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. · Oct 2020
Combined treatment of McDonald cerclage and Arabin-pessary: a chance in the prevention of spontaneous preterm birth?
Background: Patients with cervical shortening obtained by transvaginal ultrasound and/or previous preterm delivery are at increased risk for preterm birth in the current pregnancy. The aim of the present cohort study was to compare the rate of preterm birth and early neonatal parameters in patients at risk and screening patients who received either a cerclage or a combined treatment of cerclage and cervical pessary. Methods: A retrospective cohort study was conducted from March 2005 to March 2017 including all patients in our department which received a McDonald cerclage or a combined treatment of McDonald cerclage and an Arabin pessary. ⋯ The mean neonatal admission time at the neonatal intensive care unit was shorter in the combined treatment group versus in the cerclage group (p = .02). There was a trend for higher birthweight (2368 g ± 962 vs. 2650 g ± 1063) in favor of the combined treatment arm (p = .077). Conclusion: The combined treatment of cerclage with an Arabin pessary seems to be a considerable alternative in the prevention of spontaneous PTB (sPTB), especially for patients with cervical length <3rd percentile, and in particular for patients with amnion prolapse in terms of birthweight and neonatal admission time.
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J. Matern. Fetal. Neonatal. Med. · Oct 2020
Prevalence of postpartum depression regarding mode of delivery: a cross-sectional study.
Purpose: To explore the prevalence of postpartum depression (PPD), as well as the relationship between delivery mode and postpartum depression among postnatal women utilizing the Arabic validated version of the Edinburgh Postnatal Depression Scale (EPDS). Materials and methods: 412 women with singleton gestation during their 3rd trimester without medical or psychological problems preceding or during pregnancy were included. All pregnant women were asked to fill out the Arabic version of Edinburgh Postnatal Depression Scale. ⋯ The mean score of the EPDS in the normal vaginal delivery group at both assessments was significantly lower than those of the emergency and elective caesarian section groups. Conclusions: There was a strong relation between delivery mode and postpartum depression. Emergency CS showed a stronger correlation than elective caesarian section.
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J. Matern. Fetal. Neonatal. Med. · Oct 2020
Twin pregnancies treated with emergency or ultrasound-indicated cerclage to prevent preterm births.
Introduction: Multiple gestations are high-risk pregnancies associated with an increased risk of neonatal morbidity and mortality, mainly due to preterm births. Numerous interventions have been attempted in order to delay the time of delivery and subsequently, prevent preterm births in twin gestations. To date, no really effective intervention has been found. ⋯ Conclusion: Cervical cerclage in twin pregnancies may prolong pregnancy even when placed on a very short or dilated cervix. In our study, the procedure was safe and without any serious complications. The overall neonatal survival rate was high.
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J. Matern. Fetal. Neonatal. Med. · Oct 2020
Systematic review on near miss cases of placenta accreta spectrum disorders: correlation with invasion topography, prenatal imaging, and surgical outcome.
Purpose of the article: Placental accreta spectrum (PAS) is the most dangerous iatrogenic complication of cesarean potentially leading to massive intra-partum haemorrhage and death. Despite this, identification of near miss cases of PAS has not been consistently reported in the published literature. The aim of this systematic review was to explore prenatal and surgical characteristics of near miss cases of PAS disorders. ⋯ Invasion in the inferior part of the lower uterine segment, posterior bladder and parametria was associated with a high risk of morbidity. Conclusion: Near miss cases of PAS are commonly associated with posterior bladder or parametrial invasion and placenta percreta. Further studies are needed in order to identify women affected by PAS disorders at high risk of surgical complications.