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https://www.readbyqxmd.com/read/28098674/diethylstilbestrol-potential-health-risks-for-women-exposed-in-utero-and-their-offspring
#1
J Leocadia Conlon
Diethylstilbestrol (DES) is a synthetic estrogen given to pregnant women to prevent miscarriages and preterm labor; the drug was used between 1941 and 1971 in the United States and into the 1980s in other countries. DES exposure is associated with significant long-term health effects, including increased risk for breast cancer, cervical and vaginal clear cell adenocarcinoma, reproductive tract abnormalities, infertility, poor pregnancy outcomes, and early menopause. This article reviews the potential health risks associated with DES exposure, how to assess which patients are at risk, and management recommendations for patients exposed to DES...
February 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28095812/maternal-sepsis-complicating-arabin-cervical-pessary-placement-for-the-prevention-of-preterm-birth-a-case-report
#2
Begoña Martinez de Tejada
BACKGROUND: Preterm delivery is a major health problem and contributes to more than 50% of all neonatal and infant deaths. Recently, there has been a renewed interest in the use of cervical pessaries as a safe and effective intervention with few maternal side-effects for the prevention of preterm birth in both single and twin pregnancies. CASE PRESENTATION: A 43-year-old gravida 5, para 1 (previous preterm birth at 24 weeks) patient with an in vitro fertilization twin pregnancy had an Arabin cervical pessary placed at 19 weeks of pregnancy due to the presence of cervical funneling identified by ultrasound screening...
January 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28089318/analysis-and-evaluation-of-the-effectiveness-of-epidural-analgesia-and-its-relationship-with-eutocic-or-dystocic-delivery
#3
V Sánchez-Migallón, E Sánchez, M Raynard, A Miranda, R M Borràs
OBJECTIVE: Numerous studies have demonstrated the difference in the verbal rating scale with regard to obstructed labour and induced labour, so that obstructed labour and foetal macrosomia have been related to a greater sensation of pain during labour, particularly in the first stage. Even the epidural analgesia is linked to the need for instrumented or caesarean section due to foetal obstruction. The goal of the study is to analyze and evaluate the effectiveness of epidural analgesia in normal versus obstructed labour...
January 12, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28079869/racial-and-social-predictors-of-longitudinal-cervical-measures-the-cervical-ultrasound-study
#4
E W Harville, K S Miller, L R Knoepp
OBJECTIVE: To evaluate whether the racial and socioeconomic disparities are present in adverse cervical parameters, and, if so, when such disparities develop. STUDY DESIGN: A prospective cohort study was conducted. 175 women with a prior preterm birth had up to four endovaginal ultrasounds between gestational weeks 16 and 24 (Cervical Ultrasound Trial of the MFMU). Each sociodemographic factor (race/ethnicity, marital status, insurance funding and education) was examined as a predictor of short cervix or U/funnel shape, using multiple logistic and linear regression...
January 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28076940/cervical-ripening-with-self-administered-iso-sorbide-mononitrate-vaginally-in-uncomplicated-singleton-pregnancies-at-39-weeks-gestation-a-double-blind-randomised-controlled-trial
#5
RANDOMIZED CONTROLLED TRIAL
K Attanayake, M Goonewardene
Introduction: Vaginal iso sorbide mononitrate (ISMN) is effective in pre induction cervical ripening in post dated pregnancies. Objectives: To determine the effectiveness and acceptability of ISMN self-administered vaginally at home, in causing cervical ripening in uncomplicated singleton pregnancies at 39 weeks gestation. Methods: Consecutive women with uncomplicated singleton pregnancies, presenting between 01 October 2013 and 31 March 2014, with a modified Bishop score (MBS) of < 5 at a gestational age (GA) of 273 days to the University Obstetric Unit of Teaching Hospital Mahamodera Galle, were allocated by stratified (primip/multip) block randomisation to self-administer vaginally at home every other day, five doses of 60 mg of sustained release form of ISMN (ISMN-SR); (n = 72, cases), or pyridoxine 10 mgs (n=72, controls), from GA 273 to 282 days...
30, 2016: Ceylon Medical Journal
https://www.readbyqxmd.com/read/28072695/acute-pulmonary-edema-caused-by-takotsubo-cardiomyopathy-in-a-pregnant-woman-undergoing-transvaginal-cervical-cerclage-a-case-report
#6
Jae-Young Lee, Hyun-Jung Kwon, Sang-Wook Park, Yu-Mi Lee
BACKGROUND: The physiological changes associated with pregnancy may predispose pregnant women to pulmonary edema. Other known causes of pulmonary edema during pregnancy include tocolytic drugs, preeclampsia, eclampsia, and peripartum cardiomyopathy. METHODS: We describe a rare case of pulmonary edema caused by takotsubo cardiomyopathy in a pregnant woman at 14 weeks of gestation who was undergoing emergency transvaginal cervical cerclage. RESULTS: Intraoperative chest radiography revealed severe pulmonary edema and echocardiography indicated moderate left ventricular dysfunction with akinesia of the mid to apical left ventricular wall segment, which is reflective of takotsubo cardiomyopathy...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28072678/pain-anxiety-and-fatigue-during-labor-a-prospective-repeated-measures-study
#7
Ya-Ling Tzeng, Ya-Ling Yang, Pi-Chao Kuo, Ya-Chuan Lin, Shu-Ling Chen
BACKGROUND: Pain, anxiety, and fatigue are known to significantly influence labor; however, the interacting relationships among the three symptoms have not been empirically shown. PURPOSE: The aim of this study was to investigate the interrelationships among intrapartum pain, anxiety, and fatigue relative to the mode of delivery, with or without epidural analgesia (EDA). METHODS: A prospective, repeated measures design was adopted, and women with uncomplicated pregnancies at term (N = 186) were enrolled...
February 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/28068849/maternal-serum-calponin-1-level-as-a-biomarker-for-the-short-term-prediction-of-preterm-birth-in-women-with-threatened-preterm-labor
#8
Orkun Cetin, Erbil Karaman, Baris Boza, Numan Cim, Hanım Guler Sahin
PURPOSE: To assess the utility of maternal serum calponin 1 level in the prediction of delivery within 7 days among pregnancies complicated with threatened preterm labor. MATERIALS AND METHODS: Eligible women who presented at 24-34 weeks of gestation with threatened preterm labor underwent sampling for serum calponin 1 level and cervical length measurement. They were followed-up until delivery prospectively and the perinatal outcomes of the patients were recorded...
January 9, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28068594/prevention-of-spontaneous-preterm-birth-guidelines-for-clinical-practice-from-the-french-college-of-gynaecologists-and-obstetricians-cngof
#9
REVIEW
Loïc Sentilhes, Marie-Victoire Sénat, Pierre-Yves Ancel, Elie Azria, Guillaume Benoist, Julie Blanc, Gilles Brabant, Florence Bretelle, Stéphanie Brun, Muriel Doret, Chantal Ducroux-Schouwey, Anne Evrard, Gilles Kayem, Emeline Maisonneuve, Louis Marcellin, Stéphane Marret, Nicolas Mottet, Sabine Paysant, Didier Riethmuller, Patrick Rozenberg, Thomas Schmitz, Héloïse Torchin, Bruno Langer
In France, 60,000 neonates are born preterm every year (7.4%), half of them after the spontaneous onset of labor. Among preventable risk factors of spontaneous prematurity, only cessation of smoking is associated with decreased prematurity (level of evidence [LE]1). It is therefore recommended (Grade A). Routine screening and treatment of vaginal bacteriosis is not recommended in the general population (Grade A). The only population for which vaginal progesterone is recommended is that comprising asymptomatic women with singleton pregnancies, no history of preterm delivery, and a short cervix at 16-24 weeks of gestation (Grade B)...
December 30, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28064548/amniotic-fluid-sludge-prevalence-and-clinical-significans-of-it-in-asymptomatic-patients-at-high-risk-for-spontaneous-preterm-delivery
#10
Ilknur Adanir, Ozgur Ozyuncu, Ayse Filiz Gokmen Karasu, Lutfu S Onderoglu
INTRODUCTION: The aim of our study is to determine prevalence and clinical significance of the presence of amniotic fluid 'sludge' among asymptomatic patients at high-risk for spontaneous preterm delivery, prospectively. MATERIAL AND METHODS: In our study, 99 patients at high risk for spontaneous preterm delivery were evaluated for the presence of amniotic fluid sludge with transvaginal ultrasonography at 20-22., 26-28. and 32-34. gestational weeks, prospectively; between August 2009 and October 2010 in Hacettepe University Hospital...
January 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28063549/insuffisance-cervicale-et-cerclage-cervical
#11
Richard Brown, Robert Gagnon, Marie-France Delisle
OBJECTIF: La présente directive clinique a pour but de fournir un cadre de référence que les cliniciens pourront utiliser pour identifier les femmes qui sont exposées aux plus grands risques de connaître une insuffisance cervicale, ainsi que pour déterminer les circonstances en présence desquelles la mise en place d'un cerclage pourrait s'avérer souhaitable. RéSULTATS: La littérature publiée a été récupérée par l'intermédiaire de recherches menées dans PubMed ou MEDLINE, CINAHL et The Cochrane Library en 2012 au moyen d'un vocabulaire contrôlé (p...
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28061767/the-effect-of-induction-method-in-twin-pregnancies-a-secondary-analysis-for-the-twin-birth-study
#12
Elad Mei-Dan, Elizabeth V Asztalos, Andrew R Willan, Jon F R Barrett
BACKGROUND: This secondary analysis for the Twin Birth Study, an international, multicenter trial, aimed to compare the cesarean section rates and safety between methods of induction of labor in twin pregnancies. METHODS: Women with twin pregnancies where the first twin was in a cephalic presentation and who presented for labor induction, were non-randomly assigned to receive prostaglandin or amniotomy and/or oxytocin. Main outcome measures were the rates of unplanned cesarean section and neonatal and maternal mortality or serious morbidity...
January 6, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28052083/pregnancy-outcomes-after-treatment-for-cervical-cancer-precursor-lesions-an-observational-study
#13
Sheila Weinmann, Allison Naleway, Geeta Swamy, Girishanthy Krishnarajah, Bhakti Arondekar, Jovelle Fernandez, Evan Myers
OBJECTIVE: To examine whether surgical procedures involving the uterine cervix were associated with pregnancy outcomes, including preterm birth, low birth weight, cesarean delivery and pregnancy loss. DESIGN: Population-based observational study nested in retrospective matched cohort. SETTING: Kaiser Permanente Northwest integrated health plan in Oregon/Washington, U.S.A. POPULATION: Female health plan members age 14-53 years with documented pregnancies from 1998-2009...
2017: PloS One
https://www.readbyqxmd.com/read/28050333/placenta-percreta-and-incomplete-uterine-rupture-after-endometrial-ablation-and-tubal-occlusion
#14
Jaden R Kohn, Edwina Popek, Concepcion R Diaz-Arrastia, Xiaoming Guan, Alireza A Shamshirsaz, Michael A Belfort, Karin A Fox
Endometrial ablation offers symptomatic relief for menorrhagia. Pregnancy after ablation is rare but is often complicated due to pregnancy loss, growth restriction, preterm premature rupture of membranes, preterm delivery, and morbidly adherent placentation, a dangerous complication that can result in hemorrhage, intensive care unit admission, and cesarean hysterectomy. We report a case of pregnancy conceived contemporaneously with endometrial ablation and tubal occlusion. Diagnosis of pregnancy was delayed due to low suspicion...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28043143/effects-of-ala-pdt-on-hpv16-immortalized-cervical-epithelial-cell
#15
S Wu, X Ren, Y Pan, D Guan, S Liu, X Zou, C Shi, Y-Z Li, Y Zhang
Current treatments for high-grade cervical intraepithelial neoplasia (CIN) and persistent infection with high-risk human papillomavirus (HR-HPV) type are mainly surgical interventions. However, such treatments are associated with adverse side effects and pose risks for future pregnancies. In order to reduce the requirement for excisional procedures, an effective and noninvasive therapy is needed for women at reproductive age. ALA-PDT has proved to be effective in the treatment of HPV-associated disease in several clinical investigations...
January 3, 2017: Neoplasma
https://www.readbyqxmd.com/read/28042408/an-unusual-cause-of-postabortal-fever-requiring-prompt-surgical-intervention-a-pyomyoma-and-its-imaging-features
#16
Rashmi Bagga, Rakhi Rai, Jasvinder Kalra, Pradip K Saha, Tulika Singh
Pyomyoma is an unusual complication of leiomyoma, occurring most commonly in the postpartum, postabortal, and post-menopausal periods. It develops due to infection in necrotic foci within leiomyoma, which is more common during pregnancy due to rapid growth, and in postmenopausal women due to vascular insufficiency. Other contributing factors are curettage, gynecological surgery, cervical stenosis, immunodeficiency, and recently, uterine artery embolization. It presents with a typical triad of sepsis, leiomyoma, and absence of any apparent source of infection...
January 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28029461/-prevention-of-preterm-birth-by-uterine-cervical-cerclage
#17
L Marcellin
OBJECTIVE: To review the scientific literature on cervical insufficiency and indications of cervical cerclage cervix. MATERIALS AND METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and international obstetrical societies between 1972 and June 2016 have been consulted. RESULTS: Cervical insufficiency is a pathophysiological concept and to date no consensual definition is available: the diagnosis is clinical and discussed retrospectively in case of patients with a history of late miscarriages and/or spontaneous preterm delivery, with asymptomatic dilatation of the cervix (professional consensus)...
October 29, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28029460/-predictive-tools-of-preterm-birth-in-asymptomatic-high-risk-pregnancy
#18
J Blanc, F Bretelle
OBJECTIVE: Describe tools designed to predict preterm birth in asymptomatic high-risk pregnancy and determine their predictive value. METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: Obstetric history particularly spontaneous preterm birth identifies a population at risk for preterm birth for the current pregnancy (LE3). This risk is related to the number of prior preterm birth and is even higher than the term of the prior event is more premature and that the event concerns the last pregnancy (LE3)...
October 29, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28026078/screening-for-cervical-carcinoma-in-hiv-infected-women-analysis-of-main-risk-factors-for-cervical-cytologic-abnormalities
#19
Matilde Sansone, Gabriele Saccone, Annalisa Migliucci, Rosa Saviano, Angela Capone, Giuseppe Maria Maruotti, Dario Bruzzese, Pasquale Martinelli
AIM: The aim of this study was to identify potential predictive factors for cervical disease in women with HIV and to evaluate adherence during follow-up to cervical cancer screening. METHODS: In order to identify the independent role of factors associated with the presence of a cervical abnormality, all of the variables showing in univariate analyses a potential association with the outcome variable (presence of cervical abnormalities) were entered into a multivariate logistic regression model, along with age at first visit to our center, and age at diagnosis...
December 27, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28012405/an-assessment-of-mode-of-delivery-in-history-indicated-versus-ultrasound-indicated-vaginally-placed-cervical-cerclage
#20
Lisa Story, Andrew Shennan
OBJECTIVE: Treatment modalities to reduce the incidence of preterm birth are currently limited. Cerclage, is a common and established intervention in most obstetrics units worldwide, however, many questions regarding its efficacy, with respect to pregnancy outcomes remain unanswered. This study aims to investigate whether an antenatal placed cerclage affects the subsequent mode of delivery in women at high risk of preterm birth who labour. STUDY DESIGN: A retrospective case controlled study was performed at St Thomas's Hospital London...
November 27, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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