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Maternal-Fetal Medicine

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https://www.readbyqxmd.com/read/29744013/pregnancy-in-women-with-cardiovascular-diseases
#1
REVIEW
Karolina Adam
Patients with cardiovascular disease represent a significant cohort at risk for complications during pregnancy. The normal physiologic changes of pregnancy could further compromise the hemodynamics of various cardiovascular conditions, resulting in clinical deterioration and even death. The fetus of a gravida with cardiovascular disease also has an increased risk of morbidity, including an increased risk of inherited cardiac genetic disorders, fetal growth restriction, and premature delivery. These complications also increase the risk for antenatal and perinatal mortality...
October 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29743807/self-medication-practice-and-associated-factors-among-pregnant-women-in-addis-ababa-ethiopia
#2
Kidanemariam G/Michael Beyene, Solomon Worku Beza
Background: Self-medication which is the act of obtaining and using one or more medicines without medical supervision is a common practice among pregnant women. Unless proper caution is taken, it may result in maternal and fetal adverse outcomes. In Ethiopia, information on self-medication practice during pregnancy is scanty. Hence, this study aimed to assess self-medication practice and associated factors among pregnant women in government health centers in Addis Ababa. Methods: An institution-based mixed study design using a sequential explanatory approach was employed among 617 pregnant women and nine key informants in Addis Ababa from May 8, 2017, to June 30, 2017...
2018: Tropical Medicine and Health
https://www.readbyqxmd.com/read/29742665/variation-in-the-nulliparous-term-singleton-vertex-cesarean-delivery-rate
#3
Daniel N Pasko, Paula McGee, William A Grobman, Jennifer L Bailit, Uma M Reddy, Ronald J Wapner, Michael W Varner, John M Thorp, Kenneth J Leveno, Steve N Caritis, Mona Prasad, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
OBJECTIVE: To estimate the contributions of patient and health care provider-hospital characteristics to the variation in the frequency of nulliparous, term, singleton, vertex cesarean delivery in a multi-institutional U.S. cohort. METHODS: We performed a secondary analysis of the multicenter Assessment of Perinatal Excellence cohort of 115,502 mother and neonatal pairs who were delivered at 25 hospitals between March 2008 and February 2011. Women met inclusion criteria if they were nulliparous and delivered a singleton in vertex presentation at term...
May 7, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29734453/female-physicians-in-maternal-fetal-medicine-a-32-year-perspective
#4
Jacquelyn Blackstone, Vanessa K Will, William F Rayburn
OBJECTIVE:  To examine trends of female physicians either pursuing fellowships or in active practice in maternal-fetal medicine (MFM). METHODS:  This observational study examined complete sets of MFM fellows and active members of the Society for Maternal-Fetal Medicine (SMFM) between 1985 and 2016. Databases from SMFM, American College of Obstetricians and Gynecologists (ACOG), and Accreditation Council for Graduate Medical Education were used. Analysis of covariance testing was used to assess interactions over time between groups...
May 7, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29712489/sensitivity-of-prenatal-ultrasound-for-detection-of-trisomy-18
#5
David A Becker, Ying Tang, Adam P Jacobs, Joseph R Biggio, Rodney K Edwards, Akila Subramaniam
OBJECTIVES: To evaluate the sensitivity of prenatal ultrasound (US) for trisomy (T18) diagnosis and describe US findings in a large tertiary care institution in the USA. MATERIALS AND METHODS: This was a retrospective cohort of all T18 cases diagnosed at our institution from October 2004-October 2014 based on prenatal or postnatal genetic diagnostic testing. We included all women with a fetus affected by T18 who had a comprehensive US by a maternal-fetal medicine specialist performed at our institution...
April 30, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29709455/the-approach-to-peripartum-management-of-anticoagulation-a-multidisciplinary-survey
#6
Sagar Rohailla, Ann Kinga Malinowski, Shital Gandhi, Anne McLeod, Rosane Nisenbaum, Nadine Shehata
OBJECTIVE: This study sought to determine whether there is practice variation in the treatment and prevention of acute venous thromboembolism (VTE) in pregnant patients, potentially to prioritize future studies. BACKGROUND: The risk of VTE during pregnancy is five-fold that of the non-pregnant state. Guidance is often lacking for the treatment and prophylaxis of VTE because there are few RCTs. METHODS: The study used a cross-sectional study design using a self-administered electronic questionnaire consisting of 11 case scenarios that were sent to hematologists, maternal-fetal medicine specialists, obstetricians and gynaecologists, and internal medicine specialists across Canada...
April 27, 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29705191/society-for-maternal-fetal-medicine-smfm-consult-series-45-mild-fetal-ventriculomegaly-diagnosis-evaluation-and-management
#7
Nathan S Fox, Ana Monteagudo, Jeffrey A Kuller, Sabrina Craigo, Mary E Norton
Ventriculomegaly is defined as dilation of the fetal cerebral ventricles and is a relatively common finding on prenatal ultrasound. The purpose of this document is to review the diagnosis, evaluation, and management of mild fetal ventriculomegaly. When enlargement of the lateral ventricles (≥10 mm) is identified, a thorough evaluation should be performed, including detailed sonographic evaluation of fetal anatomy, amniocentesis for karyotype and chromosomal microarray analysis (CMA), and a workup for fetal infection...
April 26, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29700870/the-cost-effectiveness-of-first-trimester-screening-and-early-preventative-use-of-aspirin-in-women-at-high-risk-of-early-onset-pre-eclampsia
#8
Dayne Ortved, T Lee-Ann Hawkins, Jo-Ann Johnson, Jon Hyett, Amy Metcalfe
OBJECTIVE: Pre-eclampsia (PE) remains a leading cause of maternal and fetal morbidity and mortality. A first trimester screening algorithm predicting the risk of early onset PE has been developed and validated. Early prediction coupled with initiation of aspirin at 11 to 13 weeks in women identified as high risk is effective at reducing the prevalence of early onset PE. The aim of this study is to evaluate the cost-effectiveness of this first trimester screening program coupled with early use of low-dose aspirin in women at high risk of developing early onset PE versus current practice...
April 27, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29700085/valproate-life-saving-life-changing
#9
Rhys H Thomas
Antiepileptic medications, and valproate principally, are commonly prescribed teratogens. There is significant concern that we are not doing enough to educate clinicians and potential parents about the risks of valproate in pregnancy. There is clear advice from the Medicines and Healthcare products Regulatory Agency and the International League Against Epilepsy about the risks of valproate exposure in utero Reviews and guidelines that are focused on fetal risk, however, fall short in being able to fully replicate the complexity of a real clinical decision...
April 1, 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29698523/urine-mercury-levels-correlate-with-dna-methylation-of-imprinting-gene-h19-in-the-sperm-of-reproductive-aged-men
#10
Zhaoxu Lu, Yufeng Ma, Linying Gao, Yingjun Li, Qiang Li, Mei Qiang
BACKGROUND: Mercury (Hg) is a well-recognized environmental pollutant known by its toxicity of development and neurotoxicity, which results in adverse health outcomes. However, the mechanisms underlying the teratogenic effects of Hg are not well understood. Imprinting genes are emerging regulators for fetal development subjecting to environmental pollutants impacts. In this study, we examined the association between preconceptional Hg exposure and the alteration of DNA methylation of imprinting genes H19, Meg3, and Peg3 in human sperm DNA...
2018: PloS One
https://www.readbyqxmd.com/read/29690730/-a-clinical-retrospective-study-on-160-cases-of-multiple-umbilical-cord-around-the-neck
#11
Y Q Zhang, W Zhao, K T Chu, Y Zhao, L P Chen, Y Yu, X J Han
Objective: To compare the neonatal and maternal outcomes between the patients with umbilical cord around the neck (≥3 loops) and with (1 or 2 loops). Methods: A retrospective analysis was conducted on the clinical data of 160 cases with multiple umbilical cord around the neck (≥3 loops) in the Department of Obstetrics, Women's Hospital School of Medicine Zhejiang University between January 2014 and April 2017.For each case, two control women who gave birth at the same day with vertex position and singletons were selected...
April 17, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29689578/peripartum-morbidity-after-cesarean-delivery-for-arrest-of-dilation-at-4-to-5-cm-compared-with-6-to-10-cm
#12
Joshua D Dahlke, Jeffrey D Sperling, Phinnara Has, Todd R Lovgren, Brendan D Connealy, Dwight J Rouse
OBJECTIVE:  Given that recent consensus guidelines established to decrease cesarean delivery (CD) rates use 6 cm to define the onset of the active phase of labor, our objective was to evaluate maternal and neonatal outcomes after CD for the indication of arrest of dilation at 4 to 5 cm compared with ≥ 6 cm. STUDY DESIGN:  We performed a secondary analysis using data from the Maternal Fetal-Medicine Units Network Cesarean Registry. We included nulliparous women with term, singleton, vertex gestations who underwent primary CD for arrest of dilation...
April 24, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29686937/implementing-obstetric-early-warning-systems
#13
EDITORIAL
Alexander M Friedman, Mary L Campbell, Carolyn R Kline, Suzanne Wiesner, Mary E D'Alton, Laurence E Shields
Severe maternal morbidity and mortality are often preventable and obstetric early warning systems that alert care providers of potential impending critical illness may improve maternal safety. While literature on outcomes and test characteristics of maternal early warning systems is evolving, there is limited guidance on implementation. Given current interest in early warning systems and their potential role in care, the 2017 Society for Maternal-Fetal Medicine (SMFM) Annual Meeting dedicated a session to exploring early warning implementation across a wide range of hospital settings...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29685714/dilated-cardiomyopathy-in-pregnancy-outcomes-from-an-australian-tertiary-centre-for-maternal-medicine-and-review-of-the-current-literature
#14
Siobhan Boyle, Mugur Nicolae, Karam Kostner, Kathy Davies, Irena Cukovski, Amanda Cunliffe, Adam Morton
BACKGROUND: Peripartum cardiomyopathy is associated with significant risks of decline in left ventricular function and adverse maternal and fetal outcome in subsequent pregnancy. The risks of pregnancy in women with dilated cardiomyopathy are unclear. We aimed to assess the outcome of pregnancy in women with dilated cardiomyopathy seen at our institution and to review the literature on this subject. METHODS: A retrospective audit of the outcomes of 14 pregnancies to 12 women with dilated cardiomyopathy...
March 2, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29681180/amniocentesis-compared-with-antenatal-corticosteroids-prior-to-early-term-scheduled-cesarean-delivery
#15
Kelly B Zafman, Nathan S Fox
OBJECTIVE: There are a variety of maternal or fetal conditions that require late preterm or early term delivery. In cases where early delivery is indicated, optimal management is not always clear. Historically, obstetricians used amniocentesis to document fetal lung maturity, but recently, many have transitioned to administration of antenatal corticosteroids (ACS). The objective of this study was to compare neonatal outcomes between women undergoing amniocentesis or receiving ACS prior to scheduled cesarean delivery (CD) less than 39 weeks...
April 22, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29674195/thrombotic-microangiopathies-of-pregnancy-differential-diagnosis
#16
REVIEW
M Gupta, B B Feinberg, R M Burwick
Thrombotic microangiopathy (TMA) disorders are characterized by microangiopathic hemolytic anemia, thrombocytopenia and end-organ injury. In pregnancy and postpartum, TMA is most commonly encountered with HELLP (hemolysis, elevated liver enzymes, low platelet count syndrome) or preeclampsia with severe features, but rarely TMA is due to thrombotic thrombocytopenic purpura (TTP) or atypical hemolytic uremic syndrome (aHUS). Due to overlapping clinical and laboratory features, TTP and aHUS are often mistaken for preeclampsia or HELLP...
February 16, 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29673571/the-effect-of-hospital-acuity-on-severe-maternal-morbidity-in-high-risk-patients
#17
Mark A Clapp, Kaitlyn E James, Anjali J Kaimal
BACKGROUND: In 2015, the Society for Maternal-Fetal Medicine and the American College of Obstetricians and Gynecologists published guidelines that established levels of maternal care. These guidelines outline the nursing, provider, and facility requirements for hospitals to be designated a birthing center or one of four levels of care. To-date, these levels of maternal care have not been widely adopted, and currently, no data exists on how these designations may affect maternal or neonatal outcomes...
April 16, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29673050/postnatal-persistence-of-fetal-cardiovascular-remodeling-associated-with-assisted-reproductive-technologies-a-cohort-study
#18
Brenda Valenzuela-Alcaraz, Audrey Serafini, Alvaro Sepulveda-Martínez, Gemma Casals, Merida Rodríguez-López, Laura Garcia-Otero, Monica Cruz-Lemini, Bart Bijnens, Marta Sitges, Juan Balasch, Eduard Gratacos, Fatima Crispi
OBJECTIVE: to assess the postnatal persistence of fetal cardiovascular remodeling associated to assisted reproductive technologies (ART), in children at 3 years of age. DESIGN: A cohort study of children conceived by ART. SETTING: Maternal-Fetal Medicine Unit, Hospital Clinic Barcelona, Spain. POPULATION SAMPLE: 80 singleton pregnancies conceived by ART and 80 spontaneously conceived (controls) followed from fetal life up to childhood...
April 19, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29667343/abstracts-of-the-british-maternal-fetal-medicine-society-bmfms-20th-annual-conference-2018-19th-20th-april-2018-brighton-uk
#19
(no author information available yet)
No abstract text is available yet for this article.
April 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29613853/non-invasive-prenatal-diagnosis-of-paternally-inherited-disorders-from-maternal-plasma-detection-of-nf1-and-cftr-mutations-using-droplet-digital-pcr
#20
Aurélia Gruber, Mathilde Pacault, Laila Allach El Khattabi, Nicolas Vaucouleur, Lucie Orhant, Thierry Bienvenu, Emmanuelle Girodon, Dominique Vidaud, France Leturcq, Catherine Costa, Franck Letourneur, Olivia Anselem, Vassilis Tsatsaris, François Goffinet, Géraldine Viot, Michel Vidaud, Juliette Nectoux
BACKGROUND: To limit risks of miscarriages associated with invasive procedures of current prenatal diagnosis practice, we aim to develop a personalized medicine-based protocol for non-invasive prenatal diagnosis (NIPD) of monogenic disorders relying on the detection of paternally inherited mutations in maternal blood using droplet digital PCR (ddPCR). METHODS: This study included four couples at risk of transmitting paternal neurofibromatosis type 1 (NF1) mutations and four couples at risk of transmitting compound heterozygous CFTR mutations...
April 25, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
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