American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Sep 2007
Randomized Controlled Trial Multicenter StudyA French randomized controlled trial of ST-segment analysis in a population with abnormal cardiotocograms during labor.
The purpose of this study was to assess whether knowledge of ST-segment analysis was associated with a reduction in operative deliveries for nonreassuring fetal status (NRFS) or with a need for at least 1 scalp pH during labor. ⋯ In a population with abnormal cardiotocography in labor, cardiotocography combined with ST-segment analysis was not associated with a reduction in operative deliveries for NRFS. The proportion of infants without scalp pH sampling during labor increased substantially, however.
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Am. J. Obstet. Gynecol. · Sep 2007
ReviewCesarean delivery for HIV-infected women: recommendations and controversies.
Two studies that were published in 1999 demonstrated that cesarean delivery before labor and before the rupture of membranes (elective cesarean delivery) reduces the risk of mother-to-child transmission of the human immunodeficiency virus (HIV). On the basis of these results, the American College of Obstetricians and Gynecologists and the US Public Health Service recommend that HIV-infected pregnant women with plasma viral loads of >1000 copies per milliliter be counseled regarding the benefits of elective cesarean delivery. ⋯ Major postpartum morbidity is uncommon, and cesarean delivery among HIV-infected women is relatively safe and cost-effective. However, a number of important questions remain unanswered, including whether cesarean delivery has a role among HIV-infected women with low plasma viral loads or who receive combination antiretroviral regimens.
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Am. J. Obstet. Gynecol. · Sep 2007
Review Practice GuidelineInternational recommendations on antiretroviral drugs for treatment of HIV-infected women and prevention of mother-to-child HIV transmission in resource-limited settings: 2006 update.
The World Health Organization recommends that countries adopt more effective antiretroviral regimens to increase the effectiveness of the prevention of mother-to-child human immunodeficiency virus (HIV) transmission programs. The 2006 guidelines recommend a tiered approach for the delivery of antiretroviral to pregnant women who are infected with HIV and include triple-drug antiretroviral treatment for those women who are eligible. ⋯ Although steps are being taken to provide more effective regimens, the use of single-dose nevirapine alone should still be used in situations in which more effective regimens are not yet feasible or available. HIV transmission through breastfeeding remains a problem, and several interventions are under evaluation that include maternal and/or infant antiretroviral prophylaxis during breastfeeding.
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The purpose of this study was to investigate the significance of preterm acidosis and its risk factors. ⋯ In preterm infants, umbilical artery acidosis is significantly more common in the presence of placental abruption, fetal distress, and histologic evidence of placental vascular disease.
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Am. J. Obstet. Gynecol. · Sep 2007
Comparative StudyBetamethasone vs dexamethasone for the prevention of morbidity in very-low-birthweight neonates.
The purpose of this study was to compare neonatal outcomes in very-low-birthweight infants who were exposed to antenatal betamethasone vs dexamethasone. ⋯ Antenatal betamethasone was associated with a significantly lower rate of pulmonary complications caused by prematurity, when compared with dexamethasone.