Journal of Maternal-Fetal & Neonatal Medicine最新文献

{"title":"Neonatal transport: parental needs and potential for improvement - a single-center cross-sectional study.","authors":"Charlotte Lengauer, Beate Grass","doi":"10.1080/14767058.2024.2356036","DOIUrl":"https://doi.org/10.1080/14767058.2024.2356036","url":null,"abstract":"<p><strong>Objective: </strong>Neonates with medical problems need transfer from the place of birth to a neonatal (intensive care) unit after birth by a specialized neonatal transport team. Neonatal transport is accompanied by a high emotional burden for the families due to spatial separation, uncertainty and care for the neonate. This survey of parents' needs was a quality control project of the neonatal transport team of the University Children's Hospital Zurich, Switzerland. The aim was to identify areas for improvement of family-centred care and to derive concrete suggestions for adjustments in the transport process.</p><p><strong>Methods: </strong>This single-center prospective cross-sectional study included parents of neonates transported between January 2021 and February 2022. Based on a literature review, an anonymous questionnaire was developed (mini-Delphi method) and conducted using an online survey tool. The survey results were analyzed descriptively.</p><p><strong>Results: </strong>The response rate was 77% (168/217). The majority of parents agreed with the current procedures for neonatal transports and experienced the transport team as professional. There were no (emotional) support measures applied by the transport team which were not approved by the parents. Some parents suggested the following additions: the possibility of parental accompaniment during transport, contact by telephone on arrival at the destination hospital, and an improvement in the transmission of medical information, both prenatally and in the context of transport.</p><p><strong>Conclusion: </strong>There is potential for improvement in meeting parental needs during neonatal transport. Some parental suggestions can be implemented easily and cost-effectively. The importance of professional communication and situationally adapted information for parents was confirmed.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2356036"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711682","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}

{"title":"Clinical value of screening prenatal ultrasound combined with chromosomal microarrays in prenatal diagnosis of chromosomal abnormalities.","authors":"Hongru Jiang, Xiangtian Kong, Wenjun Bian, Jiangyue Liu, Yuanyuan Xu, Aimin Cui, Xian Cao","doi":"10.1080/14767058.2024.2324348","DOIUrl":"10.1080/14767058.2024.2324348","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical value of ultrasound findings in the screening of fetal chromosomal abnormalities and the analysis of risk factors for chromosome microarray analysis (CMA) abnormalities.</p><p><strong>Methods: </strong>We retrospectively analyzed the datasets of 15,899 pregnant women who underwent prenatal evaluations at Affiliated Maternity and Child Health Care Hospital of Nantong University between August 2018 and December 2022. Everyone underwent ultrasound screening, and those with abnormal findings underwent CMA to identify chromosomal abnormalities.</p><p><strong>Results: </strong>The detection rates for isolated ultrasound anomalies and combined ultrasound and CMA anomalies were 11.81% (1877/15,899) and 2.40% (381/15,899), respectively. Among all ultrasound abnormalities, detection rates for isolated ultrasound soft marker anomalies, isolated structural abnormalities, and both ultrasound soft marker anomalies with structural abnormalities were 82.91% (1872/2258), 15.99% (361/2258), and 1.11% (25/2258), respectively. The detection rate of abnormal chromosomes in pregnant women with abnormal ultrasound results was 16.87% (381/2258). The detection rates were 13.33% in cases with two or more ultrasound soft markers anomalies, 47.37% for two or more structural anomalies, and 48.00% for concomitant ultrasound soft marker and structural anomalies.</p><p><strong>Conclusions: </strong>Enhanced detection rates of chromosomal anomalies in fetal malformations are achieved with specific ultrasound findings (NT thickening, cardiovascular abnormalities, and multiple soft markers) or when combined with high-risk factors (advanced maternal age, familial history, parental chromosomal anomalies, etc.). When the maternal age is over 35 and with ≥2 ultrasound soft marker anomalies accompanied with any high-risk factors, CMA testing can aid in the diagnosis of prenatal chromosomal abnormalities.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2324348"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140095062","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}

{"title":"Association of congenital uterine anomaly with abnormal placental cord insertion and adverse pregnancy complications: a retrospective cohort study.","authors":"Tatsuya Yoshihara, Yasuhiko Okuda, Osamu Yoshino","doi":"10.1080/14767058.2024.2382309","DOIUrl":"https://doi.org/10.1080/14767058.2024.2382309","url":null,"abstract":"<p><strong>Objective: </strong>Congenital uterine anomalies during pregnancy increase the risk of pregnancy complications such as miscarriage, preterm delivery, fetal malpresentation, cesarean delivery, and fetal growth restriction. However, few studies have examined uterine anomalies in relation to perinatal complications other than those mentioned above. We investigated the association between pregnancies complicated by congenital uterine anomalies and various perinatal outcomes at our institution.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted from January 2009 to May 2021. We included cases of uterine anomalies, such as septate, bicornuate, unicornuate, and didelphic uterus. First, the perinatal complications and neonatal outcomes were compared between pregnancies complicated by uterine anomalies and those with normal uteri. Second, we conducted an analysis based on the type of uterine anomalies classified into two groups: the minor anomaly group consisted of anomalies limited to the uterine cavity, such as the septate uterus, whereas the major anomaly group included anomalies affecting the uterine shape, such as bicornuate, unicornuate, and didelphic uterus. We compared the incidence of perinatal complications among the major anomaly, minor anomaly, and normal uterus groups.</p><p><strong>Results: </strong>During the study period, 45 pregnancies were complicated with uterine anomalies. The minor anomaly group included 11 patients and the major anomaly group included 34 patients. The incidence of fetal malpresentation was significantly higher in the uterine anomaly group than in the normal uterus group (18% vs. 3.7%, <i>p</i> = .04). Furthermore, the frequency of abnormal placental cord insertion was significantly higher in the uterine anomaly group (16% vs. 3.7%, <i>p</i> = .01). Examination based on the type of uterine anomaly revealed significant differences in cervical incompetence, malpresentation, cesarean section, and abnormal placental cord insertion. Cervical incompetence was more likely in patients with minor anomalies. In contrast, fetal malpresentation, cesarean section, and abnormal placental cord insertion were more likely in the major anomaly group.</p><p><strong>Conclusions: </strong>In addition to the findings reported in previous studies, abnormal placental cord insertion was more frequent in pregnancies complicated by uterine anomalies.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2382309"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890760","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}

{"title":"Histopathologic characteristics of term placentas in singleton pregnancies in women with endometriosis-related infertility after ART treatment: case-control study.","authors":"S Dumancic, M Pehlic, P Mijic, M D Mimica, S Zekic Tomas, J Marusic","doi":"10.1080/14767058.2024.2385451","DOIUrl":"https://doi.org/10.1080/14767058.2024.2385451","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Endometriosis is one of the leading causes of infertility, due to negative impact on ovarian folliculogenesis and endometrial receptivity. Literature show that endometriosis could be associated with perinatal complications such as preterm birth (PTB) and preeclampsia (PE). Authors hypothesized that women with endometriosis-related infertility conceived by assisted reproductive technology (ART) treatment have higher frequency of placental disorders. Main outcome is the occurrence of histopathologic alterations of term placentas in singleton pregnancies of women with endometriosis conceived by ART treatment, compared to healthy women with infertility due to male factor (MF) conceived by ART and to healthy women with spontaneous pregnancies. Secondary outcome include the occurrence of perinatal complications and the relationship of endometriosis and placental histopathologic characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Single-center, case-control study of term placentas that were collected within Department of Obstetrics and Gynecology of University Hospital Center (UHC) Split and analyzed in the Pathology department of the same hospital, by one senior perinatal pathologist. Histopathologic analysis was reported using Amsterdam Placental Workshop Group Consensus. All the noted placental lesions were divided into following categories: anatomic, inflammatory, villous maturation and vascular malperfusion disorders. Required sample size was 80 placentas, and study results were reported with descriptives, and analyzed with chi-squared, Fisher's exact test and Kruskal-Wallis ANOVA. Multivariate regression analysis was carried with adjustment for confounding factors. Ethics approval: Class n. 520-03/24-01/83.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Study included term placentas of 107 women, of which 36 were women with endometriosis conceived by ART, 31 were healthy women with MF infertility conceived by ART and 40 healthy women with spontaneous pregnancies. Endometriosis women were predominantly primiparas, with longer infertility duration. Endometriosis group had higher occurrence of early pregnancy bleeding and imminent preterm labor. Endometriosis and MF groups had higher occurrence of Cesarian delivery (CS), while endometriosis group had newborns with lowest birthweight. Endometriosis group had shorter placental cords (PC), higher rates of increased syncytial knotting and vascular malperfusion disorders (subchorionic and perivillous fibrin, intervillous thrombosis, high grade fetal vascular malperfusion). Finally, endometriosis is showed to be associated with increased syncytial knots' formation and PC hypercoiling, after adjustment for confounding factors in the multivariate regression analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Despite low rates of perinatal complications, we report endometriosis to have higher occurrence of increased syncytial knotting and vascular malperfusion placental disorders, compared to control ","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2385451"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917959","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}

{"title":"Association of thyroid peroxidase antibody positivity in the first trimester with gestational metabolic disorders: a retrospective study.","authors":"Xinxin Yang, Nairui Zhao, Fang Gao, Yi Wu","doi":"10.1080/14767058.2024.2431091","DOIUrl":"https://doi.org/10.1080/14767058.2024.2431091","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between thyroid peroxidase antibody (TPOAb) positivity in the first trimester and maternal metabolic syndrome in pregnancy.</p><p><strong>Methods: </strong>The study retrospectively reviewed the medical records for 787 pregnant women. Serum-free thyroid hormone, thyroid stimulating hormone, and TPOAb levels were measured in early pregnancy (<13 weeks gestation). Baseline demographics, clinical characteristics, thyroid function, and pregnancy outcomes were compared between women who were TPOAb positive or TPOAb negative in the first trimester. Associations between TPOAb positivity in the first trimester and the occurrence of gestational diabetes mellitus, hypertensive disorders complicating pregnancy (HDCP), maternal metabolic syndrome in pregnancy, and adverse pregnancy outcomes were explored.</p><p><strong>Results: </strong>Data for 787 women with a singleton pregnancy were included in the analyses. In women who were TPOAb positive compared to TPOAb negative in the first trimester, baseline HDL-C was significantly lower (1.51 [1.33, 1.81] vs. 1.62 [1.40, 1.87], <i>p =</i> 0.028), and there was a significantly higher incidence of HDCP (15.8% vs. 6%, <i>p</i> < 0.0001), maternal metabolic syndrome in pregnancy (18.8% vs 6.4%, <i>p</i> < 0.0001) or preeclampsia (7% vs, 2.5%, <i>p</i> = 0.024). There was a significant nonlinear association between TPOAb levels in the first trimester and the incidence of HDCP or maternal metabolic syndrome in pregnancy (both <i>p</i> < 0.001). The logit of the probability of having HDCP or maternal metabolic syndrome in pregnancy increased rapidly at TPOAb (log₁₀) ≤ 1.5 (TPOAb (log₁₀) = 1.07 as reference). After adjusting for confounders (maternal age, pre-pregnancy BMI, gravidity, parity and history of adverse events during pregnancy), there was a significantly higher risk of HDCP (odds ratio [OR], 3.029; 95% confidence interval [CI], 1.586, 5.622, <i>p</i> = 0.001), maternal metabolic syndrome in pregnancy (OR, 2.841; 95% CI, 1.473-5.260, <i>p</i> = 0.001), or preeclampsia (OR 3.315, 95% CI 1.305-7.788, <i>p</i> = 0.008) in women who were TPOAb positive compared to TPOAb negative in the first trimester.</p><p><strong>Conclusion: </strong>TPOAb positivity in the first trimester may increase the risk of HDCP, maternal metabolic syndrome in pregnancy, and preeclampsia, emphasizing the need for universal screening for thyroid disorders and better diagnostic criteria and management strategies for metabolic disorders during pregnancy.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2431091"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711678","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}

{"title":"Low-density lipoprotein cholesterol and the risk of hyperemesis gravidarum: a Mendelian randomization study.","authors":"Xiaohu Liu, Xiaoting Zhou, Jiao Wang, Aiqi Cai, Yinhong Zhang, Jinman Zhang, Ze Wu, Baosheng Zhu","doi":"10.1080/14767058.2024.2397722","DOIUrl":"https://doi.org/10.1080/14767058.2024.2397722","url":null,"abstract":"<p><strong>Objective: </strong>The inconsistency in conclusions from early observational studies has sparked our interest in elucidating the relationship between lipid levels and susceptibility to hyperemesis gravidarum (HG). This study wishes to employed Mendelian randomization analysis to investigate the causal relationship between low-density lipoprotein cholesterol (LDL-C) and HG.</p><p><strong>Methods: </strong>We employed Tow-Sample MR analysis to investigate the causal associations between LDL-C and HG. Specific variables were selected from GWAS database for MR analysis, using single nucleotide polymorphisms (SNPs) as our instruments. The threshold for significant SNPs as genetic instruments has been set at 5 × 10^-8. F-statistic was employed to validate the strength of exposure instruments. The causality was mainly evaluated by Inverse Variance Weighted method (IVW). To address potential bias from the selection of genetic variants with pleiotropic effects, sensitivity analysis was performed by Cochrane Q-test, MR Egger, weighted median, MR-PRESSO and Leave-one-out methods. To validate the directionality of causal relationships, we employed Steiger test to filter SNPs. At last, we conducted reverse MR to exclude the causal impact of HG on LDL-C levels.</p><p><strong>Results: </strong>Our MR results identified the effect of genetically predicted increased LDL-C levels on increased genetic susceptibility to HG (<i>OR</i>:1.30; <i>95%CI</i>:1.03-1.65; <i>p</i> = 0.028). In reverse MR analyses, no evidence was found for causal effect of HG on LDL-C levels (<i>OR</i>:1.00; <i>95%CI</i>:1.00-1.01; <i>p</i> = 0.163). Sensitivity analyses were used to confirm reliability.</p><p><strong>Conclusion: </strong>This study may have provided evidence of genetically predicted increased LDL-C levels on increased genetic susceptibility to HG. Appropriate lowering LDL-C levels may serve as a preventive and treatment measure for HG.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2397722"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299821","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}

{"title":"Relationship between life's essential 8 and the risk of gestational diabetes among us adults.","authors":"Lu Qin, Zhixing Fan, Qian Shi, Hao Hu, Fang Ma, Yanlin Huang, Fengzhi Tan","doi":"10.1080/14767058.2024.2407037","DOIUrl":"10.1080/14767058.2024.2407037","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study is to explore the relationship between Life's Essential 8 (LE8) and the risk of gestational diabetes among US adults.</p><p><strong>Method: </strong>We used National Health and Nutrition Examination Surveys 2007-2018 data to perform this study. LE8 scores comprised 4 health behaviors (diet, physical activity, nicotine exposure, and sleep duration) and 4 health factors (BMI, non-high-density lipoprotein [HDL] cholesterol, blood glucose, and blood pressure). Then, LE8 were categorized into low CVH (0 to 49 scores), moderated CVH (50 to 79 scores), and high CVH (80 to 100 scores). Weighted multivariate Logistic regression analysis model were used to estimate the relationship between LE8 and gestational diabetes.</p><p><strong>Result: </strong>A total of 3,189 participants were included, and the portion of gestational diabetes was 15.33%, 11.46%, 7.71% in low CVH, moderate CVH, and high CVH, respectively. Adjustment for covariates, we found that high CVH (OR: 0.49, 95%CI: 0.29-0.83, <i>p</i> = 0.01) was associated with decreased of gestational diabetes, not moderate CVH (OR: 0.78, 95%CI: 0.50-1.20, <i>p</i> = 0.25). This inverse associations were dose-response dependent (<i>p</i>-nonlinear = 0.982). This inverse associations were significant in subgroup. Significant interaction between CVH and family diabetes with the risk of gestational diabetes was found (<i>P</i> for interaction = 0.04). High CVH (OR: 0.357, 95%CI: 0.176-0.724, <i>p</i> = 0.005) could significantly decrease the risk of gestational diabetes in the population with family diabetes. The results were generally robust in sensitivity analyses after excluding of ASCVD participants.</p><p><strong>Conclusion: </strong>The high CVH could decrease the risk of gestational diabetes, especially in the population of family diabetes.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2407037"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308981","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}

{"title":"Research on evaluation of fetal right ventricular function in normal and diabetic pregnant women during mid to late pregnancy using automated MPI ultrasound detection technology.","authors":"Zhong-Jia Ding, Jin-Zhuo Yue, Yong-Dong Zhang, Wang Yin","doi":"10.1080/14767058.2024.2424892","DOIUrl":"https://doi.org/10.1080/14767058.2024.2424892","url":null,"abstract":"<p><p><b>Objective:</b> fetal circulatory characteristics differ from those after birth; the right ventricle assumes more than 60% of the workload in the systemic circulation before birth. The right ventricle automated myocardial performance index (AM+MPI) is a simple, time-efficient, and stable assessment method used to evaluate overall cardiac function. This study aimed to apply the right ventricle AM+MPI technique to explore its role in normal mid-to-late pregnancy fetal cardiac function and compare the AM+MPI differences between diabetic and normal fetuses. <b>Methods:</b> A total of 150 pregnant women who visited the obstetric outpatient department at Daxing Hospital, Xi'an, from January 2022 to June 2022 were selected. We excluded 42 patients with comorbid conditions other than diabetes, fetal anomalies, and unclear last menstrual periods, resulting in 85 healthy pregnant patients and 17 diabetic pregnant patients. Using a Samsung WS80A color Doppler ultrasound diagnostic device, we measured the fetal right ventricle AM+MPI, isovolumic contraction time (ICT), isovolumic relaxation time (IRT), and ejection time (ET) in RMPI mode. We performed variability and correlation analyses within the normal group and compared these parameters with those of the diabetic group. <b>Results:</b> In the healthy pregnant group, there was no significant variability in the fetal MPI, ET, or ICT values among the groups (<i>p</i> > 0.05). However, the IRT was positively correlated with gestational age (<i>p</i> < 0.05), with a linear fit formula of IRT = 29.78 + 0.49 × gestational age (DW value 1.87; <i>F</i> = 32.25, <i>p</i> < 0.05), indicating that the IRT increases with gestational age. The right ventricle MPI in the diabetic group was significantly greater than that in the normal group (<i>p</i> < 0.05). <b>Conclusion:</b> The right ventricle AM+MPI technique is simple, time-efficient, and stable and can objectively assess fetal right ventricle function, providing a theoretical basis for the early diagnosis of intrauterine cardiac function abnormalities. Additionally, there are significant differences in the right ventricle MPI between diabetic and normal fetuses, providing evidence for predicting fetal developmental issues and postnatal complications. The right ventricle AM+MPI holds promise as a new method for prenatal evaluation of fetal right heart function.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2424892"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584651","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}

{"title":"Epidural ropivacaine versus bupivacaine for cesarean sections: a system review and meta-analysis.","authors":"Tao Kang, Jiwei Tao, Xuetao Wang, Yu Liu, Dan Jin","doi":"10.1080/14767058.2024.2313356","DOIUrl":"10.1080/14767058.2024.2313356","url":null,"abstract":"<p><strong>Introduction: </strong>It is still no consensus on the use of ropivacaine or bupivacaine in epidural anesthesia for cesarean section (CS), because their anesthetic potency and relative complications remains controversial. This system review and meta-analysis aimed to compare the efficacy of epidural ropivacaine and bupivacaine for elective CSs and investigate relative complications for parturients and neonates.</p><p><strong>Methods: </strong>We searched PubMed, MEDLINE, Embase, Cochrane Library, Science-Direct, and Google Scholar to June 30, 2023 for randomized controlled trials (RCTs), which compared epidural ropivacaine with bupivacaine for elective CSs. The success rate of epidural anesthesia (EA) was primary outcome. The secondary outcomes included onset times of sensory block, maternal side effects, neonatal Apgar scores and umbilical artery pH.</p><p><strong>Results: </strong>We analyzed 8 RCTs with 532 parturients. 0.75% ropivacaine is associated with a shorter onset time of sensory block than 0.5% bupivacaine (SMD = -0.43, 95% CI: -0.70 to -0.17; <i>p</i> = .001). 0.5% ropivacaine resulted in a reduced nausea than 0.5% bupivacaine (RR = 0.49, 95% CI: 0.28 to 0.83; <i>p</i> = .008). In addition, there were no significant difference between ropivacaine and bupivacaine groups in terms of success rate of epidural anesthesia, maternal side effects (hypotension, bradycardia, shivering), and neonatal Apgar scores and umbilical artery pH.</p><p><strong>Conclusions: </strong>The findings suggest that there were no significant difference between epidural ropivacaine and bupivacaine for elective CSs in terms of the success rate (85.9% vs. 83.5), maternal side effects (hypotension, bradycardia, shivering), and neonatal Apgar scores and umbilical artery pH. But compared with 0.5% bupivacaine, epidural 0.75% ropivacaine was mildly effective for reducing onset time of sensory block and 0.5% ropivacaine reduced the incidence of maternal nausea.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2313356"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139718025","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}

{"title":"Accuracy of transcutaneous bilirubinometry in term infants after phototherapy: a prospective observational study.","authors":"Charissa Joy, Taya A Collyer, Kathryn McMahon","doi":"10.1080/14767058.2023.2295808","DOIUrl":"10.1080/14767058.2023.2295808","url":null,"abstract":"<p><strong>Objective: </strong>To test the accuracy of transcutaneous bilirubinometry (TcB) in neonates 12 h after discontinuing phototherapy.</p><p><strong>Study design: </strong>In a prospective study of 91 neonates at ≥35 weeks of gestation, paired measurements of total serum bilirubin (TSB) and TcB were obtained 12 h after discontinuation of phototherapy. TcB measurements were obtained on the uncovered skin of the sternum and the covered skin of the lower abdomen. Bland-Altman plots were used to evaluate agreement between TSB and TcB.</p><p><strong>Results: </strong>TcB was found to systematically underestimate TSB on both covered and uncovered skin. The smallest but statistically significant difference between TSB and TcB was found on the covered lower abdomen (-1.03, <i>p</i> < .0001) compared with the uncovered skin of the sternum (-1.44, <i>p</i> < .0001). The correlation between TSB and TcB was excellent on both covered (<i>r</i> = 0.86, <i>p</i> < .001) and uncovered skin (<i>r</i> = 0.90, <i>p</i> < .001). Bland and Altman plots showed poor agreement between TcB and TSB.</p><p><strong>Conclusions: </strong>This study demonstrated excellent correlation between TcB and TSB 12 h after phototherapy but poor TcB-TSB agreement. TcB cannot be reliably used in neonates exposed to phototherapy.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2295808"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139038147","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}