Maternal-fetal medicine (Wolters Kluwer Health, Inc.)最新文献

{"title":"The Impact of Spontaneous Labor Before Elective Repeat Cesarean Delivery on Pregnancy Outcome: A Prospective Cohort Study","authors":"M. Ramadan, Ibtissam Jarjour, Manal Hubeish, S. Itani, S. Mneimneh, D. Badr","doi":"10.1097/FM9.0000000000000115","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000115","url":null,"abstract":"Abstract Objective: To investigate the effects of spontaneous labor before elective repeat cesarean delivery (ERCD) on short-term maternal and neonatal outcomes. Methods: This was a prospective cohort study. All consecutive ERCDs, occurring at ≥37  weeks of gestation between July 1, 2017 and December 31, 2019 in Makassed General Hospital, were evaluated. The maternal and neonatal outcomes of 183 laboring women undergoing unscheduled repeat cesarean delivery (URCD) group were compared with those of 204 women undergoing cesarean delivery (CD) without spontaneous labor (ERCD) group. Primary outcomes were “composite adverse maternal outcome” and “composite adverse neonatal outcome.” Fisher's exact and Student's t tests were used to assess the significance of differences in dichotomous and continuous variables, respectively. Two logistic regression models were constructed to identify risk factors with most significant influence on the rate of composite adverse maternal and neonatal outcomes. Results: “Composite adverse maternal outcome” was significantly more common in women who underwent spontaneous labor ((40/183) 21.9% vs. (19/204) 9.3%, P = 0.001, relative risk (RR): 2.7, 95% confidence interval (CI): 1.50–4.90). Similarly, “composite adverse neonatal outcome” was significantly increased in the URCD group ((24/183) 13.1% vs. (12/204) 5.9%, P = 0.014, RR: 2.4, 95% CI: 1.18–4.98). These adverse effects persisted after adjustment for confounders. Multivariate regression models revealed that, besides labor, CD-order impacted maternal outcome (RR: 1.5, 95%CI: 1.02–2.30, P = 0.036), while CD-order and teenage pregnancy influenced neonatal outcome (RR: 2.1, 95%CI: 1.29–3.38, P = 0.003, and RR: 16.5, 95%CI: 2.09–129.80, P = 0.008, respectively). Conclusion: In our study, spontaneous labor before ERCD, including deliveries at term, was associated with adverse maternal and neonatal outcomes, indicating that it is preferable to conduct ERCD before the onset of labor. Screening women with MRCD may identify those at increased risk for spontaneous labor for whom CD could be scheduled 1–2 weeks earlier. Further large prospective studies to assess the effects of such an approach on maternal and neonatal outcomes are strongly warranted.","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"44 8","pages":"255 - 262"},"PeriodicalIF":0.0,"publicationDate":"2021-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41285587","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":"Broad Ligament Pregnancy: Facing the Battle Unarmed.","authors":"Meenakshi Singh, Nihita Pandey, Ratna Biswas","doi":"10.1097/FM9.0000000000000122","DOIUrl":"10.1097/FM9.0000000000000122","url":null,"abstract":"<p><p>Broad ligament pregnancy is defined as gestation that grows in the space formed by anterior and posterior peritoneal folds of the broad ligament. We report a case of 30 years old lady admitted to our hospital with the diagnosis of gravida 2, para 1, live birth 1, with 24 weeks of gestation with low lying placenta with anhydramnios. She was taken up for lower segment cesarian section at 28 weeks gestation in view of low lying placenta with chorioamnionitis. The broad ligament pregnancy was diagnosed peroperatively after identifying the anatomical relationship of the pregnancy. Sac was excised and margins secured after extraction of the baby and placenta. Patient had an uneventful postoperative period. Broad ligament pregnancy may be missed in antenatal period but in cases of displaced cervix, early onset unexplained anhydramnios, and failed induction of labor, it may raise high suspicion. Laparotomy/ laparoscopic management is the mainstay of management of broad ligament pregnancy.</p>","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":" ","pages":"253-256"},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44594760","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":"Posterior Placenta Accreta Spectrum Disorders: Risk Factors, Diagnostic Accuracy, and Surgical Management","authors":"J. Palacios-Jaraquemada, F. D’Antonio","doi":"10.1097/FM9.0000000000000124","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000124","url":null,"abstract":"Abstract Posterior placenta accreta spectrum (PAS) disorders are infrequent but potentially associated with significant maternal mortality and morbidity, especially if not diagnosed prenatally. Analysis of published literature is problematic since most experiences included only a few cases. Knowledge of the risk factors associated with posterior PAS is crucial to identifying mothers at higher risk and ask for high sensitivity studies. Ultrasound has poor diagnostic accuracy in detecting posterior PAS, while magnetic resonance imaging better delineates the posterior uterine wall. In comparison, prenatal imaging's diagnostic performance in detecting posterior PAS is significantly lower than anterior placenta invasion. Management of posterior PAS depends on several factors, including maternal hemodynamic status, available resources, clinical presentation, and invasion severity. For accreta or increta cases, a compression suture is habitually enough to perform hemostasis. Nevertheless, organ involvement habitually requires a multidisciplinary team with the assistant of a general or coloproctology surgeon. The present article aims to update the risk factors, prenatal diagnosis, and surgical management of pregnancies complicated by posterior PAS.","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"3 1","pages":"268 - 273"},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43530568","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":"Expert Opinion on Placenta Accreta Spectrum Disorders in China","authors":"Jie Yan, Dunjin Chen, Huixia Yang","doi":"10.1097/fm9.0000000000000126","DOIUrl":"https://doi.org/10.1097/fm9.0000000000000126","url":null,"abstract":"","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46502457","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":"Bladder Bleeding Due to Placenta Percreta","authors":"Huidan Zhao, Xianlan Zhao, Chuanna Liu, Ya Tao, Yan Zhou","doi":"10.1097/fm9.0000000000000120","DOIUrl":"https://doi.org/10.1097/fm9.0000000000000120","url":null,"abstract":"","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49643493","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":"Ultrasound Assessment of Placenta Accreta Spectrum (PAS), Clinical Management of PAS in Our Society IS-PAS","authors":"F. Chantraine, Xinrui Yang, Jie Yan","doi":"10.1097/fm9.0000000000000118","DOIUrl":"https://doi.org/10.1097/fm9.0000000000000118","url":null,"abstract":"","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44882114","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":"Maternal Diaphragmatic Hernia Correction During Pregnancy.","authors":"Juan Sebastián Barona-Wiedmann, Mauricio Velásquez, Maria Josefa Franco, Henry Muñoz, Albaro José Nieto-Calvache","doi":"10.1097/FM9.0000000000000119","DOIUrl":"10.1097/FM9.0000000000000119","url":null,"abstract":"<p><p>Congenital diaphragmatic hernia consists of a defect in the embryonic development of the diaphragm that allows the passage of the abdominal viscera into the thoracic cavity, its diagnosis during pregnancy is quite rare. We present the case of a 31-year-old woman, with 23 weeks of gestation, who consulted for epigastric pain, nausea, and repetitive emetic episodes, without improvement with the medication provided. Due to the intense abdominal pain, a computed tomography of the abdomen and thorax was performed where the 28 mm defect was found at the left diaphragmatic level with protrusion of the gastric fundus to the thoracic cavity. She was taken to surgical management by laparoscopy with abdominal and thoracic approach, with a successful result and without maternal perinatal complications. Although the integrity of the diaphragmatic suture could be feared in relation to the increase in intraabdominal pressure due to uterine growth, the evolution of our patient and previous reports show that postoperative complications are not frequent. Successful vaginal delivery has even been described in some reports. Diaphragmatic hernias diagnosed during pregnancy are quite rare. We suggest that the optimal management of them during pregnancy is immediate surgical correction in case of persistent symptoms, more studies are needed to establish firm recommendations on the management of this pathology.</p>","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":" ","pages":"257-259"},"PeriodicalIF":0.0,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43376453","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":"Retained Placenta Creta After Selective Fetal Reduction in Twin Pregnancy","authors":"Weiran Zheng, Xinrui Yang, Yu-chun Zhu, Jie Yan, Huixia Yang","doi":"10.1097/FM9.0000000000000117","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000117","url":null,"abstract":"","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45093166","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":"Prenatal Diagnosis of a Giant Epignathus in the Second Trimester and Immediate Successful Management at Birth: A Case Report.","authors":"Xiaoyu Hu, Yijing Chu, Yunqing Chen, Min Zhao, Xiaofei Wang, Lin Xu","doi":"10.1097/FM9.0000000000000116","DOIUrl":"10.1097/FM9.0000000000000116","url":null,"abstract":"<p><p>Epignathus is an extremely rare congenital oropharyngeal teratoma. Here, we report a case of epignathus without intracranial extension in a fetus. The mass was first found by ultrasonography at 22 gestational weeks. Serial ultrasound examinations and magnetic resonance imaging confirmed that the fetus had neither central nervous system involvement nor abnormal nose or tooth. The baby was delivered at 37 weeks and six days of gestation via cesarean section set up for ex-utero intrapartum treatment. The postnatal pathologic examination confirmed the presence of mature tissues predominantly containing ectopic central nervous tissue, osseous tissue, and bronchial mucosal tissue. Most cases of epignathus are associated with malformation and death. Ultrasound and magnetic resonance imaging prenatal assessments are very important to facilitate counseling and understand prognosis. In conclusion, the ex-utero intrapartum treatment procedure is a good approach to improve the survival of infants with epignathus.</p>","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"5 1","pages":"123-127"},"PeriodicalIF":0.0,"publicationDate":"2021-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48170839","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":"Comprehensive Management of Gestational Diabetes Mellitus in China","authors":"Yumei Wei, J. Juan, Huixia Yang","doi":"10.1097/fm9.0000000000000113","DOIUrl":"https://doi.org/10.1097/fm9.0000000000000113","url":null,"abstract":"","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47728708","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}