MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'American Journal of Perinatology' source. Fri, 19 Mar 2010 17:26:19 +0100 http://www.medworm.com/index.php?rid=3373673&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1241739 This study investigated the effects of Digibind in a rat model of PE. We induced a syndrome in rats, which includes many of the phenotypic characteristics of human PE. Digibind, in escalating doses, was given on days 10 to 20 of pregnancy. Digibind produced significant lowering of the blood pressure and reduced proteinuria in our rat model of PE. However, it also did not avert IUGR. In view of these findings, in our experimental model of human PE, further studies in the quest for effective treatment of PE need to focus on pharmaceuticals that can remedy the syndrome without compromising the fetus.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3373673 Wed, 17 Mar 2010 16:35:54 +0100 3373673 http://www.medworm.com/index.php?rid=3373672&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249361 We report on two cases of abnormal midtrimester ultrasound showing placental abnormalities. Karyotype assessment showed mixoploidy, and both cases had satisfactory pregnancy outcome.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3373672 Wed, 17 Mar 2010 16:35:54 +0100 3373672 http://www.medworm.com/index.php?rid=3373671&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249765 Amer J PerinatolDOI: 10.1055/s-0030-1249765ABSTRACTWe compared maternal morbidity between planned vaginal and planned cesarean delivery. A university hospital's database was queried for delivery outcomes. Between 1995 and 2005, 26,356 deliveries occurred. Subjects were divided into two groups: planned vaginal and planned cesarean delivery. This was based on intent to deliver vaginally or by cesarean, despite actual route of delivery. Planned vaginal delivery included successful vaginal delivery and labored cesarean delivery intended for vaginal delivery. Planned cesarean delivery included unlabored and labored cesarean delivery and vaginal delivery intended for cesarean. Chart abstraction confirmed the delivery plan. Primary outcomes were chorioamnionitis, postpartum hemorrhage, and transf... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3373671 Wed, 17 Mar 2010 03:20:10 +0100 3373671 http://www.medworm.com/index.php?rid=3369824&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249359 Amer J PerinatolDOI: 10.1055/s-0030-1249359ABSTRACTEstimates of gestational age based on early second-trimester ultrasound often differ from that based on the last menstrual period (LMP) even when a woman is certain about her LMP. Discrepancies in these gestational age estimates may be associated with an increased risk of cesarean section and low birth weight. We analyzed 7228 singleton, low-risk, white women from The Routine Antenatal Diagnostic Imaging with Ultrasound trial. The women were recruited at less than 14 weeks of gestation and received ultrasound exams between 15 and 22 weeks. Our results indicate that among nulliparous women, the risk of cesarean section increased from 10% when the ultrasound-based gestational age exceeded the LMP-based estimate by 4 days to 60% when the disc... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3369824 Tue, 16 Mar 2010 17:48:50 +0100 3369824 http://www.medworm.com/index.php?rid=3369823&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249762 Amer J PerinatolDOI: 10.1055/s-0030-1249762ABSTRACTWe evaluated the efficacy, safety, and biological mechanisms of digoxin immune Fab (DIF) treatment of severe preeclampsia. Fifty-one severe preeclamptic patients were randomized in double-blind fashion to DIF ( = 24) or placebo ( = 27) for 48 hours. Primary outcomes were change in creatinine clearance (CrCl) at 24 to 48 hours and antihypertensive drug use. Serum sodium pump inhibition, a sequela of endogenous digitalis-like factors (EDLF), was also assessed. CrCl in DIF subjects was essentially unchanged from baseline versus a decrease with placebo (−3 ± 10 and −34 ± 10 mL/min, respectively,  = 0.02). Antihypertensive use was similar between treatments (46 and 52%, r... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3369823 Tue, 16 Mar 2010 03:09:51 +0100 3369823 http://www.medworm.com/index.php?rid=3358399&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249365 Amer J PerinatolDOI: 10.1055/s-0030-1249365ABSTRACTWe sought to validate center-specific published medians and estimate the effects of sonologist and Doppler measurement techniques on middle cerebral artery (MCA) peak systolic velocity (PSV) values. We studied 154 gravidas with normal singletons who underwent MCA PSV measurement at 18 to 35 weeks' gestation by one of three experienced sonologists. Pregnancies complicated by a known fetal anomaly (structural or aneuploidy), amniotic fluid volume disturbance, intrauterine growth restriction, multiple gestation, or isoimmunization were excluded. MCA PSV was measured using both manual caliper and auto-trace techniques. Regression models of log-transformed PSV values and gestational age were developed. Although auto-trace medians were significa... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3358399 Fri, 12 Mar 2010 16:23:07 +0100 3358399 http://www.medworm.com/index.php?rid=3358398&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249761 In conclusion, 44% of cases of NE following term deliveries can be attributed to a combination of antepartum and intrapartum variables.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3358398 Fri, 12 Mar 2010 16:23:07 +0100 3358398 http://www.medworm.com/index.php?rid=3358397&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249764 Amer J PerinatolDOI: 10.1055/s-0030-1249764ABSTRACTWe hypothesized that there is a significant relationship between a neonatologist's belief that feedings must be stopped in the presence of a patent ductus arteriosus (PDA) and his or her willingness to ligate a PDA. We administered the same survey questionnaire to two separate populations of neonatologists to assess their beliefs regarding PDA treatment practices. Although >90% of U.S. and non-U.S. neonatologists reported that they would ligate a PDA when infants with birth weights <900 g required mechanical ventilation (and indomethacin was contraindicated or had failed to close the PDA), U.S. neonatologists reported that they were significantly more likely to ligate a PDA when less respiratory support was required. U.S. neonatologi... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3358397 Fri, 12 Mar 2010 16:23:07 +0100 3358397 http://www.medworm.com/index.php?rid=3358396&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249763 Amer J PerinatolDOI: 10.1055/s-0030-1249763ABSTRACTTwelve cases of neonates admitted to the neonatal unit of our hospital, between January 1, 2000, and December 31, 2005, because of otorrhea due to spontaneous perforation of the tympanic membrane within the first 10 days of life are presented. Data were collected retrospectively from medical records. Cultures of the middle ear exudate grew in 10, in 1, and in 1 neonate. Cultures of nasopharyngeal secretions grew in nine, in one, in one, and in one neonate. Middle ear versus nasopharyngeal secretions cultures grew the same organism in 11 neonates. A 10-day course of parenteral antibiotics was administered (ampicillin-ceftazidime for all neonates except for the one neonate with the otitis who received netilmicin-cloxacillin). All neonates ha... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3358396 Fri, 12 Mar 2010 16:23:07 +0100 3358396 http://www.medworm.com/index.php?rid=3358395&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249362 Amer J PerinatolDOI: 10.1055/s-0030-1249362ABSTRACTWe sought to examine neonatal morbidity in four groups of offspring (asymmetric large for gestational age [LGA], symmetric LGA, asymmetric non-LGA, symmetric non-LGA) exposed in utero to maternal type 1 diabetes, and the association between rate of fetal abdominal circumference growth and asymmetric LGA. We performed a secondary analysis of 302 singleton pregnancies. Neonatal morbidity (respiratory distress syndrome, polycythemia, hypoglycemia, hyperbilirubinemia, acidosis, and composite morbidity [any of the five]) was assessed. Serial ultrasound examinations after 20 weeks' gestation were available for 35 fetuses. Logistic regression and general linear mixed modeling were used for analysis. Asymmetric LGA infants had 3.5-, 2.2-, and 3.2-... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3358395 Fri, 12 Mar 2010 03:11:22 +0100 3358395 http://www.medworm.com/index.php?rid=3330893&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249364 Amer J PerinatolDOI: 10.1055/s-0030-1249364ABSTRACTWe sought to determine whether there is an association between upper respiratory tract infection (URTI) requiring hospitalization during pregnancy and adverse perinatal complications. A retrospective population-based study comparing all singleton pregnancies of patients with and without URTI requiring hospitalization was performed. Multiple logistic regression models were performed to control for confounders. Data were collected from the computerized perinatal database. Out of 186,373 deliveries, 0.13% ( = 246) required hospitalization due to URTI during pregnancy. URTI was significantly associated with preterm deliveries (PTD; 15.9% versus 7.9%;  < 0.001), lower birth weight (3082 ± 624 versus 3183&... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3330893 Thu, 04 Mar 2010 18:11:41 +0100 3330893 http://www.medworm.com/index.php?rid=3330892&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1248937 Amer J PerinatolDOI: 10.1055/s-0030-1248937ABSTRACTWe sought to determine predictors of fetal growth restriction in maternal HIV disease. Pregnant HIV-positive women on antiretroviral therapy were monitored with serial viral load and CD4 counts. Individualized growth potential (GP) percentile was calculated for birth weight (BW). BW <10th GP percentile defined fetal growth restriction (FGR). Multiple medical and social factors, CD4 count, viral load, and antiretroviral therapy were tested for impact on fetal growth using chi-square and multiple regression analysis. Two hundred eleven women were studied. CD4 count <200 in the first trimester was strongly associated with FGR (odds ratio 8.75, 95% confidence interval 2.88 to 26.52). Maternal age ( = 0.02) and smoking (&#8201... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3330892 Thu, 04 Mar 2010 03:14:37 +0100 3330892 http://www.medworm.com/index.php?rid=3326381&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249358 Amer J PerinatolDOI: 10.1055/s-0030-1249358ABSTRACTTrauma in pregnancy remains one of the major contributors to maternal and fetal morbidity and mortality. Potential complications include maternal injury or death, shock, internal hemorrhage, intrauterine fetal demise, direct fetal injury, abruptio placentae, and uterine rupture. The leading causes of obstetric trauma are motor vehicle accidents, falls, assaults, and gunshots, and ensuing injuries are classified as blunt abdominal trauma, pelvic fractures, or penetrating trauma. Many of the assessment and management aspects of obstetric trauma are unique to pregnancy, although initial evaluation and resuscitation should always be maternally directed. Once maternal stability is established, vigilant evaluation of fetal well-being becomes war... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3326381 Wed, 03 Mar 2010 16:33:38 +0100 3326381 http://www.medworm.com/index.php?rid=3326380&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249360 Amer J PerinatolDOI: 10.1055/s-0030-1249360ABSTRACTThe incidence of twin pregnancies has increased for the last 20 years mainly as a result of assisted reproduction technologies and pregnancies occurring in older women. Both maternal and perinatal mortality and morbidity are increased in twin pregnancies when compared with singletons. A systematic and detailed first-trimester ultrasound can be a useful tool for detecting chorionicity, growth discordance, and congenital malformations. Prediction of complications at an early stage can help with directing future management and counseling of patients.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3326380 Wed, 03 Mar 2010 16:33:38 +0100 3326380 http://www.medworm.com/index.php?rid=3326379&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249367 Amer J PerinatolDOI: 10.1055/s-0030-1249367ABSTRACTWe sought to establish normative data for fetal liver volume (FLV) between 27 and 38 weeks' gestation using three-dimensional ultrasonography. The study design was a longitudinal prospective study involving 53 participants. A total of 250 FLV measurements were obtained, using the multiplanar method with 3.0-mm intervals. Polynomial regressions with adjustments using the determination coefficient () were used to assess the correlation between FLV and gestational age (GA) and fetal parameters (biparietal diameter, head circumference, abdominal circumference, and estimated fetal weight). The mean, standard deviation, and median, minimum, and maximum values were calculated for each gestational age. The intraclass correlation coefficient (ICC) ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3326379 Wed, 03 Mar 2010 03:14:13 +0100 3326379 http://www.medworm.com/index.php?rid=3321748&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1248941 Amer J PerinatolDOI: 10.1055/s-0030-1248941ABSTRACTNeonatal infection is the main complication of prelabor rupture of membranes (PROM). We studied the accuracy of measuring C-reactive protein (CRP) and leukocytes in maternal serum to predict neonatal infection. We performed a retrospective cohort study in two hospitals in the Netherlands between 2003 and 2006. We included consecutive women hospitalized for PROM. In both hospitals, CRP and leukocytes were measured routinely in maternal serum every 2 days until delivery. End points considered were clinical neonatal infection and proven neonatal sepsis. The accuracy of CRP and leukocytes was assessed using receiver operating characteristic (ROC) analysis. We included 299 women with PROM, 12 of whom had a twin pregnancy. Gestational age at inc... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3321748 Tue, 02 Mar 2010 17:35:20 +0100 3321748 http://www.medworm.com/index.php?rid=3321747&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249366 Amer J PerinatolDOI: 10.1055/s-0030-1249366ABSTRACTElevated concentrations of interleukin-6 (IL-6), C-reactive protein (CRP), and matrix metalloproteinase-9 (MMP-9) in fetal and neonatal compartments have been associated with an increased risk for preterm birth (PTB) and/or neonatal morbidity. The purpose of this study was to determine if the maternal serum concentration of IL-6, CRP, and MMP-9 in women at risk for PTB, who are not in labor and have intact membranes, are associated with an increased risk for PTB <32 weeks and/or neonatal morbidity. Maternal serum samples collected from 475 patients enrolled in a multicenter randomized controlled trial of single versus weekly corticosteroids for women at increased risk for preterm delivery were assayed. Serum was collected at randomizati... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3321747 Tue, 02 Mar 2010 17:35:20 +0100 3321747 http://www.medworm.com/index.php?rid=3321746&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1249363 Amer J PerinatolDOI: 10.1055/s-0030-1249363ABSTRACTWe compared the types (A, B, or C) of recommendations and levels (I, II, III, or others) of references in the original versus revised practice bulletins (PBs). American College of Obstetricians and Gynecologists (ACOG) compendiums and Web site were used to obtain the PBs. Chi-square test for trend or Wilcoxon matched-pairs tests were used. From December 1998 to December 2008, ACOG published 78 PBs, of which 24% (19) have been revised. Neither the median numbers of recommendations per PB (8 to 10;  = 0.235) nor the type ( = 0.155) increased significantly. Additionally, the level of references ( = 0.130) and the type of journals they were published in did not vary significantly ( = 0.554). In 1... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3321746 Tue, 02 Mar 2010 17:35:20 +0100 3321746 http://www.medworm.com/index.php?rid=3321745&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1248945 Amer J PerinatolDOI: 10.1055/s-0030-1248945ABSTRACTThe obesity epidemic challenges traditional antenatal fetal heart rate (FHR) monitoring technologies. Doppler signals in particular are attenuated. We sought to evaluate whether the performance of a novel transabdominal fetal electrocardiogram (fECG) device (AN24, Monica Healthcare) is influenced by body mass index (BMI). We performed a prospective observational study of singleton pregnancies (gestational age [GA] 20 to 41 weeks) monitored overnight with fECG. Recording quality ([RQ] %) of both the best hour and the total recording time of the FHR record were related to BMI. Two hundred four women were monitored. BMI ranged from 16.0 to 50.7 (median BMI 26.9). The correlation coefficient (with 95% confidence interval [CI]) between BMI and ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3321745 Tue, 02 Mar 2010 03:26:34 +0100 3321745 http://www.medworm.com/index.php?rid=3297858&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1248938 Amer J PerinatolDOI: 10.1055/s-0030-1248938ABSTRACTWe undertook this in vitro study to quantify the effect that addition of magnesium (Mg) sulfate to neonatal serum, as compared with adult serum, might have on ionized Mg (Mg) concentration. We used one cord blood sample and one adult blood sample that we made hypermagnesemic by adding various amounts of magnesium sulfate to study five levels of serum Mg. Each sample was then studied at one of three levels of pH, from extreme alkalosis to extreme acidosis. We measured the changes in serum Mg and serum ionized calcium (Ca) in reaction to these changes in pH and Mg. At each pH level, there was an exponential increase in the serum Mg (and no significant change in serum Ca) with increasing serum Mg. Multiple regression analysis using Mg as the ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3297858 Tue, 23 Feb 2010 16:44:10 +0100 3297858 http://www.medworm.com/index.php?rid=3297857&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1248939 This study demonstrated great variability in the duration of diuretic therapy and diuretic taper. Discharge on oxygen was associated with longer duration of diuretic therapy and taper. Active taper is successful in the majority of patients and should be considered in patients with stable BPD.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3297857 Tue, 23 Feb 2010 03:14:44 +0100 3297857 http://www.medworm.com/index.php?rid=3290504&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1248936 Amer J PerinatolDOI: 10.1055/s-0030-1248936ABSTRACTWe evaluated the maternal and perinatal complications of cesarean delivery performed in the second stage compared with the first stage of labor in nulliparous women. We performed a hospital-based cohort study in a teaching institution in Kolkata, West Bengal, India. The primary maternal outcomes measured included intraoperative surgical complications, duration of surgery, need for blood transfusion, wound infection, transfer to intensive care unit, and length of hospital stay. The neonatal outcomes included 5-minute Apgar score 3 or less, need for endotracheal intubation, admission to neonatal intensive care unit, fetal injury, septicemia, neonatal seizures, and neonatal death. There were 1702 cesarean deliveries performed in the first sta... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3290504 Sat, 20 Feb 2010 16:25:36 +0100 3290504 http://www.medworm.com/index.php?rid=3290503&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1248940 Amer J PerinatolDOI: 10.1055/s-0030-1248940ABSTRACTWe compared neonatal outcomes in twin pregnancies following moderately preterm birth (MPTB), late preterm birth (LPTB), and term birth. A secondary analysis of a multicenter, randomized controlled trial of multiple gestations was conducted. MPTB was defined as delivery between 32/ and 33/ weeks and LPTB between 34/ and 36/ weeks. Primary outcome was a neonatal outcome composite consisting of one or more of the following: neonatal death, respiratory distress syndrome, early onset culture-proven sepsis, stage 2 or 3 necrotizing enterocolitis, bronchopulmonary dysplasia, grade 3 or 4 intraventricular hemorrhage, periventricular leukomalacia, pneumonia, or severe retinopathy of prematurity. Among 552 twin pregnancies, the MPTB rate was 14.5%, ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3290503 Sat, 20 Feb 2010 16:25:36 +0100 3290503 http://www.medworm.com/index.php?rid=3290502&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1248944 Amer J PerinatolDOI: 10.1055/s-0030-1248944ABSTRACTEarly onset hypertensive disorders of pregnancy are associated with adverse maternal and neonatal outcome. The risk of recurrence influences parents' choices on subsequent pregnancies and the counseling obstetrician, but evidence so far has been limited. We performed the first systematic review on the risk of recurrence of hypertensive disorders that had caused delivery <34 weeks. We searched Medline, Embase, and the Cochrane Library for articles published until September 2009 that report on pregnancy outcome after an earlier pregnancy complicated by early hypertension, preeclampsia, or hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome, which resulted in a delivery before 34 weeks. Recurrence rates of premature deliverie... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3290502 Sat, 20 Feb 2010 16:25:36 +0100 3290502 http://www.medworm.com/index.php?rid=3290501&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1248943 Amer J PerinatolDOI: 10.1055/s-0030-1248943ABSTRACTPrune belly syndrome is a rare congenital disorder characterized by deficiency of abdominal wall muscles, cryptorchidism, and urinary tract anomalies. We have had the opportunity to study a baby with prune belly syndrome associated with an apparently de novo 1.3-megabase interstitial 17q12 microdeletion that includes the hepatocyte nuclear factor-1-β gene at 17q12. One previous patient, an adult, has been reported with prune belly syndrome and a hepatocyte nuclear factor-1-β microdeletion. Hepatocyte nuclear factor-1-β is a widely expressed transcription factor that regulates tissue-specific gene expression and is expressed in numerous tissues including mesonephric duct derivatives, the renal tubule of the metanephros, and t... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3290501 Sat, 20 Feb 2010 16:25:36 +0100 3290501 http://www.medworm.com/index.php?rid=3290500&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1248942 Amer J PerinatolDOI: 10.1055/s-0030-1248942ABSTRACTA marked reduction in infant mortality due to respiratory distress syndrome (RDS) has been reported in previous studies; however, deaths due to RDS are still more common in black infants than white infants. Because advances in respiratory care may have impacted non-RDS respiratory causes of infant mortality as well, the objective of this study was to determine if specific and total non-RDS respiratory causes of infant mortality have changed over time, and if health disparities exist. We analyzed and compared infant deaths due to RDS and other respiratory diseases from 1980 to 2005 in the United States and evaluated outcomes by race and gender. Infant mortality due to non-RDS causes declined more than twofold over this time frame, but not a... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3290500 Sat, 20 Feb 2010 03:28:27 +0100 3290500 http://www.medworm.com/index.php?rid=3222817&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1247603 We report the case of a newborn with hypoplastic left heart syndrome, restrictive interatrial communication, and atrial septal aneurysm. The latter led to formation of a large intralimbic hematoma within it, which resulted in complete obstruction of the interatrial communication after birth, which led to death. We suggest that in addition to the known associated problems encountered in patients with hypoplastic left heart syndrome and restrictive interatrial communication, aneurysmal formation of the interatrial septum should alert the fetal and postnatal echocardiographer further, and careful assessment and follow-up is recommended.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3222817 Sat, 30 Jan 2010 16:16:48 +0100 3222817 http://www.medworm.com/index.php?rid=3222816&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1247601 Amer J PerinatolDOI: 10.1055/s-0030-1247601ABSTRACTWe estimated the optimal gestational age for placement of a history-indicated cerclage in a retrospective cohort study of pregnancies during the period between 1994 to 2007. Pregnancies were divided into two groups: group 1, cerclage <14 weeks ( = 83), and group 2, cerclage ≥14 weeks ( = 59). The primary outcome was spontaneous preterm birth (SPTB) <35 weeks. Parametric and nonparametric tests were performed where appropriate. One hundred forty-two pregnancies by 130 women were included. Demographic characteristics were similar between groups. The median gestational age at cerclage was 12 weeks (group 1) and 15 weeks (group 2). There was no difference in the primary outcome, incidence of SPTB <35 week... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3222816 Sat, 30 Jan 2010 16:16:48 +0100 3222816 http://www.medworm.com/index.php?rid=3222815&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1247599 We present the outcome of a relatively large cohort of women with suspected placenta accreta who underwent prophylactic pelvic artery catheterization prior to cesarean section. All pregnant women with suspected placenta accreta who delivered in one tertiary center were included in this retrospective study. All patients underwent an elective cesarean section with prophylactic pelvic artery catheterization of internal iliac arteries through femoral or brachial approach. Thirty women underwent prophylactic catheterization; placenta accreta was clinically confirmed in 25 (83.3%) cases. Embolization was performed in 23 cases (76.6%) and hysterectomy in 2 (8%). Median estimated amount of blood loss was 2000 mL (500 to 9000 mL). There were no major catheterization-related complications. Three wom... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3222815 Sat, 30 Jan 2010 16:16:48 +0100 3222815 http://www.medworm.com/index.php?rid=3222814&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1247597 We examined if very low-birth-weight (VLBW) infants of multiple gestation pregnancies experience more complications and take longer to achieve clinical milestones compared with similar singletons. We performed a retrospective analysis of all infants less than 1500 g at birth in a large neonatal database. Singletons were compared with twins and higher-order multiples for demographic, morbidities, and process milestones including feeding, respiratory, thermoregulation, and length of stay. Multivariable regression analyses were performed to control for potential confounding variables. A total of 5507 infants were included: 3792 singletons, 1391 twins, and 324 higher-order multiples. There were no differences in Apgar scores, small for gestational age status, and incidence of necrotizing enter... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3222814 Sat, 30 Jan 2010 16:16:48 +0100 3222814 http://www.medworm.com/index.php?rid=3222813&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1247600 Amer J PerinatolDOI: 10.1055/s-0030-1247600ABSTRACTWe evaluated the clinical usefulness of near-infrared spectroscopic quantitative measurement of placental oxygenation for the noninvasive estimation of uteroplacental function in pregnant women. We performed a prospective, observational clinical study. Women without complications ( = 15), women with threatened preterm delivery (TPD;  = 6), and women with intrauterine fetal growth restriction (IUGR;  = 6) were enrolled. Measurements of placental tissue oxygenation index (TOI) using the NIRO-300 (Hamamatsu Photonics, Hamamatsu City, Japan) were recorded. Mean TOI was 72.3 ± 5.3% in women without complications, 72.9 ± 5.6% in pregnant women with TPD, and 78.7 ± 3.0% in... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3222813 Sat, 30 Jan 2010 16:16:48 +0100 3222813 http://www.medworm.com/index.php?rid=3222812&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1247604 Amer J PerinatolDOI: 10.1055/s-0030-1247604ABSTRACTWe investigated the postnatal pattern of changes in adrenal size in very low-birth-weight (VLBW) infants and its relation to late-onset glucocorticoid-responsive circulatory collapse (LGCC) that may be associated with adrenal insufficiency. In 36 VLBW infants born at <33 weeks' gestation, ultrasound examinations of postnatal changes in adrenal size during the first 3 weeks of life were performed. VLBW infants were classified into three groups: group A ( = 6), the actual adrenal area was greater than or equal to the predicted value at birth and unchanged at 3 weeks; group B ( = 24), the actual adrenal area was greater than or equal to the predicted value and decreased at 3 weeks; and group C ( = 6), th... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3222812 Sat, 30 Jan 2010 02:51:22 +0100 3222812 http://www.medworm.com/index.php?rid=3200075&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1247605 Amer J PerinatolDOI: 10.1055/s-0030-1247605ABSTRACTWe compared outcomes for neonates with forceps-assisted, vacuum-assisted, or cesarean delivery in the second stage of labor. This is a secondary analysis of a randomized trial in laboring, low-risk, nulliparous women at ≥36 weeks’ gestation. Neonatal outcomes after use of forceps, vacuum, and cesarean were compared among women in the second stage of labor at station +1 or below (thirds scale) for failure of descent or nonreassuring fetal status. Nine hundred ninety women were included in this analysis: 549 (55%) with an indication for delivery of failure of descent and 441 (45%) for a nonreassuring fetal status. Umbilical cord gases were available for 87% of neonates. We found no differences in the base excess ( = 0... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3200075 Sat, 23 Jan 2010 15:56:27 +0100 3200075 http://www.medworm.com/index.php?rid=3200074&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1247598 Amer J PerinatolDOI: 10.1055/s-0030-1247598ABSTRACTPreterm infants often receive multiple packed red blood cell (PRBC) transfusions that are intended to improve tissue oxygen levels. Near-infrared spectroscopy (NIRS) monitors regional cerebral tissue oxygen saturation (CrSO) and splanchnic tissue oxygen saturation (SrSO). Before such technology can be employed in neonatal transfusion management, it must first be established that transfusions result in an increase in tissue oxygen saturation. This prospective, observational study used NIRS to determine if PRBC transfusions increase the CrSO and SrSO of symptomatic anemic premature neonates. CrSO and SrSO values were compared for 20-minute duration immediately before, during, immediately after, and 12 hours after transfusion. As a secondary ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3200074 Sat, 23 Jan 2010 02:47:48 +0100 3200074 http://www.medworm.com/index.php?rid=3197220&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1247602 Amer J PerinatolDOI: 10.1055/s-0030-1247602ABSTRACTWe tested whether group B streptococcus (GBS) screening is performed as recommended by the Centers for Disease Control and Prevention (CDC) and evaluated the need for a rapid GBS test for women with full-term pregnancies. A retrospective cohort analysis at a single, large academic institution was performed. Women who delivered full-term (>37 weeks) infants and had documented prenatal care were included. The primary outcome was documented screening. One hundred sixty-five full-term pregnancies were included; 158 women [95.76%; 95% confidence interval (CI), 92.68 to 98.83%] were screened prior to presentation at labor and delivery. This frequency was significantly greater than the a priori hypothesis of 90% ( = 0.01). Of the 1... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3197220 Fri, 22 Jan 2010 16:24:33 +0100 3197220 http://www.medworm.com/index.php?rid=3197219&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1247607 Amer J PerinatolDOI: 10.1055/s-0030-1247607ABSTRACTWe sought to establish normative data for three-dimensional ultrasound (3DUS) first-trimester embryonic volume using the extended imaging virtual organ computer-aided analysis (XI VOCAL) technique. This cross-sectional study involved 64 normal pregnancies at 7 to 10 + 6 weeks' gestation. Embryonic volume was obtained on 3DUS using the XI VOCAL technique with manual outline of 10 sequential planes. The mean, median, standard deviation, and maximum and minimum values were obtained for each week calculated. Polynomial regression models adjusted by the determination coefficient () were created to assess the correlation between embryonic volume and gestational age (GA) and crown rump length (CRL). The intraclass correlation coeffici... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3197219 Fri, 22 Jan 2010 02:54:07 +0100 3197219 http://www.medworm.com/index.php?rid=3193187&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1247606 We report a case of a 50-day-old very low-birth-weight premature infant with novel A/H1N1 influenza virus (swine flu). There were no obvious epidemiological conditions in the NICU among patients and staff. The unique presenting symptom was apnea, which required respiratory support by nasal intermittent positive pressure ventilation. Due to the current pandemic, neonatologists should be aware of possible infection of neonates with novel A/H1N1 influenza virus.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3193187 Thu, 21 Jan 2010 02:55:44 +0100 3193187 http://www.medworm.com/index.php?rid=3118457&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243308 In conclusion, the distribution of PI varies by exposures and of high PI by race/ethnicity/gender. SGA infants with high PI have relative surplus of mass, and ostensibly, adiposity, for their frame. There is a need to use PI in exploring and defining previously observed associations between SGA and adult-onset obesity/metabolic syndrome.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3118457 Thu, 24 Dec 2009 03:17:57 +0100 3118457 http://www.medworm.com/index.php?rid=3082068&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243370 We present a case of successfully treated persistent bacteremia due to Gram-positive bacteria with daptomycin in a preterm neonate. Daptomycin was given at higher doses (6 mg/kg/dose) and shorter intervals (every 12 hours) than those recommended for adults with no adverse events. Peak and trough serum concentrations of daptomycin were 22.9 and 11.6 μg/mL at day 4 as well as 27.3 and 7.9 μg/mL at day 11 after initiation of treatment, respectively.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3082068 Sat, 12 Dec 2009 15:45:11 +0100 3082068 http://www.medworm.com/index.php?rid=3082067&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243369 Amer J PerinatolDOI: 10.1055/s-0029-1243369ABSTRACTWe compared obstetric outcomes based on gestational weight gain in normal-weight and obese women using traditional Institute of Medicine (IOM) guidelines and newly recommended Cedergren criteria. Using the New Jersey Pregnancy Risk Assessment Monitoring System (PRAMS) database and electronic birth records, perinatal outcomes were analyzed to estimate the independent effects of prepregnancy body mass index (BMI) and gestational weight gain by IOM versus Cedergren criteria. Of 9125 subjects in PRAMS database from 2002 to 2006, 53.7% had normal BMI, 12.3% were overweight, 18.2% were obese, and the rest were underweight. Among normal-weight mothers, when compared with the IOM guidelines, macrosomia (6.45% versus 4.27%) and cesarean delivery ra... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3082067 Sat, 12 Dec 2009 15:45:11 +0100 3082067 http://www.medworm.com/index.php?rid=3082066&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243367 Amer J PerinatolDOI: 10.1055/s-0029-1243367ABSTRACTWe evaluated outcomes of preterm infants following surgical ligation of patent ductus arteriosus (PDA). We performed a retrospective chart review. Our cohort ( = 82) had a median (range) gestational age of 25.5 (23 to 28) weeks and birth weight of 765 (484 to 1150) g. Ligation was the initial intervention in the primary group ( = 28) and was performed after failed medical therapy in the secondary group ( = 54). At 48 hours following ligation, an increase in fraction of inspired oxygen (FiO) and ventilatory and pressor support were observed in 49 (60%), 35 (43%), and 15 (18%) infants, respectively. The median (range) duration to return to preoperative FiO was 3 (1 to 30) days and extubation was 16 (1 to 9... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3082066 Sat, 12 Dec 2009 15:45:11 +0100 3082066 http://www.medworm.com/index.php?rid=3082065&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243309 In conclusion, only one in nine newborns had normocapnia throughout the first 72 hours. Severe hypocapnia was rare and occurred only in ventilated babies. Hypercapnia and hypocapnia in infants with hypoxic-ischemic encephalopathy during the first 72 hours of life were not associated with adverse outcome.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3082065 Sat, 12 Dec 2009 15:45:11 +0100 3082065 http://www.medworm.com/index.php?rid=3082064&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243303 Amer J PerinatolDOI: 10.1055/s-0029-1243303ABSTRACTWe investigated the relationship between illness severity and accuracy of neonatal sepsis screen. Consecutive neonates with clinically suspected early onset sepsis (EOS) were enrolled and blood culture and sepsis screen [C-reactive protein, absolute neutrophil count, immature to total ratio (ITR) and microerythrocyte sedimentation rate] were performed. Exclusion criteria were prior antibiotic exposure, nonavailable reports, and contaminated cultures. Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE-II) was used to categorize neonates into “mild to moderate” (score ≤40) and “severe” (score >40) illness. Sepsis was defined as positive blood culture, and positive screen as ≥2 parameters po... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3082064 Sat, 12 Dec 2009 15:45:11 +0100 3082064 http://www.medworm.com/index.php?rid=3082063&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243315 Amer J PerinatolDOI: 10.1055/s-0029-1243315ABSTRACTWe compared ibuprofen and indomethacin for the treatment of patent ductus arteriosus (PDA) in preterm infants. A retrospective comparative study was conducted at a pediatric tertiary center in preterm infants diagnosed with PDA. Infants born from January 2000 to June 2003 were treated with indomethacin, whereas infants born from July 2003 to November 2005 were treated with ibuprofen. The two treatment groups were compared. Demographic data and clinical, laboratory, and outcome data were collected from the medical files. Seventy-three infants were included in the ibuprofen group and 46 in the indomethacin group. No significant difference in efficacy was found between indomethacin and ibuprofen. Compared with ibuprofen, indomethacin treatmen... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3082063 Sat, 12 Dec 2009 15:45:11 +0100 3082063 http://www.medworm.com/index.php?rid=3082062&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243310 Amer J PerinatolDOI: 10.1055/s-0029-1243310ABSTRACTWe studied the effect of early (≤5 days) versus delayed (≥6 days) initiation of minimal enteral feeding (MEF) on the incidence of necrotizing enterocolitis (NEC) and feeding intolerance in preterm infants with intrauterine growth restriction (IUGR) and abnormal antenatal Doppler results. We performed a randomized, nonblinded pilot trial of infants receiving early or delayed MEF in addition to parenteral feeding within 48 hours of life. Demographic data, maternal preeclampsia, antenatal steroid exposure, Doppler studies, as well as cases of NEC and feeding intolerance were all recorded. Of the 84 infants enrolled, 81 completed the study: 40 received early (median age: 2 days, range: 1 to 5 days) and 41 delayed (median age: 7 day... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3082062 Sat, 12 Dec 2009 15:45:11 +0100 3082062 http://www.medworm.com/index.php?rid=3082061&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243306 Amer J PerinatolDOI: 10.1055/s-0029-1243306ABSTRACTWe sought to identify maternal or clinical characteristics of women likely to develop preterm labor (PTL) at <34 weeks' gestation while receiving 17 α-hydroxyprogesterone caproate (17P) prophylaxis. Current singleton gestations with prior preterm delivery enrolled for outpatient 17P administration at <27 weeks' gestation were identified ( = 1177). Maternal and clinical characteristics were compared between women hospitalized and diagnosed with PTL at <34 weeks' gestation (PTL group,  = 270) and those without PTL (No PTL group,  = 660). PTL at <34 weeks' gestation occurred in 270/1177 (22.9%) of patients receiving 17P prophylaxis (mean gestational age at diagnosis was 28.3 ± ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3082061 Sat, 12 Dec 2009 15:45:11 +0100 3082061 http://www.medworm.com/index.php?rid=3082060&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243304 Amer J PerinatolDOI: 10.1055/s-0029-1243304ABSTRACTWe evaluated pregnancy outcomes in obese women with excessive weight gain during pregnancy. A retrospective study was performed on all obese women. Outcomes included rates of preeclampsia (PEC), gestational diabetes, cesarean delivery (CD), preterm delivery, low birth weight, very low birth weight, macrosomia, 5-minute Apgar score of <7, and neonatal intensive care unit (NICU) admission and were stratified by body mass index (BMI) groups class I (BMI 30 to 35.9 kg/m), class II (36 to 39.9 kg/m), and class III (≥40 kg/m). Gestational weight change was abstracted from the mother's medical chart and was divided into four categories: weight loss, weight gain of up to 14.9 pounds, weight gain of 15 to 24.9 pounds, and weight gain of mo... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3082060 Sat, 12 Dec 2009 15:45:11 +0100 3082060 http://www.medworm.com/index.php?rid=3082059&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243307 Amer J PerinatolDOI: 10.1055/s-0029-1243307ABSTRACTWhite's classification system (WCS) was created 60 years ago to identify diabetic (DM) pregnancies at increased risk for perinatal morbidity and mortality. Our objective was to assess the association between WCS and adverse pregnancy outcome (APO) in contemporary DM pregnancies. We studied diabetic women with singleton pregnancies who delivered at >20 weeks at a single institution over a 1-year period (2007 to 2008). Perinatal outcomes were compared between WCS groups. APO was defined as any of the following: preterm birth <34 weeks, severe preeclampsia, shoulder dystocia, and neonatal respiratory disease. Presence of vascular disease was defined as presence of chronic hypertension, chronic renal insufficiency, retinopathy, coronary ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3082059 Sat, 12 Dec 2009 15:45:11 +0100 3082059 http://www.medworm.com/index.php?rid=3082058&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243314 Amer J PerinatolDOI: 10.1055/s-0029-1243314ABSTRACTWe evaluated if the development of early childhood caries is associated with the severity of unconjugated hyperbilirubinemia during the first 2 weeks after birth. We performed a retrospective case-control study of children less than 6 years of age seen for comprehensive dental examination by pediatric dentists years following a hospital stay in the neonatal intensive care unit. Exclusion criteria included genetic disorders, cleft palate, direct hyperbilirubinemia, and missing information on jaundice. Children with early childhood caries were compared with those without dental caries for a panel of perinatal and neonatal clinical variables. Seventy-six children met study criteria. Of 76 children, 42 children had early childhood caries, whil... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3082058 Sat, 12 Dec 2009 15:45:11 +0100 3082058 http://www.medworm.com/index.php?rid=3082057&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243316 Amer J PerinatolDOI: 10.1055/s-0029-1243316ABSTRACTWe investigated the association between prenatal smoking and the occurrence of medically indicated and spontaneous preterm delivery (<37 weeks). We performed a retrospective cohort study of singleton live births in the state of Missouri ( = 1,219,159) using maternally linked cohort data files covering the period 1989 to 2005. The main outcomes of interest were spontaneous and medically indicated preterm and very preterm birth. Logistic regression models were used to generate adjusted odds ratios and their 95% confidence intervals. There were 132,246 (10.8%) infants born preterm in the study population, of which 106,410 (80.5%) were classifiable as spontaneous preterm births and 25,836 (19.5%) were medically indicated preterm... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3082057 Sat, 12 Dec 2009 15:45:11 +0100 3082057 http://www.medworm.com/index.php?rid=3082056&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243305 Amer J PerinatolDOI: 10.1055/s-0029-1243305ABSTRACTNormal changes in blood pressure during pregnancy are well documented in the second and third trimesters. Little is known about first-trimester changes, particularly compared with preconceptional values. This knowledge might allow for early prediction of conditions such as preeclampsia or intrauterine growth restriction. Prior studies utilized a laboratory setting. We conducted this retrospective study to compare blood pressure readings in early pregnancy with preconceptional values in the clinical setting. The records of 44 healthy normotensive nonsmoking women with a body mass index <30 and an uncomplicated appropriately grown singleton term delivery were reviewed. Preconceptional blood pressures values were compared with values at fi... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3082056 Sat, 12 Dec 2009 15:45:11 +0100 3082056 http://www.medworm.com/index.php?rid=3082055&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243368 This study suggests an effective method of reducing prenatal weight gain in the obese population. This type of comprehensive intervention could be an important, cost-effective risk-reduction strategy.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3082055 Sat, 12 Dec 2009 15:45:11 +0100 3082055 http://www.medworm.com/index.php?rid=3082054&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243313 This study aimed to determine whether gum chewing in the immediate postoperative period facilitates a return to bowel function in cesarean-delivery patients. Three hundred eighty-eight patients who underwent cesarean delivery were randomly assigned to a gum-chewing group (group G,  = 193) or a control group (group C,  = 195). Demographic data, duration of surgery, type of anesthesia, and time of discharge from hospital were recorded. Patients in the gum-chewing group chewed gum three times per day as soon as returning from the operating theater to the ward until the time they defecated or were discharged. Patients were asked to chew gum at least half an hour each time. The test and Pearson chi-square test was used for statistical analysis. Groups were comparable in ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3082054 Sat, 12 Dec 2009 15:45:11 +0100 3082054 http://www.medworm.com/index.php?rid=3082053&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243311 Amer J PerinatolDOI: 10.1055/s-0029-1243311ABSTRACTWe sought to determine cytokine response in term and late preterm newborn infants on phototherapy. Twenty newborn infants with gestational age ≥35 weeks and birth weight ≥2000 g in the first week of life had serum interleukin (IL)-6, IL-8, IL-10, IL-1β, and tumor necrosis factor (TNF)-α measured immediately prior to and after 24 hours on phototherapy. Exclusion criteria were newborns with severe congenital malformations, congenital infections, birth asphyxia, sepsis, hemolytic anemia that required blood transfusion, maternal-infant Rh incompatibility and those who required exchange transfusion or intravenous immunoglobulin treatment for hyperbilirubinemia. Median IL-6 concentrations significantly decreased after 24 ho... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3082053 Sat, 12 Dec 2009 15:45:11 +0100 3082053 http://www.medworm.com/index.php?rid=3082052&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243371 Amer J PerinatolDOI: 10.1055/s-0029-1243371ABSTRACTWe compared the rates of medical closure of patent ductus arteriosus (PDA) and complications (renal dysfunction, necrotizing enterocolitis, spontaneous intestinal perforation, and intraventricular hemorrhage) between infants treated with indomethacin and infants treated with ibuprofen. We performed a retrospective comparative cohort study of infants treated with indomethacin or ibuprofen for symptomatic PDA at Duke University Medical Center between November 2005 and November 2007. We identified 65 infants who received indomethacin and 57 who received ibuprofen. The rate of survival without surgical ductal ligation was 62% (40/65) in the indomethacin group and 58% (33/57) in the ibuprofen group ( = 0.71). The rate of the composi... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3082052 Sat, 12 Dec 2009 15:45:11 +0100 3082052 http://www.medworm.com/index.php?rid=3082051&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1243312 Amer J PerinatolDOI: 10.1055/s-0029-1243312ABSTRACTWe performed an observational pilot study of plasma concentrations of N-terminal pro-B-type natriuretic peptide (BNP) in premature infants with a diagnosis of bronchopulmonary dysplasia (BPD) at 4 weeks of age and after 1 month of conventional therapy. Thirty-four premature infants born before 34 weeks' gestational age without cardiac or infectious diseases were included. Serum NT-pro-BNP was measured in all neonates at 4 weeks of age. In infants with the diagnosis of BPD ( = 11), measurements were repeated at 6 and 8 weeks of age under conventional treatment. Specific clinical characteristics were collected prospectively. Baseline NT-pro-BNP concentrations were high in healthy premature infants compared with previously reporte... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=3082051 Sat, 12 Dec 2009 03:09:25 +0100 3082051 http://www.medworm.com/index.php?rid=2938702&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1239496 Amer J PerinatolDOI: 10.1055/s-0029-1239496ABSTRACTWe evaluated the effectiveness of sildenafil in the treatment of neonatal pulmonary hypertension. We performed a double-blind randomized clinical trial in 51 full-term infants with persistent pulmonary hypertension confirmed by Doppler echocardiography. Patients were divided in two groups: 20 infants in group A received placebo when the oxygenation index was >20, and 31 infants in group B received 3 mg/kg of oral sildenafil every 6 hours. Arterial blood gases were taken at 1, 4, 7, 13, 19, and 25 hours after treatment was started. Main outcome measures were oxygenation changes, time on mechanical ventilation, and mortality. Both groups were comparable in general variables as well as in illness severity. We observed better oxygenation pa... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2938702 Thu, 29 Oct 2009 15:58:42 +0100 2938702 http://www.medworm.com/index.php?rid=2938701&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1241729 We examined descriptive characteristics and conducted multivariate regression models examining risk factors for mortality, during the birth hospitalization, and sepsis. Analysis of 2490 neonates with gastroschisis found 90 deaths (3.6%) and sepsis in 766 (31%). Critical comorbidities and procedures are cardiovascular defects (15%), pulmonary conditions (5%), intestinal atresia (11%), intestinal resection (12.5%), and ostomy formation (8.3%). Factors associated with mortality were large bowel resection (odds ratio [OR] 8.26, 95% confidence interval [CI] 1.17 to 58.17), congenital circulatory (OR 5.62, 95% CI 2.11 to 14.91), and pulmonary (OR 8.22, 95% CI 2.75 to 24.58) disease, and sepsis (OR 3.87, 95% CI 1.51 to 9.91). Factors associated with sepsis include intestinal ostomy (OR 2.94, 95% ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2938701 Thu, 29 Oct 2009 15:58:42 +0100 2938701 http://www.medworm.com/index.php?rid=2938700&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1241737 Amer J PerinatolDOI: 10.1055/s-0029-1241737ABSTRACTNeurofibromatosis-1 (NF-1) is an autosomal-dominant genetic disorder with many different manifestations. Some may have evidence of the disease at birth. A 66-year (1942 to 2008) retrospective review of 36 patients including 7 fetuses and 29 neonates with NF-1 was performed. Only patients with NF-1 lesions detected before birth by imaging or noted in the first month of life were entered into the review. There was a strongly positive family history of the disease of 70%. The most common presenting findings in the fetus were hydrops, macrocephaly, and thickened neck soft tissues and those in the neonate were café au lait macules, skin nodules, and buphthalmos. Survivors developed serious sequelae (e.g., progressive growth of neurofibromas wi... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2938700 Thu, 29 Oct 2009 02:52:17 +0100 2938700 http://www.medworm.com/index.php?rid=2924714&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1241735 Amer J PerinatolDOI: 10.1055/s-0029-1241735ABSTRACTWe tested the hypothesis that the cardiac biomarker N-terminal pro-brain natriuretic peptide would be elevated in hypertensive disorders of pregnancy, with an increase in levels of this biomarker across increasing gradations of disease severity. We performed a case-controlled study of women admitted to labor and delivery at the Hospital of the University of Pennsylvania between 24 and 42 weeks of gestation. Cases had hypertension that developed after 20 weeks of gestation, and controls were normotensive women presenting for delivery. N-terminal pro-brain natriuretic peptide levels were compared between cases ( = 83) and controls ( = 290). Cases were subclassified into gestational hypertension ( = 20) and... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2924714 Sun, 25 Oct 2009 15:46:08 +0100 2924714 http://www.medworm.com/index.php?rid=2924713&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1241731 Amer J PerinatolDOI: 10.1055/s-0029-1241731ABSTRACTWe sought to determine whether placental implantation site affects electromyographic (EMG) recordings of uterine activity in labor. We performed a prospective study of women randomly selected on admission to labor ward. There were acceptable recordings in 36 women, 18 in both the posterior and anterior placenta groups. There were 12 unacceptable recordings. This was mainly due to poor electrode contact. There was no difference in amplitude, frequency, activity integral, total activity integral, or power density in either group. EMG can be used to quantify uterine activity irrespective of placental position.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perina... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2924713 Sun, 25 Oct 2009 15:46:08 +0100 2924713 http://www.medworm.com/index.php?rid=2924712&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1241732 Amer J PerinatolDOI: 10.1055/s-0029-1241732ABSTRACTWe sought to determine the rate of adverse perinatal outcomes in pregnancies diagnosed with an isolated single umbilical artery (SUA). We performed a retrospective review comparing 68 pregnancies with an isolated SUA to 68 pregnancies with a three-vessel cord (3VC). Pregnancies with structural or karyotypic anomalies were excluded. Gestational age at delivery, birth weight, SGA rate, ponderal index, and rates of admission to the neonatal intensive care unit were compared between groups. Student test and chi-square analysis were performed. Neonates with isolated SUA had a significantly smaller birth weight than those with a 3VC (3279 ± 404 g versus 3423 ± 374 g,  = 0.0168). There was no significant diff... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2924712 Sun, 25 Oct 2009 02:31:22 +0100 2924712 http://www.medworm.com/index.php?rid=2908150&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1241060 Amer J Perinatol 2009; 26: 691-692DOI: 10.1055/s-0029-1241060© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2908150 Tue, 20 Oct 2009 15:19:19 +0100 2908150 http://www.medworm.com/index.php?rid=2898295&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1241730 Amer J PerinatolDOI: 10.1055/s-0029-1241730ABSTRACTAlthough increased maternal anxiety following the disclosure of positive second-trimester maternal serum screen (MSS) results has been well documented, how this anxiety correlates with the method of results disclosure has not been well defined. This pilot study aimed to determine how abnormal second-trimester MSS results are disclosed, the level of anxiety experienced by women as a result of this disclosure, and the accuracy of their risk perception. Women referred for prenatal genetic counseling were asked to complete a questionnaire including demographics, standardized Spielberger State-Trait Anxiety Inventory, results disclosure information, and perceived risk. Of the 561 questionnaires distributed, 388 (69.2%) women chose to participat... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2898295 Fri, 16 Oct 2009 14:51:31 +0100 2898295 http://www.medworm.com/index.php?rid=2898294&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1239485 Amer J PerinatolDOI: 10.1055/s-0029-1239485ABSTRACTWe sought to determine if gravidas with pregestational diabetes mellitus (DM) are at increased risk for asymptomatic bacteriuria (ASB) compared with nondiabetic gravidas. This is a retrospective case-control study of 150 pregnant patients with pregestational DM and 294 nondiabetic controls. Rates of ASB and any colony count of group B streptococcus (GBS) bacteriuria were reviewed. The incidence of ASB among pregestational diabetics was higher compared with nondiabetic gravidas (18% versus 8.2%, odds ratio [OR] 2.47, 95% confidence interval [CI] 1.37 to 4.45). GBS was the most common organism in diabetic gravidas (26%). There was no difference in incidence of ASB recurrence (OR 1.26, 95% CI 0.37 to 4.36), but antibiotic resistance was highe... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2898294 Fri, 16 Oct 2009 00:52:03 +0100 2898294 http://www.medworm.com/index.php?rid=2885994&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1241736 Amer J PerinatolDOI: 10.1055/s-0029-1241736ABSTRACTWe investigated the association between prepregnancy maternal body mass index (BMI) and preterm delivery (PTD). The study included 44,421 American women presenting for care in Saint Louis, Missouri between 1990 and 2006. Only singleton gestations were included. The authors examined the associations between categories of BMI with PTD <37 and <34 weeks, respectively. A stratified analysis by subtypes of PTD was also performed. The subtypes of PTD evaluated included spontaneous PTD without preterm premature rupture of membranes (PPROM), PPROM, and indicated PTD. Univariate and multivariable analyses were used to estimate the association between maternal BMI categories and PTD <37 weeks, PTD <34 weeks, and subtypes of PTD. Among wo... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2885994 Tue, 13 Oct 2009 15:05:54 +0100 2885994 http://www.medworm.com/index.php?rid=2885993&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1241741 We examined the effect of overnight birth on treatment and outcome (including initial cardiorespiratory stabilization) in newborns with congenital diaphragmatic hernia (CDH). CDH births between May 2005 and May 2008 were abstracted from a national CDH database. Overnight birth was defined as occurring between 8 and 8 . Patient characteristics, treatment, and outcomes were compared between birth time groups, including the subset of infants in whom a prenatal diagnosis of CDH had been made. Of 132 cases evaluated, 106 (80%) survived. Forty-nine babies (37%) were born overnight. Eighty-five infants (64%) with a prenatal diagnosis were evenly distributed between the birth time cohorts. Survival to discharge, surgical management, duration of mechanical ventilation, and length of hospital stay w... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2885993 Tue, 13 Oct 2009 15:05:54 +0100 2885993 http://www.medworm.com/index.php?rid=2885992&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1239491 Amer J PerinatolDOI: 10.1055/s-0029-1239491ABSTRACTProgesterone treatment has proven to be effective in preventing recurrent preterm birth. The use of progesterone varies widely between different obstetric clinics in the Netherlands. The study aimed to identify factors that hamper or facilitate the use of progesterone to create an implementation strategy. A Web-based survey was developed containing questions on sociopolitical factors, organizational factors, knowledge, and attitude. This survey was spread among 212 gynecologists, 203 midwives, and 130 women with a recent preterm birth. Response rates were 46% for gynecologists, 57% for midwives, and 78% for patients. Twenty-five percent of gynecologists were prescribing progesterone, 21% of midwives would recommend progesterone, and 54% of... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2885992 Tue, 13 Oct 2009 15:05:54 +0100 2885992 http://www.medworm.com/index.php?rid=2885991&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1241738 This study provides normative data for AFS using two methods in Hispanic neonates. A modest trend toward less variability with the DIAG method was noted. Male gender and longer duration of labor were associated with larger AFS.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2885991 Tue, 13 Oct 2009 15:05:54 +0100 2885991 http://www.medworm.com/index.php?rid=2885990&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1241734 We examined pregnancy outcomes in women receiving nifedipine tocolysis having recurrent preterm labor (RPTL). Singleton gestations enrolled for outpatient nursing surveillance and prescribed nifedipine tocolysis were identified ( = 4748). Women hospitalized for RPTL at <35 weeks then resuming outpatient surveillance were included ( = 1366). Pregnancy outcomes of women resuming nifedipine ( = 830) were compared with those having an alteration in treatment to continuous subcutaneous terbutaline ( = 536). Overall, 56.7% (2692/4748) experienced RPTL. Half (50.7%) were stabilized and resumed outpatient surveillance with nifedipine or continuous subcutaneous terbutaline. Infants from women resuming nifedipine versus those with alteration of trea... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2885990 Tue, 13 Oct 2009 15:05:54 +0100 2885990 http://www.medworm.com/index.php?rid=2885989&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1241739 This study investigated the effects of Digibind in a rat model of PE. We induced a syndrome in rats, which includes many of the phenotypic characteristics of human PE. Digibind, in escalating doses, was given on days 10 to 20 of pregnancy. Digibind produced significant lowering of the blood pressure and reduced proteinuria in our rat model of PE. However, it also did not avert IUGR. In view of these findings, in our experimental model of human PE, further studies in the quest for effective treatment of PE need to focus on pharmaceuticals that can remedy the syndrome without compromising the fetus.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2885989 Tue, 13 Oct 2009 00:45:27 +0100 2885989 http://www.medworm.com/index.php?rid=2871236&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1239494 Amer J PerinatolDOI: 10.1055/s-0029-1239494ABSTRACTWe sought to construct a predictive model for vaginal birth after cesarean (VBAC) that combines factors that can be ascertained only as the pregnancy progresses with those known at initiation of prenatal care. Using multivariable modeling, we constructed a predictive model for VBAC that included patient factors known at the initial prenatal visit as well as those that only become evident as the pregnancy progresses to the admission for delivery. We analyzed 9616 women. The regression equation for VBAC success included multiple factors that could not be known at the first prenatal visit. The area under the curve for this model was significantly greater ( < 0.001) than that of a model that included only factors available at th... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2871236 Thu, 08 Oct 2009 00:49:33 +0100 2871236 http://www.medworm.com/index.php?rid=2868556&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1239495 This article reviews the various management options in the different patient subpopulations and proposes a scheme for management once a short cervix is identified.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2868556 Wed, 07 Oct 2009 01:03:58 +0100 2868556 http://www.medworm.com/index.php?rid=2865200&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1241740 Amer J PerinatolDOI: 10.1055/s-0029-1241740ABSTRACTWe sought (1) to identify risk factors for meconium aspiration syndrome (MAS) among infants born to women whose labors were complicated by thick-consistency meconium-stained amniotic fluid (MSAF), and (2) to determine whether risk factors and infant prognosis differ according to the time of onset of respiratory distress. We performed a secondary analysis of a multicenter randomized trial of amnioinfusion (AI) for the prevention of MAS among women with thick-consistency MSAF. MAS was defined as onset of respiratory distress requiring oxygen supplementation within the first 4 hours of life. Patients with respiratory symptoms with onset at ≥4 hours were treated as a separate outcome category, “late-onset respiratory distress.&#822... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2865200 Tue, 06 Oct 2009 18:30:07 +0100 2865200 http://www.medworm.com/index.php?rid=2865199&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1239486 We present the neonatal complications of two premature newborn infants whose placentas demonstrated placental thrombosis in the fetal circulation. Both mothers presented with a 3-day history of decreased fetal movements before delivery. The first infant presented with thrombocytopenia and disseminated intravascular coagulation. The second infant had extended bilateral extended hemorrhagic venous infarctions. Severe fetal placental vascular lesions seem to be a predisposing factor for some adverse neonatal outcomes. We present these two cases with a brief review of the literature.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2865199 Tue, 06 Oct 2009 18:30:07 +0100 2865199 http://www.medworm.com/index.php?rid=2865198&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1241733 Amer J PerinatolDOI: 10.1055/s-0029-1241733ABSTRACTWe sought to evaluate the likelihood of recurrent diabetes in women with a prior history of diet-treated (class A) gestational diabetes mellitus (GDM). In a retrospective cohort analysis, nulliparous women diagnosed based upon National Diabetes Data Group criteria with diet-treated GDM who had recurrent diabetes in a subsequent pregnancy were compared with those who did not have recurrent diabetes. The probability of recurrent diabetes was calculated using maternal age at first pregnancy, interpregnancy interval, and body mass index (BMI) during the subsequent pregnancy. Three hundred forty-four nulliparous women with diet-treated GDM had a subsequent delivery in our database. One hundred thirty-seven (40%) had recurrent diabetes. Women wi... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2865198 Tue, 06 Oct 2009 00:40:34 +0100 2865198 http://www.medworm.com/index.php?rid=2836066&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1239493 Amer J PerinatolDOI: 10.1055/s-0029-1239493ABSTRACTThe aim of this study was to assess the accuracy of information provided by medical practitioners to families regarding the efficacy and limitations of prophylaxis with palivizumab for respiratory syncytial virus (RSV) infection in infants. A single-question survey was distributed to medical practitioners who described themselves as having both prescribed palivizumab for infants and discussed the effects of the drug with families. Responses were anonymous and returned immediately after reviewing the survey question. Respondents were requested to choose the answer that most closely resembled their understanding of palivizumab effects on the degree of illness and severity of RSV infection. All surveys distributed were completed and answers a... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2836066 Sun, 27 Sep 2009 18:10:06 +0100 2836066 http://www.medworm.com/index.php?rid=2836065&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1239492 This study sought to determine whether early treatment of premature infants with ibuprofen would result in a reduced incidence of surgical ligation of patent ductus arteriosus. Secondary outcomes included duration of hospitalization, assisted ventilation and supplemental oxygen, mortality rate, persistent patent ductus arteriosus (PDA), hypotension, intraventricular hemorrhage, and intestinal perforation. Outcomes among 105 very low-birth-weight (VLBW) infants managed by clinical use of indomethacin were compared with outcomes of 80 infants treated under a standardized protocol for ibuprofen therapy on the first day of life among infants <25 weeks estimated gestational age (EGA) and among infants of 25 to 28 weeks EGA with respiratory distress syndrome or history of antenatal steroids. ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2836065 Sun, 27 Sep 2009 18:10:06 +0100 2836065 http://www.medworm.com/index.php?rid=2836064&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1239488 In this study, we investigate the association of obesity with birth outcomes in triplets. Triplet births in the state of Missouri from 1989 through 1997 were analyzed. Obesity was defined as maternal prepregnancy body mass index (BMI) ≥30 kg/m. We assessed the association between obesity and the following outcomes: stillbirth, preeclampsia, very preterm, small for gestational age (SGA), and a composite adverse birth outcome. We employed logistic regression with further correction for intracluster correlation to obtain adjusted estimates. A total of 667 triplet gestations were analyzed. As compared with normal-weight mothers, the likelihood of stillbirth and preeclampsia was higher among obese mothers (odds ratio[OR] = 3.70; 95% confidence interval [CI] = 1.37 ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2836064 Sun, 27 Sep 2009 18:10:06 +0100 2836064 http://www.medworm.com/index.php?rid=2836063&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1239489 Amer J PerinatolDOI: 10.1055/s-0029-1239489ABSTRACTPheochromocytoma is an infrequent but well-acknowledged primary cause of malignant hypertension in pregnancy. Although the majority of pheochromocytomas are sporadic, those that present as bilateral or multifocal tumors may be a manifestation of a rare cancer susceptibility syndrome, such as Von Hippel–Lindau (VHL). Gravidae with unrecognized pheochromocytoma are at risk for recurrent paroxysmal hypertensive crises with ensuant maternal and fetal risks. To further illustrate the challenges of management of pheochromocytoma and VHL in pregnancy, we present two illustrative cases. In the first, a multigravida presented with an intrauterine fetal demise and malignant hypertension and a concurrent diagnosis of bilateral pheochromocytomas... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2836063 Sun, 27 Sep 2009 18:10:06 +0100 2836063 http://www.medworm.com/index.php?rid=2836062&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1239487 Amer J PerinatolDOI: 10.1055/s-0029-1239487ABSTRACTVaginal birth after cesarean delivery (VBAC) failure is associated with perinatal morbidity. The ability to predict VBAC failure in subgroups of high-risk women is important. Our objectives were: (1) to estimate if women with pregestational diabetes (PDM) who attempt VBAC are at increased risk of failure, and (2) to identify clinical characteristics of PDM women associated with failure. We performed a retrospective cohort study of women eligible for VBAC, delivered between 1995 and 1999 at 17 hospitals to study maternal history/outcomes and neonatal outcomes ascertained through chart abstraction. Women with gestational diabetes were excluded. Student test was used to compare continuous characteristics. Chi-square/Fisher exact tests were us... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2836062 Sun, 27 Sep 2009 18:10:06 +0100 2836062 http://www.medworm.com/index.php?rid=2836061&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1239490 Amer J PerinatolDOI: 10.1055/s-0029-1239490ABSTRACTWe sought to determine if there is a relationship between prepregnancy underweight status and placental abruption. We utilized the Missouri maternally linked cohort data files covering the period 1989 through 1997. We estimated the association between prepregnancy underweight subtypes and placental abruption using adjusted odds ratios. Subanalyses were performed to determine whether the amount of weight gained during pregnancy could modify the association. A total of 439,235 singleton pregnancies with 3696 abruptions were analyzed. Underweight mothers had a 40% greater likelihood for placental abruption (odds ratio 1.4; 95% confidence interval 1.3 to 1.5). The risk increased with ascending severity of underweight status ( for trend <0.0... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2836061 Sun, 27 Sep 2009 00:31:49 +0100 2836061 http://www.medworm.com/index.php?rid=2781454&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1234032 Amer J PerinatolDOI: 10.1055/s-0029-1234032ABSTRACTWe evaluated serial sonography for the antenatal detection of small-for-gestational-age (SGA) infants in pregnancies with elevated human chorionic gonadotropin (hCG) levels on midtrimester triple-marker screen. A retrospective cohort study was performed at Saddleback Memorial Medical Center where serial ultrasounds from 26 weeks to delivery are generally recommended for patients with hCG levels >2.0 Multiple of the Median (MoM). From 1999 to 2007, 659 subjects were identified for analysis. The incidence of intrauterine growth restriction (IUGR) and SGA were 5.2% and 7.3%, respectively. Antenatal ultrasound identified 31.3% of SGA infants. Compared with estimated fetal weight (EFW) <10th percentile alone, abdominal circumference (AC) ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2781454 Thu, 10 Sep 2009 01:03:21 +0100 2781454 http://www.medworm.com/index.php?rid=2708464&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1236439 Amer J PerinatolDOI: 10.1055/s-0029-1236439ABSTRACTMalignant peripheral nerve sheath tumors in pregnancy are an uncommon finding. This diagnosis in a pregnant patient with neurofibromatosis type 1 poses additional treatment dilemmas. A 28-year-old primigravida with known neurofibromatosis type 1 complained of increasing shortness of breath and cough. Evaluation revealed a large chest mass, biopsy proven to be a malignant schwannoma. This malignant peripheral nerve sheath tumor, discovered at 26 weeks' gestation, grew so rapidly that delivery was necessary at 30 weeks' gestation. Management of pregnant patients with rare, rapidly growing tumors may require early delivery in cases where maternal health is in jeopardy.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Ab... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2708464 Tue, 18 Aug 2009 11:40:58 +0100 2708464 http://www.medworm.com/index.php?rid=2708463&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1236440 The objective of this study was to evaluate patterns of intrauterine growth in fetal gastroschisis. This was a retrospective review of prenatally diagnosed cases of fetal gastroschisis delivered at the University of North Carolina Hospital from January 2000 to January 2007. Fetal growth (biparietal diameter, head circumference, abdominal circumference, femur length, and estimated fetal weight) and amniotic fluid volume were evaluated by gestational age. Gastroschisis was diagnosed in 83 pregnancies; outcomes were available in 71 fetuses. The mean gestational age at diagnosis was 17 weeks and 1 day. The mean gestational age at delivery was 35 weeks and 4 days. Mean birth weight was 2306 g. As early as the second trimester, all morphometric measures demonstrated impaired in utero growth, wit... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2708463 Tue, 18 Aug 2009 06:19:12 +0100 2708463 http://www.medworm.com/index.php?rid=2701905&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1236437 Amer J PerinatolDOI: 10.1055/s-0029-1236437ABSTRACTWe investigated whether the presence of symptoms predicts the timing of subsequent spontaneous preterm birth in a cohort of women with cervical length (CL) <1.5 cm. A retrospective cohort study was conducted that included patients from 23 to 28 weeks' gestation with a CL <1.5 cm on routine ultrasound. Two groups were defined on the basis of presenting symptoms at the time of the ultrasound examination: asymptomatic patients and those with symptoms of preterm labor. The incidence of delivery within 2 weeks was determined for both groups. A total of 88 patients with CL <1.5 cm were identified from an ultrasound database. There were 52 patients with CL <1.5 cm and no symptoms. Of these, 1 (1.9%) delivered within 2 weeks. The remai... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2701905 Sat, 15 Aug 2009 11:30:44 +0100 2701905 http://www.medworm.com/index.php?rid=2701904&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1236438 Amer J PerinatolDOI: 10.1055/s-0029-1236438ABSTRACTThe antioxidant enzyme paraoxonase 1 is a marker of oxidative stress and has been implicated in the pathogenesis of preeclampsia. Our objective was to determine if an association exists between low paraoxonase 1 activity at midgestation and the development of preeclampsia. We conducted a case-control study of 50 women with preeclampsia and 101 women with uncomplicated term deliveries. Maternal serum collected at 15 to 20 weeks was used to measure paraoxonase 1 activity using two substrates: paraoxon and phenylacetate (arylesterase activity). The groups did not differ with respect to maternal demographics. Paraoxonase 1 activity (paraoxon) was significantly higher in women with preeclampsia compared with controls (19.4 ± 9.4 ve... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2701904 Sat, 15 Aug 2009 00:51:28 +0100 2701904 http://www.medworm.com/index.php?rid=2666990&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1234039 Amer J PerinatolDOI: 10.1055/s-0029-1234039ABSTRACTThe purpose of this study was to analyze the association of developmental care education and training and neonatal intensive care unit (NICU) developmental team structure in promoting neonatal nursing perception and beliefs of key characteristics of family-centered care (FCC), developmental care, and kangaroo mother care (KMC). A 24-item Likert scale survey of specific perceptions and beliefs of aspects of FCC, KMC, and developmental care characteristics was conducted with 59 neonatal nurses from three distinct level III NICUs in New York City where nurses had undergone recent reeducation and developmental team configuration. There was no difference in nursing beliefs of technical developmental care approaches to infant care at all three s... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2666990 Tue, 04 Aug 2009 12:24:43 +0100 2666990 http://www.medworm.com/index.php?rid=2666989&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1234034 Amer J PerinatolDOI: 10.1055/s-0029-1234034ABSTRACTAn abnormally decreased placental weight has been linked to increased perinatal complications, including intrauterine fetal demise (IUFD) and fetal growth restriction (IUGR). Despite its promise, determining placental weight prenatally using three-dimensional systems is time-consuming and requires expensive technology and expertise. We propose a novel method using two-dimensional sonography that provides an immediate estimation of placental volume. Placental volume was calculated in 29 third-trimester pregnancies using linear measurements of placental width, height, and thickness to calculate the convex-concave shell volume within 24 hours of birth. Data were analyzed to calculate Spearman's rho (r) and significance. There was a significan... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2666989 Tue, 04 Aug 2009 00:39:01 +0100 2666989 http://www.medworm.com/index.php?rid=2657101&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1234037 Amer J PerinatolDOI: 10.1055/s-0029-1234037ABSTRACTWe sought to determine if there is a relationship between serum concentrations of cytokines and the development of preterm labor. A panel of 28 cytokines was measured using the multiplex assay in serum samples collected between 15 and 18 weeks' gestation from women who developed spontaneous preterm labor and delivered between 24 and 28 weeks' gestation ( = 25) and from women who delivered at term (≥37 weeks;  = 25). Sixteen of the 28 cytokines measured were detected. Except for vascular endothelial growth factor, which showed a trend toward a significant increase in patients who developed preterm labor, there was no difference in cytokine levels between groups in preterm labor and in term labor. Serum cytokine... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2657101 Fri, 31 Jul 2009 12:11:40 +0100 2657101 http://www.medworm.com/index.php?rid=2657100&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1234033 Amer J PerinatolDOI: 10.1055/s-0029-1234033ABSTRACTWe evaluated uterine contraction frequency in women receiving 17 α-hydroxyprogesterone caproate (17-OHP-C) for the prevention of preterm delivery. Women with singleton pregnancies and receiving weekly 17-OHP-C and outpatient tococardiography were identified from a database. The mean and maximum contraction frequencies per hour were compared from 3 days before to 3 days after 17-OHP-C dosing. McNemar χ, Mann-Whitney , and Friedman test statistics were used for analysis. Data were obtained from 388 women. Median contraction frequency was greater for women with subsequent preterm birth versus those delivering at term (1.5 [range 0, 14.5] versus 1.2 [range 0, 21.0] contractions per hour,  < 0.001). No reduction in cont... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2657100 Fri, 31 Jul 2009 12:11:40 +0100 2657100 http://www.medworm.com/index.php?rid=2657099&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1234038 Amer J PerinatolDOI: 10.1055/s-0029-1234038ABSTRACTWe evaluated the clinical usefulness of near-infrared spectroscopic quantitative measurement of placental tissue oxygenation for noninvasive estimation of uteroplacental function in pregnant women. We performed a prospective observational clinical study. Women without complications ( = 15) and women with pregnancy-induced hypertension (PIH;  = 6) were enrolled. Measurements of placental tissue oxygenation index (TOI) using NIRO-300 (Hamamatsu Photonics, Hamamatsu City, Japan) were recorded. The mean TOI in women without complications was 72.36 ± 5.36% and 80.28 ± 2.78% in pregnant women with PIH. The mean TOI in pregnant women with PIH was higher than that of pregnant women without complica... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2657099 Fri, 31 Jul 2009 12:11:40 +0100 2657099 http://www.medworm.com/index.php?rid=2657098&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1234036 Amer J PerinatolDOI: 10.1055/s-0029-1234036ABSTRACTWe compared short-term neonatal outcomes between premature infants with spontaneous preterm birth (s-PTB) and those delivered due to preeclampsia (PEC). Data were collected from women with singleton pregnancies admitted with spontaneous preterm labor (PTL) (2002 to 2005) and PEC (2005 to 2007). Patients delivering 24 to 36/ weeks were analyzed. The incidence of adverse outcomes was compared. Chi-square and Fisher exact tests compared outcomes between neonates of varying gestational ages, and Poisson regression was used to control for confounders. Data describing 368 infants are included (PTL:  = 224; PEC:  = 144). Overall, s-PTB infants had less favorable outcomes at earlier gestational ages, and at later gestationa... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2657098 Fri, 31 Jul 2009 12:11:40 +0100 2657098 http://www.medworm.com/index.php?rid=2657097&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1234030 We report the clinical characteristics and the outcome of two cases of pontocerebellar hypoplasia (PCH) in one family. The objective of this report is to describe the mode of presentation, discuss the clinical course, and address the dilemma of prenatal diagnosis and the prospects for genetic diagnosis for PCH. The first case is a 4-year-old boy in whom the diagnosis was made in the neonatal period. Despite extensive prenatal follow-up during the mother's subsequent pregnancy, prenatal diagnosis could not be made and a second affected child was born. Both siblings have severe developmental delay. The cases raise an important ethical dilemma about the most appropriate intervention if the mother of a child affected with PCH becomes pregnant. PCH is considered to have an autosomal-recessive m... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2657097 Fri, 31 Jul 2009 00:53:57 +0100 2657097 http://www.medworm.com/index.php?rid=2637491&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1234031 Amer J PerinatolDOI: 10.1055/s-0029-1234031ABSTRACTJarcho-Levin syndrome is characterized by short trunk dwarfism associated with rib and vertebral anomalies. The syndrome encompasses a group of disorders with phenotypic and inheritance variations. Here we report a prenatally diagnosed patient with spondylocostal dysostosis (SCD) with accompanying congenital inguinoscrotal hernia. A 28-year-old pregnant women, gravida 4, para 3, was referred to our clinic with a diagnosis of wedging of fetal thoracal vertebra and kyphoscoliosis at 28 weeks of gestation. Upon evaluation, fetal vertebral wedging and kyphoscoliosis were confirmed with the addition of thoracic circumference below 3rd percentile, short thorax length, and mild pyelectasis. During follow-up, in utero inguinoscrotal hernia develop... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2637491 Sat, 25 Jul 2009 00:42:17 +0100 2637491 http://www.medworm.com/index.php?rid=2629476&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1234035 Amer J PerinatolDOI: 10.1055/s-0029-1234035ABSTRACTMalaria may be complicated by development of thrombocytopenia, elevated liver enzymes, and/or hemolysis, which may be difficult to distinguish from HELLP (hemolytic anemia; elevated liver enzymes; low platelet count) syndrome in a pregnant patient. A 33-year-old woman developed a HELLP-like syndrome and persistent fever postpartum without symptoms of preeclampsia. A malaria blood smear was performed and was positive for . The patient was immediately treated with quinine. The follow-up was uneventful with total disappearance of fever and prompt resolution of biochemical signs of HELLP-like syndrome 3 days later. Malaria in a pregnant woman can masquerade as HELLP syndrome. The wide overlap in symptoms (headache, malaise, digestive symptoms)... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2629476 Thu, 23 Jul 2009 00:35:49 +0100 2629476 http://www.medworm.com/index.php?rid=2555569&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224872 Amer J PerinatolDOI: 10.1055/s-0029-1224872ABSTRACTIn addition to its hematopoietic effects, erythropoietin causes an increased release of endothelin-1 and the stimulation of angiogenesis and thereby it may have possible role in development of retinopathy of prematurity (ROP). Our objective was to determine if an association exists between recombinant human erythropoietin (rhEPO) treatment and the development of ROP. Our case-control study involved 85 very low birthweight infants with birthweights <1500 g born during 2003 and 2004. All the infants were divided into two groups on the basis of whether they got rhEPO or not. The rhEPO was given at the dose of 200 to 250 units/kg/dose three times a week for 10 doses. Further duration of rhEPO therapy was decided on the basis of the clinical... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2555569 Tue, 30 Jun 2009 16:34:02 +0100 2555569 http://www.medworm.com/index.php?rid=2555568&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1225529 Amer J PerinatolDOI: 10.1055/s-0029-1225529ABSTRACTWe sought to identify whether schizophrenia during pregnancy is associated with adverse perinatal outcomes. A population-based study comparing women with and without schizophrenia and schizoaffective disorders was performed. Stratified analysis using multiple logistic regression models was performed to control for confounders. During the study period, there were 186,554 deliveries, of which 97 occurred in patients with schizophrenia and schizoaffective disorders. The schizophrenic patients were significantly older (mean age 30.6 versus 28.6,  = 0.001), with higher prevalence of diabetes mellitus as compared with the comparison group (13.4% versus 6.7%,  = 0.009). The need for induction and augmentation of delivery, ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2555568 Tue, 30 Jun 2009 16:34:02 +0100 2555568 http://www.medworm.com/index.php?rid=2555567&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224864 Amer J PerinatolDOI: 10.1055/s-0029-1224864ABSTRACTOur objective was to compare national guidelines regarding shoulder dystocia. Along with the American College of Obstetricians and Gynecologists (ACOG) practice bulletin on shoulder dystocia, guidelines from England, Canada, Australia, and New Zealand were reviewed. The Royal College of Obstetricians and Gynaecologists (RCOG) guideline agrees with the ACOG definition of shoulder dystocia, but there are variances in the management of suspected macrosomia and resolution of impacted shoulders. How recommendations are categorized differ also. Only 53% (20 of 38) of eligible references are cited by both publications. The two national guidelines on shoulder dystocia have differences and disagreements with each other, raising concerns about how t... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2555567 Tue, 30 Jun 2009 16:34:02 +0100 2555567 http://www.medworm.com/index.php?rid=2555566&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1223281 Amer J PerinatolDOI: 10.1055/s-0029-1223281ABSTRACTWe sought to update the value of the 11- to 13-week ultrasound evaluation for prenatal screening of trisomy 21. An English literature search was conducted for pertinent original research articles, review articles, and websites related to the 11- to 13-week ultrasound evaluation. Reports from prenatal diagnostic units published since 1990 that included two- and three-dimensional ultrasound and Doppler hemodynamic evaluations for prenatal screening of trisomy 21 between weeks 10 and 13 of gestation were selected. Alternative screening methods were identified, and clinical information concerning each of them was extracted, integrated into tables, and then synthesized to provide meaningful clinical interpretations. Finally, mechanisms that cou... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2555566 Tue, 30 Jun 2009 00:55:17 +0100 2555566 http://www.medworm.com/index.php?rid=2527122&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224867 Amer J PerinatolDOI: 10.1055/s-0029-1224867ABSTRACTOur objective was to evaluate urinary cytokine excretion after daily cranberry or placebo exposure in pregnant women. Four-hour urine samples were collected from 27 pregnant women subjects who were randomized to cranberry juice cocktail or placebo in three treatment arms: A: Cranberry (C) two times daily (C, C; n = 10 pregnant); B: cranberry in the , then placebo (P) in the (C, P; n = 9 pregnant); and C: placebo two times daily (P, P; n = 8 pregnant). Urinary cytokines were measured using commercially available kits. There was a statistically significant difference in interleukin (IL)-6 of the urinary cytokines between the multiple daily cranberry dosing group (group A [C, C]): median, 3.16 (range, 0.01 ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2527122 Sat, 27 Jun 2009 11:49:53 +0100 2527122 http://www.medworm.com/index.php?rid=2527121&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224866 Amer J PerinatolDOI: 10.1055/s-0029-1224866ABSTRACTExcess weight gain in pregnancy, as defined by the Institute of Medicine (IOM), has been linked to adverse obstetrical outcomes. However, this relationship has not been examined in the younger maternal population. Our aim was to study excess weight gain in our inner-city teenage population. In this retrospective cohort study, we reviewed all nulliparous teenage deliveries between 2000 and 2004. The groups were divided by IOM criteria into “underweight” (body mass index [BMI] <20 kg/m; n = 58), “normal” (BMI, 20 to 26.0 kg/m; n = 255), “overweight” (BMI, 26.1 to 29.0 kg/m; n = 54), and “obese” (BMI > 29.0 kg/m; n = 89). The grou... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2527121 Sat, 27 Jun 2009 00:50:18 +0100 2527121 http://www.medworm.com/index.php?rid=2504458&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1223286 In this study, we attempted to validate the nomogram by improving the quality of the CSF samples obtained. We consecutively randomized 99 infants in whom LP was clinically warranted to receive either a standard, “blind” ( = 48) or “measured” ( = 51) procedure. If allocated to the measured technique, the operator marked the LP needle with a Steri-Strip at the predicted depth of insertion (i.e., MSCD) derived from the weight-based nomogram. CSF samples were classified as clear (<500 red blood cells [rbc]/mL), mildly bloodstained (500 to 10,000 rbc/mL), heavily bloodstained (>10,000 rbc/mL or clotted), or failed procedures. Clear and mildly bloodstained LPs were “successful.” Heavily bloodstained or failed procedures were consi... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2504458 Thu, 25 Jun 2009 08:51:23 +0100 2504458 http://www.medworm.com/index.php?rid=2504457&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1225531 This study was conducted to determine whether community-associated MRSA caused such an outbreak in our NICU and the extent of nasal colonization with MRSA among exposed babies and health care workers. MRSA recovered from infected and colonized babies were genotyped by pulse-field gel electrophoresis (PFGE). Infection control measures were intensified and included nasal screening for MRSA colonization of exposed babies and all new admissions to the NICU within 24 hours of delivery. PFGE type A was recovered from five infected infants and colonized 81% of the exposed infants. The colonization rate during the outbreak was 9.3% and was 1.9% during admission screening. No MRSA infection occurred during 12 months while admission screening was implemented. Hospital-associated MRSA was the dominan... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2504457 Thu, 25 Jun 2009 08:51:23 +0100 2504457 http://www.medworm.com/index.php?rid=2504456&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1225530 We describe the clinical course of our case and review some literature concerning complete hydatidiform mole with coexisting fetus.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2504456 Thu, 25 Jun 2009 08:51:23 +0100 2504456 http://www.medworm.com/index.php?rid=2504455&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1223269 Amer J PerinatolDOI: 10.1055/s-0029-1223269ABSTRACTWe sought to determine if antenatal corticosteroid treatment administered prior to 24 weeks' gestation influences neonatal morbidity and mortality in extremely low-birth-weight infants. A retrospective review was performed of all singleton pregnancies treated with one complete course of antenatal corticosteroids prior to 24 weeks' gestation and delivered between 23/ and 25/ weeks. These infants were compared with similar gestational-age controls. There were no differences in gender, race, birth weight, and gestational age between the groups. Infants exposed to antenatal corticosteroids had lower mortality (29.3% versus 62.9%,  = 0.001) and grade 3 or 4 intraventricular hemorrhage (IVH; 16.7% versus 36%,  < 0.05; ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2504455 Sat, 20 Jun 2009 00:45:44 +0100 2504455 http://www.medworm.com/index.php?rid=2456155&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224868 Amer J PerinatolDOI: 10.1055/s-0029-1224868© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2456155 Sat, 06 Jun 2009 00:57:52 +0100 2456155 http://www.medworm.com/index.php?rid=2456154&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224873 We describe a unique case of TNMG, revealing a myasthenia gravis (MG) associated with systemic lupus erythematosus (SLE) in the mother. J. M., 8 days of age, was admitted for jaundice. Examination revealed poor sucking, facial weakness, and hypotonicity. TNMG was confirmed with a high level of antiacetylcholine receptor antibodies in the infant and his mother. No sign of neonatal lupus was observed. Clinical recovery was obtained. The elder brother had autism. In case of previous maternal MG, a low percentage of infants develop TNMG (10 to 20%), but monitoring is required at birth. Improvement is usually obtained within 3 weeks. No correlation has been found between maternal symptoms, antibodies titer, and signs of TNMG. Most cases of neonatal lupus are associated with positive anti-SSA/SS... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2456154 Sat, 06 Jun 2009 00:57:52 +0100 2456154 http://www.medworm.com/index.php?rid=2456153&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224869 Amer J PerinatolDOI: 10.1055/s-0029-1224869© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2456153 Sat, 06 Jun 2009 00:57:52 +0100 2456153 http://www.medworm.com/index.php?rid=2456152&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224871 Amer J PerinatolDOI: 10.1055/s-0029-1224871ABSTRACTWe compared the efficacy and safety of fluconazole and nystatin oral suspensions for the prevention of systemic fungal infection (SFI) in very low birthweight infants. A prospective, randomized clinical trial was conducted over a 15-month period, from May 1997 through September 1998, in 80 preterm infants with birthweights <1500 g. The infants were randomly assigned to receive oral fluconazole or nystatin, beginning within the first week of life. Prophylaxis was continued until full oral feedings were attained. Blood and urine cultures were obtained at enrollment and then weekly thereafter. Thirty-eight infants were randomly assigned to receive oral fluconazole (group I), and 42 infants were assigned to receive nystatin (group II). Birt... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2456152 Sat, 06 Jun 2009 00:57:52 +0100 2456152 http://www.medworm.com/index.php?rid=2456151&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224863 Amer J PerinatolDOI: 10.1055/s-0029-1224863ABSTRACTOur objective was to determine the incidence of early neonatal problems and the neurodevelopmental status and probable risk factors associated with neurodevelopmental abnormality in preterm infants of ≤32 weeks of gestation. Preterm newborns of ≤32 weeks of gestation followed at the neonatal intensive care unit of the Department of Pediatrics of Gülhane Military Medical Academy, Ankara, Turkey, were evaluated with a complete neurological examination and the Bayley Scales of Infant Development at a mean age of 25.85 ± 11.79 months (range, 10 to 42 months). Multivariate logistic regression analyses were performed to determine the probable risk factors associated with neurodevelopmental abnormalities. Regarding the r... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2456151 Sat, 06 Jun 2009 00:57:52 +0100 2456151 http://www.medworm.com/index.php?rid=2456150&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224874 We present four cases of cesarean scar ectopic pregnancy diagnosed within a 6-month period between 2007 and 2008. Their initial presentations and management are discussed, followed by a review of the published literature summarizing both diagnostic and management recommendations.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2456150 Sat, 06 Jun 2009 00:57:52 +0100 2456150 http://www.medworm.com/index.php?rid=2456149&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224865 Amer J PerinatolDOI: 10.1055/s-0029-1224865ABSTRACTAngiopoietin-2 (Ang-2), synthesized by endothelial cells, is a marker of placental vascular remodeling. Ang-2 is expressed in the first trimester, and levels may therefore correlate to other parameters of placental vascular development. The aim of this study was to evaluate the relationships between Ang-2 and other maternal/placental factors in the first trimester. This was a prospective observational study of women presenting for first-trimester screening at 11 + 0 to 13 + 6 weeks. Consenting women underwent an ultrasound, physical examination, and blood draw. Maternal serum Ang-2 levels were determined using enzyme-linked immunosorbent assay. Results were evaluated with relation to maternal age, parity, race, body... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2456149 Sat, 06 Jun 2009 00:57:52 +0100 2456149 http://www.medworm.com/index.php?rid=2456148&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224870 We present a case of NCS that was initially thought to be amniotic band syndrome, and delayed fasciotomy and debridement were performed once the correct diagnosis was made. We review the literature of this rare and debilitating condition and emphasize the importance of early diagnosis and intervention.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2456148 Sat, 06 Jun 2009 00:42:52 +0100 2456148 http://www.medworm.com/index.php?rid=2439906&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1223270 Amer J PerinatolDOI: 10.1055/s-0029-1223270ABSTRACTThe purpose of this study was to identify maternal and neonatal characteristics affecting marked neonatal neutropenia in pregnancies complicated by hypertension. A single institution retrospective chart review over 2 years of singleton and multifetal pregnancies with hypertensive disorders meeting American College of Obstetricians and Gynecologists criteria was performed. Neutropenia and sepsis occurring within the first 16 days of life (DOL) were studied. Neutropenia was defined as an absolute neutrophil count of <1500/μL and sepsis as any positive blood, cerebrospinal fluid, or urine culture. The study group contained neonates with neutropenia. From all other hypertensive pregnancies, a presumed nonneutropenic control group was r... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2439906 Fri, 29 May 2009 02:34:40 +0100 2439906 http://www.medworm.com/index.php?rid=2439905&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1223284 Amer J PerinatolDOI: 10.1055/s-0029-1223284ABSTRACTWe evaluated if maternal demographic and ultrasound parameters predict perinatal mortality in preterm intrauterine growth restriction (IUGR). Retrospective cohort study of preterm IUGR (delivery gestational age <35 weeks and birth weight <10th percentile for gestation). We excluded twins and fetuses with aneuploidy, intrauterine infection, or major congenital malformations. Information collected included maternal demographic and medical information, estimated fetal weight, oligohydramnios (amniotic fluid index <5), abnormal umbilical artery Dopplers (absent or reverse end-diastolic flow), and abnormal biophysical score (score <6). Our outcome was perinatal mortality, which was defined as in utero death or neonatal death within ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2439905 Fri, 29 May 2009 02:34:40 +0100 2439905 http://www.medworm.com/index.php?rid=2439904&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1223268 Amer J PerinatolDOI: 10.1055/s-0029-1223268ABSTRACTThe factors associated with recurrent small-for-gestational-age birth (R-SGA) have not been previously studied in a multiracial population. This is a retrospective cohort study of 5932 black and white women who had consecutive singleton first and second births in a Midwestern metropolis, from 1995 through 2004, to measure the risk and determine the factors associated with R-SGA. The rates for second-born small-for-gestational-age birth and R-SGA were 10.3% and 4.0%, respectively. Compared with mothers of firstborns who were appropriate for gestational age, mothers of firstborns who were small for gestation age had a higher risk of second-born small-for-gestational-age infants (relative risk [RR] = 3.93; 95% confidence interval ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2439904 Fri, 29 May 2009 00:39:45 +0100 2439904 http://www.medworm.com/index.php?rid=2422832&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1223288 Amer J PerinatolDOI: 10.1055/s-0029-1223288ABSTRACTWe analyzed the effect of off-label fenoldopam (FDM) therapy on electrolyte balance, renal function, blood pressure, and urinary output in neonatal patients. We performed a retrospective review of 22 neonates treated with FDM in two neonatal intensive care units. Primary outcome compared physiological status 24 hours before FDM therapy to the first 24 hours of FDM therapy. Electrolytes, blood urea nitrogen (BUN), creatinine, fluid intake, respiratory support, blood pressure, and heart rate were also compared. FDM was used to treat oliguria and anasarca. Seven infants were supported with extracorporeal membrane oxygenation. Gestation ranged 24 to 39 weeks (median 37) and postnatal age, 1 to 89 days (median 10). FDM dose increased over time ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2422832 Wed, 20 May 2009 05:42:32 +0100 2422832 http://www.medworm.com/index.php?rid=2422831&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1214240 Amer J PerinatolDOI: 10.1055/s-0029-1214240ABSTRACTWe evaluated acute neonatal morbidities in the delivery room associated with primary cesarean performed prior to labor and in the first or second stages of labor. A retrospective cohort study was conducted on subjects undergoing term, primary cesareans at the Women's Pavilion, Miller Children's Hospital in Long Beach, California from 2000 to 2007. Acute neonatal morbidities were tabulated as a function of time during labor when cesarean was performed. Composite neonatal morbidity was defined as the presence of at least one of the following: low 5-minute Apgar score, need for intubation, and/or admission to neonatal intensive care unit. One thousand forty-five subjects delivered by cesarean without labor, 3098 in first stage, and 951 in sec... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2422831 Wed, 20 May 2009 05:42:32 +0100 2422831 http://www.medworm.com/index.php?rid=2422830&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1223282 Amer J PerinatolDOI: 10.1055/s-0029-1223282ABSTRACTGeneralized arterial calcification of infancy (GACI) is a rare genetic disorder consisting of diffuse arterial calcification and intimal proliferation. The disease typically results in progressive arterial stenosis and frequently leads to death from myocardial ischemia by 6 months of life. Affected infants are usually diagnosed before birth or in the neonatal period with symptoms of congestive heart failure. Therapy with bisphosphonate has been used to treat the condition, but with inconsistent results. The disease is associated with mutations in in the majority of the cases. Here we report a unique case of GACI associated with in utero meconium peritonitis and without coding region mutations of the gene. GACI should be considered in the d... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2422830 Wed, 20 May 2009 05:42:32 +0100 2422830 http://www.medworm.com/index.php?rid=2422829&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220792 Amer J PerinatolDOI: 10.1055/s-0029-1220792ABSTRACTChildren who are born small for gestational age (SGA) are at increased risk of adverse neurological outcomes, and there is limited evidence that maternal genitourinary (GU) infections may be associated with SGA. Our objective was to explore the possible relationship between maternal GU infection during pregnancy and SGA. We modeled the association between maternal GU infections and SGA using linked South Carolina Medicaid billing data and birth certificate records for 141,035 women and infants born from 1996 through 2002. Controlling for demographic covariates and maternal medical conditions, GU infection was not significantly associated with SGA (odds ratio = 1.03,  = 0.143). When categorizing GU infections by trim... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2422829 Wed, 20 May 2009 05:42:32 +0100 2422829 http://www.medworm.com/index.php?rid=2422828&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1223267 Amer J PerinatolDOI: 10.1055/s-0029-1223267ABSTRACTTuberous sclerosis (TSC) is an autosomal-dominant disorder that presents with highly variable clinical manifestations including seizures, mental retardation, skin lesions, and hamartomas affecting multiple organ systems such as the heart, brain, eye, and kidney. A 42-year retrospective review of 70 patients consisting of 43 fetuses and 27 neonates with TSC were analyzed. There was a 16% positive family history for the disease. Obvious signs are present in the perinatal period. Cardiac rhabdomyoma(s) detected on routine antenatal sonography, arrhythmias, cerebral lesions, hydrops, and stillbirth are the major presenting findings in the fetus, whereas respiratory distress, arrhythmias, murmurs, and cardiomegaly are the main signs initially i... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2422828 Wed, 20 May 2009 05:42:32 +0100 2422828 http://www.medworm.com/index.php?rid=2422827&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1223287 Amer J PerinatolDOI: 10.1055/s-0029-1223287ABSTRACTWe sought to describe a case series and literature review of uterine rupture in the absence of a previous cesarean delivery. In addition to four cases in our institution, a search of the literature from 1994 to 2008 identified cases of uterine rupture unrelated to a prior cesarean. Uterine rupture in the absence of a previous cesarean may be associated with remote unrecognized uterine perforation, myomectomy, thermal injury, and obstructed labor. Such ruptures may occur before or after labor onset, at term or preterm, and with or without nonreassuring fetal heart rate patterns. Spontaneous uterine rupture is associated with highly variable and nonspecific maternal complaints and fetal status, requiring a high index of diagnostic suspicion.... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2422827 Wed, 20 May 2009 05:42:32 +0100 2422827 http://www.medworm.com/index.php?rid=2422826&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1223283 Amer J PerinatolDOI: 10.1055/s-0029-1223283ABSTRACTWe assessed the effect of antihypertensive therapy guided by impedance cardiography on maternal and fetal outcomes in pregnancies at risk for hypertensive complications. We performed a retrospective review of the outcomes of 318 singleton pregnancies with chronic hypertension or prior preterm delivery due to preeclampsia whose antihypertensive therapy was guided by impedance cardiography. Hemodynamic subsets were compared using analysis of variance. Impedance cardiography was used to evaluate cardiac output and total peripheral resistance starting at less than 24 weeks. All patients received atenolol; 24% required additional therapy with a vasodilator. The mean gestational age at delivery was 37 ± 2 weeks. Preeclampsia develop... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2422826 Wed, 20 May 2009 05:42:32 +0100 2422826 http://www.medworm.com/index.php?rid=2422825&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1223285 Amer J PerinatolDOI: 10.1055/s-0029-1223285ABSTRACTWe evaluated the leukocyte differentials in women with normal pregnancies and in pregnancies complicated by preeclampsia (PE). A retrospective study was performed in 240 women who were delivered at Louisiana State University Health Sciences Center–Shreveport, Louisiana, from January 1, 2002, to July 31, 2003. A total of 80 patients were studied in each group: normal pregnancy, mild PE, or severe PE. Leukocyte total and neutrophil, lymphocyte, monocyte, eosinophil, basophil, hemoglobin, and platelet counts were analyzed by analysis of variance and pairwise comparison. Data are presented as mean ± standard deviation. A value <0.05 was set as statistically different. The total leukocyte count was significantly increased ... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2422825 Wed, 20 May 2009 05:42:32 +0100 2422825 http://www.medworm.com/index.php?rid=2422824&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1214239 We present the case of a male term neonate with shock, metabolic acidosis, distended abdomen, and falling hematocrit. His prenatal and delivery histories were uneventful except for a nuchal cord. Apgar scores were 9 and 9. Because of his dramatic presentation, certain members of the medical team suggested immediate surgical intervention. However, a calm and careful evaluation revealed the true diagnosis and course of action. Ultrasound of the abdomen showed a mass between the liver and kidney, but the origin was difficult to identify. A computed tomography scan supported the diagnosis of right adrenal hemorrhage. His serum cortisol level was normal. The patient was managed conservatively and discharged home after a 1-week stay in the hospital. Subsequent abdominal ultrasound showed resolvi... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2422824 Tue, 19 May 2009 01:09:51 +0100 2422824 http://www.medworm.com/index.php?rid=2413468&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1223289 Amer J PerinatolDOI: 10.1055/s-0029-1223289ABSTRACTA primigravida with eclampsia and hemolytic anemia, elevated liver enzymes, and low platelet count (HELLP syndrome) developed intra-abdominal compartment syndrome requiring a decompressive laparotomy, underlining the importance of including abdominal compartment syndrome in the differential diagnosis in pregnant women.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2413468 Sat, 16 May 2009 05:01:18 +0100 2413468 http://www.medworm.com/index.php?rid=2413467&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220779 We describe an infant with CDH who, after developing recurrent upper-lobe atelectasis, was found to have a right tracheal bronchus. This clinically significant anomaly can have important and potentially preventable adverse consequences.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2413467 Fri, 15 May 2009 00:40:03 +0100 2413467 http://www.medworm.com/index.php?rid=2380160&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220781 We report the case of a 39-year-old woman who had been taking warfarin for 23 years since undergoing mitral valve replacement. Thereafter, when she was found to be pregnant, the medication was switched to heparin from 6 to 21 weeks of gestation. Following this, she was prescribed oral warfarin again (3.5 mg per day), with a strict control of prothrombin time/international normalized ratio (PT/INR). At 23 weeks of gestation, fetal intracranial hemorrhage occurred because of maternal exposure to warfarin. Maternal PT/INR does not correlate well with the activity of warfarin in the fetus and currently, there is no direct way to prevent fetal intracranial hemorrhage. Hence, further research on the optimal coagulation therapy in pregnant women with valve replacement should be encouraged.[...]©... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2380160 Thu, 30 Apr 2009 19:47:56 +0100 2380160 http://www.medworm.com/index.php?rid=2380159&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220790 Conclusion: Daily administration of oral misoprostol over 3 days to women with prolonged pregnancies shortened time intervals from dosing to entry into active labor and delivery compared with placebo.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2380159 Thu, 30 Apr 2009 00:42:21 +0100 2380159 http://www.medworm.com/index.php?rid=2374717&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220778 We describe herein the case of a 3-day-old male neonate with umbilical arteriovenous malformation showing umbilical hemorrhage. The patient was born after 38 weeks and 3 days of gestation with a birth weight of 2784 g. Sudden massive umbilical hemorrhage occurred on day 3. Cardiopulmonary arrest developed, but the patient was successfully rescued by immediate cardiopulmonary resuscitation. An umbilical venous catheter was inserted for blood access. However, umbilical hemorrhage continued and hemostasis was difficult. Congenital bleeding disorders were excluded based on laboratory findings. Ultrasonography on day 15 revealed a mass with rich blood supply directly under the umbilicus. Umbilical arteriovenous malformation was suspected from abdominal contrast-enhanced computed tomography on d... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2374717 Wed, 29 Apr 2009 15:51:10 +0100 2374717 http://www.medworm.com/index.php?rid=2374716&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1214246 Amer J PerinatolDOI: 10.1055/s-0029-1214246ABSTRACTWe sought to determine if there has been any change in the proportion of mothers with preeclampsia in a sample of very low-birth-weight (VLBW) infants over time. We performed a retrospective cohort study. Study sample included infants with birth weights 1500 g or less cared for from July 1994 to July 2006 ( = 2045) from a single level 3 neonatal intensive care unit in Delaware. The main outcome examined was the occurrence of maternal preeclampsia over the study time. The proportion of mothers with preeclampsia delivering VLBW infants increased over time. After controlling for potential confounding variables, the odds of maternal preeclampsia were increased (1.3, 95% confidence interval 1.2 to 1.5) in infants born between 2003 a... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2374716 Wed, 29 Apr 2009 15:51:10 +0100 2374716 http://www.medworm.com/index.php?rid=2374715&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220780 Amer J PerinatolDOI: 10.1055/s-0029-1220780ABSTRACTWe compared two dose regimens of tocolytic oral nifedipine. Women with singleton pregnancies admitted in preterm labor (24 to 34 weeks) were randomized to high-dose (HD) nifedipine ( = 49; 20 mg loading dose, repeated in 30 minutes, daily 120 to 160 mg slow-release nifedipine for 48 hours followed by 80 to 120 mg daily until 36 weeks) or low-dose (LD) nifedipine ( = 53; 10 mg, up to four doses every 15 minutes, daily 60 to 80 mg slow-release nifedipine for 48 hours followed by 60 mg daily until 36 weeks). Uterine quiescence at 48 hours (primary outcome); delivery at 48 hours, 34 and 37 weeks; and recurrent preterm labor were similar. Gestational age at delivery was higher in HD (36.0 ± 2.8 versus 34.7&#... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2374715 Wed, 29 Apr 2009 15:51:10 +0100 2374715 http://www.medworm.com/index.php?rid=2374714&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220774 Amer J PerinatolDOI: 10.1055/s-0029-1220774ABSTRACTDespite widespread use of fetal heart rate monitoring, the timing of injury in hypoxic-ischemic encephalopathy (HIE) remains unclear. Our aim was to examine fetal heart rate patterns during labor in infants with clinical and electroencephalographic (EEG) evidence of HIE and to relate these findings to neurodevelopmental outcome. Timing of onset of pathological cardiotocographs (CTGs) was determined in each case by two blinded reviewers and related to EEG grade at birth and neurological outcome at 24 months. CTGs were available in 35 infants with HIE (17 mild, 12 moderate, 6 severe on EEG). Admission CTGs were normal in 24/35 (69%), suspicious in 8/35 (23%), and pathological in 3/35 (8%). All CTGs developed nonreassuring features prior to d... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2374714 Wed, 29 Apr 2009 15:51:10 +0100 2374714 http://www.medworm.com/index.php?rid=2374713&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1214248 Amer J PerinatolDOI: 10.1055/s-0029-1214248ABSTRACTWe sought to identify risk factors of prenatal presentation of holoprosencephaly associated with triploidy. A case report is presented with review of the literature performed using the PubMed database. The latest search was done in June 2008. Literature review showed 11 reports with a total of 15 cases of holoprosencephaly associated with triploidy. The mean maternal age at diagnosis was 27 ± 4.9 years, and the mean gestational age at diagnosis was 13.6 ± 3.3 weeks. Triploidy was mainly associated with the alobar type of holoprosencephaly. Only 3 (20%) cases had associated placental abnormalities. In all cases, the pregnancy was terminated. The latest gestational age at which termination was performed was 23 weeks... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2374713 Wed, 29 Apr 2009 15:51:10 +0100 2374713 http://www.medworm.com/index.php?rid=2374712&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220791 Amer J PerinatolDOI: 10.1055/s-0029-1220791ABSTRACTPrimary appendiceal carcinoma is extremely rare and is found in approximately 1% of appendectomy specimens. When cancer is present, the most frequent histology is mucinous adenocarcinoma. Neoplasms of the appendix that secrete mucin such as adenocarcinoma may rupture, leading to intraperitoneal seeding of the peritoneum and producing the clinical picture of pseudomyxoma peritonei (PMP). PMP is characterized by mucin-producing neoplastic cells that have seeded the peritoneum from the ruptured viscous and continue to secrete copious amounts of gelatinous material that accumulates in the abdomen producing the characteristic “jelly belly.” A review of the medical literature revealed no cases of PMP diagnosed at time of cesarean sec... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2374712 Tue, 28 Apr 2009 00:48:37 +0100 2374712 http://www.medworm.com/index.php?rid=2367054&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220783 Amer J PerinatolDOI: 10.1055/s-0029-1220783ABSTRACTEven with advance prenatal diagnostic tools, differentiating among specific types of hepatic masses continues to challenge many physicians. Here, we report a neonate with life-threatening hepatic mass, cardiac failure, and disseminated intravascular coagulopathy, which clinically resembled hepatic hemangioma. A hepatic mesenchymal hamartoma was detected by postmortem pathology.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2367054 Sat, 25 Apr 2009 19:42:22 +0100 2367054 http://www.medworm.com/index.php?rid=2367051&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220777 Amer J PerinatolDOI: 10.1055/s-0029-1220777ABSTRACTHermansky-Pudlak syndrome (HPS) is a multisystem, autosomal-recessive disorder characterized by oculocutaneous albinism, platelet storage pool deficiency resulting in prolonged bleeding, and ceroid lipofuscin deposition. Affected individuals may suffer from blindness, pulmonary fibrosis, colitis, and bleeding diathesis. Although it has been reported in various ethnic groups, HPS is most common in individuals from the northwest corner of Puerto Rico, with a carrier incidence of 1 in 21.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2367051 Sat, 25 Apr 2009 19:42:22 +0100 2367051 http://www.medworm.com/index.php?rid=2367049&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220776 Amer J PerinatolDOI: 10.1055/s-0029-1220776ABSTRACTThe purpose of our study was to evaluate perinatal and neonatal outcomes in triplet gestations in relation to placental chorionicity. We hypothesized that triplets containing a monochorionic pair (dichorionic triamniotic) would have increased morbidity compared with triplets without a monochorionic pair (trichorionic triamniotic). We retrospectively analyzed all triplet sets ≥20 weeks delivering at our institutions from January 1995 through April 2007. Data were collected via perinatal and neonatal databases, chart review, and placental pathology. Individuals in dichorionic triamniotic triplet sets ( = 75), when compared with trichorionic triamniotic triplets ( = 309), were more likely to have a lower mean bir... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2367049 Sat, 25 Apr 2009 19:42:22 +0100 2367049 http://www.medworm.com/index.php?rid=2367046&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220782 Amer J PerinatolDOI: 10.1055/s-0029-1220782ABSTRACTWe compared perinatal outcomes in pregnancies in which insulin glargine was used in the management of patients with pregnancies in which standard insulin therapy was used at a single institution. A retrospective analysis of 114 pregnant patients with diabetes (pregestational or gestational) managed at a single center between January 2004 and August 2006 was undertaken. Sixty-five patients managed with insulin glargine were compared with 49 patients managed with neutral protamine Hagedorn (NPH) insulin. Both groups were also treated with short-acting insulin (either regular, lispro, or aspart insulin). Maternal age, parity, prepregnancy weight, body mass index, duration of diabetes, hemoglobin A (at entry and final recorded) and gestational... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2367046 Sat, 25 Apr 2009 19:42:22 +0100 2367046 http://www.medworm.com/index.php?rid=2367043&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220775 Amer J PerinatolDOI: 10.1055/s-0029-1220775ABSTRACTWe systematically reviewed all published cases of zygomycosis, an increasingly important infection with high mortality, in neonates. We searched PubMed and individual references for English publications of single cases or case series of neonatal (0 to 1 month) zygomycosis. Cases were included if they fulfilled prespecified criteria. Fifty-nine cases were published through July 2007. Most of the infants (77%) were premature. The most common sites of zygomycosis were gastrointestinal (54%) and cutaneous (36%) diseases. This pattern differs from sinopulmonary and rhinocerebral patterns of older children. Fifty-six percent of cases were diagnosed by histology only and 44% by histology and culture. spp. were isolated from 18/25 (72%) cases. Thi... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2367043 Sat, 25 Apr 2009 19:42:22 +0100 2367043 http://www.medworm.com/index.php?rid=2367040&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220788 Amer J PerinatolDOI: 10.1055/s-0029-1220788ABSTRACTWe compared lymphocyte subsets and cytokine responses to bacteria among term, preterm infants, and adults. Lymphocyte subset percentages in cord blood (22 preterm, 27 term neonates) and peripheral blood from 21 adults and cytokine/chemokine interleukin (IL)-6, IL-8, IL-10, IL-12, interferon gamma (IFN gamma) responses to , group B Streptococcus (GBS), , and (Lp299v) were assessed by flow cytometry. Preterm compared with term infants had increased CD8 T cells ( = 0.02) and reduced naïve CD4 T cells ( < 0.0001). Memory T and natural killer (NK) T cells were reduced ( < 0.001) in neonates; NK and CD56161 NK cells were increased ( < 0.001). CD56CD8 NK cells were higher in preterm compar... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2367040 Sat, 25 Apr 2009 19:42:22 +0100 2367040 http://www.medworm.com/index.php?rid=2367037&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220794 Amer J PerinatolDOI: 10.1055/s-0029-1220794ABSTRACTWe evaluated triploid pregnancy to determine whether there are clinically important differences between the three karyotypes: 69,XXX, 69,XXY, and 69,XYY. Prospectively maintained cytogenetic databases at five tertiary care centers were retrospectively reviewed over a 10-year period to identify all triploid pregnancies. Targeted ultrasounds were reviewed to identify fetal and placental findings. Sonographic findings were compared by karyotype. There was a total of 549 triploid gestations; preimplantation genetic diagnosis (PGD) detected 413 triploid embryos, and the cytogenetic databases provided 136 clinical pregnancies with triploidy. In triploid embryos with PGD, the frequency of the 69,XYY karyotype was 8.7% (36/413), compared with 0.74... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2367037 Sat, 25 Apr 2009 19:42:22 +0100 2367037 http://www.medworm.com/index.php?rid=2367034&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220787 This study sought to determine if cosmetologists in New York State (NYS) have a higher risk of complications of labor/delivery or congenital malformations and poor neonatal health indicators among their offspring compared with Realtors and the general population. This retrospective cohort study matched licensing records for cosmetologists and realtors to birth records and the NYS Congenital Malformations Registry from 1997 to 2003. A random sample of NYS birth certificates, frequency matched to cosmetologists on year of child's birth, mother's ethnicity, and education, was also formed. Outcomes include malformations of each major organ system, neonatal health indicators, and complications of labor/delivery. Multivariate logistic regression was used to calculate odds ratios (ORs) and 95% co... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2367034 Sat, 25 Apr 2009 19:42:22 +0100 2367034 http://www.medworm.com/index.php?rid=2367031&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220789 We report outcomes of 10 triplet pregnancies treated by fetoscopic laser occlusion of the chorioangiopagous vessels (FLOC). The study period was August 1992 to August 2008. Inclusion criteria were gestational age ≤25 weeks and ultrasound confirmation of monochorionicity in at least one twin set and FFTS. Treatment included FLOC, exit amnioreduction, and cerclage when indicated. Hospital records, placental pathology, neonatal course, and long term follow-up of the mother and infants were reviewed. There were eight triamnionic dichorionic and two triamnionic monochorionic triplets. Mean maternal age was 29.8 years, and five conceived following in vitro fertilization. FFTS stage at treatment was ≥II in all cases, at a mean gestational age 20.9 ± 2.2 weeks. Two patient... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2367031 Sat, 25 Apr 2009 19:42:22 +0100 2367031 http://www.medworm.com/index.php?rid=2367028&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220795 In this report, the cases of two newborn infants with cerebral arteriovenous shunts and heart failure in utero are presented. Different from the malformations of the vein of Galen, which usually generate a progressive and lethal heart failure after birth, our cases show heart failure resolution after birth, together with cerebral vascular shunt disappearance. Therefore, we hypothesized that the opening of arteriovenous shunts was a secondary modification due to the intrauterine heart failure. From our cases, it appears that, despite the dramatic echographic appearance, generalized cerebral venous dilatation can resolve spontaneously without sequelae.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2367028 Sat, 25 Apr 2009 19:42:22 +0100 2367028 http://www.medworm.com/index.php?rid=2367025&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220786 Amer J PerinatolDOI: 10.1055/s-0029-1220786ABSTRACTWe sought to determine the rate and timing of full publication of clinical trials initially presented as abstracts at a national maternal-fetal medicine (MFM) research meeting and identify factors associated with publication status. All abstracts presented over a 3-year period (2000 to 2002) at the Society of MFM Annual Meeting were reviewed. Abstracts reporting outcomes for prospective, interventional research studies with human subjects were included. Multiple electronic databases were searched for evidence of full publication with a minimum of 5-year follow-up. The reporting characteristics of abstracts that were published as full research reports were compared with those not published. During the study period, 2012 abstracts were prese... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2367025 Sat, 25 Apr 2009 19:42:22 +0100 2367025 http://www.medworm.com/index.php?rid=2367021&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1220793 This study indicates that complement activation following resuscitation at birth, as manifested by increased TCC in the CNS, is positively correlated with the combination of the development of subsequent neurological sequelae and death. Further study incorporating larger sample sizes will be required to confirm this association. This step is essential before clinical trials of complement inhibitors can be justified in human neonates who suffer birth asphyxia.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology) American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2367021 Sat, 25 Apr 2009 19:42:22 +0100 2367021 http://www.medworm.com/index.php?rid=2367017&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1214251 Amer J PerinatolDOI: 10.1055/s-0029-1214251ABSTRACTHypertensive disorders in pregnancy constitute one of the most frequent medical complications during gestation. Unfortunately, maternal and perinatal mortality remains significant worldwide in this population. Not infrequently, patients with severe preeclampsia will need parenteral agents to achieve rapid blood pressure control to avoid end-organ damage. During the last decades, new antihypertensive medications have become available for management of hypertensive crisis. One of these agents is the calcium channel blocker nicardipine. Nicardipine has been used extensively in different clinical settings including neurosurgery, cardiothoracic surgery, transplant medicine, and internal medicine patients. Minimal data exist in the literature re... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2367017 Sat, 25 Apr 2009 19:42:22 +0100 2367017 http://www.medworm.com/index.php?rid=2367012&cid=s_36603_69_f&fid=36603&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1214245 Amer J PerinatolDOI: 10.1055/s-0029-1214245ABSTRACTThe purpose of this literature review is to describe the various types of brain tumors that occur in the fetus, their locations, initial findings, pathology, and outcome. Data are presented that show which patients are likely to survive or benefit from treatment compared with those who are unlikely to respond. An analysis is performed on patients with fetal brain tumors that were detected prenatally by imaging studies or discovered directly after birth. The review revealed 154 fetuses presenting with brain tumors. Teratoma was the leading neoplasm. Next was astrocytoma followed by craniopharyngioma, primitive neuroectodermal tumor, choroid plexus papilloma, meningeal tumors, and ependymoma. The most common presenting findings were macrocep... American Journal of Perinatology journals http://www.medworm.com/rss/comments.php?id=2367012 Sat, 25 Apr 2009 00:44:46 +0100 2367012