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[PMID]: 28454556
[Au] Autor:Daw MA; El-Bouzedi A; Ahmed MO; Dau AA; In association with the Libyan Study Group of Hepatitis & HIV
[Ad] Address:Department of Medical Microbiology, Faculty of Medicine, University of Tripoli, CC 82668, Tripoli, Libya. mohamedadaw@gmail.com.
[Ti] Title:Molecular and epidemiological characterization of HIV-1 subtypes among Libyan patients.
[So] Source:BMC Res Notes;10(1):170, 2017 Apr 28.
[Is] ISSN:1756-0500
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: The epidemiological and clinical aspects of human immunodeficiency virus subtypes are of great interest worldwide. These subtypes are rarely studied in North African countries. Libya is a large country with the longest coast on the Mediterranean Sea, facing the Southern European countries. Studies on the characterization of HIV-1 subtypes are limited in Libya. This study aimed to determine the magnitude of the HIV problem among the Libyan population and to better understand the genetic diversity and the epidemiologic dynamics of HIV 1, as well as to correlate that with the risk factors involved. METHODS: A total of 159 HIV-1 strains were collected from 814 HIV positive patients from the four Libyan regions during a 16-year period (1995-2010). To determine the HIV-1 subtypes, genetic analysis and molecular sequencing were carried out using provirus polygene. Epidemiologic and demographic information was obtained from each participant and correlated with HIV-1 subtypes using logistic regression. RESULTS: The overall prevalence of HIV among Libyans ranged from 5 to 10 per 100,000 during the study period. It was higher among intravenous drug users (IVDUs) (53.9%), blood recipients (25.9%) and heterosexuals (17.6%) than by vertical transmission (2.6%). Prevalence was higher among males aged 20-40 years (M:F 1:6, P > 0.001). Among the 159 strains of HIV-1 available for typing, 117 strains (73.6%) were subtype B, 29 (18.2%) were CRF02_AG, and 13 (8.2%) were subtype A. HIV-1 subtype B was the most prevalent all over the country, and it was more prevalent in the Northern region, particularly among IVDUs (P < 0.001). GRF02_AG was common in the Eastern region, particularly among blood recipients while subtype A emerged in the Western region, particularly among IVDUs. CONCLUSIONS: HIV-1 infection is emerging in Libya with a shifting prevalence of subtypes associated with the changing epidemiology of HIV-1 among risk groups. A genetic analysis of HIV-1 strains demonstrated low subtype heterogeneity with the evolution of subtype B, and CRF_20 AG, as well as HIV-1 subtype A. Our study highlights the importance of expanded surveillance programs to control HIV infection and the necessity of introducing public health strategies to target the risk groups, particularly IVDUs.
[Mh] MeSH terms primary: HIV Infections/epidemiology
HIV Infections/transmission
HIV-1/genetics
Infectious Disease Transmission, Vertical/statistics & numerical data
Phylogeny
Substance Abuse, Intravenous/epidemiology
[Mh] MeSH terms secundary: Adult
Blood Transfusion
Female
HIV Infections/complications
HIV Infections/virology
HIV-1/classification
HIV-1/isolation & purification
Humans
Libya/epidemiology
Male
Middle Aged
Molecular Epidemiology
Molecular Typing
Prevalence
Public Health Surveillance
Risk Factors
Sex Factors
Substance Abuse, Intravenous/complications
Substance Abuse, Intravenous/virology
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180223
[Lr] Last revision date:180223
[Js] Journal subset:IM
[Da] Date of entry for processing:170430
[St] Status:MEDLINE
[do] DOI:10.1186/s13104-017-2491-2

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[PMID]: 29341561
[Au] Autor:Dobrosavljevic A; Martic J; Rakic S; Pazin V; Jankovic-Raznatovic S; Sreckovic S; Dobrosavljevic B
[Ti] Title:Massive fetomaternal hemorrhage as a cause of severe fetal anemia.
[So] Source:Vojnosanit Pregl;73(11):1068-71, 2016 Nov.
[Is] ISSN:0042-8450
[Cp] Country of publication:Serbia
[La] Language:eng
[Ab] Abstract:Introduction: Fetomaternal hemorrhage (FMH) is a transfu-sion of fetal blood into the maternal circulation. A volume of transfused fetal blood required to cause severe, life-threatening fetal anemia, is not clearly defined. Some authors suggest vol-umes of 80 mL and 150 mL as a threshold which defines mas-sive FMH. Therefore, a rate of massive FMH is 1 : 1,000 and 1 : 5,000 births, respectively. Fetal and neonatal anemia is one of the most serious complications of the FMH. Clinical manifesta-tions of FMH are nonspecific, and mostly it presented as re-duced fetal movements and changes in cardiotocography (CTG). The standard for diagnosing FMH is Kleihaurer-Betke test. Case report: A 34-year-old gravida (G) 1, para (P) 1 was hospitalized due to uterine contractions at 39 weeks of gesta-tion. CTG monitoring revealed sinusoidal fetal heart rate and clinical examination showed complete cervical dilatation. Im-mediately after admission, the women delivered vaginally. Ap-gar scores were 1 and 2 at the first and fifth minute, respec-tively. Immediately baby was intubated and mechanical ventila-tion started. Initial analysis revealed pronounced acidosis and severe anemia. The patient received intravenous fluid therapy with sodium-bicarbonate as well as red cell transfusion. With all measures, the condition of the baby improved with normaliza-tion of hemoglobin level and blood pH. Kleihaurer-Betke test revealed the presence of fetal red cells in maternal circulation, equivalent to 531 mL blood loss. The level of maternal fetal hemoglobin (HbF) and elevated alpha fetoprotein also con-firmed the diagnosis of massive FMH. Conclusion: For the successful diagnosis and management of FMH direct commu-nication between the obstetrician and the pediatrician is neces-sary as presented in this report.
[Mh] MeSH terms primary: Anemia, Neonatal/etiology
Fetomaternal Transfusion/complications
Placental Circulation
[Mh] MeSH terms secundary: Adult
Anemia, Neonatal/blood
Anemia, Neonatal/diagnosis
Anemia, Neonatal/therapy
Asphyxia Neonatorum/etiology
Biomarkers/blood
Cardiotocography
Erythrocyte Transfusion
Female
Fetal Hemoglobin/metabolism
Fetomaternal Transfusion/blood
Fetomaternal Transfusion/diagnosis
Fetomaternal Transfusion/therapy
Fluid Therapy
Humans
Live Birth
Pregnancy
Treatment Outcome
alpha-Fetoproteins/metabolism
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (AFP protein, human); 0 (Biomarkers); 0 (alpha-Fetoproteins); 9034-63-3 (Fetal Hemoglobin)
[Em] Entry month:1802
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[Js] Journal subset:IM
[Da] Date of entry for processing:180118
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150605130D

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[PMID]: 29318985
[Au] Autor:Khan KS; Moore P; Wilson M; Hooper R; Allard S; Wrench I; Roberts T; McLoughlin C; Beresford L; Geoghegan J; Daniels J; Catling S; Clark VA; Ayuk P; Robson S; Gao-Smith F; Hogg M; Jackson L; Lanz D; Dodds J
[Ad] Address:Women's Health Research Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
[Ti] Title:A randomised controlled trial and economic evaluation of intraoperative cell salvage during caesarean section in women at risk of haemorrhage: the SALVO (cell SALVage in Obstetrics) trial.
[So] Source:Health Technol Assess;22(2):1-88, 2018 Jan.
[Is] ISSN:2046-4924
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Caesarean section is associated with blood loss and maternal morbidity. Excessive blood loss requires transfusion of donor (allogeneic) blood, which is a finite resource. Cell salvage returns blood lost during surgery to the mother. It may avoid the need for donor blood transfusion, but reliable evidence of its effects is lacking. OBJECTIVES: To determine if routine use of cell salvage during caesarean section in mothers at risk of haemorrhage reduces the rates of blood transfusion and postpartum maternal morbidity, and is cost-effective, in comparison with standard practice without routine salvage use. DESIGN: Individually randomised controlled, multicentre trial with cost-effectiveness analysis. Treatment was not blinded. SETTING: A total of 26 UK obstetric units. PARTICIPANTS: Out of 3054 women recruited between June 2013 and April 2016, we randomly assigned 3028 women at risk of haemorrhage to cell salvage or routine care. Randomisation was stratified using random permuted blocks of variable sizes. Of these, 1672 had emergency and 1356 had elective caesareans. We excluded women for whom cell salvage or donor blood transfusion was contraindicated. INTERVENTIONS: Cell salvage (intervention) versus routine care without salvage (control). In the intervention group, salvage was set up in 95.6% of the women and, of these, 50.8% had salvaged blood returned. In the control group, 3.9% had salvage deployed. MAIN OUTCOME MEASURES: Primary - donor blood transfusion. Secondary - units of donor blood transfused, time to mobilisation, length of hospitalisation, mean fall in haemoglobin, fetomaternal haemorrhage (FMH) measured by Kleihauer-Betke test, and maternal fatigue. Analyses were adjusted for stratification factors and other factors that were believed to be prognostic a priori. Cost-effectiveness outcomes - costs of resources and service provision taking the UK NHS perspective. RESULTS: We analysed 1498 and 1492 participants in the intervention and control groups, respectively. Overall, the transfusion rate was 2.5% in the intervention group and 3.5% in the control group [adjusted odds ratio (OR) 0.65, 95% confidence interval (CI) 0.42 to 1.01; = 0.056]. In a planned subgroup analysis, the transfusion rate was 3.0% in the intervention group and 4.6% in the control group among emergency caesareans (adjusted OR 0.58, 95% CI 0.34 to 0.99), whereas it was 1.8% in the intervention group and 2.2% in the control group among elective caesareans (adjusted OR 0.83, 95% CI 0.38 to 1.83) (interaction = 0.46, suggesting that the difference in effect between subgroups was not statistically significant). Secondary outcomes did not differ between groups, except for FMH, which was higher under salvage in rhesus D (RhD)-negative women with RhD-positive babies (25.6% vs. 10.5%, adjusted OR 5.63, 95% CI 1.43 to 22.14; = 0.013). No case of amniotic fluid embolism was observed. The additional cost of routine cell salvage during caesarean was estimated, on average, at £8110 per donor blood transfusion avoided. CONCLUSIONS: The modest evidence for an effect of routine use of cell salvage during caesarean section on rates of donor blood transfusion was associated with increased FMH, which emphasises the need for adherence to guidance on anti-D prophylaxis. We are unable to comment on long-term antibody sensitisation effects. Based on the findings of this trial, cell salvage is unlikely to be considered cost-effective. FUTURE WORK: Research into risk of alloimmunisation among women exposed to cell salvage is needed. TRIAL REGISTRATION: Current Controlled Trials ISRCTN66118656. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in ; Vol. 22, No. 2. See the NIHR Journals Library website for further project information.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180123
[Lr] Last revision date:180123
[St] Status:In-Data-Review
[do] DOI:10.3310/hta22020

  4 / 1601 MEDLINE  
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[PMID]: 29261655
[Au] Autor:Khan KS; Moore PAS; Wilson MJ; Hooper R; Allard S; Wrench I; Beresford L; Roberts TE; McLoughlin C; Geoghegan J; Daniels JP; Catling S; Clark VA; Ayuk P; Robson S; Gao-Smith F; Hogg M; Lanz D; Dodds J; SALVO study group
[Ad] Address:Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom.
[Ti] Title:Cell salvage and donor blood transfusion during cesarean section: A pragmatic, multicentre randomised controlled trial (SALVO).
[So] Source:PLoS Med;14(12):e1002471, 2017 Dec.
[Is] ISSN:1549-1676
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Excessive haemorrhage at cesarean section requires donor (allogeneic) blood transfusion. Cell salvage may reduce this requirement. METHODS AND FINDINGS: We conducted a pragmatic randomised controlled trial (at 26 obstetric units; participants recruited from 4 June 2013 to 17 April 2016) of routine cell salvage use (intervention) versus current standard of care without routine salvage use (control) in cesarean section among women at risk of haemorrhage. Randomisation was stratified, using random permuted blocks of variable sizes. In an intention-to-treat analysis, we used multivariable models, adjusting for stratification variables and prognostic factors identified a priori, to compare rates of donor blood transfusion (primary outcome) and fetomaternal haemorrhage ≥2 ml in RhD-negative women with RhD-positive babies (a secondary outcome) between groups. Among 3,028 women randomised (2,990 analysed), 95.6% of 1,498 assigned to intervention had cell salvage deployed (50.8% had salvaged blood returned; mean 259.9 ml) versus 3.9% of 1,492 assigned to control. Donor blood transfusion rate was 3.5% in the control group versus 2.5% in the intervention group (adjusted odds ratio [OR] 0.65, 95% confidence interval [CI] 0.42 to 1.01, p = 0.056; adjusted risk difference -1.03, 95% CI -2.13 to 0.06). In a planned subgroup analysis, the transfusion rate was 4.6% in women assigned to control versus 3.0% in the intervention group among emergency cesareans (adjusted OR 0.58, 95% CI 0.34 to 0.99), whereas it was 2.2% versus 1.8% among elective cesareans (adjusted OR 0.83, 95% CI 0.38 to 1.83) (interaction p = 0.46). No case of amniotic fluid embolism was observed. The rate of fetomaternal haemorrhage was higher with the intervention (10.5% in the control group versus 25.6% in the intervention group, adjusted OR 5.63, 95% CI 1.43 to 22.14, p = 0.013). We are unable to comment on long-term antibody sensitisation effects. CONCLUSIONS: The overall reduction observed in donor blood transfusion associated with the routine use of cell salvage during cesarean section was not statistically significant. TRIAL REGISTRATION: This trial was prospectively registered on ISRCTN as trial number 66118656 and can be viewed on http://www.isrctn.com/ISRCTN66118656.
[Mh] MeSH terms primary: Blood Loss, Surgical/prevention & control
Blood Transfusion, Autologous/methods
Cesarean Section
Operative Blood Salvage/methods
[Mh] MeSH terms secundary: Adult
Blood Donors
Cesarean Section/adverse effects
Cesarean Section/methods
Female
Humans
Patient Care Planning
Pregnancy
Prognosis
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Entry month:1712
[Cu] Class update date: 171227
[Lr] Last revision date:171227
[Js] Journal subset:IM
[Da] Date of entry for processing:171221
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pmed.1002471

  5 / 1601 MEDLINE  
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[PMID]: 29071724
[Au] Autor:Chon AH; Korst LM; Grubbs BH; Kontopoulos EV; Quintero RA; Chmait RH
[Ad] Address:Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Keck School of Medicine, University of Southern California.
[Ti] Title:RISK FACTORS FOR FETOMATERNAL BLEEDING AFTER LASER THERAPY FOR TWIN-TWIN TRANSFUSION SYNDROME.
[So] Source:Prenat Diagn;, 2017 Oct 26.
[Is] ISSN:1097-0223
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To quantify and assess potential risk factors for transplacental passage of fetal red blood cells (RBCs) into the maternal circulation (feto-maternal bleed, FMB) after laser surgery for twin-twin transfusion syndrome (TTTS). STUDY DESIGN: A retrospective study of Rhesus (Rh)-D negative patients that underwent laser surgery for TTTS. Patients with and without post-operative detectable fetal RBCs on Kleihauer-Betke (KB) testing were compared to determine risk factors for FMB. Patients were further sub-classified into those with a FMB < 20% and ≥ 20% of estimated fetoplacental blood volume. RESULTS: Of 60 studied patients, 26/60 (43%) had a positive postoperative KB test. The median fetal: adult RBC ratio was 0.00125, estimated to be a FMB volume of 6.25 mL. There were 17/26 (65%) of patients with FMB < 20% and 9/26 (35%) patients with ≥ 20% of the fetoplacental blood volume. Stage III-Recipient and III-Recipient/Donor patients were more likely to have a positive KB test (14/21 [66.7%] vs. 12/39 [30.8%], OR = 4.50 [1.27-16.54], p = 0.0162). No other risk factors for FMB were apparent. CONCLUSIONS: FMB appears to be a common finding after laser surgery for TTTS. TTTS Stage, particularly stage III-Recipient and III-Recipient/Donor, appears to be a risk factor for FMB.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171026
[Lr] Last revision date:171026
[St] Status:Publisher
[do] DOI:10.1002/pd.5173

  6 / 1601 MEDLINE  
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[PMID]: 28805619
[Au] Autor:Yamada S; Nishijima K; Takahashi J; Takahashi N; Tamamura C; Yoshida Y
[Ad] Address:Department of Obstetrics and Gynecology, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui 910-1193, Japan.
[Ti] Title:Intrauterine fetal death caused by seatbelt injury.
[So] Source:Taiwan J Obstet Gynecol;56(4):558-560, 2017 Aug.
[Is] ISSN:1875-6263
[Cp] Country of publication:China (Republic : 1949- )
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Severe motor vehicle accidents involving pregnant women can result in fetal and neonatal death. We describe a case in which fetal death occurred due to relatively mild seatbelt injuries and present the characteristic magnetic resonance imaging (MRI) findings of the placenta. CASE REPORT: A 26-year-old primigravid woman at 20 weeks gestation was involved in an automobile accident. Although she suffered only a seatbelt injury, fetal death subsequently occurred. Contrast-enhanced MRI showed the region compressed by the seatbelt as a low-intensity band without enhancement, and serum alpha-fetoprotein and hemoglobin F levels were elevated. CONCLUSION: Careful monitoring, including blood and abdominal examinations, should be performed when pregnant women suffer seatbelt injuries.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1708
[Cu] Class update date: 170814
[Lr] Last revision date:170814
[St] Status:In-Process

  7 / 1601 MEDLINE  
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[PMID]: 28584742
[Au] Autor:Takai IU; Sayyadi BM; Galadanci HS
[Ad] Address:Department of Obstetrics and Gynaecology, Bayero University Kano/Aminu Kano Teaching Hospital, Kano, Nigeria.
[Ti] Title:Antepartum Hemorrhage: A Retrospective Analysis from a Northern Nigerian Teaching Hospital.
[So] Source:Int J Appl Basic Med Res;7(2):112-116, 2017 Apr-Jun.
[Is] ISSN:2229-516X
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:BACKGROUND: Antepartum hemorrhage (APH) contributes significantly to maternal and perinatal morbidity and mortality globally, particularly in the developing world like ours. Prevention, early detection, and prompt management cannot be overemphasized to significantly reduce the morbidity and mortality associated with this condition. OBJECTIVES: The study is aimed at determining the prevalence, etiology, sociodemographic characteristics, and the fetomaternal outcome of pregnancies complicated by APH in Aminu Kano Teaching Hospital, Kano. MATERIALS AND METHODS: A 5 years retrospective study of all pregnancies complicated by APH at Aminu Kano Teaching Hospital, Kano, Nigeria, between January 1, 2009, and December 31, 2013, was conducted. RESULTS: A total of 224 cases of APH were recorded out of the 18,273 cases admitted for delivery during the study period, giving an institutional prevalence rate of 1.2%. Two hundred and eighteen folders were retrieved and analyzed giving a retrieval rate of 97.3%. The mean gestational age at presentation was 35.3 ± 2 weeks and the most common causes were abruptio placenta and placenta previa constituting 68.3% and 30.0%, respectively. Sociodemographic characteristics associated with the occurrence of APH included age, booking status, parity, and socioeconomic status. The peak prevalence of APH was observed in the 35-39 year age group accounting for 33.0%. There were 123 live births and 92 stillbirths. The cesarean section rate was 53.5%. Major complications were intrauterine fetal deaths in 42.8%, postpartum hemorrhage in 24.2% of cases, and anemia necessitating blood transfusion in 61.5%. There were three maternal deaths all due to abruptio placentae during the study period giving a case specific fatality rate of 2%. CONCLUSION: The prevalence of APH in our setting is high. The major causes were abruptio placenta and placenta previa. The major fetal complication was intrauterine fetal death, and the major maternal complications were postpartum hemorrhage and anemia with consequent high blood transfusion rate. Early detection, provision of antenatal care, and emergency obstetric care services can reduce the negative effects of APH.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1706
[Cu] Class update date: 170816
[Lr] Last revision date:170816
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.4103/2229-516X.205819

  8 / 1601 MEDLINE  
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[PMID]: 28419453
[Au] Autor:Yu A; Morris E; Adams R; Fung MK
[Ad] Address:Larner College of Medicine at the University of Vermont.
[Ti] Title:Obstetrics and gynecology physician knowledge of Rh immune globulin prophylaxis.
[So] Source:Transfusion;57(6):1385-1390, 2017 Jun.
[Is] ISSN:1537-2995
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Previous studies have shown that more than 20% of laboratories would have recommended inaccurate doses of Rh immune globulin (RhIG) in hypothetical cases. Efforts have been made in educating laboratories in correct dosing calculations; however, obstetricians are most often responsible for ordering RhIG. The objective of this study was to assess knowledge of RhIG indications and dosing among obstetrics and gynecology (OB/GYN) physicians in the United States. STUDY DESIGN AND METHODS: An anonymous 17- question online survey was distributed to all OB/GYN resident and attending physicians affiliated with US residency training programs. RESULTS: A total of 165 surveys were collected, with 139 fully completed. Ninety-two percent of respondents correctly recognized the need for RhIG in D- patients with negative antibody screens. In a scenario of a fetomaternal hemorrhage (FMH) of 45 mL, only 22% of respondents correctly chose the appropriate RhIG dosage. Of those who were correct, 10% had correctly identified 30 mL as the amount of fetal whole blood covered by one dose of RhIG, while 48% incorrectly identified 15 mL (n = 31). A total of 49.3% of respondents reported residency as the most recent formal training on RhIG dosing and 35% reported never (n = 140). CONCLUSIONS: Our study found that OB/GYN physicians are knowledgeable regarding indications for RhIG immunoprophylaxis but were insufficient at calculating dosages in cases of FMH. More standardized education and training among OB/GYN physicians may decrease the risk of maternal alloimmunization, in part because RhIG dosage recommendations from laboratories are not standard practice.
[Mh] MeSH terms primary: Gynecology/education
Obstetrics/education
Rho(D) Immune Globulin/therapeutic use
[Mh] MeSH terms secundary: Humans
Internship and Residency/statistics & numerical data
Physicians/statistics & numerical data
Surveys and Questionnaires
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (Rho(D) Immune Globulin)
[Em] Entry month:1709
[Cu] Class update date: 170919
[Lr] Last revision date:170919
[Js] Journal subset:IM
[Da] Date of entry for processing:170419
[St] Status:MEDLINE
[do] DOI:10.1111/trf.14125

  9 / 1601 MEDLINE  
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[PMID]: 28321338
[Au] Autor:Senkoro EE; Mwanamsangu AH; Chuwa FS; Msuya SE; Mnali OP; Brown BG; Mahande MJ
[Ad] Address:Kilimanjaro Christian Medical University College, Moshi, Tanzania.
[Ti] Title:Frequency, Risk Factors, and Adverse Fetomaternal Outcomes of Placenta Previa in Northern Tanzania.
[So] Source:J Pregnancy;2017:5936309, 2017.
[Is] ISSN:2090-2735
[Cp] Country of publication:Egypt
[La] Language:eng
[Ab] Abstract:. Placenta previa (PP) is a potential risk factor for obstetric hemorrhage, which is a major cause of fetomaternal morbidity and mortality in developing countries. This study aimed to determine frequency, risk factors, and adverse fetomaternal outcomes of placenta previa in Northern Tanzania. . A retrospective cohort study was conducted using maternally-linked data from Kilimanjaro Christian Medical Centre birth registry spanning 2000 to 2015. All women who gave birth to singleton infants were studied. Adjusted odds ratios (ORs) with 95% confidence intervals for risk factors and adverse fetomaternal outcomes associated with PP were estimated in multivariable logistic regression models. . A total of 47,686 singleton deliveries were analyzed. Of these, the frequency of PP was 0.6%. Notable significant risk factors for PP included gynecological diseases, alcohol consumption during pregnancy, malpresentation, and gravidity ≥5. Adverse maternal outcomes were postpartum haemorrhage, antepartum haemorrhage, and Caesarean delivery. PP increased odds of fetal Malpresentation and early neonatal death. The prevalence of PP was comparable to that found in past research. Multiple independent risk factors were identified. PP was found to have associations with several adverse fetomaternal outcomes. Early identification of women at risk of PP may help clinicians prevent such complications.
[Mh] MeSH terms primary: Placenta Previa/epidemiology
Pregnancy Outcome/epidemiology
Risk Factors
[Mh] MeSH terms secundary: Adult
Apgar Score
Blood Transfusion/statistics & numerical data
Cesarean Section/statistics & numerical data
Female
Humans
Incidence
Infant, Newborn
Length of Stay/statistics & numerical data
Logistic Models
Odds Ratio
Perinatal Death
Postpartum Hemorrhage/etiology
Pregnancy
Registries
Retrospective Studies
Surveys and Questionnaires
Tanzania/epidemiology
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 170925
[Lr] Last revision date:170925
[Js] Journal subset:IM
[Da] Date of entry for processing:170322
[St] Status:MEDLINE
[do] DOI:10.1155/2017/5936309

  10 / 1601 MEDLINE  
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[PMID]: 28295352
[Au] Autor:Ghesquière L; Houfflin-Debarge V; Behal H; Coulon C; Subtil D; Vaast P; Garabedian C
[Ad] Address:Jeanne de Flandre Hospital, Lille University Hospital CHRU.
[Ti] Title:Should optimal timing between two intrauterine transfusions be based on estimated daily decrease of hemoglobin or on measurement of fetal middle cerebral artery peak systolic velocity?
[So] Source:Transfusion;57(4):899-904, 2017 Apr.
[Is] ISSN:1537-2995
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: To best predict the recurrence of fetal anemia after intrauterine transfusion (IUT), the measurement of middle cerebral artery peak systolic velocity (PSV) and the estimation of hemoglobin (Hb) daily decrease are compared. STUDY DESIGN AND METHODS: A retrospective study including 38 patients who had at least two IUTs in a context of red blood cell alloimmunization was conducted. PSV values before first, second, and third IUTs were collected and expected Hb level was calculated according to various Hb daily decrease formulas as proposed in the literature. RESULTS: Comparison of PSV receiver operating characteristic curves with the various Hb levels did not find any significant difference between first and second IUTs. On the other hand, we found a significant difference between the second and third IUTs, with better prediction of fetal anemia through Hb decrease calculation, whatever the formula. Between the second and third IUTs, no formula was significantly better than the others. CONCLUSION: The timing of a second transfusion can be difficult to determine with certainty, but PSV can give an accurate assessment of when to resample the fetus with probably a higher recommended threshold for the diagnosis of fetal anemia. Subsequent to a second transfusion, the intertransfusion interval should be based on estimated Hb decrease rather than PSV thresholds, whatever the chosen formula proposed in the literature. Larger numbers are needed to definitely make this recommendation and it will be interesting to evaluate correlation between different antibodies.
[Mh] MeSH terms primary: Fetal Diseases
Fetomaternal Transfusion
Middle Cerebral Artery/physiopathology
[Mh] MeSH terms secundary: Adult
Blood Flow Velocity
Female
Fetal Diseases/blood
Fetal Diseases/diagnosis
Fetal Diseases/diagnostic imaging
Fetal Diseases/physiopathology
Fetomaternal Transfusion/diagnosis
Fetomaternal Transfusion/diagnostic imaging
Fetomaternal Transfusion/physiopathology
Humans
Pregnancy
[Pt] Publication type:CLINICAL TRIAL; COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Entry month:1706
[Cu] Class update date: 170621
[Lr] Last revision date:170621
[Js] Journal subset:IM
[Da] Date of entry for processing:170316
[St] Status:MEDLINE
[do] DOI:10.1111/trf.13980


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