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https://www.readbyqxmd.com/read/26416771/maternal-bile-acid-transporter-deficiency-promotes-neonatal-demise
#1
Yuanyuan Zhang, Fei Li, Yao Wang, Aaron Pitre, Zhong-Ze Fang, Matthew W Frank, Christopher Calabrese, Kristopher W Krausz, Geoffrey Neale, Sharon Frase, Peter Vogel, Charles O Rock, Frank J Gonzalez, John D Schuetz
Intrahepatic cholestasis of pregnancy (ICP) is associated with adverse neonatal survival and is estimated to impact between 0.4 and 5% of pregnancies worldwide. Here we show that maternal cholestasis (due to Abcb11 deficiency) produces neonatal death among all offspring within 24 h of birth due to atelectasis-producing pulmonary hypoxia, which recapitulates the neonatal respiratory distress of human ICP. Neonates of Abcb11-deficient mothers have elevated pulmonary bile acids and altered pulmonary surfactant structure...
September 29, 2015: Nature Communications
https://www.readbyqxmd.com/read/26942391/committee-opinion-no-656-guidelines-for-diagnostic-imaging-during-pregnancy-and-lactation
#2
(no author information available yet)
Imaging studies are important adjuncts in the diagnostic evaluation of acute and chronic conditions. However, confusion about the safety of these modalities for pregnant and lactating women and their infants often results in unnecessary avoidance of useful diagnostic tests or the unnecessary interruption of breastfeeding. Ultrasonography and magnetic resonance imaging are not associated with risk and are the imaging techniques of choice for the pregnant patient, but they should be used prudently and only when use is expected to answer a relevant clinical question or otherwise provide medical benefit to the patient...
February 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26627728/cervical-pessary-to-prevent-preterm-birth-in-women-with-twin-gestation-and-sonographic-short-cervix-a-multicenter-randomized-controlled-trial-pecep-twins
#3
RANDOMIZED CONTROLLED TRIAL
Maria Goya, Maria de la Calle, Laia Pratcorona, Carme Merced, Carlota Rodó, Begoña Muñoz, Miquel Juan, Ariana Serrano, Elisa Llurba, Teresa Higueras, Elena Carreras, Luis Cabero
BACKGROUND: Spontaneous preterm birth (SPB) is the leading cause of perinatal morbidity and mortality. In twins, the rate of preterm birth is higher than in singletons; interventions to prevent preterm birth are needed in this high-risk population. OBJECTIVE: We sought to test whether a cervical pessary reduces the preterm birth rate in twin pregnancies with sonographic short cervix. STUDY DESIGN: A prospective, open-label, multicenter, randomized clinical trial was conducted in 5 hospitals in Spain...
February 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26454123/-38-hepatitis-b-in-pregnancy-screening-treatment-and-prevention-of-vertical-transmission
#4
REVIEW
Jodie Dionne-Odom, Alan T N Tita, Neil S Silverman
Between 800,000-1.4 million people in the United States and more than 240 million people worldwide are infected with hepatitis B virus (HBV). Specific to pregnancy, an estimated prevalence of 0.7-0.9% for chronic hepatitis B infection among pregnant women in the United States has been reported, with >25,000 infants at risk for chronic infection born annually to these women. Vertical transmission of HBV from infected mothers to their fetuses or newborns, either in utero or peripartum, remains a major source of perpetuating the reservoir of chronically infected individuals globally...
January 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26375717/alcoholic-pancreatitis-masquerading-as-preeclampsia
#5
Tara A Lynch, Scott C Dexter
BACKGROUND: Coexisting medical complications in pregnancy can present in a fashion similar to preeclampsia and can be challenging to differentiate. CASE: We present a patient who, at 27 3/7 weeks of gestation, fulfilled diagnostic criteria for severe preeclampsia, including hypertension, proteinuria, headache, abnormal serum creatinine levels, thrombocytopenia, and liver function abnormalities, but who nevertheless did not have preeclampsia. Instead, she was diagnosed with alcoholic pancreatitis based on a history of heavy alcohol use and elevated amylase and lipase...
December 2015: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26364658/perinatal-outcomes-with-intrahepatic-cholestasis-of-pregnancy-in-twin-pregnancies
#6
Xiaohua Liu, Mark B Landon, Yan Chen, Weiwei Cheng
OBJECTIVE: To describe perinatal outcomes of twin pregnancies complicated by intrahepatic cholestasis of pregnancy (ICP). METHODS: We conducted a retrospective cohort study of women delivered at a large tertiary obstetric center in Shanghai, China from January 2006 to May 2014. Delivery data were abstracted from medical records of all twin gestations delivered at the hospital. RESULTS: A total of 129/1922(6.7%) twin and 1190/92 273 singleton (1...
2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/26334607/guidelines-for-the-management-of-a-pregnant-trauma-patient
#7
Venu Jain, Radha Chari, Sharon Maslovitz, Dan Farine, Emmanuel Bujold, Robert Gagnon, Melanie Basso, Hayley Bos, Richard Brown, Stephanie Cooper, Katy Gouin, N Lynne McLeod, Savas Menticoglou, William Mundle, Christy Pylypjuk, Anne Roggensack, Frank Sanderson
OBJECTIVE: Physical trauma affects 1 in 12 pregnant women and has a major impact on maternal mortality and morbidity and on pregnancy outcome. A multidisciplinary approach is warranted to optimize outcome for both the mother and her fetus. The aim of this document is to provide the obstetric care provider with an evidence-based systematic approach to the pregnant trauma patient. OUTCOMES: Significant health and economic outcomes considered in comparing alternative practices...
June 2015: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/26348193/the-utility-of-12-hour-urine-collection-for-the-diagnosis-of-preeclampsia-a-systematic-review-and-meta-analysis
#8
REVIEW
Molly J Stout, Shayna N Conner, Graham A Colditz, George A Macones, Methodius G Tuuli
OBJECTIVE: To systematically review the literature and synthesize data on the diagnostic performance of a 12-hour urine collection for proteinuria in pregnant women with suspected preeclampsia. DATA SOURCES: We performed a literature search of PubMed, Embase, Scopus, ClinicalTrials.gov, and CINAHL through February 2014 using key words related to gestational hypertension, preeclampsia, and proteinuria. METHODS OF STUDY SELECTION: Studies that contained results of both the 12-hour and 24-hour urine collection in the same patients were eligible...
October 2015: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26292044/fetal-presentation-and-successful-twin-vaginal-delivery
#9
Sarah Rae Easter, Ellice Lieberman, Daniela Carusi
BACKGROUND: Despite the demonstrated safety of a trial of labor for pregnancies with a vertex-presenting twin and clinical guidelines in support of this plan, the rate of planned cesarean delivery for twin pregnancies remains high. This high rate, as well as variation in cesarean rates for twin pregnancies across providers, may be influenced strongly by concern about delivery of the second twin, particularly when it is in a nonvertex presentation. There are limited data in the literature that has examined the impact of the position of the nonpresenting twin on successful vaginal delivery or maternal/neonatal morbidity...
January 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26244307/clinical-practice-pregnancy-complicated-by-venous-thrombosis
#10
REVIEW
Ian A Greer
No abstract text is available yet for this article.
August 6, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/26212180/challenging-the-4-to-5-minute-rule-from-perimortem-cesarean-to-resuscitative-hysterotomy
#11
REVIEW
Carl H Rose, Arij Faksh, Kyle D Traynor, Daniel Cabrera, Katherine W Arendt, Brian C Brost
Although perimortem delivery has been recorded in the medical literature for millennia, the procedural intent has evolved to the current fetocentric approach, predicating timing of delivery following maternal cardiopulmonary arrest to optimize neonatal outcome. We suggest a call to action to reinforce the concept that if the uterus is palpable at or above the umbilicus, preparations for delivery should be made simultaneous with initiation of maternal resuscitative efforts; if maternal condition is not rapidly reversible, hysterotomy with delivery should be performed regardless of fetal viability or elapsed time since arrest...
November 2015: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26234485/the-risks-of-planned-vaginal-breech-delivery-versus-planned-caesarean-section-for-term-breech-birth-a-meta-analysis-including-observational-studies
#12
REVIEW
Y Berhan, A Haileamlak
BACKGROUND: The mode of delivery in term singleton breech presentation has been debated for more than half a century and has been examined in both randomised and observational studies. OBJECTIVE: To determine the absolute and relative risks of perinatal mortality and morbidity in planned vaginal breech delivery. SEARCH STRATEGY: A computer-based literature search was conducted mainly in the databases of HINARI, PubMed and Google scholar for studies comparing planned vaginal delivery and planned caesarean section...
January 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/26239023/subclinical-hypothyroidism-in-the-infertile-female-population-a-guideline
#13
REVIEW
(no author information available yet)
There is controversy regarding whether to treat subtle abnormalities of thyroid dysfunction in the infertile female patient. This guideline document reviews the risks and benefits of treating subclinical hypothyroidism in female patients with a history of infertility and miscarriage, as well as obstetrical and neonatal outcomes in this population.
September 2015: Fertility and Sterility
https://www.readbyqxmd.com/read/26113232/oral-nifedipine-versus-intravenous-labetalol-for-severe-hypertension-during-pregnancy-a-systematic-review-and-meta-analysis
#14
REVIEW
S Shekhar, N Gupta, R Kirubakaran, P Pareek
BACKGROUND: Oral nifedipine is recommended along with labetalol and hydralazine for treatment of severe hypertension during pregnancy by most authorities. Although nifedipine is cheap and easily administered, the usage pattern among health care providers suggests a strong preference for labetalol despite lack of evidence for the same. OBJECTIVES: To determine the efficacy and safety of oral nifedipine for treatment of severe hypertension of pregnancy compared with intravenous labetalol...
January 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/26119227/oral-nifedipine-or-intravenous-labetalol-for-severe-hypertension
#15
COMMENT
L A Magee
No abstract text is available yet for this article.
January 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/26117440/the-association-of-skin-incision-type-at-cesarean-with-maternal-and-neonatal-morbidity-for-women-with-multiple-prior-cesarean-deliveries
#16
MULTICENTER STUDY
Anna Palatnik, William A Grobman
OBJECTIVE: In women with multiple prior cesarean deliveries (CDs), vertical skin incisions are thought by some to result in better outcomes. The objective of this study was to compare maternal and neonatal outcomes according to the type of skin incisions among women with multiple prior CDs. STUDY DESIGN: This was a secondary analysis of MFMU Cesarean Registry data. Women undergoing repeat CD with a viable singleton gestation and history of ≥2 prior CDs were included in this analysis...
August 2015: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/12057549/do-women-with-pre-eclampsia-and-their-babies-benefit-from-magnesium-sulphate-the-magpie-trial-a-randomised-placebo-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Douglas Altman, Guillermo Carroli, Lelia Duley, Barbara Farrell, Jack Moodley, James Neilson, David Smith
BACKGROUND: Anticonvulsants are used for pre-eclampsia in the belief they prevent eclamptic convulsions, and so improve outcome. Evidence supported magnesium sulphate as the drug to evaluate. METHODS: Eligible women (n=10141) had not given birth or were 24 h or less postpartum; blood pressure of 140/90 mm Hg or more, and proteinuria of 1+ (30 mg/dL) or more; and there was clinical uncertainty about magnesium sulphate. Women were randomised in 33 countries to either magnesium sulphate (n=5071) or placebo (n=5070)...
June 1, 2002: Lancet
https://www.readbyqxmd.com/read/24104790/oral-nifedipine-or-intravenous-labetalol-for-hypertensive-emergency-in-pregnancy-a-randomized-controlled-trial
#18
RANDOMIZED CONTROLLED TRIAL
Shashank Shekhar, Chanderdeep Sharma, Sita Thakur, Suresh Verma
OBJECTIVE: To compare the effectiveness of orally administered nifedipine and intravenously administered labetalol for acute blood pressure control in hypertensive emergency of pregnancy. METHODS: In this double-blind, randomized, controlled trial, pregnant women with sustained increase in systolic blood pressure of 160 mm Hg or higher or diastolic blood pressure of 110 mm Hg or higher were randomized to receive nifedipine (10 mg tablet orally up to five doses) and intravenous placebo saline injection or intravenous labetalol injection in escalating doses of 20, 40, 80, 80, and 80 mg and a placebo tablet every 20 minutes until the target blood pressure of 150 mm Hg systolic and 100 mm Hg diastolic, or lower, was achieved...
November 2013: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/25923024/management-of-persistent-postpartum-hemorrhage-caused-by-inner-myometrial-lacerations
#19
Lesley B Conrad, Lynn J Groome, Destin R Black
BACKGROUND: Postpartum hemorrhage management must involve rapid recognition of the source of bleeding. Inner myometrial laceration is an uncommonly recognized cause; most cases are demonstrated only by evaluation of peripartum hysterectomy specimens. The exact cause of this laceration is unknown; however, it can be identified by uterine cavity exploration and managed with conservative surgery that preserves fertility. CASE: Postpartum hemorrhage caused by inner myometrial lacerations is presented...
August 2015: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/25530592/suture-versus-staples-for-skin-closure-after-cesarean-a-metaanalysis
#20
COMPARATIVE STUDY
Awathif Dhanya Mackeen, Meike Schuster, Vincenzo Berghella
OBJECTIVE: We sought to perform a metaanalysis to synthesize randomized clinical trials of cesarean skin closure by subcuticular absorbable suture vs metal staples for the outcomes of wound complications, pain perception, patient satisfaction, cosmesis, and operating time. STUDY DESIGN: A systematic search was performed using MEDLINE, Cochrane Databases, and ClinicalTrials.gov registries. We included randomized trials comparing absorbable suture vs metal staples for cesarean skin closure...
May 2015: American Journal of Obstetrics and Gynecology
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