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Maternal-Fetal Medicine

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https://www.readbyqxmd.com/read/28545266/-analysis-of-misssed-diagnosis-and-misdiagnosis-of-1-212-cases-with-placental-abruption
#1
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
#2
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
#3
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
#4
Lynn M Yee, Aaron B Caughey, Yvonne W Cheng
BACKGROUND: Gestational weight gain above or below the 2009 Institute 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 IOM 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-between-cytochrome-p450-3a-progesterone-receptor-polymorphisms-plasma-17-ohpc-concentrations-and-spontaneous-preterm-birth
#5
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 before 37 weeks' gestation are of public health concern since complications associated with preterm birth are the leading cause of mortality in children under 5 years of age and a major cause of morbidity and lifelong disability. The administration of 17-hydroxyprogesterone caproate (17-OHPC) reduces preterm birth by 33% in women with history spontaneous preterm birth (SPTB). We demonstrated previously that plasma concentrations of 17-OHPC vary widely among pregnant women and that women with 17-OHPC plasma concentrations in the lowest quartile had SPTB 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
#6
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
#7
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
https://www.readbyqxmd.com/read/28491132/obstetric-medical-care-and-training-in-the-united-kingdom
#8
Adam D Jakes, Ingrid Watt-Coote, Matthew Coleman, Catherine Nelson-Piercy
The UK confidential enquiry into maternal deaths identified poor management of medical problems in pregnancy to be a contributory factor to a large proportion of indirect maternal deaths. Maternal (obstetric) medicine is an exciting subspecialty that encompasses caring for both women with pre-existing medical conditions who become pregnant, as well as those who develop medical conditions in pregnancy. Obstetrics and gynaecology trainees have some exposure to maternal medicine through their core curriculum and can then complete an advanced training skills module, subspecialise in maternal-fetal medicine or take time out to complete the Royal College of Physicians membership examination...
March 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28455087/assessing-the-potential-impact-of-extending-antenatal-steroids-to-the-late-preterm-period
#9
Vivienne Souter, Ellen Kauffman, Ms Alice J Marshall, Jodie G Katon
BACKGROUND: In 2016 guidance statements were issued by the Society for Maternal Fetal Medicine and by the American College of Obstetricians and Gynecologists about extending antenatal steroid use to selected late preterm singleton pregnancies. OBJECTIVE: To review antenatal steroid use prior to the 2016 guidance statements and assess the potential impact of these. STUDY DESIGN: This cohort study used chart-abstracted data from singleton deliveries from January 1, 2012 to March 31, 2016 at 12 centers participating in the Obstetrics Clinical Outcomes Assessment Program, a quality initiative in Washington State...
April 25, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28451583/pregnancy-an-underutilized-window-of-opportunity-to-improve-long-term-maternal-and-infant-health-an-appeal-for-continuous-family-care-and-interdisciplinary-communication
#10
REVIEW
Birgit Arabin, Ahmet A Baschat
Physiologic adaptations during pregnancy unmask a woman's predisposition to diseases. Complications are increasingly predicted by first-trimester algorithms, amplify a pre-existing maternal phenotype and accelerate risks for chronic diseases in the offspring up to adulthood (Barker hypothesis). Recent evidence suggests that vice versa, pregnancy diseases also indicate maternal and even grandparent's risks for chronic diseases (reverse Barker hypothesis). Pub-Med and Embase were reviewed for Mesh terms "fetal programming" and "pregnancy complications combined with maternal disease" until January 2017...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28448062/association-between-small-for-gestational-age-and-neurocognitive-impairment-at-two-years-of-corrected-age-among-infants-born-at-preterm-gestational-ages-a-cohort-study
#11
A I Girsen, S C Do, Y Y El-Sayed, S R Hintz, Y J Blumenfeld
OBJECTIVE: To investigate the association between small-for-gestational age (SGA) and neurocognitive impairment at 2 years of corrected age among infants born at preterm gestational ages. STUDY DESIGN: A secondary analysis of a prospectively conducted NICHD/Maternal-Fetal Medicine Units BEAM trial. Non-anomalous pregnancies delivered before 37 weeks of gestation were included in the analysis. Neurocognitive outcomes at 2 years of corrected age were compared between infants who were SGA (<10% for gestational age) and those appropriately grown (AGA)...
April 27, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28439600/factors-affecting-pregnancy-weight-gain-and-relationships-with-maternal-fetal-outcomes-in-turkey
#12
Nilufer Akgun, Huseyin L Keskin, Isık Ustuner, Gulden Pekcan, Ayse F Avsar
To determine the effects of pre-pregnancy body mass index (BMI) and gestational weight gain on maternal and fetal complications, and to examine whether Turkish women achieve the recommended gestational weight gain. We also investigated the relationship between pregnancy weight gain and mode of delivery, with an examination of maternal anthropometry.  Methods: A retrospective cross-sectional study was conducted on a population of 986 pregnant women between November 2011 and November 2015 at Atatürk Education and Research Hospital, Ankara, Turkey...
May 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28439421/factors-associated-with-cesarean-delivery-rates-a-single-institution-experience
#13
Spencer McClelland, Naomi Gorfinkle, Alan A Arslan, Maria Teresa Benedetto-Anzai, Teresa Cheon, Yuzuru Anzai
BACKGROUND: The aim of this study was to identify factors associated with variability in Cesarean delivery (CD) rates amongst providers at a single institution. METHODS: A retrospective cohort analysis was carried out on all births at NYU Langone Medical Center from 2005-2013. Data was collected for subjects and linked to diagnosis codes for singleton and twin deliveries. Descriptive characteristics were generated for all deliveries, and inferential analysis was performed including multiple covariates for singleton deliveries in the 2010-2013 cohort, including both univariate and multivariate regression analyses to identify factors associated with higher CD rates...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28438283/effects-of-prenatal-music-stimulation-on-fetal-cardiac-state-newborn-anthropometric-measurements-and-vital-signs-of-pregnant-women-a-randomized-controlled-trial
#14
J García González, M I Ventura Miranda, F Manchon García, T I Pallarés Ruiz, M L Marin Gascón, M Requena Mullor, R Alarcón Rodriguez, T Parron Carreño
BACKGROUND: Music has been used for medicinal purposes throughout history due to its variety of physiological, psychological and social effects. OBJECTIVE: To identify the effects of prenatal music stimulation on the vital signs of pregnant women at full term, on the modification of fetal cardiac status during a fetal monitoring cardiotocograph, and on anthropometric measurements of newborns taken after birth. MATERIAL AND METHOD: A randomized controlled trial was implemented...
May 2017: Complementary Therapies in Clinical Practice
https://www.readbyqxmd.com/read/28416028/attitudes-and-perceptions-of-pregnant-women-with-chd-results-of-a-single-site-survey
#15
Aarthi Sabanayagam, David Briston, Ali N Zaidi
Introduction CHD occurs in about 1% of the United States population, and is now the most common cardiac condition affecting women during pregnancy. METHODS: An anonymous, single-site, cross-sectional, 50-question survey was performed at a national Adult Congenital Heart Disease conference to assess the level of knowledge, attitudes, and perceptions regarding cardiac care during pregnancy in women with CHD. RESULTS: A total of 77 women completed the survey. Among them, 50% (n=39) had moderate and 38% (n=29) had severely complex disease; 30% (n=23) of women were told that pregnancy was contraindicated given their underlying cardiac condition...
April 18, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28412084/coding-update-of-the-smfm-definition-of-low%C3%A2-risk%C3%A2-for-cesarean-delivery-from-icd-9-cm-to%C3%A2-icd-10-cm
#16
Joanne Armstrong, Patricia McDermott, George R Saade, Sindhu K Srinivas
In 2015, the Society for Maternal-Fetal Medicine developed a low risk for cesarean delivery definition based on administrative claims-based diagnosis codes described by the International Classification of Diseases, Ninth Revision, Clinical Modification. The Society for Maternal-Fetal Medicine definition is a clinical enrichment of 2 available measures from the Joint Commission and the Agency for Healthcare Research and Quality measures. The Society for Maternal-Fetal Medicine measure excludes diagnosis codes that represent clinically relevant risk factors that are absolute or relative contraindications to vaginal birth while retaining diagnosis codes such as labor disorders that are discretionary risk factors for cesarean delivery...
April 13, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28407851/time-dependent-changes-and-prognostic-value-of-lactatemia-during-the-first-24%C3%A2-h-of-life-in-brachycephalic-newborn-dogs
#17
C Castagnetti, M Cunto, C Bini, J Mariella, S Capolongo, D Zambelli
Blood lactate concentration is known to be a good prognostic indicator associated with the severity of illness and the patient's outcome both in human and veterinary medicine. It also plays a significant role in the assessment of the newborn, being a good indicator of fetal hypoxia and the ideal predictor of morbidity at term in babies. In veterinary neonatal medicine, hyperlactatemia is considered a valid prognostic marker in critically ill foals; moreover, blood lactate measurement has been proposed for the evaluation of newborn viability and the assessment of fetal distress during delivery in dogs...
May 2017: Theriogenology
https://www.readbyqxmd.com/read/28401605/prediction-of-delivering-a-small-for-gestational-age-infant-and-adverse-perinatal-outcome-in-women-with-suspected-pre-eclampsia
#18
Melanie Griffin, Paul T Seed, Suzy Duckworth, Robyn North, Jenny Myers, Lucy Mackillop, Nigel Simpson, Jason Waugh, Dilly Anumba, Louise C Kenny, Christopher W G Redman, Andrew H Shennan, Lucy C Chappell
OBJECTIVE: To evaluate the test performance of 47 biomarkers and ultrasound parameters to predict subsequent delivery of an SGA infant and adverse perinatal outcome in women presenting with suspected preeclampsia. METHODS: In a prospective, multicentre observational study, 47 biomarkers and ultrasound parameters were measured in 397 women presenting with suspected preterm preeclampsia, with the objective of evaluating them as predictors of subsequent delivery of an SGA infant and adverse perinatal outcome...
April 12, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28382734/maternal-super-obesity-and-risk-for-intensive-care-unit-admission-in-the-mfmu-cesarean-registry
#19
Marcela C Smid, Sarah K Dotters-Katz, Arthur J Vaught, Catherine J Vladutiu, Kim A Boggess, David M Stamilio
INTRODUCTION: Obesity is risk factor for intensive care unit (ICU) admission in non-pregnant populations. Less is known about maternal obesity and ICU admission risk. The objective of this study was to estimate the association between maternal obesity and ICU admission among women who delivered via cesarean or vaginal birth after cesarean (VBAC). MATERIAL AND METHOD: This is a retrospective cohort analysis of women who delivered via VBAC or cesarean in the Maternal-Fetal Medicine Unit (MFMU) Cesarean Registry...
April 6, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28382695/discordant-non-invasive-prenatal-testing-nipt-a-systematic-review
#20
REVIEW
Tanja Schlaikjaer Hartwig, Louise Ambye, Steen Sørensen, Finn Stener Jørgensen
With a high sensitivity and specificity, NIPT is an incomparable screening test for fetal aneuploidy. However, the method is rather newly introduced and experiences with discordant results are few. We did a systematic review of literature reporting details of false positive and false negative NIPT results. Discordant sex chromosome results were not included. We identified 22 studies reporting case details. In total 206 discordant cases were included, of which 88% were false positive and 12% false negative. Details on maternal age, gestational age, platform/company, Z-score, fetal fraction, results and explanation were specified...
April 5, 2017: Prenatal Diagnosis
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