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Obstetrics complications

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https://www.readbyqxmd.com/read/28533582/angular-ectopic-pregnancy-presenting-as-rupture-of-lateral-wall-of-the-uterus-late-presentation-in-gestation-week-20
#1
Malihe Hasanzadeh, Salme Dadgar, Yalda Arian, Yousef Yousefi
The differential diagnosis of acute abdominal pain in pregnancy is broad and can be complicated by atypical manifestations that are due to the anatomic distortions and physiologic changes of pregnancy. Due to the lack of clinical understanding, angular pregnancy does not appear to be recognized as a clinical entity and many cases are likely to go undiagnosed. This is a case report of a 34-year-old woman who was referred to the obstetrics emergency department with sudden abdominal pain and in a state of hypovolemic shock...
May 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28528578/a-cluster-randomized-trial-to-reduce-caesarean-delivery-rates-in-quebec-cost-effectiveness-analysis
#2
Mira Johri, Edmond S W Ng, Clara Bermudez-Tamayo, Jeffrey S Hoch, Thierry Ducruet, Nils Chaillet
BACKGROUND: Widespread increases in caesarean section (CS) rates have sparked concerns about risks to mothers and infants and rising healthcare costs. A multicentre, two-arm, cluster-randomized trial in Quebec, Canada assessed whether an audit and feedback intervention targeting health professionals would reduce CS rates for pregnant women compared to usual care, and concluded that it reduced CS rates without adverse effects on maternal or neonatal health. The effect was statistically significant but clinically small...
May 22, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28528140/maternal-and-neonatal-outcomes-of-respiratory-failure-during-pregnancy
#3
Chen-Yiu Hung, Han-Chung Hu, Li-Chung Chiu, Chih-Hao Chang, Li-Fu Li, Chung-Chi Huang, Chuan-Chi Kao, Po-Jen Cheng, Kuo-Chin Kao
BACKGROUND: Obstetric patients comprise a limited portion of intensive care unit patients, but they often present with unfamiliar conditions and exhibit the potential for catastrophic deterioration. This study evaluated the maternal and neonatal outcomes of respiratory failure during pregnancy. METHODS: Information on 71 patients at >25 weeks gestation in the ICU with respiratory failure was recorded between 2009 and 2013. The characteristics and outcomes of mothers and fetuses were determined through a retrospective chart review and evaluated using Student's t test, chi-square test, and Fisher's exact test...
May 17, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28526012/the-pregnancy-and-fertility-prefer-study-an-italian-multicenter-prospective-cohort-study-on-fertility-preservation-and-pregnancy-issues-in-young-breast-cancer-patients
#4
Matteo Lambertini, Paola Anserini, Valeria Fontana, Francesca Poggio, Giuseppina Iacono, Annalisa Abate, Alessia Levaggi, Loredana Miglietta, Claudia Bighin, Sara Giraudi, Alessia D'Alonzo, Eva Blondeaux, Davide Buffi, Francesco Campone, Domenico F Merlo, Lucia Del Mastro
BACKGROUND: Fertility and pregnancy issues are of key importance for young breast cancer patients. Despite several advances in the field, there are still multiple unmet needs and barriers in discussing and dealing with these concerns. To address the significant challenges related to fertility and pregnancy issues, the PREgnancy and FERtility (PREFER) study was developed as a national comprehensive program aiming to optimize care and improve knowledge around these topics. METHODS: The PREFER study is a prospective cohort study conducted across several Italian institution affiliated with the Gruppo Italiano Mammella (GIM) group evaluating patterns of care and clinical outcomes of young breast cancer patients dealing with fertility and pregnancy issues...
May 19, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28523542/eating-disorders-and-epigenetics
#5
Lea Thaler, Howard Steiger
Eating disorders (EDs) are characterized by intense preoccupation with shape and weight and maladaptive eating practices. The complex of symptoms that characterize EDs often arise through the activation of latent genetic potentials by environmental exposures, and epigenetic mechanisms are believed to link environmental exposures to gene expression. This chapter provides an overview of genetic factors acting in the etiology of EDs. It then provides a background to the hypothesis that epigenetic mechanisms link stresses such as obstetric complications and childhood abuse as well as effects of malnutrition to eating disorders (EDs)...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28523399/anal-sphincter-injury-in-vaginal-deliveries-complicated-by-shoulder-dystocia
#6
Mark P Hehir, Zachary Rubeo, Karen Flood, Anne H Mardy, Colm O'Herlihy, Peter C Boylan, Mary E D'Alton
INTRODUCTION AND HYPOTHESIS: Shoulder dystocia is an obstetric emergency that occurs in 0.2-3% of all cephalic vaginal deliveries. We hypothesized that because of the difficult nature of deliveries complicated by shoulder dystocia, the condition may be associated with anal sphincter injury. We sought to identify risk factors for obstetric anal sphincter injury in women with shoulder dystocia. METHODS: This retrospective analysis included all cases of shoulder dystocia from 2007 to 2011 at two large tertiary referral centers, in the USA and Ireland...
May 18, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28522033/placenta-directed-gene-therapy-for-fetal-growth-restriction
#7
REVIEW
Tara Krishnan, Anna L David
Fetal growth restriction (FGR) is a serious pregnancy complication affecting ∼8% of all pregnancies. There is no treatment to increase fetal growth in the uterus. Gene therapy presents a promising treatment strategy for FGR, with the use of adenoviral vectors encoding for proteins such as vascular endothelial growth factor (VEGF) and insulin-like growth factor demonstrating improvements in fetal growth, placental function, and neonatal outcome in preclinical studies. Safety assessments suggest no adverse risk to the mother or fetus for VEGF maternal gene therapy; a clinical trial is in development...
May 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28514932/case-report-of-severe-maternal-hyponatremia-complicating-preeclampsia
#8
Larry Hinkson, Robert Armbrust, Annika Möller, Wolfgang Henrich
The incidence of preeclampsia associated maternal and neonatal hyponatremia is reportedly rare and can be life threatening in severe cases. The timely diagnosis and careful management requires a multidisciplinary approach between obstetric, neonatal, endocrinology and intensive care teams. We report firstly, on a case of severe hyponatremia associated with preeclampsia, secondary to inappropriate Anti Diuretic Hormone secretion, followed by a review of cases over a one year period at our institution.
May 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28511469/clinical-profile-and-outcome-of-newborns-with-acute-kidney-injury-in-a-level-3-neonatal-unit-in-western-india
#9
Satvik Chaitanya Bansal, Archana Somashekhar Nimbalkar, Amit R Kungwani, Dipen Vasudev Patel, Ankur Rajinder Sethi, Somashekhar Marutirao Nimbalkar
INTRODUCTION: Acute Kidney Injury (AKI) is a serious condition in neonatal care. It complicates the management necessitating the restrictive use of medications. AIM: To evaluate clinical profile, identify associated and prog-nostic factors in newborns with AKI. MATERIALS AND METHODS: This was a case control study done between January 2008 to January 2010. Total 1745 newborns were admitted, of which 74 babies had AKI. It was defined as serum creatinine >1...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28509326/polish-gynecological-society-recommendations-for-labor-induction
#10
Dorota Bomba-Opoń, Krzysztof Drews, Hubert Huras, Piotr Laudański, Tomasz Paszkowski, Mirosław Wielgoś
Labor induction involves artificial stimulation of childbirth before the natural, spontaneous onset of labor. It is one of the most common procedures in modern obstetrics. The frequency of labor induction has doubled in recent decades due to the development of perinatology and methods of monitoring fetal well-being in particular. Currently, one in five pregnant women and 30-40% of women delivering vaginally undergo this procedure. Reasons for induction include reduction of the perinatal mortality and morbidity of the fetus and newborn, as well as the reduction of maternal complications...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28506952/retrospective-evaluation-of-pregnant-women-with-celiac-disease
#11
Kemal Beksaç, Gökçen Örgül, Murat Çağan, Ergun Karaağaoğlu, Serap Arslan, Mehmet Sinan Beksaç
OBJECTIVE: To show celiac disease (CD) and its poor pregnancy outcome relationship, and to demonstrate the importance of a gluten-free diet together with low-dose low-molecular-weight heparin (LMWH) and low-dose corticosteroid (LDC) in the management of pregnancies with CD. MATERIAL AND METHODS: This study consisted of 2 groups of patients. Six patients with CD (control group) on a gluten-free diet were monitored during their first pregnancies within the framework of antenatal care program and their pregnancy outcomes were compared with eight poorly-treated pregnant patients with CD (study group) who were referred from other medical institutions...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28506946/maternal-mortality-due-to-hypertensive-disorders-in-pregnancy-childbirth-and-the-puerperium-between-2012-and-2015-in-turkey-a-nation-based-study
#12
Bekir Keskinkılıç, Yaprak Engin-Üstün, Sema Sanisoğlu, Dilek Şahin Uygur, Hüseyin Levent Keskin, Selma Karaahmetoğlu, Ayşe Özcan, Meral Esen, Afra Alkan, Aysun Kabasakal, İrfan Şencan
OBJECTIVE: To analyze maternal deaths in Turkey due to hypertensive disorders. MATERIAL AND METHODS: In this retrospective study 812 maternal deaths were analyzed. Maternal demographic features, presence of antenatal care, medical and obstetric history, mode of delivery, and use emergency antihypertensive therapy were recorded. The delay model for each case was investigated. RESULTS: Hypertensive disorders accounted for 15.5% (n=126) out of all maternal mortality...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28506945/urinary-fistula-a-continuing-problem-with-changing-trends
#13
Sunesh Kumar, Richa Vatsa, Juhi Bharti, Kallol Kumar Roy, Jai Bhagwan Sharma, Neeta Singh, Jyoti Meena, Seema Singhal
OBJECTIVE: Urinary fistula is a distressing complication after difficult vaginal deliveries, obstetric, and gynecologic surgeries. The present study describes a single center's experience in the management of urinary fistula at a tertiary care hospital. It was performed to analyze the etiology of genitourinary fistula, to assess the outcome after surgical repair, and to determine the changing trends in the etiology and management of urinary fistula. MATERIAL AND METHODS: This retrospective study was conducted over 5 years in the department of obstetrics and gynecology, All India Institute of Medical Sciences, New Delhi...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28502605/transphyseal-separation-of-the-distal-humerus-in-newborns
#14
Cosimo Gigante, Sunil Gurpur Kini, Carlo Origo, Andrea Volpin
Obstetric traumatic separation of the distal humeral epiphysis is a very uncommon injury, which presents a diagnostic challenge. These case serials reviewed the functional outcomes of 5 patients who had sustained a fracture-separation of the distal humeral epiphysis at birth. The diagnosis was made at a mean time of 40.8 h after delivery. All the patients were treated with gentle close manipulation, reduction under fluoroscopy and above-elbow cast application. After discharge, the patients were followed up for a mean of 30 months...
April 14, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28501235/women-s-health-pregnancy-and-conception
#15
REVIEW
Judith Cuneo
Preconception is an ideal time to assist women contemplating pregnancy to modify health behaviors. Dietary needs in pregnancy are critical and may require supplementation. The use of mind-body medicine in the antenatal period assists patients in childbirth preparation. Integrative medicine techniques can be safely and effectively used for common third-trimester obstetric complications of pregnancy.
June 2017: Primary Care
https://www.readbyqxmd.com/read/28501032/-perinatal-outcome-in-relation-to-chorionicity-in-twin-pregnancy
#16
Marta Machado, Elsa Lima Teixeira, Lígia Maria Ferreira, Filipa Rodrigues, Raquel Henriques, Eulália Afonso
INTRODUCTION: The incidence of multiple gestations is increasing worldwide and many studies have shown higher perinatal morbidity and mortality rates in monochorionic twins compared to dichorionic. The aim of this study was to assess the twin population born at a tertiary center and to evaluate the impact of chorionicity on perinatal outcomes of twin pregnancies. MATERIAL AND METHODS: Retrospective study of all twins born in a tertiary center from January 2004 to December 2013...
January 31, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28499552/puerperal-ventral-epidural-hematoma-after-epidural-labor-analgesia
#17
I Gruzman, I Shelef, A Y Weintraub, A Zlotnik, O Erez
Serious complications in obstetric anesthesia are a rare occurrence. High neuraxial block, respiratory arrest in labor and delivery, and an unrecognized spinal catheter are among the most frequently reported serious complications. A serious complication occurs in approximately 1:3000 obstetric patients. Neuraxial hematoma after obstetric epidural analgesia or anesthesia is extremely rare. We present a case of a puerperal spinal epidural hematoma following epidural labor analgesia. The patient presented with foot drop, which resolved after conservative treatment...
March 31, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28499551/lessons-learned-from-a-single-institution-s-retrospective-analysis-of-emergent-cesarean-delivery-following-external-cephalic-version-with-and-without-neuraxial-anesthesia
#18
A Ainsworth, H P Sviggum, M C Tolcher, A L Weaver, M A Holman, K W Arendt
OBJECTIVES: To evaluate the risk of emergent cesarean delivery with the use of neuraxial anesthesia for external cephalic version in a single practice. BACKGROUND: Randomized trials have shown increased external cephalic version success when neuraxial anesthesia is used, without additional risk. We hypothesized that in our actual clinical practice, outside the confines of randomized trials, neuraxial anesthesia could be associated with an increased risk of emergent cesarean delivery...
April 2, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28497181/new-directions-in-fetal-surgery-for-myelomeningocele
#19
Sandra K Kabagambe, Y Julia Chen, Melissa A Vanover, Payam Saadai, Diana L Farmer
The treatment of children with myelomeningocele (MMC) has improved over time, from supportive management to early postnatal closure to prenatal repair of the defect. The Management of Myelomeningocele Study (MOMS) showed that prenatal repair of MMC resulted in improved neurological outcomes compared to postnatal closure. Follow-up studies showed that prenatal repair was, as with any other fetal intervention, associated with higher rates of obstetrical complications. There was no significant difference in urological outcomes...
May 11, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28492031/retrospective-evidence-on-outcomes-and-experiences-of-pregnancy-and-childbirth-in-epidermolysis-bullosa-in-australia-and-new-zealand
#20
Lizbeth R A Intong, S Deanne Choi, Alexa Shipman, Yong C Kho, Shelley J E Hwang, Lesley M Rhodes, Judie R Walton, Michael G Chapman, Dédée F Murrell
BACKGROUND: Pregnancy in epidermolysis bullosa (EB) has not been comprehensively studied. OBJECTIVE: We aimed to develop a foundational database, which could provide peri-obstetric advice in EB. METHODS: Survey questionnaires were sent to obstetricians, unaffected mothers of EB babies, and mothers with EB. Results were analyzed using chi-square, Fisher exact, and t-tests. RESULTS: Out of 1346 obstetricians surveyed, 195 responded, and only 14 had encountered EB...
March 2017: International Journal of Women's Dermatology
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