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The Use of Sildenafil in Persistent Pulmonary Hypertension of the NewbornEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ...
Source: American Journal of Perinatology - October 29, 2009 Category: Perinatology & Neonatology Source Type: journals

Outcomes in Neonates with Gastroschisis in U.S. Children's HospitalsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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),...
Source: American Journal of Perinatology - October 29, 2009 Category: Perinatology & Neonatology Source Type: journals

Perinatal Neurofibromatosis: Two Case Reports and Review of the LiteratureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 tiss...
Source: American Journal of Perinatology - October 29, 2009 Category: Perinatology & Neonatology Source Type: journals

N-Terminal Pro-Brain Natriuretic Peptide as a Biomarker for Hypertensive Disorders of PregnancyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 peptid...
Source: American Journal of Perinatology - October 25, 2009 Category: Perinatology & Neonatology Source Type: journals

Comparison of Electromyographic Recordings during Labor in Women with an Anterior or Posterior PlacentaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ...
Source: American Journal of Perinatology - October 25, 2009 Category: Perinatology & Neonatology Source Type: journals

Perinatal Outcomes in Isolated Single Umbilical ArteryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 s...
Source: American Journal of Perinatology - October 25, 2009 Category: Perinatology & Neonatology Source Type: journals

Predicting VBAC Success: From Theory to Clinical PracticeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: American Journal of Perinatology - October 20, 2009 Category: Perinatology & Neonatology Tags: EDITORIAL Source Type: journals

Maternal Serum Screening: Results Disclosure, Anxiety, and Risk PerceptionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 S...
Source: American Journal of Perinatology - October 16, 2009 Category: Perinatology & Neonatology Source Type: journals

Asymptomatic Bacteriuria in Pregestational Diabetic Pregnancies and the Role of Group B StreptococcusEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 m...
Source: American Journal of Perinatology - October 16, 2009 Category: Perinatology & Neonatology Source Type: journals

The Association between Prepregnancy Maternal Body Mass Index and Preterm DeliveryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. Univari...
Source: American Journal of Perinatology - October 13, 2009 Category: Perinatology & Neonatology Source Type: journals

Does Overnight Birth Influence Treatment or Outcome in Congenital Diaphragmatic Hernia?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 diagn...
Source: American Journal of Perinatology - October 13, 2009 Category: Perinatology & Neonatology Source Type: journals

Use of Progesterone Treatment for the Prevention of Recurrent Preterm Birth: Identification of Obstacles to ChangeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 gynecolog...
Source: American Journal of Perinatology - October 13, 2009 Category: Perinatology & Neonatology Source Type: journals

Anterior Fontanel Size in Term and Late Preterm Hispanic Neonates: Description of Normative Values and an Alternative Measurement MethodEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: American Journal of Perinatology - October 13, 2009 Category: Perinatology & Neonatology Source Type: journals

An Examination of the Clinical Benefits and Cost-Effectiveness of Tocolytic Replacement Following Recurrent Preterm LaborEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 stabiliz...
Source: American Journal of Perinatology - October 13, 2009 Category: Perinatology & Neonatology Source Type: journals

The Treatment of Preeclampsia in a Rat Model Employing Digibind®Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 Pub...
Source: American Journal of Perinatology - October 13, 2009 Category: Perinatology & Neonatology Source Type: journals

Does Information Available at Admission for Delivery Improve Prediction of Vaginal Birth after Cesarean?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 p...
Source: American Journal of Perinatology - October 8, 2009 Category: Perinatology & Neonatology Source Type: journals

A Short Cervical Length in Pregnancy: Management OptionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: American Journal of Perinatology - October 7, 2009 Category: Perinatology & Neonatology Source Type: journals

Risk Factors for Early and Late Onset of Respiratory Symptoms in Babies Born through MeconiumEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ...
Source: American Journal of Perinatology - October 6, 2009 Category: Perinatology & Neonatology Source Type: journals

Fetal Placental Thrombosis and Neonatal ImplicationsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 connect...
Source: American Journal of Perinatology - October 6, 2009 Category: Perinatology & Neonatology Source Type: journals

Prediction of Diabetes Recurrence in Women with Class A1 (Diet-Treated) Gestational DiabetesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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. T...
Source: American Journal of Perinatology - October 6, 2009 Category: Perinatology & Neonatology Source Type: journals

Respiratory Syncytial Virus Infection and Palivizumab: Are Families Receiving Accurate Information?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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...
Source: American Journal of Perinatology - September 27, 2009 Category: Perinatology & Neonatology Source Type: journals

The Impact of an Early Ibuprofen Treatment Protocol on the Incidence of Surgical Ligation of the Ductus ArteriosusEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 lif...
Source: American Journal of Perinatology - September 27, 2009 Category: Perinatology & Neonatology Source Type: journals

The Association of Prepregnancy Body Mass Index with Pregnancy Outcomes in Triplet GestationsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ...
Source: American Journal of Perinatology - September 27, 2009 Category: Perinatology & Neonatology Source Type: journals

Pheochromocytoma and Von Hippel–Lindau in PregnancyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 illustr...
Source: American Journal of Perinatology - September 27, 2009 Category: Perinatology & Neonatology Source Type: journals

Pregestational Diabetes: A Risk Factor for Vaginal Birth after Cesarean Section Failure?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 th...
Source: American Journal of Perinatology - September 27, 2009 Category: Perinatology & Neonatology Source Type: journals

Increased Risk of Placental Abruption in Underweight WomenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 lik...
Source: American Journal of Perinatology - September 27, 2009 Category: Perinatology & Neonatology Source Type: journals

The Use of Ultrasound to Detect Small-for-Gestational-Age Infants in Patients with Elevated Human Chorionic Gonadotropin on Maternal Serum ScreeningEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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...
Source: American Journal of Perinatology - September 10, 2009 Category: Perinatology & Neonatology Source Type: journals

Malignant Schwannoma in Pregnancy: A Case Report and Literature ReviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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, r...
Source: American Journal of Perinatology - August 18, 2009 Category: Perinatology & Neonatology Source Type: journals

Intrauterine Growth Patterns in Fetal GastroschisisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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...
Source: American Journal of Perinatology - August 18, 2009 Category: Perinatology & Neonatology Source Type: journals

The Patient with Asymptomatic Shortened Cervix at 23 to 28 Weeks: Is Delivery Imminent?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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...
Source: American Journal of Perinatology - August 15, 2009 Category: Perinatology & Neonatology Source Type: journals

Association of Midgestational Paraoxonase 1 Activity with Pregnancies Complicated by PreeclampsiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ...
Source: American Journal of Perinatology - August 15, 2009 Category: Perinatology & Neonatology Source Type: journals

Factors That Influence Neonatal Nursing Perceptions of Family-Centered Care and Developmental Care PracticesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 re...
Source: American Journal of Perinatology - August 4, 2009 Category: Perinatology & Neonatology Source Type: journals

Determination of Placental Weight Using Two-dimensional Sonography and Volumetric Mathematic ModelingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 th...
Source: American Journal of Perinatology - August 4, 2009 Category: Perinatology & Neonatology Source Type: journals

Second-Trimester Serum Cytokines in Women Who Develop Spontaneous Preterm Labor at Less than 28 Weeks' Gestation versus Term LaborEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ...
Source: American Journal of Perinatology - July 31, 2009 Category: Perinatology & Neonatology Source Type: journals

Uterine Activity in Women Receiving 17 α-Hydroxyprogesterone Caproate for the Prevention of Preterm Birth: An Observational StudyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 subs...
Source: American Journal of Perinatology - July 31, 2009 Category: Perinatology & Neonatology Source Type: journals

Transabdominal Measurement of Placental Oxygenation by Near-infrared SpectroscopyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ...
Source: American Journal of Perinatology - July 31, 2009 Category: Perinatology & Neonatology Source Type: journals

Do Neonatal Outcomes Differ Depending on the Cause of Preterm Birth? A Comparison between Spontaneous Birth and Iatrogenic Delivery for PreeclampsiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 infant...
Source: American Journal of Perinatology - July 31, 2009 Category: Perinatology & Neonatology Source Type: journals

Two Cases of Pontocerebellar Hypoplasia: Ethical and Prenatal Diagnostic DilemmaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 importa...
Source: American Journal of Perinatology - July 31, 2009 Category: Perinatology & Neonatology Source Type: journals

Prenatal Diagnosis of Jarcho-Levin Syndrome in Combination with Inguinoscrotal HerniaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 confi...
Source: American Journal of Perinatology - July 25, 2009 Category: Perinatology & Neonatology Source Type: journals

Malaria in Pregnant Woman Masquerading as HELLP SyndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 sig...
Source: American Journal of Perinatology - July 23, 2009 Category: Perinatology & Neonatology Source Type: journals

The Effect of Recombinant Human Erythropoietin on the Development of Retinopathy of PrematurityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 no...
Source: American Journal of Perinatology - June 30, 2009 Category: Perinatology & Neonatology Source Type: journals

Pregnancy Outcome of Patients with SchizophreniaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 hig...
Source: American Journal of Perinatology - June 30, 2009 Category: Perinatology & Neonatology Source Type: journals

Shoulder Dystocia: Comparison of the ACOG Practice Bulletin with Another National GuidelineEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 re...
Source: American Journal of Perinatology - June 30, 2009 Category: Perinatology & Neonatology Source Type: journals

Report on the 11- to 13+6-Week Ultrasound Evaluation as a Screening Test for Trisomy 21 in Singleton PregnanciesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 in...
Source: American Journal of Perinatology - June 30, 2009 Category: Perinatology & Neonatology Source Type: journals

Comparison of Urinary Cytokines after Ingestion of Cranberry Juice Cocktail in Pregnant Subjects: A Pilot StudyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 statisti...
Source: American Journal of Perinatology - June 27, 2009 Category: Perinatology & Neonatology Source Type: journals

The Effect of Excess Weight Gain in Teenage PregnanciesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 =...
Source: American Journal of Perinatology - June 27, 2009 Category: Perinatology & Neonatology Source Type: journals

A Randomized Study to Validate a Midspinal Canal Depth Nomogram in NeonatesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 (...
Source: American Journal of Perinatology - June 25, 2009 Category: Perinatology & Neonatology Source Type: journals

Results of Nasal Screening for Methicillin-Resistant Staphylococcus aureus during a Neonatal Intensive Care Unit OutbreakEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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...
Source: American Journal of Perinatology - June 25, 2009 Category: Perinatology & Neonatology Source Type: journals

A Case of Complete Hydatidiform Mole with Coexistent Fetus: Conclusive Diagnosis of Androgenesis of the Molar Placenta by Variation of Paternal Acrocentric Short ArmsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: American Journal of Perinatology - June 25, 2009 Category: Perinatology & Neonatology Source Type: journals

Antenatal Corticosteroids Prior to 24 Weeks' Gestation and Neonatal Outcome of Extremely Low Birth Weight InfantsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 co...
Source: American Journal of Perinatology - June 20, 2009 Category: Perinatology & Neonatology Source Type: journals