The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
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J. Matern. Fetal. Neonatal. Med. · Sep 2016
Comparative Study Observational StudyPre-delivery remifentanil infusion for placenta accreta cesarean delivery under general anesthesia: an observational study.
General anesthesia may be required for placenta accreta cesarean delivery. Intrauterine fetal anesthetic exposure should be minimized to avoid neonatal respiratory depression; opioids are often delayed until post-delivery. ⋯ We did not observe a significant effect on neonatal Apgar scores at 1 and 5 min, or respiratory interventions at birth when remifentanil infusion was administered pre-delivery.
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J. Matern. Fetal. Neonatal. Med. · Sep 2016
Risk factors for accidental dural puncture during epidural anesthesia for laboring women.
Accidental dural puncture (ADP) during epidural analgesia is a debilitating complication. Symptoms of ADP post-dural puncture headache (PDPH) are headache while rising from supine to upright position, nausea, and neck stiffness. While age, gender and needle characteristics are established risk factors for ADP, little is known about risk factors in laboring women. ⋯ ADP during labor is a rare but debilitating complication. Risk factors for this iatrogenic complication include patient movement and repeated epidural trials. Intra-procedure identification of ADP is common, allowing early intervention with blood patching where indicated.
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J. Matern. Fetal. Neonatal. Med. · Sep 2016
Amniotic fluid levels of phospholipase A2 in fetal rats with retinoic acid induced myelomeningocele: the potential "second hit" in neurologic damage.
There is growing evidence of ongoing, in utero neurological damage in fetuses with myelomeningocele (MMC). Phospholipase A2 (PLA2) has known neurotoxic properties and is predominantly present in its secretory isoform (sPLA2) in meconium, the passage of which is increased in MMC fetuses. The objective of this study was to determine if amniotic fluid (AF) levels of PLA2 are elevated in a rat model of MMC. ⋯ PLA2 levels are elevated in the AF of fetal rats with MMC and may contribute to ongoing neural injury. This pathway may be a useful drug target to limit ongoing damage and better preserve neurologic function.
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J. Matern. Fetal. Neonatal. Med. · Sep 2016
Comparative StudyPre-eclampsia and preterm birth in Reunion Island: a 13 years cohort-based study. Comparison with international data.
To assess the prevalence of preterm birth in pre-eclamptic deliveries in Reunion Island, a tropical overseas French department (départements d'outre-mer, DOM) and to compare this prevalence with that of international literature. ⋯ Predominance of early- or late-onset pre-eclampsia has huge geographical differences. Further investigations are required to address risk factors for preterm birth and early onset pre-eclampsia in French DOM.