1,397 results match your criteria Shoulder Dystocia


Persistence of Neonatal Brachial Plexus Palsy among Nulliparous Versus Parous Women.

AJP Rep 2019 Jan 4;9(1):1-5. Epub 2019 Jan 4.

Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas.

 Our objective was to compare persistence of neonatal brachial plexus palsy (NBPP) at 1 and 2 years in children of nulliparous versus parous women.  We conducted a retrospective cohort study of children diagnosed with NBPP followed at the University of Michigan, Interdisciplinary Brachial Plexus Program (UM-BPP). Self-reported demographics, delivery history, including birth weight (BW) < versus ≥ 9 lbs, and presence of shoulder dystocia (SD) were recorded. Read More

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http://dx.doi.org/10.1055/s-0038-1677051DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327754PMC
January 2019

Association of Fast Food and Supermarket Density with Neonatal Outcomes of Pregnancies Affected by Gestational Diabetes.

Am J Perinatol 2019 Jan 15. Epub 2019 Jan 15.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern Feinberg School of Medicine, Chicago, Illinois.

Objective:  To measure the association of fast food density (FFD) and supermarket density (SD) with adverse neonatal outcomes in pregnancies with gestational diabetes mellitus (GDM).

Study Design:  This was a retrospective cohort study of women with GDM who delivered at a tertiary care center in a large metropolitan area (1/2010-2/2016). ZIP codes were used to link women with surrounding food environment. Read More

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http://dx.doi.org/10.1055/s-0038-1677478DOI Listing
January 2019

Outcomes of type 1 diabetes mellitus in pregnancy; effect of excessive gestational weight gain and hyperglycaemia on fetal growth.

Diabetes Metab Syndr 2019 Jan - Feb;13(1):84-88. Epub 2018 Aug 28.

Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar.

Aims: To study pregnancy outcomes in patients with type 1 diabetes mellitus (T1DM) and the factors associated with poor outcomes.

Methods: A retrospective study of 110 patients with T2DM who attended our diabetes in pregnancy clinic at the Women's Wellness and Research centre, Doha, between March 2015 and December 2016 and 1419 normoglycaemic controls.

Results: There was no difference in age, weight, and BMI between the two groups. Read More

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http://dx.doi.org/10.1016/j.dsx.2018.08.030DOI Listing
August 2018
1 Read

The impact of extending the second stage of labor to prevent primary cesarean section on maternal and neonatal outcomes.

Am J Obstet Gynecol 2018 Oct 25. Epub 2018 Oct 25.

Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel; Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. Electronic address:

Background: A low rate of primary cesarean delivery is expected to reduce some of the major complications that are associated with a repeat cesarean delivery such as uterine rupture, adhesive placental disorders, hysterectomy and even maternal death. Since 2014, and in alignment with the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, we changed our approach to labor dystocia, defined as abnormal progression of labor, by allowing a longer duration of the second stage of labor.

Objective: To examine the effect of prolonging the second stage of labor on the rate of cesarean delivery, and maternal and neonatal outcomes. Read More

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http://dx.doi.org/10.1016/j.ajog.2018.10.028DOI Listing
October 2018
1 Read

Prolonged second stage of labour increases maternal morbidity but not neonatal morbidity.

Aust N Z J Obstet Gynaecol 2018 Dec 21. Epub 2018 Dec 21.

Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.

Background: Prolonged second stage of labour is known to be associated with higher caesarean section rates. However, the association between prolonged second stage of labour (PSSL) and adverse neonatal outcomes remains contradictory. The aim of this study was to assess the association between prolonged second stage of labour and obstetric and neonatal outcomes. Read More

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http://doi.wiley.com/10.1111/ajo.12935
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http://dx.doi.org/10.1111/ajo.12935DOI Listing
December 2018
10 Reads

Type 2 diabetes mellitus in pregnancy: The impact of maternal weight and early glycaemic control on outcomes.

Eur J Obstet Gynecol Reprod Biol 2018 Dec 13;233:53-57. Epub 2018 Dec 13.

Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar.

Objectives: To study the pregnancy outcomes in women with type 2 diabetes mellitus (T2DM) and to relate these to maternal risk factors.

Methods: We conducted a retrospective study of 419 women with T2DM (index group)- who attended our diabetes in pregnancy clinic at the Hamad Women's Hospital, Doha, between March 2015 and December 2016 -and 1419 normoglycaemic women (control group).

Results: Compared with the controls, T2DM women were older (mean age 34. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S03012115183113
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http://dx.doi.org/10.1016/j.ejogrb.2018.12.008DOI Listing
December 2018
4 Reads

Does prenatal identification of fetal macrosomia change management and outcome?

Arch Gynecol Obstet 2018 Dec 18. Epub 2018 Dec 18.

Department of Obstetrics and Gynecology, Rambam Health Care Campus, Bnai-Zion Medical Center, Haifa, Israel Affiliated to the Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Purpose: To assess whether there is an association between predicted fetal macrosomia and adverse outcomes in macrosomic newborns (> 4000 g), based on a sonographic evaluation up to 2 weeks prior to delivery.

Methods: A retrospective cohort study of 3098 mothers of macrosomic babies who were delivered at our institution (2000-2015). We compared the management and outcomes of women with predicted fetal macrosomia with that of women with unknown fetal macrosomia. Read More

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http://dx.doi.org/10.1007/s00404-018-5003-2DOI Listing
December 2018
1 Read

Shoulder dystocia: incidence, mechanisms, and management strategies.

Int J Womens Health 2018 9;10:723-732. Epub 2018 Nov 9.

Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, Canada,

Shoulder dystocia can lead to death or brain damage for the baby. Traction on the head can damage the brachial plexus. The diagnosis should be made when the mother cannot push the shoulders out with her own efforts with the next contraction after delivery of the head. Read More

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http://dx.doi.org/10.2147/IJWH.S175088DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233701PMC
November 2018
1 Read

Early screening for gestational diabetes mellitus is not associated with improved pregnancy outcomes: an observational study including 9795 women.

Diabetes Metab 2018 Nov 28. Epub 2018 Nov 28.

Paris 13 university, Sorbonne Paris Cité, AP-HP, Jean-Verdier hospital, department of obstetrics and gynecology, Bondy, France.

Aims: In addition to screening for hyperglycaemia during pregnancy after 24 weeks of gestation (WG), the current guidelines also suggest screening in early pregnancy and referring women with early gestational diabetes mellitus (eGDM) or overt diabetes (OD) for immediate care. Our aim was to evaluate this strategy.

Methods: This study evaluated, at our hospital (2012-2016), whether the incidence of a predefined composite outcome (preeclampsia, large-for-gestational-age infant, shoulder dystocia) and secondary outcomes was different when women were screened only after 22WG ('late screening only') or before 22WG and treated for eGDM or OD if present, with repeat screening after 22WG if absent ('early ± late screening'). Read More

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http://dx.doi.org/10.1016/j.diabet.2018.11.006DOI Listing
November 2018
1 Read

Introduction of Posterior Axilla Sling Traction in Simulated Shoulder Dystocia.

AJP Rep 2018 Oct 18;8(4):e247-e250. Epub 2018 Oct 18.

Division of MFM, Department of OB/GYN, Naval Medical Center Portsmouth, Portsmouth, Virginia.

 Aim of this study was to introduce posterior axilla sling traction (PAST) in delivering providers and nursing staff as an adjunct to the management of shoulder dystocia and evaluate comfort in performing the maneuver.  A presimulation questionnaire had given to all participants. A brief training on how to perform PAST was also given. Read More

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http://dx.doi.org/10.1055/s-0038-1675350DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6193804PMC
October 2018
1 Read

Rare case of a newborn baby with left-sided Erb's palsy and a contralateral/right-sided paralysis of the diaphragm.

BMJ Case Rep 2018 Nov 8;2018. Epub 2018 Nov 8.

Department of Pediatrics, Division of Neonatology, Regina General Hospital, Regina, Saskatchewan, Canada.

Brachial plexus birth injury (BPBI) and phrenic nerve injury can sometimes occur concurrently in neonates following difficult deliveries like breech presentation, shoulder dystocia, forceps or vacuum extraction. Phrenic nerve palsy should be suspected in a newborn with respiratory distress and an elevated hemidiaphragm on the imaging studies in presence of the associated risk factors. The right side is affected more often than the left side and most of it is associated with BPBI. Read More

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http://dx.doi.org/10.1136/bcr-2018-225373DOI Listing
November 2018
2 Reads

Severe refractory bilateral shoulder dystocia released with digital hooking (Bourgeois-Siegemundin) manoeuvre.

Authors:
Dubravko Habek

J Obstet Gynaecol 2018 Nov 8. Epub 2018 Nov 8.

a University Department of Obstetrics and Gynecology, Sveti Duh University Hospital, Croatian Catholic University , Zagreb , Croatia.

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http://dx.doi.org/10.1080/01443615.2018.1499077DOI Listing
November 2018

The Association between Solo versus Group Obstetrical Practice Model and Delivery Outcomes.

Am J Perinatol 2018 Nov 5. Epub 2018 Nov 5.

Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.

Objective:  To determine if women under the care of obstetricians in solo practice have different delivery outcomes from women in a group practice.

Study Design:  This is a retrospective cohort of live, term, singleton, vertex (LTSV) deliveries at one hospital from 2011 to 2015. We compared outcomes between women whose obstetrician was in solo practice with women in a group practice model. Read More

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http://dx.doi.org/10.1055/s-0038-1675328DOI Listing
November 2018
2 Reads
1.600 Impact Factor

Can Sonographic Fetal Biometry Predict Adverse Perinatal Outcome?

Ultraschall Med 2018 Nov 5. Epub 2018 Nov 5.

Obstetrics and Gynecology, University Hospital of Erlangen, Germany.

Objective:  To evaluate the association of sonographic fetal biometry (sonographic head circumference (soHC), sonographic abdominal circumference (soAC), estimated fetal weight (EFW)) with mode of delivery and adverse perinatal outcome.

Methods:  Singleton pregnancies with a gestational age ≥ 37 weeks and an ultrasound examination with complete biometric parameters within 7 days before delivery were retrospectively included. The association between soHC, soAC, EFW and fetal (5-min Apgar < 7, pH < 7. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/a-0576-0143
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http://dx.doi.org/10.1055/a-0576-0143DOI Listing
November 2018
7 Reads

Umbilical Cord Blood Gas Analysis, Obstetric Performance and Perinatal Outcome.

Rev Bras Ginecol Obstet 2018 Dec 30;40(12):740-748. Epub 2018 Oct 30.

Department of Obstetrics and Gynecology, Centro Hospitalar Tondela-Viseu, Viseu, Portugal.

Objective:  To analyze if umbilical artery pH (pH) ≤7.00 and umbilical artery blood deficit (BD) ≥12.00 mmol/L are good predictors of adverse neonatal outcomes. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1675187
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http://dx.doi.org/10.1055/s-0038-1675187DOI Listing
December 2018
8 Reads

Impact of prenatal exercise on neonatal and childhood outcomes: a systematic review and meta-analysis.

Br J Sports Med 2018 Nov;52(21):1386-1396

R Samuel McLaughlin Foundation - Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, Children's Health Research Institute, The University of Western Ontario, London, Ontario, Canada.

Objective: We aimed to identify the relationship between maternal prenatal exercise and birth complications, and neonatal and childhood morphometric, metabolic and developmental outcomes.

Design: Systematic review with random-effects meta-analysis and meta-regression.

Data Sources: Online databases were searched up to 6 January 2017. Read More

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http://bjsm.bmj.com/lookup/doi/10.1136/bjsports-2018-099836
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http://dx.doi.org/10.1136/bjsports-2018-099836DOI Listing
November 2018
1 Read

Visual Estimation of Force Applied During Simulated Deliveries Complicated by Shoulder Dystocia.

AJP Rep 2018 Oct 9;8(4):e206-e211. Epub 2018 Oct 9.

Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland.

 Shoulder dystocia occurs when the fetal head delivers, but the shoulder is lodged behind the pubic symphysis. Training for these emergency deliveries is not optimized, and litigation can occur around a shoulder dystocia delivery.  Evaluate the ability of an outside observer to visually estimate the amount of traction applied to the fetal head during simulated deliveries complicated by shoulder dystocia. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1673377
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http://dx.doi.org/10.1055/s-0038-1673377DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6177338PMC
October 2018
2 Reads

Effects of induction of labor prior to post-term in low-risk pregnancies: a systematic review.

JBI Database System Rev Implement Rep 2018 Oct 5. Epub 2018 Oct 5.

Department of Midwifery and Therapeutic Sciences, University College Copenhagen, Copenhagen, Denmark.

Objective: The objective of this review was to identify, assess and synthesize the best available evidence on the effects of induction prior to post-term on the mother and fetus. Maternal and fetal outcomes after routine labor induction in low-risk pregnancies at 41+0 to 41+6 gestational weeks (prior to post-term) were compared to routine labor induction at 42+0 to 42+6 gestational weeks (post-term).

Introduction: Induction of labor when a pregnancy exceeds 14 days past the estimated due date has long been used as an intervention to prevent adverse fetal and maternal outcomes. Read More

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http://dx.doi.org/10.11124/JBISRIR-2017-003587DOI Listing
October 2018
3 Reads

Birthweight thresholds for increased risk for maternal and neonatal morbidity following vaginal delivery: a retrospective study.

Arch Gynecol Obstet 2018 Dec 5;298(6):1123-1129. Epub 2018 Oct 5.

Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Purpose: To determine neonatal birthweight (BW) thresholds for adverse maternal and neonatal outcome following vaginal delivery.

Methods: A retrospective cohort study of all women with singleton pregnancies who underwent vaginal delivery in a university-affiliated tertiary hospital (1996-2015). The association between BW and adverse outcome in neonates with BW ≥ 3500 g (> 90th centile BW at 37 weeks' gestation) with 100 g-increment groups was explored. Read More

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http://link.springer.com/10.1007/s00404-018-4924-0
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http://dx.doi.org/10.1007/s00404-018-4924-0DOI Listing
December 2018
3 Reads

Assessment of Current Epidemiology and Risk Factors Surrounding Brachial Plexus Birth Palsy.

J Hand Surg Am 2018 Sep 25. Epub 2018 Sep 25.

Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH.

Purpose: Brachial plexus birth palsy (BPBP) is common; however, the current incidence is unknown and more than 50% of infants with BPBP have no known risk factors. The purpose of this study was to determine the current incidence of BPBP, assess known risk factors, and evaluate hypotonia as a new risk factor, as well as estimate the length of stay (LOS) and direct costs of children with an associated BPBP injury.

Methods: Data from the 1997 to 2012 Kids' Inpatient Database data sets were evaluated to identify patients with a BPBP injury and various risk factors. Read More

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http://dx.doi.org/10.1016/j.jhsa.2018.07.020DOI Listing
September 2018
8 Reads

Relationship between 50-g glucose challenge test and large for gestational age infants among pregnant women without gestational diabetes.

J Obstet Gynaecol 2018 Sep 27:1-6. Epub 2018 Sep 27.

a Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital , Mahidol University , Bangkok , Thailand.

The study aimed to compare the incidence of large for gestational age (LGA) infants between women with a false positive and normal glucose challenge test (GCT), and to evaluate the factors associated with LGA. A total of 480 pregnant women at risk for gestational diabetes mellitus (GDM); 160 with a false positive GCT and 320 with normal GCT results were included. The incidence of LGA and other pregnancy outcomes were compared between the two groups. Read More

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http://dx.doi.org/10.1080/01443615.2018.1476474DOI Listing
September 2018
2 Reads

Association Between Gestational Weight Gain and Perinatal Outcomes.

Obstet Gynecol 2018 Oct;132(4):875-881

Departments of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, University of Texas Medical Branch, Galveston, Texas, MetroHealth Medical Center-Case Western Reserve University, Cleveland, Ohio, Columbia University, New York, New York, University of Utah Health Sciences Center, Salt Lake City, Utah, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, University of Pittsburgh, Pittsburgh, Pennsylvania, The Ohio State University, Columbus, Ohio, University of Alabama at Birmingham, Birmingham, Alabama, Wayne State University, Detroit, Michigan, Brown University, Providence, Rhode Island, University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, Texas, and Oregon Health & Science University, Portland, Oregon; the George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.

Objective: To evaluate the association between gestational weight gain and maternal and neonatal outcomes in a large, geographically diverse cohort.

Methods: Trained chart abstractors at 25 hospitals obtained maternal and neonatal data for all deliveries on randomly selected days over 3 years (2008-2011). Gestational weight gain was derived using weight at delivery minus prepregnancy or first-trimester weight and categorized as below, within, or above the Institute of Medicine (IOM) guidelines in this retrospective cohort study. Read More

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http://dx.doi.org/10.1097/AOG.0000000000002854DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6153045PMC
October 2018
2 Reads

Ten years of simulation-based shoulder dystocia training- impact on obstetric outcome, clinical management, staff confidence, and the pedagogical practice - a time series study.

BMC Pregnancy Childbirth 2018 Sep 5;18(1):361. Epub 2018 Sep 5.

Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.

Background: To assess the impact of 10 years of simulation-based shoulder dystocia training on clinical outcomes, staff confidence, management, and to scrutinize the characteristics of the pedagogical practice of the simulation training.

Methods: In 2008, a simulation-based team-training program (PROBE) was introduced at a medium sized delivery unit in Linköping, Sweden. Data concerning maternal characteristics, management, and obstetric outcomes was compared between three groups; prePROBE (before PROBE was introduced, 2004-2007), early postPROBE (2008-2011) and late postPROBE (2012-2015). Read More

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http://dx.doi.org/10.1186/s12884-018-2001-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125924PMC
September 2018
7 Reads

Outcomes associated with trial of labor after cesarean in women with one versus two prior cesarean deliveries after a change in clinical practice guidelines in an academic hospital.

J Matern Fetal Neonatal Med 2018 Sep 5:1-121. Epub 2018 Sep 5.

a Department of Obstetrics and Gynecology , Division of Maternal Fetal Medicine , Baylor College of Medicine , Houston , Texas , USA.

Objective: In 2010, the American College of Obstetricians & Gynecologists (ACOG) published a new clinical practice guideline on trial of labor after cesarean (TOLAC) that was considered less restrictive. It allowed for offering TOLAC to women with two prior cesarean deliveries, even without a prior vaginal delivery, and for labor induction. As a result, our hospital, a public tertiary care academic center, updated our TOLAC practice guideline to reflect ACOG's new recommendations. Read More

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https://www.tandfonline.com/doi/full/10.1080/14767058.2018.1
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http://dx.doi.org/10.1080/14767058.2018.1520831DOI Listing
September 2018
7 Reads

Foetal Macrosomia and Foetal-Maternal Outcomes at Birth.

J Pregnancy 2018 8;2018:4790136. Epub 2018 Aug 8.

Department of Obstetrics and Gynecology, Sundsvall County Hospital, Sundsvall 85186, Sweden.

To investigate how macrosomia affects foetal-maternal birth outcomes, we conducted a retrospective cohort study of singleton pregnant women who gave birth at gestational age ≥37+0 weeks. The patients were divided into three groups according to birth weight: "macrosomia" group, ≥4500 g, n=285; "upper-normal" group, 3500-4499 g, n=593; and "normal" group, 2500-3499 g, n=495. Foetal-maternal and delivery outcomes were compared among the three groups after adjustment for confounders. Read More

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http://dx.doi.org/10.1155/2018/4790136DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6106949PMC
August 2018
1 Read

Shoulder dystocia and range of head-body delivery interval (HBDI): The association between prolonged HBDI and neonatal outcomes: Protocol for a systematic review.

Eur J Obstet Gynecol Reprod Biol 2018 Oct 11;229:82-87. Epub 2018 Aug 11.

Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.

Objective: Shoulder dystocia (SD) is an obstetric emergency which if not carefully diagnosed and managed, can contribute to lifelong neonatal morbidities. Despite current guidelines on the definition of SD (impaction of the fetal shoulder behind the maternal symphysis pubis and need for ancillary manoeuvres or head-body delivery interval (HBDI) >60 s) its accurate diagnosis requires clinical expertise as well as overall consideration of feto-maternal condition. Based on the literature available, our study aims to determine (1) the range of HBDI as an indicator of SD and (2) the neonatal complications occurring following prolonged HBDI in normal or SD-complicated births. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S03012115183038
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http://dx.doi.org/10.1016/j.ejogrb.2018.08.016DOI Listing
October 2018
12 Reads

The impact of extremes of maternal age on maternal and neonatal pregnancy outcomes in women with pregestational diabetes mellitus.

J Matern Fetal Neonatal Med 2018 Aug 13:1-5. Epub 2018 Aug 13.

a Department of Obstetrics and Gynecology , Oregon Health & Sciences University , Portland , OR , USA.

Background: . Diabetes mellitus (DM) during pregnancy increases the risk for many complications such as preeclampsia and cesarean section. Teen (age <20) and advanced maternal age (AMA, age ≥35) pregnancies are both at increased risk for maternal and neonatal morbidity and mortality. Read More

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http://dx.doi.org/10.1080/14767058.2018.1494713DOI Listing
August 2018
9 Reads

Impact of different glycaemic treatment targets on pregnancy outcomes in gestational diabetes.

Diabet Med 2018 Aug 13. Epub 2018 Aug 13.

Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia.

Aim: With no current randomized trials, we explored the impact of tight compared with standard treatment targets on pregnancy outcomes in gestational diabetes mellitus (GDM).

Methods: This cohort study of singleton births ≥ 28 weeks' gestation was conducted at two major Australian maternity services (2009-2013). Standardized maternal, neonatal and birth outcomes were examined using routine healthcare data and compared for women with GDM at Service One (n = 2885) and Service Two (n = 1887). Read More

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http://dx.doi.org/10.1111/dme.13799DOI Listing
August 2018
1 Read

Shoulder Dystocia Delivery by Emergency Medicine Residents: A High-fidelity versus a Novel Low-fidelity Simulation Model-A Pilot Study.

AEM Educ Train 2017 Oct 23;1(4):357-362. Epub 2017 Sep 23.

Department of Emergency Medicine Hennepin County Medical Center.

Background: Shoulder dystocia (SD) requires emergent intervention to prevent maternal and fetal harm, and simulation models for training can be expensive. We developed a novel, cheap and easily transportable low-fidelity simulation (LFS) model to compare to a commercially available high-fidelity simulation (HFS) model.

Methods: Emergency medicine residents were randomized to training on the HFS or novel LFS model. Read More

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http://dx.doi.org/10.1002/aet2.10054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6001827PMC
October 2017
1 Read

Metformin for women who are overweight or obese during pregnancy for improving maternal and infant outcomes.

Cochrane Database Syst Rev 2018 Jul 24;7:CD010564. Epub 2018 Jul 24.

School of Paediatrics and Reproductive Health, Discipline of Obstetrics and Gynaecology, The University of Adelaide, Women's and Children's Hospital, 72 King William Road, Adelaide, South Australia, Australia, 5006.

Background: There has been considerable interest in providing antenatal dietary and lifestyle advice for women with obesity or who are overweight during pregnancy, as a strategy to limit gestational weight gain and improve maternal and infant health. However, such antenatal interventions appear to have a modest effect on gestational weight gain and other clinical pregnancy and birth outcomes and additional strategies are required.Metformin is an oral insulin-sensitising medication that acts to decrease blood glucose concentrations. Read More

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http://dx.doi.org/10.1002/14651858.CD010564.pub2DOI Listing
July 2018
9 Reads

Clinical features of a fatal shoulder dystocia: The hypovolemic shock hypothesis.

Med Hypotheses 2018 Sep 6;118:139-141. Epub 2018 Jul 6.

Gynecologic and Obstetric Department, Nuovo Ospedale delle Apuane, Via Enrico Mattei 21, Massa Carrara, Italy.

Shoulder dystocia is a rare but severe obstetric complication associated with an increased risk of brachial plexus palsies, fractures of the clavicle and humerus, hypoxic-ischemic encephalopathy and, rarely, neonatal death. Here we describe a fatal case of shoulder dystocia in a term newborn, although labor was uneventful, fetal heart rate tracing was normal until the delivery of the head and the head-to-body delivery interval (HBDI) occurred within 5 min. Full resuscitation was performed for 35 min without success. Read More

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http://dx.doi.org/10.1016/j.mehy.2018.07.006DOI Listing
September 2018
17 Reads

Large-for-Gestational-Age Neonates in Type 1 Diabetes and Pregnancy: Contribution of Factors Beyond Hyperglycemia.

Diabetes Care 2018 08;41(8):1821-1828

Department of Diabetes, Endocrinology & Metabolism and the Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Royal North Shore Hospital, St Leonards, Sydney, New South Wales, Australia.

Despite significant reductions in serious adverse perinatal outcomes for women with type 1 diabetes in pregnancy, the opposite effect has been observed for fetal overgrowth and associated complications, such as neonatal hypoglycemia, shoulder dystocia, and admission to the neonatal intensive care unit. In addition, infants born large for gestational age (LGA) have an increased lifetime risk of obesity, diabetes, and chronic disease. Although exposure to hyperglycemia plays an important role, women who seemingly achieve adequate glycemic control in pregnancy continue to experience a greater risk of excess fetal growth, leading to LGA neonates and macrosomia. Read More

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http://dx.doi.org/10.2337/dc18-0551DOI Listing
August 2018
1 Read

Fetus delivery time in extraperitoneal versus transperitoneal cesarean section: a randomized trial.

J Matern Fetal Neonatal Med 2018 Aug 13:1-7. Epub 2018 Aug 13.

a Department of Obstetrics and Gynecology , Atatürk University Faculty of Medicine , Erzurum , Turkey.

Objective: We compared the extraperitoneal cesarean section to transperitoneal cesarean on fetal delivery time.

Material And Methods: This randomized study included 210 pregnant women undergoing cesarean section for elective reasons, repeat cesarean (< four), or dystocia. Patients who required an urgent cesarean section, who were at high risk for obstetric or maternal bleeding, who had a uterine or adnexal mass, or who requested tubal ligation were excluded from the study. Read More

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https://www.tandfonline.com/doi/full/10.1080/14767058.2018.1
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http://dx.doi.org/10.1080/14767058.2018.1499718DOI Listing
August 2018
2 Reads

Obstetric emergencies as antecedents to neonatal hypoxic ischemic encephalopathy, does parity matter?

Acta Obstet Gynecol Scand 2018 Nov 2;97(11):1396-1404. Epub 2018 Aug 2.

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Introduction: Our aim was to investigate the risk of moderate to severe hypoxic ischemic encephalopathy (HIE) by obstetric emergencies, with focus on the distribution of obstetric emergencies by parity, taking the history of a previous cesarean into account.

Material And Methods: Population-based cohort study of 692 428 live births at ≥ 36 weeks of gestation in Sweden, 2009-2015. Data were retrieved by linking the Swedish Medical Birth Register with the Swedish Neonatal Quality Register. Read More

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http://dx.doi.org/10.1111/aogs.13423DOI Listing
November 2018
4 Reads

Birth Outcomes of Women Using a Midwife versus Women Using a Physician for Prenatal Care.

J Midwifery Womens Health 2018 Jul 26;63(4):399-409. Epub 2018 Jun 26.

Introduction: Few studies have compared midwife-led and physician-led care in the United States. Our objective was to compare the frequency of birth interventions and maternal and neonatal outcomes between women who received prenatal care from a midwife and those who received care from a physician, among women who were low risk when they initiated prenatal care.

Methods: We performed a retrospective cohort study of women giving birth at a large public hospital who had at least one prenatal visit before 20 weeks' gestation in the years 2012 through 2015. Read More

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http://dx.doi.org/10.1111/jmwh.12750DOI Listing
July 2018
9 Reads

Sonographic Estimated Fetal Weight among Diabetics at ≥ 34 Weeks and Composite Neonatal Morbidity.

AJP Rep 2018 Apr 11;8(2):e121-e127. Epub 2018 Jun 11.

Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas.

 The objective was to assess the composite neonatal morbidity (CNM) among diabetic women with sonographic estimated fetal weight (SEFW) at 10 to 90th versus >90th percentile for gestational age (GA).  The inclusion criteria for this retrospective study were singleton pregnancies at 34 to 41 weeks, complicated by diabetes, and that had SEFW within 4 weeks of delivery. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated. Read More

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http://dx.doi.org/10.1055/s-0038-1660433DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995726PMC
April 2018
4 Reads

Importance of Adopting BMI Classifications Using Public Health Action Points to Delineate Obstetric Risk Factors Resulting in Worsening Obstetric Outcomes Among Asian Population.

J Obstet Gynaecol India 2018 Jun 4;68(3):173-178. Epub 2017 May 4.

5Hospital Sultanah Aminah, Ministry of Health Malaysia, Johor Bahru, Johor Malaysia.

Aims: The aim of this study is to compare obstetric outcomes between overweight and class 1 obesity among pregnant women in their first pregnancy based on WHO's BMI cut-offs and the potential public health action points identified by WHO expert consultations specific for high-risk population such as Asians.

Methods: This is a retrospective cohort review of data obtained from the Malaysian National Obstetrics and Gynaecology Registry between the year 2010 and year 2012. All women in their first pregnancy with a booking BMI in their first trimester were included in this study. Read More

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http://dx.doi.org/10.1007/s13224-017-1000-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5972085PMC
June 2018
4 Reads

Prevention of shoulder dystocia: A randomized controlled trial to evaluate an obstetric maneuver.

Eur J Obstet Gynecol Reprod Biol 2018 Aug 4;227:52-59. Epub 2018 Jun 4.

AP-HP, Beaujon Hospital, Department of Obstetrics and Gynecology, 100 Boulevard du General Leclerc, 92110, Clichy, France; DHU Risks in Pregnancy, 75014, Paris, France; AP-HP, Bichat-Claude Bernard Hospital, Department of Obstetrics and Gynecology, 46 rue Henri-Huchard, 75018, Paris, France; Université Paris VII, Paris Diderot, Sorbonne Paris Cité, 75205, Paris, France.

Objective: Shoulder dystocia is a major obstetric emergency defined as a failure of delivery of the fetal shoulder(s). This study evaluated whether an obstetric maneuver, the push back maneuver performed gently on the fetal head during delivery, could reduce the risk of shoulder dystocia.

Study Design: We performed a multicenter, randomized, single-blind trial to compare the push back maneuver with usual care in parturient women at term. Read More

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http://dx.doi.org/10.1016/j.ejogrb.2018.06.002DOI Listing
August 2018
22 Reads

[Study on weight gain in different stages of pregnancy and pregnancy outcomes].

Zhonghua Yi Xue Za Zhi 2018 May;98(19):1493-1497

Taizhou First People's Hospital, Zhejiang Taizhou 318020, China.

By investigating the relationship of pregestational body mass index(BMI), trimester-specific gestational weight gain (rate) during the first, second, third and total trimesters of pregnancy with adverse pregnant outcomes, to evaluate the effects of different pregestational BMI, trimester-specific gestational weight gain on pregnant outcomes, and to provide evidences for gestational weight control. From April 2015 to January 2016, 964 pregnant women in Zhejiang Taizhou First People's Hospital and Taizhou Huangyan Maternal & Child Care Service Center were enrolled in random for prospective study and were divided into groups according to the Institute of Medicine 2009 guidelines[IOM2009]. (1)They were divided into four groups according to pregestational BMI: low body mass, normal body mass, over body mass and obese group. Read More

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http://dx.doi.org/10.3760/cma.j.issn.0376-2491.2018.19.008DOI Listing
May 2018
8 Reads

Hyperglycaemia in early pregnancy: the Treatment of Booking Gestational diabetes Mellitus (TOBOGM) study. A randomised controlled trial.

Med J Aust 2018 Nov 28;209(9):405-406. Epub 2018 May 28.

Campbelltown Hospital, Sydney, NSW.

Background: Gestational diabetes mellitus (GDM) causes adverse pregnancy outcomes that can be averted by treatment from 24-28 weeks' gestation. Assessing and treating women for overt diabetes in pregnancy (ODIP) at the first antenatal clinic booking is now recommended in international guidelines. As a consequence, women with milder hyperglycaemia are being diagnosed and treated for early GDM, but randomised controlled trial (RCTs) assessing the benefits and harms of such treatment have not been undertaken. Read More

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November 2018
10 Reads

The trends and risk factors to predict adverse outcomes in gestational diabetes mellitus: a 10-year experience from 2006 to 2015 in a single tertiary center.

Obstet Gynecol Sci 2018 May 17;61(3):309-318. Epub 2018 Apr 17.

Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Objective: To investigate the change of maternal characteristics, delivery and neonatal outcomes in gestational diabetes mellitus (GDM) over recent 10 years and to identify the risk factors associated with adverse outcome.

Methods: Consecutive GDM patients (n=947) delivered in our institution were included. Research period was arbitrarily divided into 2 periods (period 1: from 2006 to 2010, period 2: from 2011 to 2015). Read More

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http://dx.doi.org/10.5468/ogs.2018.61.3.309DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5956113PMC
May 2018
8 Reads

Determinants of a good perinatal outcome in 588 pregnancies in women with type 1 diabetes.

Diabetes Metab 2018 May 8. Epub 2018 May 8.

Department of diabetology, DHU AUTHORS, Paris Descartes university, Cochin hospital, Assistance publique-Hôpitaux de Paris, 75014 Paris, France.

Aim: This study assessed pregnancy outcomes in women with type 1 diabetes (T1D) over the last 15 years and identified modifiable factors associated with good perinatal outcomes.

Methods: Pregnancy outcomes were prospectively assessed in this cohort study of 588 singleton pregnancies (441 women) managed by standardized care from 2000 to 2014. A good perinatal outcome was defined as the uncomplicated delivery of a normally formed, non-macrosomic, full-term infant with no neonatal morbidity. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S12623636183008
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http://dx.doi.org/10.1016/j.diabet.2018.04.007DOI Listing
May 2018
1 Read

Discrepancy between pregnancy dating methods affects obstetric and neonatal outcomes: a population-based register cohort study.

Sci Rep 2018 May 2;8(1):6936. Epub 2018 May 2.

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

To assess associations between discrepancy of pregnancy dating methods and adverse pregnancy, delivery, and neonatal outcomes, odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for discrepancy categories among all singleton births from the Medical Birth Register (1995-2010) with estimated date of delivery (EDD) by last menstrual period (LMP) minus EDD by ultrasound (US) -20 to +20 days. Negative/positive discrepancy was a fetus smaller/larger than expected when dated by US (EDD postponed/changed to an earlier date). Large discrepancy was <10 or >90 percentile. Read More

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http://dx.doi.org/10.1038/s41598-018-24894-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932022PMC
May 2018
1 Read

Outcomes of vacuum-assisted vaginal deliveries of mothers with gestational diabetes mellitus.

J Matern Fetal Neonatal Med 2018 May 2:1-5. Epub 2018 May 2.

b Lis Maternity and Women's Hospital , Tel Aviv Sourasky Medical Center , affiliated to the Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.

Objective: To evaluate the outcomes of vacuum-assisted vaginal deliveries (VAD) among neonates of mothers with gestational diabetes mellitus (GDM).

Study Design: Retrospective cohort study of women with singleton gestation ≥37 + 0 weeks of gestation who underwent VAD at a single, tertiary, medical center (2007-2014). Women with GDM and their neonates were compared to women without diabetes and their neonates. Read More

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http://dx.doi.org/10.1080/14767058.2018.1468880DOI Listing
May 2018
2 Reads

Accuracy of immediate antepartum ultrasound estimated fetal weight and its impact on mode of delivery and outcome - a cohort analysis.

BMC Pregnancy Childbirth 2018 May 2;18(1):118. Epub 2018 May 2.

Department of Obstetrics and Gynecology, University of Rostock, Suedring 81, 18059, Rostock, Germany.

Background: The aim of the study was to investigate the accuracy of ultrasound-derived estimated fetal weight (EFW) and to determine its impact on management and outcome of delivery.

Methods: In this single-center cohort analysis, women with a singleton term pregnancy in the beginning stages of labor were included. Women with immediately antepartum EFW (N = 492) were compared to women without ultrasound (N = 515). Read More

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https://bmcpregnancychildbirth.biomedcentral.com/articles/10
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http://dx.doi.org/10.1186/s12884-018-1772-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5930666PMC
May 2018
4 Reads

Should the IADPSG criteria be applied when diagnosing early-onset gestational diabetes?

Diabetes Res Clin Pract 2018 Jun 3;140:154-161. Epub 2018 Apr 3.

Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan. Electronic address:

Aims: To investigate whether the broad interpretation of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria with application to the early pregnancy, which is adopted as the standard in Japan, is appropriate.

Methods: We conducted this investigation by comparing diabetes-related adverse pregnancy outcomes among women treated for gestational diabetes mellitus (GDM) following an early-pregnancy diagnosis (early-onset GDM, n = 528) and those treated for GDM following a mid-pregnancy diagnosis, which is the international standard (Mid-term-onset GDM, n = 147).

Results: Gestational weight gain was significantly lower in the early-onset GDM group (7. Read More

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http://dx.doi.org/10.1016/j.diabres.2018.03.048DOI Listing
June 2018
11 Reads

Postoperative care of symphysiotomy performed for severe shoulder dystocia with fetal demise.

Case Rep Womens Health 2017 Apr 7;14:6-7. Epub 2017 Mar 7.

Texas Tech Health Sciences Center at the Permian Basin, United States.

Background: Shoulder dystocia is an obstetric emergency which occurs in 0.2-3% of all births ACOG Committee on Practice Bulletins-Obstetrics and The American College of Obstetrician and Gynecologists (2002) . Symphysiotomy is a treatment option reserved primarily for developing countries where mortality rates of Cesarean delivery are 1-2% Monjok et al. Read More

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http://dx.doi.org/10.1016/j.crwh.2017.03.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842967PMC

Risk of recurrent shoulder dystocia: are we any closer to prediction?

J Matern Fetal Neonatal Med 2018 Mar 27:1-7. Epub 2018 Mar 27.

a Department of Obstetrics and Gynecology , University of Toronto, Mount Sinai Hospital , Toronto , Canada.

Objective: To determine the incidence and risk factors for recurrent shoulder dystocia in women.

Methods: We searched Medline, Pubmed, Embase, and CINAHL for relevant articles in English and French from 1980 to February 2018 that described risks of recurrent shoulder dystocia undergoing a trial of labour in subsequent pregnancies. A total of 684 articles were found, of which 13 were included as they met criteria. Read More

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http://dx.doi.org/10.1080/14767058.2018.1450382DOI Listing

Sonographic assessment of the anal sphincter after obstetric anal sphincter injury (OASI) using transperineal ultrasound (TPUS).

Ultrasound Obstet Gynecol 2018 Mar 24. Epub 2018 Mar 24.

Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, Jerusalem.

Obstetric anal sphincter injury (OASI) is the most common cause of anal incontinence and ano-rectal symptoms in women . Reported rates of anal incontinence following primary repair of OASI range between 15-61%, with a mean of 39% . Other possible complications of OASI include perineal pain, dyspareunia, and less commonly, abscess formation, wound breakdown, and rectovaginal fistulae. Read More

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http://doi.wiley.com/10.1002/uog.19058
Publisher Site
http://dx.doi.org/10.1002/uog.19058DOI Listing
March 2018
15 Reads

Anencephaly and obstetric outcome beyond the age of viability.

J Perinat Med 2018 Oct;46(8):885-888

Feto-Maternal Medicine Unit, Obstetrics and Gynecology Department, Women's Hospital, Hamad Medical Corporation, Doha, Qatar.

Objective To review the obstetric impact and natural history of anencephalic pregnancies beyond the age of viability. Study design A retrospective chart review of all cases with a prenatal diagnosis of anencephaly who delivered after 24 weeks' gestation during the period 1990 until 2016. Obstetric outcomes including mode of delivery, live births, shoulder dystocia, antepartum haemorrhage (APH), postpartum haemorrhage (PPH) and uterine rupture were studied. Read More

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http://dx.doi.org/10.1515/jpm-2017-0363DOI Listing
October 2018
7 Reads