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[PMID]:28619691
[Au] Autor:Rahman A; Cahill LS; Zhou YQ; Hoggarth J; Rennie MY; Seed M; Macgowan CK; Kingdom JC; Adamson SL; Sled JG
[Ad] Endereço:Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.
[Ti] Título:A mouse model of antepartum stillbirth.
[So] Source:Am J Obstet Gynecol;217(4):443.e1-443.e11, 2017 Oct.
[Is] ISSN:1097-6868
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Many stillbirths of normally formed fetuses in the third trimester could be prevented via delivery if reliable means to anticipate this outcome existed. However, because the etiology of these stillbirths is often unexplained and although the underlying mechanism is presumed to be hypoxia from placental insufficiency, the placentas often appear normal on histopathological examination. Gestational age is a risk factor for antepartum stillbirth, with a rapid rise in stillbirth rates after 40 weeks' gestation. We speculate that a common mechanism may explain antepartum stillbirth in both the late-term and postterm periods. Mice also show increasing rates of stillbirth when pregnancy is artificially prolonged. The model therefore affords an opportunity to characterize events that precede stillbirth. OBJECTIVE: The objective of the study was to prolong gestation in mice and monitor fetal and placental growth and cardiovascular changes. STUDY DESIGN: From embryonic day 15.5 to embryonic day 18.5, pregnant CD-1 mice received daily progesterone injections to prolong pregnancy by an additional 24 hour period (to embryonic day 19.5). To characterize fetal and placental development, experimental assays were performed throughout late gestation (embryonic day 15.5 to embryonic day 19.5), including postnatal day 1 pups as controls. In addition to collecting fetal and placental weights, we monitored fetal blood flow using Doppler ultrasound and examined the fetoplacental arterial vascular geometry using microcomputed tomography. Evidence of hypoxic organ injury in the fetus was assessed using magnetic resonance imaging and pimonidazole immunohistochemistry. RESULTS: At embryonic day 19.5, mean fetal weights were reduced by 14% compared with control postnatal day 1 pups. Ultrasound biomicroscopy showed that fetal heart rate and umbilical artery flow continued to increase at embryonic day 19.5. Despite this, the embryonic day 19.5 fetuses had significant pimonidazole staining in both brain and liver tissue, indicating fetal hypoxia. Placental weights at embryonic day 19.5 were 21% lower than at term (embryonic day 18.5). Microcomputed tomography showed no change in quantitative morphology of the fetoplacental arterial vasculature between embryonic day 18.5 and embryonic day 19.5. CONCLUSION: Prolongation of pregnancy renders the murine fetus vulnerable to significant growth restriction and hypoxia because of differential loss of placental mass rather than any compromise in fetoplacental blood flow. Our data are consistent with a hypoxic mechanism of antepartum fetal death in human term and postterm pregnancy and validates the inability of umbilical artery Doppler to safely monitor such fetuses. New tests of placental function are needed to identify the late-term fetus at risk of hypoxia to intervene by delivery to avoid antepartum stillbirth.
[Mh] Termos MeSH primário: Retardo do Crescimento Fetal/patologia
Hipóxia Fetal/patologia
Gravidez Prolongada
Natimorto
[Mh] Termos MeSH secundário: Animais
Velocidade do Fluxo Sanguíneo
Encéfalo/patologia
Feminino
Peso Fetal
Idade Gestacional
Frequência Cardíaca Fetal
Fígado/patologia
Pulmão/patologia
Camundongos
Modelos Animais
Tamanho do Órgão
Placenta/diagnóstico por imagem
Placenta/patologia
Gravidez
Artérias Umbilicais/diagnóstico por imagem
Microtomografia por Raio-X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170617
[St] Status:MEDLINE


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[PMID]:28186614
[Au] Autor:Zizzo AR; Kirkegaard I; Pinborg A; Ulbjerg N
[Ad] Endereço:Department of Obstetrics and Gynecology, Aarhus University Hospital, Skejby, Denmark.
[Ti] Título:Decline in stillbirths and perinatal mortality after implementation of a more aggressive induction policy in post-date pregnancies: a nationwide register study.
[So] Source:Acta Obstet Gynecol Scand;96(7):862-867, 2017 Jul.
[Is] ISSN:1600-0412
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: In 2011 Danish national guidelines were changed towards a more aggressive induction and fetal surveillance policy from (1) induction of labor at gestational age (GA) of 42  weeks and (2) no fetal surveillance after 40  weeks to (1) induction of labor between 41 and 41  weeks, (2) earlier induction at 41  weeks in the case of maternal age >40 years or body mass index (BMI) >35 kg/m and (3) fetal surveillance at GA 41  weeks. MATERIAL AND METHODS: This national cohort study included all pregnancies that reached 41  weeks of gestation in 2008-2014 (n = 102 167). Multivariate logistic regression analyses were used to estimate risks in the years after (2012-2014) vs. before (2008-2010) new national guidelines, adjusted for maternal age, BMI, and parity. RESULTS: We observed a decline in stillbirths from 0.9‰ to 0.5‰ [odds ratio (OR) 0.50, 95% CI 0.29-0.89, p = 0.018]. Furthermore, a decline in perinatal deaths from 1.3‰ to 0.8‰ (OR 0.62, 95% CI 0.39-0.96, p = 0.033) and vacuum extraction (OR 0.86, 95% CI 0.82-0.90, p = 0.007) was observed. The risk of cesarean section (OR 0.98, 95% CI 0.94-1.02, p = 0.251), Apgar score below 7 at five minutes (OR 0.96, 95% CI 0.81-1.14, p = 0.0.678) and admissions to the neonatal department (OR 1.04, 95% CI 1.00-1.14, p = 0.064) did not change, whereas induction of labor increased from 28.2 to 42.6% (OR 1.89, 95% CI 1.84-1.95, p < 0.001). CONCLUSIONS: This study showed a decline in stillbirths and perinatal mortality after implementation of new Danish guidelines for post-date pregnancies. The risk of interventions as cesarean section and vacuum extraction remained stable despite an increase in labor inductions.
[Mh] Termos MeSH primário: Trabalho de Parto Induzido
Mortalidade Materna/tendências
Avaliação de Resultados (Cuidados de Saúde)
Gravidez Prolongada
Natimorto
[Mh] Termos MeSH secundário: Dinamarca/epidemiologia
Feminino
Idade Gestacional
Seres Humanos
Recém-Nascido
Serviços de Saúde Materno-Infantil
Guias de Prática Clínica como Assunto
Gravidez
Resultado da Gravidez
Sistema de Registros
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170211
[St] Status:MEDLINE
[do] DOI:10.1111/aogs.13113


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[PMID]:27743479
[Au] Autor:Eggebø TM; Klefstad OA; Økland I; Lindtjørn E; Eik-Nes SH; Gjessing HK
[Ad] Endereço:Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway.
[Ti] Título:Estimation of fetal weight in pregnancies past term.
[So] Source:Acta Obstet Gynecol Scand;96(2):183-189, 2017 Feb.
[Is] ISSN:1600-0412
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The aim of the study was to investigate the accuracy of estimating fetal weight with ultrasound in pregnancies past term, using the eSnurra algorithm. MATERIAL AND METHODS: In all, 419 women with pregnancy length of 290 days, attending a specialist consultation at Stavanger University Hospital, Norway, were included in a prospective observational study. Fetal weight was estimated using biparietal diameter (BPD) and abdominal circumference (AC). The algorithm implemented in an electronic calculation (eSnurra) was used to compute estimated fetal weight (EFW). Results were compared with birthweight (BW). RESULTS: The mean interval between the ultrasound examination and birth was 2 days (SD 1.4). The median difference between BW and EFW was -6 g (CI -40 to +25 g) and the median percentage error was -0.1% (95% CI -1.0 to 0.6%). The median absolute difference was 190 g (95% CI 170-207 g). The BW was within 10% of EFW in 83% (95% CI 79-87%) of cases and within 15% of EFW in 94% (95% CI 92-96%) of cases. Limits of agreement (95%) were from -553 g to +556 g. Using 5% false-positive rates, the sensitivity in detecting macrosomic and small for gestational age fetuses was 54% (95% CI 35-72%) and 49% (95% CI 35-63%), respectively. CONCLUSION: The accuracy of fetal weight estimation was good. Clinicians should be aware of limitations related to prediction at the upper and lower end, and the importance of choosing appropriate cut-off levels.
[Mh] Termos MeSH primário: Algoritmos
Peso Fetal
Gravidez Prolongada
Ultrassonografia Pré-Natal
[Mh] Termos MeSH secundário: Adolescente
Adulto
Peso ao Nascer
Pesos e Medidas Corporais/métodos
Feminino
Macrossomia Fetal/diagnóstico
Seres Humanos
Recém-Nascido
Recém-Nascido Pequeno para a Idade Gestacional
Masculino
Valor Preditivo dos Testes
Gravidez
Estudos Prospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161016
[St] Status:MEDLINE
[do] DOI:10.1111/aogs.13044


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[PMID]:27458900
[Au] Autor:Walfisch A; Beharier O; Wainstock T; Sergienko R; Landau D; Sheiner E
[Ad] Endereço:Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel.
[Ti] Título:Early-term deliveries as an independent risk factor for long-term respiratory morbidity of the offspring.
[So] Source:Pediatr Pulmonol;52(2):198-204, 2017 Feb.
[Is] ISSN:1099-0496
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Newborns exhibit the lowest immediate respiratory morbidity rates when born following 39 completed weeks of gestation. We sought to determine whether early-term delivery (37-38 + 6 weeks' gestation) impacts on long-term pediatric respiratory morbidity. STUDY DESIGN: In this population-based prospective cohort analysis, all term singleton deliveries occurring between 1991 and 2013 at a single tertiary medical center were included. Gestational age upon delivery was sub-divided into: early (37-38 + 6 weeks' gestation), full (39-40 + 6 weeks' gestation), late (41-41 + 6 weeks' gestation), and post-term (>42 weeks) deliveries. The incidence of long-term hospitalizations (up to the age of 18 years) of the offspring due to a set of predefined respiratory morbidities was evaluated. Survival curves were used to compare cumulative morbidity incidence. A Cox hazards regression model was used to control for confounders. RESULTS: During the study period, 229,142 term deliveries met the inclusion criteria. Of those, 24% (n = 55,202) occurred at early term. Hospitalizations up to the age of 18 years, as a result of complications in the respiratory system were significantly more common in the early-term group as compared with full and late-term delivery groups. In the Cox regression model, while controlling for multiple confounders, early-term delivery exhibited an independent association with long-term respiratory morbidity (adjusted HR = 1.24, CI 1.19-1.29, P < 0.001). CONCLUSION: Deliveries occurring at early term are associated with higher rates of pediatric respiratory hospitalizations compared with full and late-term deliveries. Pediatr Pulmonol. 2017;52:198-204. © 2016 Wiley Periodicals, Inc.
[Mh] Termos MeSH primário: Idade Gestacional
Hospitalização/estatística & dados numéricos
Doenças Respiratórias/epidemiologia
Nascimento a Termo
[Mh] Termos MeSH secundário: Adolescente
Adulto
Asma/epidemiologia
Bronquiolite/epidemiologia
Criança
Pré-Escolar
Parto Obstétrico
Feminino
Seres Humanos
Incidência
Lactente
Recém-Nascido de Baixo Peso
Recém-Nascido
Influenza Humana/epidemiologia
Estudos Longitudinais
Morbidade
Pneumonia/epidemiologia
Gravidez
Gravidez Prolongada/epidemiologia
Modelos de Riscos Proporcionais
Estudos Prospectivos
Infecções Respiratórias/epidemiologia
Fatores de Risco
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160727
[St] Status:MEDLINE
[do] DOI:10.1002/ppul.23529


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[PMID]:27321698
[Au] Autor:Brusati V; Brembilla G; Cirillo F; Mastricci L; Rossi S; Paganelli AM; Ferrazzi E
[Ad] Endereço:a Department of Woman , Mother and Neonate, Unit of Obstetrics and.
[Ti] Título:Efficacy of sublingual misoprostol for induction of labor at term and post term according to parity and membrane integrity: a prospective observational study.
[So] Source:J Matern Fetal Neonatal Med;30(5):508-513, 2017 Mar.
[Is] ISSN:1476-4954
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the effectiveness and safety of 25 mcg sublingual misoprostol for induction of Labor at term according to parity and membrane integrity. METHODS: We conducted a prospective observational study on singleton pregnancies undergoing induction of Labor at term. Twenty-five mcg of misoprostol were administered sublingually every 4 h. Main outcomes were vaginal deliveries within 24 h, time-to-vaginal-delivery, hyper-stimulation syndrome, cesarean section rate, arterial pH< 7.0 and NICU admission rate. RESULTS: We studied 508 patients, 375 nulliparous and 133 multiparous women. Sixty-five percent and 78%, respectively, delivered vaginally within 24 h from first administration. Median time-to-vaginal-delivery was significantly shorter in PROM than in women with intact membranes (p < 0.001). Epidural analgesia prolonged time-to-vaginal-delivery among nulliparous women (p < 0.0005). A positive correlation between BMI and time to delivery was observed in both nulliparous and multiparous women (p < 0.05). Cesarean section rate was 22% in nulliparous and 6% in multiparous group. Induction failure was 1.4% and uterine hyper-stimulation 1%. No pH≤ 7.00 was recorded; overall 7 (1.4%) newborns were admitted to NICU. CONCLUSIONS: Sublingually administered misoprostol is an effective and safe method for induction of Labor at term. Parity, status of membranes and BMI significantly affect time to delivery.
[Mh] Termos MeSH primário: Âmnio/fisiologia
Trabalho de Parto Induzido/métodos
Trabalho de Parto/efeitos dos fármacos
Misoprostol/administração & dosagem
Ocitócicos/administração & dosagem
[Mh] Termos MeSH secundário: Administração Sublingual
Adulto
Índice de Massa Corporal
Cesárea/estatística & dados numéricos
Feminino
Seres Humanos
Paridade
Gravidez
Gravidez Prolongada
Estudos Prospectivos
Nascimento a Termo
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Oxytocics); 0E43V0BB57 (Misoprostol)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170720
[Lr] Data última revisão:
170720
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160621
[St] Status:MEDLINE
[do] DOI:10.1080/14767058.2016.1179274


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[PMID]:27002548
[Au] Autor:Bleicher I; Vitner D; Iofe A; Sagi S; Bader D; Gonen R
[Ad] Endereço:a Department of Obstetrics and Gynecology and.
[Ti] Título:When should pregnancies that extended beyond term be induced?
[So] Source:J Matern Fetal Neonatal Med;30(2):219-223, 2017 Jan.
[Is] ISSN:1476-4954
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare maternal and neonatal outcomes associated with a policy for induction of labor at ≥ 41 versus at ≥42 weeks'. STUDY DESIGN: Retrospective cohort study of a 2 years' period before and after policy change from induction of labor at ≥ 42 gestational weeks' versus ≥41 gestational weeks. RESULTS: During the 41-policy period (N = 968), the induction rate was higher, 60% versus 40% (p < 0.0001) while the cesarean delivery (CD) rate was lower, 15% versus 19.4% (p = 0.0135). Moreover, among women that were induced, the rate of CD was lower during the 41-policy period, 19% versus 27% (p = 0.0067). No significant differences in maternal or neonatal outcomes were noted. There was one case of intrauterine fetal death at 41 + 4 weeks during the 42-policy period. CONCLUSION: As a policy for induction of labor at ≥ 41 reduces the rate of CD without any adverse maternal or neonatal outcomes, such a policy seems to be superior to a policy for induction at ≥ 42 weeks.
[Mh] Termos MeSH primário: Idade Gestacional
Trabalho de Parto Induzido/normas
Guias de Prática Clínica como Assunto
Gravidez Prolongada
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Recém-Nascido
Gravidez
Resultado da Gravidez
Estudos Retrospectivos
Estatísticas não Paramétricas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170605
[Lr] Data última revisão:
170605
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160323
[St] Status:MEDLINE


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[PMID]:26645539
[Au] Autor:Linder N; Hiersch L; Fridman E; Klinger G; Lubin D; Kouadio F; Melamed N
[Ad] Endereço:Department of Neonatology, The Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.
[Ti] Título:Post-term pregnancy is an independent risk factor for neonatal morbidity even in low-risk singleton pregnancies.
[So] Source:Arch Dis Child Fetal Neonatal Ed;102(4):F286-F290, 2017 Jul.
[Is] ISSN:1468-2052
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine the independent association of post-term pregnancy with neonatal outcome in low-risk newborns. DESIGN: Retrospective cohort. SETTING: Tertiary university-affiliated medical centre. PATIENTS: All newborns of low-risk singleton pregnancies born at 39+0 to 44+0 weeks' gestation over a 5-year period. EXCLUSION CRITERIA: multiple gestation, maternal hypertensive disorder, diabetes or cholestasis, placental abruption or intrapartum fever (>38°C), small for gestational age (<10th centile) and major congenital or chromosomal anomalies. INTERVENTIONS: None. OUTCOME MEASURES: Admission to the neonatal intensive care unit (NICU), hospital length of stay, 5-min Apgar score, birth trauma, respiratory, neurological, metabolic and infectious morbidities and neonatal mortality. The adverse outcome rate was compared among three groups based on gestational age at birth: post-term (≥42+0 weeks), late term (41+0 to 41+6 weeks) and full term (39+0 to 40+6 weeks). RESULTS: Of the 23 524 eligible neonates, 747 (3.2%) were born post-term, 4632 (19.7%) late term and 18 145 (77.1%) full term. Women in the post-term group versus the late-term group had a significantly higher rate of caesarean section (8.9% vs 5.6%, p<0.001) and operative vaginal delivery (9.6% vs 7.4%, p=0.024). Post-term pregnancy versus full-term pregnancy was associated with an increased risk of NICU admission (OR 2.0, 95% CI 1.4 to 2.8), respiratory morbidity (OR 2.2, 95% CI 1.3 to 3.8) and infectious morbidity (OR 1.88, 95% CI 1.32 to 2.69). Post-term pregnancy versus late-term pregnancy was similarly associated with an increased risk of NICU admission (OR 2.0, 95% CI 1.4 to 2.9), respiratory morbidity (OR 2.7, 95% CI 1.5 to 5.0) and infectious morbidity (OR 1.8, 95% CI 1.2 to 2.7) and with hypoglycaemia (OR 2.6, 95% CI 1.2 to 5.4). Post-term delivery was not associated with neonatal mortality. CONCLUSIONS: Post-term pregnancy is an independent risk factor for neonatal morbidity even in low-risk singleton pregnancies.
[Mh] Termos MeSH primário: Doenças do Recém-Nascido/epidemiologia
Criança Pós-Termo/fisiologia
Trabalho de Parto Induzido/estatística & dados numéricos
Gravidez Prolongada/epidemiologia
[Mh] Termos MeSH secundário: Feminino
Idade Gestacional
Seres Humanos
Recém-Nascido
Mortalidade Perinatal
Gravidez
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:151210
[St] Status:MEDLINE
[do] DOI:10.1136/archdischild-2015-308553


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[PMID]:27938867
[Au] Autor:Wolff SL; Lorentzen I; Kaltoft AP; Schmidt H; Jeppesen MM; Maimburg RD
[Ad] Endereço:Department of Obstetrics and Gynaecology, Aarhus University Hospital, Brendstrupgårdsvej 100, 8200 Aarhus N, Denmark. Electronic address: sanwol@rm.dk.
[Ti] Título:Has perinatal outcome improved after introduction of a guideline in favour of routine induction and increased surveillance prior to 42 weeks of gestation?: A cross-sectional population-based registry study.
[So] Source:Sex Reprod Healthc;10:19-24, 2016 Dec.
[Is] ISSN:1877-5764
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate whether new national guidelines of routine induction of labour and increased surveillance in low risk pregnancies at 41 weeks of gestation as an alternative to expectant management until 42 weeks of gestation has improved perinatal outcome. METHODS: A questionnaire-based study regarding local induction practices among all Danish delivery units and a cross-sectional population-based registry study based on data from the Danish Medical Birth Registry (DMBR) in the years 2009-2012. OUTCOME MEASURES: Primary outcomes were frequencies of induced labour and perinatal mortality; secondary outcomes were indicators of perinatal morbidity and instrumental delivery rates. RESULTS: The questionnaire data showed that 22 of the 24 Danish delivery units complied with the new guidelines in 2012. The study population retrieved from the DMBR included 36,845 low-risk pregnancies at or beyond 41 weeks of gestation. The number of labour inductions within the study population had doubled after implementation of the new guideline. The increased proportion of induced labour did not appear to influence perinatal morbidity or instrumental delivery rates. Perinatal mortality remained steady in the years 2009, 2010 and 2011 whereas a reduction of 60 % was seen in 2012. However, this change was not statistically significant (P = 0.10). CONCLUSION: This population-based study with a high reported adherence to the new national guideline found no changes in instrumental deliveries or perinatal outcomes after implementation of earlier routine induction of labour and increased surveillance in low risk pregnancies.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos
Trabalho de Parto Induzido/estatística & dados numéricos
Educação de Pacientes como Assunto/estatística & dados numéricos
Resultado da Gravidez/epidemiologia
Gravidez Prolongada/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Estudos Transversais
Dinamarca
Feminino
Idade Gestacional
Seres Humanos
Trabalho de Parto
Guias de Prática Clínica como Assunto
Gravidez
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170404
[Lr] Data última revisão:
170404
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161213
[St] Status:MEDLINE


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[PMID]:27612522
[Au] Autor:Mahomed K; Pungsornruk K; Gibbons K
[Ad] Endereço:a Department of Obstetrics and Gynaecology , University of Queensland , Brisbane , QLD , Australia.
[Ti] Título:Induction of labour for postdates in nulliparous women with uncomplicated pregnancy - is the caesarean section rate really lower?
[So] Source:J Obstet Gynaecol;36(7):916-920, 2016 Oct.
[Is] ISSN:1364-6893
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Induction for "post-dates" is a very common procedure and in Queensland, Australia, accounts for 35.5% of all inductions. Systematic reviews all conclude that induction of labour does not increase the risk of caesarean section (CS). However, these reviews have generally included a mixed population and have not stratified for parity. We report in a retrospective cohort study involving only nulliparous women with uncomplicated singleton pregnancy at 40° to 41 weeks that compared to spontaneous labour, incidence of CS was significantly higher in the induction group, 22.2% versus 12.1% (OR 2.06; 95% CI 1.93-2.20) at 40° to 41 weeks versus spontaneous labour at 40° to 41 weeks; and also higher at 21.0% versus 14.9% (OR 1.52; 95% CI 1.34-1.73) at 40° to 40 weeks versus spontaneous labour at 41° to 41 weeks (expectant management).
[Mh] Termos MeSH primário: Cesárea
Trabalho de Parto Induzido
Gravidez Prolongada
[Mh] Termos MeSH secundário: Adulto
Austrália/epidemiologia
Cesárea/métodos
Cesárea/estatística & dados numéricos
Estudos de Coortes
Feminino
Idade Gestacional
Seres Humanos
Trabalho de Parto Induzido/métodos
Trabalho de Parto Induzido/estatística & dados numéricos
Paridade
Administração dos Cuidados ao Paciente/métodos
Administração dos Cuidados ao Paciente/estatística & dados numéricos
Gravidez
Gravidez Prolongada/epidemiologia
Gravidez Prolongada/terapia
Estudos Retrospectivos
Medição de Risco
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170620
[Lr] Data última revisão:
170620
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160911
[St] Status:MEDLINE


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[PMID]:27451487
[Au] Autor:Maimburg RD
[Ti] Título:Women's experience of post-term pregnancy.
[So] Source:Pract Midwife;19(6):21-3, 2016 Jun.
[Is] ISSN:1461-3123
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:In recent years, induction of labour has become increasingly common in many countries and has moved towards an earlier gestational age. The aim of this study was to describe how low-risk pregnant women experienced post-term pregnancy in a large university hospital in Denmark Qualitative interviews were carried out with 31 low-risk pregnant women. Pregnant women passing their estimated time of birth date experienced their last days of pregnancy as a countdown to induction, not as their last days of pregnancy. Categorisation of the women's pregnancy based on medical statistics, and a focus on medical issues caused the women to feel less involved, and contributed to them being willing to negotiate an earlier induction of labour to avoid being stigmatised as pathological patients.
[Mh] Termos MeSH primário: Idade Gestacional
Gravidez Prolongada/psicologia
[Mh] Termos MeSH secundário: Ética em Pesquisa
Feminino
Seres Humanos
Gravidez
Estereotipagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1608
[Cu] Atualização por classe:160725
[Lr] Data última revisão:
160725
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:160726
[St] Status:MEDLINE



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