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. · Aug 2020
Case ReportsBrainstem gliomas in pregnancy: a systematic review†.
Introduction: Although brainstem gliomas are a rare group of neoplasias, when they affect pregnant women, there can be challenges with diagnosis and management. This study describes a case of brainstem glioma diagnosed in pregnancy and systematically reviews the literature on brainstem gliomas in pregnancy to provide guidance for management. Material and methods: We searched five databases from inception until October 2016 using subject headings and keywords related to pregnancy and brainstem glioma, and included original research articles that described pregnancy outcomes in women with brainstem glioma. ⋯ Pregnancy outcomes are favorable although there is a risk of preterm birth. Key messageBrainstem gliomas are associated with high maternal mortality and timely diagnosis using magnetic resonance imaging and treatment including surgical resection and radiation therapy should not be delayed during pregnancy. Pregnancy outcomes are generally favorable except for risk of preterm birth.
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J. Matern. Fetal. Neonatal. Med. · Aug 2020
Observational StudyEvaluation of additive effect of quantitative fetal fibronectin to cervical length for prediction of spontaneous preterm birth among asymptomatic high-risk women.
Objective: To determine if quantitative fetal fibronectin (qFFN) in addition to transvaginal ultrasound (TVU) cervical length (CL) measurement between 180/7 and 236/7 weeks would be predictive of spontaneous preterm birth (sPTB) at <350/7 weeks among asymptomatic high-risk women as defined by those with prior sPTB > 200/7 weeks. Material and methods: A prospective observational study of asymptomatic women with singleton gestations between 180/7 and 236/7weeks and one or more prior SPTB was performed. Women at their anatomy scan who opted into universal CL screening were enrolled. ⋯ Conclusion: In women with singleton gestations with prior SPTB, qFFN can be used as an adjunct to triage patients who are found to have a shortened cervix. Sensitivity and NPVs improved with the addition of qFFN to TVU CL screening alone in women with singleton gestations with prior SPTB. However, specificity and PPVs decreased.
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J. Matern. Fetal. Neonatal. Med. · Aug 2020
Comparative StudyComparison of the Edinburgh Postnatal Depression Scale and the Whooley questions in screening for postpartum depression in Japan.
Objective: We examined the clinical utility of the Whooley questions in comparison with that of the Edinburgh Postnatal Depression Scale (EPDS) in Japan. Methods: We carried out mental health screening of all postnatal mothers (n = 258) who gave birth to singleton babies at term attending our hospital using the EPDS and the Whooley questions. For the EPDS, scores were calculated, and a score of nine points or more was regarded as "positive screening" according to the results of previous observations in Japan. ⋯ The difference in the sensitivity and positive predictive value of the two tools did not reach significance (p = .09 and .45, respectively). Conclusions: There were no significant differences in accuracy on comparing the two screening tools. We should examine how to use the two tools according to the regional support systems.
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J. Matern. Fetal. Neonatal. Med. · Aug 2020
Care-by-parent model as a tool for reduction of neonatal opioid withdrawal syndrome in neonates exposed to buprenorphine maintenance therapy in-utero.
Objective: To determine if a structured care-by-parent (CBP) protocol is associated with a reduction in diagnosis of treatment-requiring Neonatal Opioid Withdrawal Syndrome (NOWS). Study design: We performed a pilot retrospective, case control study of pregnant women enrolled in a comprehensive prenatal care program for opioid-dependent patients during which they received buprenorphine for Medication Assisted Treatment (MAT) for Opioid Use Disorder (OUD). Patients who participated in the CBP program actively roomed-in with their infants even after maternal hospital discharge while infants continued to be monitored for development of treatment-requiring NOWS. ⋯ Results: Thirty-two (32) cases that were enrolled in the CBP model were compared with 32 matched controls that were not enrolled in this model. There was a significant reduction in the rate of treatment-requiring NOWS among cases compared to the controls (OR = 0.10; p = .001). Neonates undergoing CBP had a decreased length of stay and lower Finnegan scores compared to those who did not undergo CBPConclusion: Among infants born to mothers with OUD in pregnancy, CBP significantly reduces the rate of treatment-requiring NOWS.
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J. Matern. Fetal. Neonatal. Med. · Aug 2020
Screening for trauma and anxiety recognition: knowledge, management and attitudes amongst gynecologists regarding women with fear of childbirth and postpartum posttraumatic stress disorder.
Objective: Fear of childbirth (FoC) and postpartum posttraumatic stress disorder (PP-PTSD) are often less well recognized by healthcare professionals than other peripartum mental health disorders. This study aims to evaluate knowledge, management and attitudes of gynecologists and gynecology residents regarding women with FoC and PP-PTSD. Study design: A cross-sectional study was conducted among gynecologists and gynecology residents using an online questionnaire. ⋯ For optimizing the organization of care, we would recommend the use of a clear (inter)national policy regarding maternal requests for cesarean section (CS). Brief rationaleThe objective of this study was to evaluate knowledge and awareness regarding fear of childbirth (FOC) and postpartum posttraumatic stress disorder (PP-PTSD) among gynecologists and gynecology residents, assessing their attitudes towards women suffering from these conditions, and evaluating organization of care. The main findings and recommendations of the study include that gynecologists should be better trained to appropriately recognize fear of childbirth and postpartum posttraumatic stress disorder, and they should be made more aware of how their communication is perceived by patients, given the discrepancy between patients' experiences and the attitudes gynecologists report themselves.