- Questionnaire survey on the management of pregnant women with preterm premature rupture of membranes. [Journal Article]Obstet Gynecol Sci. 2020 May; 63(3):286-292.OG
- CONCLUSIONS: The present survey showed a considerable variation in the actual management of PPROM in women, especially the optimal timing of delivery. More evidenced-based studies with statistical power are required to decrease the heterogeneity of clinical practice.
- #postbabyhankypanky: An Empirically Based Knowledge Sharing Initiative About Sex and the Transition to Parenthood. [Journal Article]Arch Sex Behav. 2020 Jun 03 [Online ahead of print]AS
- Despite the many sexual concerns experienced by new parents, and their reported desire for more information on this topic, both parents and healthcare providers remain reticent to broach the subject. The goal of this project was to disseminate evidence-based knowledge from our prior research in a way that was accessible, engaging, and would spark further interest and communication for both new pa…
Despite the many sexual concerns experienced by new parents, and their reported desire for more information on this topic, both parents and healthcare providers remain reticent to broach the subject. The goal of this project was to disseminate evidence-based knowledge from our prior research in a way that was accessible, engaging, and would spark further interest and communication for both new parents and healthcare providers. We convened a multidisciplinary advisory group that also involved community parents who provided feedback at all phases of this project. We developed five brief YouTube videos, each featuring a core research finding. Following an empirically supported strategic knowledge translation plan, we disseminated the videos to our target audiences (i.e., expectant and new parents, healthcare providers, educators, and other stakeholders) using social media from February 2018 to November 2019. Data were collected using YouTube analytics and an online survey (convenience sample: N = 225 parents; N = 161 healthcare providers). From the date of the launch, the videos had a reach of 91,766 views from 14 countries, with viewers watching an average of 90% of a video. Overall, quantitative and qualitative survey results suggested that the videos were acceptable and appropriate, and respondents were more confident and comfortable discussing sexual issues (with their partner/with their patients) and would like more information about postpartum sexuality after watching the videos. YouTube videos are an acceptable and effective way to disseminate evidence aimed at raising awareness of factors affecting sexuality in the transition to parenthood.
- Baby preparation and worry scale (Baby-PAWS): Instrument development and psychometric evaluation. [Journal Article]Early Hum Dev. 2020 May 22; 147:105080.EH
- CONCLUSIONS: Two factor-analytic techniques indicated a three-factor structure, with internal consistency for all three components and the overall scale. We labeled the three factors: Self and Partner Worry, Non-parental Childcare Worry, and Baby Caregiving Worry, based on item content. Higher Baby-PAWS scores were associated with greater anxiety and depression in the third trimester. Predictive links with postpartum anxiety/depression symptoms and infant temperament were observed for the overall Baby-PAWS score and Self and Partner Worry factor. Although this instrument requires further evaluation, it offers promising utility in research and clinical settings.
- Evaluation of High-Dose Vitamin A Treatment in Postmolar Patients with Low and Plateauing Serum Human Chorionic Gonadotropin Levels. [Journal Article]Rev Bras Ginecol Obstet. 2020 May; 42(5):240-247.RB
- CONCLUSIONS: The limited use of HD Vit-A seems to have a safe and significant effect on the treatment of postmolar patients with L&P serum hCG levels and may decrease the development of postmolar GTN in this population.
- Expectant Management is appropriate in some sIUGR monochorionic twins. [Journal Article]BJOG. 2020 Jun 01 [Online ahead of print]BJOG
- The paper by Colmant et al provides welcome new information on sIUGR (BJOG 2020 xxxx). The design is retrospective, single center, with 108 cases of type II sIUGR, with or without reversed or absent a-wave in the ductus venosus (DV)), over a 6 year period. Diagnosis was made before 26-6/7 weeks' and patients were presented with 2 interventions - selective fetoscopic laser coagulation (SFLC) or co…
The paper by Colmant et al provides welcome new information on sIUGR (BJOG 2020 xxxx). The design is retrospective, single center, with 108 cases of type II sIUGR, with or without reversed or absent a-wave in the ductus venosus (DV)), over a 6 year period. Diagnosis was made before 26-6/7 weeks' and patients were presented with 2 interventions - selective fetoscopic laser coagulation (SFLC) or cord coagulation (CC) - as well as with expectant management (EM). Quoted pregnancy loss-risks were 15%, 20% and 30% respectively.
- Treatment of early-stage mycosis fungoides: results from the PROspective Cutaneous Lymphoma International Study (PROCLIPI study). [Journal Article]Br J Dermatol. 2020 Jun 01 [Online ahead of print]BJ
- CONCLUSIONS: Disease characteristics such as presence of plaques and FMF influence physician treatment choices and that SDT was superior to systemic therapy even in patients with such disease characteristics. Consequently, future treatment guidelines for early-stage MF need to address these issues.
- Addressing Perinatal Mental Health Risk within a Fetal Care Center. [Journal Article]J Clin Psychol Med Settings. 2020 May 29 [Online ahead of print]JC
- Diagnosis of a fetal anomaly in pregnancy increases the risk for perinatal mental health difficulties, including anxiety, depression, and traumatic stress among expectant parents. Common emotional challenges include uncertainty about the diagnosis/prognosis, anticipated neonatal course, fears of fetal or neonatal demise, loss of a typical, uncomplicated pregnancy and postpartum course, and disrup…
Diagnosis of a fetal anomaly in pregnancy increases the risk for perinatal mental health difficulties, including anxiety, depression, and traumatic stress among expectant parents. Common emotional challenges include uncertainty about the diagnosis/prognosis, anticipated neonatal course, fears of fetal or neonatal demise, loss of a typical, uncomplicated pregnancy and postpartum course, and disruption of family roles due to medical care-related activities and restrictions. Psychologists in multidisciplinary fetal care centers are uniquely positioned to assess mental health risks and address the needs of expectant parents. Psychologists bring additional expertise in screening and assessment, clinical interventions to promote coping and symptom reduction while preparing for birth and a complicated neonatal course, consultation and effective communication, and programmatic development. This review paper provides an overview of the challenges and behavioral health risks for expectant parents carrying a fetus with a birth defect and the unique role psychologists play to support patients and families within fetal care settings.
- Optimizing PMTCT efforts by repeat HIV testing during antenatal and perinatal care in resource-limited settings: A longitudinal assessment of HIV seroconversion. [Journal Article]PLoS One. 2020; 15(5):e0233396.Plos
- CONCLUSIONS: The low rates of seroconversion suggest that testing pregnant women multiple times during ANC and PNC may not be cost effective, but a follow-up test during birth may be protective of the newborn.
- Extreme elevations of alkaline phosphatase in pregnancy: A case report. [Case Reports]Case Rep Womens Health. 2020 Jul; 27:e00214.CR
- CONCLUSIONS: The literature proposes that elevation of the placental isotype of ALP could be a marker for placental insufficiency, preterm delivery, or infants born large for gestational age. We report a case with delivery of a normal infant and no placental pathology at term.
- Pneumorrhachis After an Upper Respiratory Infection: A Case Report of a Rare Phenomenon. [Case Reports]Cureus. 2020 Apr 22; 12(4):e7784.C
- Pneumorrhachis (PR) is the presence of free air within the spinal canal. It is generally benign and improves with conservative management. Case reports and a literature review exist documenting the existence and potential pathogenesis of this phenomenon, but no evidence-based guidelines exist documenting what treatment, if any, is indicated for this condition. We present a case of a 21-year-old m…
Pneumorrhachis (PR) is the presence of free air within the spinal canal. It is generally benign and improves with conservative management. Case reports and a literature review exist documenting the existence and potential pathogenesis of this phenomenon, but no evidence-based guidelines exist documenting what treatment, if any, is indicated for this condition. We present a case of a 21-year-old male who developed PR after a preceding upper respiratory tract infection. His symptoms improved with expectant management and administration of high-flow oxygen. The purpose of this case report is to add to the scarce existing literature reporting this condition and to provide a short review of literature detailing the pathogenesis of PR.
- Parents who have received 'psycho-prophylaxis training' during pregnancy and their experience of childbirth - An interview study highlighting the experiences of both parents. [Journal Article]J Reprod Infant Psychol. 2020 May 27 [Online ahead of print]JR
- CONCLUSIONS: Knowledge about childbirth and the ability, by the mother, to use various breathing techniques seemed to help both parents, as it made both of them feel that they were themselves involved in the process.
- Simultaneous Midface Advancement and Orthognathic Surgery: A Powerful Technique for Managing Midface Hypoplasia and Malocclusion. [Journal Article]Plast Reconstr Surg. 2020 Jun; 145(6):1067e-1072e.PR
- CONCLUSIONS: The authors' experience reaffirms the relative safety of simultaneous Le Fort III/I advancement. This technique should be considered in select patients with global midface retrusion and class III malocclusion.
- A brief sleep focused psychoeducation program for sleep-related outcomes in new mothers: A randomised controlled trial. [Journal Article]Sleep. 2020 May 26 [Online ahead of print]S
- CONCLUSIONS: Prenatal sleep psychoeducation did not produce a sustained effect on maternal sleep throughout the postpartum period. There was little evidence of benefits on depressive symptoms.
- Planning for high-risk maternity patients: A new approach. [Journal Article]Nursing. 2020 Jun; 50(6):1-2.N
- Having a plan in place before an expectant mother comes to the healthcare facility for delivery is an important step toward quality care. Read about how one medical center in New Jersey launched an initiative to identify high-risk expectant mothers early and plan accordingly months ahead of their delivery date.
Having a plan in place before an expectant mother comes to the healthcare facility for delivery is an important step toward quality care. Read about how one medical center in New Jersey launched an initiative to identify high-risk expectant mothers early and plan accordingly months ahead of their delivery date.
- Evaluation of the Prognostic Value of the sFlt-1/PlGF Ratio in Early-Onset Preeclampsia. [Journal Article]Am J Perinatol. 2020 May 23 [Online ahead of print]AJ
- CONCLUSIONS: The sFlt-1/PlGF ratio is an additional tool in the prediction of AMFO in proven early-onset PE, which is likely to improve care by anticipating severe complications.· The sFlt-1/PlGF ratio is associated with AMFO.. · It is an additional tool for physician.. · We proposed a 293 cutoff value for the ratio..
- What women want and why. Women's preferences for induction of labour or expectant management in late-term pregnancy. [Journal Article]Women Birth. 2020 May 19 [Online ahead of print]WB
- CONCLUSIONS: Women's preference for induction of labour or a policy of expectant management in late-term pregnancy is influenced by anxiety, quality of life problems (induction), the presence of a wish for natural birth (expectant management), and a variety of additional reasons. This variation in preferences and motivations suggests that there is room for shared decision making in the management of late-term pregnancy.
- HELLP Syndrome or Acute Fatty Liver of Pregnancy: A Differential Diagnostic Challenge: Common Features and Differences. [Journal Article]Geburtshilfe Frauenheilkd. 2020 May; 80(5):499-507.GF
- HELLP syndrome and the less common acute fatty liver of pregnancy (AFL) are unpredictable, life-threatening complications of pregnancy. The similarities in their clinical and laboratory presentations are often challenging for the obstetrician when making a differential diagnosis. Both diseases are characterised by microvesicular steatosis of varying degrees of severity. A specific risk profile do…
HELLP syndrome and the less common acute fatty liver of pregnancy (AFL) are unpredictable, life-threatening complications of pregnancy. The similarities in their clinical and laboratory presentations are often challenging for the obstetrician when making a differential diagnosis. Both diseases are characterised by microvesicular steatosis of varying degrees of severity. A specific risk profile does not exist for either of the entities. Genetic defects in mitochondrial fatty acid oxidation and multiple pregnancy are considered to be common predisposing factors. The diagnosis of AFL is based on a combination of clinical symptoms and laboratory findings. The Swansea criteria have been proposed as a diagnostic tool for orientation. HELLP syndrome is a laboratory diagnosis based on the triad of haemolysis, elevated aminotransferase levels and a platelet count < 100 G/l. Generalised malaise, nausea, vomiting and abdominal pain are common symptoms of both diseases, making early diagnosis difficult. Clinical differences include a lack of polydipsia/polyuria in HELLP syndrome, while jaundice is more common and more pronounced in AFL, there is a lower incidence of hypertension and proteinuria, and patients with AFL may develop encephalopathy with rapid progression to acute liver failure. In contrast, neurological symptoms such as severe headache and visual disturbances are more prominent in patients with HELLP syndrome. In terms of laboratory findings, AFL can be differentiated from HELLP syndrome by the presence of leucocytosis, hypoglycaemia, more pronounced hyperbilirubinemia, an initial lack of haemolysis and thrombocytopenia < 100 G/l, as well as lower antithrombin levels < 65% and prolonged prothrombin times. While HELLP syndrome has a fluctuating clinical course with rapid exacerbation within hours or transient remissions, AFL rapidly progresses to acute liver failure if the infant is not delivered immediately. The only causal treatment for both diseases is immediate delivery. Expectant management between 24 + 0 and 33 + 6 weeks of gestation is recommended for HELLP syndrome, but only in cases where the mother can be stabilised and there is no evidence of foetal compromise. The maternal mortality rate for HELLP syndrome in developed countries is approximately 1%, while the rate for AFL is 1.8 - 18%. Perinatal mortality rates are 7 - 20% and 15 - 20%, respectively. While data on the long-term impact of AFL on the health of mother and child is still insufficient, HELLP syndrome is associated with an increased risk of developing cardiovascular, metabolic and neurological diseases in later life.
- Paternal violent criminality and preterm birth: a Swedish national cohort study. [Journal Article]BMC Pregnancy Childbirth. 2020 May 19; 20(1):307.BP
- CONCLUSIONS: Persistent paternal violent criminality was associated with increased risk of preterm birth, even after controlling for maternal characteristics that did not change between pregnancies.
- Intracranial emergencies during pregnancy requiring urgent neurosurgical treatment. [Journal Article]Clin Neurol Neurosurg. 2020 May 12; 195:105905.CN
- CONCLUSIONS: The individualized treatment approach in this peculiar obstetric scenario needs to consider various issues such as the clinical condition of the pregnant woman, prognosis of the disease, gestational age and the status of the pregnancy. The primary concern in this context must be the mother`s health and safety. Caesarean section is the primary mode of delivery in most cases. While contemporary care can insure survival for the majority of infants, maternal mortality still poses an extraordinary challenge. Interdisciplinary consulting of the patient and/or her family is necessary to develop a treatment strategy for both the expectant woman and her offspring.
- Dienogest And The Risk Of Endometriosis Recurrence Following Surgery: A Systematic Review And Meta-Analysis. [Review]J Minim Invasive Gynecol. 2020 May 16 [Online ahead of print]JM
- CONCLUSIONS: Patients receiving dienogest after conservative surgery for endometriosis had significantly lower risk of post-operative disease recurrence compared to those expectantly managed.
- Use of fertility services in Australian lesbian, bisexual and queer women's pathways to parenthood. [Journal Article]Aust N Z J Obstet Gynaecol. 2020 May 18 [Online ahead of print]AN
- CONCLUSIONS: These findings indicate that use of fertility clinics to access donor sperm is common for LBQ women, including those with no known fertility problems, and that most women who access donor sperm conceive using IVF rather than intrauterine insemination. More needs to be known about the context and reasons for this, including factors that influence LBQ women's decision making on their pathway to parenthood.
- Parental Views on Newborn Next Generation Sequencing: Implications for Decision Support. [Journal Article]Matern Child Health J. 2020 Jul; 24(7):856-864.MC
- CONCLUSIONS: Interviews elucidated what is important in deciding to have NGS-NBS. Understanding parental perspectives, values, and beliefs and integrating evidence-based findings into a parent-centric decision aid provides value and support in making decisions related to NGS-NBS, where there is no clear course of action.
- Using Technology to Support Expectant and Parenting Youth through Case Management: Lessons Learned in the Field. [Journal Article]Matern Child Health J. 2020 May 16 [Online ahead of print]MC
- CONCLUSIONS: Findings suggest that programs should understand the nuances of client contact preferences. To maximize the benefits of ICT, programs must develop or adapt protocols based on preference and purpose of communication.
- Home Collection of Products of Conception: Can Chromosomal Analysis be Obtained? [Journal Article]J Gynecol Obstet Hum Reprod. 2020 May 14 [Online ahead of print]JG
- CONCLUSIONS: In our study, D&C was the superior method to obtain POCs for chromosomal analysis following a miscarriage, but medical and expectant management still had clinically acceptable success rates as well. Although further study is indicated, this small case series suggests that patient counselling regarding miscarriage management and desired chromosomal analysis should continue to include misoprostol and expectant management as inferior but still appropriate alternatives to D&C.
- Impact of different prenatal management strategies in short and long-term outcomes in monochorionic twin pregnancies with selective intrauterine growth restriction and abnormal flow velocity waveforms in the umbilical artery Doppler: a retrospective observational study of 108 cases. [Journal Article]BJOG. 2020 May 16 [Online ahead of print]BJOG
- CONCLUSIONS: SFLC yielded poor result. EM seems a valid option when EFW discordance is <30% and a-wave in DV is positive. Otherwise CC should be considered to protect the AGA co-twin. The long-term outcome of both small and large twins seems unaffected by the choice in primary prenatal management strategy.
- Physical resolution of tubal ectopic pregnancy on ultrasound imaging following successful expectant management. [Journal Article]Reprod Biomed Online. 2020 Jun; 40(6):880-886.RB
- CONCLUSIONS: Physical resolution of tubal ectopic pregnancy is often prolonged and is positively correlated with initial and maximum beta-HCG concentrations. Results of this study indicate that beta-HCG resolution cannot be used as the end-point of expectant management of tubal ectopic pregnancy, which should be considered when counselling women and planning for future pregnancies.
- Fetal growth restriction as a diagnostic criterion for preeclampsia. [Journal Article]Pregnancy Hypertens. 2020 May 07; 21:58-62.PH
- CONCLUSIONS: Organ dysfunction onset may reflect PE progression more accurately than FGR onset. Further investigations on whether to include FGR into the diagnostic criteria for PE are needed.
- A Case for Early Screening: Prenatal Alcohol Risk Exposure Predicts Risk for Early Childhood Communication Delays. [Journal Article]J Dev Behav Pediatr. 2020 May 12 [Online ahead of print]JD
- CONCLUSIONS: The results of this study suggest that screening for PAR in expectant mothers may identify a group of young children at increased risk for communication delays. This research carries clinical implications and provides support for PAR screening in informing early childhood developmental screening efforts.
- Ectopic Pregnancy: Diagnosis and Management. [Journal Article]Am Fam Physician. 2020 May 15; 101(10):599-606.AF
- Ectopic pregnancy occurs when a fertilized ovum implants outside of the uterine cavity. In the United States, the estimated prevalence of ectopic pregnancy is 1% to 2%, and ruptured ectopic pregnancy accounts for 2.7% of pregnancy-related deaths. Risk factors include a history of pelvic inflammatory disease, cigarette smoking, fallopian tube surgery, previous ectopic pregnancy, and infertility. E…
Ectopic pregnancy occurs when a fertilized ovum implants outside of the uterine cavity. In the United States, the estimated prevalence of ectopic pregnancy is 1% to 2%, and ruptured ectopic pregnancy accounts for 2.7% of pregnancy-related deaths. Risk factors include a history of pelvic inflammatory disease, cigarette smoking, fallopian tube surgery, previous ectopic pregnancy, and infertility. Ectopic pregnancy should be considered in any patient presenting early in pregnancy with vaginal bleeding or lower abdominal pain in whom intrauterine pregnancy has not yet been established. The definitive diagnosis of ectopic pregnancy can be made with ultrasound visualization of a yolk sac and/or embryo in the adnexa. However, most ectopic pregnancies do not reach this stage. More often, patient symptoms combined with serial ultrasonography and trends in beta human chorionic gonadotropin levels are used to make the diagnosis. Pregnancy of unknown location refers to a transient state in which a pregnancy test is positive but ultrasonography shows neither intrauterine nor ectopic pregnancy. Serial beta human chorionic gonadotropin levels, serial ultrasonography, and, at times, uterine aspiration can be used to arrive at a definitive diagnosis. Treatment of diagnosed ectopic pregnancy includes medical management with intramuscular methotrexate, surgical management via salpingostomy or salpingectomy, and, in rare cases, expectant management. A patient with diagnosed ectopic pregnancy should be immediately transferred for surgery if she has peritoneal signs or hemodynamic instability, if the initial beta human chorionic gonadotropin level is high, if fetal cardiac activity is detected outside of the uterus on ultrasonography, or if there is a contraindication to medical management.
New Search Next
- Psychometric testing of the support and control in birth scale. [Journal Article]BMC Pregnancy Childbirth. 2020 May 14; 20(1):293.BP
- CONCLUSIONS: The C-SCIB scale was proven to have good reliability and validity, and thus can be used to measure the degree of support and the locus of control perceived by expectant women during labor.