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Maternal-Fetal Medicine

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https://www.readbyqxmd.com/read/28629273/the-association-between-maternal-race-and-adverse-outcomes-in-twin-pregnancies-with-similar-healthcare-access
#1
Marti D Soffer, Mariam Naqvi, Stephanie Melka, Aren Gottlieb, Julie Romero, Nathan S Fox
OBJECTIVE: To compare twin pregnancy outcomes between white and nonwhite women with similar access to healthcare. METHODS: Retrospective cohort study of all twin pregnancies delivered by a single maternal-fetal medicine practice from 2005-2016. All patients had private health insurance and equal access to physician care. Outcomes were compared between white and nonwhite women using logistic regression to adjust for differences at baseline. RESULTS: Of the 858 women included, 730 (85...
June 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28629247/obstetric-practice-patterns-in-pregnancies-complicated-by-fetal-trisomy-13-or-18
#2
Sarah K Dotters-Katz, Marcela C Smid, Cora Mcelwain, Jeffrey A Kuller, Jay Schulkin
PURPOSE: Describe practice patterns among obstetrician/gynecologists (OB/GYNs) when caring for women with pregnancy complicated by fetal trisomy 13(T13) or 18(T18), and compare these between maternal-fetal-medicine (MFM) and non-MFM providers. MATERIALS AND METHODS: We conducted an electronic survey using the American College of Obstetricians and Gynecologists database. Using simple statistics, we describe demographics and practice patterns among respondents, and compare those of MFM practitioners with non-MFM providers...
June 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28620542/preconception-consultations-with-maternal-fetal-medicine-for-obese-women-a-retrospective-chart-review
#3
Charlotte M Page, Elizabeth S Ginsburg, Randi H Goldman, Chloe A Zera
BACKGROUND: Obesity is associated with impaired fertility and pregnancy complications, and preconception weight loss may improve some of these outcomes. The purpose of this study was to evaluate the quality and effectiveness of Maternal Fetal Medicine (MFM) preconception consults for obese women. METHODS: We performed a retrospective chart review examining 162 consults at an academic medical center from 2008 to 2014. The main outcome measures included consultation content - e...
2017: Fertility Research and Practice
https://www.readbyqxmd.com/read/28617430/physician-views-regarding-the-benefits-and-burdens-of-prenatal-surgery-for-myelomeningocele
#4
R M Antiel, C A Collura, A W Flake, M P Johnson, N E Rintoul, J D Lantos, F A Curlin, J C Tilburt, S D Brown, C Feudtner
OBJECTIVE: Examine how pediatric and obstetrical subspecialists view benefits and burdens of prenatal myelomeningocele (MMC) closure. STUDY DESIGN: Mail survey of 1200 neonatologists, pediatric surgeons and maternal-fetal medicine specialists (MFMs). RESULTS: Of 1176 eligible physicians, 670 (57%) responded. Most respondents disagreed (68%, 11% strongly) that open fetal surgery places an unacceptable burden on women and their families. Most agreed (65%, 10% strongly) that denying the benefits of open maternal-fetal surgery is unfair to the future child...
June 15, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28612629/uterine-artery-pulsatility-index-in-the-first-trimester-assessment-of-inter-sonographer-and-inter-sampling-site-measurement-differences
#5
Piya Chaemsaithong, Yuen Ha Ting, Kwun Yue Yvonne Cheng, Chiu Yee Liona Poon, Tak Yeung Leung, Daljit Singh Sahota
OBJECTIVE: To determine inter-sonographer, intersampling site pulsatility index differences in the ascending branch of the uterine artery (UtA-PI) and their effect on detection rates (DR) for early onset preeclampsia (PE). METHODS: A prospective observational study was conducted including 52 women with singleton viable pregnancy at 11-13 weeks' gestation. Consecutive bilateral UtA-PI measurements were performed by two sonographers. Both sonographers hold the Fetal Medicine Foundation (FMF) uterine artery Doppler assessment competency certificates...
June 14, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28601764/maternal-perchlorate-exposure-in-pregnancy-and-altered-birth-outcomes
#6
Rainbow Rubin, Michelle Pearl, Martin Kharrazi, Benjamin C Blount, Mark D Miller, Elizabeth N Pearce, Liza Valentin-Blasini, Gerald DeLorenze, Jane Liaw, Andrew N Hoofnagle, Craig Steinmaus
BACKGROUND: At high medicinal doses perchlorate is known to decrease the production of thyroid hormone, a critical factor for fetal development. In a large and uniquely exposed cohort of pregnant women, we recently identified associations between environmental perchlorate exposures and decreased maternal thyroid hormone during pregnancy. Here, we investigate whether perchlorate might be associated with birthweight or preterm birth in the offspring of these women. METHODS: Maternal urinary perchlorate, serum thyroid hormone concentrations, birthweight, gestational age, and urinary nitrate, thiocyanate, and iodide were collected in 1957 mother-infant pairs from San Diego County during 2000-2003, a period when the county's water supply was contaminated with perchlorate...
June 8, 2017: Environmental Research
https://www.readbyqxmd.com/read/28599894/impact-of-aspirin-on-fetal-growth-in-diabetic-pregnancies-according-to-white-classification
#7
Katlynn Adkins, Amanda A Allshouse, Torri D Metz, Kent D Heyborne
OBJECTIVE: Current United States Preventative Services Task Force and other guidelines recommend low-dose aspirin for all pregnant women with pre-gestational diabetes mellitus to prevent preeclampsia and small for gestational age birth. The Maternal-Fetal Medicine Units High-Risk Aspirin trial did not show a reduction in either preeclampsia or small for gestational age birth in diabetic women. Our objective was to reassess the impact of aspirin on fetal growth in diabetic pregnancies overall and according to White classification...
June 6, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28594753/opioid-use-in-pregnancy-neonatal-abstinence-syndrome-and-childhood-outcomes-executive-summary-of-a-joint-workshop-by-the-eunice-kennedy-shriver-national-institute-of-child-health-and-human-development-american-college-of-obstetricians-and-gynecologists-american
#8
Uma M Reddy, Jonathan M Davis, Zhaoxia Ren, Michael F Greene
In April 2016, the Eunice Kennedy Shriver National Institute of Child Health and Human Development invited experts to a workshop to address numerous knowledge gaps and to review the evidence for the screening and management of opioid use in pregnancy and neonatal abstinence syndrome. The rising prevalence of opioid use in pregnancy has led to a concomitant dramatic fivefold increase in neonatal abstinence syndrome over the past decade. Experts from diverse disciplines addressed research gaps in the following areas: 1) optimal screening for opioid use in pregnancy; 2) complications of pregnancy associated with opioid use; 3) appropriate treatments for pregnant women with opioid use disorders; 4) the best approaches for detecting, treating, and managing newborns with neonatal abstinence syndrome; and 5) the long-term effects of prenatal opioid exposure on children...
June 7, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28587493/a-randomized-controlled-trail-of-a-new-treatment-for-labor-dystocia
#9
Eva Wiberg-Itzel, Susan Wray, Helena Åkerud
OBJECTIVE: Labor dystocia is an intransigent, high-profile issue in obstetric care. Amniotic fluid lactate (AFL) reflects the uterine metabolic status. High levels associate with subsequent need for operative intervention due to dystocia. In sports medicine it is known that lactic acid can affect muscular performance and can be decreased by bicarbonate given orally before physical activity. MATERIAL AND METHODS: Two hundred dystocic deliveries were included. At the confirmation of dystocia, the AFL- level was analyzed...
June 7, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28585843/triple-pregnancy-with-mixed-chorionicity-following-in-vitro-fertilization-is-fetal-reduction-neccesary
#10
A Sobek, M Procházka, E Klásková, B Zbořilová, M Lubušký, A Sobek
OBJECTIVE: The increasing incidence and management of monozygotic twinning in patients undergoing in vitro fertilization (IVF) has been the subject of much debate. Here, we describe the management and outcome of two triple pregnancies with mixed chorionicity with a monochorionic-diamniotic twin pair and a singleton following the transfer of two embryos during IVF treatment. DESIGN: Case report. SETTING: Department of Obstetrics and Gynaecology, Palacký University Hospital, Olomouc, Czech Republic...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28553771/the-first-trimester-combined-test-for-aneuploidies-a-single-center-experience
#11
Alina Veduta, Ana Maria Vayna, Simona Duta, Anca Panaitescu, Florin Popescu, Maria Bari, Gheorghe Peltecu, Florina Nedelea
PURPOSE: We present the results of the systematic application of the first trimester combined test for aneuploidies, in a Romanian center. METHODS: Since October 2009, in Filantropia Hospital in Bucharest, we have systematically been using the FMF (Fetal Medicine Foundation) combined first trimester test to screen for common aneuploidies at 11 to 13 + 6 weeks of gestation. We assessed the crown - rump length (CRL), nuchal translucency, fetal heart rate as well as PAPP-A and free β-hCG in maternal serum...
May 28, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28549984/the-development-and-implementation-of-checklists-in-obstetrics
#12
Peter S Bernstein, C Andrew Combs, Laurence E Shields, Steven L Clark, Catherine S Eppes
Checklists have been long used as a cognitive aid in various high-stakes environments to improve the reliability and performance of individuals and teams. When designed well, implemented thoughtfully, and monitored closely, they offer the opportunity to improve the performance of health care teams and advance patient safety. There are different types of checklists; examples include task lists, troubleshooting lists, coordination lists, discipline lists, and to-do lists. Each is useful in different situations and requires different implementation strategies...
May 23, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28549467/the-prediction-diagnosis-and-management-of-complications-in-monochorionic-twin-pregnancies-the-ommit-optimal-management-of-monochorionic-twins-study
#13
Fiona L Mackie, R Katie Morris, Mark D Kilby
BACKGROUND: Monochorionic twin pregnancies are at increased risk of complications due to sharing a single placenta and potentially developing unbalanced vascular anastomoses. Complications include twin-twin transfusion syndrome (TTTS) which affects 10-15% monochorionic twins, and if untreated has a 70-90% perinatal loss rate. We are currently unable to predict which twins will develop complications or to what severity. We have previously shown differences in angiogenic and placental growth factors in maternal blood in pregnancies complicated by TTTS compared to twin pregnancies not complicated by TTTS but matched for gestation...
May 26, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28545266/-analysis-of-misssed-diagnosis-and-misdiagnosis-of-1-212-cases-with-placental-abruption
#14
D Xu, C Liang, J W Xu, J He
Objective: To investigate the risk factors and clinical manifestations of placental abruption, and to analyze the causes of missed diagnosis and misdiagnosis. Methods: A retrospective analysis was conducted in 135 584 women who delivered in Women's Hospital, School of Medicine, Zhejiang University from January 2005 to December 2015. The diagnosis of placental abruption was made in 1 212 cases. According to the consistency of prenatal and postnatal diagnosis, they were divided into 3 groups. (1) The diagnosis was consistent prenatally and postnatally in 715 cases(58...
May 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28541280/a-quantitative-csmart-assay-for-noninvasive-prenatal-screening-of-autosomal-recessive-nonsyndromic-hearing-loss-caused-by-gjb2-and-slc26a4-mutations
#15
Mingyu Han, Zhifeng Li, Wenlu Wang, Shasha Huang, Yanping Lu, Zhiying Gao, Longxia Wang, Dongyang Kang, Linwei Li, Yiqian Liu, Mengnan Xu, David S Cram, Pu Dai
PurposeThe aim of this study was to assess the performance of a noninvasive prenatal screening (NIPS) assay for accurate fetal genotyping of pregnancies at genetic risk for autosomal recessive nonsyndromic hearing loss (ARNSHL).MethodsA total of 80 pregnant couples carrying known mutations in either the GJB2 or SLC26A4 genes associated with a risk for ARNSHL were recruited to the study. Fetal amniocyte samples were genotyped by invasive prenatal screening (IPS), whereas the cell-free fetal DNA present in maternal plasma samples was genotyped using a novel NIPS method based on circulating single-molecule amplification and resequencing technology (cSMART)...
May 25, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28531885/fetal-treatment-2017-the-evolution-of-fetal-therapy-centers-a-joint-opinion-from-the-international-fetal-medicine-and-surgical-society-ifmss-and-the-north-american-fetal-therapy-network-naftnet
#16
Anita J Moon-Grady, Ahmet Baschat, Darrell Cass, Mahesh Choolani, Joshua A Copel, Timothy M Crombleholme, Jan Deprest, Stephen P Emery, Mark I Evans, Francois I Luks, Mary E Norton, Greg Ryan, Kuojen Tsao, Ross Welch, Michael Harrison
More than 3 decades ago, a small group of physicians and other practitioners active in what they called "fetal treatment" authored an opinion piece outlining the current status and future challenges anticipated in the field. Many advances in maternal, neonatal, and perinatal care and diagnostic and therapeutic modalities have been made in the intervening years, yet a thoughtful reassessment of the basic tenets put forth in 1982 has not been published. The present effort will aim to provide a framework for contemporary redefinition of the field of fetal treatment, with a brief discussion of the necessary minimum expertise and systems base for the provision of different types of interventions for both the mother and fetus...
May 23, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28522319/association-between-gestational-weight-gain-and-perinatal-outcomes-in-women-with-chronic-hypertension
#17
Lynn M Yee, Aaron B Caughey, Yvonne W Cheng
BACKGROUND: Gestational weight gain above or below the 2009 National Academy of Medicine guidelines has been associated with adverse maternal and neonatal outcomes. Although it has been well established that excess gestational weight gain is associated with the development of gestational hypertension and preeclampsia, the relationship between gestational weight gain and adverse perinatal outcomes among women with pregestational (chronic) hypertension is less clear. OBJECTIVE: The objective of this study was to examine the relationship between gestational weight gain above and below National Academy of Medicine guidelines and perinatal outcomes in a large, population-based cohort of women with chronic hypertension...
May 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28522317/the-association-among-cytochrome-p450-3a-progesterone-receptor-polymorphisms-plasma-17-alpha-hydroxyprogesterone-caproate-concentrations-and-spontaneous-preterm-birth
#18
Martha L Bustos, Steve N Caritis, Kathleen A Jablonski, Uma M Reddy, Yoram Sorokin, John M Thorp, Michael W Varner, Ronald J Wapner, Jay D Iams, Marshall W Carpenter, Alan M Peaceman, Brian M Mercer, Anthony Sciscione, Dwight J Rouse, Susan M Ramin
BACKGROUND: Infants born <37 weeks' gestation are of public health concern since complications associated with preterm birth are the leading cause of mortality in children <5 years of age and a major cause of morbidity and lifelong disability. The administration of 17-alpha hydroxyprogesterone caproate reduces preterm birth by 33% in women with history of spontaneous preterm birth. We demonstrated previously that plasma concentrations of 17-alpha hydroxyprogesterone caproate vary widely among pregnant women and that women with 17-alpha hydroxyprogesterone caproate plasma concentrations in the lowest quartile had spontaneous preterm birth rates of 40% vs rates of 25% in those women with higher concentrations...
May 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28509324/three-dimensional-neurosonography-a-novel-field-in-fetal-medicine
#19
Michał Lipa, Ritsuko Kimata Pooh, Mirosław Wielgoś
Neurosonography is a promising technique for prenatal diagnosis, combining features of ultrasound imaging with fetal neurology. The brain is a three-dimensional structure, therefore observing brain structure in the three basic planes (sagittal, coronal and axial) is mandatory. The anterior fontanelle and sagittal suture may serve as acoustic ultrasound windows in the transvaginal brain scan, allowing to obtain high-resolution neuroimages of the intracranial structures. Furthermore, three-dimensional (3D) ultrasound combined with the transvaginal brain approach provides detailed and sophisticated neuroimages...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28502760/patterns-of-gestational-weight-gain-and-birthweight-outcomes-in-the-eunice-kennedy-shriver-national-institute-of-child-health-and-human-development-fetal-growth-studies-singletons-a-prospective-study
#20
Sarah J Pugh, Paul S Albert, Sungduk Kim, William Grobman, Stefanie N Hinkle, Roger B Newman, Deborah A Wing, Katherine L Grantz
BACKGROUND: Inadequate or excessive total gestational weight gain is associated with increased risks of small- and large-for-gestational-age births, respectively, but evidence is sparse regarding overall and trimester-specific patterns of gestational weight gain in relation to these risks. Characterizing the interrelationship between patterns of gestational weight gain across trimesters can reveal whether the trajectory of gestational weight gain in the first trimester sets the path for gestational weight gain in subsequent trimesters, thereby serving as an early marker for at-risk pregnancies...
May 11, 2017: American Journal of Obstetrics and Gynecology
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