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":"Adverse outcomes associated with twin pregnancies conceived via <i>in vitro</i> fertilization.","authors":"Moti Gulersen,&nbsp;Yael Eliner,&nbsp;Amos Grunebaum,&nbsp;Erez Lenchner,&nbsp;Liron Bar-El,&nbsp;Frank A Chervenak,&nbsp;Eran Bornstein","doi":"10.1080/14767058.2022.2122806","DOIUrl":"https://doi.org/10.1080/14767058.2022.2122806","url":null,"abstract":"<p><strong>Objective: </strong>To compare adverse pregnancy and neonatal outcomes in twin pregnancies conceived by <i>in vitro</i> fertilization (IVF) to those conceived spontaneously.</p><p><strong>Methods: </strong>Retrospective analysis of the Centers for Disease Control and Prevention, Natality Live Birth database for the years 2016-2019. All twin live births were included and stratified into two groups: those from pregnancies conceived <i>via</i> IVF and those from pregnancies conceived spontaneously. The incidence of several adverse pregnancy and neonatal outcomes were compared between the two groups. Statistical analysis included multivariable logistic regression to adjust for the following potential confounders: maternal age, race/ethnicity, body mass index, education level, type of medical insurance, chronic hypertension, pregestational diabetes, and prior preterm birth. Data were presented as adjusted odds ratios (aOR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>Twin live births from pregnancies conceived <i>via</i> IVF comprised 9.5% of the study cohort (39,356 of 415,560). Baseline characteristics varied significantly between IVF and spontaneously conceived twins. After adjusting for these variables, IVF in twins was associated with an increased risk of multiple adverse outcomes including gestational diabetes (aOR = 1.35, 95% CI = 1.30-1.39), hypertensive disorders of pregnancy (aOR = 1.70, 95% CI = 1.65-1.75), preterm birth prior to 28 weeks (aOR = 1.53, 95% CI = 1.43-1.63), maternal intensive care unit admission (aOR = 2.03, 95% CI = 1.79-2.31), maternal blood transfusion (aOR = 2.97, 95% CI = 2.75-3.20), unplanned hysterectomy (aOR = 3.37, 95% CI = 2.73-4.16), and prolonged ventilation in newborns (aOR = 1.76, 95% CI = 1.69-1.82), compared to spontaneously conceived twin pregnancies.</p><p><strong>Conclusions: </strong>Based on this large United States population-based cohort, twin pregnancies conceived <i>via</i> IVF represent a subgroup of twins that have an increased risk for several adverse pregnancy and neonatal outcomes, compared to those conceived spontaneously. With increased contemporary utilization of IVF, obstetricians should consider these risks while caring for patients with twin pregnancies conceived <i>via</i> IVF.</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":"10213-10219"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33464764","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":"Prediction of early-onset neonatal sepsis in umbilical cord blood analysis: an integrative review.","authors":"Marco Otilio Rodrigues Wilde,&nbsp;Tatiana Mezadri,&nbsp;Pollyana Bortholazzi Gouveia,&nbsp;Luciane Peter Grillo,&nbsp;Cristina Valete","doi":"10.1080/14767058.2022.2122798","DOIUrl":"https://doi.org/10.1080/14767058.2022.2122798","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to describe the inflammatory markers studied in umbilical cord blood and to analyze the performance of the three markers most frequently studied for the prediction of early-onset neonatal sepsis.</p><p><strong>Data sources: </strong>An integrative review from 1995 to 2021 was performed, with a search in the MEDLINE, Embase, Cochrane Library, SciELO, and gray literature databases, using the terms \"neonates,\" \"newborns,\" \"neonatal sepsis,\" \"early-onset neonatal sepsis,\" \"neonatal infection,\" \"inflammatory markers,\" \"biomarkers,\" \"cord blood,\" \"fetal blood.\"</p><p><strong>Study selection and data extractions: </strong>Study evaluation was limited to primary studies, prospective, observational or intervention, descriptive or analytical, that assessed the diagnosis of early-onset neonatal sepsis using inflammatory markers in umbilical cord blood, in Portuguese, English, or Spanish. Qualitative studies, reports, review studies, and case series were excluded. Only studies with a punctuation ≥ 6 in the Newcastle-Ottawa scale were included.</p><p><strong>Relevance to patient care and clinical practice: </strong>Sixteen studies were included in the qualitative synthesis. Procalcitonin, C-reactive protein, and interleukin-6 were the most frequently studied markers. The best performance for C-reactive protein was observed at a 0.2 mg/L cutoff, with a sensitivity of 82% and a negative predictive value of 99%. Procalcitonin presented the best performance at a 0.5 ng/mL cutoff with 87.5% sensitivity and 98.7% negative predictive value. Interleukin-6 presented the best performance at a 108.5 ng/mL cutoff, with 95% sensitivity and 97.4% negative predictive value.</p><p><strong>Conclusion: </strong>The evaluation of markers in the umbilical cord for the diagnosis of early-onset neonatal sepsis, could contribute to a more assertive therapy for the neonate and anticipate sepsis screening. Since the cost is less and technically easier, C-reactive protein is recommended for routine use.</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":"10187-10198"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33464765","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":"Effects of delayed cord clamping on neonatal hyperbilirubinemia in pre-gestational diabetes at term.","authors":"Carrie Bennett,&nbsp;Jessian L Munoz,&nbsp;Meng Yao,&nbsp;Katherine Singh","doi":"10.1080/14767058.2021.1946785","DOIUrl":"https://doi.org/10.1080/14767058.2021.1946785","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effects of delayed cord clamping on neonatal hyperbilirubinemia in infants born to patients diagnosed with pre-gestational diabetes (type I or type II).</p><p><strong>Methods: </strong>In January 2016, our institution implemented an organization-wide thirty-second delayed cord clamping protocol. This retrospective cross-sectional study represents infants of mothers diagnosed with pre-gestational diabetes who delivered before and after protocol implementation. The study period was from October 2014 to August 2017. The primary outcome was peak neonatal transcutaneous bilirubin (mg/dL) level during neonatal hospital stay. The secondary outcomes included neonatal serum bilirubin (mg/dL), jaundice requiring phototherapy, hypoglycemia, polycythemia, respiratory distress, and neonatal intensive care unit (NICU) admission. A subgroup analysis for outcomes stratified by type of pre-gestational diabetes was also performed.</p><p><strong>Results: </strong>145 patients were included in the final analysis. The mean peak neonatal transcutaneous bilirubin level was 10.1 mg/dL ± 3.4 mg/dL for immediate cord clamping and 9.5 mg/dL ± 3.4 mg/dL for delayed cord clamping (<i>p</i> = .25). There were no significant differences between groups for neonatal jaundice requiring phototherapy, hypoglycemia, polycythemia, respiratory distress, or NICU admission. No differences were observed in neonatal outcome by subgroup analysis of pre-gestational diabetes type.</p><p><strong>Conclusion: </strong>In our study, there was no significant increase in peak neonatal transcutaneous bilirubin in term (≥37 week) infants of mothers with pre-gestational diabetes after undergoing thirty-seconds of delayed cord clamping. In the absence of contraindications, we advocate for continued use of delayed cord clamping for these infants.</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":"7267-7275"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1946785","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39252889","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":"Biological and clinical effects of a resveratrol-based multivitamin supplement on intracytoplasmic sperm injection cycles: a single-center, randomized controlled trial.","authors":"Sandro Gerli,&nbsp;Chiara Della Morte,&nbsp;Margherita Ceccobelli,&nbsp;Monica Mariani,&nbsp;Alessandro Favilli,&nbsp;Lucio Leonardi,&nbsp;Alessandro Lanti,&nbsp;Rossana G Iannitti,&nbsp;Bernard Fioretti","doi":"10.1080/14767058.2021.1958313","DOIUrl":"https://doi.org/10.1080/14767058.2021.1958313","url":null,"abstract":"<p><strong>Background: </strong>Resveratrol display's positive effects on follicle growth and development in preclinical studies while there is scantly information from clinical trials. The aim of this study was to evaluate the biological and clinical impact of a resveratrol-based multivitamin supplement on intracytoplasmatic sperm injection (ICSI) cycles.</p><p><strong>Methods: </strong>A randomized, single-center controlled trial conducted at the University Center of Assisted Reproductive Technologies involving 101 women infertile women undergoing ICSI cycles was conducted. A pretreatment with a daily resveratrol based nutraceutical was administered to the Study Group; Control Group received folic acid. The primary outcomes were the number of developed mature follicles (>16 mm), total oocytes and MII oocytes recovered, the fertilization rate and the number of cleavage embryos/blastocysts obtained. Secondary endpoints were the duration and dosage of gonadotropins, the number of embryos for transfer, implantation, biochemical, clinical pregnancy rates, live birth and miscarriage rates.</p><p><strong>Results: </strong>A significantly higher number of oocytes and MII oocytes were retrieved in the Study Group than in Control Group (<i>p</i> = .03 and <i>p</i> = .04, respectively). A higher fertilization rate (<i>p</i> = .004), more cleavage embryos/patient (<i>p</i> = .01), blastocytes/patients (<i>p</i> = .01) and cryopreserved embryos (<i>p</i> = .03) were obtained in the Study Group. No significant differences in biochemical or clinical pregnancy, live birth, and miscarriage rates were revealed, but a trend to a higher live birth rate was revealed in the Study Group.</p><p><strong>Conclusions: </strong>A 3 months period of dietary supplementation with a resveratrol-based multivitamin nutraceutical leads to better biological effects on ICSI cycles.</p><p><strong>Trial registration number: </strong>ClinicalTrials.gov registration identifier: NCT04386499.</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":"7640-7648"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1958313","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39267656","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":"Factors affecting human milk lactoferrin.","authors":"Despina D Briana,&nbsp;Vassiliki Papaevangelou","doi":"10.1080/14767058.2021.1961731","DOIUrl":"https://doi.org/10.1080/14767058.2021.1961731","url":null,"abstract":"We thank the authors for commenting on our article [1]. Lactoferrin (Lf) is a multifunctional protein mainly secreted by the mammary and other exocrine glands, as well as secondarily by neutrophils. It is predominantly present in external secretions such as milk, saliva, tears, bile, and pancreatic fluids [2] and is particularly abundant in human colostrum [3]. Joob & Wiwanitkit point out that it would be interesting to discuss Lf in maternal blood, as “blood Lf is markedly increased in acute pneumonia and Lf might secret into breastmilk.” However, as far as we know, there is currently no evidence that maternal blood Lf concentrations correlate with respective breast milk concentrations. Therefore, the implication of maternal blood Lf does not add, in our opinion, anything further to the discussion or interpretation of our results. Furthermore, the determination of maternal blood Lf concentrations was beyond the purposes of this study. As Joob & Wiwanitkit state, several reports have suggested that both maternal and infantile factors may affect human milk Lf concentrations [4–7]. However, those reports produced highly inconsistent results. For instance, two of the studies that the authors cite demonstrated the lack [4] and presence [5] of an association between maternal milk Lf levels and maternal age, respectively. A systematic review investigated the correlation between breast milk Lf concentrations and lactation stage, as well as maternal/infantile factors, such as race/ ethnicity, parity, maternal age, socioeconomic and nutritional status, maternal/infantile infections, and prematurity [8]. The results demonstrated that milk Lf concentrations are consistently highest in colostrum and then gradually decrease, but, besides the stage of lactation, no other maternal or infant factor is consistently associated with Lf concentrations [8]. The authors claimed that a major limitation of the published studies is the small sample size and the different methods applied to determine Lf concentrations [8]. The need for multicenter studies with large sample sizes, as well as standardized design, sample collection, and Lf measurement methods was highlighted, in order to elucidate significant factors associated with breast milk Lf concentrations [8]. Nevertheless, our study population comprised of Caucasian, hospitalized women with similar nutritional status, living in Greece, who gave birth to full-term, appropriate-for-gestational age singletons and provided a milk sample on the 3rd day postpartum, under the same conditions.","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":"8111"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39296057","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":"Newborn joint mechanics.","authors":"Rakesh Mondal,&nbsp;Arnab Nandy,&nbsp;Debadyuti Datta,&nbsp;Rahul Majumdar,&nbsp;Avijit Hazra,&nbsp;Sankar Kumar Das","doi":"10.1080/14767058.2021.1946784","DOIUrl":"https://doi.org/10.1080/14767058.2021.1946784","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to evaluate joint mechanics in newborn by goniometric assessment of major joints in healthy babies born at different gestational ages (GAs).</p><p><strong>Materials and methods: </strong>An institution based observational study was carried out on healthy newborn babies within two days of birth. Study subjects were born at 28-41 completed weeks of gestation. The major joints of upper and lower limbs were assessed with manual goniometer for joint angles in relation to specific passive movements and range of motion (ROM) calculated where applicable. All measurements were made by a single observer with careful consideration of plane of movement and axes involved. Strength of association between joint angles and GA was quantified by Pearson's <i>r</i> coefficient.</p><p><strong>Results: </strong>Six major joints (shoulder, elbow, wrist, hip, knee, and ankle) were evaluated on either side in 433 babies. No significant differences were found between male and female babies and left or right side of the body. For most joints, a secular declining trend of joint angle or ROM was noted with good to strong inverse correlation with GA. The strongest associations were for flexion-extension ROM and adduction-abduction ROM at shoulder, palmar flexion at wrist and dorsiflexion at ankle joint with <i>r</i> values of -0.76, -0.75, -0.75, and -0.75, respectively.</p><p><strong>Conclusions: </strong>The reading of a specific joint angle in the newborn infants was found to be dependent on GA. Precise calibration of gestation appropriate joint angles had laid down the foundation for functional assessment of multimodal joint mechanics.HighlightsEvaluation of newborn joint angles require stringent attention toward the plane and axis of the particular joint movement being assessed.Major joint angles and range of motion in newborn infants were observed to follow a secular declining trend according to the gestational age.Precise estimation of gestation appropriate joint angle will be helpful to understand the mechanics of musculoskeletal medicine in newborn.</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":"7259-7266"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39298427","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":"Artificial intelligence and placental DNA methylation: newborn prediction and molecular mechanisms of autism in preterm children.","authors":"Ray O Bahado-Singh,&nbsp;Sangeetha Vishweswaraiah,&nbsp;Buket Aydas,&nbsp;Uppala Radhakrishna","doi":"10.1080/14767058.2021.1963704","DOIUrl":"https://doi.org/10.1080/14767058.2021.1963704","url":null,"abstract":"<p><strong>Background: </strong>Autism Spectrum Disorder (ASD) represents a heterogeneous group of disorders with a complex genetic and epigenomic etiology. DNA methylation is the most extensively studied epigenomic mechanism and correlates with altered gene expression. Artificial intelligence (AI) is a powerful tool for group segregation and for handling the large volume of data generated in omics experiments.</p><p><strong>Methods: </strong>We performed genome-wide methylation analysis for differential methylation of cytosine nucleotide (CpG) was performed in 20 postpartum placental tissue samples from preterm births. Ten newborns went on to develop autism (Autistic Disorder subtype) and there were 10 unaffected controls. AI including Deep Learning (AI-DL) platforms were used to identify and rank cytosine methylation markers for ASD detection. Ingenuity Pathway Analysis (IPA) to identify genes and molecular pathways that were dysregulated in autism.</p><p><strong>Results: </strong>We identified 4870 CpG loci comprising 2868 genes that were significantly differentially methylated in ASD compared to controls. Of these 431 CpGs met the stringent EWAS threshold (<i>p</i>-value <5 × 10^-8) along with ≥10% methylation difference between CpGs in cases and controls. DL accurately predicted autism with an AUC (95% CI) of 1.00 (1-1) and sensitivity and specificity of 100% using a combination of 5 CpGs [cg13858611 (<i>NRN1</i>), cg09228833 (<i>ZNF217</i>), cg06179765 (<i>GPNMB</i>), cg08814105 (<i>NKX2-5</i>), cg27092191 (<i>ZNF267</i>)] CpG markers. IPA identified five prenatally dysregulated molecular pathways linked to ASD.</p><p><strong>Conclusions: </strong>The present study provides substantial evidence that epigenetic differences in placental tissue are associated with autism development and raises the prospect of early and accurate detection of the disorder.</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":"8150-8159"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39320548","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":"Practices for RhD alloimmunization prevention: a vignette-based survey of midwives.","authors":"Guenola Jourdren,&nbsp;Paul Berveiller,&nbsp;Anne Rousseau","doi":"10.1080/14767058.2021.1957822","DOIUrl":"https://doi.org/10.1080/14767058.2021.1957822","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the availability guidelines to prevent RhD alloimmunization, severe hemolytic disease of fetus and newborn still occurs in high-income countries. The aim of the study was (1) To assess variations in practices for the prevention of RhD alloimmunization, and (2) to understand midwives' acceptance and appropriation of fetal RhD genotyping.</p><p><strong>Methods: </strong>Descriptive cross-sectional survey of French midwives from September 2017 through January 2018. Participants were asked to complete an internet-based questionnaire that included three clinical vignettes. They were questioned about their practices concerning early pregnancy visit by RhD-negative women, prevention of RhD alloimmunization in women with second-trimester metrorrhagia, and RhD fetal genotyping.</p><p><strong>Results: </strong>A total of 827 midwives completed the questionnaire. Only 21.1% reported that they practice all the preventive measures recommended in early pregnancy. In a situation at high risk of RhD alloimmunization during pregnancy, 97.2% of midwives would perform immunoprophylaxis. Nearly, all midwives reported providing information about RhD alloimmunization (92.4%) at the beginning of pregnancy, although only 11.3% offered both written and verbal information; at the time of systematic anti-D immunoprophylaxis (28 weeks), 78% provided information, but only 2.7% both verbally and in writing. Finally, only 50.8% of midwives preferred to include RhD fetal genotyping in routine prenatal prophylaxis.</p><p><strong>Discussion: </strong>This study showed significant variations in French midwives' practices to prevent RhD alloimmunization. Better dissemination of guidelines is needed to improve both consistent use of these practices and the quality of information delivered to RhD-negative pregnant women.</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":"7629-7639"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39343178","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":"Cost implication of CPAP use in low resource settings, surmounting the oxygen administration challenge.","authors":"Ikechukwu R Okonkwo,&nbsp;Chiamaka Aneji,&nbsp;Osayame A Ekhaguere,&nbsp;Emmanuel U Eyo-Ita,&nbsp;Angela A Okolo","doi":"10.1080/14767058.2021.1949278","DOIUrl":"https://doi.org/10.1080/14767058.2021.1949278","url":null,"abstract":"<p><strong>Purpose: </strong>Newborn respiratory support using Bubble Continuous positive airway pressure (bCPAP) has become acceptable in Nigeria as many centers are increasingly reporting its usefulness. There is increasing access to CPAP devices although the use of 100% oxygen for bCPAP administration is on the rise as oxygen/air blenders are not commonly available or insufficient. The cost of oxygen has become a significant contributor to hospital bills. The oxygen concentrator driven bCPAP device with blending capacity is expected to save lives and reduce cost of care.</p><p><strong>Objective: </strong>To compare the cost saving benefit of the use of oxygen concentrator bCPAP devices for CPAP administration to oxygen based devices in a resource limited setting.</p><p><strong>Methods: </strong>This prospective cross sectional study was done between February and December 2019. The oxygen use by CPAP devices-Improvised (IbCPAP), Fisher and Paykel and T-piece were quantified, costed, documented and compared with the same duration of use of concentrator CPAP-Diamedica.</p><p><strong>Results: </strong>CPAP services was accessed by 357 babies, 154 males and 203 females of GA range from 22 to 42 weeks and Birthweights range from 264 to 4400 grams. The main indication for CPAP was respiratory distress syndrome 201(56.3%). Oxygen supply were by oxygen pipeline 250 (70%), cylinders 39 (10.9%), concentrator CPAP 44 (12.3%) mixed source 24 (6.7%). Mean duration on the CPAP devices was 5.4 days, mean cost ₦37,645 ($104) or ₦6,971 ($20)/day, highest with IbCPAP, non-existent with concentrator bCPAP.</p><p><strong>Conclusion: </strong>The high running cost implication of CPAP use in low resource settings could deter transitioning to quality devices hence the need for non-oxygen dependent devices.</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":"7368-7374"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39374713","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":"Krukenberg tumor in pregnancy: a rare case and review of the literature.","authors":"Iulian G Goidescu,&nbsp;Georgiana Nemeti,&nbsp;Andreia Preda,&nbsp;Tunde Kovacs,&nbsp;Mihai Surcel,&nbsp;Dan T Eniu,&nbsp;Gheorghe Cruciat,&nbsp;Daniel Mureșan","doi":"10.1080/14767058.2021.1946788","DOIUrl":"https://doi.org/10.1080/14767058.2021.1946788","url":null,"abstract":"<p><p>Krukenberg's tumor diagnosed in pregnancy is an uncommon situation that raises both diagnosis and medical management issues. We performed a review of the existing literature regarding this pathology, diagnostic means and therapeutic approaches, motivated by a case in our own practice. A 35-year-old primigravida was diagnosed with an adnexal mass during the first trimester prenatal ultrasound. Ultrasound revealed a 10 cm right adnexal mass with multiple septae, richly vascularized, whose presence and characteristics were confirmed by magnetic resonance imaging. Due to the progressively increasing tumor size, laparoscopy was performed with right adnexectomy and peritoneal biopsies. Histopathology diagnosed a metastatic ovarian tumor from a mucinous colorectal adenocarcinoma. After delivery the patient was further investigated and diagnosed with sigmoid cancer. Even though ovarian cancer in pregnancy is rare, adnexal ultrasound is mandatory when scanning during the first trimester to rule out the presence of associated fallopian or ovarian masses.</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":"7290-7295"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39377334","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}