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Pregnancy guidelines

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https://www.readbyqxmd.com/read/28937575/committee-opinion-no-723-guidelines-for-diagnostic-imaging-during-pregnancy-and-lactation
#1
(no author information available yet)
Imaging studies are important adjuncts in the diagnostic evaluation of acute and chronic conditions. However, confusion about the safety of these modalities for pregnant and lactating women and their infants often results in unnecessary avoidance of useful diagnostic tests or the unnecessary interruption of breastfeeding. Ultrasonography and magnetic resonance imaging are not associated with risk and are the imaging techniques of choice for the pregnant patient, but they should be used prudently and only when use is expected to answer a relevant clinical question or otherwise provide medical benefit to the patient...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937570/committee-opinion-no-723-summary-guidelines-for-diagnostic-imaging-during-pregnancy-and-lactation
#2
(no author information available yet)
Imaging studies are important adjuncts in the diagnostic evaluation of acute and chronic conditions. However, confusion about the safety of these modalities for pregnant and lactating women and their infants often results in unnecessary avoidance of useful diagnostic tests or the unnecessary interruption of breastfeeding. Ultrasonography and magnetic resonance imaging are not associated with risk and are the imaging techniques of choice for the pregnant patient, but they should be used prudently and only when use is expected to answer a relevant clinical question or otherwise provide medical benefit to the patient...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28935064/no-231-guidelines-for-the-management-of-vasa-previa
#3
Robert Gagnon
OBJECTIVES: To describe the etiology of vasa previa and the risk factors and associated condition, to identify the various clinical presentations of vasa previa, to describe the ultrasound tools used in its diagnosis, and to describe the management of vasa previa. OUTCOMES: Reduction of perinatal mortality, short-term neonatal morbidity, long-term infant morbidity, and short-term and long-term maternal morbidity and mortality. EVIDENCE: Published literature on randomized trials, prospective cohort studies, and selected retrospective cohort studies was retrieved through searches of PubMed or Medline, CINAHL, and the Cochrane Library, using appropriate controlled vocabulary (e...
October 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28935063/no-263-maternity-leave-in-normal-pregnancy
#4
Dean Leduc
OBJECTIVE: To assist maternity care providers in recognizing and discussing health- and illness-related issues in pregnancy and their relationship to maternity benefits. EVIDENCE: Published literature was retrieved through searches of PubMed or Medline, CINAHL, and The Cochrane Library in 2009 using appropriate controlled vocabulary (e.g., maternity benefits) and key words (e.g., maternity, benefits, pregnancy). Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies...
October 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28935062/no-260-ultrasound-in-twin-pregnancies
#5
Lucie Morin, Kenneth Lim
OBJECTIVE: To review the literature with respect to the use of diagnostic ultrasound in the management of twin pregnancies. To make recommendations for the best use of ultrasound in twin pregnancies. OUTCOMES: Reduction in perinatal mortality and morbidity and short- and long-term neonatal morbidity in twin pregnancies. Optimization of ultrasound use in twin pregnancies. EVIDENCE: Published literature was retrieved through searches of PubMed and the Cochrane Library in 2008 and 2009 using appropriate controlled vocabulary (e...
October 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28935057/no-349-substance-use-in-pregnancy
#6
Alice Ordean, Suzanne Wong, Lisa Graves
OBJECTIVES: To improve awareness and knowledge of problematic substance use in pregnancy and to provide evidence-based recommendations for the management of this challenging clinical issue for all health care providers. OPTIONS: This guideline reviews the use of screening tools, general approach to care, and recommendations for the clinical management of problematic substance use in pregnancy. OUTCOMES: Evidence-based recommendations for screening and management of problematic substance use during pregnancy and lactation...
October 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28934082/evaluation-of-adherence-to-french-clinical-practice-guidelines-in-the-management-of-pregnancy-loss-issued-by-the-french-college-of-obstetricians-and-gynecologists-one-year-after-publication-a-vignette-based-study
#7
S Le Gouic, V Lavoué, M Mimouni, J Levêque, C Huchon
OBJECTIVES: To assess the adhesion of French obstetricians and gynecologists to the French clinical practice guidelines for pregnancy loss, issued by the French College of Obstetricians and Gynecologists, one year after publication. METHODS: An online vignette-based study was emailed to a sample of French obstetricians and gynecologists to compare their management of women with missed early miscarriage and incomplete early miscarriage. A descriptive statistical analysis was performed comparing the rates of appropriate management for these two indications before and after the release of the guidelines...
May 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28923288/delaying-thyroxine-until-positive-beta-human-chorionic-gonadotropin-is-safe-for-patients-receiving-fertility-therapy-applying-new-ata-guidelines-to-subclinical-hypothyroidism
#8
Alyse S Goldberg, Shoba Sujana Kumar, Ellen Greenblatt, Iliana C Lega, Heather Shapiro
OBJECTIVE: This study sought to examine the effect of changing TSH threshold recommendations from 2.5 to 4 mIU/L before fertility therapy on the prevalence of early gestational subclinical hypothyroidism (SCH) (TSH2 >2.5 mIU/L) and to evaluate implications on progression to clinical pregnancy (defined as detection of cardiac activity on ultrasound). METHODS: A retrospective chart review was performed in an academic fertility clinic on all patients with a measured pre-treatment TSH (TSH1) and positive beta-human chorionic gonadotropin following fertility treatment...
September 8, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28921563/advanced-genomic-testing-may-aid-in-counseling-of-isolated-agenesis-of-the-corpus-callosum-on-prenatal-ultrasound
#9
M C de Wit, F Boekhorst, G M Mancini, L S Smit, I A L Groenenberg, J Dudink, F A T de Vries, A T J I Go, R J H Galjaard
OBJECTIVE: Isolated agenesis of the corpus callosum (ACC) on fetal ultrasound has a varied prognosis. Microarray and exome sequencing might aid in prenatal counseling. METHOD: This study includes 25 fetuses with apparently isolated complete ACC (cACC) on ultrasound. All cases were offered SNP array. Complementary exome sequencing (ES) was offered postnatally in selected cases. Clinical physical and neurodevelopmental follow-up was collected. RESULTS: Eighteen cases opted for SNP array testing, which detected a causal anomaly in 2/18(11...
September 16, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28916245/tetanus-diphtheria-and-acellular-pertussis-vaccination-during-pregnancy-and-reduced-risk-of-infant-acute-respiratory-infections
#10
Zeina G Khodr, Anna T Bukowinski, Gia R Gumbs, Ava Marie S Conlin
BACKGROUND: To protect infants from pertussis infection, the Advisory Committee on Immunization Practices (ACIP) recommends women receive the tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (Tdap) vaccine between 27 and 36weeks of pregnancy. Here, we assessed the association between timing of maternal Tdap vaccination during pregnancy and acute respiratory infection (ARI) in infants <2months of age. METHODS: This retrospective cohort study included 99,434 infants born to active duty military women in the Department of Defense Birth and Infant Health Registry from 2006 through 2013...
September 12, 2017: Vaccine
https://www.readbyqxmd.com/read/28914636/dietary-intervention-for-preventing-food-allergy-in-children
#11
Yichao Wang, Katrina J Allen, Jennifer J Koplin
PURPOSE OF REVIEW: In the past decade, food allergy has been increasingly recognized as an important public health issue. The role of maternal and infant diet in the development of food allergy has been a major focus of research throughout this period. Recently, research in this area has moved from observational studies to intervention trials, and the findings from these trials have started to influence infant feeding guidelines. In this article, we review recent studies of dietary interventions for preventing food allergy, summarize current knowledge and discuss future research directions...
September 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28914273/patterns-and-appropriateness-of-thrombophilia-testing-in-an-academic-medical-center
#12
Nicholas Cox, Stacy A Johnson, Sara Vazquez, Ryan P Fleming, Matthew T Rondina, David Kaplan, Stephanie Chauv, Gabriel V Fontaine, Scott M Stevens, Scott Woller, Daniel M Witt
BACKGROUND: Clinical guidelines recommend against routine use of thrombophilia testing in patients with acute thromboembolism. Thrombophilia testing rarely changes acute management of a thrombotic event. OBJECTIVE: To determine appropriateness of thrombophilia testing in a teaching hospital. DESIGN: Retrospective cohort study. SETTING: One academic medical center in Utah. PARTICIPANTS: All patients who received thrombophilia testing between July 1, 2014, and December 31, 2014...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28913590/challenges-of-anticoagulation-therapy-in-pregnancy
#13
REVIEW
Annemarie E Fogerty
Thrombotic complications in pregnancy represent a major cause of morbidity and mortality. Pregnancy is a primary hypercoagulable state due to enhanced production of clotting factors, a decrease in protein S activity, and inhibition of fibrinolysis. These physiologic changes will yield a collective rate of venous thromboembolism (VTE) of about 1-2 in 1000 pregnancies for the general obstetric population, which represents a five- to tenfold increased risk in pregnancy compared to age-matched non-pregnant peers...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28911144/randomized-trial-comparing-two-algorithms-for-levothyroxine-dose-adjustment-in-pregnant-women-with-primary-hypothyroidism
#14
Shannon D Sullivan, Erin Downs, Geanina Popoveniuc, Alexander Zeymo, Jacqueline Jonklaas, Kenneth D Burman
Context: Regulation of maternal thyroid hormones during pregnancy is crucial for optimal maternal and fetal outcomes. There are no specific guidelines addressing maternal levothyroxine (LT4) dose adjustments throughout pregnancy. Objective: To compare two LT4 dose-adjustment algorithms in hypothyroid pregnant women. Design: Thirty-three women on stable LT4 doses were recruited at <10 weeks gestation during 38 pregnancies and randomized to one of two dose-adjustment groups...
September 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28910994/paediatric-and-maternal-schistosomiasis-shifting-the-paradigms
#15
Amaya L Bustinduy, J Russell Stothard, Jennifer F Friedman
Background: In endemic areas, schistosomiasis causes both overt and subclinical disease in young children and their mothers, as well as in returned travellers. Sources of data: Key recently published literature. Areas of agreement: An action plan for paediatric schistosomiasis and female genital schistosomiasis (FGS) is needed with expanded access to praziquantel (PZQ) treatment required. Areas of controversy: Schistosomiasis-related morbidity is underappreciated...
September 1, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/28904546/evidence-based-draft-guideline-for-prevention-of-midwifery-malpractices-based-on-referred-cases-to-the-forensic-medicine-commission-and-the-medical-council-from-2006-2011
#16
Leila Asadi, Marjan Beigi, Mahbube Valiani, Fardin Mardani
BACKGROUND: Medical errors are the main concerns in health systems, which considering their ascending rate in the recent years, especially in the field of midwifery, have caused a medical crisis. Considering the importance of evidence-based health services as a way to improve health systems, the aim of this study was to suggest a guideline for preventing malpractice in midwifery services. MATERIALS AND METHODS: In this cross-sectional study that was conducted in 2013, we investigated 206 cases that were referred to the Isfahan Legal Medicine Organization and Medical Council of Forensic Medicine from 2006-2011...
July 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28904049/use-of-thyroid-stimulating-hormone-tests-for-identifying-primary-hypothyroidism-in-family-medicine-patients
#17
Elizabeth Birk-Urovitz, M Elisabeth Del Giudice, Christopher Meaney, Karan Grewal
OBJECTIVE: To assess the use of thyroid-stimulating hormone (TSH) tests for identifying primary hypothyroidism in 2 academic family medicine settings. DESIGN: Descriptive study involving a retrospective electronic chart review of family medicine patients who underwent TSH testing. SETTING: Two academic family practice sites: one site is within a tertiary hospital in Toronto, Ont, and the other is within a community hospital in Newmarket, Ont...
September 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28903892/effectiveness-of-smartmoms-a-novel-ehealth-intervention-for-management-of-gestational-weight-gain-randomized-controlled-pilot-trial
#18
Leanne M Redman, L Anne Gilmore, Jeffrey Breaux, Diana M Thomas, Karen Elkind-Hirsch, Tiffany Stewart, Daniel S Hsia, Jeffrey Burton, John W Apolzan, Loren E Cain, Abby D Altazan, Shelly Ragusa, Heather Brady, Allison Davis, J Mick Tilford, Elizabeth F Sutton, Corby K Martin
BACKGROUND: Two-thirds of pregnant women exceed gestational weight gain (GWG) recommendations. Because excess GWG is associated with adverse outcomes for mother and child, development of scalable and cost-effective approaches to deliver intensive lifestyle programs during pregnancy is urgent. OBJECTIVE: The aim of this study was to decrease the proportion of women who exceed the Institute of Medicine (IOM) 2009 GWG guidelines. METHODS: In a parallel-arm randomized controlled trial, 54 pregnant women (age 18-40 years) who were overweight (n=25) or obese (n=29) were enrolled to test whether an intensive lifestyle intervention (called SmartMoms) decreased the proportion of women with excess GWG, defined as exceeding the 2009 IOM guidelines, compared to no intervention (usual care group)...
September 13, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28903473/baseline-anatomical-assessment-of-the-uterus-and-ovaries-in-infertile-women-a-systematic-review-of-the-evidence-on-which-assessment-methods-are-the-safest-and-most-effective-in-terms-of-improving-fertility-outcomes
#19
Sarah C Armstrong, Marian Showell, Elizabeth A Stewart, Robert W Rebar, Sheryl Vanderpoel, Cynthia M Farquhar
BACKGROUND: This review focuses on the initial presentation of women who suspect that they are infertile, and how best to assess the anatomy of their uterus and ovaries in order to investigate the cause of their infertility, and potentially improve desired fertility outcomes. This review was undertaken as part of a World Health Organization initiative to assess the evidence available to address guidance for the diagnosis and treatment of infertility within a global context. Providing access to care for infertile women will help to ease the psycho-social burdens, such as ostracization, intimate partner violence and other negative consequences of being involuntarily childless or unable to become pregnant despite desiring a biological child or children...
September 1, 2017: Human Reproduction Update
https://www.readbyqxmd.com/read/28900363/concerning-the-vitamin-d-reference-range-pre-analytical-and-analytical-variability-of-vitamin-d-measurement
#20
REVIEW
Davide Ferrari, Giovanni Lombardi, Giuseppe Banfi
Unlike other vitamins, the vitamin D concentration in blood varies cyclically over the course of the year in relation to genetic (gender, ethnicity, polymorphisms) and environmental factors (sunlight exposure, diet, food-related or direct vitamin D supplementation, skin pigmentation). Although the major diagnostics manufacturers have recently developed improved automated 25-hydroxy vitamin D immunoassays, the intra- and inter-laboratory variability is still high (especially at low vitamin D concentrations) which might lead to incorrect vitamin D deficiency/insufficiency diagnosis...
October 15, 2017: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
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