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Fetal and neonatal care

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https://www.readbyqxmd.com/read/28334563/quality-improvement-initiatives-lead-to-reduction-in-nulliparous-term-singleton-vertex-cesarean-delivery-rate
#1
Mary A Vadnais, Michele R Hacker, Neel T Shah, JoAnn Jordan, Anna M Modest, Molly Siegel, Toni H Golen
BACKGROUND: The nulliparous term singleton vertex (NTSV) cesarean delivery rate has been recognized as a meaningful benchmark. Variation in the NTSV cesarean delivery rate among hospitals and providers suggests many hospitals may be able to safely improve their rates. The NTSV cesarean delivery rate at the authors' institution was higher than state and national averages. This study was conducted to determine the influence of a set of quality improvement interventions on the NTSV cesarean delivery rate...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28331377/management-of-systemic-lupus-erythematosus-during-pregnancy-challenges-and-solutions
#2
REVIEW
Caroline L Knight, Catherine Nelson-Piercy
Systemic lupus erythematosus (SLE) is a chronic, multisystem autoimmune disease predominantly affecting women, particularly those of childbearing age. SLE provides challenges in the prepregnancy, antenatal, intrapartum, and postpartum periods for these women, and for the medical, obstetric, and midwifery teams who provide their care. As with many medical conditions in pregnancy, the best maternal and fetal-neonatal outcomes are obtained with a planned pregnancy and a cohesive multidisciplinary approach. Effective prepregnancy risk assessment and counseling includes exploration of factors for poor pregnancy outcome, discussion of risks, and appropriate planning for pregnancy, with consideration of discussion of relative contraindications to pregnancy...
2017: Open Access Rheumatology: Research and Reviews
https://www.readbyqxmd.com/read/28301895/association-of-fetal-heart-rate-baseline-change-and-neonatal-outcomes
#3
Michael Yang, Molly J Stout, Julia D López, Ryan Colvin, George A Macones, Alison G Cahill
Objective The objective of this study was to describe the incidence of baseline change within normal range during labor and its prediction of neonatal outcomes. Materials and Methods This was a prospective cohort of singleton, nonanomalous, term neonates with continuous electronic fetal monitoring and normal baseline fetal heart rate throughout the last 2 hours of labor. We determined baseline in 10-minute segments using Eunice Kennedy Shriver National Institute of Child Health and Human Development criteria...
March 16, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28301886/geburtshilfe-hypertensive-erkrankungen-in-der-schwangerschaft
#4
Bigna S Buddeberg, Thierry Girard
Hypertensive disorders of pregnancy are one of the most common complications in pregnancy. They are associated with a high maternal, fetal and neonatal morbidity and mortality. 99 % of all maternal deaths occur in developing countries, but we should not forget that even in highly developed countries mothers still die from the complications of hypertensive disorders of pregnancy. This term encompasses chronic hypertension as well as pregnancy specific disorders such as gestational hypertension and preeclampsia...
March 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28301484/health-facility-service-availability-and-readiness-for-intrapartum-and-immediate-postpartum-care-in-malawi-a-cross-sectional-survey
#5
Naoko Kozuki, Lolade Oseni, Angella Mtimuni, Reena Sethi, Tambudzai Rashidi, Fannie Kachale, Barbara Rawlins, Shivam Gupta
This analysis seeks to identify strengths and gaps in the existing facility capacity for intrapartum and immediate postpartum fetal and neonatal care, using data collected as a part of Malawi's Helping Babies Breath program evaluation. From August to September 2012, the Maternal and Child Health Integrated Program (MCHIP) conducted a cross-sectional survey in 84 Malawian health facilities to capture current health facility service availability and readiness and health worker capacity and practice pertaining to labor, delivery, and immediate postpartum care...
2017: PloS One
https://www.readbyqxmd.com/read/28300009/prenatal-diagnosis-of-aortopulmonary-window-associated-with-aberrant-subclavian-artery
#6
Adetola F Louis-Jacques, Sarah Obican, Thieu Nguyen, Anthony Odibo
Aortopulmonary window is a rare cardiac developmental anomaly characterised by a communication between the ascending aorta and the pulmonary artery. Aortopulmonary window may be isolated or associated with cardiac defects such as ventricular septal defect, atrial septal defect, interrupted aortic arch, and tetralogy of Fallot. We report a case of aortopulmonary window associated with aberrant subclavian artery based on fetal two-dimensional echocardiogram. The mother was referred for fetal echocardiography because of multiple fetal anomalies...
March 16, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28295792/biventricular-impact-of-mild-to-moderate-pulmonary-valve-stenosis-in-fetal-life
#7
L Guirado, F Crispi, N Masoller, M Bennasar, E Marimon, J Carretero, E Gratacós, J M Martínez, M K Friedberg, O Gómez
OBJECTIVES: to define the pattern of fetal echocardiographic changes associated with isolated pulmonary valve stenosis (PS) and to correlate the echocardiographic findings with the neonatal outcome and the need of postnatal pulmonary valvuloplasty within the first 12 months of life. METHODS: a prospective cohort study was designed on 16 fetuses with isolated PS and 48 controls matched by gestational age at scan (+/- 2 weeks). Fetal standard ultrasound and comprehensive echocardiography, which included cardiovascular morphometric parameters, systolic and diastolic functional and timing-measurements, were performed in all cases...
March 10, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28292615/perinatal-outcomes-among-singletons-after-assisted-reproductive-technology-with-single-embryo-or-double-embryo-transfer-versus-no-assisted-reproductive-technology
#8
Angela S Martin, Jeani Chang, Yujia Zhang, Jennifer F Kawwass, Sheree L Boulet, Patricia McKane, Dana Bernson, Dmitry M Kissin, Denise J Jamieson
OBJECTIVE: To examine outcomes of singleton pregnancies conceived without assisted reproductive technology (non-ART) compared with singletons conceived with ART by elective single-embryo transfer (eSET), nonelective single-embryo transfer (non-eSET), and double-embryo transfer with the establishment of 1 (DET -1) or ≥2 (DET ≥2) early fetal heartbeats. DESIGN: Retrospective cohort using linked ART surveillance data and vital records from Florida, Massachusetts, Michigan, and Connecticut...
March 11, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28286810/epidemiology-and-related-risk-factors-of-preterm-labor-as-an-obstetrics-emergency
#9
Ali Asghar Halimi Asl, Saeed Safari, Mohsen Parvareshi Hamrah
INTRODUCTION: Preterm birth is still a major health problem throughout the world, which results in 75% of neonatal mortality. Preterm labor not only inflicts financial and emotional distress, it may also lead to permanent disability. The present study was conducted to determine the related risk factors and preventive measures of preterm labor. METHODS: This retrospective cross-sectional study assessed all preterm labors, as well as an equal number of term labors, during seven years, at an educational hospital...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28285310/incidence-and-causes-of-intentional-fetal-or-neonatal-demise-in-twin-twin-transfusion-syndrome
#10
Marjolijn S Spruijt, Ellen Tameeris, De-Peng Zhao, Johanna M Middeldorp, Monique C Haak, Dick Oepkes, Enrico Lopriore
INTRODUCTION: The aim of this study is to evaluate the incidence and causes of intentional fetal and neonatal demise in twin-twin transfusion syndrome (TTTS). MATERIAL AND METHODS: All TTTS pregnancies managed at our centre between 2000 and 2014 were included. We evaluated incidence and causes of intentional fetal/neonatal demise, defined as termination of pregnancy, selective fetal reduction, or withdrawal of neonatal intensive care. RESULTS: Intentional fetal/neonatal demise occurred in 9...
March 11, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28281278/retrospective-comparison-of-perinatal-outcomes-following-emergency-cervical-cerclage-with-or-without-prolapsed-membranes
#11
Patricia Steenhaut, Corinne Hubinont, Pierre Bernard, Frédéric Debiève
OBJECTIVE: To compare perinatal outcomes following emergency cerclage between patients with singleton pregnancies with prolapsed and non-prolapsed membranes. METHODS: The present retrospective cohort study included data from women who underwent physical examination-indicated emergency cerclage at between 15 and 25 weeks of pregnancy at Saint Luc University Hospital, Brussels, Belgium, between January 1, 2000, and December 31, 2014. Outcomes were compared based on the presence of prolapsed or non-prolapsed membranes...
March 9, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28277352/sildenafil-citrate-therapy-for-oligohydramnios-a-randomized-controlled-trial
#12
Mohammad Ahmed Maher, Tarek Mohammad Sayyed, Nabih Elkhouly
OBJECTIVE: To compare sildenafil plus hydration with hydration alone in improving the amniotic fluid index and neonatal outcomes in pregnancies complicated by idiopathic oligohydramnios ( amniotic fluid index less than 5 cm without underlying maternal or fetal causes and with normal fetal growth). METHODS: This was an open-label randomized trial for women carrying singleton pregnancies at 30 weeks of gestation or more with idiopathic oligohydramnios detected during routine ultrasonogram...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28276868/population-based-birth-weight-reference-percentiles-for-chinese-twins
#13
Li Dai, Changfei Deng, Yanhua Li, Ling Yi, Xiaohong Li, Yi Mu, Qi Li, Qiang Yao, Yanping Wang
BACKGROUND: Birth weight percentiles by gestational age are important for assessing prenatal growth and predicting postnatal outcomes of newborns. Several countries have developed nation-specific birth weight references for twins, but China still lacks such references. METHODS AND RESULTS: Birth weight data for twins born between October 2006 and September 2015 were abstracted from the China National Population-based Birth Defects Surveillance System. A total of 54,786 live twin births aged ≥28 weeks of gestation without birth defects were included in the analysis...
February 28, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28270884/critical-imperative-for-the-reform-of-british-interpretation-of-fetal-heart-rate-decelerations-analysis-of-figo-and-nice-guidelines-post-truth-foundations-cognitive-fallacies-myths-and-occam-s-razor
#14
REVIEW
Shashikant L Sholapurkar
Cardiotocography (CTG) has disappointingly failed to show good predictability for fetal acidemia or neonatal outcomes in several large studies. A complete rethink of CTG interpretation will not be out of place. Fetal heart rate (FHR) decelerations are the most common deviations, benign as well as manifestation of impending fetal hypoxemia/acidemia, much more commonly than FHR baseline or variability. Their specific nomenclature is important (center-stage) because it provides the basic concepts and framework on which the complex "pattern recognition" of CTG interpretation by clinicians depends...
April 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28267444/a-multicenter-prospective-study-of-neonatal-outcomes-at-less-than-32-weeks-associated-with-indications-for-maternal-admission-and-delivery
#15
Thomas J Garite, C Andrew Combs, Kimberly Maurel, Anita Das, Kevin Huls, Richard Porreco, Dale Reisner, George Lu, Melissa Bush, Bruce Morris, April Bleich
BACKGROUND: Counseling for patients with impending premature delivery has been traditionally based primarily on the projected gestational age at delivery. There are limited data regarding how the indications for the preterm birth affect the neonatal outcome and whether this issue should be taken into account in decisions regarding management and patient counseling. OBJECTIVE: We performed a prospective study of pregnancies resulting in premature delivery at less than 32 weeks to determine the influence of both the Indications for Admission and their associated Indications for Delivery on neonatal mortality and complications of prematurity...
March 3, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28266776/gestational-age-at-diagnosis-of-early-onset-fetal-growth-restriction-and-impact-on-management-and-survival-a-population-based-cohort-study
#16
I Monier, P-Y Ancel, A Ego, I Guellec, P-H Jarreau, M Kaminski, F Goffinet, J Zeitlin
OBJECTIVE: To investigate the impact of gestational age (GA) at diagnosis of fetal growth restriction (FGR) on obstetric management and rates of live birth and survival for very preterm infants with early-onset FGR. DESIGN: Population-based cohort study. SETTING: All maternity units in 25 French regions in 2011. POPULATION: Fetuses diagnosed with FGR before 28 weeks of gestation among singleton births between 22 and 31 weeks of gestation without severe congenital anomalies...
March 7, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28264638/to-ignore-or-not-to-ignore-placental-calcifications-on-prenatal-ultrasound-a-systematic-review-and-meta-analysis
#17
Fadi G Mirza, Labib M Ghulmiyyah, Hani Tamim, Maha Makki, Dima Jeha, Anwar Nassar
OBJECTIVE: The human placenta is known to calcify with advancing gestational age, and, in fact, the presence of significant calcifications is one of the components of grade III placenta, typical of late gestation. As such, the presence of significant placental calcifications often prompts obstetric providers to expedite delivery. This practice has been attributed, in part, to the presumed association between grade III placenta and adverse pregnancy outcomes. Such approach, however, can be the source of major anxiety and may lead to unnecessary induction of labor, with its associated predisposition to cesarean delivery as well as a myriad of maternal and neonatal morbidities...
March 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28257562/planned-early-birth-versus-expectant-management-for-women-with-preterm-prelabour-rupture-of-membranes-prior-to-37-weeks-gestation-for-improving-pregnancy-outcome
#18
REVIEW
Diana M Bond, Philippa Middleton, Kate M Levett, David P van der Ham, Caroline A Crowther, Sarah L Buchanan, Jonathan Morris
BACKGROUND: Current management of preterm prelabour rupture of the membranes (PPROM) involves either initiating birth soon after PPROM or, alternatively, adopting a 'wait and see' approach (expectant management). It is unclear which strategy is most beneficial for mothers and their babies. This is an update of a Cochrane review published in 2010 (Buchanan 2010). OBJECTIVES: To assess the effect of planned early birth versus expectant management for women with preterm prelabour rupture of the membranes between 24 and 37 weeks' gestation for fetal, infant and maternal well being...
March 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28256367/impact-of-systemic-lupus-erythematosus-on-maternal-and-fetal-outcomes-following-pregnancy-a-meta-analysis-of-studies-published-between-years-2001-2016
#19
REVIEW
Pravesh Kumar Bundhun, Mohammad Zafooruddin Sani Soogund, Feng Huang
BACKGROUND: Previous research has already shown systemic lupus erythematosus (SLE) to have severe consequences on pregnancy outcomes. However, insufficient number of participants, which were mainly limited to one particular region, limited outcomes analyzed and lack of evidence based analysis to support systematic reviews of the literature were the limitations observed. Therefore, by improving these limitations, we aimed to systematically show the impact of SLE on maternal and fetal outcomes following pregnancy...
February 27, 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28251633/outcome-of-pregnancy-in-women-diagnosed-with-idiopathic-polyhydramnios
#20
Sarwat Khan, Jennifer Donnelly
INTRODUCTION: Polyhydramnios is present in approximately 2% of pregnancies and it has been associated with a variety of adverse pregnancy outcomes. OBJECTIVES: The aim of our study was to evaluate the association between polyhydramnios and adverse pregnancy outcomes. METHODS: This was a retrospective case control study of 288 singleton pregnancies delivered in the Rotunda Hospital, Dublin, between 2013 and 2014. Polyhydramnios was defined as: (i) amniotic fluid index (AFI) ≥ 25 cm; (ii) maximal vertical pocket (MVP) of ≥8 cm; and (iii) a gestational age-specific threshold for AFI...
February 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
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