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Prolonged pregnancy

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https://www.readbyqxmd.com/read/28739114/ethical-and-medical-management-of-a-pregnant-woman-with-brain-stem-death-resulting-in-delivery-of-a-healthy-child-and-organ-donation
#1
A Gopčević, B Rode, M Vučić, A Horvat, M Širanović, Ž Gavranović, V Košec, A Košec
Maternal brain death during pregnancy remains an exceedingly complex situation that requires not only a well-considered medical management plan, but also careful decision-making in a legally and ethically delicate situation. Management of brain dead pregnant patients needs to adhere to special strategies that support the mother in a way that she can deliver a viable and healthy child. Brain death in pregnant women is very rare, with only a few published cases. We present a case of a pregnant woman with previously diagnosed multiple brain cavernomas that led to intracranial hemorrhage and brain stem death during the 21st week of pregnancy...
June 24, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28738716/the-effect-of-obesity-on-early-fetal-growth-and-pregnancy-duration-a-cohort-study
#2
Ida Näslund Thagaard, Lone Krebs, Jens-Christian Holm, Michael Christiansen, Henrik Møller, Theis Lange, Torben Larsen
OBJECTIVE: To investigate the effect of maternal obesity on fetal size in first and second trimester pregnancies and to determine duration of pregnancy as estimated by a variety of methods. METHODS: Between 2006 and 2011, a cohort study included (n = 9055) singleton pregnancies that resulted in live birth at Holbaek Hospital in Denmark. This study recorded first and second trimester fetal measurements and maternal anthropometry. Characteristics considered included mother's age, parity, height, body mass index (BMI), smoking habits, and sex of child...
July 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28735900/treatment-with-enzyme-replacement-therapy-during-pregnancy-in-a-patient-with-pompe-disease
#3
Merete Holbeck-Brendel, Birgitte Klindt Poulsen
Pregnancy is in general physically demanding, even more so for women with hereditary muscular diseases (HMDs). With increasing numbers of women with HMD reaching reproductive age, there is a growing need for research into what impact pregnancy can have on their clinical condition. A 25-year-old woman was diagnosed with Pompe disease at the age of 22 and began enzyme replacement therapy (ERT) right away. At the age of 25 she became pregnant. ERT was paused during the first trimester and recommenced throughout the second and third trimesters...
July 5, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/28733084/reciprocal-regulation-of-%C3%AE-2-adrenoceptor-activated-camp-response-element-binding-protein-signalling-by-arrestin2-and-arrestin3
#4
Alexander Pearce, Lucy Sanders, Paul J Brighton, Shashi Rana, Justin C Konje, Jonathon M Willets
Activation of Gs coupled receptors (e.g. β2-adrenoreceptor (β2AR)) expressed within the uterine muscle layer (myometrium), promotes intracellular cAMP generation, inducing muscle relaxation through short-term inhibition of contractile proteins, and longer-term modulation of cellular phenotype to promote quiescence. In the myometrium cAMP-driven modulation of cell phenotype is facilitated by CREB activity, however despite the importance of CREB signalling in the promotion of myometrial quiescence during pregnancy, little is currently known regarding the molecular mechanisms involved...
July 18, 2017: Cellular Signalling
https://www.readbyqxmd.com/read/28729288/urinary-extracellular-vesicles-of-podocyte-origin-and-renal-injury-in-preeclampsia
#5
Sarwat I Gilani, Ulrik Dolberg Anderson, Muthuvel Jayachandran, Tracey L Weissgerber, Ladan Zand, Wendy M White, Natasa Milic, Maria Lourdes Gonzalez Suarez, Rangit Reddy Vallapureddy, Åsa Nääv, Lena Erlandsson, John C Lieske, Joseph P Grande, Karl A Nath, Stefan R Hansson, Vesna D Garovic
Renal histologic expression of the podocyte-specific protein, nephrin, but not podocin, is reduced in preeclamptic compared with normotensive pregnancies. We hypothesized that renal expression of podocyte-specific proteins would be reflected in urinary extracellular vesicles (EVs) of podocyte origin and accompanied by increased urinary soluble nephrin levels (nephrinuria) in preeclampsia. We further postulated that podocyte injury and attendant formation of EVs are related mechanistically to cellfree fetal hemoglobin (HbF) in maternal plasma...
July 20, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28729108/no-214-guidelines-for-the-management-of-pregnancy-at-41-0-to-42-0-weeks
#6
Martina Delaney, Anne Roggensack
OBJECTIVE: To provide evidence-based guidelines for the management of pregnancy at 41+0 to 42+0 weeks. OUTCOMES: Reduction of perinatal mortality associated with Caesarean section at 41+0 to 42+0 weeks of pregnancy. EVIDENCE: The Medline database, the Cochrane Library, and the American College of Obstetricians and Gynecologists and the Royal College of Obstetricians and Gynecologists, were searched for English language articles published between 1966 and March 2007, using the following key words: prolonged pregnancy, post-term pregnancy, and postdates pregnancy...
August 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28726273/epigallocatechin-gallate-enhances-treatment-efficacy-of-oral-nifedipine-against-pregnancy-induced-severe-pre-eclampsia-a-double-blind-randomized-and-placebo-controlled-clinical-study
#7
D-D Shi, J-J Guo, L Zhou, N Wang
WHAT IS KNOWN AND OBJECTIVE: Oral nifedipine is commonly used to treat pre-eclampsia, one of the most severe complications during pregnancy, but its clinical efficacy is less than ideal. Epigallocatechin gallate (EGCG), a natural compound from green tea, could benefit cardiovascular health especially hypertension. We investigated the clinical efficacy of EGCG, when complemented with oral nifedipine, in treating pre-eclampsia. METHODS: A total of 350 pregnant women with severe pre-eclampsia were recruited and randomized to receive oral nifedipine, together with placebo (NIF+placebo) or EGCG (NIF+EGCG)...
July 20, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28724657/prenatal-lipid-based-nutrient-supplements-do-not-affect-pregnancy-or-childbirth-complications-or-cesarean-delivery-in-bangladesh-a-cluster-randomized-controlled-effectiveness-trial
#8
Malay K Mridha, Susana L Matias, Rina Rani Paul, Sohrab Hussain, Mostofa Sarker, Mokbul Hossain, Janet M Peerson, Stephen A Vosti, Kathryn G Dewey
Background: Pregnancy and childbirth complications and cesarean delivery are common in Bangladesh.Objective: We evaluated the effect of lipid-based nutrient supplements for pregnant and lactating women (LNS-PL) on pregnancy and childbirth complications and cesarean delivery.Methods: We conducted the Rang-Din Nutrition Study, a cluster-randomized controlled effectiveness trial within a community health program in rural Bangladesh. We enrolled 4011 pregnant women in early pregnancy. Women in 48 clusters received iron and folic acid (IFA; 60 mg Fe + 400 μg folic acid/d) and women in 16 clusters received LNS-PL (20 g/d, 118 kcal) containing essential fatty acids and 22 vitamins and minerals...
July 19, 2017: Journal of Nutrition
https://www.readbyqxmd.com/read/28724213/characterization-of-serum-estradiol-level-and-tissue-estrogen-receptor-immunostaining-with-clinical-response-and-reproductive-factor-changes-in-chinese-female-patients-with-esophageal-squamous-cell-carcinoma
#9
Dongyun Zhang, Jianwei Ku, Ran Liu, Hongfang Wu, Guina Liang, Yan Wei, Peinan Chen, Xueke Zhao, Song Liu, Yin Li, Jianchao Yao, Xin Song, Lidong Wang
Pre-menopausal female patients have a prolonged survival than post-menopausal patients, indicating that estrogen and/or estrogen receptor (ER) may have some biological effects on prognosis. ER expression in cancer tissue has been reported to be a significant prognostic marker in multiple human cancers. However, the prognostic value of estrogen and/or ER on female patients with esophageal squamous cell carcinoma (ESCC) is rarely reported. The present study was undertaken to elucidate the associations of serum estradiol level, tissue estrogen receptor alpha (ERα) and estrogen receptor beta (ERβ) expression with clinical response and reproductive factor changes in 387 female ESCC patients...
July 14, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28720157/the-influence-of-azaperone-treatment-at-weaning-on-reproductive-performance-of-sows-altering-effects-of-season-and-parity
#10
T Schwarz, J Nowicki, R Tuz, P M Bartlewski
Azaperone treatment can control aggression and decrease stress due to weaning, re-grouping and hierarchical fighting of gilts and sows. However, the effects of this butyrophenone neuroleptic and sedative administered at weaning on pig reproductive function are poorly characterized. In this year-long study, a total of 619 cross-bred sows (Polish Large White×Polish Landrace) kept on a commercial farm received an i.m. injection of azaperone (Stresnil®; 2 mg/kg BW) just before weaning and were artificially inseminated during the ensuing estrus with 3×109 spermatozoa per dose of an inseminate; 1180 sows served as untreated controls...
July 19, 2017: Animal: An International Journal of Animal Bioscience
https://www.readbyqxmd.com/read/28719288/evaluation-of-the-protective-effect-of-deoxyribonucleic-acid-vaccines-encoding-granule-antigen-2-and-5-against-acute-toxoplasmosis-in-balb-c-mice
#11
Xiao Teng Ching, Mun Yik Fong, Yee Ling Lau
AbstractToxoplasma gondii infects a broad range of warm-blooded hosts, including humans. Important clinical manifestations include encephalitis in immunocompromised patients as well as miscarriage and fetal damage during early pregnancy. Toxoplasma gondii dense granule antigen 2 and 5 (GRA2 and GRA5) are essential for parasitophorous vacuole development of the parasite. To evaluate the potential of GRA2 and GRA5 as recombinant DNA vaccine candidates, these antigens were cloned into eukaryotic expression vector (pcDNA 3...
June 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28710882/mid-trimester-preterm-premature-rupture-of-membranes-pprom-etiology-diagnosis-classification-international-recommendations-of-treatment-options-and-outcome
#12
REVIEW
Michael Tchirikov, Natalia Schlabritz-Loutsevitch, James Maher, Jörg Buchmann, Yuri Naberezhnev, Andreas S Winarno, Gregor Seliger
Mid-trimester preterm premature rupture of membranes (PPROM), defined as rupture of fetal membranes prior to 28 weeks of gestation, complicates approximately 0.4%-0.7% of all pregnancies. This condition is associated with a very high neonatal mortality rate as well as an increased risk of long- and short-term severe neonatal morbidity. The causes of the mid-trimester PPROM are multifactorial. Altered membrane morphology including marked swelling and disruption of the collagen network which is seen with PPROM can be triggered by bacterial products or/and pro-inflammatory cytokines...
July 15, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28705999/the-effects-of-strict-prolonged-bedrest-on-cardio-respiratory-fitness-systematic-review-and-meta-analysis
#13
Mathias Ried-Larsen, Hugo Aarts, Michael J Joyner
The aim of this systematic review and meta-analysis (PROSPERO: CRD42017055619) was to assess the effects of strict prolonged bedrest (without counter measures) on V̇O2max and to explore sources of variation herein. Since 1949, 80 studies with a total of 949 participants (>90% males) have been published with data on strict bedrest and V̇O2max. The studies were conducted mainly in young participants (median age (interquartile range)) 24.5 (22.4 to 34.0) years. The duration of bedrest ranged from 1-90 days...
July 13, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28695270/maternal-use-of-prednisolone-is-unlikely-to-be-associated-with-neonatal-adrenal-suppression-a-single-center-study-of-16-cases
#14
Leanne de Vetten, Margriet van Stuijvenberg, Ido P Kema, Gianni Bocca
The use of supra-physiological, exogenous corticosteroids in pregnancy may lead to neonatal adrenal suppression. We report on a single-center, case series study carried out between 2006 and 2014, which included all newborns (n = 16) of mothers using prednisolone ≥10 mg/day during pregnancy. Newborns were routinely assessed according to hospital protocol, with follow-up until 6 weeks after birth. We investigated the clinical symptoms and biochemical findings of adrenal suppression occurring in the newborns...
July 10, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28694782/evaluation-of-abdominal-fetal-electrocardiography-in-early-intrauterine-growth-restriction
#15
Clarissa L Velayo, Kiyoe Funamoto, Joyceline Noemi I Silao, Yoshitaka Kimura, Kypros Nicolaides
Objectives: This descriptive study was performed to evaluate the capability of a non-invasive transabdominal electrocardiographic system to extract clear fetal electrocardiographic (FECG) measurements from intrauterine growth restricted (IUGR) fetuses and to assess whether abdominal FECG parameters can be developed as markers for evaluating the fetal cardiac status in IUGR. Methods: Transabdominal FECG was attempted in 20 controls and 15 IUGR singleton pregnancies at 20+0-33+6 weeks gestation. Standard ECG parameters were compared between the study groups and evaluated for their correlation...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28694344/prevalence-of-pregnancy-related-complications-and-course-of-labour-of-surviving-women-who-gave-birth-in-selected-health-facilities-in-rwanda-a-health-facility-based-cross-sectional-study
#16
Jean Paul Semasaka Sengoma, Gunilla Krantz, Manasse Nzayirambaho, Cyprien Munyanshongore, Kristina Edvardsson, Ingrid Mogren
OBJECTIVES: This study estimated health facility-based prevalence for pre-eclampsia/eclampsia, postpartum haemorrhage and caesarean section (CS) due to prolonged labour/dystocia. The background characteristics of Rwandan pregnant women, the course of labour and the level of healthcare were investigated in relation to pregnancy and delivery outcomes. METHODS: This is health facility-based study and data were collected in 2014-2015 through structured interviews and medical records (n=817) in Kigali and Northern Province, Rwanda...
July 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28691353/reproductive-performance-of-immobilized-cryopreserved-bovine-semen-used-for-timed-artificial-insemination
#17
A H Alm-Kristiansen, G Dalen, G Klinkenberg, L Bekk, L T Thorkildsen, K E Waterhouse, E Kommisrud
The SpermVital(®) technology comprises embedding of spermatozoa within an alginate gel to facilitate release of sperm cells over a prolonged period in utero after AI. The aim of this study was to examine whether the survival time of spermatozoa is extended when applying this immobilization technology in combination with cryopreservation. Sperm cell survival (acrosome and plasma membrane integrity) was studied in vitro for 48 hr at physiological temperature. One dose of SpermVital(®) (SV) semen was compared with single doses of Biladyl(®) (B) processed semen as well as double doses of B (B double)...
July 9, 2017: Reproduction in Domestic Animals, Zuchthygiene
https://www.readbyqxmd.com/read/28691313/moderate-mammalian-target-of-rapamycin-inhibition-induces-autophagy-in-htr8-svneo-cells-via-o-linked-%C3%AE-n-acetylglucosamine-signaling
#18
Qiuxia Zhang, Quan Na, Weiwei Song
AIM: Autophagy, a highly regulated process with a dual role (pro-survival or pro-death), has been implicated in adverse pregnancy outcomes. The aim of this study was to explore the mechanism whereby mammalian target of rapamycin (mTOR) signaling regulates autophagy by modulating protein O-GlcNAcylation in human trophoblasts. METHODS: HTR8/SVneo cells were incubated in serum-free medium for different time intervals or treated with varying doses of Torin1. Protein expression and cell apoptosis were detected by immunoblotting and flow cytometry, respectively...
July 10, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28689331/pathophysiology-and-current-clinical-management-of-preeclampsia
#19
REVIEW
Lorena M Amaral, Kedra Wallace, Michelle Owens, Babbette LaMarca
Preeclampsia is characterized by blood pressure greater than 140/90 mmHg in the second half of pregnancy. This disease is a major contributor to preterm and low birth weight babies. The early delivery of the baby, which becomes necessary for maintaining maternal well-being, makes preeclampsia the leading cause for preterm labor and infant mortality and morbidity. Currently, there is no cure for this pregnancy disorder. The current clinical management of PE is hydralazine with labetalol and magnesium sulfate to slow disease progression and prevent maternal seizure, and hopefully prolong the pregnancy...
August 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28688227/impact-factors-on-cervical-dilation-rates-in-the-first-stage-of-labor
#20
Jana Juhasova, Martina Kreft, Roland Zimmermann, Nina Kimmich
AIMS: To assess cervical dilation rates of nulliparous and multiparous women in the active first stage of labor and to evaluate significant impact factors. METHODS: In a retrospective cohort study between January 2007 and July 2014 at the University Hospital of Zurich in Switzerland, we analyzed 8378 women with singleton pregnancies in vertex presentation with a vaginal delivery at 34+0 to 42+5 gestational weeks. Median cervical dilation rates were calculated and different impact factors evaluated...
July 8, 2017: Journal of Perinatal Medicine
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