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Antenatal corticosteroid therapy

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https://www.readbyqxmd.com/read/29758177/the-efficacy-of-antenatal-steroid-therapy-is-dependent-on-the-duration-of-low-concentration-fetal-exposure-evidence-from-a-sheep-model-of-pregnancy
#1
Matthew W Kemp, Masatoshi Saito, Haruo Usuda, Shimpei Watanabe, Shinichi Sato, Takushi Hanita, Yusaku Kumagai, Timothy J Molloy, Michael Clarke, Peter J Eddershaw, Gabrielle C Musk, Augusto Schmidt, Demelza Ireland, Lucy Furfaro, Matthew S Payne, John P Newnham, Alan H Jobe
OBJECTIVE: Antenatal corticosteroids (ANS) are among the most important and widely used interventions to improve outcomes for preterm infants. ANS dosing regimens remain un-optimized and without maternal weight-adjusted dosing. We, and others, have hypothesised that once a low concentration of materno-fetal steroid exposure is achieved and maintained, the duration of the steroid exposure determines treatment efficacy. Using a sheep model of pregnancy, we tested the relationship between steroid dose, and duration of exposure, and treatment efficacy...
May 9, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29720513/glucocorticoids-antenatal-corticosteroid-therapy-and-fetal-heart-maturation
#2
Emma Agnew, Jessica Ivy, Sarah Stock, Karen Chapman
Glucocorticoids are essential in mammals to mature fetal organs and tissues in order to survive after birth. Hence, antenatal glucocorticoid treatment (termed antenatal corticosteroid therapy) can be life-saving in preterm babies and is commonly used in women at risk of preterm birth. Whilst the effects of glucocorticoids on lung maturation have been well described, the effects on the fetal heart remain less clear. Experiments in mice have shown that endogenous glucocorticoid action is required to mature the fetal heart...
May 2, 2018: Journal of Molecular Endocrinology
https://www.readbyqxmd.com/read/29496431/-in-the-case-of-premature-live-birth-is-very-early-rupture-of-the-membranes-an-additional-risk-factor-for-morbidity-and-mortality
#3
T Isnard, A Vincent-Rohfritsch, C Le Ray, F Goffinet, J Patkai, J Sibiude
OBJECTIVE: To describe survival rate after preterm premature rupture of membranes (PPROM) before 25 weeks of gestation and compare neonatal morbidity and mortality among those born alive with a control group of infants born at a similar gestational age without premature rupture of membranes. METHODS: We conducted a retrospective single-centre study at Port-Royal maternity, from 2007 to 2015, comparing neonatal outcomes between liveborninfants exposed to PPROM prior to 25 weeks of gestation (WG) and a control group not exposed to premature rupture of the membranes...
April 2018: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29348396/a-case-of-umbilical-artery-thrombosis-in-the-third-trimester-of-pregnancy
#4
Fouad Lutfallah, Nina Oufkir, Georges A Markou, Delphine Frimigacci, Christophe Poncelet
BACKGROUND Umbilical artery thrombosis is an extremely rare complication during pregnancy. Umbilical artery thrombosis has a poor prognosis and is associated with increased rates of perinatal morbidity, including intrauterine growth restriction (IUGR), and fetal mortality. CASE REPORT We report a rare case of umbilical artery thrombosis, diagnosed by ultrasound, at 33 weeks gestation in a 30-year-old woman who had previously had an uneventful pregnancy. CONCLUSIONS Umbilical artery thrombosis is a rare complication of pregnancy that is associated with high fetal mortality...
January 19, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29127622/the-joint-effects-of-antenatal-steroids-and-gestational-age-on-improved-outcomes-in-neonates
#5
Neal D Goldstein, Kaitlin M Kenaley, Robert Locke, David A Paul
OBJECTIVES: Antenatal corticosteroids are standard of care for women at risk of a preterm birth and demonstrated to be protective against poor outcomes in neonates including respiratory disorders, mortality and intraventricular hemorrhage (IVH). Its benefits may vary by gestational age, and accurate estimation is needed in a single-center population to account for practice variation. METHODS: A retrospective cohort of infants admitted to the hospital's neonatal intensive care unit, 1997-2015...
March 2018: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29119673/efficacy-of-antenatal-corticosteroids-in-preterm-twins-the-epipage-2-cohort-study
#6
D Palas, V Ehlinger, C Alberge, P Truffert, G Kayem, F Goffinet, P-Y Ancel, C Arnaud, C Vayssière
OBJECTIVES: To investigate the efficacy of antenatal corticosteroid (ACS) therapy on short-term neonatal outcomes in preterm twins, and further document the influence of the ACS-to-delivery interval. DESIGN: EPIPAGE-2 is a nationwide observational multicentre prospective cohort study of neonates born between 22 and 34 completed weeks of gestation. SETTING: All French maternity units, except in a single administrative region, between March and December 2011...
November 8, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29035425/inhaled-versus-systemic-corticosteroids-for-the-treatment-of-bronchopulmonary-dysplasia-in-ventilated-very-low-birth-weight-preterm-infants
#7
REVIEW
Sachin S Shah, Arne Ohlsson, Henry L Halliday, Vibhuti S Shah
BACKGROUND: This is an update of a review published in 2012. A related review "Inhaled versus systemic corticosteroids for preventing bronchopulmonary dysplasia in ventilated very low birth weight preterm neonates" has been updated as well. Bronchopulmonary dysplasia (BPD) is a serious and common problem among very low birth weight infants, despite the use of antenatal steroids and postnatal surfactant therapy to decrease the incidence and severity of respiratory distress syndrome...
October 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28937572/obstetric-care-consensus-no-6-periviable-birth
#8
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937567/obstetric-care-consensus-no-6-summary-periviable-birth
#9
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28858117/exacerbation-of-primary-intestinal-lymphangiectasia-during-late-pregnancy-and-recovery-after-delivery-a-case-report-and-literature-review
#10
REVIEW
Jianyang Lu, Hongbo Zhai
RATIONALE: Primary intestinal lymphangiectasia (PIL) is a rare disease characterized by dilated intestinal lacteals resulting in lymph leakage into the small bowel lumen. Main clinical features include intermittent diarrhea, hypoproteinemia. Scattered case reports suggested that PIL is compatible to pregnancy, but with increased complications. PATIENT CONCERNS: A 34-year-old woman with endoscopically diagnosed PIL presented to antenatal our clinic at 10 weeks into gestation...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28822438/-effect-of-antenatal-corticosteroids-therapy-on-the-mortality-and-morbidity-of-small-for-gestational-age-infants-born-at-24-34-completed-weeks-a-retrospective-multicenter-study
#11
(no author information available yet)
Objective: To assess the impact of antenatal corticosteroids (ACS) therapy on mortality and morbidities in small for gestational age (SGA) preterm infants. Method: A retrospective database analysis was performed. Preterm infants born at 24-34 completed weeks who were diagnosed as SGA in 14 hospitals in China between 2013 and 2014 were evaluated for mortality and major morbidities including respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), necrotising enterocolitis (NEC), retinopathy of prematurity (ROP), patent ductus arteriosus (PDA) and sepsis...
August 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28742678/committee-opinion-no-713-antenatal-corticosteroid-therapy-for-fetal-maturation
#12
(no author information available yet)
Corticosteroid administration before anticipated preterm birth is one of the most important antenatal therapies available to improve newborn outcomes. A single course of corticosteroids is recommended for pregnant women between 24 0/7 weeks and 33 6/7 weeks of gestation who are at risk of preterm delivery within 7 days, including for those with ruptured membranes and multiple gestations. It also may be considered for pregnant women starting at 23 0/7 weeks of gestation who are at risk of preterm delivery within 7 days, based on a family's decision regarding resuscitation, irrespective of membrane rupture status and regardless of fetal number...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742672/committee-opinion-no-713-summary-antenatal-corticosteroid-therapy-for-fetal-maturation
#13
(no author information available yet)
Corticosteroid administration before anticipated preterm birth is one of the most important antenatal therapies available to improve newborn outcomes. A single course of corticosteroids is recommended for pregnant women between 24 0/7 weeks and 33 6/7 weeks of gestation who are at risk of preterm delivery within 7 days, including for those with ruptured membranes and multiple gestations. It also may be considered for pregnant women starting at 23 0/7 weeks of gestation who are at risk of preterm delivery within 7 days, based on a family's decision regarding resuscitation, irrespective of membrane rupture status and regardless of fetal number...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28586580/impact-of-antenatal-corticosteroids-on-frequency-and-mortality-due-to-respiratory-distress-syndrome-in-preterm-neonates
#14
Fazeela Shahzad, Naima Umar
BACKGROUND: Prematurity is still a major problem for health care services throughout the world. Before the late 1980s, respiratory distress syndrome (RDS) was the primary cause of morbidity and mortality in preterm new-borns. Frequency of RDS and ensuing mortality in infants treated with antenatal steroid is less than those delivered without this therapy. Many pregnant females deliver before term or 37 weeks, hence may be advised this prophylactic therapy without creating significant maternal or foetal side effects...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28583603/influence-of-prenatal-maternal-corticosteroid-therapy-on-clinical-and-metabolic-features-and-pulmonary-function-of-preterm-newborn-puppies
#15
F M Regazzi, L C G Silva, C F Lúcio, G A L Veiga, D S R Angrimani, D Kishi, M M M Barbosa, C I Vannucchi
Although the effects of antenatal corticosteroid therapy in clinical improvement and pulmonary maturation in preterm have been described, little is known on premature newborn puppies. This study aimed to evaluate the effect of maternal administration of a single dose of prenatal betamethasone on lung function of preterm newborn puppies in the first hours of life, especially from the clinical point of view and acid-base balance. A prospective study was conducted involving 21 puppies allocated into three experimental groups: Term Group (63 days post-ovulation), Preterm-Treated Group (57 days post-ovulation and maternal administration of a single dose of 0...
July 15, 2017: Theriogenology
https://www.readbyqxmd.com/read/28527272/-does-corticosteroid-treatment-during-the-pre-and-postnatal-periods-affect-the-neurodevelopmental-outcome-of-premature-newborns
#16
Marita Lardón, José Uberos, Eduardo Narbona
INTRODUCTION: Glucocorticoids, widely used in the perinatal period, may be associated with adverse neurodevelopmental effects. OBJECTIVES: To analyze neurodevelopmental outcomes in a cohort of very low birth weight newborns treated with antenatal and/or postnatal corticosteroids. MATERIALS AND METHODS: This was a prospective cohort study in which we included all very low birth weight babies admitted to the neonatal intensive care unit of a tertiary hospital between 2008 and 2013...
April 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28391733/antenatal-magnesium-sulfate-for-both-tocolysis-and-fetal-neuroprotection-in-premature-rupture-of-the-membranes-before-32-weeks-gestation
#17
Eun Jung Jung, Jung Mi Byun, Young Nam Kim, Kyung Bok Lee, Moon Su Sung, Ki Tae Kim, Jong Beom Shin, Dae Hoon Jeong
OBJECTIVE: We aimed to assess the impact of antenatal MgSO4 therapy given to women with PPROM before 32 weeks' gestation on latency, maternal outcomes, perinatal outcomes, and neurodevelopmental outcomes. METHODS: We undertook a retrospective cohort observational study of 184 singleton pregnancies complicated by PPROM at 23°-316  weeks who were hospitalized and received magnesium therapy for tocolysis (MgSO4 group) or did not receive tocolytic therapy (no MgSO4 group) between 2005 and 2013...
June 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28277916/effect-of-antenatal-corticosteroids-on-morbidity-and-mortality-of-preterm-singletons-and-twins
#18
Ana Vaz, Maria Filipa Malheiro, Milton Severo, Teresa Rodrigues, Hercília Guimarães, Nuno Montenegro
PURPOSE: To compare the effect of antenatal corticosteroids (ACS) on neonatal outcomes among singleton and twin pregnancies and the impact of completeness and timing of ministration. MATERIALS AND METHODS: Retrospective cohort study involving 951 preterm deliveries (25+0 -34+6  weeks), between 2006 and 2015. Neonatal outcomes were evaluated according to completeness of ACS ("Complete" n = 441; "Rescue" n = 38; "Incomplete" n = 175; "No ACS" n = 98) and timing of therapy related to delivery ("Before 7 days" n = 260; "After 7 days" n = 181)...
March 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28246490/cystic-adrenal-lesions-focus-on-pediatric-population-a-review
#19
REVIEW
Mara Carsote, Adina Ghemigian, Dana Terzea, Ancuta Augustina Gheorghisan-Galateanu, Ana Valea
BACKGROUND AND AIM: The cysts may potentially affect any organ; adrenals cysts are rare. This is a review of the literature regarding adrenal cysts, focusing on children and young adults. GENERAL DATA: Three major types have been described: pure cysts (endothelial, epithelial, and hemorrhagic or pseudocyst), parasitic (as hydatid) cysts and cystic part of a tumour (most frequent are neuroblastoma, ganglioneuroma, pheocromocytoma, and teratoma). The complications are: bleeding, local pressure effects; infection; rupture (including post-traumatic); arterial hypertension due to renal vessels compression...
2017: Clujul Medical (1957)
https://www.readbyqxmd.com/read/28194395/gender-differences-in-respiratory-morbidity-and-mortality-of-preterm-neonates
#20
REVIEW
Courtney Denise Townsel, Sawyer F Emmer, Winston A Campbell, Naveed Hussain
For the past century, researchers have underscored the "disadvantage" observed in respiratory morbidity and mortality of male newborns. In this contemporary review, we examine gender differences in preterm infant respiratory morbidity and mortality specifically appraising differences in the very low birth weight (VLBW) population as well as the late preterm (LPT) population. In the era of postnatal surfactant and antenatal corticosteroids, the gender gap in neonatal outcomes has not narrowed. Structural, physiologic, and hormonal sex differences may be at the root of this disparity...
2017: Frontiers in Pediatrics
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