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Pregnancy simulation

Christina Riley, Stephanie Dellicour, Peter Ouma, Urbanus Kioko, Ahmeddin Omar, Simon Kariuki, Zipporah Ng'ang'a, Meghna Desai, Ann M Buff, Julie R Gutman
Prompt diagnosis and effective treatment of acute malaria in pregnancy (MiP) is important for the mother and fetus; data on health-care provider adherence to diagnostic guidelines in pregnancy are limited. From September to November 2013, a cross-sectional survey was conducted in 51 health facilities and 39 drug outlets in Western Kenya. Provider knowledge of national diagnostic guidelines for uncomplicated MiP were assessed using standardized questionnaires. The use of parasitologic testing was assessed in health facilities via exit interviews with febrile women of childbearing age and in drug outlets via simulated-client scenarios, posing as pregnant women or their spouses...
March 5, 2018: American Journal of Tropical Medicine and Hygiene
Michela Meregaglia, Livia Dainelli, Helen Banks, Chiara Benedetto, Patrick Detzel, Giovanni Fattore
BACKGROUND: The incidence of Gestational Diabetes Mellitus (GDM) is rising in all developed countries. This study aimed at assessing the short-term economic burden of GDM from the Italian healthcare system perspective. METHODS: A model was built over the last pregnancy trimester (i.e., from the 28th gestational week until childbirth included). The National Hospital Discharge Database (2014) was accessed to estimate delivery outcome probabilities and inpatient costs in GDM and normal pregnancies (i...
February 23, 2018: BMC Pregnancy and Childbirth
Donghoon Lee, Hyun-Young Shin, Sang Min Park
Background: In Korea, hepatitis B virus (HBV) infection accounts for approximately 65-75% of HBV-related diseases, such as chronic hepatitis and liver cancer, and mother-to-child transmission is presumed to be a major source of the infection. To tackle this issue, the Korean government launched the national Perinatal Hepatitis B Prevention Program (PHBPP) in 2002. This study analyzed the cost-effectiveness of the PHBPP with antiviral prophylaxis compared with the current PHBPP and/or universal vaccination, as well as identified the optimal strategy to eliminate mother-to-child transmission of HBV in Korea...
2018: Cost Effectiveness and Resource Allocation: C/E
Amy Fischer, Valerie Aw Benka, Joyce Briggs, Marc-Antoine Driancourt, Joanne Maki, Darcy So Mora, Kevin Morris, Kayla A Myers, Linda Rhodes, Lindsey M Vansandt, George Robert Weedon, Julie Wolf, Julie K Levy
Objectives Non-surgical contraceptive management of free-roaming cat populations is a global goal for public health and humane reasons. The objectives of this study were to measure the duration of contraception following a single intramuscular injection of a gonadotropin-releasing hormone-based vaccine (GonaCon) and to confirm its safe use in female cats living in colony conditions. Methods GonaCon (0.5 ml/cat) was administered intramuscularly to 20 intact female cats (queens), and saline was administered to 10 queens serving as sham-treated controls...
February 1, 2018: Journal of Feline Medicine and Surgery
D J Cottle, M Wallace, P Lonergan, A G Fahey
A bioeconomic, stochastic spreadsheet model, that included calculation of the net present value of the additional value of all future descendants resulting from increased selection intensity, was developed to study the profitability of using sexed semen in a high input-high output dairy herd. Three management strategies were modeled: (1) only heifers inseminated with sex-sorted semen and cows inseminated with unsorted semen; (2) both heifers and cows inseminated with sex-sorted semen; and (3) a reference scenario, in which all breeding females were inseminated with unsorted semen...
February 14, 2018: Journal of Dairy Science
Bradley de Vries, Rajit Narayan, Kevin McGeechan, Stanley Santiagu, Ramesh Vairavan, Minke Burke, Hala Phipps, Jon Hyett
INTRODUCTION: Cesarean section rates continue to increase globally. Prediction of intrapartum cesarean section could lead to preventive measures. Our aim was to assess the association between sonographically measured cervical length at 37 weeks of gestation and cesarean section among women planning a vaginal birth. The population was women with a low-risk pregnancy or with gestational diabetes. MATERIAL AND METHODS: This was a prospective cohort study conducted in a tertiary referral hospital in Sydney, Australia...
February 16, 2018: Acta Obstetricia et Gynecologica Scandinavica
Adriana Ferlazzo, Cristina Cravana, Esterina Fazio, Pietro Medica
In order to acquire a pattern of thyroid involvement in welfare maintenance in Ruminants and Equines, this review summarizes data concerning the reference values of total and free iodothyronines and their modifications in physiological conditions and in different management conditions (pregnancy, lactation, weaning, growth, isolation, restraint, shearing, confinement and transportation). Thyroidal and extrathyroidal tissues efficiently respond to management practices, giving a differentiated contribution to circulating iodothyronine changes...
February 2, 2018: Research in Veterinary Science
Haichong Wu, Kangfeng Jiang, Tao Zhang, Gan Zhao, Aftab Shaukat, Ganzhen Deng
During the first trimester of pregnancy in dairy cows, the fetus is mainly recognized by the expression of major histocompatibility complex class I (MHC-I) in the maternal immune system. Before the embryo begins to implant in the maternal uterus, it requires a long time to remodel and develop vessels in the placenta. During this stage, the embryos are exposed to a hypoxic environment. However, the expression of bovine MHC-I has not been determined in hypoxic bovine endometrial epithelial cells (bEECs). Hypoxia-inducible factor-1α (HIF-1α) is a marker for hypoxic conditions in cells...
January 25, 2018: Research in Veterinary Science
Kimberley A Bullard, Brian L Shaffer, Karen S Greiner, Ashley E Skeith, Maria I Rodriguez, Aaron B Caughey
OBJECTIVE: To estimate the effect of 20-week abortion bans on maternal and consequent neonatal health outcomes and costs in the setting of fetal congenital diaphragmatic hernia. METHODS: A decision-analytic model was built using TreeAge software to evaluate the effect of a 20-week ban on abortion in a theoretical cohort of 921 women diagnosed with fetal congenital diaphragmatic hernia. Probabilities, utilities, and costs were derived from the literature. The cohort size was based on the annual rate of prenatal diagnoses of congenital diaphragmatic hernia and live births among the 20 states with bans...
March 2018: Obstetrics and Gynecology
D S N'Diaye, O Launay, O Picone, V Tsatsaris, E Azria, F Rozenberg, M Schwarzinger, Y Yazdanpanah
BACKGROUND: CMV infections are the most frequent congenital infections worldwide. AIM: Assess the cost-effectiveness of vaccination strategies of adolescent girls vs. current practice (hygiene counseling) to prevent CMV seroconversions during pregnancy in France. METHOD: A Markov decision-tree model simulated overtime the trajectory of a single fictive cohort of 390,000 adolescent women aged 14 years old, living in France. Impact of vaccination was explored until the end of their reproductive live 40 years later...
February 28, 2018: Vaccine
N A Dennis, K Stachowicz, B Visser, F S Hely, D K Berg, N C Friggens, P R Amer, S Meier, C R Burke
Fertility of the dairy cow relies on complex interactions between genetics, physiology, and management. Mathematical modeling can combine a range of information sources to facilitate informed predictions of cow fertility in scenarios that are difficult to evaluate empirically. We have developed a stochastic model that incorporates genetic and physiological data from more than 70 published reports on a wide range of fertility-related traits in dairy cattle. The model simulates pedigree, random mating, genetically correlated traits (in the form of breeding values for traits such as hours in estrus, estrous cycle length, age at puberty, milk yield, and so on), and interacting environmental variables...
January 26, 2018: Journal of Dairy Science
Mei-Juan Xie, Zhi-Kun Liang, Dan He, Wei-Wen Xu, Ying-Song Wu, Xue-Xi Yang, Ming Li
Rare autosomal aneuploidies (RAAs) can cause miscarriage or other pregnancy complications and lead to inconsistent results of noninvasive prenatal testing (NIPT), but many NIPT providers have not yet started to provide related services. Our aim was to develop a semiconductor sequencing platform (SSP)-based method for detecting RAAs when pregnant women performed NIPT. Fifty-three aneuploidy samples with verified karyotyping or array comparative genomic hybridization (aCGH) results were collected and subjected to RAAs detection using an SSP to develop a method by genomic sequencing...
January 30, 2018: DNA and Cell Biology
Benjamin Anon, Béatrice Scotto, Yannick Bacq
Acute fatty liver of pregnancy (AFLP) is a rare liver disease unique to pregnancy that can lead to acute liver failure. Clinicians must have a high index of suspicion for AFLP because only early diagnosis and prompt delivery improve maternal and fetal prognosis.
January 2018: Clinical Case Reports
Tianwu Xie, Paolo Zanotti-Fregonara, Agathe Edet-Sanson, Habib Zaidi
Purpose: The radiation dose delivered to pregnant patients during radiological imaging procedures raises health concerns because the developing embryo and fetus are considered to be highly radiosensitive. To appropriately weigh the diagnostic benefits against the radiation risks, the radiologist needs reasonably accurate and detailed estimates of the fetal dose. Expanding our previously developed series of computational phantoms for pregnant women, we here describe a personalized model for twin pregnancy, based on an actual clinical scan...
January 25, 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Owain Roberts, Rajith K R Rajoli, David J Back, Andrew Owen, Kristin M Darin, Courtney V Fletcher, Mohammed Lamorde, Kimberly K Scarsi, Marco Siccardi
Background: HIV-positive women receiving efavirenz-based ART and levonorgestrel contraceptive implants are at risk of low levonorgestrel exposure and unintended pregnancy. Objectives: To investigate clinically applicable dose-adjustment strategies to overcome the known drug-drug interaction (DDI) between levonorgestrel and efavirenz, using a physiologically based pharmacokinetic (PBPK) modelling-based approach. Methods: A PBPK model was qualified against clinical data to predict levonorgestrel plasma concentrations when standard-dose (150 mg) levonorgestrel implants were administered alone (control group), as well as when standard-dose or increased-dose (300 mg) levonorgestrel implants were coadministered with either 600 or 400 mg of efavirenz...
January 22, 2018: Journal of Antimicrobial Chemotherapy
Yan-Shing Chang, Kirstie Coxon, Anayda Gerarda Portela, Marie Furuta, Debra Bick
OBJECTIVES: the objectives of this review were (1) to assess whether interventions to support effective communication between maternity care staff and healthy women in labour with a term pregnancy could improve birth outcomes and experiences of care; and (2) to synthesize information related to the feasibility of implementation and resources required. DESIGN: a mixed-methods systematic review. SETTING AND PARTICIPANTS: studies which reported on interventions aimed at improving communication between maternity care staff and healthy women during normal labour and birth, with no apparent medical or obstetric complications, and their family members were included...
December 27, 2017: Midwifery
Elizabeth A Suarez, Suzanne N Landi, Mitchell C Conover, Michele Jonsson Funk
PURPOSE: Administrative claim databases are increasingly being used to study the safety of medication exposures during pregnancy. These studies are restricted to live births due to a reliance on algorithms for estimating gestational age that are based on codes associated with live delivery. Conditioning on live birth may induce selection bias when studying the effect of a drug on a pregnancy complication if fetal death is a competing risk for the complication or is caused by the complication...
January 17, 2018: Pharmacoepidemiology and Drug Safety
Kyra Kimberly Kieskamp, Rachel Rogers Worley, Eva D McLanahan, Marc-André Verner
BACKGROUND: Multiple agencies have developed health-based toxicity values for exposure to perfluorooctanoic acid (PFOA). Although PFOA exposure occurs in utero and through breastfeeding, current health-based toxicity values have not been derived using fetal or child dosimetry. Therefore, current values may underestimate the potential risks to fetuses and nursing infants. OBJECTIVE: Using fetal and child dosimetry, we aimed to calculate PFOA maternal human equivalent doses (HEDs), corresponding to a developmental mouse study lowest observed adverse effect level (LOAEL, 1mg/kg/day)...
December 23, 2017: Environment International
Carolyn M Zelop, Sharon Einav, Jill M Mhyre, Stephanie Martin
While global maternal mortality has decreased in the last 25 years, the maternal mortality ratio in the United States has actually increased. Maternal mortality is a complex phenomenon involving multifaceted socioeconomic and clinical parameters including inequalities in access to health care, racial and ethnic disparities, maternal comorbidities, and epidemiologic ascertainment bias. Escalating maternal mortality underscores the importance of clinician preparedness to respond to maternal cardiac arrest that may occur in any maternal health care setting...
January 2, 2018: American Journal of Obstetrics and Gynecology
Alexandra Lykoudi, Aggeliki Kolialexi, George I Lambrou, Maria Braoudaki, Charalampos Siristatidis, George Konstantinos Papaioanou, Maria Tzetis, Ariadni Mavrou, Nikolas Papantoniou
INTRODUCTION: To determine the miRNA expression profile in placentas complicated by Preeclampsia (PE) and compare it to uncomplicated pregnancies. METHODS: Sixteen placentas from women with PE, [11 with early onset PE (EOPE) and 5 with late onset PE (LOPE)], as well as 8 placentas from uncomplicated pregnancies were analyzed using miRNA microarrays. For statistical analyses the MATLAB® simulation environment was applied. The over-expression of miR-518a-5p was verified using Quantitative Real-Time Polymerase Chain Reaction...
January 2018: Placenta
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