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https://www.readbyqxmd.com/read/28229528/severe-preeclampsia-before-26-weeks-gestation-how-should-we-counsel-women
#1
Olaide A Ashimi, Suneet P Chauhan
Objective observations of the uncommon occurrences can be gratifying, albeit grating. The gratifying part of the case series from Netherlands on severe preeclampsia before 26 weeks is undeniable. To convince all tertiary centres in a country to collect data on an obstetric phenomenon which occurs in 0.013% (133/1,044,287) of deliveries is an accomplishment! The rich data on maternal demographics and morbidity, along with neonatal outcomes is a remarkable. This article is protected by copyright. All rights reserved...
February 23, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28215929/each-baby-counts-national-quality-improvement-programme-to-reduce-intrapartum-related-deaths-and-brain-injuries-in-term-babies
#2
REVIEW
Louise Robertson, Zarko Alfirevic, Hannah Knight, Edward Prosser-Snelling, Emily Petch, Marian Knight, Alan Cameron
Although the most recent MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK) perinatal mortality report has shown a downward trend in perinatal mortality, the UK still lags behind the best-performing countries in Europe. The burden of perinatal morbidity and mortality is wide-reaching and devastating for the families and care-providers involved. The aim of the Each Baby Counts (EBC) project is to reduce intrapartum term stillbirths, early neonatal deaths, and severe brain injuries by 50% by 2020...
February 16, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28213434/malaria-during-pregnancy
#3
Michal Fried, Patrick E Duffy
One hundred and twenty-five million women in malaria-endemic areas become pregnant each year (see Dellicour et al. PLoS Med7: e1000221 [2010]) and require protection from infection to avoid disease and death for themselves and their offspring. Chloroquine prophylaxis was once a safe approach to prevention but has been abandoned because of drug-resistant parasites, and intermittent presumptive treatment with sulfadoxine-pyrimethamine, which is currently used to protect pregnant women throughout Africa, is rapidly losing its benefits for the same reason...
February 17, 2017: Cold Spring Harbor Perspectives in Medicine
https://www.readbyqxmd.com/read/28212182/what-s-new-in-obstetric-anesthesia-the-2016-gerard-w-ostheimer-lecture
#4
Philip E Hess
This special article presents potentially important trends and issues affecting the field of obstetric anesthesia drawn from publications in 2015. Both maternal mortality and morbidity in the United States have increased in recent years because, in part, of the changing demographics of the childbearing population. Pregnant women are older and have more pre-existing conditions and complex medical histories. Cardiovascular and noncardiovascular medical diseases now account for half of maternal deaths in the United States...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28210482/delayed-interval-delivery-can-save-the-second-twin-evidence-from-a-systematic-review
#5
REVIEW
S Feys, Y Jacquemyn
BACKGROUND: In case of preterm birth in twins, it is not well established if the second twin benefits from a delayed-interval delivery. OBJECTIVE: The main objective of this systematic review is to evaluate survival benefit of the second twin from delayed interval delivery compared to the first twin. Secondly, we will evaluate the survival benefit of the procedure when performed equal to or after 24 weeks gestational age of the first born. METHODS: Delayed interval delivery was defined as every attempt to perform a delayed interval delivery with at minimum placement of a high ligature of the umbilical cord and a delay of delivery of at least 24 hours...
December 2016: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/28206998/dynamic-outcome-prediction-in-a-socio-demographically-diverse-population-based-cohort-of-extremely-preterm-neonates
#6
M A Steurer, J Anderson, R J Baer, S Oltman, L S Franck, M Kuppermann, L Rand, K K Ryckman, J C Partridge, L L Jelliffe-Pawlowski, E E Rogers
OBJECTIVE: Accurate outcome prediction is crucial for counseling parents and providing individualized treatment to extremely premature infants. We sought to improve upon existing prediction model by using a diverse population-based cohort of extremely premature live births (⩽28 weeks' gestation) for survival and survival without severe neonatal morbidity at different times throughout the first week of life and to evaluate potential differences by race/ethnicity and maternal education...
February 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28196114/retinopathy-of-prematurity-a-comprehensive-risk-analysis-for-prevention-and-prediction-of-disease
#7
Leah A Owen, Margaux A Morrison, Robert O Hoffman, Bradley A Yoder, Margaret M DeAngelis
BACKGROUND: Retinopathy of prematurity (ROP) is a blinding morbidity of preterm infants. Our current screening criteria have remained unchanged since their inception and lack the ability to identify those at greatest risk. OBJECTIVES: We sought to comprehensively analyze numerous proposed maternal, infant, and environmental ROP risk variables in a robustly phenotyped population using logistic regression to determine the most predictive model for ROP development and severity...
2017: PloS One
https://www.readbyqxmd.com/read/28195885/eisenmenger-syndrome-and-pregnancy-novel-ecmo-configuration-as-a-bridge-to-delivery-and-recovery-utilizing-a-multidisciplinary-team
#8
Erika B Rosenzweig, Darryl Abrams, Mauer Biscotti, Diane Kerstein, Daphnie Drassinower, Daniel Brodie, Matthew Bacchetta
Pregnancy is typically contraindicated in Eisenmenger syndrome because of its association with excessively high maternal and fetal morbidity and mortality. We report on our novel approach to successfully managing a 29 year-old pregnant woman with an unrepaired patent ductus arteriosus (PDA) with Eisenmenger syndrome through delivery and recovery. Venovenous ECMO was utilized during induction of labor to stabilize maternal hemodynamics and optimize fetal oxygenation by creating an oxygenated right-to-left shunt through the PDA...
February 9, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28191626/intermittent-auscultation-ia-of-fetal-heart-rate-in-labour-for-fetal-well-being
#9
REVIEW
Ruth Martis, Ova Emilia, Detty S Nurdiati, Julie Brown
BACKGROUND: The goal of fetal monitoring in labour is the early detection of a hypoxic baby. There are a variety of tools and methods available for intermittent auscultation (IA) of the fetal heart rate (FHR). Low- and middle-income countries usually have only access to a Pinard/Laënnec or the use of a hand-held Doppler device. Currently, there is no robust evidence to guide clinical practice on the most effective IA tool to use, timing intervals and length of listening to the fetal heart for women during established labour...
February 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28188770/fetal-and-neonatal-outcomes-of-preterm-infants-born-before-32-weeks-of-gestation-according-to-antenatal-versus-postnatal-assessments-of-restricted-growth
#10
Isabelle Monier, Pierre-Yves Ancel, Anne Ego, Pierre-Henri Jarreau, Cécile Lebeaux, Monique Kaminski, François Goffinet, Jennifer Zeitlin
BACKGROUND: Fetal growth restriction is defined using ultrasound parameters during pregnancy or as a low birthweight for gestational age (GA) after birth, but these definitions are not always concordant. OBJECTIVE: To investigate fetal and neonatal outcomes based on antenatal versus postnatal assessments of growth restriction. STUDY DESIGN: From the EPIPAGE 2 population-based prospective study of very preterm births in France in 2011, we included 2919 singleton non-anomalous infants 24 to 31 weeks' GA...
February 8, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28188037/determinants-of-outcomes-in-patients-with-simple-gastroschisis
#11
Fouad Youssef, Jean-Martin Laberge, Pramod Puligandla, Sherif Emil
PURPOSE: We analyzed the determinants of outcomes in simple gastroschisis (GS) not complicated by intestinal atresia, perforation, or necrosis. METHODS: All simple GS patients enrolled in a national prospective registry from 2005 to 2013 were studied. Patients below the median for total parenteral nutrition (TPN) duration (26days) and hospital stay (34days) were compared to those above. Univariate and multivariate logistic and linear regression analyses were employed using maternal, patient, postnatal, and treatment variables...
January 28, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28186639/a-retrospective-cohort-study-of-hospital-versus-home-care-for-pregnant-women-with-preterm-prelabor-rupture-of-membranes
#12
Lynne Palmer, Kirsten Grabowska, Jason Burrows, Hilary Rowe, Erin Billing, Amy Metcalfe
OBJECTIVE: To compare maternal and neonatal outcomes between in-hospital management and prepartum care at home (PCAH) among women with preterm prelabor rupture of membranes (PPROM) before 34 weeks of pregnancy. METHODS: In a retrospective study, data were analyzed from women who experienced PPROM between 23 and 34 weeks of pregnancy, and received care from two hospitals in British Columbia, Canada, between April 2007 and March 2012. Women were included if they had been stable in hospital for at least 72 hours and met eligibility criteria for PCAH...
February 10, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28182741/etiology-of-severe-pneumonia-in-ecuadorian-children
#13
Sivani Jonnalagadda, Oswaldo Rodríguez, Bertha Estrella, Lora L Sabin, Fernando Sempértegui, Davidson H Hamer
BACKGROUND: In Latin America, community-acquired pneumonia remains a major cause of morbidity and mortality among children. Few studies have examined the etiology of pneumonia in Ecuador. METHODS: This observational study was part of a randomized, double blind, placebo-controlled clinical trial conducted among children aged 2-59 months with severe pneumonia in Quito, Ecuador. Nasopharyngeal and blood samples were tested for bacterial and viral etiology by polymerase chain reaction...
2017: PloS One
https://www.readbyqxmd.com/read/28176919/management-of-obstetric-postpartum-hemorrhage-a-national-service-evaluation-of-current-practice-in-the-uk
#14
Bassel H Al Wattar, Jennifer A Tamblyn, William Parry-Smith, Mathew Prior, Helen Van Der Nelson
BACKGROUND: Postpartum hemorrhage (PPH) continues to be one of the major causes of maternal mortality and morbidity in obstetrics. Variations in practice often lead to adverse maternity outcomes following PPH. Our objective was to assess the current practice in managing PPH in the UK. METHODS: We performed a national multicenter prospective service evaluation study over one calendar month and compared the current performance to national standards for managing PPH...
2017: Risk Management and Healthcare Policy
https://www.readbyqxmd.com/read/28159028/the-health-impact-of-the-2014-15-ebola-outbreak
#15
REVIEW
J W T Elston, C Cartwright, P Ndumbi, J Wright
OBJECTIVES: The 2014-15 outbreak in West Africa was the largest and deadliest Ebola outbreak recorded; however, there remains uncertainty over its wider health consequences. Our objective was to provide a comprehensive overview of the impact of the Ebola outbreak on population health in the three most affected countries: Sierra Leone, Liberia and Guinea. STUDY DESIGN: Narrative review. METHODS: A narrative overview of the peer-reviewed and grey literature related to the impact and consequences of the Ebola outbreak was conducted, synthesizing the findings of literature retrieved from a structured search of biomedical databases, the Web and references of reviewed articles...
February 2017: Public Health
https://www.readbyqxmd.com/read/28153661/reduction-of-severe-maternal-morbidity-from-hemorrhage-using-a-state-perinatal-quality-collaborative
#16
Elliott K Main, Valerie Cape, Anisha Abreo, Julie Vasher, Amanda Woods, Andrew Carpenter, Jeffrey B Gould
BACKGROUND: Obstetric hemorrhage is the leading cause of severe maternal morbidity and of preventable maternal mortality in the United States. The California Maternal Quality Care Collaborative developed a comprehensive quality improvement tool kit for hemorrhage based on the national patient safety bundle for obstetric hemorrhage and noted promising results in pilot implementation projects. OBJECTIVE: We sought to determine whether these safety tools can be scaled up to reduce severe maternal morbidity in women with obstetric hemorrhage using a large maternal quality collaborative...
January 30, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28153655/early-standardized-treatment-of-critical-blood-pressure-elevations-is-associated-with-a-reduction-in-eclampsia-and-severe-maternal-morbidity
#17
Laurence E Shields, Suzanne Wiesner, Catherine Klein, Barbara Pelletreau, Herman L Hedriana
BACKGROUND: Hypertensive disorders of pregnancy result in significant maternal morbidity and mortality. State and national guidelines have been proposed to increase treatment of patients with hypertensive emergencies or critically elevated blood pressures. There is limited data available to assess the impact of these recommendations on maternal morbidity. OBJECTIVE: The purpose of this prospective quality improvement project was to determine if maternal morbidity would be improved using a standardized approach for treatment of critically elevated blood pressures...
January 28, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28139946/multiple-sclerosis-in-pregnancy-prevalence-sociodemographic-features-and-obstetrical-outcomes
#18
Alex Fong, Cindy T Chau, Cara Quant, Jennifer Duffy, Deyu Pan, Dotun A Ogunyemi
OBJECTIVE: We sought to describe the prevalence, sociodemographic features, and antenatal/peripartum outcomes of multiple sclerosis (MS) in pregnancy. STUDY DESIGN: A retrospective cohort study was performed using deliveries in California from 2001-2009. Cases of MS as well as other morbidities were identified via ICD-9-CM code. Logistic regression was performed to adjust for potential confounders. RESULTS: 1,185 out of 4,424,049 deliveries were complicated by MS...
January 31, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28132012/use-of-magnesium-sulfate-before-32%C3%A2-weeks-of-gestation-a-european-population-based-cohort-study
#19
H T Wolf, L Huusom, T Weber, A Piedvache, S Schmidt, M Norman, J Zeitlin
OBJECTIVES: The use of magnesium sulfate (MgSO4) in European obstetric units is unknown. We aimed to describe reported policies and actual use of MgSO4 in women delivering before 32 weeks of gestation by indication. METHODS: We used data from the European Perinatal Intensive Care in Europe (EPICE) population-based cohort study of births before 32 weeks of gestation in 19 regions in 11 European countries. Data were collected from April 2011 to September 2012 from medical records and questionnaires...
January 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28131117/identification-and-management-of-obstetric-hemorrhage
#20
REVIEW
Emily J Baird
Obstetric hemorrhage remains the leading cause of maternal death and severe morbidity worldwide. Although uterine atony is the most common cause of peripartum bleeding, abnormal placentation, coagulation disorders, and genital tract trauma contribute to adverse maternal outcomes. Given the inability to reliably predict patients at high risk for obstetric hemorrhage, all parturients should be considered susceptible, and extreme vigilance must be exercised in the assessment of blood loss and hemodynamic stability during the peripartum period...
March 2017: Anesthesiology Clinics
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