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Obstetrics fetal

Mieke L G Ten Eikelder, Kelly Mast, Annemarie van der Velden, Kitty W M Bloemenkamp, Ben W Mol
Importance: Induction of labor is a widely used obstetric intervention, occurring in one in four pregnancies. When the cervix is unfavorable, still many different induction methods are used. Objective: We compared Foley catheter alone to different misoprostol dosages and administration routes, and the combination of Foley catheter with misoprostol. Evidence acquisition: We reviewed the literature on the best induction method regarding their safety and effectiveness, using the outcome measures hyperstimulation, fetal distress, neonatal morbidity and mortality as well as cesarean delivery, vaginal instrumental delivery, and maternal morbidity...
October 2016: Obstetrical & Gynecological Survey
Annah Lane, Ling Lee, Donna Traves, Andreas Lee
INTRODUCTION: The antenatal diagnosis of open spina bifida (OSB), a neural tube defect, is predominantly made at the second trimester morphology scan by ultrasound detection of structural abnormalities resulting from the associated Chiari II malformation. Evidence has emerged suggesting that these structural abnormalities can be detected earlier, by examination of the posterior fossa as part of the first trimester nuchal translucency scan. In particular, absence of the intra-cranial translucency (IT) of the fourth ventricle has shown promise as a diagnostic marker of OSB, although the sensitivity and specificity of this finding varies widely in the literature...
October 21, 2016: Journal of Medical Imaging and Radiation Oncology
Courtney Stanley Sundin, Lauren Bradham Mazac
Amniotic fluid embolism (AFE) is a rare but serious and potentially deadly complication of pregnancy that is unpreventable and unpredictable. Most AFE events occur during labor; however, approximately one third happen during the immediate postpartum period. Presentation is abrupt and thought to be an abnormal response to fetal materials entering maternal circulation through the placental insertion site. Care providers must recognize the signs and symptoms of AFE and react quickly in effort to treat potential complications...
October 13, 2016: MCN. the American Journal of Maternal Child Nursing
Ayaka Kawabe, Liangcheng Wang, Atsuko Kikugawa, Yuko Shibata, Kenichi Kuromaki, Akiyoshi Takagi
OBJECTIVE: Uterine rupture is a rare but serious obstetric complication. However, prediction and diagnosis at an early stage remain difficult. Herein, we report a case of primary uterine rupture found earlier by a specific symptom. CASE REPORT: A 29-year-old patient was scheduled to undergo a cesarean section (CS) due to placenta previa. However, at Week 35, she began experiencing abdominal pain and uterine contractions. Subsequently, she began experiencing severe pain, which was enhanced by fetal movements...
October 2016: Taiwanese Journal of Obstetrics & Gynecology
Masaki Ogawa, Yoshio Matsuda, Akihito Nakai, Masako Hayashi, Shoji Sato, Shigeki Matsubara
OBJECTIVES: Placental weight (PW) and fetal/placental weight ratio (F/P) have been considered to be useful parameters for understanding the pathophysiology of fetal growth. However, there have been no standard data on PW and F/P in Asian populations. This study was conducted to establish nomograms of PW and F/P in the Japanese population and to clarify characteristics of PW and F/P in this population. STUDY DESIGN: Included in the study were 79,590 Japanese cases: 58,871 vaginal and 20,719 cesarean deliveries at obstetrical facilities (2001-2002) and registered to the Japan Society of Obstetrics and Gynecology Database...
October 5, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Dazhi Fan, Song Wu, Wen Wang, Lihong Xin, Guo Tian, Li Liu, Jinping Feng, Xiaoling Guo, Zhengping Liu
BACKGROUND: Placenta previa is characterized by the abnormal placenta overlying the endocervical os, and it is known as one of the most feared adverse maternal and fetal-neonatal complications in obstetrics. OBJECTIVES: We aimed to obtain overall and regional estimates of placenta previa prevalence among deliveries in Mainland China. METHODS: The research was performed a systematic review, following the Meta-analysis of observational studies in epidemiology (MOOSE) guidelines for systematic reviews of observational studies, and the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement for reporting systematic reviews and meta-analysis...
October 2016: Medicine (Baltimore)
Xiang Kong, Yan Kong, Fangyuan Zhang, Tingting Wang, Jin Yan
BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP) is a specific pregnancy-related disorder without standard medical therapies. Ursodeoxycholic acid (UDCA) is the most used medicine, but the efficacy and safety of UDCA remain uncertain. Several meta-analyses had been made to assess the effects of UDCA in ICP. However, the samples were not large enough to convince obstetricians to use UDCA. We conducted a meta-analysis to evaluate the effects and safety of UDCA in patients with ICP, which included only randomized controlled trials (RCTs)...
October 2016: Medicine (Baltimore)
Elodie Guesdon, Aurélie Vincent-Rohfritsch, Sarah Bydlowski, Pietro Santulli, François Goffinet, Camille Le Ray
OBJECTIVE: To compare maternal, obstetric, and neonatal outcomes between women who underwent oocyte donation at or after age 50 years and from 45 through 49 years. DESIGN: Single-center, retrospective cohort study. SETTING: Maternity hospital. PATIENT(S): Forty women aged 50 years and older ("older group") and 146 aged 45-49 years ("younger group"). INTERVENTION(S): Comparison between the older and younger groups, globally and after stratification by type of pregnancy (singleton/twin pregnancy)...
October 12, 2016: Fertility and Sterility
Lynn M Yee, Grecio Sandoval, Jennifer Bailit, Uma M Reddy, Ronald J Wapner, Michael W Varner, Steve N Caritis, Mona Prasad, Alan T N Tita, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
OBJECTIVE: To describe factors associated with delayed pushing and evaluate the relationship between delayed pushing and perinatal outcomes in nulliparous women with singleton term gestations. METHODS: This was a secondary analysis of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Assessment of Perinatal Excellence cohort of 115,502 women and their neonates born in 25 U.S. hospitals from 2008 to 2011. Nulliparous women with singleton, cephalic, nonanomalous term births who achieved 10-cm cervical dilation were included...
October 6, 2016: Obstetrics and Gynecology
Martha A Monson, Karen J Gibbons, M Sean Esplin, Michael W Varner, Tracy A Manuck
OBJECTIVE: To characterize subsequent pregnancy outcomes among women with a history of previable, preterm prelabor rupture of membranes (PROM) and assess factors associated with recurrent preterm birth. METHODS: This was a retrospective cohort study of women cared for with a history of one or more singleton pregnancy complicated by preterm PROM at less than 24 weeks of gestation between 2002 and 2013 who were cared for in two tertiary care health systems by a single group of maternal-fetal medicine specialists...
October 6, 2016: Obstetrics and Gynecology
Akwugo A Eziefule, Solafa Elshatanoufy, Mili Thakur, Frederico G Rocha
Background Propofol is a widely known, commonly used drug. Complications can occur with the use of this drug, including propofol-related infusion syndrome (PRIS). PRIS, in the obstetric population, has not been documented; however, we report a case of a patient who developed PRIS after an emergent cesarean delivery of a preterm infant. Case Study A 35-year-old multigravida woman presented complaining of leakage of fluid and decreased fetal movement. Her pregnancy was complicated by methadone maintenance therapy due to a history of opioid abuse...
October 2016: American Journal of Perinatology Reports
Chandni Prakash, Susan Hatters-Friedman, Charmian Moller-Olsen, Abigail North
INTRODUCTION: Pregnancy is a vulnerable period for recurrence of bipolar disorder. Discontinuation of mood stabilisers during pregnancy and the postpartum period can significantly increase the risk of recurrence of bipolar disorder. Lamotrigine is an anti-epileptic drug that has been approved for the maintenance treatment of bipolar disorder. Epilepsy literature has indicated that lamotrigine has a reassuring safety profile in pregnancy but there is little information on its effectiveness and safety in pregnant women with mental disorders...
August 15, 2016: Psychopharmacology Bulletin
Ricardo C Cavalli, Ana Sofia Cerdeira, Elizabeth Pernicone, Henri A Korkes, Suzanne D Burke, Augustine Rajakumar, Ravi I Thadhani, Drucilla J Roberts, Manoj Bhasin, S Ananth Karumanchi, Hernan D Kopcow
Decidual NK (dNK) cells, a distinct type of NK cell, are thought to regulate uterine spiral artery remodeling, a process that allows for increased blood delivery to the fetal-placental unit. Impairment of uterine spiral artery remodeling is associated with decreased placental perfusion, increased uterine artery resistance, and obstetric complications such as preeclampsia and intrauterine growth restriction. Ex vivo manipulation of human peripheral blood NK (pNK) cells by a combination of hypoxia, TGFß-1 and 5-aza-2'-deoxycytidine yields cells with phenotypic and in vitro functional similarities to dNK cells, called idNK cells...
2016: PloS One
Bryn Putbrese, Anne Kennedy
Ventriculomegaly (VM) is a nonspecific finding on fetal imaging. Identification of the specific etiology is important as it affects prognosis and may even change the course of current or future pregnancies. In this review we will focus on the application of fetal MRI to demonstrate intracranial hemorrhage (ICH) and ischemic brain injury as opposed to other causes of VM. MRI is able to identify the specific etiology of ventriculomegaly with much more sensitivity and specificity than ultrasound and should be considered whenever VM is identified on obstetric ultrasound...
October 13, 2016: British Journal of Radiology
Amy O'Donnell, Catherine McParlin, Stephen C Robson, Fiona Beyer, Eoin Moloney, Andrew Bryant, Jennifer Bradley, Colin Muirhead, Catherine Nelson-Piercy, Dorothy Newbury-Birch, Justine Norman, Emma Simpson, Brian Swallow, Laura Yates, Luke Vale
BACKGROUND: Nausea and vomiting in pregnancy (NVP) affects up to 85% of all women during pregnancy, but for the majority self-management suffices. For the remainder, symptoms are more severe and the most severe form of NVP - hyperemesis gravidarum (HG) - affects 0.3-1.0% of pregnant women. There is no widely accepted point at which NVP becomes HG. OBJECTIVES: This study aimed to determine the relative clinical effectiveness and cost-effectiveness of treatments for NVP and HG...
October 2016: Health Technology Assessment: HTA
O M Shaaban, A M Abbas, H A Abdel Hafiz, A S Abdelrahman, M Rashwan, E R Othman
BACKGROUND: Pregnancy during lactation is common in Egypt and is often unplanned. Overlap between pregnancy and lactation could be associated with an increased risk for the pregnant mother, her fetus as well as her nursing child. AIM OF THE STUDY: The current study aims to compare the maternal and perinatal outcome of pregnancies occurred during lactation with those occurred after weaning in women with substandard nutrition. MATERIALS AND METHODS: A prospective-cohort study was carried out in six Maternal and Child Health Centers in Assiut-Egypt...
December 28, 2015: Facts, Views & Vision in ObGyn
Jerrie S Refuerzo, Fransisca Leonard, Nataliya Bulayeva, David Gorenstein, Giuseppe Chiossi, Alejandra Ontiveros, Monica Longo, Biana Godin
Preterm labor caused by uterine contractions is a major contributor to neonatal morbidity and mortality. Treatment intended to reduce uterine contractions include tocolytic agents, such as indomethacin. Unfortunately, clinically used tocolytics are frequently inefficient and cross the placenta causing fetal side effects. Here we show for the first time in obstetrics the use of a targeted nanoparticle directed to the pregnant uterus and loaded with a tocolytic for reducing its placental passage and sustaining its efficacy...
October 11, 2016: Scientific Reports
Sophie Palmer, Jessica Pudwell, Graeme N Smith, Robert L Reid
OBJECTIVE: To obtain information on women's attitudes and opinions about participation in vaccine and medication trials during pregnancy. METHODS: A quantitative, cross-sectional survey was administered to 110 consenting women over a four-week period in the waiting room of an ambulatory obstetrics and gynaecology clinic in Ontario. RESULTS: The final response rate was 74.8%, with the majority of participants agreeing with statements about the importance of obtaining safety data about products in pregnancy and the importance of a woman having the ability to choose whether to participate in such research...
October 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Jara Pascual Mancho, Sabina Marti Gamboa, Olga Redrado Gimenez, Raquel Crespo Esteras, Belen Rodriguez Solanilla, Sergio Castan Mateo
OBJECTIVE: To determine the diagnostic accuracy of fetal scalp lactate sampling (FSLS) and to establish an optimal cut-off value for intrapartum acidosis compared with fetal scalp pH. METHODS: A 20-month retrospective cohort study was conducted of all neonates delivered in our institution for whom fetal scalp blood sampling (FSBS) was performed, matching their intrapartum gasometry to their cord gasometry at delivery (n=243). The time taken from the performance of scalp blood sampling to arterial umbilical cord gas acquisition was 45 min at most...
October 8, 2016: Journal of Perinatal Medicine
Naoyuki Miyasaka, Makiko Egawa, Mitsuaki Isobe, Yoshinori Inoue, Toshiro Kubota
Little is known about the obstetrical management of patients with Takayasu arteritis (TA) who have undergone extra-anatomic vascular bypass (EAVB). We describe two cases of EAVB. Case 1 underwent EAVB due to renovascular hypertension associated with stenosis of the abdominal aorta, and Case 2 due to amaurosis fugax episodes associated with stenosis of the brachiocephalic and left common carotid arteries. Pregnancy outcomes were favorable for both cases, though the original symptoms recurred during the third trimester in each case, possibly due to increased blood flow to the pregnant uterus...
October 8, 2016: Journal of Obstetrics and Gynaecology Research
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