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Fetal and neonatal care

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https://www.readbyqxmd.com/read/29925108/febrile-neutropenia-following-parvovirus-b19-infection-and-cross-anti-kell-reaction-to-e-coli-in-pregnancy
#1
Pedro Brandão, Marília Freixo, Elisa Soares, Catarina Estevinho, Ana Sofia Portela Carvalho, Anabela Melo
Parvovirus B19 has tropism for red line blood cells, causing immune hydrops during pregnancy. A positive anti-Kell Coombs reaction usually happens during pregnancy when there is production of antibodies that target Kell antigens, but cross reactions to other antigens may occur. A 24-year-old Gypsy primigravida, 0 Rhesus positive, presented with persistent isolated hyperthermia for 2 weeks and a positive indirect Coombs test result with anti-Kell antibodies at routine tests. She had a 19-week live fetus. The blood tests revealed bicytopenia with iron deficiency anemia, leucopoenia with neutropenia, and elevated C-reactive protein...
June 20, 2018: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/29921432/no-361-caesarean-delivery-on-maternal-request
#2
Eman Alsayegh, Hayley Bos, Kim Campbell, Jon Barrett
A maternal request for an elective CS in the absence of a maternal or fetal indication may raise risk-benefit considerations and ethical concerns for a health care provider. Appropriate counselling of the patient on the risks and benefits in proceeding with a CDMR without medical indication is essential. Providers should have a clear knowledge of the risks and benefits of providing an elective CS without medical indications compared to the risks and benefits of supporting an attempt at vaginal delivery, so that the patient may reach an informed decision...
July 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29920817/predictive-accuracy-of-cerebroplacental-ratio-for-adverse-perinatal-and-neurodevelopmental-outcomes-in-suspected-fetal-growth-restriction-systematic-review-and-meta-analysis
#3
REVIEW
Agustin Conde-Agudelo, José Villar, Stephen H Kennedy, Aris T Papageorghiou
OBJECTIVE: The cerebroplacental ratio (CPR) has been proposed for the routine surveillance of pregnancies with suspected fetal growth restriction (FGR), but the predictive performance of this test is unclear. The aim of this study was to determine the accuracy of the CPR for predicting adverse perinatal and neurodevelopmental outcomes in suspected FGR. METHODS: PubMed, EMBASE, CINAHL, and Lilacs (all from inception to July 31, 2017) were searched for cohort or cross-sectional studies that reported on the accuracy of the CPR for predicting adverse perinatal and/or neurodevelopmental outcomes in singleton pregnancies with antenatally suspected FGR based on sonographic parameters...
June 19, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29915747/audit-of-emergency-obstetric-referrals-from-a-secondary-level-hospital-in-haryana-north-india
#4
Shashi Kant, Ravneet Kaur, Sumit Malhotra, Partha Haldar, Akhil Dhanesh Goel
Background: The maternal mortality ratio in India is high. An effective emergency obstetric care (EmOC) strategy has been identified as a priority to reduce maternal deaths. Since the capacity of different levels of public health facilities to provide EmOC is varied, an effective referral system is crucial. However, few studies have evaluated the functioning and quality of referral systems in India. A systematic monitoring of referrals helps to identify current gaps in the provision of essential obstetric care...
January 2018: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29914278/maternal-fetal-and-neonatal-outcome-among-different-types-of-hypertensive-disorders-associating-pregnancy-needing-intensive-care-management
#5
Ahmed M Maged, Ameer Elsherief, Hany Hassan, Doaa Salaheldin, Khaled A Omran, Maged Almohamady, Sherif Dahab, Radwa Fahmy, Ahmed AbdelHak, Amira Y Shoab, Rehab Lotfy, Yossra S Lasheen, Hala Nabil, Sahar M Y Elbaradie
OBJECTIVE: To assess the relation between maternal, fetal and neonatal outcomes and different forms of hypertensive disorders associating pregnancy in women needed intensive care units (ICU) admission. METHODS: A prospective case control study conducted on 1238 women admitted to hypertensive intensive care unit at three university hospitals. They were classified into four groups. Group I included 472 women with severe preeclampsia (PE), Group II included 243 women with eclampsia (E); Group III included 396 women diagnosed with E associated with HELLP syndrome and Group IV included 127 women diagnosed as HELLP syndrome...
June 18, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29909265/intrapartum-and-perinatal-results-associated-with-different-degrees-of-staining-of-meconium-stained-amniotic-fluid
#6
Vanesa Rodríguez Fernández, Carlos Nicolás López Ramón Y Cajal, Elena Marín Ortiz, Emilio Couceiro Naveira
OBJECTIVE: To determine the intrapartum and perinatal results associated with different degrees of staining of meconium stained amniotic fluid (MSAF). STUDY DESIGN: In a retrospective cohort study of all singleton deliveries over a period of one year (2015) in a tertiary hospital, we compared different degrees of MSAF (yellow, green and thick) to clear amniotic fluids, and analysed in each group maternal, intrapartum and neonatal variables as well as umbilical cord blood gas analysis...
March 20, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29907484/patient-attitudes-toward-influenza-and-tetanus-diphtheria-and-acellular-pertussis-vaccination-in-pregnancy
#7
Emmie R Strassberg, Michael Power, Jay Schulkin, Lauren M Stark, A Dhanya Mackeen, Katie L Murtough, Michael J Paglia
BACKGROUND: Routine influenza and tetanus, diphtheria and acellular pertussis (Tdap) vaccination of pregnant women to prevent poor maternal, fetal and neonatal outcomes is recommended practice; however, actual rates of influenza vaccine acceptance are typically well below the (Healthy People 2020, 2015) goal of 80%. OBJECTIVE: We sought to identify barriers to accepting either vaccination. MATERIALS AND METHODS: From December 2014 to April 2015 women were given a questionnaire eliciting their experiences, attitudes and history of influenza and Tdap vaccination in pregnancy during their routine prenatal care appointments at a tertiary care center...
June 12, 2018: Vaccine
https://www.readbyqxmd.com/read/29898693/peripartum-fetal-distress-in-diabetic-women-a-retrospective-case-cohort-study
#8
B Castelijn, Kwp Hollander, J F Hensbergen, R G IJzerman, A W Valkenburg-van den Berg, Jwr Twisk, Cjm De Groot, Mgaj Wouters
BACKGROUND: Major concerns of pregnancies complicated by diabetes mellitus are an increased risk of adverse perinatal outcome. The objective of this study was to analyse the rate of fetal distress during labor in women with type 1, type 2 and gestational diabetes compared to control women. METHODS: A retrospective case-cohort study was conducted at the VU University Medical Center, Amsterdam; a tertiary care hospital. 117 women with type 1 diabetes, 59 women with type 2 diabetes, 303 women with gestational diabetes and 15,260 control women were included, who delivered between March 2004 and February 2014...
June 14, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29896725/-preliminary-analysis-of-the-cause-for-the-failure-of-non-invasive-prenatal-testing-using-cell-free-fetal-dna-derived-from-peripheral-maternal-blood
#9
Bin Zhang, Cong Shen, Huiyan Wang, Zhengmao Cai, Beiyi Lu, Xiaoqing Zhang, Bin Yu, Ting Wang
OBJECTIVE: To explore the cause of failure of non-invasive prenatal testing (NIPT) using cell-free fetal DNA from peripheral maternal blood. METHODS: A total of 31 832 cases of NIPT were retrospectively analyzed. The clinical data of pregnant women were analyzed and the outcome of pregnancy was followed up. RESULTS: Among the 31 832 cases, 200 patients have failed for the first NIPT test. Second test has succeeded in 171 (85.9%) of 199 cases, while 28 cases (14...
June 10, 2018: Zhonghua Yi Xue Yi Chuan Xue za Zhi, Zhonghua Yixue Yichuanxue Zazhi, Chinese Journal of Medical Genetics
https://www.readbyqxmd.com/read/29895996/maternal-and-early-perinatal-outcomes-of-triplet-pregnancy-study-of-82-triplets-from-a-single-perinatal-centre-in-south-india
#10
Priya Rajan, Srinivas Murki, Suseela Vavilala, Nirupama Surubhotla
Objectives: To study the recent trends in maternal and perinatal outcomes of triplet pregnancy from a perinatal centre in South India. Methods: All triplet pregnancies booked at Fernandez hospital, Hyderabad (a tertiary care perinatal centre in South India), or those referred between 2000 and 2014 were included in the study. The maternal, fetal and neonatal outcome and any interventions like cerclage, steroid administration were studied. Results: There were 82 triplet deliveries over the study period of 15 years (82 per 69,584 live births)...
June 2018: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/29895718/impact-of-prematurity-for-pancreatic-islet-and-beta-cell-development
#11
Frank H Bloomfield
As increasing numbers of babies born preterm survive into adulthood, it is becoming clear that, in addition to the well-described risks of neurodevelopmental sequelae, there also are increased risks for non-communicable diseases, including diabetes. Epidemiological studies indicate that risks are increased even for birth at late preterm and early term gestations and for both type 1 and type 2 diabetes. Thus, factors related to preterm birth likely affect development of the fetal and neonatal beta-cell in addition to effects on peripheral insulin sensitivity...
June 12, 2018: Journal of Endocrinology
https://www.readbyqxmd.com/read/29890949/complexity-of-gastroschisis-predicts-outcome-epidemiology-and-experience-in-an-australian-tertiary-centre
#12
Sarah J Melov, Irene Tsang, Ralph Cohen, Nadia Badawi, Karen Walker, Soundappan S V Soundappan, Thushari I Alahakoon
BACKGROUND: Gastroschisis is a congenital anomaly of the fetal abdominal wall, usually to the right side of umbilical insertion. It is often detected by routine antenatal ultrasound. Significant maternal and pediatric resources are utilised in the care of women and infants with gastroschisis. Increasing rates of gastroschisis worldwide have led institutions to review local data and investigate outcomes. A collaborative project was developed to review local epidemiology and investigate antenatal and neonatal factors influencing hospital length of stay (LOS) and total parental nutrition (TPN) in infants born with gastroschisis...
June 11, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29889717/cerebellar-differentiation-in-ovarian-teratoma-a-report-of-6-cases
#13
Colin J R Stewart, Maxine L Crook
Ovarian teratomas potentially demonstrate a wide range of tissue elements including central nervous system differentiation. The latter can include cerebellar tissue, which in our experience remains an under-recognized phenomenon. In the current study we present a review of 6 ovarian teratomas including 4 mature cystic teratomas and 2 immature teratomas showing cerebellar differentiation. Two cases were seen in consultation because the cerebellar elements were initially misinterpreted as immature teratomas. Two mature cystic teratomas focally demonstrated a distinct cerebellar architecture including folial type structures, but in all cases the cerebellar elements usually showed a less organized anatomic appearance, and sometimes these were concerning for immature teratomas upon initial examination...
July 2018: International Journal of Gynecological Pathology
https://www.readbyqxmd.com/read/29886760/estimating-risk-of-severe-neonatal-morbidity-in-preterm-births-under-32-weeks-of-gestation
#14
Emily F Hamilton, Alina Dyachenko, Antonio Ciampi, Kimberly Maurel, Philip A Warrick, Thomas J Garite
BACKGROUND: A large recent study analyzed the relationship between multiple factors and neonatal outcome and in preterm births. Study variables included reason for admission, indication for delivery, optimal steroid use, gestational age and other potentially prognostic factors. Using stepwise multivariable analysis, the only two variables independently associated with serious neonatal morbidity were gestational age and the presence of suspected intrauterine growth restriction as a reason for admission...
June 10, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29886318/prevention-of-shoulder-dystocia-a-randomized-controlled-trial-to-evaluate-an-obstetric-maneuver
#15
Olivier Poujade, Elie Azria, Pierre-François Ceccaldi, Carine Davitian, Carine Khater, Paul Chatel, Emilie Pernin, Nizar Aflak, Martin Koskas, Agnès Bourgeois-Moine, Laurence Hamou-Plotkine, Morgane Valentin, Jean-Paul Renner, Carine Roy, Candice Estellat, Dominique Luton
OBJECTIVE: Shoulder dystocia is a major obstetric emergency defined as a failure of delivery of the fetal shoulder(s). This study evaluated whether an obstetric maneuver, the push back maneuver performed gently on the fetal head during delivery, could reduce the risk of shoulder dystocia. STUDY DESIGN: We performed a multicenter, randomized, single-blind trial to compare the push back maneuver with usual care in parturient women at term. The primary outcome, shoulder dystocia, was considered to have occurred if, after delivery of the fetal head, any additional obstetric maneuver, beginning with the McRoberts maneuver, other than gentle downward traction and episiotomy was required...
June 4, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29885712/interdisciplinary-team-huddles-for-fetal-heart-rate-tracing-review
#16
Lisa Thompson, Cynthia Krening, Dolores Parrett
To address an increase in unexpected poor outcomes in term neonates, our team developed a goal of high reliability and improved fetal safety in the culture of the Labor and Delivery nursing department. We implemented interdisciplinary reviews of fetal heart rate, along with a Category II fetal heart rate management algorithm and a fetal heart rate assessment rapid response alert to call for unscheduled reviews when needed. Enhanced communication between nurses and other clinicians supported an interdisciplinary approach to fetal safety, and we observed an improvement in health outcomes for term neonates...
June 2018: Nursing for Women's Health
https://www.readbyqxmd.com/read/29884601/the-rise-and-need-for-mobile-apps-for-maternal-and-child-health-care-in-china-survey-based-on-app-markets
#17
Puhong Zhang, Le Dong, Huan Chen, Yanling Chai, Jianbo Liu
BACKGROUND: Mobile health services are thriving in the field of maternal and child health in China due to expansions in the field of electronic health and the introduction of the two-child policy. There are numerous maternal and child health apps in computer stores, but the exact number of apps, number of downloads, and features of these apps is not known. OBJECTIVE: This study aimed to explore the use of maternal and child health apps in Android and iOS app stores and to describe the key functional features of the most popular apps, with the purpose of providing insight into further research and development of maternal and child health mobile health products...
June 8, 2018: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29884513/acquired-antibodies-to-%C3%AE-iib%C3%AE-3-in-glanzmann-thrombasthenia-from-transfusion-and-pregnancy-to-bone-marrow-transplants-and-beyond
#18
REVIEW
Alan T Nurden
Patients with the inherited bleeding disorder Glanzmann thrombasthenia (GT) possess platelets that lack αIIbβ3 integrin and fail to aggregate, and have moderate to severe mucocutaneous bleeding. Many become refractory to platelet transfusions due to the formation of isoantibodies to αIIbβ3 with the rapid elimination of donor platelets and/or a block of function. Epitope characterization has shown isoantibodies to be polyclonal and to recognize different epitopes on the integrin with β3 a major site and αvβ3 on endothelial and vascular cells a newly recognized target...
May 23, 2018: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/29883985/mode-of-delivery-in-previable-births
#19
Robert M Rossi, Emily A DeFranco
OBJECTIVE:  Preterm birth before 23 weeks of gestation typically results in neonatal death (5% survival). Society for Maternal-Fetal Medicine and American College of Obstetricians and Gynecologists published consensus guidelines recommending cesarean delivery (CD) not be performed for fetal indications between 20 and 226/7 weeks given the lack of proven benefit. We sought to quantify the previable CD rate and identify characteristics associated with previable CD. METHODS:  We performed a population-based retrospective cohort study of all live births in Ohio (2006-2015)...
June 8, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29866484/neonatal-echocardiogram-in-duodenal-obstruction-is-unnecessary-after-normal-fetal-cardiac-imaging
#20
Caroline Q Stephens, Stephanie Dukhovny, Kathryn J Rowland, Nicholas A Hamilton
BACKGROUND: Duodenal obstruction (DO) is associated with congenital cardiac anomalies that may complicate the delivery of anesthesia during surgical repair. As most infants undergo fetal ultrasounds that identify cardiac anomalies, our aim was to determine the utility of obtaining preoperative neonatal echocardiograms in all DO patients. METHODS: We conducted a retrospective cohort study of all DO patients treated at two tertiary care children's hospitals between January 2005 and February 2016...
May 6, 2018: Journal of Pediatric Surgery
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