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Preconception management

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https://www.readbyqxmd.com/read/29305820/authoring-the-identity-of-learner-before-doctor-in-the-figured-world-of-medical-school
#1
Evangeline Stubbing, Esther Helmich, Jennifer Cleland
INTRODUCTION: Students enter the 'figured world' of medical school with preconceptions of what it means to be a doctor. The meeting of these early preconceptions and their newly developing identities can create emotional tensions. The aim of this study was to advance our understanding of how such tensions were experienced and managed. Using figured worlds as a theoretical framework we explored students' interactions of preconceptions with their newly developing professional identities in their first year at medical school...
January 5, 2018: Perspectives on Medical Education
https://www.readbyqxmd.com/read/29245354/anesthesia-for-a-parturient-with-intraneural-perineurioma-a-case-report
#2
Jiao Li, Hong Zeng, Zhengqian Li, Jun Wang
RATIONALE: Intraneural perineurioma is an extremely rare form of peripheral nerve sheath tumor; and the anesthetic management of a parturient with intraneural perineurioma, especially affecting spinal roots and nerves of extremities, is very rare. PATIENT CONCERNS: A 28-year-old woman was referred to the hospital at 37+5 weeks' gestation, presenting with a 10-year history of paroxysmal acroanesthesia and aching with distal limbs. DIAGNOSES: Based on the biopsy results, including immunohistochemical and electron microscopic findings, and molecular studies, her condition was diagnosed as intraneural perineurioma...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29240048/why-patients-are-afraid-of-opioid-analgesics-study-on-opioid-perception-in-patients-treated-for-chronic-pain
#3
Michał Graczyk, Alina Borkowska, Małgorzata Krajnik
INTRODUCTION    Opiophobia is deemed one of the key barriers in effective pain management.  OBJECTIVES    The study aimed to assess overall perception of opioids in cancer patients suffering from and treated for chronic pain, as well as determine the nature of their most common, related fears.  PATIENTS AND METHODS    The study comprised 100 palliative care patients who suffered from chronic cancer or non-cancer pain. Initially, they had to complete a survey exploring their knowledge on analgesics and potential fear of using opioids...
December 14, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29203504/frequencies-and-ethnic-distribution-of-abo-and-rhd-blood-groups-in-china-a-population-based-cross-sectional-study
#4
Jue Liu, Shikun Zhang, Qiaomei Wang, Haiping Shen, Yiping Zhang, Min Liu
OBJECTIVES: ABO and RhD blood groups are key factors affecting blood transfusion safety. The distribution of ABO and RhD blood groups varies globally, but limited data exist for ethnic distributions of these blood groups in Asian populations. We aimed to evaluate the distribution of ABO and RhD blood groups among Chinese ethnic groups. DESIGN: A population-based cross-sectional study. SETTING: Data on ABO groups and ethnicities were obtained from the National Free Preconception Health Examination Project (NFPHEP) with participants from 220 counties of 31 provinces in China PARTICIPANTS: There were 3 832 034 participants aged 21-49 years who took part in the NFPHEP from January 2010 to December 2012 and were included in this study...
December 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/29165607/an-evidence-based-approach-to-pre-pregnancy-counselling-for-patients-with-systemic-lupus-erythematosus
#5
Y K Onno Teng, Edwin O W Bredewold, Ton J Rabelink, Tom W J Huizinga, H C Jeroen Eikenboom, Maarten Limper, Ruth D E Fritsch-Stork, Kitty W M Bloemenkamp, Marieke Sueters
Patients with SLE are often young females of childbearing age and a pregnancy wish in this patient group is common. However, SLE patients are at high risk for adverse pregnancy outcomes that require adequate guidance. It is widely acknowledged that pre-pregnancy counselling is the pivotal first step in the management of SLE patients with a wish to become pregnant. Next, management of these patients is usually multidisciplinary and often requires specific expertise from the different physicians involved. Very recently a EULAR recommendation was published emphasizing the need for adequate preconception counselling and risk stratification...
November 20, 2017: Rheumatology
https://www.readbyqxmd.com/read/29116720/the-croatian-model-of-integrative-prospective-management-of-epilepsy-and-pregnancy
#6
Snježana Miškov, Romana Gjergja Juraški, Ivan Mikula, Silvio Bašić, Marija Bošnjak Pašić, Vesna Košec, Zlatko Sabol, Aleksandra Fučić, Tomislav Sajko, Vanja Bašić Kes
Epilepsy is the most common neurological complication in pregnancy. Women with epilepsy have a higher risk of complications in pregnancy. In Croatia, women with epilepsy are treated by neurologists at tertiary centers according to the place of residence. We prospectively followed-up pregnancies in women with epilepsy and healthy controls, and analyzed the factors responsible for their delivery outcomes and development of their babies. Healthy pregnant women had a higher level of education and economic status, but pregnant women with epilepsy took folic acid in a higher proportion than controls, possibly due to timely preconception counseling...
December 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29116583/innovative-clinical-pathways-for-obese-pregnant-women-design-and-feasibility-of-the-padua-project-north-eastern-italy
#7
A Lapolla, D Scibetta, P Gallina, G Iorizzo, M G Dalfrà, S Visentin, G B Nardelli, R Vettor
BACKGROUND: Obesity during pregnancy can adversely affect the wellbeing of the mother and the newborn, as well as the latter's long-term health. Preconception counseling, careful prenatal management, and strict follow-up during pregnancy are, therefore, essential for obese fertile women in order to prevent the negative effects of obesity. METHODS: In this setting, we developed a project that consisted in creating an integrated network of primary, secondary, and tertiary care providers and designing new clinical pathways for managing pregnancy in obese women...
November 7, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/29115118/adenomyosis-fertility-and-obstetric-outcome-a-comprehensive-literature-review
#8
Laura Buggio, Ermelinda Monti, Umberto Gattei, Dhohua Dridi, Paolo Vercellini
Adenomyosis is a benign condition characterized by the presence of endometrial glands and stroma deep within the myometrium. In recent years, the potential negative impact of adenomyosis on in vitro fertilization clinical outcomes has gained momentum, as well as, the possible link of this condition with obstetrical complications. The aim of this narrative review is to elucidate the possible association between uterine adenomyosis, infertility, and poor obstetrical outcomes. Several theories have been proposed to clarify the potential harmful impact of adenomyosis on fertility, such as a functional and structural defect of both the eutopic endometrium and the inner myometrium, an impairment of the uterine system of sperm transport, the presence of uterine dysperistalsis and of high levels of free radicals in the uterine milieu of women with the disease...
November 7, 2017: Minerva Ginecologica
https://www.readbyqxmd.com/read/29096233/parvovirus-b19-infection-in-pregnancy-awareness-and-opportunities
#9
REVIEW
Francesca Bonvicini, Gloria Bua, Giorgio Gallinella
Parvovirus B19 (B19V) is a human pathogenic virus associated with a wide range of clinical conditions. In pregnancy, B19V poses a potential hazard to the fetus as crossing the placental barrier and infecting erythroid progenitor cells in bone marrow and liver, it blocks fetal erythropoiesis leading to profound anemia, hydrops and/or fetal death. The virus is not regarded as a teratogen, however more scientific awareness is emerging on mechanisms and consequences of intrauterine infection and possible sequelae in the neonatal development...
December 2017: Current Opinion in Virology
https://www.readbyqxmd.com/read/29094891/fetal-alcohol-syndrome-and-fetal-alcohol-spectrum-disorders
#10
LeeAnne Denny, Sarah Coles, Robin Blitz
Fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASD) result from intrauterine exposure to alcohol and are the most common nonheritable causes of intellectual disability. The percentage of women who drink or binge drink during pregnancy has increased since 2012. FAS is commonly missed or misdiagnosed, preventing affected children from receiving needed services in a timely fashion. Diagnosis is based on the presence of the following clinical features, all of which must be present: prenatal and/or postnatal growth retardation, facial dysmorphology, central nervous system dysfunction, and neurobehavioral disabilities...
October 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/29045765/oral-anti-diabetic-agents-for-women-with-established-diabetes-impaired-glucose-tolerance-or-previous-gestational-diabetes-planning-pregnancy-or-pregnant-women-with-pre-existing-diabetes
#11
REVIEW
Joanna Tieu, Suzette Coat, William Hague, Philippa Middleton, Emily Shepherd
BACKGROUND: While most guidance recommends the use of insulin in women whose pregnancies are affected by pre-existing diabetes, oral anti-diabetic agents may be more acceptable to women. The effects of these oral anti-diabetic agents on maternal and infant health outcomes need to be established in pregnant women with pre-existing diabetes or impaired glucose tolerance, as well as in women with previous gestational diabetes mellitus preconceptionally or during a subsequent pregnancy. This review is an update of a review that was first published in 2010...
October 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28961800/zika-virus-and-reproduction-facts-questions-and-current-management
#12
Sylvie Epelboin, Emmanuel Dulioust, Loïc Epelboin, Alexandra Benachi, Françoise Merlet, Catherine Patrat
BACKGROUND: Zika virus (ZIKV) is an arthropod-borne virus of the family Flaviviridae, genus Flavivirus. ZIKV is currently the focus of an ongoing pandemic and worldwide public health emergency. Although originally isolated in 1947, its pathogenesis was poorly known and very few documented infections were published until recently. Its route of transmission and its impact on reproduction and pregnancy have only recently begun to be disclosed. OBJECTIVE AND RATIONALE: This review summarizes the most recent knowledge about ZIKV infection and pathogenesis and focuses on its impacts on male and female genital tracts, including the risks of sexual transmission and to pregnancy...
November 1, 2017: Human Reproduction Update
https://www.readbyqxmd.com/read/28918404/combined-caesarean-with-splenectomy-in-pregnancy-with-portal-hypertension-defining-plausibility
#13
Manjunath Maruti Pol, Latika Uniyal Chawla, Yashwant Singh Rathore, Ritesh Goel
24-year-old woman at 28 weeks gestation was referred from peripheral hospital with diagnosis of pregnancy with portal hypertension. She had received multiple transfusion for pancytopaenia in the past and had undergone endoscopic sclerotherapy for oesophageal varices. Initially, she was admitted in our hospital at 28 weeks gestation for blood transfusion and was evaluated by multispecialty team of doctors. She was advised splenectomy for transfusion-dependent pancytopaenia secondary to hypersplenism in non-cirrhotic portal hypertension...
September 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28863222/chronic-kidney-disease-in-pregnancy
#14
REVIEW
Abhilash Koratala, Deepti Bhattacharya, Amir Kazory
With the increasing prevalence of chronic kidney disease (CKD) worldwide, the number of pregnant women with various degrees of renal dysfunction is expected to increase. There is a bidirectional relation between CKD and pregnancy in which renal dysfunction negatively affects pregnancy outcomes, and the pregnancy can have a deleterious impact on various aspects of kidney disease. It has been shown that even mild renal dysfunction can increase considerably the risk of adverse maternal and fetal outcomes. Moreover, data suggest that a history of recovery from acute kidney injury is associated with adverse pregnancy outcomes...
September 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28828743/pregnancy-in-women-with-congenital-heart-disease
#15
REVIEW
Evin Yucel, Doreen DeFaria Yeh
Advances in cardiac surgical interventions in infancy and childhood have led to an increased number of women with congenital heart disease of childbearing age. For these women, individualized preconception counseling and pregnancy planning should be a vital component of their medical management, and presentation for obstetric care may even be an opportunity to re-establish cardiovascular care for patients who have been lost to follow-up. These patients have unique cardiovascular anatomy and physiology, which is dependent upon the surgical intervention they may have undergone during childhood or adolescence...
August 22, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28780660/update-on-valvular-heart-disease-in-pregnancy
#16
REVIEW
Lucy M Safi, Sarah V Tsiaras
Valvular heart disease in women of childbearing age poses an increased risk of adverse maternal and fetal outcomes, and management in pregnancy can be challenging. Ideally, patients with suspected valvular disease should have preconception counseling by a multidisciplinary team including cardiologists with expertise in pregnancy and a maternal-fetal medicine specialist. Preconception planning should include a cardiac assessment of maternal risk, determination of frequency of surveillance, and a cardiovascular management plan during delivery...
September 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28738750/pregnancy-outcome-in-patients-with-takayasu-s-arteritis-cohort-study-and-review-of-the-literature
#17
Michal Kirshenbaum, Michal J Simchen
OBJECTIVE: The objective of this study is to investigate the clinical features of pregnancy in women with Takayasu's arteritis managed in a tertiary medical center and review the literature in order to establish the course and recommended follow up and treatment for these pregnancies. MATERIALS AND METHODS: Retrospective analysis of 20 pregnancies in 6 women with Takayasu's arteritis. Patients were recruited from the high risk pregnancy clinics at Sheba Medical Center, where follow up included strict control of blood pressure and treatment of obstetric and disease-related complications...
August 4, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28724408/learning-intraprofessional-collaboration-by-participating-in-a-consultation-programme-what-and-how-did-primary-and-secondary-care-trainees-learn
#18
Marijn Janssen, Margaretha H Sagasser, Elisabeth A M Laro, Jacqueline de Graaf, Nynke D Scherpbier-de Haan
BACKGROUND: A growing number of patients require overview and management in both primary and secondary care. This situation requires that primary and secondary care professionals have well developed collaborative skills. While knowledge about interprofessional collaboration and education is rising, little is known about intraprofessional collaboration and education between physicians of various disciplines. This study examines a newly developed consultation programme for trainees in general practice and internal medicine to acquire intraprofessional collaboration skills...
July 19, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28711073/lupus-nephritis-and-pregnancy-concerns-and-management
#19
Liz Lightstone, Michelle A Hladunewich
Pregnancy associated with lupus, especially lupus nephritis, is often fraught with concern for both the mother and fetus. Thus, it is paramount that care begins preconception so that proper planning in terms of optimizing the medical regimen, discontinuation of fetotoxic agents, and treatment of active disease can occur. It is well known that active nephritis at the time of conception is associated with poor outcomes. Even with quiescent disease, recent data indicate that being lupus anticoagulant-positive, nonwhite or Hispanic, and using antihypertensive medications were all predictors of worse pregnancy outcomes...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28678065/pregnancy-and-reproductive-aspects-of-systemic-lupus-erythematosus
#20
Laura Andreoli, Francesca Crisafulli, Angela Tincani
PURPOSE OF REVIEW: To discuss pregnancy and reproductive aspects in women with systemic lupus erythematosus (SLE) with particular focus on preconception counselling, maternal and foetal outcomes, safety and beneficial effects of drugs during pregnancy as well as contraception methods, assisted reproduction techniques and strategies for thromboembolism prophylaxis in patients with positive antiphospholipid antibodies. RECENT FINDINGS: Evidence-based recommendations for the management of family planning and women's health issues in SLE and/or APS have been developed by a multidisciplinary panel of experts...
September 2017: Current Opinion in Rheumatology
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