共查询到20条相似文献,搜索用时 31 毫秒
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Alexander Michael Friedman Sindhu K. Srinivas 《The journal of maternal-fetal & neonatal medicine》2016,29(11):1710-1714
Objective: The objective of this study is to determine whether chart documentation of patient counseling on trial of labor after cesarean (TOLAC) during prenatal care is associated with patient knowledge of risks and benefits of TOLAC and repeat cesarean delivery (RCD).Study design: Prenatal patients eligible for TOLAC completed a questionnaire that assessed their knowledge of basic maternal and neonatal risks and benefits of TOLAC versus planned repeat cesarean delivery. Patient electronic medical records were reviewed for documentation of TOLAC counseling. Women were included at both early and late time points in pregnancy to include those who both had and had not undergone counseling.Results: Patients with documented completed TOLAC counseling did not perform better on the knowledge survey. Patients who had documentation of counseling on specific subjects such as TOLAC success rates, risk of uterine rupture, and downstream health risks of cesarean section were no more likely to answer questions on these topics correctly than patients without counseling. However, patients with documented completed counseling generally felt that they were well informed.Conclusion: Chart documentation of TOLAC counseling was not correlated with patient knowledge. Patients may not be gaining the knowledge from counseling that providers believe is important for informed decision making. 相似文献
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Yaakov Rosenfeld Avshalom Strulov 《Journal of assisted reproduction and genetics》2009,26(2-3):99-103
Purpose
Accurate clinical reports of In Vitro Fertilization Cycle Rank (IVF-CR) are important because of their predictive value of treatment success—clinical pregnancy. Our district currently provides more than a hundred IVF pick-up cycles per month. The study objective was to evaluate and improve the accuracy of IVF units’ reports of IVF-CR.Methods
Reports of IVF-CR from local IVF units were correlated with administrative data. Couples who were having IVF treatments during the 3-month study period were included in the study. Data were collected before and after an intervention program.Results
During the study period accurate IVF-CR reporting rate improved from 27% (29 out of 108) to 83% (91 out of 110).Conclusions
Accuracy of clinical reports of IVF-CR from local units significantly improved after the intervention. It is recommended that national regulatory bodies should issue compulsory guidelines for the recording and reporting of IVF-CR. 相似文献3.
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Susana Santo Luísa Pinto Nuno Clode Edite Cardoso João Paulo Marques Antonieta Melo 《The journal of maternal-fetal & neonatal medicine》2013,26(3):209-211
Aneurysms of the vein of Galen (AVG) represent less than 1% of all intracranial arteriovenous malformations. Two cases of prenatal diagnosis made by color Doppler ultrasonography at 32 weeks of gestation are reported. Both cases presented with antenatal mild cardiomegaly and both developed severe cardiac failure in the neonatal period. Embolization was unsuccessful and both infants died. These cases highlight the need for a careful evaluation of the time and mode of delivery; embolization must be performed after a fully informed decision. 相似文献
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OBJECTIVE: Testing of hypothesis that the order of twins is random. DESIGN: Confrontation of birthweight and incidence of stillbirth between twins. MATERIALS AND METHODS: The group of 829 twin deliveries was investigated. Probability of distribution was assessed according to Bernoullie's trials schema. RESULTS: The first twin was usually heavier then the second one (p = 0.05), especially at term. Order of twin delivery was influenced by a birthweight difference > 250 g. In cases of single twin intrauterine death, the alive, term baby was delivered as the first one statistically more common (p = 0.029), despite of smaller number of cases. Discussion suggests that differences between twins are rather reasons of observed order than results. CONCLUSION: Hypothesis of natural selection of stronger baby for the first delivery was presented. 相似文献
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Pathological characteristics of a series of rare chronic histiocytic intervillositis of the placenta
Chronic histiocytic intervillositis of the placenta (CHI) is a rare and poorly understood pathology which may occur in all trimesters. The most conspicuous feature is a histiocytic infiltration of the intervillous space without involvement of the villous parenchyma. In this report on CHI, we re-evaluate a series of four cases and focus on histological, immunohistological and fluorescence in situ hybridisation-derived findings, fetal status and clinical data for previously unrecognised CHI-associated features. Our approach revealed that assisted reproduction-induced pregnancy had been performed in 2 of 4 CHI cases, but other factors and comorbidities are likely to contribute to CHI. 相似文献
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《The journal of maternal-fetal & neonatal medicine》2013,26(11):2359-2362
Objective: To compare the safety and effectiveness of vaginal misoprostol 25 μg with those of 50 μg in induction of labor. Method: One hundred and sixty eligible women of low parity with indications for induction of labor at term were enrolled for the study. The subjects were randomized into two groups of vaginal misoprostol 25 µg and 50 µg dose regimens. Maternal characteristics, labor and newborn outcome were compared. Results: The total duration of labor was significantly shorter in the 50 µg group (8.24?±?1.5?h) than 25 µg group (9.09?±?2.7?h), p = 0.02. Oxytocin augmentation was significantly higher in the 25 µg group (18.75%) than in the 50 µg group (7.5%), p = 0.04. The indications for caesarean section were significantly different, (p = 0.02) between the two groups although the incidence was similar. The intrapartum adverse effects like fetal distress, meconium stained liquor, and tachysystole were significantly higher in the 50 µg group, p = 0.003. Similarly, the postpartum adverse effects such as cervical and vaginal tears were significantly higher in 50 µg group, p = 0.01. Conclusion: The two dose regimens were both effective in induction of labor, but 50 µg dose regimen resulted in significantly shorter duration of labor but with higher rate of labor complications than the 25 µg dose regimen. 相似文献
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Hilary O.D. Critchley Louise E. Bath W. Hamish B. Wallace 《Human fertility (Cambridge, England)》2013,16(2):61-66
At the present time approximately 1 in 1000 young people aged between 16 and 35 years will have been cured of cancer in childhood and some of the treatment regimens used will have predictable effects on their future fertility prospects. In young women who have been exposed to radiotherapy below the diaphragm, the reproductive problems include the risk of ovarian failure and significantly impaired development of the uterus. The magnitude of the risk is related to the radiation field, total dose and fractionation schedule. Premature labour and low birth weight infants have been reported after flank abdominal radiotherapy. Female long-term survivors treated with total body irradiation and marrow transplantation are also at risk of ovarian follicular depletion and impaired uterine growth and blood flow, and of early pregnancy loss and premature labour if pregnancy is achieved. Despite standard oestrogen replacement, the uterus of these young girls is often reduced to 40% of normal adult size. Uterine volume correlates with the age at which radiation was received. Regrettably, it is likely that radiation damage to the uterine musculature and vasculature adversely affects prospects for pregnancy in these women. It has been demonstrated that, in women treated with total body irradiation, sex steroid replacement in physiological doses significantly increases uterine volume and endometrial thickness, as well as re-establishing uterine blood flow. However, it is not known whether standard regimens of oestrogen replacement therapy are sufficient to facilitate uterine growth in adolescent women treated with total body irradiation in childhood. Even if the uterus is able to respond to exogenous sex steroid stimulation, and appropriate assisted reproductive technologies are available, a successful pregnancy outcome is by no means ensured. The uterine factor remains a concern and women who are survivors of childhood cancer and their carers must recognize that these pregnancies will be at high risk. 相似文献
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Eran Ashwal Avital Wertheimer Amir Aviram Arnon Wiznitzer Liran Hiersch 《The journal of maternal-fetal & neonatal medicine》2016,29(16):2665-2670
Objective: To determine predictive factors for vaginal birth after cesarean section (VBAC).Methods: A retrospective cohort study of all women with singleton pregnancies and a prior single low transverse cesarean section (CS) who attempted vaginal delivery in a tertiary hospital (2010–2014). Pregnancy outcome of women with VBAC was compared to those who failed vaginal delivery. Sub-analysis for women with no prior vaginal deliveries was performed. Pregnancies with non-cephalic presentation, estimated fetal weight?>4000 g and any contraindications for vaginal delivery were excluded.Results: Of the 40 714 deliveries, 1767 women met inclusion criteria. Among them 1563 (88.5%) had a VBAC and 204 (11.5%) failed. There was no significant difference between the groups regarding maternal age, comorbidities and pregnancy complications. Predictors for VBAC were (odds ratio, 95% confidence interval) interval from prior CS (1.13, 1.04–1.22, p=0.004), previous VBAC (2.77, 1.60–4.78, p?<?0.001), prior vaginal delivery prior to the CS (3.05, 1.73–5.39, p?<?0.001) and induction of labor (0.62, 0.40–0.97, p?=?0.03). For women with no prior vaginal birth, only birthweight was associated with VBAC (0.99, 0.99–1.00, p?=?0.02).Conclusion: While different variables may influence the rate of VBAC, the predictive ability of VBAC for women with no previous vaginal deliveries remains poor. 相似文献
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G. Justus Hofmeyr Bukola Fawole N. Patrick Godi Lindeka Mangesi Mandisa Singata Leanne Brady Jennifer Blum 《International journal of gynaecology and obstetrics》2011,112(2):98-102
Objective
To assess the effectiveness and safety of the administration of misoprostol, an orally active prostaglandin, in addition to routine uterotonic therapy as part of the active management of the third stage of labor.Methods
The present study was a hospital-based, decentralized, multi-center, randomized, placebo-controlled, double-blind trial. We enrolled 1103 women (out of a target sample size of 1180) at 4 hospitals in South Africa, Uganda, and Nigeria. Participants received a sublingual dose of 400 μg of misoprostol or a placebo, in addition to standard active management of the third stage of labor, after vaginal birth.Results
The baseline characteristics of the participants were comparable. The difference in the primary outcome of blood loss of 500 mL or more within 1 hour of randomization was not significant between the 2 groups (misoprostol 22/546 [4.0%] versus placebo 35/553 [6.3%]; relative risk, 0.64; 95% confidence interval, 0.38-1.07). Shivering and pyrexia occurred more frequently in the misoprostol group. No maternal deaths occurred.Conclusion
The present study did not confirm a beneficial effect of administering 400 μg of misoprostol, in addition to routine uterotonic therapy, during the third stage of labor, but was consistent with other trials showing a cumulative modest benefit. Where routine uterotonics are available for prophylactic use, any potential benefit of misoprostol might not outweigh the likelihood of adverse effects. Trial registered on clinical trials.gov: NCT 00124540. 相似文献17.
Soo Ran Choi Nae Ri Yoon Sung Ook Hwang 《The journal of maternal-fetal & neonatal medicine》2017,30(22):2711-2715
Objective: Tocolytic agents are used to inhibit uterine contraction in preterm. The authors undertook this study to determine whether using of tocolytic agents before delivery is associated with increase postpartum hemorrhage in preterm delivered women.Method: 296 singleton pregnancies delivered preterm from 24?+?1 to 37?+?0 weeks gestation were retrospectively reviewed. Hemoglobin (HB) and hematocrit (HCT) levels were checked before and after delivery to access postpartum blood loss. Multivariate logistic regression analysis was performed to determine whether delivery within the half-lives of tocolytic agents was associated with decreased HB and HCT levels.Results: After adjusting for maternal age, parity, gestational age at delivery, birth weight, delivery method, and induction of labor, postpartum HB and HCT levels of those delivered within half-lives of tocolytic agents were found to be significantly diminished (HB: OR 3.306, 1.308–8.356 95% CI, p?=?0.011; HCT: OR 2.692, 1.077–6.726 95% CI, p?=?0.034). In addition, blood transfusion rates were elevated for deliveries made within the half-lives of tocolytic agents, (p?=?0.006).Conclusions: Delivery within half-lives of tocolytic agents was found to be associated with low HB and HCT levels after delivery and higher blood transfusion rates in preterm delivered women. 相似文献
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