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High risk obstetrics

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https://www.readbyqxmd.com/read/29456849/high-preoperative-glasgow-prognostic-score-is-a-negative-prognostic-factor-for-patients-with-endometrial-carcinoma
#1
Kohei Nakamura, Kentaro Nakayama, Toshiko Minamoto, Tomoka Ishibashi, Kaori Sanuki, Hitomi Yamashita, Ruriko Ono, Hiroki Sasamori, Takayoshi Komatsu-Fujii, Masako Ishikawa, Satoru Kyo
The aim of the present study was to determine the prognostic value of the Glasgow prognostic score (GPS) in endometrial carcinoma (EC). Patients with EC who underwent surgery at the Shimane University Hospital between January 1997 and December 2013 were enrolled (n=118). The associations between pretreatment GPS and clinical parameters, including age, histological type, International Federation of Gynecology and Obstetrics stage, tumor grade, carbohydrate antigen 19-9 and carcinoembryonic antigen levels, progression-free survival (PFS), and overall survival (OS), were investigated...
March 2018: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29456577/is-ultrasound-screening-for-vasa-praevia-clinically-justified-and-a-financially-viable-screening-test-a-literature-review
#2
REVIEW
Gillian Coleman, Heather Venables
Vasa praevia is an obstetric complication currently not screened for within the United Kingdom, which if undetected prenatally can lead to fetal death when the membranes rupture. Internationally, guidelines are available providing guidance on the best screening policy and management pathways. However, the UK National Screening Committee and Royal College of Obstetricians and Gynaecologists do not support screening due to a lack of evidence. Recent studies explore the ability of ultrasound to detect vasa praevia prenatally in both the general and high-risk populations...
February 2018: Ultrasound: Journal of the British Medical Ultrasound Society
https://www.readbyqxmd.com/read/29455772/prenatal-diagnosis-of-congenital-heart-disease-a-review-of-current-knowledge
#3
REVIEW
Nathalie Jeanne Bravo-Valenzuela, Alberto Borges Peixoto, Edward Araujo JĂșnior
This article reviews important features to improve the diagnosis of congenital heart disease (CHD) by applying ultrasound in prenatal cardiac screening. As low and high-risk pregnancies for CHD are subject to routine obstetric ultrasound, the diagnosis of structural heart defects represents a challenge that involves a team of specialists and subspecialists on fetal ultrasonography. In this review, the images highlight normal anatomy of the heart as well as pathologic cases consistent with cardiac malposition and isomerism, septal defects, pulmonary stenosis/atresia, aortic malformations, hypoplastic left ventricle, conotruncal anomalies, tricuspid dysplasia, and Ebstein's anomaly, and univentricular heart, among other congenital cardiovascular defects...
January 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29455616/is-the-fetal-cerebroplacental-ratio-better-that-the-estimated-fetal-weight-in-predicting-adverse-perinatal-outcomes-in-a-low-risk-cohort
#4
Christopher Flatley, Sailesh Kumar
OBJECTIVE: In high-risk pregnancies combining the cerebro-placental ratio (CPR) with the estimated fetal weight (EFW) improves the identification of vulnerable fetuses. The purpose of this study was to assess the CPR and EFW's ability to predict adverse obstetric and perinatal outcomes in a low-risk pregnancy, when measured late in gestation. METHODS: This was a retrospective study of women who birthed at Mater Mothers Hospitals, Brisbane, Australia between 2010 and 2015...
February 18, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29455380/clinical-features-and-peripartum-outcomes-in-pregnant-women-with-cardiac-disease-a-nationwide-retrospective-cohort-study-in-japan
#5
Toshiaki Isogai, Hiroki Matsui, Hiroyuki Tanaka, Akira Kohyama, Kiyohide Fushimi, Hideo Yasunaga
Although the number of pregnancies in women with cardiac disease is increasing worldwide, there are few data concerning their clinical characteristics and peripartum outcomes. Using the Diagnosis Procedure Combination database between 2008 and 2014 in Japan, we retrospectively identified pregnant women who underwent high-risk delivery due to obstetric or non-obstetric comorbidities. We classified eligible women into those with pre-existing cardiac disease (cardiac disease group) and those with non-cardiac comorbidities (non-cardiac disease group) and compared their characteristics and peripartum outcomes...
February 17, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29449131/the-treatment-of-anti-phospholipid-syndrome-a-comprehensive-clinical-approach
#6
REVIEW
Cecilia Beatrice Chighizola, Laura Andreoli, Maria Gerosa, Angela Tincani, Amelia Ruffatti, Pier Luigi Meroni
Anti-phospholipid syndrome (APS) is an acquired pro-thrombotic autoimmune disease that predisposes to thrombotic events and/or obstetric complications, in the persistent presence of anti-phospholipid antibodies (aPL). Life long moderate-intensity anticoagulation is the option of choice for aPL-positive patients with a previous thrombosis; critical issues concern the management of those with a history of arterial event due to the high rate of recurrence. Alternatives comprise anti-platelet agents and high-intensity anticoagulation...
February 12, 2018: Journal of Autoimmunity
https://www.readbyqxmd.com/read/29447147/assisted-reproductive-technology-surveillance-united-states-2015
#7
Saswati Sunderam, Dmitry M Kissin, Sara B Crawford, Suzanne G Folger, Sheree L Boulet, Lee Warner, Wanda D Barfield
PROBLEM/CONDITION: Since the first U.S. infant conceived with assisted reproductive technology (ART) was born in 1981, both the use of ART and the number of fertility clinics providing ART services have increased steadily in the United States. ART includes fertility treatments in which eggs or embryos are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Although the majority of infants conceived through ART are singletons, women who undergo ART procedures are more likely than women who conceive naturally to deliver multiple-birth infants...
February 16, 2018: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/29447091/obesity-in-pregnancy-a-comparison-of-four-national-guidelines
#8
Dana Vitner, Kristin Harris, Cynthia Maxwell, M D Farine
BACKGROUND: Obesity in pregnancy has become one of the most important challenges in obstetrical care given its prevalence and potential adverse impact on both mother and fetus. The primary objective of this descriptive review is to identify common themes and distinctions within the current recommendations for maternal obesity in the most updated version of four published national guidelines. METHODS: We reviewed the following guidelines for obesity in pregnancy: American College of Obstetricians and Gynecologists (ACOG) 2015, Royal Australian and New Zealand College of Obstetricians and Gynecologists (RANZCOG) 2013, Royal College of Obstetrics and Gynecology (RCOG) 2010, and Society of Obstetrics and Gynecologists of Canada (SOGC) 2010...
February 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29442402/ectopic-pregnancy-in-women-with-recurrent-miscarriage
#9
Carlo Ticconi, Maria V Capogna, Federica Martelli, Barbara Borelli, Valentina Bruno, Raffaella Ergasti, Roberto Sorge, Emilio Piccione, Adalgisa Pietropolli
AIM: The aim of this study was to investigate the possible association between recurrent miscarriage (RM) and ectopic pregnancy (EP). METHODS: In this case-control retrospective study, the clinical cards of women followed as outpatients in the RM and low-risk pregnancy offices of the Obstetrics and Gynecology Unit at the Policlinico Tor Vergata University Hospital were carefully reviewed for the occurrence of EP. RESULTS: Overall, 598 women with RM and 2043 normal women without RM (controls) were included in the study...
February 14, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29440934/prevalence-and-risk-factors-for-maternal-mortality-in-referral-hospitals-in-nigeria-a-multicenter-study
#10
Lorretta F Ntoimo, Friday E Okonofua, Rosemary N Ogu, Hadiza S Galadanci, Mohammed Gana, Ola N Okike, Kingsley N Agholor, Rukiyat A Abdus-Salam, Adetoye Durodola, Eghe Abe, Abdullahi J Randawa
Introduction: While reports from individual hospitals have helped to provide insights into the causes of maternal mortality in low-income countries, they are often limited for policymaking at national and subnational levels. This multisite study was designed to determine maternal mortality ratios (MMRs) and identify the risk factors for maternal deaths in referral health facilities in Nigeria. Methods: A pretested study protocol was used over a 6-month period (January 1-June 30, 2014) to obtain clinical data on pregnancies, births, and maternal deaths in eight referral hospitals across eight states and four geopolitical zones of Nigeria...
2018: International Journal of Women's Health
https://www.readbyqxmd.com/read/29437696/clinical-outcomes-after-conservative-management-of-cervical-intraepithelial-neoplasia-grade-2-cin2-in-women-ages-21-39-years
#11
Michelle I Silver, Julia C Gage, Mark Schiffman, Barbara Fetterman, Nancy E Poitras, Thomas Lorey, Li C Cheung, Hormuzd A Katki, Alexander Locke, Walter K Kinney, Philip E Castle
Cervical intraepithelial neoplasia grade 2 (CIN2) frequently regresses, is typically slow-growing, and rarely progresses to cancer. Some women forgo immediate treatment, opting for conservative management (heightened surveillance with cytology and colposcopy), to minimize overtreatment and increased risk of obstetric complications; however, there are limited data examining clinical outcomes in these women. We performed a retrospective cohort analysis of younger women diagnosed with initially untreated CIN1/2, CIN2 and CIN2/3 lesions at Kaiser Permanente Northern California between 2003-2015...
February 5, 2018: Cancer Prevention Research
https://www.readbyqxmd.com/read/29433369/postpartum-thromboprophylaxis-in-a-multireligious-cohort-a-retrospective-review-of-indications-and-uptake
#12
Hian Yan Voon, Ming Cheng Chai, Ling Yien Hii, Rafaie Amin, Haris Njoo Suharjono
Strategies to prevent mortality from obstetric venous thromboembolism begin with identification, risk stratification and subsequently, implementation of prophylactic measures. We sought to identify the burden of pharmacologic thromboprophylaxis in postpartum women, including the main clinical indications and its uptake in a multireligious population, with Islam as the official religion. A total of 2514 deliveries between 1st January to 31st December 2016, across three centres in Malaysia were reviewed retrospectively from hospital-based registries...
February 12, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29430623/perinatal-outcome-of-monochorionic-and-dichorionic-twins-after-spontaneous-and-assisted-conception-a-retrospective-cohort-study
#13
Karien E A Hack, Marijn E M S Vereycken, Helen L Torrance, Corine Koopman-Esseboom, Jan B Derks
INTRODUCTIO: The aim of this study was to compare pregnancy outcomes in twin pregnancies after ACand spontaneous conception, according to chorionicity. MATERIAL AND METHODS: Retrospective cohort study of 1305 twin pregnancies between 1995 and 2015. All spontaneous (n=731) and assisted conception conceived twin pregnancies (n=574) with antenatal care and delivery in University Medical Center Utrecht, The Netherlands, a tertiary obstetric care center were studied according to chorionicity...
February 11, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29426745/single-institutional-outcomes-of-adjuvant-brachytherapy-for-stage-i-endometrial-cancer-are-outcomes-consistent-with-randomized-studies
#14
Michael J Dohopolski, Zachary D Horne, Brian J Gebhardt, Scott M Glaser, Robert P Edwards, Joseph L Kelley, John T Comerci, Alexander B Olawaiye, Madeleine Courtney-Brooks, Jessica L Berger, Paniti Sukumvanich, Sushil Beriwal
PURPOSE: Vaginal brachytherapy (VBT) alone has been shown to be a viable adjuvant treatment strategy for most patients with Stage I endometrioid endometrial cancer. We sought to examine our institutional data following practice pattern changes resulting from the publications of GOG-99 and PORTEC-2. METHODS AND MATERIALS: We retrospectively analyzed women who underwent adjuvant VBT after surgical staging for Stage 1 endometrioid endometrial cancer at our institution from 2007 to 2014...
February 6, 2018: Brachytherapy
https://www.readbyqxmd.com/read/29423189/early-neonatal-mortality-in-twin-pregnancy-findings-from-60-low-and-middle-income-countries
#15
Saverio Bellizzi, Howard Sobel, Ana Pilar Betran, Marleen Temmerman
Background: Around the world, the incidence of multiple pregnancies reaches its peak in the Central African countries and often represents an increased risk of death for women and children because of higher rates of obstetrical complications and poor management skills in those countries. We sought to assess the association between twins and early neonatal mortality compared with singleton pregnancies. We also assessed the role of skilled birth attendant and mode of delivery on early neonatal mortality in twin pregnancies...
June 2018: Journal of Global Health
https://www.readbyqxmd.com/read/29422727/pattern-and-outcome-of-obstetric-admissions-into-the-intensive-care-unit-of-a-southeast-nigerian-hospital
#16
Benjamin Chukwuma Ozumba, Leonard Ogbonna Ajah, Vitus Okwuchukwu Obi, Uche Anthony Umeh, Joseph Tochukwu Enebe, Kingsley Chukwu Obioha
Background and Aims: Although pregnancy and labor are considered physiological processes, the potential for catastrophic complications is constant and may develop rapidly. There is growing evidence that admission of high-risk patients into the Intensive Care Unit (ICU) is associated with a reduction in maternal mortality. This study was aimed at reviewing all obstetric patients admitted into the ICU. Materials and Methods: This was a retrospective study of all obstetric patients who were admitted into the ICU between January 1, 2012, and December 31, 2013...
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29420168/obstetric-outcomes-and-delivery-related-health-care-utilization-and-costs-among-pregnant-women-with-multiple-chronic-conditions
#17
Lindsay K Admon, Tyler N A Winkelman, Michele Heisler, Vanessa K Dalton
Our objective was to measure obstetric outcomes and delivery-related health care utilization and costs among pregnant women with multiple chronic conditions. We used 2013-2014 data from the National Inpatient Sample to measure obstetric outcomes and delivery-related health care utilization and costs among women with no chronic conditions, 1 chronic condition, and multiple chronic conditions. Women with multiple chronic conditions were at significantly higher risk than women with 1 chronic condition or no chronic conditions across all outcomes measured...
February 8, 2018: Preventing Chronic Disease
https://www.readbyqxmd.com/read/29419921/the-evolving-contribution-of-non-communicable-diseases-ncds-to-maternal-mortality-in-jamaica-1998-2015-a-population-based-study
#18
Affette M McCaw-Binns, Leroy V Campbell, Simone S Spence
OBJECTIVE: Describe trends in indirect cause-specific pregnancy-related mortality from 1998-2015. DESIGN: Secondary analysis of annual, national cross-sectional database of maternal and late maternal deaths, identified through active surveillance of deaths among women 10-50 years. SETTING: Jamaica, a middle-income Caribbean country. POPULATION: Maternal and late maternal deaths. METHODS: Descriptive trend analyses of demographic and cause-specific maternal and pregnancy-related mortality ratios undertaken comparing the periods 1998-2003, 2004-9 and 2010-15...
February 8, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29416214/prevalence-of-specific-types-of-human-papiloma-virus-in-cervical-intraepithelial-lesions-and-cervical-cancer-in-macedonian-women
#19
Irena Aleksioska-Papestiev, Vesna Chibisheva, Megi Micevska, Goran Dimitrov
Introduction: Cervical cancer is a malignancy originating in the transformation zone of the cervix, most commonly in the squamous cells. It is the fourth most common cancer in women worldwide, and the third most common cause of female cancer death. Genital human papilloma viruses (HPV) are sexually transmitted and approximately 630 milion people worldwide are infected. More than 200 genotypes, subtypes and variants have been reported, 13-15 being oncogenic type, which could be responsible for cervical intraepithelial lesions (CIN) or cancer...
February 2018: Medical Archives
https://www.readbyqxmd.com/read/29408744/the-use-of-antenatal-fetal-magnetic-resonance-imaging-in-the-assessment-of-patients-at-high-risk-of-preterm-birth
#20
REVIEW
L Story, J Hutter, T Zhang, A H Shennan, M Rutherford
Preterm birth, defined as birth occurring prior to 37 weeks gestation is a common obstetric complication affecting 8% of pregnancies and is associated with significant morbidity and mortality. Infection/inflammation has been implicated in both the aetiology of preterm birth itself and associated neonatal pulmonary and neurological morbidity. Treatment options are currently limited to prolongation of the pregnancy using cervical cerclage, pessaries or progesterone or administration of drugs including steroids to promote lung maturity and neuroprotective agents such as magnesium sulphate, the timing of which are highly critical...
March 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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