Reproductive, Female and Child Health最新文献

Placenta accreta spectrum disorders: A retrospective continuous audit of clinical outcomes of 82 cases over 18 years in a large outer London associated teaching hospital 胎盘早剥谱系障碍：对伦敦外围一家大型教学医院 18 年来 82 个病例的临床结果进行回顾性连续审计

Reproductive, Female and Child Health Pub Date : 2024-04-22 DOI: 10.1002/rfc2.81

Emily Leung, Michael Magro, C. Otigbah, Sorina Bologa

{"title":"Placenta accreta spectrum disorders: A retrospective continuous audit of clinical outcomes of 82 cases over 18 years in a large outer London associated teaching hospital","authors":"Emily Leung, Michael Magro, C. Otigbah, Sorina Bologa","doi":"10.1002/rfc2.81","DOIUrl":"https://doi.org/10.1002/rfc2.81","url":null,"abstract":"To analyse and describe the clinical outcomes for the women with placenta accreta spectrum (PAS) disorders managed in our Trust over the last 18 years.Hospital‐based retrospective continuous audit.Continuous audit of the women diagnosed with PAS between 2005 and 2023.Large outer London teaching hospital.All women with low‐lying placenta on a previous caesarean scar were screened during their anomaly scan. Those with suspected PAS were referred to foetal medicine and once confirmed, managed using a multidisciplinary team approach.Time of diagnosis, risk factors, timing of and gestation at delivery, type of surgical procedure, length of stay, intensive therapy unit admission, blood transfusion requirements, use of cell salvage, haemostatic techniques, histology, in‐utero transfer rate, need for emergency delivery and complications.Of the 82 women, 61% were nonwhite and 76% overweight or obese. Thirty‐four percent occurred in women with one previous caesarean. The number managed each year increased, with 39% occurring since 2018. Twenty‐two percent were transferred from other Trusts. Eighty‐four percent delivered >32 weeks gestation with only two women delivering live births <28 weeks. Eighty‐three percent delivered by planned caesarean. Complication rates were low overall, haemorrhage >3 L occurred in 35%. Since 2018, 72% had excision and these cases had better surgical outcomes and fewer complications.Our data demonstrates that our cohort of women are a high‐risk population but despite this, our results are favourable and demonstrate a move to excision surgery with associated reduced morbidity, low rate of complications, a short hospital stay and very low rates of extremely premature deliveries.","PeriodicalId":510696,"journal":{"name":"Reproductive, Female and Child Health","volume":"34 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140674623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Appropriateness, timeliness and perinatal outcomes of obstetric referrals managed by caesarean section: A prospective observational cohort study 剖腹产产科转诊的适当性、及时性和围产期结果：前瞻性观察队列研究

Reproductive, Female and Child Health Pub Date : 2024-04-15 DOI: 10.1002/rfc2.79

Yuda Munyaw, R. Moshiro, M. Ngarina, Godfrey Guga, H. Ersdal, Jorgen Linde

{"title":"Appropriateness, timeliness and perinatal outcomes of obstetric referrals managed by caesarean section: A prospective observational cohort study","authors":"Yuda Munyaw, R. Moshiro, M. Ngarina, Godfrey Guga, H. Ersdal, Jorgen Linde","doi":"10.1002/rfc2.79","DOIUrl":"https://doi.org/10.1002/rfc2.79","url":null,"abstract":"To evaluate the appropriateness, timeliness and perinatal outcomes of obstetric referrals compared to nonreferrals managed by caesarean section (CS) at a tertiary hospital.Research assistants observed and recorded every delivery prospectively. Neonates were followed to discharge or up to 7 days, and outcomes were recorded. Proportions were used to describe baseline characteristics of the groups, and logistic regression was used to determine factors associated with CS in the referral group.A total of 10 353 deliveries occurred during the study period: 7.4% (768) were referrals and 92.6% (9585) were nonreferrals. The proportion of CS among referrals was 41.5% (319), nonreferrals 22.5% (2152) and overall 23.8% (2471). Compared to nonreferrals, referred women arrived at the second stage of labour with complications, ending up with emergency CS (p < 0.001). Factors associated with CS with odds ratio (OR) in the referral group were previous CS (11.06), abnormal foetal heart rate (4.96), breech presentation (4.61) and thick meconium (3.61). The referral group had higher proportions of stillbirths and neonatal admissions compared to nonreferrals (p < 0.001).Referred women arrived late with complications ending with CSs and adverse perinatal outcomes. Earlier identification of complications and timely referral from lower‐level facilities may have the potential to prevent adverse outcomes.","PeriodicalId":510696,"journal":{"name":"Reproductive, Female and Child Health","volume":"338 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140703267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The value of an extended postnatal program for contraceptive use during the first year postpartum 产后第一年延长避孕计划的价值

Reproductive, Female and Child Health Pub Date : 2024-03-01 DOI: 10.1002/rfc2.78

Kajsa S. Kedfors, Helena Hognert, Ian Milsom, Mattias Molin, Ingela Lindh

{"title":"The value of an extended postnatal program for contraceptive use during the first year postpartum","authors":"Kajsa S. Kedfors, Helena Hognert, Ian Milsom, Mattias Molin, Ingela Lindh","doi":"10.1002/rfc2.78","DOIUrl":"https://doi.org/10.1002/rfc2.78","url":null,"abstract":"To investigate if earlier and repeated postpartum care visits (PPCVs) (3 and 7 weeks) compared to a standard visit (7 weeks) would increase early initiation of contraception and contraceptive use at 1‐year postpartum.Comparative clinical trial.Six maternity clinics in Gothenburg, Sweden.There were 447 women in the intervention group and 511 in the standard group.Comparing standard postpartum care with an intervention model of care.Initiation of contraception and method used.From January 2019 to June 2020, 1159, participants were enrolled. Analyses included 958 subjects where the intervention group had higher use of contraception (55.5%) compared to the standard group (48.5%), (95% confidence interval [CI]: 0.4–13.5), p = 0.037. Long‐acting reversible contraceptives were higher among users in the intervention group (56.9%) compared to the standard group (48%), (95% CI: −0.3 to 18.0), p = 0.059. Condom use was higher in the standard group (19%) compared to the intervention group (12.1%), (95% CI: 0.1–13.6), p = 0.047. Contraceptive use 1‐year postpartum was higher in the intervention group (55.7%) compared to the standard group (47.2%), (95% CI: 1.2–15.9), p = 0.023 and more pregnancies were reported in the standard group (7.8%) compared to the intervention group (4.1%), (95% CI: 0.5–7.0), p = 0.040.These results indicate the importance of earlier and additional PPCVs to increase early start‐up of contraception and to obtain a higher frequency of contraceptive use 1‐year postpartum to reduce pregnancies close to delivery.","PeriodicalId":510696,"journal":{"name":"Reproductive, Female and Child Health","volume":"103 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140088872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Second trimester maternal serum progesterone and estradiol concentrations with live and demised fetuses: Secondary analysis results from a randomized controlled trial 第二孕期母体血清孕酮和雌二醇浓度与活胎和死胎的关系：随机对照试验的二次分析结果

Reproductive, Female and Child Health Pub Date : 2024-03-01 DOI: 10.1002/rfc2.77

E. Allanson, Sean Copson, Katrina Spilsbury, Sonya Criddle, Belinda Jennings, Dorota A. Doherty, Antonia M. Wong, Jan E. Dickinson

{"title":"Second trimester maternal serum progesterone and estradiol concentrations with live and demised fetuses: Secondary analysis results from a randomized controlled trial","authors":"E. Allanson, Sean Copson, Katrina Spilsbury, Sonya Criddle, Belinda Jennings, Dorota A. Doherty, Antonia M. Wong, Jan E. Dickinson","doi":"10.1002/rfc2.77","DOIUrl":"https://doi.org/10.1002/rfc2.77","url":null,"abstract":"To provide data on maternal levels of estradiol and progesterone in the second trimester of pregnancy with a live foetus and those complicated by a spontaneous foetal demise.Within a randomised trial to assess efficacy of mifepristone in termination following foetal demise from 14 to 28 weeks of gestation, we measured progesterone and estradiol levels in trial patients and in women undergoing termination with a live foetus. Women admitted to King Edward Memorial Hospital (Western Australia) from 2013 to 2016 were considered for eligibility and enroled. Scatter plots with 95% confidence intervals were generated for hormone levels by gestation. Generalised linear models were used to estimate mean values of estradiol and progesterone, accounting for maternal age, gestation and parity.Overall, women with a foetal demise had lower estradiol levels compared to women with a live foetus, (mean difference of 10 460 pmol/L). With a live foetus, higher levels of estradiol were observed with increasing gestations: with a mean of 17 010 pmol/L at 14 ≤ 17 weeks, 31 180 pmol/L at 23–28 weeks and similarly progesterone with a mean of 113 nmol/L at 14 ≤ 17 weeks and 183 nmol/L at 23–28 weeks. Progesterone levels in women with foetal demise were 37 nmol/L higher than women in the live foetus group. In all women, each unit increase in parity was associated with a decrease of 10nmol/l of progesterone (95% confidence interval: 4–16, p = 0.001).Estradiol and progesterone levels in the second trimester vary between pregnant women with a live and demised foetus.","PeriodicalId":510696,"journal":{"name":"Reproductive, Female and Child Health","volume":"525 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140281157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Contraceptive choice and decision‐making among college students in a Southeastern US state 美国东南部某州大学生的避孕选择和决策

Reproductive, Female and Child Health Pub Date : 2024-03-01 DOI: 10.1002/rfc2.76

Clare Kimiecik, Sarah B. Maness, Beth Sundstrom

引用次数: 0

Misgav‐Ladach or modified Misgav‐Ladach versus Pfannenstiel‐Kerr methods for cesarean deliveries: A systematic review and meta‐analysis Misgav-Ladach 或改良 Misgav-Ladach 与 Pfannenstiel-Kerr 剖宫产方法的比较：系统回顾和荟萃分析

Reproductive, Female and Child Health Pub Date : 2023-11-22 DOI: 10.1002/rfc2.65

Natalie E Bourdakos, Fatma A. Abdulsalam, Marie Michele Macaron, Maya L. Nasser, Nathanael Yap, Reem H. Matar, Maamoun Adra, H. Nakanishi, Christian A. Than, Sabaratnam Arulkumaran

{"title":"Misgav‐Ladach or modified Misgav‐Ladach versus Pfannenstiel‐Kerr methods for cesarean deliveries: A systematic review and meta‐analysis","authors":"Natalie E Bourdakos, Fatma A. Abdulsalam, Marie Michele Macaron, Maya L. Nasser, Nathanael Yap, Reem H. Matar, Maamoun Adra, H. Nakanishi, Christian A. Than, Sabaratnam Arulkumaran","doi":"10.1002/rfc2.65","DOIUrl":"https://doi.org/10.1002/rfc2.65","url":null,"abstract":"Caesarean sections (CSs) constitute a large proportion of fetal deliveries, yet no consensus exists on optimal surgical method.To investigate the safety and efficacy of the Pfannenstiel‐Kerr method (PKM) in comparison to Misgav‐Ladach method (MLM) and Modified Misgav‐Ladach method (MMLM) for CS.Cochrane, Embase, PubMed, CiNAHL, Scopus, and Web of Science were searched from database inception to March 2023.Prospective studies comparing MLM with PKM or MMLM with PKM.Three authors independently conducted data extraction and assessed quality. Pooled means and proportions were analyzed using inverse variance and Mantel‐Haenszel methods.Twenty‐seven studies with 15 251 patients, met the selection criteria. Both MLM (mean difference [MD]: −12.09 min, 95% confidence interval [CI]: −14.40, −9.77, Tau2 = 16.79, I2 = 97%), (MD: −125.98 mL, 95% CI: −172.13, −79.83, Tau2 = 3458.59, I2 = 87%) and MMLM (MD: −11.38 min, 95% CI: −14.72, −8.04, Tau2 = 30.56, I2 = 100%), (MD: −62.61 mL, 95% CI: −103.13, −22.09, Tau2 = 1451.35, I2 = 92%) demonstrated shorter operative time and decreased blood loss, respectively, compared to PKM. Similarly, both MLM (MD: −1.70 min, 95% CI: −2.26, −1.14, Tau2 = 0.51, I2 = 97%), (MD: −0.77 d, 95% CI: −1.35, −0.19, Tau2 = 0.60, I2 = 98%) and MMLM (MD: −2.80 min, 95% CI: −3.89, −1.70, Tau2 = 1.74, I2 = 100%), (MD: −0.58 d, 95% CI: −1.00, −0.17, Tau2 = 0.29, I2 = 100%) demonstrated shorter fetal extraction time and length of hospital stay, respectively, compared to PKM.MLM and MMLM should be considered safe and effective alternative approaches to CSs.","PeriodicalId":510696,"journal":{"name":"Reproductive, Female and Child Health","volume":"41 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139249301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0