Christine Sävervall, Freja Lærke Sand, Simon Francis Thomsen
Dermatoses unique to pregnancy are important to recognize for the clinician as they carry considerable morbidity for pregnant mothers and in some instances constitute a risk to the fetus. These diseases include pemphigoid gestationis, polymorphic eruption of pregnancy, intrahepatic cholestasis of pregnancy, and atopic eruption of pregnancy. This review discusses the pathogenesis, clinical importance, and management of the dermatoses of pregnancy.
2015: Dermatology Research and Practice
Chiara Bazzani, Laura Andreoli, Michele Agosti, Cecilia Nalli, Angela Tincani
The impact of rheumatic disease on fertility and reproduction can be remarkable. Many disease-related factors can influence patients' sexual functioning, perturb fertility and limit family planning. Antirheumatic pharmacological treatment can also have a crucial role in this field. Proper counselling, preferably provided by a multidisciplinary team of rheumatologists, obstetricians, gynaecologists and neonatologists, is recommended for patients taking antirheumatic drugs, not only at the beginning, but also during the course of treatment...
2015: RMD Open
Miray Yilmaz Celebi, Serdar Alan, Dilek Kahvecioglu, Ufuk Cakir, Duran Yildiz, Omer Erdeve, Saadet Arsan, Begum Atasay
OBJECTIVE: This study aims to evaluate the effect of the prophylactic continuous positive airway pressure (CPAP) administration in the delivery room to newborns who were delivered by elective cesarean section (CS). STUDY DESIGN: Inborn infants with gestational age between 34(0/7) to 38(6/7) and born by elective CS were prospectively randomized to receive either prophylactic CPAP for 20 minutes via face mask or standardized care without CPAP in the delivery room...
January 2016: American Journal of Perinatology
Ulla Kampmann, Lene Ring Madsen, Gitte Oeskov Skajaa, Ditte Smed Iversen, Niels Moeller, Per Ovesen
Gestational diabetes mellitus (GDM) is increasing in prevalence in tandem with the dramatic increase in the prevalence of overweight and obesity in women of childbearing age. Much controversy surrounds the diagnosis and management of gestational diabetes, emphasizing the importance and relevance of clarity and consensus. If newly proposed criteria are adopted universally a significantly growing number of women will be diagnosed as having GDM, implying new therapeutic challenges to avoid foetal and maternal complications related to the hyperglycemia of gestational diabetes...
July 25, 2015: World Journal of Diabetes
P Bor, S Ledertoug, S Boie, N O Knoblauch, I Stornes
OBJECTIVE: To investigate whether discontinuation of oxytocin infusion increases the duration of the active phase of labour and reduces maternal and neonatal complications. DESIGN: Randomised controlled trial. SETTING: Department of Obstetrics and Gynaecology, Regional Hospital of Randers, Denmark. POPULATION: Women with singleton pregnancy in the vertex position undergoing labour induction or augmentation. METHODS: Two hundred women were randomised when cervical dilation was ≤4 cm to either continue or discontinue oxytocin infusion when cervical dilation reached 5 cm...
January 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Jessica McPherson, Sarah Smiley, David Stamilio
OBJECTIVE: Given the association between risk of cerebral palsy and children born to obese women, the study aim was to estimate whether maternal obesity is associated with reduced effectiveness of conventional antenatal magnesium sulfate dosing for the prevention of cerebral palsy and death. STUDY DESIGN: This is a secondary cohort analysis of a multicenter randomized clinical trial completed by the Maternal-Fetal Medicine Units Network. Women were included in the original trial if deemed high risk for preterm delivery in the subsequent 24 hours...
October 2015: American Journal of Obstetrics and Gynecology
Mary E Norton, Bo Jacobsson, Geeta K Swamy, Louise C Laurent, Angela C Ranzini, Herb Brar, Mark W Tomlinson, Leonardo Pereira, Jean L Spitz, Desiree Hollemon, Howard Cuckle, Thomas J Musci, Ronald J Wapner
BACKGROUND: Cell-free DNA (cfDNA) testing for fetal trisomy is highly effective among high-risk women. However, there have been few direct, well-powered studies comparing cfDNA testing with standard screening during the first trimester in routine prenatal populations. METHODS: In this prospective, multicenter, blinded study conducted at 35 international centers, we assigned pregnant women presenting for aneuploidy screening at 10 to 14 weeks of gestation to undergo both standard screening (with measurement of nuchal translucency and biochemical analytes) and cfDNA testing...
April 23, 2015: New England Journal of Medicine
Cameron C Grant, Suhina Kaur, Ellen Waymouth, Edwin A Mitchell, Robert Scragg, Alec Ekeroma, Alistair Stewart, Julian Crane, Adrian Trenholme, Carlos A Camargo
AIM: To determine whether vitamin D supplementation reduces primary care visits for acute respiratory infection (ARI). METHODS: A randomised, double-blind, placebo-controlled trial was conducted in New Zealand and powered to determine the vitamin D dose needed to achieve normal vitamin D status during infancy. Healthy pregnant women, from 27 weeks' gestation to birth, and their infants, from birth to age 6 months, were assigned to placebo or one of the two dosages of daily oral vitamin D3 ...
April 2015: Acta Paediatrica
Dodie L Arnold, Daniel A Enquobahrie, Chungfang Qiu, Jonathan Huang, Nancy Grote, Ann VanderStoep, Michelle A Williams
BACKGROUND: While associations of vitamin D deficiency with type 2 diabetes have been well demonstrated, investigations of vitamin D and risk of gestational diabetes mellitus (GDM) reported inconsistent findings. We examined associations of vitamin D status with GDM. METHODS: In a nested case-cohort study (135 GDM cases and 517 non-GDM controls), we measured maternal serum vitamin D status (total 25[OH]D and 25[OH]D3 ) in early pregnancy (16 weeks on average) using liquid chromatography-tandem mass spectroscopy...
May 2015: Paediatric and Perinatal Epidemiology
Karen Y Oh, Victoria H J Roberts, Matthias C Schabel, Kevin L Grove, Mark Woods, Antonio E Frias
PURPOSE: To determine the extent to which gadolinium chelate is found in nonhuman primate fetal tissues and amniotic fluid at 19-45 hours after intravenous injection of a weight-appropriate maternal dose of the contrast agent gadoteridol. MATERIALS AND METHODS: Gravid Japanese macaques (n = 14) were maintained as approved by the institutional animal care and utilization committee. In the 3rd trimester of pregnancy, the macaques were injected with gadoteridol (0...
July 2015: Radiology
H Marret, E Simon, G Beucher, M Dreyfus, A Gaudineau, C Vayssière, M Lesavre, M Pluchon, N Winer, H Fernandez, J Aubert, T Bejan-Angoulvant, A P Jonville-Bera, E Clouqueur, V Houfflin-Debarge, A Garrigue, F Pierre
The literature suggests that misoprostol can be offered to patients for off-label use as it has reasonable efficacy, risk/benefit ratio, tolerance and patient satisfaction, according to the criteria for evidence-based medicine. Both the vaginal and sublingual routes are more effective than the oral route for first-trimester cervical dilatation. Vaginal misoprostol 800μg, repeated if necessary after 24 or 48h, is a possible alternative for management after early pregnancy failure. However, misoprostol has not been demonstrated to be useful for the evacuation of an incomplete miscarriage, except for cervical dilatation before vacuum aspiration...
April 2015: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Ravi Retnakaran, Caroline K Kramer, Chang Ye, Simone Kew, Anthony J Hanley, Philip W Connelly, Mathew Sermer, Bernard Zinman
OBJECTIVE: Retrospective analyses of perinatal databases have raised the intriguing possibility of an increased risk of gestational diabetes mellitus (GDM) in women carrying a male fetus, but it has been unclear if this was a spurious association. We thus sought to evaluate the relationship between fetal sex and maternal glucose metabolism in a well-characterized cohort of women reflecting the full spectrum of gestational glucose tolerance from normal to mildly abnormal to GDM. RESEARCH DESIGN AND METHODS: A total of 1,074 pregnant women underwent metabolic characterization, including oral glucose tolerance test (OGTT), at mean 29...
May 2015: Diabetes Care
Shital Gandhi, Dongmei Sun, Alison L Park, Michelle Hladunewich, Candice K Silversides, Joel G Ray
BACKGROUND: Women with preeclampsia may develop pulmonary edema, but the reasons for this are largely unknown. METHODS: We performed a case-control study of women with preeclampsia at two major obstetrical centres in Toronto, ON, between 2005 and 2012. Cases (n = 28) were women with preeclampsia who had pulmonary edema on a chest CT or plain X-ray during the index delivery hospitalization. Control subjects (n = 64) were those with preeclampsia but no diagnosis of pulmonary edema or heart failure in the index hospitalization for delivery...
December 2014: Journal of Obstetrics and Gynaecology Canada: JOGC
Brendan Carvalho, Cynthia A Wong
This commentary outlines the current drug labeling practices that potentially compromise the clinical care of pregnant women and their children. We highlight the need for drug manufacturers and lawmakers to change the status quo and consider practices and regulations that will provide much-needed guidance to clinicians on the safe administration of drugs to certain populations such as pregnant and nursing women. Current practices have de facto contributed to a situation in which evidence is inadequate for individual physicians and patients to weigh the risks and benefits of drug administration and make informed decisions for drug use during pregnancy and lactation...
January 2015: American Journal of Obstetrics and Gynecology
Jennifer L Bailit, William Grobman, Yuan Zhao, Ronald J Wapner, Uma M Reddy, Michael W Varner, Kenneth J Leveno, Steve N Caritis, Jay D Iams, Alan T Tita, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa, J Peter VanDorsten
OBJECTIVE: The purpose of this study was to compare maternal and neonatal outcomes in nulliparous women with nonmedically indicated inductions at term vs those expectantly treated. STUDY DESIGN: Data were obtained from maternal and neonatal charts for all deliveries on randomly selected days across 25 US hospitals over a 3-year period. A low-risk subset of nulliparous women with vertex nonanomalous singleton gestations who delivered 38 0/7 to 41 6/7 weeks were selected...
January 2015: American Journal of Obstetrics and Gynecology
John T Repke
This month we focus on current research in labor management. Dr. Repke discusses five recent publications, and each is concluded with a "bottom line" that is the take-home message. The complete reference for each can be found in on this page, along with direct links to the abstracts.
December 2014: Obstetrics and Gynecology
Laura Brouwers, Maria P H Koster, Godelieve C M L Page-Christiaens, Hans Kemperman, Janine Boon, Inge M Evers, Auke Bogte, Martijn A Oudijk
OBJECTIVE: The primary aim of this study was to investigate the correlation between pregnancy outcome and bile acid (BA) levels in pregnancies that were affected by intrahepatic cholestasis of pregnancy (ICP). In addition, correlations between maternal and fetal BA levels were explored. STUDY DESIGN: We conducted a retrospective study that included women with pruritus and BA levels ≥10 μmol/L between January 2005 and August 2012 in 3 large hospitals in the Netherlands...
January 2015: American Journal of Obstetrics and Gynecology
Swaroopa Pulivarthi, Murali Krishna Gurram
Venous thromboembolism (VTE) is the leading cause of morbidity and mortality among hospitalized patients. We searched the PubMed database and reviewed the articles published until June 2011. Articles related to the D-dimer and VTE were considered to write this paper. Many factors play a key role in changing the sensitivity and specificity of D-dimer testing, including the extent of thrombosis and fibrinolytic activity, duration of symptoms, anticoagulant therapy, comorbidity due to surgical or medical illnesses, inflammatory diseases, cancer, elderly age, pregnancy and the postpartum period, and previous VTE...
October 2014: North American Journal of Medical Sciences
Jin Guo, Shuyu Long, Huafeng Li, Jinfeng Luo, Dongmei Han, Teng He
BACKGROUND: Early oral feeding (EOF) after cesarean delivery is still controversial. OBJECTIVES: To assess whether EOF is superior to delayed oral feeding (DOF) after cesarean in terms of safety and effectiveness. SEARCH STRATEGY: PubMed, Embase, and the Cochrane Library were searched for reports related to early feeding and cesarean published in English before June 30, 2014. SELECTION CRITERIA: Randomized controlled trials comparing at least one of six outcomes after EOF (≤12 hours after surgery) and DOF (after return of bowel sounds/movement or >12 hours) after cesarean delivery were included...
February 2015: International Journal of Gynaecology and Obstetrics
Cecilia Pegelow Halvorsen, Lilly-Ann Mohlkert, Mikael Norman, Sven-Erik Sonesson
AIM: Intrauterine laser treatment is used to alleviate abnormal circulatory load and cardiac morbidity affecting foetuses with twin-twin transfusion syndrome (TTTS). We conducted this childhood follow-up study to fill the gap in knowledge about final cardiac outcomes after such interventions. METHODS: We investigated 19 TTTS pairs - 11 male and eight female - with a mean age of four and a half years (range 1.1-9.9) using 2D, blood flow and tissue Doppler, 3D and speckle tracking echocardiography, and compared them with 19 age-matched and gender-matched singletons...
March 2015: Acta Paediatrica
2014-12-13 16:46:53
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