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High risk obstetrics

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https://www.readbyqxmd.com/read/28326963/the-stillbirth-classification-system-for-the-safe-passage-study
#1
Theonia K Boyd, Colleen A Wright, Hein J Odendaal, Amy J Elliott, Mary Ann Sens, Rebecca D Folkerth, Drucilla J Roberts, Hannah C Kinney
Objective Describe the classification system for assigning the cause of stillbirth in the Safe Passage Study, an international, multi-institutional, prospective analysis conducted by the NIAAA/NICHD-funded Prenatal Alcohol in SIDS and Stillbirth (PASS) Research Network. The study mission is to determine the role of prenatal alcohol and/or cigarette smoke exposure in adverse pregnancy outcomes, including stillbirth, in a high-risk cohort of 12,000 maternal/fetal dyads. Methods The PASS Network classification system is based upon 5 "sites of origin" for cause of stillbirth, further subdivided into mechanism subcategories; both are employed to assign an ultimate cause of death...
March 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/28326464/meningiomas-in-pregnancy-timing-of-surgery-and-clinical-outcomes-as-observed-in-104-cases-and-establishment-of-a-best-management-strategy
#2
REVIEW
Yosef Laviv, Ahmed Bayoumi, Anand Mahadevan, Brett Young, Myles Boone, Ekkehard M Kasper
BACKGROUND: There is a strong correlation between the level of circulating female sex hormones and the parturient growth of meningiomas. As a result, rapid changes in meningioma size occur during pregnancy, putting both the mother and fetus at risk. Large, symptomatic meningiomas require surgical resection, regardless of the status of pregnancy. However, the preferred timing of such complex intervention is a matter of debate. The rarity of this clinical scenario and the absence of prospective trials make it difficult to reach evidence-based conclusions...
March 22, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28325856/prevalence-of-undiagnosed-asymptomatic-bacteriuria-and-associated-risk-factors-during-pregnancy-a-cross-sectional-study-at-two-tertiary-centres-in-cairo-egypt
#3
Mohamed Abdel-Aziz Elzayat, Ashton Barnett-Vanes, Mohamed Farag Elmorsy Dabour, Feng Cheng
BACKGROUND: The prevalence of asymptomatic bacteriuria (ASB) during pregnancy is poorly understood in Egypt-a country with a high birth rate. OBJECTIVES: To determine the prevalence of ASB among pregnant women booking at El Hussein and Sayed Galal Hospitals in Al-Azhar University in Egypt; and to observe the relationship between ASB prevalence and risk factors such as socioeconomic level and personal hygiene. SETTING: Obstetrics and gynaecology clinics of 2 university hospitals in the capital of Egypt...
March 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28321847/antenatal-corticosteroids-for-accelerating-fetal-lung-maturation-for-women-at-risk-of-preterm-birth
#4
REVIEW
Devender Roberts, Julie Brown, Nancy Medley, Stuart R Dalziel
BACKGROUND: Respiratory morbidity including respiratory distress syndrome (RDS) is a serious complication of preterm birth and the primary cause of early neonatal mortality and disability. While researching the effects of the steroid dexamethasone on premature parturition in fetal sheep in 1969, Liggins found that there was some inflation of the lungs of lambs born at gestations at which the lungs would be expected to be airless. Liggins and Howie published the first randomised controlled trial in humans in 1972 and many others followed...
March 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28321491/adverse-pregnancy-outcomes-in-healthcare-workers-a-korean-nationwide-population-based-study
#5
Chulyong Park, Mo-Yeol Kang, Dohyung Kim, Jaechan Park, Huisu Eom, Eun-A Kim
PURPOSE: To assess female healthcare workers' pregnancy complications and outcomes including abortion, fetal screening abnormalities, intrauterine growth retardation (IUGR), and preterm labor using nationwide population data and compare these results with those of the general population in Korea. METHODS: Korean National Health Insurance (NHI) claim data was used. We choose 3 different reference groups for comparison: (1) dependents of employees insured by NHI, i...
March 20, 2017: International Archives of Occupational and Environmental Health
https://www.readbyqxmd.com/read/28316278/high-risk-obstetrical-call-center-a-model-for-regions-with-limited-access-to-care
#6
Sarah J Rhoads, Hari Eswaran, Christian E Lynch, Songthip T Ounpraseuth, Everett F Magann, Curtis L Lowery
PURPOSE: High-risk obstetrical care can be challenging for women in rural states with limited access. MATERIALS AND METHODS: Data were evaluated from 62,342 obstetrical calls from pregnant and postpartum patients within rural Arkansas to a nurse call center. Call center nurses provided triage using evidence-based guidelines to patients across the state. Data were extracted and analyzed using retrospective data collection and descriptive statistical methods. RESULTS: Women had an average maternal age of 28 years old, average weeks gestation was 27...
March 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28306682/training-future-anesthesiologists-in-obstetric-care
#7
Mauricio Vasco Ramírez
PURPOSE OF REVIEW: In order for the obstetric anesthesiologist to become a true perioperative / peripartum physician, a change in formative programs and certification process in anesthesia are needed. RECENT FINDINGS: Anesthesia training programs are migrating to competency based medical education (CBME) worldwide. The traditional model of attending lectures, grand rounds, reading textbooks and journal papers should be complemented by virtual modalities such as massive open online courses or online teaching tools...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28303822/human-papillomavirus-and-chlamydia-trachomatis-infection-in-gyneco-obstetric-outpatients-from-a-mexican-hospital
#8
Laura Conde-Ferráez, Jorge Ramiro Carrillo Martíez, Guadalupe Ayora-Talavera, María Del Refugio González Losa
CONTEXT: Human papillomavirus (HPV) and Chlamydia trachomatis are the most frequent sexually transmitted infections, usually asymptomatic. Persistent infection with high-risk HPV types and other cofactors such as the concomitant infection with C. trachomatis can represent a higher risk to develop cervical lesions; therefore, screening with sensitive methods could aid to identify women at risk. AIMS: The aim is to determine the prevalence and concurrence of both infections, detected with in-house molecular methods, and to identify the risk factors associated to the infections in Mexican women...
January 2017: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28297592/a-systematized-review-of-atypical-antipsychotics-in-pregnant-women-balancing-between-risks-of-untreated-illness-and-risks-of-drug-related-adverse-effects
#9
Sarah Tosato, Umberto Albert, Simona Tomassi, Felice Iasevoli, Claudia Carmassi, Silvia Ferrari, Maria Giulia Nanni, Alessandra Nivoli, Umberto Volpe, Anna Rita Atti, Andrea Fiorillo
OBJECTIVE: To summarize risks related to (1) illness and (2) second-generation antipsychotic (SGA) treatment in pregnant women and their offspring. Concerning illness-related risks, we focused on bipolar disorder and schizophrenia, psychiatric disorders for which SGAs are preferentially prescribed. DATA SOURCES: PubMed, Ovid, Scopus, PsycINFO, and Cochrane Library were searched from the date of the first available article to October 2015 using the following key terms: pregnancy OR gestation OR bipolar disorder OR schizophrenia...
March 14, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28294527/peripartum-type-b-aortic-dissection-in-patients-with-marfan-syndrome-who-underwent-aortic-root-replacement-a-case-series-study
#10
Seisuke Sayama, Norifumi Takeda, Takayuki Iriyama, Ryo Inuzuka, Sonoko Maemura, Daishi Fujita, Haruo Yamauchi, Kan Nawata, Masahiko Bougaki, Hironobu Hyodo, Rieko Shitara, Toshio Nakayama, Atsushi Komatsu, Takeshi Nagamatsu, Yutaka Osuga, Tomoyuki Fujii
OBJECTIVE: To investigate pregnancy outcomes, especially the risk of pregnancy-related aortic dissection (AD), in patients with Marfan syndrome (MFS) after prophylactic aortic root replacement (ARR). DESIGN: Retrospective case series study. SETTING: Tertiary perinatal care center at a university hospital. POPULATION: Pregnant women fulfilling the revised Ghent nosology (2010) criteria for MFS that were managed at our institute...
March 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28291236/acute-fatty-liver-disease-of-pregnancy-updates-in-pathogenesis-diagnosis-and-management
#11
REVIEW
Joy Liu, Tara T Ghaziani, Jacqueline L Wolf
Acute fatty liver of pregnancy (AFLP) is an obstetric emergency characterized by maternal liver failure and may have complications for the mother and fetus, including death. This review examines recent literature on the epidemiology, pathogenesis, diagnosis, and treatment of acute fatty liver of pregnancy. Pathogenesis of this disease has been linked to defects in fatty acid metabolism during pregnancy, especially in the setting of fetal genetic defects in fatty acid oxidation. The value of screening all patients for these genetic defects remains to be determined...
March 14, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28286001/understanding-high-utilization-of-unscheduled-care-in-pregnant-women-of-low-socioeconomic-status
#12
Pooja K Mehta, Tamala Carter, Cjloe Vinoya, Shreya Kangovi, Sindhu K Srinivas
BACKGROUND: Pregnant high utilizers of unscheduled care may be at particular risk for poor perinatal outcomes, but the drivers of this association have not been explored from the patient perspective. PURPOSE: We sought to understand maternal preference for unscheduled hospital-based obstetric care to inform interventions and improve value of publicly funded care during pregnancy. METHODS: We conducted a comparative qualitative analysis of in-depth semistructured interviews...
March 9, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28284877/midwifery-continuity-of-carer-in-an-area-of-high-socio-economic-disadvantage-in-london-a-retrospective-analysis-of-albany-midwifery-practice-outcomes-using-routine-data-1997-2009
#13
Caroline Se Homer, Nicky Leap, Nadine Edwards, Jane Sandall
OBJECTIVE: in 1997, The Albany Midwifery Practice was established within King's College Hospital NHS Trust in a South East London area of high social disadvantage. The Albany midwives provided continuity of care to around 216 women per year, including those with obstetric, medical or social risk factors. In 2009, the Albany Midwifery Practice was closed in response to concerns about safety, amidst much publicity and controversy. The aim of this evaluation was to examine trends and outcomes for all mothers and babies who received care from the practice from 1997-2009...
February 27, 2017: Midwifery
https://www.readbyqxmd.com/read/28277908/antenatal-depression-among-women-hospitalized-due-to-threatened-preterm-labor-in-a-high-risk-pregnancy-unit-in-greece
#14
Themistoklis Dagklis, Ioannis Tsakiridis, Foteini Chouliara, Apostolos Mamopoulos, David Rousso, Apostolos Athanasiadis, Georgios Papazisis
PURPOSE: Estimates for the prevalence of antenatal depression vary widely across different studies and especially concerning high-risk pregnancies. Threatened preterm labor is the most common indication for antenatal obstetric hospitalization. The aim of this study was to screen for depressive symptoms among pregnant women hospitalized in a high-risk pregnancy unit due to threatened preterm labor and also to investigate possible associated risk factors. MATERIALS AND METHODS: 103 pregnant women admitted at > 24 and <36 gestational weeks were eligible to participate in the study...
March 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28277383/the-use-of-vasopressors-during-spinal-anaesthesia-for-caesarean-section
#15
Warwick D Ngan Kee
PURPOSE OF REVIEW: Hypotension remains one of the most researched subjects in obstetric anaesthesia. The purpose of this study is to review the most recent published articles on the use of vasopressors during spinal anaesthesia for caesarean section. RECENT FINDINGS: Despite continued research indicating advantages of phenylephrine over ephedrine, practitioners in some countries continue to favour ephedrine. Recent research has continued to compare the two drugs with some work emerging on high-risk patients...
March 8, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28277357/in-pursuit-of-progress-toward-effective-preterm-birth-reduction
#16
James N Martin, Mary DʼAlton, Bo Jacobsson, Jane E Norman
Recently the March of Dimes and the International Federation of Gynecology and Obstetrics Working Group on Preterm Birth released its findings from an extensive cross-country individual patient data analysis of 4.1 million singleton births in five high-income, very high human development index countries. The specific contributions of 21 risk factors for both spontaneous and health care provider-initiated preterm birth were assessed to better understand how these vary among the countries selected for intensive study...
March 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28277324/risk-factors-for-severe-postpartum-hemorrhage-after-cesarean-delivery-case-control-studies
#17
Alexander J Butwick, Bharathi Ramachandran, Priya Hegde, Edward T Riley, Yasser Y El-Sayed, Lorene M Nelson
BACKGROUND: Women who undergo intrapartum caesarean delivery (CD) are at increased risk of postpartum hemorrhage (PPH) compared with those undergoing prelabor CD. To determine whether the presence and strength of the associations between individual risk factors and severe PPH vary among women undergoing prelabor CD or intrapartum CD, stratified analyses are needed according to CD subtype. METHODS: To identify risk factors for severe PPH within 2 distinct CD populations, prelabor CD and intrapartum CD, we performed 2 case-control studies...
March 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28268196/prenatal-ultrasound-diagnosis-and-outcome-of-placenta-previa-accreta-after-caesarean-delivery-a-systematic-review-and-meta-analysis
#18
REVIEW
Eric Jauniaux, Amar Bhide
BACKGROUND: Women with a history of previous caesarean delivery, presenting with a placenta previa have become the largest group with the highest risk for placenta previa accreta. OBJECTIVE: To evaluate the accuracy of ultrasound imaging in the prenatal diagnosis of placenta accreta and the impact of the depth of villous invasion on management in women presenting with placenta previa or low-lying placenta and with one or more prior caesarean deliveries. STUDY DESIGN: Data sources: We searched PubMed, Google Scholar, clinicalTrials...
March 4, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28268060/irresponsible-and-responsible-resource-management-in-obstetrics
#19
REVIEW
Birgit Arabin
Low budgets constrain and high budgets stimulate choices. In high-income countries, this economic reality may lead to overuse of healthcare services and pose unnecessary risks for mothers and infants. Options for improvement can be created at different levels of healthcare systems. Pregnancy provides an effective opportunity to profile maternal risks and represents a vulnerable but potentially modifiable period from prenatal life to adulthood. In response to system-inherent false incentives, professional responsibility requires obstetricians to strive to improve the future health of families and their offspring despite disincentives for doing so...
January 25, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28264621/high-risk-and-low-risk-human-papilloma-virus-in-association-to-spontaneous-preterm-labor-a-case-control-study-in-a-tertiary-center-egypt
#20
Alaa Mosbah, Rafik Barakat, Yasmin Nabiel, Ghada Barakat
INTRODUCTION: This study aimed to detect the correlation between human papillomavirus (HPV) and spontaneous preterm labor in Egyptian women and its association to the human papilloma viral load and MPP2 gene expression. MATERIAL AND METHODS: We performed an observational comparative case-control study in Department of Obstetric and Gynecology, Mansoura University Hospitals over women presented with spontaneous preterm labor, besides females admitted for giving birth at full term to detect conserved sequence in HPV-L1 gene (GP5/GP6) followed by genotype detection of high- and low-risk HPVs with quantification of the viral load and the MMP2 gene expression using real-time polymerase chain reaction (PCR)...
March 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
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