Journal of Maternal-Fetal and Neonatal Medicine (J MATERN-FETAL NEO M )

Publisher: European Association of Perinatal Medicine; Federation of Asia and Oceania Perinatal Societies; International Society of Perinatal Obstetricians, Taylor & Francis


The official journal of The European Association of Perinatal Medicine, The Federation of Asia and Oceania Perinatal Societies, and The International Society of Perinatal Obstetricians.

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    Journal of maternal-fetal & neonatal medicine (Online), Journal of maternal-fetal and neonatal medicine
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    Document, Periodical, Internet resource
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    Internet Resource, Computer File, Journal / Magazine / Newspaper

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Taylor & Francis

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    • Publisher last contacted on 25/03/2014
    • 'Taylor & Francis (Psychology Press)' is an imprint of 'Taylor & Francis'
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Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Objective: Preterm birth is a major cause of neonatal morbidity and mortality in the developed world. In order to better understand the pathophysiological pathway of this condition, the role of genetic factors and/or inflammation-associated molecules, as well as of socioeconomic parameters, is therefore under intense investigation. The purpose of this review study was to examine the potential role of maternal serum relaxin levels in the etiology of preterm birth. Methods: Electronic databases (Pubmed, Embase, Cochrane Library) were searched for previously published research studies that investigated the biological role of relaxin and the mechanisms in which this hormone is involved during pregnancy and labor. Results: It is evident that while relaxin is an essential endometrial/decidual angiogentic factor playing a vital role in maternal accommodation of pregnancy, elevated levels of this hormone could well be associated with preterm birth. Conclusions: There are strong indications that maternal serum hyperrelaxinemia correlates with an increased risk of preterm birth.
    Journal of Maternal-Fetal and Neonatal Medicine 11/2014;
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    ABSTRACT: Background Necrotizing enterocolitis (NEC) is the most important gastrointestinal emergency in the neonatal period and early detection is very important for its management. Bowel ischemia-hypoperfusion is one of the main etiological factors. In the literature, a few studies have focused on arterial Doppler ultrasonography (DUS) features of splanchnic arteries; however, their clinical implications are not clear. Objective In this study, we aimed to quantitatively evaluate the blood flow features in the hepatic portal vein (PV) and hepatic veins (HV) by using DUS in newborns with NEC. Patients-Method Enrolled subjects were divided into two groups as NEC+ (n:24) and NEC- (n:25). Daily serial Doppler US examinations were performed after the onset of the suspicion of NEC and continued until the initial day of the enteral feeding. Portal blood flow (PBF) and “hepatic blood flow ratio” (RHBF) were calculated manually by using DUS findings. Two groups were compared with respect to their PBF and RoHBF values. Results PBF and RHBF levels were significantly lower in NEC+ group than those in control group. Clinical improvement in patients with NEC was associated with improvement in the PBF and RHBF. Cut-off level of the RHBF for the diagnosis of NEC was 0.66. Conclusion DUS seems to be useful for the diagnosis and follow-up of NEC by providing quantitative information on liver blood flow. Daily measurements of the PBF and RoHBF in newborns with NEC may be beneficial to make the decision of starting enteral feeding.
    Journal of Maternal-Fetal and Neonatal Medicine 10/2014;
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    ABSTRACT: Objective: We aimed to characterize gestational age assessment and fetal growth evaluation among obstetricians. Methods: Observational, cross-sectional study. We applied a questionnaire to obstetrics specialists and residents, during a national congress on obstetrics. Results: Almost all 179 respondents correct gestational age in the first trimester by ultrasound, but 63% only if there is a difference of 2-9 days. Ultrasound at 11-13 weeks was considered more accurate than at 8-10 weeks by 81%, with a higher proportion of specialists choosing correctly the last answer (p=0,05). One third of the respondents did not correctly point the error associated with the ultrasound estimation of fetal weight (EFW). Of the 88% who use a growth table, only 32% were able to identify it by publication/author. 98% identify fetal growth restriction risk (FGR) with centiles (10(th) in 76%) and 73% of doctors diagnose FGR without other pathological findings (10(th) in 49%). 44% finds that a low EFW centile maintenance (4(th) to 3(rd)) is more worrisome than the crossing of two quartiles (75(th) to 24th). Conclusions: The role of ultrasound in gestational age assessment and use of EFW use for FGR classification was disparate among participants. EFW and respective centiles may be over relied upon.
    Journal of Maternal-Fetal and Neonatal Medicine 10/2014;
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    ABSTRACT: Abstract Objective: To investigate the association of perinatal risk factors including delivery mode with mortality in very low birthweight (VLBW) in a tertiary hospital setting. Methods: Medical records of 241 live-born VLBW infants (≤1500 g) were retrospectively reviewed. Details of maternal, obstetrical, perinatal risk factors and their associations with infant mortality were evaluated. Results: The overall infant mortality rate was 23.2%. Mortality was significantly higher for infants born at ≤27 gestational weeks and with a birthweight of ≤750 g (p = 0.000 and p = 0.000, respectively), showing a steep decrease thereafter. On ROC analysis, a cut off of 26.5 weeks was determined for mortality with a sensitivity of 57.1% and a specificity of 90.3% (area under the curve = 0.792, 95% CI: 0.719-0.866). On multivariate regression analysis, gestational week at birth, birthweight, antenatal steroid treatment and pathologic Doppler ultrasound findings were found as independent risk factors for mortality. Conclusions: Gestational week at birth, birthweight and antenatal steroid treatment remain the most important perinatal risk factors for infant mortality in VLBW infants. Mode of delivery does not seem to be associated with mortality when adjusted for other perinatal risk factors.
    Journal of Maternal-Fetal and Neonatal Medicine 09/2014;
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    ABSTRACT: Abstract Objective: To delineate thromboelastographic profiles of the premature infants with and without intracranial hemorrhage during the first 21 days of life. Methods: 49 premature infants (24 female; 25 male) consecutively admitted at our neonatal intensive care unit during a 6 months period were subject to thromboelastography and standard coagulation assessments at birth and weekly up to 21 days. 16/49 infants developed intracranial hemorrhage at birth. Results: 127/196 test results were considered eligible for analysis. Overall significant changes of the main thromboelastographic parameters were observed shortly after birth. Newborns with intracranial hemorrhage showed increased thromboelastogram-defined thrombin generation (shorter R and time to maximum amplitude times) from birth onward, suggesting a hypercoagulable state. No significant differences concerning thromboelastographic and coagulation assays parameters were found at birth between infants with and without intracranial hemorrhage, except for higher plasma D-Dimer concentration (p = 0.002) in the former infants. Finally, a positive correlation between clot lysis time and gestational age [Spearman's rho = 0.502, p = 0.002] was observed. Conclusions: thromboelastographic profiles of the premature infants suggest an effective hemostatic function during the first post-natal weeks. Further study is needed to determine whether thromboelastography may be more useful than coagulation assays to reflect the bleeding risk of the premature infants.
    Journal of Maternal-Fetal and Neonatal Medicine 09/2014; 23:1-19.
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    ABSTRACT: Despite the widespread usage of oxytocin, there is still no consensus on its mode of administration. The scope of the present meta-analysis was to assess the effect of oxytocin discontinuation after the active phase of labor is established on maternal fetal and neonatal outcomes. We searched Medline, Scopus, Popline, and Google Scholar databases. Eight studies were finally retrieved, which involved 1232 parturient. We observed significantly decreased rates of cesarean sections among parturient that discontinued oxytocin (OR 0.51, 95% CI 0.35, 0.74) as well as decreased rates of uterine hyperstimulation (OR 0.33, 95% CI 0.19, 0.58). Similarly, cases of non-reassuring fetal heart rates were fewer among women that did not receive oxytocin after the establishment of the active phase of labor (OR 0.63, 95% CI 0.41, 0.97). Keeping in mind the aforementioned maternal and neonatal adverse effects that seem to result from infusion of oxytocin until delivery, future practice should aim towards its discontinuation after the establishment of the active phase of labor, as it does not seem to influence the total duration of labor. Future studies should aim towards specific populations of parturient in order to clarify whether different approaches are needed.
    Journal of Maternal-Fetal and Neonatal Medicine 08/2014;
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    ABSTRACT: Abstract Introduction: Acute pancreatitis is a recognised rare complication in pregnancy. The reported incidence varies between 3 to 7 in 10,000 pregnancies and is higher in the third trimester. The commonest causes in pregnancy include gallstones, alcohol and hypertriglyceridaemia. Non-gallstone pancreatitis is associated with more complications and poorer outcome with hypertriglyceridaemia-induced acute pancreatitis having mortality rates ranging from 7.5-9.0% and 10.0-17.5% for mother and fetus, respectively. Case History: A 40-year-old para 4 woman, who presented at 15(+4) weeks' gestation, was diagnosed with acute pancreatitis. Past medical history included Graves' disease and hypertriglyceridaemia. Fenofibrate was discontinued immediately after discovery of the pregnancy. Initial investigations showed elevated amylase (475.0 u/L) and triglycerides (46.6 mmol/L). Imaging revealed an inflamed pancreas without evidence of biliary obstruction/gallstones hence confirming the diagnosis of hypertriglyceridaemia-induced acute pancreatitis. Laboratory tests gradually improved (triglyceride 5.2 mmol/L on day 17). On day 18 ultrasound confirmed fetal demise (18(+1) weeks) and a hysterotomy was performed as she had had 4 previous caesarean sections. Conclusion: Management of acute pancreatitis in pregnancy requires a multi-disciplinary approach. Hypertriglyceridaemia-induced acute pancreatitis has poor outcomes when diagnosed in early pregnancy. Identifying those at risk pre-pregnancy and antenatally can allow close monitoring through pregnancy to optimise care.
    Journal of Maternal-Fetal and Neonatal Medicine 07/2014;
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    ABSTRACT: Abstract Objective: Neonatal hypoxic-ischemic encephalopathy (HIE) is caused by brain injury that occurs in a developing fetus or infant. Stem cell transplantation can reportedly induce functional recovery in animal models of HIE. Murine neonatal splenocytes are enriched with immature blood stem cells and are used for the investigation of murine models of syngeneic transplantation. The aim of this study was to investigate the therapeutic potential of newborn splenocytes in a murine model of neonatal ischemia-reperfusion brain injury. Methods: C57BL/6N mice (postnatal day 7) underwent right common carotid artery occlusion with an aneurysm clip. Following hypoxic exposure, reperfusion was achieved by unclamping the artery. Newborn splenocytes were transplanted intravenously at 3 weeks after injury. Results: The splenocytes transplanted group tended to show an improvement in behavioral tests, but it was not significantly different compared with the control groups. The transplanted cells were localized in various organs including injured brain tissue over 3 weeks. In the penumbra region of the brain, vascular endothelial growth factor (VEGF) expression was upregulated after transplantation. conclusions: these results showed that syngeneic transplantation of newborn splenocytes achieved the long-term survival of the grafts and exerted influence the microenvironment in the injured brains of mice.
    Journal of Maternal-Fetal and Neonatal Medicine 06/2014;
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    ABSTRACT: Abstract Objective: To evaluate the influence of delivery mode on oxidative stress in human breast milk. Method: Thirty-three women delivered by vaginal birth and 55 women underwent to cesarean section (CS) were included in this study. Colostral samples were collected on the 2nd day after delivery. Total antioxidant status (TAS), total oxidative status (TOS), oxidative stress index (OSI), malonyl dealdehyte (MDA), and glutathione peroxidase (GSH-Px) levels were determined and compared. Results: Colostrum TAS was significantly higher in women of vaginal birth, than in women with CS (P<0.001). Milk TOS and OSI was found to be significantly increased in women with CS under general anesthesia. A marked increase in colostral GSH-Px levels after vaginal delivery was also noticed (P<0.001). Conclusion: This study revealed that VB is associated with decreased oxidative stress in colostrum than CS which suggest that mode of delivery place an important role in the antioxidative protection of breast milk.
    Journal of Maternal-Fetal and Neonatal Medicine 06/2014;
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    ABSTRACT: Objective:To assess maternal perception of fetal movement types and its association with maternal factors in normal pregnancies with good pregnancy outcome. Methods:This study was conducted on 729 normotensive singleton pregnant women with good pregnancy outcome who had referred for prenatal visit. After completing a questionnaire, the participants were asked to count fetal movements for one hour/3times/day.They were also asked to identify the type of fetal movement: general body movement(GBM)(rolling and stretching/strong),isolated limb movement(ILM)(simple flutter or kicks/weak),trunk movement(TM)(strong jab,startle/strong),or hiccup movement(HM)(high frequency and rapid/weak).All the participants were followed till delivery to exclude pregnant women with preterm birth and/or small for gestational age from the study. Results:90.8% of participants perceived GBM, which was independently associated with maternal unemployment(OR=2.28, 95%CI=1.18–4.4).74.2% of participants perceived TM, which was associated with multiparity(OR=1.69, 95%CI=1.18–2.4).86.3% perceived ILM, which was independently associated with maternal unemployment(OR=2.67, 95%CI=1.53–4.68),lower gestational age(OR=2.17, 95%CI=1.28–3.67),perception of fetal movements at night(OR=2.05, 95%CI=1.27–3.32),and multiparity(OR=1.68, 95%CI=1.04–2.72).36.6% perceived HM, which was independently associated with higher gestational age(OR=1.71, 95%CI=1.2–2.44). Conclusions:Most pregnant women could discriminate changes in fetal movement type that follow a general pattern through the third gestational trimester, however this can be affected by maternal employment, parity and time of perception. Read More:
    Journal of Maternal-Fetal and Neonatal Medicine 05/2014;
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    ABSTRACT: Abstract Objective: The aim of this study was to investigate the protein glycosylation pattern and AXIN1 protein expression n human placentae of normal pregnancies and compare them with placentae of pregnancies complicated with intrauterine growth restriction (IUGR). Methods: A total of 38 placentae (17 placentae of IUGR fetuses from singleton pregnancies and gestational age-matched 21 control placentae from normal singleton pregnancies) were collected from the Clinical Hospital Sveti Duh, Department of Gynecology and Obstetrics, Zagreb, Croatia. Gestational age was determined according to the last menstrual period (LMP) and by ultrasound measurements. Expression of glycoproteins was measured by Western blotting with SNA, UEA-I, PHA-E and DBA lectins as probes whereas expression of AXIN1 was determined by Immunohistochemistry. Results: Comparison of detected sugars revealed differences in protein glycosylation between normal and IUGR placentae. Higher expression of AXIN1 protein located mostly in the cytoplasm of syncytiotrophoblast and to a lesser extent in its nuclei was found in IUGR placentae. Conclusion: Results of our study suggest that changes in glycoprotein content may contribute to restricted placenta growth and development. Higher expression of AXIN1 protein in IUGR placentae indicates a role of Wnt/β-catenin signaling pathway in pathology of placental development.
    Journal of Maternal-Fetal and Neonatal Medicine 05/2014;
  • Journal of Maternal-Fetal and Neonatal Medicine 05/2014;
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    ABSTRACT: Objective: The aim of this study is to determine the consequences of delayed presentation of anorectal malformations and emphasize the causes of delayed diagnosis of these malformations. Methods: We retrospectively reviewed 54 neonatal patients with a diagnosis of anorectal malformations. Group 1 consisted of 35 patients diagnosed within the first 48 hours of life and Group 2 included 19 patients diagnosed after 48 hours of life. Results: Obstructive symptoms at the time of diagnosis, overall complications and the mean postoperative hospitalization period in Group 2 were markedly higher than that of Group 1. A comprehensive neonatal examination within the first 48 hours of life was performed in 32 (91.4%) patients in Group 1 and 5 (26.3%) of the patients in Group 2 (p<0.001). Conclusions: The passage of meconium is not the only sign of correctly positioned anus. A careful physical examination and awareness of this anomaly are of great importance in making a timely diagnosis of anorectal malformations.
    Journal of Maternal-Fetal and Neonatal Medicine 04/2014;
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    ABSTRACT: Abstract Objective: The neonatal intensive care unit (NICU) is an ideal setting to intervene with an under served population on secondhand smoke exposure (SHSe). Unfortunately, attrition may compromise outcomes. Baseline characteristics associated with intervention and follow-up attendance were investigated in mothers who participated in a novel SHSe prevention study designed for households with a smoker and a NICU-admitted infant. Methods: Intervention participants received 2 motivational, NICU-based counseling sessions; usual care participants received pamphlets. Home-based follow-up assessments occurred at 1, 3, and 6 months. Sociodemographic, smoking history, and psychosocial factors were analyzed. Results: Mothers from households with greater numbers of cigarettes smoked and fewer children had higher odds of both intervention and follow-up attendance. Maternal smoking abstinence (lifetime), more adults in the home, and higher perceived interpersonal support were also associated with higher odds of follow-up visit completion. Conclusions: Innovative strategies are needed to engage mothers in secondhand smoke interventions, especially mothers who smoke, have lower levels of social support, and have greater childcare responsibilities.
    Journal of Maternal-Fetal and Neonatal Medicine 01/2014;
  • Journal of Maternal-Fetal and Neonatal Medicine 01/2014;