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Intrapartum compromise

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https://www.readbyqxmd.com/read/29227010/pre-labour-screening-for-intrapartum-fetal-compromise-in-low-risk-pregnancies-at-term-cerebroplacental-ratio-and-placental-growth-factor
#1
Larissa N Bligh, Amal A Alsolai, Ristan M Greer, Sailesh Kumar
OBJECTIVES: We sought to determine the screening performance of a low fetal cerebroplacental ratio (a marker of fetal adaptation to suboptimal growth) and maternal placental growth factor levels, respectively, both in isolation and in combination, for the detection of cesarean section for intrapartum fetal compromise and serious composite neonatal outcome. METHODS: A prospective cohort study was performed on low risk women with uncomplicated singleton pregnancies from 36 weeks to delivery...
December 11, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29149182/comparison-between-public-and-private-sectors-of-care-and-disparities-in-adverse-neonatal-outcomes-following-emergency-intrapartum-cesarean-at-term-a-retrospective-cohort-study
#2
Woonji Jang, Christopher Flatley, Ristan M Greer, Sailesh Kumar
BACKGROUND: Perinatal outcomes may be influenced by a variety of factors including maternal demographics and medical condition as well as socio-economic status. The evidence for disparities in health outcomes stratified by type of care (public or private) is lacking. The aim of this study was to investigate short term neonatal outcomes following category 1 and 2 emergency cesareans at term between publicly and privately funded women at a single major tertiary centre in Australia. Category 1-immediate threat to life (maternal or fetal); Category 2-maternal or fetal compromise that is not immediately life-threatening...
2017: PloS One
https://www.readbyqxmd.com/read/29130772/assessment-of-left-ventricular-function-using-the-myocardial-performance-index-in-term-fetuses-that-develop-intrapartum-compromise
#3
Amal A Alsolai, Larissa N Bligh, Ristan M Greer, Alexander Gooi, Sailesh Kumar
OBJECTIVE: To investigate the relationship between the prelabour left ventricular myocardial Performance Index (LVMPI) and intrapartum fetal compromise (IFC) in low risk term pregnancies. METHODS: A blinded, prospective observational cohort study at the Mater Mother's Hospital, Brisbane, Australia. A cohort of 284 women with uncomplicated singleton pregnancies underwent fortnightly ultrasound from 36 weeks until delivery. The LVMPI was assessed by conventional Doppler ultrasound and correlated with intrapartum outcomes...
November 12, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29111145/risk-of-operative-delivery-for-intrapartum-fetal-compromise-in-small-for-gestational-age-fetuses-at-term-an-internally-validated-prediction-model
#4
Erkan Kalafat, Jose Morales-Rosello, Basky Thilaganathan, Fathema Tahera, Asma Khalil
BACKGROUND: Small-for-gestational-age fetuses are at an increased risk of intrapartum fetal compromise requiring operative delivery. Factors associated with the risk of intrapartum fetal compromise are yet to be established, and a comprehensive model accounting for both the antenatal and intrapartum variables is lacking. OBJECTIVE: We aimed to develop and validate a predictive model for the risk of operative delivery for presumed intrapartum fetal compromise in fetuses suspected to be small for gestational age at term...
October 31, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29017154/screening-performance-of-placental-growth-factor-for-the-prediction-of-low-birth-weight-and-adverse-intrapartum-and-neonatal-outcomes-in-a-term-low-risk-population
#5
Larissa N Bligh, Ristan M Greer, Sailesh Kumar
INTRODUCTION: Fetuses who fail to reach their genetic growth potential are thought to have sub-optimal placental function. Low placental growth factor (PlGF) levels have been shown to be predictive of placentally mediated conditions, such as pre-eclampsia or fetal growth restriction. We investigated the screening performance of PlGF for the prediction of low birth weight (<10th centile for gestation) and adverse intrapartum and neonatal outcomes in apparently low-risk term pregnancies...
October 11, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28915123/placental-examination-in-nonmacerated-stillbirth-versus-neonatal-mortality
#6
Jerzy Stanek
AIM: To retrospectively statistically compare clinical and placental phenotypes of nonmacerated fetuses and live-born perinatal deaths in 3rd trimester pregnancies. METHODS: Twenty-five clinical and 47 placental phenotypes were statistically compared among 93 cases of nonmacerated (intrapartum, or recent antepartum death) 3rd trimester fetal deaths (Group 1), 118 3rd trimester neonatal deaths (Group 2) and 4285 cases without perinatal mortality (Group 3). RESULTS: Sixteen clinical and placental phenotypes were statistically significantly different between Group 3 and the two groups of perinatal deaths, which included eight placental phenotypes of fetal vascular malperfusion and eight other placental phenotypes of various etiology (amnion nodosum, 2-vessel umbilical cord, villous edema, increased extracellular matrix of chorionic villi, erythroblasts in fetal blood and trophoblastic lesions of shallow placentation)...
September 18, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28808578/antibiotic-use-during-pregnancy-a-retrospective-study-of-prescription-patterns-and-birth-outcomes-at-an-antenatal-clinic-in-rural-ghana
#7
Kwesi Boadu Mensah, Kwame Opoku-Agyeman, Charles Ansah
BACKGROUND: Babies are increasingly being exposed to antibiotics intrapartum in the bid to reduce neonatal and maternal deaths. Intrapartum antibiotic exposure, including even those considered safe in pregnancy, have been associated with childhood obesity and compromised immunity. Data on the extent of antibiotic use, safety and its impact on birth outcomes and neonatal health in Sub-Saharan Africa is very limited. This study sought to ascertain the extent of antibiotic use in pregnancy and its effects on birth outcomes in a rural hospital in Ghana...
2017: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/28746928/diagnostic-performance-of-cerebroplacental-ratio-thresholds-at-term-for-prediction-of-low-birthweight-and-adverse-intrapartum-and-neonatal-outcomes-in-a-term-low-risk-population
#8
Larissa N Bligh, Amal Al Solai, Ristan M Greer, Sailesh Kumar
OBJECTIVES: To investigate the screening performance and best threshold centile (5th vs. 10th) of the cerebroplacental ratio (CPR) in low-risk, term pregnancies to predict low birthweight and adverse intrapartum and neonatal outcomes in a term, low-risk population. METHODS: This was a blinded, prospective, cross-sectional study of low-risk singleton pregnancies at term. Women attended fortnightly from 36 weeks for CPR and estimated fetal weight assessment. Intrapartum and neonatal outcomes were recorded...
July 27, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28618098/pre-labor-fetal-cardiac-function-and-its-relationship-with-intrapartum-fetal-compromise-and-neonatal-status-at-term
#9
Amal A Alsolai, Larissa N Bligh, Ristan M Greer, Sailesh Kumar
OBJECTIVES: To prospectively investigate the relationship between fetal cardiac function and Doppler parameters with intrapartum fetal compromise (IFC) in term appropriately grown fetuses prior to labour. Secondary outcomes were to correlate prenatal cardiac function with neonatal acid base status, intrapartum fetal heart rate abnormalities adverse neonatal outcomes. METHODS: This was a blinded, prospective, observational, cohort study, at the Mater Mother's Hospital, Brisbane, Australia...
June 15, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28594099/cerebroplacental-ratio-thresholds-measured-within-two-weeks-of-birth-and-the-risk-of-cesarean-section-for-intrapartum-fetal-compromise-and-adverse-neonatal-outcome
#10
Larissa N Bligh, Amal A Alsolai, Ristan M Greer, Sailesh Kumar
OBJECTIVES: Prediction of intrapartum fetal compromise in uncomplicated, term pregnancies is a global obstetric challenge. Currently, no widely accepted screening test for this condition exists, although the cerebroplacental ratio (CPR) shows promise. We aimed to prospectively evaluate the screening performance of the CPR 10(th) centile for detection of Cesarean section for intrapartum fetal compromise (IFC) and composite adverse neonatal outcome (ANO) in low-risk women from 36 weeks and to determine the best CPR threshold from three previously described in the literature...
June 8, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28483254/teratoma-of-the-neonatal-head-and-neck-a-41-year-experience
#11
Jacob R Brodsky, Alexandria L Irace, Amanda Didas, Karen Watters, Judy A Estroff, Carol E Barnewolt, Antonio Perez-Atayde, Reza Rahbar
OBJECTIVE: To review our institution's experience with the presentation, evaluation, and management of teratoma of the head and neck in the neonatal population. DESIGN: Retrospective case series (November 1970 through September 2011). SETTING: Tertiary care children's hospital. PATIENTS: 14 patients (12 boys and 2 girls). INTERVENTION: Detailed review of presentation, diagnostic approaches, surgical management, and outcomes...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28369712/computerized-data-driven-interpretation-of-the-intrapartum-cardiotocogram-a-cohort-study
#12
Antoniya Georgieva, Christopher W G Redman, Aris T Papageorghiou
INTRODUCTION: Continuous intrapartum fetal monitoring remains a significant clinical challenge. We propose using cohorts of routinely collected data. We aim to combine non-classical (data-driven) and classical cardiotocography features with clinical features into a system (OxSys), which generates automated alarms for the fetus at risk of intrapartum hypoxia. We hypothesize that OxSys can outperform clinical diagnosis of "fetal distress", when optimized and tested over large retrospective data sets...
July 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28341515/computerised-interpretation-of-fetal-heart-rate-during-labour-infant-a-randomised-controlled-trial
#13
(no author information available yet)
BACKGROUND: Continuous electronic fetal heart-rate monitoring is widely used during labour, and computerised interpretation could increase its usefulness. We aimed to establish whether the addition of decision-support software to assist in the interpretation of cardiotocographs affected the number of poor neonatal outcomes. METHODS: In this unmasked randomised controlled trial, we recruited women in labour aged 16 years or older having continuous electronic fetal monitoring, with a singleton or twin pregnancy, and at 35 weeks' gestation or more at 24 maternity units in the UK and Ireland...
April 29, 2017: Lancet
https://www.readbyqxmd.com/read/28288537/exit-procedure-for-fetal-mediastinal-teratoma-with-large-pericardial-effusion-a-case-report-with-review-of-literature
#14
Arpit Agarwal, Eliot Rosenkranz, Salih Yasin, Sethuraman Swaminathan
BACKGROUND: Large mediastinal teratomas in the fetus are rare and can present with direct compression of intrathoracic structures as well as pericardial and pleural effusions. Mediastinal fetal teratoma may be detected as a mass in the chest during a routine prenatal ultrasound. Because of the pressure on mediastinal structures it may result in non-immune fetal hydrops (NIFH) and polyhydramnios. The development of hydrops may lead to fetal demise. Timely obstetric and/or surgical intervention is important to improve survival in this patient population...
April 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28279215/quality-of-the-delivery-services-in-health-facilities-in-northern-ethiopia
#15
MULTICENTER STUDY
Girmatsion Fisseha, Yemane Berhane, Alemayehu Worku, Wondwossen Terefe
BACKGROUND: Substantial improvements have been observed in the coverage of and access to maternal health service, especially in skilled birth attendants, in Ethiopia. However, the quality of care has been lagging behind. Therefore, this study investigated the status of the quality of delivery services in Northern Ethiopia. METHODS: A facility based survey was conducted from December 2014 to February 2015 in Northern Ethiopia. The quality of delivery service was assessed in 32 health facilities using a facility audit checklist, by reviewing delivery, by conducting in-depth interview and observation, and by conducting exit interviews with eligible mothers...
March 9, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28270884/critical-imperative-for-the-reform-of-british-interpretation-of-fetal-heart-rate-decelerations-analysis-of-figo-and-nice-guidelines-post-truth-foundations-cognitive-fallacies-myths-and-occam-s-razor
#16
REVIEW
Shashikant L Sholapurkar
Cardiotocography (CTG) has disappointingly failed to show good predictability for fetal acidemia or neonatal outcomes in several large studies. A complete rethink of CTG interpretation will not be out of place. Fetal heart rate (FHR) decelerations are the most common deviations, benign as well as manifestation of impending fetal hypoxemia/acidemia, much more commonly than FHR baseline or variability. Their specific nomenclature is important (center-stage) because it provides the basic concepts and framework on which the complex "pattern recognition" of CTG interpretation by clinicians depends...
April 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28251626/intrapartum-intervention-rates-and-perinatal-outcomes-following-induction-of-labour-compared-to-expectant-management-at-term-from-an-australian-perinatal-centre
#17
COMPARATIVE STUDY
Yi Zhao, Christopher Flatley, Sailesh Kumar
BACKGROUND: Induction of labor (IOL) is a common obstetric intervention, yet its impact on intervention rates and perinatal outcomes is conflicting. AIMS: To evaluate the impact of IOL on intrapartum intervention rates and perinatal outcomes in women with singleton pregnancies at term. MATERIAL AND METHODS: This was a retrospective, cross-sectional study of term singleton deliveries at the Mater Mother's Hospital in Brisbane, Australia in 2007-2013...
February 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28216258/review-systematic-review-of-the-utility-of-the-fetal-cerebroplacental-ratio-measured-at-term-for-the-prediction-of-adverse-perinatal-outcome
#18
REVIEW
Liam Dunn, Helen Sherrell, Sailesh Kumar
AIM: This systematic review evaluates the utility of the fetal cerebroplacental ratio (CPR) when assessed at term (from 37 + 0 weeks gestation) as a predictor of adverse obstetric and perinatal outcomes. DATA SOURCES AND SEARCH STRATEGY: An electronic search of Pubmed and Embase using variations of 'cerebroplacental ratio' and 'cerebroumbilical ratio' was conducted by two independent reviewers. Full text studies written in English that reported on low CPR and its correlation with relevant obstetric and perinatal outcomes were included...
June 2017: Placenta
https://www.readbyqxmd.com/read/28157275/continuous-cardiotocography-ctg-as-a-form-of-electronic-fetal-monitoring-efm-for-fetal-assessment-during-labour
#19
REVIEW
Zarko Alfirevic, Declan Devane, Gillian Ml Gyte, Anna Cuthbert
BACKGROUND: Cardiotocography (CTG) records changes in the fetal heart rate and their temporal relationship to uterine contractions. The aim is to identify babies who may be short of oxygen (hypoxic) to guide additional assessments of fetal wellbeing, or determine if the baby needs to be delivered by caesarean section or instrumental vaginal birth. This is an update of a review previously published in 2013, 2006 and 2001. OBJECTIVES: To evaluate the effectiveness and safety of continuous cardiotocography when used as a method to monitor fetal wellbeing during labour...
February 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28121831/committee-opinion-no-687-approaches-to-limit-intervention-during-labor-and-birth
#20
REVIEW
(no author information available yet)
Obstetrician-gynecologists, in collaboration with midwives, nurses, patients, and those who support them in labor, can help women meet their goals for labor and birth by using techniques that are associated with minimal interventions and high rates of patient satisfaction. Many common obstetric practices are of limited or uncertain benefit for low-risk women in spontaneous labor. For women who are in latent labor and are not admitted, a process of shared decision making is recommended. Admission during the latent phase of labor may be necessary for a variety of reasons...
February 2017: Obstetrics and Gynecology
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