Journal of Perinatal Medicine最新文献_第6页

Respect for history: an important dimension of contemporary obstetrics & gynecology 尊重历史：当代妇产科学的一个重要方面

IF 2.4 4区医学

Journal of Perinatal Medicine Pub Date : 2024-09-14 DOI: 10.1515/jpm-2024-0348

Yinka Oyelese, Amos Grünebaum, Frank Chervenak

{"title":"Respect for history: an important dimension of contemporary obstetrics & gynecology","authors":"Yinka Oyelese, Amos Grünebaum, Frank Chervenak","doi":"10.1515/jpm-2024-0348","DOIUrl":"https://doi.org/10.1515/jpm-2024-0348","url":null,"abstract":"“Those who cannot remember the past are condemned to repeat it.” This maxim underscores the importance of historical awareness in medicine, particularly for obstetricians and gynecologists (ObGyns). ObGyns significantly impact societal health through their care for pregnant women, fetuses, and newborns, uniquely positioning them to advocate for health initiatives with lasting societal benefits. Despite its importance, the history of medicine is underrepresented in medical curricula, missing opportunities to foster critical thinking and ethical decision-making. In today’s climate of threatened reproductive rights, vaccine misinformation, and harmful ideologies, it is imperative for ObGyns to champion comprehensive historical education. The history of medicine, particularly in relation to societal issues – such as racism, discrimination, genocides, pandemics, and wars – provides valuable context for addressing challenges like maternal mortality, reproductive rights, vaccine hesitancy, and ethical issues. Understanding historical milestones and notable ethical breaches, such as the Tuskegee Study and the thalidomide tragedy, informs better practices and safeguards patient rights. Technological advancements in hygiene, antibiotics, vaccines, and prenatal care have revolutionized the field, yet contemporary ObGyns must remain vigilant about lessons learned from past challenges and successes. Integrating historical knowledge into medical training enhances clinical proficiency and ethical responsibility, fostering innovation and improving health outcomes. By reflecting on historical achievements and their impacts, current and future ObGyns can advance the field, ensuring comprehensive and ethically sound approaches to patient care. This paper highlights the crucial role of historical knowledge in shaping modern ObGyn practices, advocating for its integration into medical education to address contemporary health challenges and ethical considerations.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":"1 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Echocardiographic markers at diagnosis of persistent pulmonary hypertension of the newborn 诊断新生儿持续性肺动脉高压时的超声心动图指标

IF 2.4 4区医学

Journal of Perinatal Medicine Pub Date : 2024-09-14 DOI: 10.1515/jpm-2023-0346

Sujith S. Pereira, Xander Jacquemyn, Shelby Kutty

{"title":"Echocardiographic markers at diagnosis of persistent pulmonary hypertension of the newborn","authors":"Sujith S. Pereira, Xander Jacquemyn, Shelby Kutty","doi":"10.1515/jpm-2023-0346","DOIUrl":"https://doi.org/10.1515/jpm-2023-0346","url":null,"abstract":"Objectives Clinical parameters along with echocardiographic markers are used to interrogate the haemodynamics in persistent pulmonary hypertension of the newborn (PPHN). The aim of this study was to compare different echocardiographic markers in recent cohort of newborn infants with and without PPHN. Methods In this retrospective study, common echocardiographic markers were examined in infants>34 weeks’ gestation with PPHN (cases) and without PPHN (controls). Infants with congenital heart disease were excluded. Binary regression testing was used to evaluate echocardiographic markers predicting PPHN and death. In addition, diagnostic accuracy testing of echocardiographic markers using ROC was also performed. Intra-observer reliability for echocardiographic markers was examined using coefficient of variation (CoV) and intraclass correlation. Results Fifty-two infants were studied; 22 (42 %) infants with PPHN had significantly higher oxygen requirement, oxygenation index and ventilation days when compared with controls. Echocardiographic markers such as TR Vmax, S/D TR, PAAT, TAPSE and eccentricity index (EI) were significantly different between cases and controls. Receiver operator characteristics analysis of echocardiographic markers revealed TR Vmax 0.96 (0.9–1.0), S/D TR 0.95 (0.87–1.0) and end systolic EI 0.94 (0.87–1.0). These markers were found to predict death in this cohort of infants. CoV and Intra-observer reliability was good for various echocardiographic markers. Conclusions Among the various echocardiographic markers studied, TR Vmax when present along with S/D TR and end systolic EI had good intra-observer reliability and were diagnostic of PPHN and predicted death in this cohort. Future trials could use these markers in studies examining PPHN.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":"1 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The potential impact of universal screening for vasa previa in the prevention of stillbirths 普遍筛查前置胎盘对预防死胎的潜在影响

IF 2.4 4区医学

Journal of Perinatal Medicine Pub Date : 2024-09-09 DOI: 10.1515/jpm-2024-0203

Weiyu Zhang, Yinka Oyelese, Ali Javinani, Alireza Shamshirsaz, Ranjit Akolekar

{"title":"The potential impact of universal screening for vasa previa in the prevention of stillbirths","authors":"Weiyu Zhang, Yinka Oyelese, Ali Javinani, Alireza Shamshirsaz, Ranjit Akolekar","doi":"10.1515/jpm-2024-0203","DOIUrl":"https://doi.org/10.1515/jpm-2024-0203","url":null,"abstract":"Objectives To estimate the number of pregnancies complicated by vasa previa annually in nine developed countries, and the potential preventable stillbirths associated with undiagnosed cases. We also assessed the potential impact of universal screening for vasa previa on reducing stillbirth rates. Methods We utilized nationally-reported birth and stillbirth data from public databases in the United States, United Kingdom, Canada, Germany, Ireland, Greece, Sweden, Portugal, and Australia. Using the annual number of births and the number and rate of stillbirths in each country, and the published incidence of vasa previa and stillbirth rates associated with the condition, we estimated the expected annual number of cases of vasa previa, those that would result in a livebirth, and the potential preventable stillbirths with and without prenatal diagnosis. Results There were 6,099,118 total annual births with 32,550 stillbirths, corresponding to a summary stillbirth rate of 5.34 per 1,000 pregnancies. The total expected vasa previa cases was estimated to be 5,007 (95 % CI: 3,208–7,201). The estimated number of livebirths would be 4,937 (95 % CI: 3,163–7,100) and 3,610 (95 % CI: 2,313–5,192) in pregnancies with and without a prenatal diagnosis of VP. This implies that prenatal diagnosis would potentially prevent 1,327 (95 % CI: 850–1,908) stillbirths in these countries, corresponding to a potential reduction in stillbirth rate by 4.72 % (95 % CI: 3.80–5.74) if routine screening for vasa previa was performed. Conclusions Our study highlights the importance of universal screening for vasa previa and suggests that prenatal diagnosis of prevention could potentially reduce 4–5 % of stillbirths.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142180079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Chorioamnionitis and respiratory outcomes in prematurely born children: a systematic review and meta analysis. 绒毛膜羊膜炎与早产儿呼吸系统预后：系统综述与元分析。

IF 1.7 4区医学

Journal of Perinatal Medicine Pub Date : 2024-08-28 Print Date: 2024-10-28 DOI: 10.1515/jpm-2024-0232

Eleanor Jeffreys, Allan Jenkinson, Theodore Dassios, Anne Greenough

{"title":"Chorioamnionitis and respiratory outcomes in prematurely born children: a systematic review and meta analysis.","authors":"Eleanor Jeffreys, Allan Jenkinson, Theodore Dassios, Anne Greenough","doi":"10.1515/jpm-2024-0232","DOIUrl":"10.1515/jpm-2024-0232","url":null,"abstract":"Introduction: To conduct a systematic review and meta-analysis of the association between chorioamnionitis and respiratory outcomes of prematurely born children.Content: Pubmed, Medline and Embase were searched for relevant studies. Studies were included if they assessed prematurely born children, who had been exposed to chorioamnionitis and had either lung function testing or assessment of wheeze or asthma following NICU discharge. Two reviewers independently screened the search results, applied inclusion criteria and assessed methodological quality. One reviewer extracted the data and these were checked by a second reviewer.Summary: A total of 1,237 studies were identified, but only eight which included 35,000 infants, fulfilled the inclusion criteria. One study looked at both lung function results and wheeze or asthma in childhood. Four of five studies found an association between wheeze/asthma in childhood and exposure to chorioamnionitis: the overall Odds Ratio (OR) for developing wheeze/asthma in childhood was OR 1.71 (95 % CI: 1.55-1.89). Four studies looked at lung function in childhood, three of which showed no statistically significant association between chorioamnionitis exposure and altered lung function. One study found lower lung function in those exposed to chorioamnionitis and lower expiratory flows with increasing levels of chorioamnionitis (forced expiratory flow at 50 % of exhaled forced vital capacity (=FEF50) p=0.012, forced expiratory flow at 25-75 % of the forced vital capacity is exhaled (=FEF25-75) p=0.014).Outlook: There was a significant association between chorioamnionitis and the development of wheeze or asthma in childhood, but overall not in impairment of lung function.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"797-803"},"PeriodicalIF":1.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Non-binary patients in ART: new challenges and considerations. 抗逆转录病毒疗法中的非二元患者：新的挑战和考虑因素。

IF 1.7 4区医学

Journal of Perinatal Medicine Pub Date : 2024-08-15 Print Date: 2024-10-28 DOI: 10.1515/jpm-2024-0256

Aleksandar Ljubić, Milan Stanojević, Frank A Chervenak, Asim Kurjak

{"title":"Non-binary patients in ART: new challenges and considerations.","authors":"Aleksandar Ljubić, Milan Stanojević, Frank A Chervenak, Asim Kurjak","doi":"10.1515/jpm-2024-0256","DOIUrl":"10.1515/jpm-2024-0256","url":null,"abstract":"Objectives: To discuss the increasing visibility of non-binary individuals and inclusive policies and practices in assisted reproductive technologies (ART).Methods: Comparison between traditional ART approach designed for binary genders and propose approach in non-binary individuals.Results: Traditional ART services, designed for binary genders, must adapt to address the unique fertility needs of non-binary patients. This includes using gender-neutral language, providing comprehensive fertility assessments, and offering hormone therapy and fertility preservation options. Children of non-binary parents benefit from open communication about gender diversity, enhancing psychological well-being. Positive societal attitudes and inclusive environments in schools are crucial for preventing discrimination and promoting mental health. A systemic approach is required to make ART inclusive. This involves training staff, adjusting facilities, updating documentation, and advocating for supportive legislation. Addressing the reproductive needs of non-binary individuals ensures equitable access to care and supports their family-building goals.Conclusions: Ensuring the well-being of children in non-binary families requires psychological support, inclusive healthcare, legal recognition, social support, and comprehensive education.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"804-810"},"PeriodicalIF":1.7,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Does atenolol use during pregnancy cause small for gestational age neonates? A meta-analysis. 孕期使用阿替洛尔会导致胎龄小的新生儿吗？一项荟萃分析。

IF 1.7 4区医学

Journal of Perinatal Medicine Pub Date : 2024-08-08 Print Date: 2024-10-28 DOI: 10.1515/jpm-2024-0114

Shauna Bratton, Megan K Taylor, Priscilla Cortez, Antonio Schiattarella, Cecilia Fochesato, Giovanni Sisti

{"title":"Does atenolol use during pregnancy cause small for gestational age neonates? A meta-analysis.","authors":"Shauna Bratton, Megan K Taylor, Priscilla Cortez, Antonio Schiattarella, Cecilia Fochesato, Giovanni Sisti","doi":"10.1515/jpm-2024-0114","DOIUrl":"10.1515/jpm-2024-0114","url":null,"abstract":"Objectives: Atenolol is a commonly used beta bloscker in non-pregnant women. Many providers are hesitant in prescribing atenolol in pregnancy because of a possible association with poor fetal growth. We aimed to assess the association between atenolol and the occurrence of small for gestational age neonates compared to other beta blockers, as described in the existing literature.Methods: We used the meta-analytic method to generate a forest plot for risk ratios (RR) of small for gestational age in patients who used atenolol vs. other beta blockers. Statistical heterogeneity was assessed with the I2 statistic.Results: Two studies were included, with a resultant RR of 1.94 [95 % confidence interval (CI) 1.60; 2.35]. A study by Duan et al. in 2018 noted the following rate of small for gestational age for each beta blocker use: 112/638 atenolol, 590/3,357 labetalol, 35/324 metoprolol, and 50/489 propranolol. A study by Tanaka et al. in 2016 noted the following rate of small for gestational age: 8/22 for propranolol, 2/12 for metoprolol, 2/6 for atenolol, 0/5 for bisoprolol. Heterogeneity (I2) was 0 %.Conclusions: Our results suggested an elevated risk of small for gestational age associated with atenolol use in comparison to other beta blockers, specifically labetalol, propranolol, bisoprolol, and metoprolol.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"858-862"},"PeriodicalIF":1.7,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141902077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current practice of ultrasound in the management of postpartum hemorrhage: a secondary analysis of a national survey 超声波治疗产后出血的当前做法：对一项全国调查的二次分析

IF 2.4 4区医学

Journal of Perinatal Medicine Pub Date : 2024-07-31 DOI: 10.1515/jpm-2024-0231

Ilenia Mappa, Bianca Masturzo, Tullio Ghi, Giuseppe Rizzo

{"title":"Current practice of ultrasound in the management of postpartum hemorrhage: a secondary analysis of a national survey","authors":"Ilenia Mappa, Bianca Masturzo, Tullio Ghi, Giuseppe Rizzo","doi":"10.1515/jpm-2024-0231","DOIUrl":"https://doi.org/10.1515/jpm-2024-0231","url":null,"abstract":"Objectives Although frequently employed in the delivery room, current guidelines do not recommend the use of ultrasound in the setting of postpartum hemorrhage (PPH). The aim of this survey was to evaluate the routine use of ultrasonography during PPH. Methods A questionnaire, composed by a series of questions that assess participant characteristics and ultrasound use during PPH, was sent to members of the Italian Society of Ultrasound in Obstetrics and Gynecology currently employed in obstetrical units. Answers were subsequently grouped based on participant characteristics. Results Based on the responses of 200 participants it was found that ultrasound was routinely employed by 67 % of participants during PPH, by 85 % if Retained Products of Conception (RPOC) was suspected, by 67 % during Bakri balloon placement and by 69 % during curettage procedures. Routine ultrasound use was higher amongst participants working in hospitals with a higher number of deliveries, by those with more years of experience using ultrasound in labor, and by those that had attended specific postgraduate training courses. Conclusions Despite the lack of recommendations in the current guidelines, the results of this survey show that ultrasound seems to be commonly employed by maternal fetal medicine practitioners in the management of PPH.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":"74 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141870743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Does placental VEGF-A protein expression predict early neurological outcome of neonates from FGR complicated pregnancies? 胎盘血管内皮生长因子-A 蛋白表达能否预测 FGR 并发症妊娠新生儿的早期神经系统预后？

IF 1.7 4区医学

Journal of Perinatal Medicine Pub Date : 2024-07-22 Print Date: 2024-09-25 DOI: 10.1515/jpm-2024-0138

Maja Grah, Ljiljana Poljak, Mirta Starčević, Milan Stanojević, Katarina Vukojević, Mirna Saraga-Babić, Aida Kadić Salihagić

{"title":"Does placental VEGF-A protein expression predict early neurological outcome of neonates from FGR complicated pregnancies?","authors":"Maja Grah, Ljiljana Poljak, Mirta Starčević, Milan Stanojević, Katarina Vukojević, Mirna Saraga-Babić, Aida Kadić Salihagić","doi":"10.1515/jpm-2024-0138","DOIUrl":"10.1515/jpm-2024-0138","url":null,"abstract":"Objectives: Fetal hypoxia due to placental dysfunction is the hallmark of fetal growth restriction (FGR). Preferential perfusion of the brain (brain-sparing effect), as a part of physiological placental cardiovascular compensatory mechanisms to hypoxia, in FGR was reported. Therefore, the correlation between vascular endothelial growth factor A (VEGF-A) protein expression in the FGR placentas and newborns' early neurological outcome was examined.Methods: This study included 50 women with FGR complicated pregnancies and 30 uneventful pregnancies. Fetal hemodynamic parameters, neonatal acid-base status after delivery, placental pathohistology and VEGF-A expression were followed. Early neonatal morphological brain evaluation by ultrasound and functional evaluation of neurological status by Amiel - Tison Neurological Assessment at Term (ATNAT) were performed.Results: VEGF-A protein expression level was significantly higher in the FGR placentas than normal term placentas (Fisher-Freeman-Halton's test, p≤0.001). No statistically significant correlation between placental VEGF-A expression and different prenatal and postnatal parameters was noticed. Whereas the alteration of an early neurological status assessed by ATNAT was found in 58 % of FGR newborns, morphological brain changes evaluated by UZV was noticed in 48 % of cases. No association between the level of placental VEGF-A expression and the early neurological deficits was found.Conclusions: As far as we know this is the first study of a possible connection between VEGF-A protein expression in the FGR placentas and neonates' early neurological outcomes. The lack of correlation between the FGR placental VEGF-A expression and neonates' neurological outcome could indicate that optimal early neurodevelopment may take place due to compensatory mechanism not related to placental VEGF-A expression.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"783-792"},"PeriodicalIF":1.7,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of acidic vaginal pH on the efficacy of dinoprostone (PGE₂) vaginal tablet for labor induction in full term pregnant women: a randomized controlled trial. 酸性阴道 pH 值对地诺前列酮（PGE2）阴道片剂对足月孕妇引产疗效的影响：随机对照试验。

IF 1.7 4区医学

Journal of Perinatal Medicine Pub Date : 2024-07-02 Print Date: 2024-09-25 DOI: 10.1515/jpm-2024-0176

Michail Panagiotopoulos, Vasilios Pergialiotis, Panagiotis Antsaklis, Marianna Theodora, Michail Sindos, Maria-Anastasia Daskalaki, Pelopidas Koutroumanis, George Daskalakis

{"title":"Effect of acidic vaginal pH on the efficacy of dinoprostone (PGE2) vaginal tablet for labor induction in full term pregnant women: a randomized controlled trial.","authors":"Michail Panagiotopoulos, Vasilios Pergialiotis, Panagiotis Antsaklis, Marianna Theodora, Michail Sindos, Maria-Anastasia Daskalaki, Pelopidas Koutroumanis, George Daskalakis","doi":"10.1515/jpm-2024-0176","DOIUrl":"10.1515/jpm-2024-0176","url":null,"abstract":"Objectives: There is controversial evidence that acidification of vaginal pH may increase the efficacy of vaginal prostaglandins in labor induction, with research being mainly focused on misoprostol. This study aims to evaluate the impact of this intervention on the progress of labor induction with dinoprostone (PGE2) vaginal tablet.Methods: This double-blind, parallel-group, randomized study was conducted between October 2021 and December 2022 at Alexandra General Hospital, Athens, Greece. A total of 230 women with singleton, full term pregnancy that were scheduled for labor induction were randomly divided into two groups: Group A, who received acidic vaginal wash (5 % acetic acid) and Group B, who received a normal saline vaginal wash. Afterwards, participants received a vaginal tablet of 3 mg dinoprostone every 6 h (maximum two doses).Results: There were no statistically significant differences in mode of delivery, duration of different labor stages, Bishop score changes and possible complications. Participants in the acidification group needed less often labor augmentation with oxytocin and epidural anesthesia (p=0.03).Conclusions: Vaginal acidification seems to have no effect on the efficacy of the dinoprostone vaginal tablet. Even though it may reduce the need for oxytocin augmentation, there is no apparent benefit on clinical outcomes, such as reduction in cesarean section rates or shorter labor duration. Future research is necessary in order to validate these findings.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"730-736"},"PeriodicalIF":1.7,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reproductive genetic carrier screening in pregnancy: improving health outcomes and expanding access. 妊娠期生殖遗传携带者筛查：改善健康结果和扩大可及性。

IF 1.7 4区医学

Journal of Perinatal Medicine Pub Date : 2024-06-27 Print Date: 2024-09-25 DOI: 10.1515/jpm-2024-0059

Jenny Y Mei, Lawrence D Platt

{"title":"Reproductive genetic carrier screening in pregnancy: improving health outcomes and expanding access.","authors":"Jenny Y Mei, Lawrence D Platt","doi":"10.1515/jpm-2024-0059","DOIUrl":"10.1515/jpm-2024-0059","url":null,"abstract":"Reproductive genetic carrier screening (RGCS) serves to screen couples for their risk of having children affected by monogenic conditions. The included conditions are mostly autosomal recessive or X-linked with infantile or early-childhood onset. Cystic fibrosis, spinal muscular atrophy, and hemoglobinopathies are now recommended by the American College of Obstetricians and Gynecologists (ACOG) for universal screening. Recommendations for further RGCS remain ethnicity based. The American College of Medical Genetics and Genomics and the National Society of Genetic Counselors in recent years have recommended universal expanded-panel RGCS and moving towards a more equitable approach. ACOG guidelines state that offering RGCS is an acceptable option, however it has not provided clear guidance on standard of care. Positive results on RGCS can significantly impact reproductive plans for couples, including pursuing in vitro fertilization with preimplantation genetic testing, prenatal genetic testing, specific fetal or neonatal treatment, or adoption. RGCS is a superior approach compared to ethnicity-based carrier screening and moves away from single race-based medical practice. We urge the obstetrics and gynecology societies to adopt the guidelines for RGCS put forward by multiple societies and help reduce systemic inequalities in medicine in our new genetic age. Having national societies such as ACOG and the Society for Maternal-Fetal Medicine officially recommend and endorse RGCS would bolster insurance coverage and financial support by employers for RGCS. The future of comprehensive reproductive care in the age of genomic medicine entails expanding access so patients and families can make the reproductive options that best fit their needs.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"688-695"},"PeriodicalIF":1.7,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141457517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0