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":"<i>Streptococcus agalactiae</i> in pregnancy and the impact of recommendations on adherence to guidelines: an Italian area-based study.","authors":"Enrico Finale,&nbsp;Teresa Spadea,&nbsp;Luisa Mondo,&nbsp;Alberto Arnulfo,&nbsp;Andrea Capuano,&nbsp;Paola Ghiotti,&nbsp;Michelangelo Barbaglia,&nbsp;Andrea Guala","doi":"10.1080/14767058.2021.1937982","DOIUrl":"https://doi.org/10.1080/14767058.2021.1937982","url":null,"abstract":"<p><strong>Introduction: </strong>Streptococcus agalactiae, a species of β-haemolytic streptococcus belonging to Lancefield's group B (GBS), is known as a common infecting agent transmitted to infants during childbirth, causing sepsis, meningitis, or both, with a high incidence of mortality. Following the observation of a great variability between regional laboratories both in the methodology and in the results of tests for the detection of GBS in pregnancy, with high percentages of false negative results, in 2010 the Department for Health Policies of Piedmont, Italian region, issued specific recommendations for adhere to international guidelines. Our aim was to assess whether the impact of the publication of the recommendations has been lasting over time.</p><p><strong>Methods: </strong>We analyzed the regional birth certificate register from 2006 to 2018, to evaluate the annual number of deliveries, the number of <i>Streptococcus agalactiae</i> tests in pregnancy and the percentage of positive culture results. We also evaluated the consistency of the percentage of positive tests with the expectations based on the guidelines and compared the two time periods before and after introduction of regional recommendations using a multivariate regression model.</p><p><strong>Results: </strong>The mean proportion of women tested for GBS vaginal-rectal swabs during pregnancy increased from 83.5% in 2006 to 90.7% in 2018 with the biggest rise in 2010, the t-test for the comparison of the two means was statistically significant (<i>p</i> < .001). The mean positivity rate increased from 12.7% to 19.2%, with a rise in 2010, with a significant t-test (<i>p</i> < .001).</p><p><strong>Conclusion: </strong>The results suggested a significant impact of the recommendations on the compliance and results regarding the carrying out and culture of vagino-rectal swabs for GBS, with better appropriateness of peripartum antibiotic therapy and possible reduction of GBS related neonatal sepsis.</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":"7826-7830"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1937982","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39081326","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":"Characteristics of pregnant women with diabetes using injectable glucose-lowering drugs in the EVOLVE study.","authors":"Elisabeth R Mathiesen,&nbsp;Norsiah Ali,&nbsp;Eleni Anastasiou,&nbsp;Katarzyna Cypryk,&nbsp;Harold W de Valk,&nbsp;Jorge M Dores,&nbsp;Fidelma P Dunne,&nbsp;Magnus Ekelund,&nbsp;Santiago Durán García,&nbsp;Hélène Hanaire,&nbsp;Lise Lotte N Husemoen,&nbsp;Marina Ivanisevic,&nbsp;Hans-Peter Kempe,&nbsp;Rikke B Nordsborg,&nbsp;David R McCance","doi":"10.1080/14767058.2021.1940132","DOIUrl":"https://doi.org/10.1080/14767058.2021.1940132","url":null,"abstract":"<p><strong>Aims: </strong>To examine clinical parameters, glycemic control, folic acid supplementation, and the presence of other chronic diseases during early pregnancy in the EVOLVE study population (women with pre-existing diabetes treated with injectable glucose-lowering drugs).</p><p><strong>Methods: </strong>Cross-sectional baseline evaluation of EVOLVE: an international, multicenter, non-interventional study investigating the safety of injectable glucose-lowering drugs in pregnant women with pre-existing type 1 (T1D) or type 2 diabetes (T2D). Data were collected at enrollment visit interviews before gestational week 16.</p><p><strong>Results: </strong>In total, 2383 women from 17 mainly European countries were enrolled in the study: 2122 with T1D and 261 with T2D; mean age was 31 and 33 years, and duration of diabetes was 15 and 6 years, respectively. For women with T1D or T2D, 63% and 75%, respectively, received basal and rapid-acting insulin, 36% and 3% rapid-acting insulin only, 0.7% and 14.0% basal insulin only, 0.2% and 5.4% premix insulin, 0.0% and 1.2% injectable glucagon-like peptide-1 receptor agonist treatment without insulin. In women with T1D or T2D, respectively, during early pregnancy, 59% and 62% had HbA_1c <7.0% (53 mmol/mol); 16% and 36% reported not taking folic acid before or during early pregnancy. Overall, >40% of women had ≥1 chronic concomitant condition (predominantly thyroid disease or hypertension). Retinopathy was the most commonly reported diabetic complication. The most commonly reported previous pregnancy complication was miscarriage.</p><p><strong>Conclusions: </strong>Baseline data from this large multinational population of women with pre-existing diabetes indicate that sub-optimal glycemic control, poor pregnancy planning, and chronic concomitant conditions were common in early pregnancy.</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":"7992-8000"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1940132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39117196","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":"Effect of the unfavorable maternal-fetal environment cause by mitigation measures of the covid-19 pandemic in the public maternity of reference of Uruguay.","authors":"Leonel Briozzo,&nbsp;Giselle Tomasso,&nbsp;Stephanie Viroga,&nbsp;Hugo Selma,&nbsp;Virginia Cardozo,&nbsp;Clara Niz,&nbsp;Fernanda Nozar,&nbsp;Ana Bianchi","doi":"10.1080/14767058.2021.1946791","DOIUrl":"https://doi.org/10.1080/14767058.2021.1946791","url":null,"abstract":"<p><strong>Introduction: </strong>The mitigation measures to face the health emergency due to the COVID 19 pandemic generated a deep economic, social, and psychological crisis at the community level. This effect is greater in the people, who are the most violated in their rights. In relation to the social crisis and gender perspective, women are particularly affected by the pandemic. Given the disadvantaged situation of women socially, economically, and politically, their self-care is diminished.</p><p><strong>Objective: </strong>To identify whether there is an association between the classic risk factors for prematurity and fetal growth restriction and the increase in these pathologies in the period March-September 2020, in a maternity hospital that assists women from low resources.</p><p><strong>Materials and methods: </strong>A retrospective study, with a comparative analysis of the periods between 15 March and 30 September 2019 and the same period in 2020. The data were obtained from an electronic clinical database. The prevalence of preterm birth and small-for-gestational age newborn was analyzed. Indicators available in the database that reflect maternal conditions that lead to an unfavorable maternal environment were selected and they were classified into categories.</p><p><strong>Results: </strong>In the period of 2019, 3225 births were registered and in the period of 2020, 3036 births. In the 2019 period, 12.2% of prematurity was evidenced, while in the 2020 period, 14.5% (RR = 1.19, IC 95% = 1.05-1.35, <i>p</i> = .005). In relation to PEG 5.5% in the first period versus 6.9% in the second (RR = 1.26, CI 95% = 1.04-1.53, <i>p</i> = .01). No increases were found in the indicators that are traditionally related to the etiologies proposed to explain the increase in prematurity and small-for-age gestational, there was no evidence of an increase in inflammatory or vascular conditions.</p><p><strong>Conclusion: </strong>The economic, psychological and social crises, in the 1st semester of the health emergency, seriously affected the social determinants of the health of pregnant women who use the Public Maternity of reference in Uruguay. This situation is at the base of the poor perinatal results in the period of the maximum mediated mitigation of the pandemic.</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":"7312-7315"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1946791","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39146293","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":"Placental weight mediates association between prenatal exposure to cooking oil fumes and preterm birth.","authors":"Pian Hu,&nbsp;Chanmin Wang,&nbsp;Peng Ding,&nbsp;Yan-Hui He,&nbsp;Chuanbo Xie,&nbsp;Fu-Ying Tian,&nbsp;Shixin Yuan,&nbsp;Deqin Jia,&nbsp;Wei-Qing Chen","doi":"10.1080/14767058.2021.1946783","DOIUrl":"https://doi.org/10.1080/14767058.2021.1946783","url":null,"abstract":"<p><p><b>Background:</b> There are some reports on association between maternal prenatal cooking oil fume (COF) exposure and preterm birth (PTB), but its mechanism remains poorly understood. Therefore, this study aims to assess whether placental weight mediates their associations.<b>Method:</b> We enrolled 619 pregnant women delivering PTB newborns as cases and 1701 delivering full-term appropriate for gestational age newborns as controls. They were inquired with a self-reported questionnaire about prenatal COF exposure, socio-demographics and obstetric characteristics at Women and Children's Hospitals of Shenzhen and Foshan. After controlling for the potential confounders, a series of logistic and linear regressions were conducted to assess associations among COF exposure, placental weight and PTB, and the mediation of placental weight in the association between COF exposure and PTB.<b>Results:</b> Maternal prenatal COF exposure was significantly associated with PTB and the frequency of prenatal COF exposure was negatively associated with placental weight. Compared with mother who never cooked, those cooking occasionally, sometimes or often increased the risk of PTB, and similarly, those cooking between half to an hour was also showed a higher risk of PTB. Typical Chinese cooking methods including stir-frying, pan-frying and deep-frying were also associated with PTB. Different oil types mainly used, including peanut oil, corn oil and animal oil were associated with PTB as well. Mediation analysis illustrated that placental weight partially mediated 13.60% (95% CI = 10.62-33.20%) of the effects on the association between the frequency of maternal prenatal COF exposure and PTB.<b>Conclusion:</b> Maternal cooking during pregnancy and the frequency of prenatal COF exposure might increase the risk of PTB, in which placenta might play mediation role.</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":"7248-7258"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1946783","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39147657","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":"Doppler abnormalities and perinatal outcomes in pregnant women with early-onset fetal growth restriction.","authors":"Cesaltina Soares Muniz,&nbsp;Beatriz Frota Dias,&nbsp;Paula Vitória Pereira Motoyama,&nbsp;Camila Timbó Catunda Almeida,&nbsp;Francisco Edson de Lucena Feitosa,&nbsp;Edward Araujo Júnior,&nbsp;Júlio Augusto Gurgel Alves","doi":"10.1080/14767058.2021.1946786","DOIUrl":"https://doi.org/10.1080/14767058.2021.1946786","url":null,"abstract":"<p><strong>Objective: </strong>To compare Doppler alterations and perinatal outcomes in pregnant women who evolved with early- and late-onset fetal growth restriction (FGR).</p><p><strong>Methods: </strong>A retrospective, observational cohort study with pregnant women who evolved with FGR treated between January 2018 and April 2019, in which all live births from singleton pregnancies, over 24 weeks, with FGR ultrasound diagnosis and under 2700 g weight were included in the study.</p><p><strong>Results: </strong>Pregnancies with early-onset FGR were more associated with hypertensive disorders (<i>p</i> = .00) and placental vascular insufficiency, resulting in a high degree of umbilical artery Doppler involvement (<i>p</i> = .00) in a short period of pregnancy and higher rates of adverse perinatal outcomes (<i>p</i> = .00). The time of prenatal follow-up of early- and late-onset FGR cases was similar, but the degree of prematurity of the former made the evolution more unfavorable.</p><p><strong>Conclusion: </strong>Early-onset FGR had a lower prevalence but was associated with higher maternal and fetal morbidity and mortality than late-onset FGR.</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":"7276-7279"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1946786","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39161376","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":"The effect of adolescent and advanced-age pregnancies on maternal and early neonatal clinical data.","authors":"Pinar Yavuz,&nbsp;Mustafa Taze,&nbsp;Ozgul Salihoglu","doi":"10.1080/14767058.2021.1949445","DOIUrl":"https://doi.org/10.1080/14767058.2021.1949445","url":null,"abstract":"<p><strong>Background: </strong>This study compared early post-natal clinical data of adolescent and advanced maternal-age mothers and their infants and early post-natal clinical data of mothers 20-34 years old who delivered and their infants.</p><p><strong>Methods: </strong>This retrospective study included 1676 newborns who were born at or after 25 gestational weeks and 1638 puerperal women who gave birth at the Health Sciences University Bakırköy Dr. Sadi Konuk Health Practice and Research Center Gynecology and Obstetrics Clinic between January 2017 and January 2018. Maternal demographic and clinical data and neonatal demographic, anthropometric, and early delivery room clinical data of the study group patients were transcribed from clinical file records to electronic records.</p><p><strong>Results: </strong>We found that the intensive care admission/2nd- or 3rd-level intensive care referral rates of newborns of advanced-age and adolescent mothers were significantly higher than those of the control group. No significant differences were found between intensive care admission and referral rates among age groups when only healthy pregnancies were considered. Cesarean sections, abortion and smoking rates of mothers with advanced maternal age; LGA rates of newborns of women in this age group; macrosomic rates; and free-flow oxygen requirements were significantly higher than in the other age groups. In advanced-age healthy pregnancies, abortion rates were the same as those in the control group, and there was no significant difference in the LGA rate or free-flow oxygen requirement of newborns in this group. Additionally, the 1-min APGAR scores of the newborns of advanced-age mothers were significantly lower than those of the control newborns, and the pCO₂ values measured in the cord or blood gases obtained within the first hour were significantly higher. In healthy pregnancies, no significant differences in APGAR scores or pCO₂ values were found between age groups. The cord or blood gas lactate values of newborns who were born from adolescent pregnancies taken within the first hour were significantly higher than those of newborns born in other age groups; considering only healthy adolescent pregnancies, the results did not change. Newborns born from healthy adolescent pregnancies had significantly lower resuscitation needs than those born from other age groups.</p><p><strong>Conclusions: </strong>Newborns who are born from adolescent and advanced-age pregnancies are more likely to have risky early post-natal clinical findings than are newborns who were born from mothers 20-34 years of age. The early period clinical approach and follow-up of newborns born from adolescent and advanced-age maternal pregnancies are very important for pediatric management.</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":"7399-7405"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1949445","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39161463","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":"Genome-wide methylation analysis of pre-pregnancy women in hypothyroidism.","authors":"Wenqian Cai,&nbsp;Xijiang Hu","doi":"10.1080/14767058.2021.1874907","DOIUrl":"https://doi.org/10.1080/14767058.2021.1874907","url":null,"abstract":"<p><strong>Background: </strong>Hypothyroidism is a systemic metabolic deficiency syndrome caused by a deficiency in thyroid hormone or a decrease in the action of thyroid hormones. It has a high incidence among women of child-bearing age, and pregnant women with hypothyroidism may have a higher risk of birth defects.</p><p><strong>Objective: </strong>To explore the specific biological mechanism affecting the occurrence of hypothyroidism.</p><p><strong>Methods: </strong>This study determined key molecules by comparing and analyzing the difference in methylation levels between pre-pregnancy women and normal controls using the Illumina Infinium MethylationEPIC BeadChip.</p><p><strong>Results: </strong>3493 Differential methylation positions (DMPs) related genes and 47 differentially methylated regions (DMRs) related genes were found between the Hypothyroidism group and the control group. Among them, miR-21 has been found to be closely related to thyroid hormone regulation. The results of enrichment analysis showed that the DMPs or DMRs-related genes are both significantly enriched in human T-cell leukemia virus 1 infection, osteoclast differentiation and sphingolipid signaling pathway, which were also closely related to the occurrence and development of hypothyroidism. In addition, the combined analysis of CNVs and DMRs showed that significant differences occurred near the regions of 16 M bp in chromosome 1 between the two groups, and the genes involved in these regions included NDUFS2, FCER1G and SHC1.</p><p><strong>Conclusion: </strong>This work screened molecular markers and key signaling pathways that are involved in the development of hypothyroidism in pre-pregnancy women, which may provide new targets for the research and diagnosis of hypothyroidism in the future.</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":"5035-5042"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1874907","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38761395","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":"Trends, gaps, and future directions of research in cervical remodeling during pregnancy: a bibliometric analysis.","authors":"Ourlad Alzeus G Tantengco,&nbsp;Joy Y Vink,&nbsp;Ramkumar Menon","doi":"10.1080/14767058.2021.1974387","DOIUrl":"https://doi.org/10.1080/14767058.2021.1974387","url":null,"abstract":"<p><strong>Purpose: </strong>The cervix undergoes a dynamic remodeling process throughout pregnancy. Appropriate timing of cervical remodeling is essential in maintaining the fetus inside the uterus and ensuring cervical dilatation for safe delivery of the fetus at term. This study aims to determine the characteristics and trends of published articles in the field of cervical remodeling during pregnancy through a bibliometric analysis.</p><p><strong>Materials and methods: </strong>A systematic review of the literature on cervical remodeling during pregnancy was performed on using the Scopus database from inception to 2020. The following information was obtained for each article: authors, year of publication, title, journal, institution, country, title, keywords, citation frequency, and relative citation ratio. The visualization of collaboration networks of countries and keywords related to cervical remodeling during pregnancy was conducted using VOSviewer software.</p><p><strong>Results: </strong>A total of 1979 bibliographic records were obtained from Scopus database. The number of publications increased in the 1980s and peaked in 2010. A total of 80 countries produced research in cervical remodeling during pregnancy. The USA contributed the greatest number of publications (<i>n</i>= 541), total citations (<i>n</i>= 11,971), and number of international collaborations (<i>n</i>= 28 countries). The <i>American Journal of Obstetrics and Gynecology</i>, <i>Obstetrics and Gynecology</i>, and <i>BJOG: An International Journal of Obstetrics and Gynaecology</i> are the top three contributors in this field in terms of number of publications and total citations. The <i>Karolinska Institutet</i> produced the greatest number of publications while <i>UT Southwestern Medical Center</i> was the most cited institution in this field. The topics of the top cited articles were studies regarding the role of collagen degradation in cervical remodeling during pregnancy; dynamics, anatomy, and physiology of cervical remodeling; and the use of misoprostol for cervical ripening and labor induction.</p><p><strong>Conclusions: </strong>Our bibliometric analysis shows the trends and development, scientific impact, and collaboration in the field of cervical remodeling research. These results show the important discoveries in the past and provided new avenues for scientific and clinical investigations in the field.</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":"8355-8363"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39440102","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":"Mild gestational thrombocytopenia in primiparous women, does it affect risk of early postpartum hemorrhage? A retrospective cohort study.","authors":"Misgav Rottenstreich,&nbsp;Reut Rotem,&nbsp;Itamar Glick,&nbsp;Ori Shen,&nbsp;Sorina Grisaru-Granovsky,&nbsp;Hen Y Sela","doi":"10.1080/14767058.2021.1977793","DOIUrl":"https://doi.org/10.1080/14767058.2021.1977793","url":null,"abstract":"<p><strong>Purpose: </strong>To assess whether women with mild gestational thrombocytopenia have a higher risk of postpartum hemorrhage.</p><p><strong>Methods: </strong>A retrospective computerized database. Primiparous women that delivered at our center (2005-2019) were included; we excluded women with possible etiologies for thrombocytopenia such as systemic lupus or coagulation disorders, and hypertensive disorder of pregnancy. Demographics, obstetric characteristics, and maternal as well as neonatal data were compared between groups. The exposure measure of the study was mild thrombocytopenia (100,000-150,000) versus normal thrombocyte count (>150,000) at admission for labor. Postpartum hemorrhage (PPH) is defined as a clinical estimated blood loss of > 500 mL and/or a hemoglobin drop of ≥ 3 g/dl.</p><p><strong>Results: </strong>Overall, 39,886 primiparous met the study's criteria, 5,209 (13.1%) had mild gestational thrombocytopenia (mean platelet count of 132.4 ± 13.2, study group) while 34,677 (86.9%) had normal platelet count at admission (mean of 221.6 ± 50.6, comparison group.) PPH occurred in 17.6% of the study group as opposed to 14% in the comparison group (<i>p</i> < .001). Similarly, all measures of increased bleeding were more common in the study group as compared to the comparison group, including rates of hemoglobin drop greater than 4 and 5 gram/dl, parenteral iron infusion, and blood products transfusion. On multivariable analysis, the aOR for PPH among women in the study group was 1.23 [1.11-1.36].</p><p><strong>Conclusion: </strong>Primiparous women with mild gestational thrombocytopenia are at increased risk of peripartum hemorrhage, this should be considered a risk factor when assessing parturients' risk of PPH.</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":"8426-8433"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39442071","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":"Castor oil for labor initiation in women with a previous cesarean section: a double-blind randomized study.","authors":"Yomna Ali Bayoumi,&nbsp;Mahmoud Alalfy,&nbsp;Mohamed Sharkawy,&nbsp;Ahmed S Ali,&nbsp;Hisham Mohamed Gouda,&nbsp;Dina Latif Hatem","doi":"10.1080/14767058.2021.2008350","DOIUrl":"https://doi.org/10.1080/14767058.2021.2008350","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the efficacy of castor oil in initiation of labor in women who had one previous cesarean section. This study was conducted as a trial to increase the rate of vaginal birth after cesarean (VBAC) and decrease the rate of elective repeated cesarean section (ERCS).<b>Methods:</b> A double-blinded randomized controlled study was conducted in an Egyptian University Hospital from July 2019 to July 2020. The participants were 70 pregnant women who had one previous cesarean section, singleton pregnancy in cephalic presentation, with a Bishop score ≤6 attempting to perform a trial of labor. Sixty mL castor oil was administered to group A and 60 mL sunflower oil was administered to group B (as a placebo) for initiation of labor at the start of week 39. Primary outcomes were the percentage of women entering the active phase of labor within 24 h after receiving castor oil or placebo and the number of successful VBAC deliveries.<b>Results:</b> Labor started in 16 patients (45.7%) within 24 h in the castor oil group and in 3 patients in the placebo group (8.5%), while the rate of successful VBAC was 65.7% (23 patients) in the castor oil group and 48.5% (17 patients) in the placebo group.<b>Conclusion:</b> Castor oil appears to be an effective, low-cost, and non-harmful method for the initiation of labor in patients with a previous cesarean section.</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":"8945-8951"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39586206","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}