder, affecting approximately 2.5-3/1000 live term births, and up to 22/1000 prematurely born babies. CP results from injury to the developing brain incurred before, during, or after birth. The most common form of this condition, spastic CP, is primarily associated with injury to the cerebral cortex and subcortical white matter as well as the deep gray matter. The major etiological factors of spastic CP are hypoxia/ischemia (HI), occurring during the last third of pregnancy and around birth age...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27120931/-not-available
#11
A Dussart, J De Buyst, C Djeunang, M Janssens, M-F Müller, E Strebelle, K Mathe, S Infantino, G Malfilâtre
This is the clinical history of a term baby born at home who presents a severe hyperbilirubinémia. The medical monitoring was assessed by a private midwife according to parental choice. On the third day of life, the newborn presented an icterus and was exposed to natural daylight in the familial greenhouse under the midwife recommandations. On that day, no laboratory test precised the bilirubin level. On the fifth day, a blood sampling revealed a very high blood bilirubinémia (31 mg/dl or 527 mmol/L), the baby is refered to our NICU and underwent an exchange transfusion...
January 2016: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/27022888/melatonin-for-women-in-pregnancy-for-neuroprotection-of-the-fetus
#12
REVIEW
Dominic Wilkinson, Emily Shepherd, Euan M Wallace
BACKGROUND: Melatonin is an antioxidant with anti-inflammatory and anti-apoptotic effects. Animal studies have supported a fetal neuroprotective role for melatonin when administered maternally. It is important to assess whether melatonin, given to the mother, can reduce the risk of neurosensory disabilities (including cerebral palsy) and death, associated with fetal brain injury, for the preterm or term compromised fetus. OBJECTIVES: To assess the effects of melatonin when used for neuroprotection of the fetus...
2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26919411/risk-factors-for-cerebral-palsy-in-pprom-and-preterm-delivery-with-intact-membranes
#13
Federica Accordino, Sara Consonni, Tiziana Fedeli, Gaia Kullman, Francesca Moltrasio, Alessandro Ghidini, Anna Locatelli
OBJECTIVE: Gestational age (GA) at delivery and spontaneous prematurity are independent risk factors for cerebral palsy (CP). The aim of this study is to investigate perinatal risk factors for CP in spontaneous preterm delivery. METHODS: A retrospective cohort study of all single pregnancies complicated by spontaneous preterm labor (PTL) or PPROM with delivery at <34 weeks from January 2006 to December 2012 was performed. We compared demographic, obstetric, neonatal, and placental histology variables in cases of spontaneous preterm birth in reference to the development of CP...
December 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/26916889/prediction-of-neurodevelopmental-outcome-of-preterm-babies-using-risk-stratification-score
#14
Radhika Sujatha, Naveen Jain
OBJECTIVES: To study the incidence of major neurodevelopmental disability (NDD) at 1 y age (corrected for prematurity) in a cohort of preterm Indian babies (≤33 wk) and to predict NDD based on perinatal risk factors. METHODS: This prospective cohort study was conducted at a referral neonatal intensive care unit (NICU) with a developmental follow up clinic in private sector in Kerala, India. The study was conducted for 4.5 y - January 2005 to July 2009. All preterm babies ≤33 wk at birth, discharged from the NICU were included...
July 2016: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/26835378/the-case-of-late-preterm-birth-sliding-forwards-the-critical-window-for-cognitive-outcome-risk
#15
Giovanni Mento, Chiara Nosarti
Many survivors of preterm birth experience neurodevelopmental disabilities, such as cerebral palsy, visual and hearing problems. However, even in the absence of major neurological complications, premature babies show significant neuropsychological and behavioural deficits during childhood and beyond. While the clinical tools routinely used to assess neurocognitive development in those infants have been useful in detecting major clinical complications in early infancy, they have not been equally sensitive in identifying subtle cognitive impairments emerging during childhood...
July 2015: Translational pediatrics
https://www.readbyqxmd.com/read/26767411/reducing-the-risk-of-fetal-distress-with-sildenafil-study-ridstress-a-double-blind-randomised-control-trial
#16
RANDOMIZED CONTROLLED TRIAL
Liam Dunn, Vicki Flenady, Sailesh Kumar
BACKGROUND: Labour is perhaps the most hazardous time in pregnancy. As many as 20 % of cerebral palsy cases in term infants result from intrapartum events and up to 63 % of babies who develop intrapartum compromise have no prior risk factors. Sildenafil citrate (SC), a phosphodiesterase 5 inhibitor, improves uterine blood supply through vasodilatation and potentially could improve placental perfusion and hence reduce the risk of intrapartum fetal hypoxia. The aim of this study is to evaluate the efficacy of SC to reduce the risk of intrapartum fetal compromise and the need for emergency operative delivery...
January 14, 2016: Journal of Translational Medicine
https://www.readbyqxmd.com/read/26735551/effects-and-safety-of-magnesium-sulfate-on-neuroprotection-a-meta-analysis-based-on-prisma-guidelines
#17
REVIEW
Xianling Zeng, Yan Xue, Quan Tian, Rong Sun, Ruifang An
To evaluate the evidence of effects and safety of magnesium sulfate on neuroprotection for preterm infants who had exposure in uteri. We searched electronic databases and bibliographies of relevant papers to identify studies comparing magnesium sulfate (MgSO4) with placebo or other treatments in patients at high risk of preterm labor and reporting effects and safety of MgSO4 for antenatal infants. Then, we did this meta-analysis based on PRISMA guideline. The primary outcomes included fatal death, cerebral palsy (CP), intraventricular hemorrhage, and periventricular leukomalacia...
January 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26379991/aortic-dissection-in-women-during-the-course-of-pregnancy-or-puerperium-a-report-of-11-cases-in-central-south-china
#18
Guifang Yang, Wen Peng, Qin Zhao, Jing Peng, Xudong Xiang, Xiangping Chai
We have characterized 11 women diagnosed with aortic dissection during the course pregnancy or puerperium by analysis of 1,271 patients enrolled at the Second Xiangya Hospital in central south university of China from 2010 to 2013. The age of these patients ranged from 22 to 39 years old (30.6 ± 5.6 years old). Among which, 5 cases were noted secondary to Marfan syndrome. Three patients were diagnosed at the late stage of pregnancy, 6 cases were in the postpartum stage, and 2 cases occurred in the early stage of pregnancy...
2015: International Journal of Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/26307566/the-provide-study-the-impact-of-protein-intravenous-nutrition-on-development-in-extremely-low-birthweight-babies
#19
RANDOMIZED CONTROLLED TRIAL
Frank H Bloomfield, Caroline A Crowther, Jane E Harding, Cathryn A Conlon, Yannan Jiang, Barbara E Cormack
BACKGROUND: Preterm birth and very small size at birth have long-term effects on neurodevelopment and growth. A relatively small percentage of extremely low birthweight babies suffer from severe neurological disability; however, up to 50% experience some neurodevelopmental or learning disability in childhood. Current international consensus is that increased protein intake in the neonatal period improves both neurodevelopment and growth, but the quantum of protein required is not known...
August 26, 2015: BMC Pediatrics
https://www.readbyqxmd.com/read/26283623/barriers-and-enablers-to-implementing-antenatal-magnesium-sulphate-for-fetal-neuroprotection-guidelines-a-study-using-the-theoretical-domains-framework
#20
Emily Bain, Tanya Bubner, Pat Ashwood, Emer Van Ryswyk, Lucy Simmonds, Sally Reid, Philippa Middleton, Caroline A Crowther
BACKGROUND: Strong evidence supports administration of magnesium sulphate prior to birth at less than 30 weeks' gestation to prevent very preterm babies dying or developing cerebral palsy. This study was undertaken as part of The WISH (Working to Improve Survival and Health for babies born very preterm) Project, to assess health professionals' self-reported use of antenatal magnesium sulphate, and barriers and enablers to implementation of 2010 Australian and New Zealand clinical practice guidelines...
2015: BMC Pregnancy and Childbirth
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