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https://www.readbyqxmd.com/read/29456577/is-ultrasound-screening-for-vasa-praevia-clinically-justified-and-a-financially-viable-screening-test-a-literature-review
#1
REVIEW
Gillian Coleman, Heather Venables
Vasa praevia is an obstetric complication currently not screened for within the United Kingdom, which if undetected prenatally can lead to fetal death when the membranes rupture. Internationally, guidelines are available providing guidance on the best screening policy and management pathways. However, the UK National Screening Committee and Royal College of Obstetricians and Gynaecologists do not support screening due to a lack of evidence. Recent studies explore the ability of ultrasound to detect vasa praevia prenatally in both the general and high-risk populations...
February 2018: Ultrasound: Journal of the British Medical Ultrasound Society
https://www.readbyqxmd.com/read/29455793/maternal-and-fetal-outcome-in-operated-vs-non-operated-cases-of-congenital-heart-disease-cases-in-pregnancy
#2
Vikas Yadav, J B Sharma, S Mishra, A Kriplani, Neerja Bhatla, Garima Kachhawa, Rajesh Kumari, Karthik, Isha Kriplani
OBJECTIVES: To study pregnancy outcomes in operated vs non-operated cases of congenital heart disease cases during pregnancy. MATERIALS AND METHODS: A total of 55 patients of congenital heart disease who delivered in the authors unit in last 10 years were taken in this retrospective study. These were divided into two groups Group 1:29 (52.7%) patient who had no cardiac surgery and Group 2: 26(47.2%) who had cardiac surgery to correct their cardiac defect before pregnancy...
January 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29455772/prenatal-diagnosis-of-congenital-heart-disease-a-review-of-current-knowledge
#3
REVIEW
Nathalie Jeanne Bravo-Valenzuela, Alberto Borges Peixoto, Edward Araujo Júnior
This article reviews important features to improve the diagnosis of congenital heart disease (CHD) by applying ultrasound in prenatal cardiac screening. As low and high-risk pregnancies for CHD are subject to routine obstetric ultrasound, the diagnosis of structural heart defects represents a challenge that involves a team of specialists and subspecialists on fetal ultrasonography. In this review, the images highlight normal anatomy of the heart as well as pathologic cases consistent with cardiac malposition and isomerism, septal defects, pulmonary stenosis/atresia, aortic malformations, hypoplastic left ventricle, conotruncal anomalies, tricuspid dysplasia, and Ebstein's anomaly, and univentricular heart, among other congenital cardiovascular defects...
January 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29455616/is-the-fetal-cerebroplacental-ratio-better-that-the-estimated-fetal-weight-in-predicting-adverse-perinatal-outcomes-in-a-low-risk-cohort
#4
Christopher Flatley, Sailesh Kumar
OBJECTIVE: In high-risk pregnancies combining the cerebro-placental ratio (CPR) with the estimated fetal weight (EFW) improves the identification of vulnerable fetuses. The purpose of this study was to assess the CPR and EFW's ability to predict adverse obstetric and perinatal outcomes in a low-risk pregnancy, when measured late in gestation. METHODS: This was a retrospective study of women who birthed at Mater Mothers Hospitals, Brisbane, Australia between 2010 and 2015...
February 18, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29454359/change-in-practice-a-qualitative-exploration-of-midwives-and-doctors-views-about-the-introduction-of-stan-monitoring-in-an-australian-hospital
#5
M E Mayes, C Wilkinson, S Kuah, G Matthews, D Turnbull
BACKGROUND: The present study examines the introduction of an innovation in intrapartum foetal monitoring practice in Australia. ST-Analysis (STan) is a technology that adds information to conventional fetal monitoring (cardiotocography) during labour, with the aim of reducing unnecessary obstetric intervention. Adoption of this technology has been controversial amongst obstetricians and midwives, particularly as its use necessitates a more invasive means of monitoring (a scalp clip), compared to external monitoring from cardiotocography alone...
February 17, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29453792/impact-of-tsh-during-the-first-trimester-of-pregnancy-on-obstetric-and-fetal-complications-usefulness-of-2-5-miu-l-cut-off-value
#6
Marta Hernández, Carolina López, Berta Soldevila, Laura Cecenarro, María Martínez-Barahona, Elisabet Palomera, Ferran Rius, Albert Lecube, Maria José Pelegay, Jordi García, Dídac Mauricio, Manel Puig Domingo
OBJECTIVE: An association of pregnancy outcomes with subclinical hypothyroidism has been reported, however there still exists a strong controversy regarding whether subclinical hypothyroidism ought to be dealt with or not. The objective of the study was to evaluate the association of fetal-maternal complications with first trimester maternal TSH values. DESIGN: A retrospective study in a single tertiary care hospital was performed. PATIENTS: 1981 pregnant women were studied during 2012...
February 17, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29447728/no-148-guidelines-for-operative-vaginal-birth
#7
Yvonne M Cargill, Catherine Jane MacKinnon
OBJECTIVE: To provide guidelines for operative vaginal birth in the management of the second stage of labour. OPTIONS: Non-operative techniques, episiotomy, and Caesarean section are compared to operative vaginal birth. OUTCOME: Reduced fetal and maternal morbidity and mortality. EVIDENCE: MEDLINE and Cochrane databases were searched using the key words ''vacuum" and "birth" as well as "forceps" and "birth" for literature published in English from january 1970 to June 2004...
February 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29447726/no-129-exercise-in-pregnancy-and-the-postpartum-period
#8
Gregory A L Davies, Larry A Wolfe, Michelle F Mottola, Catherine MacKinnon
OBJECTIVE: To design Canadian guidelines advising obstetric care providers of the maternal, fetal, and neonatal implications of aerobic and strength-conditioning exercises in pregnancy. OUTCOMES: Knowledge of the impact of exercise on maternal, fetal, and neonatal morbidity, and of the maternal measures of fitness. EVIDENCE: MEDLINE search from 1966 to 2002 for English language articles related to studies of maternal aerobic and strength conditioning in a previously sedentary population, maternal aerobic and strength conditioning in a previouslyactive population, impact of aerobic and strength conditioning on early and late pregnancy outcomes, and impact of aerobic and strength conditioning on neonatal outcomes, as well as for review articles and meta-analyses related to exercise in pregnancy...
February 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29447662/cell-free-dna-for-the-detection-of-fetal-aneuploidy
#9
REVIEW
Tamar Goldwaser, Susan Klugman
Screening for fetal aneuploidy via cell-free DNA was described more than two decades ago and has been used clinically by obstetric providers in the United States for more than 5 years. Cell-free DNA affords excellent detection of fetal Down syndrome and other common aneuploidies and thus is sought by patients and providers. However, owing to the source of the DNA and the nature of the screening test, scenarios may arise that require expert counseling about complex issues regarding fetal and maternal health, test interpretation, and management...
February 2018: Fertility and Sterility
https://www.readbyqxmd.com/read/29447245/adverse-obstetric-outcomes-during-delivery-hospitalizations-complicated-by-suicidal-behavior-among-us-pregnant-women
#10
Qiu-Yue Zhong, Bizu Gelaye, Jordan W Smoller, Paul Avillach, Tianxi Cai, Michelle A Williams
OBJECTIVE: The effects of suicidal behavior on obstetric outcomes remain dangerously unquantified. We sought to report on the risk of adverse obstetric outcomes for US women with suicidal behavior at the time of delivery. METHODS: We performed a cross-sectional analysis of delivery hospitalizations from 2007-2012 National (Nationwide) Inpatient Sample. From the same hospitalization record, International Classification of Diseases codes were used to identify suicidal behavior and adverse obstetric outcomes...
2018: PloS One
https://www.readbyqxmd.com/read/29447091/obesity-in-pregnancy-a-comparison-of-four-national-guidelines
#11
Dana Vitner, Kristin Harris, Cynthia Maxwell, M D Farine
BACKGROUND: Obesity in pregnancy has become one of the most important challenges in obstetrical care given its prevalence and potential adverse impact on both mother and fetus. The primary objective of this descriptive review is to identify common themes and distinctions within the current recommendations for maternal obesity in the most updated version of four published national guidelines. METHODS: We reviewed the following guidelines for obesity in pregnancy: American College of Obstetricians and Gynecologists (ACOG) 2015, Royal Australian and New Zealand College of Obstetricians and Gynecologists (RANZCOG) 2013, Royal College of Obstetrics and Gynecology (RCOG) 2010, and Society of Obstetrics and Gynecologists of Canada (SOGC) 2010...
February 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29447050/added-value-of-cerebro-placental-ratio-and-uterine-artery-doppler-at-routine-third-trimester-screening-as-a-predictor-of-sga-and-fgr-in-nonselected-pregnancies
#12
M Rial-Crestelo, R J Martinez-Portilla, A Cancemi, J Caradeux, L Fernandez, A Peguero, E Gratacos, Francesc Figueras
OBJECTIVES: To determine the added value of cerebroplacental ratio (CPR) and uterine Doppler velocimetry at third trimester scan in an unselected obstetric population to predict smallness and growth restriction. METHODS: We constructed a prospective cohort study of women with singleton pregnancies attended for routine third trimester screening (32 +0 -34 +6 weeks). Fetal biometry and fetal-maternal Doppler ultrasound examinations were performed by certified sonographers...
February 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29447043/re-engineering-the-interpretation-of-electronic-fetal-monitoring-to-identify-reversible-risk-for-cerebral-palsy-a-case-control-series
#13
Mark I Evans, Robert D Eden, David W Britt, Shara M Evans, Barry S Schifrin
BACKGROUND: Even Key Opinion leaders now concede that electronic fetal monitoring (EFM) cannot reliably identify fetal acidemia which many vouch as the only labor mediated pathophysiologic precursor for cerebral palsy (CP). We have developed the "Fetal Reserve Index" - an algorithm combining five dynamic components of EFM (1. Rate, 2. Variability, 3. Accelerations, 4. Decelerations, and 5. Excessive uterine activity) considered individually that are combined with the presence of: 6...
February 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29444695/the-impact-of-manual-rotation-of-the-occiput-posterior-position-on-spontaneous-vaginal-delivery-rate-study-protocol-for-a-randomized-clinical-trial-rmos
#14
C Verhaeghe, E Parot-Schinkel, P E Bouet, S Madzou, F Biquard, P Gillard, P Descamps, G Legendre
BACKGROUND: The frequency of posterior presentations (occiput of the fetus towards the sacrum of the mother) in labor is approximately 20% and, of this, 5% remain posterior until the end of labor. These posterior presentations are associated with higher rates of cesarean section and instrumental delivery. Manual rotation of a posterior position in order to rotate the fetus to an anterior position has been proposed in order to reduce the rate of instrumental fetal delivery. No randomized study has compared the efficacy of this procedure to expectant management...
February 14, 2018: Trials
https://www.readbyqxmd.com/read/29433462/early-onset-neonatal-hyperkalemia-associated-with-maternal-hypermagnesemia-a-case-report
#15
Kenichi Tanaka, Hiroko Mori, Rieko Sakamoto, Shirou Matsumoto, Hiroshi Mitsubuchi, Kimitoshi Nakamura, Masanori Iwai
BACKGROUND: Neonatal nonoliguric hyperkalemia (NOHK) is a metabolic abnormality that occurs in extremely premature neonates at approximately 24 h after birth and is mainly due to the immature functioning of the sodium (Na + )/potassium (K + ) pump. Magnesium sulfate is frequently used in obstetrical practice to prevent preterm labor and to treat preeclampsia; this medication can also cause hypermagnesemia and hyperkalemia by a mechanism that is different from that of NOHK. Herein, we report the first case of very early-onset neonatal hyperkalemia induced by maternal hypermagnesemia...
February 13, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29422013/first-and-second-trimester-urinary-metabolic-profiles-and-fetal-growth-restriction-an-exploratory-nested-case-control-study-within-the-infant-development-and-environment-study
#16
Gauri Luthra, Ivan Vuckovic, A Bangdiwala, H Gray, J B Redmon, E S Barrett, S Sathyanarayana, R H N Nguyen, S H Swan, S Zhang, P Dzeja, S I Macura, K S Nair
BACKGROUND: Routine prenatal care fails to identify a large proportion of women at risk of fetal growth restriction (FGR). Metabolomics, the comprehensive analysis of low molecular weight molecules (metabolites) in biological samples, can provide new and earlier biomarkers of prenatal health. Recent research has suggested possible predictive first trimester urine metabolites correlating to fetal growth restriction in the third trimester. Our objective in this current study was to examine urinary metabolic profiles in the first and second trimester of pregnancy in relation to third trimester FGR in a US population from a large, multi-center cohort study of healthy pregnant women...
February 8, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29419619/second-trimester-ultrasound-detection-of-fetal-anomalies-in-the-obese-obstetrical-population-a-systematic-review-protocol
#17
Christina Preen, Zachary Munn, Smita Raju, Nicholas Flack
The objective of this review is to identify, appraise and synthesize the best available evidence on the impact of maternal obesity on mid second trimester ultrasound detection of fetal anomalies in pregnancy.
February 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29418029/procedural-and-obstetrical-outcomes-after-embryo-reduction-or-fetal-reduction-in-multifetal-pregnancies-a-retrospective-study
#18
Mi Sun Kim, Dong Hee Choi, Hwang Kwon, Eunhee Ahn, Hee Young Cho, Min Jung Baek, Ji Eun Shin, Myoung Jin Moon
OBJECTIVES: Few studies have compared embryo reduction (ER) and fetal reduction (FR) for multifetal pregnancy reduction (MPR). This study investigated the procedure-related adverse events and the obstetrical outcomes in women with multifetal pregnancies (MPs) in whom MPRs to twins or a single fetus were performed at different gestational ages. METHODS: We retrospectively analyzed the data from MPs on which transvaginal ER (n = 181) at a mean gestational age of 7...
February 8, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29412326/-hospitalizations-due-to-complications-of-pregnancy-and-maternal-and-perinatal-outcomes-in-a-cohort-of-pregnant-women-in-the-brazilian-unified-national-health-system-in-s%C3%A3-o-paulo-brazil
#19
Barbara Laisa Alves Moura, Gizelton Pereira Alencar, Zilda Pereira da Silva, Marcia Furquim de Almeida
Maternal morbidity, fetal mortality, and neonatal mortality are important indicators of maternal and child health. The study aimed to describe maternal and perinatal outcomes (low birth weight, prematurity, fetal and neonatal deaths, postpartum hospitalizations, and readmission of newborns) in a cohort of pregnant women whose deliveries were covered by the Brazilian Unified National Health System (SUS) in the city of São Paulo, Brazil, in the second semester of 2012. We obtained a retrospective cohort of 55,404 pregnant women with deterministic and probabilistic linkage of data from the Hospital Information System of the SUS (SIH/SUS), Information System on Live Births (SINASC), Mortality Information System (SIM), and National Registry of Health Establishments (CNES) databases...
February 5, 2018: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/29408744/the-use-of-antenatal-fetal-magnetic-resonance-imaging-in-the-assessment-of-patients-at-high-risk-of-preterm-birth
#20
REVIEW
L Story, J Hutter, T Zhang, A H Shennan, M Rutherford
Preterm birth, defined as birth occurring prior to 37 weeks gestation is a common obstetric complication affecting 8% of pregnancies and is associated with significant morbidity and mortality. Infection/inflammation has been implicated in both the aetiology of preterm birth itself and associated neonatal pulmonary and neurological morbidity. Treatment options are currently limited to prolongation of the pregnancy using cervical cerclage, pessaries or progesterone or administration of drugs including steroids to promote lung maturity and neuroprotective agents such as magnesium sulphate, the timing of which are highly critical...
March 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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