bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal and Neonatal Outcomes Following Abnormally Invasive Placenta: A Population-based Record Linkage Study
Authors: Baldwin H.J. , Patterson J.A. , Nippita T.A. , Torvaldsen S. , Ibiebele I. , Simpson J.M. , Ford J.B. 
Published: August 2018

(Acta Obstet Gynecol Scand 2017;96:1373–1381)
Abnormally invasive placenta (AIP), which includes placenta accreta, increta, and percreta, is associated with serious complications, especially severe postpartum hemorrhage. Several studies have reported an increased prevalence of this condition in conjunction with the increasing cesarean delivery rates in many countries. Most previous studies of AIP have focused only on maternal morbidity and have been limited by small sample sizes. The aim of this population-based Australian study was to examine both maternal and neonatal outcomes after AIP using data from a 10-year period.
Maternal Near-misses at a Provincial Hospital in Papua New Guinea: A Prospective Observational Study
Authors: Bolnga J.W. , Morris M. , Totona C. , Laman M. 
Published: August 2018

(Aust N Z J Obstet Gynaecol 2017;57:624–629)
Life-threatening pregnancy-related adverse outcomes and maternal deaths are high in developing countries due to health care systems that are weak and resources that are limited. As laboratory facilities with the capacity to undertake postmortem examinations in order to determine causes of maternal deaths are limited in less developed countries, maternal near-miss cases are increasingly being used as a proxy with the goal of understanding factors associated with maternal mortality as well as morbidity. Even within a developing country, the maternal mortality ratio (MMR) tends to be significantly higher in rural areas than urban areas as there is better access to health care facilities in the urban regions. This prospective observational study aimed to determine the near-miss ratio and MMR as well as understand the contributing factors of maternal near-misses and mortality in a provincial level hospital in the Madang Province in Papua New Guinea (PNG). The majority of women living in this province are underprivileged and reside in rural areas.
Nonmedically Indicated Induction in Morbidly Obese Women is Not Associated With an Increased Risk of Cesarean Delivery
Authors: Kawakita T. , Iqbal S.N. , Huang C.C. , Reddy U.M. 
Published: August 2018

(Am J Obstet Gynecol. 2017;217:451.e1–e8)
Morbid obesity is associated with an increased risk of cesarean delivery and maternal comorbidities compared with normal-weight women, hence the high prevalence of class II and class III obesity in women is concerning. Obesity is also a risk factor for stillbirth, especially at >39 weeks gestation. Data regarding the rate of cesarean delivery associated with nonmedically indicated induction of labor compared with expectant management in morbidly obese women are very limited. This retrospective cohort study aimed to evaluate the rate of cesarean delivery associated with nonmedically indicated induction of labor compared with expectant management in morbidly obese women without other comorbidities at term. Secondary outcomes were severe maternal and neonatal outcomes.
Pregnant Trauma Victims Experience Nearly 2-Fold Higher Mortality Compared With their Nonpregnant Counterparts
Authors: Deshpande N.A. , Kucirka L.M. , Smith R.N. , Oxford C.M. 
Published: August 2018

(Am J Obstet Gynecol 2017;217:590.e1–e9)
Among all women of reproductive age (14 to 49 y), the leading nonobstetric cause of death is trauma, which affects 1 in 12 pregnancies. Trauma in pregnant women presents unique challenges, such as altered anatomy and hemodynamics and a lack of formal guidelines for treating pregnant women affected by trauma. This study aimed to categorize types of traumatic injuries in pregnant women compared with their nonpregnant counterparts and determine whether pregnancy is an independent risk factor for death among women experiencing trauma. The study also aimed to identify risk factors for death in pregnant women affected by trauma.
Trauma in Pregnancy: An Underappreciated Cause of Maternal Death
Authors: Kilpatrick S.J. 
Published: August 2018

(Am J Obstet Gynecol 2017;217:499–500)
While the maternal mortality ratio (MMR) drastically decreased from 1917 to 1980, the MMR in the United States has been steadily on the rise since 1980. Increased obesity, high maternal age, higher cesarean section rate and other factors may contribute to this increase. Currently, deaths from trauma in pregnant women are not counted in the MMR or pregnancy-related maternal death statistics and therefore many deaths are not captured.
Antenatal Corticosteroids: It’s All about Timing
Authors: Gyamfi-Bannerman C. 
Published: August 2018

(BJOG 2017;124:1575)
The important effect of timing of corticosteroid administration on the likelihood of benefit has been known for a decade. Subsequent studies have examined possible adverse neonatal outcomes after inappropriately timed antenatal corticosteroids, finding evidence of increased likelihood of ventilator support for infants delivered >14 days following steroids.
Spontaneous and Indicated Preterm Delivery Risk is Increased Among Overweight and Obese Women Without Pregnancy Chronic Disease
Authors: Kim S.S. , Mendola P. , Zhu Y. , Hwang B.S. , Grantza K.L. 
Published: August 2018

(BJOG 2017;124:1708–1716)
Premature delivery is the leading cause of infant death in the United States. The relationship between preterm delivery and maternal obesity is not clear, as previous studies have treated factors such as gestational age, parity, and indicated versus spontaneous delivery in varying ways. This study used data from the Consortium on Safe Labor, a large, contemporary US cohort, to investigate preterm delivery risk associated with prepregnancy body mass index in women without chronic diseases by parity, etiological category, and gestational age.
Delivery Parameters, Neonatal Parameters and Incidence of Urinary Incontinence 6 Months Postpartum: A Cohort Study
Authors: Wesnes S.L. , Hannestad Y. , Rortveit G. 
Published: August 2018

(Acta Obstet Gynecol Scand 2017;96:1214–1222)
Research on postpartum urinary incontinence (UI) has yielded contradictory results regarding delivery parameters as risk factors for developing this condition. Clear identification of risk factors could be useful for understanding the mechanisms by which UI develops postpartum as well as potentially decreasing the risk of UI if modifiable risk factors are found. The current study used data from a large population-based cohort study to investigate the association between both single risk factors and combinations of risk factors and the development of UI.
Intrapartum and Neonatal Outcomes in Singleton Pregnancies Following Conception by Assisted Reproduction Techniques
Authors: Rozdarz K.M. , Flatley C.J. , Kumar S. 
Published: August 2018

(Aust N Z J Obstet Gynaecol 2017;57:588–592)
With the expansion of medically assisted reproductive techniques, including assisted reproductive technologies (ART) and non-ART treatments, a large number of successful pregnancies and births have been achieved in couples affected by infertility. For prospective parents seeking such treatments, awareness regarding intrapartum and perinatal outcomes associated with medically assisted reproductive techniques is essential. Therefore, the current retrospective study was undertaken.
Intravenous Dexmedetomidine for Cesarean Delivery and Its Concentration in Colostrum
Authors: Yoshimura M. , Kunisawa T. , Suno M. , Sugawara A. , Kurosawa A. , Nakanishi R. , Aoki K. , Toriumia T. 
Published: August 2018

(Int J Obstet Anesth 2017;32:28–32)
Dexmedetomidine (DEX) has been reported to be useful for reducing postoperative pain after cesarean delivery under spinal anesthesia. The transfer of DEX into the colostrum in humans has not previously been investigated. This study aimed to measure postoperative DEX concentrations in blood and colostrum after elective cesarean delivery performed under spinal-epidural anesthesia in which a DEX infusion was administered during surgery.
Effects on Adult Cognitive Function after Neonatal Exposure to Clinically Relevant Doses of Ionising Radiation and Ketamine in Mice
Authors: Buratovic S. , Stenerlow B. , Sundell-Bergman S. , Fredricksson A. , Viberg H. , Gordh T. , Eriksson P. 
Published: August 2018

(Br J Anaesth. 2018;120:546–554)
The “brain growth spurt” (BGS) during fetal development is a vulnerable period characterized by synaptogenesis, dendritic arborization, extensive myelination, and chemical changes. Exposure to ionizing radiation (IR) may have detrimental effects on this period of development. In experimental rodent models, a single neonatal IR dose of 0 to 100 mGy during the BGS period induced modification in behavior of the mice, with a proposed developmental neurotoxicity at 350 mGy, and alteration in cerebral cortex tau levels at 500 mGy. In addition, rodent neonatal exposure to ketamine has been shown to cause acute apoptotic neurodegeneration, alterations of essential neuroproteins, induction of hyperactive phenotype, and cognitive impairment. As pediatric patients often undergo radiotherapy or sedation/anesthesia before or during radiologic procedures, the authors of the present study explored whether IR doses in the range of exposure associated with computerized tomography (CT) scans could interact with low doses of ketamine to induce neurotoxicity in the developing mouse brain.
The Effects of Gestational Use of Antidepressants and Antipsychotics on Neonatal Outcomes for Women With Severe Mental Illness
Authors: Frayne J. , Nguyen T. , Bennett K. , Allen S. , Hauck Y. , Liira H. 
Published: August 2018

(Aust N Z J Obstet Gynaecol 2017;57:526–532)
Approximately 4% to 7.6% of fetuses are exposed to psychotropic medications in pregnant women with mental illness. Negative neonatal outcomes and poor neonatal adaptation syndrome are strongly associated with selective serotonin reuptake inhibitor exposure in pregnancy. High rates of special care nursery (SCN) admission appear to be greater in fetuses of women with severe mental illness (SMI). This study aimed to analyze the association between psychotropic medication use and the rates of SCN admission in a cohort of women with SMI and to also examine the neonatal outcomes associated with third trimester exposure to antidepressant medication alone, antipsychotic medication alone, or a combination of both.
Postoperative Antimicrobial Prophylaxis Following Cesarean Delivery in Obese Women: An Exception to the Rule?
Authors: Calfee D.P. , Grünebaum A. 
Published: August 2018

(JAMA 2017;318(11):1012–1013)
Cesarean delivery represents approximately a third of all US births and is the most important risk factor for postpartum infection. Obesity is one of the most common risk factors for postcesarean surgical site infection (SSI).
Tenofovir Versus Placebo to Prevent Perinatal Transmission of Hepatitis B
Authors: Jourdain G. , Ngo-Giang-Huong N. , Harrison L. , Decker L. , Khamduang W. , Tierney C. , Salvadori N. , Cressey T.R. , Sirirungsi W. , Achalapong J. , Yuthavisuthi P. , Kanjanavikai P. , Ayudhaya O.P. Na , Siriwachirachai T. , Prommas S. , Sabsanong P. , Limtrakul A. , Varadisai S. , Putiyanun C. , Suriyachai P. , Liampongsabuddhi P. , Sangsawang S. , Matanasarawut W. , Buranabanjasatean S. , Puernngooluerm P. , Bowonwatanuwong C. , Puthanakit T. , Klinbuayaem V. , Thongsawat S. , Thanprasertsuk S. , Siberry G.K. , Watts D.H. , Chakhtoura N. , Murphy T.V. , Nelson N.P. , Chung R.T. , Pol S. , Chotivanich N. 
Published: August 2018

(N Engl J Med 2018;378:911–923)
Despite vaccination and administration of hepatitis B immune globulin at birth, mother-to-child transmission of hepatitis B virus (HBV) can still occur, specifically in infants born to women who test positive of hepatitis B e antigen (HBeAg), have a high HBV viral load (>200,000 IU/mL), or have a mutant HBV strain that escapes the vaccine or immune globulin. Antiviral agents like lamivudine, tenofovir disoproxil fumarate (TDF), and telbivudine have been used prophylactically in pregnant women with high HBV viral loads. However, the evidence on the relative benefits or harm of this intervention are limited or of low quality. Therefore, these authors present the results of a clinical trial, in which they assessed the efficacy and safety of TDF in the prevention of mother-to-child HBV transmission in pregnant women positive for HBeAg.
Fetal Survival in Second-trimester Termination of Pregnancy Without Feticide
Authors: Springer S. , Gorczyca M.E. , Arzt J. , Pils S. , Bettelheim D. , Ott J. 
Published: August 2018

(Obstet Gynecol 2018;131:575–579)
The recommendations of the Society of Family Planning and guidelines of the Royal College of Obstetricians and Gynaecologists are that, in cases of late termination of pregnancy, feticide should be offered beyond 22 weeks of gestation to ensure stillbirth. However, data on live birth rates and survival times after pregnancy between 20 0/7 and 24 0/7 weeks of gestation are scarce and contradictory. In the present study, the authors reported on their own experience with termination of pregnancy procedures between 20 0/7 and 24 0/7 weeks of gestation not preceded by feticide; they evaluated the live birth rate and in cases of live birth, the duration of neonatal survival.
Patients Undergoing Cesarean Delivery After Exposure to Oxytocin During Labor Require Higher Postpartum Oxytocin Doses
Authors: Foley A. , Gunter A. , Nunes K.J. , Shahul S. , Scavone B.M. 
Published: August 2018

(Anesth Analg. 2018;126:920–924)
The effective dose in 90% of patients (ED90) of oxytocin infusion after cesarean delivery (CD) without labor has been reported to be 17.4 IU/h. A recent study has demonstrated an increased ED90 of 44.2 IU/h for patients who were exposed to oxytocin during labor and then progressed to CD. The University of Chicago Family Birth Center protocol for oxytocin administration in the third stage of labor calls for administration of 18 IU/h of oxytocin, with the option for doubling the infusion rate to 36 IU/h in cases of inadequate response. In this retrospective study, the authors determined the clinical relevance of increased dosing requirements for third-stage oxytocin among those patients who were exposed to oxytocin before CD versus those who were not, with the hypothesis that patients exposed to oxytocin before CD would require a higher infusion rate than called for in the protocol.
Onset of Labour Epidural Analgesia With Low-dose Bupivacaine and Different Doses of Fentanyl
Authors: Vedagiri Sai R. , Singh S.I. , Qasem F. , Nguyen D. , Dhir S. , Marmai K. , Adam R. , Jones P.M. 
Published: August 2018

(Anaesthesia 2017;72:1371–1378)
While low-concentration local anesthetic solutions combined with opioids have been shown to decrease motor block without affecting the quality of labor analgesia, the onset of analgesia may be delayed when using these solutions. Previous studies have suggested that the onset of labor analgesia may be improved by the addition of a fentanyl bolus to the initial epidural dose. However, previous studies that evaluated the onset of time of epidural labor analgesia used higher concentrations of local anesthetics than are commonly used in current practice. This dose-comparison study aimed to evaluate the onset of epidural labor analgesia with different doses of fentanyl (20, 50, and 100 μg) administered with a low-concentration bupivacaine (0.08%) solution.
Labor Epidural Analgesia and Breastfeeding
Authors: Chestnut D.H. 
Published: August 2018

(Anesthesiology 2017;V:127)
Breastfeeding is paramount for both maternal and neonatal well-being and incurs substantial long-term and short-term health benefits to the infant and the mother. A previous randomized controlled study observed that women receiving high-dose fentanyl labor epidural analgesia (cumulative dose >150 µg) were more likely to stop breastfeeding 6 weeks postpartum compared with women receiving less fentanyl or no fentanyl. In addition, the 24-hour neonatal neurobehavioral scores were also lowest in the neonates of women receiving high-dose epidural fentanyl. A systematic review of 23 studies found the evidence substantiating the association between labor epidural analgesia and breastfeeding success to be inconclusive.
Patients’ Preferences for Labor Analgesic Counseling: A Qualitative Analysis
Authors: Toledo P. , Pumarino J. , Grobman W.A. , Wong C.A. , Holl J.L. , Hasnain-Wynia R. 
Published: August 2018

(Birth 2017;44:345–351)
Women’s decisions to use or not use neuraxial analgesia for labor may be influenced by fears and concerns about the neuraxial procedure. The aim of this qualitative study was to evaluate patients’ information sources, the timing and content of antepartum labor analgesia counseling, and patients’ preferences for counseling. An interview guide was developed and focused on the sources used for obtaining information about neuraxial analgesia, communication with practitioners about analgesia, perceptions of analgesia counseling received during labor, and preferences for analgesia counseling.
Intrathecal Clonidine as an Adjuvant for Neuraxial Anaesthesia During Cesarean Delivery: A Systematic Review and Meta-Analysis of Randomized Trials
Authors: Crespo S. , Dangelser G. , Haller G. 
Published: August 2018

(Int J Obstet Anesth 2017;32:64–76)
Several adjuvants are commonly used with spinal anesthesia, including fentanyl, sufentanil, morphine, epinephrine, and clonidine, in an attempt to decrease the required dose of local anesthetic. While the benefits of intrathecal clonidine administration for acute and postoperative pain control have been confirmed by various studies, there is limited knowledge about any potential harmful effects. Just one systematic review has been published addressing the risk-benefit ratio of spinal clonidine, and that review included only one obstetric study. In fact, regulatory agencies in several countries, including the US Food and Drug Administration, have not yet approved clonidine for intrathecal use so it is currently being used “off-label.” This current systematic review and meta-analysis aimed to identify the risks and benefits associated with intrathecal clonidine used as an adjuvant to spinal local anesthesia for cesarean delivery.
A Random-allocation Graded Dose-Response Study of Norepinephrine and Phenylephrine for Treating Hypotension During Spinal Anesthesia for Cesarean Delivery
Authors: Ngan Kee W.D. 
Published: August 2018

(Anesthesiology 2017;127:934–941)
While phenylephrine is the established preferred vasopressor for maintaining blood pressure during spinal anesthesia for cesarean delivery, it is often associated with decreased heart rate and cardiac output. Both norepinephrine and phenylephrine are potent α-adrenergic agonists, yet norepinephrine also possesses weak β-adrenergic agonist activity. Recent studies have compared phenylephrine with norepinephrine; however, the doses of norepinephrine have varied. This random-allocation, graded dose-response study aimed to determine the relative potencies of norepinephrine and phenylephrine in treatment of hypotension during spinal anesthesia for cesarean delivery.
Strategies for Prevention of Spinal-associated Hypotension During Cesarean Delivery: Are We Paying Attention?
Authors: Uppal V. , McKeen D.M. 
Published: August 2018

(Can J Anaesth 2017;64:991–996)
Spinal anesthesia (SA)-induced hypotension is a common complication during cesarean delivery (CD) and can cause a wide range of adverse maternal and neonatal outcomes if untreated. Moore et al’s clinical trial aimed at assessing the median seated time to prevent hypotension in 50% of parturients undergoing elective CD after SA using an up-down sequential methodology. The participants were randomized to receive either 11.25 or 15 mg hyperbaric bupivacaine along with fentanyl 15 µg and morphine 150 µg. It was noted that the median seated time in the 11.25 mg bupivacaine group was a little more than 2 minutes whereas in the 15 mg bupivacaine group the median seated time was approximately 8 minutes, suggesting that extended seated time after SA could prevent hypotension in CD. Further studies elucidating the association of extended seated time and hypotension are essential to design effective prevention strategies for hypotension in CD. The current study was only powered to detect the intervention that prevented hypotension in 50% of patients, which questions its clinical relevance. Disadvantages of the prolonged seated strategy include a delay in surgical start time, reduced operating room efficiency, and shorter duration of anesthesia.
A Prospective Study of Post-cesarean Delivery Hypoxia After Spinal Anesthesia With Intrathecal Morphine 150 μg
Authors: Ladha K.S. , Kato R. , Tsen L.C. , Bateman B.T. , Okutomi T. 
Published: August 2018

(Int J Obstet Anesth. 2017;32:48–53)
Neuraxial morphine is one of the most common postoperative analgesia techniques for women who have undergone cesarean delivery. Delayed respiratory depression is a concerning side effect of intrathecal morphine (ITM), as it can potentially increase morbidity and mortality. While the incidence of bradypnea associated with ITM has been reported to be 0.25% or lower, this rate may not account for all cases of ITM-induced respiratory depression because respiratory rate was not continuously monitored in the studies from which these rate were calculated. In addition, patients may develop hypoxia or hypercarbia without the presence of bradypnea. This study aimed to analyze the incidence and timing of hypoxic events in patients receiving post-cesarean analgesia in the form of ITM 150 μg, in order to better define populations at risk of developing hypoxia following ITM.
A Randomized, Controlled Trial of Rectus Sheath Bupivacaine and Intrathecal Bupivacaine, Without or With Intrathecal Morphine, versus Intrathecal Bupivacaine and Morphine After Caesarean Section
Authors: Lui M.W. , Li T.K.T. , Lui F. , Ong C.Y.T. 
Published: August 2018

(Anaesthesia 2017;72:1225–1229)
Adequate analgesia after cesarean delivery plays a role in earlier mobilization after surgery and discharge from the hospital. Intrathecal morphine is one of the most common forms of analgesia used for postcesarean analgesia. It is associated with bothersome side effects of pruritus and nausea/vomiting, however. The rectus sheath block has been found to decrease opioid requirements after many types of surgeries, including cesarean delivery without intrathecal morphine. This study sought to determine the efficacy and side-effects of intrathecal morphine, rectus sheath block with bupivacaine, and their combination for women undergoing elective cesarean deliveries.
Intrathecal Hematoma and Arachnoiditis Mimicking Bacterial Meningitis After an Epidural Blood Patch
Authors: Roy-Gash F. , Engrand N. , Lecarpentier E. , Bonneta M.P. 
Published: August 2018

(Int J Obstet Anesth 2017;32:77–78)
Epidural blood patch (EBP) is the most effective method to treat postdural puncture headache and has a low rate of complications. However, severe complications such as cauda equina syndrome and seizures have rarely been reported. This case report describes a woman who underwent an EBP and later presented with symptoms concerning for meningitis, but was ultimately found to have arachnoiditis from an intrathecal hematoma.