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 2006
ReviewLow-molecular-weight heparin for thromboprophylaxis in pregnant women with mechanical heart valves.
Pregnancy in a woman with a mechanical heart valve is a life-threatening situation. Due to the inability of unfractionated heparin to prevent valvular thromboses, warfarin or other vitamin K antagonists have been the preferred anticoagulants for the mother. They are, however, potentially harmful to the fetus. With the advent of low-molecular-weight heparins, clinicians were hopeful for an alternative that was safe for the fetus, but more effective than unfractionated heparin, which carries a 29-33% risk of life-threatening thromboses and a 7-15% chance of mortality. Unfortunately, fatal thromboses have occurred with low-molecular-weight heparin as well. ⋯ While pregnant women with mechanical heart valves who receive low-molecular-weight heparin for thromboprophylaxis are at extremely high risk of life-threatening thromboses, there is no evidence that low-molecular-weight heparin is inferior to unfractionated heparin.
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J. Matern. Fetal. Neonatal. Med. · Jul 2006
Neonatal outcome in polycystic ovarian syndrome patients treated with metformin during pregnancy.
The present study aimed to evaluate the effect of metformin exposure during pregnancy on neonates of polycystic ovarian syndrome (PCOS) patients. ⋯ Although metformin is an attractive option for induction of ovulation in PCOS patients, there is a need for more evidence related to its safety during pregnancy.
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J. Matern. Fetal. Neonatal. Med. · Jun 2006
The interval to spontaneous delivery following discontinuation of maintenance tocolysis.
To determine the interval to spontaneous delivery following discontinuation of continuous subcutaneous terbutaline (SQT). ⋯ Spontaneous preterm delivery occurred in 63.0% of singletons and 87.9% of twins. Although stable at SQT discontinuation, 32.5% of singletons and 59.9% of twins delivered within three days. The interval from discontinuation of SQT to delivery was less for twin than singleton gestations (5.1 +/- 6.5 vs. 11.0 +/- 10.5 days, respectively, p < 0.001). CONCLUSIONS. Preterm discontinuation of SQT should be avoided if additional pregnancy prolongation is desired.
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J. Matern. Fetal. Neonatal. Med. · May 2006
Randomized Controlled Trial Comparative StudyA prospective randomized study comparing misoprostol and oxytocin for premature rupture of membranes at term.
The aim of this randomized trial was to compare the efficacy and safety of vaginal misoprostol and oxytocin for cervical ripening and labor induction in patients with premature rupture of membrane (PROM) at term. ⋯ Our study demonstrates that, intravaginally, misoprostol results in a similar interval from induction of labor to delivery when compared to oxytocin.
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J. Matern. Fetal. Neonatal. Med. · Apr 2006
The effect of continuous morphine administration on maternal plasma oxytocin concentration and uterine contractions after open fetal surgery.
A major complication of open fetal surgery is prematurity. We propose that fetal and maternal stress/pain after surgery may affect the concentration of circulating oxytocin and the frequency of uterine contractions, thus increasing the risk of preterm delivery. The objective of this study was to test whether continuous morphine sulfate administration after open fetal surgery has an effect on maternal plasma oxytocin concentration and the frequency of uterine contractions. ⋯ These data suggest that maternal plasma oxytocin concentration and uterine activity after open fetal surgery may be related to inadequate maternal/fetal analgesia/sedation.