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Pre conceptional counseling

Basilio Pecorino, Maria Cristina Teodoro, Paolo Scollo
Type III Polyglandular Autoimmune Syndrome is a multiple endocrine disorders disease determined by autoimmunity; it can be diagnosed if a patient is affected by Type 1 Diabetes Mellitus and another autoimmune disease, except Addison Disease, for example Autoimmune Hashimoto Thyroiditis or Celiac Disease. R.D., 34-year-old woman (gravida 2 para 1), was referred to the High Risk Pregnancy Outpatient Clinic at Cannizzaro Hospital in Catania at 8 weeks' gestation. She was affected from type III Polyglandular Autoimmune Disease (Type 1 Diabetes Mellitus, Autoimmune Hashimoto Thyroiditis and Celiac Disease)...
September 2016: Italian Journal of Gynaecology & Obstetrics: Official Publication of the Societa Italiana di Ginecologia e Ostetricia (SIGO)
Innocenzo Bianca, Giovanna Geraci, Michele Massimo Gulizia, Gabriele Egidy-Assenza, Chiara Barone, Marcello Campisi, Annalisa Alaimo, Rachele Adorisio, Francesca Comoglio, Silvia Favilli, Gabriella Agnoletti, Maria Gabriella Carmina, Massimo Chessa, Berardo Sarubbi, Maurizio Mongiovì, Maria Giovanna Russo, Sebastiano Bianca, Giuseppe Canzone, Marco Bonvicini, Elsa Viora, Marco Poli
The success of cardiac surgery over the past 50 years has increased numbers and median age of survivors with congenital heart disease (CHD). Adults now represent two-thirds of patients with CHD; in the United States alone the number is estimated to exceed 1 million.In this population many affected women reach reproductive age and wish to have children. While in many CHD patients pregnancy can be accomplished successfully, some special situations with complex anatomy, iatrogenic or residual pathology are associated with an increased risk of severe maternal and fetal complications...
September 2016: Giornale Italiano di Cardiologia
Bharti Kalra, Yashdeep Gupta, Sanjay Kalra
Endocrine function is closely interlinked with pregnancy. Maternal and foetal outcomes can be improved if optimal endocrine function is achieved, and maintained prior to conception. This needs a systematic approach which includes rational screening, appropriate management, and pragmatic counseling. This review describes aspects of pre conception management related to various endocrine glands. Pre conception management of diabetes and thyroid will be covered in later articles.
November 2016: JPMA. the Journal of the Pakistan Medical Association
Stefan Orwat, Gerhard-Paul Diller, Iris M van Hagen, Renate Schmidt, Daniel Tobler, Matthias Greutmann, Regina Jonkaitiene, Amro Elnagar, Mark R Johnson, Roger Hall, Jolien W Roos-Hesselink, Helmut Baumgartner
BACKGROUND: Controversial results on maternal risk and fetal outcome have been reported in women with aortic stenosis (AS). OBJECTIVES: The authors sought to investigate maternal and fetal outcomes in patients with AS in a large cohort. METHODS: The Registry on Pregnancy and Cardiac Disease (ROPAC) is a global, prospective observational registry of women with structural heart disease, providing a uniquely large study population. Data of women with moderate (peak gradient 36 to 63 mm Hg) and severe AS (peak gradient ≥64 mm Hg) were analyzed...
October 18, 2016: Journal of the American College of Cardiology
Anupama Nair, S Radhakrishnan
OBJECTIVE: To determine the referral pattern for fetal echocardiography (FE) at our tertiary referral center for pediatric cardiac care in northern India. We also aimed to determine the incidence of CHD in each group and intend to highlight the need of identifying the various risk factors and appropriate timely referral of patients for detailed evaluation. METHODS: This is a prospective study including 201 consecutive patients referred for fetal echo to our center...
October 2016: Journal of Obstetrics and Gynaecology of India
Huan Zhou, Yongping Liu, Lu Liu, Min Zhang, Xingzhi Chen, Yulong Qi
OBJECTIVE: To assess the relationship of the pre-pregnancy modifiable risks with miscarriage. STUDY DESIGN: We randomly selected 51 communities or villages from January 2013 to December 2014 in Anhui, China. We calculated incidence rate ratios (RR) and 95% confidence intervals (CIs) for each risk factor for miscarriage. RESULTS: The incidence rate of miscarriage was 7.45%, and pre-embryonic loss account for 12.66%, embryonic loss account for 38%, and fetal losses account for 49...
November 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
R Douglas Wilson, Isabelle De Bie, Christine M Armour, Richard N Brown, Carla Campagnolo, June C Carroll, Nan Okun, Tanya Nelson, Rhonda Zwingerman, Francois Audibert, Jo-Ann Brock, Richard N Brown, Carla Campagnolo, June C Carroll, Isabelle De Bie, Jo-Ann Johnson, Nan Okun, Melanie Pastruck, Karine Vallée-Pouliot, R Douglas Wilson, Rhonda Zwingerman, Christine Armour, David Chitayat, Isabelle De Bie, Sara Fernandez, Raymond Kim, Josee Lavoie, Norma Leonard, Tanya Nelson, Sherry Taylor, Margot Van Allen, Clara Van Karnebeek
OBJECTIVE: This guideline was written to update Canadian maternity care and reproductive healthcare providers on pre- and postconceptional reproductive carrier screening for women or couples who may be at risk of being carriers for autosomal recessive (AR), autosomal dominant (AD), or X-linked (XL) conditions, with risk of transmission to the fetus. Four previous SOGC- Canadian College of Medical Geneticists (CCMG) guidelines are updated and merged into the current document. INTENDED USERS: All maternity care (most responsible health provider [MRHP]) and paediatric providers; maternity nursing; nurse practitioner; provincial maternity care administrator; medical student; and postgraduate resident year 1-7...
August 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Joris Robert Vermeesch, Thierry Voet, Koenraad Devriendt
The past decade has seen the development of technologies that have revolutionized prenatal genetic testing; that is, genetic testing from conception until birth. Genome-wide single-cell arrays and high-throughput sequencing analyses are dramatically increasing our ability to detect embryonic and fetal genetic lesions, and have substantially improved embryo selection for in vitro fertilization (IVF). Moreover, both invasive and non-invasive mutation scanning of the genome are helping to identify the genetic causes of prenatal developmental disorders...
September 15, 2016: Nature Reviews. Genetics
Ainsley J Newson, Samantha J Leonard, Alison Hall, Clara L Gaff
BACKGROUND: Genomic testing has reached the point where, technically at least, it can be cheaper to undertake panel-, exome- or whole genome testing than it is to sequence a single gene. An attribute of these approaches is that information gleaned will often have uncertain significance. In addition to the challenges this presents for pre-test counseling and informed consent, a further consideration emerges over how - ethically - we should conceive of and respond to this uncertainty. To date, the ethical aspects of uncertainty in genomics have remained under-explored...
2016: BMC Medical Genomics
Yu Kanzaki, Eiji Kondoh, Kaoru Kawasaki, Haruta Mogami, Yoshitsugu Chigusa, Ikuo Konishi
AIM: There are an increasing number of reports of pregnancy following liver transplantation, but many questions remain regarding preconception counseling and management of the pregnancy. The aim of this study was to report pregnancy outcomes in women who had undergone liver transplants and to gain insight into these issues. METHODS: We conducted a retrospective review of liver transplant recipients who had received prenatal care at Kyoto University Hospital between January 2001 and December 2015...
November 2016: Journal of Obstetrics and Gynaecology Research
V Arling, J Knispel, W Spijkers
BACKGROUND: Due to prevailing future challenges in vocational rehabilitation, development process RehaFutur (BMAS) was initiated. In this context, recommendations were made to secure a future-oriented, innovative vocational rehabilitation in Germany. Deutsche Rentenversicherung (DRV) Westfalen transferred these recommendations into a new and applicable counseling concept RehaFutuReal(®). Rehabilitation managers (RM) are central protagonists in counseling process. Therefore, RehaFuturReal(®) focused on optimization of counseling performance...
August 2016: Die Rehabilitation
Julia Shinnick, M Bridget Spelke, Ashley Rae Martinez
BACKGROUND AND OBJECTIVES: Medical students are often apprehensive in approaching basic women's health concepts, including wellness exams, reproductive health concerns, and patient counseling. This study evaluates a novel student-developed and student-run Women's Health Training Day (WHTD) as a means of cultivating medical student confidence in women's primary care early in medical training. METHODS: Sixty-six first-year medical students participated in WHTD, a voluntary 6-hour weekend day of interactive workshops...
July 2016: Family Medicine
Dominika L Seidman, Shannon Weber, Maria Teresa Timoney, Karishma K Oza, Elizabeth Mullins, Deborah L Cohan, Rodney L Wright
BACKGROUND: Pregnancy may increase a woman's susceptibility to HIV. Maternal HIV acquisition during pregnancy and lactation is associated with increased perinatal and lactational HIV transmission. There are no published reports of preexposure prophylaxis use after the first trimester of pregnancy or during lactation. OBJECTIVE: The purpose of this study was to report the use of preexposure prophylaxis and to identify gaps in HIV prevention services for women who were at substantial risk of HIV preconception and during pregnancy and lactation at 2 United States medical centers...
July 19, 2016: American Journal of Obstetrics and Gynecology
Giorgia Mangili, Edgardo Somigliana, Veronica Giorgione, Fabio Martinelli, Francesca Filippi, Maria Cristina Petrella, Massimo Candiani, Fedro Peccatori
Borderline ovarian tumours (BOT) may occur in young women and have an excellent survival rate. Therefore, there is the obligation to put emphasis on fertility preservation in affected women. On the other hand, it has also been underlined that the disease should be managed with caution because these tumours can relapse and, albeit rare, malignant transformation can also occur. Unfortunately, evidence on fertility preservation in women with BOT is scanty. In this opinion paper, we tried to draw some clinical indications based on the few available studies on the clinical management of BOT and their possible relation with controlled ovarian hyper-stimulation (COH)...
September 2016: Cancer Treatment Reviews
Gabriella Moroni, Andrea Doria, Elisa Giglio, Enrico Imbasciati, Chiara Tani, Margherita Zen, Francesca Strigini, Barbara Zaina, Angela Tincani, Mariele Gatto, Federica de Liso, Claudia Grossi, Pier Luigi Meroni, Gianfranca Cabiddu, Piergiorgio Messa, Pietro Ravani, Marta Mosca
Retrospective studies reported a high incidence of maternal complications in pregnant women with lupus. In this paper we prospectively assessed the rate of risk and the risk factors of maternal outcome in women with stable lupus nephritis who received pre-pregnancy counseling. This prospective multicenter study includes 71 pregnancies in 61 women with lupus nephritis who became pregnant between 2006 and 2013. Complete renal remission was present before pregnancy in 56 cases (78.9%) and mild active nephritis in 15 cases...
November 2016: Journal of Autoimmunity
Nadya Helena Alves-Santos, Ilana Eshriqui, Ana Beatriz Franco-Sena, Paula Guedes Cocate, Ana Amélia Freitas-Vilela, Camila Benaim, Juliana Dos Santos Vaz, Maria Beatriz Trindade Castro, Gilberto Kac
OBJECTIVE: To estimate food intake changes from pre-conception to gestational period according to the degree of food processing. METHODS: Prospective cohort conducted in a public health care center in Rio de Janeiro with Brazilian pregnant women (n = 189). A food frequency questionnaire was applied at the first (5(th)-13(th)) and third (30(th)-36(th)) gestational trimesters. The food items were classified according to characteristics of food processing in four groups: unprocessed/minimally processed foods; sugar/fat; processed foods and ultra-processed foods...
October 1, 2016: Appetite
Liesl Zühlke, Letitia Acquah
The World Health Organisation (WHO) supports pre-conception care (PCC) towards improving health and pregnancy outcomes. PPC entails a continuum of promotive, preventative and curative health and social interventions. PPC identifies current and potential medical problems of women of childbearing age towards strategising optimal pregnancy outcomes, whereas antenatal care constitutes the care provided during pregnancy. Optimised PPC and antenatal care would improve civil society and maternal, child and public health...
March 2016: Cardiovascular Journal of Africa
Anupama Nair, Sitaraman Radhakrishnan, Krishna S Iyer
The Fontan connection, originally described in 1971, is used to provide palliation for patients with many forms of CHDs that cannot support a biventricular circulation. An increasing number of females who have undergone these connections in childhood are now surviving into adulthood and some are becoming pregnant. We report a case of a 29-year-old woman who presented with a twin pregnancy at 33 weeks of gestation. She had significant deterioration of her cardiovascular status before the twin babies were delivered by emergency caesarean section owing to associated obstetric complications...
August 2016: Cardiology in the Young
Ales Sobek, Martin Prochazka, Eva Klaskova, Marek Lubusky, Radovan Pilka
BACKGROUND: Monozygotic twinning is associated with increased perinatal morbidity and mortality. There is evidence that the number of monozygotic twins increases after assisted reproductive techniques. METHODS: We searched PUBMED, MEDLINE, and Scopus from 1987 to 2015 for studies analyzing the incidence and possible etiology of monozygotic twinning in infertility patients and critically reviewed the current state of knowledge. RESULTS AND CONCLUSIONS: Monozygotic twinning is a rare in natural conception but occurs around twice the normal rate after assisted reproduction...
September 2016: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Siaw-Cheok Liew
INTRODUCTION: folic acid is a water soluble vitamin, which is synthetically-produced and found in fortified foods and supplements. Folate is found naturally in plants, such as the dark green leafy vegetables. Folate is not synthesized de novo by humans, therefore the daily requirements are met from the dietary intake of folic acid supplements or food rich in this vitamin. Folate deficiency could lead to numerous common health problems. Hyperhomocysteinemia and the possibility of malignancy developments are the long term consequences of this deficit albeit contradictory findings on these claims...
January 2016: Revista da Associação Médica Brasileira
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