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Protocol for preterm labor

Masamitsu Nakamura, Junichi Hasegawa, Tatsuya Arakaki, Shoko Hamada, Hiroko Takita, Tomohiro Oba, Keiko Koide, Ryu Matsuoka, Akihiko Sekizawa
AIM: The aim of this study was to evaluate the effect of long-term use of tocolytic agents to prevent preterm delivery and improve perinatal outcome. METHODS: A historical cohort study was performed in a single perinatal center. The maternal characteristics, frequency of preterm labor and prescribed dose of tocolytic agents were compared before and after changing the management protocol for threatened premature delivery. RESULTS: A total of 1548 deliveries were carried out before changing the protocol for the use of tocolytic agents for threatened premature delivery and 1444 deliveries afterwards...
December 2016: Journal of Obstetrics and Gynaecology Research
Ashish Kc, Johan Wrammert, Uwe Ewald, Robert B Clark, Jageshwor Gautam, Gehanath Baral, Kedar P Baral, Mats Målqvist
BACKGROUND: Each year, 1.2 million intrapartum stillbirths occur globally. In Nepal, about 50 % of the total number of stillbirths occur during the intrapartum period. An understanding of the risk factors associated with intrapartum stillbirth will facilitate the development of preventative strategies to reduce the associated burden of death. This study was conducted in a tertiary-care setting with the aim to identify risk factors associated with intrapartum stillbirth. METHODS: A case-control study was completed from July 2012 to September 2013...
August 31, 2016: Reproductive Health
Matthew W Kemp, Masatoshi Saito, Haruo Usuda, Timothy J Molloy, Yuichiro Miura, Shinichi Sato, Shimpei Watanabe, Michael Clarke, Michael Fossler, Augusto Scmidt, Suhas G Kallapur, Boris W Kramer, John P Newnham, Alan H Jobe
BACKGROUND: Antenatal steroids are standard of care for cases of anticipated preterm labor to improve neonatal outcomes. However, steroids are potent drugs, and their use in pregnancy remains largely unoptimized. OBJECTIVE: The objective of the study was to measure the maternofetal pharmacokinetics of constant, low-dose intravenous betamethasone phosphate infusions and correlate these data with the transcriptional effect exerted by subclinical betamethasone exposures on the ovine fetal lung...
December 2016: American Journal of Obstetrics and Gynecology
Reva Tripathi, Shakun Tyagi, Yedla M Mala, Nilanchali Singh, Nalini B Pandey, Preeti Yadav
OBJECTIVE: To compare the accuracy of rapid bedside tests for phosphorylated insulin-like growth factor-binding protein 1 (phIGFBP-1) and fetal fibronectin (fFN) to predict preterm delivery among women with threatened preterm labor. METHODS: A prospective observational study was conducted among women with a singleton pregnancy of 28-36 weeks, intact membranes, and symptoms suggestive of preterm labor who attended a center in New Delhi, India, between April 1, 2011, and March 31, 2014...
October 2016: International Journal of Gynaecology and Obstetrics
Ana Laura Merlos-Gutiérrez, Manuel Martínez-García, Andrés Pérez-Martínez, Sareni Chávez-Martínez, José Antonio Sereno-Coló
BACKGROUND: Pheochromocytoma is a tumor originating in the chromaffin cells. These tumors secrete catecholamines which act on target organs and cause hypertensive crises. They are rare during pregnancy, and a differential diagnosis must be carried out mainly with pregnancy-induced hypertension. CLINIC CASE: A 22-year-old patient in week 11.5 of pregnancy presented at the Hospital General Dr. Miguel Silva in Morelia, Michoacán with hypertension that had existed for more than two years with poor adherence to treatment...
November 2015: Ginecología y Obstetricia de México
Kathryn A Ziegler, David A Paul, Matthew Hoffman, Robert Locke
OBJECTIVES: Admission to the NICU is influenced by physiologic compromise and by hospital care protocols. Providing appropriate care must be balanced with adverse consequences of NICU admission, such as interrupting maternal-infant bonding and unnecessary interventions. This study aims to determine the variation in NICU admissions in term and late preterm infants among 19 hospitals. METHODS: We used the Consortium on Safe Labor (CSL) database to determine NICU admission rates...
May 2016: Hospital Pediatrics
Steven J Korzeniewski, Roberto Romero, Tinnakorn Chaiworapongsa, Piya Chaemsaithong, Chong Jai Kim, Yeon Mee Kim, Jung-Sun Kim, Bo Hyun Yoon, Sonia S Hassan, Lami Yeo
BACKGROUND: Placental lesions consistent with maternal vascular underperfusion (MVU) are thought to be pathogenically linked to preeclampsia, small-for-gestational-age newborns, fetal death, and spontaneous preterm labor and delivery; yet, these lesions cannot be diagnosed antenatally. We previously reported that patients with such conditions and lesions have an abnormal profile of the angiogenic placental growth factor (PlGF) and antiangiogenic factors (eg, soluble vascular endothelial growth factor receptor [sVEGFR]-1)...
May 2016: American Journal of Obstetrics and Gynecology
Arata Itoh, Yoshifumi Saisho, Kei Miyakoshi, Marie Fukutake, Yoshifumi Kasuga, Daigo Ochiai, Tadashi Matsumoto, Mamoru Tanaka, Hiroshi Itoh
Though recommended for pregnant women at risk of preterm birth to improve perinatal outcomes, antenatal corticosteroid (ACS) treatment can cause maternal hyperglycemia, especially in cases of glucose intolerance. A standardized protocol for preventing hyperglycemia during ACS treatment remains to be established. We herein retrospectively investigated the time-dependent changes in insulin dose required for maternal glycemic control during ACS treatment in gestational diabetes (GDM). Twelve singleton pregnant women with GDM who received 12 mg of betamethasone intramuscularly twice 24 hours apart were included in this analysis...
2016: Endocrine Journal
Ella Kurz, Deborah Davis
BACKGROUND: Early-onset group B streptococcus disease, recognized as the most common cause of early onset neonatal sepsis in developed countries, is transmitted vertically from the group B streptococcus carrier mother to the neonate in the peripartum. Accordingly, early-onset group B streptococcus disease is prevented by halting the transmission of the microorganism from the mother to the infant. Two main methods, routine culture-based screening and risk-based management, may be used in the identification of mothers requiring intrapartum antibiotic prophylaxis in labor...
March 2015: JBI Database of Systematic Reviews and Implementation Reports
Mauro Cozzolino, Viola Seravalli, Giulia Masini, Lucia Pasquini, Mariarosaria Di Tommaso
BACKGROUND: Preterm delivery is the most common complication of multiple gestations and is associated with high perinatal mortality. When preterm labor occurs, delivery of the first fetus is inevitable. However, successfully delaying the delivery of the second fetus can be lifesaving. CASE REPORT: We report 2 cases of delayed-interval delivery of dichorionic diamniotic twin pregnancies admitted to our emergency department at 17+5 and 22+1 weeks of gestation. After abortion of the first fetus, the second twin was left in utero, and uterine contractions ceased...
2015: Ochsner Journal
Melinda Zeron Mullins, Konia M Trouton
BACKGROUND: Bacterial vaginosis is associated with increased transmission of sexually transmitted infections, preterm labor, post-surgical infections, and endometritis. Current treatment for symptomatic bacterial vaginosis includes antibiotics, such as metronidazole, which are 70-80 % effective at one month after treatment and result in high recurrence rates and secondary candida infections. Intravaginal boric acid has been used for over a hundred years to treat vaginal infections, such as bacterial vaginosis...
July 26, 2015: Trials
Asgeir Alexandersson, Thora Steingrimsdottir, Jeremy Terrien, Catherine Marque, Brynjar Karlsson
External recordings of the electrohysterogram (EHG) can provide new knowledge on uterine electrical activity associated with contractions. Better understanding of the mechanisms underlying labor can contribute to preventing preterm birth which is the main cause of mortality and morbidity in newborns. Promising results using the EHG for labor prediction and other uses in obstetric care are the drivers of this work. This paper presents a database of 122 4-by-4 electrode EHG recordings performed on 45 pregnant women using a standardized recording protocol and a placement guide system...
2015: Scientific Data
V Karamisheva, St Ivanov, A Nikolov, D Jordanova, G Dimitrov, A Nachev
UNLABELLED: Fibronectins represent a group of glycoproteins, which form "molecular glue" and are necessary in the interaction between a cell and a cell. The existence of fetal fibronectin in pregnant woman's vagina up to 22 g.w. is normal. In a normally proceeding pregnancy between 22 g.w. and 35 g.w. there is not supposed to be found fetal fibronectin in cervico-vaginal secretion. Its presence is a highly informative biological marker for the risk of premature birth. AIM: The aim of this research was to determine the risk for premature birth through applying fetal fibronectin test as a specific marker to pregnant women with or withthout symptoms of threatened birth...
2015: Akusherstvo i Ginekologii︠a︡
José Ignacio Garcia-de la Torre, Antonio Delgado-Rosas, Gerardo Gonzélez-Cantú
OBJECTIVE: Search Histologic Chorioamnionitis frequency in patients in week 28 (+/-) and pregnancy with premature rupture of membranes. PATIENTS AND METHOD: Retrospective and observational study in which we studied all patients who came between June 28, 2011 and November 15, 2011 to receive obstetric care in the service of Tocochirurgical of the University Hospital of Saltillo, with greater than or equal 28 weeks of pregnancy. RESULTS: 598 patients were studied, and the frequency of premature rupture of membranes with histologic chorioamnionitis at term patients was, respectively, 1...
December 2014: Ginecología y Obstetricia de México
Gabriele Saccone, Anju Suhag, Vincenzo Berghella
We sought to evaluate the efficacy of maintenance tocolysis with 17-alpha-hydroxyprogesterone caproate (17P) compared to control (either placebo or no treatment) in singleton gestations with arrested preterm labor (PTL), in a metaanalysis of randomized trials. Electronic databases (MEDLINE, OVID, Scopus,, and the Cochrane Central Register of Controlled Trials) were searched from 1966 through July 2014. Key words included "progesterone," "tocolysis," "preterm labor," and "17-alpha-hydroxyprogesterone caproate...
July 2015: American Journal of Obstetrics and Gynecology
Carine B Bourguet, William D Lubell
Premature birth is a steadily increasing unmet medical need, for which new "tocolytic" agents are required to arrest contractions and delay labor. A peptide-based approach was developed to produce modulators of the prostaglandin F2α receptor as a novel target for tocolytic development. In this strategy, the solution-phase synthesis and alkylation of aza-glycyl-proline building blocks were key for the preparation of a series of modulators exhibiting biased signaling. An optimized method is now provided for making the aza-Gly-Pro unit with minimum side product, and alkylation of the unit is described to illustrate the library diversification step...
2015: Methods in Molecular Biology
V Karamisheva, S Ivanov, A Nikolov, D Jordanova, G Dimitrov, A Nachev
AIM: To determine whether the presence of fetal fibronectin in vaginal secretions of patients with symptoms suggestive of preterm labor predicts preterm delivery. Fetal fibronectin, a large molecular weight glycoprotein produced in the chorion, is expressed in cervical and vaginal secretions in women with disruption of the choriodecidual junction by labor or by inflammation. METHODS: A prospective observational longitudinal study from January 2013 till December 2013 was performed on patients between 24 and 32 weeks of gestation with symptoms of preterm labor, intact membranes, and cervical dilation < 4 cm (total patients = 86)...
2014: Akusherstvo i Ginekologii︠a︡
Marija Hadži-Lega, Ana Daneva Markova, Milan Stefanovic, Mile Tanturovski
OBJECTIVE: The aim of this study was to determine the relationship between sonographic cervical length, fetal fibronectin (fFN), phIGFBP-1 (actim partus test), cytokines (IL-6, IL-2R, and TNF-α), and spontaneous preterm birth (SPTB) up to 14 days from sampling. METHODS: Fifty-eight patients were recruited in a period of 6 months from September 2013 until March 2014 with symptoms or complaints suggestive of preterm labor. Consenting women were treated according to usual hospital protocol, with addition of vaginal swabs taken for fetal fibronectin, phIGFBP-1 (actim partus test) and cervical IL6, IL2R, and TNF-α...
September 2015: Journal of Perinatal Medicine
Adriane Farias Patriota, Gláucia Virgínia de Queiroz Lins Guerra, Alex Sandro Rolland Souza
PURPOSE: To describe the perinatal outcomes after preterm premature rupture of membranes. METHODS: A retrospective cohort study was carried out at Instituto de Medicina Integral Prof. Fernando Figueira - IMIP from January 2008 to December 2012. A total of 124 preterm premature rupture of membranes singleton pregnancies, with gestational age <35, were included in the study. Pregnant women carrying fetuses with malformations, hypertensive syndromes, diabetes, or diagnosis of infections at admission were excluded...
July 2014: Revista Brasileira de Ginecologia e Obstetrícia
Hinke de Lau, Chiara Rabotti, Herman P Oosterbaan, Massimo Mischi, Guid S Oei
BACKGROUND: Traditional methods used for prediction of preterm delivery are subjective and inaccurate. The Electrohysterogram (EHG) and in particular the estimation of the EHG conduction velocity, is a relatively new promising method for detecting imminent preterm delivery. To date the analysis of the conduction velocity has relied on visual inspection of the signals. As a next step towards the introduction of EHG analysis as a clinical tool, we propose an automated method for EHG conduction velocity estimation for both the speed and direction of single spike propagation...
2014: BMC Pregnancy and Childbirth
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