Bertramweaver0045
The association between the most severe types of placenta accreta spectrum disorders and caesarean scar pregnancy (CSP) poses the question of whether early diagnosis may impact the clinical outcome of these anomalies. The aim of this study is to report the outcome of cesarean scar pregnancy (CSP) diagnosed in the early (≤9 weeks) versus late (>9 weeks) first trimester of pregnancy.
Medline, Embase and Clinicaltrail.gov databases were searched. Studies including cases of CSP with an early (≤9 weeks of gestation) compared to a late (>9 weeks) first trimester diagnosis of CSP, followed by immediate treatment, were included in this systematic review. The primary outcome was a composite measure of severe maternal morbidity including either severe first trimester bleeding, need for blood transfusion, uterine rupture or emergency hysterectomy. The secondary outcomes were the individual components of the primary outcome. Random-effect meta-analyses were used to combine data.
Thirty-six studies (724 women nificantly lower risk of maternal complications, thus supporting a policy of universal screening for these anomalies in women with a prior cesarean delivery although the cost-effectiveness of such policy should be tested in future studies.
Early first trimester diagnosis of CSP is associated with a significantly lower risk of maternal complications, thus supporting a policy of universal screening for these anomalies in women with a prior cesarean delivery although the cost-effectiveness of such policy should be tested in future studies.
A bicornuate uterus results from failure of the Müllerian ducts to completely fuse. If patients with bicornuate uterus are diagnosed with infertility, they can conceive with help from in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Ipatasertib clinical trial With few studies on the reproductive performances of bicornuate uterus following IVF/ICSI treatment, the aim of present study is to investigate whether a bicornuate uterus would affect pregnancy rates and obstetric outcomes of infertile women.
A retrospective cohort study contained 232 women (58 with bicornuate uterus and 174 with normal uterus) was conducted. Patient data for IVF/ICSI treatment and follow-up were collected and analyzed. Cumulative pregnancy rate and cumulative live birth rate after one complete assisted reproductive technology (ART) cycle were the primary outcomes.
Baseline characteristics were comparable between the bicornuate uterus group and the control group. Ovarian response to stimulation and embryological results were similar betweeatment between women with bicornuate uterus and women with normal uterus. Bicornuate uterus had no significant negative effects on cumulative IVF/ICSI outcomes of infertile patients.
There were no significant differences in ovarian responses, pregnancy outcomes, and obstetric outcomes after IVF/ICSI treatment between women with bicornuate uterus and women with normal uterus. Bicornuate uterus had no significant negative effects on cumulative IVF/ICSI outcomes of infertile patients.
The aim of this study was to compare the perinatal outcomes associated with spatulas or forceps assisted delivery.
This is a bicentric retrospective cohort study including all assisted deliveries in cephalic presentation after 37 weeks of gestation, performed on singleton pregnancy with forceps and with spatulas in two tertiary centers. The main outcome was the rate of episiotomy. Secondary outcomes included obstetric anal sphincter injuries (OASIS), maternal outcomes and neonatal parameters.
Out of 37 002 deliveries, the overall rate of assisted delivery was 11.4 %, and 1 041 (2.8 %) assisted deliveries with forceps and 2 462 (6.7 %) spatulas deliveries were included. The rate of episiotomy was 90.3 % after forceps-assisted delivery and 70.9 % for spatulas (p < 0.001). The rate of OASIS was 7.2 % and 5.6 % respectively (p = 0.06). A slight but significant decrease in neonatal trauma after spatulas was observed.
In this retrospective cohort study, the episiotomy rate was higher with forceps assisted deliveries than with spatulas. Both instruments have low neonatal morbidity and are similar regarding OASIS.
In this retrospective cohort study, the episiotomy rate was higher with forceps assisted deliveries than with spatulas. Both instruments have low neonatal morbidity and are similar regarding OASIS.
Recent studies suggest that intrapartum ZigZag pattern of fetal heart rate (FHR) is significantly associated with cord blood acidaemia and neonatal complications. For the clinical significance of this pattern, it is mandatory that ZigZag episodes in cardiotocographic (CTG) recording are correctly identified. The aim of the present study was to examine maternal, fetal and delivery-related factors that could explain the occurrence of ZigZag pattern of FHR during the last 2 h of labour in a large obstetric cohort.
CTG recordings from 5150 singleton childbirths at ≥33 weeks of gestation during one year were evaluated retrospectively and blinded to pregnancy and neonatal outcomes in a university hospital in Helsinki, Finland. All women in the cohort were in the active phase of labour with regular uterine contractions. ZigZag FHR pattern was defined as FHR baseline amplitude changes of >25 bpm with a duration of 2-30 min. The following maternal, fetal and labour/delivery-related variables were determined matlated variables are imperative in order to interpret correctly the findings of CTG and to prevent adverse neonatal outcome.
ZigZag pattern occurred in term pregnancies after 37 weeks of gestation only. Fetal male gender, nulliparity and post-term pregnancy are significantly associated with ZigZag FHR pattern during the last two hours of labour. Identification of maternal, fetal and delivery-related variables are imperative in order to interpret correctly the findings of CTG and to prevent adverse neonatal outcome.A new Ebola outbreak is currently ongoing in the Democratic Republic of Congo, after the most severe outbreak in West Africa in 2014-2016 was controlled. Ebola outbreaks are usually a significant cause of death among pregnant women. The clinical presentation of Ebola Virus infection in pregnancy often mimics common pregnancy related bleeding complications or febrile conditions common in pregnancy. The large amount of body fluids discharged during the management of these conditions make pregnancy a highly risky intervention for nosocomial infection transmission, especially to health workers. In this review, we discuss the Ebola virus, its pathogenesis, clinical features, diagnosis and the current supportive intensive medical and obstetric- specific practices to ensure safe management of Ebola positive pregnant women. We present how Ebola may be managed in highly resourced settings where experience is limited in the management of pregnancy complicated by Ebola infection and how wherever these patients are managed, postpartum contraceptive support is necessary because of lingering concerns about sexual transmission.