American journal of perinatology
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We evaluated acute neonatal morbidities in the delivery room associated with primary cesarean performed prior to labor and in the first or second stages of labor. A retrospective cohort study was conducted on subjects undergoing term, primary cesareans at the Women's Pavilion, Miller Children's Hospital in Long Beach, California from 2000 to 2007. Acute neonatal morbidities were tabulated as a function of time during labor when cesarean was performed. ⋯ Composite neonatal morbidity was not significantly different among the stages. Acute neonatal morbidities were not affected by the presence or absence of labor. Potential long-term sequelae require further study.
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Hypertensive disorders in pregnancy constitute one of the most frequent medical complications during gestation. Unfortunately, maternal and perinatal mortality remains significant worldwide in this population. Not infrequently, patients with severe preeclampsia will need parenteral agents to achieve rapid blood pressure control to avoid end-organ damage. ⋯ Nicardipine has been used extensively in different clinical settings including neurosurgery, cardiothoracic surgery, transplant medicine, and internal medicine patients. Minimal data exist in the literature regarding the use of this medicine during pregnancy. The purpose of this article is to review the pharmacological properties of nicardipine, the available literature regarding its use during pregnancy, and potential interactions with other medicines used commonly in preeclampsia, as well as potential side effects directly affecting the peripartum period.
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Intrauterine closure of the fetal ductus arteriosus is a rare but serious condition. It can lead to congestive heart failure, fetal hydrops, and fetal death. ⋯ Postnatal therapies aimed at pulmonary hypertension or with medications that maintain the patency of the ductus arteriosus are variably successful. We present the neonatal course of a full-term neonate with severe pulmonary hypertension and intrauterine closure of the ductus arteriosus who survived to early infancy.
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Fetal tachycardia caused by the transplacental passage of thyroid stimulating immunoglobulin is well established, but very little information exists regarding the fetal heart rate appearance of this form of tachycardia. Two cases of fetal tachycardia are described in pregnancies complicated by fetal thyrotoxicosis where maternal thyroid history was unknown at the time of testing. ⋯ The tracings were essentially normal except for the baseline rate. When reviewing the differential for fetal tachycardia presenting in the antenatal period, this pattern is unique to fetal thyrotoxicosis, especially if the mother is afebrile and there is no history of medication usage that could explain this presentation.
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Comparative Study
Comparison of maternal risk factors between placental abruption and placenta previa.
The purpose of this study was to compare risk factors between placental abruption and placenta previa among primiparous and multiparous singleton pregnancies. We analyzed data from a population-based retrospective cohort with singleton pregnancies in the United States for 1995 to 2000. Maternal risk factors for placenta previa and placental abruption were examined using multiple logistic regressions. ⋯ The effects of maternal age, race, parity, and previous cesarean section were stronger on placenta previa than on placental abruption, and the effects of cigarette smoking, alcohol drinking, and prenatal care were stronger on placental abruption than on placenta previa. A composite outcome of selected medical and pregnancy complications was related with placental abruption but not with placental previa. Placental abruption is more likely to be affected by conditions occurring during pregnancy, and placenta previa is more likely to be affected by conditions existing prior to pregnancy.