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
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.
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J. Matern. Fetal. Neonatal. Med. · Jul 2020
Perinatal transmission with SARS-CoV-2 and route of pregnancy termination: a narrative review.
Analyze newborns diagnosed with SARS-CoV-2 performed with RT-PCR at birth or during the first days of birth and to look for an association with the route of birth. ⋯ This review shows that there is perinatal or neonatal infection with SARS-CoV-2 by finding a positive PCR in the first days of birth. In addition, that there is more possibility of neonatal infection if the birth is vaginal or if there is premature rupture of the membranes before cesarean section. Vaginal delivery and premature rupture of membranes should be considered as risk factors for perinatal infection.
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J. Matern. Fetal. Neonatal. Med. · Jul 2020
Perinatal management of SARS-CoV-2 infection in a level III University Hospital.
Over the past 4 months, SARS-CoV-2 pandemic has spread all over the world. The lack of understanding of this pandemic epidemiological characteristics, clinical implications and long term consequences have raised concern among healthcare workers. Pregnant women and newborns are a particularly worrisome population since data referring to real infection impact in these patients are scarce and management controversial. ⋯ No evidence of vertical transmission was found (all NP swab and bronchial secretions SARS-CoV-2 RT-PCR were negative). No newborn developed clinical evidence of infection. In the face of current scientific uncertainty, decisions of perinatal management, such as mother-infant separation and breastfeeding, must involve parents in a process of shared decision making.
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J. Matern. Fetal. Neonatal. Med. · Jul 2020
SARS-CoV-2 is not present in the vaginal fluid of pregnant women with COVID-19.
Data concerning the presence of SARS-CoV-2 in the female genital system is scarce; however, this information is important for understanding whether the virus can transmit sexually or from mother to child. The aim of this study was to investigate whether pregnant women with COVID-19 have virus in their lower genital tract. ⋯ We demonstrated that SARS-CoV-2 was not present in the vaginal fluid of pregnant women. This finding may indicate that the female genital tract is not a route of SARS-CoV-2 transmission.