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Fetal and neonatal care

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https://www.readbyqxmd.com/read/28817167/body-mass-index-50-kg-m2-and-beyond-perioperative-care-of-pregnant-women-with-superobesity-undergoing-cesarean-delivery
#1
Marcela Carolina Smid, Sarah K Dotters-Katz, Robert M Silver, Jeffrey A Kuller
Importance: Superobesity, defined as body mass index 50 kg/m(2) or greater, is the fastest-growing obesity group in the United States. Currently, 2% of pregnant women in the United States are superobese, and 50% will deliver via cesarean delivery. Objective: To review evidence of perioperative care during cesarean delivery among superobese women. Evidence Acquisition: We performed an evidence-based review of maternal and neonatal risks of cesarean delivery and of intraoperative management and immediate postpartum care of superobese pregnant women...
August 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28805619/intrauterine-fetal-death-caused-by-seatbelt-injury
#2
Shizuka Yamada, Koji Nishijima, Jin Takahashi, Nozomu Takahashi, Chiyo Tamamura, Yoshio Yoshida
OBJECTIVE: Severe motor vehicle accidents involving pregnant women can result in fetal and neonatal death. We describe a case in which fetal death occurred due to relatively mild seatbelt injuries and present the characteristic magnetic resonance imaging (MRI) findings of the placenta. CASE REPORT: A 26-year-old primigravid woman at 20 weeks gestation was involved in an automobile accident. Although she suffered only a seatbelt injury, fetal death subsequently occurred...
August 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28802248/utility-of-rapid-whole-exome-sequencing-in-the-diagnosis-of-neonatal-niemann-pick-disease-type-c-presenting-with-fetal-hydrops-and-liver-failure
#3
Mersedeh Rohanizadegan, Sarah El-Almery, Anne O'Donnell-Luria, Ivana Mihalek, Peggy Chen, Marilyn Sanders, Kristen Leeman, Megan Cho, Christina Hung, Olaf Bodamer
Rapid whole exome sequencing (rWES) is increasingly used in critically ill newborn infants to inform about diagnosis, clinical management and prognosis. Here we report a male newborn infant with hydrops, pancytopenia and acute liver failure who was listed for liver transplantation. Given the acuity of the presentation, the procedure related morbidity and mortality and lack of diagnosis we employed rWES in the proband and both parents with a turn-around time of 10 business days. rWES returned one maternally inherited, likely pathogenic and one paternally inherited, likely pathogenic variant in NPC1 suggestive of a diagnosis of Niemann Pick disease type C (NPC)...
August 11, 2017: Cold Spring Harbor Molecular Case Studies
https://www.readbyqxmd.com/read/28800671/-outcomes-of-planned-out-of-hospital-and-low-risk-hospital-births-in-lower-saxony
#4
Antje Petersen, Lea-Marie Köhler, Christiane Schwarz, Bernhard Vaske, Mechthild M Gross
Introduction Internationally, there is debate on the safety of different birth settings inside and outside of hospitals. Low-risk women in Germany can choose where they give birth, and out-of-hospital births are especially necessary in regions lacking infrastructure. To date, national studies are required. Materials and Methods We investigated planned out-of-hospital (OH) and hospital births in Lower Saxony, Germany, in 2005. Women with a singleton fetus in the vertex position were included once they reached 34+0 gestational weeks...
August 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28795220/achieving-and-maintaining-lung-volume-in-the-preterm-infant-from-the-first-breath-to-the-nicu
#5
REVIEW
Gianluca Lista, Andrés Maturana, Fernando R Moya
Please check if statements under Abstract section are presented correctly.The main goal for the neonatologist is to facilitate the adaptation to extra-uterine life during initial transition, while minimizing lung injury opening and protecting the premature lung from the first breath onwards. An appropriate management from birth should lead to the achievement of an early functional residual capacity (FRC), and the following steps should aim at maintaining an adequate lung volume. To date, different strategies are available to optimize fetal-neonatal transition and promote lung recruitment...
August 10, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28793129/clinical-characteristics-of-women-with-gestational-diabetes-comparison-of-two-cohorts-enrolled-20-years-apart-in-southern-brazil
#6
Angela Jacob Reichelt, Letícia Schwerz Weinert, Livia Silveira Mastella, Vanessa Gnielka, Maria Amélia Campos, Vânia Naomi Hirakata, Maria Lúcia Rocha Oppermann, Sandra Pinho Silveiro, Maria Inês Schmidt
CONTEXT AND OBJECTIVE: The prevalence and characteristics of gestational diabetes mellitus (GDM) have changed over time, reflecting the nutritional transition and changes in diagnostic criteria. We aimed to evaluate characteristics of women with GDM over a 20-year interval. DESIGN AND SETTING: Comparison of two pregnancy cohorts enrolled in different periods, in university hospitals in Porto Alegre, Brazil: 1991 to 1993 (n = 216); and 2009 to 2013 (n = 375). METHODS: We applied two diagnostic criteria to the cohorts: International Association of Diabetes and Pregnancy Study Groups (IADPSG)/World Health Organization (WHO); and National Institute for Health and Care Excellence (NICE)...
July 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28791262/clinical-characteristics-of-pregnancies-complicated-by-congenital-myotonic-dystrophy
#7
Cheonga Yee, Suk-Joo Choi, Soo-Young Oh, Chang-Seok Ki, Cheong-Rae Roh, Jong-Hwa Kim
OBJECTIVE: Although the conventional prevalence of myotonic dystrophy is 1:8,000, the prevalence in Korean population was recently reported as 1:1,245. With higher domestic result than expected, we aimed to investigate the clinical characteristics of pregnancies complicated by congenital myotonic dystrophy in our institution. METHODS: We have reviewed 11 paired cases of neonates diagnosed with congenital myotonic dystrophy and their mothers between July 2004 and May 2014, with clinical features including maternal history of infertility, prenatal ultrasonographic findings, and neonatal outcomes...
July 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28782398/perinatal-outcomes-in-uncomplicated-late-preterm-pregnancies-with-borderline-oligohydramnios
#8
Erdem Sahin, Yusuf Madendag, Ahter Tanay Tayyar, Mefkure Eraslan Sahin, Ilknur Col Madendag, Gokhan Acmaz, Deniz Unsal, Vesile Senol
PURPOSE: The purpose of this study is to determine the adverse perinatal outcomes in uncomplicated late preterm pregnancies with borderline oligohydramnios. METHODS: A total of 430 pregnant women with an uncomplicated singleton pregnancy at a gestational age of 34 + 0-36 + 6 weeks were included. Borderline oligohydramnios was defined as an amniotic fluid index (AFI) of 5.1-8 cm, which was measured using the four-quadrant technique. Adverse perinatal outcomes were compared between the borderline and normal AFI groups...
August 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28771438/fetal-goitrous-hypothyroidism-treated-by-intra-amniotic-levothyroxine-administration-case-report-and-review-of-the-literature
#9
Mami Kobayashi, Hideaki Yagasaki, Tomohiro Saito, Atsushi Nemoto, Atsushi Naito, Kanji Sugita
BACKGROUND: Fetal goitrous hypothyroidism is mainly caused by maternal treatment of Graves' disease. Fetal goiter sometimes compresses the trachea and esophagus and may cause polyhydramnios, preterm labor, complications of labor and delivery, and neonatal respiratory disorder. CASE PRESENTATION: We report a case of fetal goitrous hypothyroidism in which the mother had Graves' disease, which was treated with propylthiouracil. Intra-amniotic levothyroxine (L-T4) administration was performed, and the fetal goiter decreased in size...
August 3, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28771211/the-fetus-can-teach-us-oxygen-and-the-pulmonary-vasculature
#10
REVIEW
Payam Vali, Satyan Lakshminrusimha
Neonates suffering from pulmonary hypertension of the newborn (PPHN) continue to represent an important proportion of patients requiring intensive neonatal care, and have an increased risk of morbidity and mortality. The human fetus has evolved to maintain a high pulmonary vascular resistance (PVR) in utero to allow the majority of the fetal circulation to bypass the lungs, which do not participate in gas exchange, towards the low resistance placenta. At birth, oxygen plays a major role in decreasing PVR to enhance pulmonary blood flow and establish the lungs as the organ of gas exchange...
August 3, 2017: Children
https://www.readbyqxmd.com/read/28770341/prenatal-depression-screening-and-antidepressant-prescription-obstetrician-gynecologists-practices-opinions-and-interpretation-of-evidence
#11
Laura H Taouk, Kristen A Matteson, Lauren M Stark, Jay Schulkin
Obstetrician-gynecologists (ob-gyns) are well-positioned to detect symptoms of perinatal depression; however, little is known about how ob-gyns respond. The purpose of this study was to evaluate ob-gyns' beliefs and practices related to prenatal depression screening and antidepressant prescription during pregnancy. A larger survey on prenatal medication was developed at the American College of Obstetricians and Gynecologists (ACOG) and distributed to a sample of 1000 Fellows. The overall response rate was 37...
August 2, 2017: Archives of Women's Mental Health
https://www.readbyqxmd.com/read/28755869/maternal-exposure-to-childhood-maltreatment-and-risk-of-stillbirth
#12
Alexa A Freedman, Alison L Cammack, Jeff R Temple, Robert M Silver, Donald J Dudley, Barbara J Stoll, Michael W Varner, George R Saade, Deborah Conway, Robert L Goldenberg, Carol J Hogue
PURPOSE: To determine the association between maternal exposure to childhood maltreatment (CM) and risk of stillbirth (fetal death at or after 20 weeks' gestation). METHODS: Population-based case-control study from the Stillbirth Collaborative Research Network (SCRN) conducted in 2006-2008, and the follow-up study, SCRN-Outcomes after Study Index Stillbirth (SCRN-OASIS), conducted in 2009 in the United States. Cases (n = 133) included women who experienced a stillbirth, excluding stillbirths attributed to genetic/structural or umbilical cord abnormalities and intrapartum stillbirths...
July 13, 2017: Annals of Epidemiology
https://www.readbyqxmd.com/read/28749484/communication-related-allegations-against-physicians-caring-for-premature-infants
#13
J Nguyen, H Muniraman, M Cascione, R Ramanathan
OBJECTIVE: Maternal-fetal medicine physicians (MFMp) and neonatal-perinatal medicine physicians (NPMp) caring for premature infants and their families are exposed to significant risk for malpractice actions. Effective communication practices have been implicated to decrease litigious intentions but the extent of miscommunication as a cause of legal action is essentially unknown in this population. Analysis of communication-related allegations (CRAs) may help toward improving patient care and physician-patient relationships as well as decrease litigation risks...
July 27, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28749055/a-failure-to-be-candid
#14
Jennifer McGuirl
I was a second-year neonatal-perinatal fellow in a meeting between other members of the neonatal intensive care team and parents who had just received devastating news about their planned-for and highly desired baby, born after what had been an uncomplicated pregnancy. At home, a little sister was waiting to meet her new brother. These conversations are never easy, but this one I found particularly disturbing. John had been born at term via emergency cesarean section after his mother, Muriel, had come for a routine obstetrical visit and reported decreased fetal movement...
July 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28747161/factors-associated-with-perinatal-mortality-among-public-health-deliveries-in-addis-ababa-ethiopia-an-unmatched-case-control-study
#15
Yemisrach Getiye, Mesganaw Fantahun
BACKGROUND: perinatal mortality is the sum of still birth (fetal death) and early neonatal death (ENND) i.e. death of live newborn before the age of 7 completed days. Perinatal mortality accounts three fourth of the deaths of the neonatal period and is one of the major challenges for under-five mortality. Therefore this study was conducted to better understand the common and avoidable factors that affect perinatal mortality in Addis Ababa, Ethiopia. METHODS: An unmatched case control study design using secondary data as a source of information was conducted...
July 26, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28744256/corticotropin-releasing-hormone-as-the-homeostatic-rheostat-of-feto-maternal-symbiosis-and-developmental-programming-in-utero-and-neonatal-life
#16
REVIEW
Viridiana Alcántara-Alonso, Pamela Panetta, Patricia de Gortari, Dimitris K Grammatopoulos
A balanced interaction between the homeostatic mechanisms of mother and the developing organism during pregnancy and in early neonatal life is essential in order to ensure optimal fetal development, ability to respond to various external and internal challenges, protection from adverse programming, and safeguard maternal care availability after parturition. In the majority of pregnancies, this relationship is highly effective resulting in successful outcomes. However, in a number of pathological settings, perturbations of the maternal homeostasis disrupt this symbiosis and initiate adaptive responses with unpredictable outcomes for the fetus or even the neonate...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28742677/committee-opinion-no-712-intrapartum-management-of-intraamniotic-infection
#17
(no author information available yet)
Intraamniotic infection, also known as chorioamnionitis, is an infection with resultant inflammation of any combination of the amniotic fluid, placenta, fetus, fetal membranes, or decidua. Intraamniotic infection is a common condition noted among preterm and term parturients. However, most cases of intraamniotic infection detected and managed by obstetrician-gynecologists or other obstetric care providers will be noted among term patients in labor. Intraamniotic infection can be associated with acute neonatal morbidity, including neonatal pneumonia, meningitis, sepsis, and death...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742671/committee-opinion-no-712-summary-intrapartum-management-of-intraamniotic-infection
#18
(no author information available yet)
Intraamniotic infection, also known as chorioamnionitis, is an infection with resultant inflammation of any combination of the amniotic fluid, placenta, fetus, fetal membranes, or decidua. Intraamniotic infection is a common condition noted among preterm and term parturients. However, most cases of intraamniotic infection detected and managed by obstetrician-gynecologists or other obstetric care providers will be noted among term patients in labor. Intraamniotic infection can be associated with acute neonatal morbidity, including neonatal pneumonia, meningitis, sepsis, and death...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28738721/the-clinical-value-of-maternal-and-fetal-doppler-parameters-in-low-risk-postdates-pregnancies-%C3%A2-a-prospective-study
#19
Oshrit Lebovitz, Eran Barzilay, Shali Mazaki-Tovi, Itai Gat, Reuven Achiron, Yinon Gilboa
OBJECTIVE: To determine the clinical significance of maternal and fetal ultrasound Doppler flow indices in postdates pregnancies. METHODS: This prospective study comprised 120 low-risk pregnant women beyond 40 weeks of gestation. All participants underwent Doppler assessment including of fetal middle cerebral artery (MCA), umbilical and uterine arteries. Perinatal outcomes were recorded and evaluated for possible associations with Doppler flow values. Adverse perinatal outcomes were defined as umbilical cord arterial pH < 7...
July 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28737543/a-program-aimed-at-reducing-anxiety-in-pregnant-women-diagnosed-with-a-small-for-gestational-age-fetus-evaluative-findings-from-a-spanish-study
#20
Ángela Arranz Betegón, Marta García, Sandra Parés, Gala Montenegro, Georgina Feixas, Nelly Padilla, Alba Camacho, Josefina Goberna, Francesc Botet, Eduard Gratacós
The objective of this study was to evaluate the effect of anxiety-reducing techniques including music therapy, sophrology, and creative visualization in pregnant women with a fetus diagnosed as small for gestational age and improved fetal and neonatal weight. This was a quasi-experimental study with a nonrandomized clinical trial design. We compared 2 groups of pregnant women with a fetus diagnosed as small for gestational age with no abnormalities on Doppler studies. The control group (n = 93) received standard care, and the intervention group (n = 65), in addition to standard care, underwent a program of 6 sessions led by a midwife or nurse who taught anxiety-reduction techniques...
July 2017: Journal of Perinatal & Neonatal Nursing
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