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. · May 2020
Review Case ReportsAmniotic fluid embolism and spontaneous hepatic rupture during uncomplicated pregnancy: a case report and literature review.
Amniotic fluid embolism (AFE) and spontaneous hepatic rupture both are extremely rare complications of pregnancy that can be fatal to mother and/or child. AFE is characterized by a sudden collapse of the cardiovascular system, a change in mental status, and disseminated intravascular coagulation (DIC), occurring immediately during labor, delivery, or postpartum, caused by the inflow of amniotic components into the maternal circulation. Spontaneous hepatic rupture during pregnancy which is most often occurs alongside hypertensive disorders, eclampsia, or HELLP syndrome. ⋯ The lack of typical clinical signs and symptoms resulted to the difficulty of early diagnosis. If AFE and hepatic rupture is highly suspected in a pregnant patient, a collaborative multidisciplinary approach is mandatory. Pregnancy women is simultaneously complicated in amniotic fluid embolism and spontaneous hepatic rupture, similar cases are infrequent in the literature, which is reviewed in this report, explore the pathophysiological changes, we hope that can be helpful for the prevention, diagnosis and treatment of similar cases.
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J. Matern. Fetal. Neonatal. Med. · May 2020
Meta AnalysisThe impact of omega-3 fatty acid supplementation on glycemic control in patients with gestational diabetes: a systematic review and meta-analysis of randomized controlled studies.
Background: Omega-3 fatty acid supplementation shows some treatment efficacy for gestational diabetes. This systematic review and meta-analysis is conducted to investigate the efficacy of omega-3 fatty acid supplementation for glycemic control in patients with gestational diabetes. Methods: The databases including PubMed, Embase, Web of science, EBSCO, and Cochrane Library databases are systematically searched for collecting the randomized controlled trials (RCTs) regarding the efficacy of omega-3 fatty acid versus placebo for gestational diabetes. ⋯ However, notably decreased high sensitivity C-reactive protein (hs-CRP) is revealed after omega-3 fatty acids supplementation (std. MD = -1.14; 95% CI = -2.0 to -0.29; p = .009). Conclusions: Omega-3 fatty acids supplementation can provide substantially beneficial effects on glycemic control and inflammatory response for gestational diabetes.
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J. Matern. Fetal. Neonatal. Med. · May 2020
Observational StudyRisk factors associated with neonatal thrombocytopenia in pregnant women with immune thrombocytopenic purpura.
Objectives: To characterize the risk factors associated with neonatal thrombocytopenia among pregnant women with immune thrombocytopenic purpura (ITP). Methods: We reviewed the records of ITP patients who delivered during 2006-2016 at our medical center. Results: Of 253 pregnancies, median maternal age at diagnosis was 29 [25-33] years, 222 (87.7%) had previously-diagnosed ITP and 31 (12.3%) were diagnosed with new-onset ITP during pregnancy. ⋯ Conclusion: Neonatal thrombocytopenia presented following almost one-tenth of pregnancies with ITP. New pregnancy-onset disease was the only prognostic marker for neonatal thrombocytopenia. This finding could contribute to risk stratification and individualized patient management.
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J. Matern. Fetal. Neonatal. Med. · May 2020
Case ReportsNIRS improves hemodynamic monitoring and detection of risk for cerebral injury: cases in the neonatal intensive care nursery.
Near-infrared spectroscopy (NIRS) monitoring provides a noninvasive, bedside measure of cerebral and somatic oxygenation in neonates at risk for hemodynamic instability and brain injury. This technology has been increasingly utilized in the neonatal intensive care unit, however, clinicians perceive a lack of evidence for the added value of NIRS monitoring. We present six clinical scenarios illustrating the value of NIRS monitoring for the diagnosis and management of critically ill newborns.