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Sample records for asfixia perinatal con

  1. Fatores associados à asfixia perinatal Factors associated with perinatal asphyxia

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    Alfredo de Almeida Cunha

    2004-12-01

    Full Text Available OBJETIVO: avaliar fatores de risco associados ao índice de Apgar baixo. MÉTODOS: o estudo teve delineamento transversal. A população de estudo foi amostra randômica da população internada em maternidade nível III no ano de 2001. O desfecho foi índice de Apgar baixo, definido como de 1-6 (grupo de estudo comparado a 7-10 (controle no primeiro minuto. A primeira etapa foi avaliar a associação isolada de cada possível fator de risco. A segunda etapa consistiu em análise multivariada com modelagem usando regressão logística (modo passo a passo, reverso. RESULTADOS: houve 39 (14% recém-nascidos (RN deprimidos que foram comparados a 238 (86% não deprimidos. A análise final (multivariada revelou associação do índice de Apgar baixo com os seguintes fatores de risco: antecedente de natimorto (OR=52,6, ameaça de parto prematuro, caracterizada pela existência de contrações uterinas não típicas de trabalho de parto (OR=33,8, baixo peso do RN, inferior a 2.500 g (OR=11,2, antecedente de cesariana (OR=7,4. Funcionaram como fatores de proteção o peso do RN medido em gramas (OR=0,9, sexo feminino do RN (OR=0,1, presença de intercorrência clínica (OR=0,4 e prematuridade, com idade gestacional inferior a 37 semanas (OR=0,1 CONCLUSÃO: o estudo do resultado pode auxiliar na identificação de fetos com risco de asfixia, possibilitando seu encaminhamento dentro do sistema de saúde, bem como o planejamento da assistência em unidades terciárias.PURPOSE: to assess risk factors for low Apgar score. METHODS: this was a cross-sectional study preformed in a random sample of patients admitted to a level III maternity hospital in 2001. The outcome was low Apgar score defined as an Apgar score 1-6 (study group versus Apgar score 7-10 (control group in the first minute of life. The first step was the evaluation of the association of each possible risk factor with low Apgar score. The second step was multivariate analysis with the backward

  2. Asfixia perinatal associada à mortalidade neonatal precoce: estudo populacional dos óbitos evitáveis Asfixia perinatal asociada a la mortalidad neonatal temprana: estudio de población de los óbitos evitables Perinatal asphyxia associated with early neonatal mortality: populational study of avoidable deaths

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    Mandira Daripa

    2013-03-01

    TODOS: Cohorte de población constituida por 2.873 óbitos evitables hasta seis días de vida asociados a la asfixia perinatal ocurridos entre enero de 2001 y diciembre de 2003. Se consideró como asfixia perinatal la presencia de hipoxia intraútero, asfixia al nacer o síndrome de aspiración de meconio en cualquier línea de la Declaración de Óbito original. Variables epidemiológicas también fueron extraídas de las Declaraciones de Nacido Vivo. RESULTADOS: En el trienio, 1,71 muertes por 1.000 nacidos vivos estaban asociadas a la asfixia perinatal, correspondiendo al 22% de los óbitos neonatales tempranos. De los 2.873 óbitos evitables, 761 (27% tuvieron lugar en São Paulo, capital; 640 (22%, en la región metropolitana de la capital; y 1.472 (51% en el interior de la provincia. En las dos primeras regiones predominaron las muertes en hospitales públicos, recién nacidos con edad gestacional inferior a 37 semanas y peso inferior a 2.500g. En el interior, los óbitos fueron más frecuentes en entidades benéficas, recién nacidos a término y con peso superior a 2.500g. La mayoría de los bebés nació durante el día en el municipio de residencia materna y evolucionó a óbito en el hospital de nacimiento hasta 24 horas después del parto. El síndrome de aspiración de meconio estuvo presente en el 18% de los óbitos. CONCLUSIONES: La asfixia perinatal es un contribuyente frecuente a la muerte neonatal temprana evitable en la provincia con el más grande producto interno bruto per capita de Brasil, lo que evidencia la necesidad de intervenciones específicas con enfoque regionalizado en la asistencia al parto y al nacimiento.OBJECTIVE: To compare the epidemiological profile of avoidable early neonatal deaths associated with perinatal asphyxia according to region of death in the State of São Paulo, Brazil. METHODS: Population-based cohort study including 2,873 avoidable deaths up to six days of life associated with perinatal asphyxia from January 2001 to December

  3. Asfixia perinatal e problemas cardíacos Perinatal asphyxia and heart problems

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    Gesmar Volga H. Herdy

    1998-08-01

    Full Text Available OBJETIVO: Avaliar a gravidade das complicações cardíacas na asfixia neonatal, sua evolução e correlacioná-las com o grau e duração do processo hipóxico. MÉTODOS: Foram estudados 90 bebês nos últimos 7 anos com grau de Apgar PURPOSE: To evaluate the severity of cardiac complications of neonatal asphyxia in relation to the length and degree of hipoxia. METHODS: Ninety babies with an Apgar score <6 were examined in the intensive care unit at our institution during seven years. Arterial blood for measuring pH, glucose, LDH and MB fraction of CK, together with serial electrocardiogram (ECG, echocardiogram and chest X rays was obtained. The fatal cases were studied with macro and microscopic examination. RESULTS: From a total of 90 cases, 73 were premature: 30 (41% appropriate for gestation age (AGA and 43 (59% small for gestation age (SGA. Twenty one (23% cases had arterial pH <7.2. The most common clinical conditions were: pneumonia 28 (31%, anemia 24 (26% and jaundice 12 (13%. The main cardiological findings were: systolic murmur in 46 (50%, signs of heart hypertrophy in 18 (20% and heart failure in 8 (9%. On ECG the main findings were ST and T abnormalities. The echocardiogram showed a patent ductus arteriosus (PDA in 20 (22%, tricuspid regurgitation in 6 (7%, pulmonary hypertension in 6 (7%, dyskinesia and ventricular dilatation in 4 (5%. Necropsy was performed in 23 cases and macro and microscopy obtained in 14; the most frequent findings were: myocite necrosis in 8 (54%, congestion, vacuolization and loss of striae in 4 (29%. CONCLUSION: In the majority of cases, patients had a benign course, even those presenting with severe acidemia. Many abnormal EKGs and echocardiograms became normal after a few weeks. Among those who had a fatal outcome, the severity of histological lesions was observed in babies who had suffered asphyxia for more prolonged periods.

  4. Factores de Accesibilidad Relacionados con Muerte Perinatal

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    Vilma del Socorro Catalán Álvarez

    2010-12-01

    Full Text Available Introducción: Objetivo Describir diferencias de factores relacionados con accesibilidad a servicios de salud, entre un grupo de mujeres que tuvieron parto en instituciones prestadoras de servicios de salud de Bucaramanga, cuyos productos sufrieron muerte perinatal y otro grupo con productos vivos, procedentes de Lebrija Santander año 2004. Materiales y métodos: estudio de caso descriptivo, retrospectivo. De 15 muerte perinatal reportadas, sólo 7 cumplían criterios de inclusión. Por cada muerte perinatal, se seleccionaron por conveniencia, 3 madres con niños vivos. Las variables estudiadas, mediante frecuencia absoluta y relativa, fueron: Características de la madre, del niño, Oportunidad, Percepción de atención, Funcionalidad, Costos. Resultados: 6 muerte perinatal previsibles, 1 no previsible. 3 pertenecían al régimen subsidiado, 1 al contributivo, 3 no aseguradas. Se observó, falta de oportunidad para remisión de madres e intervención del parto. Mujeres con 3 ó más controles, presentaron mayor frecuencia relativa de muerte perinatal. También se observó insatisfacción en la percepción de atención, en 3 aspectos estudiados, en 3 niveles de atención. Discusión y Conclusiones: Implementar políticas encaminadas a mejorar la oportunidad de atención materna-perinatal, facilitando acceso oportuno para prestación de servicios de salud. Controles prenatales enfocados en búsqueda de factores relacionados con muerte perinatal. Fortalecer Sistemas de Vigilancia Epidemiológica y Centro Regulador de Urgencias. (Rev Cuid 2010;1(1:26-34.Palabras clave: Mortalidad perinatal, Accesibilidad, Servicios de Salud. (Fuente DeCs, BIREME.

  5. ENCEFALOPATÍA NEONATAL. ALGO MAS QUE ASFIXIA AL NACER Neonathal encefhalopathy something more that perinatal asphysia

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    Yolanda Cifuentes C

    2007-06-01

    Full Text Available La hiperglicinemia no cetósica (HGNC es un error innato del metabolismo, de carácter recesivo, debido a un defecto en el sistema de clivaje, que ocasiona acumulación de glicina en la sangre y en el sistema nervioso central, donde activa dos receptores diferentes. El receptor localizado en la médula espinal, inhibitorio, provoca la apnea y el hipo de estos pacientes. El receptor cortical, excitatorio, produce la lesión cerebral y las convulsiones. Se presenta la historia de un recién nacido masculino, a término, que se torna encefalopático en los primeros días de vida. No presentó hipoglicemia, acidosis metabólica, cetosis ni hiperamonemia. La ecografía transfontanelar fue normal. A los seis días ameritó ventilación mecánica. La cromatografía en capa fina mostró banda de glicina en plasma y orina. El paciente recibió manejo con benzoato de sodio, diazepam y restricción proteica. A los 20 días de vida presentó mejoría neurológica y salió del hospital a los 42 días de vida con igual manejo. El estudio de acilcarnitinas en sangre por tandem-masas hecho en Santiago de Compostela fue normal. La cuantificación de aminoácidos hecha en el CEDEM mostró aumento de los niveles de glicina en plasma y LCR y la relación glicina LCR / plasma confirmó el diagnóstico de hiperglicinemia no cetósica típica. Se revisan las causas de encefalopatía neonatal y se plantea una secuencia para el diagnóstico.Nonketotic hyperglycinemia is an inborn error of metabolism resulting from a defect in the glycine cleavage enzyme system, is inherited as an autosomal recessive trait. It is characterized by elevated concentrations of glycine in blood and central nervous system. Accumulation of glycine in the brain is thought to cause excessive stimulation of the inhibitory and excitatory receptors presenting apnea, hipcus, seizures and brain damage. We report a full-term male newborn with encephalopathy in the first days of life. He did not present

  6. Aciduria piroglutámica en un neonato con anemia hemolítica

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    Cifuentes C., Yolanda; Bermúdez, Martha

    2011-01-01

    Los errores innatos del metabolismo en la época neonatal son de difícil diagnóstico por el amplio espectro del cuadro clínico que va desde asintomáticos o con presentación de síntomas como apnea, alteraciones neurológicas (convulsiones,  encefalopatía, alteración de la conciencia o del tono muscular), dificultad en la alimentación, asfixia perinatal severa sin causa evidente, acidosis metabólica persistente, infección a repetición o falta de respuesta al tratamiento antibiótico, hipoglicemia ...

  7. El recién nacido con agresión hipóxico-isquémica perinatal. Proyecto ARAHIP The newborn with perinatal hypoxic-ischemic injury. ARAHIP project

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    J. Arnáez Solís

    2012-01-01

    La agresión hipóxico-isquémica perinatal es causa de potenciales consecuencias para el recién nacido (RN) con elevada morbi-mortalidad en el periodo neonatal y discapacidad ulterior en el niño. La encefalopatía hipóxico-isquémica (EHI) es la principal causa de muerte, disfunción neurológica grave y convulsiones durante el periodo neonatal en los recién nacidos a término.

  8. Compensatory rebound of body movements during sleep, after asphyxia in neonatal rats Resposta compensatória dos movimentos corporais do sono após a asfixia em ratos recém-nascidos

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    Olivia Adayr Xavier Suarez

    2008-06-01

    Full Text Available PURPOSE: The usefulness of body movements that occur during sleep when assessing perinatal asphyxia and predicting its long-term consequences is contradictory. This study investigated whether neonatal rats manifest these movements in compensatory rebound after asphyxia, and if these alterations play an important role in its pathogenesis. METHODS: Eight neonatal rats (aged 6-48h were implanted with small EMG and EKG electrodes and sleep movements were recorded over a 30-minute control period. Recordings were continued during asphyxia caused by the enclosure of the animal in a polyvinyl sheet for 60 minutes, followed by a 30-minute recovery period. RESULTS: Heart rate was lowered to bradycardic level during asphyxia causing behavioral agitation and increased waking time during the initial phase (30 minutes. Sleep-related movements were also significantly reduced from 12.5 ± 0.5 (median ± SE/2min to 9.0 ± 0.44 in the final half of the period (Anova, pOBJETIVO: A utilidade dos movimentos corporais (MC que ocorrem durante o sono para diagnosticar e predizer as conseqüências, em longo prazo, da asfixia perinatal é contraditório. Este estudo investigou se ratos recém-nascidos (RN manifestam MC em resposta compensatória à asfixia, e se estas alterações podem ter alguma importância na sua patogênese. MÉTODOS: Oito ratos RN (6-48h de vida foram submetidos à implantação de pequenos eletrodos para registros da eletromiografia e eletrocardiografia. Os MC e a freqüência cardíaca (FC foram registrados durante períodos de 30 min: fase controle (F1, fases de asfixia (F2; F3 e fase de recuperação pós-asfixia (F4. A asfixia foi promovida pelo envolvimento completo do animal com uma lâmina de polivinil. RESULTADOS: A FC diminuiu progressivamente durante F2 e F3 até a bradicardia. Em F2 houve grande agitação dos animais e aumento dos períodos de vigília. Em F3 houve redução significante dos MC de 12,5 ± 0,5 (Md ± SE/2min para 9,0

  9. Síndrome de Asfixia Sumersión Asphyxia Drowning Syndrome

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    A. Sibón Olano

    2005-07-01

    Full Text Available El hallazgo de un cadáver en el agua siempre nos plantea dudas diagnósticas: ¿Estamos ante un cadáver arrojado o caído al agua? ¿El sujeto ha fallecido por causas distintas a la sumersión, incluidas las de origen natural? ¿Se trata de una verdadera muerte por sumersión?. La utilización de exámenes complementarios en el diagnóstico de asfixia por sumersión ha sufrido diversos avatares. Las determinaciones bioquímicas han tropezado con los artefactos debidos a la putrefacción, lo que ha llevado a la aparición de determinados métodos de diagnóstico muy controvertidos. Además, los experimentos realizados en animales no siempre son extrapolables al ser humano, dado que hasta la cantidad de agua absorbida por vía aérea, parece ser mucho menor para estos últimos. El diagnóstico de muerte por sumersión se realizará, por lo tanto, estableciendo una correlación entre los hallazgos propios de la sumersión observados en la autopsia y las diferentes pruebas analíticas realizadas en el laboratorio.The finding of a corpse in water always raise doubts for a proper diagnosis: Are we before a corpse thrown or fallen into the water? Was the death due to causes different from drowning, including naturals?. It is a true death by drowning?. The use of complementary examinations in the diagnosis of drowning has undergone diverse ups and downs. The biochemical determinations have been confronted with the artefacts related to the putrefaction which has favoured the appearance of certain very controverted methods of diagnosis. In addition, the experiments made in animals not always must be applied to the human's beings, since the absorbed amount of water by air passages seems to be much smaller for the latest's. The diagnosis of death by drowning will be made, therefore, establishing a correlation between the typical findings of the submersion observed in the autopsy and the different complementary laboratory tests.

  10. Perinatal depression

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    Alhusen, Jeanne L.; Alvarez, Carmen

    2016-01-01

    Abstract: Perinatal depression is a common condition with significant adverse maternal, fetal, neonatal, and early childhood outcomes. The perinatal period is an opportune time to screen, diagnose, and treat depression. Improved recognition of perinatal depression, particularly among low-income women, can lead to improved perinatal health outcomes.

  11. Neuroprotección en la encefalopatia hipóxico isquémica perinatal: Tratamientos con eficacia clínica demostrada y perspectivas futuras Neuroprotection in perinatal hypoxic-ischemic encephalopathy: Effective treatment and future perspectives

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    Agustín Legido

    2007-01-01

    Full Text Available El objetivo de este trabajo es revisar el resultado de estudios clínicos recientes que han demostrado el efecto neuroprotector de algunas terapias en la encefalopatía hipóxico-isquémica (EHI perinatal y presentar las perspectivas futuras de otras investigaciones clínicas y experimentales. Terapias con eficacia clínica demostrada. Alopurinol: Bloquea la producción de radicales libres tras hipoxia-isquemia. En un estudio reciente, los niños con corazón izquierdo hipoplásico tratados con alopurinol, pero no aquéllos con otras cardiopatías, tuvieron un número significativamente menor de complicaciones que los controles, incluyendo muerte, convulsiones, coma o problemas cardíacos. Opiáceos: En otro estudio reciente, un grupo de recién nacidos con EHI tratados con morfina o fentanil tuvieron un grado menor de lesión cerebral en la RMN y un mejor pronóstico neurológico. Hipotermia: Tanto la hipotermia localizada (cerebral como la sistémica (todo el cuerpo tienen un efecto neuroprotector en recién nacidos seleccionados tras sufrir EHI. Perspectivas Futuras. Fármacos antiepilépticos. Estos tienen mecanismos de acción múltiple que pueden bloquear la cascada bioquímica de lesión neuronal en EHI. Otras modalidades terapéuticas. Entre ellas hay que destacar el estudio de la terapia neuroprotectora combinada, los factores de crecimiento, la terapia genética, el transplante de células madre y la vacunación neuroprotectora. En conclusión, un mejor conocimiento de los mecanismos moleculares de la patogenia de la EHI y mejores estudios clínicos con terapias neuroprotectoras abrirá nuevas posibilidades terapéuticas aplicables en la práctica clínica. Todo ello mejorará sin lugar a duda el pronóstico de los recién nacidos con EHI.The aim of this paper is to review the results of recent clinical studies of some therapies that have demonstrated a neuroprotective effect in perinatal hypoxic-ischemic encephalopathy (HIE and to

  12. La estandarización de la escritura. La asfixia del pensamiento filosófico en la academia actual The standardization of writing. Asfixia of philosophical Thought in Academia today

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    Marina Garcés Mascareñas

    2013-03-01

    Full Text Available

    En este artículo se aborda el problema del lugar de la filosofía en la educación universitaria actual a través del análisis de una cuestión concreta: la estandarización de la escritura académica y sus efectos sobre la práctica de la filosofía y su enseñanza. A partir del análisis formal del “paper” académico como patrón único de producción y de valoración de la investigación actual, se valoran sus consecuencias sobre la relación entre pensamiento, escritura y educación. Se llega a la conclusión de que la estandarización de la escritura en la universidad globalmente homologada actual conduce a una asfixia del pensamiento no sólo en la filosofía sino en todos los ámbitos del saber. A la vez, nos da la clave para diagnosticar y localizar, en cada uno de estos ámbitos, cuáles son los espacios de lo innegociable a partir de lo cual debemos repensar nuestra relación con la educación y el pensamiento dentro y fuera de la universidad.

    This article addresses the problem of the place of philosophy in higher education today through the analysis of a single issue: the standardization of academic writing and its effects on the practice of philosophy and teaching. From the formal analysis of the academic "paper", as the unique pattern of production and evaluation of current research, this article evaluates its impact on the relationship between thinking, writing and education. It concludes that standardization of writing in the globally homologated university, leads to a stifling of thought not only in philosophy but in all areas of knowledge. At the same time gives us the key to diagnose and locate, in each of these areas, what are the spaces of the non-negotiable from which we must rethink our relationship with education and thinking inside and outside the university.

  13. ENCEFALOPATÍA NEONATAL. ALGO MAS QUE ASFIXIA AL NACER Neonathal encefhalopathy something more that perinatal asphysia

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    Yolanda Cifuentes C; Martha Bermúdez; Clara Arteaga D

    2007-01-01

    La hiperglicinemia no cetósica (HGNC) es un error innato del metabolismo, de carácter recesivo, debido a un defecto en el sistema de clivaje, que ocasiona acumulación de glicina en la sangre y en el sistema nervioso central, donde activa dos receptores diferentes. El receptor localizado en la médula espinal, inhibitorio, provoca la apnea y el hipo de estos pacientes. El receptor cortical, excitatorio, produce la lesión cerebral y las convulsiones. Se presenta la historia de un recién nacido m...

  14. Hemoglobina materna en el Perú: diferencias regionales y su asociación con resultados adversos perinatales Maternal hemoglobin in Perú: regional differences and its asociation with adverse perinatal outcomes

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    Gustavo F. Gonzales

    2011-09-01

    Full Text Available Objetivos. Establecer la frecuencia de anemia y eritrocitosis en gestantes de diferentes regiones del Perú y la asociación con los resultados adversos perinatales utilizando los datos del Sistema de Información Perinatal (SIP del Ministerio de Salud (MINSA. Materiales y métodos. Se obtuvieron datos de 379 816 partos de 43 centros asistenciales del Ministerio de Salud entre los años 2000 y 2010. Se determinó la frecuencia de anemia y eritrocitosis en cada región geográfica así como de los resultados adversos perinatales. Resultados. La frecuencia de anemia leve fue mayor en la costa (25,8 % y en la selva baja (26,2 %. La frecuencia de anemia moderada/severa es más alta en la selva baja (2,6 % seguido de la costa (1,0 %. En la sierra, las frecuencia más alta de anemia moderada/severa se observa en la sierra sur (0,6 %. La mayor frecuencia de eritrocitosis (Hb>14,5 g/dL fue encontrada en la sierra centro (23,7 %, seguido de 11,9 % en la sierra sur y 9,5 % en la sierra norte. La anemia severa y la eritrocitosis estuvieron relacionadas con los resultados adversos perinatales. Conclusiones. Hay diferencias por región geográfica en la frecuencia de anemia. En la sierra central se encontró mayor frecuencia de eritrocitosis con respecto a la sierra sur. Tanto la anemia severa como la eritrocitosis aumentan los resultados adversos perinatales.Objectives. To evaluate hemoglobin (Hb levels in pregnant women from different geographical regions from Peru; to establish anemia and erythrocytocis rates and to establish the role of Hb on adverse perinatal outcomes using the Perinatal Information System (PIS database of Peruvian Ministry of Health. Materials and methods. Data were obtained from 379,816 births of 43 maternity care units between 2000 and 2010. Anemia and erythrocytocis rates were determined in each geographical region as well as rates of adverse perinatal outcomes. To analyze data the STATA program (versión 10.0,Texas, USA was used

  15. NOCIÓN DE LA PALABRA ESCRITA Y NOCIÓN GRAMATICAL DE LA ORACIÓN ESCRITA EN NIÑOS CON ANTECEDENTE DE ENCEFALOPATÍA PERINATAL/ THE NOTION OF THE WRITTEN WORD AND THE GRAMMATICAL NOTION OF THE WRITTEN SENTENCE IN CHILDREN WITH A HISTORY OF PERINATAL ENCEPHALOPATHY/ NOÇÃO DA PALAVRA ESCRITA E NOÇÃO GRAMATICAL DA ORAÇÃO ESCRITA EM CRIANÇAS COM ANTECEDENTE DE ENCEFALOPATIA PERINATAL

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    Dora Elizabeth Granados Ramos

    2011-12-01

    Full Text Available El objetivo de esta investigación fue describir las características de la noción de la palabra escrita y la noción gramatical de la oración escrita, en 28 niños de 4 a 8 años con encefalopatías hipóxicoisquémica, hiperbilirrubinémica y mixta en el periodo perinatal. Para tal fin, se aplicaron las pruebas Monterrey y Terman Merrill, y se documentó la secuela neuropsicológica. El 75% de los niños presentó secuela cognoscitiva leve; 82% estuvo en el nivel esperado de las nociones evaluadas acordes con su edad, y del 18% de los niños con atraso en la lectura cuatro tuvieron antecedentes de encefalopatía mixta y uno antecedentes de hiperbilirrubinemia. Se discuten los niveles de conceptualización de lecto-escritura y su relación con variables biológicas y sociales.

  16. NOCIÓN DE LA PALABRA ESCRITA Y NOCIÓN GRAMATICAL DE LA ORACIÓN ESCRITA EN NIÑOS CON ANTECEDENTE DE ENCEFALOPATÍA PERINATAL/ THE NOTION OF THE WRITTEN WORD AND THE GRAMMATICAL NOTION OF THE WRITTEN SENTENCE IN CHILDREN WITH A HISTORY OF PERINATAL ENCEPHALOPATHY/ NOÇÃO DA PALAVRA ESCRITA E NOÇÃO GRAMATICAL DA ORAÇÃO ESCRITA EM CRIANÇAS COM ANTECEDENTE DE ENCEFALOPATIA PERINATAL

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    Dora Elizabeth Granados Ramos; Gabriela Romero Esquiliano; Ignacio Méndez Ramírez; Juan Fernández Ruiz

    2011-01-01

    El objetivo de esta investigación fue describir las características de la noción de la palabra escrita y la noción gramatical de la oración escrita, en 28 niños de 4 a 8 años con encefalopatías hipóxicoisquémica, hiperbilirrubinémica y mixta en el periodo perinatal. Para tal fin, se aplicaron las pruebas Monterrey y Terman Merrill, y se documentó la secuela neuropsicológica. El 75% de los niños presentó secuela cognoscitiva leve; 82% estuvo en el nivel esperado de las nociones evaluadas acord...

  17. Noción de la palabra escrita y noción gramatical de la oración escrita en niños con antecedente de encefalopatía perinatal/the notion of the written word and the grammatical notion of the written sentence in children with a history of perinatal ...

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    Granados Ramos, Dora Elizabeth; Romero Esquiliano, Gabriela; Méndez Ramírez, Ignacio; Fernández Ruiz, Juan

    2011-01-01

    El objetivo de esta investigación fue describir las características de la noción de la palabra escrita y la noción gramatical de la oración escrita, en 28 niños de 4 a 8 años con encefalopatías hipóxicoisquémica, hiperbilirrubinémica y mixta en el periodo perinatal. Para tal fin, se aplicaron las pruebas Monterrey y Terman Merrill, y se documentó la secuela neuropsicológica. El 75% de los niños presentó secuela cognoscitiva leve; 82% estuvo en el nivel esperado de las nociones evaluadas acord...

  18. INTERACCIONES TEMPRANAS MADRE - NIÑO Y PREDICCIÓN DE DESARROLLO MOTOR MEDIANTE ECUACIONES ESTRUCTURALES APLICACIÓN DEL MODELO EN NIÑOS CON RIESGO DE DAÑO NEUROLÓGICO PERINATAL

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    PATRICIA MUÑOZ LEDO RÁBAGO

    2013-01-01

    Full Text Available Los impactos más importantes de las expresiones tempranas del daño neurológico en los niños, son las dificultades para establecer intercambios con su medio social, afectando en la etapa inicial las primeras interacciones con su madre. Niños con riesgo biológico muestran grandes dificultades para iniciar interacciones. Cuando las madres se ajustan en una relación bidireccional se logra un aumento en las iniciaciones del niño; si las madres responden menos, los niños disminuyen las iniciaciones y aumentan la irritabilidad. Los programas de intervención temprana que integran en sus estrategias el manejo de las interacciones madre-niño se han considerado exitosos por sus implicaciones directas en el desarrollo del niño. Se requiere mayor soporte empírico sobre la influencia de patrones específicos de interacciones tempranas madre-hijo y el desarrollo posterior de niños con daño neurológico perinatal, en términos de prevención de alteraciones o discapacidad. Se realizó un estudio longitudinal y se reporta el efecto de las interacciones de reciprocidad madre-hijo en el desarrollo motor observado en niños a los 4, 8 y 12 meses de edad, a través del empleo del Modelo de Ecuaciones Estructurales (Curva de Crecimiento Latente. Se concluye que el modelo permitió mostrar que en niños de riesgo perinatal, las interacciones madre-hijo representan un buen predictor del desarrollo motor en el primer año de vida. Estos hallazgos tienen importantes implicaciones en la práctica clínica como estrategia integral para el diseño de acciones de intervención temprana debido a que los logros motores en los primeros meses representan un indicador predictivo del desarrollo infantil posterior.

  19. Diabetes Mellitus and Pregnancy. Perinatal Results in a 3 years Study. Diabetes mellitus y embarazo. Resultados perinatales en estudio de 3 años.

    Directory of Open Access Journals (Sweden)

    Amparo Ocampo Sánchez

    >Métodos: Se realizó un estudio descriptivo, de serie de casos. De un universo de 13 603 partos realizados desde el 1ro de enero del 2003 al 31 de diciembre del 2005, en el Servicio de Obstetricia del Hospital Universitario “Dr. Gustavo Aldereguía Lima” de Cienfuegos, se tomó una muestra de 229 gestantes con diabetes. Se determinaron las tasas de bajo peso, prematuridad, malformaciones congénitas, muertes fetales tardías, macrosomía, asfixia y tasa de cesárea en las gestantes diabéticas; así como el riesgo de estas complicaciones para este grupo con respecto a las gestantes no diabéticas y entre la diabetes gestacional y pregestacional. Resultados: La incidencia de diabetes y embarazo fue de 1,68 %. El riesgo de prematuridad (17,4 %, de bajo peso del recién nacido (13,1 %, macrosomía (15,3 %, malformaciones (3,5 %, muerte neonatal (0,4 %, muerte fetal tardía (0,9 % y parto por cesárea (64,2 % se incrementó en la población diabética, con respecto a la no diabética. La diabetes pregestacional resultó tener mayores riesgos con respecto a la gestacional, para el parto pretérmino, las malformaciones congénitas mayores y las muertes fetales tardías. Conclusiones: A pesar de que la provincia muestra una incidencia baja de diabetes en el embarazo, el riesgo de resultados perinatales adversos es considerable para este grupo, en especial en pacientes con diabetes pregestacional.

  20. O uso de células-tronco na asfixia perinatal: do laboratório à prática clínica

    Directory of Open Access Journals (Sweden)

    Simone de Paula

    2010-12-01

    Full Text Available OBJETIVOS: Apresentar evidências científicas recentes sobre os efeitos do transplante com células-tronco em modelos animais de lesão cerebral hipóxico-isquêmica neonatal e abordar os aspectos translacionais relevantes à aplicação clínica da terapia celular nesse contexto. FONTES DOS DADOS: Para a seleção dos artigos, utilizou-se a base de dados PubMed e Scopus. O critério de seleção de artigos foi a especificidade em relação ao tema estudado, preferencialmente a partir do ano de 2000. Também foram revisados artigos clássicos de anos anteriores que se aplicavam ao propósito desta revisão. SÍNTESE DOS DADOS: Células-tronco de diferentes fontes exógenas podem exibir propriedades neuroprotetoras em modelos experimentais de hipóxia-isquemia neonatal. Na maioria dos experimentos animais, os benefícios morfológicos e funcionais observados foram independentes da diferenciação neural, sugerindo mecanismos de ação associados, tais como a liberação de fatores tróficos e a modulação inflamatória. CONCLUSÕES: Baseado nos estudos experimentais analisados, a terapia celular pode tornar-se uma promissora abordagem terapêutica no tratamento de crianças com encefalopatia hipóxico-isquêmica. No entanto, estudos adicionais necessitam ser realizados a fim de elucidar os possíveis mecanismos de ação dessas células e definir estratégias clínicas seguras e efetivas.

  1. O uso de células-tronco na asfixia perinatal: do laboratório à prática clínica

    OpenAIRE

    Simone de Paula; Samuel Greggio; Jaderson Costa DaCosta

    2010-01-01

    OBJETIVOS: Apresentar evidências científicas recentes sobre os efeitos do transplante com células-tronco em modelos animais de lesão cerebral hipóxico-isquêmica neonatal e abordar os aspectos translacionais relevantes à aplicação clínica da terapia celular nesse contexto. FONTES DOS DADOS: Para a seleção dos artigos, utilizou-se a base de dados PubMed e Scopus. O critério de seleção de artigos foi a especificidade em relação ao tema estudado, preferencialmente a partir do ano de 2000. Também ...

  2. Mortalidad perinatal y duelo materno

    OpenAIRE

    Laverde Rubio, Eduardo

    2011-01-01

    Se investigaron desde el punto de vista médico-psicológico dos grupos de madres cuyos hijos murieran durante el periodo perinatal (entre 28 semanas de gestación y 28 días de nacido). EI primer grupo de estudio lo configuraban 20 pacientes que reaccionaron con un duelo prolongado ante la perdida de su hijo. EI segundo grupo esta conformado por 20 pacientes (grupo de comparación) que elaboraron la perdida de su hijo mediante un duelo no complicado. La hipótesis general que obtento este trabajo ...

  3. Eliminating Perinatal HIV Transmission

    Centers for Disease Control (CDC) Podcasts

    2012-11-26

    In this podcast, CDC’s Dr. Steve Nesheim discusses perinatal HIV transmission, including the importance of preventing HIV among women, preconception care, and timely HIV testing of the mother. Dr. Nesheim also introduces the revised curriculum Eliminating Perinatal HIV Transmission intended for faculty of OB/GYN and pediatric residents and nurse midwifery students.  Created: 11/26/2012 by Division of HIV/AIDS Prevention.   Date Released: 11/26/2012.

  4. Factores psicológicos implicados en el Duelo Perinatal Psychological factors involved in perinatal grief

    Directory of Open Access Journals (Sweden)

    Manuel Fernández-Alcántara

    2012-06-01

    Full Text Available Justificación: El duelo perinatal, hasta hace poco escasamente reconocido, está adquiriendo un estatuto propio. Esto es debido sus características singulares e idiosincrásicas. Objetivo: Con esta revisión se pretende señalar y analizar las diferentes variables que interactúan en el duelo perinatal. Metodología: Se utilizaron las bases de SCOPUS, Medline y Web of Science, obteniéndose un total de 146 referencias, de las cuales se seleccionaron 48. Resultados: El análisis se agrupa en cuatro categorías: las reacciones a la pérdida, la diferencia entre hombres y mujeres, las intervenciones más adecuadas por parte del personal sanitario, así como los principales problemas que presenta la práctica para ellos. Conclusión: Se realiza un análisis crítico de la situación del duelo perinatal y se plantea el desarrollo de nuevas líneas de investigación que puedan mejorar la práctica clínica y dar pie a futuras investigaciones.Justification: Perinatal grief hasn't been recognized in the past, but now it's acquiring an appropriate statute. Objective: With this review, it is expected to point out and analyze the diverse variables that interact in perinatal grief. Methodology: For the articles selection process, data bases from SCOPUS, Medline and Web of Science were consulted. After the process, 48 references (from a total of 146 were obtained. Results: The analysis was grouped in four categories: the initial reactions to the loss, the difference between men and women, the most suitable interventions by sanitary staff, and the main problems which are present in their practise. Conclusion: A critical analysis about the situation of perinatal grief is made and the development of new ways of research.

  5. Perinatal tuberculosis: a diagnostic challenge

    Directory of Open Access Journals (Sweden)

    Edna Lúcia S. de Souza

    2006-06-01

    Full Text Available Despite the high prevalence of tuberculosis in adults and children, the congenital and perinatal forms of tuberculosis are rare. In Brazil, there has been only one published case of congenital tuberculosis and two cases of the perinatal form of this disease. We report a case of perinatal tuberculosis presenting with pneumonia. Alcohol-acid-resistant bacilli were found in the gastric lavage. Diagnosis of this disease presentation requires a high index of suspicion.

  6. Perinatal Hypoxic-Ischemic Encephalopathy

    OpenAIRE

    Ming-Chi Lai; San-Nan Yang

    2010-01-01

    Perinatal hypoxic-ischemic encephalopathy (HIE) is an important cause of brain injury in the newborn and can result in long-term devastating consequences. Perinatal hypoxia is a vital cause of long-term neurologic complications varying from mild behavioural deficits to severe seizure, mental retardation, and/or cerebral palsy in the newborn. In the mammalian developing brain, ongoing research into pathophysiological mechanism of neuronal injury and therapeutic strategy after perinatal hypoxia...

  7. Perinatal risk factors for strabismus

    DEFF Research Database (Denmark)

    Torp-Pedersen, Tobias; Boyd, Heather A; Poulsen, Gry; Haargaard, Birgitte; Wohlfahrt, Jan; Holmes, Jonathan M; Melbye, Mads

    2010-01-01

    Little is known about the aetiological factors underlying strabismus. We undertook a large cohort study to investigate perinatal risk factors for strabismus, overall and by subtype.......Little is known about the aetiological factors underlying strabismus. We undertook a large cohort study to investigate perinatal risk factors for strabismus, overall and by subtype....

  8. Respect in the Perinatal Experience

    OpenAIRE

    DeLellis, Anthony J.

    2000-01-01

    Perinatal educators wish to respect all parties in the perinatal experience. To accomplish this, some may need to learn and practice ways to express feelings of respect. Respect can be written into policy or procedure and is implicit in personal interaction. While all the possible ways to demonstrate respect cannot be listed and passed along, principles of respect can be offered for guidance.

  9. INTERACCIONES TEMPRANAS MADRE - NIÑO Y PREDICCIÓN DE DESARROLLO MOTOR MEDIANTE ECUACIONES ESTRUCTURALES APLICACIÓN DEL MODELO EN NIÑOS CON RIESGO DE DAÑO NEUROLÓGICO PERINATAL

    OpenAIRE

    PATRICIA MUÑOZ LEDO RÁBAGO; IGNACIO MÉNDEZ RAMÍREZ; CARMEN SÁNCHEZ PÉREZ; MARIO MANDUJANO VALDÉS; CHIHARU MURATA

    2013-01-01

    Los impactos más importantes de las expresiones tempranas del daño neurológico en los niños, son las dificultades para establecer intercambios con su medio social, afectando en la etapa inicial las primeras interacciones con su madre. Niños con riesgo biológico muestran grandes dificultades para iniciar interacciones. Cuando las madres se ajustan en una relación bidireccional se logra un aumento en las iniciaciones del niño; si las madres responden menos, los niños disminuyen las iniciaciones...

  10. Atención temprana en educación infantil: actividades para la inclusión de una niña con secuelas por hipoxia perinatal

    OpenAIRE

    Alonso González, Andrea

    2016-01-01

    Atención Temprana en Educación Infantil: Actividades para la inclusión de una niña con secuelas por hipoxia perinatal’ es el tema que se aborda en este Trabajo de Fin de Grado. Consta de dos partes bien diferenciadas. En la primera de ellas se presenta un marco teórico en el cual se hace un recorrido histórico de la Atención Temprana en España. En la segunda parte se plantean un conjunto de actividades para poder llevar a cabo en el aula con una alumna con necesidades educativas especiales, d...

  11. Maternal and perinatal mortality.

    Science.gov (United States)

    Krishna Menon, M K

    1972-01-01

    A brief analysis of data from the records of the Government Hospital for Women and Children in Madras for a 36-year period (1929-1964) is presented. India with a population of over 550 million has only 1 doctor for each 6000 population. For the 80% of the population which is rural, the doctor ratio is only 88/1 million. There is also a shortage of paramedical personnel. During the earlier years of this study period, abortions, puerperal infections; hemorrhage, and toxemia accounted for nearly 75% of all meternal deaths, while in later years deaths from these causes were 40%. Among associated factors in maternal mortality, anemia was the most frequent, it still accounts for 20% and is a contributory factor in another 20%. The mortality from postpartum hemorrhage was 9.3% but has now decreased to 2.8%. Eclampsia is a preventable disease and a marked reduction in maternal and perinatal mortality from this cause has been achieved. Maternal deaths from puerperal infections have dropped from 25% of all maternal deaths to 7%. Uterine rupture has been reduced from 75% to 9.3% due to modern facilities. Operative deliveries still have an incidence of 2.1% and a mortality rate of 1.4% of all deliveries. These rates would be further reduced by more efficient antenatal and intranatal care. Reported perinatal mortality of infants has been reduced from 182/1000 births to an average of 78/1000 in all areas, but is 60.6/1000 in the city of Madras. Socioeconomic standards play an important role in perinatal mortality, 70% of such deaths occurring in the lowest economic groups. Improvement has been noted in the past 25 years but in rural areas little progress has been made. Prematurity and low birth weights are still larger factors in India than in other countries, with acute infectious diseases, anemia, and general malnutrition among mothers the frequent causes. Problems requiring further efforts to reduce maternal and infant mortality are correct vital statistics, improved

  12. Countrywide analysis of perinatal outcome.

    Science.gov (United States)

    Stembera, Z; Kravka, A; Mandys, F

    1988-01-01

    The computer laboratory of the Research Institute for the Care of Mother and Child in Prague performs annually a countrywide analysis of perinatal outcome in order to obtain a background for the preparation of the optimal strategy for improving perinatal care in CSR in the future. The total as well as weight specific perinatal mortality rate further sub-divided into early neonatal death rate and late fetal death rate and differentiated according to the birthweight, was correlated with the incidence of different factors influencing the perinatal mortality rate both countrywide and for each of the eight provinces of CSR. This way a correlation was found between some of the mentioned perinatal outcomes and e.g. instrumental equipment of obstetrical departments and neonatal intensive care units, frequency of caesarean sections, or transport of LBW newborns in incubators or "in utero" etc. The results of this analysis have proved that there still remain in some provinces opportunity for further decrease in perinatal mortality due to the incomplete observance of the two intervention strategies "Risk approach" and "New technology" which were introduced in the whole country during the last 10 years. PMID:3221298

  13. Perinatal programming prevention measures.

    Science.gov (United States)

    Larguía, A Miguel; González, María Aurelia; Dinerstein, Néstor Alejandro; Soto Conti, Constanza

    2015-01-01

    Over the past 10 years, there has been outstanding scientific progress related to perinatal programming and its epigenetic effects in health, and we can anticipate this trend will continue in the near future. We need to make use and apply these achievements to human neurodevelopment via prevention interventions. Based on the concept of the interaction between genome and ambiome, this chapter proposes low-cost easy-implementation preventive strategies for maternal and infant health institutions.Breastfeeding and human milk administration are the first preventive measures, as has been reviewed in the policy statement of the American Academy of Pediatrics. Another strategy is the Safe and Family-Centered Maternity Hospitals initiative that promotes and empowers the inclusion of the families and the respect for their rights, especially during pregnancy and birth. (This change of paradigm was approved and is recommended by both United Nations Children's Fund, UNICEF, and Pan American Health Organization, PAHO.) Then, there is also an important emphasis given to the sacred hour-which highlights the impact of bonding, attachment, and breastfeeding during the first hour of life-the pain prevention and treatment in newborns, the control of the "new morbidity" represented by late preterm infants, and finally, the importance of avoiding intrauterine and extrauterine growth restriction. (However, there are not yet clear recommendations about nutritional interventions in order to diminish the potential metabolic syndrome consequence in the adult.). PMID:25287552

  14. Perinatal and neurodevelopmental outcome of late-onset growth restricted fetuses

    OpenAIRE

    Orós López, Daniel

    2010-01-01

    [spa] DE LA TESIS: "Resultado perinatal y del neurodesarrollo en fetos con retraso de crecimiento intrauterino de instauración tardía" TEXTO: El retraso de crecimiento intrauterino es una de las patologías más graves del desarrollo fetal, asociándose con un incremento la mortalidad intrauterina, mortalidad perinatal y prematuridad, siendo un conocido factor de riesgo para el desarrollo de déficits neurológicos durante la infancia y la adolescencia. Se considera "pequeños" a todos los fetos co...

  15. Antenatal umbilical cord parameters and perinatal outcome

    Directory of Open Access Journals (Sweden)

    Athira Narayanan

    2016-04-01

    Conclusions: No association between antenatal umbilical cord characteristics and perinatal outcome was found in pregnancies at high risk for poor perinatal outcome. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1211-1215

  16. Situação de saúde materna e perinatal no Estado de São Paulo, Brasil Maternal and perinatal health position in the State of S. Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Ana Cristina d'Andretta Tanaka

    1989-02-01

    Full Text Available Pelos dados oficiais disponíveis, para o Estado de São Paulo (Brasil analisou-se a assistência oferecida na gestação, no parto e ao recém-nascido e suas relações com a mortalidade materna e perinatal. Com referência ao pré-natal, houve indícios de quantidade de consultas por gestação, numericamente suficiente, porém de qualidade discutível. Quanto ao parto observou-se uma alta percentagem de cesarianas (46,2%. A mortalidade materna foi de 4,86 por dez mil n.v., valor este subestimado. A primeira causa de óbitos maternos foram as toxemias, seguidas das hemorragias e do aborto, causas estas evitáveis em sua maioria, com uma boa qualidade de assistência pré-natal e ao parto. Quanto aos óbitos do período perinatal, o coeficiente foi de 29,2 por mil nascimentos em 1984, valor este também elevado. A análise das causas de óbitos mostrou que as afecções de origem perinatal ocorreram em cerca de 90% dos óbitos, tendo como principais causas as hipóxias intra-uterinas, asfixias, síndromes de angústia respiratória e aspiração maciça. Esses dados revelam a má qualidade de assistência recebida por este grupo. Sugere-se que a nova política de Sistema Unificado e Descentralizado de Saúde deveria levar em conta tanto a qualidade de assistência como a integração dos serviços para poder-se fazer frente à situação precária de saúde materna e perinatal do Estado.The assistance offered during pregnancy and labour as also to the newborn child, and its relationship to maternal and perinatal mortality in the State of S. Paulo in 1984, is analysed on the basis of official available data. With respect to prenatal care the number of visits per woman was considered to be "sufficient" though of doubtful quality. The proportion of cesarean sections was very high (46.2%. Maternal mortality was found to be 4.86 deaths per 10,000 live births, but despite its being high, this figure is certainly too low and the correct figure is

  17. FACTORS CONTRIBUTING TO PERINATAL MORTALITY : OPTIMIZING OUTCOME

    OpenAIRE

    Lakshmi; Menon Nalini; Aravind

    2015-01-01

    OBJECTIVE: To evaluate the various causes of perinatal deaths and adopt strategies to improve perinatal outcome at a referral teaching hospital in North Kerala. METHODS: A prospective observational study conducted at Institute of Maternal and Child Health, Government Medical College, Kozhikode. All perinatal deaths during the period January 2013 to December 2014 were analysed and from this factors responsible for ...

  18. FACTORS CONTRIBUTING TO PERINATAL MORTALITY : OPTIMIZING OUTCOME

    Directory of Open Access Journals (Sweden)

    Lakshmi

    2015-03-01

    Full Text Available OBJECTIVE: To evaluate the various causes of perinatal deaths and adopt strategies to improve perinatal outcome at a referral teaching hospital in North Kerala. METHODS: A prospective observational study conducted at Institute of Maternal and Child Health, Government Medical College, Kozhikode. All perinatal deaths during the period January 2013 to December 2014 were analysed and from this factors responsible for perinatal deaths were identified. RESULTS: Out of total 30,042 deliveries , there were 966 perinatal deaths during the study period. 566 were still births and 400 early neonatal deaths. The perinatal mortality rate was 31.1 per 1000 live births. Perinatal asphyxia was the major cause of perinatal mortality. The important factors contributing to perinatal asphyxia were prematurity (39%, abruptio placenta (19% and MSAF ( 12%. Among the antenatal factors, hypertensive disorders of pregnancy leading to iatrogenic elective preterm delivery were the most important. CONCLUSION: Perinatal asphyxia due to prematurity and low birth weight emerged as the most important cause of perinatal mortality in this study and hypertensive disorders of pregnancy were the most important antenatal complication leading to prematurity

  19. Predictors of Perinatal Hemorrhagic Stroke

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-04-01

    Full Text Available The prevalence and predictors of perinatal hemorrhagic stroke were determined in a case-control study of infants born from 1993 to 2003 in the Northern California Kaiser Permanente Medical Care Program, Oakland, CA, and reported from the University of California, San Francisco, CA.

  20. Predictors of Perinatal Hemorrhagic Stroke

    OpenAIRE

    J Gordon Millichap

    2009-01-01

    The prevalence and predictors of perinatal hemorrhagic stroke were determined in a case-control study of infants born from 1993 to 2003 in the Northern California Kaiser Permanente Medical Care Program, Oakland, CA, and reported from the University of California, San Francisco, CA.

  1. Experiences with perinatal loss from the health professionals’ perspective La vivencia de la pérdida perinatal desde la perspectiva de los profesionales de la salud A experiência da perda perinatal a partir da perspectiva dos profissionais de saúde

    Directory of Open Access Journals (Sweden)

    Sonia María Pastor Montero

    2011-12-01

    Full Text Available The purpose of this paper is to know the experience of health professionals in situations of perinatal death and grief and to describe their action strategies in the management of perinatal loss. A qualitative study with a phenomenological approach was carried out through interviews conducted with 19 professionals. Three thematic categories were identified: Healthcare practice, feelings aroused by perinatal loss and meaning and beliefs about perinatal loss and grief. The results revealed that the lack of knowledge and skills to deal with perinatal loss are identified as the main reason behind unsuitable attitudes that are usually adopted in these situations. This generates anxiety, helplessness and frustration that compromise professional competency. The conclusion reached is that the promotion of training programs to acquire knowledge, skills and abilities in management of perinatal bereavement and the development of a clinical practice guideline for perinatal loss are necessary.El objetivo de este artículo es conocer la experiencia vivida por los profesionales de la salud en situaciones de muerte y duelo perinatal y describir las estrategias de actuación ante la pérdida perinatal. Se trata de un estudio cualitativo con un enfoque fenomenológico realizado a 19 profesionales a través de entrevistas. Se identificaron 3 categorías temáticas: la práctica asistencial, los sentimientos que despierta la pérdida perinatal y significado y creencias sobre la pérdida y el duelo perinatal. Los resultados ponen de manifiesto que la falta de conocimientos y de recursos para enfrentar la pérdida perinatal hace que se adopten actitudes poco adecuadas en estas situaciones, generando una sensación de ansiedad, impotencia y frustración que compromete la competencia profesional. Se concluye que es fundamental promover programas de formación para adquirir conocimientos y destrezas sobre el duelo perinatal y elaborar una guía de práctica cl

  2. Identification of peripartum near-miss for perinatal audit

    OpenAIRE

    Kerkhofs, C; De Bruyn, C.; Mesens, T.; Theyskens, C.; Vanhoestenberghe, M.; E. Bruneel; Van Holsbeke, C; Bonnaerens, A.; Gyselaers, W.

    2014-01-01

    Introduction: Today, perinatal audit focuses basically on cases of perinatal mortality. In most centres in Western Europe, perinatal mortality is low. Identification of metabolic acidosis at birth may increase index cases eligible for evaluation of perinatal care, and this might improve quality of perinatal audit. The aim of this study is to assess the incidence of metabolic acidosis at birth in order to estimate its impact on perinatal audit. Patients and Methods: Cord blood was analysed for...

  3. Mortes perinatais evitáveis em Belo Horizonte, Minas Gerais, Brasil, 1999 Avoidable perinatal deaths in Belo Horizonte, Minas Gerais, Brazil, 1999

    Directory of Open Access Journals (Sweden)

    Sônia Lansky

    2002-10-01

    Full Text Available Tendo em vista a elevada taxa de mortalidade perinatal em Belo Horizonte, foi realizado estudo dos 826 óbitos perinatais da coorte de nascimentos ocorridos no município em 1999, com análise da possibilidade de sua prevenção, utilizando-se o enfoque de evitabilidade de Wigglesworth. A taxa de mortalidade perinatal observada foi 20,2 por mil e o risco de morte perinatal foi vinte vezes maior para as crianças com baixo peso ao nascer. Cerca de um quarto das crianças tinham peso maior que 2.500g e a asfixia intraparto foi a principal causa de óbito neste grupo. A causa anteparto contribuiu com 30% dos óbitos e 25% destas crianças tinham peso maior que 2.500g. Observou-se ainda a ocorrência de óbitos perinatais fora do hospital e óbitos de crianças cujas mães chegaram à maternidade já em período expulsivo. Cerca de 40% dos óbitos perinatais e 60% dos óbitos neonatais poderiam ter sido evitados. Estas mortes precoces sugerem falhas na assistência à gestante e ao recém-nascido no município, tanto no atendimento clínico como na organização da rede assistencial, sendo necessário avançar na qualificação e responsabilização dos serviços e do sistema de saúde como um todo sobre esta população.The perinatal mortality rate is still high in Belo Horizonte. This study investigated all 826 perinatal deaths taking place in 1999, focusing on the possibility of their prevention, using the Wigglesworth classification. The perinatal mortality rate was 20.2 per one thousand births, and the risk of perinatal death was 20 times higher in children with low birthweight. Some 24.6% of the children weighed more than 2,500g, and the main cause of death in this group was asphyxia during labor. The antepartum cause of death contributed to 30% of all deaths, and 25% of these children weighed more than 2,500g. Some deaths occurred out of hospital, and in some cases the mother arrived at hospital in end-stage labor. About 40% of all perinatal

  4. Maternidad tras una muerte perinatal

    OpenAIRE

    Rozas García, M. Rosa; Francés Ribera, Lidia

    2001-01-01

    La nueva gestación tras una muerte perinatal está llena de dudas, miedos e inseguridades, y es una situación que va a suponer un desgaste físico y emocional para la familia, especialmente para la mujer. Esta gestación se caracteriza por un aumento de la ansiedad, que puede continuar después del nacimiento y manifestarse mediante conductas de sobreprotección del nuevo hijo. Las matronas deben conocer las posibles respuestas emocionales de la mujer y proporcionar cuidados y apoyo específicos du...

  5. Maternal diabetes and perinatal programming.

    Science.gov (United States)

    Plagemann, A

    2011-11-01

    Alterations of the intrauterine and neonatal environment may predispose for disorders and diseases throughout later life (perinatal programming). Especially, hormones and nutrients are dose-dependent organizers of the developing organism. Studies in offspring of diabetic mothers (ODM) have paradigmatically contributed to the perception of this developmental principle and our understanding of causal mechanisms. Fetal and neonatal hyperinsulinism in consequence of materno-fetal hyperglycaemia is the pathognomic feature in ODM. Epidemiological, clinical, as well as experimental data indicate that both insulin and glucose, when occurring in elevated concentrations during perinatal life, may epigenetically program a predisposition for obesity and diabetes later on. Similar may occur due to pre- and neonatal overfeeding. From a clinical point of view, avoidance of materno-fetal overnutrition, universal diabetes screening in all pregnant women and adequate therapy of all forms of diabetes during pregnancy, as well as avoidance of neonatal overfeeding are therefore recommended. These measures might serve as causal approaches of a genuine prevention to the benefit of long-term offspring health. PMID:21945359

  6. The perinatal loss and parental reflection

    Directory of Open Access Journals (Sweden)

    Kamile Kukulu

    2010-12-01

    Full Text Available In this review, the causes of prenatal losses, pregnancy termination and reflection of this situation for the parents were investigated. Despite great attention in improving perinatal care, perinatal loss (fetal loss and newborn death continues to occur. According to the World Health Organization (WHO, the perinatal period extends from the 20th gestational week through 1 month after birth. However, researchers who study perinatal loss use a broader definition that includes early (during the first 12 weeks following conception as well as late fetal loss (>20 weeks’ gestation. Of all known pregnancies, an estimated ratio of 12% to 20% ends in an early fetal loss. The most recent available data have revealed that the rates translate to about 1.03 million annual fetal losses and, for 2004, 18.602 newborn deaths. According to the results of 2008, infant mortality rate decreased very rapidly in Turkey. Of the many parents who suffer a perinatal loss, at least 80% become pregnant again, an event that occurs within 18 months. Therefore, it is important for nurses and health care professionals to understand the impact of a perinatal loss on a subsequent pregnancy. The purpose of this article is to perform an investigation on parental, primarily maternal, responses to pregnancy subsequent to perinatal loss, and to describe nursing implications for parents during the subsequent pregnancy.

  7. La mortalidad perinatal según 2 fuentes de información Perinatal mortality according to 2 information sources

    Directory of Open Access Journals (Sweden)

    Adriana Freitas Ramírez

    2008-08-01

    Full Text Available Objetivo: Evaluar la diferencia en muertes perinatales (MP ocurridas en Cataluña y su evolución según 2 fuentes de información sanitaria. Métodos: Los datos proceden de la estadística de mortalidad (Departament de Salut e Institut d'Estadística de Catalunya y del Conjunto Mínimo Básico de Datos de Altas Hospitalarias (CMBDAH del Servei Català de la Salut del período 2000-2003. Se describen las frecuencias totales de MP según si cumplen o no criterio legal de declaración. Resultados: La estadística de mortalidad registró un 27,2% menos de MP, un 44,77% menos de muertes fetales y un 13,5% más de muertes neonatales precoces que el CMBDAH. Estos porcentajes son menores considerando sólo los casos con criterios legales de declaración. Conclusión: Las diferencias de casos entre ambas fuentes están relacionadas con características del recién nacido: bajo peso al nacer, prematuridad y lugar en que se produjo. Los datos hospitalarios podrían mejorar la estadística de mortalidad perinatal.Objective: To evaluate differences in the number of cases of perinatal mortality in Catalonia (Spain recorded in 2 health information systems, as well as trends in this phenomenon. Methods: Data were obtained from the mortality statistics (Health Department and the Catalan Institute of Statistics and the minimum data set (MDS for hospital discharges of the Catalan Health Service from 2000-2003. The frequencies are given for the cases reported and for cases following the legal criteria for reporting. Results: The mortality statistics registered 27.2% fewer perinatal deaths, 44.77% fewer fetal deaths and 13.5% more early neonatal deaths than the MDS. These percentages were lower when only the cases following the legal criteria for reporting were considered. Conclusion: The differences between the two sources were related to low birth weight, prematurity, and the place of occurrence. Use of hospital data might improve the quality of perinatal

  8. Masas retroperitoneales en el período perinatal Retroperitoneal masses in the perinatal period

    Directory of Open Access Journals (Sweden)

    Nelda María Castagnaro Rosini

    2011-03-01

    Full Text Available Objetivo: identificar las causas más frecuentes de masa retroperitoneal durante el período fetal y neonatal e ilustrar los hallazgos imagenológicos basados en los resultados obtenidos de nuestra experiencia. Material y método: estudio retrospectivo observacional de las causas de masas retroperitoneales en recién nacidos (RN. Se analizaron historias clínicas y hallazgos radiológicos y ultrasonográficos de 487 neonatos a los que se les había realizado ecografía abdominal entre enero de 2008 y diciembre de 2009. Se seleccionaron 47 RN con diagnóstico de lesión retroperitoneal, respetando los siguientes criterios: Inclusión: pacientes con diagnóstico ecográfico prenatal de masa intraabdominal retroperitoneal y neonatos que presentaron al examen físico masa abdominal palpable y fueron estudiados con diferentes técnicas de diagnóstico por imagen. Exclusión: neonatos con patología abdominal gastrointestinal e intraperitoneal. Resultados: del total de pacientes (n =47, 42 presentaron masas de origen renal (89% y 5 retroperitoneal extrarrenal (11%. Las patologías prevalentes fueron hidronefrosis con 36 casos (76% y displasia renal multiquística con 4 (9%. Se registró un caso de nefroma mesoblástico congénito y 1 con enfermedad poliquística autosómica recesiva. Se detectaron 3 RN con hemorragia suprarrenal (6% y 2 con neuroblastoma (4%. Conclusión: la incidencia de Masas Retroperitoneales en la población estudiada fue del 9,65%, coincidente con la bibliografía. El presente trabajo destaca el valor del US prenatal, importante para definir conducta obstétrica, y la coordinación entre la ecografía pre y posnatal para lograr una mayor aproximación al diagnóstico. El rol fundamental de la TC para definir conducta quirúrgica en el nefroma mesoblástico congénito y para estadificación en los casos de neuroblastoma.Purpose: To identify the most frequent causes of retroperitoneal mass during the fetal and neonatal period, and

  9. ASISTENCIA A PADRES DE EMBARAZOS CON RECIEN NACIDOS CON PROBLEMAS VITALES

    OpenAIRE

    Pablo Valenzuela F; Sandra Ahumada G.; Ana María González A; Carmen Quezada V; Sergio Valenzuela P; Ana María Sougarret S; Luis Martínez M

    2003-01-01

    El Consultorio de Asistencia Perinatal atiende a padres de embarazos con fetos en riesgo vital, malformados complejos y nacidos con problemas graves que impliquen impacto familiar, basados en la hipótesis de que la atención de los padres incide en el bienestar del feto y del recién nacido. Se ha construido un protocolo multiprofesional con participación de pediatra, psicóloga, matronas, obstetra y servicio social que sigue el caso con reuniones grupales y de especialidad desde antes del parto...

  10. Perinatal risk factors including malformation

    International Nuclear Information System (INIS)

    The study gives a survey of the factors most frequently mentioned in the literature as factors likely to adversely affect a pregnancy. One essential aspect is the discussion of those factors that can be counted among the causes of malformations, as among others, prenatal radiation exposure. The study prepared within the framework of the research project 'Radiobiological environmental monitoring in Bavaria' is intended to serve as a basis for a retrospective and prospective evaluation of infant mortality, perinatal conditions and occurrence of malformations in Bavaria, with the principal idea of drawing up an environment - related health survey. The study therefore, in addition to ionizing radiation also takes into account other detectable risks within the ecologic context, as e.g. industrial installations, refuse incineration plants or waste dumps, or urbanity. (orig./MG)

  11. Maternal haemoglobin and perinatal outcome

    Directory of Open Access Journals (Sweden)

    Bharathi Anjanappa

    2015-10-01

    Full Text Available Background: Maternal anaemia is common medical disorder in developing countries. WHO defines anaemia as haemoglobin concentration of and #8804;11 g/dl. However, in developing countries like India, the lower limit is accepted as 10 g/dl. Results: Of 218 women, 69 had anaemia. The prevalence of anaemia was 31.65%; of which 84% had mild anaemia, 14.6% had moderate and only 1.4% had severe anaemia. Mean Hb levels were 12.04% among non-anaemic mothers and mean birth weight was 2.89 Kg whereas 9.14%, 2.18 kg in anaemic mothers respectively. In our study, 21% in anaemic group has birth weight <2.5 kg and only 0.06% in non-anaemic mothers (p<0.0012 3.6 times higher. The risk of IUGR was 3.77 times higher, low APGAR score at 1 min was 3.8 times higher (p<0.0001, meconium stained liquor was 2.3 times higher and NICU admissions 2.96 times higher in anaemic mothers than non-anaemic mothers. Conclusions: Anaemia in pregnancy is one of the causes of poor perinatal outcome. Maternal anaemia is associated with the high risk of low birth weight, IUGR babies, low APGAR scores and NICU admissions and overall increase in perinatal morbidity. Hence proper antenatal care and counseling can reduce occurrence of anaemia in pregnancy. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1335-1338

  12. Trends in perinatal health after assisted reproduction

    DEFF Research Database (Denmark)

    Henningsen, Anna-Karina Aaris; Gissler, M.; Skjaerven, R.;

    2015-01-01

    STUDY QUESTIONS Has the perinatal outcome of children conceived after assisted reproductive technology (ART) improved over time? SUMMARY ANSWER The perinatal outcomes in children born after ART have improved over the last 20 years, mainly due to the reduction of multiple births. WHAT IS KNOWN AND...... ART outcome and health data from Denmark, Finland, Norway and Sweden. PARTICIPANTS, SETTING AND METHODS We analysed the perinatal outcome of 62 379 ART singletons and 29 758 ART twins, born from 1988 to 2007 in four Nordic countries. The ART singletons were compared with a control group of 362 215...... affected the observed trends. WIDER IMPLICATIONS OF THE FINDINGS It is assuring that data from four countries confirm an overall improvement over time in the perinatal outcomes of children conceived after ART. Furthermore, data show the beneficial effect of single embryo transfer, not only in regard to...

  13. Perinatal mental illness: definition, description and aetiology.

    Science.gov (United States)

    O'Hara, Michael W; Wisner, Katherine L

    2014-01-01

    Perinatal mental illness is a significant complication of pregnancy and the postpartum period. These disorders include depression, anxiety disorders, and postpartum psychosis, which usually manifests as bipolar disorder. Perinatal depression and anxiety are common, with prevalence rates for major and minor depression up to almost 20% during pregnancy and the first 3 months postpartum. Postpartum blues are a common but lesser manifestation of postpartum affective disturbance. Perinatal psychiatric disorders impair a woman's function and are associated with suboptimal development of her offspring. Risk factors include past history of depression, anxiety, or bipolar disorder, as well psychosocial factors, such as ongoing conflict with the partner, poor social support, and ongoing stressful life events. Early symptoms of depression, anxiety, and mania can be detected through screening in pregnancy and the postpartum period. Early detection and effective management of perinatal psychiatric disorders are critical for the welfare of women and their offspring. PMID:24140480

  14. Antenatal umbilical cord parameters and perinatal outcome

    OpenAIRE

    Athira Narayanan; Priya Ballal; Nikil Shetty; Pralhad Kushtagi

    2016-01-01

    Background: The objective of the study was to study the association between antenatally determined umbilical cord thickness and coiling index at/after 34 weeks of gestation and the measures of perinatal outcome. Methods: Umbilical cord thickness and coiling index were determined sonographically at or after 34 weeks of gestation in 100 singleton pregnancies. The influence of the antenatal cord findings was analyzed for their associations with measures of perinatal outcome in high and low ri...

  15. Perinatal Safety: From Concept to Nursing Practice

    OpenAIRE

    Lyndon, Audrey; Kennedy, Holly Powell

    2010-01-01

    Communication and teamwork problems are leading causes of documented preventable adverse outcomes in perinatal care. An essential component of perinatal safety is the organizational culture in which clinicians work. Clinicians’ individual and collective authority to question the plan of care and take action to change the direction of a clinical situation in the patient’s best interest can be viewed as their “agency for safety.” However, collective agency for safety and commitment to support n...

  16. Genetic and perinatal effects of abused substances

    Energy Technology Data Exchange (ETDEWEB)

    Brande, M.C.; Zimmerman, A.M.

    1987-01-01

    This book provides an overview of the effects of several abused drugs, including opiates, cannabinoids, alcohol, nicotine, and cocaine, with special emphasis on the actions of these substances at the molecular and cellular levels. The first half deals with genetic effects, including molecular genetics, biochemical genetics, pharmacogenetics, cytogenetics, and genetic toxicity. The second half focuses on perinatal effects and covers: drug abuse during pregnancy; biochemical aspects of marihuana on male reproduction; and long-term behavioral and neuroendocrine effects of perinatal alcohol exposure.

  17. Neonatal intracranial hemorrhages (perinatal onset)

    International Nuclear Information System (INIS)

    1. We have reviewed 34 cases of neonatal intracranial hemorrhages (perinatal onset, 23 mature and 11 premature infants) experienced in 10-year period from 1971 to 1980, with special reference to gestational age, birth weight, type of delivery, presence or absence of asphyxia, symptoms and cause of death. 2. Regarding 9 autopsied cases and 7 cases diagnosed by CT-scan, 10 mature infants composed of 3 subarachnoid hemorrhages, 2 intraventricular hemorrhages, 2 subdural hematomas, 2 intracerebral and 1 subependymal hemorrhage; 6 premature infants consisted of 4 subependymal hemorrhages with ventricular rupture and 2 subarachnoid hemorrhages. Most of them presented with respiratory distress, vomiting and convulsive seizures which developed within 5 days after birth. 3. Poor outcome including death amounted 49% of mature and 63% of premature infants. Along with degree of intracranial hematoma, prematurity and pulmonary complication were felt to be important prognostic factors. 4. Introduction of CT-scan led to prompt diagnosis and treatment, thus lowering mortality rate of neonatal intracranial hemorrhages. (author)

  18. Congenital and perinatal cytomegalovirus infection

    Directory of Open Access Journals (Sweden)

    Chun Soo Kim

    2010-01-01

    Full Text Available Cytomegalovirus (CMV is currently the most common agent of congenital infection and the leading infectious cause of brain damage and hearing loss in children. Symptomatic congenital CMV infections usually result from maternal primary infection during early pregnancy. One half of symptomatic infants have cytomegalic inclusion disease (CID, which is characterized by involvement of multiple organs, in particular, the reticuloendothelial and central nervous system (CNS. Moreover, such involvement may or may not include ocular and auditory damage. Approximately 90% of infants with congenital infection are asymptomatic at birth. Preterm infants with perinatal CMV infection can have symptomatic diseases such as pneumonia, hepatitis, and thrombocytopenia. Microcephaly and abnormal neuroradiologic imaging are associated with a poor prognosis. Hearing loss may occur in both symptomatic and asymptomatic infants with congenital infection and may progress through childhood. Congenital infection is defined by the isolation of CMV from infants within the first 3 weeks of life. Ganciclovir therapy can be considered for infants with symptomatic congenital CMV infection involving the CNS. Pregnant women of seronegative state should be counseled on the importance of good hand washing and other control measures to prevent CMV infection. Heat treatment of infected breast milk at 72?#608;for 5 seconds can eliminate CMV completely.

  19. Hipoxia perinatal y su impacto en el neurodesarrollo

    Directory of Open Access Journals (Sweden)

    José Luis Flores-Compadre

    2013-07-01

    Full Text Available Durante el periodo perinatal el cerebro puede quedar privado de oxígeno por dos mecanismos importantes: la hipoxemia y la isquemia. El primero consiste en una disminución de la concentración de oxígeno en sangre y el segundo en la cantidad de sangre que riega al cerebro. Clínicamente se le conoce como encefalo- patía hipoxia-isquémica al síndrome caracterizado por la suspensión o grave disminución del intercambio gaseoso a nivel de la placenta o de los pulmones, que resulta en hipoxemia, hipercapnia e hipoxia tisular con acidosis metabólica. Los cambios metabólicos resultantes provocan a corto plazo daño necrótico y a largo plazo daño apoptótico. Las principales lesiones neurológicas que se presentan son la necrosis neuronal selectiva, la lesión cerebral parasagital y la leucomalacia periventricular, provocando secuelas como la parálisis cerebral, epilepsia, problemas en el habla y el lenguaje, auditivos y neuropsicológicos, siendo los procesos, atencionales, mnémicos, y visuoespaciales los más representativos en este rubro. En México se reporta una incidencia de 14.6 por cada 1,000 recién nacidos vivos, con una letalidad del 8.5% y un índice de secuelas de 3.6%. A pesar de la gran cantidad de estos estudios sobre secuelas de la hipoxia perinatal aún son pocos los programas a nivel institucional enfocados en el diagnóstico y tratamiento temprano.

  20. Recomendaciones para la prevención de la transmisión perinatal del virus de la inmunodeficiencia humana en Costa Rica

    OpenAIRE

    Oscar Porras; María-Paz León-Bratti; Alfredo Messino-Julio; Antonio Solano-Chinchilla; Carmen Vargas-Mejia; Damaris Víquez-Ortiz

    2013-01-01

    Se conoce que la transmisión perinatal del VIH es prevenible con la toma de algunas medidas generales y otras específicas. La acción fundamental para lograr esta prevención es identificar temprano durante el embarazo, cuáles mujeres embarazadas están infectadas por VIH. Para conseguir este objetivo es necesario realizar la prueba del ELISA para VIH, a toda embarazada, en su primera consulta prenatal. Las guías para la prevención de la transmisión perinatal de VIH se desarrollaron con el fin d...

  1. Género, salud materna y la paradoja perinatal

    Directory of Open Access Journals (Sweden)

    Simone Grilo DINIZ

    2010-12-01

    Full Text Available En los últimos 20 años mejoraron prácticamente todos los indicadores de salud materna en el Brasil, así como hubo un amplio acceso a los servicios de salud. Gender, maternal health and the perinatal paradox1 Gênero, saúde materna e o paradoxo perinatal Género, salud materna y la paradoja perinatal REFLEXÕES SOBRE HUMANIZAÇÃO E A REALIDADE DOS SERVIÇOS REFLECTIONS ON HUMANIZATION AND THE REALITY OF HEALTH SERVICES REFLEXIONES SOBRE LA HUMANIZACIÓN Y LA REALIDAD DE LOS SERVICIOS 50 // Rev Tempus Actas Saúde Col Paradoxalmente, no existe ninguna evidencia de mejora de la mortalidad materna. El objetivo de este texto es ofrecer elementos para comprender esta paradoja, a través de la evaluación de los modelos típicos de asistencia al parto, en el Sistema Único de Salud (SUS y en el sector privado. Analizaremos las propuestas de cambio para una asistencia basada en evidencias sobre la seguridad de estos modelos, su relación con los derechos de las mujeres, y con los conflictos de interés y resistencias al cambio de los modelos. Examinamos los presupuestos de género que modulan la asistencia y los sesgos de género en la investigación en este campo, que se expresan en la sobrevalorización de los beneficios de la tecnología, y en la subvalorización o en la negación de los desconfortos y efectos adversos de las intervenciones. Creencias de la cultura sexual no raramente son consideradas como explicaciones ‘científicas’ sobre el cuerpo, la parturición y la sexualidad, y se reflejan en la imposición de sufrimientos y riesgos innecesarios, en las intervenciones dañinas a la integridad genital, y en la negación del derecho a acompañantes. Este ‘pesimismo del parto’ es instrumento para favorecer, por comparación, el modelo de la cesárea de rutina. Por fin, discutimos como el uso de la categoría género puede contribuir para promover derechos y cambios institucionales, como en el caso de los acompañantes en el parto.

  2. Inflammatory and Epigenetic Pathways for Perinatal Depression.

    Science.gov (United States)

    Garfield, Lindsey; Mathews, Herbert L; Janusek, Linda Witek

    2016-05-01

    Depression during the perinatal period is common and can have adverse consequences for women and their children. Yet, the biobehavioral mechanisms underlying perinatal depression are not known. Adverse early life experiences increase the risk for adult depression. One potential mechanism by which this increased risk occurs is epigenetic embedding of inflammatory pathways. The purpose of this article is to propose a conceptual model that explicates the linkage between early life adversity and the risk for maternal depression. The model posits that early life adversity embeds a proinflammatory epigenetic signature (altered DNA methylation) that predisposes vulnerable women to depression during pregnancy and the postpartum period. As proposed, women with a history of early life adversity are more likely to exhibit higher levels of proinflammatory cytokines and lower levels of oxytocin in response to the demands of pregnancy and new motherhood, both of which are associated with the risk for perinatal depression. The model is designed to guide investigations into the biobehavioral basis for perinatal depression, with emphasis upon the impact of early life adversity. Testing this model will provide a better understanding of maternal depressive risk and improve identification of vulnerable women who would benefit from targeted interventions that can reduce the impact of perinatal depression on maternal-infant health. PMID:26574573

  3. Methadone and perinatal outcomes: a prospective cohort study.

    LENUS (Irish Health Repository)

    Cleary, Brian J

    2012-08-01

      Methadone use in pregnancy has been associated with adverse perinatal outcomes and neonatal abstinence syndrome (NAS). This study aimed to examine perinatal outcomes and NAS in relation to (i) concomitant drug use and (ii) methadone dose.

  4. New uses of legacy systems: examples in perinatal care.

    OpenAIRE

    Margolis, A; Vázquez, R.; Mendoza, G.; Zignago, A.; López, A.; Lucián, H.

    1999-01-01

    In this article, new uses of the Perinatal Information System at the Uruguayan Social Security health care facilities are described. The perinatal information system has been in place for over 13 years, with about 40 thousand clinical records on electronic files. A newly created Web interface allows a distributed access to existing perinatal information within the National Social Security Wide Area a Network. Perinatal data is also exported to a management information system, allowing to dyna...

  5. Perinatal Health Statistics as the Basis for Perinatal Quality Assessment in Croatia

    Directory of Open Access Journals (Sweden)

    Urelija Rodin

    2015-01-01

    Full Text Available Context. Perinatal mortality indicators are considered the most important measures of perinatal outcome. The indicators reliability depends on births and deaths reporting and recording. Many publications focus on perinatal deaths underreporting and misclassification, disabling proper international comparisons. Objective. Description of perinatal health care quality assessment key indicators in Croatia. Methods. Retrospective review of reports from all maternities from 2001 to 2014. Results. According to reporting criteria for birth weight ≥500 g, perinatal mortality (PNM was reduced by 31%, fetal mortality (FM by 32%, and early neonatal mortality (ENM by 29%. According to reporting criteria for ≥1000 g, PNM was reduced by 43%, FM by 36%, and ENM by 54%. PNM in ≥22 weeks’ (wks gestational age (GA was reduced by 28%, FM by 30%, and ENM by 26%. The proportion of FM at 32–36 wks GA and at term was the highest between all GA subgroups, as opposed to ENM with the highest proportion in 22–27 wks GA. Through the period, the maternal mortality ratio varied from 2.4 to 14.3/100,000 live births. The process indicators have been increased in number by more than half since 2001, the caesarean deliveries from 11.9% in 2001 to 19.6% in 2014. Conclusions. The comprehensive perinatal health monitoring represents the basis for the perinatal quality assessment.

  6. Perinatal Chicken Pox (Varicella Zoster Virus Infection

    Directory of Open Access Journals (Sweden)

    Ali Annagur

    2013-04-01

    Full Text Available Chickenpox is due to infection with the varicella zoster virus (VZV, a human alphaherpervirus found worldwide. Classically, the cinical disease is a febrile illness with a pruritic vesicular rash. Maternal chickenpox between 5 days before delivery to 2 days after delivery (perinatal varicella can cause severe and even fatal illness in the newborn. A 7-day old girl baby presented on day 4 of postnatal with the complaints of widespread vesicular rash and non-suckling. Mother of the baby also had a similar eruption four day prior to delivery, which was clinically characteristic of varicella. Considering history and clinical presentation, a diagnosis of perinatal chickenpox was considered and the baby was treated with acyclovir which she responded and recovered. Herein, the clinical feasures and treatment of chickenpox infection in the perinatal period have been emphasized with this case report. [Cukurova Med J 2013; 38(2.000: 311-314

  7. Design and evaluation of a regional perinatal audit

    NARCIS (Netherlands)

    Alderliesten, Marianne E.; Stronks, Karien; Bonsel, Gouke J.; Smit, Bert J.; van Campen, Maarten M. J.; van Lith, Jan M. M.; Bleker, Otto P.

    2008-01-01

    Objective: To describe the experiences of a regional audit of perinatal deaths, including the experiences of the audit members, to discuss similarities and differences with other, existing perinatal audits and to summarize the implications for future implementation. Study design: Perinatal audit wit

  8. Perinatal episodes across the mood disorder spectrum.

    Science.gov (United States)

    Di Florio, Arianna; Forty, Liz; Gordon-Smith, Katherine; Heron, Jess; Jones, Lisa; Craddock, Nicholas; Jones, Ian

    2013-02-01

    CONTEXT Affective disorders are common in women, with many episodes having an onset in pregnancy or during the postpartum period. OBJECTIVE To investigate the occurrence and timing of perinatal mood episodes in women with bipolar I disorder, bipolar II disorder, and recurrent major depression (RMD). SETTING AND PATIENTS Women were recruited in our ongoing research on the genetic and nongenetic determinants of major affective disorders. Participants were interviewed and case notes were reviewed. Best-estimate diagnoses were made according to DSM-IV criteria. The 1785 parous women identified included 1212 women with bipolar disorder (980 with type I and 232 with type II) and 573 with RMD. Data were available on 3017 live births. MAIN OUTCOME MEASURES We report the lifetime occurrence of perinatal mood episodes, the rates of perinatal episodes per pregnancy/postpartum period, and the timing of the onset of episodes in relation to delivery. RESULTS More than two-thirds of all diagnostic groups reported at least 1 lifetime episode of illness during pregnancy or the postpartum period. Women with bipolar I disorder reported an approximately 50% risk of a perinatal major affective episode per pregnancy/postpartum period. Risks were lower in women with RMD or bipolar II disorder, at approximately 40% per pregnancy/postpartum period. Mood episodes were significantly more common in the postpartum period in bipolar I disorder and RMD. Most perinatal episodes occurred within the first postpartum month, with mania or psychosis having an earlier onset than depression. CONCLUSIONS Although episodes of postpartum mood disorder are more common in bipolar I disorder and manic and psychotic presentations occur earlier in the postpartum period, perinatal episodes are highly prevalent across the mood disorder spectrum. PMID:23247604

  9. Perinatal asphyxia in the term newborn

    Directory of Open Access Journals (Sweden)

    Roberto Antonucci

    2014-06-01

    Full Text Available Despite the important advances in perinatal care in the past decades, asphyxia remains a severe condition leading to significant mortality and morbidity. Perinatal asphyxia has an incidence of 1 to 6 per 1,000 live full-term births, and represents the third most common cause of neonatal death (23% after preterm birth (28% and severe infections (26%. Many preconceptional, antepartum and intrapartum risk factors have been shown to be associated with perinatal asphyxia. The standard for defining an intrapartum hypoxic-ischemic event as sufficient to produce moderate to severe neonatal encephalopathy which subsequently leads to cerebral palsy has been established in 3 Consensus statements. The cornerstone of all three statements is the presence of severe metabolic acidosis (pH < 7 and base deficit ≥ 12 mmol/L at birth in a newborn exhibiting early signs of moderate or severe encephalopathy. Perinatal asphyxia may affect virtually any organ, but hypoxic-ischemic encephalopathy (HIE is the most studied clinical condition and that is burdened with the most severe sequelae. The feasibility of providing neuroprotection after HIE has been proven by hypothermia therapy, which is able to reduce the risk of death or major neurodevelopmental disability. Many promising neuroprotective agents might contribute to reduce hypoxic-ischemic brain injury through different mechanisms of action, but further studies are required to confirm their efficacy. The prognosis is dependent on the severity of the perinatal asphyxia. Only a minority of infants with severe HIE survive without handicap. Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken

  10. Recomendaciones para la prevención de la transmisión perinatal del Virus de la Inmunodeficiencia Humana en Costa Rica Recommendations for the prevention of perinatal transmission of the Human Immunodeficiency Virus in Costa Rica

    Directory of Open Access Journals (Sweden)

    Oscar Porra

    2008-12-01

    Full Text Available Se conoce que la transmisión perinatal del VIH de madre a hijo es prevenible con la toma de algunas medidas generales y otras específicas. La acción fundamental para lograr esta prevención es identificar cuales embarazadas son portadoras del VIH temprano durante el embarazo. Para lograr este objetivo es necesario realizar la prueba del ELISA para VIH a toda mujer embarazada en su primera consulta prenatal. Las presentes son unas guías sobre el tema desarrolladas con el fin de facilitar la aplicación de todas las acciones necesarias para la prevención de la transmisión perinatal en Costa Rica, brindando una óptima atención médica a la madre y el recién nacido.It is known that the perinatal transmission of HIV from mother to child is preventable applying some general and some specific measures. The basic action to achive the prevention is to identify which pregnant women are HIV positive early during the pregnancy. To obtain this aim it is fundamental to carry out the HIV-ELISA test to every pregnant woman early during the pregnancy. The present guides were developed to help aply all the preventive actions necessary to achive the prevention of perinatal HIV transmission in Costa Rica, offering an optimal medical attention to the mother and the newborn.

  11. Estudio del duelo perinatal: interrupciones médicas del embarazo, muertes prenatales y muertes postnatales

    OpenAIRE

    Ridaura Pastor, Isabel

    2015-01-01

    El objetivo principal del estudio fue describir la evolución del proceso de duelo y la sintomatología depresiva a lo largo de un año después de haber sufrido una pérdida perinatal y estudiar qué factores se asocian a unos peores/mejores resultados a largo plazo. Se contactó con 125 mujeres que habían sufrido una pérdida perinatal y fueron atendidas en el Hospital de la Vall d’Hebron. Se establecieron dos grupos según el tipo de pérdida: interrupción médica del embarazo (IME) y muerte pren...

  12. La salud perinatal de la mujer en una comunidad indígena

    Directory of Open Access Journals (Sweden)

    Cleotilde García Reza

    2008-01-01

    Full Text Available La salud perinatal es una parte de la salud reproductiva que favorece la maternidad saludable y sin riesgo, por medio de estrategias para disminuir la morbilidad y mortalidad. Se describe la experiencia de la mujer en su etapa reproductiva y la influencia en la salud perinatal. Este estudio es de naturaleza cualitativa y exploratoria y fue desarrollado con siete mujeres. Los datos se obtuvieron por medio de la entrevista semiestructurada y observación participante. Los resultados resaltaron las creencias y costumbres durante el embarazo, parto y posparto. El conocimiento adquirido en ese contexto cultural de manera cotidiana promueve el bienestar de la familia y la capacidad de la mujer para autocuidarse

  13. Efficacy of light therapy for perinatal depression: a review

    Directory of Open Access Journals (Sweden)

    Crowley Shannon K

    2012-06-01

    Full Text Available Abstract Perinatal depression is an important public health problem affecting 10% to 20% of childbearing women. Perinatal depression is associated with significant morbidity, and has enormous consequences for the wellbeing of the mother and child. During the perinatal period, treatment of depression, which could affect the mother and child during pregnancy and lactation, poses a complex problem for both mother and clinician. Bright light therapy may be an attractive treatment for perinatal depression because it is low cost, home-based, and has a much lower side effect profile than pharmacotherapy. The antidepressant effects of bright light are well established, and there are several rationales for expecting that bright light might also be efficacious for perinatal depression. This review describes these rationales, summarizes the available evidence on the efficacy of bright light therapy for perinatal depression, and discusses future directions for investigation of bright light therapy as a treatment for perinatal depression.

  14. Perinatal mortality--an analysis of causes and strategies.

    Science.gov (United States)

    Gupta, Neeru

    2011-04-01

    Perinatal mortality is the most sensitive index while imparting healthcare to mother during pregnancy and delivery and also to the baby in perinatal period. Perinatal mortality is higher in rural areas than in urban areas. Worldover perinatal or infant mortality rate is on decline. Developed countries are ahead of developing nations in giving good antenatal, intrapartal as well as neonatal care. Factors responsible for perinatal mortality in Indian context lie in sociodemographic, maternal and foetal aspects. Regional differences also are there in India while assessing perinatal mortality and delivery practices. The lacunae are to be identified while recommending strategies to be taken to lower the perinatal mortality. A community based data system should be developed so that the information should flow from down to above, from village to subcentre to primary health centre and further from district to state. Some newborns need special care. Since newborns need early recognition of danger signs and prompt treatment measures. PMID:22187796

  15. Perinatal Outcomes after Assisted Reproductive Technology

    Directory of Open Access Journals (Sweden)

    Setenay Arzu Yilmaz

    2014-08-01

    The aim of this review is to summarize perinatal outcomes and the congenital anomaly risk of IVF pregnancies and also examine the risks of different technologies including ICSI, blastocyst culture, and cryopreservation on this topic. [Archives Medical Review Journal 2014; 23(4.000: 575-586

  16. Perinatal Major Depression Biomarkers: A systematic review.

    Science.gov (United States)

    Serati, M; Redaelli, M; Buoli, M; Altamura, A C

    2016-03-15

    Postpartum depression, now termed perinatal depression by the DSM-5, is a clinically relevant disorder reaching 15% of incidence. Although it is quite frequent and associated with high social dysfunction, only recently its underpinning biological pathways have been explored, while multiple and concomitant risk factors have been identified (e.g. psychosocial stress). Peripartum depression usually has its onset during the third trimester of pregnancy or in the postpartum, being one of the most common medical complications in new mothers. Purpose of the present review is to summarize the state of art of biological biomarkers involved in the pathogenesis of perinatal depression, in view of the fact that suboptimal prenatal milieu can induce permanent damage in subsequent offspring life and have a negative impact on mother-child relationship. Furthermore, parents' biological changes due to medical/psychiatric disorders or stress exposure could influence offspring life: a concept known as 'intergenerational transmission', acting by variations into gametes and the gestational uterine environment. Given the evidence that perinatal mental disorders involve risks for the mother and offspring, the search for reliable biomarkers in high-risk mothers actually represents a medical priority to prevent perinatal depression. PMID:26802316

  17. Recomendaciones para la prevención de la transmisión perinatal del virus de la inmunodeficiencia humana en Costa Rica Recommendations for prevention of perinatal transmission of the Human Immunodeficiency Virus in Costa Rica

    Directory of Open Access Journals (Sweden)

    Oscar Porras

    2013-06-01

    Full Text Available Se conoce que la transmisión perinatal del VIH es prevenible con la toma de algunas medidas generales y otras específicas. La acción fundamental para lograr esta prevención es identificar temprano durante el embarazo, cuáles mujeres embarazadas están infectadas por VIH. Para conseguir este objetivo es necesario realizar la prueba del ELISA para VIH, a toda embarazada, en su primera consulta prenatal. Las guías para la prevención de la transmisión perinatal de VIH se desarrollaron con el fin de facilitar la aplicación de todas las acciones necesarias para prevenir la transmisión perinatal de VIH en Costa Rica, brindando una óptima atención médica a la madre y al recién nacido. Los elementos fundamentales de estas guías incluyen: tratamiento con 3 antirretrovirales a las mujeres embarazadas VIH+, a partir de la 12ava semana de gestación, uso intravenoso de Zidovudina en labor, vía de parto por cesárea, suspensión de la lactancia materna, y profilaxis con Zidovudina al recién nacido a partir de las 8 horas de edad. Las guías proveen también recomendaciones para proceder en situaciones especiales relacionadas con la embarazada VIH+ y su hijo.It is known that perinatal transmission of HIV is preventable by taking some general and some specific measures. The key action to achieve this is to identify which pregnant women are HIV infected early in pregnancy. To achieve this goal it is necessary to perform the ELISA HIV test to all pregnant women at their first prenatal visit. Guidelines for prevention of perinatal transmission of HIV were developed to facilitate the implementation of all necessary actions for the prevention of perinatal transmission of HIV in Costa Rica, providing optimal care to the mother and newborn. The key elements of these guidelines include: treatment with 3 antiretrovirals to pregnant women HIV+ from the 12th week of gestation, intravenous zidovudine in labor, cesarean delivery, suspension of breastfeeding

  18. Etiological analysis of presumed perinatal stroke.

    Science.gov (United States)

    Kocaman, Canan; Yilmaz, Yuksel

    2012-02-01

    This study aimed to investigate the maternal, pre- and perinatal, and prothrombotic factors with congenital hemiparesis due to presumed perinatal stroke (PPS). Prothrombotic risk factors including protein C and S, antithrombin III, lipoprotein (a), homocystein, factor VIII levels; anticardiolipin antibodies and lupus anticoagulant; methylenetetrahydrofolate reductase mutations, factor V Leiden, prothrombin G20210A mutations were investigated. Arterial ischemic stroke was detected in 60% and periventricular venous infarction in 40%. At least one prothrombotic risk factor was present in 69%, two in 17%, and three or more in 8.5% of cases. The most common combination was methylenetetrahydrofolate reductase C677T and factor V Leiden heterozygosity. The etiology and pathogenesis of PPS is still unclear. According to this study, most of the patients with PPS might have one or more prothrombotic risk factors and certain prenatal risk factors including intrauterine growth retardation, twin gestation and preeclampsia might be related to PPS. PMID:21561729

  19. Sleep and perinatal mood disorders: a critical review

    Science.gov (United States)

    Ross, Lori E.; Murray, Brian J.; Steiner, Meir

    2005-01-01

    Pregnancy and the postpartum period are recognized as times of vulnerability to mood disorders, including postpartum depression and psychosis. Recently, changes in sleep physiology and sleep deprivation have been proposed as having roles in perinatal psychiatric disorders. In this article we review what is known about changes in sleep physiology and behaviour during the perinatal period, with a focus on the relations between sleep and postpartum “blues,” depression and psychosis and on sleep-based interventions for the treatment and prevention of perinatal mood disorders. The interaction between sleep and perinatal mood disorders is significant, but evidence-based research in this field is limited. Studies that measure both sleep and mood during the perinatal period, particularly those that employ objective measurement tools such as polysomnography and actigraphy, will provide important information about the causes, prevention and treatment of perinatal mood disorders. PMID:16049568

  20. Microbiome Aspects of Perinatal and Neonatal Health

    OpenAIRE

    Gregory, Katherine E.

    2011-01-01

    Our human cells are outnumbered ten to one by bacterial cells. For this reason, the role of microorganisms, specifically bacteria, in health and disease has brought forth intense research via the Human Microbiome Project (HMP). The HMP is a National Institutes of Health sponsored effort to build upon the Human Genome Project in understanding human genetic and physiologic diversity. Perinatal and neonatal health represents areas of high importance for knowledge generated by the HMP as the micr...

  1. Perinatal Chicken Pox (Varicella Zoster Virus) Infection

    OpenAIRE

    Ali Annagur; Ayhan Tastekin; Pervin Gunaslan; Oguzhan Demirel; Ahmet Hakan Dikener

    2013-01-01

    Chickenpox is due to infection with the varicella zoster virus (VZV), a human alphaherpervirus found worldwide. Classically, the cinical disease is a febrile illness with a pruritic vesicular rash. Maternal chickenpox between 5 days before delivery to 2 days after delivery (perinatal varicella) can cause severe and even fatal illness in the newborn. A 7-day old girl baby presented on day 4 of postnatal with the complaints of widespread vesicular rash and non-suckling. Mother of the baby also ...

  2. Gestational diabetes versus pregestational diabetes. Perinatal results.

    OpenAIRE

    Cristóbal Torres González; Joselin Moreno Torres; Juan Carlos Pastrana Tapia; Vivian Vázquez Martínez

    2004-01-01

    Fundament: Diabetes Mellitus is one of the most affecting diseases in the development of pregnancy. This greatly depends on the metabolic control achieved, which has demanded several proyects of treatment, thus decreasing the risks that the gestational process carries out. Objective: to compare the perinatal results between the diabetic gestational women and pregestational ones admitted at Cienfuegos Hospital. Method: Comparative study developed at the Gynecological-Obstetric Universitary Hos...

  3. Diabetes and perinatal mortality in twin pregnancies.

    Directory of Open Access Journals (Sweden)

    Zhong-Cheng Luo

    Full Text Available BACKGROUND: Diabetes in pregnancy has been associated with a paradoxically reduced risk of neonatal death in twin pregnancies. Risk "shift" may be a concern in that the reduction in neonatal deaths may be due to an increase in fetal deaths (stillbirths. This study aimed to clarify the impact of diabetes on the risk of perinatal death (neonatal death plus stillbirth in twin pregnancies. METHODS: This was a retrospective cohort study of twin births using the largest available dataset on twin births (the U.S. matched multiple birth data 1995-2000; 19,676 neonates from diabetic pregnancies, 541,481 from non-diabetic pregnancies. Cox proportional hazard models were applied to estimate the adjusted hazard ratios (aHR of perinatal death accounting for twin cluster-level dependence. RESULTS: Comparing diabetic versus non-diabetic twin pregnancies, overall perinatal mortality rate was counterintuitively lower [2.1% versus 3.3%, aHR 0.70 (95% confidence intervals 0.63-0.78]. Individually, both stillbirth and neonatal mortality rates were lower in diabetic pregnancies, but we identified significant differences by gestational age and birth weight. Diabetes was associated with a survival benefit in pregnancies completed before 32 weeks [aHR 0.55 (0.48-0.63] or with birth weight =2500 g [aHR 2.20 (1.55-3.13]. CONCLUSIONS: Diabetes in pregnancy appears to be "protective" against perinatal death in twin pregnancies ending in very preterm or very low birth weight births. Prospective studies are required to clarify whether these patterns of risk are real, or they are artifacts of unmeasured confounders. Additional data correlating these outcomes with the types of diabetes in pregnancy are also needed to distinguish the effects of pre-gestational vs. gestational diabetes.

  4. Blood Biomarkers for Evaluation of Perinatal Encephalopathy

    Science.gov (United States)

    Graham, Ernest M.; Burd, Irina; Everett, Allen D.; Northington, Frances J.

    2016-01-01

    Recent research in identification of brain injury after trauma shows many possible blood biomarkers that may help identify the fetus and neonate with encephalopathy. Traumatic brain injury shares many common features with perinatal hypoxic-ischemic encephalopathy. Trauma has a hypoxic component, and one of the 1st physiologic consequences of moderate-severe traumatic brain injury is apnea. Trauma and hypoxia-ischemia initiate an excitotoxic cascade and free radical injury followed by the inflammatory cascade, producing injury in neurons, glial cells and white matter. Increased excitatory amino acids, lipid peroxidation products, and alteration in microRNAs and inflammatory markers are common to both traumatic brain injury and perinatal encephalopathy. The blood-brain barrier is disrupted in both leading to egress of substances normally only found in the central nervous system. Brain exosomes may represent ideal biomarker containers, as RNA and protein transported within the vesicles are protected from enzymatic degradation. Evaluation of fetal or neonatal brain derived exosomes that cross the blood-brain barrier and circulate peripherally has been referred to as the “liquid brain biopsy.” A multiplex of serum biomarkers could improve upon the current imprecise methods of identifying fetal and neonatal brain injury such as fetal heart rate abnormalities, meconium, cord gases at delivery, and Apgar scores. Quantitative biomarker measurements of perinatal brain injury and recovery could lead to operative delivery only in the presence of significant fetal risk, triage to appropriate therapy after birth and measure the effectiveness of treatment. PMID:27468268

  5. Serotonin reuptake inhibitor-induced perinatal complications.

    Science.gov (United States)

    Gentile, Salvatore

    2007-01-01

    There are a growing number of concerns about the utilization of serotonin reuptake inhibitors (SRIs) in late pregnancy and the onset of perinatal complications. This review aimed to analyze and summarize the studies evaluating the risk of perinatal complications (such as low birth weight, preterm delivery, withdrawal or toxic phenomena, and other detrimental events/poor neonatal outcomes) related to maternal SRI use in late pregnancy. A computerized search of MEDLINE (1966-January 2007) and PsycINFO (1974-January 2007) databases was performed. Articles describing perinatal complications after late in utero exposure to SRIs were selected and also reviewed for additional references. Fifty studies met the inclusion criteria. Exposure to SRIs late in pregnancy is clearly associated with an increased risk of infants developing a constellation of symptoms, including CNS and respiratory effects, often requiring close infant observation and supportive or specific treatment in intensive care units. Such symptoms are not always due to toxic or withdrawal reactions. Indeed, some evidence suggests that SRIs may interfere with the physiology of the respiratory system and parasympathetic activity in neonates. Of the most methodologically relevant studies reviewed, 50% have been published in the last 3 years. Hence, it is possible that further concerning data will become available in the future. For these reasons, the opportunity of tapering and discontinuing SRIs in late pregnancy should be taken into consideration, although to date the evidence to support such a clinical decision is preliminary. PMID:17407365

  6. Perinatal risk factors for acute myeloid leukemia.

    Science.gov (United States)

    Crump, Casey; Sundquist, Jan; Sieh, Weiva; Winkleby, Marilyn A; Sundquist, Kristina

    2015-12-01

    Infectious etiologies have been hypothesized for acute leukemias because of their high incidence in early childhood, but have seldom been examined for acute myeloid leukemia (AML). We conducted the first large cohort study to examine perinatal factors including season of birth, a proxy for perinatal infectious exposures, and risk of AML in childhood through young adulthood. A national cohort of 3,569,333 persons without Down syndrome who were born in Sweden in 1973-2008 were followed up for AML incidence through 2010 (maximum age 38 years). There were 315 AML cases in 69.7 million person-years of follow-up. We found a sinusoidal pattern in AML risk by season of birth (P birth order, parental age, and parental country of birth were not associated with AML. In this large cohort study, birth in winter was associated with increased risk of AML in childhood through young adulthood, possibly related to immunologic effects of early infectious exposures compared with summer birth. These findings warrant further investigation of the role of seasonally varying perinatal exposures in the etiology of AML. PMID:26113060

  7. Potentially avoidable perinatal deaths in Denmark and Sweden 1991

    DEFF Research Database (Denmark)

    Langhoff-Roos, J; Borch-Christensen, H; Larsen, S; Lindberg, B; Wennergren, M

    1996-01-01

    BACKGROUND: Since 1950 the perinatal mortality has been significantly higher in Denmark than in Sweden. In 1991 the rate in Denmark was 8.0/1000 deliveries compared to 6.5/1000 in Sweden. An international audit was designed to investigate whether the perinatal death rates in the two countries to...... some extent could reflect differences in the quality of care, indicated by the numbers of perinatal deaths in categories of potentially avoidable deaths. MATERIAL AND METHODS: Medical records of 97% of all perinatal deaths in 1991 in the two countries were analyzed. A new classification focusing on...

  8. Recomendaciones para la prevención de la transmisión perinatal del virus de la inmunodeficiencia humana en Costa Rica

    Directory of Open Access Journals (Sweden)

    Oscar Porras

    2013-06-01

    Full Text Available Se conoce que la transmisión perinatal del VIH es prevenible con la toma de algunas medidas generales y otras específicas. La acción fundamental para lograr esta prevención es identificar temprano durante el embarazo, cuáles mujeres embarazadas están infectadas por VIH. Para conseguir este objetivo es necesario realizar la prueba del ELISA para VIH, a toda embarazada, en su primera consulta prenatal. Las guías para la prevención de la transmisión perinatal de VIH se desarrollaron con el fin de facilitar la aplicación de todas las acciones necesarias para prevenir la transmisión perinatal de VIH en Costa Rica, brindando una óptima atención médica a la madre y al recién nacido. Los elementos fundamentales de estas guías incluyen: tratamiento con 3 antirretrovirales a las mujeres embarazadas VIH+, a partir de la 12ava semana de gestación, uso intravenoso de Zidovudina en labor, vía de parto por cesárea, suspensión de la lactancia materna, y profilaxis con Zidovudina al recién nacido a partir de las 8 horas de edad. Las guías proveen también recomendaciones para proceder en situaciones especiales relacionadas con la embarazada VIH+ y su hijo.

  9. Perinatal characterization of multiple pregnancy in Cienfuegos city from 2001 to 2002 Caracterización perinatal del embarazo gemelar en Cienfuegos (2001-2002.

    Directory of Open Access Journals (Sweden)

    Alexis Díaz Brito

    2004-08-01

    morbimortalidad del embarazo gemelar en Cienfuegos. Método : Se realizó un estudio retrospectivo descriptivo sobre los embarazos gemelares tratados en el Hospital General Universitario ¨Dr: Gustavo Aldereguía Lima¨ de Cienfuegos durante los años 2001 - 2002. La muestra fue constituida por todos los embarazos de este tipo con más de 28 semanas y partos ocurridos en el citado hospital. Se analizó la influencia de estos embarazos en los principales indicadores de morbimortalidad perinatal. Resultados: De un total de 9 558 nacimientos, 95 fueron gemelares, para una incidencia de 0,9 %. El incremento del peso materno por encima de 12 Kg. se asoció con mayor peso del recién nacido. El 61 % de las madres presentaron enfermedades obstétricas, las más frecuentes fueron el parto pretérmino, la enfermedad hipertensiva del embarazo y la rotura prematura de la membrana. El parto por cesárea ocupó el 51 % para ambos gemelares y sus principales causas fueron la malposición de uno o ambos gemelos, distocia de partes blandas y la enfermedad hipertensiva del embarazo. Las afecciones más frecuentes en la morbimortalidad perinatal fueron el bajo peso al nacer, muerte fetal tardía anteparto y la procidencia del cordón umbilical.

  10. Substandard factors in perinatal care in The Netherlands : a regional audit of perinatal deaths

    NARCIS (Netherlands)

    Wolleswinkel-van den Bosch, JH; Vredevoogd, CB; Borkent-Polet, M; van Eyck, J; Fetter, WPF; Lagro-Janssen, TLM; Rosink, IH; Treffers, PE; Amelink, M; Richardus, JH; Verloove-Vanhorick, P; Mackenbach, JP

    2002-01-01

    Background. To determine: 1) whether substandard factors were present in cases of perinatal death, and to what extent another course of action might have resulted in a better outcome, and 2) whether there were differences in the frequency of substandard factors by level of care, particularly between

  11. Treatment of severe perinatal mood disorders on a specialized perinatal psychiatry inpatient unit.

    Science.gov (United States)

    Kimmel, Mary C; Lara-Cinisomo, S; Melvin, K; Di Florio, A; Brandon, A; Meltzer-Brody, S

    2016-08-01

    Perinatal patients with bipolar and psychotic mood disorder exacerbations are challenging to treat and often receive suboptimal care. We sought to examine the treatment patterns and outcomes on one of the only US-based Perinatal Psychiatry Inpatient Units (PPIU). Perinatal patients admitted to the PPIU completed self-report measures at admission and before discharge. Retrospective chart reviews extracted history, diagnoses (current and past), and medication treatment. Patients who had discharge diagnoses of bipolar disorder, major depression with psychotic features, or postpartum psychosis were included. Forty-seven met the diagnostic inclusion criteria. Over an average length of stay (ALOS) of 9.96 days, there was significant improvement in depressive and anxiety symptoms and daily functioning (Work and Social Adjustment Scale). Psychiatric comorbidity was common. Polypharmacy was utilized in 87 %. The most common medications prescribed at discharge were antipsychotics, alone or in combination with mood stabilizers or antidepressants. ECT was performed in 10 % of cases. The complexity of patients with severe mood disorders or psychosis admitted to the PPIU supports individualized treatment plans that address both primary diagnosis and psychiatric comorbidities. Our results provide important information that can be disseminated to others to improve clinical outcomes for severe perinatal mood disorders. PMID:26802019

  12. Modifying CBT for Perinatal Depression: What Do Women Want?

    Science.gov (United States)

    O'Mahen, Heather; Fedock, Gina; Henshaw, Erin; Himle, Joseph A.; Forman, Jane; Flynn, Heather A.

    2012-01-01

    The evidence for the efficacy of CBT for depression during the perinatal period is mixed. This was a qualitative study that aimed to understand the perinatal-specific needs of depressed women in an effort to inform treatment modifications that may increase the relevance and acceptability of CBT during this period. Stratified purposeful sampling…

  13. Perinatal Screening for Chagas Disease in Southern Texas.

    Science.gov (United States)

    Edwards, Morven S; Rench, Marcia A; Todd, Charles W; Czaicki, Nancy; Steurer, Francis J; Bern, Caryn; Montgomery, Susan P

    2015-03-01

    Perinatal screening for Trypanosoma cruzi in a cohort of 4000 predominantly Hispanic women in southern Texas revealed that Chagas disease occurs with sufficient frequency (0.25%) that targeted perinatal screening should be considered to identify infected mothers and infants at risk for congenital infection. PMID:26407360

  14. Cortical Reorganization of Language Functioning Following Perinatal Left MCA Stroke

    Science.gov (United States)

    Tillema, Jan-Mendelt; Byars, Anna W.; Jacola, Lisa M.; Schapiro, Mark B.; Schmithorst, Vince J.; Szaflarski, Jerzy P.; Holland, Scott K.

    2008-01-01

    Objective: Functional MRI was used to determine differences in patterns of cortical activation between children who suffered perinatal left middle cerebral artery (MCA) stroke and healthy children performing a silent verb generation task. Methods: Ten children with prior perinatal left MCA stroke (age 6-16 years) and ten healthy age matched…

  15. Lessons learned from perinatal exposure to diethylstilbestrol

    International Nuclear Information System (INIS)

    The synthetic estrogen diethylstilbestrol (DES) is well documented to be a perinatal carcinogen in both humans and experimental animals. Exposure to DES during critical periods of differentiation permanently alters the programming of estrogen target tissues resulting in benign and malignant abnormalities in the reproductive tract later in life. Using the perinatal DES-exposed rodent model, cellular and molecular mechanisms have been identified that play a role in these carcinogenic effects. Although DES is a potent estrogenic chemical, effects of low doses of the compound are being used to predict health risks of weaker environmental estrogens. Therefore, it is of particular interest that developmental exposure to very low doses of DES has been found to adversely affect fertility and to increase tumor incidence in murine reproductive tract tissues. These adverse effects are seen at environmentally relevant estrogen dose levels. New studies from our lab verify that DES effects are not unique; when numerous environmental chemicals with weak estrogenic activity are tested in the experimental neonatal mouse model, developmental exposure results in an increased incidence of benign and malignant tumors including uterine leiomyomas and adenocarcinomas that are similar to those shown following DES exposure. Finally, growing evidence in experimental animals suggests that some adverse effects can be passed on to subsequent generations, although the mechanisms involved in these trans-generational events remain unknown. Although the complete spectrum of risks to DES-exposed humans are uncertain at this time, the scientific community continues to learn more about cellular and molecular mechanisms by which perinatal carcinogenesis occurs. These advances in knowledge of both genetic and epigenetic mechanisms will be significant in ultimately predicting risks to other environmental estrogens and understanding more about the role of estrogens in normal and abnormal development

  16. Perinatal Generalized Anxiety Disorder: Assessment and Treatment.

    Science.gov (United States)

    Misri, Shaila; Abizadeh, Jasmin; Sanders, Shawn; Swift, Elena

    2015-09-01

    Perinatal generalized anxiety disorder (GAD) has a high prevalence of 8.5%-10.5% during pregnancy and 4.4%-10.8% postpartum. Despite its attendant dysfunction in the patient, this potentially debilitating mental health condition is often underdiagnosed. This overview will provide guidance for clinicians in making timely diagnosis and managing symptoms appropriately. A significant barrier to the diagnosis of GAD in the perinatal population is difficulty in distinguishing normal versus pathological worry. Because a perinatal-specific screening tool for GAD is nonexistent, early identification, diagnosis and treatment is often compromised. The resultant maternal dysfunction can potentially impact mother-infant bonding and influence neurodevelopmental outcomes in the children. Comorbid occurrence of GAD and major depressive disorder changes the illness course and its treatment outcome. Psychoeducation is a key component in overcoming denial/stigma and facilitating successful intervention. Treatment strategies are contingent upon illness severity. Cognitive behavior therapy (CBT), relaxation, and mindfulness therapy are indicated for mild GAD. Moderate/severe illness requires pharmacotherapy and CBT, individually or in combination. No psychotropic medications are approved by the FDA or Health Canada in pregnancy or the postpartum; off-label pharmacological treatment is instituted only if the benefit of therapy outweighs its risk. SSRIs/SNRIs are the first-line treatment for anxiety disorders due to data supporting their efficacy and overall favorable side effect profile. Benzodiazepines are an option for short-term treatment. While research on atypical antipsychotics is evolving, some can be considered for severe manifestations where the response to antidepressants or benzodiazepines has been insufficient. A case example will illustrate the onset, clinical course, and treatment strategies of GAD through pregnancy and the postpartum. PMID:26125602

  17. Perinatal tuberculosis: Diagnostic and therapeutic approach

    Directory of Open Access Journals (Sweden)

    Čegar Svetlana

    2012-01-01

    Full Text Available Introduction. The number of people suffering from tuberculosis has increased rapidly in the whole world over the past three decades. The classical age distribution of disease has also changed. According to the epidemiological data the number of pregnant women having tuberculosis has also risen with the resulting increase in the incidence of perinatal tuberculosis. Pregnancy and Tuberculosis. The presentation of tuberculosis in pregnancy varies. The effects of tuberculosis on pregnancy depend upon various factors: site and extent of the disease, nutritional status and immune status of mother, concomitant diseases, stage of pregnancy when the treatment started and others. A delay between the onset and diagnosis occurs regularly. Treatment response, time to clearance of bacilli from sputum, and prognosis are similar to non pregnant women. Prinatal tuberculosis. Perinatal tuberculosis is extremely rare if the mother is effectively treated in pregnancy, but disease is usually fatal if untreated. Diagnosis of perinatal tuberculosis is very often problematic and difficult. The reason of this is the fact that the initial manifestations of disease are nonspecific and may be delayed. In practice, congenital and early neonatal infections have almost the same mode of presentations, treatment and prognosis. Epidemiological data on the active tuberculosis in mother or some other family member are of the utmost importance in diagnoing tuberculosis. Differences in immune responses in the fetus and neonate add to the diagnostic difficulties already recognised in young children. Tuberculin tests are negative in at least 75% of cases. Conclusion. If the condition is recognized and treated according to existing tuberculosis protocols, the outcome is favourable.

  18. Preventing Workplace Injuries Among Perinatal Nurses.

    Science.gov (United States)

    Harolds, Laura; Hurst, Helen

    2016-01-01

    Many aspects of perinatal nursing put nurses at risk for injuries, including frequent repetitive bending, lifting of clients, and exposure to potentially large amounts of body fluids such as blood and amniotic fluid. Violence is also a potential risk with stressful family situations that may arise around childbirth. Workplace injuries put a health care facility at risk for staff turnover, decreases in the number of skilled nurses, client dissatisfaction, workers' compensation payouts, and employee lawsuits. Through the use of safety equipment, improved safety and violence training programs, "no manual lift" policies, reinforcement of personal protective equipment usage, and diligent staff training to improve awareness, these risks can be minimized. PMID:26902445

  19. Perinatal transmission of human papilomavirus DNA

    Directory of Open Access Journals (Sweden)

    Serafini Eduardo P

    2009-06-01

    Full Text Available Abstract The purpose was to study the perinatal transmission of human papillomavirus DNA (HPV-DNA in 63 mother-newborn pairs, besides looking at the epidemiological factors involved in the viral DNA transmission. The following sampling methods were used: (1 in the pregnant woman, when was recruited, in cervix and clinical lesions of the vagina, vulva and perineal region; (2 in the newborn, (a buccal, axillary and inguinal regions; (b nasopharyngeal aspirate, and (c cord blood; (3 in the children, buccal was repeated in the 4th week and 6th and 12th month of life. HPV-DNA was identified using two methodologies: multiplex PCR (PGMY09 and MY11 primers and nested-PCR (genotypes 6/11, 16, 18, 31, 33, 42, 52 and 58. Perinatal transmission was considered when concordance was found in type-specific HPV between mother/newborn or mother/child. HPV-DNA genital was detected in 49 pregnant women submitted to delivery. Eleven newborns (22.4%, n = 11/49 were HPV-DNA positive. In 8 cases (16.3%, n = 8/49 there was type specific HPV concordance between mother/newborn samples. At the end of the first month of life three children (6.1%, n = 3/49 became HPV-DNA positive, while two remained positive from birth. In 3 cases (100%, n = 3/3 there was type specific HPV concordance between mother/newborn samples. In the 6th month, a child (2%, n = 1/49 had become HPV-DNA positive between the 1st and 6th month of life, and there was type specific HPV concordance of mother/newborn samples. All the HPV-DNA positive children (22.4%, n = 11/49 at birth and at the end first month of life (6.1%, n = 3/49 became HPV-DNA negative at the age of 6 months. The HPV-DNA positive child (2%, n = 1/49 from 1st to the 6th month of life became HPV-DNA negative between the 6th and 12th month of life and one child had anogenital warts. In the twelfth month all (100%, n = 49/49 the children studied were HPV-DNA negative. A positive and significant correlation was observed between perinatal

  20. Undiagnosed xiphopagus twins: a perinatal malady

    OpenAIRE

    Gowri Dorairajan

    2012-01-01

    Conjoined twins are a very rare entity. It is associated with poor survival rate in the presence of vital organ sharing. The entity can be diagnosed as early as the first trimester. A conjoined twin diagnosed late in labor is a malady with high perinatal mortality and maternal morbidity. We present one such case of xiphopagus twins. The management of a case diagnosed late in labor can be very challenging. Such obstetric challenges can be avoided by a meticulous early scan with a high index of...

  1. Perinatal Risk Factors for Childhood Leukemia

    OpenAIRE

    Naumburg, Estelle

    2002-01-01

    The aim of the studies described in this thesis was to assess the association between certain perinatal factors and the risk of childhood lymphatic and myeloid leukemia and infant leukemia. The five studies presented were all conducted in Sweden as population-based case-control studies. All cases were born and diagnosed between 1973-89 with leukemia up to the age of 16 years. A control was individually matched to each case. As Down’s syndrome entails a major risk for childhood leukemia, chil...

  2. Undiagnosed xiphopagus twins: a perinatal malady

    Directory of Open Access Journals (Sweden)

    Gowri Dorairajan

    2012-02-01

    Full Text Available Conjoined twins are a very rare entity. It is associated with poor survival rate in the presence of vital organ sharing. The entity can be diagnosed as early as the first trimester. A conjoined twin diagnosed late in labor is a malady with high perinatal mortality and maternal morbidity. We present one such case of xiphopagus twins. The management of a case diagnosed late in labor can be very challenging. Such obstetric challenges can be avoided by a meticulous early scan with a high index of suspicion, especially in the absence of separating membrane while scanning multiple pregnancies.

  3. Presumed Perinatal Stroke: Risk Factors, Clinical and Radiological Findings.

    Science.gov (United States)

    Ilves, Pilvi; Laugesaar, Rael; Loorits, Dagmar; Kolk, Anneli; Tomberg, Tiiu; Lõo, Silva; Talvik, Inga; Kahre, Tiina; Talvik, Tiina

    2016-04-01

    It is unknown why some infants with perinatal stroke present clinical symptoms late during infancy and will be identified as infants with presumed perinatal stroke. The risk factors and clinical and radiological data of 42 infants with presumed perinatal stroke (69% with periventricular venous infarction and 31% with arterial ischemic stroke) from the Estonian Pediatric Stroke Database were reviewed. Children with presumed perinatal stroke were born at term in 95% of the cases and had had no risk factors during pregnancy in 43% of the cases. Children with periventricular venous infarction were born significantly more often (82%) vaginally (P = .0213) compared to children with arterial stroke (42%); nor did they require resuscitation (P = .0212) or had any neurological symptoms after birth (P = .0249). Periventricular venous infarction is the most common type of lesion among infants with the presumed perinatal stroke. Data suggest that the disease is of prenatal origin. PMID:26446909

  4. Current concepts in perinatal mineral metabolism.

    Science.gov (United States)

    Ohata, Yasuhisa; Ozono, Keiichi; Michigami, Toshimi

    2016-01-01

    The serum levels of calcium (Ca) and phosphate are maintained higher in the fetus than in the pregnant mother, especially in late gestation, to meet the demands of fetal bone development. In order to maintain this fetal stage-specific mineral homeostasis, the placenta plays a critical role through active transcellular mineral transport. Although the molecular mechanism of transplacental Ca transport has been well studied, little is known about the transport mechanism of phosphate and magnesium. Maternal mineral homeostasis is also altered during pregnancy to supply minerals to the fetus. In the lactating mother, osteocytic osteolysis is suggested to be involved in the supply of minerals to the baby. The levels of some calcitropic and phosphotropic (Ca- and phosphate-regulating, respectively) hormones in the fetus are also different from those in the adult. The PTH level in the fetus is lower than that in the mother and nonpregnant adult. It is suggested, however, that low fetal PTH plays an important role in fetal mineral metabolism. The concentration of PTHrP in the fetus is much higher than that of PTH and plays a critical role in perinatal Ca homeostasis. Uncovering the molecular mechanisms for fetal stage-specific mineral metabolism will lead to better management of perinatal patients with mineral abnormalities. PMID:26865750

  5. Perinatal mortality in Indonesia: an unfinished agenda

    Directory of Open Access Journals (Sweden)

    Riawati Jahja

    2011-10-01

    Full Text Available Perinatal mortality is a profound issue in maternal and child health due to its close relation with the maternal condition. There exist Millennium Development Goals (MDGs which are to be achieved by 2015. These are coupled with a continuing need for comprehensively monitoring and identifying factors associated with perinatal mortality, which is a primary concern for developing countries inclusive of Indonesia. Previous and on-going health programs could have brought about strategic interventions but as different attributes can emerge due to epidemiological transition, and given the fact that associated factors may remain persistent, forward thinking strategies in public health are forever in need of renewal.     Results from our research show that educational variables, poor awareness towards proper antenatal care visits and weak services at the front-line of healthcare delivery (community outreach worsen the condition of childbearing women, raising the question of biological risk factors in line with socio-economic variables.

  6. [Perinatal corticosteroid therapy: modalities, efficacy, consequences].

    Science.gov (United States)

    Magny, J F; Rigourd, V; Kieffer, F; Voyer, M

    2001-02-01

    During perinatal period, corticosteroid treatment has two major indications: first antenatally to improve fetal maturity and then to treat postnatal bronchopulmonary dysplasia. Antenatal corticosteroid treatment is widely proved to be efficient in reducing hyaline membrane disease and perinatal mortality incidence. Moreover, it has positive effects on intraventricular hemorrhage incidence, on hemodynamic failure, on persistent patent ductus arteriosus and on necrotizing enterocolitis. Side-effects are few and mild considering expected benefits and they usually occurs after multiple courses. Contra-indications are rare. Bronchopulmonary dysplasia comes with early, important and prolonged inflammatory processes. Corticotherapy allows decreasing significantly length of mechanical ventilation and oxygenotherapy among ventilated premature infants diagnosed with bronchopulmonary dysplasia. In the meantime, acute side-effects are frequent and benefits on mortality rate and long term outcome are not obvious. Main concern remains on possible long-term deleterious consequences on growth, lung and central nervous system development. In this field, clinical data are still insufficient as animal experimentation data promote caution and search for a minimal efficient therapeutic pathway. PMID:11240516

  7. Maternal Malaria and Perinatal HIV Transmission, Western Kenya 1 , 2

    OpenAIRE

    Ayisi, John G; Van Eijk, Anna M; Newman, Robert D; ter Kuile, Feiko O; Shi, Ya Ping; Yang, Chunfu; Kolczak, Margarette S.; Otieno, Juliana A.; Misore, Ambrose O.; Kager, Piet A.; Lal, Renu B.; Steketee, Richard W; Nahlen, Bernard L

    2004-01-01

    To determine whether maternal placental malaria is associated with an increased risk for perinatal mother-to-child HIV transmission (MTCT), we studied HIV-positive women in western Kenya. We enrolled 512 mother-infant pairs; 128 (25.0%) women had malaria, and 102 (19.9%) infants acquired HIV perinatally. Log10 HIV viral load and episiotomy or perineal tear were associated with increased perinatal HIV transmission, whereas low-density malaria (10,000 parasites/μL) was associated with increased...

  8. Current trends in Irish perinatal mortality.

    LENUS (Irish Health Repository)

    Mahony, R

    2010-06-01

    This was a retrospective review of normally formed perinatal deaths among 176,620 births at the National Maternity Hospital (1984-2007). Prelabor stillbirths were categorised by presumed cause of death including unexplained, intrauterine growth retardation (IUGR), placental abruption, red cell alloimmunisation (RCA) and deaths related to prematurity. Peripartum deaths included intrapartum and first week neonatal deaths. The post-mortem rate, initially almost 100%, fell to 60%. Data were analysed using the Mantel-Haenszel chi square test for trends. In the study period there was a significant reduction in the PNM, largely because of a fall in death related to prematurity, term peripartum death, death at 42 weeks or greater, placental abruption, death related to IUGR and RCA (P < 0.01). Overall the unexplained still birth rate was unchanged throughout the study period (p = 0.8) despite a highly significant (p < 0.001) increase in obstetric intervention particularly induction of labor and caesarean section.

  9. Mortality in mothers after perinatal loss

    DEFF Research Database (Denmark)

    Hvidtjørn, Dorte; Wu, C; Schendel, D;

    2016-01-01

    included in the cohort at time of their first delivery from 1 January 1980 to 31 December 2008 and followed until 31 December 2009 or death, whichever came first. METHODS: The association between perinatal loss and total and cause-specific mortality in mothers was estimated with hazard ratios (HR) and 95......% confidence intervals (95% CI) calculated using Cox proportional hazards regression analyses. MAIN OUTCOME MEASURES: Overall mortality and cause-specific mortality. RESULTS: During the follow-up period, 838 331 mothers in the cohort gave birth to one or more children and 7690 mothers (0.92%) experienced a......OBJECTIVE: To assess whether mothers who lost a child from stillbirth or in the first week of life have an increased overall mortality and cause-specific mortality. DESIGN: A population based follow-up study. SETTING: Data from Danish national registers. POPULATION: All mothers in Denmark were...

  10. Perinatal mortality at pre-Columbian Teotihuacan.

    Science.gov (United States)

    Storey, R

    1986-04-01

    The skeletal population of 166 individuals from a low-status apartment compound of the pre-Columbian city of Teotihuacan contained 52 perinatal individuals. The most perilous time of the lifespan was around birth, as revealed by life table analysis. Femur length was not increasing during the last month of gestation, and individuals were probably shorter somatically at birth than modern standards or historic-period Arikara skeletal controls. The possibility of intrauterine growth retardation is investigated through paleo-pathological indicators of prenatal growth arrest. The evidence of prenatal stress and the high rate of mortality at birth seem to indicate that this New World preindustrial urban population faced similar health and nutritional stresses as Old World preindustrial cities. PMID:3521307

  11. Cytokines in the perinatal period - Part I.

    Science.gov (United States)

    Chau, A; Markley, J C; Juang, J; Tsen, L C

    2016-05-01

    Successful pregnancy requires a state of immune homeostasis. Maternal tolerance of the genetically distinct fetoplacental unit is in part mediated by maternal and fetal pro- and anti-inflammatory cytokines; these cytokines have also been implicated in different pregnancy-related pathologic states. This two-part series seeks to provide anesthesiologists with an overview on selected perinatal cytokines in an effort to identify opportunities for research and improvements in clinical care. In part one, we review basic and pregnancy-related elements of the immune system, with an emphasis on the role of cytokines. From this foundation, we offer a perspective of a unique phenomenon witnessed within obstetric anesthesia - maternal temperature elevation associated with labor epidural analgesia. PMID:26970932

  12. PERINATAL OUTCOME IN SEVERE ANAEMIA COMPLICATING PREGNANCY

    Directory of Open Access Journals (Sweden)

    Nirmala Devi

    2015-06-01

    Full Text Available BACKGROUND: Anaemia is the commonest global public health problem and especially harmful when the pregnancy is complicated by anaemia. Women in reproductive age group are more vulnerable for iron deficiency anaemia with an estimated prevalence of around 70 to 80% in pregnant women. MATERIAL AND METHODS: The aim of the study was to analyse the foetal outcome in the hospitalised pregnant women with severe anaemia. This is a prospective study carried out at maternity ward of Government G eneral H ospital, Kurnool of Andhra Pradesh, India over a period of one year from October 2007 to September 2008. RESULTS: Total of 9731 deliveries occurred during the study period, 282 (2.89 % were severely anaemic at the time of delivery. Majority of the women w ere of 20 - 24 years age (68.4% with second gravidas 37.5%, term gestation 52.1%, preterm deliveries 47.9%, lower socio - economic status 87.6% and Unbooked cases 67.4% and low birth weight in 53.2% cases, intra uterine growth retardation and intra uterine foetal death contributes to 12.8% and 16.7% cases respectively. A total of 36 (12.8% neonates required admission in neonatal intensive care unit and 16(5.7% of them died. CONCLUSION: Severe anaemia during pregnancy has adverse perinatal outcome in the fo rm of low birth weight, preterm birth, intrauterine growth retardation and intrauterine death. Regular iron supplementation during the antenatal period, management of anaemia and improving the nutritional status of the mother will improve the adverse neona tal outcome and decreases perinatal morbidity and mortality.

  13. Recomendaciones para la prevención de la transmisión perinatal del Virus de la Inmunodeficiencia Humana en Costa Rica

    Directory of Open Access Journals (Sweden)

    Oscar Porra

    2008-12-01

    Full Text Available Se conoce que la transmisión perinatal del VIH de madre a hijo es prevenible con la toma de algunas medidas generales y otras específicas. La acción fundamental para lograr esta prevención es identificar cuales embarazadas son portadoras del VIH temprano durante el embarazo. Para lograr este objetivo es necesario realizar la prueba del ELISA para VIH a toda mujer embarazada en su primera consulta prenatal. Las presentes son unas guías sobre el tema desarrolladas con el fin de facilitar la aplicación de todas las acciones necesarias para la prevención de la transmisión perinatal en Costa Rica, brindando una óptima atención médica a la madre y el recién nacido.

  14. Factores asociados a mortalidad perinatal en el hospital general de Chiapas, México

    Directory of Open Access Journals (Sweden)

    Rivera Leonor

    2003-01-01

    Full Text Available OBJETIVO: El objetivo del estudio es identificar factores socioeconómicos, gineco-obstétricos y del producto asociados a mortalidad perinatal. MÉTODOS: Se realizó un estudio de casos y controles pareado. Se consideró caso a los nacidos vivos o muertos que nacieron y fallecieron entre las 28 semanas de gestación a los 7 días de vida extrauterina. y control al producto nacido vivo entre las 28 semanas de gestación y los 7 días de vida extrauterina. Los datos se obtuvieron de los expedientes clínicos hospitalarios. Se estudiaron 99 casos y 197 controles. Se hizo un análisis estadístico utilizando Stata 6.0. RESULTADOS La media de edad de la madre fue de 24.82 años y del producto de 37.78 semanas de gestación. El promedio de peso del producto fue de 2,760 gramos. Los factores asociados a mortalidad perinatal fueron: ocupación del padre agricultor (RM ajustada 3,31; IC 95% 1,26-8,66; índice de riesgo obstétrico alto (RM ajustada 10,57; IC 95% 2,82-39,66, antecedente de cesárea (RM ajustada 2,75; IC 95% 1,37-5,51; cinco y más consultas prenatales (RM ajustada 4,43; IC 95% 1.86-10,54; producto pretérmino (RM ajustada 9,20; IC 95% 4,39-19,25. CONCLUSIONES: Los resultados muestran que es necesario implementar medidas de prevención y control que aseguren la identificación del riesgo en las mujeres embarazadas, con el fin de abatir la incidencia de mortalidad perinatal.

  15. Hipotermia en el recién nacido a término. Una nueva técnica para cuidados de enfermería.

    OpenAIRE

    Busto Naval, Covadonga del

    2014-01-01

    La encefalopatía hipóxico-isquémica en el recién nacido es un problema neurológico manifestación de la asfixia perinatal. La evidencia científica actual muestra que la hipotermia terapéutica aplicada a neonatos puede reducir tanto la lesión tisular en neonatos a término cómo la probabilidad de muerte. En este trabajo se describen los cuidados de enfermería realizados en los casos tratados con hipotermia activa en el HUCA en los años 2011-2012

  16. Web Sites that Address Gestational Diabetes and Perinatal Obesity

    OpenAIRE

    Montgomery, Kristen S.

    2003-01-01

    Obesity contributes to multiple health problems during pregnancy and predisposes a woman to develop gestational diabetes. This column reviews the currently best Web sites that address gestational diabetes and obesity during the perinatal period.

  17. La red perinatal del sur-oriente D.C. una estrategia para mejorar la atención de la madre y el niño

    Directory of Open Access Journals (Sweden)

    Monterrosa Esperanza de

    1996-06-01

    Full Text Available Con el objeto de argumentar el tema y a la vez justificar la creación de la red perinatal en el sur-oriente de Santafé de Bogotá, es necesario acudir a indicadores que describan así sea de manera general la situación materno infantil, en el contexto nacional y específicamente en el distrito capital.

  18. Perinatal Antidepressant Use: Understanding Women’s Preferences and Concerns

    OpenAIRE

    Battle, Cynthia L.; Salisbury, Amy L.; SCHOFIELD, CASEY A.; ORTIZ-HERNANDEZ, SAMIA

    2013-01-01

    Perinatal depression is prevalent and linked with a host of adverse consequences for women and newborns. Rates of engagement in depression treatment are, however, strikingly low among pregnant and postpartum women, with the majority of affected women receiving no mental health treatment. Research indicates that perinatal women are extremely reluctant to take antidepressant medications, yet the nature of women’s concerns and treatment decisionmaking patterns have not been well documented. Deve...

  19. Management of renal dysfunction following term perinatal hypoxia-ischaemia.

    LENUS (Irish Health Repository)

    Sweetman, Deirdre U

    2013-03-01

    Acute kidney injury frequently develops following the term perinatal hypoxia-ischaemia. Quantifying the degree of acute kidney injury is difficult, however, as the methods currently in use are suboptimal. Acute kidney injury management is largely supportive with little evidence basis for many interventions. This review discusses management strategies and novel biomarkers that may improve diagnosis and management of renal injury following perinatal hypoxia-ischaemia.

  20. Perinatal mortality attributable to complications of childbirth in Matlab, Bangladesh.

    OpenAIRE

    Kusiako, T.; Ronsmans, C.; van der Paal, L

    2000-01-01

    Very few population-based studies of perinatal mortality in developing countries have examined the role of intrapartum risk factors. In the present study, the proportion of perinatal deaths that are attributable to complications during childbirth in Matlab, Bangladesh, was assessed using community-based data from a home-based programme led by professional midwives between 1987 and 1993. Complications during labour and delivery--such as prolonged or obstructed labour, abnormal fetal position, ...

  1. Eclampsia: maternal and perinatal outcomes in a tertiary care centre

    OpenAIRE

    Sunita Mor; Daya Sirohiwal; Reetu Hooda

    2015-01-01

    Background: Eclampsia is a life threatening emergency that continues to be a major cause of maternal and perinatal mortality. The purpose of our study was to analyse the trend of eclampsia in a tertiary care teaching institute and to find out maternal and perinatal outcomes of eclampsia. Methods: A prospective study was undertaken in a tertiary care teaching institute over a period of one year. Patients of eclampsia were followed up with regard to the management and maternal and fetal morb...

  2. Towards improving perinatal maternal mental health in Vietnam

    OpenAIRE

    Niemi, Maria

    2012-01-01

    Major depression is increasing world-wide, and is the third leading cause of the global disease burden. In Vietnam, perinatal depression is underdiagnosed and under-treated, leading to severe consequences for the pregnant mother, her child and surroundings. AIMS: The overall aim was to improve knowledge about perinatal depression to contribute to evidence based development of prevention and treatment strategies in Vietnam. The specific aims were: To generate a report of the mental health prio...

  3. Perinatal Depression and Patterns of Attachment: A Critical Risk Factor?

    OpenAIRE

    Valentina Meuti; Franca Aceti; Nicoletta Giacchetti; Giuseppe Mattia Carluccio; Michela Zaccagni; Isabella Marini; Orazio Giancola; Paola Ciolli; Massimo Biondi

    2015-01-01

    Background. This study aims to verify if the presence and severity of perinatal depression are related to any particular pattern of attachment. Methods. The study started with a screening of a sample of 453 women in their third trimester of pregnancy, who were administered a survey data form, the Edinburgh Postnatal Depression Scale (EPDS) and the Experience in Close Relationship (ECR). A clinical group of subjects with perinatal depression (PND, 89 subjects) was selected and compared with a ...

  4. Sleep and perinatal mood disorders: a critical review

    OpenAIRE

    Ross, Lori E.; Murray, Brian J.; Steiner, Meir

    2005-01-01

    Pregnancy and the postpartum period are recognized as times of vulnerability to mood disorders, including postpartum depression and psychosis. Recently, changes in sleep physiology and sleep deprivation have been proposed as having roles in perinatal psychiatric disorders. In this article we review what is known about changes in sleep physiology and behaviour during the perinatal period, with a focus on the relations between sleep and postpartum “blues,” depression and psychosis and on sleep-...

  5. MATERNAL AND PERINATAL OUTCOME IN ECLAMPSIA IN A TE RTIARY CARE CENTRE

    Directory of Open Access Journals (Sweden)

    Bharti

    2013-04-01

    Full Text Available ABSTRACT: BACKGROUND : Eclampsia is a life threatening emergency that con tinues to be a major cause of serious maternal morbidity and is st ill the leading cause of maternal mortality worldwide. OBJECTIVE: Analysis of all cases of Eclampsia patients to find out the incidence, to evaluate the clinical course, medical & obstetric m anagement, and complications and to study the maternal &perinatal outcome. METHODS : This study was a hospital based prospective observational study. We obtained the data for this study from the case records of all Eclampsia patients who admitted in the Department of Obstetrics & Gynaecology, Gandhi Medical College, Bhopal from 01.01.2011 to 31.12.2011 and data were r ecorded on a predesigned proforma. All the obstetrical women with convulsions after 20 wee ks pregnancy or in postpartum period were evaluated. Each case was documented with respec t to age, socioeconomic status, education, occupation, gestational age, time of onse t of Eclampsia, duration and frequency of seizures, mode of delivery, use of drugs (anticonvu lsant and antihypertensive, maternal and perinatal outcome RESULTS: Out of total 203 Eclampsia patients, 144 cases(70.93% were Antepartum Eclampsia, 22 patients (10.84% were intrapa rtum Eclampsia, 35 cases (17.24% were postpartum Eclampsia & 2 cases (0.9% were status Eclampticus.30% Patients did not have oedema,14% had BP<140/90 mm of Hg and 11.4% di d not have proteinuria at the time of admission. There were 21 maternal deaths and morbid ity consisted of pulmonary oedema in 31(33.6% cases, CVA in 17(18.4% cases, renal fail ure in 7(7.6% cases, HELLP syndrome in 6(6.5% cases and aspiration pneumonia in 2(2.2% cas es. Perinatal mortality was 44.3% with majority being related to extreme prematurity. CONCLUSIONS: There is a need of proper antenatal care to prevent Eclampsia and the need for intensive monitoring of women with Eclampsia throughout the hospitalization to improve bo th the maternal

  6. Paradoxical centrally increased diffusivity in perinatal arterial ischemic stroke

    International Nuclear Information System (INIS)

    Restricted diffusion on acute MRI is the diagnostic standard for perinatal arterial ischemic stroke. In a subset of children with perinatal arterial ischemic stroke, primarily those with large infarct volumes, we noted a core of centrally increased diffusivity with a periphery of restricted diffusion. Given the paradoxical diffusion-weighted imaging (DWI) appearance observed in some children with perinatal arterial ischemic stroke, we sought to determine its significance and hypothesized that: (1) centrally increased diffusivity is associated with larger infarcts in perinatal arterial ischemic stroke and (2) this tissue is irreversibly injured (infarcted). We reviewed all perinatal arterial ischemic stroke cases in a prospective cohort study from Aug. 1, 2000, to Jan. 1, 2012. Infarct volumes were measured by drawing regions of interest around the periphery of the area of restricted diffusion on DWI. The Mann-Whitney U test was used to compare means between groups. Of 25 eligible cases, centrally increased diffusivity was seen in 4 (16%). Cases with centrally increased diffusivity had larger average infarct volumes (mean 117,182 mm3 vs. 36,995 mm3; P = 0.008), higher average apparent diffusion coefficient (ADC) values in the infarct core (1,679 x 10-6 mm2/s vs. 611 x 10-6 mm2/s, P < 0.0001), and higher ADC ratio (1.2 vs. 0.5, P < 0.0001). At last clinical follow-up, children with perinatal arterial ischemic stroke and centrally increased diffusivity were more often treated for ongoing seizures (75% vs. 0%; P < 0.001) than those without. Centrally increased diffusivity was associated with larger stroke volume and the involved tissue was confirmed to be infarcted on follow-up imaging. Radiologists should be aware of this unusual appearance of perinatal arterial ischemic stroke in order to avoid underestimating infarct volume or making an incorrect early diagnosis. (orig.)

  7. Paradoxical centrally increased diffusivity in perinatal arterial ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Stence, Nicholas V.; Mirsky, David M.; Deoni, Sean C.L. [University of Colorado Anschutz School of Medicine, Department of Radiology, Aurora, CO (United States); Children' s Hospital Colorado, Department of Radiology, Aurora, CO (United States); Armstrong-Wells, Jennifer [University of Colorado Anschutz School of Medicine, Department of Pediatrics (Neurology) and OB/GYN, Aurora, CO (United States); University of Colorado Hemophilia and Thrombosis Center, Aurora, CO (United States)

    2016-01-15

    Restricted diffusion on acute MRI is the diagnostic standard for perinatal arterial ischemic stroke. In a subset of children with perinatal arterial ischemic stroke, primarily those with large infarct volumes, we noted a core of centrally increased diffusivity with a periphery of restricted diffusion. Given the paradoxical diffusion-weighted imaging (DWI) appearance observed in some children with perinatal arterial ischemic stroke, we sought to determine its significance and hypothesized that: (1) centrally increased diffusivity is associated with larger infarcts in perinatal arterial ischemic stroke and (2) this tissue is irreversibly injured (infarcted). We reviewed all perinatal arterial ischemic stroke cases in a prospective cohort study from Aug. 1, 2000, to Jan. 1, 2012. Infarct volumes were measured by drawing regions of interest around the periphery of the area of restricted diffusion on DWI. The Mann-Whitney U test was used to compare means between groups. Of 25 eligible cases, centrally increased diffusivity was seen in 4 (16%). Cases with centrally increased diffusivity had larger average infarct volumes (mean 117,182 mm{sup 3} vs. 36,995 mm{sup 3}; P = 0.008), higher average apparent diffusion coefficient (ADC) values in the infarct core (1,679 x 10{sup -6} mm{sup 2}/s vs. 611 x 10{sup -6} mm{sup 2}/s, P < 0.0001), and higher ADC ratio (1.2 vs. 0.5, P < 0.0001). At last clinical follow-up, children with perinatal arterial ischemic stroke and centrally increased diffusivity were more often treated for ongoing seizures (75% vs. 0%; P < 0.001) than those without. Centrally increased diffusivity was associated with larger stroke volume and the involved tissue was confirmed to be infarcted on follow-up imaging. Radiologists should be aware of this unusual appearance of perinatal arterial ischemic stroke in order to avoid underestimating infarct volume or making an incorrect early diagnosis. (orig.)

  8. Perinatal lethal skeletal dysplasia: a case report

    Directory of Open Access Journals (Sweden)

    Sunita Dubey

    2016-01-01

    Full Text Available The word dysplasia originates from ancient Greek words dys (anomalous and plasia (formation. Skeltal dysplasia (SD is a heterogeneous group of congenital anomalies characterized by abnormalities in the development of the bone and cartilage tissue. This results in mark disproportion of the long bones, the spine and fetal head relation to the trunk. Perinatal lethal skeletal dysplasia leads to still birth or early neonatal death due to pulmonary hypoplasia. 30 yrs old G3P3L2 at 32 weeks presented with leaking per vaginum. Her serial scan was done as she had previous stillborn male child with short limbs. Her antenatal scan revealed short limbs from 24 weeks. From18 weeks to 24 weeks she did not underwent any sonography. She went into spontaneous labor and delivered still born male baby with clinical and radiological features suggestive of skeletal dysplasia. Skeletal dysplasia can be diagnosed on antenatal 2 D ultrasound from 14 - 16 weeks onwards. Prenatal genetic testing should be done to diagnose the genetic anomaly and patient should be referred to higher institute for this test. Even if genetic test not done even then termination of pregnancy should be considered based on ultrasound diagnosis especially with family history because of poor fetal prognosis and long term morbidity if survived. [Int J Reprod Contracept Obstet Gynecol 2016; 5(1.000: 224-229

  9. Gestational diabetes versus pregestational diabetes. Perinatal results.

    Directory of Open Access Journals (Sweden)

    Cristóbal Torres González

    2004-12-01

    Full Text Available Fundament: Diabetes Mellitus is one of the most affecting diseases in the development of pregnancy. This greatly depends on the metabolic control achieved, which has demanded several proyects of treatment, thus decreasing the risks that the gestational process carries out. Objective: to compare the perinatal results between the diabetic gestational women and pregestational ones admitted at Cienfuegos Hospital. Method: Comparative study developed at the Gynecological-Obstetric Universitary Hospital from Cienfuegos province, from January to december 2003, including 167 pregnant women with Diabetes mellitus during pregnancy. The variables under study were: type of Diabetes, Márquez Guillén classification about good or bad fetal-maternal prognosis , treatment used, type of delivery, gestational age at labor, newborn weight, prenatal and maternal complication. Results: There was a predominance of gestational diabetes (73, 6 % over the cases with pregestational diabetes (26,3 %. According to Marquez Guillén classification , the bad fetal-maternal prognosis (X=16.37, p

  10. Provider communication on perinatal depression: a population-based study.

    Science.gov (United States)

    Farr, Sherry L; Ko, Jean Y; Burley, Kim; Gupta, Seema

    2016-02-01

    Women's lack of knowledge on symptoms of perinatal depression and treatment resources is a barrier to receiving care. We sought to estimate the prevalence and predictors of discussing depression with a prenatal care provider. We used the 2011 population-based data from 24 sites participating in the Pregnancy Risk Assessment Monitoring System (n = 32,827 women with recent live births) to examine associations between maternal characteristics and report that a prenatal care provider discussed with her what to do if feeling depressed during or after pregnancy. Overall, 71.9 % of women reported discussing perinatal depression with their prenatal care provider (range 60.7 % in New York City to 85.6 % in Maine). Women were more likely to report a discussion on perinatal depression with their provider if they they were 18-29 years of age than over 35 years of age compared to older (adjusted prevalence ratio [aPR] 18 to 19 y = 1.08, 20 to 24 y = 1.10, 25 to 29 y = 1.09), unmarried (aPR = 1.07) compared to married, had 12 years, and had no previous live births (aPR = 1.03) compared to ≥ 1 live births. Research is needed on effective ways to educate women about perinatal depression and whether increased knowledge on perinatal depression results in higher rates of treatment and shorter duration of symptoms. PMID:25578631

  11. Low perinatal autopsy rate in Malaysia: time for a change.

    Science.gov (United States)

    Tan, Geok Chin; Hayati, Abdul Rahman; Khong, Teck Yee

    2010-01-01

    Our objectives were to determine the perinatal autopsy rate in a tertiary hospital in Malaysia and to quantify the value of the perinatal autopsy. All stillbirths, miscarriages, therapeutic abortions, and neonatal deaths between January 1, 2004, and August 31, 2009, were identified from the archives. The autopsy findings were compared with the clinical diagnoses. The autopsy reports were also reviewed to determine if it would be possible to improve the quality of the autopsies. There were 807 perinatal deaths, of which 36 (4.5%) included an autopsy. There were ethnic differences in the rate of autopsy, with the lowest rate among the Malays. The autopsy provided the diagnosis, changed the clinical diagnosis, or revealed additional findings in 58.3% of cases. Ancillary testing, such as microbiology, chromosomal analysis, and biochemistry, could improve the quality of the autopsy. This study provides further data on the perinatal autopsy rate from an emerging and developing country. It reaffirms the value of the perinatal autopsy. Attempts must be made to improve on the low autopsy rate while recognizing that the performance of autopsies can be enhanced through the use of ancillary testing. PMID:20367214

  12. Dancing with the One Who “Brung” You into Perinatal Education

    OpenAIRE

    Humenick, Sharron S.

    2002-01-01

    The childbirth education movement began with creating a cultural shift to foster understanding that women should have choice in their birth. It has moved to the perinatal education movement with recognition that there are many teachable perinatal moments.

  13. Prevalence and Change in Psychiatric Disorders Among Perinatally HIV-Infected and HIV-Exposed Youth

    OpenAIRE

    Mellins, Claude A.; Elkington, Katherine S.; Leu, Cheng-Shiun; Santamaria, E. Karina; Dolezal, Curtis; Wiznia, Andrew; Bamji, Mahrukh; McKay, Mary M.; Abrams, Elaine J

    2012-01-01

    As the pediatric HIV epidemic in resource-rich countries evolves into an adolescent epidemic, there is a substantive need for studies elucidating mental health needs of perinatally HIV-infected (PHIV+) youth as they transition through adolescence. This article examines the role of perinatal HIV infection in influencing mental health by comparing changes in psychiatric disorders and substance use disorders (SUD) in perinatally HIV-infected (PHIV+) and perinatally HIV-exposed, but uninfected (P...

  14. Perinatal Outcomes in Advanced Age Pregnancies

    Directory of Open Access Journals (Sweden)

    Ertuğrul Yılmaz

    2016-06-01

    Full Text Available Objective: The aim of this study is to evaluate the impact of advanced maternal age on pregnancy outcomes Methods: A retrospective analysis of 951 birth registry records of Zeynep Kamil Hospital, were analyzed between Janu­ary 2003 and December 2007. Study group was made up of women ≥40 years old and control group was made up of women younger than 40 years. Results: Mean maternal age was 41.48 years in the study group and 26.41 years in the control group. Mean gesta­tional age at the time of delivery is 37.73 weeks in study group and 38.10 weeks in the control group. There was no statistical difference in terms of preterm delivery, multiple pregnancy, fetal anomaly, IUGR, superimpose preeclampsia oligohidramnios, presentation anomaly and placenta previa rates between the study and control groups. Incidence of preeclampsia (p=0.041, Chronic hypertension (p=0.001, GDM (p= 0.003,is found to be higher in study group. Cesar­ean birth rate is higher (p<0.05 and hospitalization time is longer in study group (p=0.001. 1st minute and 5th minute APGAR scores of the study group (6.99±2, 8.27±2 was lower than the 1st minute and 5th Minutes APGAR scores of the control group (7.38±1.6, 8.58±1.7. Neonatal intensive care unit administration rate is seen also higher in study group (p<0.01. Conclusion: Advanced maternal age was related to increased pregnancy complications and poor perinatal outcome. Preeclampsia, GDM, chronic hypertension is seen more common in advanced age pregnancies. Neonatal intensive care administration is higher and APGAR scores are lower; cesarean delivery was performed more common, and hospitaliza­tion time was longer in advanced age pregnancies. J Clin Exp Invest 2016; 7 (2: 157-162

  15. Stillbirth: The other half of perinatal mortality

    LENUS (Irish Health Repository)

    Murphy, JFA

    2012-01-01

    Stillbirth is fetal death after 20 weeks gestation1. There are a number of definitions and classifications. WHO defines a stillbirth as a baby BW ≥500g, ≥22 weeks gestation who died before or during birth. However for international comparisons it recommends that reporting be restricted to those with BW>1000g and gestation ≥28 weeks. In Ireland stillbirths must be registered, the definition being BW≥500g or having reached a gestational age ≥ 24 weeks. Stillbirth affects 1 in 160 pregnancies2 and numerically it equals the number of infant deaths in the first year of life. At the beginning of the third trimester of pregnancy the baby weighs 1 Kg and the risk of stillbirth is 1- 2%. The possibility of a stillbirth increases with maturity throughout the third trimester and is 3 times greater at 40 weeks than at earlier gestational ages3. This is relevant for the 5-10% of pregnancies that continue ≥42 weeks. If managed expectantly one in 400 post-term pregnancies will end in a stillbirth. Since 2003 the stillbirth rate has remained static in the US at 3.0 stillbirths per 1000 births. Prior to 2003 the stillbirth rate had declined 1.4% annually while the infant mortality rate fell twice as fast at 2.8%. Globally there are 2.6 million stillbirths annually. In Ireland the stillbirth rate is 3.3 per 1000 births which equates to 230 deaths per year. Despite its frequent occurrence stillbirth has been a relatively neglected component of perinatal medicine. Because a definitive cause cannot be identified in many cases, counselling is very difficult. This lack of scientific causation data has resulted in professional fatalism towards the stillbirth problem.

  16. Obstetric and perinatal outcome of multiple pregnancy

    International Nuclear Information System (INIS)

    To determine the obstetric and perinatal outcome in multiple pregnancies at a teaching hospital. The analysis included data on all women between 20 and 35 years of age with 24 completed weeks gestation having multiple pregnancies during the study period after applying the exclusion criteria. The data retrieved from the hospital-based maternal health medical records included demographic details, complications of pregnancy, and maternal and neonatal outcomes. The data was expressed as frequencies, percentages, mean and standard deviation. Normal distribution of continuous variables was determined by Shapiro Wilk test. The differences in the mean birth weight of the first and second twin were compared by student's t-test considering a p-value less than 0.05 as statistically significant. There were a total of 161 multiple pregnancies with the overall incidence of 37.1 per 1,000 births (3.2%) during the study period. One hundred and twenty two cases had the inclusion criteria applicable. There were 9 triplets among these of whom seven were received as intrauterine death and the other two were lost to follow-up. The four leading maternal adverse outcomes were anemia (74.6%), preterm delivery (31%), pregnancy - induced hypertension (30%) and preterm premature rupture of membranes (26.2%). Median gestational age at delivery was 37 weeks. Most common route of delivery was caesarean section (53.3%). Most common neonatal complication was low birth weight. Prematurity was the most common cause of neonatal death. Multiple pregnancy have high maternal and neonatal complications, especially preterm delivery that increases risk of significant neonatal morbidity and mortality. (author)

  17. Idiopathic Polyhydramnios: Severity and Perinatal Morbidity.

    Science.gov (United States)

    Wiegand, Samantha L; Beamon, Carmen J; Chescheir, Nancy C; Stamilio, David

    2016-06-01

    Objective To estimate the association between the severity of idiopathic polyhydramnios and adverse outcomes. Study Design Retrospective cohort study of deliveries at one hospital from 2000 to 2012 with an amniotic fluid index (AFI) measurement ≥24 + 0 weeks' gestation. Pregnancies complicated by diabetes, multiples, or fetal anomalies were excluded. Exposure was the degree of polyhydramnios: normal (AFI 5-24 cm), mild (≥ 24-30 cm), and moderate-severe (> 30 cm). Primary outcomes were perinatal mortality, neonatal intensive care unit (NICU) admission, and postpartum hemorrhage. Results There were 10,536 pregnancies: 10,188 with a normal AFI, 274 mild (78.74%), and 74 moderate-severe polyhydramnios (21.26%). Adverse outcomes were increased with idiopathic polyhydramnios: NICU admission (adjusted odds ratio [AOR] 3.71, 95% confidence interval [CI] 2.77-4.99), postpartum hemorrhage (AOR 15.81, 95% CI 7.82-31.96), macrosomia (AOR 3.41, 95% CI 2.61-4.47), low 5-minute Apgar score (AOR 2.60, 95% CI 1.57-4.30), and cesarean (AOR 2.16, 95% CI 1.74-2.69). There were increasing odds of macrosomia (mild: AOR 3.19, 95% CI 2.36-4.32; moderate-severe: AOR 4.44, 95% CI 2.53-7.79) and low 5-minute Apgar score (mild: AOR 2.24, 95% CI 1.23-4.08; moderate-severe: AOR 3.93, 95% CI 1.62-9.55) with increasing severity of polyhydramnios. Conclusion Idiopathic polyhydramnios is independently associated with increased risks of morbidity. There appears to be a dose-response relationship for neonatal macrosomia and low 5-minute Apgar score risks. PMID:26862725

  18. Low cerebral blood flow in hypotensive perinatal distress

    International Nuclear Information System (INIS)

    Hypoxic brain injury is the most important neurological problem in the neonatal period and accounts for more neurological deficits in children than any other lesion. The neurological deficits are notably mental retardation, epilepsy and cerebral palsy. The pathogenesis has hitherto been poorly understood. Arterial hypoxia has been taken as the obvious mechanism but this does not fully explain the patho-anatomical findings. In the present investigation we have examined the arterial blood pressure and the cerebral blood flow in eight infants a few hours after birth. The 133Xe clearance technique was used for the cerebral blood flow measurements. The study confirmed that perinatal distress may be associated with low arterial blood pressure, and it was shown that cerebral blood flow is very low, 20 ml/100 g/min or less, in hypotensive perinatal distress. It is concluded that cerebral ischaemia plays a crucial role in the development of perinatal hypoxic brain injury. (author)

  19. Resultado de los embarazos complicados con rubéola, 1990-1997

    OpenAIRE

    Figueroa-Damián Ricardo; Ortiz-Ibarra Federico J.; Arredondo-García José Luis; Ahued-Ahued José R.

    1999-01-01

    OBJETIVO. Describir la experiencia del manejo de embarazadas con rubéola, evaluando el resultado perinatal. MATERIAL Y MÉTODOS. Del 1 de enero de 1990 al 31 de octubre de 1997 se incluyeron 67 embarazadas con diagnóstico de rubéola, corroborada con la determinación de anticuerpos séricos IgM. Se dio seguimiento hasta la resolución del embarazo en 66 de estas mujeres: en cuatro se realizó un aborto electivo y una tuvo un embarazo molar. En 61 pacientes se pudo evaluar el efecto de la rubéola s...

  20. Gestational diabetes versus pregestational diabetes. Perinatal results. Diabetes gestacional versus diabetes pregestacional. Resultados perinatales.

    Directory of Open Access Journals (Sweden)

    Vivian Vázquez Martínez

    >Métodos: Estudio comparativo realizado en el Servicio de Obstetricia del Hospital Universitario ¨Dr. Gustavo Aldereguía Lima¨ de Cienfuegos desde enero a diciembre del 2003, en el que se incluyeron 167 gestantes con diabetes durante el embarazo. Se estudiaron las siguientes variables: tipo de diabetes, clasificación de Márquez Guillén (buen o mal pronóstico materno fetal, tratamiento usado, tipo de parto, tiempo gestacional al parto, peso del recién nacido, complicaciones perinatales y maternas. Resultados: Predominó la diabetes gestacional (73, 6 % sobre los casos con diabetes pregestacional (26,3 %,el riesgo de mal pronóstico de la DMPG respecto a la DMG en este estudio fue de 2,41 IC 95 % (1,60;3,63 en relación al tratamiento con insulina fue de 4,26 IC 95 % (1,94;9,44 en relación al aborto fue de 7,97 IC 95 % (3,48;18,54 con relación al parto pretermino fue de 4,22 IC 95 % (1,47;12,27 , con relación a la morbilidad materna fue de 10,62 IC 95 % (4,44;25,82 y de morbilidad perinatal fue de 10,84 IC 95 % (4,52;26,43.

  1. Perinatal and neonatal outcome in meconium stained amniotic fluid

    Directory of Open Access Journals (Sweden)

    Shazia Qadir

    2016-05-01

    Conclusions: The significance of meconium in amniotic fluid is a widely debated subject. Traditionally meconium has been considered as a sign of fetal distress occurring due to hypoxia. However it is now recognized as a manifestation of a normally maturing gastrointestinal tract. In a global sense it is still considered a marker for adverse perinatal outcomes. The presence of thick meconium is associated with increase in the perinatal morbidity and mortality and hence its presence should not be overlooked. [Int J Reprod Contracept Obstet Gynecol 2016; 5(5.000: 1400-1405

  2. Perinatal and Neonatal Health Information Technology: Past, Present, and Future.

    Science.gov (United States)

    McCartney, Patricia Robin; Drake, Emily Eiwen

    2016-01-01

    The 3 decades of The Journal of Perinatal & Neonatal Nursing history share the same 3 decades as the birth of the information age and health information technology (HIT). This article summarizes the history of HIT and the corresponding publication history of The Journal of Perinatal & Neonatal Nursing. Health information technology content has evolved from being the "how-to operate" topic of a publication to being integrated within a nursing practice publication. The article concludes with current HIT challenges and implications for the future. PMID:27465451

  3. Evaluación de la mortalidad perinatal en mujeres autóctonas e inmigrantes: influencia de la exhaustividad y la calidad de los registros Perinatal mortality assessment in native and immigrant women: influence of exhaustiveness and quality of the registries

    Directory of Open Access Journals (Sweden)

    Isabel Río Sánchez

    2009-10-01

    Full Text Available Objetivo: Realizar un análisis comparativo de la exhaustividad de los datos sobre mortalidad perinatal en la Comunitat Valenciana recogidos en el Instituto Nacional de Estadística (INE y en el Registro de Mortalidad Perinatal (RMPCV. Posteriormente, calcular y comparar la tasa de mortalidad perinatal (TMP y sus componentes en gestantes autóctonas e inmigrantes, tomando como referencia los casos notificados a ambos registros durante 2005 y 2006. Métodos: Se definieron los distintos tipos de mortalidad de acuerdo con los criterios establecidos por la OMS. La magnitud de la infradeclaración se analizó calculando las frecuencias y porcentajes de muertes infradeclaradas para el período 2005-2006. Se calcularon y compararon las diversas tasas entre mujeres autóctonas e inmigrantes de los cuatro grupos mayoritarios a partir de ambos registros, así como los intervalos de confianza del 95% para dichas tasas. Resultados: En el INE existe un importante subregistro de muertes fetales y neonatales. Además, constan neonatos fallecidos de madre extranjera con nacionalidad española asignada. Ambos factores distorsionan la proporción de muertes fetales y neonatales en inmigrantes, y provocan una infraestimación de la TMP y sus componentes en estos colectivos, pues las obtenidas a partir del RMPCV son muy superiores en las mujeres inmigrantes, en particular en las de Europa del Este y las subsaharianas, en comparación con las autóctonas. Conclusiones: En definitiva, nuestros resultados indican que ambos registros son complementarios, pero el RMPCV presenta una mayor exhaustividad y fiabilidad para el cálculo de tasas. Además, sugieren la necesidad de monitorizar la evolución de la TMP en la población inmigrante en España.Objective: To analyze the exhaustiveness and reliability of the data on perinatal mortality in two Spanish registries, namely, the National Statistics Institute and the Perinatal Mortality Registry of the Valencian Community

  4. Mortalidade perinatal e evitabilidade: revisão da literatura Perinatal mortality and evitability: a review

    Directory of Open Access Journals (Sweden)

    Sônia Lansky

    2002-12-01

    Full Text Available Neste artigo, realizou-se uma revisão da literatura sobre mortalidade perinatal com maior enfoque na evitabilidade desses óbitos. Foram pesquisadas, sobretudo, publicações da década de 90 nas bases Medline e Lilacs (América Latina e Caribe. Discutiram-se as dificuldades para a realização de estudos nesta área, ainda em número restrito no Brasil, em decorrência do grande subregistro de óbitos fetais e da má qualidade da informação nas declarações de óbitos. Foram apresentadas as principais propostas de classificação dos óbitos perinatais baseadas em enfoque de evitabilidade, com destaque para a classificação de Wigglesworth. Nesta abordagem, os óbitos perinatais foram relacionados a momentos específicos da assistência, sendo evidenciadas as possibilidades de sua prevenção. Recomenda-se o enfoque de evitabilidade para a abordagem da mortalidade perinatal no Brasil, dado que as taxas são ainda elevadas, a maioria dos óbitos é considerada evitável e poderia ser prevenida com a melhoria da assistência pré-natal, ao parto e ao recém-nascido, não apenas quanto à sua resolubilidade clínica, mas também à organização da assistência em sistemas hierarquizados e regionalizados, assegurando o acesso da gestante e do recém-nascido em tempo oportuno a serviços de qualidade.This is a literature review onperinatal mortality focusing its evitability. A Medline and Lilacs (Latin-America and Caribbean search was conducted for the 90s. There are few research studies on this subject in Brazil due to the great number of underreported fetal deaths and the low quality information provided in death certificates. Different proposals for perinatal death classification are presented. Most are based on grouping the underlying causes of deaths in a functional system in order to facilitate the analysis. In the Wigglesworth classification system, one of the most recommended methods, deaths are related to the different stages of care

  5. Estudio de la fusión del asta mayor del hioides en relacion con la edad y revisión bibliográfica sobre las fracturas del hioides en medicina forense A study of the coalition of major cornua of the hioides in connection with the age and bibliographical revision on the fractures of the hioides in forensic medicine

    Directory of Open Access Journals (Sweden)

    PM. Garamendi

    2007-10-01

    Full Text Available Se presenta un estudio de revisión sobre las características generales de las fracturas del hioides en el contexto de la medicina forense. Junto con esta revisión, se incluye un estudio sobre el estado de fusión de las astas mayores con el cuerpo del hioides en una muestra de Ortopantomografías dentales digitales. La conclusión del trabajo es la de que el estado de fusión en la unión de las astas mayores del hioides con el cuerpo no puede predecirse por la edad o el sexo de un sujeto, ni tampoco puede presuponerse por este estado que vayan a existir o no fracturas de las astas mayores en casos de asfixia mecánica por compresión cervical. Se recomienda la práctica previa, en todos los casos de autopsias por asfixia mecánica con sospecha de compresión cervical de un estudio radiográfico del bloque cervical previo a la disección y, tras ésta, el análisis histopatológico del mismo para evitar errores de diagnóstico diferencial entre fracturas vitales y postmortales y ausencias de fusión del asta mayor con el cuerpo del hioides.We present a review of the medico legal literature on hyoid bone fractures. It is also included a research on bone fusion of major cornua and hyoid bone body. This research has been conducted in a sample of digital dental Orthopantomographies. This research suggests that it isn´t possible to predict the state of fusion of the major cornua in subjects of known sex and age. In cases of non union of major cornua it shouldn´t be supossed that fractures of the hyoid won’t happen. In all cases of forensic autopsies when mechanical asphyxia is suspected it is recommended to perform a radiological study of cervical tissues prior to extraction and after extraction it should be performed hystopathological studies.

  6. Resultado perinatal em mulheres portadoras de hipertensão arterial crônica: revisão integrativa da literatura Resultado perinatal en mujeres que sufren de hipertensión crónica: revisión integradora de la literatura Perinatal outcome in women suffering from chronic hypertension: literature integrative review

    Directory of Open Access Journals (Sweden)

    Angelita José Henrique

    2012-12-01

    Full Text Available Objetivou-se identificar as principais complicações relativas à Hipertensão Arterial Crônica observadas em mulheres gestantes e conhecer a evolução nos padrões de riscos dos resultados perinatais em duas décadas. Realizou-se uma revisão integrativa da literatura com abrangência temporal entre os anos de 1990 e 2010, nas bases de dados LILACS, SciELO e MEDLINE. Entre os resultados, observou-se que gestantes hipertensas crônicas apresentaram pré-eclâmpsia sobreposta (20% a 78%, restrição do crescimento fetal (8,5% a 30,7%, prematuridade (32,4% a 86,4%, cesárea (69,2%, descolamento prematuro da placenta (3,75% a 8,4%, óbito fetal (9,5% a 27,2%, complicações cardiovasculares, renais e pulmonares maternas. Conclui-se que a associação entre hipertensão crônica e gestação mostra forte risco para complicações maternas e perinatais, principalmente quando associados à severidade e etiologia da hipertensão, não mostrando evolução no decorrer das duas décadas pesquisadas sobre o resultado perinatal.Objetivó-se identificar los patrones en la evolución del riesgo de resultados perinatales de las mujeres embarazadas con hipertensión crónica con el fin de comparar los resultados de la evolución del embarazo. Realizó-se una revisión integradora de la literatura, con lapso de tiempo entre los años 1990 y 2010, en las databases LILACS, SciELO y MEDLINE. En los resultados, fue observado que las mujeres embarazadas con hipertensión crónica apresentaran preeclampsia superpuesta (20% a 78%, restricción del crecimiento fetal (8,5% a 30,7%, prematuridad (32,4% a 86,4%, cesárea (69 2%, desprendimiento abrupto de la placenta (3,75% a 8,4%, muerte fetal (9,5% a 27,2%, complicaciones cardiovasculares, renales y pulmonares materna. Concluye-se que la asociación de hipertensión crónica y embarazo presenta riesgo importante para complicaciones maternas y perinatales, especialmente cuando se asocia con la gravedad y etiología de

  7. Association Between Isolated Single Umbilical Artery and Perinatal Outcomes: A Meta-Analysis.

    Science.gov (United States)

    Xu, Yajuan; Ren, Lidan; Zhai, Shanshan; Luo, Xiaohua; Hong, Teng; Liu, Rui; Ran, Limin; Zhang, Yingying

    2016-01-01

    BACKGROUND To evaluate the association between the isolated single umbilical artery (iSUA) and perinatal outcomes, including pregnancy outcomes and perinatal complications. MATERIAL AND METHODS We performed a meta-analysis of 15 eligible studies regarding the relationship between the iSUA and perinatal outcomes, including gestational age at delivery, nuchal cord, placental weight, small for gestational age (SGA), oligohydramnios, polyhydramnios, pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), preeclampsia, and perinatal mortality. The overall odds ratios (OR) or standardized mean difference (SMD) were calculated. RESULTS The occurrence of nuchal cord was not found to be different between an iSUA and a three-vessel cord (TVC) fetus. For perinatal complications, the SGA, oligohydramnios, polyhydramnios, GDM, and perinatal mortality showed dramatic difference between women with an iSUA and women with a TVC fetus, which implied that the presence of iSUA significantly increased the risk of perinatal complications. For other perinatal complications, such as PIH and preeclampsia, no significant association was detected. CONCLUSIONS Our meta-analysis suggests that the presence of iSUA would increase the risk of perinatal complications such as SGA, oligohydramnios, polyhydramnios, GDM, and perinatal mortality. Therefore, pregnant women with an iSUA fetus have poorer perinatal outcomes and more attention should be given to the management of their pregnancy compared to women with a TVC fetus. PMID:27130891

  8. Prenatal and Perinatal Risk Factors for Autism in China

    Science.gov (United States)

    Zhang, Xin; Lv, Cong-Chao; Tian, Jiang; Miao, Ru-Juan; Xi, Wei; Hertz-Picciotto, Irva; Qi, Lihong

    2010-01-01

    We conducted a case-control study using 190 Han children with and without autism to investigate prenatal and perinatal risk factors for autism in China. Cases were recruited through public special education schools and controls from regular public schools in the same region (Tianjin), with frequency matching on sex and birth year. Unadjusted…

  9. Multiple endocrine disrupting effects in rats perinatally exposed to butylparaben

    DEFF Research Database (Denmark)

    Boberg, Julie; Petersen, Marta Axelstad; Svingen, Terje;

    2016-01-01

    Parabens comprise a group of preservatives commonly added to cosmetics, lotions and other consumer products. Butylparaben has estrogenic and anti-androgenic properties and is known to reduce sperm counts in rats following perinatal exposure. Whether butylparaben exposure can affect other endocrine...

  10. STUDY OF MATERNAL AND PERINATAL OUTCOME IN REFERRED OBSTETRICS CASES

    OpenAIRE

    Umesh; Alka Murlidhar

    2015-01-01

    OBJECTIVE: To review the referred obstetric cases for reason of referral and to study the maternal and perinatal outcome. DESIGN: Prospective Observational study . STUDY POPULATION: 380 cases referred from periphery to tertiary care institute in one year duration. METHODS: INCLUSION C RITERIA : All referred ANC cases to our tertiary care i...

  11. Assessing the knowledge of perinatal mental illness among student midwives.

    Science.gov (United States)

    Phillips, Louise

    2015-11-01

    The experience of perinatal mental illness (mental illness occurring around the time of pregnancy) currently affect 1 in 10 women and can have adverse effects on the mother and her child (Massie and Szajnberg, 2002; O'Connor et al., 2002). The care and effective management of women experiencing perinatal mental illness is therefore an important issue for health care staff, managers, psychiatrists, commissioners and campaigners. Midwives play a significant part in caring for women throughout their pregnancies, during labour and up to the first month after birth. Midwives are in a unique position to assess a woman's well-being and to offer appropriate support. However, previous research has revealed that midwives often have poor understanding and knowledge of perinatal mental health issues and require improved training (Ross-Davie et al, 2006; McCann and Clark, 2010). This research project aims to systematically assess student midwives awareness of perinatal mental illness. The findings of this study will inform curriculum development for graduate and post-graduate midwifery students therefore improving the care and support women with mental illness receive from antenatal services. The findings from this study will also be used for the formation of an educational web-based programme for student and qualified midwives. PMID:25300675

  12. Maternal and perinatal outcome in severe preeclampsia and eclampsia

    Directory of Open Access Journals (Sweden)

    Neha Saxena

    2016-07-01

    Conclusions: Maternal and perinatal complications are more in patients with eclampsia. The incidence of eclampsia can be reduced by better antenatal care, early recognition and prompt treatment of severe pre-eclampsia. [Int J Reprod Contracept Obstet Gynecol 2016; 5(7.000: 2171-2176

  13. PREGNANCY AND PERINATAL HEALTH, BAMEN, INNER MONGOLIA, CHINA

    Science.gov (United States)

    For developing countries, especially in remote rural areas, measures of maternal and perinatal health may be difficult to obtain because it is not systematically collected and/or electronic data is not available. We assisted the public health officials of Bayingnormen (BaMen), In...

  14. Psychosocial impact of perinatal loss among Muslim women

    Directory of Open Access Journals (Sweden)

    Sutan Rosnah

    2012-06-01

    Full Text Available Abstract Background Women of reproductive age are vulnerable to psychosocial problems, but these have remained largely unexplored in Muslim women in developing countries. The aim of this study was to explore and describe psychosocial impact and social support following perinatal loss among Muslim women. Methods A qualitative study was conducted in a specialist centre among Muslim mothers who had experienced perinatal loss. Purposive sampling to achieve maximum variation among Muslims in relation to age, parity and previous perinatal death was used. Data was collected by focus group discussion and in-depth unstructured interview until the saturation point met. Sixteen mothers who had recent perinatal loss of wanted pregnancy, had received antenatal follow up from public or private health clinics, and had delivery in our centre participated for the study. All of them had experienced psychological difficulties including feelings of confusion, emptiness and anxiety over facing another pregnancy. Results Two out of sixteen showed anger and one felt guilt. They reported experiencing a lack of communication and privacy in the hospital during the period of grief. Family members and friends play an important role in providing support. The majority agreed that the decision makers were husbands and families instead of themselves. The respondents felt that repetitive reminder of whatever happened was a test from God improved their sense of self-worth. They appreciated this reminder especially when it came from husband, family or friends closed to them. Conclusion Muslim mothers who had experienced perinatal loss showed some level of adverse psychosocial impact which affected their feelings. Husbands and family members were the main decision makers for Muslim women. Health care providers should provide psychosocial support during antenatal, delivery and postnatal care. On-going support involving husband should be available where needed.

  15. Approaching the millennium: perinatal problems and software solutions.

    Science.gov (United States)

    Sokol, R J; Chik, L; Zador, I

    1992-01-01

    Strategic planning for rational development of perinatal computing capabilities for the year 2000 should be driven by anticipated trends in (1) the health care business, (2) computer technology and (3) medicine, as well as (4) the needs of perinatal practitioners. In the USA, health care is the fastest growing segment of the economy. This will produce increasing attention from hardware and software developers, and vendors, and will lead to a proliferation of computing platforms, operating systems and specific medical application software. Desktop computers, already capable of 20 million instructions per second (MIPS) with massive storage capacities, will continue to evolve and fall in price. Increasingly, perinatologists will develop software packages to facilitate patient care in their own environments. All of these trends will lead to severe fragmentation in medical computing. Simultaneously, however, the need for integrated institutional computer-based data access for quality assurance and fiscal and operations management will increase. Perinatal care will be more regionalized, complex and rigorous with new clinical trial- and effectiveness research-based interventions, as well as molecular diagnosis and therapy. To practice appropriately, clinicians will need to be familiar with computer capabilities. Having been exposed to computer-aided instruction (CAI) at the undergraduate and postgraduate levels, they will except on-line access to detailed and accurate patient information with linkage to laboratory, radiology and other medical databases, as well as to reference databases, such as Medlines and the Oxford Database of Perinatal Trials. Artificial intelligence (AI) software may support perinatal decision making; computerized professional and facility billing will be available. PMID:1396279

  16. Mozambican midwives' views on barriers to quality perinatal care.

    Science.gov (United States)

    Pettersson, Karen Odberg; Johansson, Eva; Pelembe, Maria de Fatima M; Dgedge, Clemencia; Christensson, Kyllike

    2006-02-01

    Our purpose in this study was to explore the midwives' perception of factors obstructing or facilitating their ability to provide quality perinatal care at a central labor ward in Maputo. In-depth interviews were undertaken with 16 midwives and were analyzed according to grounded theory technique. Barriers to provision of quality perinatal care were identified as follows: (i) the unsupportive environment, (ii) nonempowering and limited interaction with women in labor, (iii) a sense of professional inadequacy and inferiority, and (iv) nonappliance of best caring practices. A model based on the midwives' reflections on barriers to quality perinatal care and responses to these were developed. Actions aimed at overcoming the barriers were improvising and identifying areas in need of change. Identified evading actions were holding others accountable and yielding to dysfunction and structural control. In order to improve perinatal care, the midwives need to see themselves as change agents and not as victims of external and internal causal relationships over which they have no influence. It is moreover essential that the midwives chose actions aiming at overcoming barriers to quality perinatal care instead of choosing evading actions, which might jeopardize the health of the unborn and newborn infant. We suggest that local as well as national education programs need to correspond with existing reality, even if they provide knowledge that surpasses the present possibilities in practice. Quality of intrapartum and the immediate newborn care requires a supportive environment, however, which in the context of this study presented such serious obstacles that they need to be addressed on the national level. Structural and administrative changes are difficult to target as these depend on national organization of maternal health care (MHC) services and national health expenditures. PMID:16484159

  17. Automedicación en gestantes que acuden al Instituto Nacional Materno Perinatal, Perú 2011 Self-medication behavior among pregnant women user of the Instituto Nacional Materno Perinatal, Peru 2011

    Directory of Open Access Journals (Sweden)

    Elsy Miní

    2012-06-01

    Full Text Available Con el objetivo de determinar la prevalencia de automedicación en gestantes y sus características, se realizó un estudio descriptivo transversal. Se entrevistó a 400 gestantes que acudían a control prenatal en el Instituto Nacional Materno Perinatal de Lima. El 10,5% (42 pacientes se automedicó durante la gestación, el 64,6% opinó que la automedicación puede producir malformaciones congénitas a sus bebes. Los medicamentos consumidos por las gestantes estuvieron en categoría A y B de la clasificación de la Administración de Alimentos y Drogas de EUA (FDA; principalmente, consumieron paracetamol (47,6% y amoxicilina (16,7%. Todas las mujeres que se automedicaron durante la gestación lo habían hecho antes de estar embarazadas. De acuerdo con estos resultados concluimos que la prevalencia de automedicación en gestantes del estudio es baja, comparado con la literatura internacional.We aim to determine the prevalence of self prescribing behaviour during pregnancy and its characteristics. For this purpose, we designed a cross sectional study and interviewed 400 pregnant women who had their prenatal care at Instituto Nacional Materno Perinatal, Lima. We found that 10.5% of the patients (42 patients had a self prescribing behavior during pregnancy, 64.5% think that self prescribing behavior can produce congenital malformations. The medications used were classified as type A and B according to the Food and Drug Administration (FDA. Paracetamol was used more frequently (47.6% followed by amoxicillin (16.7%. All the women who self-prescribed have had this behavior before pregnancy. According to these results, we conclude there is a low prevalence of self-prescribing behavior during pregnancy compared to the international literature.

  18. Introduction of a qualitative perinatal audit at Muhimbili National Hospital, Dar es Salaam, Tanzania

    Directory of Open Access Journals (Sweden)

    Thomas Angela N

    2009-09-01

    Full Text Available Abstract Background Perinatal death is a devastating experience for the mother and of concern in clinical practice. Regular perinatal audit may identify suboptimal care related to perinatal deaths and thus appropriate measures for its reduction. The aim of this study was to perform a qualitative perinatal audit of intrapartum and early neonatal deaths and propose means of reducing the perinatal mortality rate (PMR. Methods From 1st August, 2007 to 31st December, 2007 we conducted an audit of perinatal deaths (n = 133 with birth weight 1500 g or more at Muhimbili National Hospital (MNH. The audit was done by three obstetricians, two external and one internal auditors. Each auditor independently evaluated the cases narratives. Suboptimal factors were identified in the antepartum, intrapartum and early neonatal period and classified into three levels of delay (community, infrastructure and health care. The contribution of each suboptimal factor to adverse perinatal outcome was identified and the case graded according to possible avoidability. Degree of agreement between auditors was assessed by the kappa coefficient. Results The PMR was 92 per 1000 total births. Suboptimal factors were identified in 80% of audited cases and half of suboptimal factors were found to be the likely cause of adverse perinatal outcome and were preventable. Poor foetal heart monitoring during labour was indirectly associated with over 40% of perinatal death. There was a poor to fair agreement between external and internal auditors. Conclusion There are significant areas of care that need improvement. Poor monitoring during labour was a major cause of avoidable perinatal mortality. This type of audit was a good starting point for quality assurance at MNH. Regular perinatal audits to identify avoidable causes of perinatal deaths with feed back to the staff may be a useful strategy to reduce perinatal mortality.

  19. Linkages among reproductive health, maternal health, and perinatal outcomes.

    Science.gov (United States)

    Bhutta, Zulfiqar A; Lassi, Zohra S; Blanc, Ann; Donnay, France

    2010-12-01

    Some interventions in women before and during pregnancy may reduce perinatal and neonatal deaths, and recent research has established linkages of reproductive health with maternal, perinatal, and early neonatal health outcomes. In this review, we attempted to analyze the impact of biological, clinical, and epidemiologic aspects of reproductive and maternal health interventions on perinatal and neonatal outcomes through an elucidation of a biological framework for linking reproductive, maternal and newborn health (RHMNH); care strategies and interventions for improved perinatal and neonatal health outcomes; public health implications of these linkages and implementation strategies; and evidence gaps for scaling up such strategies. Approximately 1000 studies (up to June 15, 2010) were reviewed that have addressed an impact of reproductive and maternal health interventions on perinatal and neonatal outcomes. These include systematic reviews, meta-analyses, and stand-alone experimental and observational studies. Evidences were also drawn from recent work undertaken by the Child Health Epidemiology Reference Group (CHERG), the interconnections between maternal and newborn health reviews identified by the Global Alliance for Prevention of Prematurity and Stillbirth (GAPPS), as well as relevant work by the Partnership for Maternal, Newborn and Child Health. Our review amply demonstrates that opportunities for assessing outcomes for both mothers and newborns have been poorly realized and documented. Most of the interventions reviewed will require more greater-quality evidence before solid programmatic recommendations can be made. However, on the basis of our review, birth spacing, prevention of indoor air pollution, prevention of intimate partner violence before and during pregnancy, antenatal care during pregnancy, Doppler ultrasound monitoring during pregnancy, insecticide-treated mosquito nets, birth and newborn care preparedness via community-based intervention

  20. Improving survival among Brazilian children with perinatally-acquired AIDS

    Directory of Open Access Journals (Sweden)

    Luiza Harunari Matida

    2004-12-01

    Full Text Available Brazil was the first developing country to provide free, universal access to antiretroviral treatment for AIDS patients. The Brazilian experience thus provides the first evidence regarding the impact of such treatment on the survival of perinatally acquired AIDS cases in the developing world. MATERIAL AND METHODS: This retrospective cohort study used medical record reviews to examine characteristics and trends in the survival of a representative sample of 914 perinatally acquired AIDS cases in 10 Brazilian cities diagnosed between 1983 and 1998. RESULTS: Survival time increased steadily and substantially. Whereas half of the children died within 20 months of diagnosis at the beginning of the epidemic, 75% of children diagnosed in 1997 and 1998 were still alive after four years of follow-up. CONCLUSIONS: Advances in management and treatment have made a great difference in the survival of Brazilian children with AIDS. These results argue strongly for making such treatment available to children in the entire developing world.

  1. Perinatal Depression and Patterns of Attachment: A Critical Risk Factor?

    Directory of Open Access Journals (Sweden)

    Valentina Meuti

    2015-01-01

    Full Text Available Background. This study aims to verify if the presence and severity of perinatal depression are related to any particular pattern of attachment. Methods. The study started with a screening of a sample of 453 women in their third trimester of pregnancy, who were administered a survey data form, the Edinburgh Postnatal Depression Scale (EPDS and the Experience in Close Relationship (ECR. A clinical group of subjects with perinatal depression (PND, 89 subjects was selected and compared with a control group (C, regarding psychopathological variables and attachment patterns. Results. The ECR showed a prevalence of “Fearful-Avoidant” attachment style in PND group (29.2% versus 1.1%, p<0.001; additionally, the EPDS average score increases with the increasing of ECR dimensions (Avoidance and Anxiety. Conclusion. The severity of depression increases proportionally to attachment disorganization; therefore, we consider attachment as both an important risk factor as well as a focus for early psychotherapeutic intervention.

  2. A community based surveillance system for perinatal and neonatal care.

    Science.gov (United States)

    Dyal Chand, A; Khale, M

    1989-11-01

    The impact of maternal health services on perinatal and neonatal mortality depends on both the quantitative and qualitative coverage of pregnant women with obstetric services. In rural areas this becomes all the more difficult because of the requirement of a large decentralized infrastructure extending from village based health workers and subcentres to the Primary Health Centre and tertiary levels of referral. An effective introduction of socio-cultural, biomedical and managerial interventions is required to reduce perinatal and neonatal mortality. A community based surveillance and monitoring system is central to and facilitates the introduction of all other interventions. Finally, the system operated by grass-root level workers is a motivational tool for achieving expected levels of performance. PMID:2630471

  3. Mobile phone intervention reduces perinatal mortality in Zanzibar

    DEFF Research Database (Denmark)

    Lund, Stine; Rasch, Vibeke; Hemed, Maryam; Boas, Ida Marie; Said, Azzah; Said, Khadija; Makundu, Mkoko Hassan; Nielsen, Birgitte Bruun

    2014-01-01

    BACKGROUND: Mobile phones are increasingly used in health systems in developing countries and innovative technical solutions have great potential to overcome barriers of access to reproductive and child health care. However, despite widespread support for the use of mobile health technologies......, evidence for its role in health care is sparse. OBJECTIVE: We aimed to evaluate the association between a mobile phone intervention and perinatal mortality in a resource-limited setting. METHODS: This study was a pragmatic, cluster-randomized, controlled trial with primary health care facilities in...... care facilities in six districts were randomized to either mobile phone intervention or standard care. The intervention consisted of a mobile phone text message and voucher component. Secondary outcome measures included stillbirth, perinatal mortality, and death of a child within 42 days after birth as...

  4. Suicide during Perinatal Period: Epidemiology, Risk Factors, and Clinical Correlates.

    Science.gov (United States)

    Orsolini, Laura; Valchera, Alessandro; Vecchiotti, Roberta; Tomasetti, Carmine; Iasevoli, Felice; Fornaro, Michele; De Berardis, Domenico; Perna, Giampaolo; Pompili, Maurizio; Bellantuono, Cesario

    2016-01-01

    Perinatal period may pose a great challenge for the clinical management and treatment of psychiatric disorders in women. In fact, several mental illnesses can arise during pregnancy and/or following childbirth. Suicide has been considered a relatively rare event during the perinatal period. However, in some mental disorders (i.e., postpartum depression, bipolar disorder, postpartum psychosis, etc.) have been reported a higher risk of suicidal ideation, suicide attempt, or suicide. Therefore, a complete screening of mothers' mental health should also take into account thoughts of suicide and thoughts about harming infants as well. Clinicians should carefully monitor and early identify related clinical manifestations, potential risk factors, and alarm symptoms related to suicide. The present paper aims at providing a focused review about epidemiological data, risk factors, and an overview about the main clinical correlates associated with the suicidal behavior during the pregnancy and postpartum period. Practical recommendations have been provided as well. PMID:27570512

  5. Caracterización de depresión perinatal en mujeres atendidas en hospitales de la ciudad de Bogotá

    OpenAIRE

    Caamaño Gómez, Adriana Marcela; Contreras Hernández, Diana Constanza

    2015-01-01

    Objetivos: Determinar la prevalencia de Depresión Perinatal, tanto en la etapa prenatal como en el puerperio tardío, en mujeres atendidas en hospitales seleccionados de la red pública de Bogotá en el 2015 e identificar factores de relacionados con esta patología. Métodos: Estudio descriptivo de corte transversal, dos grupos de trabajo, el primero conformado por una muestra consecutiva de 151 gestantes de 36 a 41 semanas atendidas en el control prenatal de las dos instituciones escogidas, y el...

  6. Physiological consequences of perinatal treatment of rats with 5-hydroxytryptophan

    OpenAIRE

    BLAŽEVIĆ, SOFIA; DOLENEC, PETRA; Hranilović, Dubravka

    2011-01-01

    Background and Purpose: Serotonin (5-hydroxytryptamine, 5HT) is present in brain and peripheral tissues and mediates various physiological functions. It also regulates perinatal development of serotonergic neurons and target tissues. It is assumed that dysregulation of the peripheral 5HT--homeostasis, which causes elevated blood 5HT concentrations, could inhibit development of serotonergic neurons and lead to anatomical/functional alterations of the brain. In this study we have investigate...

  7. Severe myocardial injury and extracorporeal membrane oxygenation following perinatal asphyxia

    OpenAIRE

    P Benson Ham; Pinkal Patel; Linda J. Wise; Christian Walters; Stansfield, Brian K.

    2015-01-01

    Perinatal asphyxia is a common cause of morbidity and mortality in the newborn and is associated with myocardial injury in a significant proportion of cases. Biomarkers, echocardiography, and rhythm disturbances are sensitive indicators of myocardial ischemia and may predict mortality. We present a case of severe myocardial dysfunction immediately after delivery managed with extracorporeal membrane oxygenation (ECMO) and discuss the role of cardiac biomarkers, echocardiography, electrocardiog...

  8. The Success of Cardiotocography in predicting Perinatal Outcome

    OpenAIRE

    Kaban, Alpaslan; Cengiz, Hüseyin; Kaban, Işık; Özcan, Alim; Karakaş, Sema

    2012-01-01

    Objectives: The determination of the fetal condition during labor is important to minimize fetal death due to asphyxia and the neurological sequelae of fetal hypoxia. This study evaluated the success of fetal cardiotocography in predicting perinatal consequences. Materials and methods: This study enrolled 101 full-term pregnant women admitted for delivery to Vakif Gureba Training and Research Hospital between October 2009 and February 2010. Women were included if they were aged 18-45 year...

  9. Cardiotocography in a perinatal armamentarium: boon or bane?

    OpenAIRE

    Ambily Anu Xavier; Deeksha Pandey; Luvdeep Dogra; Leslie Edward Lewis

    2015-01-01

    Background: As electronic foetal monitoring (EFM) is becoming commoner in obstetric armamentarium, so are caesarean deliveries. Present study was conducted with an aim to find out correlation between cardiotocography (CTG) findings, intraoperative findings, and perinatal outcome in subjects who underwent emergency caesarean deliveries. We also intended to estimate the sensitivity, specificity and positive predictive value of CTG in diagnosing foetal distress. Methods: A total of 271 women ...

  10. The success of cardiotocography in predicting perinatal outcome

    OpenAIRE

    Alpaslan Kaban; Hüseyin Cengiz; Işık Kaban; Alim Özcan; Sema KarakaşBakirköy Dr. Sadi Konuk Teaching and Research Hospital, Department of Gynecology and Obstetrics, Istanbul, Turkey

    2012-01-01

    Objectives: The determination of the fetal condition duringlabor is important to minimize fetal death due to asphyxiaand the neurological sequelae of fetal hypoxia.This study evaluated the success of fetal cardiotocographyin predicting perinatal consequences.Materials and methods: This study enrolled 101 full-termpregnant women admitted for delivery to Vakif GurebaTraining and Research Hospital between October 2009and February 2010. Women were included if they wereaged 18-45 years and within ...

  11. Interpersonal Psychotherapy in the Treatment of Perinatal Depression

    OpenAIRE

    Gamze Ergil Altin

    2012-01-01

    Perinatal depression is a psychiatric disorder that is not sufficiently diagnosed and directed to treatment. Its acute and chronic outcomes influence not only the mother but also the infant and the relationship between them. Both pregnancy and the postpartum periods are the times of significant physiological and emotional changes which also influence interpersonal relationships. Interpersonal risk factors like insufficient social support and increased social conflict can have an important imp...

  12. Management of Gestational Diabetes Mellitus: Selfefficacy and Perinatal Outcomes

    OpenAIRE

    Emine Gerçek; Hakan Şen

    2015-01-01

    The purpose of this review is to give knowledge about effects on perinatal outcomes of self-efficacy in management of gestational diabetes. Gestational diabetes mellitus (GDM) is a significant health concern due to the potentially adverse outcomes for the mother and the fetus/infant. Close monitoring and treatment of GDM are important to the long-term health of a pregnant woman and her baby. More over, maternal metabolic control during pregnancy may positively impact women’s...

  13. Severe myocardial injury and extracorporeal membrane oxygenation following perinatal asphyxia

    Directory of Open Access Journals (Sweden)

    P. Benson Ham

    2015-05-01

    Full Text Available Perinatal asphyxia is a common cause of morbidity and mortality in the newborn and is associated with myocardial injury in a significant proportion of cases. Biomarkers, echocardiography, and rhythm disturbances are sensitive indicators of myocardial ischemia and may predict mortality. We present a case of severe myocardial dysfunction immediately after delivery managed with extracorporeal membrane oxygenation (ECMO and discuss the role of cardiac biomarkers, echocardiography, electrocardiography, and ECMO in the asphyxiated newborn.

  14. Experience of the Manitoba Perinatal Screening Program, 1965-85.

    OpenAIRE

    Fox, J. G.

    1987-01-01

    The Manitoba Perinatal Screening Program is guided by a committee of medical specialists with skills in the diagnosis and management of disorders of metabolism in the newborn. The program is voluntary and is centralized at Cadham Provincial Laboratory, in Winnipeg. A filter card blood specimen is collected from newborns on discharge from hospital, and a filter card urine sample is collected and mailed to the laboratory by the mother when the infant is about 2 weeks of age. The overall complia...

  15. Complementary and Alternative Medicine Therapies for Perinatal Depression

    OpenAIRE

    Deligiannidis, Kristina M.; Freeman, Marlene P.

    2013-01-01

    Complementary and Alternative Medicine (CAM) therapies are increasingly sought out by patients with psychiatric disorders. This article provides a review of the evidence for several commonly utilized CAM therapies (i.e. omega-3 fatty acids, folate, S-adenosyl-methionine (SAMe), St. John’s Wort, bright light therapy, exercise, massage, and acupuncture) in the treatment of perinatal depression. A number of these treatments may be reasonable to consider for women during pregnancy or the postpart...

  16. Perinatal asphyxia: CNS development and deficits with delayed onset

    Directory of Open Access Journals (Sweden)

    MarioHerrera-Marschitz

    2014-03-01

    Full Text Available Perinatal asphyxia constitutes a prototype of obstetric complications occurring when pulmonary oxygenation is delayed or interrupted. The primary insult relates to the duration of the period lacking oxygenation, leading to death if not re-established. Re-oxygenation leads to a secondary insult, related to a cascade of biochemical events required for restoring proper function. Perinatal asphyxia interferes with neonatal development, resulting in long-term deficits associated to mental and neurological diseases with delayed clinical onset, by mechanisms not yet clarified.In the experimental scenario, the effects observed long after perinatal asphyxia have been explained by over expression of sentinel proteins, such as poly(ADP-ribose polymerase-1 (PARP-1, competing for NAD+ during re-oxygenation, leading to the idea that sentinel protein inhibition constitutes a suitable therapeutic strategy. Asphyxia induces transcriptional activation of pro-inflammatory factors, in tandem with PARP-1 overactivation, and pharmacologically induced PARP-1 inhibition also down-regulates the expression of proinflammatory cytokines. Nicotinamide has been proposed as a suitable PARP-1 inhibitor. Its effect has been studied in an experimental model of global hypoxia in rats. In that model, the insult is induced by immersing rat foetuses into a water bath for various periods of time. Following asphyxia, the pups are delivered, treated, and nursed by surrogate dams, pending further experiments. Nicotinamide rapidly distributes into the brain following systemic administration, reaching steady state concentrations sufficient to inhibit PARP-1 activity for several hours, preventing several of the long-term consequences of perinatal asphyxia, supporting the idea that it constitutes a lead for exploring compounds with similar or better pharmacological profiles.

  17. Obstetric and Perinatal Outcomes in Type 1 Diabetic Pregnancies

    OpenAIRE

    Persson, Martina; Norman, Mikael; Hanson, Ulf

    2009-01-01

    OBJECTIVE To perform comparative analyses of obstetric and perinatal outcomes between type 1 diabetic pregnancies and the general obstetric population in Sweden between 1991 and 2003. RESEARCH DESIGN AND METHODS This was a population-based study. Data were obtained from the Medical Birth Registry, covering >98% of all pregnancies in Sweden. A total of 5,089 type 1 diabetic pregnancies and 1,260,207 control pregnancies were included. Odds ratios (ORs) were adjusted for group differences in mat...

  18. A pedigree study of perinatally lethal renal disease.

    OpenAIRE

    Bankier, A; de Campo, M; Newell, R.; Rogers, J. G.; Danks, D M

    1985-01-01

    A family study of perinatally lethal renal disease (PLRD) was undertaken in the State of Victoria, Australia, for the years 1961 to 1980. A total of 221 cases was ascertained through hospital and necropsy records and confirmed by necropsy findings. There were 134 cases of bilateral renal agenesis (BRA), 34 cases of unilateral agenesis with dysplasia of the other kidney (URA/RD), 42 cases of bilateral renal dysplasia (BRD), and 11 cases of renal aplasia. Parents of 131 babies were interviewed ...

  19. Screening of Substance Abuse Among Women in Perinatal Care

    OpenAIRE

    Tazanu Fossung, Joakem; Cudjoe, Kwame

    2013-01-01

    The purpose of this review was to describe contemporary screening methodologies and processes for determining the substance abuse status of perinatal women using recent literary works. It also outlines potential innovations to improve the screening process and subsequent treatment of the aforementioned. The study was undertaken as part of the Kuitinmäki project in Laurea University of Applied Sciences. This study sought to answer the research question; What is entailed in the screening of sub...

  20. Perinatal factors, growth and development, and osteosarcoma risk

    OpenAIRE

    Troisi, R; Masters, M N; Joshipura, K; Douglass, C; Cole, B. F.; Hoover, R N

    2006-01-01

    Osteosarcoma incidence patterns suggest an aetiologic role for perinatal factors, and growth and development. Osteosarcoma patients (n=158) and controls with benign orthopaedic conditions (n=141) under age 40 were recruited from US orthopaedic surgery departments. Exposures were ascertained by interview, birth, and growth records. Age- and sex-adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated. Current height and age- and sex-specific height percentiles were not associ...

  1. Eclampsia: maternal and perinatal outcomes in a tertiary care centre

    Directory of Open Access Journals (Sweden)

    Sunita Mor

    2015-06-01

    Conclusions: Eclampsia is one of the important causes of maternal and perinatal morbidity and mortality due to lack of proper antenatal care, low socio-economic status and lack of education. Early attention and intensive management are essential for improving the maternal and fetal outcomes. Unless the social and educational status of women is uplifted and obstetric care is brought to the doorstep, no miracle can be expected. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 653-657

  2. Pregnancy care in two adolescents perinatally infected with HIV.

    OpenAIRE

    Meloni, Alessandra; Tuveri, Milena; Floridia, Marco; Zucca, Francesca; Borghero, Grazia; Gariel, Donatella; Melis, Gian Benedetto

    2009-01-01

    Abstract We describe the main issues encountered in pregnancy care in two perinatally infected adolescents with HIV. Despite the young maternal age, both mothers complied well with visits and treatment during pregnancy and delivered at week 38 through elective caesarean section. Both, however, missed the regular gynaecological and the routine HIV visits scheduled after pregnancy. Both infants following HIV exposure were confirmed HIV negative at the end of tests performed in the fi...

  3. Words in Maternity Wards: An Aproximation to Perinatal Psychology

    OpenAIRE

    Alicia Oiberman

    2016-01-01

    The acknowledgment that just born babies interact with human and physical contexts originated changes in behaviors of health teems working in maternity wards settings. Concepts such as initial interactions, attachment, dyads, maternal vulnerability, behavioral competences of the just born babies and their applications to perinatal psychology, marked a transformation in different professionals involved in birth’s approaches. From one side, it can be said that medicalization of the birth act in...

  4. Care of the newborn in perinatal units in New Brunswick

    OpenAIRE

    Stephen, David L.

    1986-01-01

    A survey of 23 perinatal units in New Brunswick hospitals was conducted by means of a mailed questionnaire to determine the type of care provided to newborns. The results showed various degrees of conformity with published guidelines for the care of newborns. Deficiencies were noted in several areas of care: failing to give or improperly giving vitamin K1 prophylaxis (in 7 of the units), flushing the eyes after silver nitrate prophylaxis (in 10), using hexachlorophene to bathe newborns (in 11...

  5. Gestational, perinatal and family findings of patients with Patau syndrome

    OpenAIRE

    Rafael Fabiano M. Rosa; Melina Vaz Sarmento; Janaina Borges Polli; Daniela de Paoli Groff; Patrícia Petry; Vinícius Freitas de Mattos; Rosana Cardoso M. Rosa; Patrícia Trevisan; Paulo Ricardo G. Zen

    2013-01-01

    OBJECTIVE: To describe gestational, perinatal and family findings of patients with Patau syndrome (PS). METHODS: The study enrolled patients with PS consecutively evaluated during 38 years in a Clinical Genetics Service of a pediatric referral hospital in Southern Brazil. The clinical data and the results of cytogenetic analysis were collected from the medical records. For statistical analysis, the two-tailed Fisher's exact test and the chi-square test with Yates' correction were used, b...

  6. Somatosensory evoked potentials and outcome in perinatal asphyxia.

    OpenAIRE

    Gibson, N A; Graham, M.; Levene, M I

    1992-01-01

    Somatosensory evoked potentials (SEP) can be measured in the term newborn infant and given an index of function in the areas of the brain most likely to be damaged in perinatal asphyxia. We studied the median nerve SEP in 30 asphyxiated term infants over the course of their encephalopathy and until discharge from the neonatal unit. Three types of response were noted: normal waveform, abnormal waveform, or absence of cortical response. Follow up of the survivors was undertaken at a mean age of...

  7. How mothers experience personal growth after a perinatal loss

    OpenAIRE

    Thomadaki, Olga

    2012-01-01

    In the UK, babies are considered stillborn when they are born dead after the 24th week of gestation. Death within the first four weeks of life is defined as a neonatal death. Both stillbirths and neonatal deaths comprise perinatal deaths. This type of bereavement constitutes a traumatic loss and although there is a plethora of research focusing on the resulting parental psychopathology, research on adaptive grief resolution and posttraumatic growth is scarce. Qualitative methodologies explori...

  8. Perinatal risk factors for asthma in Finnish adolescent twins

    OpenAIRE

    Rasanen, M.; Kaprio, J.; Laitinen, T.; Winter, T.; Koskenvuo, M.; Laitinen, L

    2000-01-01

    BACKGROUND—Previous studies have suggested that, in addition to genetic liability and environment in early childhood, intrauterine life also influences the risk for asthma beyond childhood. Low birth weight, prematurity, young maternal age, and maternal smoking have all shown an association with asthma. The effect of perinatal factors on the risk for asthma in relation to familial and social risk factors was studied in a nationwide population-based sample of adolescent tw...

  9. Doppler prediction of adverse perinatal outcome in intrauterine growth restriction

    Directory of Open Access Journals (Sweden)

    Nina Mahale

    2015-02-01

    Full Text Available Background: Objective of current study was to determine and compare the diagnostic performance of Doppler ultrasonography of the fetal Middle Cerebral Artery (MCA and Umbilical Artery (UA for prediction of adverse perinatal outcome in suspected intrauterine growth restriction (IUGR. Methods: Fifty singleton pregnancies in third trimester of pregnancy with suspected intrauterine growth restriction were examined with Doppler ultrasonography of fetal MCA and UA. Results: Twenty patients of the fifty included patients had at least one major or minor adverse outcome. Major adverse outcome included perinatal deaths which included both intrauterine deaths and early neonatal deaths, hypoxic ischemic encephalopathy, intraventricular hemorrhage, periventricular leukomalacia, pulmonary hemorrhage, necrotizing enterocolitis and septicemia. Minor outcomes included cesarean section for fetal distress, Apgar score below 7 at 5 minutes and admission to Neonatal Intensive Care Unit (NICU for treatment. MCA PI is the most sensitive(90% index in predicting any adverse perinatal outcome i.e. including both major and minor outcomes, Positive Predictive Value (PPV and specificity being greatest for MCA/UA PI (96.6%, 93.7%. For the major adverse outcome most sensitive (86.6% most specific (91.4% and with highest PPV (81.2% and NPV (94.1%, is MCA/UA PI. Ratio of MCA/UAPI is more sensitive (90% than PI of both the arteries alone for overall prediction of adverse perinatal outcome. Conclusions: Thus we conclude that the Doppler studies of the multiple vessels in the fetoplacental unit can help in the monitoring of the compromised fetus and can help us predicting neonatal morbidity. This may be helpful in determining the optimal time of deliveries in pregnancies complicated by IUGR. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 119-130

  10. Perinatal and neonatal outcome in meconium stained amniotic fluid

    OpenAIRE

    Shazia Qadir; Sami Jan; Javaid A Chachoo; Shameem parveen

    2016-01-01

    Background: Meconium passage in new born is a developmentally programmed event normally occurring within the first 24 to 48 hours after birth. Intrauterine meconium passage in near-term or term fetuses has been associated with fetomaternal stress factor like hypoxia and infection independent of fetal maturity. The incidence of meconium stained amniotic fluid is 1-18%. The objective of this study was to correlate the presence of meconium in amniotic fluid with perinatal outcome. Methods: A...

  11. Perinatal and early life risk factors for inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Stephen E Roberts; Clare J Wotton; John G Williams; Myfanwy Griffith; Michael J Goldacre

    2011-01-01

    AIM: To investigate associations between perinatal risk factors and subsequent inflammatory bowel disease (IBD) in children and young adults.METHODS: Record linked abstracts of birth registrations,maternity, day case and inpatient admissions in a defined population of southern England. Investigation of 20 perinatal factors relating to the maternity or the birth: maternal age, Crohn's disease (CD) or ulcerative colitis (UC) in the mother, maternal social class, marital status, smoking in pregnancy, ABO blood group and rhesus status, pre-eclampsia, parity, the infant's presentation at birth, caesarean delivery, forceps delivery, sex, number of babies delivered, gestational age, birthweight, head circumference, breastfeeding and Apgar scores at one and five minutes.RESULTS: Maternity records were present for 180 children who subsequently developed IBD. Univariate analysis showed increased risks of CD among children of mothers with CD (P = 0.011, based on two cases of CD in both mother and child) and children of mothers who smoked during pregnancy. Multivariate analysis confirmed increased risks of CD among children of mothers who smoked (odds ratio = 2.04, 95% CI =1.06-3.92) and for older mothers aged 35+ years (4.81,2.32-9.98). Multivariate analysis showed that there were no significant associations between CD and 17 other perinatal risk factors investigated. It also showed that, for UC, there were no significant associations with the perinatal factors studied.CONCLUSION: This study shows an association between CD in mother and child; and elevated risks of CD in children of older mothers and of mothers who smoked.

  12. Maternal and perinatal outcomes in critically ill obstetric patients

    Directory of Open Access Journals (Sweden)

    Arati Appinabhavi

    2014-02-01

    Conclusions: Pregnancy-induced hypertensive disorders and hemorrhage were the major risk factors apart from pneumonia and hepatitis that continue to take toll in obstetric patients. Adequate antenatal care, increased vigilance of women during pregnancy for subtle signs and symptoms, early transfer to tertiary centre and aggressive management to prevent complications can bring about the desired reduction in maternal-perinatal morbidity and mortality. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 189-194

  13. Perinatal Lamb Model of Respiratory Syncytial Virus (RSV) Infection

    OpenAIRE

    Ackermann, Mark R.; Rachel J. Derscheid

    2012-01-01

    Respiratory syncytial virus (RSV) is the most frequent cause of bronchiolitis in infants and children worldwide. Many animal models are used to study RSV, but most studies investigate disease in adult animals which does not address the unique physiology and immunology that makes infants more susceptible. The perinatal (preterm and term) lamb is a useful model of infant RSV disease as lambs have similar pulmonary structure including airway branching, Clara and type II cells, submucosal glands ...

  14. Robotic Quantification of Position Sense in Children With Perinatal Stroke.

    Science.gov (United States)

    Kuczynski, Andrea M; Dukelow, Sean P; Semrau, Jennifer A; Kirton, Adam

    2016-09-01

    Background Perinatal stroke is the leading cause of hemiparetic cerebral palsy. Motor deficits and their treatment are commonly emphasized in the literature. Sensory dysfunction may be an important contributor to disability, but it is difficult to measure accurately clinically. Objective Use robotics to quantify position sense deficits in hemiparetic children with perinatal stroke and determine their association with common clinical measures. Methods Case-control study. Participants were children aged 6 to 19 years with magnetic resonance imaging-confirmed unilateral perinatal arterial ischemic stroke or periventricular venous infarction and symptomatic hemiparetic cerebral palsy. Participants completed a position matching task using an exoskeleton robotic device (KINARM). Position matching variability, shift, and expansion/contraction area were measured with and without vision. Robotic outcomes were compared across stroke groups and controls and to clinical measures of disability (Assisting Hand Assessment) and sensory function. Results Forty stroke participants (22 arterial, 18 venous, median age 12 years, 43% female) were compared with 60 healthy controls. Position sense variability was impaired in arterial (6.01 ± 1.8 cm) and venous (5.42 ± 1.8 cm) stroke compared to controls (3.54 ± 0.9 cm, P Robotic measures correlated with functional disability. Sensitivity and specificity of clinical sensory tests were modest. Conclusions Robotic assessment of position sense is feasible in children with perinatal stroke. Impairment is common and worse in arterial lesions. Limited correction with vision suggests cortical sensory network dysfunction. Disordered position sense may represent a therapeutic target in hemiparetic cerebral palsy. PMID:26747126

  15. Perinatal mortality and season of birth in captive wild ungulates.

    Science.gov (United States)

    Kirkwood, J K; Gaskin, C D; Markham, J

    1987-04-18

    The magnitude of perinatal mortality in 50 species of captive wild ungulates born at the Zoological Society of London's collections at Regent's Park and Whipsnade between 1975 and 1985 is reviewed. Thirty-five per cent of 2471 ungulates born during this 11 year period died before six months old and most deaths occurred in the first week after birth. Similar findings have been reported at other zoos and in the wild. The seasonal distribution of births is described in 43 species. Significantly higher perinatal mortality was found in species which breed throughout the year (notably axis deer and sitatunga) than in seasonal breeders, and differences associated with system of management were apparent in some species (eg, mouflon and scimitar-horned oryx) kept at Regent's Park and Whipsnade. Considerable advances have been made in the management of captive wild ungulates in recent years but it is likely that perinatal mortality rates could be further reduced by improved management and veterinary care of the dams and neonates. PMID:3590601

  16. The challenges of success: adolescents with perinatal HIV infection

    Directory of Open Access Journals (Sweden)

    Lynne M Mofenson

    2013-06-01

    Full Text Available The great success in the prevention and treatment of pediatric HIV in high resource countries, and now in low resource countries, has changed the face of the HIV epidemic in children from one of near certain mortality to that of a chronic disease. However, these successes pose new challenges as perinatally HIV-infected youth survive into adulthood. Increased survival of HIV-infected children is associated with challenges in maintaining adherence to what is likely life-long therapy, and in selecting successive antiretroviral drug regimens, given the limited availability of pediatric formulations, limitations in pharmacokinetic and safety data of drugs in children, and the development of extensive drug resistance in multi-drug-experienced children. Pediatric HIV care must now focus on morbidity related to long-term HIV infection and its treatment. Survival into adulthood of perinatally HIV-infected youth in high resource countries provides important lessons about how the epidemic will change with increasing access to antiretroviral therapy for children in low resource countries. This series of papers will focus on issues related to management of perinatally infected youth and young adults.

  17. Infertility and Perinatal Loss: When the Bough Breaks.

    Science.gov (United States)

    Bhat, Amritha; Byatt, Nancy

    2016-03-01

    Infertility and perinatal loss are common, and associated with lower quality of life, marital discord, complicated grief, major depressive disorder, anxiety disorders, and post-traumatic stress disorder. Young women, who lack social supports, have experienced recurrent pregnancy loss or a history of trauma and / or preexisting psychiatric illness are at a higher risk of experiencing psychiatric illnesses or symptoms after a perinatal loss or during infertility. It is especially important to detect, assess, and treat depression, anxiety, or other psychiatric symptoms because infertility or perinatal loss may be caused or perpetuated by such symptoms. Screening, psychoeducation, provision of resources and referrals, and an opportunity to discuss their loss and plan for future pregnancies can facilitate addressing mental health concerns that arise. Women at risk of or who are currently experiencing psychiatric symptoms should receive a comprehensive treatment plan that includes the following: (1) proactive clinical monitoring, (2) evidence-based approaches to psychotherapy, and (3) discussion of risks, benefits, and alternatives of medication treatment during preconception and pregnancy. PMID:26847216

  18. Epidemiological Risk Factors and Perinatal Outcomes of Congenital Anomalies.

    Science.gov (United States)

    Almeida, Lissa Fernandes Garcia; Araujo Júnior, Edward; Crott, Gerson Claudio; Okido, Marcos Masaru; Berezowski, Aderson Tadeu; Duarte, Geraldo; Marcolin, Alessandra Cristina

    2016-07-01

    Objectives To identify the epidemiological risk factors for congenital anomalies (CAs) and the impact of these fetal malformations on the perinatal outcomes. Methods This prospective cohort study comprised 275 women whose fetuses had CAs. Maternal variables to establish potential risk factors for each group of CA and perinatal outcomes were evaluated. The primary outcome was CA. Secondary outcomes included: fetal growth restriction (FGR); fetal distress (FD); premature rupture of membranes (PROM); oligohydramnios or polyhydramnios; preterm delivery (PTD); stillbirth; cesarean section; low birth weight; Apgar score  7, and need for assisted ventilation at birth. On the other hand, the prevalence of the other considered outcomes varied significantly among groups. Preterm delivery was significantly more frequent in gastrointestinal tract/abdominal wall defects. The stillbirth rate was increased in all CAs, mainly in isolated fetal hydrops (odds ratio [OR]: 27.13; 95% confidence interval [95%CI]: 2.90-253.47). Hospitalization time was higher for the urinary tract and congenital heart disease groups (p < 0.01). Neonatal death was significantly less frequent in the central nervous system anomalies group. Conclusion It was possible to identify several risk factors for CAs. Adverse perinatal outcomes were presented in all CA groups, and may differ according to the type of CA considered. PMID:27459392

  19. Healthcare justice and human rights in perinatal medicine.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B

    2016-06-01

    This article describes an approach to ethics of perinatal medicine in which "women and children first" plays a central role, based on the concept of healthcare justice. Healthcare justice requires that all patients receive clinical management based on their clinical needs, which are defined by deliberative (evidence-based, rigorous, transparent, and accountable) clinical judgment. All patients in perinatal medicine includes pregnant, fetal, and neonatal patients. Healthcare justice also protects the informed consent process, which is intended to empower the exercise of patient autonomy in the decision-making process about patient care. In the context of healthcare justice, the informed consent process should not be influenced by ethically irrelevant factors. Healthcare justice should be understood as a basis for the human rights to healthcare and to participate in decisions about one's healthcare. Healthcare justice in perinatal medicine creates an essential role for the perinatologist to be an effective advocate for pregnant, fetal, and neonatal patients, i.e., for "women and children first." PMID:26811097

  20. Tuberkulosis Perinatal Bermanifestasi sebagai Tuberkulosis Milier dan Meningitis

    Directory of Open Access Journals (Sweden)

    Heda Melinda D. Nataprawira

    2014-10-01

    Full Text Available Perinatal tuberculosis (TB is rarely reported, because the clinical manifestations are not specific and there is a problem in its laboratory and radiology examination which caused undiagnosed. Perinatal TB is the preferred description that encompasses TB acquired either intra uterine, during or post delivery in early newborn period. A-3- month old baby was transferred to Pediatric Emergency Hasan Sadikin Hospital because of prolong fever and unable to breastfeed. There was no problem with delivery. Lethargic, fever, tachypnea, and hepatosphlenomegali were found on physical examination. Ziehl Neelsen smear of gastric lavage yielded positive acid fast bacilli. Tuberculine test was non reactive, chest x-ray showed a miliary pattern, and cerebral spinal fluid analysis gave tuberculous meningitis interpretation. By active finding, his father and grandfather were detected as a source of TB transmission. In additon to oral antituberculosis regimen, antibiotics and prednison were also given. Septic shock and disseminated intravascular coagulation were occurred during his illness and the baby died. Staphylococcus haemolyticus was identified from blood culture. In conclusion, although there were no problems during labor, active investigation of perinatal TB possibility is required on the family with a source of TB. Caution on TB in pregnant women is necessary at developing country with high rates of TB.

  1. Perinatal Outcomes in Pregnant Women Users of Illegal Drugs.

    Science.gov (United States)

    Oliveira, Tenilson Amaral; Bersusa, Ana Aparecida Sanches; Santos, Tatiana Fiorelli Dos; Aquino, Márcia Maria Auxiliadora de; Mariani Neto, Corintio

    2016-04-01

    Objective The purpose of this study was to evaluate the perinatal outcomes in pregnant women who use illicit drugs. Methods A retrospective observational study of patients who, at the time of delivery, were sent to or who spontaneously sought a public maternity hospital in the eastern area of São Paulo city. We compared the perinatal outcomes of two distinct groups of pregnant women - illicit drugs users and non-users - that gave birth in the same period and analyzed the obstetric and neonatal variables. We used Student's t-test to calculate the averages among the groups, and the Chi-square test or Fisher's exact test to compare categorical data from each group. Results We analyzed 166 women (83 users and 83 non-users) in both groups with a mean of age of 26 years. Ninety-five percent of the drug users would use crack or pure cocaine alone or associated with other psychoactive substances during pregnancy. Approximately half of the users group made no prenatal visit, compared with 2.4% in the non-users group (p syphilis (15.7% versus 0%, p < 0.001) were associated with the use of these illicit drugs. Conclusions The use of illicit drugs, mainly crack cocaine, represents an important perinatal risk. Any medical intervention in this population should combine adherence to prenatal care with strategies for reducing maternal exposure to illicit drugs. PMID:27088708

  2. Exposure to Perinatal Infections and Bipolar Disorder: A Systematic Review.

    Science.gov (United States)

    Barichello, T; Badawy, M; Pitcher, M R; Saigal, P; Generoso, J S; Goularte, J A; Simões, L R; Quevedo, J; Carvalho, A F

    2016-01-01

    Bipolar disorder (BD) is a debilitating psychiatric disorder and a growing global public health issue. Notwithstanding BD has been conceptualized as a neuroprogressive illness, there are some evidences to suggest a role for neurodevelopmental pathways in the patho-etiology of this disorder. Evidences on the associations between perinatal infections and risk for bipolar disorder have been inconsistent across studies. Here, we performed a systematic review of observational studies on the relationship between exposure to perinatal pathogens and bipolar disorder. A computerized literature search of the PubMed, Embase, and PsyINFO databases till January 31(st), 2015 was performed. Twenty-three studies ultimately met inclusion criteria. Studies investigated exposure to several pathogens namely Cytomegalovirus (CMV), Epstein-Barr Virus (EBV), Herpes simplex virus-1 (HSV-1), Herpes simplex virus-2 (HSV-2), Human herpesvirus 6 (HHV-6), Toxoplasma gondii, Influenza, and Varicella zoster virus (VZV). Overall, studies provided mixed evidences. Thus, contrary to schizophrenia, the role of perinatal infections as risk factors for BD remain inconclusive. Larger studies with a prospective design would be necessary to elucidate the role of previous exposure to infectious agents as a potential risk factor for BD. PMID:26812921

  3. Social equity in perinatal survival : a case-control study at hospitals in Kigali, Rwanda

    OpenAIRE

    Musafili, Aimable; Essén, Birgitta; Baribwira, Cyprien; Ekholm Selling, Katarina; Persson, Lars-Åke

    2015-01-01

    AIM: Rwanda has invested heavily in improving maternal and child health, but knowledge is limited regarding social equity in perinatal survival. We analysed whether perinatal mortality risks differed between social groups in hospitals in the country's capital. METHODS: A case-control study was carried out on singleton births aged at least 22 weeks of gestation and born in district or tertiary referral hospitals in Kigali from July 2013 to May 2014. Perinatal deaths were recorded as they occur...

  4. New insights into perinatal depression: pathogenesis and treatment during pregnancy and postpartum

    OpenAIRE

    Meltzer-Brody, Samantha

    2011-01-01

    Maternal perinatal mental health has enormous consequences for the well-being of the mother, her baby, and the family. Although it is well documented that perinatal depression is both common and morbid, with a prevalence of 10% to 15% in the general population, there remain many critically important unanswered questions about the pathogenesis of perinatal depression and most effective treatment regimens. Current lines of evidence from both human and animal models implicate hormonal dysregulat...

  5. The long-term psychiatric and medical prognosis of perinatal mental illness

    OpenAIRE

    Meltzer-Brody, Samantha; Stuebe, Alison

    2013-01-01

    The perinatal period provides an important window into a woman’s long-term health. Perinatal mental illness is a common condition conferring potential serious long-term psychiatric and medical consequences for the mother and family. It is known that childbirth acts as a powerful trigger for depressive episodes in some women, and that women with histories of a mood disorder are particularly vulnerable. Some evidence links perinatal mental illness with obstetrical complications and reduced lact...

  6. Under-reporting of maternal and perinatal adverse events in New Zealand

    OpenAIRE

    Farquhar, Cynthia; Armstrong, Sarah; Kim, Boa; Masson, Vicki; Sadler, Lynn

    2015-01-01

    Objectives To determine the proportion of maternal and perinatal mortality and morbidity cases, identified by the Perinatal and Maternal Mortality Review Committee (PMMRC), that are also reported within the annual serious adverse events (SAEs) reports published by the Health Quality and Safety Commission (HQSC). Setting Nationally collated data from the PMMRC and HQSC, New Zealand. Participants Analysis of maternal and perinatal mortality and morbidity data 2009–2012. Interventions Every SAE ...

  7. The Role of Cytokines and Inflammatory Cells in Perinatal Brain Injury

    OpenAIRE

    McAdams, Ryan M.; Juul, Sandra E.

    2012-01-01

    Perinatal brain injury frequently complicates preterm birth and leads to significant long-term morbidity. Cytokines and inflammatory cells are mediators in the common pathways associated with perinatal brain injury induced by a variety of insults, such as hypoxic-ischemic injury, reperfusion injury, toxin-mediated injury, and infection. This paper examines our current knowledge regarding cytokine-related perinatal brain injury and specifically discusses strategies for attenuating cytokine-med...

  8. Aprendiendo a cuidar al recién nacido: un cuidado congruente con la cultura

    OpenAIRE

    NORMA YANETH NOGUERA ORTIZ; MARÍA RAQUEL RODRÍGUEZ RODRÍGUEZ

    2010-01-01

    El presente artículo es resultado del trabajo de grado para optar al título como Enfermera Especialista en Enfermería Materno Perinatal, el cual tuvo como propósito realizar una propuesta de cuidado de enfermería al recién nacido desde lo cultural, con base en las prácticas de cuidado que las madres adolescentes realizan con sus hijos durante la etapa de puerperio. Dicha propuesta se desarrolló a partir de los resultados obtenidos en la investigación "Prácticas de cuidado que las madres adole...

  9. Improvement in perinatal care for extremely premature infants in Denmark from 1994 to 2011

    DEFF Research Database (Denmark)

    Hasselager, Asbjørn Børch; Børch, Klaus; Pryds, Ole Axel

    2016-01-01

    gestational age and administration of surfactant. CONCLUSIONS: Centralisation of treatment of extremely premature infants has been implemented because more children are being born at highly specialised perinatal centres. Care improved as more infants received evidence-based treatment. IVH 3-4 rates declined......INTRODUCTION: Major advances in perinatal care over the latest decades have increased the survival rate of extremely premature infants. Centralisation of perinatal care was implemented in Denmark from 1995. This study evaluates the effect of organisational changes of perinatal care on survival and...

  10. Audit of perinatal mortality at SSMCHRC-(Rural teaching hospital a retrospective study

    Directory of Open Access Journals (Sweden)

    M.S. Kokila

    2013-04-01

    Full Text Available Objective: To estimate magnitude, determinants of perinatal mortality and suggest remedial measures for its reduction. Background: Perinatal mortality is mirror reflection of maternal and child health and socioeconomic environment of community. It is influenced by various medicosocial preventable causes. It can be reduced by improving maternal and child health services and by health education. Methods: A retrospective hospital based study of perinatal deaths among 2333 deliveries was conducted from June 2008 to June 2010 in our hospital. Fetomaternal factors like maternal age, religion, residence, parity, mode of delivery, booking status, antenatal complications, baby’s sex, birth weight, congenital anomalies, neonatal complications influencing perinatal mortality rate were tabulated and analyzed. Cause of perinatal death was assessed. Results: perinatal mortality rate was 127.4/1000 total births. Maternal factors like age more than 35 years, muslim religion, inadequate antenatal care, primiparity, grand multiparity, induced deliveries and neonatal factors like low birth weight, prematurity were associated with increased perinatal mortality. The leading cause of stillbirth was antepartum hemorrhage and prematurity for neonatal mortality. Conclusion: Apart from clinical causes high perinatal mortality was due to poverty, illiteracy, lack of health awareness, inadequate antenatal care and delayed referral. Health education, identification of high risk mothers, timely referral, advanced life support of preterm neonates should significantly help to reduce perinatal deaths.

  11. Maternal and perinatal results of preeclamsia before 31 weeks of gestation at clinica maternidad Rafael calvo cartagena, colombia

    Directory of Open Access Journals (Sweden)

    Mogollon-Saker Sandra Patricia

    2011-12-01

    perinatales en maternas con diagnóstico de preeclampsia severa lejos deltérmino, atendidas en la Clínica de Maternidad Rafael Calvo de Cartagena entre enero– diciembre 2009.Resultados: Se analizaron las historias clínicas de 47 pacientes y de 43 de losproductos. Se presentaron cuatro óbitos fetales. Hallazgos maternos: edad promedio24 años; edad gestacional promedio 31 semanas; 55% de las mujeres multíparas, el49% sin control prenatal, 56% de las pacientes recibieron corticoides para maduraciónpulmonar y la complicación materna más frecuente fue el desprendimiento de placentanormoinserta (13%. La vía del parto más usada fue el parto por cesárea. El 14% delas pacientes requirió UCI intermedio para monitoreo hemodinámico. No se presentóningún caso de muerte materna. Hallazgos neonatales: 1602 gramos de peso promedioal nacer, Apgar promedio al minuto de 6 y a los cinco minutos de 8. El 86% requirió UCIneonatal. La estancia promedio en UCI: 18 días. La morbilidad más frecuente observadafue el síndrome de distres respiratorio secundario a enfermedad de membrana hialina(50%. Además ese síndrome fue la principal causa relacionada con muerte fetal. Lamortalidad neonatal fue del 19%.Conclusiones: la preeclampsia severa lejos del término incrementa las tasas demorbimortalidad materna y perinatal. El manejo expectante puede recomendarse deforma individualizada y bajo criterio médico. Se requiere estrecha vigilancia maternofetaly la disponibilidad de infraestructura de cuidados intensivos tanto maternos comoneonatales.

  12. Gestacional diabetes and perinatal morbimortality in Medellín, Colombia Diabetes mellitus durante la gestación y morbimortalidad perinatal

    Directory of Open Access Journals (Sweden)

    Juan Nicolás Franco Baena

    1996-02-01

    Full Text Available Retrospective analysis of 166 pregnant women with gestational diabetes mellitus, at San Vicente de Paúl Hospital, Medellín, Colombia, evidenced inadequate registration of information and lack of clinical management protocols, despite the fact that this is a reference institution. Gestational diabetes mellitus (GDM was found in 81 patients (48.8%, non-insulin-dependent diabetes mellitus (NIDDM in 69 (41.5% and insulin-dependent diabetes mellitus (IDDM in 16 (9.6%. Perinatal morbidity rate was 52.2% (72 cases among the 138 in which information was available, distributed as follows: macrosomy (16 cases; 22.2%, acute fetal distress (15 cases; 20.8%, chronic fetal distress (10 cases; 13.9%, polyhydramnios (9 cases; 12.5%, hypoglycemia (8 cases; 11.1 % and delivery fetal trauma (6 cases; 8.3%. It was remarkable that the potentially preventable entities (macrosomy, acute and chronic fetal distress, polyhydramnios, fetal trauma and respiratory failure syndrome were more frequent in NIDDM and GDM groups, indicating an inadequate clinical management; fetal mortality was 3.6% (5 patients mostly associated to maternal hypertension. These results point out to the urgent need of establishing in this third level hospital an interdisciplinary management protocol of gestational diabetes, with apropriate registration of information and clear clinical guides

    El análisis retrospectivo de 166 pacientes embarazadas y con diagnóstico de diabetes mellitus, atendidas en el Hospital Universitario San Vicente de Paúl, de Medellín, Colombia, permite apreciar un registro inadecuado de la información, lo que le resta confiabilidad, y la carencia de protocolos apropiados de manejo. La diabetes gestacional (DMG se presentó en 81 pacientes (48.8%, seguida por la diabetes mellitus no insulino dependiente (DMNID (69 pacientes; 41.5% y por último la

  13. AVANCES DE LA MEDICINA PERINATAL Y LA CRECIENTE INTOLERANCIA A LA DISCAPACIDAD

    Directory of Open Access Journals (Sweden)

    Natalia López Moratalla

    2012-01-01

    Full Text Available La Medicina Perinatal considera al feto como paciente al que se puede no sólo diagnosticar mejor y con mayor precisión sino también tratar. Requiere el Diagnóstico Prenatal para aquellas malformaciones o enfermedades para las que sea necesario tratamiento antes de nacer. Las posibilidades de Terapia prenatal llevan retraso respecto a las posibilidades de diagnóstico. Lo que unido a la despenalización del aborto por anomalías fetales, ha llevado a una cultura en creciente intolerancia a la discapacidad, y a mirar más el sufrimiento que causa un hijo enfermo, que al derecho a nacer y vivir sin plenitud de salud sin sufrir discriminación por ello. Y al derecho de ser atendido médicamente en las consecuencias de la enfermedad y en los cuidados paliativos neonatales. Al mismo tiempo, las Técnicas de Reproducción Asistida están haciendo crecer el riesgo de padecer enfermedades incurables a los generados con la ayuda de esta tecnología respecto a los engendrados naturalmente. También va en aumento la aparición, y transmisión, de defectos congénitos por factores ambientales. En este análisis se ofrece junto a una visión global de los avances de la Perinatología y la situación de los Cribados y Diagnósticos Prenatal y Genético Preimplantacional. Urge una sensibilización de la sociedad hacia la diferencia. Y urge la potenciación de las Terapias Perinatales y los centros de cuidados paliativos perinatales, como un interés prioritario en las políticas sanitarias y de investigación biomédica.

  14. Marketing and Quality of Life: A Model for Improving Perinatal Health Status

    Science.gov (United States)

    Dever, G. E. Alan; Smith, Leah T.; Stamps, Bunnie V.

    2005-01-01

    Introduction: A marketing/business model using non-traditional Quality of Life measures was developed to assess perinatal health status on a micro-geographic level. This perinatal health status needs assessment study for Georgia South Central Region was conducted for the years 1994-1999. The model may be applied to any geographic unit in the…

  15. Perinatal Factors, Parenting Behavior, and Reactive Aggression: Does Cortisol Reactivity Mediate This Developmental Risk Process?

    Science.gov (United States)

    Ryan, Stacy R.; Schechter, Julia C.; Brennan, Patricia A.

    2012-01-01

    Little is known about the mechanisms of action that link perinatal risk and the development of aggressive behavior. The aim of this study was to examine whether perinatal risk and parenting interacted to specifically predict reactive aggression, as opposed to general aggressive behavior, and to examine cortisol reactivity as a mediator of this…

  16. Social inequality in fetal and perinatal mortality in the Nordic Countries

    DEFF Research Database (Denmark)

    Jørgensen, Tina; Mortensen, Laust Hvas; Andersen, Anne-Marie Nybo

    2008-01-01

    The aim of this study is to review the epidemiological literature from the past 27 years on social inequality in fetal and perinatal mortality in the Nordic countries in order to examine whether social inequalities in fetal and perinatal mortality exist, and whether there are differences between ...

  17. Congenital heart defects in europe: prevalence and perinatal mortality, 2000 to 2005

    DEFF Research Database (Denmark)

    Dolk, Helen; Loane, Maria; Garne, Ester

    2011-01-01

    This study determines the prevalence of Congenital Heart Defects (CHD), diagnosed prenatally or in infancy, and fetal and perinatal mortality associated with CHD in Europe.......This study determines the prevalence of Congenital Heart Defects (CHD), diagnosed prenatally or in infancy, and fetal and perinatal mortality associated with CHD in Europe....

  18. Identifying perinatal risk factors for infant maltreatment: an ecological approach

    Directory of Open Access Journals (Sweden)

    Hallisey Elaine J

    2006-12-01

    Full Text Available Abstract Background Child maltreatment and its consequences are a persistent problem throughout the world. Public health workers, human services officials, and others are interested in new and efficient ways to determine which geographic areas to target for intervention programs and resources. To improve assessment efforts, selected perinatal factors were examined, both individually and in various combinations, to determine if they are associated with increased risk of infant maltreatment. State of Georgia birth records and abuse and neglect data were analyzed using an area-based, ecological approach with the census tract as a surrogate for the community. Cartographic visualization suggested some correlation exists between risk factors and child maltreatment, so bivariate and multivariate regression were performed. The presence of spatial autocorrelation precluded the use of traditional ordinary least squares regression, therefore a spatial regression model coupled with maximum likelihood estimation was employed. Results Results indicate that all individual factors or their combinations are significantly associated with increased risk of infant maltreatment. The set of perinatal risk factors that best predicts infant maltreatment rates are: mother smoked during pregnancy, families with three or more siblings, maternal age less than 20 years, births to unmarried mothers, Medicaid beneficiaries, and inadequate prenatal care. Conclusion This model enables public health to take a proactive stance, to reasonably predict areas where poor outcomes are likely to occur, and to therefore more efficiently allocate resources. U.S. states that routinely collect the variables the National Center for Health Statistics (NCHS defines for birth certificates can easily identify areas that are at high risk for infant maltreatment. The authors recommend that agencies charged with reducing child maltreatment target communities that demonstrate the perinatal risks

  19. PELAYANAN KESEHATAN PERINATAL DI DAERAH PEDESAAN UJUNG BERUNG

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    Anna Alisjahbana

    2012-09-01

    Full Text Available A survey on perinatal care in a rural area at Ujung Berung district, located 15—20 km outside Bandung, West Java was conducted. Three villages with a population of 40,787 were selected. Health services were provided by one health post and several family planning posts. In this study 1303 pregnant women were followed throughout the 28 weeks of pregnancy until the infant is 28 days of age. Among the 1303 pregnant women 5.7% had received tetanus toxoid immunization. Perinatal mortality rate (PMR was 43.6 per thousand and incidence of low birth weight was 14.3 percent. Only 12.8% pregnant women were using some kind of contraception before the last pregnancy. The PMR decreased in spite of the low percentage users. The main causes of death during perinatal period vece asphyxia neonatorum and infections. The incidence of tetanus neonatorum during neonatal period was 17 per thousand live births. An evaluation of health service activities showed 47.5% of these pregnant women had antenatal care. Care during delivery and early postnatal period was carried out by TBAs. No significant difference was found between the PMR of trained and untrained TBAs. Another aspect of health service activities is referral to the health centre or hospital. A total of 3.8 percent infants were referred because of neo­natal problems; among these, refusal was 12.5% due to the totalistic attitude of the parents in the village. The results showed that coverage of pregnant women and their infants by safe health care services is very low. This may be due to lack of facilities and health personnel, and probably also due to the confidence of village people for traditional health care providers. Thus, education and training as well as supervision of traditional health care providers and their integration into the formal health care structure is of extreme importance.  

  20. A pilot study of heart rate variability biofeedback therapy in the treatment of perinatal depression on a specialized perinatal psychiatry inpatient unit.

    Science.gov (United States)

    Beckham, A Jenna; Greene, Tammy B; Meltzer-Brody, Samantha

    2013-02-01

    Heart rate variability biofeedback (HRVB) therapy may be useful in treating the prominent anxiety features of perinatal depression. We investigated the use of this non-pharmacologic therapy among women hospitalized with severe perinatal depression. Three questionnaires, the State Trait Anxiety Inventory (STAI), Warwick-Edinburgh Mental Well-Being Scale, and Linear Analog Self Assessment, were administered to 15 women in a specialized inpatient perinatal psychiatry unit. Participants were also contacted by telephone after discharge to assess continued use of HRVB techniques. The use of HRVB was associated with an improvement in all three scales. The greatest improvement (-13.867, p anxiety features of perinatal depression, both in inpatient and outpatient settings. PMID:23179141

  1. Organochlorine exposure and changes in the perinatal period: a review

    OpenAIRE

    Priscila Campos Bueno; Raphael Mendonça Guimarães; Paulo Guilherme Molica Rocha

    2014-01-01

    Objective: The aim of this review is to survey the state of the art on key perinatal outcomes associated with contamination by organochlorines. Data Source: This is an integrative review. A search was performed in MEDLINE / PubMed for the descriptors “organochlorine” AND “infertility”; “organochlorine” AND “fetal loss”; “organochlorine” AND “preterm delivery”; and “organochlorine” AND “low birth weight,” without time restrictions. As an exclusion criterion, we only considered the analytical s...

  2. Maternal physical activity, birth weight and perinatal mortality.

    Science.gov (United States)

    Briend, A

    1980-11-01

    As a result of the acquisition of upright posture, adaptation to muscular exercise seems to be unique in man. It involves a redistribution of the cardiac output mediated by the sympathetic system towards priority organs which apparently do not include the pregnant uterus. This could explain the poor tolerance of the human fetus to maternal exercise. The hypothesis is supported by the independence of a detrimental effect of work from the effect of maternal nutrition and by an influence of maternal posture in late pregnancy on its outcome. Possible relations between maternal activity before and during late pregnancy and perinatal mortality are discussed in the context of this hypothesis. PMID:7005626

  3. Hipoxia perinatal y su impacto en el neurodesarrollo

    OpenAIRE

    José Luis Flores-Compadre; Felipe Cruz; Gabriela Orozco; Alicia Vélez

    2013-01-01

    Durante el periodo perinatal el cerebro puede quedar privado de oxígeno por dos mecanismos importantes: la hipoxemia y la isquemia. El primero consiste en una disminución de la concentración de oxígeno en sangre y el segundo en la cantidad de sangre que riega al cerebro. Clínicamente se le conoce como encefalo- patía hipoxia-isquémica al síndrome caracterizado por la suspensión o grave disminución del intercambio gaseoso a nivel de la placenta o de los pulmones, que resulta en hipoxemia, hipe...

  4. Obstetric interventions and perinatal asphyxia in growth retarded term infants

    DEFF Research Database (Denmark)

    Langhoff-Roos, J; Lindmark, G

    1997-01-01

    BACKGROUND: The monitoring of fetal growth during pregnancy is usually justified because of the increased perinatal risk of these babies. METHODS: In 1552 infants from the Scandinavian Small for Gestational Age Study the need for obstetric interventions, risk of fetal asphyxia and immediate...... neonatal outcome at term have been studied in relation to different types of fetal growth retardation, including sub-groups with low ponderal index or low amount of subcutaneous fat. RESULTS: The need for obstetric intervention indicated by suspected fetal asphyxia before or during labor was increased 3...

  5. Evaluation of the estrogenic effects of dietary perinatal Trifolium pratense

    OpenAIRE

    Yatkin, Emrah; Daglioglu, Suzan

    2011-01-01

    This study was designed to investigate the potential estrogenic effects of perinatal dietary phytoestrogens on the rat uterus. Pregnant rats were divided to three groups provided the following diets: (1) rat chow, (2) rat chow with 7.5% Trifolium (T.) pratense, or (3) rat chow supplemented with 17β-estradiol (0.5 mg/kg). The dams in each group were kept on the same diet during pregnancy and lactation. Female offspring were euthanized on day 21 at which time body and organ weights were recorde...

  6. Can the preterm lung recover from perinatal stress?

    Science.gov (United States)

    Hütten, Matthias C; Wolfs, Tim G A M; Kramer, Boris W

    2016-12-01

    After birth, adequate lung function is necessary for the successful adaptation of a preterm baby. Both prenatal and postnatal insults and therapeutic interventions have an immediate effect on lung function and gas exchange but also interfere with fetal and neonatal lung development. Prenatal insults like chorioamnionitis and prenatal interventions like maternal glucocorticosteroids interact but might also determine the preterm baby's lung response to postnatal interventions ("second hit") like supplementation of oxygen and drug therapy. We review current experimental and clinical findings on the influence of different perinatal factors on preterm lung development and discuss how well-established interventions in neonatal care might be adapted to attenuate postnatal lung injury. PMID:27075524

  7. The future of pediatric and perinatal postmortem imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gorincour, Guillaume [Assistance Publique des Hopitaux de Marseille - Aix-Marseille University, Pediatric and Prenatal Imaging Department, La Timone Children Hospital, Marseille, Marseille Cedex 5 (France); CERIMED, Aix-Marseille University, Experimental and Interventional Imaging Laboratory, Marseille (France); Sarda-Quarello, Laure [La Timone Hospital, Department of Fetopathology, Marseille (France); Laurent, Pierre-Eloi [CERIMED, Aix-Marseille University, Experimental and Interventional Imaging Laboratory, Marseille (France); Brough, Alison; Rutty, Guy N. [University of Leicester, East Midlands Forensic Pathology Unit, Leicester (United Kingdom)

    2015-04-01

    The field and applications of postmortem imaging are exponentially growing. Its potential to identify the cause of death in trauma and ballistic cases is now properly documented, as well as its use in drug mule identification. In pediatric and perinatal practice, large significant series are less available, except for MRI and central nervous system analysis where scientific evidence is now robust. In this review, after a short historical review and analysis of current problems and challenges, we will try to depict the way we see the future of this subspecialty of postmortem cross-sectional imaging, including all specific situations: terminations of pregnancy, intrauterine death, sudden unexpected infant death and identification issues. (orig.)

  8. Perinatal stroke in Saudi children: clinical features and risk factors

    International Nuclear Information System (INIS)

    To describe the clinical features and presentations of perinatal stroke in a prospective and retrospective cohort of Saudi children and ascertain the risk factors. Patients with perinatal stroke were identified from within a cohort of 104 Saudi children who were evaluated at the Division of Pediatric Neurology at King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia from July 1992 to February 2001 (retrospective study) and February 2001 to March 2003 (prospective study). Neuroimaging for suspected cases of stroke consisted of cranial CT, MRI, or both. During the study period, 23 (22%) of 104 children (aged one months to 12 years) were diagnosed to have had perinatal stroke. The male: female ratio was 1.6:1. Ten (67%) of the 15 children who had unilateral ischemic involvement had their lesion in the left hemisphere. The presentation of the ischemic result was within 24-72 hours of life in 13 (57%) patients, and in 6 children (26%), motor impairment was recognized at or after the age of 4 months. Nine children (39%) had seizures at presentation. Pregnancy, labor, and delivery risk factors were ascertained in 18 (78%) cases. The most common of these included emergency cesarean section in 5 cases, and instrumental delivery in other 5. Screening for prothrombotic risk factors detected abnormalities in 6 (26%) patients on at least one test carried out between 2 months and 9 years of age. Four children (17%) had low protein C, which was associated low protein S and raised anticardiolipin antibodies (ACA) in one patient, and low antithrombin III in another. Low proteins S was detected in a 42-month-old boy. The abnormality in the sixth child was confined to raised ACA. The present study highlights the non-specific features by which stroke presents during the neonatal period. The data are in keeping with the potential role for inherited and acquired thrombophilia as being the underlying cause. However, the high prevalence of

  9. The future of pediatric and perinatal postmortem imaging

    International Nuclear Information System (INIS)

    The field and applications of postmortem imaging are exponentially growing. Its potential to identify the cause of death in trauma and ballistic cases is now properly documented, as well as its use in drug mule identification. In pediatric and perinatal practice, large significant series are less available, except for MRI and central nervous system analysis where scientific evidence is now robust. In this review, after a short historical review and analysis of current problems and challenges, we will try to depict the way we see the future of this subspecialty of postmortem cross-sectional imaging, including all specific situations: terminations of pregnancy, intrauterine death, sudden unexpected infant death and identification issues. (orig.)

  10. Cuidados con el anciano con tos productiva.

    OpenAIRE

    Costa de Moura, María Lucia

    2005-01-01

    A partir de las informaciones y con la motivación para hacer un estudio dirigido a los cuidados con el anciano, sigue la necesidad del desarrollo de acciones pertinentes para la práctica de cuidar, o sea, la asistencia de enfermería prestada directamente al anciano, principalmente a aquellos que llegan a la unidad de salud quejándose de tos. El objeto de este estudio es la asistencia de enfermería basándome en las cuestiones que rodean la percepción del enfermero y cómo el...

  11. Cifrado con cubos marcados

    OpenAIRE

    Coriat, Moisés; María C. Cañadas

    2011-01-01

    Con cuatro de los 8 tetracubos y con la ayuda de la noción de cubo mínimo (cubo formado por dos tetracubos), introducimos los “cubo marcados”. A su vez, usamos esta idea para generar claves con las que cabe transmitir mensajes cifrados. Damos ejemplos de claves y mencionamos algunas posibilidades más de cifrado con dichos cubos marcados. En la introducción presentamos algunas facetas del cifrado. Después, describimos algunos policubos y prestamos especial atención a los cuatro tetracubo...

  12. Methadone and perinatal outcomes: a retrospective cohort study.

    LENUS (Irish Health Repository)

    Cleary, Brian J

    2012-02-01

    OBJECTIVE: The purpose of this study was to examine the relationship among methadone maintenance treatment, perinatal outcomes, and neonatal abstinence syndrome. STUDY DESIGN: This was a retrospective cohort study of 61,030 singleton births at a large maternity hospital from 2000-2007. RESULTS: There were 618 (1%) women on methadone at delivery. Methadone-exposed women were more likely to be younger, to book late for antenatal care, and to be smokers. Methadone exposure was associated with an increased risk of very preterm birth <32 weeks of gestation (adjusted odds ratio [aOR], 2.47; 95% confidence interval [CI], 1.40-4.34), being small for gestational age <10th percentile (aOR, 3.27; 95% CI, 2.49-4.28), admission to the neonatal unit (aOR, 9.14; 95% CI, 7.21-11.57), and diagnosis of a major congenital anomaly (aOR, 1.94; 95% CI, 1.10-3.43). There was a dose-response relationship between methadone and neonatal abstinence syndrome. CONCLUSION: Methadone exposure is associated with an increased risk of adverse perinatal outcomes, even when known adverse sociodemographic factors have been accounted for. Methadone dose at delivery is 1 of the determinants of neonatal abstinence syndrome.

  13. PERINATAL TUBERCULOSIS WITH MILLIARY PATTERN IN INFANT AGED 28 DAYS

    Directory of Open Access Journals (Sweden)

    Dian Savitri

    2015-07-01

    Full Text Available Perinatal  tuberculosis  (TB was a very  rare  case.  Its  clinical manifestations  could mimic bacterialinfection. The clinical course was often fulminant and characterized by dissemination and meningitis.Its mortality was very high, could achieve 100% in untreated patient. We reported a case of infant aged28  days  admitted with  breathlessness,  fever,  and  poor  feeding.  Physical  examination  showedbreathlessness, pale, lethargy, and hepatomegaly. Chest radiograph showed a feature of milliary patternwith fine tubercles in both lung, supported with positive result on gastric aspirates for acid fast bacilli3 days respectively. Gastric aspirate culture for Mycobacterium tuberculosis showed positive result.Patient then diagnosed with perinatal TB with milliary pattern. This condition was accompanied withsevere sepsis and meningitis. Four TB regimens (isoniazid, rifampisin, pirazinamide, and ethambutol,corticosteroid, antibiotics were given. The patient was eventually died after receiving TB therapy for 13days. [MEDICINA 2014;45:208-212].

  14. Bone health in children and adolescents with perinatal HIV infection

    Directory of Open Access Journals (Sweden)

    George K Siberry

    2013-06-01

    Full Text Available The long-term impact on bone health of lifelong HIV infection and prolonged ART in growing and developing children is not yet known. Measures of bone health in youth must be interpreted in the context of expected developmental and physiologic changes in bone mass, size, density and strength that occur from fetal through adult life. Low bone mineral density (BMD appears to be common in perinatally HIV-infected youth, especially outside of high-income settings, but data are limited and interpretation complicated by the need for better pediatric norms. The potential negative effects of tenofovir on BMD and bone mass accrual are of particular concern as this drug may be used more widely in younger children. Emphasizing good nutrition, calcium and vitamin D sufficiency, weight-bearing exercise and avoidance of alcohol and smoking are effective and available approaches to maintain and improve bone health in all settings. More data are needed to inform therapies and monitoring for HIV-infected youth with proven bone fragility. While very limited data suggest lack of marked increase in fracture risk for youth with perinatal HIV infection, the looming concern for these children is that they may fail to attain their expected peak bone mass in early adulthood which could increase their risk for fractures and osteoporosis later in adulthood.

  15. Gestational, perinatal and family findings of patients with Patau syndrome

    Directory of Open Access Journals (Sweden)

    Rafael Fabiano M. Rosa

    2013-12-01

    Full Text Available OBJECTIVE: To describe gestational, perinatal and family findings of patients with Patau syndrome (PS. METHODS: The study enrolled patients with PS consecutively evaluated during 38 years in a Clinical Genetics Service of a pediatric referral hospital in Southern Brazil. The clinical data and the results of cytogenetic analysis were collected from the medical records. For statistical analysis, the two-tailed Fisher's exact test and the chi-square test with Yates' correction were used, being significant p<0.05. RESULTS: The sample was composed of 27 patients, 63% were male, with a median age of nine days at the first evaluation. Full trisomy of chromosome 13 was the main cytogenetic finding (74%. Only six patients were submitted to obstetric ultrasound and none had prenatal diagnosis of PS. The patients' demographic characteristics, compared to born alive infants in the same Brazilian state showed a higher frequency of: mothers with 35 years old or more (37.5%; multiparous mothers (92.6%; vaginal delivery (77%; preterm birth (34.6%; birth weight <2500g (33.3%, and Apgar scores <7 in the 1st (75% and in the 5th minute (42.9%. About half of them (53% died during the first month of life. CONCLUSIONS: The understanding of the PS patients' gestational, perinatal and family findings has important implications, especially on the decision about the actions to be taken in relation to the management of these patients.

  16. Congenital malformations and perinatal morbidity associated with intestinal neuronal dysplasia.

    Science.gov (United States)

    Berger, S; Ziebell, P; OFFsler, M; Hofmann-von Kap-herr, S

    1998-09-01

    A close relation between different forms of dysganglionosis such as intestinal neuronal dysplasia (IND) type B and aganglionosis has been established. No systematic analysis of other malformations and diseases accompanying IND has been made as yet. Congenital malformations and perinatal morbidity were analyzed in 109 patients with IND seen at the Department of Pediatric Surgery in Mainz from 1977 to 1996. IND was associated with Hirschsprung's disease in 47 cases; 22 children with IND had other abdominal malformations, including anal atresia, rectal stenosis, sigmoidal stenosis, ileal atresia, pyloric stenosis, and esophageal atresia. A cystic bowel duplication, a choledochal cyst, and a persisting urachus were also found. Extra-abdominal malformations such as Down's syndrome, congenital diaphragmatic hernia, aortic stenosis, and malformations of vertebral bodies were seen. Twin siblings of children with IND were either healthy (n=3) or died in utero (n=1). Seventeen children with IND developed severe intra-abdominal complications during the perinatal period such as necrotizing enterocolitis (NEC), meconium ileus, or bowel perforations. NEC was frequently associated with preterm birth. Bowel perforations were seen in mature and preterm newborns with IND. Taken together, IND is found in a variety of obstructive bowel diseases. This may support the hypothesis that IND is a secondary phenomenon or that congenital atresias and stenoses of the digestive tract have a pathogenesis similar to that of intestinal innervation disturbances. IND may also be a part of complex malformation patterns since it occurs with a number of extraintestinal and non-obstructive intestinal malformations. PMID:9716673

  17. Effect of therapeutic hypothermia on chromosomal aberration in perinatal asphyxia

    Directory of Open Access Journals (Sweden)

    Bahubali D Gane

    2016-01-01

    Full Text Available Introduction: Perinatal asphyxia is a major cause for neonatal mortality and morbidity around the world. The reduction of O2results in the generation of reactive oxygen species which interact with nucleic acid and make alteration in the structure and functioning of the genome. We studied the effect of therapeutic hypothermia on chromosomes with karyotyping. Subjects and Methods: Babies in the hypothermia group were cooled for the first 72 h, using gel packs. Rectal temperature of 33–34°C was maintained. Blood sample was collected after completion of therapeutic hypothermia for Chromosomal analysis. It was done with IKAROS Karyotyping system, Metasystems, based on recommendations of International system of human cytogenetic nomenclature. Results: The median chromosomal aberration was lower in hypothermia [2(0-5] than control group [4(1-7] and chromatid breakage was commonest aberration seen. Chromosomal aberration was significantly higher in severe encephalopathy group than moderate encephalopathy group. Conclusion: We conclude that the TH significantly reduces DNA damage in perinatal asphyxia.

  18. Diet-induced obesity resistance of adult female mice selectively bred for increased wheel-running behavior is reversed by single perinatal exposure to a high-energy diet.

    Science.gov (United States)

    Guidotti, Stefano; Meyer, Neele; Przybyt, Ewa; Scheurink, Anton J W; Harmsen, Martin C; Garland, Theodore; van Dijk, Gertjan

    2016-04-01

    Female mice from independently bred lines previously selected over 50 generations for increased voluntary wheel-running behavior (S1, S2) resist high energy (HE) diet-induced obesity (DIO) at adulthood, even without actual access to running wheels, as opposed to randomly bred controls (CON). We investigated whether adult S mice without wheels remain DIO-resistant when exposed - via the mother - to the HE diet during their perinatal stage (from 2 weeks prior to conception until weaning on post-natal day 21). While S1 and S2 females subjected to HE diet either perinatally or from weaning onwards (post-weaning) resisted increased adiposity at adulthood (as opposed to CON females), they lost this resistance when challenged with HE diet during these periods combined over one single cycle of breeding. When allowed one-week access to wheels (at week 6-8 and at 10 months), however, tendency for increased wheel-running behavior of S mice was unaltered. Thus, the trait for increased wheel-running behavior remained intact following combined perinatal and post-weaning HE exposure, but apparently this did not block HE-induced weight gain. At weaning, perinatal HE diet increased adiposity in all lines, but this was only associated with hyperleptinemia in S lines irrespective of gender. Because leptin has multiple developmental effects at adolescence, we argue that a trait for increased physical activity may advance maturation in times of plenty. This would be adaptive in nature where episodes of increased nutrient availability should be exploited maximally. Associated disturbances in glucose homeostasis and related co-morbidities at adulthood are probably pleiotropic side effects. PMID:26850290

  19. Psychological and social consequences among mothers suffering from perinatal loss: perspective from a low income country

    Directory of Open Access Journals (Sweden)

    Ali Mohammed

    2011-06-01

    Full Text Available Abstract Background In developed countries, perinatal death is known to cause major emotional and social effects on mothers. However, little is known about these effects in low income countries which bear the brunt of perinatal mortality burden. This paper reports the impact of perinatal death on psychological status and social consequences among mothers in a rural area of Bangladesh. Methods A total of 476 women including 122 women with perinatal deaths were assessed with the Edinburgh Postnatal Depression Scale (EPDS-B at 6 weeks and 6 months postpartum, and followed up for negative social consequences at 6 months postpartum. Trained female interviewers carried out structured interviews at women's home. Results Overall 43% (95% CI: 33.7-51.8% of women with a perinatal loss at 6 weeks postpartum were depressed compared to 17% (95% CI: 13.7-21.9% with healthy babies (p = Conclusions This study highlights the greatly increased vulnerability of women with perinatal death to experience negative psychological and social consequences. There is an urgent need to develop appropriate mental health care services for mothers with perinatal deaths in Bangladesh, including interventions to develop positive family support.

  20. Hidropesía fetal en una gestante con enfermedad hipertensiva grave. Presentación de un caso

    OpenAIRE

    Maribel Rodríguez Matos; Laritza Isabel Mengana Fontes; Mayda Urrutia Carmenaty

    2013-01-01

    La hidropesía fetal es un grave proceso de elevada mortalidad perinatal, de etiología multifactorial, caracterizado por un síndrome edematoso generalizado, con o sin acumulación de líquido en las cavidades serosas del organismo fetal. Se presenta un caso de hidropesía fetal no inmunológica en una paciente de sexo femenino, de color de piel blanca y de 20 años de edad con enfermedad hipertensiva grave, diagnosticada mediante ultrasonido, como estudio de bienestar fetal a las 35,1 semanas de ge...

  1. Late pregnancy thyroid-binding globulin predicts perinatal depression.

    Science.gov (United States)

    Pedersen, Cort; Leserman, Jane; Garcia, Nacire; Stansbury, Melissa; Meltzer-Brody, Samantha; Johnson, Jacqueline

    2016-03-01

    Previously we found that late pregnancy total and free thyroxine (TT4, FT4) concentrations were negatively related to greater pre and/or postpartum depressive symptoms. In a much larger cohort, the current study examined whether these thyroid indices measured earlier in the third trimester (31-33 weeks) predict subsequent perinatal depression and anxiety ratings as well as syndromal depression. Thyroid-binding globulin (TBG) concentrations increase markedly during pregnancy and may be an index of sensitivity to elevated estrogen levels. TBG was examined in this study because prior findings suggest that postpartum depression is related to sensitivity to mood destabilization by elevated sex hormone concentrations during pregnancy. Our cohort was 199 euthyroid women recruited from a public health obstetrics clinic (63.8% Hispanic, 21.6% Black). After screening and blood draws for hormone measures at pregnancy weeks 31-33, subjects were evaluated during home visits at pregnancy weeks 35-36 as well as postpartum weeks 6 and 12. Evaluations included psychiatric interviews for current and life-time DSM-IV psychiatric history (M.I.N.I.-Plus), subject self-ratings and interviewer ratings for depression and anxiety (Edinburgh Postnatal Depression Scale, Montgomery-Ǻsberg Depression Rating Scale; Spielberger State-Trait Anxiety Inventory, Hamilton Anxiety Inventory), as well as a standardized interview to obtain life-time trauma history. Numerous covariates were included in all regression analyses. Trauma and major depression history were robustly significant predictors of depression and anxiety ratings over the study period when these variables were analyzed individually or in a combined model including FT4 or TBG (pdepression and anxiety ratings (pdepression history, were significant individual predictors of syndromal depression during the study period (pdepression history, FT4 and TBG generally were not significantly predictive of depression or anxiety ratings, and FT4

  2. Localized intestinal perforations as a potential complication of brain hypothermic therapy for perinatal asphyxia.

    Science.gov (United States)

    Nishizaki, Naoto; Maiguma, Atsuko; Obinata, Kaoru; Okazaki, Tadaharu; Shimizu, Toshiaki

    2016-08-01

    Brain hypothermic therapy (BHT) is becoming a frequently used standard of care for perinatal asphyxia. Although cardiovascular side effects, coagulation disorders, renal impairment, electrolyte abnormalities, impaired liver function, opportunistic infections, and skin lesions are well-known adverse effects of BHT in newborns, little information is available on the clinical features of intestinal perforation-related BHT. We herein report a case of therapeutic brain cooling for perinatal asphyxia complicated by localized intestinal perforation. In practice, the neonatologist should be aware that intestinal perforation in an infant with perinatal asphyxia is possible, particularly following BHT. PMID:26445344

  3. con marcos extradensos

    Directory of Open Access Journals (Sweden)

    Manuel Rodríguez

    2007-01-01

    Full Text Available El cultivo del plátano vianda al igual que el de la papaya, en la región occidental del país, son fuertemente atacados por enfermedades que hacen que las plantaciones, por el grado de deterioro que estas les producen, no duren más de un ciclo de cultivo. Sembrar una misma área, un año tras de otro con el mismo cultivo, trae consigo el establecimiento en el suelo de elementos parásitos dañinos al mismo, que pueden ser eliminados o atenuados con una rotación con otro cultivo. El presente trabajo expone los resultados experimentales de dos años de trabajo de la rotación de estos cultivos, plantados con dos marcos de plantación de alta densidad, 2 x 4 x 1 m y 3 x 1 m, con una densidad de 3333 plantas/ha y regados con la técnica de riego por goteo. Se obtuvieron rendimientos de 40,73 t/ha en plátano y de 71,42 t/ha en papaya, con una relación beneficio costo de 1,15, tasa interna de retorno de 36,27 %, valor actual neto de 21,47 y plazo de recuperación de la inversión de 3,01 años.

  4. Human Cytomegalovirus: detection of congenital and perinatal infection in Argentina

    Directory of Open Access Journals (Sweden)

    Pardon Fabián

    2004-06-01

    Full Text Available Abstract Background Human cytomegalovirus (CMV is one of the most commonly found agents of congenital infections. Primary maternal infection is associated with risk of symptomatic congenital diseases, and high morbidity is frequently associated with very low birth weight. Neonates with asymptomatic infection develop various sequelae during infancy. This is the first Argentine study performed in neonates with congenital and postnatal HCMV infection. The purpose of this study was to evaluate the performance of the polymerase chain reaction (PCR technique with different pairs of primers, to detect cytomegalovirus isolated in tissue cultures and directly in urine and dried blood spot (DBS specimens. Results were compared with IgM detection. Methods The study was performed between 1999 and 2001 on routine samples in the Laboratory. A total of 61 urine and 56 serum samples were selected from 61 newborns/infants, 33 patients whose samples were analyzed during the first two to three weeks of life were considered congenital infections; the remaining 28 patients whose samples were taken later than the third week were grouped as perinatal infections, although only in 4 the perinatal transmission of infection was determined unequivocally Cytomegalovirus diagnosis was made by isolating the virus from urine samples in human foreskin fibroblast cells. Three different primer pairs directed to IE, LA and gB genes were used for the HCMV PCR assay in viral isolates. Subsequently, PCR and nested PCR (nPCR assays with gB primers were performed directly in urine and in 11 samples of dried blood spot (DBS on Guthrie Card, these results were then compared with serology. Results The main clinical manifestations of the 33 patients with congenital infection were purpura, jaundice, hepatomegaly and anaemia. Three patients presented low birth weight as single symptom, 10, intracranial calcifications, and 2, kidney failure. In the 28 patients grouped as with perinatal

  5. Perinatal characteristics, older siblings, and risk of ankylosing spondylitis

    DEFF Research Database (Denmark)

    Lindström, Ulf; Forsblad-d'Elia, Helena; Askling, Johan;

    2016-01-01

    BACKGROUND: The effect of circumstances and exposures early in life on the risk of developing ankylosing spondylitis (AS) is largely unknown. The purpose of this study was to determine whether perinatal characteristics predict development of AS. METHODS: AS cases (n = 1960; 59 % men) were defined....... Odds ratios (OR) for developing AS were determined through conditional logistic regression, with regard to: birth weight, birth order, season of birth, maternal age, gestational length, size for gestational age, type of birth, mode of delivery, congenital malformations, mothers' country of birth......, mothers' civil status and size of delivery unit. RESULTS: In the univariate analyses statistically significant increases in risk for developing AS were observed for having older siblings (OR 1.18; 95 % Cl 1.06-1.30). No association was observed for the remainder of analysed exposures, although there was a...

  6. Endocrine and other physiologic modulators of perinatal cardiomyocyte endowment.

    Science.gov (United States)

    Jonker, S S; Louey, S

    2016-01-01

    Immature contractile cardiomyocytes proliferate to rapidly increase cell number, establishing cardiomyocyte endowment in the perinatal period. Developmental changes in cellular maturation, size and attrition further contribute to cardiac anatomy. These physiological processes occur concomitant with a changing hormonal environment as the fetus prepares itself for the transition to extrauterine life. There are complex interactions between endocrine, hemodynamic and nutritional regulators of cardiac development. Birth has been long assumed to be the trigger for major differences between the fetal and postnatal cardiomyocyte growth patterns, but investigations in normally growing sheep and rodents suggest this may not be entirely true; in sheep, these differences are initiated before birth, while in rodents they occur after birth. The aim of this review is to draw together our understanding of the temporal regulation of these signals and cardiomyocyte responses relative to birth. Further, we consider how these dynamics are altered in stressed and suboptimal intrauterine environments. PMID:26432905

  7. Duelo perinatal: Un secreto dentro de un misterio.

    Directory of Open Access Journals (Sweden)

    Ana Pía López García de Amindabieta

    2011-01-01

    Full Text Available La muerte del feto durante el embarazo, en el parto o pocos días después del nacimiento constituye un tema delicado, condicionado por numerosos factores. Esta pérdida puede desencadenar reacciones de duelo en los progenitores y situaciones de difícil manejo para los profesionales sanitarios. Son duelos que reciben escasa consideración y que pueden complicarse dando lugar a trastornos psiquiátricos. Es necesario conocer el significado de la pérdida perinatal desde la perspectiva de los progenitores para no caer en posturas paternalistas o en protocolos dogmáticos que consideran iguales a todos los progenitores ante pérdidas a las que ellos atribuyen significados diferentes.

  8. Neuroradiological findings in perinatally HIV-infected children

    International Nuclear Information System (INIS)

    The neuroradiological studies (CT, MRI, angiography) in 21 children with perinatal HIV infection were reviewed retrospectively. No patient showed an intracranial mass lesion; after intravenous contrast medium application there was no case with disturbed blood-brain barrier. Common non-specific findings were atrophy and delayed myelination. In 7 cases atrophy was combined with multifocal nearly symmetric white matter lesions, which characteristically spared the U-fibres. Further findings included an intramedullary ring-shaped structure in the cervical cord, an AIDS-associated vasculopathy and symmetric calcifications in the basal ganglia. The spectrum of neuroradiological findings in paediatric AIDS patients differs from that in adults. Knowledge of these age-specific findings is important because the number of HIV-infected children is rising. (orig.)

  9. Interpersonal Psychotherapy in the Treatment of Perinatal Depression

    Directory of Open Access Journals (Sweden)

    Gamze Ergil Altin

    2012-06-01

    Full Text Available Perinatal depression is a psychiatric disorder that is not sufficiently diagnosed and directed to treatment. Its acute and chronic outcomes influence not only the mother but also the infant and the relationship between them. Both pregnancy and the postpartum periods are the times of significant physiological and emotional changes which also influence interpersonal relationships. Interpersonal risk factors like insufficient social support and increased social conflict can have an important impact on the women’s mental and physiological health during this period. Studies have shown that women prefer psychological and social management over drugs during this period. Interpersonal psychotherapy is a time-limited treatment approach, especially focusing on interpersonal difficulties with the goal of reducing depressive symptoms and improving interpersonal functioning. Such distressing factors which can occur during pregnancy and delivery are compatible with the four main problem areas that interpersonal psychotherapy addresses so that the therapist can easily use interpersonal psychotherapy in order to solve such difficulties.

  10. Normal perinatal and paediatric postmortem magnetic resonance imaging appearances

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, Owen J. [Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London (United Kingdom); UCL Institute of Child Health, London (United Kingdom); Barber, Joy L. [Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London (United Kingdom); Taylor, Andrew M. [Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London (United Kingdom); UCL Institute of Cardiovascular Science, Centre for Cardiovascular Imaging, London (United Kingdom); Sebire, Neil J. [UCL Institute of Child Health, London (United Kingdom); Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London (United Kingdom)

    2015-04-01

    As postmortem imaging becomes more widely used following perinatal and paediatric deaths, the correct interpretation of images becomes imperative, particularly given the increased use of postmortem magnetic resonance imaging. Many pathological processes may have similar appearances in life and following death. A thorough knowledge of normal postmortem changes is therefore required within postmortem magnetic resonance imaging to ensure that these are not mistakenly interpreted as significant pathology. Similarly, some changes that are interpreted as pathological if they occur during life may be artefacts on postmortem magnetic resonance imaging that are of limited significance. This review serves to illustrate briefly those postmortem magnetic resonance imaging changes as part of the normal changes after death in fetuses and children, and highlight imaging findings that may confuse or mislead an observer to identifying pathology where none is present. (orig.)

  11. Neuroblastoma Perinatal – Um Desafio para o Neonatologista

    OpenAIRE

    Oliveira, Alexandra; Jerónimo, Mónica; Fonseca, Margarida; Heitor, Fátima; Mimoso, Gabriela

    2015-01-01

    Introdução: O neuroblastoma é o tumor maligno mais frequente no período neonatal. O diagnóstico pré-natal aumentou devido à qualidade da ecografia obstétrica com deteção de massas assintomáticas nas glândulas suprarrenais. Relato dos casos: Quatro recém-nascidos (RN) tiveram diagnóstico de neuroblastoma perinatal. Três fetos apresentavam uma massa da suprarrenal. Um dos fetos associava hidrópsia e foi estabelecido o diagnóstico em pré-natal. O RN sem alterações da suprarrenal em pré-natal apr...

  12. Perinatal tumours: the contribution of radiology to management

    Energy Technology Data Exchange (ETDEWEB)

    Donoghue, Veronica; Ryan, Stephanie; Twomey, Eilish [Children' s University Hospital, Radiology Department, Dublin (Ireland)

    2008-06-15

    A formal classification does not exist and they are probably best classified by their location. Overall the most common neoplasms are - Extracranial teratoma - Neuroblastoma - Soft-tissue tumours - Brain tumours - Leukaemia - Renal tumours - Liver tumours - Retinoblastoma. The prognosis is generally poor, although there are some exceptions such as congenital neuroblastoma and hepatoblastoma. These tumours have a tendency to regress and have a benign clinical course despite a clear malignant histological picture. Other tumours, though histologically benign, may be fatal because of their size and location. Large benign masses may cause airway or cardiovascular compromise and death. Others may cause significant mass effect preventing normal organ development. As normal embryonic cells have a high mitotic rate it is not surprising that perinatal tumours may have a rapid growth rate and become enormous in size. (orig.)

  13. Faith, Trust and the Perinatal Healthcare Maze in Urban India

    Directory of Open Access Journals (Sweden)

    S. Raman

    2014-05-01

    Full Text Available How women access and utilise health services through pregnancy, childbirth and infancy needs to be understood if we are to improve the delivery of and access to appropriate healthcare. Drawing on ethnographic observations of clinic encounters and in-depth interviews with women in Bangalore, South India, this paper reports on the complexities of negotiating healthcare throughout the perinatal continuum in urban India. Key themes identified include faith and trust in health services, confusion over right to healthcare; and the contested nature of choice for women. What is revealed is a socially restrictive framework that results in choices that seem arbitrary, irrational and self-defeating; poor women being particularly vulnerable. Given the current policy support for public-private-partnerships in reproductive healthcare delivery in India, both public and private health services need to move substantially to achieve true partnership and provide care that is respectful and valued by women and children in urban India.

  14. Perinatal complications and schizophrenia: involvement of the immune system

    Directory of Open Access Journals (Sweden)

    Trisha Anne Jenkins

    2013-06-01

    Full Text Available The neurodevelopmental hypothesis of schizophrenia suggests that, at least in part, events occurring within the intrauterine or perinatal environment at critical times of brain development underlies emergence of the psychosis observed during adulthood, and brain pathologies that are hypothesised to be from birth. All potential risks stimulate activation of the immune system, and are suggested to act in parallel with an underlying genetic liability, such that an imperfect regulation of the genome mediates these prenatal or early postnatal environmental effects. Epidemiologically based animal models looking at environment and with genes have provided us with a wealth of knowledge in the understanding of the pathophysiology of schizophrenia, and give us the best possibility for interventions and treatments for schizophrenia.

  15. Personality and Perinatal Maternal Insomnia: A Study Across Childbirth.

    Science.gov (United States)

    Dørheim, Signe K; Garthus-Niegel, Susan; Bjorvatn, Bjørn; Eberhard-Gran, Malin

    2016-01-01

    Personality may influence sleep in perinatal women. A follow-up study was conducted among 3,752 pregnant, then postpartum women at Akershus University Hospital, Norway. The Big Five personality dimensions were measured by the Mini-International Personality Item Pool in week 17 of pregnancy. Insomnia was measured by the Bergen Insomnia Scale in pregnancy week 32 and 8 weeks postpartum, along with self-reported sleep times. The Edinburgh Postnatal Depression Scale measured depression, and the Hopkins Symptom Checklist measured anxiety. Adjusted for current anxiety, depression, and demographic variables, the personality traits Neuroticism and Agreeableness were associated with insomnia in pregnancy. No personality traits were associated with postpartum insomnia. Extraversion was associated with longer postpartum sleep duration and better sleep efficiency, and Agreeableness with shorter sleep duration. PMID:25174718

  16. Normal perinatal and paediatric postmortem magnetic resonance imaging appearances

    International Nuclear Information System (INIS)

    As postmortem imaging becomes more widely used following perinatal and paediatric deaths, the correct interpretation of images becomes imperative, particularly given the increased use of postmortem magnetic resonance imaging. Many pathological processes may have similar appearances in life and following death. A thorough knowledge of normal postmortem changes is therefore required within postmortem magnetic resonance imaging to ensure that these are not mistakenly interpreted as significant pathology. Similarly, some changes that are interpreted as pathological if they occur during life may be artefacts on postmortem magnetic resonance imaging that are of limited significance. This review serves to illustrate briefly those postmortem magnetic resonance imaging changes as part of the normal changes after death in fetuses and children, and highlight imaging findings that may confuse or mislead an observer to identifying pathology where none is present. (orig.)

  17. Breastfeeding and risk of schizophrenia in the Copenhagen Perinatal Cohort

    DEFF Research Database (Denmark)

    Sørensen, Holger Jelling; Mortensen, Erik Lykke; Reinisch, J M;

    2005-01-01

    OBJECTIVE: The aim was to study whether early weaning from breastfeeding may be associated with increased risk of schizophrenia. METHOD: The current sample comprises 6841 individuals from the Copenhagen Perinatal Cohort of whom 1671 (24%) had been breastfed for 2 weeks or less (early weaning) and...... 5170 (76%) had been breastfed longer. Maternal schizophrenia, parental social status, single mother status and gender were included as covariates in a multiple regression analysis of the effect of early weaning on the risk of hospitalization with schizophrenia. RESULTS: The sample comprised 93 cases of...... schizophrenia (1.4%). Maternal schizophrenia was the strongest risk factor and a significant association between single mother status and elevated offspring risk of schizophrenia was also observed. Early weaning was significantly related to later schizophrenia in both unadjusted and adjusted analyses (adjusted...

  18. Mortalidade perinatal e evitabilidade: revisão da literatura

    Directory of Open Access Journals (Sweden)

    Sônia Lansky

    2002-12-01

    Full Text Available Neste artigo, realizou-se uma revisão da literatura sobre mortalidade perinatal com maior enfoque na evitabilidade desses óbitos. Foram pesquisadas, sobretudo, publicações da década de 90 nas bases Medline e Lilacs (América Latina e Caribe. Discutiram-se as dificuldades para a realização de estudos nesta área, ainda em número restrito no Brasil, em decorrência do grande subregistro de óbitos fetais e da má qualidade da informação nas declarações de óbitos. Foram apresentadas as principais propostas de classificação dos óbitos perinatais baseadas em enfoque de evitabilidade, com destaque para a classificação de Wigglesworth. Nesta abordagem, os óbitos perinatais foram relacionados a momentos específicos da assistência, sendo evidenciadas as possibilidades de sua prevenção. Recomenda-se o enfoque de evitabilidade para a abordagem da mortalidade perinatal no Brasil, dado que as taxas são ainda elevadas, a maioria dos óbitos é considerada evitável e poderia ser prevenida com a melhoria da assistência pré-natal, ao parto e ao recém-nascido, não apenas quanto à sua resolubilidade clínica, mas também à organização da assistência em sistemas hierarquizados e regionalizados, assegurando o acesso da gestante e do recém-nascido em tempo oportuno a serviços de qualidade.

  19. The success of cardiotocography in predicting perinatal outcome

    Directory of Open Access Journals (Sweden)

    Alpaslan Kaban

    2012-06-01

    Full Text Available Objectives: The determination of the fetal condition duringlabor is important to minimize fetal death due to asphyxiaand the neurological sequelae of fetal hypoxia.This study evaluated the success of fetal cardiotocographyin predicting perinatal consequences.Materials and methods: This study enrolled 101 full-termpregnant women admitted for delivery to Vakif GurebaTraining and Research Hospital between October 2009and February 2010. Women were included if they wereaged 18-45 years and within 36-41 weeks of gestation.During a 20-min period of fetal monitoring, a change inFHR (fetal heart rate lasting for 15 s or two elevated runsof 15 beats was evaluated as a reactive NST (non-stresstest. The umbilical artery pH was used as the “gold standard”for assessing fetal asphyxia.Results: The mean age of the women included in thestudy was 27.82 ± 5.29 years, the average parity was1.09± 0.96. The pH was normal in 85 neonates, while 13 hadfetal asphyxia. No significant difference in umbilical cordblood pH, pO2, or pCO2 was observed between these twogroups (p = 0.497, p = 0.722, and p = 0.053, respectively.No significant difference in maternal age, parity, or birthweight was found between the group with fetal distressbased on CTG (cardiotocography and the normal group.Conclusion: Cardiotocography is an important test duringlabor for labor management, it is insufficient for predictingthe perinatal outcome. Therefore, labor should beevaluated on an individualized basis. J Clin Exp Invest2012; 3(2: 168-171

  20. Women's health groups to improve perinatal care in rural Nepal

    Directory of Open Access Journals (Sweden)

    Manandhar Dharma

    2005-03-01

    Full Text Available Abstract Background Neonatal mortality rates are high in rural Nepal where more than 90% of deliveries are in the home. Evidence suggests that death rates can be reduced by interventions at community level. We describe an intervention which aimed to harness the power of community planning and decision making to improve maternal and newborn care in rural Nepal. Methods The development of 111 women's groups in a population of 86 704 in Makwanpur district, Nepal is described. The groups, facilitated by local women, were the intervention component of a randomized controlled trial to reduce perinatal and neonatal mortality rates. Through participant observation and analysis of reports, we describe the implementation of this intervention: the community entry process, the facilitation of monthly meetings through a participatory action cycle of problem identification, community planning, and implementation and evaluation of strategies to tackle the identified problems. Results In response to the needs of the group, participatory health education was added to the intervention and the women's groups developed varied strategies to tackle problems of maternal and newborn care: establishing mother and child health funds, producing clean home delivery kits and operating stretcher schemes. Close linkages with community leaders and community health workers improved strategy implementation. There were also indications of positive effects on group members and health services, and most groups remained active after 30 months. Conclusion A large scale and potentially sustainable participatory intervention with women's groups, which focused on pregnancy, childbirth and the newborn period, resulted in innovative strategies identified by local communities to tackle perinatal care problems.

  1. Words in Maternity Wards: An Aproximation to Perinatal Psychology

    Directory of Open Access Journals (Sweden)

    Alicia Oiberman

    2016-02-01

    Full Text Available The acknowledgment that just born babies interact with human and physical contexts originated changes in behaviors of health teems working in maternity wards settings. Concepts such as initial interactions, attachment, dyads, maternal vulnerability, behavioral competences of the just born babies and their applications to perinatal psychology, marked a transformation in different professionals involved in birth’s approaches. From one side, it can be said that medicalization of the birth act in Western societies had allowed to minimize risk factors. But this progress had been carried out without taking into account emotional expressions. The introduction of psychological interventions in neonatal periods is a new field of knowledge. History shows that in different periods and cultures there were amulets, potions and other elements associated with magic that were used to swear baby or mother’s death risk during childbirth. All these practices were taken the place of words, in a hard emotional moment: parturition. It was necessary to walk a long and difficult road for Perinatal Psycholy to recuperate the ancient place of old good women and incorporate words in maternity wards, knowing that the main scenery is first occupied by the mother’s body and then by the baby. Our daily job in a maternity ward, working together with pediatricians and neonatologists, allowed us to verify that words come out when psychologists themselves “include their body” as well as do mothers, babies and the medical teem. Words contribute to facilitate emotional expressions related to motherhood and place the baby in the family history, making able his or her “psychological birth”. 

  2. Perinatal outcome after in-vitro fertilization-surrogacy.

    Science.gov (United States)

    Parkinson, J; Tran, C; Tan, T; Nelson, J; Batzofin, J; Serafini, P

    1999-03-01

    The perinatal outcome of pregnancies (both single and multiple) established after in-vitro fertilization (IVF)-surrogacy was evaluated and compared to the outcome of pregnancies that resulted from standard IVF. Analysis of medical records and a telephone interview with physicians, IVF-surrogates, and commissioning mothers were conducted to assess prenatal follow up and delivery care in several hospitals. 95 IVF-surrogates delivered 128 liveborn (65 singletons, 27 sets of twins and two sets of triplets). The commissioning mothers and the IVF-surrogates average ages were 37.7 +/- 5.0 and 30.4 +/- 4.7 years old respectively. IVF-surrogates carrying twin and triplet gestations delivered substantially earlier than those who gestated singleton pregnancies (36.2 +/- 0.4 versus 35.5 versus 38.7 +/- 0.3 weeks gestation respectively; P surrogacy (2.7 +/- 0.06 versus 3.5 +/- 0.07 kg; P surrogacy. The incidence of prematurity was significantly greater in both twins delivered by IVF-surrogates (20.4%) and infertile IVF patients (58%). The occurrence of pregnancy-induced hypertension and bleeding in the third trimester was four to five times lower in the IVF-surrogates, independently of whether they were carrying multiples. The incidence of Caesarean section was 21.3% for singleton gestations, while two times higher in the IVF-surrogates carrying multiples (56.3%). Postpartum complications occurred in 6.3% of patients and the incidence of malformation was similar to those reported for the general population. The results provide general reassurance regarding perinatal outcome to couples who wish to pursue IVF-surrogacy. PMID:10221693

  3. Perinatally Influenced Autonomic System Fluctuations Drive Infant Vocal Sequences.

    Science.gov (United States)

    Zhang, Yisi S; Ghazanfar, Asif A

    2016-05-23

    The variable vocal behavior of human infants is the scaffolding upon which speech and social interactions develop. It is important to know what factors drive this developmentally critical behavioral output. Using marmoset monkeys as a model system, we first addressed whether the initial conditions for vocal output and its sequential structure are perinatally influenced. Using dizygotic twins and Markov analyses of their vocal sequences, we found that in the first postnatal week, twins had more similar vocal sequences to each other than to their non-twin siblings. Moreover, both twins and their siblings had more vocal sequence similarity with each other than with non-sibling infants. Using electromyography, we then investigated the physiological basis of vocal sequence structure by measuring respiration and arousal levels (via changes in heart rate). We tested the hypothesis that early-life influences on vocal output are via fluctuations of the autonomic nervous system (ANS) mediated by vocal biomechanics. We found that arousal levels fluctuate at ∼0.1 Hz (the Mayer wave) and that this slow oscillation modulates the amplitude of the faster, ∼1.0 Hz respiratory rhythm. The systematic changes in respiratory amplitude result in the different vocalizations that comprise infant vocal sequences. Among twins, the temporal structure of arousal level changes was similar and therefore indicates why their vocal sequences were similar. Our study shows that vocal sequences are tightly linked to respiratory patterns that are modulated by ANS fluctuations and that the temporal structure of ANS fluctuations is perinatally influenced. PMID:27068420

  4. Ranking risk factors for perinatal mortality. Analysis of a nation-wide study.

    Science.gov (United States)

    Samueloff, A; Mor-Yosef, S; Seidman, D S; Adler, I; Persitz, E; Schenker, J G

    1989-01-01

    This paper analyses data from the Israeli nationwide perinatal census, with the aim of revealing the possible causes of perinatal death, and to assess the effects of risk factors, using a logistic regression analysis. The analysis provided an estimate of the net effect of each characteristic independently, thus identifying high-risk pregnancies that should be monitored with greater intensity. Five variables were found to have a significant effect on perinatal death. Among these, in order of decreasing risk: fetal presentation, maternal diseases complicating pregnancy, number of fetuses, ethnic origin, and maternal age. Other variables such as parity, standard of hospital, the mother's country of birth and domiciliary circumstances, did not significantly affect perinatal mortality. PMID:2631538

  5. Social Ecological Predictors of Longitudinal HIV Treatment Adherence in Youth With Perinatally Acquired HIV

    OpenAIRE

    Naar-King, Sylvie; Montepiedra, Grace; Garvie, Patricia; Kammerer, Betsy; Malee, Kathleen; Sirois, Patricia A.; Aaron, Lisa; Sharon L. Nichols

    2013-01-01

    Objective To apply a social ecological model to explore the psychosocial factors prospectively associated with longitudinal adherence to antiretroviral treatment in youth perinatally infected with HIV. Methods Randomly selected youth, age 8 to

  6. Maternal drinking water arsenic exposure and perinatal outcomes in Inner Mongolia, China

    Science.gov (United States)

    Exposure to high levels of arsenic has been reported to increase adverse birth outcomes including spontaneous abortion, preterm birth, and low birthweight. This study evaluated the relationship between maternal arsenic exposure and perinatal endpoints (term birthweight, preterm ...

  7. Utility of local health registers in measuring perinatal mortality: A case study in rural Indonesia

    Directory of Open Access Journals (Sweden)

    Adair Timothy

    2011-03-01

    Full Text Available Abstract Background Perinatal mortality is an important indicator of obstetric and newborn care services. Although the vast majority of global perinatal mortality is estimated to occur in developing countries, there is a critical paucity of reliable data at the local level to inform health policy, plan health care services, and monitor their impact. This paper explores the utility of information from village health registers to measure perinatal mortality at the sub district level in a rural area of Indonesia. Methods A retrospective pregnancy cohort for 2007 was constructed by triangulating data from antenatal care, birth, and newborn care registers in a sample of villages in three rural sub districts in Central Java, Indonesia. For each pregnancy, birth outcome and first week survival were traced and recorded from the different registers, as available. Additional local death records were consulted to verify perinatal mortality, or identify deaths not recorded in the health registers. Analyses were performed to assess data quality from registers, and measure perinatal mortality rates. Qualitative research was conducted to explore knowledge and practices of village midwives in register maintenance and reporting of perinatal mortality. Results Field activities were conducted in 23 villages, covering a total of 1759 deliveries that occurred in 2007. Perinatal mortality outcomes were 23 stillbirths and 15 early neonatal deaths, resulting in a perinatal mortality rate of 21.6 per 1000 live births in 2007. Stillbirth rates for the study population were about four times the rates reported in the routine Maternal and Child Health program information system. Inadequate awareness and supervision, and alternate workload were cited by local midwives as factors resulting in inconsistent data reporting. Conclusions Local maternal and child health registers are a useful source of information on perinatal mortality in rural Indonesia. Suitable training

  8. Investigando con personas con dificultades de aprendizaje

    Directory of Open Access Journals (Sweden)

    Borja González Luna

    2013-12-01

    Full Text Available El artículo muestra los orígenes de lo que Walmsley (2008 denomina «investigación inclusiva». Para comprender qué se entiende por investigación inclusiva tenemos que remontarnos a los debates epistemológicos sobre las metodologías cuantitativas y cualitativas, acontecidos en la década de los 90, en torno a la revista Disability & Society. A partir de una síntesis de dichos debates, focalizados en el ámbito de la «discapacidad intelectual y del desarrollo», se exponen dos estrategias de colaboración con dicha población: a una aproximación etnográfica (de trabajo grupal, y b una aproximación biográfica (de trabajo individual. A continuación se esboza un posible diseño de trabajo de campo que intenta superar el paradigma cualitativo «clásico» con el objetivo de incluir a dicho colectivo más allá del rol de «sujetos de la investigación». Para finalizar se recoge el debate sobre la accesibilidad de los resultados de la investigación a los participantes en dichas investigaciones, y con ello la necesaria innovación en el ámbito de las «devoluciones» de los resultados, cuando se trata de incluir a personas que presentan limitaciones para la comprensión del lenguaje abstracto oral y/o escrito.

  9. Perinatal outcome in anaemic pregnant women in South-Western Nigeria

    Directory of Open Access Journals (Sweden)

    Kehinde S. Okunade

    2014-04-01

    Conclusion: This study has thus highlighted the importance of considering maternal anaemia as an indicator of adverse perinatal outcomes. There is therefore, a need to counsel intending mothers and their partners about early antenatal booking, compliance with routine antenatal medications and prompt identification and treatment of anaemia in pregnancy, all as means of curtailing the overwhelming perinatal morbidity and mortality associated with the condition. [Int J Res Med Sci 2014; 2(2.000: 607-611

  10. Neonatal seizures triple the risk of a remote seizure after perinatal ischemic stroke.

    OpenAIRE

    Fox, CK; Glass, HC; Sidney, S; Smith, SE; Fullerton, HJ

    2016-01-01

    To determine incidence rates and risk factors of remote seizure after perinatal arterial ischemic stroke.We retrospectively identified a population-based cohort of children with perinatal arterial ischemic stroke (presenting acutely or in a delayed fashion) from a large Northern Californian integrated health care system. We determined incidence and predictors of a remote seizure (unprovoked seizure after neonatal period, defined as 28 days of life) by survival analyses, and measured epilepsy ...

  11. Influences of ethnicity on perinatal and child mortality in the Netherlands

    OpenAIRE

    Schulpen, T.W.J.; van Steenbergen, J.E.; van Driel, H F

    2001-01-01

    AIMS—To investigate the differences in perinatal death and child mortality between different ethnic groups in the Netherlands.
METHODS—Retrospective analysis of data collected between 1990 and 1993 in the national obstetric registry comprising 569 743 births. Retrospective analysis of all death certificates of 0 to 15 year old children routinely collected between 1979 and 1993, comprising 20 211 deaths.
RESULTS—Black mothers had the highest perinatal death rate compared w...

  12. MMPI-2: Cluster Analysis of Personality Profiles in Perinatal Depression—Preliminary Evidence

    OpenAIRE

    2014-01-01

    Background. To assess personality characteristics of women who develop perinatal depression. Methods. The study started with a screening of a sample of 453 women in their third trimester of pregnancy, to which was administered a survey data form, the Edinburgh Postnatal Depression Scale (EPDS) and the Minnesota Multiphasic Personality Inventory 2 (MMPI-2). A clinical group of subjects with perinatal depression (PND, 55 subjects) was selected; clinical and validity scales of MMPI-2 were used a...

  13. Perinatal nutrition programs neuroimmune function long-term: mechanisms and implications

    Directory of Open Access Journals (Sweden)

    SarahJSpencer

    2013-08-01

    Full Text Available Our early life nutritional environment can influence several aspects of physiology, including our propensity to become obese. There is now evidence to suggest perinatal diet can also independently influence development of our innate immune system. This review will address three not-necessarily-exclusive mechanisms by which perinatal nutrition can program neuroimmune function long-term: by predisposing the individual to obesity, by altering the gut microbiota, and by inducing epigenetic modifications that alter gene transcription throughout life.

  14. Tobacco control policies and perinatal health: a national quasi-experimental study

    OpenAIRE

    Myrthe J. Peelen; Aziz Sheikh; Marjolein Kok; Petra Hajenius; Zimmermann, Luc J.; Kramer, Boris W.; Hukkelhoven, Chantal W.; Reiss, Irwin K.; Mol, Ben W; Been, Jasper V.

    2016-01-01

    We investigated whether changes in perinatal outcomes occurred following introduction of key tobacco control policies in the Netherlands: smoke-free legislation in workplaces plus a tobacco tax increase and mass media campaign (January-February 2004); and extension of the smoke-free law to the hospitality industry, accompanied by another tax increase and mass media campaign (July 2008). This was a national quasi-experimental study using Netherlands Perinatal Registry data (2000–2011; registra...

  15. Intimate Partner Violence amongst women with eating disorders during the perinatal period

    OpenAIRE

    Kothari, Radha; Easter, Abigail; Lewis, Rebecca; Howard, Louise Michele; Micali, Nadia

    2015-01-01

    Objective: Prevalence of intimate partner violence (IPV) during pregnancy is estimated to be 4%-8%. Women with mental health difficulties are at increased risk for IPV during the perinatal period. Prevalence of IPV is high among women with eating disorders (ED); however, prevalence of IPV during the perinatal period among women with ED is unknown. Method: We studied women from a population-based cohort, the Avon Longitudinal Study of Parents and Children. Prevalence and odds of physical and e...

  16. Low prevalence of dental caries in children with perinatal HIV infection

    OpenAIRE

    Srinath Sahana; Krishnappa, Srinath S; Vishwanath S Krishnappa

    2013-01-01

    Aim and Objective: The objective is to assess the prevalence of caries in children with perinatal human immunodeficiency virus (HIV) infection. Materials and Methods: Oral examination was performed on children aged 2-12 years with perinatal HIV infection who stayed at ′Calvary Chapel home of hope for special children′ to assess decayed, missing, or filled primary teeth/decayed, missing, or filled permanent teeth (dmft/DMFT). Results: Prevalence of tooth decay in primary teeth (dmft) for the a...

  17. Perinatal Depression – the Fourth Inflammatory Morbidity of Pregnancy? Theory and Literature Review

    OpenAIRE

    Osborne, Lauren M.; Monk, Catherine

    2013-01-01

    Perinatal depression is one of the leading causes of maternal morbidity and mortality. The biological etiology of this disorder remains in question, despite considerable research into the contributions of hormonal imbalance, the role of monoamines, and dysregulation of the HPA axis. Because inflammation is known to be associated with major depression in men and non-perinatal women as well as with other important morbidities of pregnancy (such as preeclampsia, preterm birth, and gestational di...

  18. Understanding the mental health of youth living with perinatal HIV infection: lessons learned and current challenges

    OpenAIRE

    Malee, Kathleen M.; Mellins, Claude A.

    2013-01-01

    Introduction: Across the globe, children born with perinatal HIV infection (PHIV) are reaching adolescence and young adulthood in large numbers. The majority of research has focused on biomedical outcomes yet there is increasing awareness that long-term survivors with PHIV are at high risk for mental health problems, given genetic, biomedical, familial and environmental risk. This article presents a review of the literature on the mental health functioning of perinatally HIV-infected (PHIV+) ...

  19. The Perinatal Risk Index: Early Risks Experienced by Domestic Adoptees in the United States

    OpenAIRE

    Marceau, Kristine; De Araujo-Greecher, Marielena; Miller, Emily S.; Massey, Suena H.; Mayes, Linda C.; Ganiban, Jody M.; Reiss, David; Shaw, Daniel S.; Leve, Leslie D.; Neiderhiser, Jenae M.

    2016-01-01

    We aimed to assess comprehensively the prevalence of perinatal risks experienced by a potentially high-risk yet understudied population of children domestically adopted in the United States. Data are from participant report and medical records from mothers (n = 580) who completed a domestic adoption placement with nonrelatives at or near birth (Mean placement age = 7 days). We describe a comprehensive measure of perinatal risks, including divergences from previous assessment tools and the inc...

  20. High sugar intake exacerbates cardiac reperfusion injury in perinatal taurine depleted adult rats

    OpenAIRE

    Kulthinee Supaporn; Wyss J Michael; Jirakulsomchok Dusit; Roysommuti Sanya

    2010-01-01

    Abstract Perinatal taurine depletion and high sugar diets blunted baroreflex function and heightens sympathetic nerve activity in adult rats. Cardiac ischemia/reperfusion also produces these disorders and taurine treatment appears to improve these effects. This study tests the hypothesis that perinatal taurine exposure predisposes recovery from reperfusion injury in rats on either a basal or high sugar diet. Female Sprague-Dawley rats were fed normal rat chow with 3% beta-alanine (taurine dep...

  1. Perinatal Outcomes of Polyhydramnios without Associated Congenital Fetal Anomalies after a Gestational Age of 20 weeks.

    OpenAIRE

    Kuang-Chao Chen; Jui-Der Liou; Tai-Ho Hung; Dong-Ming Kuo; Jenn-Jeih Hsu; Ching-Chang Hsieh; T'sang-T'ang Hsieh

    2005-01-01

    Background: Polyhydramnios carries a high rate of complications during pregnancy andadverse perinatal outcomes. We could find no studies of this condition in alarge Asian population. The aim of this investigation was to evaluate therisks of adverse perinatal outcomes in a large study population with polyhydramnioswithout associated fetal anomalies after the gestational age of 20weeks in Taiwan.Methods: We retrospectively reviewed the computerized records of women who hadbabies without associa...

  2. The service needs of mothers with schizophrenia: A qualitative study of perinatal psychiatric and antenatal workers

    OpenAIRE

    Wan M, Moulton S, Abel K.

    2008-01-01

    AbstractObjective: The study sought to: (1) understand the perspectives of perinatal psychiatric and antenatal health service workers on the service and support needs of mothers with schizophrenia; (2) obtain their views on the feasibility and potential effectiveness of a proposed parenting intervention tailored for this group. Method: Twenty-eight perinatal psychiatry and antenatal service workers were interviewed using a semi-structured methodology, and anonymised verbatim transcripts analy...

  3. Inequalities in Perinatal Mortality Rates Among Immigrant and Native Population in Spain, 2005–2008

    OpenAIRE

    Barona, Carmen; López-Maside, Aurora; Bosch-Sánchez, Susana; Pérez-Panadés, Jordi; Melchor-Alós, Inmaculada; Mas-Pons, Rosa; Zurriaga, Óscar

    2014-01-01

    We compared perinatal mortality rates (PMRs) and the risk from certain causes among immigrant and native population in the Valencian Community (Spain). Using data from the Perinatal Mortality Registry, crude and age standardized mortality ratios were obtained in the different groups of mothers. Mortality rate ratios were calculated to compare the causes of death resulting from prematurity, congenital anomalies, infectious diseases and Sudden Infant Death Syndrome between Spanish and foreign w...

  4. UK vaccination schedule: persistence of immunity to hepatitis B in children vaccinated after perinatal exposure

    OpenAIRE

    Yates, Tom A.; Paranthaman, Karthikeyan; Yu, Ly-Mee; Davis, Elizabeth; Lang, Sarah; Hackett, Scott J; Steven B Welch; Andrew J Pollard; Snape, Matthew D

    2013-01-01

    Objective To assess persistence of immunity to hepatitis B (HBV) in primary school children vaccinated following perinatal exposure. Design Serological survey. Setting Five UK sites (Berkshire East, Birmingham, Buckinghamshire, Milton Keynes and Oxfordshire). Participants Children from 3 years 4 months to 10 years of age (mean age 6.2 years), vaccinated against HBV from birth following perinatal exposure. Interventions A single booster dose of the paediatric formulation of a recombinant HBV v...

  5. Self-Efficacy and Postpartum Depression Teaching Behaviors of Hospital-Based Perinatal Nurses

    OpenAIRE

    Logsdon, M. Cynthia; Foltz, Melissa Pinto; Scheetz, James; Myers, John A.

    2010-01-01

    Based upon the Self-Efficacy Theory, this study examined the relationship between self-efficacy, self-efficacy-related variables, and postpartum depression teaching behaviors of hospital-based perinatal nurses. Findings revealed that teaching new mothers about postpartum depression is related to a perinatal nurse's self-efficacy in postpartum-depression teaching, self-esteem, and the following self-efficacy-related variables: social persuasion (supervisor's expectations for teaching); mastery...

  6. Barriers to Emergency Obstetric Care Services in Perinatal Deaths in Rural Gambia: A Qualitative In-Depth Interview Study

    OpenAIRE

    Siri Vangen; Johanne Sundby; Abdou Jammeh

    2011-01-01

    Objective. The Gambia has one of the world's highest perinatal mortality rates. We explored barriers of timely access to emergency obstetric care services resulting in perinatal deaths and in survivors of severe obstetric complications in rural Gambia. Method. We applied the “three delays” model as a framework for assessing contributing factors to perinatal deaths and obstetric complications. Qualitative in-depth interviews were conducted with 20 survivors of severe obstetric complications at...

  7. TIME COURSE MODIFICATIONS INDUCED BY PERINATAL ASPHYXIA IN RAT CNS

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    Francisco Capani

    2015-04-01

    Full Text Available Perinatal asphyxia (PA induced short and long term biochemical, synaptic, cytoskeletal and astrocytes alterations that has been associated with neuronal cell death following hypoxia . The lack of knowledge about the mechanisms underlying this dysfunction prompted us to investigate the changes in the synapse and neuronal cytoskeleton and related structures. For this study we used a well established murine model of PA. Full-term pregnant rats were rapidly decapitated and the uterus horns were placed in a water bath at 37 °C for different time of asphyxia. When their physiological conditions improved, they were given to surrogate mothers. One month, four month, 6 month and 18 month after PA rats were included in this study. Modifications were analyzed using photooxidation with phalloidin-eosin, conventional electron microscopy (EM, inmunocytochemistry and ethanolic phosphotungstic acid (E-PTA staining combining with electron tomography and 3-D reconstruction techniques and molecular biology studies. After one month of the PA insult, an increase in the F-actin staining in neostriatum and hippocampus synapses was observed using correlative fluorescent electron microscopy for phalloidin-eosin. Mushroom-shaped spines showed the most consistent staining. Strong alterations in the dendrite and astroglial cytoskeleton were found at four months of PA (1. After six months of PA, postsynaptic densities (PSDs of the rat neostriatum are highly modified . We observed an increment of PSDs thickness related with the duration and severity of the hypoxic insult. In addition, PSDs showed and increase in the ubiquitination level. Using 3-d reconstruction and electron tomography we observed showed clear signs of damage in the asphyctic PSDs. These changes are correlated with intense staining for ubiquitin (2. Finally, in 18 months old rat was observed a reduction in the number of synapses in the PA animals related with a decrease in BDNF staining.(3 Using protocols

  8. Hyaline membrane disease (HMD: the role of the perinatal pathologist

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    Giorgia Locci

    2014-06-01

    Full Text Available Hyaline membrane disease (HMD, the pathologic correlate of respiratory distress syndrome (RDS of the newborn, is an acute lung disease of premature infant caused by inadequate amounts of surfactant. Decreased surfactant results in insufficient surface tension in the alveolus during expiration, leading to atelectasis, decreased gas exchange, severe hypoxia and acidosis. HMD predominantly occurs in infants younger than 32 weeks of gestation and weighing less than 1,200 g. In the interpretation of perinatal lung pathology, it is necessary to consider the development of the immature lung, particulary in the third trimester. Microscopically HMD is characterized by the occurrence of dilated terminal and respiratory bronchioles and of alveolar ducts lined by acellular eosinophilic hyaline membranes. The membranes are composed of necrotic alveolar lining cells, amniotic fluid constituents and fibrin. Retinopathy of prematurity and bronchopulmonary dysplasia are late complications of RDS that usually occur in infants who weigh less than 1,500 g and were maintained on a mechanical respiration more than 6 days. Here a pratical approach to a microscopic analysis of the lung in newborns died with the clinical setting of RDS is presented. The most important pathological findings for a complete clinical pathological diagnosis are: the evaluation of the architectural lung development; the endothelial cell lesions; the interstitial edema; the occurrence of disseminated intravascular coagulation; the presence of associated inflammatory lesions. The usefulness of some immunohistochemical stains is also underlined, including anti-surfactant, anti-smooth muscle actin and anti-CD31 to better evaluate surfactant production, pulmonary artery maturation and endothelial cell damage, respectively. Finally, the prevalent role of endothelial dysfunction and endothelial barrier loss is underlined, representing a major pathological event in the deposition of HMD

  9. STUDY OF MATERNAL AND PERINATAL OUTCOME IN REFERRED OBSTETRICS CASES

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    Umesh

    2015-03-01

    Full Text Available OBJECTIVE: To review the referred obstetric cases for reason of referral and to study the maternal and perinatal outcome. DESIGN: Prospective Observational study . STUDY POPULATION: 380 cases referred from periphery to tertiary care institute in one year duration. METHODS: INCLUSION C RITERIA : All referred ANC cases to our tertiary care institute >20 weeks gestation. The total number of deliveries during this period were 11106. The total number of referred cases in above study period was 1980. Out of these 1520 met the inclusion criteria & according to the sample size calculated 380 cases were selected for the study. Selection of cases were done by systematic sampling technique. RESULTS: The proportion of referral cases to the tertiary care institute is 17.83%. Majority (42.37% of referred cases were from district level hospitals showing lacunae in the emergency obstetric care given at the district level hospitals. In present study, there was unavailability of ambulance in 65.26% of cases for transport. Most (92.89% of the patients were not accompanied by any medical assistance during transport. Major complication during immediate postpartum period was postpartum hemorrhage (19.99%. In our study, 31.84% of the patients required blood/blood products transfusion. There were 3(0.79% maternal mortalities in present study & behind these there were total 70(18.42% near miss cases which provide valuable information on the quality of antenatal care at the periphery. 54.87% of all neonates had low birth weight in this study. In present study, 45.90% babies were p reterm. Total NICU admission rate was 14.36%. Neonatal mortality documented in present study was 5.38%. CONCLUSION: The present study has shown that improper antenatal & intranatal care at the periphery level is responsible for poor maternal & perinatal outcome. Rural women have very poor access to MCH services. There is lack of Transportation facilities for referral patients & they have to

  10. en pacientes con obesidad

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    Alcia María Alvarado Sánchez

    2005-01-01

    Full Text Available El objetivo de este estudio fue evaluar la eficacia de una intervención psicológica en pacientes con obesidad. Se utilizó un diseño cuasiexperimental con un grupo de estudio y un grupo control. Después de la intervención, se encontró una diferencia significativa en la reducción de peso entre los grupos. Asimismo, hubo un incremento significativo en la autoestima del grupo estudiado.

  11. Funcionando con la computadora

    OpenAIRE

    Álvarez, Eduardo; Astiz, Mercedes; Medina, Perla; Montero, Y.; Oliver, María; Rocerau, M. Cristina; Valdez, Guillermo; Vecino, María; Vilanova, Silvia

    2004-01-01

    En este trabajo se presenta la descripción y resultados de la segunda etapa de una experiencia planteada con el objetivo de indagar la manera en que los alumnos determinan e interpretan funciones que explican situaciones problemáticas valiéndose de una nueva forma de trabajo en el aula: la utilización de la computadora como herramienta y un programa asistente matemático. La primera etapa consistió en el desarrollo de un taller optativo con alumnos de entre 14 y 15 años de edad del Colegio Dr....

  12. Integralidade e acessibilidade no cuidado à criança portadora de paralisia cerebral Integralidad y accesibilidad en el cuidado del niño portador de parálisis cerebral Integration and accessibility of care for children with brain paralysis

    OpenAIRE

    Viviane Marten Milbrath; Simone Coelho Amestoy; Deise Cardoso Soares; Hedi Crecencia Heckler de Siqueira

    2009-01-01

    Objetivo: Conhecer como as crianças portadoras de paralisia cerebral, decorrente de asfixia perinatal grave, recebem os princípios da integralidade e da acessibilidade do Sistema Único de Saúde. Métodos: A investigação contemplou uma metodologia descritiva, exploratória com abordagem qualitativa. Participaram do estudo seis famílias de crianças portadoras de paralisia cerebral decorrente de asfixia perinatal grave. A coleta dos dados foi realizada através de entrevista semi-estruturada, no do...

  13. Episode-Based Payment for Perinatal Care in Medicaid: Implications for Practice and Policy.

    Science.gov (United States)

    Jarlenski, Marian; Borrero, Sonya; La Charité, Trey; Zite, Nikki B

    2016-06-01

    Medicaid is an important source of health insurance coverage for low-income pregnant women and covers nearly half of all deliveries in the United States. In the face of budgetary pressures, several state Medicaid programs have implemented or are considering implementing episode-based payments for perinatal care. Under the episode-based payment model, Medicaid programs make a single payment for all pregnancy-related medical services provided to women with low- and medium-risk pregnancies from 40 weeks before delivery through 60 days postpartum. The health care provider who delivers a live birth is assigned responsibility for all care and must meet certain quality metrics and stay within delineated cost-per-episode parameters. Implementation of cost- and quality-dependent episode-based payments for perinatal care is notable because there is no published evidence about the effects of such initiatives on pregnancy or birth outcomes. In this article, we highlight challenges and potential adverse consequences related to defining the perinatal episode and assigning a responsible health care provider. We also describe concerns that perinatal care quality metrics may not address the most pressing health care issues that are likely to improve health outcomes and reduce costs. In their current incarnations, Medicaid programs' episode-based payments for perinatal care may not improve perinatal care delivery and subsequent health outcomes. Rigorous evaluation of the new episode-based payment initiatives is critically needed to inform policymakers about the intended and unintended consequences of implementing episode-based payments for perinatal care. PMID:27159762

  14. Perinatal outcomes and unconventional natural gas operations in Southwest Pennsylvania.

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    Shaina L Stacy

    Full Text Available Unconventional gas drilling (UGD has enabled extraordinarily rapid growth in the extraction of natural gas. Despite frequently expressed public concern, human health studies have not kept pace. We investigated the association of proximity to UGD in the Marcellus Shale formation and perinatal outcomes in a retrospective cohort study of 15,451 live births in Southwest Pennsylvania from 2007-2010. Mothers were categorized into exposure quartiles based on inverse distance weighted (IDW well count; least exposed mothers (first quartile had an IDW well count less than 0.87 wells per mile, while the most exposed (fourth quartile had 6.00 wells or greater per mile. Multivariate linear (birth weight or logistical (small for gestational age (SGA and prematurity regression analyses, accounting for differences in maternal and child risk factors, were performed. There was no significant association of proximity and density of UGD with prematurity. Comparison of the most to least exposed, however, revealed lower birth weight (3323 ± 558 vs 3344 ± 544 g and a higher incidence of SGA (6.5 vs 4.8%, respectively; odds ratio: 1.34; 95% confidence interval: 1.10-1.63. While the clinical significance of the differences in birth weight among the exposure groups is unclear, the present findings further emphasize the need for larger studies, in regio-specific fashion, with more precise characterization of exposure over an extended period of time to evaluate the potential public health significance of UGD.

  15. Stress Response and Perinatal Reprogramming: Unraveling (Mal)adaptive Strategies.

    Science.gov (United States)

    Musazzi, Laura; Marrocco, Jordan

    2016-01-01

    Environmental stressors induce coping strategies in the majority of individuals. The stress response, involving the activation of the hypothalamic-pituitary-adrenocortical axis and the consequent release of corticosteroid hormones, is indeed aimed at promoting metabolic, functional, and behavioral adaptations. However, behavioral stress is also associated with fast and long-lasting neurochemical, structural, and behavioral changes, leading to long-term remodeling of glutamate transmission, and increased susceptibility to neuropsychiatric disorders. Of note, early-life events, both in utero and during the early postnatal life, trigger reprogramming of the stress response, which is often associated with loss of stress resilience and ensuing neurobehavioral (mal)adaptations. Indeed, adverse experiences in early life are known to induce long-term stress-related neuropsychiatric disorders in vulnerable individuals. Here, we discuss recent findings about stress remodeling of excitatory neurotransmission and brain morphology in animal models of behavioral stress. These changes are likely driven by epigenetic factors that lie at the core of the stress-response reprogramming in individuals with a history of perinatal stress. We propose that reprogramming mechanisms may underlie the reorganization of excitatory neurotransmission in the short- and long-term response to stressful stimuli. PMID:27057367

  16. Perinatal Hypoxic-Ischemic brain injury; MR findings

    International Nuclear Information System (INIS)

    To characterize the MR findings of hypoxic-ischemic brain injury and to assess the value of the MR imaging. SE T1-, T2-weighted, and IR brain MR images of 44 infants and children with the past history of perinatal hypoxic insults were reviewed. Abnormal brain MR findings of 8 patients with birth history of prematurity and 36 patients with birth history of full-term/posterm including 7 with severe anoxic insult history, were compared in regard to the location and the character of the lesions. MRI demonstrated the followings; (1)abnormal signal intensity lesions of subcortical and/or deep cerebral white matter, cortex, and deep gray matter, (2)atrophy of the cerebral white matter, cortex and corpus callosum, with/without ventriculomegaly, and (3)delay in myelination. Periventricular and deep white matter lesions were demonstrated in the prematurity, the deep white matter lesions and/ or subcortical white matter lesions in the term/post-term, and deep gray matter lesions in the 7 patients with severe anoxic insults history. MR imaging was useful in the diagnosis of the hypoxic-ischemic brain injury, and the white and gray matter lesions were correlated with the time of the injury and the severity of hypoxic insult

  17. Neonatal body water turnover: a putative index of perinatal morbidity

    International Nuclear Information System (INIS)

    The water metabolism of 46 newborn babies was determined during a 10 day period by means of an isotope dilution technique, and correlations were sought with the clinical assessment of the babies by multiple obstetric and pediatric clinical criteria. The babies, 48 to 72 hours of age, were given a single oral dose (2 ml/kg) of deuterated water (D2O), a nonradioactive tracer, and the urinary excretion rate was followed by means of infrared spectrophotometry. After a period of equilibration of the D2O with body water (20 hours), the rate of D2O clearance was found to be a single exponential decay process, thus allowing the fraction of total body water lost each hour (the rate constant) to be calculated for each baby. The median values of the rate constants X 10(4)(h-1) for 14 growth-retarded babies ws 104 (98% confidence limits, 97.8 to 122) compared with 76.3 (67.0 to 80.2) for 16 normal mature babies and 82.1 (73.4 to 90.6) for 16 normal premature babies. These data indicate that, compared with normal mature or normal premature babies, growth-retarded infants have a significantly (P less than 0.05) faster turnover of water during the first 10 days of postnatal life. Since there was little overlap in results between the normally grown and the retarded infants, the measurement of water turnover may provide a useful index of perinatal morbidity

  18. Management of Gestational Diabetes Mellitus: Selfefficacy and Perinatal Outcomes

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    Emine Gerçek

    2015-12-01

    Full Text Available The purpose of this review is to give knowledge about effects on perinatal outcomes of self-efficacy in management of gestational diabetes. Gestational diabetes mellitus (GDM is a significant health concern due to the potentially adverse outcomes for the mother and the fetus/infant. Close monitoring and treatment of GDM are important to the long-term health of a pregnant woman and her baby. More over, maternal metabolic control during pregnancy may positively impact women’s risk of later onset of type II diabetes and the risk of obesity and type II diabetes in their children. There are few studies which focus on selfefficacy and adoption of health behaviors in women with GDM; however, there is strong evidence demonstrating that health promotion behavior such as weight loss, exercise, healthy diet and self-monitoring blood glucose concentrations will decrease the risk of developing diabetes mellitus (DM. In addition, lifestyle modifications (e.g. weight loss, healthy diet, and exercise, compliance with physician appointments, and postpartum glucose screening are essential for early diagnosis and prevention of DM in women with GDM.

  19. PERINATAL AND MATERNAL OUTCOME IN PREMATURE RUPTURE OF MEMBRANES

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    Mercy Rodrigo

    2016-06-01

    Full Text Available BACKGROUND The objectives of this study are 1 To find out the incidence of premature rupture of membranes, 2 To evaluate the aetiology of premature rupture of membranes, 3 To assess foetal and maternal outcome in premature rupture of membranes. MATERIAL AND METHODS This prospective case control study was conducted in Govt. RSRM Lying In Hospital, Chennai, over a period of 6 months and 100 cases of spontaneous rupture of membranes attending the Department of Obstetrics and Gynaecology were studied. Maternal and neonatal outcome were compared with controls. RESULTS Incidence of PROM was 9.06%. Most of them belonged to low socioeconomic class and in the age group 20-29 years, commonly seen primi gravida and in unbooked cases. Aetiological analysis revealed infection in 15% of cases, which is evident by positive amniotic fluid culture, h/o recent coitus in 20%, mal-presentation in 7%. Cause is unknown in most of the cases. The caesarean section rate is 24% when compared to 12% in control group. The PROM group had higher morbidities like postpartum haemorrhage, postpartum fever, wound infection, neonatal sepsis. CONCLUSION This study showed significantly increased morbidity for both mother and baby. PROM causes major increase in the incidence of prematurity, hence careful screening of high risk factors and treatment of infection promptly is needed to decrease the perinatal morbidity and mortality.

  20. fertilizada con diferentes abonos

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    Jorge Alberto Elizondo-Salazar

    2007-01-01

    Full Text Available Producción y calidad de la biomasa de morera (Morus alba fertilizada con diferentes abonos. Se llevó a cabo un experimento en la Estación Experimental “Alfredo Volio Mata” de la Universidad de Costa Rica con el fi n de evaluar la aplicación de 150 kg de N/ha/año proveniente de dos abonos orgánicos: lombriabono y compostaje; y de un fertilizante químico, sobre la producción y calidad de la biomasa de morera. El periodo experimental comprendió un ciclo de 12 meses, iniciando en julio del 2003 y fi nalizando en julio del 2004. Se utilizó una plantación de morera de 12 años de establecida con una densidad de siembra de 27.777 plantas/ ha. Se empleó un diseño de bloques completos al azar con cuatro tratamientos: dos abonos orgánicos, nitrato de amonio (33,5% N y un control. Las plantas se podaron a 0,6 m sobre el nivel del suelo al inicio del ensayo. Durante el periodo experimental, las plantas fueron podadas consecutivamente cada 90 días. Las hojas y los tallos fueron separados y analizados para determinar el contenido de materia seca y proteína cruda. La producción de materia seca fue 23% superior y el contenido de proteína cruda fue signifi cativamente mayor con el nitrógeno químico, mientras que el contenido de materia seca fue menor. No se encontraron diferencias signifi cativas entre el tratamiento control y los tratamientos orgánicos.

  1. Embarazo y Adolescencia: Resultados Perinatales Pregnancy and adolescence: Perinatal results

    OpenAIRE

    Viviana Sáez Cantero

    2005-01-01

    Se realizó un estudio retrospectivo de caso control con el objetivo de conocer los resultados perinatales en las adolescentes atendidas en el Hospital "Clodomira Acosta Ferrales" de Ciudad Habana, del 1ro. de enero de 1999 al 31 de marzo de 2000. El grupo de estudio, 184 adolescentes, se comparó con un grupo control representado por las gestantes de 20 a 24 años (n = 439) atendidas en dicho centro en igual periodo de tiempo. Datos referentes como edad gestacional, modo de parto y peso y Apgar...

  2. The Perinatal Risk Index: Early Risks Experienced by Domestic Adoptees in the United States.

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    Kristine Marceau

    Full Text Available We aimed to assess comprehensively the prevalence of perinatal risks experienced by a potentially high-risk yet understudied population of children domestically adopted in the United States. Data are from participant report and medical records from mothers (n = 580 who completed a domestic adoption placement with nonrelatives at or near birth (Mean placement age = 7 days. We describe a comprehensive measure of perinatal risks, including divergences from previous assessment tools and the incorporation of multiple reporters, and report the prevalence of various types of perinatal risks. The prevalence of each specific risk factor was generally low, although several risks were more prevalent in this sample than estimates from nationally representative publicly available data. Nearly the entire sample (99% experienced some type of risk exposure. Birth mothers who placed their children for adoption domestically in the US experience higher levels of perinatal risks than the national average, but not for all specific types of risk. Thus, the developmental trajectories of children adopted domestically may systematically differ from the general population to the extent that these specific perinatal risks impact development.

  3. Perinatal distress and depression in Malawi: an exploratory qualitative study of stressors, supports and symptoms.

    Science.gov (United States)

    Stewart, Robert C; Umar, Eric; Gleadow-Ware, Selena; Creed, Francis; Bristow, Katie

    2015-04-01

    Quantitative studies have demonstrated that depression and anxiety in the perinatal period are common amongst women in low- and middle-income countries and are associated with a range of psychosocial and health-related stressors. In this exploratory qualitative study conducted in southern Malawi, we investigated the thoughts and emotions experienced by women in pregnancy and the postnatal period, their expectations of support from husband and others, problems and difficulties faced and the impact of these on psychological wellbeing. We conducted 11 focus group discussions with a total of 98 parous women. A thematic analysis approach was used. Three major themes were identified: pregnancy as a time of uncertainty, the husband (and others) as support and stressor, and the impact of stressors on mental health. Pregnancy was seen as bringing uncertainty about the survival and wellbeing of both mother and unborn child. Poverty, lack of support, HIV, witchcraft and child illness were identified as causes of worry in the perinatal period. Husbands were expected to provide emotional, financial and practical support, with wider family and friends having a lesser role. Infidelity, abuse and abandonment were seen as key stressors in the perinatal period. Exposure to stressors was understood to lead to altered mental states, the symptoms of which are consistent with the concept of common perinatal mental disorder. This study confirms and expands on evidence from quantitative studies and provides formative data for the development of a psychosocial intervention for common perinatal mental disorder in Malawi. PMID:24957779

  4. A 10-year history of perinatal care at the Brockington Mother and Baby Unit Stafford.

    Science.gov (United States)

    Green, Debra J; Hofberg, Kristina; Carr, Caroline; Fanneran, Tina; Sumathipala, Athula

    2016-06-01

    Perinatal mother and baby units are an essential service for women suffering from perinatal mental illness by allowing the baby to stay with the mother whilst receiving inpatient mental health care. Such units enable the mother to develop a relationship with her baby in a safe and supportive environment whilst caring for her mental health needs and allow her to gain confidence in her role as a mother. This article presents the development of the Brockington Mother and Baby unit and its progressive advancement towards an exemplary service for women suffering from perinatal mental illness. The Brockington Mother and Baby unit (MBU) at South Staffordshire and Shropshire Healthcare Foundation Trust (SSSFT) is celebrating its 10th anniversary and is one of six MBUs accredited as excellent by the Royal College of Psychiatry (RCPsych). The unit is a member of the Royal College of Psychiatrists' Quality Care Network and thereby adheres to their national standard of care. This article describes the journey from a single lone worker in perinatal mental health to an exemplary service caring for women with perinatal mental illness during the first 12 months following the birth of their child. PMID:26439484

  5. Perinatal outcome in singleton pregnancies complicated with preeclampsia and eclampsia in Ecuador.

    Science.gov (United States)

    Phoa, K Y N; Chedraui, P; Pérez-López, F R; Wendte, J F; Ghiabi, S; Vrijkotte, T; Pinto, P

    2016-07-01

    Preeclampsia in Ecuador is an understudied subject since available epidemiological data are scarce. The aim of this study was to describe perinatal outcomes among singleton pregnancies complicated with preeclampsia and eclampsia in a sample of low-income Ecuadorian women. Pregnant women complicated with preeclampsia (mild and severe) and eclampsia (defined according to criteria of the ACOG) delivering at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, Ecuador were surveyed with a structured questionnaire containing maternal (socio-demographic) and neonatal data. Perinatal outcomes were compared according to severity of clinical presentation. A total of 163 women with preeclampsia [mild (23.9%), severe (68.7%) and eclampsia (7.4%)] were surveyed. Perinatal mortality and stillbirth rate was similar among studied groups (mild vs. severe preeclampsia/eclampsia cases). However, severe cases displayed higher rates of adverse perinatal outcomes: lower birth Apgar scores, more preterm births, and more low birth weight and small for gestational age infants. Caesarean-section rate and the number of admissions to intensive or intermediate neonatal care were higher in severe cases. A similar trend was found when analysis excluded preterm gestations. In conclusion, in this specific low-income Ecuadorian population perinatal outcome was adverse in pregnancies complicated with severe preeclampsia/eclampsia. PMID:26790539

  6. Evaluation of perinatal outcomes in pregnant women with preterm premature rupture of membranes

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    Alex Sandro Rolland Souza

    2016-06-01

    Full Text Available SUMMARY Objective: To determine the association between amniotic fluid index (AFI and perinatal outcomes in preterm premature rupture of membranes (PPROM. Method: A retrospective cohort study was conducted between 2008 and 2012. 86 pregnant women were included, with a diagnosis of PPROM and gestational age from 24 to 35 weeks. Women who presented hypertensive disorders, diabetes, fetuses with birth defects and infection at admission were excluded. To determine the association between AFI and perinatal outcomes, chi-square and Fisher’s exact test were used if necessary, as well as risk ratio (RR and 95% confidence intervals (95CI. Correlation between AFI and perinatal outcomes was determined by using simple linear regression, and AFI progression during pregnancy was analyzed by Z-test. Results: When comparing newborns presenting ultrasound with AFI5cm, there was a higher frequency of perinatal mortality when the AFI was lower than 5 cm. However, when the oligohydramnios was diagnosed as severe (AFI3cm. There was a positive correlation between AFI and gestational age at delivery, birth weight and Apgar scores at minutes 1 and 5. There was also a decrease in amniotic fluid volume with increased gestational age. Conclusion: The presence of severe oligohydramnios after PPROM contributed to a higher frequency of perinatal complications and death.

  7. Social and cultural factors associated with perinatal grief in Chhattisgarh, India.

    Science.gov (United States)

    Roberts, Lisa R; Montgomery, Susanne; Lee, Jerry W; Anderson, Barbara A

    2012-06-01

    Stillbirth is a globally significant public health problem with many medical causes. There are also indirect causal pathways including social and cultural factors which are particularly salient in India's traditional society. The purpose of this study was to explore women's perceptions of stillbirth and to determine how issues of gender and power, social support, coping efforts, and religious beliefs influence perinatal grief outcomes among poor women in rural Chhattisgarh, India. Structured interviews were done face-to-face in 21 randomly selected villages among women of reproductive age (N=355) who had experienced stillbirth (n=178) and compared to those who had not (n=177), in the Christian Hospital, Mungeli catchment area. Perinatal grief was significantly higher among women with a history of stillbirth. Greater perinatal grief was associated with lack of support, maternal agreement with social norms, and younger maternal age. These predictors must be understood in light of an additional finding-distorted sex ratios, which reflect gender discrimination in the context of Indian society. The findings of this study will allow the development of a culturally appropriate health education program which should be designed to increase social support and address social norms, thereby reducing psychological distress to prevent complicated perinatal grief. Perinatal grief is a significant social burden which impacts the health women. PMID:21956647

  8. Validation of Verbal Autopsy in Perinatal Deaths – A Prospective Study in Belgaum District, Karnataka, India

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    Mubashir Angolkar

    2012-01-01

    Full Text Available Background: The first goal of National Rural Health Mission (NRHM and the fourth goal of Millennium Development are to reduce under-five mortality rate. In India, data is available for aprox. 3% of the perinatal deaths. The need for good quality data on perinatal deaths is mandatory for public health planning and resources allocation. This has lead to a renewed interest in Verbal autopsy (VA in poor resource settings. Objective: To validate a simplified community-based VA instrument. Materials and Methods: A simplified community-based VA instrument was developed. The sample size of 50 was calculated at power – 80%, significance – 5% and sensitivity – 70%. ANMs were trained to assign COD according to the ICD – 10. Following which they administered Verbal Autopsies for every perinatal death occurring in their area. A panel of 3 Physicians was formed who reviewed the VA data and assigned cause of death according to the ICD–10. Kappa Statistics was used to measure the degree of agreement between the ANM and Physician panel assigned COD. Results: Out of 50 Perinatal Deaths, the COD assigned by ANM and the COD assigned by the Physician panel were same for 40 of the perinatal deaths, which showed the agreement of 80% [Kappa Statistics = 0.838; P = 0.000 (<0.001] which indicates statistically significant agreement. There was agreement of 93% for 14 Stillbirths and 75% agreement for 36 Early Neonatal Deaths.

  9. Population Attributable Risk Fractions of Maternal Overweight and Obesity for Adverse Perinatal Outcomes.

    Science.gov (United States)

    MacInnis, Natasha; Woolcott, Christy G; McDonald, Sarah; Kuhle, Stefan

    2016-01-01

    The objective of the current study was to determine the proportion of adverse perinatal outcomes that could be potentially prevented if maternal obesity were to be reduced or eliminated (population attributable risk fractions, PARF); and the number needed to treat (NNT) of overweight or obese women to prevent one case of adverse perinatal outcome. Data from the Atlee Perinatal Database on 66,689 singleton infants born in Nova Scotia, Canada, between 2004 and 2014, and their mothers were used. Multivariable-adjusted PARFs and NNTs of maternal pre-pregnancy weight status were determined for various perinatal outcomes under three scenarios: If all overweight and obese women were to i) become normal weight before pregnancy; ii) shift down one weight class; or iii) lose 10% of their body weight, significant relative reductions would be seen for gestational diabetes mellitus (GDM, 57/33/15%), hypertensive disorders of pregnancy (HDP, 26/16/6%), caesarean section (CS, 18/10/3%), and large for gestational age births (LGA, 24/14/3%). The NNT were lowest for the outcomes GDM, induction of labour, CS, and LGA, where they ranged from 13 to 73. The study suggests that a substantial proportion of adverse perinatal outcomes may be preventable through reductions in maternal pre-pregnancy weight. PMID:26961675

  10. The Perinatal Risk Index: Early Risks Experienced by Domestic Adoptees in the United States.

    Science.gov (United States)

    Marceau, Kristine; De Araujo-Greecher, Marielena; Miller, Emily S; Massey, Suena H; Mayes, Linda C; Ganiban, Jody M; Reiss, David; Shaw, Daniel S; Leve, Leslie D; Neiderhiser, Jenae M

    2016-01-01

    We aimed to assess comprehensively the prevalence of perinatal risks experienced by a potentially high-risk yet understudied population of children domestically adopted in the United States. Data are from participant report and medical records from mothers (n = 580) who completed a domestic adoption placement with nonrelatives at or near birth (Mean placement age = 7 days). We describe a comprehensive measure of perinatal risks, including divergences from previous assessment tools and the incorporation of multiple reporters, and report the prevalence of various types of perinatal risks. The prevalence of each specific risk factor was generally low, although several risks were more prevalent in this sample than estimates from nationally representative publicly available data. Nearly the entire sample (99%) experienced some type of risk exposure. Birth mothers who placed their children for adoption domestically in the US experience higher levels of perinatal risks than the national average, but not for all specific types of risk. Thus, the developmental trajectories of children adopted domestically may systematically differ from the general population to the extent that these specific perinatal risks impact development. PMID:27010541

  11. Are all immigrant mothers really at risk of low birth weight and perinatal mortality? The crucial role of socio-economic status

    OpenAIRE

    Racape, Judith; Schoenborn, Claudia; Sow, Mouctar; Alexander, Sophie; De Spiegelaere, Myriam

    2016-01-01

    Background Increasing studies show that immigrants have different perinatal health outcomes compared to native women. Nevertheless, we lack a systematic examination of the combined effects of immigrant status and socioeconomic factors on perinatal outcomes. Our objectives were to analyse national Belgian data to determine 1) whether socioeconomic status (SES) modifies the association between maternal nationality and perinatal outcomes (low birth weight and perinatal mortality); 2) the effect ...

  12. sistema Web con JSP

    Directory of Open Access Journals (Sweden)

    César Viloria Núñez

    2014-01-01

    Full Text Available Este artículo presenta el desarrollo de un sistema de información que permite la adquisición y la administración de información relacionada con los signos vitales como la presión arterial, la frecuencia cardiaca y respiratoria, y la saturación de oxígeno en la sangre de un paciente. La implementación del sistema se basa en una solución Web, permitiendo así que médicos especialistas puedan monitorear a sus pacientes desde cualquier punto conectado a la red en tiempo real y, al mismo tiempo, dar indicaciones críticas al personal médico que se encuentra en el lugar con el paciente.

  13. pacientes con falla cardiaca

    Directory of Open Access Journals (Sweden)

    Diana Marcela Achury Saldaña

    2007-01-01

    Full Text Available Objetivo: determinar la adherencia al tratamiento de pacientes con falla cardiaca hospitalizados, al aplicar un plan educativo quefomenta el autocuidado.Método: estudio cuasiexperimental (entrevistas enfermera-paciente realizado entre diciembre de 2004 y mayo de 2006, con unamuestra de 50 pacientes seleccionados por conveniencia. Se diseñó un instrumento para evaluar los comportamientos de los pacientes,con base en algunos resultados de la adherencia y sus respectivos indicadores de la taxonomía NOC (Nursing out comes classification. Laadherencia al tratamiento fue medida en dos momentos: el primero durante la hospitalización, seguido de la aplicación del plan educativoantes del alta, que proporcionaba información en el manejo de su enfermedad desde una dimensión física, psicológica y social quepromueve el autocuidado; y el segundo un mes después del alta en su domicilio.Resultados: diferencias estadísticamente significativas (P=0,0001 que demuestran cómo mediante la capacitación al paciente enel manejo de su tratamiento farmacológico y no farmacológico, el establecimiento de una sana relación entre el profesional de enfermeríay el paciente, y la participación de la familia, se logra una total adherencia al tratamiento.Conclusiones: para lograr una adherencia total del paciente con falla cardiaca al tratamiento es necesario un proceso educativo y unseguimiento continuo y personalizado que motive permanentemente al paciente y se le reconozca el papel protagónico en su cuidado y manejo de la enfermedad.

  14. Contemos con la publicidad

    OpenAIRE

    Muñoz Santonja, José

    1995-01-01

    En este artículo se presentan algunas propuestas para utilizar la publicidad en clases de Matemáticas, como apoyo didáctico a algunos temas que hay que analizar en el currículum de esta materia a lo largo del curso. Se plantean, al mismo tiempo, una serie de actividades para realizar con la publicidad en el ámbito de la prensa escrita.

  15. Los experimentos con ajusticiados.

    OpenAIRE

    Bert, Paul

    2011-01-01

    Los experimentos realizados con ajusticiados se multiplican y son muy pocos los decapitados que escapan a las investigaciones más o menos preparadas y ejecutadas. Es conveniente indicar a los médicos y también al público lo que puede ser interesante intentar, lo que es inútil y sobretodo lo que no se puede permitir.

  16. Maternal and perinatal risk factors for childhood leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Zack, M.; Adami, H.O.; Ericson, A. (Centers for Disease Control, Atlanta, GA (USA))

    1991-07-15

    This report describes an exploratory population-based study of maternal and perinatal risk factors for childhood leukemia in Sweden. The Swedish National Cancer Registry ascertained 411 cases in successive birth cohorts from 1973 through 1984 recorded in the Swedish Medical Birth Registry. Using the latter, we matched five controls without cancer to each case by sex and month and year of birth. Mothers of children with leukemia were more likely to have been exposed to nitrous oxide anesthesia during delivery than mothers of controls (odds ratio (OR) = 1.3; 95% confidence interval (CI) = 1.0, 1.6). Children with leukemia were more likely than controls to have Down's syndrome (OR = 32.5; 95% CI = 7.3, 144.0) or cleft lip or cleft palate (OR = 5.0; 95% CI = 1.0, 24.8); to have had a diagnosis associated with difficult labor but unspecified complications (OR = 4.5; 95% CI = 1.1, 18.2) or with other conditions of the fetus or newborn (OR = 1.5; 95% CI = 1.1, 2.1), specifically, uncomplicated physiological jaundice (OR = 1.9; 95% CI = 1.2, 2.9); or to have received supplemental oxygen (OR = 2.6; 95% CI = 1.3, 1.3, 4.9). Because multiple potential risk factors were analyzed in this study, future studies need to check these findings. The authors did not confirm the previously reported higher risks for childhood leukemia associated with being male, having a high birth weight, or being born to a woman of advanced maternal age.

  17. Resilience in perinatal HIV+ adolescents in South Africa

    Science.gov (United States)

    Bhana, Arvin; Mellins, Claude A.; Small, Latoya; Nestadt, Danielle F.; Leu, Cheng-Shiun; Petersen, Inge; Machanyangwa, Sphindile; McKay, Mary

    2016-01-01

    ABSTRACT Increasing numbers of perinatally HIV (PHIV+)-infected youth are surviving into adulthood with better access to treatment. However, few studies examine positive outcomes in the face of adversity (resilience) for PHIV+ youth. Social Action Theory (SAT) provided the theoretical framework for this study of PHIV + youth in South Africa (SA), allowing examination of contextual, social, and self-regulatory factors that influence behavioral health. Data were from youth and caregiver baseline interviews, simply pooled from a pilot (N=66) and larger (n=111) randomized control trial (RCT) of the VUKA Family program. For this analysis, outcomes included emotional and behavioral functioning (total difficulties), and prosocial behaviors. Potential SAT correlates included socio-demographics; caregiver health and mental health; parent-child relationship factors; stigma, and child coping, support; and self-esteem. Regression analyses adjusted for age, gender, and study revealed significant associations at the contextual, social, and self-regulation level. Lower total child difficulties scores were associated with lower caregiver depression (β = 3.906,p self-esteem (β = -0.119, p = .020). Greater prosocial behaviors were associated with greater caregiver-reported communication (β = 0.722, p = .020) and child use of wishful thinking for coping (β = 5.532, p = .009). Less youth depression was associated with higher caregiver education (β =−0.399, p = .010), greater caregiver supervision (β = −1.261, p = .012), more social support seeking (β = −0.453, p = .002), higher youth self-esteem (β = −0.067, p self-regulation skills to enhance the health and mental health of PHIV+ youth. PMID:27391999

  18. Resilience in perinatal HIV+ adolescents in South Africa.

    Science.gov (United States)

    Bhana, Arvin; Mellins, Claude A; Small, Latoya; Nestadt, Danielle F; Leu, Cheng-Shiun; Petersen, Inge; Machanyangwa, Sphindile; McKay, Mary

    2016-03-01

    Increasing numbers of perinatally HIV (PHIV+)-infected youth are surviving into adulthood with better access to treatment. However, few studies examine positive outcomes in the face of adversity (resilience) for PHIV+ youth. Social Action Theory (SAT) provided the theoretical framework for this study of PHIV + youth in South Africa (SA), allowing examination of contextual, social, and self-regulatory factors that influence behavioral health. Data were from youth and caregiver baseline interviews, simply pooled from a pilot (N=66) and larger (n=111) randomized control trial (RCT) of the VUKA Family program. For this analysis, outcomes included emotional and behavioral functioning (total difficulties), and prosocial behaviors. Potential SAT correlates included socio-demographics; caregiver health and mental health; parent-child relationship factors; stigma, and child coping, support; and self-esteem. Regression analyses adjusted for age, gender, and study revealed significant associations at the contextual, social, and self-regulation level. Lower total child difficulties scores were associated with lower caregiver depression (β = 3.906,p self-esteem (β = -0.119, p = .020). Greater prosocial behaviors were associated with greater caregiver-reported communication (β = 0.722, p = .020) and child use of wishful thinking for coping (β = 5.532, p = .009). Less youth depression was associated with higher caregiver education (β =-0.399, p = .010), greater caregiver supervision (β = -1.261, p = .012), more social support seeking (β = -0.453, p = .002), higher youth self-esteem (β = -0.067, p self-regulation skills to enhance the health and mental health of PHIV+ youth. PMID:27391999

  19. Long lasting cerebellar alterations after perinatal asphyxia in rats.

    Science.gov (United States)

    Campanille, Verónica; Saraceno, G Ezequiel; Rivière, Stéphanie; Logica, Tamara; Kölliker, Rodolfo; Capani, Francisco; Castilla, Rocío

    2015-07-01

    The developing brain may be particularly vulnerable to injury before, at and after birth. Among possible insults, hypoxia suffered as a consequence of perinatal asphyxia (PA) exhibits the highest incidence levels and the cerebellar circuitry appears to be particularly susceptible, as the cellular makeup and the quantity of inputs change quickly during days and weeks following birth. In this work, we have used a murine model to induce severe global PA in rats at the time of birth. Short-term cerebellar alterations within this PA model have been previously reported but whether such alterations remain in adulthood has not been conclusively determined yet. For this reason, and given the crucial cerebellar role in determining connectivity patterns in the brain, the aim of our work is to unveil long-term cerebellum histomorphology following a PA insult. Morphological and cytological neuronal changes and glial reaction in the cerebellar cortex were analyzed at postnatal 120 (P120) following injury performed at birth. As compared to control, PA animals exhibited: (1) an increase in molecular and granular thickness, both presenting lower cellular density; (2) a disarrayed Purkinje cell layer presenting a higher number of anomalous calbindin-stained cells. (3) focal swelling and marked fragmentation of microtubule-associated protein 2 (MAP-2) in Purkinje cell dendrites and, (4) an increase in glial fibrillary acidic protein (GFAP) expression in Bergmann cells and the granular layer. In conclusion, we demonstrate that PA produces long-term damage in cellular histomorphology in rat cerebellar cortex which could be involved in the pathogenesis of cognitive deficits observed in both animals and humans. PMID:26116983

  20. Trends in fetal and perinatal mortality in the United States, 2006-2012.

    Science.gov (United States)

    Gregory, Elizabeth C W; MacDorman, Marian F; Martin, Joyce A

    2014-11-01

    Total, early, and late fetal mortality rates were generally flat in the United States from 2006 through 2012. Over this same period, fetal mortality rates were also essentially unchanged among each of the three largest race and Hispanic origin groups: non-Hispanic white, non-Hispanic black, and Hispanic women. The perinatal mortality rate declined 4% from 2006 through 2011, a result of a decrease in early neonatal mortality. The perinatal mortality rate fell 8% for non- Hispanic black women; declines among non-Hispanic white and Hispanic women were not statistically significant. The continued decline in the perinatal mortality rate is noteworthy. The rate is down 10% since 2000 (4), and the pace of decline for the most current period, 2006–2011, is consistent with that for 2000–2005. The U.S. fetal mortality rate, however, did not improve during 2006–2012. PMID:25408960

  1. A prospective study of twinning and perinatal mortality in urban Guinea-Bissau

    DEFF Research Database (Denmark)

    Bjerregaard-Andersen, Morten; Lund, Najaaraq; Jepsen, Frida Staarup;

    2012-01-01

    . Data regarding obstetric history and pregnancy were collected at the hospital. Live children were examined clinically. For a subset of twin pairs zygosity was established by using genetic markers. RESULTS: Out of the 5262 births from mothers included in the BHP study area, 94 were twin births, i.e. a.......88-3.57) were borderline non-significant. Sixty-five percent (245/375) of the mothers who delivered at the hospital were unaware of their twin pregnancy. CONCLUSIONS: Twins had a very high perinatal mortality, three-fold higher than singletons. A birth weight <2000g was the strongest risk factor for perinatal...... death, and unrecognized twin pregnancy was common. Urgent interventions are needed to lower perinatal twin mortality in Guinea-Bissau....

  2. Decrease of perinatal mortality associated with congenital anomalies after prenatal screening was introduced in the Netherlands

    DEFF Research Database (Denmark)

    Faber, H. H.; Bouman, K.; Walle, H. E. K.; Haeusler, M.; Garne, E.; Rissmann, A.; O'Mahony, M.; Lynch, C.; McDonnell, M.; Rankin, J.; Pierini, A.; Zurriaga, O.; Addor, M. C.; Tucker, D.; Zymak-Zakutnia, N.; Groen, H.

    OBJECTIVES: There has been much discussion about the relatively high perinatal mortality seen in the Netherlands (Buitendijk 2004, Europeristat 2009), for which congenital anomalies (CA) are known to be one of the four main risk factors. There was no nationwide routine prenatal screening for CA in...... the Netherlands until 2007. We have analysed data for a 14-year period from the EUROCAT registries to investigate the effect of the introduction of screening for CA on the perinatal mortality rate in the Netherlands and compared the results with those from other European registries. METHODS: We used...... from an average of 1.35 per 1000 births in the period 1998-2006 to 1.15 per 1000 births in the period 2007-2011. In the northern Netherlands, it dropped from 1.73 per 1000 births in the period 1998-2006 to 1.00 per 1000 births in the period 2007- 2011. In 2011, the perinatal mortality associated with...

  3. Repeatability of Maternal Report on Prenatal, Perinatal and Early Postnatal Factors

    DEFF Research Database (Denmark)

    Hermann, Diana; Suling, Marc; Reisch, Lucia;

    2011-01-01

    and length, Caesarean (C)-section, week of delivery) and early postnatal factors (exclusive breastfeeding, breastfeeding, introduction of solid food). Intra-class correlation coefficients (ICCs) were calculated to compare maternal reports on prenatal, perinatal and early postnatal factors between the......To investigate the repeatability of maternal self-reported prenatal, perinatal and early postnatal factors within the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study. Design: Data are from the baseline survey of the longitudinal...... cohort study IDEFICS in eight European countries. Subjects: A total of 420 parents from eight countries (43–61 per country) were asked to complete the parental questionnaire (PQ) twice at least 1 month apart. Measurements: The PQ assesses prenatal (maternal weight gain), perinatal (child's birth weight...

  4. STUDY OF AMNIOTIC FLUID INDEX AT THE ONSET OF LABOUR ON PERINATAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Supriya

    2015-01-01

    Full Text Available Aim of the present study is to determine amniotic fluid index in labour and to assess the course of labour, mode of delivery and perinatal outcome in relation to AFI. Objective of the study is the early detection of fetal distress and prevention of neonatal morbidity and mortality. This study was conducted in Department of Obstetrics and Gynecology, Rangaraya Medical College, Kakinada from October, 2011 to October 2013, to evaluate perinatal outcome in relation to AFI with a gestational age between 37 - 42 weeks. AFI was measured and the perinatal o utcome compared between three groups. The cesarean section rate for fetal distress and low birth weight babies, <2.5 kgs was higher in patients with oligohydroamnios. There was a significant difference in meconium staining, APGAR at 1 & 5 mins <7 at the time of birth between three groups. Oligohydroamnios has a significant correlation with cesarean section for fetal distress and low birth weight babies.

  5. Risk factors for perinatal mortality in an urban area of Southern Brazil, 1993 Fatores de risco para mortalidade perinatal em Pelotas, RS, 1993

    Directory of Open Access Journals (Sweden)

    Ana M. B. Menezes

    1998-06-01

    Full Text Available INTRODUCTION: Although there was a considerable reduction in infant mortality in Pelotas, Rio Grande do Sul in the last decade, its perinatal causes were reduced only by 28%. The associated factors of these causes were analised. MATERIAL AND METHOD: All hospital births and perinatal deaths were assessed by daily visits to all the maternity hospitals in the city, throughout 1993 and including the first week of 1994. RESULTS: The perinatal mortality rate was 22.1 per thousand births. The multivariate analysis showed the following risk factors: low socioeconomic level, male sex and maternal age above 35 years . Among multigravidae women, the fetal mortality rate was significantly increased for mothers with a previously low birthweight and a previous stillbirth. For early neonatal mortality the risk was significantly increased by a smaller number of antenatal visits than 5 and low birthweight. CONCLUSIONS: Main risk factors for perinatal mortality: low socioeconomic level, maternal age above 35 years and male sex. For early neonatal mortality the risk was significantly increased by a smaller number of antenatal visits than 5 and low birthweight.INTRODUÇÃO: Apesar de importante redução da mortalidade infantil em Pelotas, RS, na última década, as causas perinatais foram reduzidas em apenas 28%. Analisou-se os principais fatores associados a essas causas. MATERIAL E MÉTODO: Todos os nascimentos hospitalares e óbitos perinatais, em Pelotas, foram acompanhados através de visitas diárias aos hospitais, durante 1993 até a primeira semana de 1994. RESULTADOS: O coeficiente de mortalidade perinatal foi 22,1/1.000 nascimentos. A análise multivariada apontou os seguintes fatores de risco: baixo nível socioeconômico, sexo masculino e idade materna acima de 35 anos. Nas multíparas, encontrou-se maior risco para a mortalidade fetal naquelas que relatavam baixo peso prévio e natimorto prévio. A mortalidade neonatal precoce esteve associada com n

  6. A thematic analysis of factors influencing recruitment to maternal and perinatal trials

    Directory of Open Access Journals (Sweden)

    Middleton Philippa F

    2008-08-01

    Full Text Available Abstract Background Recruitment of eligible participants remains one of the biggest challenges to successful completion of randomised controlled trials (RCTs. Only one third of trials recruit on time, often requiring a lengthy extension to the recruitment period. We identified factors influencing recruitment success and potentially effective recruitment strategies. Methods We searched MEDLINE and EMBASE from 1966 to December Week 2, 2006, the Cochrane Library Methodology Register in December 2006, and hand searched reference lists for studies of any design which focused on recruitment to maternal/perinatal trials, or if no studies of maternal or perinatal research could be identified, other areas of healthcare. Studies of nurses' and midwives' attitudes to research were included as none specifically about trials were located. We synthesised the data narratively, using a basic thematic analysis, with themes derived from the literature and after discussion between the authors. Results Around half of the included papers (29/53 were specific to maternal and perinatal healthcare. Only one study was identified which focused on factors for maternal and perinatal clinicians and only seven studies considered recruitment strategies specific to perinatal research. Themes included: participant assessment of risk; recruitment process; participant understanding of research; patient characteristics; clinician attitudes to research and trials; protocol issues; and institutional or organisational issues. While no reliable evidence base for strategies to enhance recruitment was identified in any of the review studies, four maternal/perinatal primary studies suggest that specialised recruitment staff, mass mailings, physician referrals and strategies targeting minority women may increase recruitment. However these findings may only be applicable to the particular trials and settings studied. Conclusion Although factors reported by both participants and clinicians

  7. Perinatal mortality in rural Burkina Faso: a prospective community-based cohort study

    Directory of Open Access Journals (Sweden)

    Diallo Abdoulaye

    2010-08-01

    Full Text Available Abstract Background There is a scarcity of reliable data on perinatal mortality (PNM in Sub-Saharan Africa. The PROMISE-EBF trial, during which we promoted exclusive breastfeeding, gave us the opportunity to describe the epidemiology of PNM in Banfora Health District, South-West in Burkina Faso. Study objectives To measure the perinatal mortality rate (PNMR in the PROMISE-EBF cohort in Banfora Health District and to identify potential risk factors for perinatal death. Methods We used data collected prospectively during the PROMISE-EBF-trial to estimate the stillbirth rate (SBR and early neonatal mortality rate (ENMR. We used binomial regression with generalized estimating equations to identify potential risk factors for perinatal death. Results 895 pregnant women were enrolled for data collection in the EBF trial and followed-up to 7 days after birth. The PNMR, the SBR and the ENMR, were 79 per 1000 (95% CI: 59-99, 54 per 1000 (95% CI: 38-69 and 27 per 1000 (95% CI: 9-44, respectively. In a multivariable analysis, nulliparous women (RR = 2.90, 95% CI: 1.6-5.0, primiparae mothers (RR = 2.20, 95% CI: 1.2-3.9, twins (RR = 4.0, 95% CI: 2.3-6.9 and giving birth during the dry season (RR = 2.1 95% CI: 1.3-3.3 were factors associated with increased risk of perinatal death. There was no evidence that risk of perinatal death differed between deliveries at home and at a health centre Conclusion Our study observed the highest PNMR ever reported in Burkina. There is an urgent need for sustainable interventions to improve maternal and newborn health in the country.

  8. Meta-analysis to obtain a scale of psychological reaction after perinatal loss: focus on miscarriage

    Directory of Open Access Journals (Sweden)

    Annsofie Adolfsson

    2011-03-01

    Full Text Available Annsofie Adolfsson1,21School of Life Sciences, University of Skövde, 2Department of Obstetrics and Gynecology, Skaraborg Hospital, Skövde, SwedenAbstract: Pregnancy has different meanings to different women depending upon their circumstances. A number of qualitative studies have described the experience of miscarriage by women who had desired to carry their pregnancy to full term. The aim of this meta-analysis was to identify a scale of psychological reaction to miscarriage. Meta-analysis is a quantitative approach for reviewing articles from scientific journals through statistical analysis of findings from individual studies. In this review, a meta-analytic method was used to identify and analyze psychological reactions in women who have suffered a miscarriage. Different reactions to stress associated with the period following miscarriage were identified. The depression reaction had the highest average, weighted, unbiased estimate of effect (d+ = 0.99 and was frequently associated with the experience of perinatal loss. Psychiatric morbidity was found after miscarriage in 27% of cases by a diagnostic interview ten days after miscarriage. The grief reaction had a medium d+ of 0.56 in the studies included. However, grief after miscarriage differed from other types of grief after perinatal loss because the parents had no focus for their grief. The guilt is greater after miscarriage than after other types of perinatal loss. Measurement of the stress reaction and anxiety reaction seems to be difficult in the included studies, as evidenced by a low d+ (0.17 and 0.16, respectively. It has been recommended that grief after perinatal loss be measured by an adapted instrument called the Perinatal Grief Scale Short Version.Keywords: psychological, perinatal loss, pregnancy, depression 

  9. Factors related to main preventable perinatal injuries of public hospital in the Brazilian Federal District.

    Directory of Open Access Journals (Sweden)

    Pamella Padilha BRITO

    2015-02-01

    Full Text Available Introduction: The quality of prenatal care, childbirth and newborn are determinants of perinatal morbidity and mortality. The realization of a adequate prenatal care and skilled birth assistance would reduce the incidence of injuries and perinatal deaths that are largely preventable. Method: Descriptive and exploratory study of quantitative and qualitative nature.  Interview and review of medical records of thirty mothers and newborns were made. The results were chart using the SPSS software, version 20.0, for processing and statistical analysis. We performed thematic analysis of interviews, and tabulated according to their frequencies, identifying the differences and similarities between data. Results: The most frequent perinatal injuries were prematurity (74.2%, Respiratory Distress (71%, Underweight (51.6%, Infection or Sepsis (41.9%, Perinatal Asphyxia (19.4%  and Oligohydramnio (19.4%. These injuries were related to several factors such as inadequate prenatal care, with fewer than six prenatal consultations (70% and late onset (50%, and presence of maternal health problems such as: changes in amniotic fluid (50% and preterm labor (50%. The interviewees added other factors such as failures in the care professional (43%, failures in care and service (33%, difficulty of access (19% and breast self-care failures (16.6%. Conclusion: Stood out in this study the occurrence of perinatal injuries in children of mothers with stable socio-demographic profile and in term newborns as also the percentage of deaths (16.1%. The perinatal injuries and deaths could have been avoided with qualified prenatal care, childbirth and newborn care.

  10. Cerebellar cytokine expression in a rat model for fetal asphyctic preconditioning and perinatal asphyxia

    DEFF Research Database (Denmark)

    Vlassaks, Evi; Brudek, Tomasz; Pakkenberg, Bente; Gavilanes, Antonio W D

    2014-01-01

    effects of perinatal asphyxia and fetal asphyctic preconditioning on the inflammatory cytokine response in the cerebellum. Fetal asphyxia was induced at embryonic day 17 by clamping the uterine vasculature for 30 min. At term birth, global perinatal asphyxia was induced by placing the uterine horns in...... saline for 19 min. Pro- and anti-inflammatory cytokine expression were assessed by real-time PCR and immunohistochemistry in cerebella of newborn rats. We found that tumor necrosis factor alpha and interleukin-10 mRNA were increased 12 h after fetal asphyxia, while the inflammatory cytokine response was...

  11. Birth and perinatal outcomes and complications for babies conceived following ART

    DEFF Research Database (Denmark)

    Henningsen, Anna-Karina Aaris; Pinborg, Anja

    2014-01-01

    Children born after assisted reproductive techniques (ART) have an increased risk of several adverse perinatal outcomes compared with their naturally conceived peers. This has various causes such as higher multiple birth rates, parental characteristics and higher maternal age, with more being...... nulliparous. Furthermore the in-vitro techniques, the controlled ovarian stimulation, culture media, and possibly additional freezing or vitrification procedures seem to play a role. However, when analyzing the perinatal trends over time, the differences between ART and naturally conceived children appear to...

  12. Intimate partner violence among women with eating disorders during the perinatal period

    OpenAIRE

    Kothari, R; Easter, A; Lewis, R; Howard, L.M.; Micali, N

    2015-01-01

    ABSTRACT Objective  Prevalence of intimate partner violence (IPV) during pregnancy is estimated to be 4%–8%. Women with mental health difficulties are at increased risk for IPV during the perinatal period. Prevalence of IPV is high among women with eating disorders (ED); however, prevalence of IPV during the perinatal period among women with ED is unknown. Method  We studied women from a population‐based cohort, the Avon Longitudinal Study of Parents and Children. Prevalence and odds of physi...

  13. Expression and Localization of microRNAs in Perinatal Rat Pancreas

    DEFF Research Database (Denmark)

    Larsen, Louise; Rosenstierne, Maiken Worsøe; Gaarn, Louise Winkel;

    2011-01-01

    OBJECTIVE: To investigate the expression of pancreatic microRNAs (miRNAs) during the period of perinatal beta-cell expansion and maturation in rats, determine the localization of these miRNAs and perform a pathway analysis with predicted target mRNAs expressed in perinatal pancreas. RESEARCH DESIGN...... AND METHODS: RNA was extracted from whole pancreas at embryonic day 20 (E20), on the day of birth (P0) and two days after birth (P2) and hybridized to miRNA microarrays. Differentially expressed miRNAs were verified by northern blotting and their pancreatic localization determined by in situ hybridization...

  14. Perinatal sadness among Shuar women: support for an evolutionary theory of psychic pain.

    Science.gov (United States)

    Hagen, Edward H; Barrett, H Clark

    2007-03-01

    Psychiatry faces an internal contradiction in that it regards mild sadness and low mood as normal emotions, yet when these emotions are directed toward a new infant, it regards them as abnormal. We apply parental investment theory, a widely used framework from evolutionary biology, to maternal perinatal emotions, arguing that negative emotions directed toward a new infant could serve an important evolved function. If so, then under some definitions of psychiatric disorder, these emotions are not disorders. We investigate the applicability of parental investment theory to maternal postpartum emotions among Shuar mothers. Shuar mothers' conceptions of perinatal sadness closely match predictions of parental investment theory. PMID:17405696

  15. Cementos con cenizas volantes

    Directory of Open Access Journals (Sweden)

    Ossa M., Mauricio

    1984-03-01

    additions of 20 and 30% .

    Casi la generalidad de los estudios realizados sobre cementos con adición de cenizas volantes se refieren a sus características y comportamiento en pastas, morteros y hormigones, siempre en relación con aquéllos del cemento portland. Esta vez, se desarrolló un trabajo experimental orientado a relacionar entre sí los cementos con adiciones de cenizas volantes y de puzolana natural. Para ello se fabricaron a escala de laboratorio cementos de ambos tipos, empleando como materias primas comunes clinker y yeso y, como variables, diferentes porcentajes de las dos adiciones, que cumplieron previamente los requisitos normalizados en cuanto a sus actividades puzolánicas. La calidad de los cementos fabricados resultó adecuada y concordante con la del cemento portland-puzolánico obtenido a escala industrial con los mismos clinker, yeso y puzolana natural de este estudio. Posteriormente, se determinaron las características de los cementos experimentales y se confeccionaron morteros normales para la realización de ensayos físicos y mecánicos. Los resultados de ensayos indicaron que los cementos con adición de cenizas volantes (CCV requieren menos agua para consistencia normal, presentan tiempos de fraguado mayores y expansiones en autoclave menores que los cementos con adición de puzolana (CP. Los calores de hidratación a 7 y 28 días de edad fueron aproximadamente similares para ambos tipos de cemento. En morteros normales, los cementos CCV mostraron menor retracción de secado, mayor retentividad y mayor fluidez (para igual cantidad de agua que los cementos CP. En los ensayos de exudación se observó que ésta depende más de la finura que el tipo de adición. Finalmente, los ensayos mecánicos señalaron que las resistencias a compresión y flexotracción de los morteros con cementos CCV son menores a edades inferiores que 14 días (del orden de 5 a 10% a un día de edad, pero que a partir de entonces pasan a ser mayores que las de

  16. Funciones con Microsoft Excel

    OpenAIRE

    Castillo, Dalia Imelda; Estrada, Ana Luisa; Hernández, Brenda Amalia

    2009-01-01

    En este documento se presenta el desarrollo de algunas actividades que se trabajaron con estudiantes de primer semestre de la Universidad Autónoma de Nayarit; utilizando la hoja de cálculo Excel en el tema de visualización de funciones, para la materia de lenguaje y pensamiento matemático. Ya que la tecnología ha adquirido un papel muy importante en el proceso enseñanza-aprendizaje, nos ofrece un medio para que el estudiante explore, analice, verifique y desarrolle habilidades que se serán út...

  17. Creo con mis dedos

    OpenAIRE

    S??nchez Aniceto, Monta??a

    2015-01-01

    Las artes pl??sticas son muy importantes para los ni??os/as sobre todo para Educaci??n Infantil ya que promueven la creatividad mediante diferentes recursos y t??cnicas lo que favorece su motivaci??n en las competencias desde la edad temprana hasta la adolescencia. Es la primera forma que tiene el ni??o/a de expresarse en el mundo (a trav??s de los garabatos), de comunicarse, compartir sus emociones con los dem??s, creando su propio lenguaje que evolucionar?? hacia el lenguaje oral y escri...

  18. Historia editorial con moraleja

    Directory of Open Access Journals (Sweden)

    José Luis de Diego

    2012-06-01

    Full Text Available Cuando lo conocí, R. ya tendría cuarenta. Un hombre de esos con el pelo como un cepillo, que anda bronceado todo el año, que ostenta ropa de marca y que cuando entra a un boliche estira el cogote, ansioso por conocer a alguien y que otros lo reconozcan a él. Había hecho una buena carrera en Económicas y la influencia decisiva de un profesor le dio la oportunidad de hacer un posgrado en el exterior en algo que llaman Business Process Management, y que ignoro prolijamente qué diablos es, pero c...

  19. Eugenistas, pero con prudencia

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    Pogliano, Claudio

    1999-12-01

    Full Text Available Thinking that one could not describe eugenics like a unique movement, since numerous bound varians took place related to the geographical and cultural context, this article tries to demostrate the peculiarity of the Italian case. If already in 1889 Giuseppe Sergi wanted that the artificial selection take it to end what should make the natural, avoiding the risk of the so called «degeneration», only in the face of the First World War seems to grow the alarm for the decadent quality of the population, finding a more and more wide echo. In 1919 the Siges was born (Società italiana de genetica ed eugenica shocked under the impression of the difusse fear about the butcher the war had caused. From there from now on fastens a «nazional» direction closely related to the traditional thought and also with the new political temper. A «moderate» direction, Fascist, Catholic, that was built in consonance with the pronatalism of the regime and in rough polemic with the presumed Anglo-Saxon eugenics aberration.

    Partiendo de la base de que no se puede describir la eugénica como un movimiento unitario, ya que se produjeron numerosas variantes ligadas al contexto geográfico y cultural, este artículo intenta demostrar la peculiaridad del caso italiano. Si ya en 1889 Giuseppe Sergi deseaba que la selección artificial llevase a cabo lo que debía de hacer la natural, evitando así el riesgo de la «degeneración », sólo ante la Primera Guerra Mundial parece crecer la alarma por la decadente calidad de la población, encontrando un eco cada vez más amplio. En 1919 nació la Sige (Società italiana de genetica ed eugenica bajo la impresión del difuso temor que la carnicería bélica había provocado. De ahí en adelante prende rápidamente una dirección «nazional» que se imbrica tanto con una tradición del pensamiento como con el nuevo temple político. Una dirección «moderada» fascista, católica, que se construyó en consonancia con el

  20. con problemas de aprendizaje

    Directory of Open Access Journals (Sweden)

    Claudia Jaquelina González Trujillo

    2007-01-01

    Full Text Available Un grupo de niños con diversos problemas de aprendizaje fue atendido bajo un programa de intervención de integración y adaptación social. Mejoras importantes se obtienen en competencias académicas bajo el presente programa de intervención y delimitan áreas de oportunidad para la mejora en aspectos cognitivos como el del proceso de atención e integración social. Las implicaciones de los resultados se discuten bajo un programa de apoyo psicopedagógico para la educación especial.

  1. Mayonesa con quitosano

    OpenAIRE

    Gaffrey, María Celeste

    2014-01-01

    Introducción: El quitosano es un polímero natural que se obtiene a partir de la quitina, la cual forma parte de la estructura de soporte de numerosos organismos vivos, tales como artrópodos (crustáceos e insectos), moluscos y hongos. Presenta propiedades aplicables en los alimentos, como estabilizante, emulsificante, y quelante. No puede ser digerido por los seres humanos por lo cual está considerado como una fibra dietética con un contenido calórico cero. Objetivos: Evaluar...

  2. Arquitectura con discurso

    OpenAIRE

    Schaposnik, Viviana

    2001-01-01

    En particular a la Carrera Arquitectura le compete un doble rol social: uno general, "educar" desde la Universidad y otro, específico, el que le es propio: dar respuesta a las necesidades planteadas por la sociedad haciéndole su lugar: construyéndolo junto con ella. Aparece la figura del "alumno de arquitectura"' nuestro destinatario específico. El alumno de arquitectura, también deberá tomar conciencia, entender, que el "espacio" que él deberá dominar a través de su proyecto, le ser...

  3. Conversando con... BENEDETTA TAGLIABUE

    OpenAIRE

    Torres, Ana; Cabanes, Miguel

    2011-01-01

    Esta entrevista se realiza en el marco del XIII Congreso Internacional de Expresión Gráfica Arquitectónica realizado en la Escuela Técnica Superior de Arquitectura de Valencia los días 27 al 30 de Mayo de 2010.Benedetta Tagliabue es, en la actualidad, una de las arquitectas con mayor prestigio en el panorama internacional. El Pabellón de España para la Expo de Shanghai 2010, es una de sus últimas obras más representativas, en el que se acentúa y desarrolla un conjunto de características arqui...

  4. Con-tacto

    OpenAIRE

    Arietti, María Luz; Baeza, María Elena; Enriori, Adriana Amalia

    2009-01-01

    Proyecto de Educación Sexual con modalidad de Taller realizado en todos los años de la Escuela Normal “R.J.Cárcano” de Monte Caseros Corrientes, durante el ciclo lectivo 2008. Áreas: Ciencias Naturales, Educación Física, Artística y Matemática. Se realizó el diagnóstico a partir de una encuesta anónima e individual, para trabajar preconceptos sobre Educación sexual que nos permite indagar las ideas previas y representaciones que los alumnos poseen sobre pubertad, desarrollo, caracteres sec...

  5. Pulsaciones con ondas sonoras

    OpenAIRE

    Beléndez Vázquez, Augusto; Álvarez López, Mariela Lázara; Beléndez Vázquez, Tarsicio; Bernabeu Pastor, José Guillermo; Bleda Pérez, Sergio; Calzado Estepa, Eva María; Campo Bagatín, Adriano; Dale Valdivia, Roberto; Durá Domenech, Antonio; Fernández Varó, Elena; Gallego Rico, Sergi; Hernández Prados, Antonio; Marco Tobarra, Amparo; Márquez Ruiz, Andrés; Martín García, Agapito

    2010-01-01

    El objetivo de esta práctica es la demostración del efecto de interferencia que se produce al superponerse varias ondas sonoras. Para ello se emplearán dos diapasones con sus cajas de resonancia, un martillo, un micrófono y un ordenador. Los diapasones nos servirán para crear dos señales sonoras de dos únicas frecuencias. El martillo se empleará para golpear los diapasones y así hacerlos vibrar. El micrófono lo emplearemos para captar el sonido generado por los diapasones e introducirlo en el...

  6. Perinatal Mortality Magnitude, Determinants and Causes in West Gojam: Population-Based Nested Case-Control Study

    Science.gov (United States)

    Yirgu, Robel; Molla, Mitike; Sibley, Lynn; Gebremariam, Abebe

    2016-01-01

    Introduction In Ethiopia, even if a significant reduction in child mortality is recorded recently, perinatal mortality rate is still very high. This study assessed the magnitude, determinants and causes of perinatal death in West Gojam zone, Ethiopia. Methods and materials A nested case control study was conducted on 102 cases (mothers who lost their newborns for perinatal death) and 204 controls (mothers who had live infants in the same year) among a cohort of 4097 pregnant mothers in three districts of the West Gojam zone, from Feb 2011 to Mar 2012. Logistic regression models were used to identify the independent determinant factors for perinatal mortality. The World Health Organization verbal autopsy instrument for neonatal death was used to collect mortality data and cause of death was assigned by a pediatrician and a neonatologist. Result Perinatal mortality rate was 25.1(95% CI 20.3, 29.9) per 1000 live and stillbirths. Primiparous mothers had a higher risk of losing their newborn babies for perinatal death than mothers who gave birth to five or more children (AOR = 3.15, 95% CI 1.03–9.60). Babies who were born to women who had a previous history of losing their baby to perinatal death during their last pregnancy showed higher odds of perinatal death than their counterparts (AOR = 9.55, 95% CI 4.67–19.54). Preterm newborns were more at risk for perinatal death (AOR = 9.44, 95%CI 1.81–49.22) than term babies. Newborns who were born among a household of more than two had a lesser risk of dying during the perinatal period as compared to those who were born among a member of only two. Paradoxically, home delivery was found to protect against perinatal death (AOR = 0.07 95% CI, 0.02–0.24) in comparison to institutional delivery. Bacterial sepsis, birth asphyxia and obstructed labour were among the leading causes of perinatal death. Conclusion Perinatal mortality rate remains considerably high, but proper maternal and child health care services can

  7. Perinatal Guidelina - Book of Neurosurgery. Major Nurological Syndromes

    Directory of Open Access Journals (Sweden)

    Salcedo-Ramos Francisco

    2010-12-01

    Full Text Available GUIA PERINATALEn el prologo el doctor Antonio Soto Yances profesor titular de la Universidad de Cartagena dijo: “Libro con variedad de temas de la Obstetricia y la perinatología, escritos por profesionales locales en su mayoría miembros del departamento de Obstetricia y Ginecología de la Universidad de Cartagena y por reconocidos autores nacionales e internacionales de amplia trayectoria académica y científica en nuestra especialidad”. “En el ejercicio actual de la medicina moderna, para nadie es desconocido que la Gineco-Obstetricia y enespecial la perinatología representan los más grandes e importantes conocimientos que han permitido conocer y valorar las condiciones de vida intrauterina que apoyados en los cada vez mayores métodos tecnológicos, redundad en la calidad de vida materna mediante un control prenatal adecuado y la obtención de un recién nacido vivo y sano. Por lo anterior consideramos que lo importante y meritorio de este libro, lo constituye el esfuerzo y la dedicación de los doctores, Salcedo, Rodríguez y Borre quienes venciendo los obstáculos comunes de nuestro medio, han logrado plasmar en la realidad temas de gran importancia didáctica y científica con el interés de transmitir a los estudiantes, especialistas y al cuerpo médico en general, en forma por demás positiva y trascendental, que sin duda alguna tendrá una amplia acogida y quedara como constancia del tesón, la capacidad y la perseverancia que servirán de ejemplo y justo premio a su brillante labor. Finalmente felicitar con paternal sinceridad a los doctores, Salcedo, Rodríguez y Borre y resaltar la invaluable colaboración de todos y cada uno de los que participaron en esta obra”GRANDES SINDROMES NEUROLÓGICOSVoluminoso libro de texto que Contiene una exposición detallada en las diferentes partes del cerebro, así como de las diferentes patologías que afectan a este órgano. El libro aborda con detenimiento tanto la anatom

  8. Entrevista con Geoffrey Lloyd.

    Directory of Open Access Journals (Sweden)

    Fernando Colina Pérez

    2008-01-01

    Full Text Available Helenista y también sinólogo de relieve internacional, Geoffrey E. R. Lloyd nació en Londres (1933, de padres galeses. Es un gran historiador de la ciencia y del pensamiento griegos. En 1940 fue evacuado de Londres con su madre. Sus estudios significativos comenzaron, tras algún rodeo, en el King’s College donde estudiaba su hermano. Éste sería, como su padre, médico, y él mismo dudó en estudiar esa profesión, que late en sus libros. Pero un profesor de clásicas como John Raven –que redactó, con Geoffrey Kirk, Los filósofos presocráticos–, le indujo a ocuparse de la filosofía antigua; y otro maestro, William Guthrie –a quien debemos la gran Historia de la filosofía griega–, le inició, además, en la medicina griega.

  9. Congenital adrenal hyperplasia: Clinical characteristics and genotype in newborn, childhood and adolescence Hiperplasia suprarrenal congénita: Características clínicas, seguimiento y genotipo en la etapa perinatal, la niñez y la adolescencia

    Directory of Open Access Journals (Sweden)

    Titania Pasqualini

    2007-06-01

    Full Text Available Congenital adrenal hyperplasia (CAH due to 21-hydroxylase deficiency is a disorder which can adopt three clinical expressions: two classical forms -salt-wasting (SW, with residual enzymatic activity (EA La hiperplasia suprarrenal congénita por déficit de 21-hidroxilasa presenta tres formas clínicas: dos clásicas, perdedora de sal, con actividad enzimática (AE < 1% y virilizante simple, con AE 1-2% y una no clásica, con AE 10-60%. Nuestro objetivo es describir las características clínicas y el genotipo de un grupo de pacientes con hiperplasia suprarrenal congénita; este último también se determinó en todos los miembros de la familia. Se estudiaron 9 pacientes diagnosticados en la etapa perinatal y 8 durante la etapa pre y postpuberal. Se analizaron diez mutaciones en el gen CYP21A2 y se evaluó crecimiento y densidad mineral ósea. Once pacientes presentaron la forma clásica: 9 con diagnóstico perinatal y 2 diagnosticados más tardíamente, uno de ellos con agrandamiento testicular por restos adrenales. Todos los pacientes, salvo 1 con una mutación de novo R356W en un alelo, presentaron ambos alelos mutados con un genotipo que predice AE < 2%. Seis pacientes presentaron la forma no clásica, todos con signos clínicos de hiperandrogenismo salvo un familiar asintomático que se diagnosticó por el estudio molecular. Todos, a excepción de uno con un alelo aún no determinado, presentaron la mutación V281L acompañada de otra que predice AE < 2%. Durante la evolución de los pacientes de diagnóstico perinatal se observó talla baja al año con recuperación de la misma en la etapa prepuberal. La densidad mineral ósea fue normal. Podemos concluir que el diagnóstico en la etapa perinatal en pacientes con la forma clásica posibilita un mejor seguimiento y crecimiento. La genotipificación de todos los miembros de una familia permite el diagnóstico de formas asintomáticas. La presencia de mutaciones de novo y de un alelo con una

  10. Women's Use of Multi sector Mental Health Services in a Community-Based Perinatal Depression Program

    Science.gov (United States)

    Price, Sarah Kye

    2010-01-01

    Low-income and ethnic minority women have been described as at risk for experiencing depression during and around the time of pregnancy, a finding complicated by low levels of mental health service use within this population. This study retrospectively examined data from a community-based perinatal depression project targeting low-income women in…

  11. Perinatal inflammation: a common factor in the early origins of cardiovascular disease?

    Science.gov (United States)

    Nguyen, Maria U; Wallace, Megan J; Pepe, Salvatore; Menheniott, Trevelyan R; Moss, Timothy J; Burgner, David

    2015-10-01

    Cardiovascular disease continues to be the leading cause of global morbidity and mortality. Traditional risk factors account for only part of the attributable risk. The origins of atherosclerosis are in early life, a potential albeit largely unrecognized window of opportunity for early detection and treatment of subclinical cardiovascular disease. There are robust epidemiological data indicating that poor intrauterine growth and/or prematurity, and perinatal factors such as maternal hypercholesterolaemia, smoking, diabetes and obesity, are associated with adverse cardiovascular intermediate phenotypes in childhood and adulthood. Many of these early-life risk factors result in a heightened inflammatory state. Inflammation is a central mechanism in the development of atherosclerosis and cardiovascular disease, but few studies have investigated the role of overt perinatal infection and inflammation (chorioamnionitis) as a potential contributor to cardiovascular risk. Limited evidence from human and experimental models suggests an association between chorioamnionitis and cardiac and vascular dysfunction. Early life inflammatory events may be an important mechanism in the early development of cardiovascular risk and may provide insights into the associations between perinatal factors and adult cardiovascular disease. This review aims to summarise current data on the early life origins of atherosclerosis and cardiovascular disease, with particular focus on perinatal inflammation. PMID:26223841

  12. Mothers' Perceptions of Benefits of Perinatal Loss Support Offered at a Major University Hospital

    OpenAIRE

    Sanchez, Nancy Anne

    2001-01-01

    This qualitative research investigated the perception of mothers regarding hospital support after perinatal loss. Twelve in-depth interviews demonstrated that the mothers recalled the circumstances of the loss. Most identified the hospital's support services and made comments on aspects of hospital support as influential in grief recovery. Most interviewees considered themselves somewhat recovered from the loss.

  13. Neutralizing antibodies to hepatitis C virus in perinatally infected children followed up prospectively

    DEFF Research Database (Denmark)

    Meunier, Jean-Christophe; Bukh, Jens; Diaz, Giacomo;

    2011-01-01

    Little is known about the presence and role of neutralizing antibodies (NtAbs) in perinatal hepatitis C virus (HCV) infection. Using HCV pseudoparticles, NtAbs were studied longitudinally in 12 HCV-infected children with or without evidence of acute hepatitis during the first year of life. Broadly...

  14. Impact of Prematurity and Perinatal Antibiotics on the Developing Intestinal Microbiota: A Functional Inference Study

    Directory of Open Access Journals (Sweden)

    Silvia Arboleya

    2016-04-01

    Full Text Available Background: The microbial colonization of the neonatal gut provides a critical stimulus for normal maturation and development. This process of early microbiota establishment, known to be affected by several factors, constitutes an important determinant for later health. Methods: We studied the establishment of the microbiota in preterm and full-term infants and the impact of perinatal antibiotics upon this process in premature babies. To this end, 16S rRNA gene sequence-based microbiota assessment was performed at phylum level and functional inference analyses were conducted. Moreover, the levels of the main intestinal microbial metabolites, the short-chain fatty acids (SCFA acetate, propionate and butyrate, were measured by Gas-Chromatography Flame ionization/Mass spectrometry detection. Results: Prematurity affects microbiota composition at phylum level, leading to increases of Proteobacteria and reduction of other intestinal microorganisms. Perinatal antibiotic use further affected the microbiota of the preterm infant. These changes involved a concomitant alteration in the levels of intestinal SCFA. Moreover, functional inference analyses allowed for identifying metabolic pathways potentially affected by prematurity and perinatal antibiotics use. Conclusion: A deficiency or delay in the establishment of normal microbiota function seems to be present in preterm infants. Perinatal antibiotic use, such as intrapartum prophylaxis, affected the early life microbiota establishment in preterm newborns, which may have consequences for later health.

  15. Why do singletons conceived after assisted reproduction technology have adverse perinatal outcome?

    DEFF Research Database (Denmark)

    Pinborg, A; Wennerholm, U B; Romundstad, L B; Loft, A; Aittomaki, K; Söderström-Anttila, V; Nygren, K G; Hazekamp, J; Bergh, C

    2013-01-01

    Assisted reproduction technology (ART) is used worldwide, at increasing rates, and data show that some adverse outcomes occur more frequently than following spontaneous conception (SC). Possible explanatory factors for the well-known adverse perinatal outcome in ART singletons were evaluated....

  16. Prenatal, Perinatal, and Neonatal Risk Factors for Specific Language Impairment: A Prospective Pregnancy Cohort Study

    Science.gov (United States)

    Whitehouse, Andrew J. O.; Shelton, W. M. R.; Ing, Caleb; Newnham, John P.

    2014-01-01

    Purpose: Although genetic factors are known to play a causal role in specific language impairment (SLI), environmental factors may also be important. This study examined whether there are prenatal, perinatal, and neonatal factors that are associated with childhood SLI. Method: Participants were members of the Raine Study, a prospective cohort…

  17. The Influence of Perinatal Complications and Environmental Adversity on Boys' Antisocial Behavior

    Science.gov (United States)

    Beck, Joy E.; Shaw, Daniel S.

    2005-01-01

    Background: The purpose of the present study was to test components of Raine's (2002) biosocial model, specifically the interactive effects of perinatal complications, rejecting parenting, and family adversity on the development of early-onset antisocial behavior (ASB). Boys' internalizing problems were also tested to investigate the specificity…

  18. Early Gesture Predicts Language Delay in Children with Pre- Or Perinatal Brain Lesions

    Science.gov (United States)

    Sauer, Eve; Levine, Susan C.; Goldin-Meadow, Susan

    2010-01-01

    Does early gesture use predict later productive and receptive vocabulary in children with pre- or perinatal unilateral brain lesions (PL)? Eleven children with PL were categorized into 2 groups based on whether their gesture at 18 months was within or below the range of typically developing (TD) children. Children with PL whose gesture was within…

  19. Perinatal and chronic hypothyroidism impair behavioural development in male and female rats.

    NARCIS (Netherlands)

    Wijk, van N.; Rijntjes, E.; Heijning, van de B.J.

    2008-01-01

    Perinatal and chronic hypothyroidism impair behavioural development in male and female rats. EXP PHYSIOL 00(0) 000-000, 0000. - A lack of thyroid hormone, i.e. hypothyroidism, during early development results in multiple morphological and functional alterations in the developing brain. In the presen

  20. Epilepsy in Hemiplegic Cerebral Palsy Due to Perinatal Arterial Ischaemic Stroke

    Science.gov (United States)

    Wanigasinghe, Jithangi; Reid, Susan M.; Mackay, Mark T.; Reddihough, Dinah S.; Harvey, A. Simon; Freeman, Jeremy L.

    2010-01-01

    Aim: The aim of this study was to describe the frequency, risk factors, manifestations, and outcome of epilepsy in children with hemiplegic cerebral palsy (CP) due to perinatal arterial ischaemic stroke (AIS). Method: The study group comprised 63 participants (41 males, 22 females) from a population-based CP register whose brain imaging showed…

  1. A prospective study of twinning and perinatal mortality in urban Guinea-Bissau

    Directory of Open Access Journals (Sweden)

    Bjerregaard-Andersen Morten

    2012-12-01

    Full Text Available Abstract Background Despite twinning being common in Africa, few prospective twin studies have been conducted. We studied twinning rate, perinatal mortality and the clinical characteristics of newborn twins in urban Guinea-Bissau. Methods The study was conducted at the Bandim Health Project (BHP, a health and demographic surveillance site in Bissau, the capital of Guinea-Bissau. The cohort included all newborn twins delivered at the National Hospital Simão Mendes and in the BHP study area during the period September 2009 to August 2011 as well as singleton controls from the BHP study area. Data regarding obstetric history and pregnancy were collected at the hospital. Live children were examined clinically. For a subset of twin pairs zygosity was established by using genetic markers. Results Out of the 5262 births from mothers included in the BHP study area, 94 were twin births, i.e. a community twinning rate of 18/1000. The monozygotic rate was 3.4/1000. Perinatal mortality among twins vs. singletons was 218/1000 vs. 80/1000 (RR = 2.71, 95% CI: 1.93-3.80. Among the 13783 hospital births 388 were twin births (28/1000. The hospital perinatal twin mortality was 237/1000. Birth weight  Conclusions Twins had a very high perinatal mortality, three-fold higher than singletons. A birth weight 

  2. Prenatal, Perinatal and Neonatal Risk Factors for Intellectual Disability: A Systemic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Jichong Huang

    Full Text Available The etiology of non-genetic intellectual disability (ID is not fully known, and we aimed to identify the prenatal, perinatal and neonatal risk factors for ID.PubMed and Embase databases were searched for studies that examined the association between pre-, peri- and neonatal factors and ID risk (keywords "intellectual disability" or "mental retardation" or "ID" or "MR" in combination with "prenatal" or "pregnancy" or "obstetric" or "perinatal" or "neonatal". The last search was updated on September 15, 2015. Summary effect estimates (pooled odds ratios were calculated for each risk factor using random effects models, with tests for heterogeneity and publication bias.Seventeen studies with 55,344 patients and 5,723,749 control individuals were eligible for inclusion in our analysis, and 16 potential risk factors were analyzed. Ten prenatal factors (advanced maternal age, maternal black race, low maternal education, third or more parity, maternal alcohol use, maternal tobacco use, maternal diabetes, maternal hypertension, maternal epilepsy and maternal asthma, one perinatal factor (preterm birth and two neonatal factors (male sex and low birth weight were significantly associated with increased risk of ID.This systemic review and meta-analysis provides a comprehensive evidence-based assessment of the risk factors for ID. Future studies are encouraged to focus on perinatal and neonatal risk factors and the combined effects of multiple factors.

  3. Maternal and perinatal outcomes of dengue in PortSudan, Eastern Sudan

    Directory of Open Access Journals (Sweden)

    Elbashir Hagir M

    2010-07-01

    Full Text Available Abstract Aim To investigate maternal and perinatal outcomes (maternal death, preterm delivery, low birth weight and perinatal mortality of dengue at PortSudan and Elmawani hospitals in the eastern Sudan. Method This was a retrospective Cohort study where medical files of women with dengue were reviewed. Results There were 10820 deliveries and 78 (0.7% pregnant women with confirmed dengue IgM serology at the mean (SD gestational age of 29.4(8.2 weeks. While the majority of these women had dengue fever (46, 58.9%, hemorrhagic fever and dengue shock syndrome were the presentations in 18 (23.0% and 12, (15.3% of these women, respectively. There were 17(21.7% maternal deaths. Fourteen (17.9% of these 78 women had preterm deliveries and 19 (24.3% neonates were admitted to neonatal intensive care unit. Nineteen (24.3% women gave birth to low birth weight babies. There were seven (8.9% perinatal deaths. Eight (10.2% patients delivered by caesarean section due to various obstetrical indications. Conclusion Thus dengue has poor maternal and perinatal outcomes in this setting. Preventive measures against dengue should be employed in the region, and more research on dengue during pregnancy is needed.

  4. Reaching perinatal women online: the Healthy You, Healthy Baby website and app.

    Science.gov (United States)

    Hearn, Lydia; Miller, Margaret; Lester, Leanne

    2014-01-01

    Overwhelming evidence reveals the close link between unwarranted weight gain among childbearing women and childhood adiposity. Yet current barriers limit the capacity of perinatal health care providers (PHCPs) to offer healthy lifestyle counselling. In response, today's Internet savvy women are turning to online resources to access health information, with the potential of revolutionising health services by enabling PHCPs to guide women to appropriate online resources. This paper presents the findings of a project designed to develop an online resource to promote healthy lifestyles during the perinatal period. The methodology involved focus groups and interviews with perinatal women and PHCPs to determine what online information was needed, in what form, and how best it should be presented. The outcome was the development of the Healthy You, Healthy Baby website and smartphone app. This clinically-endorsed, interactive online resource provides perinatal women with a personalised tool to track their weight, diet, physical activity, emotional wellbeing, and sleep patterns based on the developmental stage of their child with links to quality-assured information. One year since the launch of the online resource, data indicates it provides a low-cost intervention delivered across most geographic and socioeconomic strata without additional demands on health service staff. PMID:24872891

  5. Development and Preliminary Evaluation of a Cognitive-Behavioral Intervention for Perinatal Grief

    Science.gov (United States)

    Bennett, Shannon M.; Ehrenreich-May, Jill; Litz, Brett T.; Boisseau, Christina L.; Barlow, David H.

    2012-01-01

    Perinatal loss, typically defined as fetal death beyond 20 weeks gestation through infant death 1-month postpartum, is a potentially traumatizing experience for parents occurring in approximately 1% of births in the United States. Although many women recover, 15% to 25% have enduring grief-related symptomatology and functional impairment.…

  6. Measuring Grief Following Miscarriage: Psychometric Properties of the Chinese Version of the Perinatal Grief Scale

    Science.gov (United States)

    Lai, Beatrice P. Y.; Chung, Tony K. H.; Lee, Dominic T. S.; Kong, Grace W. S.; Lok, Ingrid H.

    2013-01-01

    Grief following miscarriage is a complex psychological response. This study was conducted to examine the psychometric properties of the Chinese version of the Perinatal Grief Scale (PGS). A total of 280 Chinese women completed the PGS immediately following a diagnosis of miscarriage (baseline) and were reassessed at 12 months follow-up. The factor…

  7. Plasticity in the Developing Brain: Intellectual, Language and Academic Functions in Children with Ischaemic Perinatal Stroke

    Science.gov (United States)

    Ballantyne, Angela O.; Spilkin, Amy M.; Hesselink, John; Trauner, Doris A.

    2008-01-01

    The developing brain has the capacity for a great deal of plasticity. A number of investigators have demonstrated that intellectual and language skills may be in the normal range in children following unilateral perinatal stroke. Questions have been raised, however, about whether these skills can be maintained at the same level as the brain…

  8. Sexual and Drug Use Behavior in Perinatal HIV-Infected Youth: Mental Health and Family Influences

    Science.gov (United States)

    Mellins, Claude A.; Elkington, Katherine S.; Brackis-Cott, Elizabeth; Bauermeister, Jose A.; Dolezal, Curtis; McKay, Mary; Wiznia, Andrew; Bamji, Mahrukh; Abrams, Elaine J.

    2009-01-01

    A study found that youth and caregiver mental health problem have greater impact than key environmental factors and family functioning on sex and drug use risk behaviors in perinatally human immunodeficiency virus (HIV)-infected (PHIV+) and PHIV- youths. No differences in the rates of sexual risk behavior and substance use were observed between…

  9. Tobacco control policies and perinatal health: a national quasi-experimental study.

    Science.gov (United States)

    Peelen, Myrthe J; Sheikh, Aziz; Kok, Marjolein; Hajenius, Petra; Zimmermann, Luc J; Kramer, Boris W; Hukkelhoven, Chantal W; Reiss, Irwin K; Mol, Ben W; Been, Jasper V

    2016-01-01

    We investigated whether changes in perinatal outcomes occurred following introduction of key tobacco control policies in the Netherlands: smoke-free legislation in workplaces plus a tobacco tax increase and mass media campaign (January-February 2004); and extension of the smoke-free law to the hospitality industry, accompanied by another tax increase and mass media campaign (July 2008). This was a national quasi-experimental study using Netherlands Perinatal Registry data (2000-2011; registration: ClinicalTrials.gov NCT02189265). Primary outcome measures were: perinatal mortality, preterm birth, and being small-for-gestational age (SGA). The association with timing of the tobacco control policies was investigated using interrupted time series logistic regression analyses with adjustment for confounders. Among 2,069,695 singleton births, there were 13,027 (0.6%) perinatal deaths, 116,043 (5.6%) preterm live-births and 187,966 (9.1%) SGA live-births. The 2004 policies were not associated with significant changes in the odds of developing any of the primary outcomes. After the 2008 policy change, a -4.4% (95% CI -2.4; -6.4, p law to bars and restaurants in conjunction with a tax increase and mass media campaign. PMID:27103591

  10. Therapeutic Hypothermia Modifies Perinatal Asphyxia-Induced Changes of the Corpus Callosum and Outcome in Neonates

    NARCIS (Netherlands)

    Alderliesten, Thomas; de Vries, Linda S.; Khalil, Yara; van Haastert, Ingrid C.; Benders, Manon J. N. L.; Koopman-Esseboom, Corine; Groenendaal, Floris

    2015-01-01

    What Is Known about this Subject? Diffusion-weighted MRI has demonstrated changes in the corpus callosum of term neonates with perinatal asphyxia. The severity of cerebral changes demonstrated using diffusion-weighted MRI is difficult to assess without measuring values of the Apparent Diffusion Coef

  11. Impact of Prematurity and Perinatal Antibiotics on the Developing Intestinal Microbiota: A Functional Inference Study

    Science.gov (United States)

    Arboleya, Silvia; Sánchez, Borja; Solís, Gonzalo; Fernández, Nuria; Suárez, Marta; Hernández-Barranco, Ana M.; Milani, Christian; Margolles, Abelardo; de los Reyes-Gavilán, Clara G.; Ventura, Marco; Gueimonde, Miguel

    2016-01-01

    Background: The microbial colonization of the neonatal gut provides a critical stimulus for normal maturation and development. This process of early microbiota establishment, known to be affected by several factors, constitutes an important determinant for later health. Methods: We studied the establishment of the microbiota in preterm and full-term infants and the impact of perinatal antibiotics upon this process in premature babies. To this end, 16S rRNA gene sequence-based microbiota assessment was performed at phylum level and functional inference analyses were conducted. Moreover, the levels of the main intestinal microbial metabolites, the short-chain fatty acids (SCFA) acetate, propionate and butyrate, were measured by Gas-Chromatography Flame ionization/Mass spectrometry detection. Results: Prematurity affects microbiota composition at phylum level, leading to increases of Proteobacteria and reduction of other intestinal microorganisms. Perinatal antibiotic use further affected the microbiota of the preterm infant. These changes involved a concomitant alteration in the levels of intestinal SCFA. Moreover, functional inference analyses allowed for identifying metabolic pathways potentially affected by prematurity and perinatal antibiotics use. Conclusion: A deficiency or delay in the establishment of normal microbiota function seems to be present in preterm infants. Perinatal antibiotic use, such as intrapartum prophylaxis, affected the early life microbiota establishment in preterm newborns, which may have consequences for later health. PMID:27136545

  12. Mesenchymal stem/stromal cells-a key mediator for regeneration after perinatal morbidity?

    Science.gov (United States)

    Mueller, Martin; Wolfs, Tim G A; Schoeberlein, Andreina; Gavilanes, Antonio W D; Surbek, Daniel; Kramer, Boris W

    2016-12-01

    Perinatal complications in both term- and preterm-born infants are a leading cause of neonatal morbidities and mortality. Infants face different challenges in the neonatal intensive care unit with long-term morbidities such as perinatal brain injury and bronchopulmonary dysplasia being particularly devastating. While advances in perinatal medicine have improved our understanding of the pathogenesis, effective therapies to prevent and/or reduce the severity of these disorders are still lacking. The potential of mesenchymal stem/stromal cell (MSC) therapy has emerged during the last two decades, and an increasing effort is conducted to address brain- and lung-related morbidities in neonates at risk. Various studies support the notion that MSCs have protective effects. MSCs are an easy source and may be readily available after birth in a clinical setting. MSCs' mechanisms of action are diverse, including migration and homing, release of growth factors and immunomodulation, and the potential to replace injured cells. Here, we review the pathophysiology of perinatally acquired brain and lung injuries and focus on MSCs as potential candidates for therapeutic strategies summarizing preclinical and clinical evidence. PMID:26869264

  13. Among perinatal factors, only the Apgar score is associated with specific language impairment

    NARCIS (Netherlands)

    Diepeveen, F.B.; Kroon, M.L. de; Dusseldorp, E.; Snik, A.F.

    2013-01-01

    The purpose of this study was to assess the relation of perinatal risk factors with later development of specific language impairment (SLI). METHOD: In a case-control study, 179 children attending special needs schools for SLI were matched with non-affected children attending mainstream schools. Bot

  14. Skeletal measurements among infants who die during the perinatal period: new population-based reference

    International Nuclear Information System (INIS)

    Background: Reference data for roentgen skeletal measurements among infants who die during the perinatal period is not available, although it might prove helpful in the study of pre-autopsy radiographs. Objective: Our aim was to define new population-based reference data for skeletal measurements among infants who die during the perinatal period. Materials and methods: We routinely took standardised pre-autopsy radiographs of aborted and stillborn fetuses from 16 weeks gestational age to 7 days after delivery during a period of 11 years in our hospital. The data presented here represents nearly all perinatal deaths in a well-defined geographical area during the study period. We calculated detailed plots of estimated 10th-90th centiles and quartiles of different skeletal measurements by gestational age at death. Results: High correlations were seen between birth weight and the different skeletal measurements, including cranial width (r>0.9, P<0.001). We were not able to identify any asymmetrical pattern of skeletal growth. Reference plots for femoral, tibial, humeral, radial and lumbar spine lengths, and for pelvic width are presented. Conclusions: We suggest that the current population-based reference data might be beneficial, and that skeletal radiographic measurements might contribute substantially in the assessment of fetal growth stage and in detection of skeletal abnormalities in infants who die during the perinatal period. (orig.)

  15. Skeletal measurements among infants who die during the perinatal period: new population-based reference

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, Oeystein E.; Rosendahl, Karen [Department of Radiology, Haukeland University Hospital, 5021 Bergen (Norway); Lie, Rolv T. [Section for Medical Statistics and Medical Birth Registry of Norway, University of Bergen, Bergen (Norway); Maartmann-Moe, Helga [Department of Pathology, Haukeland University Hospital, Bergen (Norway); Pirhonen, Jouko [Department of Obstetrics and Gynaecology, Ullevaal Hospital, University of Oslo, Oslo (Norway); Lachman, Ralph S. [International Skeletal Dysplasia Registry, Cedars-Sinai Medical Center, Los Angeles, California (United States)

    2002-09-01

    Background: Reference data for roentgen skeletal measurements among infants who die during the perinatal period is not available, although it might prove helpful in the study of pre-autopsy radiographs. Objective: Our aim was to define new population-based reference data for skeletal measurements among infants who die during the perinatal period. Materials and methods: We routinely took standardised pre-autopsy radiographs of aborted and stillborn fetuses from 16 weeks gestational age to 7 days after delivery during a period of 11 years in our hospital. The data presented here represents nearly all perinatal deaths in a well-defined geographical area during the study period. We calculated detailed plots of estimated 10th-90th centiles and quartiles of different skeletal measurements by gestational age at death. Results: High correlations were seen between birth weight and the different skeletal measurements, including cranial width (r>0.9, P<0.001). We were not able to identify any asymmetrical pattern of skeletal growth. Reference plots for femoral, tibial, humeral, radial and lumbar spine lengths, and for pelvic width are presented. Conclusions: We suggest that the current population-based reference data might be beneficial, and that skeletal radiographic measurements might contribute substantially in the assessment of fetal growth stage and in detection of skeletal abnormalities in infants who die during the perinatal period. (orig.)

  16. Rates and Types of Psychiatric Disorders in Perinatally Human Immunodeficiency Virus-Infected Youth and Seroreverters

    Science.gov (United States)

    Mellins, Claude Ann; Brackis-Cott, Elizabeth; Leu, Cheng-Shiun; Elkington, Katherine S.; Dolezal, Curtis; Wiznia, Andrew; McKay, Mary; Bamji, Mahrukh; Abrams, Elaine J.

    2009-01-01

    Background: The purpose of this study was to examine 1) the prevalence of psychiatric and substance use disorders in perinatally HIV-infected (HIV+) adolescents and 2) the association between HIV infection and these mental health outcomes by comparing HIV+ youths to HIV exposed but uninfected youths (HIV-) from similar communities. Methods: Data…

  17. Features of hearing impairment in children with perinatal pathology of the central nervous system

    OpenAIRE

    KHAYDAROVA GAVKHAR SAIDAKHMATOVNA; MATKULIEV HAITBAY MATKULIEVICH; SHAYKHOVA KHALIDA ERKINOVNA

    2016-01-01

    The analysis of hearing loss in 58 children with perinatal CNS. The correlation of peripheral sensorineural disorders and degree of hemodynamic disorders in vertebrate arteries. The results showed a significant increase in the severity of peripheral hearing loss with increasing severity of the ground state from light to heavy.

  18. Safer Beginnings: Perinatal Child-Parent Psychotherapy for Newborns and Mothers Exposed to Domestic Violence

    Science.gov (United States)

    Lieberman, Alicia F.; Diaz, Manuela A.; Van Horn, Patricia

    2009-01-01

    Pregnancy is a time of heightened risk for domestic violence and of increased vulnerability to traumatic events. In this article, the authors explain how the experience of domestic violence during pregnancy threatens the newborn's healthy development as well as the parent-child relationship. San Francisco General Hospital's Perinatal Child-Parent…

  19. Factors associated with and causes of perinatal mortality in northeastern Tanzania

    DEFF Research Database (Denmark)

    Schmiegelow, Christentze; Minja, Daniel; Oesterholt, Mayke; Pehrson, Caroline; Suhrs, Hannah Elena; Boström, Stéphanie; Lemnge, Martha; Magistrado, Pamela; Rasch, Vibeke; Lusingu, John; Theander, Thor G.; Nielsen, Birgitte Bruun

    2012-01-01

    , including preeclampsia, small-for-gestational age, preterm delivery, anemia, and health-seeking behavior. Fetal growth was monitored using ultrasound. Finally, the specific causes of the perinatal deaths were evaluated. Main outcome measure. Perinatal mortality. Results. Forty-six deaths occurred. Key...... factors associated with perinatal mortality were preterm delivery (adjusted odds ratio (OR) 14.47, 95% confidence interval (CI) 3.23-64.86, p < 0.001), small-for-gestational age (adjusted OR 3.54, 95%CI 1.18-10.61, p = 0.02), and maternal anemia (adjusted OR 10.34, 95%CI 1.89-56.52, p = 0.007). Adherence...... to the antenatal care program (adjusted OR 0.027, 95%CI 0.003-0.26, p = 0.002) protected against perinatal mortality. The cause of death in 43% of cases was attributed to complications related to labor and specifically to intrapartum asphyxia (30%) and neonatal infection (13%). Among the remaining...

  20. Abnormal umbilical artery Doppler in third trimester and perinatal outcome: a retrospective study

    Directory of Open Access Journals (Sweden)

    Shiny Varghese

    2016-07-01

    Conclusions: Umbilical artery Doppler helps in the prediction of possible maternal and foetal complications in cases of compromised placental flow. Monitoring of antenatal parameters, availability of emergency facility for early surgical intervention and neonatal care pave a long way in curtailing perinatal morbidity and mortality. [Int J Reprod Contracept Obstet Gynecol 2016; 5(7.000: 2196-2199

  1. Impact of perinatal chronic hypoxia on cardiac tolerance to acute ischemia

    Czech Academy of Sciences Publication Activity Database

    Ošťádal, Bohuslav; Ošťádalová, Ivana; Kolář, František; Netuka, I.; Szárszoi, O.

    New York : Springer, 2011 - (Dhalla, N.; Nagano, M.; Ošťádal, B.), s. 55-67 ISBN 978-1-4419-7129-6 R&D Projects: GA MŠk(CZ) 1M0510 Institutional research plan: CEZ:AV0Z50110509 Keywords : perinatal period * cardiac development * chronic hypoxia Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  2. Risk factors for perinatal mortality in an urban area of Southern Brazil, 1993

    Directory of Open Access Journals (Sweden)

    Ana M. B. Menezes

    1998-06-01

    Full Text Available INTRODUCTION: Although there was a considerable reduction in infant mortality in Pelotas, Rio Grande do Sul in the last decade, its perinatal causes were reduced only by 28%. The associated factors of these causes were analised. MATERIAL AND METHOD: All hospital births and perinatal deaths were assessed by daily visits to all the maternity hospitals in the city, throughout 1993 and including the first week of 1994. RESULTS: The perinatal mortality rate was 22.1 per thousand births. The multivariate analysis showed the following risk factors: low socioeconomic level, male sex and maternal age above 35 years . Among multigravidae women, the fetal mortality rate was significantly increased for mothers with a previously low birthweight and a previous stillbirth. For early neonatal mortality the risk was significantly increased by a smaller number of antenatal visits than 5 and low birthweight. CONCLUSIONS: Main risk factors for perinatal mortality: low socioeconomic level, maternal age above 35 years and male sex. For early neonatal mortality the risk was significantly increased by a smaller number of antenatal visits than 5 and low birthweight.

  3. Presumed Perinatal Stroke in a Child with Down Syndrome and Moyamoya Disease

    Science.gov (United States)

    Pysden, Karen; Fallon, Penny; Moorthy, Bhagavatheswaran; Ganesan, Vijeya

    2010-01-01

    Moyamoya disease describes a cerebral arteriopathy characterized by stenosis or occlusion of the terminal internal carotid and/or the proximal middle cerebral arteries. We report a female child with trisomy 21 and bilateral moyamoya disease who presented, unusually, with a presumed perinatal cerebral infarct. The clinical, radiological, and…

  4. Term perinatal mortality audit in the Netherlands 2010-2012 : a population-based cohort study

    NARCIS (Netherlands)

    Eskes, Martine; Waelput, Adja J. M.; Erwich, Jan Jaap H. M.; Brouwers, Hens A. A.; Ravelli, Anita C. J.; Achterberg, Peter W.; Merkus, Hans (J) M. W. M.; Bruinse, Hein W.

    2014-01-01

    Objective: To assess the implementation and first results of a term perinatal internal audit by a standardised method. Design: Population-based cohort study. Setting: All 90 Dutch hospitals with obstetric/ paediatric departments linked to community practices of midwives, general practitioners in the

  5. To study the effect of maternal basal metabolic index on the pregnancy and perinatal outcome

    Directory of Open Access Journals (Sweden)

    Rekha Wadhwani

    2016-06-01

    Conclusions: From this tudy, we concluded that the health of women throughout their child bearing years should be addressed, to improve the pregnancy and the perinatal outcomes. Therefore, education programs, health services and nutrition consultation are recommended for women in reproductive age. [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000: 1953-1958

  6. Reaching Perinatal Women Online: The Healthy You, Healthy Baby Website and App

    Directory of Open Access Journals (Sweden)

    Lydia Hearn

    2014-01-01

    Full Text Available Overwhelming evidence reveals the close link between unwarranted weight gain among childbearing women and childhood adiposity. Yet current barriers limit the capacity of perinatal health care providers (PHCPs to offer healthy lifestyle counselling. In response, today’s Internet savvy women are turning to online resources to access health information, with the potential of revolutionising health services by enabling PHCPs to guide women to appropriate online resources. This paper presents the findings of a project designed to develop an online resource to promote healthy lifestyles during the perinatal period. The methodology involved focus groups and interviews with perinatal women and PHCPs to determine what online information was needed, in what form, and how best it should be presented. The outcome was the development of the Healthy You, Healthy Baby website and smartphone app. This clinically-endorsed, interactive online resource provides perinatal women with a personalised tool to track their weight, diet, physical activity, emotional wellbeing, and sleep patterns based on the developmental stage of their child with links to quality-assured information. One year since the launch of the online resource, data indicates it provides a low-cost intervention delivered across most geographic and socioeconomic strata without additional demands on health service staff.

  7. Perinatal outcomes after hypertensive disorders in pregnancy in a low resource setting

    NARCIS (Netherlands)

    Browne, J. L.; Vissers, K. M.; Antwi, E.; Srofenyoh, E. K.; Van der Linden, E. L.; Agyepong, I. A.; Grobbee, D. E.; Klipstein-Grobusch, K.

    2015-01-01

    Objective: The objective of this study was to evaluate perinatal outcomes of pregnancies complicated by hypertensive disorders in pregnancy in an urban sub-Saharan African setting. Methods: A prospective cohort study of 1010 women of less than 17 weeks of gestation was conducted at two antenatal cli

  8. Impacts of perinatal induced photothrombotic stroke on sensorimotor performance in adult rats

    Czech Academy of Sciences Publication Activity Database

    Brima, Tufikameni; Mikulecká, Anna; Otáhal, Jakub

    2013-01-01

    Roč. 62, č. 1 (2013), s. 85-94. ISSN 0862-8408 R&D Projects: GA ČR(CZ) GAP303/10/0999 Institutional support: RVO:67985823 Keywords : photothrombosis * perinatal ischemic stroke * sensorimotor performance * immature rats Subject RIV: FH - Neurology Impact factor: 1.487, year: 2013

  9. Study of correlation between placental morphology and adverse perinatal outcome in different conditions affecting pregnancy

    Directory of Open Access Journals (Sweden)

    Manik Sirpurkar

    2015-08-01

    Conclusions: These conditions also affect the perinatal outcome. Placental parameters are also altered along with foetal parameters like foetal weight. So the diagnosis of such risk factors in pregnancies during antenatal period will improve the outcome. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 1165-1168

  10. PREGNANCY AND PERINATAL OUTCOMES IN RELATION TO DRINKING WATER ARSENIC EXPOSURE IN BAMEN, INNER MONGOLIA, CHINA

    Science.gov (United States)

    Pregnancy and Perinatal Outcomes in Relation to Drinking Water Arsenic Exposure in BaMen, Inner Mongolia, ChinaDanelle T. Lobdell, Zhixiong Ning, Richard K. Kwok, Judy Mumford, Zhi Yi Liu, Pauline MendolaIntroduction: Close to 40 million people worldwide are exposed t...

  11. Pre- and perinatal risk factors for pyloric stenosis and their influence on the male predominance

    DEFF Research Database (Denmark)

    Krogh, Camilla; Gørtz, Sanne; Wohlfahrt, Jan;

    2012-01-01

    Pyloric stenosis occurs with a nearly 5-fold male predominance. To what extent this is due to environmental factors is unknown. In a cohort of all children born in Denmark, 1977-2008, the authors examined the association between pre- and perinatal exposures and pyloric stenosis and investigated w...

  12. Mechanisms underlying the associations of maternal age with adverse perinatal outcomes

    DEFF Research Database (Denmark)

    Lawlor, Debbie A; Mortensen, Laust; Andersen, Anne-Marie Nybo

    2011-01-01

    The mechanisms underlying the association between maternal age (both young and older maternal age) and adverse perinatal outcomes are unclear. Methods We examined the association of maternal age at first birth with preterm birth (<37 weeks gestation) and small for gestational age (SGA) in a cohor...

  13. Perinatal exposure to methoxychlor enhances adult cognitive responses and hippocampal neurogenesis in mice.

    Directory of Open Access Journals (Sweden)

    Mariangela eMartini

    2014-06-01

    Full Text Available During perinatal life, sex steroids, such as estradiol, have marked effects on the development and function of the nervous system. Environmental estrogens or xenoestrogens are man-made chemicals, which animal and human population encounter in the environment and which are able to disrupt the functioning of the endocrine system. Scientific interest in the effects of exposure to xenoestrogens has focused more on fertility and reproductive behaviors, while the effects on cognitive behaviors have received less attention. Therefore, the present study explored whether the organochlorine insecticide Methoxychlor (MXC, with known xenoestrogens properties, administered during the perinatal period (from gestational day 11 to postnatal day 8 to pregnant-lactating females, at an environmentally relevant dose (20µg/kg (body weight/day, would also affect learning and memory functions depending on the hippocampus of male and female offspring mice in adulthood. When tested in adulthood, MXC perinatal exposure led to an increase in anxiety-like behavior and in short-term spatial working memory in both sexes. Emotional learning was also assessed using a contextual fear paradigm and MXC treated male and female mice showed an enhanced freezing behavior compared to controls. These results were correlated with an increased survival of adult generated cells in the adult hippocampus. In conclusion, our results show that perinatal exposure to an environmentally relevant dose of MXC has an organizational effect on hippocampus-dependent memory and emotional behaviors.

  14. Efficiency of various preventive methods of perinatal mother and child complications

    Directory of Open Access Journals (Sweden)

    Sadretdinova T.L.

    2012-03-01

    Full Text Available Purpose: to study efficiency of various methods of prevention of perinatal complications in mother and child. Material and methods. In three risk groups preventive treatment of intrauterine infected fetus (IUIF, gestosis, noncarrying of pregnancy and fetoplacental insufficiency has been carried out. In group I consisted of 71 pregnant women preventive treatment has included medication with application of antioxidants; stimulators of processes of carboxylation in cycle Krebs; endogenic synthesis prostaglandins, prostacyclin; drugs improving processes of microcirculation, stabilizing function of endothelium ofvessels, an exchange of homocysteine. In group II consisted of 67 pregnant women prevention of IUIF and complications has been carried out by means of physical exercises in combination with aqua aerobics. In group III consisted of 100 women prevention of IUIF has been standard. In the control group IV consisted of 70 women pregnancy has not been complicated. Parameters of oxidant and antioxidant systems, central hemodynamics, determined in this group have been determined as normal for comparison. Results. In relation to group III medicamen-tous treatment in group I, regular aqua aerobics in group II have allowed to lower frequency of IUIF, perinatal mother complications, perinatal diseases, death rates in newborns and morbidity in children of early age. Conclusion. For the prevention of IUIF, mother and child perinatal complications, morbidity in children of early age it has been proposed to use medication and regular aqua aerobics which provides nonmedicamentous pregnancy course

  15. Sleep, daily activity rhythms and postpartum mood: A longitudinal study across the perinatal period.

    Science.gov (United States)

    Krawczak, Elizabeth M; Minuzzi, Luciano; Simpson, William; Hidalgo, Maria Paz; Frey, Benicio N

    2016-01-01

    Women with a diagnosis of bipolar and major depressive disorders are at higher risk to develop postpartum depression. The primary objective of this longitudinal study was to determine whether daily activity rhythms and sleep parameters differ between women with and without a history of a mood disorder across the perinatal period. A secondary objective was to determine whether changes in these parameters were associated with postpartum mood. In total, 33 women were included in this study, 15 of which had a history of a mood disorder (high-risk group) and 18 who did not (low-risk group). Sleep and daily rhythms were assessed subjectively and objectively during the third trimester (≥26 weeks gestation) and again at 6-12 weeks postpartum. Mood was also assessed at both time points. Women in the high-risk group showed greater subjective daily rhythms and sleep disturbances across the perinatal period. Objective sleep efficiency was worse in the high-risk group in the postpartum period. Changes in both subjective daily rhythms and objective sleep efficiency were predictive of changes in depressive symptoms across the perinatal period. These findings encourage the development of preventative therapeutics to ensure circadian rhythm and sleep stability throughout the perinatal period. PMID:27097327

  16. Entrevista con Juan Marichal.

    Directory of Open Access Journals (Sweden)

    - Consejo de Redacción

    1997-01-01

    Full Text Available Juan Marichal nació en Santa Cruz de Tenerife, en 1922, en el seno de una familia ligada al partido republicano insular. Muy joven, en 1935, se trasladó a Madrid, ciudad en la que vive el estallido de la guerra civil. En 1937, pasa a Valencia y luego a Barcelona; tras su exilio en 1938, prosigue sus estudios secundarios en un liceo de París, concluyéndolos en Casablanca. En 1941 emigra a México, formándose en la UNAM: fue alumno de los exiliados José Gaos y Joaquín Xirau así como del mexicano Edmundo O 'Gorman. Luego, becado en Princeton desde 1946, lo fue de América Castro, donde preparó una tesis sobre Feijoo. Apoyado en las vastas perspectivas de sus maestros, fue orientándose hada nuestra historia intelectual, desde el siglo XV hasta hoy. Su carrera profesional se ha desarrollado en los Estados Unidos (coincidiendo con Amado Alonso y con Ferrater Mora: ha sido profesor de estudios hispánicos en la Universidad de Harvard, desde 1948 hasta 1988, año en que se jubiló voluntariamente como numerario (aunque había permanecido en el Bryn Mawr College, entre 1953 y 1957. A este trabajo se suman, con todo, sus conferencias en América Latina y en España. Ha colaborado en las revistas más importantes, en este campo, de México, Nueva York, Puerto Rico, La Habana, Buenos Aires o París así como de las españolas, desde los sesenta. Juan Marichal -hoy, miembro de la Junta Directiva de los Amigos de la Residencia de Estudiantes, director del Boletín de la Institución Libre de Enseñanza y asociado al Instituto Universitario Ortega y Gasset-, reside en España desde otoño de 1989: se considera a sí mismo «voluntario en Madrid», como había dicho Alfonso Reyes en su estancia madrileña (1914-1924.

  17. Entrevista con Geoffrey Lloyd.

    OpenAIRE

    Fernando Colina Pérez; Mauricio Jalón

    2008-01-01

    Helenista y también sinólogo de relieve internacional, Geoffrey E. R. Lloyd nació en Londres (1933), de padres galeses. Es un gran historiador de la ciencia y del pensamiento griegos. En 1940 fue evacuado de Londres con su madre. Sus estudios significativos comenzaron, tras algún rodeo, en el King’s College donde estudiaba su hermano. Éste sería, como su padre, médico, y él mismo dudó en estudiar esa profesión, que late en sus libros. Pero un profesor de clásicas como John Raven –que redactó,...

  18. Entrevista con Georges Duby.

    Directory of Open Access Journals (Sweden)

    - Consejo de Redacción

    1994-01-01

    Full Text Available Duby, heredero de dos grandes historiadores como Marc Bloch y Lucien Febvre, es uno de los más importantes medievalistas europeos. Fue, y sigue siendo, un motor de la importante reforma en la historia producida desde los sesenta. En sus primeros trabajos se acusa la recepción de las ideas económicas y geográficas de la mejor historiografía. Su riguroso estudio sobre la base material de la Edad Media, le permitirá luego irrumpir en la historia de las mentalidades, analizando, como decía Febvre, el utillaje mental (vocabulario, sintaxis, lugares comunes, cuadros lógicos, etc. del Medioevo. Así, el ejemplo de Mauss y LéviStrauss le anima a trabajar sobre el matrimonio, la sexualidad y ciertos sistemas del pensamiento: el primero, con su defensa de los hechos sociales totales, y el segundo, que buscaba las dimensiones simbólicas de lo social, le impulsan a trabajar sobre la ideología entendida no como mero reflejo de la situación material sino como «proyecto de acción sobre lo vivido». A su obra individual, atenta a los impulsos culturales más vivos, se suma su empuje decisivo en la realización de proyectos colectivos como la Historia de la vida privada o la Historia de las mujeres. Prácticamente, han sido traducidos todos sus libros al castellano, y han podido verse en España asimismo varios de sus programas televisivos (ha sido presidente de la SEPT, cadena de televisión cultural fundada en 1985. La amplitud de sus intereses intelectuales, transmitidos en su obra con un lenguaje a la vez muy claro y bellamente elaborado, se hace palpable también en este diálogo.

  19. A coarsened multinomial regression model for perinatal mother to child transmission of HIV

    Directory of Open Access Journals (Sweden)

    Brown Elizabeth R

    2008-07-01

    Full Text Available Abstract Background In trials designed to estimate rates of perinatal mother to child transmission of HIV, HIV assays are scheduled at multiple points in time. Still, infection status for some infants at some time points may be unknown, particularly when interim analyses are conducted. Methods Logistic regression models are commonly used to estimate covariate-adjusted transmission rates, but their methods for handling missing data may be inadequate. Here we propose using coarsened multinomial regression models to estimate cumulative and conditional rates of HIV transmission. Through simulation, we compare the proposed models to standard logistic models in terms of bias, mean squared error, coverage probability, and power. We consider a range of treatment effect and visit process scenarios, while including imperfect sensitivity of the assay and contamination of the endpoint due to early breastfeeding transmission. We illustrate the approach through analysis of data from a clinical trial designed to prevent perinatal transmission. Results The proposed cumulative and conditional models performed well when compared to their logistic counterparts. Performance of the proposed cumulative model was particularly strong under scenarios where treatment was assumed to increase the risk of in utero transmission but decrease the risk of intrapartum and overall perinatal transmission and under scenarios designed to represent interim analyses. Power to estimate intrapartum and perinatal transmission was consistently higher for the proposed models. Conclusion Coarsened multinomial regression models are preferred to standard logistic models for estimation of perinatal mother to child transmission of HIV, particularly when assays are missing or occur off-schedule for some infants.

  20. Study of Risk Factors of Perinatal Death in Pregnancy Induced Hypertension (PIH

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    Mehul T Parmar, Harsha M Solanki, Vibha V Gosalia

    2012-01-01

    Full Text Available Background: Hypertensive disorders are common complication occurring during pregnancy responsible for maternal & fetal mortality & morbidity. Though the condition is on decline, still stands a public health problem. Objectives: To determine risk factors of perinatal death in women with pregnancy induced hypertension. Materials & Method: A cross-sectional study was conducted over period of one year in the department of Obstetrics & Gynecology in NHL municipal college, Ahmadabad. A total of 100 pregnant women with PIH were enrolled in the study. A pre-tested structured Performa was prepared & women were interviewed to collect necessary information such as detailed history, clinical examination findings & investigations performed. Results were analyzed using MS Excel & Epi Info. Results: In the present study, 29%, 21% & 50 % were of mild PIH, moderate PIH & severe PIH respectively. The incidence of PIH was found more among teenage pregnancy, among primigravidas, those from low socio-economic status, those with history of PIH in previous pregnancy, having family history of PIH & those who were found obese. Emergency delivery, having diastolic blood pressure > 90 mm Hg, higher degree of proteinuria & low birth weight among PIH cases had an adverse perinatal outcome in terms of higher perinatal death. The findings were statistically significant On Univariate analysis; diastolic blood pressure & degree of proteinuria were found to be significant risk factors responsible for perinatal mortality among PIH women. Conclusion: Pregnancy induced hypertension is a common medical disorder associated with pregnancy. In the present study, PIH cases who delivered in emergency, with raised diastolic blood pressure & more proteinuria & neonate with low birth weight were found risk factors for perinatal death. Fetal morbidity & mortality can be reduced by early recognition & institutional management.

  1. Community mobilization in Mumbai slums to improve perinatal care and outcomes: a cluster randomized controlled trial.

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    Neena Shah More

    Full Text Available INTRODUCTION: Improving maternal and newborn health in low-income settings requires both health service and community action. Previous community initiatives have been predominantly rural, but India is urbanizing. While working to improve health service quality, we tested an intervention in which urban slum-dweller women's groups worked to improve local perinatal health. METHODS AND FINDINGS: A cluster randomized controlled trial in 24 intervention and 24 control settlements covered a population of 283,000. In each intervention cluster, a facilitator supported women's groups through an action learning cycle in which they discussed perinatal experiences, improved their knowledge, and took local action. We monitored births, stillbirths, and neonatal deaths, and interviewed mothers at 6 weeks postpartum. The primary outcomes described perinatal care, maternal morbidity, and extended perinatal mortality. The analysis included 18,197 births over 3 years from 2006 to 2009. We found no differences between trial arms in uptake of antenatal care, reported work, rest, and diet in later pregnancy, institutional delivery, early and exclusive breastfeeding, or care-seeking. The stillbirth rate was non-significantly lower in the intervention arm (odds ratio 0.86, 95% CI 0.60-1.22, and the neonatal mortality rate higher (1.48, 1.06-2.08. The extended perinatal mortality rate did not differ between arms (1.19, 0.90-1.57. We have no evidence that these differences could be explained by the intervention. CONCLUSIONS: Facilitating urban community groups was feasible, and there was evidence of behaviour change, but we did not see population-level effects on health care or mortality. In cities with multiple sources of health care, but inequitable access to services, community mobilization should be integrated with attempts to deliver services for the poorest and most vulnerable, and with initiatives to improve quality of care in both public and private sectors. TRIAL

  2. Perinatal hypoxia increases susceptibility to high-altitude polycythemia and attendant pulmonary vascular dysfunction.

    Science.gov (United States)

    Julian, Colleen Glyde; Gonzales, Marcelino; Rodriguez, Armando; Bellido, Diva; Salmon, Carlos Salinas; Ladenburger, Anne; Reardon, Lindsay; Vargas, Enrique; Moore, Lorna G

    2015-08-15

    Perinatal exposures exert a profound influence on physiological function, including developmental processes vital for efficient pulmonary gas transfer throughout the lifespan. We extend the concept of developmental programming to chronic mountain sickness (CMS), a debilitating syndrome marked by polycythemia, ventilatory impairment, and pulmonary hypertension that affects ∼10% of male high-altitude residents. We hypothesized that adverse perinatal oxygenation caused abnormalities of ventilatory and/or pulmonary vascular function that increased susceptibility to CMS in adulthood. Subjects were 67 male high-altitude (3,600-4,100 m) residents aged 18-25 yr with excessive erythrocytosis (EE, Hb concentration ≥18.3 g/dl), a preclinical form of CMS, and 66 controls identified from a community-based survey (n = 981). EE subjects not only had higher Hb concentrations and erythrocyte counts, but also lower alveolar ventilation, impaired pulmonary diffusion capacity, higher systolic pulmonary artery pressure, lower pulmonary artery acceleration time, and more frequent right ventricular hypertrophy, than controls. Compared with controls, EE subjects were more often born to mothers experiencing hypertensive complications of pregnancy and hypoxia during the perinatal period, with each increasing the risk of developing EE (odds ratio = 5.25, P = 0.05 and odds ratio = 6.44, P = 0.04, respectively) after other factors known to influence EE status were taken into account. Adverse perinatal oxygenation is associated with increased susceptibility to EE accompanied by modest abnormalities of the pulmonary circulation that are independent of increased blood viscosity. The association between perinatal hypoxia and EE may be due to disrupted alveolarization and microvascular development, leading to impaired gas exchange and/or pulmonary hypertension. PMID:26092986

  3. [Peloid therapy in the complex sanatorium treatment of children of early age with complications of perinatal brain damage].

    Science.gov (United States)

    Ponomareva, S O; Babina, L M

    2003-01-01

    The search for novel approaches to multimodality prophylaxis and treatment of sequelae of perinatal nervous system affection as well as introduction of the early diagnostic criteria are topical problems in present-day pediatric neurology. Peloid therapy efficacy in combined sanatorium treatment was studied (Peloterm unit) in 44 infants aged 1 to 3 years. They suffered from sequelae of perinatal affections of the central nervous system including infantile cerebral paralysis. A positive effect (improvement of motor and psychic-speech development) was achieved in 98% cases. This indicates validity of this method in the treatment of CNS affections following perinatal affection of the brain in infants over 1 year of age. PMID:14753007

  4. A longitudinal study of the interactive effects of perinatal complications and early family adversity on cognitive ability.

    Science.gov (United States)

    Stanton, W R; McGee, R O; Silva, P A

    1989-06-01

    The effects of high, medium and low levels of perinatal complications and family adversity on intelligence quotient (IQ) scores were examined in a large sample of Dunedin children tested every second year in the age group 3-13 years. The aim was to test the hypothesis that favourable environmental circumstances attenuate the effects of perinatal complications on later cognitive ability. The results did not support this hypothesis but rather suggested that perinatal complications and family adversity have independent adverse effects on the development of children's cognitive ability. PMID:2764834

  5. Integralidade e acessibilidade no cuidado à criança portadora de paralisia cerebral Integralidad y accesibilidad en el cuidado del niño portador de parálisis cerebral Integration and accessibility of care for children with brain paralysis

    Directory of Open Access Journals (Sweden)

    Viviane Marten Milbrath

    2009-12-01

    Full Text Available Objetivo: Conhecer como as crianças portadoras de paralisia cerebral, decorrente de asfixia perinatal grave, recebem os princípios da integralidade e da acessibilidade do Sistema Único de Saúde. Métodos: A investigação contemplou uma metodologia descritiva, exploratória com abordagem qualitativa. Participaram do estudo seis famílias de crianças portadoras de paralisia cerebral decorrente de asfixia perinatal grave. A coleta dos dados foi realizada através de entrevista semi-estruturada, no domicílio dos sujeitos, na cidade do Rio Grande - RS. Resultados: A análise dos dados revelou as dificuldades encontradas pelas famílias em relação aos princípios da integralidade dos serviços e ações de saúde e acessibilidade além de evidenciar as lacunas no que concerne ao ideal da assistência prestada pela atenção básica e a realidade a que são expostos. Conclusão: A inacessibilidade da assistência não se restringe ao nível da atenção básica, mas estende-se a todas as esferas de atenção, não contemplando a referência e contra-referência.Objetivo: Conocer como los niños portadores de parálisis cerebral, provenientes de asfixia perinatal grave, reciben los principios de integralidad y de accesibilidad del SUS. Métodos: La investigación contempló una metodología descriptiva, exploratoria con abordaje cualitativo. Participaron del estudio seis familias de niños portadores de parálisis cerebral, provenientes de asfixia perinatal grave. La recolección de datos fue realizada a través de entrevistas semi-estructuradas, en el domicilio de los sujetos, en la ciudad de Rio Grande (RS. Resultados: El análisis de los datos reveló las dificultades encontradas por las familias en relación a los principios de integralidad de los servicios, de acciones de salud y de accesibilidad, además de colocar en evidencia las diferencias entre lo ideal de la asistencia de la atención básica y la realidad de los servicios. Conclusi

  6. autorregulado con estudiantes universitarios

    Directory of Open Access Journals (Sweden)

    Jairo Andrés Montes

    2005-01-01

    Full Text Available El propósito del presente estudio es describir la forma en la que se presentan los procesos de aprendizaje autorregulado con un grupo de estudiantes (22 estudiantes de tercer semestre de Psicología de la PUJ, Cali, en el evento de preparación para la presentación un examen. Asimismo se describen las correlaciones que ocurren entre las distintas fases de dicho proceso de autorregulación del aprendizaje. Para conseguir los objetivos propuestos se ha hecho uso de una observación de desempeño en tiempo real, es decir, de la observación durante una sesión de preparación de examen de los estudiantes, en la cual se emplearon protocolos verbales para dar cuenta de lo que «pasaba por su mente» mientras estudiaban. Una entrevista semi-estructurada y una prueba objetiva. Los resultados fueron analizados a la luz del modelo mixto de procesamiento de información y constructivismo abordado por Winne(1998. Como resultado se encontró una relación significativa entre los niveles de desempeño en el proceso de ARR y el resultado del examen. Igualmente se encontraron bajos niveles de regulación en una parte importante de la muestra y un desfase significativo entre conocimiento declarativo de ARR y desempeño en el mismo

  7. [Experience of extracorporeal membrane oxygenation in critical care of respiratory failure in newborn with congenital diaphragmatic hernia in perinatal center].

    Science.gov (United States)

    Burov, A A; Nikiforov, D V; Podurovskaia, Iu L; Dorofeeva, E I; Abramian, M A; Makhalin, M V; Shatalov, K V; Nikiforov, V S; Degtiarev, D N

    2013-01-01

    The article deals with an experience of veno-arterial extracorporeal membrane oxygenation use in preterm infants with congenital diaphragmatic hernia during postoperative period in the perinatal center. PMID:24749262

  8. A Systematic Review of the Physical, Mental, Social, and Economic Problems of Immigrant Women in the Perinatal Period in Japan.

    Science.gov (United States)

    Kita, Sachiko; Minatani, Mariko; Hikita, Naoko; Matsuzaki, Masayo; Shiraishi, Mie; Haruna, Megumi

    2015-12-01

    The perinatal mortality of immigrants in Japan is higher than that of Japanese women. However, details of the problems of immigrant perinatal women that contribute to worsening of their health are still unknown. This review describes the physical, psychological, social, and economic problems of immigrant women during the perinatal period in Japan. Medline, CINAHL, PsycINFO, and Igaku-Chuo Zasshi were searched and 36 relevant articles were reviewed. The related descriptions were collected and analyzed by using content analysis. The results showed that immigrant perinatal women in Japan experienced the following problems: language barriers, a problematic relationship with a partner, illegal residency, emotional distress, physical distress, adjustment difficulties, lack of utilization of services, social isolation, lack of support, lack of information, low economic status, unsatisfactory health care, and discrimination. These results indicated that multilingual services, strengthening of social and support networks, and political action are necessary to resolve their problems. PMID:25784144

  9. Psychosocial adjustment in perinatally human immunodeficiency virus infected or exposed children – a Retrospective Cohort Study

    Science.gov (United States)

    Zalwango, Sarah K; Kizza, Florence N; Nkwata, Allan K; Sekandi, Juliet N; Kakaire, Robert; Kiwanuka, Noah; Whalen, Christopher C; Ezeamama, Amara E

    2016-01-01

    Objective To determine whether perinatal HIV infection and exposure adversely affected psychosocial adjustment (PA) between 6 and 18 years of life (i.e. during school-age and adolescence). Methods We enrolled 58 perinatally HIV-infected, 56 HIV-exposed uninfected and 54 unexposed controls from Kampala, Uganda. Perinatal HIV status was determined by 18 months of age using a DNA-polymerase chain-reaction test and was confirmed via HIV rapid diagnostic test at psychosocial testing when the children were 6 to 18 years old. Five indicators of PA (depressive symptoms, distress, hopelessness, positive future orientation and esteem) were measured using validated, culturally adapted and translated instruments. Multivariable linear regression analyses estimated HIV-status-related percent differences (β) in PA indicators and corresponding 95% confidence intervals (CIs). Results During school-age and adolescence, positive outlook (β=−3.8, 95% CI: −7.2, −0.1) and self-esteem (β=−4.3, 95% CI: −6.7, −1.8) scores were significantly lower, whereas depressive (β=11.4, 95% CI: 3.3, 19.5) and distress (β=12.3, 95% CI: 5.9, 18.7) symptoms were elevated for perinatally HIV-infected, compared to unexposed controls and exposed uninfected children. Similarly, positive outlook (β=−4.3, 95% CI: −7.3, −1.2) and self-esteem were lower for exposed controls versus HIV-unexposed children. Hopelessness was similar by perinatal HIV status. Likewise, the distress and depressive symptom levels were comparable for HIV-exposed uninfected and HIV-unexposed children. Conclusions Perinatal HIV infection predicted higher distress and depressive symptoms, while HIV-affected status (infection/exposure) predicted low self-esteem and diminished positive outlook in the long term. However, HIV-affected status had no impact on hopelessness, suggesting that psychosocial interventions as an integral component of HIV care for infected children or primary care exposed uninfected children may

  10. Psychosocial adjustment in perinatally human immunodeficiency virus infected or exposed children – a Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Sarah K Zalwango

    2016-06-01

    Full Text Available Objective: To determine whether perinatal HIV infection and exposure adversely affected psychosocial adjustment (PA between 6 and 18 years of life (i.e. during school-age and adolescence. Methods: We enrolled 58 perinatally HIV-infected, 56 HIV-exposed uninfected and 54 unexposed controls from Kampala, Uganda. Perinatal HIV status was determined by 18 months of age using a DNA-polymerase chain-reaction test and was confirmed via HIV rapid diagnostic test at psychosocial testing when the children were 6 to 18 years old. Five indicators of PA (depressive symptoms, distress, hopelessness, positive future orientation and esteem were measured using validated, culturally adapted and translated instruments. Multivariable linear regression analyses estimated HIV-status-related percent differences (β in PA indicators and corresponding 95% confidence intervals (CIs. Results: During school-age and adolescence, positive outlook (β=−3.8, 95% CI: −7.2, −0.1 and self-esteem (β=−4.3, 95% CI: −6.7, −1.8 scores were significantly lower, whereas depressive (β=11.4, 95% CI: 3.3, 19.5 and distress (β=12.3, 95% CI: 5.9, 18.7 symptoms were elevated for perinatally HIV-infected, compared to unexposed controls and exposed uninfected children. Similarly, positive outlook (β=−4.3, 95% CI: −7.3, −1.2 and self-esteem were lower for exposed controls versus HIV-unexposed children. Hopelessness was similar by perinatal HIV status. Likewise, the distress and depressive symptom levels were comparable for HIV-exposed uninfected and HIV-unexposed children. Conclusions: Perinatal HIV infection predicted higher distress and depressive symptoms, while HIV-affected status (infection/exposure predicted low self-esteem and diminished positive outlook in the long term. However, HIV-affected status had no impact on hopelessness, suggesting that psychosocial interventions as an integral component of HIV care for infected children or primary care exposed uninfected

  11. A prospective study of effect of amniotic fluid index less than 5 at term on perinatal outcome

    OpenAIRE

    Padmini C. P.; Chaitra R; Indra N; Sriram Adithya M

    2016-01-01

    Background: To study the effect of oligohydramnios in pregnancy and its value in predicting adverse perinatal outcome. Methods: A prospective case control study of pregnancy outcome in 100 cases with ultrasound diagnosis of oligohydramnios at term compared with 100 controls with no oligohydramnios. The study was done over a period of 3 years at SSMC Tumkur, India. Results: Oligohydramnios at term is associated with poor perinatal outcome. Significant increase in abnormal foetal heart ra...

  12. Effects of long term perinatal administration of Bupropion on population spike amplitude in neonatal rat hippocampal slices

    OpenAIRE

    Soomaayeh Heysieattalab; Samad Zare; Firouz Ghaderi Pakdel

    2010-01-01

    Introduction: The perinatal effects of antidepressants on CNS due to its common usage are importantissues in neuroscience research. Bupropion is an atypical antidepressant that is used in smoke cessationunder FDA approve widely. The study of synaptic effects of bupropion can reveal its mechanism fornicotine dependence cessation. In this study the long term effects of perinatal bupropion on populationspike (PS) amplitudes were investigated. The PS amplitude is a good parameter for synaptic pla...

  13. Concurrent expression of erythroid and renal aquaporin CHIP and appearance of water channel activity in perinatal rats.

    OpenAIRE

    Smith, B L; Baumgarten, R; Nielsen, S; D. Raben; Zeidel, M L; Agre, P

    1993-01-01

    Major phenotypic changes occur in red cell membranes during the perinatal period, but the underlying molecular explanations remain poorly defined. Aquaporin CHIP, the major erythroid and renal water channel, was studied in perinatal rats using affinity-purified anti-CHIP IgG for immunoblotting, flow cytometry, and immunofluorescence microscopy. CHIP was not detected in prenatal red cells but was first identified in circulating red cells on the third postnatal day. Most circulating red cells w...

  14. Perinatal iron deficiency predisposes the developing rat hippocampus to greater injury from mild to moderate hypoxia-ischemia

    OpenAIRE

    Rao, Raghavendra; Tkac, Ivan; Townsend, Elise L.; Ennis, Kathleen; Gruetter, Rolf; Georgieff, Michael K.

    2007-01-01

    The hippocampus is injured in both hypoxia-ischemia (HI) and perinatal iron deficiency that are co-morbidities in infants of diabetic mothers and intrauterine growth restricted infants. We hypothesized that preexisting perinatal iron deficiency predisposes the hippocampus to greater injury when exposed to a relatively mild HI injury. Iron-sufficient and iron-deficient rats (hematocrit 40% lower and brain iron concentration 55% lower) were subjected to unilateral HI injury of 15, 30, or 45 min...

  15. Eclampsia: maternal and perinatal outcome among tribal population of Bastar, Chhattisgarh, India in a tertiary care centre

    OpenAIRE

    Indu Sharma; Alpana Bansal

    2016-01-01

    Background: Eclampsia is one of the major causes of maternal and perinatal morbidity and mortality in India and other developing countries. This problem is continued in spite of challenging efforts to reviev each and every pregnant woman with eclampsia and to analyse the factors affecting the outcome. The aim of the research is to study the demographic profile, maternal as well as perinatal outcome of patients with eclampsia and factor affecting it in tertiary care centre of tribal population...

  16. Estimation of perinatal mortality rate for institutional births in Rajasthan state, India, using capture–recapture technique

    OpenAIRE

    Mony, Prem K.; Varghese, Beena; Thomas, Tinku

    2015-01-01

    Objective The objective of our investigation was to estimate the perinatal mortality rate among institutional births and to compare the sensitivities of different data collection methods. Setting A hospital-based prospective cohort study was undertaken during late-2012 in 21 public sector health facilities of 10 districts of the northern state of Rajasthan, India. Participants A total of 6872 births were included in this epidemiological study. Primary and secondary outcome measures Perinatal ...

  17. Perinatal Mortality And Pregnancy Wastage In Ten Punjab Villages During 1991-1996 - A Population Based Study

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    Sachar R.K

    1998-01-01

    Full Text Available Research question: What is the extent of perinatal mortality and pregnancy wastage in rural Punjab and what are risk factors for the same. Objective: To quantify the perinatal; wastage and risk factors including the prevalence of these factors to determine the loss attributable to these factors in ten Punjab villages during the period 1991-1996. Study Design: Case control. Sample Size: 2519 pregnant women with Known outcome of pregnancy. Study Variables: Cause, timing and factors affecting perinatal mortality and pregnancy wastage (viz Wt.<40kg; Ht, <152cm,BMI, <20 illiteracy, birth to conception interval <100wks, Prematurity (Gestation <37 wks. Registered in IIIrd trimester, Registered in IInd Trimester, Home delivery. Outcome variables: Contribution of these factors in perinatal loss and pregnancy wastage. Analysis; Percentages, Odds ratio, confidence interval and population attributable risk%. Results: The perinatal mortality rate was 34.57/1000 and pregnancy wastage was 7.23%. Prematurity was the leading cause of perinatal loss. 31.25% of perinatal deaths took place within 24 hours and 87.5% within 96 hours. In case of perinatal mortality the odds ration were significant (p<0.05 for the following risk factors: weight, height, body mass index, illiteracy, birth to conception interval <1000 weeks, prematurity, registration of pregnancy in IInd trimester, registration of pregnancy in IIIrd trimester, home delivery. In case of pregnancy wastage the odds ratio were significant for the following risk factors: weight, height, body mass index, illiteracy, birth to conception interval <100weeks, prematurity, past history of abortion and low socio-economic status.

  18. Reflections on Doing Research Grounded in My Experience of Perinatal Loss: From Auto/biography to Autoethnography

    OpenAIRE

    Deborah Davidson

    2011-01-01

    This article, derived from my doctoral dissertation (Davidson 2007) examining the emergence of hospital protocols for perinatal bereavement during the last half of the twentieth century in Canada, focuses on the methodological complexities – the draw, the drain, and the delight of doing qualitative research grounded in my own experience of perinatal loss. With my dissertation now a fait a complete, reflecting back on my research, my use of autoethnography at this point allows a return to a ...

  19. Gestational weight loss and perinatal outcomes in overweight and obese women subsequent to diagnosis of gestational diabetes mellitus

    OpenAIRE

    Yee, Lynn M.; Cheng, Yvonne W.; Inturrisi, Maribeth; CAUGHEY, Aaron B.

    2013-01-01

    OBJECTIVE To investigate whether gestational weight loss after the diagnosis of gestational diabetes mellitus (GDM) in overweight and obese women is associated with improved perinatal outcomes. Obesity and GDM are risk factors for adverse perinatal outcomes, but few studies have investigated weight loss during pregnancy in women with these comorbidities. METHODS Retrospective cohort study of 26,205 overweight and obese gestational diabetic women enrolled in the California Diabetes and Pregnan...

  20. Calentamiento global con Scratch y escuelas eficientes con Arduino

    OpenAIRE

    Ainzua Cemborain, José Ignacio

    2014-01-01

    Este trabajo final de máster está formado por dos proyectos con metodología de aprendizaje basado en proyectos (ABP). El primero de ellos se realiza en la asignatura de Tecnología y en coordinación con la asignatura de Ciencias Naturales, y el segundo únicamente para Tecnología. En la primera parte del proyecto se analiza la metodología ABP utilizada y se compara con la tradicional. Posteriormente se estudian las tres herramientas utilizadas en este proyecto como son; Scratch, Scratch for...

  1. Entrevista con Alberto Tenenti.

    Directory of Open Access Journals (Sweden)

    - Consejo de Redacción

    1995-01-01

    Full Text Available Gran especialista en historia moderna, Alberto Tenenti nació en Viareggio, en 1924. Tras realizar estudios superiores en Italia, trabajó en el Centre National de la Recherche Scientifique varios años, asesorado por Lucien Febvre. Ha dirigido el Archivo del Estado de Brescia; y, más tarde, ha enseñado en París, desde una cátedra en la École Pratique des Hautes Études en Sciences Sociales (VI Sección, alIado de Braudel. Su Il senso della morte e l'amore della vita nel Rinascimento, de 1957, es una obra maestra sobre los orígenes de la sensibilidad moderna: sin olvidar el naciente vitalismo, estudia el desarrollo de dos motivos, el del ars moriendi, que tiene su evolución propia desde 1350 hasta su difusión impresa, y el de lo macabro, que refleja la crisis de conciencia del siglo XV y adquiere «unas dimensiones desconocidas y verdaderamente anormales». En este libro sobre un problema clave como la muerte, apela de modo notable a la iconografía: Tenenti ha recordado que la cultura tradicional, eclesiástica sobre todo, percibió un mayor peligro en la capacidad de reflexión autónoma y de crítica de los hombres de letras, que en las renovaciones radicales de los artistas. Numerosos trabajos de conjunto realizados por él han perseguido una historia global: Los fundamentos del mundo moderno; Florencia en la época de los Medicis; La formación del mundo moderno; El Renacimiento; el primero de ellos estaba firmado con un historiador de su misma generación, R. Romano, estudioso de las relaciones comerciales en la época moderna en Europa y en la América española. Tenenti ha publicado monografías (Venezia e i corsari, 1961, colecciones de artículos (Credence, ideologie, libertinismi tra medioevo ed eta moderna, 1978; Stato: un'idea, una logica. Dal comune italiano all'assolutismo francese, 1987 y editado a clásicos como Il libri della famiglia de L. B. Alberti, 1969. Es también especialista en temas económicos, como el del

  2. Complicaciones maternas y mortalidad perinatal en el Síndrome de Hellp: Registro multicéntrtico en unidades de cuidados intensivos del área Buenos Aires Maternal morbidity and perinatal mortality in HELLP syndrome. Multicentric studies in intensive care units in Buenos Aires area

    Directory of Open Access Journals (Sweden)

    Eduardo Malvino

    2005-03-01

    Full Text Available Se analizaron en forma retrospectiva las características clínicas, complicaciones, gravedad, y sobrevivencia materna y fetal, en un grupo de gestantes con síndrome HELLP ( Hemolysis , Elevated Liver enzyme levels, Low Platelet count que requirieron admisión en cuatro unidades de cuidados intensivos del área metropolitana Buenos Aires, Argentina. Durante el período comprendido entre marzo de 1997 y marzo de 2003 se evaluaron 62 pacientes en la segunda mitad del embarazo o el puerperio inmediato que cumplían criterios diagnósticos de hipertensión inducida por el embarazo, asociado a plaquetopenia 70 UI/l, láctico deshidrogenasa >600 UI/l, bilirrubina total >1.2 mg / dl , y/o frotis de sangre periférica con signos de hemólisis. La edad promedio fue 28 ± 8 años; número de gestas promedio 2.7 ± 2.3; edad gestacional media 33 ± 4 semanas. Según el grado de plaquetopenia, 23 casos pertenecieron a la clase 1, 29 a la clase 2 y el resto a la clase 3 de la clasificación de Martin . Hubo 16 formas eclámpticas. El recuento plaquetario promedio fue 67 604 ± 31 535/ mm3 ; TGO 271 ± 297 UI/l; TGP 209 ± 178 UI/l; LDH 1 444 ± 1 295 UI/l; creatininemia 1.1 ± 0.8 mg / dl. Cuarenta y una pacientes cursaron con diverso grado de deterioro del filtrado glomerular, con requerimiento de tratamiento hemodialítico y plasmaféresis en un caso. Se presentó insuficiencia respiratoria vinculada a síndrome de distrés respiratorio del adulto en cuatro enfermas. Todas las puérperas sobrevivieron y se comprobaron cuatro muertes perinatales. En la población estudiada, se observó baja prevalencia de complicaciones graves, óptima sobrevivencia materna y baja mortalidad perinatal.We analized the clinical characteristics, complications, severity, and maternal and fetal survival of patients suffering from HELLP syndrome ( Hemolysis , Elevated Liver enzymes level, Low Platelet count requiring admission to the intensive care unit in four hospitals from

  3. A Generalized Loss Network Model with Overflow for Capacity Planning of a Perinatal Network

    CERN Document Server

    Asaduzzaman, Md

    2011-01-01

    We develop a generalized loss network framework for capacity planning of a perinatal network in the UK. Decomposing the network by hospitals, each unit is analyzed with a GI/G/c/0 overflow loss network model. A two-moment approximation is performed to obtain the steady state solution of the GI/G/c/0 loss systems, and expressions for rejection probability and overflow probability have been derived. Using the model framework, the number of required cots can be estimated based on the rejection probability at each level of care of the neonatal units in a network. The generalization ensures that the model can be applied to any perinatal network for renewal arrival and discharge processes.

  4. Perinatal outcomes among immigrant mothers over two periods in a region of central Italy

    Directory of Open Access Journals (Sweden)

    Di Lallo Domenico

    2011-05-01

    Full Text Available Abstract Background The number of immigrants has increased in Italy in the last twenty years (7.2% of the Italian population, as have infants of foreign-born parents, but scanty evidence on perinatal outcomes is available. The aim of this study was to investigate whether infants of foreign-born mothers living in Italy have different odds of adverse perinatal outcomes compared to those of native-born mothers, and if such measures changed over two periods. Methods The source of this area-based study was the regional hospital discharge database that records perinatal information on all births in the Lazio region. We analysed 296,739 singleton births born between 1996-1998 and 2006-2008. The exposure variable was the mother's region of birth. We considered five outcomes of perinatal health. We estimated crude and adjusted odds ratios and 95% confidence intervals (CIs to evaluate the association between mother's region of birth and perinatal outcomes. Results Perinatal outcomes were worse among infants of immigrant compared to Italian mothers, especially for sub-Saharan and west Africans, with the following crude ORs (in 1996-1998 and 2006-2008 respectively: 1.80 (95%CI:1.44-2.28 and 1.95 (95%CI:1.72-2.21 for very preterm births, and 1.32 (95%CI:1.16-1.50 and 1.32 (95%CI:1.25-1.39 for preterm births; 1.18 (95%CI:0.99-1.40 and 1.17 (95%CI:1.03-1.34 for a low Apgar score; 1.22 (95%CI:1.15-1.31 and 1.24 (95%CI:1.17-1.32 for the presence of respiratory diseases; 1.47 (95%CI:1.30-1.66 and 1.45 (95%CI:1.34-1.57 for the need for special or intensive neonatal care/in-hospital deaths; and 1.03 (95%CI:0.93-1.15 and 1.07 (95%CI:1.00-1.15 for congenital malformations. Overall, time did not affect the odds of outcomes differently between immigrant and Italian mothers and most outcomes improved over time among all infants. None of the risk factors considered confounded the associations. Conclusion Our findings suggest that migrant status is a risk factor for

  5. Psychiatric disorders and cognitive outcomes in children and adolescent with perinatally acquired HIV – a review

    Directory of Open Access Journals (Sweden)

    Zielińska, Anna

    2013-06-01

    Full Text Available The main focus of research on consequences of HIV infection is on adult population and not much attention is given to children, especially to children with perinatally acquired HIV. Researches have shown higher frequency of mental disorders in this group. HIV infection also has a negative impact on cognitive functions, especially attention concentration. Among the possible causes of mental disorders and cognitive impairment, attention is not only paid to the neurotoxic effects of HIV on the CNS, but also on other factors, such as awareness of chronic disease, the impact of opportunistic infections and side effects of antiviral therapy. Comorbid psychiatric disorders correlate with worse compliance and higher prevalence of risk behaviors among infected adolescents. This article reviews what is known about psychiatric disorders and cognitive disorders among perinatal HIV-infected children.

  6. Redox status in the blood of ewes in the perinatal period and during lactation

    Directory of Open Access Journals (Sweden)

    Ognik Katarzyna

    2015-12-01

    Full Text Available The aim of the study was to determine the effect of the perinatal period on redox status indicators in the blood of ewes before and after lambing and during lactation. The study was performed on 12 ewes of the synthetic SCP line. Blood for testing of redox parameters was collected seven times: before pregnancy, 1.5 months and 24 h before lambing, 2 and 24 h after lambing, and in the fourth and eighth weeks of lactation. The following blood indices were determined by spectrophotometry: lipid peroxides, malondialdehyde, superoxide dismutase, catalase, plasma total antioxidant capacity, uric acid, urea, bilirubin, and creatinine. The tests showed that during the perinatal period reactions are generated which lead to oxidative stress. Oxidative stress in pregnant ewes was found to increase during the period before lambing and may persist even up to weeks 4-8 of lactation.

  7. Use of brain lactate levels to predict outcome after perinatal asphyxia

    DEFF Research Database (Denmark)

    Leth, H; Toft, P.B.; Peitersen, Birgit;

    1996-01-01

    Perinatal asphyxia is an important cause of neurological disability, but early prediction of outcome can be difficult. We performed proton magnetic resonance spectroscopy (MRS) and global cerebral blood flow measurements by xenon-133 clearance in 16 infants with evidence of perinatal asphyxia....... Cerebral blood flow was determined daily in the first 3 days after birth in seven cases. Proton MRS was performed in 11 infants within the first week (mean 3.7 days), the rest within the first month (mean 22.2 days), and all had a scan around 3 months of age. Four infants died neonatally, three showed...... min-1), (p = 0.02) and outcome. The diagnostic and prognostic implications of early MRS and CBF are predictive of poor outcome in severely asphyxiated infants...

  8. Perinatal stem cells: A promising cell resource for tissueengineering of craniofacial bone

    Institute of Scientific and Technical Information of China (English)

    Jia-Wen Si; Xu-Dong Wang; Steve GF Shen

    2015-01-01

    In facing the mounting clinical challenge and suboptimaltechniques of craniofacial bone defects resulting fromvarious conditions, such as congenital malformations,osteomyelitis, trauma and tumor resection, the ongoingresearch of regenerative medicine using stem cells andconcurrent advancement in biotechnology have shiftedthe focus from surgical reconstruction to a novel stemcell-based tissue engineering strategy for customizedand functional craniofacial bone regeneration. Given theunique ontogenetical and cell biological properties ofperinatal stem cells, emerging evidence has suggestedthese extraembryonic tissue-derived stem cells to be apromising cell source for extensive use in regenerativemedicine and tissue engineering. In this review, wesummarize the current achievements and obstaclesin stem cell-based craniofacial bone regeneration andsubsequently we address the characteristics of varioustypes of perinatal stem cells and their novel applicationin tissue engineering of craniofacial bone. We proposethe promising feasibility and scope of perinatal stemcell-based craniofacial bone tissue engineering for futureclinical application.

  9. Teaching ethics in neonatal and perinatal medicine: What is happening in Canada?

    OpenAIRE

    Daboval, Thierry; Moore, Gregory P; Rohde, Kristina; Moreau, Katherine; Ferretti, Emanuela

    2014-01-01

    Ethically challenging clinical situations are frequently encountered in neonatal and perinatal medicine (NPM), resulting in a complex environment for trainees and a need for ethics training during NPM residency. In the present study, the authors conducted a brief environmental scan to investigate the ethics teaching strategies in Canadian NPM programs. Ten of 13 (77%) accredited Canadian NPM residency programs participated in a survey investigating teaching strategies, content and assessment ...

  10. A coarsened multinomial regression model for perinatal mother to child transmission of HIV

    OpenAIRE

    Brown Elizabeth R; Gard Charlotte C

    2008-01-01

    Abstract Background In trials designed to estimate rates of perinatal mother to child transmission of HIV, HIV assays are scheduled at multiple points in time. Still, infection status for some infants at some time points may be unknown, particularly when interim analyses are conducted. Methods Logistic regression models are commonly used to estimate covariate-adjusted transmission rates, but their methods for handling missing data may be inadequate. Here we propose using coarsened multinomial...

  11. Perinatal exposure to polychlorinated biphenyls and dioxins and its effect on neonatal neurological development

    OpenAIRE

    Huisman, Martijn; Koopman-Esseboom, Corine; Fidler, Vaclav; Hadders-Algra, Mijna; Paauw, Cornelis; Tuinstra, L.G.M.Th.; Weisglas-Kuperus, Nynke; Sauer, Pieter; Touwen, Bert C.; Boersma, Eric

    1995-01-01

    textabstractPolychlorinated biphenyls (PCBs) and dioxins (polychlorinated dibenzo-p-dioxins (PCDDs), and dibenzofurans (PCDFs)) are widespread environmental contaminants which are neurotoxic in animals. Perinatal exposure to PCBs, PCDDs, and PCDFs occurs prenatally via the placenta and postnatally via breast milk. To investigate whether such an exposure affects the neonatal neurological condition, the neurological optimality of 418 Dutch newborns was evaluated with the Prechtl neurological ex...

  12. Perinatal outcome in oligohydramnios and borderline amniotic fluid index: a comparative study

    OpenAIRE

    Pradip R. Gaikwad; Mona S. Oswal; Manisha R. Gandhewar; Binti R. Bhatiyani

    2016-01-01

    Background: Oligohydramnios is associated with adverse perinatal outcome in the form of meconium staining, intrauterine growth restriction (IUGR), caesarean section for abnormal fetal heart rate tracing, low Apgar score and neonatal intensive care unit (NICU) admission. Methods: This was a prospective study of 100 singleton pregnancies beyond 28 weeks of gestation with AFI< 8 cm, delivered within seven days of admission. Patients were divided in two groups, those with AFI and #8804; 5 cm ...

  13. Four Research Findings That Will Change What We Think About Perinatal Depression

    OpenAIRE

    Kendall-Tackett, Kathleen

    2010-01-01

    Research by health psychologists is changing what we know about perinatal depression. In this guest editorial, the author examines depression in pregnant and breastfeeding women in light of this recent research and describes four major findings that are influencing how we think about depression in new mothers: inflammation has an etiologic role in depression, a relationship exists between sleep disturbances and depression, breastfeeding protects maternal mental health, and all effective treat...

  14. Prioritizing WHO normative work on maternal and perinatal health: a multicountry survey

    OpenAIRE

    Coltart Cordelia EM; Souza João; Gülmezoglu Ahmet M

    2011-01-01

    Abstract Background WHO develops evidence-based guidelines for setting global standards and providing technical support to its Member States and the international community, as a whole. There is a clear need to ensure that WHO guidance is relevant, rigorous and up-to date. A key activity is to ascertain the guidance needs of the countries. This study provides an international comparison of priority guidance needs for maternal and perinatal health. It incorporates data from those who inform po...

  15. Is the ferret a suitable species for studying perinatal brain injury?

    OpenAIRE

    Empie, Kristen; Rangarajan, Vijayeta; Juul, Sandra E.

    2015-01-01

    Complications of prematurity often disrupt normal brain development and/or cause direct damage to the developing brain, resulting in poor neurodevelopmental outcomes. Physiologically relevant animal models of perinatal brain injury can advance our understanding of these influences and thereby provide opportunities to develop therapies and improve long-term outcomes. While there are advantages to currently available small animal models, there are also significant drawbacks th...

  16. Effects of Administration of Perinatal Bupropion on the Population Spike Amplitude in Neonatal Rat Hippocampal Slice

    OpenAIRE

    Soomaayeh Heysieat-talab; Samad Zare; Firouz Ghaderi Pakdel; Mina Mokhtari hashtjin

    2010-01-01

    Objective(s)Bupropion is an atypical antidepressant that is widely used in smoke cessation under FDA approval. The study of synaptic effects of bupropion can help to finding out its mechanism(s) for stopping nicotine dependence. In this study the effects of perinatal bupropion on the population spike (PS) amplitude of neonates were investigated. Materials and Methods Hippocampal slices were prepared from 18-25 days old rat pups. The experimental groups included control and bupropion-treated. ...

  17. Pre- and perinatal hypoxia associated with hippocampus/amygdala volume in bipolar disorder

    OpenAIRE

    2013-01-01

    Background Pre- and perinatal adversities may increase the risk for schizophrenia and bipolar disorder. Hypoxia-related obstetric complications (OCs) are associated with brain anatomical abnormalities in schizophrenia, but their association with brain anatomy variation in bipolar disorder is unknown. Method Magnetic resonance imaging brain scans, clinical examinations and data from the Medical Birth Registry of Norway were obtained for 219 adults, including 79 patients with a DSM-IV diagno...

  18. Perinatal mortality in the Netherlands. Backgrounds of a worsening international ranking

    Directory of Open Access Journals (Sweden)

    Joop Garssen

    2004-12-01

    Full Text Available Perinatal mortality rates have dropped sharply in the past few decades, in the Netherlands as well as in all other European countries. However, as the decrease has generally slowed down since the 1980s, the Netherlands has lost its prominent position in the international ranking of countries with favourable perinatal mortality rates. This lower ranking is not only the result of the dialectics of progress, but also the consequence of a relatively restrained use of antenatal diagnostics. In addition, the Netherlands is among the European countries scoring highest on a number of important risk factors. This article examines the effect on perinatal mortality rates of known risk factors, in particular the presence of non-western foreigners, multiple births and older mothers. With respect to the latter factor, it is concluded that children of older mothers run a significantly higher risk of foetal mortality, whereas babies of young mothers (including women in their early twenties run a higher risk of infant mortality. For babies of non-western mothers, infant mortality rates are higher, although there are substantial differences between ethnic backgrounds. First week mortality is most unfavourable for Surinamese and Antillean/Aruban children, and post-neonatal mortality is highest among Turkish and Moroccan babies. The fact that relatively many non-western foreigners from countries with relatively high risks of perinatal mortality have settled in the Netherlands, is one of the reasons for the fall in the international ranking. Lastly, the increase in the number of multiple births has been stronger in the Netherlands than in most other countries. The higher incidence of assisted reproduction explains most of this increase.

  19. Perinatal Risk Factors for Feeding and Eating Disorders in Children Aged 0 to 3 Years

    DEFF Research Database (Denmark)

    Hvelplund, Carolina; Hansen, Bo Mølholm; Koch, Susanne Vinkel;

    2016-01-01

    OBJECTIVE: To describe the incidence, age at diagnosis, and associations between perinatal risk factors of feeding and eating disorders (FED) diagnosed at hospital in children aged 0 to 3 years. METHODS: A nationwide cohort of 901 227 children was followed until 48 months of age in the national...... in the clinical management of young children with persistent problems of feeding, eating, and weight faltering....

  20. The SATELLITE Sexual Violence Assessment and Care Guide for Perinatal Patients

    OpenAIRE

    Ross, Ratchneewan; Roller, Cyndi; Rusk, Tom; Martsolf, Donna; Draucker, Claire

    2009-01-01

    Sexual violence (SV) is a prevalent public health problem affecting millions of women across the lifespan. Poor pregnancy outcomes have been shown to be related to SV experiences; therefore, the perinatal period is an important time for healthcare practitioners (HCPs) to intervene. Various healthcare organizations suggest or even mandate screening for SV. Although SV screening tools are available, many practitioners do not routinely screen their patients. Barriers to screening include lack of...

  1. Premature Birth with Complicated Perinatal Course Delaying Diagnosis of Prader-Willi Syndrome

    OpenAIRE

    S. Demarini; Pecile, V.; G. Ciana; Fertz, M. C.

    2011-01-01

    Prader-Willi syndrome in the newborn is essentially characterized by marked hypotonia, feeding difficulties, hypogonadism, and possible characteristic facial features. However, diagnosis at this age may be particularly difficult, and dysmorphic features may be subtle or absent. Prematurity can furthermore delay clinical features recognition and typical complications due to preterm birth may contribute to divert the diagnosis. We describe a preterm baby with a complicated perinatal course late...

  2. Perspectives on glenohumeral joint contractures and shoulder dysfunction in children with perinatal brachial plexus palsy.

    Science.gov (United States)

    Gharbaoui, Idris S; Gogola, Gloria R; Aaron, Dorit H; Kozin, Scott H

    2015-01-01

    Shoulder joint deformities continue to be a challenging aspect of treating upper plexus lesions in children with perinatal brachial plexus palsy (PBPP). It is increasingly recognized that PBPP affects the glenohumeral joint specifically, and that abnormal scapulothoracic movements are a compensatory development. The pathophysiology and assessment of glenohumeral joint contractures, the progression of scapular dyskinesia and skeletal dysplasia, and current shoulder imaging techniques are reviewed. PMID:25835253

  3. Reaching Perinatal Women Online: The Healthy You, Healthy Baby Website and App

    OpenAIRE

    Lydia Hearn; Margaret Miller; Leanne Lester

    2014-01-01

    Overwhelming evidence reveals the close link between unwarranted weight gain among childbearing women and childhood adiposity. Yet current barriers limit the capacity of perinatal health care providers (PHCPs) to offer healthy lifestyle counselling. In response, today’s Internet savvy women are turning to online resources to access health information, with the potential of revolutionising health services by enabling PHCPs to guide women to appropriate online resources. This paper presents the...

  4. Hospital-based Perinatal Outcomes and Complications in Teenage Pregnancy in India

    OpenAIRE

    Mukhopadhyay, Prianka; Chaudhuri, R. N.; Paul, Bhaskar

    2010-01-01

    Teenage pregnancy is a worldwide problem bearing serious social and medical implications relating to maternal and child health. A cross-sectional observational study was undertaken to compare the different sociodemographic characteristics and perinatal outcomes of teenage primigravida mothers with those of adult primigravida mothers in a tertiary-care hospital in eastern India. A sample of 350 each in cases and comparison group comprised the study subjects. Data were collected through intervi...

  5. Building a national perinatal database without the use of unique personal identifiers

    OpenAIRE

    Schnell, R.; Borgs, C

    2015-01-01

    To assess the quality of hospital care, national databases of standard medical procedures are common. A widely known example are national databases of births. If unique personal identification numbers are available (as in Scandinavian countries), the construction of such databases is trivial from a computational point of view. However, due to privacy legislation, such identifiers are not available in all countries. Given such constraints, the construction of a national perinatal database has ...

  6. Drug-related perinatal damage from the pathological point of view

    OpenAIRE

    Daniela Fanni; Vassilios Fanos; Clara Gerosa; Rossano Ambu; Yukio Gibo; Gavino Faa

    2014-01-01

    Drug dosage in the perinatal period represents a continuous challenge for the neonatologist because of interindividual variability of drug metabolism. The human liver plays a central role in the uptake, transport, metabolism and excretion of the vast majority of xenobiotics and drugs. The protein products of human CYP3A account for the largest portion of CYP450 proteins in human liver. At least 50% of currently used drugs in neonatal intensive care units (NICUs) are substrates of CYP3A4 inclu...

  7. Glutamate receptors: The cause or cure in perinatal white matter injury?

    OpenAIRE

    Fields, R. Douglas

    2010-01-01

    Glutamate toxicity from hypoxia-ischemia during the perinatal period causes white matter injury that can result in long-term motor and intellectual disability. Blocking ionotropic glutamate receptors has been shown to inhibit oligodendrocyte injury in vitro, but glutamate receptor antagonists have not yet proven helpful in clinical studies. The opposite approach of activating glutamate receptors on developing oligodendrocytes shows promise in experimental studies on rodents. Group I metabotro...

  8. A call to the use of the clinical method in the practice of perinatal medicine

    OpenAIRE

    Carlos Esteban Zerquera Álvarez

    2010-01-01

    A reflection on the appropriateness and current application of the clinical method, defined as the diagnostic process inherent to the practice of human medicine is presented. Considerations about the scientific nature of the clinical method and its application in perinatal medicine along with its specific characteristics in this field are stated. Several considerations about the impact of high technology and the risk of its use when the appropriate balance is not achieved, which could lead to...

  9. Calcineurin/Nfat signaling is required for perinatal lung maturation and function

    OpenAIRE

    Davé, Vrushank; Childs, Tawanna; Xu, Yan; Ikegami, Machiko; Besnard, Valérie; Maeda, Yutaka; Wert, Susan E.; Neilson, Joel R.; Crabtree, Gerald R.; Whitsett, Jeffrey A.

    2006-01-01

    Pulmonary surfactant proteins and lipids are required for lung function after birth. Lung immaturity and resultant surfactant deficiency cause respiratory distress syndrome, a common disorder contributing to morbidity and mortality in preterm infants. Surfactant synthesis increases prior to birth in association with formation of the alveoli that mediate efficient gas exchange. To identify mechanisms controlling perinatal lung maturation, the Calcineurin b1 (Cnb1) gene was deleted in the respi...

  10. Psychiatric disorders and cognitive outcomes in children and adolescent with perinatally acquired HIV – a review

    OpenAIRE

    Zielińska, Anna; Kaźmierczak-Mytkowska, Anna; Bryńska Anita

    2013-01-01

    The main focus of research on consequences of HIV infection is on adult population and not much attention is given to children, especially to children with perinatally acquired HIV. Researches have shown higher frequency of mental disorders in this group. HIV infection also has a negative impact on cognitive functions, especially attention concentration. Among the possible causes of mental disorders and cognitive impairment, attention is not only paid to the neurotoxic effects of HIV on the...

  11. Computer- or web-based interventions for perinatal mental health: A systematic review

    OpenAIRE

    Ashford, M. T.; Olander, E. K.; Ayers, S.

    2016-01-01

    Background: Treating prenatal mental health issues is of great importance, but access to treatment is often poor. One way of accessing treatment is through computer- or web-based interventions. Reviews have shown that these interventions can be effective for a variety of mental health disorder across different populations. However, their effectiveness for women in the perinatal period has not been reviewed. This review therefore aimed to provide a first overview of computer- or web-based i...

  12. An unusual prenatal manifestation of a huge congenital cystic adenomatoid malformation with favorable perinatal outcome

    OpenAIRE

    Suk, Hye-Jin; Won, Hye-Sung; Lee, Eun Jung; Lee, Mi-Young

    2014-01-01

    Congenital cystic adenomatoid malformation (CCAM) is a rare condition which is easily detectable by prenatal ultrasonography. Fetuses with large CCAMs associating with hydrops are predisposed to perinatal mortality, therefore prenatal intervention is required. While macrocystic CCAM is treated prenatally by thoracentesis or thoraco-amniotic shunt, microcystic or mixed CCAM is difficult to manage in the fetus. In these latter lesions, fetal lobectomy, sclerotherapy, or laser ablation was used ...

  13. Perinatal programming of body weight control by leptin: putative roles of AMP kinase and muscle thermogenesis

    Czech Academy of Sciences Publication Activity Database

    Pico, C.; Macek Jílková, Zuzana; Kůs, Vladimír; Palou, A.; Kopecký, Jan

    2011-01-01

    Roč. 94, 6 suppl. (2011), 1830S-1837S. ISSN 0002-9165. [International Conference on The Power of Programming - Developmental Origins of Health and Disease. Munich, 06.05.2010-08.05.2010] Institutional research plan: CEZ:AV0Z50110509 Keywords : leptin * perinatal programming * AMPK * muscle thermogenesis Subject RIV: FB - Endocrinology, Diabetology, Metabolism, Nutrition Impact factor: 6.669, year: 2011

  14. Perinatal taurine exposure alters renal potassium excretion mechanisms in adult conscious rats

    OpenAIRE

    Roysommuti, Sanya; Malila, Pisamai; Lerdweeraphon, Wichaporn; Jirakulsomchok, Dusit; Wyss, J. Michael

    2010-01-01

    Perinatal taurine exposure has long-term effects on the arterial pressure and renal function. This study tests its influence on renal potassium excretion in young adult, conscious rats. Female Sprague-Dawley rats were fed normal rat chow and given water alone (C), 3% beta-alanine in water (taurine depletion, TD) or 3% taurine in water (taurine supplementation, TS), either from conception until delivery (fetal period; TDF or TSF) or from delivery until weaning (lactation period; TDL or TSL). I...

  15. Prioritizing WHO normative work on maternal and perinatal health: a multicountry survey

    Directory of Open Access Journals (Sweden)

    Coltart Cordelia EM

    2011-10-01

    Full Text Available Abstract Background WHO develops evidence-based guidelines for setting global standards and providing technical support to its Member States and the international community, as a whole. There is a clear need to ensure that WHO guidance is relevant, rigorous and up-to date. A key activity is to ascertain the guidance needs of the countries. This study provides an international comparison of priority guidance needs for maternal and perinatal health. It incorporates data from those who inform policy and implementation strategies at a national level, in addition to targeting those who use and most need the guidance at grassroot level. Methods An online multi-country survey was used to identify WHO guidance priorities for the next five years in the field of maternal and perinatal health. WHO regional and country offices were requested to respond the survey and obtain responses from Ministries of Health around the world. In addition, the survey was disseminated through other networks and relevant electronic forums. Results A total of 393 responses were received, including 56 from Ministries of Health and 54 from WHO/UN country offices. 75% of responses were from developing countries and 25% from developed countries. Guidance on strategies focusing on 'quality of care' issues to reduce all-cause maternal/perinatal mortality was considered the most important domain to target, which includes for instance guidance to improve access, dissemination, implementation of effective practices and health professionals' education. Conclusions This study provides a panorama of international priority guidance needs for maternal and perinatal health. Although clinical guidance remains a priority, there are other areas related to health systems guidance, which seem to be even more important. Overall, the domain ranked highest in terms of greatest need for guidance was around quality of care, which included questions related to educational needs, access to and

  16. Concentrations of Methadone in Breast Milk and Plasma in the Immediate Perinatal Period

    OpenAIRE

    Jansson, Lauren M.; Choo, Robin E.; Harrow, Cheryl; Velez, Martha; Schroeder, Jennifer R.; Lowe, Ross; Huestis, Marilyn A.

    2007-01-01

    This study evaluates concentrations of methadone in breast milk and plasma among a sample of methadone-maintained women in the immediate perinatal period. Twelve methadone-maintained, lactating women provided blood and breast milk specimens 1, 2, 3, and 4 days after delivery. Specimens were collected at the time of trough (just before methadone dose) and peak (3 hours after dosing) maternal methadone levels. Paired specimens of foremilk (prefeed) and hindmilk (postfeed) were obtained at each ...

  17. CLINICAL STUDY TO EVALUATE THE MATERNAL AND PERINATAL OUTCOME OF PREGNANCIES WITH POLYHYDRAMNIOS

    OpenAIRE

    Sudha; Juhi; Mahendra

    2013-01-01

    ABSTRACT: BACKGROUND : Due to active involvement of fetal system in regulation of amn iotic fluid volume, AFI has been identified as indicator of intrauterine fetal status. USG has revolutionized the process of assessment of amniotic fluid thus becoming an integral part of fetal surveillance . Polyhydramnios is an obstetrical condition assoc iated with significant perinatal and maternal morbidity and mortality. In a low resource health facility as Ind...

  18. Assessment of perinatal outcome after sustained tocolysis in early labour (APOSTEL-II trial

    Directory of Open Access Journals (Sweden)

    Scherjon Sicco A

    2009-09-01

    Full Text Available Abstract Background Preterm labour is the main cause of perinatal morbidity and mortality in the Western world. At present, there is evidence that tocolysis for 48 hours is useful in women with threatened preterm labour at least before 32 weeks. This allows transfer of the patient to a perinatal centre, and maximizes the effect of corticosteroids for improved neonatal survival. It is questionable whether treatment with tocolytics should be maintained after 48 hours. Methods/Design The APOSTEL II trial is a multicentre placebo-controlled study. Pregnant women admitted for threatened preterm labour who have been treated with 48 hours corticosteroids and tocolysis will be eligible to participate in the trial between 26+0 and 32+2 weeks gestational age. They will be randomly allocated to nifedipine (intervention or placebo (control for twelve days or until delivery, whatever comes first. Primary outcome is a composite of perinatal death, and severe neonatal morbidity up to evaluation at 6 months after birth. Secondary outcomes are gestational age at delivery, number of days in neonatal intensive care and total days of the first 6 months out of hospital. In addition a cost-effectiveness analysis will be performed. Analysis will be by intention to treat. The power calculation is based on an expected 11% difference in adverse neonatal outcome. This implies that 406 women have to be randomised (two sided test, β 0.2 at alpha 0.05. Discussion This trial will provide evidence as to whether maintenance tocolysis reduces severe perinatal morbidity and mortality in women with threatened preterm labour before 32 weeks. Trial Registration Clinical trial registration: http://www.trialregister.nl, NTR 1336, date of registration: June 3rd 2008.

  19. Gestational and Pregestational Diabetes Mellitus in Omani Women; Comparison of obstetric and perinatal outcomes

    Directory of Open Access Journals (Sweden)

    Adel T. Abu-Heija

    2015-11-01

    Full Text Available Objectives: The aim of this study was to assess the prevalence of gestational diabetes mellitus (GDM and pregestational diabetes mellitus (PGDM among pregnant women in Oman and compare their obstetric and perinatal outcomes. Methods: This retrospective study assessed the obstetric and perinatal outcomes of pregnant Omani women with GDM or PGDM who delivered at the Sultan Qaboos University Hospital in Muscat, Oman, between January 2009 and December 2010. Results: There were a total of 5,811 deliveries during the study period. Of the 5,811 women who gave birth, 639 women were found to have diabetes mellitus (11.0%. A total of 581 of the diabetic women had GDM (90.9% and only 58 (9.1% had PGDM. Women with PGDM had a significantly higher incidence of pre-eclampsia (P = 0.022, preterm deliveries (P <0.001 and Caesarean sections (P <0.001. Neonatal complications, such as respiratory distress syndrome (RDS, neonatal hypoglycaemia, neonatal jaundice and subsequent admission to a neonatal intensive care unit (NICU were significantly higher for neonates born to mothers with PGDM compared to those born to mothers with GDM (P <0.001. The corrected perinatal mortality rates for women with PGDM and GDM were 34.5 and 13.7 per 1,000 live births, respectively. Conclusion: In this Omani cohort, women with PGDM were at higher risk of developing obstetric and perinatal complications such as pre-eclampsia, preterm delivery and Caesarean delivery compared to women with GDM. In addition, neonates who had mothers with PGDM had higher rates of RDS, neonatal hypoglycaemia, neonatal jaundice and admission to the NICU.

  20. Perinatal taurine depletion increases susceptibility to adult sugar-induced hypertension in rats

    OpenAIRE

    Roysommuti, Sanya; Suwanich, Atchariya; Jirakulsomchok, Dusit; Wyss, J. Michael

    2009-01-01

    This study tests the hypothesis that perinatal taurine depletion produces autonomic nervous system dysregulation and increases arterial pressure in young male rats on a high sugar diet. Sprague-Dawley dams were taurine depleted (beta-alanine 3% in water) or untreated from conception to weaning. Their male offspring were fed normal rat chow with or without 5% glucose. At 7–8 weeks of age, male offspring were tested in a conscious, unrestrained or an anesthetic state. Body weight was slightly l...

  1. Interpretative views on Hispanics' perinatal problems of low birth weight and prenatal care.

    OpenAIRE

    Balcazar, H.; Aoyama, C; X. Cai

    1991-01-01

    From a public health perspective, there is a need to recognize that Hispanics, and in particular Mexican Americans, are a very heterogeneous group. They represent all shades of acculturation, education, income, and citizenship status. As this minority group continues to increase in numbers, pertinent information about their perinatal health problems in the context of their sociocultural characteristics will be required. This review examines critically the recent literature related to low birt...

  2. Sexual differentiation of the brain requires perinatal kisspeptin-GnRH neuron signaling.

    Science.gov (United States)

    Clarkson, Jenny; Busby, Ellen R; Kirilov, Milen; Schütz, Günther; Sherwood, Nancy M; Herbison, Allan E

    2014-11-12

    Sex differences in brain function underlie robust differences between males and females in both normal and disease states. Although alternative mechanisms exist, sexual differentiation of the male mammalian brain is initiated predominantly by testosterone secreted by the testes during the perinatal period. Despite considerable advances in understanding how testosterone and its metabolite estradiol sexually differentiate the brain, little is known about the mechanism that generates the male-specific perinatal testosterone surge. In mice, we show that a male-specific activation of GnRH neurons occurs 0-2 h following birth and that this correlates with the male-specific surge of testosterone occurring up to 5 h after birth. The necessity of GnRH signaling for the sexually differentiating effects of the perinatal testosterone surge was demonstrated by the persistence of female-like brain characteristics in adult male, GnRH receptor knock-out mice. Kisspeptin neurons have recently been identified to be potent, direct activators of GnRH neurons. We demonstrate that a population of kisspeptin neurons appears in the preoptic area of only the male between E19 and P1. The importance of kisspeptin inputs to GnRH neurons for the process of sexual differentiation was demonstrated by the lack of a normal neonatal testosterone surge, and disordered brain sexual differentiation of male mice in which the kisspeptin receptor was deleted selectively from GnRH neurons. These observations demonstrate the necessity of perinatal GnRH signaling for driving brain sexual differentiation and indicate that kisspeptin inputs to GnRH neurons are essential for this process to occur. PMID:25392497

  3. Maternal and perinatal aspects of birth defects: a case-control study

    OpenAIRE

    Geiza Cesar Nhoncanse; Germano, Carla Maria R.; Lucimar Retto da S. de Avo; Debora Gusmao Melo

    2014-01-01

    Objective: To assess the prevalence of congenital defects and to investigate their maternal and perinatal associated aspects by reviewing Birth Certificates. Methods: Among all born alive infants from January 2003 to December 2007 in Maternidade da Santa Casa de Misericórdia of São Carlos, Southeast Brazil (12,199 infants), cases were identified as the newborns whose Birth Certificates registered any congenital defect. The same sex neonate born immediately after the case was chosen as a ...

  4. THE POTENTIAL FOR CELL-BASED THERAPY IN PERINATAL BRAIN INJURIES

    OpenAIRE

    Phillips, Andre W.; Johnston, Michael V.; Fatemi, Ali

    2013-01-01

    Perinatal brain injuries are a leading cause of cerebral palsy worldwide. The potential of stem cell therapy to prevent or reduce these impairments has been widely discussed within the medical and scientific communities and an increasing amount of research is being conducted in this field. Animal studies support the idea that a number of stem cells types, including cord blood and mesenchymal stem cells have a neuroprotective effect in neonatal hypoxia-ischemia. Both these cell types are readi...

  5. Intimate Partner Violence and Maternal Depression During the Perinatal Period: A Longitudinal Investigation of Latinas

    OpenAIRE

    Rodriguez, Michael A.; Valentine, Jeannette; Ahmed, Sawssan R.; Eisenman, David P; Sumner, Lekeisha A.; Heilemann, MarySue V.; Liu, Honghu

    2010-01-01

    This study assessed the course of perinatal depression amongst 210 Latinas who were and were not affected by intimate partner violence (IPV) and identified associated psychosocial factors. Peak depression prevalence occurred prenatally among 45.7% of IPV-exposed and 24.6% of non-IPV-exposed Latinas. At each assessment, depression was significantly higher for IPV-exposed compared to non-IPV-exposed mothers. Mastery and social support were associated with lower depression, while history of IPV,...

  6. Effects of nutritional management intervention on gestational weight gain and perinatal outcome

    OpenAIRE

    Luo, Xiao-Dong; Dong, Xiaojing; Zhou, Jin

    2014-01-01

    ABSTRACT Objectives: To evaluate whether nutritional management intervention can prevent excessive weight gain during pregnancy and improve perinatal outcomes. Methods: This cross-sectional study included 276 pregnant women undergoing prenatal care between June 2010 and December 2011 at the Obstetrics and Gynecology Department of the Second Affiliate Hospital of the ChongQing University of Medical Sciences, Chongqing, China. Of them, 131 women received individualized nutritional management in...

  7. Unintended pregnancy and perinatal depression trajectories in low-income, high-risk Hispanic immigrants

    OpenAIRE

    2011-01-01

    Perinatal depression is a prevalent and detrimental condition. Determining modifiable factors associated with it would identify opportunities for prevention. This paper: 1) identifies depressive symptom trajectories and heterogeneity in those trajectories during pregnancy through the first year postpartum, and 2) examines the association between unintended pregnancy and depressive symptoms. Depressive symptoms (BDI-II) were collected from low-income Hispanic immigrants (n= 215) 5 times from e...

  8. Depression during pregnancy in women with a medical disorder: risk factors and perinatal outcomes

    OpenAIRE

    Gláucia Rosana Guerra Benute; Roseli Mieko Yamamoto Nomura; Juliana Siracuza Reis; Renério Fraguas Junior; Mara Cristina Souza de Lucia; Marcelo Zugaib

    2010-01-01

    BACKGROUND: Approximately one‐fifth of women present depression during pregnancy and puerperium, and almost 13% of pregnant women experience a major depressive disorder. OBJECTIVE: The aim of this study was to identify risk factors for depression among pregnant women with a medical disorder and to evaluate the influence of depression on perinatal outcomes. METHODS: Three hundred and twenty‐six pregnant women with a medical disorder were interviewed. A semistructured interview was conducted fo...

  9. con el aborto provocado

    Directory of Open Access Journals (Sweden)

    José Luis Redondo Calderón

    2008-01-01

    Full Text Available Las vacunas de células diploides humanas (WI-38, MRC-5 tienen un origen éticamente objetable, dado que dichas células proceden de abortos provocados. Entre ellas destacan vacunas empleadas contra rubéola, sarampión, parotiditis, rabia, poliomielitis, viruela, hepatitis A, varicela y herpes zóster. Actualmente se encuentran en desarrollo otras vacunas cultivadas en células (293, PER.C6 transformadas mediante virus, procedentes de abortos. Entre ellas hay vacunas contra la gripe, virus respiratorio sincitial, parainfl uenza, HIV, virus del Nilo Occidental, virus Ébola, Marburg y Lassa, hepatitis B y C, glosopeda, encefalitis japonesa, dengue, tuberculosis, carbunco, peste, tétanos y paludismo. También con igual origen se trabaja en la elaboración de anticuerpos monoclonales y otras proteínas, terapia génica y genómica. Existe la tecnología necesaria para producir todo lo descrito sin recurrir a abortos provocados. Debe indicarse en los prospectos de vacunas y otros productos el origen de las células empleadas. Debe facilitarse el acceso a las vacunas existentes no cultivadas en células procedentes de abortos provocados. Debe potenciarse la investigación de opciones en aquellos casos en los que no exista una vacuna no originada en células procedentes de abortos provocados. Debe potenciarse la elaboración de anticuerpos monoclonales y de otras proteínas, así como la terapia génica y la genómica sin recurrir a células procedentes de abortos provocados. No sería consecuente rechazar productos obtenidos a partir de células troncales embrionarias y aceptar los originados en células procedentes de abortos provocados. Se debe evitar que la biotecnología basada en el aborto provocado invada todos los terrenos de la medicina.

  10. Perinatal outcome in sickle cell anemia: a prospective study from India.

    Science.gov (United States)

    Daigavane, Mayoor M; Jena, Rabindra K; Kar, Tushar J

    2013-01-01

    Sickle cell anemia, the homozygous genotype of sickle cell disease is one of the most common heritable diseases in the world. The Arab-Asian haplotype present in India is one of the least severe of all haplotypes. Many sickle cell anemia patients are now leading a symptom-free productive life due to hydroxyurea (HU) and better supportive care. Although pregnancy in sickle cell anemia patients is considered a high-risk category, it perinatal outcome is least studied, particularly among carriers of the Arab-Asian haplotype. Thus, the present prospective, randomized study was performed to assess the perinatal outcome in sickle cell anemia. Neonatal outcome such as low birth weight, perinatal mortality rate, special care newborn unit (SCNU) admission, intrauterine growth retardation (IUGR) and pre term births were significantly higher in sickle cell anemia mothers. Maternal outcome such as severe anemia, preeclampsia, vasoocclusive crisis (VOC), pulmonary complications, jaundice and blood transfusion requirements were significantly higher in sickle cell anemia mothers, which were successfully managed. Cesarian section rate was not significantly different from normal controls. Successful pregnancies were achieved in 84.44% of cases. However, we strongly recommend that pregnancies in these patients should be managed in an institutional setup. PMID:23952263

  11. Perinatal outcomes of Southeast Asians with pregnancies complicated by gestational diabetes mellitus or preeclampsia.

    Science.gov (United States)

    Cripe, Swee May; O'Brien, William; Gelaye, Bizu; Williams, Michelle A

    2012-10-01

    To examine risks for adverse perinatal outcomes among Southeast Asian women with pregnancies complicated by gestational diabetes mellitus (GDM) or preeclampsia. Perinatal outcomes of singleton births of Cambodian (3,489), Laotian (2,038), Vietnamese (11,605), Japanese (3,083) and non-Hispanic White women (33,088) were analyzed using Washington state linked birth certificate and hospitalization discharge records (1993-2006). Both Cambodian (aOR = 1.68) and Laotian (aOR = 1.71) women with GDM had increased odds of macrosomia when compared with Japanese women with GDM. Southeast Asian women with GDM had reduced odds of macrosomia when compared with White women. Southeast Asian women with preeclampsia had increased odds for preterm delivery when compared with Japanese and White women with preeclampsia. Research is needed to understand why Southeast Asian women with GDM are more likely to have better perinatal outcomes when compared with White women. Vigilant monitoring and culturally sensitive care for Southeast Asian women with preeclampsia is needed. PMID:22002706

  12. Evaluating Rate and Causes of Perinatal Mortality in Hospitals of Yazd Province in 2012

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    F Ghasemi

    2015-12-01

    Full Text Available Introduction: Prenatal mortality rate is regarded as an important index of health in a community. In order to maintain and promote health of infants, as a vulnerable group, factors affecting prenatal mortality need to be identified and appropriate strategies should be designed. Therefore, the present study aimed to investigate the causes of prenatal mortality on the basis of babies’ record in hospitals of Yazd province. Methods: This descriptive study was conducted using the available data in the files. The study population entailed children who were born dead in 2012 in 15 medical centers in Yazd or who were born alive after 22 weeks of pregnancy, but died within 29 days after the birth. Causes of death were extracted from the files  according to the related doctor’s opinion. Results: A total of 390 perinatal deaths were registered in Yazd hospital. The perinatal mortality rate was reported 14 out of 1000 alive births. The most common causes of perinatal mortality belonged to respiratory distress syndrome (42.05 %, late delivery (22.7 %, as well as abruption (4.6% in regard with fetus- recorded,  mother-recorded, and  placenta-recorded causes respectively. Conclusion: Emphasizing prenatal care, detecting and tracking  high risk pregnancies as well as developing neonatal intensive care units might be taken into account as the most important factors in prevention of prenatal death.

  13. Impact of antenatal depression on perinatal outcomes and postpartum depression in Korean women

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    Sae Kyung Choi

    2014-01-01

    Full Text Available Background: Maternal prenatal mental health has been shown to be associated with adverse consequences for the mother and the child. However, studies considering the effect of prenatal depressive symptoms are lacking. The aim of this study was to examine the influence of antenatal depressive symptoms on obstetric outcomes and to determine associations between antenatal and postpartum depressions. Materials and Methods: This was a prospective cohort study. The Edinburgh postnatal depression scale (EPDS questionnaire was completed by pregnant women receiving obstetrical care at Seoul St. Mary′s hospital in the third trimester of gestation. The electronic medical records were reviewed after delivery and perinatal outcomes were evaluated. The association between antenatal and postpartum depression was analyzed using the EPDS questionnaire, which was completed by the same women within 2 months of delivery. Results: Of the 467 participants, 26.34% (n = 123 had antenatal depressive symptoms, with EPDS scores of ≥10. There were no significant perinatal outcomes associated with antenatal depressive symptoms. During the postpartum period, 192 of the women in the initial study cohort were given the EPDS again as a follow-up. Of the 192 participants, 56 (29.17% scored >10. Spearman correlation coefficient between the antenatal and postpartum EPDS scores was 0.604, which was statistically significant (P < 0.001. Conclusion: Antenatal depression does not lead to unfavorable perinatal outcomes. However, screening for antenatal depression may be helpful to identify women at risk of postpartum depression.

  14. MMPI-2: Cluster Analysis of Personality Profiles in Perinatal Depression—Preliminary Evidence

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    Valentina Meuti

    2014-01-01

    Full Text Available Background. To assess personality characteristics of women who develop perinatal depression. Methods. The study started with a screening of a sample of 453 women in their third trimester of pregnancy, to which was administered a survey data form, the Edinburgh Postnatal Depression Scale (EPDS and the Minnesota Multiphasic Personality Inventory 2 (MMPI-2. A clinical group of subjects with perinatal depression (PND, 55 subjects was selected; clinical and validity scales of MMPI-2 were used as predictors in hierarchical cluster analysis carried out. Results. The analysis identified three clusters of personality profile: two “clinical” clusters (1 and 3 and an “apparently common” one (cluster 2. The first cluster (39.5% collects structures of personality with prevalent obsessive or dependent functioning tending to develop a “psychasthenic” depression; the third cluster (13.95% includes women with prevalent borderline functioning tending to develop “dysphoric” depression; the second cluster (46.5% shows a normal profile with a “defensive” attitude, probably due to the presence of defense mechanisms or to the fear of stigma. Conclusion. Characteristics of personality have a key role in clinical manifestations of perinatal depression; it is important to detect them to identify mothers at risk and to plan targeted therapeutic interventions.

  15. Perinatal Obstetric Office Depression Screening and Treatment: Implementation in a Health Care System.

    Science.gov (United States)

    Flanagan, Tracy; Avalos, Lyndsay A

    2016-05-01

    Perinatal depression affects between 12% and 20% of pregnant and postpartum women and is underdiagnosed. The American College of Obstetricians and Gynecologists and the U.S. Preventive Services Task Force recently recommended universal perinatal depression screening. We discuss challenges to instituting universal screening, describe the development and implementation between 2007 and 2014 of Kaiser Permanente Northern California's successful program, and highlight key measures of success. A quality improvement system approach with four steps guided development: 1) identify and use best practices, 2) identify champions and educate clinicians, 3) use data that drive performance, and 4) streamline office workflow. Clinical success was determined by at least 50% improvement in depression care metrics from diagnosis to 120 days afterward. Depression diagnoses, Patient Health Questionnaire-9 scores, medication dispensation, and treatment for all births in 2014 (N=37,660) were extracted from electronic health records. Ninety-six percent of pregnant and postpartum women were screened at least once. Fourteen percent screened positive for depression (Patient Health Questionnaire-9 score of 10 or greater). Approximately 6% of pregnant and postpartum women had severe depression with a Patient Health Questionnaire-9 of 15 or greater and a depression diagnosis, and 80% of these women received treatment. Forty percent of women with a depression diagnosis demonstrated improved symptoms. Kaiser Permanente Northern California's universal perinatal depression screening program can serve as a model for the feasibility and clinical effectiveness of universal depression screening in obstetric care. PMID:27054937

  16. A retrospective chart review to identify perinatal factors associated with food allergies

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    Karpa Kelly

    2012-10-01

    Full Text Available Abstract Background Gut flora are important immunomodulators that may be disrupted in individuals with atopic conditions. Probiotic bacteria have been suggested as therapeutic modalities to mitigate or prevent food allergic manifestations. We wished to investigate whether perinatal factors known to disrupt gut flora increase the risk of IgE-mediated food allergies. Methods Birth records obtained from 192 healthy children and 99 children diagnosed with food allergies were reviewed retrospectively. Data pertaining to delivery method, perinatal antibiotic exposure, neonatal nursery environment, and maternal variables were recorded. Logistic regression analysis was used to assess the association between variables of interest and subsequent food allergy diagnosis. Results Retrospective investigation did not find perinatal antibiotics, NICU admission, or cesarean section to be associated with increased risk of food allergy diagnosis. However, associations between food allergy diagnosis and male gender (66 vs. 33; p=0.02 were apparent in this cohort. Additionally, increasing maternal age at delivery was significantly associated with food allergy diagnosis during childhood (OR, 1.05; 95% CI, 1.017 to 1.105; p=0.005. Conclusions Gut flora are potent immunomodulators, but their overall contribution to immune maturation remains to be elucidated. Additional understanding of the interplay between immunologic, genetic, and environmental factors underlying food allergy development need to be clarified before probiotic therapeutic interventions can routinely be recommended for prevention or mitigation of food allergies. Such interventions may be well-suited in male infants and in infants born to older mothers.

  17. Prenatal, Perinatal and Neonatal Risk Factors for Intellectual Disability: A Systemic Review and Meta-Analysis

    Science.gov (United States)

    Qu, Yi; Mu, Dezhi

    2016-01-01

    Background The etiology of non-genetic intellectual disability (ID) is not fully known, and we aimed to identify the prenatal, perinatal and neonatal risk factors for ID. Method PubMed and Embase databases were searched for studies that examined the association between pre-, peri- and neonatal factors and ID risk (keywords “intellectual disability” or “mental retardation” or “ID” or “MR” in combination with “prenatal” or “pregnancy” or “obstetric” or “perinatal” or “neonatal”. The last search was updated on September 15, 2015. Summary effect estimates (pooled odds ratios) were calculated for each risk factor using random effects models, with tests for heterogeneity and publication bias. Results Seventeen studies with 55,344 patients and 5,723,749 control individuals were eligible for inclusion in our analysis, and 16 potential risk factors were analyzed. Ten prenatal factors (advanced maternal age, maternal black race, low maternal education, third or more parity, maternal alcohol use, maternal tobacco use, maternal diabetes, maternal hypertension, maternal epilepsy and maternal asthma), one perinatal factor (preterm birth) and two neonatal factors (male sex and low birth weight) were significantly associated with increased risk of ID. Conclusion This systemic review and meta-analysis provides a comprehensive evidence-based assessment of the risk factors for ID. Future studies are encouraged to focus on perinatal and neonatal risk factors and the combined effects of multiple factors. PMID:27110944

  18. Introduction and overview. Perinatal carcinogenesis: growing a node for epidemiology, risk management, and animal studies

    International Nuclear Information System (INIS)

    Perinatal carcinogenesis as a cross-disciplinary concern is the subject of this special issue of Toxicology and Applied Pharmacology, which consists of a total of eight reviews or commentaries in the areas of epidemiology, risk assessment, and animal models. Some of the conclusions from these articles, and the Questions and Answers section that follows most of them, are summarized here. There is adequate reason to suspect that perinatal exposures contribute to human cancer risk, both childhood cancers, and those appearing later in life. The latter type of risk may actually be quantitatively the more important, and involve a wide range of types of effects, but has received only limited attention. With regard to childhood cancers, fetal irradiation and diethylstilbestrol exposure are known etiological agents, and it is likely, but not yet certain, there are additional external causes of a portion of these. Some current focal points of interest here include nitroso compounds, DNA topoisomerase inhibitors, viruses, anti-AIDS drugs, and endocrine disruptors. Regulatory agencies must rely heavily on animal data for estimation of human risk due to perinatal exposures to chemicals, and the quantity and quality of these data presently available for this purpose are greatly limiting. Correctly designed conventional animal studies with suspect chemicals are still needed. Furthermore, genetically engineered mouse models for childhood cancers, especially medulloblastoma, have become available, and could be used for screening of candidate causative agents for this cancer type, and for better understanding of gene-environment interactions

  19. Head morphology in perinatal dolphins: a window into phylogeny and ontogeny.

    Science.gov (United States)

    Rauschmann, Michael A; Huggenberger, Stefan; Kossatz, Lars S; Oelschläger, Helmut H A

    2006-11-01

    In this paper on the ontogenesis and evolutionary biology of odontocete cetaceans (toothed whales), we investigate the head morphology of three perinatal pantropical spotted dolphins (Stenella attenuata) with the following methods: computer-assisted tomography, magnetic resonance imaging, conventional X-ray imaging, cryo-sectioning as well as gross dissection. Comparison of these anatomical methods reveals that for a complete structural analysis, a combination of modern imaging techniques and conventional morphological methods is needed. In addition to the perinatal dolphins, we include series of microslides of fetal odontocetes (S. attenuata, common dolphin Delphinus delphis, narwhal Monodon monoceros). In contrast to other mammals, newborn cetaceans represent an extremely precocial state of development correlated to the fact that they have to swim and surface immediately after birth. Accordingly, the morphology of the perinatal dolphin head is very similar to that of the adult. Comparison with early fetal stages of dolphins shows that the ontogenetic change from the general mammalian bauplan to cetacean organization was characterized by profound morphological transformations of the relevant organ systems and roughly seems to parallel the phylogenetic transition from terrestrial ancestors to modern odontocetes. PMID:17051542

  20. Perinatal outcome and near-miss morbidity between placenta previa versus abruptio placentae

    International Nuclear Information System (INIS)

    To compare perinatal outcome and near-miss morbidities between placenta previa versus abruptio placentae in patients of antepartum haemorrhage (APH). Patients with APH diagnosed as placenta previa and abruptio placentae who delivered after 24 weeks of regnancy were selected from labour room. Outcome measures were birth weight, neonatal intensive care admission, stillbirth, perinatal mortality rates, near-miss, surgical intensive care admission, postpartum haemorrhage, hysterectomy, massive transfusion, renal failure, coagulopathy and maternal death. Stillbirth was defined as a fetus weighing greater or equal to 500 gm showing no sign of life after birth. Near-miss was defined as severe organ dysfunction which if not treated appropriately, could result in death. Descriptive statistics were calculated and chi-square was applied with significance level < 0.05. Stillbirths and perinatal mortality rates were significantly higher in abruptio placentae, 52.97% versus 18.18% and 534/1000 versus 230/1000 (p < 0.01). Near-miss cases were also significantly higher in abruptio placentae, 22.27%. Verus 11.18% (p < 0.01). Hypovolemic shock and coagulation failure were also significantly higher in abruptio placentae (p < 0.05). (author)

  1. Perceptions of predisposing and protective factors for perinatal depression in same-sex parents.

    Science.gov (United States)

    Ross, Lori E; Steele, Leah; Sapiro, Beth

    2005-01-01

    Increasing numbers of women are choosing to have children in the context of same-sex relationships or as "out" lesbian or bisexual individuals. This study used qualitative methods to assess perceived predisposing and protective factors for perinatal depression in lesbian, gay, bisexual, and queer (LGBQ) women. Two focus groups with LGBQ women were conducted: 1) biological parents of young children and 2) nonbiological parents of young children or whose partners were currently pregnant. Three major themes emerged. Issues related to social support were primary, particularly related to disappointment with the lack of support provided by members of the family of origin. Participants also described issues related to the couple relationship, such as challenges in negotiating parenting roles. Finally, legal and policy barriers (e.g., second parent adoption) were identified as a significant source of stress during the transition to parenthood. Both lack of social support and relationship problems have previously been identified as risk factors for perinatal depression in heterosexual women, and legal and policy barriers may represent a unique risk factor for this population. Therefore, additional study of perinatal mental health among LGBQ women is warranted. PMID:16260356

  2. Adverse Perinatal Outcome in Subsequent Pregnancy after Stillbirth by Placental Vascular Disorders.

    Directory of Open Access Journals (Sweden)

    Francesca Monari

    Full Text Available To evaluate outcome in the pregnancy following a stillbirth (SB by a placental vascular disorders.A prospective, observational, multicenter study was conducted in woman with a history of stillbirth (> 22 weeks between 2005 and June 2013, in 3 Italian University Hospitals. Causes of SB were previously identified after extensive investigations. Pregnant women were enrolled within the first trimester. The main outcome was "adverse neonatal outcome", including perinatal death, fetal growth restriction, early preterm birth <33+6 weeks, hypoxic-ischemic encephalopathy, intracranial hemorrhage or respiratory distress.Out of 364 index pregnancies, 320 women (87.9% had a subsequent pregnancy during the study period. Forty-seven had an early pregnancy loss. Out of 273 babies, 67 (24.5% had an adverse perinatal outcome, including 1 SB and 1 early neonatal death (3.7/1000. Women who had a SB related to placental vascular disorders (39.6%, were at higher risk of an adverse neonatal outcome compared with women whose SB was unexplained or resulted from other causes (Adj. OR = 2.1, 95%CI: 1.2-3.8. Moreover, also obesity independently predicts an adverse perinatal outcome (Adj OR = 2.1, 95%CI: 1.1-4.3.When previous SB is related to placental vascular disorders there is a high risk for adverse neonatal outcomes in the subsequent pregnancy. Maternal obesity is an additional risk factor.

  3. Umbilical Coiling Index as a Marker of Perinatal Outcome: An Analytical Study

    Directory of Open Access Journals (Sweden)

    T. Chitra

    2012-01-01

    Full Text Available Objectives. To measure umbilical coiling index (UCI postnatally and to study the association of normocoiling, hypocoiling and hypercoiling to maternal and perinatal outcome. Method(s. One thousand antenatal women who went into labour were studied and umbilical coiling index calculated at the time of delivery. UCI was determined by dividing the total number of coils by the total umbilical cord length in centimeters. Its association with various maternal and perinatal risk factors were noted. The statistical tests were the Chi-square test and assessed with SPSS version 13.0 software and statistically analyzed. P value of less than 0.05 was regarded as statistically significant. Results. The mean umbilical coiling index was found to be 0.24 ± 0.09. Hypocoiling (0.36 was found to be associated with diabetes mellitus, polyhydramnios, cesarean delivery, congenital anomalies, and respiratory distress of the newborn. Conclusion. Abnormal umbilical coiling index is associated with several antenatal and perinatal adverse features.

  4. Perinatal Exposure to Glufosinate Ammonium Herbicide Impairs Neurogenesis and Neuroblast Migration through Cytoskeleton Destabilization

    Science.gov (United States)

    Herzine, Ameziane; Laugeray, Anthony; Feat, Justyne; Menuet, Arnaud; Quesniaux, Valérie; Richard, Olivier; Pichon, Jacques; Montécot-Dubourg, Céline; Perche, Olivier; Mortaud, Stéphane

    2016-01-01

    Neurogenesis, a process of generating functional neurons from neural precursors, occurs throughout life in restricted brain regions such as the subventricular zone (SVZ). During this process, newly generated neurons migrate along the rostral migratory stream to the olfactory bulb to replace granule cells and periglomerular neurons. This neuronal migration is pivotal not only for neuronal plasticity but also for adapted olfactory based behaviors. Perturbation of this highly controlled system by exogenous chemicals has been associated with neurodevelopmental disorders. We reported recently that perinatal exposure to low dose herbicide glufosinate ammonium (GLA), leads to long lasting behavioral defects reminiscent of Autism Spectrum Disorder-like phenotype in the offspring (Laugeray et al., 2014). Herein, we demonstrate that perinatal exposure to low dose GLA induces alterations in neuroblast proliferation within the SVZ and abnormal migration from the SVZ to the olfactory bulbs. These disturbances are not only concomitant to changes in cell morphology, proliferation and apoptosis, but are also associated with transcriptomic changes. Therefore, we demonstrate for the first time that perinatal exposure to low dose GLA alters SVZ neurogenesis. Jointly with our previous work, the present results provide new evidence on the link between molecular and cellular consequences of early life exposure to the herbicide GLA and the onset of ASD-like phenotype later in life.

  5. MANAGEMENT OF ECLAMPSIA IN A TERTIARY CARE CENTRE-MATERNAL AND PERINATAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Usha Rani

    2015-11-01

    Full Text Available AIM: Management of 240 cases of eclampsia during a period of 1yr 6 months. MATERIALS AND METHODS : A study of 240 cases of eclampsia over a period of 1yr 6months at a tertiary level referral centre.They were analyzed regarding age, parity, socio economic status, period of gestation, antenatal care, No.of convulsions, condition at the time of admission.Management of eclampsia ,maternal and perinatal outcome analyzed. RESULTS: Out of 240 cases of eclampsia most of them were primigravida belonging to low socio economic stata 73% had antenatal care but not regularly. 215 cases were given Mg So4 and the remaining patients Lorazepam and Phenytoin were added. The total perinatal mortality in our study was 28.3%.The perinatal mortality decreases with increasing gestational age and birth weight.Maternal Complications we encountered were Encephalopathy, Pyrexia, RTI, Retained Placenta. 6/240 Maternal deaths, in this two undelivered,CVA was the major cause of death. CONCLUSIONS: Eclampsia is a life endangering obstetric emergency still prevails in developing countries due to inadequate antenatal care, low socio economic stata and lack of transport facility, more common in primis. Good antenatal care helps in preventing ecampsia. Attentive nursing and individualized treatment algorithms, include prompt fluid replacement, anticonvulsant therapy (Mg So4 aggressive antihypertensive therapy and prompt delivery, availability of CT scan with good neonatal unit will improve the maternal and fetal outcome

  6. Perinatal morbidity and mortality associated with chlamydial infection: a meta-analysis study

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    Maria José Penna Maisonnette de Attayde Silva

    2011-12-01

    Full Text Available OBJECTIVE: To evaluate the effect of Chlamydia trachomatis infection during pregnancy on perinatal morbidity and mortality. METHODS: Systematic review and meta-analysis in an electronic database and manual, combining high sensitivity specific descriptors seeking to answer the research objective. The articles considered to be of high methodological quality (score above 6 on the Newcastle-Ottawa Scale were assessed by meta-analysis. RESULTS: Summary estimates of 12 studies were calculated by means of Mantel-Haenszel test with 95% confidence interval. It was observed that Chlamydia infection during pregnancy increased risk of preterm labor (relative risk (RR = 1.35 [1.11, 1.63], low birth weight (RR = 1.52 [1.24, 1.87] and perinatal mortality (RR = 1.84 [1.15, 2.94]. No evidence of increased risk was associated with Chlamydia infection in regard to premature rupture of membranes (RR = 1.13 [0.95, 1.34], abortion and postpartum endometritis (RR = 1.20 [0.65, 2.20] and 0.89 [0.49, 1.61] respectively. CONCLUSION: The diagnosis and treatment of Chlamydia cervicitis during pregnancy can reduce perinatal morbidity and mortality associated with this infection. However, clinical trials are needed to confirm these findings.

  7. Different Plasticity Patterns of Language Function in Children With Perinatal and Childhood Stroke

    Science.gov (United States)

    Tomberg, Tiiu; Kepler, Joosep; Laugesaar, Rael; Kaldoja, Mari-Liis; Kepler, Kalle; Kolk, Anneli

    2014-01-01

    Plasticity of language function after brain damage can depend on maturation of the brain. Children with left-hemisphere perinatal (n = 7) or childhood stroke (n = 5) and 12 controls were investigated using functional magnetic resonance imaging. The verb generation and the sentence comprehension tasks were employed to activate the expressive and receptive language areas, respectively. Weighted laterality indices were calculated and correlated with results assessed by neuropsychological test battery. Compared to controls, children with childhood stroke showed significantly lower mean scores for the expressive (P < .05) and receptive (P = .05) language tests. On functional magnetic resonance imaging they showed left-side cortical activation, as did controls. Perinatal stroke patients showed atypical right-side or bilateral language lateralization during both tasks. Negative correlation for stroke patients was found between scores for expressive language tests and laterality index during the verb generation task. (Re)organization of language function differs in children with perinatal and childhood stroke and correlates with neurocognitive performance. PMID:23748202

  8. Predictors of Study Attrition in a Randomized Controlled Trial Evaluating a Perinatal Home-Visiting Program with Mothers with Psychosocial Vulnerabilities

    OpenAIRE

    Foulon, Stéphanie; Greacen, Tim; Pasquet, Blandine; Dugravier, Romain; Saïas, Thomas; Guedeney, Nicole; Guedeney, Antoine; Tubach, Florence; ,

    2015-01-01

    Objective Randomised controlled trials evaluating perinatal home-visiting programs are frequently confronted with the problem of high attrition rates. The aim of the present study is to identify predictors of study attrition in a trial evaluating a perinatal home-visiting program in France. Materials and Methods CAPEDP is a French randomized trial comparing a perinatal home-visiting program using psychologists versus usual care (N = 440). The first assessment was at inclusion into the trial a...

  9. Reprodução assistida como causa de morbidade materna e perinatal Assisted reproduction as a cause of maternal and perinatal morbidity

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    João Luiz Pinto e Silva

    2005-12-01

    Full Text Available OBJETVOS: realizar revisão bibliográfica do impacto das técnicas de fertilização assistida e reprodução assistida (RA na morbidade materna e perinatal. MÉTODOS: foram pesquisadas fontes bibliográficas pelo SCI e MEDLINE, com o intuito de identificar o maior número de estudos relacionados com os termos: fertilização in vitro, reprodução assistida, técnicas reprodutivas, combinadas com morbidade e com mortalidade materna, perinatal e neonatal. RESULTADOS: a literatura permite concluir que o maior problema de morbidade materna relaciona-se à ocorrência de maior número de gravidezes múltiplas, destacando-se em alguns estudos a maior freqüência de hipertensão induzida pela gravidez e diabetes gestacional. A ocorrência de maior número de gravidezes múltiplas aumenta consideravelmente as complicações maternas, fetais e dos recém-nascidos. Recomenda-se um pré-natal diferenciado, de enfoque multidisciplinar para otimizar resultados. Há evidências de maior número de malformações congênitas. Discutem-se as características especiais deste grupo de mulheres e das diferentes técnicas de RA, particularmente a ICSI, na etiologia dos defeitos congênitos, embora não existam diferenças claras entre os procedimentos. Algumas meta-análises recentes mostraram que o número de malformações congênitas em crianças nascidas por ICSI é maior do que entre as nascidas espontaneamente, mas não mais freqüentes que as nascidas por outras técnicas de RA. Não existe consenso se este fato é decorrente do procedimento per se, da manipulação dos gametas, da indução da ovulação ou do fato de que estes casais são inférteis e do tempo que levam para engravidar. Existem poucos estudos que avaliaram de modo consistente, sistemático e prolongado a evolução perinatal de crianças nascidas mediante a utilização de embriões congelados. CONCLUSÕES: em relação às malformações fetais há, definitivamente, maior n

  10. Una experiencia con los kuna

    OpenAIRE

    Villalobos, Leonor Cristina de

    1996-01-01

    Me encuentro en la difícil tarea de materializar en palabras una experiencia única. De transmitir sensaciones y vivencias cargadas de magia que desestructuraron en gran medida lo que hasta ese momento formaba parte de mi vida. Es así como puedo definir mi experiencia con los indios Kuna. Tuve la oportunidad de convivir con ellos dos meses, invitada por investigadores de la Universidad de Miami, para realizar estudios sobre ectoparasitosis que afectan a esta comunidad india.

  11. Evaluación serológica de la inmunización pasiva-activa en la profilaxis de la transmisión perinatal de la hepatitis B

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    Marité Bello

    2012-04-01

    Full Text Available La administración conjunta de gammaglobulina antihepatitis B y la vacuna se recomienda mundialmente para prevenir la transmisión perinatal en hijos de madres HBsAg(+. Se evaluó la inmunización pasiva-activa a los tres días, 7 y 18 meses de vida, como forma preventiva de esta transmisión. Se estudiaron 87 sueros de hijos de madres HBsAg(+, tomados a los 3 días, 7 y 18 meses de nacidos, para un total de 261 muestras. A los recién nacidos se les administró una dosis de inmunoglobulina humana antihepatitis B cubana (Ganmahep B y de vacuna recombinante cubana Heberbiovac-HB ® antes de las 12 horas de nacidos y posteriormente a los 1, 2 y 12 meses, según el esquema de vacunación Los niños fueron evaluados con los marcadores HBsAg y anti-HBs. Al tercer día el 8,0% de los niños fueron HBsAg(+, el 92,5% de los niños HBsAg(- resultaron seroprotegidos. A los 7 meses de edad el 1,1% fue HBsAg(+, la seroprotección de los niños HBsAg(- fue de 89,5%. El 3,4% fue HBsAg(+ a los 18 meses, con un 97,6% de seroprotección en los niños HBsAg(-. Predominó la respuesta normoprotectora en los tres tiempos, con diferencias estadísticamente significativas en la seroprotección y títulos ³ 100 UI/L. Los títulos promedios geométricos (TPG fueron 72,9 UI/L, 168,66 UI/L y 175,62 UI/L, respectivamente, con significación estadística entre ellos. Se sugiere que el uso de Ganmahep B, conjuntamente con la vacuna cubana reduce el riesgo de transmisión perinatal del VHB y es el primer estudio realizado en Cuba para evaluar la eficacia profiláctica en este grupo de riesgo.

  12. Domestic violence and perinatal mental disorders: a systematic review and meta-analysis.

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    Louise M Howard

    Full Text Available BACKGROUND: Domestic violence in the perinatal period is associated with adverse obstetric outcomes, but evidence is limited on its association with perinatal mental disorders. We aimed to estimate the prevalence and odds of having experienced domestic violence among women with antenatal and postnatal mental disorders (depression and anxiety disorders including post-traumatic stress disorder [PTSD], eating disorders, and psychoses. METHODS AND FINDINGS: We conducted a systematic review and meta-analysis (PROSPERO reference CRD42012002048. Data sources included searches of electronic databases (to 15 February 2013, hand searches, citation tracking, update of a review on victimisation and mental disorder, and expert recommendations. Included studies were peer-reviewed experimental or observational studies that reported on women aged 16 y or older, that assessed the prevalence and/or odds of having experienced domestic violence, and that assessed symptoms of perinatal mental disorder using a validated instrument. Two reviewers screened 1,125 full-text papers, extracted data, and independently appraised study quality. Odds ratios were pooled using meta-analysis. Sixty-seven papers were included. Pooled estimates from longitudinal studies suggest a 3-fold increase in the odds of high levels of depressive symptoms in the postnatal period after having experienced partner violence during pregnancy (odds ratio 3.1, 95% CI 2.7-3.6. Increased odds of having experienced domestic violence among women with high levels of depressive, anxiety, and PTSD symptoms in the antenatal and postnatal periods were consistently reported in cross-sectional studies. No studies were identified on eating disorders or puerperal psychosis. Analyses were limited because of study heterogeneity and lack of data on baseline symptoms, preventing clear findings on causal directionality. CONCLUSIONS: High levels of symptoms of perinatal depression, anxiety, and PTSD are significantly

  13. Integration of umbilical venous and arterial Doppler flow parameters for prediction of adverse perinatal outcome

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    Hebbar Shripad

    2015-01-01

    Full Text Available Background: Quantification of umbilical vein (UV blood flow rate and umbilical artery Doppler indices might be valuable in assessing fetuses at increased risk of perinatal complications as they receive their supply of oxygen and nutrients through this vessel. Previous studies have indicated that UV blood volume flow rate to umbilical artery pulsatility index (UAPI ratio (venous arterial index [VAI] evaluates both venous and arterial arm of fetal umbilical circulation and hence, can be adopted as a screening tool in management of high risk pregnancy. Objectives: To compare umbilical VAI with adverse perinatal outcome and also to evaluate its efficacy with other flow indices in determining perinatal outcome. Materials and Methods: Various Doppler indices such as normalized blood flow rate in UV (nUV, ml/kg estimated fetal weight/min, VAI (nUV/UAPI, umbilical artery resistance index (RI, UAPI, and systolic diastolic ratio were determined in 103 pregnant women within 2 weeks of the delivery. A risk score was devised using APGAR at 5 min, birth weight, preterm delivery, fetal distress, Neonatal Intensive Care Unit (NICU care, and perinatal death and this score was correlated with antenatal Doppler findings. Results: Subjects with low VAI were found to have a greater association with intrauterine growth restricted fetuses (28.5% and low liquor (35.7%, preterm deliveries (46.4%, lower mean birth weight (2.25 kg, higher NICU admission rates (32.1%. The unfavorable score was noticed in 25.2% of the neonates. They had lower VAI (156 vs. 241, UV diameter (6.2 mm vs. 7.8 mm, UV velocity (16.2 vs. 17.8, nUV (163.7 vs. 206.4, and higher PI (1.3 vs. 0.9. A cut-off of VAI of 105 ml/kg/min had sensitivity of 86.7% and a specificity of 93.5% for predicting poor perinatal outcome. Conclusion: VAI with a cut-off of 105 ml/kg/min can be used as an additional tool along with the other conventional Doppler indices in order to predict adverse fetal outcome.

  14. Association between perinatal depression in mothers and the risk of childhood infections in offspring: a population-based cohort study

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    West Joe

    2010-12-01

    Full Text Available Abstract Background Previous studies have suggested that children of mothers who experience depression during the perinatal period may have more infections, but such studies are few in number and none have been carried out in the United Kingdom (UK population. The aim of this study was to investigate the association between perinatal depression in mothers and the risk of childhood infections in offspring in the UK general population. Methods We used data from The Health Improvement Network (THIN, a large database of electronic primary care medical records to conduct a cohort study among all first-born singleton children born and enrolled in THIN between 1988 and 2004. We used Poisson regression to compare the incidence of gastrointestinal infections and lower respiratory tract infections reported between birth and age 4 years among children of mothers with a record of perinatal depression with those born to mothers with no such history. Results Children of mothers with perinatal depression had a 40% increased risk of gastrointestinal infections and a 27% increased risk of lower respiratory tract infections compared with children of mothers without perinatal depression (incidence rate ratios = 1.40 and 1.27; 95% confidence intervals 1.37-1.42 and 1.22-1.32, respectively. On restricting to antibiotic-treated infections there was a slight increase in the magnitude of association with gastrointestinal infections but a decrease in that with lower respiratory tract infections (incidence rate ratios = 1.47 and 1.19; 95% confidence intervals 1.34-1.61 and 1.11-1.27, respectively. Conclusions Maternal perinatal depression is associated with increased rates of childhood gastrointestinal infections, particularly more severe infections, and lower respiratory tract infections in the UK. Preventing maternal perinatal depression may avoid substantial morbidity among offspring, although further work is also needed to investigate the detailed reasons for these

  15. con mala calidad de vida

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    Agustín Martín-Rodríguez

    2007-01-01

    Full Text Available En este estudio ex post facto se ha analizado si los familiares de pacientes con mala calidad de vida presentan diferencias en las variables clínicas de personalidad y relaciones familiares en función de que el paciente haya estado o no ingresado en una Unidad de Cuidados Intensivos. Seleccionamos dos grupos: 29 familiares de pacientes traumatizados graves transcurridos cuatro años de su ingreso en una UCI de Traumatología y con mala calidad de vida (debido a secuelas físicas y/o psicológicas tras el ingreso, tales como traumatismos craneoencefálicos, politraumatismos y tetraplejias traumáticas y 32 familiares de pacientes con mala calidad de vida con cuatro años de evolución de su enfermedad física (hipertensión, diabetes, artritis reumatoide y síndrome de intestino irritable que no han estado ingresados en la UCI. Para alcanzar nuestro objetivo empleamos una Encuesta Psicosocial y los siguientes instrumentos: Cuestionario de Análisis Clínico, Escala de Clima Social en la Familia y Escala de Adaptación Psicosocial de la Enfermedad. Los resultados mostraron que los familiares de pacientes con mala calidad de vida que estuvieron ingresados en la UCI hace cuatro años, presentan diferencias significativas en las variables agitación y expresividad comparados con los familiares de pacientes con mala calidad de vida que no han estado ingresados en la UCI.

  16. The physical and psychological effects of HIV infection and its treatment on perinatally HIV-infected children

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    Rachel C Vreeman

    2015-12-01

    Full Text Available Introduction: As highly active antiretroviral therapy (HAART transforms human immunodeficiency virus (HIV into a manageable chronic disease, new challenges are emerging in treating children born with HIV, including a number of risks to their physical and psychological health due to HIV infection and its lifelong treatment. Methods: We conducted a literature review to evaluate the evidence on the physical and psychological effects of perinatal HIV (PHIV+ infection and its treatment in the era of HAART, including major chronic comorbidities. Results and discussion: Perinatally infected children face concerning levels of treatment failure and drug resistance, which may hamper their long-term treatment and result in more significant comorbidities. Physical complications from PHIV+ infection and treatment potentially affect all major organ systems. Although treatment with antiretroviral (ARV therapy has reduced incidence of severe neurocognitive diseases like HIV encephalopathy, perinatally infected children may experience less severe neurocognitive complications related to HIV disease and ARV neurotoxicity. Major metabolic complications include dyslipidaemia and insulin resistance, complications that are associated with both HIV infection and several ARV agents and may significantly affect cardiovascular disease risk with age. Bone abnormalities, particularly amongst children treated with tenofovir, are a concern for perinatally infected children who may be at higher risk for bone fractures and osteoporosis. In many studies, rates of anaemia are significantly higher for HIV-infected children. Renal failure is a significant complication and cause of death amongst perinatally infected children, while new data on sexual and reproductive health suggest that sexually transmitted infections and birth complications may be additional concerns for perinatally infected children in adolescence. Finally, perinatally infected children may face psychological

  17. Tratamiento con implantes Leader-Nano en paciente con oligodoncia

    OpenAIRE

    Salvador Javier Santos Medina; Mayelín Cruz Acosta; Danilo Córdova González

    2015-01-01

    Los implantes dentales de titanio han revolucionado el mundo de la rehabilitación desde su surgimiento. De manera particular, el empleo de implantes de carga inmediata acorta el tiempo quirúrgico y protésico, con el consiguiente bienestar estético. Se presenta el caso de una paciente femenina de 32 años de edad, con antecedentes de oligodoncia de ambos incisivos laterales superiores y portadora de prótesis parcial acrílica. Fue atendida por el equipo multidisciplinario de implantes en la Clín...

  18. Exposure to Pre- and Perinatal Risk Factors Partially Explains Mean Differences in Self-Regulation between Races

    Science.gov (United States)

    Barnes, J. C.; Boutwell, Brian B.; Miller, J. Mitchell; DeShay, Rashaan A.; Beaver, Kevin M.; White, Norman

    2016-01-01

    Objectives To examine whether differential exposure to pre- and perinatal risk factors explained differences in levels of self-regulation between children of different races (White, Black, Hispanic, Asian, and Other). Methods Multiple regression models based on data from the Early Childhood Longitudinal Study, Birth Cohort (n ≈ 9,850) were used to analyze the impact of pre- and perinatal risk factors on the development of self-regulation at age 2 years. Results Racial differences in levels of self-regulation were observed. Racial differences were also observed for 9 of the 12 pre-/perinatal risk factors. Multiple regression analyses revealed that a portion of the racial differences in self-regulation was explained by differential exposure to several of the pre-/perinatal risk factors. Specifically, maternal age at childbirth, gestational timing, and the family’s socioeconomic status were significantly related to the child’s level of self-regulation. These factors accounted for a statistically significant portion of the racial differences observed in self-regulation. Conclusions The findings indicate racial differences in self-regulation may be, at least partially, explained by racial differences in exposure to pre- and perinatal risk factors. PMID:26882110

  19. Entrevista con Hans Robert Jauss.

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    - Consejo de Redacción

    1997-01-01

    Full Text Available El importante teórico y crítico literario alemán nació en 1921. Tras el largo paréntesis de la segunda guerra mundial, Jauss realizará sus estudios superiores, a partir de 1948, en Heidelberg, licenciándose en filología románica. Se doctora pronto con una tesis, publicada en 1955, sobre el tiempo y el recuerdo en la obra capital de Marcel Proust, En busca del tiempo perdido, y se habilita en 1957 con un trabajo sobre la epopeya animal en la Edad Media. A continuación, escribe un conjunto de estudios sobre la alegoría, y codirige con el gran especialista Erich Kohler una monumental historia de la literatura medieval, campo al que ha dedicado otros artículos, a la par que proseguía sus investigaciones iniciales.

  20. Tratamiento con implantes Leader-Nano en paciente con oligodoncia

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    Salvador Javier Santos Medina

    2015-03-01

    Full Text Available Los implantes dentales de titanio han revolucionado el mundo de la rehabilitación desde su surgimiento. De manera particular, el empleo de implantes de carga inmediata acorta el tiempo quirúrgico y protésico, con el consiguiente bienestar estético. Se presenta el caso de una paciente femenina de 32 años de edad, con antecedentes de oligodoncia de ambos incisivos laterales superiores y portadora de prótesis parcial acrílica. Fue atendida por el equipo multidisciplinario de implantes en la Clínica Estomatológica Docente “3 de Octubre” y se le realizó tratamiento de rehabilitación integral con implantes Leader-Nano y prótesis fija con corona acrílica sobre dichos implantes. La implantología fue satisfactoria en la paciente; la mejoría estética y funcional, así como la satisfacción de la paciente, fueron los principales logros obtenidos