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Perinatal care

Tatiane Aparecida Ribeiro, Kelly Valério Prates, Audrei Pavanello, Ananda Malta, Laize Peron Tófolo, Isabela Peixoto Martins, Júlio Cezar de Oliveira, Rosiane Aparecida Miranda, Rodrigo Mello Gomes, Elaine Vieira, Claudinéia Conationi da Silva Franco, Luiz Felipe Barella, Flávio Andrade Francisco, Vander Silva Alves, Sandra da Silva Silveira, Veridiana Mota Moreira, Gabriel Sergio Fabricio, Kesia Palma-Rigo, Deborah M Sloboda, Paulo Cezar de Freitas Mathias
Acephate has been used extensively as an insecticide in agriculture. Its downstream sequelae are associated with hyperglycemia, lipid metabolism dysfunction, DNA damage, and cancer, which are rapidly growing epidemics and which lead to increased morbidity and mortality rates and soaring health-care costs. Developing interventions will require a comprehensive understanding of which excess insecticides during perinatal life can cause insulin resistance and type 2 diabetes. A Wistar rat animal model suggests that acephate exposure during pregnancy and lactation causes alterations in maternal glucose metabolism and programs the offspring to be susceptible to type 2 diabetes at adulthood...
October 17, 2016: Toxicology
Letícia Schwerz Weinert, Angela Jacob Reichelt, Leonardo Rauber Schmitt, Roberta Boff, Maria Lucia Rocha Oppermann, Joiza Lins Camargo, Sandra Pinho Silveiro
BACKGROUND: Gestational diabetes mellitus (GDM) and vitamin D deficiency have been associated with increased risk of adverse perinatal outcomes but the consequences of both conditions simultaneously present in pregnancy have not yet been evaluated. Our objective was to study the influence of vitamin D deficiency in neonatal outcomes of pregnancies with GDM. METHODS: 184 pregnant women with GDM referred to specialized prenatal monitoring were included in this cohort and had blood sampled for 25-hydroxyvitamin D measurement...
2016: PloS One
Isabell B Purdy, Mary Alice Melwak, Joan R Smith, Carole Kenner, Rebecca Chuffo-Siewert, Donna J Ryan, Sue Hall
BACKGROUND: The neonatal intensive care unit (NICU) can be a stressful environment for infants, their families, and the healthcare team. There is an immediate need for neonatal nurses to embrace and translate the new National Perinatal Association recommendations for psychosocial support of NICU parents into clinical practice to demonstrate best practices for infants, their families, and the whole team. PURPOSE: To summarize the current evidence-based practice recommendations and to provide suggestions for team members to develop strategies to adopt and implement them through quality improvement (QI) projects...
October 19, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Nassib Bezerra Bueno, Telma Toledo Florêncio, Fabiana Albuquerque Cavalcante, Isabela Lopes Lins, Ana Grotti Clemente, Ana Lydia Sawaya
BACKGROUND: Short stature in adult life, a possible consequence of poor perinatal conditions, is associated with higher risk of mortality and social disabilities. We aimed to determine whether low-income, overweight/obese, short-stature (SS) women show alterations in body composition, self-body-image perception, and biochemical profile compared to their non-short (NS) counterparts. METHODS: A cross-sectional study was conducted with women living in shantytowns and mother or relatives to undernourished children treated in a center for recuperation and nutritional education...
2016: PeerJ
Miia Tuominen, Anne Kaljonen, Pia Ahonen, Juha Mäkinen, Päivi Rautava
INTRODUCTION: Primary maternity care services are globally provided according to various organisational models. Two models are common in Finland: a maternity health clinic and an integrated maternity and child health clinic. The aim of this study was to clarify whether there is a relation between the organisational model of the maternity health clinics and the utilisation of maternity care services, and certain maternal and perinatal health outcomes. METHODS: A comparative, register-based cross-sectional design was used...
July 8, 2016: International Journal of Integrated Care
Brodie Parent, Ira Martopullo, Noel S Weiss, Saurabh Khandelwal, Emily E Fay, Ali Rowhani-Rahbar
Importance: Metabolic changes after maternal bariatric surgery may affect subsequent fetal development. Many relevant perinatal outcomes have not been studied in this postoperative population, and the risks associated with short operation-to-birth (OTB) intervals have not been well examined. Objective: To examine the risk for perinatal complications in women with a history of bariatric surgery (postoperative mothers [POMs]) by comparing them with mothers without operations (nonoperative mothers [NOMs]) and examining the association of the OTB interval with perinatal outcomes...
October 19, 2016: JAMA Surgery
Diane VonBehren, Molly M Killion, Carol Burke, Betsy Finkelmeier, Brigit Zamora
Three teams of perinatal expert nurses participated in planning and designing a new maternity unit, operationalizing the move to the new space, and evaluating care processes and workflows after the move. The hospitals involved were University of California, San Francisco Benioff Children's Hospital, Prentice Women's Hospital of Northwestern Memorial Healthcare in Chicago, IL, and Florida Hospital Orlando, Florida Hospital for Women. Although each team discussed specific details and lessons learned, there is remarkable consistency among the experiences of these teams and with the discussion of the process by the team at Mercy Hospital St...
November 2016: MCN. the American Journal of Maternal Child Nursing
Alice Keely, Sarah Cunningham-Burley, Lawrie Elliott, Jane Sandall, Anne Whittaker
INTRODUCTION: women with a raised BMI are more likely to gain excessive weight in pregnancy compared to women with a BMI in the normal range. Recent behaviour change interventions have had moderate to no influence on GWG, and no effect on other perinatal outcomes. Evidence is required regarding the social and cultural contexts of weight and pregnancy. No studies to date have included the views of partners. AIMS: to explore the experiences, attitudes and health-related behaviours of pregnant women with a BMI >40kg/m(2); and to identify the factors and considerations which shape their beliefs, experiences and behaviours, and how these may change during and after pregnancy...
September 28, 2016: Midwifery
Kylee Trevillion, Jill Domoney, Andrew Pickles, Debra Bick, Sarah Byford, Margaret Heslin, Jeannette Milgrom, Rachel Mycroft, Carmine Pariante, Elizabeth Ryan, Myra Hunter, Louise Michele Howard
BACKGROUND: Depression is a common antenatal mental disorder and is associated with an increased risk of adverse effects on the fetus and significant morbidity for the mother; if untreated it can also continue into the post-natal period and affect mother-infant interactions. There has been little research evaluating the effectiveness or cost-effectiveness of antenatal psychological interventions for antenatal depression, particularly for mild to moderate disorders. International guidelines recommend a stepped care approach starting with Guided Self Help, and the aim of this exploratory trial is to investigate Guided Self Help modified for pregnancy...
October 18, 2016: Trials
Courtney Stanley Sundin, Lauren Bradham Mazac
Amniotic fluid embolism (AFE) is a rare but serious and potentially deadly complication of pregnancy that is unpreventable and unpredictable. Most AFE events occur during labor; however, approximately one third happen during the immediate postpartum period. Presentation is abrupt and thought to be an abnormal response to fetal materials entering maternal circulation through the placental insertion site. Care providers must recognize the signs and symptoms of AFE and react quickly in effort to treat potential complications...
October 13, 2016: MCN. the American Journal of Maternal Child Nursing
T Munk-Olsen, M L Maegbaek, B M Johannsen, X Liu, L M Howard, A di Florio, V Bergink, S Meltzer-Brody
Perinatal psychiatric episodes comprise various disorders and symptom severity, which are diagnosed and treated in multiple treatment settings. To date, no studies have quantified the incidence and prevalence of perinatal psychiatric episodes treated in primary and secondary care, which we aimed to do in the present study. We designed a descriptive prospective study and included information from Danish population registers to study first-time ever and recurrent psychiatric episodes during the perinatal period, including treatment at psychiatric facilities and general practitioners (GPs)...
October 18, 2016: Translational Psychiatry
Lourdes A Blanco Esquivel, Jorge Macia Urbina, Hugo Mendieta Zerón
BACKGROUND: Severe obstetric morbidity constitutes a serious problem worldwide; however, an effective obstetrical prognosis scale is still missing. OBJECTIVE: To propose a modified Sequential Organ Failure Assessment Score (SOFA) score based on time before reaching specialized medical attention. METHOD: This was an ambispective, descriptive study, including all women treated at the Obstetrical Intensive Care Unit (OICU) of the "Mónica Pretelini Sáenz" Maternal-Perinatal Hospital (HMPMPS), Toluca, Mexico, from June 2009 to June 2013...
September 2016: Ghana Medical Journal
Tiffany Y Peng, Samantha F Ehrlich, Yvonne Crites, John L Kitzmiller, Michael W Kuzniewicz, Monique H Hedderson, Assiamira Ferrara
BACKGROUND: Despite concern for adverse perinatal outcomes in women with diabetes prior to pregnancy, recent data on the prevalence of pregestational type 1 and type 2 diabetes in the U.S. are lacking. OBJECTIVE: To estimate changes in the prevalence of overall pregestational diabetes (all types) and pregestational type 1 and type 2 diabetes, and whether changes varied by race-ethnicity between 1996 and 2014. STUDY DESIGN: Cohort study conducted among 655,428 pregnancies at a Northern California integrated health delivery system in 1996-2014...
October 14, 2016: American Journal of Obstetrics and Gynecology
Cath Rogers, Laurence Lepherd, Rahul Ganguly, Sebastian Jacob-Rogers
PROBLEM: Autistic Spectrum Disorder (ASD) is an increasingly commonly diagnosed disability. People with ASD commonly report challenges in social interaction and a heightened sensory perception. These challenges may be particularly difficult for women during pregnancy, birthing and beyond. BACKGROUND: Very little is known about the experiences and needs of birthing women who have ASD. There is a large body of literature about women who have autistic children, but almost nothing about women who may have this disability themselves...
October 14, 2016: Women and Birth: Journal of the Australian College of Midwives
Annamagreth M Mukwenda, Columba K Mbekenga, Andrea B Pembe, Pia Olsson
BACKGROUND: Eclampsia is a major cause of maternal and perinatal mortality that requires advanced care and long hospital stays with uncertain outcomes for mother and baby. Care of eclamptic women is particularly challenging in low-income settings. Standards for medical care for eclampsia are established but the psychosocial needs of women are under-researched. AIM: To explore and describe women's experiences of having had, and recovered from, eclampsia at a tertiary hospital in Tanzania...
October 14, 2016: Women and Birth: Journal of the Australian College of Midwives
Ricardo Mauricio Malagón Reyes, Rubén Castorena de Ávila, María de Jesús Ángeles Vázquez, César Augusto Núñez Monteagudo, Hugo Mendieta Zerón
OBJECTIVE: Placenta accreta is one of the main obstetrical complications worldwide. The aim of this study was to report the experience of managing placenta accreta with a 6% polidocanol solution sclerotherapy. MATERIALS AND METHODS: We selected patients between 37 weeks of gestation and 38 weeks of gestation, diagnosed with placenta accreta, treated at the Maternal Perinatal Hospital "Monica Pretelini Sáenz", Toluca, Mexico, during the period from November 2013 to August 2014...
October 2016: Taiwanese Journal of Obstetrics & Gynecology
Zehra Ordulu, Tammy Kammin, Harrison Brand, Vamsee Pillalamarri, Claire E Redin, Ryan L Collins, Ian Blumenthal, Carrie Hanscom, Shahrin Pereira, India Bradley, Barbara F Crandall, Pamela Gerrol, Mark A Hayden, Naveed Hussain, Bibi Kanengisser-Pines, Sibel Kantarci, Brynn Levy, Michael J Macera, Fabiola Quintero-Rivera, Erica Spiegel, Blair Stevens, Janet E Ulm, Dorothy Warburton, Louise E Wilkins-Haug, Naomi Yachelevich, James F Gusella, Michael E Talkowski, Cynthia C Morton
In this exciting era of "next-gen cytogenetics," integrating genomic sequencing into the prenatal diagnostic setting is possible within an actionable time frame and can provide precise delineation of balanced chromosomal rearrangements at the nucleotide level. Given the increased risk of congenital abnormalities in newborns with de novo balanced chromosomal rearrangements, comprehensive interpretation of breakpoints could substantially improve prediction of phenotypic outcomes and support perinatal medical care...
October 5, 2016: American Journal of Human Genetics
George J Daskalakis, Alexis K Karambelas
OBJECTIVE: To examine the influence of vaginal probiotic administration as an adjunct to standard antibiotic treatment on perinatal outcome in women with preterm premature rupture of membranes (PPROM). MATERIALS AND METHODS: This was a prospective randomized trial of cases with PPROM (24-34 weeks) that were admitted to our department between 2011 and 2015. Forty-nine cases received vaginal probiotics for 10 days in combination with antibiotic prophylaxis and were compared to 57 others that received only antibiotics for the same time period...
October 15, 2016: Fetal Diagnosis and Therapy
Anonh Xeuatvongsa, Siddhartha Sankar Datta, Edna Moturi, Kathleen Wannemuehler, Phanmanisone Philakong, Viengnakhone Vongxay, Vansy Vilayvone, Minal K Patel
BACKGROUND: Hepatitis B vaccine birth dose (HepB-BD) was introduced in Lao People's Democratic Republic to prevent perinatal hepatitis B virus transmission in 2008; high coverage is challenging since only 38% of births occur in a health facility. Healthcare workers report being unaware of home births and thus unable to conduct timely postnatal care (PNC) home visits. A quasi-experimental pilot study was conducted wherein mobile phones and phone credits were provided to village health volunteers (VHV) and healthcare workers (HCWs) to assess whether this could improve HepB-BD administration, as well as birth notification and increase home visits...
October 11, 2016: Vaccine
Anna-Barbara Schlüer
While the problem of Pressure Ulcers (PU) in adults has received a great deal of attention, far less is known about PUs in neonates and children. The overall health status of children is generally better and multi-morbidity is limited to a small percentage of patients, like very low term neonates (born before 32 weeks of gestation age), newborns with congenital abnormalities, genetic disorders, perinatal distress syndrome or children with a limited immunity. Survival rates of both critically and chronically ill neonates, infants and children have improved dramatically in recent years, introducing new challenges for medical and nursing care...
October 8, 2016: Journal of Tissue Viability
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