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https://read.qxmd.com/read/30873565/exploring-obstetrical-interventions-and-stratified-cesarean-section-rates-using-the-robson-classification-in-tertiary-care-hospitals-in-the-united-arab-emirates
#1
Mahera Abdulrahman, Sara Saad Abdullah, Aminah Fuad Khalil Alaani, Noora Hassan AlAbdool, Fatma Elzahraa Yehia Sherif, Zainab SalahEldin Ahmed, Hiba Issa Al-Rawi, Nawal Mahmood Hubaishi, Muna AbdulRazzaq Tahlak, Frederick R Carrick
OBJECTIVE:  The objective of the present study was to explore obstetric management in relation to clinical, maternal and child health outcomes by using the Robson classification system. METHODS:  Data was collected from obstetrics registries in tertiary care hospitals in Dubai, United Arab Emirates (UAE). RESULTS:  The analysis of > 5,400 deliveries (60% of all the deliveries in 2016) in major maternity hospitals in Dubai showed that groups 5, 8 and 9 of Robson's classification were the largest contributors to the overall cesarean section (CS) rate and accounted for 30% of the total CS rate...
March 14, 2019: Revista Brasileira de Ginecologia e Obstetrícia
https://read.qxmd.com/read/30870741/preterm-premature-rupture-of-the-membranes-guidelines-for-clinical-practice-from-the-french-college-of-gynaecologists-and-obstetricians-cngof
#2
REVIEW
Thomas Schmitz, Loïc Sentilhes, Elsa Lorthe, Denis Gallot, Hugo Madar, Muriel Doret-Dion, Gaël Beucher, Caroline Charlier, Charles Cazanave, Pierre Delorme, Charles Garabédian, Elie Azria, Véronique Tessier, Marie-Victoire Sénat, Gilles Kayem
In France, the frequency of premature rupture of the membranes (PROM) is 2%-3% before 37 weeks' gestation (level of evidence [LE] 2) and less than 1% before 34 weeks (LE2). Preterm delivery and intrauterine infection are the major complications of preterm PROM (PPROM) (LE2). Prolongation of the latency period is beneficial (LE2). Compared with other causes of preterm delivery, PPROM is associated with a clear excess risk of neonatal morbidity and mortality only in cases of intrauterine infection, which is linked to higher rates of in utero fetal death (LE3), early neonatal infection (LE2), and necrotizing enterocolitis (LE2)...
March 2, 2019: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://read.qxmd.com/read/30859845/prevalence-and-factors-affecting-the-negative-childbirth-experiences-a-systematic-review
#3
Monirolsadate Hosseini Tabaghdehi, Sakineh Kolahdozan, Afsaneh Keramat, Zohreh Shahhossein, Mahmood Moosazadeh, Zahra Motaghi
BACKGROUND: Childbirth and its related experiences have the potential physical and psychological effects on women's lives in the short and long term. Many factors play an effective role in the positive and negative childbirth experiences of the mother. This study aimed to examine the prevalence and factors affecting negative labor experiences. METHODS: The current research reviewed articles related to "childbirth experiences" in international databases (Pub Med - Scopus - Web of Science - Ovid - clinical key - ProQuest - ScienceDirect - the Cochrane Library), and national databases (SID, Magiran, Iranmedex, and Irandoc)...
March 12, 2019: Journal of Maternal-fetal & Neonatal Medicine
https://read.qxmd.com/read/30846246/a-case-of-20-week-abortion-in-a-rare-communicating-rudimentary-horn-of-a-misinterpreted-unicornuate-uterus-incorrectly-diagnosed-as-bicornuate-a-serious-hazard
#4
Luigi Della Corte, Annamaria Fabozzi, Pierluigi Giampaolino, Gabriele Saccone, Laura Micol Pizzuti, Valeria Romeo, Simone Maurea, Giuseppe Bifulco
Female genital malformations, as the unicornuate uterus, are deviations from normal anatomy that could impair the reproductive potential of a woman or her health. We present a rare case of a 20-week spontaneous abortion in a 24 years old patient affected by a misunderstood unicornuate uterus with communicating rudimentary horn, previously diagnosed as bicornuate, and for this reason subjected to induction of abortive labor, using mifepristone and gemeprost. Following the ultrasound exam and MRI, performed due to the failure of the abortive procedure, revealed the diagnosis of unicornuate uterus with (not clear) communicating accessory horn pregnancy, then treated with laparotomy...
February 27, 2019: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://read.qxmd.com/read/30835985/the-collaborative-laborist-and-midwifery-model-an-accepted-and-sustainable-model
#5
Keely Krolikowski-Ulmer, Travor J Watson, Elizabeth M Westhoff, Sarah L Ashmore, Paul A Thompson, Laurie B Landeen
In 2010, the OB/GYN physicians at this mid-sized midwestern medical center implemented a laborist model on the obstetrics ward. A laborist is a dedicated obstetrician within the obstetric ward who oversees the management of labor and performs deliveries as both the primary physician and also when consulted by other providers, including community obstetricians, family physicians and nurse midwives. In 2014, a collaborative obstetric model was implemented with the addition of an in-house certified nurse midwife (CNM) to assist the laborist in obstetric care...
December 2018: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://read.qxmd.com/read/30822801/disparate-rates-of-cesarean-delivery-in-term-nulliparous-women-with-hypertensive-disorders-of-pregnancy
#6
Christina A Penfield, Michael P Nageotte, Deborah A Wing
OBJECTIVE:  To evaluate the prevalence of cesarean delivery in women with hypertensive disorders of pregnancy (HDP), and explore whether maternal, sociodemographic, or obstetric comorbidities contribute to cesarean delivery rates. STUDY DESIGN:  This is a retrospective cohort study of nulliparous, term, singleton, vertex women using the 2013 U.S. National Vital Statistics Report. We compared prevalence of risk factors for cesarean delivery between women with and without HDP, and then calculated probabilities of cesarean delivery after controlling for these risk factors...
March 1, 2019: American Journal of Perinatology
https://read.qxmd.com/read/30817905/elective-induction-of-labor-at-39-weeks-compared-to-expectant-management-a-meta-analysis-of-cohort-studies
#7
REVIEW
William A Grobman, Aaron B Caughey
BACKGROUND: Elective induction of labor at 39 weeks among low-risk nulliparous women has reduced the chance of cesarean and other adverse maternal and perinatal outcomes in a randomized trial, although its clinical effectiveness in non-research settings remains uncertain. OBJECTIVE: To perform a systematic review of observational studies that compared elective induction of labor at 39 weeks among nulliparous women to expectant management, and to use meta-analytic techniques to estimate the association of elective induction with cesarean delivery, as well as other maternal and perinatal outcomes...
February 25, 2019: American Journal of Obstetrics and Gynecology
https://read.qxmd.com/read/30813131/pregnancy-outcomes-of-elective-induction-in-low-risk-term-pregnancies-a-propensity-score-analysis
#8
Eun Duc Na, Sung Woon Chang, Eun Hee Ahn, Sang Hee Jung, Young Ran Kim, Inkyung Jung, Hee Young Cho
We investigated the mode of delivery and perinatal outcomes in low-risk pregnant women whose labor was electively induced or expectantly managed at term.Healthy women with viable, vertex singleton pregnancies at 37 to 40 weeks of gestation were included. Women electively induced (n = 416) in each week (37-37, 38-38, 39-39, 40-40 weeks) were compared with pregnant women with spontaneous labor (n = 487). The primary outcome was mode of delivery. A propensity score (PS) was derived using logistic regression to model the probability of elective induction group as a function of potential confounders...
February 2019: Medicine (Baltimore)
https://read.qxmd.com/read/30810422/a-comparison-of-cervical-ripening-modalities-among-overweight-and-obese-nulliparous-gravidas
#9
Mojirayo A Sarumi, Robert B Gherman, Theodore D Bell, Puneet Jairath, Mary J Johnson, Adriane L Burgess
OBJECTIVE: To determine if differences exist among nulliparous overweight and obese gravidas undergoing cervical ripening employing three different agents (dinoprostone, misoprostol, or cervical catheter). METHODS: A retrospective cohort study of nulliparous overweight and obese women who underwent induction of labor at two south-central Pennsylvania hospitals between January 2014 and December 2017. Nulliparous gravidas, ≥37 weeks' gestational age, with singleton pregnancies in the vertex presentation, were included in the study...
March 11, 2019: Journal of Maternal-fetal & Neonatal Medicine
https://read.qxmd.com/read/30806629/-the-effects-of-induced-labor-at-41-week-of-pregnancy-on-mode-of-delivery-and-outcome
#10
Asta Hlin Olafsdottir, Dadi Mar Kristofersson, Sigfridur Inga Karlsdottir
INTRODUCTION: Rates of induction of labor (IOL) in Iceland and most neighboring countries have increased. Recent literature on IOL provided contradicting effects on mode of delivery, maternal and neonatal outcome. MATERIAL AND METHODS: The aim of this study was to evaluate the impact of IOL in late term pregnancies (≥41 weeks) on mode of delivery, maternal and neonatal outcome. A retrospective cohort study of deliveries after 41 weeks of pregnancy was conducted for all deliveries in Landspitali in the period 2013-2016, comparing outcomes of IOL deliveries to spontaneous labor deliveries...
2019: Læknablađiđ
https://read.qxmd.com/read/30803714/rethinking-thymic-tolerance-lessons-from-mice
#11
REVIEW
Sarah Inglesfield, Emilie J Cosway, William E Jenkinson, Graham Anderson
In the thymus, distinct cortex and medulla areas emphasize the division of labor in selection events shaping the αβT cell receptor repertoire. For example, MHC restriction via positive selection is a unique property of epithelial cells in the thymic cortex. Far less clear are the events controlling tolerance induction in the medulla. By acting in concert through multiple roles, including antigen production/presentation and chemokine-mediated control of migration, we propose that medullary epithelium and dendritic cells collectively enable the medulla to balance T cell production with negative selection and Foxp3+ regulatory T cell (Treg) development...
February 22, 2019: Trends in Immunology
https://read.qxmd.com/read/30799137/age-related-ranges-of-respiratory-inductance-plethysmography-rip-reference-values-for-infants-and-children
#12
REVIEW
Sona Lakshme Balasubramaniam, Yanping Wang, Lauren Ryan, Jobayer Hossain, Tariq Rahman, Thomas H Shaffer
The current noninvasive method for respiratory monitoring is respiratory inductance plethysmography (RIP); two bands are connected, one each to the chest and the abdomen, to measure the breathing pattern. RIP requires post hoc analysis to calculate indices such as respiratory rate, phase angle, labored breathing index, and percent of rib cage contribution to breathing. Clinical studies have provided patient RIP values and age-matched normal values, but they lack global evaluation of normative data for a wide age range of pediatric subjects...
May 19, 2018: Paediatric Respiratory Reviews
https://read.qxmd.com/read/30793763/prediction-models-for-determining-the-success-of-labor-induction-a-systematic-review
#13
Kennedy Meier, Jacqueline Parrish, Rohan D'Souza
INTRODUCTION: The purpose of this study was to systematically identify and compare clinical models using universally accessible clinical and demographic factors, which have been derived and/or validated to predict the success of labor induction with a view to making recommendations for practice. MATERIAL AND METHODS: MEDLINE, Embase, www.clinicaltrials.gov, and PubMed for non-MEDLINE and in-progress studies were searched from inception to November, 2017. Studies that derived and/or validated clinical prediction models containing antenatal history and digital cervical examination were included while studies with models containing radiological and/or biochemical findings not accessible to all providers were excluded...
February 22, 2019: Acta Obstetricia et Gynecologica Scandinavica
https://read.qxmd.com/read/30786256/unexpected-term-nicu-admissions-a-marker-of-obstetrical-care-quality
#14
Mark A Clapp, Kaitlyn E James, Sara V Bates, Anjali J Kaimal
BACKGROUND: Unexpected admissions of term neonates to the neonatal intensive care unit (NICU) and unexpected postnatal complications have been proposed as neonatal-focused quality metrics for intrapartum care. Previous studies have noted significant variation in overall hospital NICU admission rates; however, little is known about the influence of obstetric practices on these rates or whether variation among unanticipated admissions in low risk, term neonates can be attributed to systemic hospital practices...
February 13, 2019: American Journal of Obstetrics and Gynecology
https://read.qxmd.com/read/30779773/multiplexing-polysome-profiling-experiments-to-study-translation-in-escherichia-coli
#15
Huong Le Nguyen, Marie-Pierre Duviau, Muriel Cocaign-Bousquet, Sébastien Nouaille, Laurence Girbal
Polysome profiling is a widely used method to monitor the translation status of mRNAs. Although it is theoretically a simple technique, it is labor intensive. Repetitive polysome fractionation rapidly generates a large number of samples to be handled in the downstream processes of protein elimination, RNA extraction and quantification. Here, we propose a multiplex polysome profiling experiment in which distinct cellular extracts are pooled before loading on the sucrose gradient for fractionation. We used the multiplexing method to study translation in E...
2019: PloS One
https://read.qxmd.com/read/30778727/maternal-hypothyroidism-and-future-pediatric-neurological-morbidity-of-the-offspring
#16
Gil Gutvirtz, Asnat Walfisch, Tamar Wainstock, Daniella Landau, Eyal Sheiner
BACKGROUND: Maternal hypothyroidism in pregnancy has been associated with neurocognitive impairment in exposed children, ranging from psychomotor-developmental delay to lower IQ scores. OBJECTIVE: To investigate the long-term neurological morbidity of children to hypothyroid mothers during pregnancy. STUDY DESIGN: A population-based cohort study was performed including all deliveries occurring in a period of 20 years at a tertiary medical center...
February 18, 2019: Archives of Gynecology and Obstetrics
https://read.qxmd.com/read/30777545/thymoglobulin-resistant-t-cell-mediated-acute-rejection-in-a-pregnant-renal-transplant-recipient-case-report-and-review-of-the-literature
#17
Mohamed Balaha, Torki Al-Otaibi, Osama A Gheith, Medhat A Halim, Mohamed Shaker, Zohair Fayyad, Prasad Nair, Zakaria Zakaria, Hasaneen Abo-Atya, Yahya Makkeyia
To avoid graft rejection during pregnancy, frequent monitoring of serum drug levels is recommended. Pregnancy induces hyperfiltration in transplanted kidneys, as in native kidneys; therefore, detection of rejection can be difficult when monitoring by serum creatinine. If rejection is suspected, ultrasonographguided graft biopsy can be done; once proven, it can be treated with pulse steroids, but data are scarce regarding other agents. Here, we present a 28-year-old pregnant female patient with resistant acute rejection but with successful pregnancy outcome...
January 2019: Experimental and Clinical Transplantation
https://read.qxmd.com/read/30777350/-neuraxial-labor-analgesia-a-literature-review
#18
REVIEW
Fábio Farias de Aragão, Pedro Wanderley de Aragão, Carlos Alberto Martins, Karlla Fernanda Custódia Silva Leal, Alexandro Ferraz Tobias
The use of analgesia techniques for labor has become increasingly frequent, with neuraxial techniques being the most commonly used and most effective. Labor pain entails a number of physiological consequences that may be negative for the mother and fetus, and therefore must be treated. This literature review was performed through a search in the PubMed database, from July to November 2016, and included articles in English or Portuguese, published between 2011 and 2016 or anteriorly, if relevant to the topic...
February 15, 2019: Revista Brasileira de Anestesiologia
https://read.qxmd.com/read/30773821/ethnic-differences-in-prevalence-risk-factors-and-perinatal-outcomes-of-gestational-diabetes-mellitus-a-comparison-between-immigrant-ethnic-chinese-women-and-australian-born-caucasian-women-in-australia
#19
Ching Shan Wan, Sally Abell, Rosalie Aroni, Alison Nankervis, Jacqueline Boyle, Helena Teede
BACKGROUND: The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. Ethnic differences in risk factors and perinatal outcomes are clinically important. Chinese women constitute approximately 10% of the world's population, and are an increasing migrant population, yet prevalence, risk factors, and outcomes of GDM in this population are insufficiently explored. METHODS: A retrospective study of a large pregnancy dataset comparing GDM prevalence, risk factors, and perinatal outcomes between immigrant ethnic Chinese women and Australian-born Caucasian women was conducted using logistic regression...
February 18, 2019: Journal of Diabetes
https://read.qxmd.com/read/30771243/the-efficacy-of-misoprostol-vaginal-insert-compared-with-oral-misoprostol-in-the-induction-of-labor-of-nulliparous-women-a-randomized-national-multicenter-trial
#20
Emma Hokkila, Heidi Kruit, Leena Rahkonen, Susanna Timonen, Mirjami Mattila, Liisa Laatio, Maija-Riitta Ordén, Jukka Uotila, Tiina Luukkaala, Kati Tihtonen
INTRODUCTION: Our objective was to compare the efficacy of a 200-μg misoprostol vaginal insert vs oral misoprostol regarding the cesarean section rate and the time interval to vaginal delivery in nulliparous women with unfavorable cervix. MATERIAL AND METHODS: In this prospective multicenter trial, 283 nulliparous women at term with Bishop score <6 were randomized to induction of labor with either a misoprostol vaginal insert (n = 140) or oral misoprostol (n = 143)...
February 16, 2019: Acta Obstetricia et Gynecologica Scandinavica
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