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REVIEW
Aurio Fajardo, Asariel Rodríguez, Carmen Chica, Carmelo Dueñas, Raúl Carrillo, Ximena Olaya, Fabricio Vera
There is very limited evidence regarding the use of prone position as part of the treatment of severe ARDS in pregnant patients. Currently, recommendations for invasive ventilatory management in this population are very scarce and are based on the extrapolation of conclusions obtained in studies of non-pregnant patients. The available literature asserts that the anatomy and physiology of the pregnant woman undergoes complex adaptive changes that must be considered during invasive ventilatory support and prone position...
June 29, 2023: Clínica e Investigación en Ginecología y Obstetricia
#2
JOURNAL ARTICLE
Yossi Bart, Suneet P Chauhan, Michal Fishel Bartal, Sean Blackwell, Baha M Sibai
BACKGROUND: The recent paradigm shift of treating individuals at risk of late preterm birth with antenatal corticosteroids warrants an assessment of the effect of single dosage. OBJECTIVE: To compare outcomes of neonates born in the late preterm period (34.0-36.6 weeks) following a single dose of antenatal corticosteroids versus placebo. STUDY DESIGN: We performed a secondary analysis of the Antenatal Late Preterm Steroids (ALPS) trial (Gyamfi-Bannerman C...
April 6, 2024: American Journal of Obstetrics and Gynecology
#3
JOURNAL ARTICLE
Dan Shan, Jinbiao Han, Tao Li, Yayi Hu
PURPOSE: The "en caul" cesarean section (CS) is a method to keep the amnion intact during CS. This amnion protection effect may have benefits in preterm twin pregnancy. This study aimed to explore the benefits and risks of this method in preterm twin pregnancy. METHODS: This study is a retrospective analysis of preterm twin pregnancies underwent CS in West China Second University Hospital of Sichuan University from January 2011 to December 2022. Data on maternal and fetal outcomes were collected...
April 4, 2024: Archives of Gynecology and Obstetrics
#4
REVIEW
Stephen E Lapinsky, Daniela N Vasquez
Respiratory failure may affect up to 1 in 500 pregnancies, due to pregnancy-specific conditions, conditions aggravated by the pregnant state, or other causes. Management during pregnancy is influenced by altered maternal physiology, and the presence of a fetus influencing imaging, and drug therapy choices. Few studies have addressed the approach to invasive mechanical ventilatory management in pregnancy. Hypoxemia is likely harmful to the fetus, but precise targets are unknown. Hypocapnia reduces uteroplacental circulation, and some degree of hypercapnia may be tolerated in pregnancy...
April 2024: Critical Care Clinics
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RANDOMIZED CONTROLLED TRIAL
Hilda Yenuberi, Benjamin Ross, Richa Sasmita Tirkey, Santosh Joseph Benjamin, Swati Rathore, Reka Karuppusami, Aadarsh Lal, Niranjan Thomas, Jiji Elizabeth Mathew
OBJECTIVE: To evaluate the efficacy of antenatal corticosteroids in reducing neonatal respiratory complications when administered to those at risk of preterm delivery between 34 and 36 6/7 weeks of gestation. METHODS: This was a single-center, triple-blind, randomized, placebo-controlled trial in southern India enrolling pregnant participants at risk of preterm delivery between 34 and 36 6/7 weeks of gestation. Computer-generated block randomization was used with participants randomized to either one course of intramuscular betamethasone or placebo...
April 1, 2024: Obstetrics and Gynecology
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JOURNAL ARTICLE
Aytaj Jafarzade, Sveta Aghayeva, Tamer M Mungan, Aydan Biri, Elchin Jabiyev, Osman Ufuk Ekiz
OBJECTIVE: This study aims to compare the perinatal outcomes of emergency and elective cervical cerclages. MATERIAL AND METHODS: This retrospective study included a total of 247 patients, with a total of 142 emergency (with a history of mid-trimester miscarriage or vaginal delivery of < 34 weeks and cervical length < 25 mm) and 105 electives cerclage patients (with painless cervical dilation and cervical length <25 mm) who had cerclage with the vaginal cervical McDonald technique between 1...
March 2024: European journal of obstetrics & gynecology and reproductive biology: X
#7
MULTICENTER STUDY
Xiao-Yu Dong, Jian-Hong Qi, Qing-Cui Zhuo, Yan-Jie Ding, Xin Qiao, Yan Wang, De-Juan Yang, Dan Li, Li Li, Hai-Yan Jiang, Qiong-Yu Liu, Zhong-Liang Li, Xiang Zhang, Bing-Jin Zhang, Yong-Hui Yu
BACKGROUND: Hypertensive disorders of pregnancy (HDP) is the most common cause of indicated preterm delivery, but the impact of prenatal steroid exposure on the outcomes of preterm infants born to HDP mothers, who may be at risk for intrauterine hypoxia-ischemia, remains uncertain. The study objective is to evaluate the mortality and morbidities in HDP for very preterm infants (VPIs) exposed to different course of ANS. METHODS: This is a prospective cohort study comprising infants with < 32 weeks gestation born to women with HDP only from 1 Jan...
February 5, 2024: BMC Pregnancy and Childbirth
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JOURNAL ARTICLE
Shlomi Toussia-Cohen, Elias Castel, Lior Friedrich, Nizan Mor, Aviran Ohayon, Gabriel Levin, Raanan Meyer
PURPOSE: Pregnancies complicated by placenta accreta spectrum (PAS) are associated with severe maternal morbidities. The aim of this study is to describe the neonatal outcomes in pregnancies complicated with PAS compared with pregnancies not complicated by PAS. METHODS: A retrospective cohort study conducted at a single tertiary center between 03/2011 and 01/2022, comparing women with PAS who underwent cesarean delivery (CD) to a matched control group of women without PAS who underwent CD...
January 23, 2024: Archives of Gynecology and Obstetrics
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JOURNAL ARTICLE
Jaime Ferro, Vicente Diago, Diana M Diago, Nuria Pellicer, Inés Olmo, Sheila Vázquez, Coral Lara, Alfredo Perales, Vicente Serra
OBJECTIVE: To analyze the effectiveness of cerclage in twin pregnancies with a short cervix. STUDY DESIGN: Retrospective cohort study performed in two University Institutions in Valencia (Spain) with two different protocols for the management of asymptomatic dichorionic diamniotic twin pregnancies with mid-trimester cervical length ≤ 25 mm: treatment with indomethacin, antibiotics and cerclage (cerclage group) (N = 43) versus expectant management (control group) (N = 37)...
March 2024: European Journal of Obstetrics, Gynecology, and Reproductive Biology
#10
JOURNAL ARTICLE
Isabel Cristina Melo Mendes, Ana Luiza Martins de Oliveira, Priscila Martins Pinheiro Trindade, Wallace Mendes da Silva, Patricia Pontes Frankel, Carolina Carvalho Mocarzel, Marta de Alencar Rosa, Ana Paula Santos Nascimento, Glaucia de Melo Rodrigues, Clarisse Pimentel, Raissa de Moraes Perlingeiro, Alessandra Gonçalves Lisbôa Pereira, Claudia Caminha Escosteguy, Rafael Mello Galliez
BACKGROUND: SARS-CoV-2 infection is associated with worse maternal and fetal outcomes. This study aims to describe the characteristics of pregnant and postpartum women with severe Covid-19 admitted to ICU. METHODS AND FINDINGS: It's a retrospective cohort study evaluating pregnant and postpartum women referenced to a specialized ICU between May 2020 and June 2022. Covid-19 was confirmed with RT-PCR or rapid antigen test on a nasopharyngeal swab. Variables were described by median and IQR when numerical, and by frequency and percentage when categorical...
2023: PloS One
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JOURNAL ARTICLE
Marina Sourouni, Ariane Germeyer, Manuel Feißt, Alexandra Balzer, Helen Köster, Annemarie Minte, Dörthe Brüggmann, Celine Kohll, Kristin Reinhardt, Michaela Möginger, Anja Leonhardt, Constanze Banz-Jansen, Michael Bohlmann, Christiane Fröhlich, Clara Backes, Dietrich Hager, Lisa Kaup, Elsa Hollatz-Galuschki, Charlotte Engelbrecht, Filiz Markfeld-Erol, Carsten Hagenbeck, Hening Schäffler, Jennifer Winkler, Johannes Stubert, Katharina Rathberger, Laura Lüber, Linda Hertlein, Antonia Machill, Manuela Richter, Martin Berghäuser, Michael Weigel, Mirjam Morgen, Nora Horn, Peter Jakubowski, Bastian Riebe, Babett Ramsauer, Robert Sczesny, Ute Margaretha Schäfer-Graf, Susanne Schrey, Sven Kehl, Julia Lastinger, Sven Seeger, Olaf Parchmann, Antonella Iannaccone, Jens Rohne, Luise Gattung, Christine A Morfeld, Michael Abou-Dakn, Markus Schmidt, Michaela Glöckner, Anja Jebens, Kathleen Marie Sondern, Ulrich Pecks, Ralf Schmitz, Mareike Möllers
INTRODUCTION: Studies have shown that pregnant women with COVID-19 have a higher risk of intensive care unit admission and invasive mechanical ventilation support than non-pregnant women. Pregnancy-associated physiological changes in respiratory function may contribute to the elevated risk. Alteration in lung volumes and capacities are attributed to the mechanical impediment caused by the growing fetus. Multiple pregnancies may therefore compromise functional lung capacity earlier than singleton pregnancies and contribute to severe respiratory symptoms of COVID-19...
December 2023: Geburtshilfe und Frauenheilkunde
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JOURNAL ARTICLE
Thais G Sardinha, Giuliane J Lajos, Renato T Souza, Jose G Cecatti, Adriana G Luz, Maria Lúcia R Oppermann, Rodolfo C Pacagnella, Carolina C Ribeiro-Do-Valle, Guilherme M Nobrega, Thayna B Griggio, Charles M Charles, Carla Silveira, Maria J Miele, Ricardo P Tedesco, Karayna G Fernandes, Sérgio Ha Martins-Costa, Frederico Ja Peret, Francisco E Feitosa, Evelyn Traina, Edson V Cunha Filho, Janete Vettorazzi, Samira M Haddad, Carla B Candreucci, José P Guida, Mario D Correa Junior, Marcos Ab Dias, Leandro G Oliveira, Elias F Melo Junior, Marília Gq Da Luz, Maria Laura Costa
OBJECTIVES: To compare maternal and perinatal outcomes among women with obesity, overweight, and normal body mass index, associated with COVID-19 infection during pregnancy and postpartum. METHOD: Prospective Cohort Study, within the REBRACO (Brazilian Network of COVID-19 in Pregnancy) multicenter initiative. Confirmed positive cases of SARS-CoV-2 were included, and women categorized into three groups according to their pre-pregnancy BMI: obesity (BMI ≥ 30), overweight (BMI <30 but >25), and normal BMI...
November 27, 2023: International Journal of Gynaecology and Obstetrics
#13
JOURNAL ARTICLE
Jeffrey Carlson, Regina M Simeone, Sascha Ellington, Romeo Galang, Carla L DeSisto, Katherine Fleming-Dutra, Laura Riley, Dana Meaney-Delman, Van T Tong
OBJECTIVE: To examine the relationship between coronavirus disease 2019 (COVID-19) diagnosis at delivery and adverse maternal health and pregnancy outcomes during pre-Delta, Delta, and Omicron variant predominance, with a focus on the time period of Omicron variant predominance. METHODS: We conducted a cross-sectional observational study with data from delivery hospitalizations in the Premier Healthcare Database from February 2020 to August 2023. The pre-Delta (February 2020-June 2021), Delta (July 2021-December 2021), and Omicron (January 2022-August 2023) periods of variant predominance were examined...
November 2, 2023: Obstetrics and Gynecology
#14
JOURNAL ARTICLE
Jennifer Rodrigues Boock, Alexis Strickler, María Teresa Silva Elgueta, Loreto Twele Montecinos, Carolina Lizama Deluchi
INTRODUCTION: Adolescent pregnancy is a physiological process, but it can evolve with premature delivery, severe obstetric or clinical pathologies, mortality, or sequelae for mother and child. We aim to report the progressive multiple organ dysfunction syndrome secondary to pyelonephritis and sepsis during prepartum, delivery, and puerperium of adolescent pregnancy and its sequelae. CASE REPORT: A 14-year-old adolescent with a pregnancy of 27 weeks of gestation controlled from 8 to 25 weeks...
October 13, 2023: Medwave
#15
JOURNAL ARTICLE
Xi Deng, Jieshu Zhou, Min Diao, Hao Li, Xuemei Lin
OBJECTIVE: Gas embolism is a common complication of hysteroscopic surgery that causes serious concern among gynecologists and anesthesiologists due to the potential risk to patients. The factors influencing gas embolism in hysteroscopic surgery have been extensively studied. However, the effect of the oxygen concentration inhaled by patients on gas embolism during hysteroscopic surgery remains elusive. Therefore, we designed a double-blind, randomized, controlled trial to determine whether different inhaled oxygen concentrations influence the occurrence of gas embolism during hysteroscopic surgery...
October 4, 2023: International Journal of Gynaecology and Obstetrics
#16
JOURNAL ARTICLE
Kana Saito, Etsuko Nishimura, Erika Ota, Fumihiko Namba, Toshiyuki Swa, Jenny Ramson, Tina Lavin, Jenny Cao, Joshua Peter Vogel
OBJECTIVE: This study aimed to synthesise available evidence on the efficacy of antenatal corticosteroid (ACS) therapy among women at risk of imminent preterm birth with pregestational/gestational diabetes, chorioamnionitis or fetal growth restriction (FGR), or planned caesarean section (CS) in the late preterm period. METHODS: A systematic search of MEDLINE, EMBASE, CINAHL, Cochrane Library, Web of Science and Global Index Medicus was conducted for all comparative randomised or non-randomised interventional studies in the four subpopulations on 6 June 2021...
September 22, 2023: BMJ Open
#17
JOURNAL ARTICLE
Kailash Bhatia, Malachy Columb, Bhaskar Narayan, Anthony Wilson
INTRODUCTION: Few studies have described obstetric and critical care outcomes in pregnant women with COVID-19 needing intensive care unit (ICU) admission. MATERIAL AND METHODS: Obstetric and critical care outcomes of COVID-19 women admitted to eight ICUs from April 1, 2020 to September 15, 2021, in the North West of England were retrospectively analyzed. Women admitted to ICU were assigned to three groups: antepartum women discharged from ICU prior to delivery (antepartum ICU-discharged group), antepartum women who had expedited delivery (antepartum ICU-delivered group) and a postpartum group...
September 20, 2023: Acta Obstetricia et Gynecologica Scandinavica
#18
JOURNAL ARTICLE
Gabriel Figueroa-Parra, Jose A Meade-Aguilar, Hannah E Langenfeld, Mariana González-Treviño, Mehmet Hocaoglu, Andrew C Hanson, Larry J Prokop, M Hassan Murad, Rodrigo Cartin-Ceba, Ulrich Specks, Vikas Majithia, Cynthia S Crowson, Alí Duarte-García
BACKGROUND: Antiphospholipid syndrome (APS) is a systemic autoimmune disease clinically associated with thrombotic and obstetric events. Additional manifestations have been associated with APS, like diffuse alveolar hemorrhage (DAH). We aimed to summarize all the evidence available to describe the presenting clinical features, their prognostic factors, and short- and long-term outcomes. METHODS: We performed a mixed-method approach combining a multicenter cohort with a systematic literature review (SLR) of patients with incident APS-associated DAH...
September 16, 2023: Clinical Immunology: the Official Journal of the Clinical Immunology Society
#19
JOURNAL ARTICLE
Fanny Eckel, Katrin Klebermass-Schrehof, Zsuzsanna Bago-Horvath, Alex Farr
Preterm birth is a significant cause of perinatal morbidity and mortality, especially in multiple pregnancies. Delayed interval delivery can prolong pregnancy for the remaining fetus(es) in an imminent stillbirth or extremely preterm birth of the first fetus, improving the lastborn's outcomes. We present a case of delayed interval delivery of a triplet pregnancy following preterm prelabour rupture of membranes and progressive cervical insufficiency. Following vaginal delivery of the first fetus at 24+1 gestational weeks, the patient received antibiotics and tocolysis...
September 15, 2023: BMJ Case Reports
#20
JOURNAL ARTICLE
Brittany A Austin, Kelli M McFarling, Benjamin Likins, Alison Chapman, Ryan D Cuff, Barbara Head, Matthew M Finneran
OBJECTIVE: Late preterm and early term deliveries are common in pregnancies complicated by diabetes due to higher rates of obstetric complications including increased stillbirth risk. However, early delivery is associated with multiple neonatal adverse outcomes, which may be further increased by maternal diabetes. We examined whether there is an additive effect on adverse neonatal outcomes in the setting of maternal diabetes in the late preterm and early term periods. STUDY DESIGN: This was a retrospective cohort study of women with a singleton, nonanomalous pregnancy delivering at a single academic medical center in the late preterm (340/7 -366/7 weeks) or early term (370/7 -386/7 weeks) period between 2010 and 2019...
September 11, 2023: American Journal of Perinatology
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