Journal articles on the topic 'Delivery (Obstetrics) Case studies'
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Johnson, John W. C., Douglas S. Richards, and Rebecca A. Wagaman. "The case for routine umbilical blood acid-base studies at delivery." American Journal of Obstetrics and Gynecology 162, no. 3 (March 1990): 621–25. http://dx.doi.org/10.1016/0002-9378(90)90970-i.
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Ray Chaudhuri Bhatta, Smriti, and Remon Keriakos. "Review of the Recent Literature on the Mode of Delivery for Singleton Vertex Preterm Babies." Journal of Pregnancy 2011 (2011): 1–5. http://dx.doi.org/10.1155/2011/186560.
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Choosing the safest method of delivery and preventing preterm labour are obstetric challenges in reducing the number of preterm births and improving outcomes for mother and baby. Optimal route of delivery for preterm vertex neonates has been a controversial topic in the obstetric and neonatal community for decades and continues to be debated. We reviewed 22 studies, most of which have been published over the last five years with an aim to find answers to the clinical questions relevant to deciding the mode of delivery. Findings suggested that the neonatal outcome does not depend on the mode of delivery. Though Caesarean section rates are increasing for preterm births, it does not prevent neurodisability and cannot be recommended unless there are other obstetric indications to justify it. Therefore, clinical judgement of the obstetrician depending on the individual case still remains important in deciding the mode of delivery.
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MEMON, NAILLA YOUSUF, FIRDOUS MUMTAZ, and SHAISTA FAROOQ. "INCIDENCE OF PLACENTAL ABRUPTION;." Professional Medical Journal 20, no. 03 (March 25, 2013): 422–28. http://dx.doi.org/10.29309/tpmj/2013.20.03.699.
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Objective: To determine the Incidence of Placental Abruption and the morbidity / mortality associated with it. Design:Prospective and Observational case Study. Setting & Duration: Department of Obstetrics & Gynecology, Liaquat University of Medicaland Health Sciences Hyderabad, for a period of 15 months from January 2007 to March 2008. Patients & Methods: Among all theantenatal patients delivered during the period under review, those suffering from Placental abruption were entered into this study bycompleting a proforma for each patient. After history, examination and initial management, investigations were carried out. These patientswere managed on case to case basis depending on the progression of abruption and delivery. After delivery whether spontaneous or bycesarean section the condition of mother and subsequent complications were recorded and results analyzed on SPSS version 10.Results: During the period 15 months, 2760 patients were admitted to labour room /labour ward and delivered. Among these, 100patients had abruption making an incidence of 2.89% per year. According to the degree of abruption 33 had mild, 50 had moderate and 17had severe abruption. 42% had spontaneous vaginal delivery, and 52% underwent cesarean section. 36% of Abruptio patients, developedcomplications like shock, PPH and DIC. One (1%) patient died in severe abruption. Conclusions: The incidence of Abruptio Placentae inthis study is comparable to local studies and studies from developing countries, but is high in comparison to studies from developedcountries. The maternal morbidity and mortality rate is not as high as in other studies.
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HERBST, ANDREAS, and KARIN KÄLLÉN. "TERM BREECH DELIVERY." Fetal and Maternal Medicine Review 16, no. 4 (November 2005): 289–322. http://dx.doi.org/10.1017/s0965539505001634.
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In October 2000, Hannah et al published a randomised controlled trial comparing perinatal and maternal outcome between planned vaginal and planned caesarean deliveries of term breech pregnancies. The study was closed after an interim analysis, showing a reduced perinatal morbidity and mortality with planned caesarean section. The result was not unexpected, although a trial like this had been called for over many years to resolve the issue. Many cohort- and case-control studies, and two small randomised studies had been performed since 1959, when Wright reported a reduced perinatal mortality and morbidity with CS. A few large registry studies had shown a better perinatal outcome with caesarean delivery, whereas smaller studies often showed no statistically significant difference in outcome, often with the conclusion that vaginal delivery (VD) is safe.
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Hosiani, Ali, James Brown, and Indika T. Alahakoon. "Delayed Interval Delivery in Preterm Premature Rupture of Membranes in Dichorionic Triamniotic Triplets: Ethical Considerations for Maternal Health Case Report." Case Reports in Obstetrics and Gynecology 2022 (July 21, 2022): 1–4. http://dx.doi.org/10.1155/2022/4766523.
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Background. Although there are numerous studies on delayed interval delivery in twins, this study is one of few reporting on preterm premature rupture of membranes in triplets and even fewer on dichorionic triamniotic triplet twins. The case presented here highlights the important interplay between informed consent and patient autonomy. Case Presentation. A 37-year-old woman gravida 1, para 0 with a dichorionic triamniotic triplet pregnancy experienced preterm premature rupture of membranes of the singleton triplet at 15 weeks and six days of gestation. Delayed interval delivery was offered to the parents, who chose to continue the pregnancy while acknowledging the risks for maternal and foetal health. The patient was treated with prophylactic intravenous antibiotics and discharged on oral antibiotics after an eight-day admission. Two days after being discharged, she was readmitted with clinical signs of chorioamnionitis. Within six hours, the preterm premature rupture of membranes singleton was delivered. Three days later, she again presented to the hospital with preterm premature rupture of membranes of one of the dichorionic twins. After discussion with the maternal foetal medicine team, the parents chose to terminate the pregnancy. Delayed interval delivery was not successful in this patient, and it is unclear at which gestational age it is too early to offer expectant management. Conclusions. The case affirmed the very poor foetal survival rate when the first delivery occurs at under 20 weeks’ gestation. A standardised management of delayed interval delivery should be established to assist with consistent parental counselling.
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Partab, Priya, Aneela Habib, Gulfishan Tariq, Urooj Naz, Sana Shameer, and Sarah Kazi. "The Outcome of Planned Breech Vaginal Delivery among Obstetrics Patients Presenting at Tertiary Care Hospital, Karachi." Pakistan Journal of Medical and Health Sciences 16, no. 4 (April 30, 2022): 617–19. http://dx.doi.org/10.53350/pjmhs22164617.
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Background: Vaginal breech delivery (VBD) is known to be associated with more perinatal and maternal complications. The safest mode of delivery in case of breech presentation has long been a debate in obstetrics. Selective vaginal breech deliveries, proper technique of breech delivery, rigorous intrapartum monitoring and presence of experienced obstetrician and pediatricians are most important factors for good outcome in vaginal breech delivery without affecting the maternal and fetal well-being and helps in decreasing the caesarean section rate. Very few studies on the subject have been carried out in poor-resource settings. The aim of the study was to determine the outcome of planned breech vaginal delivery among obstetrics patients presenting at Tertiary Care Hospital, Karachi. Study Design: This Cross sectional study was conducted at Department of Gynaecology and Obstetrics, Civil Hospital, Karachi for the duration of Six months from November, 2019 to May, 2020. Subjects and Methods: Data was prospectively collected from patients after taking a verbal consent. 89 pregnant who met the diagnostic criteria were included. Quantitative data was presented as simple descriptive statistics giving mean and standard deviation and qualitative variables was presented as frequency and percentages. Effect modifiers were controlled through stratification to see the effect of these on the outcome variable. Post stratification chi square test was applied taking p-value of ≤0.05 as significant. Results: A total of 89 patients were included in this study. Mean age, gestational age and duration of labour in our study was 31.78±2.81 years, 37.72±1.58 weeks and 10.72±1.56 hours. Out of 89 patients, 11.2%, 23.6%, 12.4% neonates had had APGAR score < 7, NICU admission and brachial plexus injury. Conclusion: Vaginal delivery of term breech fetus is a safe option in a carefully selected group of women. Pre-delivery assessment, vigilant labour monitoring and delivery by trained doctors can minimize poor feto-maternal outcome. Keywords: Pregnancy, planned breech vaginal delivery, APGAR score.
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Morris, D. G. "Using telemedicine to facilitate training in cardiotocography (CTG) interpretation." Journal of Telemedicine and Telecare 6, no. 1_suppl (February 2000): 53–55. http://dx.doi.org/10.1258/1357633001934140.
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Electronic fetal monitoring is a controversial practice in modern obstetric care and is frequently an aspect of medicolegal cases involving the management of labour and delivery. The interpretation of the cardiotocograph (CTG) produced by such monitors is a skill required by those caring for the pregnant woman. Studies have shown that most ‘experts’ do not interpret CTGs in a consistent manner, when compared with either other experts or themselves. However, it has also been shown that consistency can be improved with training. Telemedicine has been used to advantage in the training of obstetrics and gynaecology registrars in CTG interpretation.
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Nicholson, James M., and Lisa C. Kellar. "The Active Management of Impending Cephalopelvic Disproportion in Nulliparous Women at Term: A Case Series." Journal of Pregnancy 2010 (2010): 1–5. http://dx.doi.org/10.1155/2010/708615.
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Background. The Active Management of Risk in Pregnancy at Term (AMOR-IPAT) protocol has been associated in several studies with significant reductions of group cesarean delivery rate. Present within each of these studies were nulliparous women with risk factors for cephalopelvic disproportion. Risk factors for cephalopelvic disproportion in nulliparous women are especially important because they represent the precursors for the most common indication for primary cesarean delivery.Cases. Three examples of exposure of urban nulliparous women to the AMOR-IPAT protocol are presented. Each woman's risk factor profile for Cephalopelvic Disproportion (CPD) was used to estimate her Upper Limit of Optimal Time of Vaginal Delivery for CPD (UL-OTDcpd). Labor management and clinical outcomes for each case are presented. A simple table summarizing induction rates and birth outcome rates of exposed versus nonexposed nulliparous women is also presented.Conclusion. Because the mode of delivery of the first birth substantially impacts birth options in later pregnancies, the impact of AMOR-IPAT on nulliparous patients is particularly important. Determining the UL-OTDcpd in nulliparous patients, and carefully inducing each patient who has not entered labor by her UL-OTDcpd, may be an effective way of lowering rates of cesarean delivery in nulliparous women.
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Ryazanova, Oksana V., Efim M. Shifman, Anna A. Olina, Yury S. Alexandrovich, Dzhaminat R. Medzhidova, Veronika O. Ezhova, and Igor Yu Kogan. "Application of enhanced recovery after cesarean delivery. A review." Journal of obstetrics and women's diseases 70, no. 6 (December 15, 2021): 127–38. http://dx.doi.org/10.17816/jowd65171.
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Caesarean section is the most common surgical intervention over the world, so the development of the enhanced recovery after cesarean delivery is turning out to be a vital problem. The practical application of the enhanced recovery after cesarean requires multidisciplinary collaboration and well-coordinated teamwork of an anesthesiologist, an obstetrician-gynecologist, nursing staff and other specialists. In this review, we have studied recent domestic and foreign articles dedicated to the enhanced recovery after cesarean. Particular attention was paid to the case management at all stages of the perioperative period, especially preoperative preparation, postoperative care and womens awareness raising. The presented studies included such program criteria as avoidance of prolonged preoperative fasting accompanied by early postoperative feeding, early breastfeeding attachment of the newborn, the use of multimodal analgesia in the postoperative period, the early activation of the postoperative patient, and the minimization of the detention period of hospital stay. The reviewed articles indicated the positive impact of this program on maternal and newborn outcomes and demonstrated the need for detailed further study of several issues and standardization of the enhanced recovery after cesarean methods.
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Wu, Michael, Jennifer Tang, Nicole Etherington, Mark Walker, and Sylvain Boet. "Interventions for improving teamwork in intrapartum care: a systematic review of randomised controlled trials." BMJ Quality & Safety 29, no. 1 (October 10, 2019): 77–85. http://dx.doi.org/10.1136/bmjqs-2019-009689.
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BackgroundThe labour and delivery environment relies heavily on interdisciplinary collaboration from anaesthesiologists, obstetricians and nurses or midwives to deliver optimal patient care. A large number of adverse events in obstetrics are associated with failure in communication and teamwork among team members, with substantive consequences. The objective of this study is to perform a systematic review of interventions aimed at improving teamwork in obstetrics.MethodsThis systematic review identified and assessed randomised controlled trials (RCTs) of interventions aimed at improving teamwork among interdisciplinary teams in obstetrical care. Medline, CENTRAL, CINAHL and Embase were searched for studies evaluating one of: patient outcomes, team performance or processes of clinical efficiency. Identified citations were reviewed in duplicate for eligibility.ResultsNine RCTs met the inclusion criteria; five of these RCTs were conducted under simulated clinical environments. Simulation-based teamwork training interventions were the most represented (n=7 studies, 3047 healthcare providers (HCPs), 107 782 births), followed by checklists (n=1 study, 136 HCPs) and an electronic-based decision support tool (n=1 study, 296 HCPs). Simulation-based teamwork training was found to improve team performance in 100% of relevant studies (3 of 3 studies assessing team performance) and patient morbidity in 75% of relevant studies (3 of 4 studies assessing patient morbidity). However, no direct mortality benefit was identified among all the studies reviewed. Studies were assessed to be of low-moderate quality and had significant limitations in their study designs.ConclusionWhile the evidence is still limited and from low to moderate quality RCTs, simulation-based teamwork interventions appear to improve team performance and patient morbidity in labour and delivery care.PROSPERO Trial registration numberCRD42018090452
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Najafian, Mahin, and Maria Cheraghi. "Occurrence of Fetal Macrosomia Rate and Its Maternal and Neonatal Complications: A 5-Year Cohort Study." ISRN Obstetrics and Gynecology 2012 (November 14, 2012): 1–5. http://dx.doi.org/10.5402/2012/353791.
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Background. Macrosomia is defined as an infant’s birth weight of more than 4000 g at term which is to different maternal and neonatal complications. Several studies have been done on factors influencing risk of macrosomia, but there is lack of information and study in our country regarding macrosomia complications. Objective. The aim of this study was to determine the prevalence of macrosomia and its complications. Method. A cohort study was conducted from 2007 to 2011 at Obstetrics and Gynecology Department, Razi Hospital in Ahvaz city, Iran. All pregnant mothers who were referred to Obstetrics and Gynecology Department for delivery were included in this study. The total number of 201,102 pregnant mothers was recruited and divided into case and control groups after delivery (macrosomia (case) and normal weight infants (control) groups). Results. Out of total deliveries (201,102), there were 1800 macrosomia, (9%). Gestational diabetes, maternal obesity (BMI), maternal aged and positive history of previous macrosomia were the major risk factors for macrosomia which were compared with the normal weight infant groups ( for all parameters). Neonatal complications associated with macrosomia included humerus—clavicle fractures and arm—brachial plexus injury which were significant compared to the control group ( for all parameters). Conclusion. The macrosomia is potentially dangerous for the mother and the neonate. It is important to recognize the suspected fetal macrosomia to prevent its risk factors and complications. There is a need to provide all delivery facilities and care services to prevent and reduce the maternal and neonatal macrosomia complications.
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Browne, Roy, Majella Byrne, Mary Morris, Eadbhard O'Callaghan, Niamh Mulryan, Ann Scully, Anthony Kinsella, Thomas F. McNeil, and Dermot Walsh. "Labour and delivery complications at birth and later mania." British Journal of Psychiatry 176, no. 4 (April 2000): 369–72. http://dx.doi.org/10.1192/bjp.176.4.369.
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BackgroundSeveral reports postulate that manic depression and schizophrenia share environmental risk factors. Although obstetric adversity has been suggested as a risk factor for schizophrenia, few studies have examined its relationship to bipolar affective disorder.AimsTo assess the rate of obstetric complications incurred by patients with mania compared with controls.MethodFrom the Dublin Psychiatric Case Register we identified individuals with a discharge diagnosis of mania and traced their birth records. Each case was matched with a control of the same gender, born in the same hospital, in the same year, matched for maternal age, parity and social class. Two obstetric complication scales were used to make blind evaluations of labour and delivery data.ResultsPatients with mania did not experience a greater frequency or severity of labour and delivery complications than their matched controls. Rates of obstetric adversity were unrelated to the presence or absence of family history of psychiatric disorder. Obstetric adversity was unrelated to the age at first diagnosis.ConclusionsThese findings suggest that obstetric adversity is not a risk factor for later mania.
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Stephens, Angela J., John R. Barton, Nana-Ama Ankumah Bentum, Sean C. Blackwell, and Baha M. Sibai. "General Guidelines in the Management of an Obstetrical Patient on the Labor and Delivery Unit during the COVID-19 Pandemic." American Journal of Perinatology 37, no. 08 (April 28, 2020): 829–36. http://dx.doi.org/10.1055/s-0040-1710308.
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Novel coronavirus disease 2019 (COVID-19) is a respiratory tract infection that was first identified in China. Since its emergence in December 2019, the virus has rapidly spread, transcending geographic barriers. The World Health Organization and the Centers for Disease Control and Prevention have declared COVID-19 as a public health crisis. Data regarding COVID-19 in pregnancy is limited, consisting of case reports and small cohort studies. However, obstetric patients are not immune from the current COVID-19 pandemic, and obstetric care will inevitably be impacted by the current epidemic. As such, clinical protocols and practice on labor and delivery units must adapt to optimize the safety of patients and health care workers and to better conserve health care resources. In this commentary, we provide suggestions to meet these goals without impacting maternal or neonatal outcomes. Key Points • Novel coronavirus disease 2019 (COVID-19) is a pandemic.• COVID-19 impacts care of obstetric patients.• Health care should be adapted for the COVID-19 pandemic.
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Mulik, Jayashree, and Tanvi Vibhute. "Emergency obstetric hysterectomy: experience at a tertiary care centre in Central India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 8 (July 26, 2019): 3280. http://dx.doi.org/10.18203/2320-1770.ijrcog20193551.
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Background: Obstetric hysterectomy is an important procedure in modern obstetrics and its proper indications, risks and complications need to be studied for judicious usage and improvement in outcome.Methods: A retrospective, record-based study was carried out over one and a half years at a tertiary care government hospital. All the patients who underwent emergency obstetric hysterectomy at the study centre during study period were studied. Labour room register, operation room register for emergency and elective cases, case records, referral slips and mortality register data were reviewed for the same and outcomes analysed.Results: Total 33 patients underwent emergency obstetric hysterectomy, with the incidence observed at 0.21%. The most common indications were atonic post-partum hemorrhage (42.4%), uterine rupture (33.3%) and morbidly adherent placenta (18.1%). Prior cesarean section (36.4%) and placenta previa (15.1%) were the commonest predisposing factors associated with PPH and uterine rupture. Subtotal hysterectomy (66.7%) was observed to be the preferred type of surgery. Out of total 7 maternal deaths that occurred, 4 (57%) were because of disseminated intravascular coagulation.Conclusions: There is increasing trend in the rate of obstetric hysterectomy along with rise in rate of previous LSCS, emphasizing the importance of the mode of delivery. Measures to reduce the rate of primary cesarean section are advisable.
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Jovanović, J., P. Frémondière, and S. Stefanović. "Reconstruction of Two Mother-Infant Dyads and Obstetrical Consequences of the Mesolithic-Neolithic Transition: A Case Study from Lepenski Vir and Vlasac (Serbia)." Bulletins et Mémoires de la Société d'Anthropologie de Paris 31, no. 1-2 (January 30, 2019): 60–68. http://dx.doi.org/10.3166/bmsap-2018-0042.
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The current world population of approximately seven billion people shows that despite the complexities of human birthing, the human species is thriving. Changes in human pelvic morphology resulting from bipedalism and encephalisation, often described as the “obstetric dilemma”, have made the birthing process extremely difficult and risky for both mothers and neonates. The major Mesolithic- Neolithic shift in lifestyle could have had important obstetric consequences. It is often hypothesised that the shift to an agricultural diet, with a lower protein content and higher glycaemic loading than the hunter-gatherer diet, could have led to a decrease in maternal height and an increase in neonatal birth weight, brain size and foetal-pelvic strain, which may have exacerbated the obstetric dilemma. The Mesolithic-Neolithic osteological collection from the Danube Gorges (7400-5500 cal BC, Balkans) provides material (2 pelvises and a neonate skull) to test this hypothesis by virtually reconstructing the fossil dyads and their foetal-pelvic relationship.We compared these dyads with a large obstetrical sample of mother-child dyads with a known birthing history, conducting a lineardiscriminant analysis in order to predict the most probable delivery outcomes for the prehistoric dyads. The results suggest that delivery was dystocic for the Mesolithic motherchild dyad and eutocic for the Neolithic mother-child dyad; obstetrically, the former is notably more efficient. However, due to the small sample size, further research is required with a larger series in order to determine whether the development of obstetrically efficient pelvic bones in the Neolithic was widespread and whether it had an impact on the birthing process and thus potentially contributed to the increasing size of the population.
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Bihon, Abera Molla, Henok Kumsa Meikena, and Selamawit Serka. "Survival Modeling on the Determinants of Time to Recovery from Obstetric Fistula: The Case of Mekelle Hamlin Fistula Center, Ethiopia." International Journal of Reproductive Medicine 2022 (November 14, 2022): 1–9. http://dx.doi.org/10.1155/2022/8313575.
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Background. An obstetric fistula is an abnormal opening between the vagina, rectum, and/or bladder. Obstetric fistula has a devastating impact on women’s physical, social, and psychological health. Despite the numerous health consequences in developing countries, including Ethiopia, there have been few studies on the determinants of time to recovery from obstetric fistula. Therefore, this study is aimed at addressing the gap. Methods. A retrospective cohort study was employed to include 328 randomly selected records of women admitted for obstetric fistula treatment at Mekelle Hamlin Fistula Center from January 2015 to 2020. Data collected from the medical records was coded and entered into SPSS software version 20 and exported to STATA 10 and R statistical software for data cleaning and data analysis. The Kaplan-Meier and log-rank tests were computed to explore the data. The log-logistic inverse Gaussian shared frailty model was employed using a 95% CI, and variables with a p value < 0.05 were declared as determinants of recovery time. Results. Of 328 fistula patients, 293 (89.33%) were physically cured. The Kaplan-Meier result showed that the overall mean and median survival time of time to recovery from obstetric fistula patients at Mekelle Hamlin Fistula Center is 42 and 33 days, respectively. In a log-logistic inverse Gaussian shared frailty model analysis, extensive fistula size (AHR : 1.282; 95% CI = 1.175-1.388), secondary and above education level (AHR : 0.830; 95% CI = 0.693-0.967), rural residence (AHR : 1.357; 95% CI = 1.236-1.479), and physiotherapy use ( AHR : 0.801 , 95% CI = 0662 -0.940, 95% CI = 1.175 -1.388) were statistically significant predictors of recovery from obstetrics fistula. Conclusion. Rural place of residence, home delivery, and large and extensive size of the fistula prolong the timing of healing from the obstetric fistula. However, having tall height, physiotherapy treatment, secondary and above-educated women, and RVF type of fistula has a short time of healing for obstetric fistula in Mekelle Hamlin Fistula Center. Therefore, we recommend that health professionals promote institutional delivery and physiotherapy, shorten the duration of catheterization, and manage urine incontinence. In addition, we recommend that the regional health bureau promotes female education and pregnancy after 18 years. The survival probability of patients with obstetric fistulas is better predicted by the log-logistic inverse Gaussian shared frailty model. Therefore, it would be good for future researchers to take this model into account.
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Vygivska, Liudmyla A., Olena A. Yakovenko, Evgen V. Blagoveschenskiy, Yevheniia M. Babadzhanian, Lesia A. Rudenko, and Kyrylo V. Yakovenko. "CURRENT STATE OF THE PROBLEM OFABNORMAL INVASION OF THE PLACENTA IN OBSTETRICS." Wiadomości Lekarskie 73, no. 12 (2020): 2688——2693. http://dx.doi.org/10.36740/wlek202012124.
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The aim: On the basis of literature data, as well as a clinical case study, to assess the state of the problem of abnormal invasion of the placenta in obstetrics at the present stage. Materials and methods: Based on the materials of the world’s leading citation databases (MEDLINE, EMBASE, Cochrane), a brief review of the literature data over the past 5 years is presented, dedicated to the issues of abnormal placental invasion. The possibilities of a complex of diagnostic studies and clinical management of women with an anomaly of placenta attachment are considered. A clinical case study of abnormal placental invasion is presented. Conclusions: AIP is an extremely serious condition with not fully understood etiological and pathogenic mechanisms. Correct and timely verification of this pathological condition, based on the simultaneous use of a whole complex of diagnostic studies (history taking, 2D, 3D, energy and color Doppler mapping, MRI), contributes to the development of individual tactics for the management and delivery in women with AIP, making it possible to reduce maternal morbidity and mortality and improve perinatal outcomes.
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Jayakumar, Sai Priya Remadevi, Elizabeth Jacob, Rajani Somanathan, and Karen Kanagasabhapathy. "A case control study on obstetric outcome following a previous spontaneous abortion." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 11, no. 6 (May 26, 2022): 1709. http://dx.doi.org/10.18203/2320-1770.ijrcog20221444.
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Background: Spontaneous abortion is pregnancy resulting in miscarriages without the application of any deliberate methods to terminate it, during the early weeks after conception. Studies on effects of recurrent miscarriages on subsequent reproductive adverse outcomes are many in literature. However, studies showing outcome of pregnancy following a spontaneous complete abortion is scanty in literature.This study looks for association between a previous spontaneous abortion and recurrence of adverse maternal outcome like recurrence of abortion, preeclampsia, premature rupture of membrane (PROM), operative delivery, and fetal outcome like preterm labour (PTL), low birth weight (LBW) to that of primi gravida.Methods: A case control observational study was done on 200 antenatal women who attended the obstetrics department and fulfilling the inclusion criteria. Of this, 100 pregnant women were with history of a spontaneous abortion (case group) and 100 primi gravida (control group). Maternal and fetal adverse outcome were compared between the two groups.Results: Recurrence of adverse maternal outcome like recurrence of abortion, PROM, caesarean delivery and adverse fetal outcome like PTL, LBW were more in women with prior spontaneous abortion than that of primi gravida.Conclusions: Women with a history of previous one spontaneous abortion are at an increased risk of maternal and fetal complications. So, these women should be considered as high-risk group and hence frequent antenatal visits and close antenatal surveillance should be provided to such women for early detection of complications and for its effective management.
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Bahadur, B. Rao, Prabhadevi Kodey, Jeevitha Tanniru, and Suhasini Tirumala. "Study of outcome of obstetric emergencies admitted to intensive care unit." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 7 (June 27, 2018): 2909. http://dx.doi.org/10.18203/2320-1770.ijrcog20182905.
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Background: Critically ill obstetric patients pose challenges to the intensive care unit team due to their altered physiology as well as due the presence of the foetus and safety of both the mother and the foetus is of paramount importance.Methods: All antenatal and postnatal cases within 42days of delivery requiring ICU admission from October 2014 to September 2016. Detailed history taken and outcome noted. Results were subjected to statistical evaluation using SSP software.Results: (n=75): obstetric reasons (n=51, 68%) of which 21(28%) had PPH and 17(22.6) had hypertensive disorders of pregnancy. Non-obstetric reasons (n=24, 32%) of which 7(9.3%) cases had jaundice and 4(5.3%) had malaria. Mechanical ventilation was needed in the majority of cases (n=44, 58.7%) followed by inotropic support (n=30, 40%).Maternal mortality was 16%. Mortality was higher (n=8, 66.6%) among patients admitted for obstetric reasons as opposed to non-obstetric indications (n=4, 33.3%).Conclusions: Early detection and prompt referral to the tertiary centre with intensive care facilities should be promoted among the medical fraternity to reduce the incidence of ICU admissions and maternal mortality. All residents of obstetrics and gynaecology should have short mandatory training phase in critical care. Multicentre randomised studies are required for formulating evidence-based national guidelines.
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Tambawaala, Zenab, and Deepali Kale. "Perinatal outcomes in abruptio placenta." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 3 (February 26, 2019): 1070. http://dx.doi.org/10.18203/2320-1770.ijrcog20190881.
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Background: Abruptio placentae is an obstetric emergency where placenta completely or partially separates before delivery of the baby. It occurs approximately in one in 120 deliveries. It is an important cause of perinatal morbidity and mortality.Methods: This was a prospective hospital-based study design conducted over a period of 2 years, in the Department of Obstetrics and Gynecology at a tertiary care hospital in Mumbai comprising of 60 cases.Results: The incidence of abruption placentae in Present study is 0.51%. Authors had perinatal mortality in 6.6% of the cases. Out of 60 cases, 2 deaths occurred in utero. Out of the remaining 58 cases, 24 babies needed NICU care, out of them, 22 went home alive and 2 had neonatal deaths. Perinatal morbidity in the form of hyperbilirubinemia, CNS depression, septicemia, neonatal anemia and neonatal DIC were noted.Conclusions: High incidence of perinatal mortality in abruptio placentae is because of increased number of still births. In our studies, the perinatal mortality is 6.6% as compared to all other studies. This decline in perinatal mortality is due to improved obstetric care and excellent NICU facilities which are required for a majority of the cases.
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Berg, Rigmor C., and Vigdis Underland. "The Obstetric Consequences of Female Genital Mutilation/Cutting: A Systematic Review and Meta-Analysis." Obstetrics and Gynecology International 2013 (2013): 1–15. http://dx.doi.org/10.1155/2013/496564.
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Various forms of female genital mutilation/cutting (FGM/C) have been performed for millennia and continue to be prevalent in parts of Africa. Although the health consequences following FGM/C have been broadly investigated, divergent study results have called into question whether FGM/C is associated with obstetric consequences. To clarify the present state of empirical research, we conducted a systematic review of the scientific literature and quantitative meta-analyses of the obstetric consequences of FGM/C. We included 44 primary studies, of which 28 were comparative, involving almost 3 million participants. The methodological study quality was generally low, but several studies reported the same outcome and were sufficiently similar to warrant pooling of effect sizes in meta-analyses. The meta-analyses results showed that prolonged labor, obstetric lacerations, instrumental delivery, obstetric hemorrhage, and difficult delivery are markedly associated with FGM/C, indicating that FGM/C is a factor in their occurrence and significantly increases the risk of delivery complications. There was no significant difference in risk with respect to cesarean section and episiotomy. These results can make up the background documentation for health promotion and health care decisions that inform work to reduce the prevalence of FGM/C and improve the quality of services related to the consequences of FGM/C.
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Curtis, Peter, Remy R. Coeytaux, and Patrice Hapke. "Acupuncture for Birth Preparation and Delivery: How Investigating Mechanisms of Action Can Generate Research." Complementary health practice review 11, no. 3 (January 2006): 176–92. http://dx.doi.org/10.1177/1533210106298060.
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Acupuncture has become an accepted and validated part of Western mainstream medicine and is increasingly used by clinicians, midwives, and acupuncturists for reproductive care, induction of labor, and analgesia. Most studies of the effects of obstetrical acupuncture are descriptive, many in foreign languages. Only a few have evaluated efficacy. Results suggest that acupuncture ripens the cervix, initiates labor, reduces labor pain, and shortens the first stage of labor. There is some evidence suggesting that certain acupuncture points have very specific effects on the fetus and uterus, which may be mediated through the hypopituitary-thalamic axis or by local neurovascular stimulation. The substantial maternal hormonal changes occurring just before and during labor offer a unique opportunity to clarify the mechanisms of action of acupuncture. Using a conceptual model based on possible mechanisms of action of the use of acupuncture in obstetrics, the authors propose specific research questions into the physiology of acupuncture administered before and at parturition.
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Mozalyova, Olga L., and Anna V. Samarina. "Specific features of pregnancy and delivery in HIV-infected women." Journal of obstetrics and women's diseases 70, no. 3 (August 16, 2021): 103–13. http://dx.doi.org/10.17816/jowd48672.
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HIV-infected women have a higher risk of complications during pregnancy and delivery (chronic placental insufficiency, anemia, placental abruption, preterm birth) compared with HIV-negative women, especially in case of opportunistic infections, immunodeficiency and a high viral load in the blood. The obstetrical pathologies are hard to study in these women because the above conditions are associated with a range of confounding factors that are not directly related to HIV infection but are often present, such as drug addiction, weight deficit, and chronic viral hepatitis coinfection. The literature review provides data from domestic and international studies on the correlation between HIV infection and the frequency of complications during pregnancy, delivery and the postpartum period, as well as the effect of the infection on the condition of newborns. The article cites current recommendations on the choice of delivery types for HIV-infected women.
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Kirollos, Dina W., and Mohamed E. Abdel-Latif. "Mode of delivery and outcomes of infants with gastroschisis: a meta-analysis of observational studies." Archives of Disease in Childhood - Fetal and Neonatal Edition 103, no. 4 (September 28, 2017): F355—F363. http://dx.doi.org/10.1136/archdischild-2016-312394.
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BackgroundThere is controversy among the literature for electing caesarean section (CS) delivery for infants with gastroschisis in an attempt to reduce mortality and morbidity.ObjectiveThis meta-analysis investigates whether there is enough evidence to support CS delivery over vaginal delivery.Data sourcesWe conducted our search in April 2017. We searched Cochrane, Medline, Premedline, Embase, CINAHL, GoogleScholar and Web of Science. We also searched conferences for abstracts online. Additional studies were retrieved by reviewing reference lists.Study selectionObservational studies, excluding case series, were eligible if data compared relevant outcomes of infants with gastroschisis in relation to mode of delivery.Data extractionRelevant information were extracted and assessed the methodological quality of the retrieved records.ResultsThirty-eight studies were included. Evidence suggested that mode of delivery is not significantly associated with overall mortality (OR 0.82, 95% CI 0.57 to 1.18), primary repair (OR 0.82, 95% CI 0.57 to 1.18), neonatal mortality (OR 1.08, 95% CI 0.54 to 2.15), necrotising enterocolitis, secondary repair, sepsis, short gut syndrome, duration until enteral feeding and duration of hospital stay. Furthermore, sensitivity analyses based on economic status and quality of study showed no significant difference between the impact of mode of delivery for all investigated outcomes.LimitationsDue to uncontrolled variables between and within studies, particularly regarding characteristics of delivery and postdelivery care, it is difficult to extract meaningful results from the literature.ConclusionsThere is insufficient evidence to advocate the use of CS over vaginal delivery for infants with gastroschisis.
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David, Rodreck, Ruth Evans, and Hamish SF Fraser. "Modelling Prenatal Care Pathways at a Central Hospital in Zimbabwe." Health Services Insights 14 (January 2021): 117863292110627. http://dx.doi.org/10.1177/11786329211062742.
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Background: Maternal mortality remains a problem in low-income countries (LICs). In Zimbabwe, there has been an unprecedented increase in maternal mortality in the last 2.5 decades. Effective prenatal care delivery, particularly early visits, appropriate number of visits, and receiving recommended care is viewed as key to reducing fatal care outcomes. Aims: This study sought to model and identify gaps requiring service and care delivery improvement in prenatal care pathways for pregnant women visiting Mpilo Central Hospital in Bulawayo, Zimbabwe. Methods: This was a case study of the services offered by an antenatal care department at Mpilo Central Hospital in Bulawayo, Zimbabwe. Evidence from literature in low-income countries was used to develop prenatal care pathway guidelines as a tool to guide care delivery and identify gaps in care and service delivery. One hundred cases of prenatal care records were reviewed to determine the prenatal care pathway and care delivered to pregnant women. This data was complemented by interviews with 20 maternity care clinicians. Results: In 100 maternity case records studied, 53% booked for prenatal care. Of the 53% (n = 53) pregnant women who booked, their first visit on their pregnancy was late at an average gestational age of 27.1 weeks with extremes of 30 to 40 weeks in 38% (n = 20) cases. Missing scheduled prenatal care appointments was prevalent, with only 11% (n = 6) having attended all the expected 5 visits, whilst 60% (n = 32) missed 3 or more. There were inadequacies in the care delivered to women in each visit compared to that expected in such areas as obstetrics, physical examinations and haematological tests. Maternity care clinicians attributed the cost of prenatal booking fees in the background of poverty and poor family support systems as key factors hindering women’s access to prenatal services. Conclusions: The current prenatal care pathway at MCH requires improvement in the areas of referral, adherence to appointment by pregnant women and visiting prenatal care early. Clinicians also need to adhere to standard clinical tests recommended for each specific pregnant woman’s visit. In the Zimbabwean setting with limited resources, where the number of visits is already low, pathways with reduced visits may not be appropriate. An investment into prenatal care by the government is recommended to enable the utilisation of interventions such as e-health technologies that may improve care delivery as well as adherence to best practices. E-health and mobile health technologies involving e-referrals, e-booking, decision support, and reminder systems are recommended for clinicians to manage and deliver appropriate care to patients as well as pregnant women to adhere to scheduled visits.
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Sahu, Priyanka, Prachi Goyal, Nirbhay Mehta, and Somen Bhattacharjee. "Perinatal outcome of babies born to mothers with antepartum eclampsia: A study from tertiary care hospital of Central India." Asian Journal of Medical Sciences 13, no. 7 (July 1, 2022): 138–44. http://dx.doi.org/10.3126/ajms.v13i7.43177.
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Background: Eclampsia is a major cause of perinatal mortality. There is a need for studies that will correlate maternal factors and perinatal outcome, which will provide potential strategies to improve fetal outcomes in pregnancies complicated by eclampsia. Aims and Objectives: This study aims to study perinatal outcome of babies born to mothers with antepartum eclampsia and to correlate outcomes with convulsion delivery interval. Materials and Methods: A study included 200 patients diagnosed and managed as antepartum eclampsia in the Department of Obstetrics and Gynaecology in MGM Medical College, Indore. A detailed pro forma was prepared and was filled with patient’s information, investigations, treatment, and birth details. The final outcome of both, the mother and her newborn, including stillbirths and early neonatal deaths was included in the study and the perinatal outcome was correlated with convulsion delivery interval. Results: Incidence of antepartum eclampsia in our study was 2.1%. About 86.4% of women lack regular antenatal care at health care center. Only 7% of women delivered within 6 h of onset of convulsion. Case fatality rate was found to be 13%. There were 59.5% premature deliveries. Perinatal mortality (stillbirth and early neonatal deaths) was 42.5%. Significant association was found between convulsion delivery interval and perinatal outcome (P<0.05). Furthermore, association between use of multiple antiepileptic agents and perinatal outcomes was statistically significant. Conclusion: Eclampsia being a major cause of perinatal mortality need early diagnosis, prompt referral from peripheral health centers, and timely intervention for improvising both perinatal and maternal outcomes.
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Park, Kristen E., Nicole L. Vestal, Michael S. Awadalla, and Sharon A. Winer. "Successful Vaginal Delivery after External Cephalic Version in a Woman with a Large Partial Uterine Septum." Case Reports in Obstetrics and Gynecology 2021 (May 19, 2021): 1–4. http://dx.doi.org/10.1155/2021/9912271.
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Septate uteri have been associated with adverse pregnancy outcomes including spontaneous abortion, preterm delivery, and malpresentation. It is unclear if uterine septa are associated with infertility. Although some studies have shown improved pregnancy outcomes after septum resection, indications for resection are not well established. We describe a case of a woman with a large partial uterine septum diagnosed during workup for infertility who conceived without septum resection. Both of her subsequent pregnancies were initially breech presentations for which the patient underwent external cephalic version followed by full-term vaginal deliveries. This case adds evidence that an unresected uterine septum should not be considered a contraindication to external cephalic version.
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Valencia Mejia, Erika, Cesar Rodriguez Villan, Yanet Fermin Aldama, Fernando Martinez Gonzalez, Jose Eduardo Serratos Garduno, and Cristian de la Rosa Ramos. "Appendicitis in pregnancy: case report in a navy medical center of Mexico City." International Journal of Pregnancy & Child Birth 7, no. 6 (December 7, 2021): 145–46. http://dx.doi.org/10.15406/ipcb.2021.07.00246.
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Acute appendicitis represents the most common non-obstetric surgical emergency during pregnancy, the most important clinical feature is abdominal pain in the right lower quadrant. Imaging studies can be used for diagnosis, where ultrasound and magnetic resonance imaging are mostly recommended. Timely diagnosis can prevent complications including fetal loss and preterm delivery. The case report orients the surgeon and obstetrician to make decisions in patients with this pathology
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Salazar-Pousada, Danny, Dalton Arroyo, Luis Hidalgo, Faustino R. Pérez-López, and Peter Chedraui. "Depressive Symptoms and Resilience among Pregnant Adolescents: A Case-Control Study." Obstetrics and Gynecology International 2010 (2010): 1–7. http://dx.doi.org/10.1155/2010/952493.
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Background. Data regarding depression and resilience among adolescents is still lacking.Objective. To assess depressive symptoms and resilience among pregnant adolescents.Method. Depressive symptoms and resilience were assessed using two validated inventories, the 10-item Center for Epidemiologic Studies Short Depression Scale (CESD-10) and the 14-item Wagnild and Young Resilience Scale (RS), respectively. A case-control approach was used to compare differences between adolescents and adults.Results. A total of 302 pregnant women were enrolled in the study, 151 assigned to each group. Overall, 56.6% of gravids presented total CESD-10 scores 10 or more indicating depressed mood. Despite this, total CESD-10 scores and depressed mood rate did not differ among studied groups. Adolescents did however display lower resilience reflected by lower total RS scores and a higher rate of scores below the calculated median (P<.05). Logistic regression analysis could not establish any risk factor for depressed mood among studied subjects; however, having an adolescent partner (OR, 2.0 CI 95% 1.06–4.0,P=.03) and a preterm delivery (OR, 3.0 CI 95% 1.43–6.55,P=.004) related to a higher risk for lower resilience.Conclusion. In light of the findings of the present study, programs oriented at giving adolescents support before, during, and after pregnancy should be encouraged.
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Andonova, Irena, Vasil Iliev, Nikica Živković, Edita Sušič, Ivana Bego, and Vesna Kotevska. "Can Oral Anaerobic Bacteria cause Adverse Pregnancy Outcomes?/ Дали Оралните Анаеробни Бактерии Можат Да Доведат До Лоши Опстетрички Исходи?" PRILOZI 36, no. 1 (May 1, 2015): 137–43. http://dx.doi.org/10.1515/prilozi-2015-0038.
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Abstract Aim: Maternal periodontal infection has been recognized as a risk factor for premature and low birthweight infants. It is suspected that pathogens causing periodontal disease may translocate to the amniotic cavity and so contribute to triggering an adverse pregnancy outcome. The aim of this study was to evaluate whether the presence of specific periodontal pathogens may influence the incidence of preterm labor and premature birth. Material and Methods: This study was designed as a hospital-based case-control study. A total of 70 pregnant women, aged 18-40 with single live pregnancy were recruited from the Departement of Gynecolgy and Obstetrics at a General hospital in Sibenik, Croatia, between March 2013 to March 2014. The case group: 30 pregnant women who were hospitalised with signs of premature labor. Control group: 40 patients with normal pregnancy post-delivery up to 48 hrs, who had given birth at term, and the baby had a weight of more than 2500 gr. These women had undergone microbiological examination at the time of recruitment, microbial samples, paper point subgingival swabs were obtained in both groups and processed by anaerobic culturing. Standard procedures were used for culture and identification of bacteria. Information was collected on demographics, health behaviors, and obstetric and systemic diseases that may have influence the premature delivery. Results: The levels of periodontal pathogens tended to be higher in the premature (case group) labor compared to the term deliveries (control group). Levels of Porphyromonas gingivalis, Fuscobacterium nucleatum, Actinomyces actinomycetecomitans were statistically significantly higher in premature births as compared to term deliveries, adjusting for baseline levels. The joint effects of red and orange microbial clusters were significantly higher in the premature group compared to the term group. Conclusions: The study shows a significant association betwen periodontal anaerobic infection and adverse pregnancy outcome. High levels of periodontal pathogens during pregnancy are associated with an increased risk for preterm delivery. Further studies elucidating the role of the microbial load and maternal immune response as related to pregnancy outcome seem merited.
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Poudel, Rekha, Ganesh Dangal, Aruna Karki, Hema Pradhan, Ranjana Shrestha, Kabin Bhattachan, Nishma Bajracharya, and Kenusha Devi Tiwari. "Vesicocervical Fistula Post Emergency Repeat Caesarean Delivery." Nepal Journal of Obstetrics and Gynaecology 13, no. 2 (November 18, 2018): 56–57. http://dx.doi.org/10.3126/njog.v13i2.21702.
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Urogenital fistula is an abnormal communication between the urinary tract and genital tract at different levels, vesicocervical fistula being rare. It has been the consequence of poor obstetric care in developing world and iatrogenic following gynecologic surgeries in developed world. Diagnosis is mainly done by clinical examination, conventional dye test with methylene blue and imaging studies and cystoscopy, if required. Though prevention is better than cure, early detection followed by transurethral bladder drainage and surgical correction via vaginal or abdominal approach is the mainstay of treatment. A 30 years postnatal mother was referred to our centre with complaints of continuous involuntary leakage of urine per vaginum following emergency repeat caesarean delivery done six weeks back. There was pooling of urine over Sim’s speculum and dye test was positive. Under spinal anesthesia, vesicocervical fistula was repaired vaginally and patient was kept on Foley’s catheter for three weeks. Dye test performed at the end was negative. She went home dry and continent. We present here a rare case of successful repair of vesicocervial fistula post emergency repeat caesarean delivery.
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Sara, Jarso, Yusuf Haji, and Achamyelesh Gebretsadik. "Determinants of Maternal Death in a Pastoralist Area of Borena Zone, Oromia Region, Ethiopia: Unmatched Case-Control Study." Obstetrics and Gynecology International 2019 (January 20, 2019): 1–9. http://dx.doi.org/10.1155/2019/5698436.
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Background. Globally, more than 830 maternal deaths happen daily, and nearly, all of these occur in developing countries. Similarly, in Ethiopia, maternal mortality is still very high. Studies done in pastoralist women are almost few. Therefore, the objective of this study was to assess the determinant factors of maternal death in the pastoralist area of Borena zone, Oromia region, Ethiopia. Methods. Community-based unmatched case-control study was conducted on 236 mothers (59 maternal deaths (cases) and 177 controls). The sample included pregnant women aged 15–49 years from September 2014 to March 2017. Data were collected using a structured questionnaire adapted from Maternal Death Surveillance and Response Technical Guideline, entered into the EpiData, exported into SPSS for analyses. Odds ratios (ORs) and 95% confidence interval (CI) were computed to determine contributing factors of maternal death and control potential confounding variables. Results. About 51 (86%) of all maternal deaths were due to direct obstetric causes. Of this, hemorrhage (45%), hypertensive disorders of pregnancy (23%), and obstructed labor (18%) were the leading direct causes of maternal deaths. Husbands who had no formal education were 5 times higher compared with their counterparts (AOR = 5.1, 95% CI: 1.6–16). Mothers who were not attending ANC were 5 times more at risk for death than those who attend (AOR 5.3, 95% CI 2.3–12.1). Mothers who gave birth at home/on transit were twice to die compared to health facility delivery (AOR 2.6, 95% CI 2.4–6) that were contributing factors of maternal deaths. Conclusions. Husband’s level of education, lack of antenatal care, and home delivery were the factors contributing to maternal deaths in the zone. Frequent and tailored antenatal care, skilled delivery, and access to education also need due attention.
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den Boer, Maria C., Mirjam Houtlosser, Elizabeth E. Foglia, Enrico Lopriore, Martine Charlotte de Vries, Dirk P. Engberts, and Arjan B. te Pas. "Deferred consent for delivery room studies: the providers’ perspective." Archives of Disease in Childhood - Fetal and Neonatal Edition 105, no. 3 (August 19, 2019): 310–15. http://dx.doi.org/10.1136/archdischild-2019-317280.
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ObjectiveTo gain insight into neonatal care providers’ perceptions of deferred consent for delivery room (DR) studies in actual scenarios.MethodsWe conducted semistructured interviews with 46 neonatal intensive care unit (NICU) staff members of the Leiden University Medical Center (the Netherlands) and the Hospital of the University of Pennsylvania (USA). At the time interviews were conducted, both NICUs conducted the same DR studies, but differed in their consent approaches. Interviews were audio-recorded, transcribed and analysed using the qualitative data analysis software Atlas.ti V.7.0.ResultsAlthough providers reported to regard the prospective consent approach as the most preferable consent approach, they acknowledged that a deferred consent approach is needed for high-quality DR management. However, providers reported concerns about parental autonomy, approaching parents for consent and ethical review of study protocols that include a deferred consent approach. Providers furthermore differed in perceived appropriateness of a deferred consent approach for the studies that were being conducted at their NICUs. Providers with first-hand experience with deferred consent reported positive experiences that they attributed to appropriate communication and timing of approaching parents for consent.ConclusionInsight into providers’ perceptions of deferred consent for DR studies in actual scenarios suggests that a deferred consent approach is considered acceptable, but that actual usage of the approach for DR studies can be improved on.
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Liem, Sophie M. S., Mariëlle G. van Pampus, Ben Willem J. Mol, and Dick J. Bekedam. "Cervical Pessaries for the Prevention of Preterm Birth: A Systematic Review." Obstetrics and Gynecology International 2013 (2013): 1–10. http://dx.doi.org/10.1155/2013/576723.
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Introduction. Reduction of preterm birth is a major goal in obstetric care. We performed a systematic review of randomized controlled trials and cohort studies on the effectiveness of the cervical pessary to prevent preterm birth.Methods. We searched the electronic databases of MEDLINE and Embase from inception until April 2012 to identify studies investigating treatment with a cervical pessary to prevent preterm birth. We constructed two-by-two tables for delivery before 28, 34, and 37 weeks of gestation and calculated relative risks (RRs) with 95% confidence intervals.Results. The search revealed 103 potentially eligible abstracts of which six cohort studies and four randomized controlled trials (RCTs) investigated the effectiveness of the pessary. One RCT (n=380) demonstrated a lower delivery rate prior to 34 weeks (RR 0.24; 95% CI 0.13–0.43) in the pessary group, while another RCT (n=108) showed no positive effect of pessary for delivery before 34 weeks (RR 1.73; 95% CI 0.43–6.88). Two older quasi randomized studies and cohort studies indicated potential effect of the pessary.Conclusions. Available randomized and nonrandomized studies indicate potential effectiveness of a cervical pessary in the prevention of preterm birth. More randomized clinical trials are needed before this device can be used in clinical practice.
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De Miranda, Ridelson Alves da Costa, Mariana Diniz Prado Sena, Larissa Machado Da Costa, and Fábio Roberto Ruiz De Rodrigues Moraes. "INDUÇÃO DE PARTO VAGINAL EM PACIENTE COM CESARIANA ANTERIOR." Revista de Patologia do Tocantins 4, no. 2 (June 20, 2017): 8. http://dx.doi.org/10.20873/uft.2446-6492.2017v4n2p8.
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O Brasil possui números alarmantes de cesarianas. Em 2009, a cesariana chegou a corresponder a mais da metade do número de partos realizados no país - realidade que se revela bastante além do preconizado pela OMS e pela Sociedade Brasileira de Ginecologia e Obstetrícia. Em contrapartida, existe atualmente a popularização do conceito de humanização do parto e maior valorização do parto normal. Diante dessa realidade, muitas gestantes que tiveram filho por meio de parto cesáreo, agora desejam o parto vaginal. Contudo, até pouco tempo, a literatura desencorajava a indução de parto normal em pacientes com cicatriz uterina prévia, pelo maior risco de ruptura uterina. Entretanto, estudos mais recentes têm mostrado que, em locais adequados, a indução do parto vaginal após cesárea é uma opção aceitável para mulheres, sem apresentar contraindicações, e é uma conduta obstétrica recomendável. No presente relato, os autores descrevem um caso de indução de parto vaginal em gestante com histórico de cesariana prévia.Palavras-chave: Indução de Parto, Parto Iterativo, Parto Vaginal Pós-Cesárea, Gestação de Alto risco, Misoprostol.
ABSTRACT
Brazil has alarming numbers of caesarean births. In 2009, the cesarean surgery corresponded to more than half of the number of births performed in the country - a reality that goes far beyond what was recommended by the OMS and the Brazilian Society of Gynecology and Obstetrics. In contrast, there is currently popularization of the concept of humanization of childbirth and greater appreciation of normal childbirth. Faced with this reality, many pregnant women who had a child through caesarean delivery now desire vaginal delivery. However, until recently, the literature discouraged the induction of normal delivery in patients with previous uterine scarring, due to the higher risk of uterine rupture. However, more recent studies have shown that induction of vaginal delivery after cesarean section is an acceptable option for women, without contraindications, and is a recommended obstetric behavior. In the present report, the authors describe a case of induction of vaginal delivery in pregnant women with a previous cesarean history. Keywords: Childbirth Induction; Vaginal Birth after Cesarean; High Risk Pregnancy.
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Demmouche, Abbassia, and Faiza Moussaoui. "Relation between low birth weight and Maternal blood lead levels in Sidi Bel Abbes, Algeria: a case-control study." Journal of Drug Delivery and Therapeutics 10, no. 2-s (April 15, 2020): 115–19. http://dx.doi.org/10.22270/jddt.v10i2-s.4023.
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Background: Several epidemiological studies have investigated high lead (Pb) exposure and pregnancy outcomes,but few studies have investigated the association of low lead exposure and low birth weight (LBW). The aims of this study were to estimate the maternal blood lead levels (BLL), to identify determinants for BLL among parturient woman and to evaluate the association of maternal BLL andLBW. Methods: From July 2017 to February 2018, we carried out a case control study in the genecology and obstetrics hospital of Sidi Bel Abbes, Algeria. Lead concentrations in maternal blood samples collected at delivery were measured in 29mother who delivered term LBW cases group and 29mother who give birth to a term normal weight baby matched controls.Blood lead levels were analyzed by inductively coupled plasma mass spectrometry. Results: Mean maternal BLLwere higher among normal groups than in mothers of LBW, but this difference was not significant (23,076 ±16,120, versus 18,086 ± 6,641 ug/l p=0.247).Our results indicate that the mean lead level was nothigher in LBW neonates, and the whole blood lead was not related to the birth weight. In addition,there was interaction of daily kohl use and maternal BLL. Conclusion:This study suggeststhat maternal BLL was not significantly associated with LBW. Mothers with daily use of kohl during pregnancy were more likely to have elevate blood lead concentrations.
Keywords: case-control study, low birth weight, Algeria, lead, kohl.
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Eltaweel, Nashwa, Samuel Lockley, Irshad Ahmed, and Bee K. Tan. "SARS-CoV-2: do corticosteroids for fetal lung maturation worsen maternal or fetal outcomes?" British Journal of Midwifery 29, no. 2 (February 2, 2021): 90–92. http://dx.doi.org/10.12968/bjom.2021.29.2.90.
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Immune system changes during pregnancy could make pregnant women more susceptible to SARS-Cov-2 infection. The use of corticosteroids within obstetrics has been shown to reduce the risks of respiratory distress syndrome, intraventricular haemorrhage, necrotizing enterocolitis and neonatal death in the baby associated with premature delivery. During the COVID-19 pandemic, corticosteroids have been trialled as a treatment to dampen the ‘cytokine storm’ and associated inflammatory processes. Corticosteroids have long been known to have immunosuppressive effects that could hinder the body's ability to mount a defence against COVID-19 and thereby delaying viral clearance. In this clinical case studies, antenatal steroids for fetal lung maturation appear to be of benefit and did not result in a deterioration of maternal disease. Our clinical case studies support the current recommendations from the Royal College of Obstetricians and Gynaecologists ie corticosteroids for fetal lung maturation is appropriate in patients who are suspected or have confirmed SARS-CoV-2 infection.
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Galibert, Stephanie, Nicholas O'Rourke, Penny Wolski, and Bart Schmidt. "Hepatic cirrhosis with portal hypertension secondary to alpha-1 antitrypsin deficiency and autoimmune hepatitis in pregnancy: A case report." Journal of Case Reports and Images in Obstetrics and Gynecology 8, no. 2 (November 21, 2022): 38–44. http://dx.doi.org/10.5348/100132z08sg2022cr.
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Introduction: Previously, women with cirrhosis rarely became pregnant due to hypothalamic-pituitary dysfunction. However, with advancements in the care of patients with chronic liver disease, pregnancy is becoming more common in this cohort. We will outline the complex, multidisciplinary approach toward managing an obstetrics patient with portal hypertension in the context of previously decompensated liver cirrhosis. Case Report: A 29-year-old primigravida woman was referred to the Obstetric Medicine Clinic with an unplanned pregnancy at 16 weeks’ gestation. This was on a background of previously decompensated liver cirrhosis and portal hypertension, in the context of alpha-1 antitrypsin deficiency and autoimmune hepatitis. The patient had one upper gastrointestinal bleed at 19 weeks’ gestation and underwent three gastroscopies throughout her pregnancy. At 32+6 weeks gestation, she had an elective lower uterine segment Caesarean Section and delivered a healthy liveborn female. Conclusion: Currently, there are no studies that explore pregnancy outcomes in women with cirrhosis secondary to alpha-1 antitrypsin deficiency. This case describes the pregnancy of a woman with previously decompensated liver cirrhosis and portal hypertension, in the context of alpha-1 antitrypsin deficiency and explores the associated management dilemmas.
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Justin, Shajil A., and Merin S. Johnson. "A prospective study on evaluation of maternal and foetal outcomes of hypothyroidism with levothyroxine and prevalence of hypothyroidism in pregnancy in a tertiary care teaching hospital in Kerala." International Journal of Basic & Clinical Pharmacology 9, no. 3 (February 25, 2020): 392. http://dx.doi.org/10.18203/2319-2003.ijbcp20200709.
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Background: Pregnancy influences a profound alteration in thyroid function and hypothyroidism has a massive impact on adverse pregnancy outcomes. An appropriate treatment with appropriate dose of levothyroxine is much essential during pregnancy. The present study evaluates the effect of levothyroxine dose in preventing maternal and foetal outcomes and the prevalence of hypothyroidism among pregnant women.Methods: 1500 antenatal women with singleton gestation attending outpatient of Obstetrics and Gynaecology Department, were analysed. Apart from routine obstetrical investigations, thyroid stimulating hormone (TSH) tests were done at the first antenatal visit. Patients were followed up till delivery after levothyroxine treatment. Their obstetrical and perinatal outcomes were noted. TSH estimation was done 3 days after delivery in new-borns to screen for neonatal thyroid disorders.Results: The prevalence of hypothyroidism was 10.54%. The common adverse maternal and foetal complications were preeclampsia (15.19%) and low birth weight babies (17.72%) respectively. The mean age of pregnant women was 26.66 years. As age advances there is an increased risk of developing hypothyroidism in pregnancy. Levothyroxine 25 μg daily was highly prescribed in 63.92% hypothyroid patients.Conclusions: Overall, the prevalence of hypothyroidism was high. Since maternal and foetal complications were higher in patients with hypothyroidism, levothyroxine treatment had decreased the risk of maternal and foetal outcome. Pre-pregnancy screening should be implemented at least in patients with high risk factors for thyroid dysfunction. Universal screening for new-borns is also recommended to detect hypothyroidism. Expert decisions and cost-effectiveness studies will promulgate the impact of universal screening.
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Kafle, Deepak Raj. "Obstetrics Outcomes: A Comparison between Birthing Center and Conventional Labor Ward." Medical Journal of Pokhara Academy of Health Sciences 3, no. 2 (December 31, 2020): 254–60. http://dx.doi.org/10.3126/mjpahs.v3i2.35597.
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Introduction: Birthing Centers (BC) are increasingly accepted worldwide as an alternate low cost place of birth. The concept is especially relevant for developing countries with limited resources and constraints regarding availability of specialists and hospital beds. The various studies have concluded that when proper risk analyses are conducted and referral rules followed, there is no evidence of increased maternal or perinatal risk at BC compared to standard hospital deliveries.
Materials and Methods: This was a prospective, observational and comparative hospital based study done at Paropakar Maternity and Women’s Hospital (PMWH),Kathmandu. The study was conducted on pregnant women without any known risk factors for complications who were admitted in BC and labor ward (LW) for delivery. Details on mode of delivery, genital tract status, Postpartum hemorrhage (PPH) and neonatal outcomes were collected. Descriptive data analysis was done using SPSS.
Results: Out of 5132 deliveries, 25.3% had no known risk factor and hence were eligible for study; no statistically significant difference was observed between BC & LW in relation to mode of delivery, perineal trauma, PPH and neonatal outcomes; however, practice of episiotomy was significantly less frequent in BC.
Conclusion: When proper risk analyses are conducted and referral rules followed, there is no evidence of adverse obstetrics outcome at BC as compared to standard hospital deliveries. Triaging of low risk pregnancy to a BC is a viable strategy, especially in a resource poor country. This lessens the burden in standard maternity unit so that specialists will be able to provide a quality care to high risk pregnancies.
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Kothari, Sanjana, and Emily S. Patterson. "Maternal Mortality Litigation Review." Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care 10, no. 1 (June 2021): 313–16. http://dx.doi.org/10.1177/2327857921101225.
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Obstetrics and gynecology is considered one of the most litigious medical specialties; medical negligence and malpractice lawsuits are frequently filed to seek damages for improper medical care during childbirth. In fact, several studies have shown that a much greater percentage of maternal injury claims result in settlements or judgments as compared to other specialties. A considerable number of these claims can be linked to postpartum hemorrhage, or excessive bleeding following vaginal birth or cesarean delivery. This study aims to identify cases where postpartum hemorrhage contributed to maternal morbidity or mortality and led to a lawsuit. A review of litigation surrounding this topic was conducted using the Nexis Uni database from January 2011 to December 2020. Inclusion criteria consisted of maternal mortality cases due to postpartum hemorrhage, which discussed legal causes like medical negligence or obstetric violence. Evaluation of the litigation search results demonstrated various elements most associated with postpartum hemorrhage-related maternal injury litigation. Understanding challenges which arise most frequently in postnatal care settings will be useful in improving maternal health outcomes.
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Hangekar, Parag M., Anand Karale, and Neelesh Risbud. "Our experience of nifedipine as a tocolytic agent in preterm labor (24 weeks to 36 weeks 6 days)." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 2 (January 31, 2017): 636. http://dx.doi.org/10.18203/2320-1770.ijrcog20170397.
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Background: Preterm birth is defined as birth between the age of viability and 37 completed weeks of gestation. The aim of this study is to evaluate the safety and efficacy of nifedipine, a calcium channel blocker, as a tocolytic in prolonging duration of pregnancy in case of preterm labor.Methods: This is a retrospective analytical study conducted in Department of Obstetrics and Gynaecology, SKNMC and GH, Pune, India conducted over a period of one year from June 2014 to May 2015. All uncomplicated, singleton preterm labor cases were given Cap. Nifedipine as tocolytic and Inj. Betamethasone for enhancing fetal lung maturity. Maternal parameters studied were Gravida and Parity, previous history of preterm labor, gestational age at delivery, mode of delivery, side effects. Neonatal parameters studied were weight at birth, APGAR score at birth, complications at birth, NICU admissions, mortality.Results: Out of total 4478 deliveries from June 2014 to May 2015, 252 women with preterm labor were treated with nifedipine. 214 out of 252 delivered at term with overall success rate of 84.92%. Out of remaining 38 cases, 36 cases delivered as preterm normal deliveries and 2 required Caesarean section. No major side effects observed in mothers receiving nifedipine. As regards neonatal outcome, 12 babies required NICU admission and mortality was of 2.Conclusions: Nifedipine is safe and effective in prolonging preterm labor and has minimal maternal and neonatal side effects. It eliminates the need for intensive maternal monitoring as required in case of betamimetics.
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Markwei, Metabel, and Oluwatosin Goje. "Optimizing mother–baby wellness during the 2019 coronavirus disease pandemic: A case for telemedicine." Women's Health 17 (January 2021): 174550652110132. http://dx.doi.org/10.1177/17455065211013262.
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Background: The 2019 coronavirus disease pandemic poses unique challenges to healthcare delivery. To limit the exposure of providers and patients to severe acute respiratory syndrome coronavirus 2, the Centers for Disease Control and Prevention encourages providers to use telehealth platforms whenever possible. Given the maternal mortality crisis in the United States and the compounding 2019 coronavirus disease public health emergency, continued access to quality preconception, prenatal, intrapartum, and postpartum care are essential to the health and well-being of mother and baby. Objective: This commentary explores unique opportunities to optimize virtual obstetric care for low-risk and high-risk mothers at each stage of pregnancy. Methods: In this review paper, we present evidence-based literature and tools from first-hand experience implementing telemedicine in obstetric care clinics during the pandemic. Results: Using the best evidence-based practices with telemedicine, health care providers can deliver care in the safest, most respectful, and appropriate way possible while providing the critical support necessary in pregnancy. In reviewing the literature, several studies endorse the implementation of specific tools outlined in this article, to facilitate the implementation of telemedicine. From a quality improvement standpoint, evidence-based telemedicine provides a solution for overburdened healthcare systems, greater confidentiality for obstetric services, and a personalized avenue for health care providers to meet maternal health needs in the pandemic. Conclusion: During the COVID-19 pandemic, continued access to quality prenatal, intrapartum, and postpartum care are essential to the health and well-being of mother and baby.
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Stone, Sophia, and Joanna C. Girling. "Deranged liver function tests in pregnancy: the importance of postnatal follow-up." Obstetric Medicine 2, no. 1 (March 2009): 32–33. http://dx.doi.org/10.1258/om.2008.080036.
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We report an asymptomatic 40-year-old woman with persistently deranged liver function tests found incidentally in the first trimester of her second pregnancy. No cause was apparent clinically, serologically or with imaging studies until a new finding of hepatomegaly led to a repeat ultrasound scan six weeks following delivery. A mass in the region of the common hepatic duct was confirmed to be a cholangiocarcinoma, with vascular invasion precluding curative surgical resection. This case highlights the need for close vigilance of patients with unexplained and persistently abnormal liver function tests, antenatally and postdelivery.
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Gibbins, K. J., A. E. Tebo, S. K. Nielsen, and D. W. Branch. "Antiphospholipid antibodies in women with severe preeclampsia and placental insufficiency: a case-control study." Lupus 27, no. 12 (July 20, 2018): 1903–10. http://dx.doi.org/10.1177/0961203318787035.
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Objective Preterm delivery for preeclampsia or placental insufficiency (PREPI) is a clinical criterion for antiphospholipid syndrome (APS), but no prior prospective studies have used the international classification criteria for APS. Our objective is to determine the proportion of women with PREPI who test positive for aPL using international criteria for antiphospholipid antibody (aPL) assays. Methods We conducted a prospective, case-control study of 148 women delivered < 36 weeks because of PREPI compared to 148 controls. PREPI cases delivered < 36 weeks were compared to matched controls. Cases and controls were tested for aPL. Demographic variables were compared with chi-squared and Wilcoxon-rank-sum statistics. Rates of + aPL were compared using adjusted odds ratios (aORs) for maternal body mass index (BMI) and Caucasian race. Positive aPL (+aPL) was defined as lupus anticoagulant (LA), anticardiolipin (aCL) immunoglobulin G (IgG) (GPL) or immunoglobulin M (IgM) (MPL) ≥ 40, or anti-β2-glycoprotein I (aβ2GPI) IgG (SGU) or IgM (SMU) ≥ 40. Results Controls were more likely to be Caucasian (87% vs 70%, p = 0.006) and had lower BMIs (BMI 26 vs 33, p < 0.001). Positive aPL were found more commonly in cases than controls (11.5% vs 1.4%, aOR 8.9 (95% CI 1.9–41.4)). In + aPL cases, 76% had + LA, 41% had + aCL, and 24% had + aβ2GPI. Conclusion Women requiring early delivery for PREPI are more likely to have aPL (and thus APS) than controls. This is the first prospective study using both obstetric definitions and laboratory criteria in accordance with APS international criteria.
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Ruiz Labarta, Francisco Javier, María Pilar Pintado Recarte, Laura Joigneau Prieto, Coral Bravo Arribas, Julia Bujan, Miguel A. Ortega, and Juan A. De León-Luis. "Factors Associated with Failure of Bakri Balloon Tamponade for the Management of Postpartum Haemorrhage. Case Series Study and Systematic Review." Healthcare 9, no. 3 (March 8, 2021): 295. http://dx.doi.org/10.3390/healthcare9030295.
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Background: Postpartum haemorrhage (PPH) is an unpredictable obstetric emergency that requires a multidisciplinary approach. Bakri balloon tamponade (BBT) is recommended when PPH does not respond to medical treatment. Nowadays few published studies have performed a multivariate analysis to determine the variables independently associated with BBT failure. Methods: Our study purpose was to determine the variables independently associated with BBT failure: first, in a large single-centre cohort study between 2010 and 2020, and second, in a systematic literature review using Medline and the Cochrane Library. Maternal and perinatal variables, PPH characteristics, technique-related variables and complications were recorded in the case series study, comparing between successful and failed BBT patients. Study characteristic and variables significantly associated with BBT failure were recorded in the systematic review. All studies used a logistic regression test. Results: The case series included 123 patients. The profile of these patients were primiparous, with vaginal delivery and a full-term new-born. BBT was successful in 81.3% of cases. Five studies were included in the systematic review, providing data from 551 patients. BBT was successful in 79.5% of cases. Conclusions: Maternal age, caesarean delivery, ≥7 red blood cells units (RBCU) transfused and curettage before BBT insertion, history of caesarean section, pre-pregnancy obesity, anteriorly placed placenta, placenta accreta, caesarean delivery, estimated blood loss before insertion of BBT, long operation duration, and coagulopathy were independent factors for BBT failure.
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Sacker, A., D. J. Done, and T. J. Crow. "Obstetric complications in children born to parents with schizophrenia: a meta-analysis of case–control studies." Psychological Medicine 26, no. 2 (March 1996): 279–87. http://dx.doi.org/10.1017/s003329170003467x.
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SynopsisOn the basis of previous findings, we used meta-analyses to consider whether births to parents with schizophrenia have an increased risk of obstetric complications. Meta-analyses were based on published studies satisfying the following selection criteria. The schizophrenic diagnosis could apply to either parent: parents with non-schizophrenic psychoses were not included: only normal controls were accepted. In all, 14 studies provided effect sizes or data from which these could be derived. Studies were identified by data searches through MEDLINE, PSYCLIT and through references of papers relating to the subject. Births to individuals with schizophrenia incur an increased risk of pregnancy and birth complications, low birthweight and poor neonatal condition. However, in each case the effect size is small (mean r = 0·155; 95% CI = 0·057). The risk is greater for mothers with schizophrenia and is not confined to mothers with onset pre-delivery or to the births of the children who become schizophrenic themselves.
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Parada-Niño, Laura, Luisa Fernanda Castillo-León, and Adrien Morel. "Preeclampsia, Natural History, Genes, and miRNAs Associated with the Syndrome." Journal of Pregnancy 2022 (February 14, 2022): 1–12. http://dx.doi.org/10.1155/2022/3851225.
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Preeclampsia (PE) is a hypertensive disease that affects pregnant women after 20 weeks of gestation. This disease is associated with an important risk of maternal and fetal mortality. PE is described as a placental pathology because, after delivery, most women recover normal arterial pressure. Poor invasion of the spiral arteries is a phenomenon well described in PE; this leads to a hypoxic uterine bed and imbalance of antiangiogenic and proangiogenic factors in the uteroplacental region, which in turn triggers the disease phenotype. The causes of the pathology are unclear; nevertheless, numerous approaches, including next-generation sequencing, association, and case control and miRNA studies, have shed light on the genetic/molecular basis of PE. These studies help us better understand the disease to advance new treatment strategies.
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C. S., Manjunath, and Jyoti Bandi. "Utility of prophylactic cervical cerclage in intra-cytoplasmic sperm injection twins: a prospective study." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 10 (September 25, 2020): 4004. http://dx.doi.org/10.18203/2320-1770.ijrcog20203971.
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Background: Several interventions have been used to reduce the rate of preterm birth and prolonging gestation in a twin pregnancy and routine usage of cervical cerclage in twin pregnancy conceived after intra-cytoplasmic sperm injection (ICSI) procedure has found to be beneficial.Methods: Prospective case series studies, series of expectant mothers with twin pregnancy conceived by ICSI were studied under tertiary care hospital setting. A total of 108 cases with twin pregnancy were included during a period of 2016 to 2019. Obstetric profile of all the cases was taken; cervical cerclage procedure was done at 14-16 weeks of gestation (McDonald method) after a normal nuchal translucency scan and a double marker test. Pregnancy outcome parameters like abortion, preterm labour/delivery, premature rupture of membranes (PROM), and mode of delivery, gestational age at delivery, birth weight and neonatal complications were assessed.Results: Mean age of the mothers was 30.61±4.45 years, rates of the pregnancy outcome parameters were abortion 0%, preterm labour 11.1%, premature rupture of membranes (PROM) 9.3%, mean gestational age at delivery was at 34.56±1.71 weeks. Neonatal outcome parameters were mean birth weight was at 2279±470 grams, 77.8% of the neonates had normal APGAR scores. The rates of NICU admission was 28%, RDS– 24.1%, 3.7% had sepsis and 92.6% of neonates survived and 7.4% died.Conclusions: In ICSI twin pregnancies with normal cervical measurements, prophylactic cervical cerclage is effective in prolonging pregnancy and preventing preterm delivery and thereby minimizing neonatal morbidity and mortality.
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Triantafyllidou, Olga, Konstantinos Stavridis, Stavroula Lila Kastora, and Nikolaos Vlahos. "Road to conception and successful delivery for a facioscapulohumeral muscular dystrophy patient." SAGE Open Medical Case Reports 10 (January 2022): 2050313X2210813. http://dx.doi.org/10.1177/2050313x221081359.
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Facioscapulohumeral muscular dystrophy is a muscular dystrophy affecting all ages, primarily people in the second decade. The disease is initially presented with face, shoulder girdle, and upper arm involvement, followed by lower extremity muscle weakness. Disease progression is usually slow, although about one-fifth of patients will require a wheelchair to accommodate mobility. Women with this muscular dystrophy could rarely have poor birth outcomes, with facioscapulohumeral muscular dystrophy symptom deterioration post-partum. In this study, we present a case of a woman with a genetically confirmed facioscapulohumeral muscular dystrophy 1 who underwent cesarean section with epidural anesthesia with favorable outcomes following the procedure. Eight months post cesarean section, the patient reported no facioscapulohumeral muscular dystrophy symptom deterioration. We reviewed the literature with emphasis on large studies concerning facioscapulohumeral muscular dystrophy and birth outcomes and concluded that the hereby presented approach is important for the comprehensive obstetric care and future risk assessment and management in such patients.