The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians最新文献

{"title":"Management of late preterm preeclampsia: a comparison of maternal and fetal indications for delivery.","authors":"Stephanie Galibert,&nbsp;Emerson Keenan,&nbsp;Roxanne Hastie,&nbsp;Fiona C Brownfoot","doi":"10.1080/14767058.2021.1882980","DOIUrl":"https://doi.org/10.1080/14767058.2021.1882980","url":null,"abstract":"<p><strong>Objective: </strong>To investigate delivery indications for women with late preterm preeclampsia and evaluate whether disease characteristics at presentation are predictive of delivery indication.</p><p><strong>Methods: </strong>We conducted a retrospective case-control study at the Mercy Hospital for Women (a tertiary hospital in Melbourne, Australia). Indication for delivery was assessed among women presenting with preeclampsia between 30⁺⁰ and 36⁺⁰ weeks' gestation. Baseline maternal and disease characteristics, preeclampsia features at delivery and postnatal outcomes were compared between patients delivering for maternal, fetal, or for both maternal and fetal indications.</p><p><strong>Results: </strong>173 women were diagnosed with preeclampsia between 30⁺⁰ and 36⁺⁰ weeks' gestation. Maternal baseline characteristics were similar between the groups. We found that 55.5% of women were delivered on maternal grounds compared to 27.2% requiring delivery for fetal indications; and 17.3% for both maternal and fetal indications (<i>p</i> < .0001). At diagnosis, intrauterine growth restriction and abnormal Dopplers increased the risk of requiring delivery for fetal indications by 3.5 times and 2.4 times respectively.</p><p><strong>Conclusion: </strong>Women presenting with late preterm preeclampsia primarily required delivery for maternal disease progression rather than fetal compromise.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"5431-5437"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1882980","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25350244","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}

{"title":"Prolonged second stage effect on pelvic floor dysfunction: a follow up survey to a randomized controlled trial.","authors":"Alexis C Gimovsky,&nbsp;Jaclyn M Phillips,&nbsp;Molly Amero,&nbsp;Jordan Levine,&nbsp;Vincenzo Berghella","doi":"10.1080/14767058.2021.1887122","DOIUrl":"https://doi.org/10.1080/14767058.2021.1887122","url":null,"abstract":"<p><strong>Background: </strong>Pelvic floor dysfunction is a group of disorders that can significantly impact quality of life due to persistent urinary and anal incontinence. Data evaluating the effect of prolonged second stage of labor and postpartum pelvic floor dysfunction is heterogenous and limited.</p><p><strong>Objective: </strong>To evaluate whether extending the length of labor in nulliparous women with prolonged second stage affects the presence of self-reported pelvic floor dysfunction after a randomized controlled trial of prolonged second stage.</p><p><strong>Study design: </strong>We conducted a planned follow up survey to our randomized controlled trial of prolonged second stage of labor using the Pelvic Floor Distress Inventory-20 (PFDI-20). The primary outcome was the PFDI-20 summary score. Secondary outcomes included urinary and fecal incontinence, prolapse, and patient satisfaction. Women surveyed were nulliparous patients with epidural anesthesia, previously enrolled in a randomized controlled trial that assigned them to <i>extended labor</i>, at least 1 additional hour in the second stage if they were undelivered after three hours, or to <i>usual labor</i>, defined as expedited delivery after three hours in the second stage. Women were surveyed at 12 - 36 months postpartum.</p><p><strong>Results: </strong>Thirty-four of the seventy-eight women responded to the survey (43.6%). 17 women (50.0%) were from the extended labor group and 17 from the usual labor group (50.0%). Maternal demographic data were not significantly different between groups. The PFDI-20 summary score was 13.8 ± 23.3 in the extended labor group and 13.1 ± 20.9 in the usual labor group (<i>p</i> = 0.9). The Pelvic Organ Prolapse Distress Inventory-6 was 1.2 ± 2.9 in the extended labor group and 2.7 ± 6.4 in the usual labor group (<i>p</i> = 0.4). The Colorectal-Anal Distress Inventory-8 was 0.8 ± 2.8 in the extended labor group and 2.1 ± 4.0 in the usual labor group (<i>p</i> = 0.6). The Urinary Distress Inventory-6 was 11.8 ± 21.1 in the extended labor group and 8.3 ± 14.5 in the usual labor group (<i>p</i> = 0.6). Maternal and neonatal outcomes, as well as patient satisfaction, were not statistically significantly different between groups.</p><p><strong>Conclusion: </strong>Extending the length of labor in nulliparas with singleton gestations, epidural anesthesia, and prolonged second stage did not have an impact on PFDI-20 scores at 12-36 months postpartum. However, our study was underpowered to detect small, but potentially clinically important, differences.</p><p><strong>Clinical trial number: </strong>NCT02101515 (Study Registration Date March 28, 2014) https://clinicaltrials.gov/ct2/show/NCT02101515.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"5520-5525"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1887122","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25369372","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}

{"title":"Middle-East OBGYN Graduate Education (MOGGE) Foundation practice guidelines: prevention of group B Streptococcus infection in pregnancy and in newborn. Practice guideline no. 02-O-20.","authors":"Sherif A Shazly,&nbsp;Ahmad A Radwan,&nbsp;Abdelrahman A Shawki,&nbsp;Aliaa E Said,&nbsp;Yasmin I Mohamed,&nbsp;Heba N Hemdan,&nbsp;Menna N Hemdan,&nbsp;Norhan G Mohamed,&nbsp;Rania I Adam,&nbsp;Ahmed A Nassr,&nbsp;Nashwa A Eltaweel,&nbsp;Ismet Hortu,&nbsp;Amr Shehata,&nbsp;Mohamed S Abdo,&nbsp;Hajer Y Moustafa,&nbsp;Ahmed Yassien Abd-Elkariem,&nbsp;Shimaa Salah Ali,&nbsp;Nermeen B Ahmed,&nbsp;Esraa M Hosny,&nbsp;Mostafa H Abouzeid","doi":"10.1080/14767058.2021.1875211","DOIUrl":"https://doi.org/10.1080/14767058.2021.1875211","url":null,"abstract":"<p><p>Rectovaginal colonization with group B streptococcus (GBS) is commonly encountered in pregnancy. GBS is the most common cause of early onset neonatal sepsis, which is associated with 12% case-fatality rate. Although screening protocols and prophylactic treatment are readily available worldwide, practice in low-resource countries is challenged by lack of awareness and limited implementation of these protocols. In addition, antibiotic susceptibility pattern may vary globally owing to different regulations of antibiotic prescription or prevalence of certain bacterial serotypes. This guideline appraises current evidence on screening and management of GBS colonization in pregnancy particularly in low-resource settings.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"5087-5098"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1875211","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25400380","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}

{"title":"Cardiac and obstetric outcomes in pregnant patients with heart disease: a retrospective cohort study.","authors":"Beatriz A Fernández-Campos,&nbsp;Joaquin Vargas-Peñafiel,&nbsp;María P Cruz-Dominguez,&nbsp;Janet Mijangos-Chavez,&nbsp;Edgar Mendoza-Reyes,&nbsp;Ilze J Huerta-L,&nbsp;Sara Morales-Hernández,&nbsp;Nelly Berenice Gonzalez Tovar","doi":"10.1080/14767058.2021.1875433","DOIUrl":"https://doi.org/10.1080/14767058.2021.1875433","url":null,"abstract":"<p><strong>Background: </strong>Cardiac diseases complicate 4% of pregnancies, with a mortality rate between 0 and 15%. Early referral has shown to reduce the risk of maternal major cardiac events (MACEs).</p><p><strong>Methods: </strong>We retrospectively analyzed a cohort of pregnant women with heart disease from two referral centers in Mexico City. We examined MACEs: maternal death, pulmonary edema, acute heart failure, endocarditis, stroke, myocardial infarction, acute aortic syndromes, arrhythmias requiring urgent treatment, and the need for an urgent intervention; preterm birth and obstetric events such as HELLP syndrome, preeclampsia, eclampsia, placental abruption, obstetric hemorrhage. We analyzed the association between each modified World Health Organization (mWHO) group and MACEs, preterm birth and obstetric outcomes between March 2014 and March 2019.</p><p><strong>Results: </strong>Using the mWHO classification, 399 deliveries were included and stratified as follows: I, 162; II, 133; II-III, 21; III, 18; and IV, 52 patients. MACEs were observed in 12.5% of the cohort and were associated with mWHO II (odds ratio [OR], 3.0; 95% confidence interval [95% CI], 1.1-8.1; <i>p</i> = 0.027), II-III (OR, 3.3; 95% CI, 0.9-1.0; <i>p</i> = 0.116), III (OR, 5.3; 95% CI, 1.2-23; <i>p</i> = 0.026), and IV (OR, 8.2; 95% CI, 2.7-24.5; <i>p</i> < 0.001) after adjusting for age, desaturation, previous functional class, and gestational age at referral. An association between mWHO and frequency of preterm birth was observed. Association between mWHO and obstetric events, even when adjusted, was not observed.</p><p><strong>Conclusions: </strong>The prevalence of MACEs and preterm birth is similar to that seen worldwide; MACEs and preterm birth are associated with the severity of heart disease stratified by mWHO, but there is no association between the severity of heart disease and obstetric events.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"5140-5148"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1875433","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25405491","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}

{"title":"Proteomic signatures predict preeclampsia in individual cohorts but not across cohorts - implications for clinical biomarker studies.","authors":"Mohammad S Ghaemi,&nbsp;Adi L Tarca,&nbsp;Roberto Romero,&nbsp;Natalie Stanley,&nbsp;Ramin Fallahzadeh,&nbsp;Athena Tanada,&nbsp;Anthony Culos,&nbsp;Kazuo Ando,&nbsp;Xiaoyuan Han,&nbsp;Yair J Blumenfeld,&nbsp;Maurice L Druzin,&nbsp;Yasser Y El-Sayed,&nbsp;Ronald S Gibbs,&nbsp;Virginia D Winn,&nbsp;Kevin Contrepois,&nbsp;Xuefeng B Ling,&nbsp;Ronald J Wong,&nbsp;Gary M Shaw,&nbsp;David K Stevenson,&nbsp;Brice Gaudilliere,&nbsp;Nima Aghaeepour,&nbsp;Martin S Angst","doi":"10.1080/14767058.2021.1888915","DOIUrl":"https://doi.org/10.1080/14767058.2021.1888915","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Early identification of pregnant women at risk for preeclampsia (PE) is important, as it will enable targeted interventions ahead of clinical manifestations. The quantitative analyses of plasma proteins feature prominently among molecular approaches used for risk prediction. However, derivation of protein signatures of sufficient predictive power has been challenging. The recent availability of platforms simultaneously assessing over 1000 plasma proteins offers broad examinations of the plasma proteome, which may enable the extraction of proteomic signatures with improved prognostic performance in prenatal care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The primary aim of this study was to examine the generalizability of proteomic signatures predictive of PE in two cohorts of pregnant women whose plasma proteome was interrogated with the same highly multiplexed platform. Establishing generalizability, or lack thereof, is critical to devise strategies facilitating the development of clinically useful predictive tests. A second aim was to examine the generalizability of protein signatures predictive of gestational age (GA) in uncomplicated pregnancies in the same cohorts to contrast physiological and pathological pregnancy outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Serial blood samples were collected during the first, second, and third trimesters in 18 women who developed PE and 18 women with uncomplicated pregnancies (Stanford cohort). The second cohort (Detroit), used for comparative analysis, consisted of 76 women with PE and 90 women with uncomplicated pregnancies. Multivariate analyses were applied to infer predictive and cohort-specific proteomic models, which were then tested in the alternate cohort. Gene ontology (GO) analysis was performed to identify biological processes that were over-represented among top-ranked proteins associated with PE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The model derived in the Stanford cohort was highly significant (&lt;i&gt;p&lt;/i&gt; = 3.9E-15) and predictive (AUC = 0.96), but failed validation in the Detroit cohort (&lt;i&gt;p&lt;/i&gt; = 9.7E-01, AUC = 0.50). Similarly, the model derived in the Detroit cohort was highly significant (&lt;i&gt;p&lt;/i&gt; = 1.0E-21, AUC = 0.73), but failed validation in the Stanford cohort (&lt;i&gt;p&lt;/i&gt; = 7.3E-02, AUC = 0.60). By contrast, proteomic models predicting GA were readily validated across the Stanford (&lt;i&gt;p&lt;/i&gt; = 1.1E-454, &lt;i&gt;R&lt;/i&gt; = 0.92) and Detroit cohorts (&lt;i&gt;p&lt;/i&gt; = 1.1.E-92, &lt;i&gt;R&lt;/i&gt; = 0.92) indicating that the proteomic assay performed well enough to infer a generalizable model across studied cohorts, which makes it less likely that technical aspects of the assay, including batch effects, accounted for observed differences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Results point to a broader issue relevant for proteomic and other omic discovery studies in patient cohorts suffering from a clinical syndrome, such as PE, driven by heterogeneous pathophysiologies. While novel technolo","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"5621-5628"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1888915","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25429318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical presentation and management of urolithiasis in the obstetric patient: a matched cohort study.","authors":"Natasha Sebastian,&nbsp;Nicholas Czuzoj-Shulman,&nbsp;Andrea R Spence,&nbsp;Haim Arie Abenhaim","doi":"10.1080/14767058.2021.1915274","DOIUrl":"https://doi.org/10.1080/14767058.2021.1915274","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of pregnancy on the clinical presentation, inpatient procedure rates, and length of hospital stay, on women with urolithiasis.</p><p><strong>Materials and methods: </strong>We carried out a matched cohort study using the United States' Healthcare Cost and Utilization Project-Nationwide Inpatient Sample database from 1999 to 2015. Pregnant women with urolithiasis were compared to age-matched non-pregnant women (1:1) with urolithiasis. Baseline clinical characteristics were compared between the two cohorts and the effect of pregnancy on select inpatient procedural and clinical outcomes was evaluated using conditional logistic regression models.</p><p><strong>Results: </strong>There were 42,113 pregnant patients diagnosed with urolithiasis during the study period. It was observed that pregnant patients were less likely to present with classic clinical symptoms of urinary tract stones, such as flank pain, OR 0.63, 95% CI 0.56-0.70, and fever, 0.22 (0.16-0.30), but tended to have longer hospital stays. The pregnant patients were less commonly affected by infectious conditions, namely urinary tract infections, 0.56 (0.53-0.59), sepsis, 0.17 (0.14-0.20), and pyelonephritis, 0.34 (0.36-0.44). Invasive and surgical procedures were less commonly performed in pregnant women.</p><p><strong>Conclusions: </strong>Pregnant women admitted with urolithiasis appear to be less symptomatic with fewer interventions and complications than non-pregnant women with urolithiasis.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"6449-6454"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1915274","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38966505","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}

{"title":"Case report and literature review: antenatal diagnosis of a fetal anaplastic astrocytoma.","authors":"Shu-Jing Huang,&nbsp;Xian-Lan Liu,&nbsp;Mei Huang,&nbsp;Yan-Qing Wang,&nbsp;Jin-Rong Lin,&nbsp;Xiao-Dong Zhang,&nbsp;Jin-Na Jiang,&nbsp;Dong-Yu Bai,&nbsp;Zhan-Xiang Wang,&nbsp;Yi-Ming Su","doi":"10.1080/14767058.2021.1918668","DOIUrl":"https://doi.org/10.1080/14767058.2021.1918668","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the ultrasonographic appearance of congenital anaplastic astrocytoma, so as to provide diagnostic clues for it. An updated review of the literature was also carried out.</p><p><strong>Results: </strong>There was a case of fetal anaplastic astrocytoma detected by ultrasound at 37 + 1 weeks of gestation. It showed that a hypoechoic mass was located in the left hemisphere with a relatively clear margin and subtle color flows. Prenatal magnetic resonance imaging (MRI) which was taken subsequently confirmed the result of ultrasound. Intratumoral hemorrhage was observed in later follow-up and further confirmed by histological examination. The fetus was delivered vaginally at 39 + 6 weeks. The infant died 2 h after delivery due to respiration failure. The histological examination confirmed an anaplastic astrocytoma.</p><p><strong>Conclusions: </strong>Congenital anaplastic astrocytoma commonly detected by ultrasound has a relatively better perinatal prognosis, especially compared with glioblastoma. Prenatal ultrasonography diagnosis accurately is of critical importance. The anaplastic astrocytoma should be considered in cases in which fetal images reveal a heterogeneous echogenic mass in the brain, especially in the presence of intratumoral hemorrhage, subtle color flow, and relatively clear margin.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"6631-6637"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1918668","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38966507","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}

{"title":"Are we preventing the primary cesarean delivery at the second stage of labor following ACOG-SMFM new guidelines? Retrospective cohort study.","authors":"Einav Kadour-Peero,&nbsp;Shlomi Sagi,&nbsp;Janan Awad,&nbsp;Inna Bleicher,&nbsp;Ron Gonen,&nbsp;Dana Vitner","doi":"10.1080/14767058.2021.1920913","DOIUrl":"https://doi.org/10.1080/14767058.2021.1920913","url":null,"abstract":"<p><strong>Objective: </strong>In 2014, the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal Fetal Medicine (SMFM) published an Obstetric Care Consensus for safe prevention of primary cesarean delivery. We aimed to assess whether these guidelines decreased the primary CD rate during the second stage of labor, in our department.</p><p><strong>Design, setting, and population: </strong>A retrospective cohort study of all women reaching the second stage of labor, at term, in a single university-affiliated medical center between2010 and 2017.</p><p><strong>Methods: </strong>We compared maternal and neonatal outcomes over three year's periods:-pre-guidelines (2010-2013) vs. 2nd period - post-guidelines (2014-2017).</p><p><strong>The main outcome measures: </strong>CD rate at 2ndstage of labor.</p><p><strong>Results: </strong>The study included 11,464 women. The CD rate in the 2nd stage of labor has increased significantly from 4% to 5.9% in the post-guidelines period (OR 1.48, 95% CI 1.16-1.89, <i>p</i> = .001). After a sub-analysis of specific subgroups, and adjustment for confounders, the increase was solely observed in nulliparous women (aOR 1.418, 95% CI 1.067-1.885, <i>p</i> = .016). Furthermore, increased odds for vaginal operative delivery were observed in the multiparous women in the post-guidelines period (2.7% vs. 4.1%, <i>p</i> = .046).</p><p><strong>Conclusions: </strong>The implementation of the new ACOG and SMFM guidelines was not associated with a change in the CD rate performed at the 2nd stage of labor in the whole study population. However, there was a rise in the CD rate performed at the 2nd stage in nulliparous women. Furthermore, there was an increase in operative deliveries in the whole study population, especially in multiparous women, without an apparent increase in other immediate adverse neonatal or maternal outcomes.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"6708-6713"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1920913","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38974667","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}

{"title":"Perinatal hypoxia leads to primordial follicle activation and premature depletion of ovarian reserve.","authors":"Ola Gutzeit,&nbsp;Roee Iluz,&nbsp;Yuval Ginsberg,&nbsp;Keren Nebenzahl,&nbsp;Ron Beloosesky,&nbsp;Zeev Weiner,&nbsp;Ofer Fainaru","doi":"10.1080/14767058.2021.1937985","DOIUrl":"https://doi.org/10.1080/14767058.2021.1937985","url":null,"abstract":"<p><strong>Background: </strong>The human ovary contains 6-million follicles during the 20th week of embryonic development and 1 million at birth. Girls born at small for gestational age weight demonstrate higher FSH levels during infancy, an earlier onset of puberty, and menarche. In light of these observations, we hypothesized that exposure to hypoxia at the early neonatal period might impact the primordial follicular pool and lead to premature depletion of ovarian reserve.</p><p><strong>Methods: </strong>Ovarian development in the rat model at days 1-5 postpartum reflects its human counterpart in the late perinatal period. We exposed newborn rat pups (<i>n</i> = 5) to controlled hypoxia, (5% oxygen/95% nitrogen) for 10 min three times daily for days 1-5 postpartum. On day 5, ovaries were harvested, H&E, Ki-67, and TUNEL staining were performed.</p><p><strong>Results: </strong>The percentage of primordial follicles out of total follicles in ovaries of pups exposed to hypoxia was lower compared to control (76 ± 8.2% and 90.33 ± 6.3% respectively, <i>p</i> < .05). Correspondingly the percentage of primary and secondary follicles was higher than in control. The mean stromal Ki67 staining score was significantly lower in the study group (1.67 ± 0.58 and 2.5 ± 0.55 respectively, <i>p</i> < .05). TUNEL staining demonstrated no difference in stromal apoptosis rates between both groups.</p><p><strong>Conclusions: </strong>We provide evidence for the first time that perinatal hypoxia causes premature activation and growth initiation of dormant follicles. These changes were associated with decreased stromal cell proliferation, suggesting hypoxia-induced impairment of the support cell pool as a possible mechanism for accelerated follicular activation.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"7844-7848"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1937985","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39009213","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}

{"title":"Peripartum anesthetic management of women with SARS-CoV-2 infection in eight medical centers across three European countries: prospective cohort observation study.","authors":"Alexander Ioscovich,&nbsp;Emilia Guasch,&nbsp;Nicolas Brogly,&nbsp;Daniel Shatalin,&nbsp;Susana Manrique-Muñoz,&nbsp;Maria Elena Sánchez Royo,&nbsp;Sabastine Zimro,&nbsp;Yehuda Ginosar,&nbsp;Neusa Lages,&nbsp;Jacob Weinstein,&nbsp;Haim Berkenstadt,&nbsp;Chaim Greenberger,&nbsp;Alexey Lazutkin,&nbsp;Alexander Izakson,&nbsp;Daniel Ioscovich,&nbsp;Sharon Orbach-Zinger,&nbsp;Carolyn F Weiniger","doi":"10.1080/14767058.2021.1937105","DOIUrl":"https://doi.org/10.1080/14767058.2021.1937105","url":null,"abstract":"<p><strong>Objective: </strong>Several reports of obstetric anesthesia management have been published since the onset of the COVID-19 pandemic. We aimed to collect high-quality broad and detailed data from different university medical centers in several European Society of Anesthesiologist countries.</p><p><strong>Methods: </strong>This prospective observational survey was performed in eight medical centers in Spain, Israel and Portugal from 1^st April to 31^st July 2020. Institutional review board approval was received at each participating center. Inclusion criteria: all women with a positive test for COVID-19. Retrieved data included maternal, delivery, anesthetic, postpartum details, and neonatal outcomes. Descriptive data are presented, and outcomes were compared for women with versus without respiratory signs and symptoms.</p><p><strong>Results: </strong>Women with respiratory symptoms (20/12.1%) had significantly higher mean (standard deviation) temperature (37.2 °C (0.8) versus 36.8 °C (0.6)), were older (34.1 (6.7) years versus 30.5 (6.6)) and had higher body mass index kg m^-2 - (29.5 (7.5) versus 28.2 (5.1)). Women with respiratory symptoms delivered at a significantly earlier gestational age (50% < 37 weeks) with a 65% cesarean delivery rate (versus 22.1% in the group without respiratory symptoms) and 5-fold increased rate of emergency cesarean delivery, 30% performed under general anesthesia. A higher rate of intrauterine fetal death (3%) was observed than expected from the literature (0.2-0.3%) in developed countries. There was no evidence of viral vertical transmission.</p><p><strong>Conclusion: </strong>Well-functioning neuraxial analgesia should be available to manage laboring women with respiratory symptoms, as there is a higher frequency of emergency cesarean delivery. We report a higher rate of undiagnosed parturient and intrauterine fetal death.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"7756-7763"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1937105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39010646","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}