scholarly journals Oral Fluconazole in Pregnancy and Risk of Stillbirth and Neonatal Death

JAMA ◽  
2018 ◽  
Vol 319 (22) ◽  
pp. 2333 ◽  
Author(s):  
Björn Pasternak ◽  
Viktor Wintzell ◽  
Kari Furu ◽  
Anders Engeland ◽  
Martin Neovius ◽  
...  
Keyword(s):  
Neonatal Death ◽  
Oral Fluconazole ◽  
In Pregnancy

scholarly journals Mediation of the effect of malaria in pregnancy on stillbirth and neonatal death in an area of low transmission: observational data analysis

BMC Medicine ◽  
2017 ◽  
Vol 15 (1) ◽  
Author(s):  
Kerryn A. Moore ◽  
Freya J. I. Fowkes ◽  
Jacher Wiladphaingern ◽  
Nan San Wai ◽  
Moo Kho Paw ◽  
...  
Keyword(s):  
Data Analysis ◽  
Observational Data ◽  
Neonatal Death ◽  
Malaria In Pregnancy ◽  
Low Transmission ◽  
In Pregnancy

scholarly journals Adverse Birth Outcomes in Botswana Among Women With Vertically or Horizontally Acquired Human Immunodeficiency Virus

2020 ◽  
Author(s):  
Christina Fennell ◽  
George R Seage ◽  
Rebecca Zash ◽  
Kelesitse Phiri ◽  
Modiegi Diseko ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Neonatal Death ◽  
Regression Models ◽  
Antiretroviral Treatment ◽  
Birth Outcome ◽  
Adverse Birth Outcomes ◽  
Binomial Regression ◽  
Immunodeficiency Virus ◽  
Risk Ratios ◽  
In Pregnancy

Abstract Background Women with vertically acquired HIV (VHIV) may have a greater risk of adverse birth outcomes than women with horizontally acquired HIV (HHIV). Methods The Tsepamo study performed birth outcomes surveillance at 8 government delivery sites in Botswana from July 2014 through March 2019. Pregnant women diagnosed with HIV before their 11th birthday received VHIV status, and other women had HHIV. Small for gestational age (SGA), preterm delivery (PTD), stillbirth, and neonatal death were compared using χ2 and Fisher’s exact tests. Log-binomial regression models determined risk ratios (RRs). Results VHIV women (n = 402) aged 15–27 years were identified over 4 years of surveillance and compared with HHIV women (n = 8465) of the same age. VHIV women were more likely to use nevirapine (NVP)-based antiretroviral treatment (ART) in pregnancy and to have SGA and very SGA infants, but less likely to have very PTD infants. In unadjusted analyses, VHIV women had a higher risk of any adverse birth outcome combined (RR = 1.21, 95% confidence interval [CI], 1.08–1.36). After adjusting for potential confounders, particularly use of NVP-based regimens, the risk of adverse birth outcomes among VHIV and HHIV women was similar. Conclusions NVP-based ART is a primary and modifiable risk factor for adverse birth outcomes. Updating ART regimens could improve birth outcomes for women with HIV.

scholarly journals Repeat screening for syphilis in pregnancy as an alternative screening strategy in the UK: a cost-effectiveness analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038505
Author(s):  
Susie Huntington ◽  
Georgie Weston ◽  
Farah Seedat ◽  
John Marshall ◽  
Heather Bailey ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Pregnant Women ◽  
Neonatal Death ◽  
Cost Effective ◽  
Screening Strategy ◽  
Base Case ◽  
Scenario Analyses ◽  
The Uk ◽  
The Cost ◽  
In Pregnancy

ObjectivesTo assess the cost-effectiveness of universal repeat screening for syphilis in late pregnancy, compared with the current strategy of single screening in early pregnancy with repeat screening offered only to high-risk women.DesignA decision tree model was developed to assess the incremental costs and health benefits of the two screening strategies. The base case analysis considered short-term costs during the pregnancy and the initial weeks after delivery. Deterministic and probabilistic sensitivity analyses and scenario analyses were conducted to assess the robustness of the results.SettingUK antenatal screening programme.PopulationHypothetical cohort of pregnant women who access antenatal care and receive a syphilis screen in 1 year.Primary and secondary outcome measuresThe primary outcome was the cost to avoid one case of congenital syphilis (CS). Secondary outcomes were the cost to avoid one case of intrauterine fetal demise (IUFD) or neonatal death and the number of women needing to be screened/treated to avoid one case of CS, IUFD or neonatal death. The cost per quality-adjusted life year gained was assessed in scenario analyses.ResultsBase case results indicated that for pregnant women in the UK (n=725 891), the repeat screening strategy would result in 5.5 fewer cases of CS (from 8.8 to 3.3), 0.1 fewer cases of neonatal death and 0.3 fewer cases of IUFD annually compared with the single screening strategy. This equates to an additional £1.8 million per case of CS prevented. When lifetime horizon was considered, the incremental cost-effectiveness ratio for the repeat screening strategy was £120 494.ConclusionsUniversal repeat screening for syphilis in pregnancy is unlikely to be cost-effective in the current UK setting where syphilis prevalence is low. Repeat screening may be cost-effective in countries with a higher syphilis incidence in pregnancy, particularly if the cost per screen is low.

Grandfathers’ Experiences of Grief and Support Following Pregnancy Loss or Neonatal Death of a Grandchild

2021 ◽  
pp. 104973232110413
Author(s):  
Jane Lockton ◽  
Melissa Oxlad ◽  
Clemence Due
Keyword(s):  
Thematic Analysis ◽  
Neonatal Death ◽  
Pregnancy Loss ◽  
Neonatal Period ◽  
Professional Support ◽  
Access To Information ◽  
Structured Interviews ◽  
Early Access ◽  
Written Materials ◽  
In Pregnancy

Pregnancy loss and neonatal death are recognized as distressing experiences for parents and other family members. However, no research has specifically addressed the experiences of grandfathers. This study aimed to understand grandfathers’ grief experiences, and to identify supports they provide, receive, and desire following the loss of a grandchild in pregnancy or the neonatal period. Semi-structured interviews with 10 Australian grandfathers were analyzed, applying principles of thematic analysis. Three themes related to grief and three themes related to support were identified. Findings indicated that grandfathers expressed grief in a range of ways, and emotional expressiveness did not reflect the extent of their grief. Grandfathers typically provided extensive support to their child and family; however, few supports were available to help grandfathers. Recognition and validation of grandfathers’ grief, early access to information, and guidance to a variety of supports including written materials, peer and professional support, is required.

Pregnancy

2020 ◽  
pp. 761-824
Author(s):  
Chantal Simon ◽  
Hazel Everitt ◽  
Françoise van Dorp ◽  
Nazia Hussain ◽  
Emma Nash ◽  
...  
Keyword(s):  
General Practice ◽  
Early Pregnancy ◽  
Postnatal Care ◽  
Neonatal Death ◽  
Multiple Pregnancy ◽  
Screening Tests ◽  
Antenatal Screening ◽  
Haemolytic Disease ◽  
Care Health ◽  
In Pregnancy

This chapter in the Oxford Handbook of General Practice explores pregnancy in general practice. It covers pre-conception and early pregnancy counselling through to labour and postnatal care. It discusses bleeding in early pregnancy, haemolytic disease and rhesus isoimmunization, antenatal care, health promotion for pregnant women, and advice on location of delivery. It explores screening and medical conditions seen in pregnancy, including specific antenatal screening tests, common symptoms, pruritus and rashes, hypertension, diabetes, and epilepsy. It examines intrauterine growth, multiple pregnancy and malpresentation, and ante- and postpartum haemorrhage. It also discusses common postnatal problems, stillbirth, and neonatal death.

scholarly journals Management of hemophagocytic lymphohistiocytosis in pregnancy

2021 ◽  
Author(s):  
Congcong Liu ◽  
Jinsong Gao ◽  
Juntao Liu
Keyword(s):  
Gestational Age ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Neonatal Death ◽  
Treatment Options ◽  
Termination Of Pregnancy ◽  
Singleton Pregnancy ◽  
College Hospital ◽  
Good Efficiency ◽  
First Choice ◽  
In Pregnancy

Abstract Background: The diagnosis of hemophagocytic lymphohistiocytosis (HLH) in pregnancy is challenging due to its rarity. There is currently no consensus on the treatment of HLH during pregnancy. We aim to analyze and summarize the clinical characteristics of HLH in pregnancy, and to discuss effective diagnostic and treatment options.Methods: Thirteen patients with HLH during pregnancy who were diagnosed and treated at the Peking Union Medical College Hospital of the Chinese Academy of Medical Sciences from January 2000 to December 2019 were studied retrospectively. We collected data on treatment regimens and on maternal and pregnancy outcomes.Results: All patients had a singleton pregnancy, with a median age of 28 years (range, 22–33 years) and a median gestational age of 23 weeks (7–36 weeks). There were underlying associated diagnoses in six patients; of the patients, 12 (92.3%, 12/13) were treated with corticosteroids, and a good efficiency was achieved in 5 (41.7%, 5/12) of them. Two patients who were treated with dexamethasone and etoposide after termination of pregnancy achieved CR. Two patients attained remission after termination of pregnancy. Four pregnant women died, and the mortality rate was 30.77% (4/13). Fetal or neonatal death up to 1 week after delivery occurred in eight (61.54%) pregnancies, and there were four cases of miscarriage, two of stillbirth, and two of neonatal death. Complications included premature birth (57.14% of neonates), small for gestational age (SGA, 7.70%), premature rupture of membranes (15.38%), and fetal stress (15.38%).Conclusion: Early diagnosis and treatment are important for maternal survival, and corticosteroids are the first choice for most patients with HLH during pregnancy. For patients who do not respond to corticosteroids, etoposide, and termination of pregnancy may be life- saving.

Parents’ experiences and expectations of care in pregnancy after stillbirth or neonatal death: a metasynthesis

2014 ◽  
Vol 121 (8) ◽  
pp. 943-950 ◽  
Author(s):  
TA Mills ◽  
C Ricklesford ◽  
A Cooke ◽  
AEP Heazell ◽  
M Whitworth ◽  
...  
Keyword(s):  
Neonatal Death ◽  
In Pregnancy ◽  
Parents Experiences
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