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High risk obstetrics

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https://www.readbyqxmd.com/read/28722565/high-iron-levels-are-associated-with-increased-malaria-risk-in-infants-during-the-first-year-of-life-in-benin
#1
Violeta Moya-Alvarez, Gilles Cottrell, Smaila Ouédraogo, Manfred Accrombessi, Achille Massougbodgi, Michel Cot
The World Health Organization (WHO) estimates that 40% of children in low-income countries are anemic. Therefore, iron supplements are recommended by WHO in areas with high anemia rates. However, some studies have set into question the benefits of iron supplementation in malaria-endemic regions. In Benin, a west African country with high prevalence of anemia and malaria, no iron supplements are given systematically to infants so far despite the WHO recommendations. In this context, we wanted to investigate the effect of iron levels during the first year of life on malarial risk in Benin considering complementary risk factors...
June 19, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28721634/minimally-invasive-abdominal-cerclage-compared-to-laparotomy-a-comparison-of-surgical-and-obstetric-outcomes
#2
Soorin Kim, Amanda Hill, Gulden Menderes, Sarah Cross, Masoud Azodi, Mert Ozan Bahtiyar
The objective of this study is to report surgical and obstetric outcomes of patients following abdominal cerclage placement through either minimally invasive or open techniques. Subjects of this retrospective cohort study were patients at two referral centers specializing in high-risk pregnancy and minimally invasive gynecologic surgery. Electronic medical records of all patients who underwent abdominal cerclage placement between December 2011 and December 2015 at Yale New Haven Hospital and Bridgeport Hospital were reviewed...
July 18, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28718408/a-common-clinical-dilemma-management-of-persistent-hrhpv-infection
#3
Yifan Meng, Ding Ma, Peng Wu
Persistent infection with high-risk human papillomavirus (hrHPV) is a key step in the development of cervical cancer. However, making clinical decisions about how to deal with these cases has become a challenge for obstetrics and gynecology (Ob/Gyn) practitioners. Here, we review the latest research findings and propose possible solutions for the management of persistent hrHPV infections.
May 2017: Trends in Cancer
https://www.readbyqxmd.com/read/28717722/gestational-trophoblastic-neoplasia-treatment-at-the-butaro-cancer-center-of-excellence-in-rwanda
#4
Ignace Nzayisenga, Roanne Segal, Natalie Pritchett, Mary J Xu, Paul H Park, Edgie V Mpanumusingo, Denis G Umuhizi, Donald P Goldstein, Ross S Berkowitz, Vedaste Hategekimana, Clemence Muhayimana, Fidel Rubagumya, Temidayo Fadelu, Neo Tapela, Tharcisse Mpunga, Rahel G Ghebre
PURPOSE: Gestational trophoblastic neoplasia (GTN) is a highly treatable disease, most often affecting young women of childbearing age. This study reviewed patients managed for GTN at the Butaro Cancer Center of Excellence (BCCOE) in Rwanda to determine initial program outcomes. PATIENTS AND METHODS: A retrospective medical record review was performed for 35 patients with GTN assessed or treated between May 1, 2012, and November 30, 2014. Stage, risk score, and low or high GTN risk category were based on International Federation of Gynecology and Obstetrics staging and the WHO scoring system and determined by beta human chorionic gonadotropin level, chest x-ray, and ultrasound per protocol guidelines for resource-limited settings...
December 2016: Journal of Global Oncology
https://www.readbyqxmd.com/read/28716434/training-midwives-to-perform-basic-obstetric-point-of-care-ultrasound-in-rural-areas-using-a-tablet-platform-and-mobile-phone-transmission-technology-a-wfumb-coe-project
#5
Sudhir Vinayak, Joyce Sande, Harvey Nisenbaum, Christian Pállson Nolsøe
Point-of-care ultrasound (POCUS) has become a topical subject and can be applied in a variety of ways with differing outcomes. The cost of all diagnostic procedures including obstetric ultrasound examinations is a major factor in the developing world and POCUS is only useful if it can be equated to good outcomes at a lower cost than a routine obstetric examination. The aim of this study was to assess a number of processes including accuracy of images and reports generated by midwives, performance of a tablet-sized ultrasound scanner, training of midwives to complete ultrasounds, teleradiology solution transmissions of images via internet, review of images by a radiologist, communication between midwife and radiologist, use of this technique to identify high-risk patients and improvement of the education and teleradiology model components...
July 14, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28715784/elemental-content-of-the-placenta-a-comparison-between-two-high-risk-obstetrical-populations-adult-women-carrying-multiples-and-adolescents-carrying-singletons
#6
Paolo de Angelis, Richard K Miller, Thomas H Darrah, Philip J Katzman, Eva K Pressman, Tera R Kent, Kimberly O O'Brien
BACKGROUND: The placenta is responsible for the exchange of nutrients and for preventing harmful compounds from entering the fetal circulation. With increasing industrialization, exposures to commercial and toxic metals become a concern for both pregnant women and those planning a pregnancy. The understanding of transport mechanisms and pharmacokinetics for most inorganic elements is incomplete and limited to normal term deliveries. OBJECTIVES: To obtain novel data on 46 inorganic elements in placentae from two high-risk obstetric populations, women carrying multiples and adolescents carrying singletons, evaluating differences, if present, and identifying predictors of placental content...
July 14, 2017: Environmental Research
https://www.readbyqxmd.com/read/28715339/development-of-a-low-cost-medical-ultrasound-scanner-using-a-monostatic-synthetic-aperture
#7
Thomas L A van den Heuvel, David J Graham, Kristopher J Smith, Chris L de Korte, Jeffrey A Neasham
OBJECTIVE: In this paper, we present the design of low-cost medical ultrasound scanners aimed at the detection of maternal mortality risk factors in developing countries. METHOD: Modern ultrasound scanners typically employ a high element count transducer array with multichannel transmit and receive electronics. To minimize hardware costs, we employ a single piezoelectric element, mechanically swept across the target scene, and a highly cost-engineered single channel acquisition circuit...
July 17, 2017: IEEE Transactions on Biomedical Circuits and Systems
https://www.readbyqxmd.com/read/28713513/the-prevalence-and-risk-factors-of-group-b-streptococcus-colonization-in-iranian-pregnant-women
#8
Roksana Darabi, Sima Tadi, Mitra Mohit, Erfan Sadeghi, Gita Hatamizadeh, Bahareh Kardeh, Mina Etminan-Bakhsh, Yekta Parsa
BACKGROUND: Group B Streptococcus (GBS) is a leading cause of serious neonatal infections. Although great progress has been made in preventing prenatal GBS, its colonization rate in different regions of Iran remains unknown. AIM: To determine GBS colonization prevalence and its risk factors among Iranian pregnant women. METHODS: This prospective cross-sectional study was performed on 186 pregnant women, who attended Boo-Ali hospital which is affiliated with Islamic Azad University in Tehran, Iran, from March 2014 to June 2015...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28711396/social-adversity-in-pregnancy-and-trajectories-of-women-s-depressive-symptoms-a-longitudinal-study
#9
Ann M Kingsbury, Maria Plotnikova, Alexandra Clavarino, Abullah Mamun, Jake M Najman
BACKGROUND: Sound evidence has linked the experience of adversity with depression. Less is known about this association over time. AIM: The aim of this study is to determine whether or not social adversity experienced by pregnant women is associated with their patterns of depressive symptoms over their reproductive life course. METHODS: Data were obtained from a cohort of women collected at their first obstetrical clinic visit of an index pregnancy (time-point 1) and at a further six time-points to 27 years following the birth...
July 12, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/28708899/the-cost-effectiveness-of-a-quality-improvement-program-to-reduce-maternal-and-fetal-mortality-in-a-regional-referral-hospital-in-accra-ghana
#10
David M Goodman, Rohit Ramaswamy, Marc Jeuland, Emmanuel K Srofenyoh, Cyril M Engmann, Adeyemi J Olufolabi, Medge D Owen
OBJECTIVE: To evaluate the cost-effectiveness of a quality improvement intervention aimed at reducing maternal and fetal mortality in Accra, Ghana. DESIGN: Quasi-experimental, time-sequence intervention, retrospective cost-effectiveness analysis. METHODS: Data were collected on the cost and outcomes of a 5-year Kybele-Ghana Health Service Quality Improvement (QI) intervention conducted at Ridge Regional Hospital, a tertiary referral center in Accra, Ghana, focused on systems, personnel, and communication...
2017: PloS One
https://www.readbyqxmd.com/read/28700425/ultrastaging-of-sentinel-lymph-nodes-in-endometrial-carcinoma-according-to-use-of-2-different-methods
#11
Elizabeth Euscher, Dawen Sui, Pamela Soliman, Shannon Westin, Preetha Ramalingam, Roland Bassett, Anais Malpica
Sentinel lymph node (SLN) sampling may provide staging information without exposing patients to risks of lymph node dissection. There is no consensus protocol for optimal pathologic handling of these specimens. This study compares 2 ultrastaging protocols of SLN in endometrial carcinoma (EC). All SLN were serially sectioned perpendicular to the long axis in 2 mm intervals and entirely submitted for routine hematoxylin and eosin (H&E) processing. SLN negative by routine processing had ultrastaging (US) by one of the following: method 1 (M1), 5 H&E levels at 250 μm intervals with 2 unstained slides at each level; pankeratin immunohistochemistry (IHC) performed on level 1 in cases with negative H&E levels or method 2 (M2), 1 H&E level + 2 unstained slides cut 250 μm into the tissue block; pankeratin IHC performed in cases with negative H&E...
July 11, 2017: International Journal of Gynecological Pathology
https://www.readbyqxmd.com/read/28700029/ethos-and-pathos-in-the-delivery-room
#12
Virgínia Junqueira Oliveira, Claudia Maria de Mattos Penna
Objective: To understand the ethos and pathos in the discourses of pregnant women and healthcare professionals in the context of the delivery room. Method: This is a qualitative and interpretative study. The research approach was discourse analysis. The study participants were 36 women and 24 health workers from seven maternity hospitals in midwestern Minas Gerais, Brazil. Results: The discourses indicate the notion the women have of childbirth, centered in the eyes of others and in their representations...
July 6, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28699385/intravaginal-practices-among-young-hiv-infected-women-in-lusaka-zambia
#13
Maureen Chisembele, Violeta J Rodriguez, Megan R Brown, Deborah L Jones, Maria L Alcaide
Intravaginal practices (IVP) are linked to bacterial vaginosis (BV), obstetric/gynecological complications, and HIV. Late adolescent and young adult (LAYA) women in Zambia have high rates of HIV. Adult and mature (AM) HIV-infected women in Zambia engage in IVP for hygiene, health, and sexuality reasons; however, to our knowledge, IVP use among LAYA women has not been examined. This study compares IVP use between LAYA and AM women to identify age-specific factors to target when developing IVP reduction interventions for LAYA women...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28698073/does-a-body-mass-index-greater-than-25kg-m-2-increase-maternal-and-neonatal-morbidity-a-french-historical-cohort-study
#14
Philippe Deruelle, Elie Servan-Schreiber, Olivier Riviere, Charles Garabedian, Françoise Vendittelli
OBJECTIVES: To evaluate, in a French multicenter cohort, the risk of C-section based on a high pre-pregnancy body mass index (BMI). Secondary objectives were to assess the risk of elective C-section, severe post-partum hemorrhage (> 1 L), severe perineal tears (3(rd) and 4(th) degree) and neonatal complications according to pre-pregnancy BMI. STUDY DESIGN: This historical cohort study analyzed records from the French AUDIPOG perinatal database. Inclusion criteria were deliveries ≥ 22 weeks (or with a birth weight ≥ 500g)...
July 8, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28693518/the-third-delay-understanding-waiting-time-for-obstetric-referrals-at-a-large-regional-hospital-in-ghana
#15
David M Goodman, Emmanuel K Srofenyoh, Adeyemi J Olufolabi, Sung Min Kim, Medge D Owen
BACKGROUND: Delay in receiving care significantly contributes to maternal morbidity and mortality. Much has been studied about reducing delays prior to arrival to referral facilities, but the delays incurred upon arrival to the hospital have not been described in many low- and middle-income countries. METHODS: We report on the obstetric referral process at Ridge Regional Hospital, Accra, Ghana, the largest referral hospital in the Ghana Health System. This study uses data from a prospectively-collected cohort of 1082 women presenting with pregnancy complications over a 10-week period...
July 11, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28689208/staging-with-unilateral-salpingo-oophorectomy-and-expert-pathological-review-result-in-no-recurrences-in-a-series-of-81-intestinal-type-mucinous-borderline-ovarian-tumors
#16
Kobe Dewilde, Philippe Moerman, Karin Leunen, Frederic Amant, Patrick Neven, Ignace Vergote
OBJECTIVE: Recent studies suggest that mucinous borderline ovarian tumors (MBOTs) belong to a high-risk group that is more likely to develop an invasive recurrence. The objective is to determine these risk factors. METHODS: A monocentric retrospective review of all consecutive patients with intestinal-type MBOT diagnosed between 1993 and 2013. All tumors were evaluated by one pathologist without knowledge of clinical outcome. Extensive surgical staging and pathological tumor sampling (1 block/cm diameter in tumors <10 cm and 2 blocks/cm diameter in tumors >10 cm) were performed in all cases...
July 8, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28689083/management-of-hereditary-antithrombin-deficiency-in-pregnancy
#17
Andra H James, Shannon M Bates, Kenneth A Bauer, Ware Branch, Kenneth Mann, Michael Paidas, Neil Silverman, Barbara A Konkle
Antithrombin (AT) deficiency is a high-risk thrombophilia and a rare condition. Despite full anticoagulation during pregnancy and the postpartum period, women with AT deficiency may still be vulnerable to developing venous thromboembolism (VTE), including fatal events. There is limited guidance on the management of AT deficiency in pregnancy, including the role of AT concentrates. Following a comprehensive review of the state of the art with respect to recommendations and guidelines, our expert panel in maternal-fetal medicine, hematology and basic science reached consensus on key issues in the recognition and management of AT deficiency in pregnancy...
May 24, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28681178/heart-disease-and-pregnancy
#18
REVIEW
Reza Ashrafi, Stephanie L Curtis
Cardiac disease remains a major cause of morbidity and mortality in pregnant and post-partum women, although progress has been made, with specialist joint obstetric-cardiology clinics providing an integrated, safe and personalised service to these women. As a result, fewer non-specialist cardiologists are managing women in pregnancy with cardiovascular disease. The aim of this review is to provide a brief overview of current knowledge and practice in the field, with an emphasis on the major physiological changes which occur during pregnancy, focussing on progress through the trimesters, clinical assessment in pregnancy, management of delivery (concentrating on managed vaginal delivery), drug treatment, key conditions and risk assessment...
July 5, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28671322/factors-related-to-retinal-haemorrhage-in-infants-born-at-high-risk
#19
Qinglan Pu, Ping Li, Huiqin Jiang, Hong Wang, Qiaoyun Zhou, Jia Liu, Wenhua Zhong, Huafei Huang
PURPOSE: This study aims to determine risk factors for retinal haemorrhage (RH) in high-risk infants. METHODS: A total of 3123 cases with high-risk pregnancy and/or neonatal asphyxia 72 hr after delivery were enrolled into this study. Fundus examinations were performed on newborns utilizing a wide-angle imaging system (RetCam III). Retinal haemorrhage (RH) was classified into three grades. Maternal, obstetric and neonatal parameters from high-risk infants with RH were compared with parameters from infants without RH...
July 3, 2017: Acta Ophthalmologica
https://www.readbyqxmd.com/read/28662632/timing-of-delivery-in-a-high-risk-obstetric-population-a-clinical-prediction-model
#20
Dane A De Silva, Sarka Lisonkova, Peter von Dadelszen, Anne R Synnes, Laura A Magee
BACKGROUND: The efficacy of antenatal corticosteroid treatment for women with threatened preterm birth depends on timely administration within 7 days before delivery. We modelled the probability of delivery within 7 days of admission to hospital among women presenting with threatened preterm birth, using routinely collected clinical characteristics. METHODS: Data from the Canadian Perinatal Network (CPN) were used, 2005-11, including women admitted to hospital with preterm labour, preterm pre-labour rupture of membranes, short cervix without contractions, or dilated cervix or prolapsed membranes without contractions at preterm gestation...
June 29, 2017: BMC Pregnancy and Childbirth
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