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Fetal and neonatal care

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https://www.readbyqxmd.com/read/28641304/hyperemesis-gravidarum-a-review-of-recent-literature
#1
Viktoriya London, Stephanie Grube, David M Sherer, Ovadia Abulafia
BACKGROUND: In the United States, hyperemesis gravidarum is the most common cause of hospitalization during the first half of pregnancy and is second only to preterm labor for hospitalizations in pregnancy overall. In approximately 0.3-3% of pregnancies, hyperemesis gravidarum is prevalent and this percentage varies on account of different diagnostic criteria and ethnic variation in study populations. Despite extensive research in this field, the mechanism of the disease is largely unknown...
June 23, 2017: Pharmacology
https://www.readbyqxmd.com/read/28629247/obstetric-practice-patterns-in-pregnancies-complicated-by-fetal-trisomy-13-or-18
#2
Sarah K Dotters-Katz, Marcela C Smid, Cora Mcelwain, Jeffrey A Kuller, Jay Schulkin
PURPOSE: Describe practice patterns among obstetrician/gynecologists (OB/GYNs) when caring for women with pregnancy complicated by fetal trisomy 13(T13) or 18(T18), and compare these between maternal-fetal-medicine (MFM) and non-MFM providers. MATERIALS AND METHODS: We conducted an electronic survey using the American College of Obstetricians and Gynecologists database. Using simple statistics, we describe demographics and practice patterns among respondents, and compare those of MFM practitioners with non-MFM providers...
June 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28629237/improved-pregnancy-outcome-following-earlier-splenectomy-in-women-with-immune-thrombocytopenia-a-5-year-observational-study
#3
Mohamed Rezk, Alaa Masood, Ragab Dawood, Mahmoud Emara, Hanan El-Sayed
OBJECTIVE: to assess prospectively the maternal and fetal outcome in women with immune thrombocytopenic purpura (ITP) who undergone earlier splenectomy compared to women on medical therapy. METHODS: a 5-year observational study included pregnant women in the first trimester previously diagnosed with primary ITP with 74 patients underwent splenectomy before pregnancy and 86 patients on medical therapy. Patients were followed throughout pregnancy and labor to record their obstetric outcome...
June 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28628847/the-importance-of-declining-insulin-requirements-during-pregnancy-in-patients-with-pre-gestational-gestational-diabetes-mellitus
#4
Maya Ram, Larissa Feinmesser, Shiri Shinar, Sharon Maslovitz
OBJECTIVE: In patients with pre-gestational and gestational diabetes mellitus (GDM), insulin requirements often increase during the third trimester of pregnancy in order to maintain proper glycemic control. However, a fraction of patients demonstrate a significant decrease in insulin requirements in late gestation. We aimed to evaluate the clinical significance of decreasing insulin requirements in patients with pre-gestational diabetes and GDM with respect to fetal wellbeing and pregnancy outcome...
June 3, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28622146/relationship-between-various-maternal-conditions-and-lactic-acid-dehydrogenase-activity-in-umbilical-cord-blood-at-birth
#5
Evangelos Patavoukas, Josefina Åberg-Liesaho, Cecilia Pegelow Halvorsen, Birger Winbladh, Eva Wiberg-Itzel
BACKGROUND: Lactic acid dehydrogenase (LDH) is a valuable marker for some of the most important diseases in newborns and the plasma LDH activity in newborns correlates well with conditions such as asphyxia. If LDH should be considered as a useful tool also in obstetric care, key factors associated with maternal health before and during pregnancy which could affect umbilical cord LDH activity need to be known. The aims of this study were to explore relationships between selected maternal conditions and arterial lactic acid dehydrogenase activity (aLDH) in umbilical cord blood at delivery...
June 15, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28617151/lithium-exposure-during-pregnancy-outcomes-for-women-who-attended-a-specialist-antenatal-clinic
#6
Jacqueline Frayne, Thinh Nguyen, Tabitha Mok, Yvonne Hauck, Helena Liira
INTRODUCTION: Lithium treatment in pregnancy represents a significant dilemma for women and treating health professionals alike. The complexity of risk-benefit analysis is impacted by limited information. METHODS: A cohort study of 33 women with severe mental illness, who were prescribed lithium at any time during the pregnancy, and gave birth between December 2007 and January 2015 at a specialist antenatal clinic in Western Australia. A descriptive comparison for women who continued lithium throughout pregnancy, and those who ceased on discovery of pregnancy was undertaken examining demographic, obstetric, neonatal and psychiatric variables...
June 15, 2017: Journal of Psychosomatic Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28614956/interventions-for-treating-hyperemesis-gravidarum-a-cochrane-systematic-review-and-meta-analysis
#7
Rupsa C Boelig, Samantha J Barton, Gabriele Saccone, Anthony J Kelly, Steven J Edwards, Vincenzo Berghella
INTRODUCTION: While nausea and vomiting in early pregnancy are very common, affecting approximately 80% of pregnancies, hyperemesis gravidarum is a severe form affecting 0.3-1.0% of pregnancies. Although hyperemesis gravidarum is rarely a source of mortality, it is a significant source of morbidity. It is one of the most common indications for hospitalization in pregnancy. Beyond the maternal and fetal consequences of malnutrition, the severity of hyperemesis symptoms causes a major psychosocial burden leading to depression, anxiety, and even pregnancy termination...
June 14, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28613398/fetal-and-umbilical-doppler-ultrasound-in-high-risk-pregnancies
#8
REVIEW
Zarko Alfirevic, Tamara Stampalija, Therese Dowswell
BACKGROUND: Abnormal blood flow patterns in fetal circulation detected by Doppler ultrasound may indicate poor fetal prognosis. It is also possible that false positive Doppler ultrasound findings could lead to adverse outcomes from unnecessary interventions, including preterm delivery. OBJECTIVES: The objective of this review was to assess the effects of Doppler ultrasound used to assess fetal well-being in high-risk pregnancies on obstetric care and fetal outcomes...
June 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28609711/birth-characteristics-of-women-with-marfan-syndrome-obstetric-and-neonatal-outcomes-of-their-pregnancies-a-nationwide-cohort-and-case-control-study
#9
Kristina Kernell, Gunilla Sydsjö, Marie Bladh, Ann Josefsson
OBJECTIVE: The aim was to investigate birth characteristics, obstetric and neonatal outcomes of the first childbirth in women with Marfan syndrome by use of Swedish national registers since pregnancy-related outcomes in women with Marfan syndrome have only been sparsely investigated. STUDY DESIGN: In this national population-based cohort study and matched case-control study of Swedish women born 1973-1993, women with Marfan syndrome (n=273) were compared to women without the condition (n=1 017 265)...
June 1, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28608631/a-descriptive-single-centre-experience-of-the-management-and-outcome-of-maternal-alloantibodies-in-pregnancy
#10
V Chatziantoniou, N Heeney, T Maggs, C Rozette, C Fountain, T Watts, C Harrison, D Pasupathy, S Sankaran, P Kyle, S Robinson
BACKGROUND: Haemolytic disease of the fetus and newborn (HDFN) occurs when maternal IgG alloantibodies to fetal red blood cell antigens cross the placenta, causing haemolysis in the fetus and/or neonate. After delivery, the main concern is hyperbilirubinaemia, which can cause neurological damage. OBJECTIVES: To summarise our current management and outcome data to inform health-care professionals counselling women whose pregnancies are at risk of HDFN and to compare these data with relevant studies...
June 13, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28605006/treating-periodontal-disease-for-preventing-adverse-birth-outcomes-in-pregnant-women
#11
REVIEW
Zipporah Iheozor-Ejiofor, Philippa Middleton, Marco Esposito, Anne-Marie Glenny
BACKGROUND: Periodontal disease has been linked with a number of conditions, such as cardiovascular disease, stroke, diabetes and adverse pregnancy outcomes, all likely through systemic inflammatory pathways. It is common in women of reproductive age and gum conditions tend to worsen during pregnancy. Some evidence from observational studies suggests that periodontal intervention may reduce adverse pregnancy outcomes. There is need for a comprehensive Cochrane review of randomised trials to assess the effect of periodontal treatment on perinatal and maternal health...
June 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28600918/impact-of-customized-growth-curves-on-screening-for-small-for-gestational-age-twins
#12
Sophie Cordiez, Philippe Deruelle, Elodie Drumez, Sophie Bodart, Damien Subtil, Véronique Houfflin-Debarge, Charles Garabedian
OBJECTIVE: The choice of a growth curve determines the screening for small-for-gestational-age (SGA) fetuses and little data is available on SGA twins. Our aim was to evaluate small-for-gestational-age (SGA) detection rate in twin pregnancies and assess whether the use of a customized curve allowed better identification of SGA fetuses. STUDY DESIGN: Retrospective study including all twins between 2010 and 2013. Two groups were formed: the SGA and the non-SGA group...
June 3, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28600043/placenta-associated-pregnancy-complications-in-pregnancies-complicated-with-placenta-previa
#13
Yael Baumfeld, Reli Herskovitz, Zehavi Bar Niv, Salvatore Andrea Mastrolia, Adi Y Weintraub
OBJECTIVES: The purpose of our study was to examine the hypothesis that pregnancies complicated with placenta previa have an increased risk of placental insufficiency associated pregnancy complications (IUGR, preeclampsia, placental abruption and perinatal mortality). MATERIALS AND METHODS: Our study included all deliveries that occurred at Soroka University Medical Center (Beer Sheva, Israel) between January 1998 and December 2013. Of them 1,249 were complicated by placenta previa and represented our study group...
June 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28596740/ultrasound-imaging-of-mouse-fetal-intracranial-hemorrhage-due-to-ischemia-reperfusion
#14
Kenichi Funamoto, Takuya Ito, Kiyoe Funamoto, Clarissa L Velayo, Yoshitaka Kimura
Despite vast improvement in perinatal care during the 30 years, the incidence rate of neonatal encephalopathy remains unchanged without any further Progress towards preventive strategies for the clinical impasse. Antenatal brain injury including fetal intracranial hemorrhage caused by ischemia/reperfusion is known as one of the primary triggers of neonatal injury. However, the mechanisms of antenatal brain injury are poorly understood unless better predictive models of the disease are developed. Here we show a mouse model for fetal intracranial hemorrhage in vivo developed to investigate the actual timing of hypoxia-ischemic events and their related mechanisms of injury...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28594099/cerebroplacental-ratio-thresholds-measured-within-two-weeks-of-birth-and-the-risk-of-cesarean-section-for-intrapartum-fetal-compromise-and-adverse-neonatal-outcome
#15
Larissa N Bligh, Amal A Alsolai, Ristan M Greer, Sailesh Kumar
OBJECTIVES: Prediction of intrapartum fetal compromise in uncomplicated, term pregnancies is a global obstetric challenge. Currently, no widely accepted screening test for this condition exists, although the cerebroplacental ratio (CPR) shows promise. We aimed to prospectively evaluate the screening performance of the CPR 10(th) centile for detection of Cesarean section for intrapartum fetal compromise (IFC) and composite adverse neonatal outcome (ANO) in low-risk women from 36 weeks and to determine the best CPR threshold from three previously described in the literature...
June 8, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28591672/global-variation-in-pregnancy-complications-in-women-with-epilepsy-a-meta-analysis
#16
John Allotey, David Aroyo-Manzano, Patricia Lopez, Luz Viale, Javier Zamora, Shakila Thangaratinam
OBJECTIVE: Women with epilepsy are at risk of pregnancy complications. Whether these vary globally is unknown. We undertook a systematic review to assess the overall rates of obstetric outcomes in women with epilepsy, and variations in estimates across geographical region, economic status of country, and over time. STUDY DESIGN: We searched Medline, Embase, Cochrane, AMED and CINAHL, (January 1, 1990 and November 29, 2016), without any language restrictions for studies reporting core maternal and fetal outcomes in women with epilepsy...
May 30, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28586127/cervical-stitch-cerclage-for-preventing-preterm-birth-in-singleton-pregnancy
#17
REVIEW
Zarko Alfirevic, Tamara Stampalija, Nancy Medley
BACKGROUND: Cervical cerclage is a well-known surgical procedure carried out during pregnancy. It involves positioning of a suture (stitch) around the neck of the womb (cervix), aiming to give mechanical support to the cervix and thereby reduce risk of preterm birth. The effectiveness and safety of this procedure remains controversial. This is an update of a review last published in 2012. OBJECTIVES: To assess whether the use of cervical stitch in singleton pregnancy at high risk of pregnancy loss based on woman's history and/or ultrasound finding of 'short cervix' and/or physical exam improves subsequent obstetric care and fetal outcome...
June 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28579865/adaptation-of-maternal-fetal-physiology-to-exercise-in-pregnancy-the-basis-of-guidelines-for-physical-activity-in-pregnancy
#18
REVIEW
Edward R Newton, Linda May
Only 50 years ago obstetric care providers and women had many concerns regarding whether exercise during pregnancy created a harmful competition for substrate resources between the fetus and the mother. Animal and human research in the past 50 years, which includes acute and chronic aerobic exercise during pregnancy, has a reassuring margin of safety throughout gestation in women. Maternal physiology adapts to pregnancy changes involving the cardiorespiratory and glucometabolic alterations. Due to these changes, pregnant women have slight differences in response to acute exercise sessions...
2017: Clinical Medicine Insights. Women's Health
https://www.readbyqxmd.com/read/28571229/role-of-echocardiography-in-prenatal-screening-of-congenital-heart-diseases-and-its-correlation-with-postnatal-outcome
#19
Shivani Sharma, Navkiran Kaur, Khushpreet Kaur, Naveen Chandrashekhar Pawar
INTRODUCTION: Congenital Heart Defects (CHDs) are one of the most common forms of congenital anomalies. Fetal echocardiography performed during second trimester aims at early diagnosis of congenital heart disease which is instrumental in proper planning of delivery, perinatal care and counselling of parents. AIM: To evaluate the role of fetal echocardiography in prenatal screening of CHDs and to study the role of associated extracardiac anomalies. MATERIALS AND METHODS: This was a hospital based prospective and correlative type of study, done over a period of one year...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28566819/neonates-with-critical-congenital-heart-defects-impact-of-fetal-diagnosis-on-immediate-and-short-term-outcomes
#20
Sylvia Michael Colaco, Tanuja Karande, Prashant Raviprakash Bobhate, Rashmi Jiyani, Suresh G Rao, Snehal Kulkarni
BACKGROUND: Fetal echocardiography is being increasingly used for prenatal diagnosis of congenital cardiac malformations, but its impact on the neonatal outcomes in low- and middle-income countries is still unknown. AIMS: The objective of this study is to determine the impact of fetal echocardiography on immediate postnatal and short-term outcome in a tertiary pediatric cardiac center. STUDY DESIGN: This is a prospective study. MATERIALS AND METHODS: One hundred consecutive patients with critical congenital heart defects (CHD) requiring active medical or surgical interventions in the 1(st) month of life were included in the study...
May 2017: Annals of Pediatric Cardiology
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