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Fetal and neonatal care

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https://www.readbyqxmd.com/read/28434210/changes-in-perinatal-hospital-deaths-occurring-outside-the-neonatal-intensive-care-unit-over-a-decade
#1
Amélie Du Pont-Thibodeau, Keith Barrington, Catherine Taillefer, Annie Janvier
AIM: Perinatal deaths occurring outside the neonatal intensive care unit (NICU) are rarely recorded in outcome studies, despite having a direct impact on perinatal statistics. Our aim was to investigate the timing and modes of perinatal deaths that occurred outside the NICU and changes over time. METHOD: We reviewed all perinatal deaths from 22 weeks of gestation onwards, without NICU admissions, during two periods in a Canadian tertiary mother and baby hospital and categorised deaths according to nine specific categories...
April 23, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28425156/universal-versus-selective-ultrasonography-to-screen-for-large-for-gestational-age-infants-and-associated-morbidity
#2
Ulla Sovio, Alexandros A Moraitis, Hilary S Wong, Gordon C S Smith
OBJECTIVE: To compare the diagnostic effectiveness of selective versus universal ultrasonography as a screening test for large for gestational age (LGA) infants, and to determine whether previously described ultrasonic markers of excessive fetal growth could identify which suspected LGA fetuses were at increased risk of neonatal morbidity. METHODS: We analysed data from a prospective cohort study of nulliparous women, the Pregnancy Outcome Prediction study. All women had clinically indicated scans as per routine care...
April 20, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28422948/beyond-the-uterine-environment-nonhuman-primate-model-to-investigate-maternal-fetal-and-neonatal-outcomes-following-chronic-intrauterine-infection
#3
Meredith A Kelleher, Zheng Liu, Xiaojie Wang, Christopher D Kroenke, Lisa A Houser, Brandy L Dozier, Lauren D Martin, Ken B Waites, Cindy McEvoy, Robert L Schelonka, Peta L Grigsby
BACKGROUND: Intrauterine infection is a significant cause of early preterm birth. We have developed a fetal-neonatal model in the rhesus macaque to determine the impact of chronic intrauterine infection with Ureaplasma parvum on early neonatal reflexes and brain development. METHODS: Time-mated, pregnant rhesus macaques were randomized to be inoculated with U. parvum (serovar 1; 10(5)cfu) or control media at ~120 dGA. Neonates were delivered by elective hysterotomy at 135-147 dGA (term=167d) stabilized and cared for in our nonhuman primate neonatal intensive care unit...
April 19, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28422862/prevalence-of-abnormally-invasive-placenta-among-deliveries-in-mainland-china-a-prisma-compliant-systematic-review-and-meta-analysis
#4
Dazhi Fan, Song Li, Shuzhen Wu, Wen Wang, Shaoxin Ye, Qing Xia, Li Liu, Jinping Feng, Song Wu, Xiaoling Guo, Zhengping Liu
BACKGROUND: Abnormally invasive placenta (AIP) or placenta accreta (PA) is considered numerous adverse maternal and fetal-neonatal complications. There has been no detailed study to characterize the prevalence of AIP among deliveries in mainland China. OBJECTIVES: We aimed to fill this gap and obtained overall and regional estimates of AIP prevalence via a systematic review and meta-analysis. METHODS: This systematic review and meta-analysis was totally performed following the Meta-analysis of Observational Studies in Epidemiology guidelines for systematic reviews of observational studies, and the Preferred Reporting Items for Systematic reviews and Meta-Analysis statement for reporting systematic reviews and meta-analysis...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28419406/routine-oro-nasopharyngeal-suction-versus-no-suction-at-birth
#5
REVIEW
Jann P Foster, Jennifer A Dawson, Peter G Davis, Hannah G Dahlen
BACKGROUND: Oro/nasopharyngeal suction is a method used to clear secretions from the oropharynx and nasopharynx through the application of negative pressure via a suction catheter or bulb syringe. Traditionally, airway oro/nasopharyngeal suction at birth has been used routinely to remove fluid rapidly from the oropharynx and nasopharynx in vigorous and non-vigorous infants at birth. Concerns relating to the reported adverse effects of oro/nasopharyngeal suctioning led to a practice review and routine oro/nasopharyngeal suctioning is no longer recommended for vigorous infants...
April 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28417027/decision-to-delivery-time-intervals-in-emergency-caesarean-section-cases-repeated-cross-sectional-study-from-oman
#6
Kaukab Tashfeen, Malini Patel, Ilham M Hamdi, Ibrahim H A Al-Busaidi, Mansour N Al-Yarubi
OBJECTIVES: In cases of fetal intolerance to labour, meeting the standard decision-to-delivery time interval (DDI) of ≤30 minutes is challenging. This study aimed to assess DDIs in emergency Caesarean section (CS) cases to identify factors causing DDI delays and the impact of a delayed DDI on perinatal outcomes. METHODS: This repeated cross-sectional study included all emergency CS procedures performed due to acute fetal distress, antepartum haemorrhage or umbilical cord prolapse at the Nizwa Hospital, Nizwa, Oman...
February 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/28413896/congenital-malformations-palliative-care-and-postnatal-redirection-to-more-intensive-treatment-a-review-at-a-swiss-tertiary-center
#7
Ulrich Pfeifer, Deborah Gubler, Eva Bergstraesser, Dirk Bassler
PURPOSE: The so-called lethal malformations pose ethical challenges. Most affected fetuses die before or at birth. Live-born neonates commonly receive palliative care. If the postnatal course is better than expected, redirection towards more treatment may occur. We aimed to analyze this in a Swiss patient cohort. MATERIALS AND METHODS: Over 6 years, fetal malformation was suspected in 1113 cases. We identified patients prenatally assigned to palliative care, assessed pre- and postnatal diagnoses, and outcomes...
April 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28413694/first-neonatal-demise-with-travel-associated-zika-virus-infection-in-the-united-states-of-america
#8
Nikolaos Zacharias, Janice Whitty, Sarah Noblin, Sophia Tsakiri, Jose Garcia, Michael Covinsky, Meenakshi Bhattacharjee, David Saulino, Nina Tatevian, Sean Blackwell
Zika virus is increasingly recognized as a fetal pathogen worldwide. We describe the first case of neonatal demise with travel-associated Zika virus infection in the United States of America, including a novel prenatal ultrasound finding. A young Latina presented to our health care system in Southeast Texas for prenatal care at 23 weeks of gestation. Fetal Dandy-Walker malformation, asymmetric cerebral ventriculomegaly, single umbilical artery, hypoechoic fetal knee, dorsal foot edema, and mild polyhydramnios were noted upon initial screening prenatal sonography at 26 weeks...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28413274/evaluation-of-decision-to-delivery-interval-in-emergency-cesarean-section-a-1-year-prospective-audit-in-a-tertiary-care-hospital
#9
Sunanda Gupta, Udita Naithani, C Madhanmohan, Ajay Singh, Pradeep Reddy, Apoorva Gupta
BACKGROUND AND AIMS: The American College of Obstetricians and Gynecologists (ACOG) committee on professional standards and the National Institute of Clinical Excellence (NICE) guidelines suggest that decision-to-delivery interval (DDI) and emergency cesarean section (CS) should not be more than 30 min, and a delay of more than75 min in the presence of maternal or fetal compromise can lead to poor outcome. This prospective 1-year study was conducted on emergency CS in a tertiary care hospital to evaluate the DDI, factors affecting it and to analyze their effects on maternal and neonatal outcome...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28412852/transitional-hemodynamics-in-infants-of-diabetic-mothers-by-targeted-neonatal-echocardiography-electrocardiography-and-peripheral-flow-study
#10
Ingrid Anne Mandy Schierz, Giuseppa Pinello, Ettore Piro, Mario Giuffrè, Simona La Placa, Giovanni Corsello
OBJECTIVE: Metabolic alterations of intrauterine environment in diabetes mellitus (DM) lead to fetal cardiac dysfunctions that can persist after birth. The aim of the study was to assess the cardiovascular adaptation in infants born to diabetic mothers (IDM) with different degrees of glycometabolic control, in relation to revised guidelines for diagnosis of DM and quality improvements in neonatal care. MATERIALS AND METHODS: An observational case-control study was conducted on IDM with gestational, type 1, and type 2 DM...
April 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28412676/investigation-of-sub-health-status-of-neonates-in-heping-street-region-beijing-and-analysis-on-related-risk-factors
#11
Chen Jie, Shi Mai, Li Qiuju, Ye Fang, Liu Fang, Fan Qinying, Zhang Yong, Wang Lin
To investigate sub-health status of neonates in Heping Street Region and related risk factors. Then, 7436 maternal women admitted to hospital in Heping Street Region, Beijing were enrolled from October 2013 to September 2015, including 293 women, who gave birth to sub-health neonates. Questionnaire survey was conducted to collect maternal age, education degree, experiences and income, occupation, life habit, condition in pregnancy, condition in perinatal period, adverse reaction in pregnancy, etc. Finally, 281 effective questionnaires were regained with effective regain rate of 95...
November 2016: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28410945/diagnostic-approach-in-fetal-coarctation-of-the-aorta-a-cost-utility-analysis
#12
Patrick D Evers, Daksha Ranade, Mark Lewin, Bhawna Arya
BACKGROUND: Coarctation of the aorta (CoA) is difficult to diagnose by fetal echocardiogram (F-Echo), often requiring multiple F-Echos during gestation and neonatal echocardiograms (N-Echos) after birth. Furthermore, CoA is the most common ductal-dependent lesion missed on routine physical exam. OBJECTIVES: We sought to determine the most cost-effective diagnostic approach in caring for infants in whom an initial F-Echo is concerning for CoA. METHODS: Four paradigms for management after initial F-Echo could not rule out CoA were compared, with a single paradigm involving additional F-Echos: (1) multiple F-Echos for diagnostic clarity and performance of N-Echo on neonates with remaining high suspicion for CoA on F-Echos (prenatal-multiple), (2) no further F-Echo and performance of N-Echo on neonates with high suspicion for CoA on initial F-Echo (postnatal-selective), (3) no further F-Echo and performance of N-Echo on all neonates (postnatal-all), and (4) no further F-Echo or N-Echo with reliance on routine physical exam to identify afflicted infants (postnatal-none)...
April 11, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28407219/multiple-micronutrient-supplementation-for-women-during-pregnancy
#13
REVIEW
Batool A Haider, Zulfiqar A Bhutta
BACKGROUND: Multiple-micronutrient (MMN) deficiencies often coexist among women of reproductive age in low- to middle-income countries. They are exacerbated in pregnancy due to the increased demands, leading to potentially adverse effects on the mother and developing fetus. Though supplementation with MMNs has been recommended earlier because of the evidence of impact on pregnancy outcomes, a consensus is yet to be reached regarding the replacement of iron and folic acid supplementation with MMNs...
April 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28401538/women-s-attitude-towards-routine-hpa-screening-in-pregnancy
#14
Dian Winkelhorst, Rosanne M Loeff, Elske van den Akker-van Marle, Masja de Haas, Dick Oepkes
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a potentially life-threatening disease with excellent preventative treatment available for subsequent pregnancies. In order to prevent index cases, the effectiveness of a population-based screening program has been suggested repeatedly. Therefore, we aimed to evaluate women's attitude towards possible future human platelet antigen (HPA)-screening in pregnancy MATERIAL AND METHODS: We performed a cross-sectional questionnaire study amongst healthy pregnant women receiving prenatal care in one of seven participating midwifery practices...
April 12, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28395175/oxygen-and-oxidative-stress-in-the-perinatal-period
#15
REVIEW
Isabel Torres-Cuevas, Anna Parra-Llorca, Angel Sánchez-Illana, Antonio Nuñez-Ramiro, Julia Kuligowski, Consuelo Cháfer-Pericás, María Cernada, Justo Escobar, Máximo Vento
Fetal life evolves in a hypoxic environment. Changes in the oxygen content in utero caused by conditions such as pre-eclampsia or type I diabetes or by oxygen supplementation to the mother lead to increased free radical production and correlate with perinatal outcomes. In the fetal-to-neonatal transition asphyxia is characterized by intermittent periods of hypoxia ischemia that may evolve to hypoxic ischemic encephalopathy associated with neurocognitive, motor, and neurosensorial impairment. Free radicals generated upon reoxygenation may notably increase brain damage...
March 12, 2017: Redox Biology
https://www.readbyqxmd.com/read/28391748/small-for-gestational-age-babies-of-low-risk-term-pregnancies-does-antenatal-detection-matter
#16
Catarina Policiano, Andreia Fonseca, Jorge M Mendes, Nuno Clode, Luís M Graça
OBJECTIVES: To compare delivery route and admission rate to neonatal intensive care unit between small- and appropriate-for-gestational-age babies among low-risk term pregnancies. METHODS: A retrospective study was conducted using the database of deliveries in 2014 at a tertiary hospital. Babies delivered at ≥37 weeks with birthweight <10th centile were considered small-for-gestational-age (SGA) and >90th centile were considered large-for-gestational-age...
April 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28390923/ethical-considerations-in-perinatal-palliative-care
#17
Joana Mendes, Jesse Wool, Charlotte Wool
Clinicians may face new ethical considerations when parents continue pregnancies after receiving life-limiting fetal diagnoses and desire palliative care. In this article we present four ethical considerations in perinatal palliative care: ambiguous terminology in relation to diagnosis or prognosis, differences between bereavement support and palliative care, neonatal organ donation, and postdeath cooling. In this article, we enable readers to consider current topics from different perspectives and reflect on care when confronted with sensitive clinical scenarios...
April 6, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28384079/maternal-cancer-during-pregnancy-and-risks-of-stillbirth-and-infant-mortality
#18
Donghao Lu, Jonas F Ludvigsson, Karin E Smedby, Katja Fall, Unnur Valdimarsdóttir, Sven Cnattingius, Fang Fang
Purpose To examine whether maternal cancer during pregnancy is associated with increased risks of stillbirth and infant mortality. Methods On the basis of nationwide health registers, we conducted a study of 3,947,215 singleton births in Sweden from 1973 through 2012. Exposure was defined as maternal cancer diagnosed during pregnancy (number of births = 984) or during the year after pregnancy (number of births = 2,723). We calculated incidence rate ratios (IRRs) for stillbirth and infant mortality, comparing exposed births to unexposed births...
March 6, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28376548/effect-of-an-educational-presentation-about-extremely-preterm-infants-on-knowledge-and-attitudes-of-health-care-providers
#19
Stefani Doucette, Brigitte Lemyre, Thierry Daboval, Sandra Dunn, Salwa Akiki, Nick Barrowman, Gregory P Moore
Objective To determine healthcare providers' knowledge (HCP) about survival rates of extremely preterm infants (EPI) and attitudes toward resuscitation before and after an educational presentation and, to examine the relationship between knowledge and attitudes toward resuscitation. Study Design Participants completed a survey before and after attending a presentation detailing evidence-based estimates of survival rates and surrounding ethical issues. Respondents included neonatologists, obstetricians, pediatricians, maternal-fetal medicine specialists, trainees in pediatrics, obstetrics, neonatal-perinatal medicine and neonatal and obstetrical nurses...
April 4, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28369720/the-contribution-of-multiple-pregnancies-from-overseas-fertility-treatment-to-obstetric-services-in-a-western-australian-tertiary-obstetric-hospital
#20
Kylie Anne Waller, Jan E Dickinson, Roger J Hart
BACKGROUND: Increasingly couples are travelling overseas to access assisted reproductive technology, known as cross border reproductive care, although the incidence, pregnancy outcomes and healthcare costs are unknown. AIMS: To determine obstetric and neonatal outcomes for multiple pregnancies conceived through fertility treatment overseas, and estimate cost of these pregnancies to the health system. MATERIALS AND METHODS: Retrospective study of women receiving care for a multiple gestation between July 2013 and June 2015 at Western Australia's sole tertiary obstetric hospital, where conception was by overseas fertility treatment...
March 29, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
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