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high risk pregnance

Rada M Savic, Prasanna Jagannathan, Richard Kajubi, Liusheng Huang, Nan Zhang, Moses Were, Abel Kakuru, Mary K Muhindo, Norah Mwebaza, Erika Wallender, Tamara D Clark, Bishop Opira, Moses Kamya, Diane V Havlir, Philip J Rosenthal, Grant Dorsey, Francesca T Aweeka
Background: Dihydroartemsinin-piperaquine is highly efficacious as intermittent preventive therapy for malaria during pregnancy (IPTp). Determining associations between piperaquine exposure, malaria risk, and adverse birth outcomes informs optimal dosing strategies. Methods: HIV-uninfected pregnant women were enrolled in a placebo-controlled trial of IPTp at 12-20 weeks gestation and randomized to: sulfadoxine-pyrimethamine every 8 weeks (n=106), dihydroartemsinin-piperaquine every 8 weeks (n=94), or dihydroartemsinin-piperaquine every 4 weeks (n=100) during pregnancy...
March 14, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Gillian A Ryan, Sarah M Nicholson, John J Morrison
Vaginal birth after caesarean (VBAC) delivery remains a controversial topic, and one for which there is a lack of robust data to guide clinicians and parturients regarding their best option for mode of delivery in a subsequent pregnancy. In many developed countries the trend observed in recent years is that of progressively reduced VBAC rates, and hence increased use of elective repeat caesarean section (ERCS). This factor has contributed, more than any other, to the disproportionately high caesarean section (CS) rates in many countries...
March 7, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Charalampos S Siristatidis, Eleni Sertedaki, Dennis Vaidakis, Christos Varounis, Marialena Trivella
BACKGROUND: In order to overcome the low effectiveness of assisted reproductive technologies (ART) and the high incidence of multiple births, metabolomics is proposed as a non-invasive method to assess oocyte quality, embryo viability, and endometrial receptivity, and facilitate a targeted subfertility treatment. OBJECTIVES: To evaluate the effectiveness and safety of metabolomic assessment of oocyte quality, embryo viability, and endometrial receptivity for improving live birth or ongoing pregnancy rates in women undergoing ART, compared to conventional methods of assessment...
March 16, 2018: Cochrane Database of Systematic Reviews
Petteri Oura, Markus Paananen, Juha Auvinen, Jaakko Niinimäki, Maarit Niinimäki, Jaro Karppinen, Juho-Antti Junno
STUDY DESIGN: A population-based birth cohort study. OBJECTIVE: To investigate the association between gravidity, parity and vertebral geometry among middle-aged women. SUMMARY OF BACKGROUND DATA: Vertebral size is a recognized determinant of vertebral fracture risk. Yet only a few lifestyle factors that influence vertebral size are known. Pregnancy is a labile period which may affect the maternal vertebral size or shape. The lumbar lordosis angle is permanently deepened by pregnancy, but it remains unclear whether vertebral shape or size contribute to this deepened angle...
March 15, 2018: Spine
Ramiro Manzano Núñez, James Alejandro Zapata, Herney A García-Perdomo, Diego A Gomez, Mónica A Solís Velasco
INTRODUCTION: Few reports are available about perinatal dengue, with controversial results in regards the risk of perinatal outcome. OBJECTIVE: To report a case of perinatal dengue as a differential diagno sis with neonatal sepsis, which must be considered in endemic areas. CLINICAL CASE: Male newborn of a 23 year-old female, who presented a Non-Structural Protein 1 (NS1) antigen positive to dengue at 36 weeks of gestation and negative anti-dengue antibodies...
December 2017: Revista Chilena de Pediatría
Sonam Puri, Kelly A Hyland, Kristine Crowe Weiss, Gillian C Bell, Jhanelle E Gray, Richard Kim, Hui-Yi Lin, Aasha I Hoogland, Brian D Gonzalez, Ashley M Nelson, Anita Y Kinney, Stacy M Fischer, Daneng Li, Paul B Jacobsen, Howard L McLeod, Heather S L Jim
PURPOSE: Chemotherapy-induced nausea and vomiting (CINV) is common among cancer patients. Early identification of patients at risk for CINV may help to personalize anti-emetic therapies. To date, few studies have examined the combined contributions of patient-reported and genetic risk factors to CINV. The goal of this study was to evaluate these risk factors. METHODS: Prior to their first chemotherapy infusion, participants completed demographic and risk factor questionnaires and provided a blood sample to measure genetic variants in ABCB1 (rs1045642) and HTR3B (rs45460698) as well as CYP2D6 activity score...
March 15, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Kris Poppe, Candice Autin, Flora Veltri, Pierre Kleynen, Lidia Grabczan, Serge Rozenberg, Lieveke Ameye
Background: Since 2010, three meta-analyses have been published on the impact of thyroid autoimmunity (TAI) on pregnancy outcomes in infertile women treated with assisted reproductive technology (ART). The initially observed high risk of miscarriage became very low in the most recent meta-analysis published in 2016. Objective: To investigate whether the lower risk of miscarriage in the latest meta-analysis was associated with the increased use of intracytoplasmic sperm injection (ICSI) in recent studies...
March 12, 2018: Journal of Clinical Endocrinology and Metabolism
Karolina Louvanto, Michel Roger, Marie-Claude Faucher, Kari Syrjänen, Seija Grenman, Stina Syrjänen
Role of host factors in transmission of human papillomavirus (HPV)-infection from mother to her offspring is not known. Our aim was to study whether human leukocyte antigen (HLA)-G allele concordance among the mother-child pairs could facilitate vertical transmission of HPV, because HLA-G may contribute to immune tolerance in pregnancy. Altogether, 310 mother-child pairs were included from the Finnish Family HPV study. Overall, nine different HLA-G alleles were identified. The HLA-G genotype concordance of G∗01:01:01/01:04:01 increased the risk of high risk (HR)-HPV genotype positivity in cord blood and infant's oral mucosa...
March 12, 2018: Human Immunology
Tamara Barghouthi, Cheryl Bushnell
Stroke risk is 3 times higher in pregnancy than in the general young adult population and carries high morbidity and mortality risks. The recognition of signs and symptoms of stroke and other serious cerebrovascular disorders in pregnant and postpartum patients is important for the obstetrician to be able to initiate urgent evaluation and management. The objective of this review is to provide an evidence-based summary of stroke incidence, risk factors, prevention, and treatment of stroke in pregnancy. The impact of postpartum contraceptive use can on stroke risk is summarized...
March 14, 2018: Clinical Obstetrics and Gynecology
Moataz M Hassan, Zied Gaifer, Ibrahim S Al-Zakwani
Background Colistin is used to treat gram-negative infections but it's highly associated with nephrotoxicity. Objectives To determine the incidence and risk factors as well as mortality in patients on colistin. Setting Sultan Qaboos University Hospital, Muscat, Oman. Methods This was a retrospective cohort study of patients admitted and who received colistin for ≥ 48 h. The exclusion criteria included inhaled colistin therapy, cystic fibrosis, or pregnancy. The study period was from January 2010 to June 2016...
March 14, 2018: International Journal of Clinical Pharmacy
Bangari Haldipur, Prudhvi Lal Bhukya, Vidya Arankalle, Kavita Lole
Molecular mechanisms of liver pathology and clinical disease in HEV infection remain unclear. MicroRNAs are known to modulate viral pathogenesis either by directly altering viral gene expression or by enhancing cellular antiviral responses. Given the importance of microRNA-122 (miR-122) in liver pathobiology, we investigated possible role of miR-122 in HEV infection. In silico predictions using genotype 1, 2, 3 and 4 HEV sequences showed that majority of genomes (203/222) harbor at least one miR-122/miR-122* target site...
March 14, 2018: Journal of Virology
Kathrine Vauvert R Hviid, Sara Sofia Malchau, Anja Pinborg, Henriette Svarre Nielsen
BACKGROUND: The incidence of monozygotic twins (MZT) after ART appears to be higher than the incidence after spontaneous conceptions contradicting the aim of ART to avoid multiple pregnancies because of the associated risks. OBJECTIVE AND RATIONALE: The aim was to study the frequency of MZT after IVF and ICSI and how it is influenced by the day of embryo transfer, maternal age, zona pellucida manipulation, controlled ovarian stimulation, stimulation protocol, culture media and embryo quality...
March 12, 2018: Human Reproduction Update
Athena P Souka, Ioannis Papastefanou, Athanasios Pilalis, Dimitrios Kassanos, George Papadopoulos
OBJECTIVES: To assess the feasibility and the results of introducing a policy of universal screening for preterm delivery. METHODS: Transvaginal sonography for cervical length (CL) measurement was performed at 20-24 weeks of gestation. Vaginal progesterone therapy was offered to women with CL ≤ 15mm. RESULTS: 10,969 singleton pregnancies were assessed. The decline rate was 1.32%. Spontaneous preterm delivery at less than 32 weeks (SPD32), less than 34 weeks (SPD34) and less than 37 weeks (SPD37) occurred in 0...
March 14, 2018: Ultrasound in Obstetrics & Gynecology
M Y Tan, D Wright, A Syngelaki, R Akolekar, S Cicero, D Janga, M Singh, E Greco, A Wright, K Maclagan, L C Poon, K H Nicolaides
OBJECTIVE: To test the hypothesis that the performance of first-trimester screening for pre-eclampsia (PE) by a method that uses Bayes' theorem to combine maternal factors with biomarkers is superior to that defined by current National Institute for Health and Care Excellence (NICE) guidelines. METHODS: This was a prospective multicenter study (screening program for pre-eclampsia (SPREE)) in seven National Health Service maternity hospitals in England, of women recruited between April and December 2016...
March 14, 2018: Ultrasound in Obstetrics & Gynecology
Shiri Shinar, Howard Berger
The present literature review was conducted to evaluate early diabetes screening in pregnancy. The review focuses on the various guidelines for early screening, the target populations for screening, and the assessment of various early screening targets and strategies. The advantages and disadvantages of each screening method are highlighted. The review emphasizes that there are no validated criteria for selecting high-risk pregnant women for early screening. The different early screening modalities, including fasting plasma glucose, random plasma glucose, postload glucose, and hemoglobin A1c, lack concordance and have not been validated for the early diagnosis of diabetes in pregnancy...
March 14, 2018: International Journal of Gynaecology and Obstetrics
Elizabeth G Raymond, Tara Shochet, Hillary Bracken
OBJECTIVES: To summarize data on the accuracy and acceptability of a strategy for identifying ongoing pregnancy after medical abortion treatment using a low-sensitivity pregnancy test (LSPT). STUDY DESIGN: We searched PubMed to identify studies that evaluated the use of a single post-treatment LSPT for detection of ongoing pregnancy after treatment with mifepristone and misoprostol. We extracted, assessed, and summarized data from each study. RESULTS: We found 10 studies that evaluated 6 LSPTs with human chorionic gonadotropin detection thresholds of 1000, 1500, or 2000 mIU/ml...
March 10, 2018: Contraception
Elva Jiménez-Hernández, Arturo Fajardo-Gutiérrez, Juan Carlos Núñez-Enriquez, Jorge Alfonso Martín-Trejo, Laura Eugenia Espinoza-Hernández, Janet Flores-Lujano, José Arellano-Galindo, Aurora Medina-Sanson, Rogelio Paredes-Aguilera, Laura Elizabeth Merino-Pasaye, Martha Margarita Velázquez-Aviña, José Refugio Torres-Nava, Rosa Martha Espinosa-Elizondo, Raquel Amador-Sánchez, Juan José Dosta-Herrera, Javier Anastacio Mondragón-García, Heriberto Valdés-Guzmán, Laura Mejía-Pérez, Gilberto Espinoza-Anrubio, María Minerva Paz-Bribiesca, Perla Salcedo-Lozada, Rodolfo Ángel Landa-García, Rosario Ramírez-Colorado, Luis Hernández-Mora, María Luisa Pérez-Saldivar, Marlene Santamaría-Ascencio, Anselmo López-Loyola, Arturo Hermilo Godoy-Esquivel, Luis Ramiro García-López, Alison Ireri Anguiano-Ávalos, Karina Mora-Rico, Alejandro Castañeda-Echevarría, Roberto Rodríguez-Jiménez, José Alberto Cibrian-Cruz, Karina Anastacia Solís-Labastida, Rocío Cárdenas-Cardos, Armando Martínez-Avalos, Luz Victoria Flores-Villegas, José Gabriel Peñaloza-González, Ana Itamar González-Ávila, Martha Beatriz Altamirano-García, Norma López-Santiago, Martin Sánchez-Ruiz, Roberto Rivera-Luna, Luis Rodolfo Rodríguez-Villalobos, Francisco Hernández-Pérez, Jaime Ángel Olvera-Durán, Luis Rey García-Cortés, Minerva Mata-Rocha, Omar Alejandro Sepúlveda-Robles, Cesar Raúl González-Bonilla, Vilma Carolina Bekker-Méndez, Silvia Jiménez-Morales, Haydee Rosas-Vargas, Juan Manuel Mejía-Aranguré
In Mexico, due to the high rates of diabetes, overweight, and obesity, there has also been noted an increased newborn weight, which may be contributing to the elevated incidence rate of childhood acute leukemia (AL). We conducted a case-control study in public hospitals of Mexico City aimed to know whether a greater weight at birth is associated with a higher risk of developing leukemia. We included incident cases with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) diagnosed between 2010 and 2015...
March 13, 2018: Cancer Medicine
Ayako Ohyama, Hiroto Tsuboi, Hisashi Noma, Mayu Terasaki, Masaru Shimizu, Hirofumi Toko, Fumika Honda, Mizuki Yagishita, Hiroyuki Takahashi, Hiromitsu Asashima, Shinya Hagiwara, Yuya Kondo, Isao Matsumoto, Takayuki Sumida
OBJECTIVES: The purpose of this study is to clarify associations between maternal clinical features and adverse pregnancy outcomes (APOs) in mothers with connective tissue diseases (CTDs). METHODS: We retrospectively examined maternal clinical features including backgrounds, autoantibodies, CTD flare-ups, and therapies during pregnancies as well as fetal outcomes in 90 pregnancies (66 mothers) at our hospital from January 2006 to September 2016. RESULTS: Underlying CTDs were SLE (N = 41), MCTD (N = 10), RA (N = 15), SS (N = 10), and others (N = 14)...
March 13, 2018: Modern Rheumatology
Giuseppe Cali, Francesco Forlani, Francesca Foti, Gabriella Minneci, Lamberto Manzoli, Maria Elena Flacco, Danilo Buca, Marco Liberati, Giovanni Scambia, Francesco D'Antonio
OBJECTIVES: To ascertain the diagnostic accuracy of ultrasound in detecting AIP during the first trimester (11-14 weeks of gestation) of pregnancy in women at risk of these conditions. METHODS: Retrospective analysis on prospectively collected data on women at risk for AIP based upon the presence of at least one prior CS and/or uterine surgery and placenta previa who had an ultrasound assessment for AIP since the 11-14 weeks scan. The ultrasound signs explored in the present study were: loss of clear zone, placental lacunae, bladder wall interruption, uterovescical hypervascularity...
March 13, 2018: Ultrasound in Obstetrics & Gynecology
Vijaya Kancherla, Robert E Black
Neural tube defects (NTD) are major congenital malformations affecting births worldwide. NTD are associated with life-long disability, significant medical care costs, and child mortality. Their prevalence varies worldwide. We conducted a review of published literature and surveillance systems to examine challenges in estimating an overall global prevalence estimate for NTD. Our review showed that most low- and middle-income countries do not track NTD and indicate a high prevalence of these malformations where data are available...
February 2018: Annals of the New York Academy of Sciences
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