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Fetal and neonatal care

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https://www.readbyqxmd.com/read/27904846/complete-congenital-heart-block-in-a-neonate-with-a-complex-congenital-heart-defect-in-africa
#1
Clovis Nkoke, Edvine Yonta Wawo, Liliane Kuate Mfeukeu, Larissa Makamte, Sandrine Dikosso Edie, Flore Esiene Balana
Congenital heart block (CHB) is rare disorder that has a higher mortality when associated with structural congenital heart defects. Very few cases have been reported in Sub-Saharan Africa (SSA). We present a case of complete CHB associated with a complex congenital heart defect in a neonate in Cameroon. A 1-month-old neonate in Cameroon was referred for the evaluation of bradycardia. The obstetrical ultrasound done during pregnancy revealed fetal bradycardia without further evaluation. Clinical examination showed well a developed neonate with bradycardia at 62 beats/minute, and mild cyanosis with oxygen saturation at 93% at room air...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27901552/diagnosis-and-management-of-hyperthyroidism-in-pregnancy-a-review
#2
Jennifer Renae King, Ruben Lachica, Richard H Lee, Martin Montoro, Jorge Mestman
Importance: Hyperthyroidism has important implications for pregnancy, affecting both mother and fetus. Appropriate maternal and fetal management iscritical to avoiding adverse pregnancy outcomes and requires a multidisciplinary approach. Objective: To describe maternal diagnosis and management of hyperthyroidism, across all stages of pregnancy. In addition, to review clinical signs of fetal thyroid dysfunction due to maternal Graves disease and discuss management considerations...
November 2016: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/27893837/cell-type-specific-modulation-of-cobalamin-uptake-by-bovine-serum
#3
Hua Zhao, Kalani Ruberu, Hongyun Li, Brett Garner
Tracking cellular 57Co-labelled cobalamin (57Co-Cbl) uptake is a well-established method for studying Cbl homeostasis. Previous studies established that bovine serum is not generally permissive for cellular Cbl uptake when used as a supplement in cell culture medium, whereas supplementation with human serum promotes cellular Cbl uptake. The underlying reasons for these differences are not fully defined. In the current study we address this question. We extend earlier observations by showing that fetal calf serum inhibits cellular 57Co-Cbl uptake by HT1080 cells (a fibrosarcoma-derived fibroblast cell line)...
2016: PloS One
https://www.readbyqxmd.com/read/27878783/prediction-of-significant-hyperbilirubinemia-in-term-neonates-by-early-non-invasive-bilirubin-measurement
#4
Manish Jain, Akash Bang, Anju Tiwari, Shuchi Jain
BACKGROUND: Neonatal jaundice is a common problem. We evaluated the utility and best cut-off values of 24-and 48-hour transcutaneous bilirubin indices (TcBI) in predicting subsequent significant hyperbilirubinemia and evaluated various associated maternal and fetal risk factors. METHODS: TcBI at 24 and 48 hours and serum bilirubin levels at 72 hours of age were obtained for healthy, term, appropriate for gestational age neonates. Neonates with prematurity, birth weight <2500 g, ABO or Rh incompatibility, onset of clinical jaundice <24 hours, clinical suspicion of septicemia, positive pressure ventilation at birth, admission in neonatal intensive care unit and contraindications for BiliChek were excluded...
November 23, 2016: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/27874184/antenatal-ultrasound-features-in-fetuses-with-gastroschisis-and-its-prediction-in-neonatal-outcome
#5
Jessica A Robertson, Roy M Kimble, Kellie Stockton, Renuka Sekar
BACKGROUND: Gastroschisis is the most common major congenital anomaly managed by paediatric surgeons. The significance of certain associated antenatal ultrasound features in determining fetal outcome is under discussion. AIM: The study aims to define if associated antenatal ultrasound features of gastroschisis are useful prognostic markers for fetal outcome. By establishing the significance of features, including extra- and intra-abdominal bowel dilatation, stomach herniation, stomach dilatation, bowel matting, growth restriction, abnormal umbilical artery (UA) Doppler ultrasounds, and abnormal amniotic fluid volume, it is hoped clinicians will have enhanced ability to counsel parents about the likely outcomes for their infant...
November 22, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27871474/the-relationship-between-maternal-placental-growth-factor-levels-and-intrapartum-fetal-compromise
#6
Larissa N Bligh, Ristan M Greer, Sailesh Kumar
INTRODUCTION: Whilst some cases of intrapartum fetal compromise are the result of unpredictable catastrophic events, the majority arise from an unrecognised reduction in feto-placental reserve in otherwise healthy pregnancies. There is currently no reliable technique prior to labour that identifies the at-risk fetus. We aimed to investigate the relationship between maternal levels of serum placental growth factor (PlGF) and intrapartum fetal compromise in term pregnancies prior to labour...
December 2016: Placenta
https://www.readbyqxmd.com/read/27862683/is-the-neonatal-creatine-phosphokinase-level-a-reliable-marker-for-fetal-hypoxia
#7
Mitsue Muraoka, Koichiro Takagi, Yoshihiro Morita, Hiroaki Nagano, Nobuhide Henmi, Hisaya Hasegawa
AIM: The creatine phosphokinase (CPK) level is believed to increase in neonatal peripheral blood after tissue damage, including damage from perinatal hypoxia. However, it is not clear whether it is truly a reliable marker for fetal hypoxia. We investigated the chronological changes in neonatal CPK and the reliability of CPK as a marker for fetal hypoxia. METHODS: Sixty term neonates admitted to the neonatal intensive care unit at Tokyo Women's Medical University Medical Center East from April 2009 to April 2010 were enrolled in this study...
November 12, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27860117/development-of-a-core-outcome-set-for-epilepsy-in-pregnancy-e-core-a-national-multi-stakeholder-modified-delphi-consensus-study
#8
B H Al Wattar, K Tamilselvan, R Khan, A Kelso, A Sinha, A M Pirie, D McCorry, K S Khan, S Thangaratinam
OBJECTIVE: To develop a set of core outcomes for studies on pregnant women with epilepsy. DESIGN: Delphi consensus study. POPULATION: Healthcare professionals, and patient representatives with lived experience of epilepsy in the UK. METHODS: We used a modified Delphi method and a consultation meeting to achieve consensus. Potential outcomes were identified by systematic review, and were scored using a Likert scale anchored between 1 (least important) and 5 (most important)...
November 16, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27859836/outcome-in-monochorionic-twin-pregnancies-with-selective-intrauterine-growth-restriction-according-to-the-umbilical-artery-doppler-pattern-of-the-smaller-twin-a-systematic-review-and-meta-analysis
#9
REVIEW
Danilo Buca, Giorgio Pagani, Giuseppe Rizzo, Alessandra Familiari, Maria Elena Flacco, Lamberto Manzoli, Marco Liberati, Francesco Fanfani, Giovanni Scambia, Francesco D'Antonio
OBJECTIVE: To explore the outcome of monochorionic (MC) twin pregnancies affected by selective intra-uterine growth restriction (sIUGR) according to the umbilical artery Doppler pattern of the smaller twin. METHODS: Medline, Embase, Cinhal and ClinicalTrials.gov databases (2000-2016) were searched. sIUGR was defined as the presence of one twin with estimated fetal weight and/or abdominal circumference less than 10(th) or 5(th) percentile and classified according to the umbilical artery Doppler flow pattern of the smaller twin (type I: persistently positive, type II: persistently absent/reversed, type III: intermittently absent/reversed)...
November 18, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27852228/pregnancy-outcome-in-women-with-eisenmenger-s-syndrome-a-case-series-from-west-china
#10
Ruiqi Duan, Xiumei Xu, Xiaodong Wang, Haiyan Yu, Yong You, Xinghui Liu, Aiyun Xing, Rong Zhou, Mingrong Xi
BACKGROUND: Eisenmenger's syndrome (ES) consists of pulmonary hypertension with a reversed or bidirectional shunt at the atrioventricular, or aortopulmonary level. The cardiovascular changes that occur during the pregnancy contribute to the high maternal morbidity and mortality in patients with ES. This study is to assess maternal and fetal outcomes in patients with ES. METHODS: This study is a retrospective analysis of 11 pregnancies in women with ES who delivered at a tertiary care center in west China between 2010 and 2014...
November 16, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27849163/fifteen-minute-consultation-perinatal-palliative-care
#11
Peter Sidgwick, Emily Harrop, Brenda Kelly, Ana Todorovic, Dominic Wilkinson
Perinatal palliative medicine is an emerging subspecialty within paediatric palliative medicine, neonatal medicine, fetal medicine and obstetrics. It comprises patient-focused, non-judgemental shared decision making and aims to provide holistic multidisciplinary support for families. In this paper we define and describe one model for providing perinatal palliative care, drawing on the personal and professional experience of the authors.
November 14, 2016: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/27843776/a-randomized-controlled-trial-comparing-use-of-enthonox-with-pethidine-for-pain-relief-in-primigravid-women-during-the-active-phase-of-labor
#12
Noshin Mobaraki, Mahzad Yousefian, Solmaz Seifi, Mehran Sakaki
BACKGROUND: The use of pain-relieving drugs during labor is now part of standard care in many countries throughout the world. Each method of pain relief has its own risks and benefits, variations in effectiveness, and availability and acceptability. OBJECTIVES: This study aimed to assess the efficacy and safety of intramuscular pethidine as an analgesic during labor by comparing it to inhaled 50% nitrous oxide (Entonox). METHODS: In this clinical trial study, 100 women who expected to have a natural childbirth were observed...
August 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27835686/clinical-outcome-in-singleton-and-multiple-pregnancies-with-placental-chorangioma
#13
Meeli Sirotkina, Konstantinos Douroudis, Nikos Papadogiannakis, Magnus Westgren
INTRODUCTION: Chorangiomas (CAs) are the most common non-trophoblastic tumor-like-lesions of the placenta. Although the clinical significance of small CAs is unknown, the large lesions are often associated with maternal and fetal complications. The aim of our study was to assess the maternal clinical characteristics and neonatal outcome in singleton and multiple pregnancies with placental CA. MATERIALS AND METHODS: Among 15742 selected placentas 170 CAs were diagnosed...
2016: PloS One
https://www.readbyqxmd.com/read/27829878/glanzmann-thrombasthenia-in-pregnancy-optimising-maternal-and-fetal-outcomes
#14
A Wijemanne, I Watt-Coote, S Austin
Glanzmann thrombasthenia is a rare autosomal recessive haemorrhagic disorder. The risks of miscarriage, antepartum and postpartum haemorrhage, and neonatal complications are all increased in individuals presenting with the disease in pregnancy. Some individuals may develop antibodies to platelet glycoproteins; the presence of these antibodies is a rare cause of neonatal alloimmune thrombocytopenia and potential intracranial haemorrhage. Multidisciplinary care is paramount for ensuring optimal fetal and maternal outcomes in such cases...
December 2016: Obstetric Medicine
https://www.readbyqxmd.com/read/27822105/the-danish-national-quality-database-for-births
#15
REVIEW
Charlotte Brix Andersson, Christina Flems, Ulrik Schiøler Kesmodel
AIM OF THE DATABASE: The aim of the Danish National Quality Database for Births (DNQDB) is to measure the quality of the care provided during birth through specific indicators. STUDY POPULATION: The database includes all hospital births in Denmark. MAIN VARIABLES: Anesthesia/pain relief, continuous support for women in the delivery room, lacerations (third and fourth degree), cesarean section, postpartum hemorrhage, establishment of skin-to-skin contact between the mother and the newborn infant, severe fetal hypoxia (proportion of live-born children with neonatal hypoxia), delivery of a healthy child after an uncomplicated birth, and anesthesia in case of cesarean section...
2016: Clinical Epidemiology
https://www.readbyqxmd.com/read/27816163/obstetric-transport
#16
REVIEW
Julie Scott
Obstetric transport is a specialized medical transport for maternal, fetal, and neonatal concerns. Perinatal regionalization of care provides a broader geographic availability of obstetric services with defined levels of maternal and neonatal care so that women can be transported to centers with increased resources and capabilities to reduce morbidity and mortality. The Emergency Medical Treatment and Active Labor Act provides regulatory guidance for care of laboring women who require transfer to a higher level of care...
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27814911/population-based-outcomes-data-for-counseling-at-the-margin-of-gestational-viability
#17
Patrick Myers, Naomi Laventhal, Bree Andrews, Joanne Lagatta, William Meadow
OBJECTIVE: To survey neonatologists as to how many use population-based outcomes data to counsel families before and after the birth of 22- to 25-week preterm infants. STUDY DESIGN: An anonymous online survey was distributed to 1022 neonatologists in the US. Questions addressed the use of population-based outcome data in prenatal and postnatal counseling. RESULTS: Ninety-one percent of neonatologists reported using population-based outcomes data for counseling...
November 1, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27809899/prenatal-sonographic-diagnosis-of-fetal-valproate-syndrome-a-case-report
#18
Norihiko Kikuchi, Satoshi Ohira, Ryoichi Asaka, Kyoko Tanaka, Akiko Takatsu, Tanri Shiozawa
BACKGROUND: Prenatal exposure of mother to valproate (VPA) causes teratogenic effects in the fetus, namely fetal valproate syndrome (FVS). We report a case of fetal valproate syndrome rarely diagnosed by prenatal sonographic examination. CASE PRESENTATION: Our patient was a female infant who was born to a 27-year-old nulliparous Japanese woman with epilepsy. The mother was diagnosed with infantile epilepsy at 1 year of age and had been using three antiepileptic drugs, including valproate, but preconceptional counseling was not performed...
November 3, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27798035/effect-of-simple-targeted-diet-in-pregnant-women-with-metabolic-risk-factors-on-maternal-and-fetal-outcomes-esteem-study-protocol-for-a-pragmatic-multicentre-randomised-trial
#19
Bassel H Al Wattar, Julie Dodds, Anna Placzek, Eleni Spyreli, Amanda Moore, Richard Hooper, Lee Beresford, Tessa J Roseboom, Maira Bes-Rastrollo, Graham Hitman, Khalid S Khan, Shakila Thangaratinam
INTRODUCTION: Women with metabolic risk factors are at higher risk of adverse pregnancy outcomes. Mediterranean-based dietary interventions have the potential to minimise these risks. We aim to evaluate the effectiveness of a simple, targeted intervention modelled on Mediterranean diet in preventing maternal and fetal complications in pregnant women with metabolic risk factors. METHODS AND ANALYSIS: Pregnant women with a singleton pregnancy <18 weeks gestation, and without pre-existing diabetes, chronic renal disease and autoimmune diseases will be recruited...
October 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27793395/assessment-of-progressive-pathophysiology-after-early-prenatal-diagnosis-of-the-ebstein-anomaly-or-tricuspid-valve-dysplasia
#20
Elif Seda Selamet Tierney, Doff B McElhinney, Lindsay R Freud, Wayne Tworetzky, Bettina F Cuneo, Maria C Escobar-Diaz, Catherine Ikemba, Brian T Kalish, Rukmini Komarlu, Stéphanie M Levasseur, Michael D Puchalski, Gary M Satou, Norman H Silverman, Anita J Moon-Grady
In fetuses with Ebstein anomaly or tricuspid valve dysplasia (EA/TVD), poor hemodynamic status is associated with worse neonatal outcome. It is not known whether EA/TVD fetuses with more favorable physiology earlier in gestation progress to more severe disease in the third trimester. We evaluated if echocardiographic indexes in EA/TVD fetuses presenting <24 weeks of gestation are reliable indicators of physiologic status later in pregnancy. This multicenter, retrospective study included 51 fetuses presenting at <24 weeks of gestation with EA/TVD and serial fetal echocardiograms ≥4 weeks apart...
September 29, 2016: American Journal of Cardiology
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