Acta obstetricia et gynecologica Scandinavica
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Acta Obstet Gynecol Scand · May 2020
Hemodynamic changes in women with symptoms of supine hypotensive syndrome.
Supine positioning during late pregnancy causes the gravid uterus to compress the inferior vena cava, resulting in dramatic hemodynamic changes. The maintenance of placental perfusion requires maternal circulatory and autonomic adaptations. Women with supine hypotensive syndrome (defined as a drop in systolic blood pressure of anything between 15 and 30 mmHg or an increase in heart rate of 20 bpm, with or without symptoms) may have reduced ability to compensate for the effects of supine positioning. ⋯ Maternal hemodynamic adaptations were found to be consistent across groups irrespective of whether the women had symptoms of supine hypotension. In both groups a reduction in blood flow through the inferior vena cava occurred in the supine position with a subsequent reduction in cardiac output. Both groups showed a compensatory increase in blood flow through the azygos vein in order to partially compensate for this. Taking into account the effect of maternal position, women with symptoms were found to have reduced azygos flow compared with asymptomatic women. There was a significant increase in heart rate when the women were supine than when they were in the left lateral position.
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Acta Obstet Gynecol Scand · Apr 2020
Pregnancy outcome in women with cerebral palsy: A nationwide population-based cohort study.
Cerebral palsy (CP) is a lifelong disorder with a high rate of comorbidities and complications. We hypothesized that women with CP are at increased risk of adverse pregnancy outcome. ⋯ Women with CP are at increased risk of preterm birth and other adverse pregnancy outcomes, suggesting that they deserve extra surveillance during antenatal care. Further studies, with information on type of CP and gross motor function, are warranted to better understand the association between CP and pregnancy outcome.
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Acta Obstet Gynecol Scand · Apr 2020
Efficacy of mifepristone and misoprostol for medical treatment of missed miscarriage in clinical practice-A cohort study.
It has been estimated that one out of every four women experience first-trimester miscarriage. Missed miscarriage is a common form of early miscarriage where the products of conception are not expelled from the uterus. It is diagnosed by ultrasound. The primary objective of this study was to evaluate the success rate of a combination treatment with mifepristone and misoprostol for missed miscarriage in clinical practice. The secondary objective was to identify significant factors influencing the rate of success. ⋯ The medical regimen for missed miscarriage offered in this study appears to be safe and with high rates of success. Conclusions about which women to exclude from medical treatment could not be made. Medical treatment may therefore benefit all women with missed miscarriage who wish to avoid primary surgery.