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Intrapartum compromise

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https://www.readbyqxmd.com/read/27929532/post-term-surveillance-and-birth-outcomes-in-south-asian-born-compared-with-australian-born-women
#1
C Yim, L Wong, C Cabalag, E M Wallace, M Davies-Tuck
OBJECTIVE: To determine if apparently healthy post-term South Asian-born (SA) women were more likely to have abnormal post-term fetal surveillance than Australian- and New Zealand-born (AUS/NZ) women, whether those abnormalities were associated with increased rates of obstetric intervention and adverse perinatal outcomes, and whether SA women and their babies were at higher risk of adverse outcomes in the post-term period irrespective of their post-term surveillance outcomes. STUDY DESIGN: Post-term surveillance and perinatal outcomes of 145 SA and 272 AUS/NZ nulliparous women with a singleton post-term pregnancy were compared in a retrospective multicentre cohort analysis...
December 8, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27871474/the-relationship-between-maternal-placental-growth-factor-levels-and-intrapartum-fetal-compromise
#2
Larissa N Bligh, Ristan M Greer, Sailesh Kumar
INTRODUCTION: Whilst some cases of intrapartum fetal compromise are the result of unpredictable catastrophic events, the majority arise from an unrecognised reduction in feto-placental reserve in otherwise healthy pregnancies. There is currently no reliable technique prior to labour that identifies the at-risk fetus. We aimed to investigate the relationship between maternal levels of serum placental growth factor (PlGF) and intrapartum fetal compromise in term pregnancies prior to labour...
December 2016: Placenta
https://www.readbyqxmd.com/read/27806661/intrapartum-intervention-rates-and-perinatal-outcomes-following-induction-of-labour-after-41%C3%A2-%C3%A2-0-weeks-compared-to-expectant-management
#3
Elaine Yuzhen Teo, Sailesh Kumar
OBJECTIVE: There is limited evidence regarding the incidence of intrapartum fetal compromise in women who are induced compared to those managed expectantly. The aim of this study was to investigate intrapartum and perinatal outcomes in women who were induced at >41 + 0 weeks compared to an expectantly managed cohort. METHODS: This was a retrospective cohort study of singleton, non anomalous pregnancies delivering between 41 + 0-43 + 0 weeks at the Mater Mothers' Hospital, Brisbane...
November 2, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27762166/birth-weight-centiles-risk-of-intrapartum-compromise-and-adverse-perinatal-outcomes-in-term-infants
#4
Danielle Dowdall, Christopher Flatley, Sailesh Kumar
OBJECTIVE: The objective of this study is to evaluate the association between birth weight centiles and the risk of intrapartum compromise and adverse neonatal outcomes in term pregnancies. METHODS: Retrospective study of 32 468 term singleton births at a major tertiary maternity hospital in Australia. Data comprised gestation, mode, and indication for delivery and adverse perinatal outcomes. Fetal sex and gestational age-specific birth weight centiles were the main exposure variable...
October 20, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27687377/a-randomized-trial-comparing-prophylactic-phenylephrine-and-ephedrine-infusion-during-spinal-anesthesia-for-emergency-cesarean-delivery-in-cases-of-acute-fetal-compromise
#5
Kajal Jain, Jeetinder Kaur Makkar, Siva Subramani Vp, Shalini Gander, Praveen Kumar
BACKGROUND: Previous evidence showed that use of phenylephrine was associated with higher umbilical artery pH (UA pH) than ephedrine after elective cesarean delivery (CD). However, the best choice of vasopressor and its effect on funic gases in cases of acute fetal compromise require additional studies. METHODS: Ninety parturients showing acute fetal compromise during intrapartum period and taken up for CD (category II) under spinal anesthesia were randomized to receive prophylactic infusion of ephedrine 2...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27651599/caesarean-section-for-foetal-distress-and-correlation-with-perinatal-outcome
#6
Richa Gangwar, Sarita Chaudhary
BACKGROUND: The main documented indication of intrapartum caesarean section is foetal distress (MacKenzie and Cooke in BMJ 323(7318):930, 2001). Foetal distress indicates foetal hypoxia and acidosis during intrauterine life. PURPOSE: To correlate the diagnosis of foetal distress and perinatal outcome. METHODS: This was a prospective observational study of women who underwent caesarean section for foetal distress as detected by cardiotocography and not responding to intrauterine resuscitation...
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27646638/ep16-10-prelabour-fetal-cardiac-output-and-risk-of-intrapartum-fetal-compromise
#7
A A Alsolai, L Bligh, S Kumar
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27645918/ep16-06-the-relationship-between-the-cerebroumbilical-ratio-and-cardiac-output-in-fetuses-that-develop-intrapartum-compromise-at-term
#8
A A Alsolai, L Bligh, S Kumar
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27606061/can-surveys-of-women-accurately-track-indicators-of-maternal-and-newborn-care-a-validity-and-reliability-study-in-kenya
#9
Katharine J McCarthy, Ann K Blanc, Charlotte E Warren, James Kimani, Brian Mdawida, Charity Ndwidga
BACKGROUND: Tracking progress on maternal and newborn survival requires accurate information on the coverage of essential interventions. Despite widespread use, most indicators measuring maternal and newborn intervention coverage have not been validated. This study assessed the ability of women delivering in two Kenyan hospitals to recall critical elements of care received during the intrapartum and immediate postnatal period at two time points: hospital discharge and 13-15 months following delivery...
December 2016: Journal of Global Health
https://www.readbyqxmd.com/read/27261818/the-association-between-a-low-cerebro-umbilical-ratio-at-30-34-weeks-gestation-increased-intrapartum-operative-intervention-and-adverse-perinatal-outcomes
#10
Sarah Twomey, Christopher Flatley, Sailesh Kumar
INTRODUCTION: The aim of this study was to investigate the relationship between the cerebro-umbilical ratio (CUR), measured at 30-34 weeks, and adverse intrapartum and perinatal outcomes. METHODS: This was a retrospective cross-sectional cohort study of women delivering at the Mater Mothers' Hospital in Brisbane, Australia. Fetal Doppler indices for 1224 singleton pregnancies were correlated with maternal demographics and intrapartum and perinatal outcomes. Only women who attempted vaginal delivery were included in the study...
August 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27132111/immediate-operative-management-of-the-fetus-with-airway-anomalies-resulting-from-congenital-malformations
#11
REVIEW
Pablo Laje, Sasha J Tharakan, Holly L Hedrick
Prenatal diagnosis has transformed the outcome of fetuses with airway obstruction. The thorough evaluation of prenatal imaging allows for categorizing fetuses with airway compromise into those who will require a special mode of delivery and those who can be delivered without any special resources. The ex-utero intrapartum treatment (EXIT) approach allows accessing the airway while the fetus is under placental support, converting a potentially catastrophic situation into a controlled one. An expert multidisciplinary team is the key to success...
August 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27098566/does-st-analysis-have-a-place-in-electronic-fetal-monitoring
#12
Tamara L Turnbull, Ben Willem J Mol, Geoff Matthews, Chris Wilkinson, Edwin Chandraharan, Sabrina Kuah
Intrapartum cardiotocography (CTG) has a high false positive rate. This has contributed to the rapid increase in obstetric interventions without a strong improvement in perinatal outcomes. We explore the role of ST analysis (STAN®) as an adjunct to CTG in identifying fetal asphyxia during labour. We conclude that STAN(®) reduces the rate of fetal blood sampling and instrumental vaginal deliveries, and has potential to reduce the number of Australian operative interventions without compromising neonatal outcome...
April 20, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/26831896/neonatal-and-maternal-outcomes-following-midtrimester-preterm-premature-rupture-of-the-membranes-a-retrospective-cohort-study
#13
Laura Aoife Linehan, Jennifer Walsh, Aoife Morris, Louise Kenny, Keelin O'Donoghue, Eugene Dempsey, Noirin Russell
BACKGROUND: Preterm premature rupture of membranes (PPROM) complicates 1% of all pregnancies and occurs in one third of all preterm deliveries. Midtrimester PPROM is often followed by spontaneous miscarriage and elective termination of ongoing pregnancies is offered in many countries. The aim of this retrospective descriptive cohort study was to investigate the natural history of midtrimester PPROM in a jurisdiction where termination of pregnancy in the absence of maternal compromise is unavailable...
2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/26767411/reducing-the-risk-of-fetal-distress-with-sildenafil-study-ridstress-a-double-blind-randomised-control-trial
#14
RANDOMIZED CONTROLLED TRIAL
Liam Dunn, Vicki Flenady, Sailesh Kumar
BACKGROUND: Labour is perhaps the most hazardous time in pregnancy. As many as 20 % of cerebral palsy cases in term infants result from intrapartum events and up to 63 % of babies who develop intrapartum compromise have no prior risk factors. Sildenafil citrate (SC), a phosphodiesterase 5 inhibitor, improves uterine blood supply through vasodilatation and potentially could improve placental perfusion and hence reduce the risk of intrapartum fetal hypoxia. The aim of this study is to evaluate the efficacy of SC to reduce the risk of intrapartum fetal compromise and the need for emergency operative delivery...
January 14, 2016: Journal of Translational Medicine
https://www.readbyqxmd.com/read/26730589/placental-insufficiency-in-fetuses-that-slow-in-growth-but-are-born-appropriate-for-gestational-age-a-prospective-longitudinal-study
#15
Nadia Bardien, Clare L Whitehead, Stephen Tong, Antony Ugoni, Susan McDonald, Susan P Walker
OBJECTIVES: To determine whether fetuses that slow in growth but are then born appropriate for gestational age (AGA, birthweight >10th centile) demonstrate ultrasound and clinical evidence of placental insufficiency. METHODS: Prospective longitudinal study of 48 pregnancies reaching term and a birthweight >10th centile. We estimated fetal weight by ultrasound at 28 and 36 weeks, and recorded birthweight to determine the relative change in customised weight across two timepoints: 28-36 weeks and 28 weeks-birth...
2016: PloS One
https://www.readbyqxmd.com/read/26655714/-anesthesia-for-ex-utero-intrapartum-treatment-renewed-insight-on-a-rare-procedure
#16
Miguel Vieira Marques, João Carneiro, Marta Adriano, Filipa Lança
The ex utero intrapartum treatment is a rare surgical procedure performed in cases of expected postpartum fetal airway obstruction. The technique lies on a safe establishment of a patent airway during labor in anticipation of a critical respiratory event, without interrupting maternal-fetal circulation. Anesthetic management is substantially different from that regarding standard cesarean delivery and its main goals include uterine relaxation, fetal anesthesia and preservation of placental blood flow. We present the case of an ex utero intrapartum treatment procedure performed on a fetus with a large cervical lymphangioma and prenatal evidence of airway compromise...
November 2015: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/26614153/anesthesia-for-ex-utero-intrapartum-treatment-renewed-insight-on-a-rare-procedure
#17
Miguel Vieira Marques, João Carneiro, Marta Adriano, Filipa Lança
The ex utero intrapartum treatment is a rare surgical procedure performed in cases of expected postpartum fetal airway obstruction. The technique lies on a safe establishment of a patent airway during labor in anticipation of a critical respiratory event, without interrupting maternal-fetal circulation. Anesthetic management is substantially different from that regarding standard cesarean delivery and its main goals include uterine relaxation, fetal anesthesia and preservation of placental blood flow. We present the case of an ex utero intrapartum treatment procedure performed on a fetus with a large cervical lymphangioma and prenatal evidence of airway compromise...
November 2015: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/26564381/immediate-delivery-compared-with-expectant-management-after-preterm-pre-labour-rupture-of-the-membranes-close-to-term-ppromt-trial-a-randomised-controlled-trial
#18
RANDOMIZED CONTROLLED TRIAL
Jonathan M Morris, Christine L Roberts, Jennifer R Bowen, Jillian A Patterson, Diana M Bond, Charles S Algert, Jim G Thornton, Caroline A Crowther
BACKGROUND: Preterm pre-labour ruptured membranes close to term is associated with increased risk of neonatal infection, but immediate delivery is associated with risks of prematurity. The balance of risks is unclear. We aimed to establish whether immediate birth in singleton pregnancies with ruptured membranes close to term reduces neonatal infection without increasing other morbidity. METHODS: The PPROMT trial was a multicentre randomised controlled trial done at 65 centres across 11 countries...
January 30, 2016: Lancet
https://www.readbyqxmd.com/read/26499019/ex-utero-intrapartum-treatment-exit-procedure-for-giant-fetal-epignathus
#19
Pooja Agarwal Jayagobi, Suresh Chandran, Bhavani Sriram, Kenneth T E Chang
BACKGROUND: Large fetal oropharyngeal tumors are rare, and have the potential to cause airway obstruction during birth. CASE CHARACTERISTICS: A 35-year-old woman with antenatally diagnosed large heterogenous mass in fetal neck displacing trachea and filling up the orophanygeal space. INTERVENTION: The infant was delivered at 31 weeks of gestation by ex-utero intrapartum therapy procedure to secure the airway. OUTCOME: Tumor was resected successfully on day 8 of life...
October 2015: Indian Pediatrics
https://www.readbyqxmd.com/read/26244423/an-interventional-airway-delivery-service-for-congenital-high-airway-obstruction
#20
M M C Yaneza, A Cameron, W A Clement, R Fairgrieve, M A Ledingham, M S Morrissey, J Simpson, D M Wynne, H Kubba
BACKGROUND: Congenital airway obstruction is rare but potentially fatal. We developed a complex airways interventional delivery team to manage such cases. Antenatal imaging detects airway compromise at an early stage and facilitates the planning of delivery procedures ('ex utero intrapartum treatment' and 'operation on placental support') which maintain feto-placental circulation whilst an airway is secured. METHOD: A retrospective review was performed of cases in which ENT input was required at birth for airway obstruction...
August 2015: Journal of Laryngology and Otology
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