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Margo S Harrison, Robert L Goldenberg
The global burden of preterm birth (PTB) includes the morbidity and mortality of babies born before 37 completed weeks of gestation. Prematurity has been the leading worldwide cause of neonatal mortality for at least a decade, but has now also become the leading cause of childhood mortality through age five years. Globally, each year, 15 million babies are born preterm, which is estimated to be about 11% of all deliveries. Preterm birth appears to be increasing in most countries. This review will address the epidemiology, rates, and etiology of PTB around the globe as well as survival by gestational age and interventions and preventative measures known to improve outcomes in high-burden countries...
April 2016: Seminars in Fetal & Neonatal Medicine
Heather A Frey, Mark A Klebanoff
After decades of rising preterm birth rates in the USA and other countries, recent prematurity rates seem to be on the decline. Despite this optimistic trend, preterm birth rates remain higher in the USA, where nearly one in every eight infants is born early, compared to other developed countries. The prevention of preterm birth is considered a public health priority because of the potential to reduce infant and childhood morbidity and mortality related to this condition. Unfortunately, progress has been modest...
April 2016: Seminars in Fetal & Neonatal Medicine
Stephan Scherneck, Franziska Lilli Schöpa, Michael Entezami, Angela Kayser, Corinna Weber-Schoendorfer, Christof Schaefer
The use of non-steroidal anti-inflammatory drugs like diclofenac in the third trimester of pregnancy can cause severe side effects, in particular oligohydramnios, premature closure of ductus arteriosus, and fetal kidney damage. However, the treatment with non-steroidal anti-inflammatory drugs until gestational week 28 is accepted as relatively safe. Here we describe two retrospectively reported cases of early-onset oligohydramnios associated with long-term diclofenac exposure of at least 150mg per day. The pathological findings were detected at gestational weeks 22 and 23, respectively...
December 2015: Reproductive Toxicology
Amy L Hammers, Luis Sanchez-Ramos, Andrew M Kaunitz
OBJECTIVE: The purpose of this study was to provide an updated summary of the literature regarding the effects of tocolysis with indomethacin on neonatal outcome by systematically reviewing previously and recently reported data. STUDY DESIGN: All previously reported studies pertaining to indomethacin tocolysis and neonatal outcomes along with recently reported data were identified with the use of electronic databases that had been supplemented with references that were cited in original studies and review articles...
April 2015: American Journal of Obstetrics and Gynecology
S H Westby Eger, J Kessler, T Kiserud, T Markestad, K Sommerfelt
AIM: Fetoplacental Doppler abnormalities have been associated with increased neonatal mortality and morbidity. This study evaluated the associations between prenatal Doppler assessments and neonatal mortality and morbidity in premature infants born small for gestational age or after pre-eclampsia. METHODS: This was a population-based study of infants born alive at 22(0) -33(6) weeks of gestation, a birthweight <10th percentile for gestational age and/or maternal pre-eclampsia...
April 2015: Acta Paediatrica
Lilach Marom-Haham, Shali Mazaki-Tovi, Itamar Zilberman, Anat Kalter, Jigal Haas, Eyal Sivan, Eyal Schiff, Yoav Yinon
OBJECTIVE: Magnesium sulfate (MgSO4) administered to women at risk for preterm delivery decreases the risk of cerebral palsy in their children. However, the neuroprotective effect of MgSO4 has not been shown in twin gestations. Thus, the aim of this study was to determine the maternal serum levels of magnesium in twin vs. singleton pregnancies following intravenous treatment of MgSO4. METHODS: Case control study including two groups of pregnant women who received intravenous MgSO4: (1) twin gestations (n=83) and (2) singleton pregnancies (n=83)...
September 2015: Journal of Perinatal Medicine
Mayra A Cruz Ithier, Jose A Prieto, Jasmine Steele
INTRODUCTION: The objective of this study was to prove that the chronic use of indomethacin as a tocolytic agent does not affect neonatal outcomes. METHODS: This is a retrospective cohort study of obstetrical patients from All Children's Perinatology Group diagnosed with preterm labor, cervical insufficiency, or both and exposed to prolonged indomethacin therapy (more than 48 hours). Patients were given a loading dose of 50 mg every 6 hours for 48 hours followed by a maintenance dose of 50 mg twice a day...
May 2014: Obstetrics and Gynecology
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