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Maternal-Fetal Medicine

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https://www.readbyqxmd.com/read/29329576/spontaneous-prematurity-in-fetuses-with-congenital-diaphragmatic-hernia-a-retrospective-cohort-study-about-prenatal-predictive-factors
#1
Bruna Maria Lopes Barbosa, Agatha S Rodrigues, Mario Henrique Burlacchini Carvalho, Roberto Eduardo Bittar, Rossana Pulcineli Vieira Francisco, Lisandra Stein Bernardes
BACKGROUND: To evaluate possible predictive factors of spontaneous prematurity in fetuses with congenital diaphragmatic hernia (CDH). METHODS: A retrospective cohort study was performed. Inclusion criteria were presence of CDH; absence of fetoscopy; absence of karyotype abnormality; maximum of one major malformation associated with diaphragmatic hernia; ultrasound monitoring at the Obstetrics Clinic of Clinicas Hospital at the University of São Paulo School of Medicine, from January 2001 to October 2014...
January 12, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29324603/pregnancy-associated-hypertension-and-offspring-cardiometabolic-health
#2
Madeline Murguia Rice, Mark B Landon, Michael W Varner, Brian M Casey, Uma M Reddy, Ronald J Wapner, Dwight J Rouse, Alan T N Tita, John M Thorp, Edward K Chien, George Saade, Alan M Peaceman, Sean C Blackwell
OBJECTIVE: To evaluate whether pregnancy-associated hypertension (gestational hypertension and preeclampsia) was associated with the cardiometabolic health of young offspring. METHODS: This was a prospective observational follow-up study from 2012 to 2013 of children born to women previously enrolled in a mild gestational diabetes mellitus treatment trial or nongestational diabetes mellitus observational study. At 5-10 years after birth, children were examined and fasting blood samples obtained to determine the following cardiometabolic risk factors: blood pressure (BP), high-density lipoprotein cholesterol, triglycerides, glucose, homeostatic model assessment of insulin resistance, waist circumference, and body mass index (BMI)...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29318732/association-between-fetal-fraction-on-cell-free-dna-testing-and-first-trimester-markers-for-pre-eclampsia
#3
Daniel L Rolnik, Fabricio da Silva Costa, Timothy J Lee, Maximilian Schmid, Andrew C McLennan
AIMS: To evaluate the association of fetal fraction on cell-free DNA (cfDNA) testing with first trimester markers for pre-eclampsia and to investigate a possible association of low fetal fraction with increased risk for pre-eclampsia (PE) and fetal growth restriction (FGR). METHODS: This was a retrospective cohort study including all women with singleton pregnancies who had risk calculation for PE and FGR between 11+0 and 13+6 weeks' gestation and also decided to have cfDNA as a primary or secondary screening test for chromosomal abnormalities at any gestational age in two Fetal Medicine clinics in Sydney and Melbourne, Australia, between March 2013 and May 2017...
January 10, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29318630/conflict-of-interest-related-to-clinical-practice-is-under-reported-the-case-of-non-invasive-prenatal-testing
#4
Adam J Wolfberg
Authors of policy statements from the American College of Obstetrics and Gynecology and from the Society for Maternal-Fetal Medicine do not acknowledge the potential for their clinical income to influence their opinions, or the positions of the societies they represent. These policy statements were published in Obstetrics and Gynecology and the American Journal of Obstetrics and Gynecology, again, without acknowledgement of the potential for conflict of interest. The case of non-invasive prenatal testing, which has threatened the role of maternal-fetal medicine in the practice of prenatal screening and diagnosis, and has significantly reduced the demand for invasive prenatal diagnosis, illustrates the importance of identifying this potential conflict...
January 9, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29315690/joint-position-statement-from-the-international-society-of-prenatal-diagnosis-ispd-the-society-of-maternal-fetal-medicine-smfm-and-the-perinatal-quality-foundation-pqf-on-the-use-of-genome-wide-sequencing-for-fetal-diagnosis
#5
https://www.readbyqxmd.com/read/29315677/acog-and-smfm-guidelines-for-prenatal-diagnosis-is-karyotyping-really-sufficient
#6
Sara B Hay, Trilochan Sahoo, Mary K Travis, Karine Hovanes, Natasa Dzidic, Charles Doherty, Michelle N Strecker
OBJECTIVE: The American College of Obstetricians and Gynecologists (ACOG) and Society for Maternal-Fetal Medicine (SMFM) recommend chromosomal microarray analysis (CMA) for prenatal diagnosis in cases with one or more fetal structural abnormalities. For patients who elect prenatal diagnosis and have a structurally normal fetus, either microarray or karyotype is recommended. This study evaluates the frequency of clinically significant chromosomal abnormalities (CSCA) that would have been missed if all patients offered the choice between CMA and karyotyping chose karyotyping...
January 9, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29305293/beyond-screening-for-chromosomal-abnormalities-advances-in-non-invasive-diagnosis-of-single-gene-disorders-and-fetal-exome-sequencing
#7
REVIEW
Jane Hayward, Lyn S Chitty
Emerging genomic technologies, largely based around next generation sequencing (NGS), are offering new promise for safer prenatal genetic diagnosis. These innovative approaches will improve screening for fetal aneuploidy, allow definitive non-invasive prenatal diagnosis (NIPD) of single gene disorders at an early gestational stage without the need for invasive testing, and improve our ability to detect monogenic disorders as the aetiology of fetal abnormalities. This presents clinicians and scientists with novel challenges as well as opportunities...
January 2, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29291413/impact-of-recommended-changes-in-labor-management-for-prevention-of-the-primary-cesarean-delivery
#8
Claire Thuillier, Sophie Roy, Violaine Peyronet, Thibaud Quibel, Aurélie Nlandu, Patrick Rozenberg
BACKGROUND: The dramatic rise in cesarean delivery (CD) rates worldwide in recent decades, without evidence of a concomitant decrease in cerebral palsy rates, has raised concerns about its potential negative consequences for maternal and infant health. In 2014, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine jointly published an Obstetric Care Consensus for safe prevention of the primary cesarean delivery. OBJECTIVE: We sought to assess whether modification of our protocol to implement these recommendations helped to decrease our primary CD rate safely...
December 29, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29288642/improving-staff-communication-and-transitions-of-care-between-obstetric-triage-and-labor-and-delivery
#9
Kathleen O'Rourke, Joseph Teel, Erika Nicholls, Daniel D Lee, Alyssa Covelli Colwill, Sindhu K Srinivas
OBJECTIVE: To improve staff perception of the quality of the patient admission process from obstetric triage to the labor and delivery unit through standardization. DESIGN: Preassessment and postassessment online surveys. SETTING: A 13-bed labor and delivery unit in a quaternary care, Magnet Recognition Program, academic medical center in Pennsylvania. PARTICIPANTS: Preintervention (n = 100), postintervention (n = 52), and 6-month follow-up survey respondents (n = 75) represented secretaries, registered nurses, surgical technicians, certified nurse-midwives, nurse practitioners, maternal-fetal medicine fellows, anesthesiologists, and obstetric and family medicine attending and resident physicians from triage and labor and delivery units...
December 27, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/29274715/no-133-prevention-of-rh-alloimmunization
#10
Karen Fung Kee Fung, Erica Eason
OBJECTIVE: To provide guidelines on use of anti-D prophylaxis to optimize prevention of rhesus (Rh) alloimmunization in Canadian women. OUTCOMES: Decreased incidence of Rh alloimmunization and minimized practice variation with regards to immunoprophylaxis strategies. EVIDENCE: The Cochrane Library and MEDLINE were searched for English-language articles from 1968 to 200 I, relating to the prevention of Rh alloimmunization. Search terms included: Rho(D) immune globulin, Rh iso- or aile-immunization, anti-D, anti-Rh, WinRho, Rhogam, and pregnancy...
January 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29258478/pregnancy-prescription-medicines-and-the-potential-risk-of-herb-drug-interactions-a-cross-sectional-survey
#11
James S McLay, Naila Izzati, Abdul R Pallivalapila, Ashalatha Shetty, Binita Pande, Craig Rore, Moza Al Hail, Derek Stewart
BACKGROUND: Pregnant women are routinely prescribed medicines while self-medicating with herbal natural products to treat predominantly pregnancy related conditions. The aim of this study was to assess the potential for herb-drug interactions (HDIs) in pregnant women and to explore possible herb-drug interactions and their potential clinical significance. METHODS: A cross-sectional survey of women during early pregnancy or immediately postpartum in North-East Scotland...
December 19, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/29240547/implementing-cdc-s-level-of-care-assessment-tool-locate-a-national-collaboration-to-improve-maternal-and-child-health
#12
Andrea Catalano, Amanda Bennett, Ashley Busacker, Alethia Carr, David Goodman, Charlan Kroelinger, Ekwutosi Okoroh, Mary Brantley, Wanda Barfield
Perinatal regionalization, or risk-appropriate care, is an approach that classifies facilities based on capabilities to ensure women and infants receive care at a facility that aligns with their risk. The CDC designed the Levels of Care Assessment Tool (LOCATe) to assist jurisdictions working in risk-appropriate care in assessing a facility's level of maternal and neonatal care aligned with the most current American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine (ACOG/SMFM) and American Academy of Pediatrics (AAP) guidelines...
December 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/29215645/cherchez-la-femme-maternal-incidental-findings-can-explain-discordant-prenatal-cell-free-dna-sequencing-results
#13
REVIEW
Diana W Bianchi
Circulating DNA fragments in a pregnant woman's plasma derive from three sources: placenta, maternal bone marrow, and fetus. Prenatal sequencing to noninvasively screen for fetal chromosome abnormalities is performed on this mixed sample; results can therefore reflect the maternal as well as the fetoplacental DNA. Although it is recommended that pretest counseling include the possibility of detecting maternal genomic imbalance, this seldom occurs. Maternal abnormalities that can affect a prenatal screening test result include disorders that affect the size and metabolism of DNA, such as B12 deficiency, autoimmune disease, and intrahepatic cholestasis of pregnancy...
December 7, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29193867/improved-safety-margin-for-embryotoxicity-in-rats-for-the-new-endoperoxide-artefenomel-oz439-as-compared-to-artesunate
#14
Robert L Clark, Tammye L Edwards, Monica Longo, Joseph Kinney, Don K Walker, Jon Rhodes, Sally A Clode, Thomas Rückle, Timothy Wells, Nicole Andenmatten, Anna Christine Huber
BACKGROUND: Combination medicines including an artemisinin are the mainstay of antimalarial therapy. Artemisinins are potent embryotoxicants in animal species due to their trioxane moiety. METHODS: As part of its development, the new synthetic trioxolane antimalarial artefenomel (OZ439) was tested in rat whole embryo culture and in rat embryo-fetal toxicity studies with dosing throughout organogenesis or with a single dose on Gestational Day (GD) 12. The single-dose studies included groups treated with artesunate to allow a direct comparison of the embryotoxicity of the two antimalarials and included toxicokinetics hematology and histological examination of embryos...
November 28, 2017: Birth Defects Research
https://www.readbyqxmd.com/read/29193244/an-efficient-sequence-for-fetal-brain-imaging-at-3t-with-enhanced-t1-contrast-and-motion-robustness
#15
Giulio Ferrazzi, Anthony N Price, Rui Pedro A G Teixeira, Lucilio Cordero-Grande, Jana Hutter, Ana Gomes, Francesco Padormo, Emer Hughes, Torben Schneider, Mary Rutherford, Maria Kuklisova Murgasova, Joseph V Hajnal
PURPOSE: Ultrafast single-shot T2 -weighted images are common practice in fetal MR exams. However, there is limited experience with fetal T1 -weighted acquisitions. This study aims at establishing a robust framework that allows fetal T1 -weighted scans to be routinely acquired in utero at 3T. METHODS: A 2D gradient echo sequence with an adiabatic inversion was optimized to be robust to fetal motion and maternal breathing optimizing grey/white matter contrast at the same time...
November 28, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/29191448/adverse-perinatal-outcomes-associated-with-crown-rump-length-discrepancy-in-in%C3%A2-vitro-fertilization-pregnancies
#16
Kristy Cho, Caitlin Dunne, Arianne Y K Albert, Jon C Havelock
OBJECTIVE(S): To determine whether an association exists between small crown-rump length (CRL) and adverse obstetrical outcomes in pregnancies conceived by IVF and to compare a CRL reference based on IVF pregnancies to a reference based on spontaneous pregnancies. DESIGN: Retrospective cohort study. CRL was classified as small by comparing it with the local university hospital maternal fetal medicine standard and the Monash IVF reference chart. SETTING: University-affiliated fertility center...
November 28, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29190847/adverse-maternal-and-neonatal-outcomes-in-indicated-compared-with-spontaneous-preterm-birth-in-healthy-nulliparas-a-secondary-analysis-of-a-randomized-trial
#17
Alan T Tita, Lindsay Doherty, Jim M Roberts, Leslie Myatt, Kenneth J Leveno, Michael W Varner, Ronald J Wapner, John M Thorp, Brian M Mercer, Alan Peaceman, Susan M Ramin, Marshall W Carpenter, Jay Iams, Anthony Sciscione, Margaret Harper, Jorge E Tolosa, George R Saade, Yoram Sorokin
No abstract text is available yet for this article.
November 30, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/29183819/smfm-special-report-reducing-racial-and-ethnic-disparities-in-maternal-morbidity-and-mortality-a-call-to-action
#18
Joses A Jain, Lorene A Temming, Mary E D'Alton, Cynthia Gyamfi-Bannerman, Methodius Tuuli, Judette M Louis, Sindhu K Srinivas, Aaron B Caughey, William A Grobman, Mark Hehir, Elizabeth Howell, George R Saade, Alan T N Tita, Laura E Riley
Racial and ethnic disparities in maternal morbidity and mortality are an important public health problem in the United States. As racial and ethnic minorities are expected to comprise over one half of the U.S. population by 2050, this issue that must be urgently addressed. Research suggests that the drivers of health disparities occur at three levels: patient, provider, and system. Although we have recognized this issue and identified elements that contribute to it, knowledge must be converted into action to address it...
November 25, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29155504/cervical-funneling-or-intra-amniotic-debris-and-preterm-birth-among-nulliparous-women-with-a-midtrimester-cervical-length-less-than-30-mm
#19
George R Saade, Elizabeth A Thom, William A Grobman, Jay D Iams, Brian M Mercer, Uma M Reddy, Alan T N Tita, Dwight J Rouse, Yoram Sorokin, Ronald J Wapner, Kenneth J Leveno, Sean C Blackwell, M Sean Esplin, Jorge E Tolosa, John M Thorp, Steve N Caritis, J Peter VanDorsten
OBJECTIVE: To evaluate whether the presence of cervical funneling or intra-amniotic debris identified in the second trimester is associated with higher rates of preterm birth (PTB) in asymptomatic nulliparous women with a midtrimester cervical length (CL) less than 30 mm (i.e., less than the 10(th) percentile). METHODS: A secondary cohort analysis of a multicenter trial of women between 16 and 22 weeks with a singleton gestation and a CL less than 30 mm by transvaginal ultrasound randomized to either 17-alpha hydroxyprogesterone caproate or placebo...
November 20, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29142784/the-value-of-implementing-multidisciplinary-perinatal-care-conference-in-the-private-practice-setting
#20
Robert C Johnston, Sina Haeri, Richard T Hale, William Lindsley, Annette McCormick, Eric Su
Objective  The objective of this study was to estimate the impact of multidisciplinary (Multi-D) perinatal care conference (PCC) implementation in the private practice setting. Methods  After the initial 12-month period following implementation of the monthly PCC by private maternal-fetal medicine and neonatology practitioners, conference attendees were asked to completed a modified version of the Attitudes Toward Health Care Teams Scale, involving 19 questions assessing their attitudes and opinions toward Multi-D team care on a five-point Likert's scale...
October 2017: American Journal of Perinatology Reports
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