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[PMID]: 28428183
[Au] Autor:Kozuki N; Katz J; Khatry SK; Tielsch JM; LeClerq SC; Mullany LC
[Ad] Address:Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
[Ti] Title:Risk and burden of adverse intrapartum-related outcomes associated with non-cephalic and multiple birth in rural Nepal: a prospective cohort study.
[So] Source:BMJ Open;7(4):e013099, 2017 Apr 20.
[Is] ISSN:2044-6055
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVES: Intrapartum-related complications are the second leading cause of neonatal death worldwide. We estimate the community-level risk and burden of intrapartum-related fetal/neonatal mortality and morbidity associated with non-cephalic and multiple birth in rural Sarlahi District, Nepal. DESIGN: Community-based prospective cohort study. SETTING: Rural Sarlahi District, Nepal. PARTICIPANTS: Pregnant women residing in the study area. METHODS: We collected data on maternal background characteristics, conditions during labour and delivery, fetal presentation and multiple birth during home visits. We ran log-binomial regression models to estimate the associations between non-cephalic/multiple births and fresh stillbirth, early neonatal mortality and signs of neonatal encephalopathy, respectively, and calculated the per cent attributable fraction. To better understand the context under which these adverse birth outcomes are occurring, we also collected data on maternal awareness of non-cephalic presentation and multiple gestation prior to delivery. PRIMARY OUTCOME MEASURES: Risk of experiencing fresh stillbirth, early neonatal encephalopathy and early neonatal mortality associated with non-cephalic and multiple birth, respectively. RESULTS: Non-cephalic presentation had a particularly high risk of fresh stillbirth (aRR 12.52 (95% CI 7.86 to 19.95), reference: cephalic presentation). 20.2% of all fresh stillbirths were associated with non-cephalic presentation. For multiple births, there was a fourfold increase in early neonatal mortality (aRR: 4.57 (95% CI 1.44 to 14.50), reference: singleton births). 3.4% of early neonatal mortality was associated with multiple gestation. CONCLUSIONS: Globally and in Nepal, a large percentage of stillbirths and neonatal mortality is associated with intrapartum-related complications. Despite the low incidence of non-cephalic and multiple birth, a notable proportion of adverse intrapartum-related outcomes is associated with these conditions. As the proportion of neonatal deaths attributable to intrapartum-related complications continues to rise, there is a need to investigate how best to advance diagnostic capacity and management of these conditions. TRIAL REGISTRATION NUMBER: NCT01177111; pre-results.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1704
[Cu] Class update date: 171103
[Lr] Last revision date:171103
[St] Status:In-Process
[do] DOI:10.1136/bmjopen-2016-013099

  2 / 3717 MEDLINE  
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[PMID]: 28431858
[Au] Autor:Chandra I; Sun L
[Ad] Address:Department of Obstetrics and Gynecology, First Affiliated Hospital of Nanjing Medical University, Jiangsu, China.
[Ti] Title:Third trimester preterm and term premature rupture of membranes: Is there any difference in maternal characteristics and pregnancy outcomes?
[So] Source:J Chin Med Assoc;80(10):657-661, 2017 Oct.
[Is] ISSN:1728-7731
[Cp] Country of publication:China (Republic : 1949- )
[La] Language:eng
[Ab] Abstract:BACKGROUND: The clinical significance and management of preterm premature rupture of membranes (PPROM) remains a topic of a controversy. Although PROM is associated with a low rate of complications, PPROM may lead to significant neonatal and maternal morbidity. METHODS: We performed a retrospective study of 714 women who presented to Jiangsu Province Hospital with third trimester PPROM or PROM between January and December 2015. The data were analyzed by SPSS; the significance of maternal characteristics, and maternal and neonatal outcomes were tested using Student's t test and the χ test. A two-sided p value < 0.05 was considered statistically significant. RESULTS: There were 714 women included in this analysis. We identified 577 (80.8%) women with PROM and 137 (19.2%) with PPROM. In the PPROM group, we further divided the women into 28 -31 weeks (n = 21) and 32 -36 weeks (n = 116) of gestational age. PPROM was associated with a significantly lower gestational age, and patients in this group showed higher C-reactive protein and body temperature when admitted to the hospital (p < 0.05). Breech presentation and history of previous cesarean section were associated with occurrence of PPROM compared with PROM (p < 0.05). The PPROM group showed a significantly longer latency period compared with the PROM group, in which the latency period increased with the lower gestational age (28 -31 weeks). Significantly higher neonatal intensive care unit (NICU) admission rate was shown in the PPROM group as compared with the PROM group, and gestational age 28 -31 weeks yielded a significantly higher rate of NICU admission than 32 -36 weeks did (p < 0.05). CONCLUSION: Higher C-reactive protein and body temperature in the PPROM group suggest an asymptomatic infection that requires close monitoring to prevent any adverse effect on pregnancy outcome. Longer latency period in PPROM group is predictable in order to minimize perinatal morbidity and mortality because of prematurity itself. Therefore, an increase in gestational age plays an important role that can affect a clinician's decision making regarding whether to transfer to the NICU.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1704
[Cu] Class update date: 171102
[Lr] Last revision date:171102
[St] Status:In-Process

  3 / 3717 MEDLINE  
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[PMID]: 29041923
[Au] Autor:Kuppens SM; Smailbegovic I; Houterman S; de Leeuw I; Hasaart TH
[Ad] Address:Department of Obstetrics and Gynecology, Catharina Hospital, P.O. Box 1350, 5602 ZA, Eindhoven, the Netherlands. simone.kuppens@catharinaziekenhuis.nl.
[Ti] Title:Fetal heart rate abnormalities during and after external cephalic version: Which fetuses are at risk and how are they delivered?
[So] Source:BMC Pregnancy Childbirth;17(1):363, 2017 Oct 17.
[Is] ISSN:1471-2393
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Fetal heart rate abnormalities (FHR) during and after external cephalic version (ECV) are relatively frequent. They may raise concern about fetal wellbeing. Only occasionally they may lead to an emergency cesarean section. METHODS: Prospective cohort study in 980 women (> 34 weeks gestation) with a singleton fetus in breech presentation. During and after external cephalic version (ECV) FHR abnormalities were recorded. Obstetric variables and delivery outcome were evaluated. Primary outcome was to identify which fetuses are at risk for FHR abnormalities. Secondary outcome was to identify a possible relationship between FHR abnormalities during and after ECV and mode of delivery and fetal distress during subsequent labor. RESULTS: The overall success rate of ECV was 60% and in 9% of the attempts there was an abnormal FHR pattern. In two cases FHR abnormalities after ECV led to an emergency CS. Estimated fetal weight per 100 g (OR 0.90, CI: 0.87-0.94) and longer duration of the ECV-procedure (OR 1.13, CI: 1.05-1.21) were factors significantly associated with the occurrence of FHR abnormalities. FHR abnormalities were not associated with the mode of delivery or the occurrence of fetal distress during subsequent labor. CONCLUSIONS: FHR abnormalities during and after ECV are more frequent with lower estimated fetal weight and longer duration of the procedure. FHR abnormalities during and after ECV have no consequences for subsequent mode of delivery. They do not predict whether fetal distress will occur during labor. TRIAL REGISTRATION: The Eindhoven Breech Intervention Study, NCT00516555 . Date of registration: August 13, 2007.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171027
[Lr] Last revision date:171027
[St] Status:In-Process
[do] DOI:10.1186/s12884-017-1547-6

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[PMID]: 28889774
[Au] Autor:Ekéus C; Norman M; Åberg K; Winberg S; Stolt K; Aronsson A
[Ad] Address:a Department of Women's and Children's Health, Division of Reproductive Health , Karolinska Institutet , Stockholm , Sweden.
[Ti] Title:Vaginal breech delivery at term and neonatal morbidity and mortality - a population-based cohort study in Sweden.
[So] Source:J Matern Fetal Neonatal Med;:1-6, 2017 Sep 22.
[Is] ISSN:1476-4954
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:INTRODUCTION: The routine to deliver almost all term breech cases by elective cesarean section (CS) has continued to be debated due to the risk of maternal and neonatal complications. The aims of the study were (1) to investigate if mode of delivery impacts on the risk of morbidity and mortality among term infants in breech presentation and (2) to compare the rates of severe neonatal complications and mortality in relation to presentation and mode of delivery. METHODS: This population-based cohort study used data from the Swedish Medical Birth Register. All women (and their newborn infants) with singleton pregnancies who gave birth at term to an infant in breech (n = 27,357) or cephalic presentation (n = 837,494) between 2001 and 2012 were included. Births with vacuum extraction and induced labors were excluded, as well as antepartum stillbirths, births with infants diagnosed with congenital malformations and multiple births. RESULTS: On one hand, the rates of neonatal complications and mortality were higher among infants born in vaginal breech compared to the vaginal cephalic group. On the other hand, after CS, the rates of all neonatal complications under study and neonatal mortality were lower among infants in breech presentation than in those in cephalic presentation. After adjustment for confounders, infants delivered in vaginal breech had 23.8 times higher odds AOR (ratio) for brachial plexus injury, 13.3 times higher odds ratio for Apgar score <7 at 5 min, 6.7 times higher odds of intracranial hemorrhage (ICH), or convulsions and 7.6 higher odds ratio for perinatal mortality than those delivered by elective CS. CONCLUSIONS: Despite a probable selection of women who before-hand were considered at low risk and, therefore, could be recommended vaginal breech delivery, infants delivered in vaginal breech faced substantially increased risks of severe neonatal complications compared with infants in breech presentations delivered by elective CS. Key message Vaginal breech delivery is associated with increased risk for severe neonatal complications.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 171026
[Lr] Last revision date:171026
[St] Status:Publisher
[do] DOI:10.1080/14767058.2017.1378328

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[PMID]: 28760068
[Au] Autor:Hickland P; Gargan P; Simpson J; McCabe N; Costa J
[Ad] Address:a Royal Jubilee Maternity Service , Belfast , Northern Ireland.
[Ti] Title:A novel and dedicated multidisciplinary service to manage breech presentation at term; 3 years of experience in a tertiary care maternity unit.
[So] Source:J Matern Fetal Neonatal Med;:1-7, 2017 Aug 09.
[Is] ISSN:1476-4954
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVE: In order to provide uniform and unbiased multidisciplinary counselling on the options available, including vaginal breech delivery (VBD) and external cephalic version (ECV), the latter of which could then be performed, a weekly Breech Clinic was introduced to a tertiary care maternity unit in Northern Ireland in June 2013, replacing the traditional ECV Clinic introduced in June 2012. METHODS: Retrospective data collection was undertaken using clinic proformas, Northern Ireland Maternity System data and case notes of women who attended the clinics (ECV and Breech) from June 2012 to May 2015. RESULTS: There were 434 referrals to the clinic over the 3-year period; 356 women attended. The proportion of women attending increased from 69% to 85% since the introduction of the Breech Clinic. Two hundred and thirty-two were deemed eligible and 179 of these underwent ECV after counselling. Although the proportion of women undergoing ECV decreased from 69% to 46%, 11 women opted for and achieved VBD during the 2 years of the Breech Clinic, compared with one woman in the year of the ECV Clinic. Seventy-one of the attempted ECVs were successful, with 61 women having a normal vaginal delivery. Notably, the success rate of ECV increased from 33% to 42%. The number of caesarean sections performed solely for breech at term decreased from 199 in the 12 months before the introduction of ECV clinic, to 188 during the ECV clinic, and 154 in the final 12 months of Breech Clinic. CONCLUSIONS: A dedicated service to counsel women on the management of breech presentation can decrease caesarean sections for breech presentation through increased uptake and success of ECV, and encouraging suitable women to opt for VBD when ECV is unsuccessful, contraindicated or declined.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1708
[Cu] Class update date: 171026
[Lr] Last revision date:171026
[St] Status:Publisher
[do] DOI:10.1080/14767058.2017.1362382

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[PMID]: 28279119
[Au] Autor:Diguisto C; Winer N; Descriaud C; Tavernier E; Weymuller V; Giraudeau B; Perrotin F
[Ad] Address:a Department of Obstetrics, Gynecology and Fetal Medicine , University Hospital of Tours , Tours , France.
[Ti] Title:Amnioinfusion for women with a singleton breech presentation and a previous failed external cephalic version: a randomized controlled trial.
[So] Source:J Matern Fetal Neonatal Med;:1-7, 2017 Mar 28.
[Is] ISSN:1476-4954
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:PURPOSE: Our trial aimed to assess the effectiveness of amnioinfusion for a second attempt at external cephalic version (ECV). MATERIAL AND METHODS: This open randomized controlled trial was planned with a sequential design. Women at a term ≥36 weeks of gestation with a singleton fetus in breech presentation and a first unsuccessful ECV were recruited in two level-3 maternity units. They were randomly allocated to transabdominal amnioinfusion with a 500-mL saline solution under ultrasound surveillance or no amnioinfusion before the second ECV attempt. Trained senior obstetricians performed all procedures. The primary outcome was the cephalic presentation rate at delivery. Analyses were conducted according to intention to treat (NCT00465712). RESULT: Recruitment difficulties led to stopping the trial after a 57-month period, 119 women were randomized: 59 allocated to amnioinfusion + ECV and 60 to ECV only. Data were analyzed without applying the sequential feature of the design. The rate of cephalic presentation at delivery did not differ significantly according to whether the second version attempt was or was not preceded by amnioinfusion (20 versus 12%, p = .20). Premature rupture of the membranes occurred for 15% of the women in the amnioinfusion group. CONCLUSION: Amnioinfusion before a second attempt to external version does not significantly increase the rate of cephalic presentation at delivery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1703
[Cu] Class update date: 171026
[Lr] Last revision date:171026
[St] Status:Publisher
[do] DOI:10.1080/14767058.2017.1304909

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[PMID]: 28274162
[Au] Autor:Hunter T; Shah J; Synnes A; Shivananda S; Ryan G; Shah PS; Murphy KE; ; on behalf of the Canadian Neonatal Network
[Ad] Address:a Department of Obstetrics & Gynaecology , University of Toronto , Toronto , Canada.
[Ti] Title:Neonatal outcomes of preterm twins according to mode of birth and presentation.
[So] Source:J Matern Fetal Neonatal Med;:1-7, 2017 Mar 08.
[Is] ISSN:1476-4954
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:PURPOSE: To compare neonatal outcomes of twins delivered <33 weeks' gestation in tertiary centers in Canada according to the mode of birth and presentation. MATERIALS AND METHODS: This retrospective cohort from the Canadian Neonatal Network database studied preterm twins born from 24 + 0 to 32 + 6 weeks' gestation between 2005 and 2012. Twins were grouped by the mode of birth: both vaginal, combined vaginal/cesarean section (CS), and both CS. Additionally, twins were grouped by the mode of presentation: both vertex, vertex/breech, breech/vertex, and both breech. The primary outcome was a composite of mortality or severe neonatal morbidity (severe neurological injury [intraventricular hemorrhage grade 3/4 or periventricular leukomalacia], bronchopulmonary dysplasia, retinopathy of prematurity, and necrotizing enterocolitis). RESULTS: Of the 6636 twins, 1934 (29%) were delivered vaginally, 418 (6%) by combined vaginal birth/CS, and 4284 (65%) were born by CS. The composite did not differ between the groups. However, severe neurological injury was decreased (adjusted odds ratio [AOR], 0.77; 95% confidence interval [CI], 0.61-0.98) and respiratory distress syndrome (AOR, 1.34; 95%CI, 1.15-1.56) was increased when both the twins were delivered by CS. CONCLUSIONS: Preterm twin infants born via CS experienced less severe neurological injury when compared to those delivered vaginally, but had an increase in respiratory distress syndrome.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1703
[Cu] Class update date: 171026
[Lr] Last revision date:171026
[St] Status:Publisher
[do] DOI:10.1080/14767058.2017.1295441

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[PMID]: 28110591
[Au] Autor:Robillard PY; Boukerrou M; Bonsante F; Hulsey TC; Dekker G; Gouyon JB; Iacobelli S
[Ad] Address:a Service de Néonatologie , Centre Hospitalier Universitaire Sud Réunion , La Réunion , Saint Pierre , France.
[Ti] Title:Linear association between maternal age and spontaneous breech presentation in singleton pregnancies after 32 weeks gestation.
[So] Source:J Matern Fetal Neonatal Med;:1-6, 2017 Feb 09.
[Is] ISSN:1476-4954
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:PURPOSE: To investigate the association between maternal age and spontaneous breech presentation. MATERIAL AND METHODS: Fifteen-year observational study over (2001-2015). All consecutive singleton births delivered at the Centre Hospitalier Universitaire Sud Reunion's maternity. The only single exclusion criterion was uterine malformations (N = 123) women. RESULTS: Of the 60,963 singleton births, there was a linear association (χ for linear trend, p< 0.0001) between maternal age and spontaneous breech presentation. Overall rate of breech presentation was 2.7% in deliveries over 32 weeks gestation, while it was 1.9% in women aged 15 to 19 years and 4.0% in women aged 45+, with a linear progression for each 5-year age category. This linearity remained significant controlling for early prematurity (<33 weeks) and severe fetal malformations (χ for linear trend = 64, p < 0.0001). Controlling in a multiple logistic regression model for other major risk factors gestational age, female sex, primiparity, maternal age remained significantly an independent risk factor, p < 0.0001. CONCLUSION: Maternal age (x) is an independent factor for breech presentation in singleton pregnancies after 32 weeks gestation with a linear association that may be approximated at y = 0.1x. (y: incidence, percent).
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1701
[Cu] Class update date: 171026
[Lr] Last revision date:171026
[St] Status:Publisher
[do] DOI:10.1080/14767058.2017.1285897

  9 / 3717 MEDLINE  
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[PMID]: 28664740
[Au] Autor:Hederlingova J; Psenkova P; Zahumensky J
[Ti] Title:The impact of physiological peripartal stress on the lifelong health of newborn.
[So] Source:Bratisl Lek Listy;118(6):324-327, 2017.
[Is] ISSN:0006-9248
[Cp] Country of publication:Slovakia
[La] Language:eng
[Ab] Abstract:In the last decades the exponential increase in frequency of Caesarean sections is being observed. At the same time, there is growing amount of epidemiologic data showing higher lifetime risk of incidence of several diseases in offspring who do not experience natural labour. These findings lead to investigation of mechanisms which are responsible for maladaptation of several organ systems. Authors of this article describe these mechanisms, focusing especially on epigenetic programming, production of microbiome and positive effect of peripartal stress on successful beginning of extrauterine life.The best prevention strategy is following the strict indications of elective Caesarean sections. The current trend worldwide is to prepare the chronically ill patient for vaginal birth instead of indicating elective Caesarean section. From obstetric point of view it is possible to offer the external version of the foetus in breech presentation, the possibility of vaginal birth after Caesarean section and leave out controversial indications. The inevitable elective Caesarean sections should be planned close to term or after the beginning of spontaneous labour. The composition of intestinal microbiome could be partially influenced by application of vaginal secretion on newborn born by Caesarean section but there is not enough data proving long term positive outcomes (Ref. 48).
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1706
[Cu] Class update date: 171023
[Lr] Last revision date:171023
[St] Status:In-Process
[do] DOI:10.4149/BLL_2017_063

  10 / 3717 MEDLINE  
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[PMID]: 28295324
[Au] Autor:Shmueli A; Aviram A; Bardin R; Wiznitzer A; Chen R; Gabbay-Benziv R
[Ad] Address:Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.
[Ti] Title:Effect of fetal presentation on sonographic estimation of fetal weight according to different formulas.
[So] Source:Int J Gynaecol Obstet;137(3):234-240, 2017 Jun.
[Is] ISSN:1879-3479
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To compare the accuracy of various sonographic estimation of fetal weight (sEFW) formulas for breech-presenting fetuses. METHODS: A retrospective analysis of sEFW performed within 3 days of delivery in a tertiary medical center in Israel between July 2007 and December 2014 was conducted. Breech-presenting singleton fetuses were matched by sex and birth weight to vertex-presenting fetuses. sEFW was calculated using 21 formulas. Systematic and random errors, proportion of estimates (POE) within 10% of actual birth weight, and reliability analysis were used to compare sonographic accuracy. The best performing formula was determined by Euclidean distance. RESULTS: Both groups contained 274 fetuses. Systematic error was lower for breech fetuses when compared with control fetuses in 17 of 21 formulas; there was no significant difference in random error between the breech and vertex groups. For vertex fetuses, Euclidean distance was smaller in 17 of 21 formulas, and POE within 10% of birth weight was higher in most formulas. Cronbach α value was higher for vertex fetuses than for breech fetuses in all formulas. The formulas of Combs et al. and Hadlock et al. were highest ranking for breech-presenting fetuses. CONCLUSION: sEFW might be more accurate for vertex than for breech fetuses.
[Mh] MeSH terms primary: Breech Presentation/diagnostic imaging
Fetal Weight
Ultrasonography, Prenatal
[Mh] MeSH terms secundary: Adult
Birth Weight
Female
Humans
Infant, Newborn
Labor Presentation
Middle Aged
Pregnancy
Reproducibility of Results
Retrospective Studies
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171020
[Lr] Last revision date:171020
[Js] Journal subset:IM
[Da] Date of entry for processing:170315
[St] Status:MEDLINE
[do] DOI:10.1002/ijgo.12152


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