المؤلفون: Abuduxike, Gulifeiya, Cali, Sanda, Vaizoğlu, Songül Acar, Aşut, Özen, Çavuş, Mahmut, Olgu, Musa, Çavuş, Simay Naime, Arkut, Meryem, Idehen, Blessing Oluwaseun, Almezghwi, Heyam Abdalla Saleh, Asswayeh, Hana Muftah Ali, Abawu, Janet James, Hossain, Mohammad Jayed, Almawali, Nusaiba AbdulMunaem

المصدر: Maternal & Child Health Journal; Apr2024, Vol. 28 Issue 4, p667-678, 12p

مصطلحات موضوعية: CESAREAN section, RISK assessment, PUBLIC hospitals, DELIVERY (Obstetrics), VAGINA, CYPRIOTS, SCIENTIFIC observation, PREMATURE infants, RETROSPECTIVE studies, DESCRIPTIVE statistics, CHI-squared test, AGE distribution, BIRTH rate, RESEARCH methodology, MEDICAL records, ACQUISITION of data, DATA quality, COMPARATIVE studies, DATA analysis software, TURKISH Cypriots, PREGNANCY complications, CHILDBIRTH, FETAL presentation, PREMATURE labor

مصطلحات جغرافية: ISLANDS of the Mediterranean

مستخلص: Objective: We aimed to understand the utilization of the mode of delivery and related risk factors. Further aimed to apply the Robson classification system to evaluate the data quality and analyze the CS rates in subgroups. Methods: We conducted a retrospective descriptive study by reviewing the medical records of all women who delivered at the State Hospital in 2019. A proforma was developed for extracting data from patient records. All women with six obstetric parameters were categorized into Robson groups to determine the absolute and relative contributions of each group to the overall CS rate. Results: Of 797 deliveries, 401 (50.2%) were CSs. Being older, being Turkish Cypriot, having preterm births, previous CS, multiple fetuses, and having breech or transverse fetal presentations were related to having higher risks of CS. The most common medical indication for CSs (52.3%) was a history of previous CSs. Robson Group 5 contributed the most (50.7%) to the overall CS rate, with the highest absolute contribution of 21.8%. Group 10 and Group 8 were the second and third highest contributors to the overall CS rate, with relative contributions of 25.3% and 9.0%, respectively. Conclusions: Findings revealed the substandard quality of obstetric data and a noticeably high overall CS rate. The top priority should be given to improving the quality of medical records. It underscored the necessity of implementing the Robson classification system as a standard clinical practice to enhance data quality, which helps to effectively evaluate and monitor the CS rates in obstetric populations. Significance: Caesarean section rates are increasing worldwide, and the Robson Classification System is recommended by the WHO to evaluate and monitor the CS rates. This study is the first to use Robson classifications and revealed high CS rates in specific subgroups of the obstetric population. The inadequate, substandard data quality highlighted the areas that urgently needed improvement in clinical practices at the largest state hospital. The study lays the foundation for further nationwide studies and demonstrates the importance of the Robson classification system. Specific recommendations were provided to the hospital management for improving the quality of the obstetric data and monitoring CS rates. [ABSTRACT FROM AUTHOR]

: Copyright of Maternal & Child Health Journal is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Orimoloye, Helen T., He, Di, Li, Tong, Janzen, Carla, Barjaktarevic, Igor, Wang, Xuexia, Hansen, Johnni, Heck, Julia E.

المصدر: PLoS ONE; 1/2/2024, Vol. 19 Issue 1, p1-14, 14p

مصطلحات موضوعية: PREGNANCY complications, TRYPSIN inhibitors, LOW birth weight, CHILDBIRTH, POISSON regression, DELIVERY (Obstetrics), PREMATURE labor

مصطلحات جغرافية: DENMARK

مستخلص: Background: Alpha-1 antitrypsin deficiency (AATD) is related to developing lung and liver disease, but no large-scale studies examine its association with birth outcomes. Objective: We investigated the risk of pregnancy complications and adverse birth outcomes in mothers and children with AATD. Methods: Using a large cohort data of Danish mothers and children with AATD from 1973 to 2013 (n = 2,027,229), with 559 cases (305 mothers and 254 children). We conducted Poisson regression to examine associations between alpha-1 antitrypsin deficiency, adverse birth outcomes, and pregnancy complications in mothers and children. Results: AATD was related to term low birth weight [<2500g; Risk Ratio(RR) = 2.04, 95% confidence interval (CI): 1.50–2.79], lowest quartile of abdominal circumference at birth in children of non-smoking mothers (RR = 1.55, 95% CI: 1.14–2.11), delivery via Cesarean-section (RR = 1.59, 95% CI: 1.05–2.40), preterm birth (RR = 1.54, 95% CI: 1.19–2.00) and preeclampsia (RR = 2.64, 95% CI: 1.76–3.94). Conclusions: This emphasizes the need for mothers with AATD to be monitored closely during pregnancy to reduce the risk of adverse birth outcomes. Routine screening for alpha-1 antitrypsin in pregnancy may be considered among mothers with a pulmonary and liver disease history. [ABSTRACT FROM AUTHOR]

: Copyright of PLoS ONE is the property of Public Library of Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Garti, Isabella^1,2 Isabella.garti@cdu.edu.au, Donkor, Elorm³, Musah, Nafisatu⁴, Appiah, Evans Osei², Gyekye, Sandra², Menlah, Awube^1,2, Akuoko, Cynthia Pomaa^5,6

المصدر: BMC Pregnancy & Childbirth. 5/20/2021, Vol. 21 Issue 1, p1-9. 9p.

مصطلحات موضوعية: *PREMATURE labor, *DELIVERY (Obstetrics), *CHILDBIRTH, *MATERNAL health, *PREGNANCY complications

مستخلص: Background: Preterm delivery is the birth of a baby before 37 weeks of gestation. This global phenomenon is a critical issue of concern especially in developing countries that are resource-constrained when it comes to the management of preterm babies. Complications associated with prematurity contribute significantly to under-five mortality and are linked with feelings of despair, grief, and anxiety among mothers.Methods: This was a qualitative descriptive study in an urban setting in the Greater Accra region of Ghana. Eleven mothers whose babies had been discharged from the neonatal intensive care unit in a major hospital and resided in Accra were interviewed in their homes using a semi-structured interview guide. Data were audiotaped, transcribed verbatim, and analyzed inductively by content analysis.Results: All the mothers had formal education and the mean maternal age was 27.9 years. The majority of the mothers were multiparous. The gestational age at birth ranged from 32 to 34 weeks and the average birth weight of their babies was 1.61 kg. Four major themes emerged which included: Around the clock care; mothers' self-perceptions and attitudes of significant others; mothers' health and wellbeing; and support. Most of the mothers experienced physical exhaustion from the extra demands involved with care, had negative emotions, and unmet social needs.Conclusions: The findings indicate that home management of preterm babies poses multiple stressors and is associated with poor psychological and physical wellbeing among mothers. Hence, the need for extensive education and identification of other social support systems to augment facility-based care for mothers and their preterm babies. [ABSTRACT FROM AUTHOR]

المؤلفون: Martinez-Perez, Oscar¹ Oscarmartinezgine@gmail.com, Prats Rodriguez, Pilar², Muner Hernandez, Marta³, Encinas Pardilla, Maria Begoña¹, Perez Perez, Noelia⁴, Vila Hernandez, Maria Rosa⁵, Villalba Yarza, Ana⁶, Nieto Velasco, Olga⁷, Del Barrio Fernandez, Pablo Guillermo⁸, Forcen Acebal, Laura⁹, Orizales Lago, Carmen Maria¹⁰, Martinez Varea, Alicia¹¹, Muñoz Abellana, Begoña¹², Suarez Arana, Maria¹³, Fuentes Ricoy, Laura¹⁴, Martinez Diago, Clara¹⁵, Janeiro Freire, Maria Jesus¹⁶, Alférez Alvarez-Mallo, Macarena¹⁷, Casanova Pedraz, Cristina¹⁸, Alomar Mateu, Onofre¹⁹

المصدر: BMC Pregnancy & Childbirth. 4/1/2021, Vol. 21 Issue 1, p1-11. 11p.

مصطلحات موضوعية: *COVID-19 pandemic, *PREMATURE labor, *DELIVERY (Obstetrics), *CHILDBIRTH, *PREGNANCY complications

مستخلص: Background: To determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the cause of COVID-19 disease) exposure in pregnancy, compared to non-exposure, is associated with infection-related obstetric morbidity.Methods: We conducted a multicentre prospective study in pregnancy based on a universal antenatal screening program for SARS-CoV-2 infection. Throughout Spain 45 hospitals tested all women at admission on delivery ward using polymerase-chain-reaction (PCR) for COVID-19 since late March 2020. The cohort of positive mothers and the concurrent sample of negative mothers was followed up until 6-weeks post-partum. Multivariable logistic regression analysis, adjusting for known confounding variables, determined the adjusted odds ratio (aOR) with 95% confidence intervals (95% CI) of the association of SARS-CoV-2 infection and obstetric outcomes.Main Outcome Measures: Preterm delivery (primary), premature rupture of membranes and neonatal intensive care unit admissions.Results: Among 1009 screened pregnancies, 246 were SARS-CoV-2 positive. Compared to negative mothers (763 cases), SARS-CoV-2 infection increased the odds of preterm birth (34 vs 51, 13.8% vs 6.7%, aOR 2.12, 95% CI 1.32-3.36, p = 0.002); iatrogenic preterm delivery was more frequent in infected women (4.9% vs 1.3%, p = 0.001), while the occurrence of spontaneous preterm deliveries was statistically similar (6.1% vs 4.7%). An increased risk of premature rupture of membranes at term (39 vs 75, 15.8% vs 9.8%, aOR 1.70, 95% CI 1.11-2.57, p = 0.013) and neonatal intensive care unit admissions (23 vs 18, 9.3% vs 2.4%, aOR 4.62, 95% CI 2.43-8.94, p <  0.001) was also observed in positive mothers.Conclusion: This prospective multicentre study demonstrated that pregnant women infected with SARS-CoV-2 have more infection-related obstetric morbidity. This hypothesis merits evaluation of a causal association in further research. [ABSTRACT FROM AUTHOR]

المؤلفون: Barnea, Eytan R.^1,2 barnea@earlypregnancy.org, Muller, Martin^3,4, Di Simone, Nicoletta^5,6, Inversetti, Annalisa^5,6, Pacagnella, Rodolfo⁷, Borovac-Pinheiro, Anderson⁶, Nicholson, Wanda⁸

المصدر: International Journal of Gynecology & Obstetrics. 2023 Supplement, Vol. 163, p34-39. 6p.

مصطلحات موضوعية: *DELIVERY (Obstetrics), *LABOR (Obstetrics), *PREMATURE labor, *CESAREAN section, *HIGH-risk pregnancy, *MATERNITY nursing

مستخلص: Childbirth is an intense event in which decisions may need to be made in seconds to guarantee the health of both mother and newborn. Despite health systems and care approaches varying widely according to real-life scenarios, availability of facilities, beliefs, resources, staff, and geography, among others, optimal outcomes should be ensured worldwide. Triaging low-risk pregnancies from high-risk pregnancies is the first step to ensure proper allocation of resources. From this need, we developed FIGO's Prep-For-Labor triage methods, a series of 2-minute labor and delivery bundles of care, with special regard given to low-and middle-income countries and rural settings. Around 80% of women, once properly triaged, can pursue vaginal delivery with minimal intervention, while those at risk can either be managed on site or transferred promptly to an advanced care site. FIGO's bundles of care and good practice recommendations for labor and delivery and immediate newborn triage cover four clinical scenarios: (1) preterm labor; (2) induced or spontaneous labor at term; (3) cesarean delivery; and (4) newborn care. From rapid triage of the mother (low vs high risk) to the list of required equipment, description of skilled staff, and coordination of resources, the recommendations for care are introduced across these four areas in this overview article. Implementing the proposed management steps described in each summary can improve maternal and neonatal outcomes. [ABSTRACT FROM AUTHOR]

المؤلفون: Di Tommaso, Mariarosaria¹ (AUTHOR) mariarosaria.ditommaso@unifi.it, Seravalli, Viola¹ (AUTHOR), Arduino, Silvana² (AUTHOR), Bossotti, Carlotta² (AUTHOR), Sisti, Giovanni¹ (AUTHOR), Todros, Tullia² (AUTHOR)

المصدر: Journal of Obstetrics & Gynaecology. Aug2016, Vol. 36 Issue 6, p715-718. 4p.

مصطلحات موضوعية: *PREMATURE labor prevention, *CERVIX uteri, *TWINS, *CHILDBIRTH, *DELIVERY (Obstetrics)

مستخلص: A retrospective study was conducted to evaluate the effect of Arabin cervical pessary in twin pregnancies with cervical length (CL)  <25 mm between 21 and 31 weeks. Forty patients receiving pessary were matched with 40 controls without pessary. They were matched for gestational age (GA) at admission and CL. GA at delivery, delivery before 36, 34 and 32 weeks, latency between detection of short cervix and delivery, and duration of hospital admission were compared between groups. Women with the pessary delivered at higher GA compared to controls (35 vs. 33 weeks, p = 0.02). Cervical pessary significantly reduced the incidence of delivery  <36 and  < 34 weeks (p < 0.05), but not before 32 weeks. Interval between detection of short cervix and delivery was longer in the pessary group and duration of hospital admission was shorter (p = 0.03) compared to women without pessary. [ABSTRACT FROM AUTHOR]

المؤلفون: Berezowsky, Alexandra¹ (AUTHOR), Mazkereth, Ram² (AUTHOR), Ashwal, Eran¹ (AUTHOR), Mazaki-Tovi, Shali¹ (AUTHOR), Schiff, Eyal¹ (AUTHOR), Weisz, Boaz¹ (AUTHOR), Lipitz, Shlomo¹ (AUTHOR), Yinon, Yoav¹ (AUTHOR) yoav.yinon27@gmail.com

المصدر: Journal of Maternal-Fetal & Neonatal Medicine. Apr2016, Vol. 29 Issue 8, p1252-1256. 5p.

مصطلحات موضوعية: *TWINS, *RISK factors in premature labor, *DELIVERY (Obstetrics), *CHILDBIRTH, *DURATION of pregnancy, *GESTATIONAL age, *HOSPITAL admission & discharge, *HYPOTHERMIA, *PREMATURE infants, *NEONATAL jaundice, *LONGITUDINAL method, *MULTIPLE pregnancy, *NEONATAL intensive care, *OXYGEN therapy, *PATIENTS, *PHOTOTHERAPY, *RESPIRATORY distress syndrome, *NEONATAL intensive care units, *RETROSPECTIVE studies

مصطلحات جغرافية: ISRAEL

مستخلص: Objective: To determine the neonatal outcome at late prematurity of uncomplicated monochorionic (MC) twin pregnancies.Methods: A retrospective cohort study of 166 patients with uncomplicated MC diamniotic twins delivered between 34 and 37 weeks of gestation at a single tertiary center. The study population was classified into four groups according to the gestational age at delivery: (1) 34 weeks, (2) 35 weeks, (3) 36 weeks and (4) 37 weeks. Neonatal outcome measures were compared between the groups.Results: Neonatal morbidity was significantly higher at 34 weeks of gestation compared to the other three groups including respiratory distress syndrome, oxygen requirement, hypothermia and hyperbilirubinemia. Moreover, the rate of admission to the special care unit and need for phototherapy were significantly higher in newborns born at 36 weeks compared to 37 weeks of gestation (p = 0.02 and 0.03 respectively). Multiple regression analysis revealed that the risk for adverse neonatal outcome was significantly associated with gestational age at delivery. Of note, there were no fetal or neonatal deaths in our cohort.Conclusions: The risk of neonatal morbidity of uncomplicated MC twins delivered at 34-37 weeks of gestation significantly decreases with advanced gestation. Therefore, under close fetal surveillance, uncomplicated MC twin pregnancies should be delivered at 37 weeks of gestation. [ABSTRACT FROM AUTHOR]

المؤلفون: Papanna, R.¹, Mann, L. K.¹, Baschat, A. A.², Bebbington, M. W.¹, Khalek, N.³, Johnson, A.¹, Snowise, S.¹, Moise, K. J.¹

المصدر: Ultrasound in Obstetrics & Gynecology. Feb2015, Vol. 45 Issue 2, p175-182. 8p.

مصطلحات موضوعية: *PREMATURE labor, *DELIVERY (Obstetrics), *CHILDBIRTH, *OBSTETRICS, *LABOR (Obstetrics), *LASER surgery

مستخلص: ABSTRACT Objectives To determine the risk factors for spontaneous preterm delivery ( PTD) or preterm prelabor rupture of membranes ( PPROM) at < 34 weeks' gestation after fetoscopic laser surgery for twin-twin transfusion syndrome and to identify the optimal threshold for preoperative cervical length ( CL) that indicates a high risk for spontaneous PTD. Methods This was a secondary analysis of data prospectively collected from 449 patients at three fetal centers. CL measurements were obtained by preoperative transvaginal ultrasound, at a gestational age of 16-26 weeks. The risk factors associated with spontaneous PTD before 34 weeks' gestation were determined using multivariable logistic regression analysis. We excluded patients with dual fetal demise and those with maternal or fetal indications for delivery without PPROM ( n = 63). The optimal threshold for cervical length to predict spontaneous PTD before 34 weeks was determined using a receiver-operating characteristics ( ROC) curve and Youden index. Additionally, the CL threshold for spontaneous PTD at 2-week intervals between 24 and 34 weeks was determined. Results Spontaneous PTD before 34 weeks occurred in 206 (53.4%) of the included patients. Only the preoperative CL was significantly associated with spontaneous PTD. The preoperative CL was normally distributed with a mean of 37.6 ± 10.3 mm (range, 5-66 mm). Maternal age and parity were positively associated, and gestational age at procedure and anterior placenta were negatively associated, with CL on multivariable linear regression analysis. The area under the ROC curve for predicting spontaneous PTD with CL measurements was 0.61 ( P = 0.02) and the optimal threshold was 28 mm with a Youden index of 0.19 (sensitivity and specificity of 92% and 27%, respectively). A CL measurement of < 28 mm increased the risk of spontaneous PTD for all gestational age thresholds. Conclusions Spontaneous PTD at < 34 weeks' gestation is associated with a preoperative CL of < 28 mm. Preventive strategies should focus on this high-risk group. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

المؤلفون: Gyamfi-Bannerman, Cynthia^1,2,3 cg2231@cumc.columbia.edu, Ananth, Cande V.^1,2,3

المصدر: Obstetrics & Gynecology. Dec2014, Vol. 124 Issue 6, p1069-1074. 6p.

مصطلحات موضوعية: *PREMATURE labor, *DELIVERY (Obstetrics), *PREGNANCY, *CHILDBIRTH, *GESTATIONAL age, *OBSTETRICAL research

مصطلحات جغرافية: UNITED States

مستخلص: OBJECTIVE: For the first time in decades, the rate of U.S. preterm delivery has declined consistently since 2005. Recent nationwide policies enforcing elective delivery at or beyond 39 weeks of gestation suggest this decrease may be the result of changes in practice patterns; however, this is not known. Thus, we sought to evaluate whether the decline in preterm delivery was the result of a decrease in indicated or spontaneous preterm delivery and to assess this decrease by race and ethnicity. METHODS: This was a population-based retrospective analysis using U.S. vital statistics data restricted to singleton live births from 2005 to 2012. The main outcome measures were overall, indicated, and spontaneous pre-term delivery rates. Preterm deliveries were defined as births from 24 to 36 weeks of gestation. We used an algorithm to designate births as indicated or spontaneous. Gestational age was further grouped into early pre-term (24-31 weeks of gestation), moderate preterm (32-34 weeks of gestation), late preterm (34-36 weeks of gestation), early term (37-38 weeks of gestation), full term (39-40 weeks of gestation), late term (41 weeks of gestation), and postterm (42-44 weeks of gestation). Analyses were based on the best obstetric estimate of gestational age. RESULTS: Of 19,984,436 included births, the spontaneous preterm delivery rate declined by 15.4% between 2005 (5.3%) and 2012 (4.5%), whereas indicated preterm delivery rates declined by 17.2% (3.9 to 3.2%). The largest decline was in the postterm pregnancies (238.5%) followed by early term (219.1%), early preterm (217.1%), moderate preterm (212.4%), and late preterm (215.8%) with concurrent increases in full term (+14.3%) and late term (+18.7%) gestations. The patterns were similar across race groups. CONCLUSION: The noted decline in preterm delivery rates is accompanied by a concurrent decline in both spontaneous and indicated preterm deliveries of almost equal magnitudes. [ABSTRACT FROM AUTHOR]

المؤلفون: Bailey, Beth A.¹ nordstro@etsu.edu, McCook, Judy G.¹, Chaires, Caitlyn¹

المصدر: Southern Medical Journal. Oct2014, Vol. 107 Issue 10, p624-629. 6p.

مصطلحات موضوعية: *PREMATURE labor, *DELIVERY (Obstetrics), *RURAL health, *CHILDBIRTH, NEWBORN infant health

مستخلص: Objectives: Infants delivered at >37 weeks' gestation are considered full term, but research has demonstrated those born at 37 to 38 weeks (early term) have a higher risk for poor birth outcomes than deliveries at 39 to 41 weeks (full term). Despite this, many deliveries occur elective (scheduled, no medical indication) before 39 weeks. This study examined the risks of elective early-term delivery in a disadvantaged, rural sample and compared these results with national findings. Methods: Data were available for 638 rural women, recruited prenatally from three counties in rural southern Appalachia, who delivered electively at >37 weeks. Results: Compared with electively delivered full-term infants, those delivered electively at early term were 7.7 times more likely to be lo birth weight, 4.4 times more likely to have a neonatal intensive care unit admission, and 2.5 times more likely to develop jaundice. Those living furthest from the hospital were most likely to deliver electively at <39 weeks. Although rates of elective deliveries <39 weeks were no higher than national rates, adjusted odds ratios (aOR) of associated admission to a neonatal intensive care unit doubled (aOR 4.4 vs aOR 2.2). Conclusions: Results demonstrate that initiatives targeting earlyterm elective deliveries are needed in rural, disadvantaged regions. [ABSTRACT FROM AUTHOR]