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Fetal intervention

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https://www.readbyqxmd.com/read/28222038/evidence-based-ethically-justified-counseling-for-fetal-bilateral-renal-agenesis
#1
Alana N Thomas, Laurence B McCullough, Frank A Chervenak, Frank X Placencia
BACKGROUND: Not much data are available on the natural history of bilateral renal agenesis, as the medical community does not typically offer aggressive obstetric or neonatal care asbilateral renal agenesis has been accepted as a lethal condition. AIM: To provide an evidence-based, ethically justified approach to counseling pregnant women about the obstetric management of bilateral renal agenesis. STUDY DESIGN: A systematic literature search was performed using multiple databases...
February 21, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28217680/first-reported-case-of-fetal-aortic-valvuloplasty-in-asia
#2
Sun-Young Yoon, Hye-Sung Won, Mi-Young Lee, Min Kyong Cho, Euiseok Jung, Ki-Soo Kim, Young-Hwue Kim
Prenatal intervention of severe fetal aortic valve stenosis by ultrasound-guided percutaneous balloon valvuloplasty has been performed to prevent the progression to hypoplastic left heart syndrome, and achieve biventricular circulation in neonates. Here we report a case of fetal aortic valvuloplasty prenatally diagnosed with aortic stenosis at 24 weeks of gestation and showed worsening features on a follow-up echocardiography. Prenatal aortic valvuloplasty was performed at 29 weeks of gestation, and was a technical success...
January 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28215834/time-to-resolution-a-prospective-evaluation-from-the-society-for-fetal-urology-hydronephrosis-registry
#3
R S Zee, C D Anthony Herndon, C S Cooper, C Kim, P H McKenna, A Khoury, K W Herbst
INTRODUCTION: The resolution rate of prenatal urinary tract dilation (UTD) has been documented in several retrospective studies. The present study analyzed prospective observational registry data, with the aim of determining time to resolution among patients prenatally identified with mild postnatal UTD. MATERIALS AND METHODS: A total of 248 subjects, from four centers, were prospectively enrolled from 2008 to 2015. Exclusion criteria included other anomalies (n = 69), fewer than two ultrasounds, and/or <3 months follow-up (n = 26)...
January 19, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28213060/prediction-of-cesarean-delivery-in-the-term-nulliparous-woman-results-from-the-prospective-multi-center-genesis-study
#4
Naomi Burke, Gerard Burke, Fionnuala Breathnach, Fionnuala Mcauliffe, John J Morrison, Michael Turner, Samina Dornan, John R Higgins, Amanda Cotter, Michael Geary, Peter Mcparland, Sean Daly, Fiona Cody, Pat Dicker, Elizabeth Tully, Fergal D Malone
BACKGROUND: In contemporary practice many nulliparous women require intervention during childbirth such as operative vaginal delivery or Cesarean delivery (CD). Despite the knowledge that the rising CD rate is associated with increasing maternal age, obesity and larger infant birthweight, we lack a reliable method to predict the requirement for such potentially hazardous obstetric procedures during labor and delivery. This issue is important as there are higher rates of morbidity and mortality associated with unplanned CD performed in labor compared to scheduled Cesarean deliveries...
February 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28212591/maternal-bonding-through-pregnancy-and-postnatal-findings-from-an-australian-longitudinal-study
#5
Larissa Rossen, Delyse Hutchinson, Judy Wilson, Lucinda Burns, Steve Allsop, Elizabeth J Elliott, Sue Jacobs, Jacqui A Macdonald, Craig Olsson, Richard P Mattick
Background Mother-infant bonding provides the foundation for secure attachment through the lifespan and organizes many facets of infant social-emotional development, including later parenting. Aims To describe maternal bonding to offspring across the pregnancy and postnatal periods, and to examine a broad range of sociodemographic and psychosocial predictors of the maternal-offspring bond. Methods Data were drawn from a sample of 372 pregnant women participating in an Australian population-based longitudinal study of postnatal health and development...
February 17, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28211140/anesthesia-for-fetal-surgery
#6
REVIEW
Monica A Hoagland, Debnath Chatterjee
Fetal therapy is an exciting and growing field of medicine. Advances in prenatal imaging and continued innovations in surgical and anesthetic techniques have resulted in a wide range of fetal interventions including minimally invasive, open mid-gestation, and ex-utero intrapartum treatment procedures. The potential for maternal morbidity is significant and must be carefully weighed against claimed benefits to the fetus. Appropriate patient selection is critical, and a multidisciplinary team-based approach is strongly recommended...
February 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28208659/developmental-origins-of-chronic-kidney-disease-should-we-focus-on-early-life
#7
REVIEW
You-Lin Tain, Chien-Ning Hsu
Chronic kidney disease (CKD) is becoming a global burden, despite recent advances in management. CKD can begin in early life by so-called "developmental programming" or "developmental origins of health and disease" (DOHaD). Early-life insults cause structural and functional changes in the developing kidney, which is called renal programming. Epidemiological and experimental evidence supports the proposition that early-life adverse events lead to renal programming and make subjects vulnerable to developing CKD and its comorbidities in later life...
February 11, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28207498/an-analysis-of-variations-of-indications-and-maternal-fetal-prognosis-for-caesarean-section-in-a-tertiary-hospital-of-beijing-a-population-based-retrospective-cohort-study
#8
Yajun Liu, Xin Wang, Liying Zou, Yan Ruan, Weiyuan Zhang
In recent decades, we have observed a remarkable increase in the rate of caesarean section (CS) in both developed and developing countries, especially in China. According to the World Health Organization (WHO) systematic review, if the increase in CS rate was between 10% and 15%, the maternal and neonatal mortality was decreased. However, above this level, increasing the rate of CS is no longer associated with reduced mortality. To date, no consensus has been reached on the main factors driving the cesarean epidemic...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28207425/evidence-based-interventions-for-improvement-of-maternal-and-child-nutrition-in-low-income-settings-what-s-new
#9
Tyler Vaivada, Michelle F Gaffey, Jai K Das, Zulfiqar A Bhutta
PURPOSE OF REVIEW: Maternal and child malnutrition continues to disproportionately affect low and middle-income countries, contributing to high rates of morbidity, mortality, and suboptimal development. This article reviews evidence from recent systematic reviews and studies on the effectiveness of interventions to improve nutritional status in these especially vulnerable populations. RECENT FINDINGS: Macronutrients provided to expectant mothers in the form of balanced protein energy supplements can improve fetal growth and birth outcomes, and new research suggests that lipid nutrient supplements can reduce both stunting and wasting in newborns...
February 15, 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/28198038/likelihood-of-cesarean-delivery-after-applying-leading-active-labor-diagnostic-guidelines
#10
Jeremy L Neal, Nancy K Lowe, Julia C Phillippi, Sharon L Ryan, Amy M Knupp, Mary S Dietrich, Stephen F Thung
BACKGROUND: Friedman, the United Kingdom's National Institute for Health and Care Excellence (NICE), and the American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine (ACOG/SMFM) support different active labor diagnostic guidelines. Our aims were to compare likelihoods for cesarean delivery among women admitted before vs in active labor by diagnostic guideline (within-guideline comparisons) and between women admitted in active labor per one or more of the guidelines (between-guideline comparisons)...
February 15, 2017: Birth
https://www.readbyqxmd.com/read/28191778/generation-of-human-induced-pluripotent-stem-cell-derived-bona-fide-neural-stem-cells-for-ex-vivo-gene-therapy-of-metachromatic-leukodystrophy
#11
Vasco Meneghini, Giacomo Frati, Davide Sala, Silvia De Cicco, Marco Luciani, Chiara Cavazzin, Marianna Paulis, Wieslawa Mentzen, Francesco Morena, Serena Giannelli, Francesca Sanvito, Anna Villa, Alessandro Bulfone, Vania Broccoli, Sabata Martino, Angela Gritti
Allogeneic fetal-derived human neural stem cells (hfNSCs) that are under clinical evaluation for several neurodegenerative diseases display a favorable safety profile, but require immunosuppression upon transplantation in patients. Neural progenitors derived from patient-specific induced pluripotent stem cells (iPSCs) may be relevant for autologous ex vivo gene-therapy applications to treat genetic diseases with unmet medical need. In this scenario, obtaining iPSC-derived neural stem cells (NSCs) showing a reliable "NSC signature" is mandatory...
February 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28191626/intermittent-auscultation-ia-of-fetal-heart-rate-in-labour-for-fetal-well-being
#12
REVIEW
Ruth Martis, Ova Emilia, Detty S Nurdiati, Julie Brown
BACKGROUND: The goal of fetal monitoring in labour is the early detection of a hypoxic baby. There are a variety of tools and methods available for intermittent auscultation (IA) of the fetal heart rate (FHR). Low- and middle-income countries usually have only access to a Pinard/Laënnec or the use of a hand-held Doppler device. Currently, there is no robust evidence to guide clinical practice on the most effective IA tool to use, timing intervals and length of listening to the fetal heart for women during established labour...
February 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28188789/biomarker-identification-and-pathway-analysis-of-preeclampsia-based-on-serum-metabolomics
#13
Tingting Chen, Ping He, Yong Tan, Dongying Xu
Preeclampsia presents serious risk of both maternal and fetal morbidity and mortality. Biomarkers for the detection of preeclampsia are critical for risk assessment and targeted intervention. The goal of this study is to screen potential biomarkers for the diagnosis of preeclampsia and to illuminate the pathogenesis of preeclampsia development based on the differential expression network. Two groups of subjects, including healthy pregnant women, subjects with preeclampsia, were recruited for this study. The metabolic profiles of all of the subjects' serum were obtained by liquid chromatography quadruple time-of-flight mass spectrometry...
February 7, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28188612/hepatitis-b-immunoglobulin-during-pregnancy-for-prevention-of-mother-to-child-transmission-of-hepatitis-b-virus
#14
REVIEW
Ahizechukwu C Eke, George U Eleje, Uzoamaka A Eke, Yun Xia, Jiao Liu
BACKGROUND: Hepatitis is a viral infection of the liver. It is mainly transmitted between people through contact with infected blood, frequently from mother to baby in-utero. Hepatitis B poses significant risk to the fetus and up to 85% of infants infected by their mothers at birth develop chronic hepatitis B virus (HBV) infection. Hepatitis B immunoglobulin (HBIG) is a purified solution of human immunoglobulin that could be administered to the mother, newborn, or both. HBIG offers protection against HBV infection when administered to pregnant women who test positive for hepatitis B envelope antigen (HBeAg) or hepatitis B surface antigen (HBsAg), or both...
February 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28186614/decline-in-stillbirths-and-perinatal-mortality-after-implementation-of-a-more-aggressive-induction-policy-in-post-date-pregnancies-a-nationwide-register-study
#15
Anne R Zizzo, Ida Kirkegaard, Anja Pinborg, Niels Ulbjerg
INTRODUCTION: In 2011 the Danish national guidelines were changed towards a more aggressive induction and fetal surveillance policy from 1) induction of labor at gestational age (GA) of 42(+0) weeks and 2) no fetal surveillance after 40(+0) to 1) induction of labor between 41(+2) -41(+6) , 2) earlier induction at 41(+0) weeks in case of maternal age > 40 years or body mass index (BMI) > 35 kg/m(2) and 3) fetal surveillance at GA 41(+0) . MATERIAL AND METHODS: This national cohort study included all pregnancies that reached 41(+0) weeks of gestation from 2008 to 2014 (N=102 167)...
February 10, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28183146/prenatal-and-postnatal-management-of-gastroschisis-in-german-speaking-countries-is-there-a-standardized-management
#16
Katharina Schib, Marc Schumacher, Martin Meuli, Sasha Tharakan, Ulrike Subotic
Introduction Evidence-based guidelines or protocols regarding the perinatal management of babies born with gastroschisis are lacking. The aim of this work is to evaluate the different current treatment modalities for newborns with gastroschisis during the perinatal period in the German-speaking countries Germany, Austria, and Switzerland. These data could serve as a starting point for the development of a multicenter randomized controlled trial. Materials and Methods A questionnaire was developed with 30 questions divided into five sections: (1) prenatal diagnosis, (2) fetal therapy, (3) mode and timing of delivery, (4) operative management, and (5) postoperative management...
February 9, 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28182812/management-and-outcomes-of-fetal-hydrops-in-a-tertiary-care-centre-in-singapore
#17
Xin Yi Thong, Le Ye Lee, Dawn Ak Chia, Yee Chee Wong, Arijit Biswas
Introduction: Fetal hydrops is a serious condition which can be caused by immune and non-immune aetiologies. We aimed to review the management of fetal hydrops at our hospital. Materials and Methods: A retrospective review of all cases of fetal hydrops diagnosed in our institution from 2006 to 2013 was carried out. Results: Out of the 30 cases of fetal hydrops diagnosed antenatally, 17 were cases of Bart's hydrops which were all terminated in-utero. Of the remaining 13 cases, 11 cases consisted of non-immune causes of hydrops...
January 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28182335/how-to-monitor-pregnancies-complicated-by-fetal-growth-restriction-and-delivery-below-32-weeks
#18
W Ganzevoort, N Mensing van Charante, B Thilaganathan, F Prefumo, B Arabin, C M Bilardo, C Brezinka, J B Derks, A Diemert, J J Duvekot, E Ferrazzi, T Frusca, K Hecher, N Marlow, P Martinelli, E Ostermayer, A T Papageorghiou, D Schlembach, Ktm Schneider, T Todros, A Valcamonico, Gha Visser, A van Wassenaer-Leemhuis, C C Lees, H Wolf
OBJECTIVES: In the recent TRUFFLE study it appeared that, in pregnancies complicated by fetal growth restriction (FGR) between 26 and 32 weeks, monitoring of the ductus venosus (DV) combined with computerised cardiotocography (cCTG) as a trigger for delivery, increased the chance of infant survival without neurological impairment. However, concerns in interpretation were raised as DV monitoring appeared associated with a non-significant increase in fetal death, and part of the infants were delivered after 32 weeks, after which the study protocol was no longer applied...
February 9, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28180019/spontaneous-pushing-in-lateral-position-versus-valsalva-maneuver-during-second-stage-of-labor-on-maternal-and-fetal-outcomes-a-randomized-clinical-trial
#19
Farideh Vaziri, Amene Arzhe, Nasrin Asadi, Saeedeh Pourahmad, Zeinab Moshfeghy
BACKGROUND: There are concerns about the harmful effects of the Valsalva maneuver during the second stage of labor. OBJECTIVES: Comparing the effects of spontaneous pushing in the lateral position with the Valsalva maneuver during the second stage of labor on maternal and fetal outcomes. METHODS: Inclusion criteria in this randomized clinical trial conducted in Iran were as follows: nulliparous mothers, live fetus with vertex presentation, gestational age of 37 - 40 weeks, spontaneous labor, and no complications...
October 2016: Iranian Red Crescent Medical Journal
https://www.readbyqxmd.com/read/28178933/pregnancy-termination-for-fetal-abnormality-are-health-professionals-perceptions-of-women-s-coping-congruent-with-women-s-accounts
#20
Caroline Lafarge, Kathryn Mitchell, Andrew C G Breeze, Pauline Fox
BACKGROUND: Pregnancy termination for fetal abnormality (TFA) may have profound psychological consequences for those involved. Evidence suggests that women's experience of care influences their psychological adjustment to TFA and that they greatly value compassionate healthcare. Caring for women in these circumstances presents challenges for health professionals, which may relate to their understanding of women's experience. This qualitative study examined health professionals' perceptions of women's coping with TFA and assessed to what extent these perceptions are congruent with women's accounts...
February 8, 2017: BMC Pregnancy and Childbirth
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