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Seminars in Perinatology

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https://read.qxmd.com/read/30755340/pharmacological-treatment-of-opioid-use-disorder-in-pregnancy
#1
REVIEW
Christina E Rodriguez, Kaylin A Klie
Pharmacotherapy, or medication-assisted treatment (MAT), is a critical component of a comprehensive treatment plan for the pregnant woman with opioid use disorder (OUD). Methadone and buprenorphine are two types of opioid-agonist therapy which prevent withdrawal symptoms and control opioid cravings. Methadone is a long-acting mu-opioid receptor agonist that has been shown to increase retention in treatment programs and attendance at prenatal care while decreasing pregnancy complications. However methadone can only be administered by treatment facilities when used for OUD...
January 21, 2019: Seminars in Perinatology
https://read.qxmd.com/read/30711196/obstetric-management-of-women-with-opioid-use-disorder
#2
REVIEW
Emily W Rosenthal, Jason K Baxter
Pregnancy presents a window of opportunity for effecting positive change in the lives of women with opioid use disorder (OUD). Care should be empathetic and nonjudgmental with a focus on counseling for initiation and maintenance of beneficial health behaviors as well as development of a strong patient-provider relationship.1 These include adherence to treatment of OUD through pharmacotherapy and behavioral counseling, smoking cessation, healthy nutrition, treatment of coexisting medical and psychosocial conditions, as well as preparation for the postpartum period through breastfeeding education and antenatal discussion of contraception...
January 14, 2019: Seminars in Perinatology
https://read.qxmd.com/read/30711195/the-united-states-opioid-epidemic
#3
REVIEW
Jennifer Lyden, Ingrid A Binswanger
The United States opioid epidemic is a nationwide public health crisis. Initially driven by increased consumption and availability of pharmaceutical opioids, an increasing number of opioid overdoses are now related to heroin and illicitly manufactured fentanyl and fentanyl analogs. Addressing this epidemic requires addressing the stigma associated with opioid use disorders and its treatment, improving access to efficacious treatment options, specifically methadone and buprenorphine, and reducing opioid overdose fatalities with distribution of the opioid antagonist and overdose reversal agent naloxone...
January 14, 2019: Seminars in Perinatology
https://read.qxmd.com/read/30691693/introduction
#4
REVIEW
Torri Metz, Mona Prasad
No abstract text is available yet for this article.
January 14, 2019: Seminars in Perinatology
https://read.qxmd.com/read/30616865/introduction
#5
EDITORIAL
Dena Goffman, Leslie Moroz
No abstract text is available yet for this article.
December 21, 2018: Seminars in Perinatology
https://read.qxmd.com/read/30739750/management-of-early-pregnancy-loss-with-a-focus-on-patient-centered-care
#6
REVIEW
Jade M Shorter, Jessica M Atrio, Courtney A Schreiber
Early pregnancy loss is the most common complication in pregnancy. Management options for miscarriage include expectant management, medical intervention, or surgical aspiration. Non-surgical and surgical management are all safe and acceptable options for medically uncomplicated patients. Patient and provider preferences contribute profoundly to clinical decisions about miscarriage management. Shared-decision making and evidence based counseling have been shown to significantly improve patient satisfaction with early pregnancy loss care...
December 20, 2018: Seminars in Perinatology
https://read.qxmd.com/read/30683511/uterine-factor-in-recurrent-pregnancy-loss
#7
REVIEW
Jenna M Turocy, Beth W Rackow
OBJECTIVE: To review the current understanding of the role the uterus plays in recurrent pregnancy loss. FINDINGS: Congenital and acquired uterine abnormalities are associated with recurrent pregnancy loss in the first and second trimester. Relevant congenital Mullerian tract anomalies include unicornuate, didelphys, bicornuate and septate uteri. Pregnancy loss has also been associated with acquired uterine abnormalities that distort the uterine cavity such as intrauterine adhesions and submucosal myomas...
December 20, 2018: Seminars in Perinatology
https://read.qxmd.com/read/30665726/endocrine-causes-of-recurrent-pregnancy-loss
#8
REVIEW
Selma Amrane, Rachel McConnell
OBJECTIVE: To review the available data on endocrine disorders and recurrent pregnancy loss. FINDINGS: Our group found that most endocrine disorders do not seem to be correlated with a diagnosis of recurrent pregnancy loss (RPL). The exception to this is testing for thyroid stimulating hormone and thyroid antibodies, which is recommended due to a strong correlation with recurrent pregnancy loss and positive anti-thyroid peroxidase antibodies. CONCLUSION: The available literature supports testing thyroid function and antibodies in women with RPL...
December 20, 2018: Seminars in Perinatology
https://read.qxmd.com/read/30655022/preimplantation-genetic-diagnosis-in-early-pregnancy-loss-%C3%A2
#9
REVIEW
Sally F Vitez, Eric J Forman, Zev Williams
Miscarriage is a frequent outcome seen in obstetrics with 1 in 5 pregnancies ending in an early pregnancy loss. Aneuploidy is the most significant single factor affecting early pregnancy failure and miscarriage. The risk of aneuploidy increases significantly with increasing maternal age. There has been tremendous advancement in technology that has made preimplantation genetic testing for aneuploidy reliable and accessible. For women in their mid-to-late 30s there is great utility in the use of PGT-A to facilitate single embryo transfer, reduce the risk of clinical miscarriage and ongoing aneuploidy gestations...
December 20, 2018: Seminars in Perinatology
https://read.qxmd.com/read/30642578/review-of-current-guidelines-for-recurrent-pregnancy-loss-new-strategies-for-optimal-evaluation-of-women-who-may-be-superfertile
#10
REVIEW
Dalia Khalife, Ghina Ghazeeri, William Kutteh
The current evidence-based guidelines for the evaluation of recurrent pregnancy loss recommended by the American Society for Reproductive Medicine and by the European Society of Human Reproduction and Embryology are compared and contrasted in this review. The clinical use of either of these guidelines will result in a probable diagnosis for only half of the affected patients. New strategies for a full evaluation of recurrent pregnancy loss incorporating 24- chromosome microarary on the products of conception offer more explanations for patients and caregivers...
December 20, 2018: Seminars in Perinatology
https://read.qxmd.com/read/30638881/miscarriage-chromosome-testing-indications-benefits-and-methodologies
#11
REVIEW
Dana B McQueen, Ruth B Lathi
Rapid advances in genomics have expanded the use of chromosome testing following miscarriage. In addition to conventional cytogenetics, the availability of single nucleotide polymorphism microarray technology and array comparative geneomic hybridization have provided further options for clinicians. This review will cover the indications for testing and the advantages/disadvantages of the various methodologies available.
December 20, 2018: Seminars in Perinatology
https://read.qxmd.com/read/30606496/pregnancy-of-unknown-location-evaluation-and-management
#12
REVIEW
Daniela Carusi
Early diagnosis of an extrauterine pregnancy is important for safe and effective management. However, a pregnancy's location often cannot be easily determined with abnormal implantations or prior to 5-6 weeks' gestation. Multiple testing strategies exist to diagnose an abnormal pregnancy when location is unknown, but caution needs to be used to avoid a false diagnosis. Medical treatment is optimal when an abnormal pregnancy is diagnosed early. Because most of these pregnancies are intrauterine, additional testing to localize the pregnancy will allow the correct choice of therapy and avoids unnecessary exposure to a toxic therapy...
December 20, 2018: Seminars in Perinatology
https://read.qxmd.com/read/30598188/introduction
#13
EDITORIAL
Zev Williams
No abstract text is available yet for this article.
December 20, 2018: Seminars in Perinatology
https://read.qxmd.com/read/30638594/genetic-abnormalities-and-pregnancy-loss
#14
REVIEW
Nathan R Blue, Jessica M Page, Robert M Silver
Genetic abnormalities, whether occurring in the conceptus or the parents, can predispose to sporadic or recurrent pregnancy loss (RPL). Abnormalities in the conceptus include aneuploidy, copy number changes, skewed X inactivation, and single gene disorders or mutations. Among parents who suffer RPL, the best studied genetic cause is balanced chromosomal translocations. For evaluation of genetic abnormalities in cases of pregnancy loss, chromosomal microarray is more likely to yield interpretable results than karyotype due to cell culture failure...
December 19, 2018: Seminars in Perinatology
https://read.qxmd.com/read/30482592/in-search-of-suggesting-a-course-of-action-for-the-scientific-community-to-research-potential-impacts-of-heritable-gene-editing-on-the-maternal-carrier
#15
REVIEW
Robyn Gravelle
Prospective parents with a high risk of transmission of a disease-causing mutation may want to have an unaffected genetically related child. With advances in scientific technologies, including CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats), they may be able to do so through heritable gene editing of the human germline at the pre-implantation stage. CRISPR technology in the reproduction and fertility context could potentially correct mutations in the germline, allow for the production of embryos that are free from a mutation and terminate the transmission of a disease-causing mutation from parent to child...
December 2018: Seminars in Perinatology
https://read.qxmd.com/read/30482591/public-health-applications-of-crispr-how-children-s-health-can-benefit
#16
REVIEW
Vivian S Vigliotti, Isabel Martinez
Children under the age of five years old face significant mortality risks around the world. Public health innovations, particularly gene-editing technologies such as clustered regularly interspaced short palindromic repeats (CRISPR) could help to reduce the risk of death in children under the age of five years old. For example, CRISPR-based strategies could reduce infectious disease morbidity by gene editing mosquitoes to prevent transmission of malaria. CRISPR gene editing technology could also help to screen for influenza virus and prevent it from replicating; influenza is a particularly difficult to treat and severe virus causing many deaths in children...
December 2018: Seminars in Perinatology
https://read.qxmd.com/read/30482590/crispr-cas9-gene-editing-research-technologies-clinical-applications-and-ethical-considerations
#17
REVIEW
Fani Memi, Aglaia Ntokou, Irinna Papangeli
Gene therapy carries the potential to treat more than 10,000 human monogenic diseases and benefit an even greater number of complex polygenic conditions. The repurposing of CRISPR/Cas9, an ancient bacterial immune defense system, into a gene-editing technology has armed researchers with a revolutionary tool for gene therapy. However, as the breadth of research and clinical applications of this technology continues to expand, outstanding technical challenges and ethical considerations will need to be addressed before clinical applications become commonplace...
December 2018: Seminars in Perinatology
https://read.qxmd.com/read/30420296/treatment-of-heritable-diseases-using-crispr-hopes-fears-and-reality
#18
REVIEW
Natalie Kofler, Katherine L Kraschel
CRISPR gene editing is poised to transform the therapeutic landscape for diseases of genetic origin. The ease and agility by which CRISPR can make specific changes to DNA holds great promise not only for the treatment of heritable diseases, but also their prevention through germline editing. CRISPR-based therapeutic strategies are currently under development for numerous monogenic diseases. These strategies range from proof of concept studies demonstrating pre-fertilization gamete editing to recently initiated clinical trials for postnatal ex vivo therapies...
December 2018: Seminars in Perinatology
https://read.qxmd.com/read/30415764/crispr-diagnostics-underappreciated-uses-in-perinatology
#19
REVIEW
Adam Pan, Katherine L Kraschel
CRISPR-based therapeutics have the potential to revolutionize the treatment of hereditary diseases, but current efforts to translate research to the bedside face significant technical, regulatory, and ethical hurdles. In this article, we discuss an underappreciated application of CRISPR: diagnostic testing, and argue that: (1) CRISPR diagnostics are poised to disrupt diagnostic practices including perinatal screening and (2) since CRISPR diagnostics pose minimal technical, regulatory and ethical hurdles (unlike CRISPR therapeutic uses) they are likely to be clinically relevant before CRISPR-based therapies, and thus warrant medical community's attention...
December 2018: Seminars in Perinatology
https://read.qxmd.com/read/30389228/compassionate-use-of-gene-therapies-in-pediatrics-an-ethical-analysis
#20
REVIEW
Carolyn P Neuhaus, Rachel L Zacharias
In this commentary, we raise concerns about the compassionate use of CRISPR-mediated gene therapies in pediatric and perinatal patients. There is already a precedent for obtaining gene therapies for pediatric patients through compassionate use programs, and the recent passage of a federal Right to Try law may contribute to an increase in the number of patients who seek access to investigational products outside of a clinical trial. Clinicians, nurses, drug companies, and parents need support as they grapple with whether compassionate use of CRISPR-mediated gene therapies is the right thing to pursue for a child...
December 2018: Seminars in Perinatology
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