In order to provide the best genetic counseling possible for women who learn of a diagnosis of Down syndrome prenatally, we sought to assess the timing of the decision to continue a pregnancy and the satisfaction these women had with learning this information. Fifty-six mothers of children with Down syndrome ...

: The neonatal risks of late preterm (34 0/7-36 6/7 weeks of gestation) and early-term (37 0/7-38 6/7 weeks of gestation) births are well established. However, there are a number of maternal, fetal, and placental complications in which either a late-preterm or early-term delivery is warranted. The timing of delivery ...

The avoidance of twin or higher-order multiple pregnancies is in the best interest of families, medical practitioners and health services, given the health hazards and costs associated with higher-order multiples. This commentary explores the background to and ideas in the paper by Legendre et al. in this issue, which makes ...

The aims of the study were to explore factors influencing the decision to continue or terminate pregnancy due to detection of fetal malformation following ultrasound examination, to elucidate the need for more information or other routines to facilitate the decision-making process and to assess satisfaction with the decision made. Descriptive ...

A woman with a viable intrauterine 12 week pregnancy and an intra-abdominal levonorgestrel-releasing intrauterine device (IUD) had the device successfully removed under local anesthesia. The pregnancy continued without complication. The decision to remove an intra-abdominal levonorgestrel-releasing IUD during pregnancy remains controversial.

: Uterine rupture of an unscarred uterus is a rare complication in a quadruplet pregnancy. : A 30-year-old woman, gravida 4 para 0030, with a quadruplet pregnancy and no previous uterine surgeries presented with moderate vaginal bleeding at 32 4/7 weeks of gestation. Fetal testing was reassuring, and the cervix ...

ABSTRACT:: Fertility treatments have contributed significantly to the increase in multifetal pregnancies. The first approach to the problem of multifetal pregnancies should be prevention, and strategies to limit multifetal pregnancies, especially high-order multifetal pregnancies, should be practiced by all physicians who treat women for infertility. Incorporating the ethical frameworks presented ...

BACKGROUND: Over 3% of pregnancies are complicated by a fetal abnormality, of which, approximately 80% are terminated. Despite early screening options, women often present at the cusp of legal limits for termination. STUDY DESIGN: A qualitative study was conducted with women terminating pregnancies for fetal abnormalities. Semi-structured interviews explored reasons ...

INTRODUCTION: In order to better identify those women requesting abortion who are not certain of their decision and would like more detailed discussion, we piloted use of a self-completed validated questionnaire containing the London Measure of Unintended Pregnancy (LMUP) amongst women requesting an abortion at a hospital clinic in Scotland. ...

Despite the growing number of women living with and affected by HIV, there is still insufficient attention to their pregnancy-related needs, rights, decisions and desires in research, policy and programs. We carried out a review of the literature to ascertain the current state of knowledge and highlight areas requiring further ...

The detection of foetal urinary abnormalities in the antenatal period will help in an adequate post natal management and it will also have a bearing on the decision of the termination of the pregnancy. The purpose of the present study was to detect urinary anomalies in the antenatal period by ...

The combination of kidney disease and pregnancy has long been recognized as a high-risk situation. When renal disease is recognized for the first time during pregnancy, it presents unique problems for both the obstetric and the renal teams. Particularly difficult can be distinguishing preeclampsia from preexisting kidney disease in women ...

Quantitative β-hCG measurements and transvaginal ultrasound findings interpreted in light of a β-hCG "cutoff" can reliably guide clinical decisions.

Prenatal counselling can be helpful to parents in making a decision with regard to continuation of the pregnancy or to help prepare for the birth and the future life of a child with Spina bifida. We aimed to assess the effectiveness of our specialist neuro counselling sessions and to highlight ...

Objective Placental calcification is associated with an increased risk of perinatal morbidity and mortality. The subjectivity of current ultrasound methods of assessment of placental calcification indicate that a more objective method is required. The aim of this study was to correlate the percentage of calcification defined by the clinician using ...

To evaluate the spectrum of diagnostic findings in hysterosalpingography (HSG) examinations performed at our institution between 2006-2010 and their prognostic significance for treatment decisions and fertility outcomes. Patients were filtered from our PACS. Pathological HSG studies were re-evaluated. Indications for referral, technical success and diagnostic findings were analysed. Pathological findings ...

Abstract Objective: To evaluate prospectively the efficacy to screen for congenital heart defects (CHD) during the first trimester nuchal translucency (NT) ultrasound examination by assessing the four chambers' view of fetal heart. Methods: Pregnancies that were examined prospectively by ultrasound in the first trimester (11th - 14th week), the second ...

Today, ultrasound is the main diagnostic tool in the prenatal detection of congenital abnormalities. Therefore, ultrasound examination should be offered to all pregnant women. A detailed sonographic examination of the fetus is usually performed between 18 and 22 weeks of pregnancy. The accurate recognition of normal fetal anatomy is very ...

Adolescents in Latin America and the Caribbean confront difficult decisions when faced with unwanted pregnancies, especially given the region's legal restrictions on and widespread cultural opposition to abortion. Little research has been conducted on pregnancy decisionmaking among young people in this region. This study examines the role of peers, partners, ...

Many women with psychiatric disorders want to become mothers and only a minority seek advise prior to becoming pregnant. In those women, in whom pregnancy can be planned, the decision, if a medication is required for stabilisation and which one to choose if this is the case, is easier to ...

In this column, the author explores current understandings of risk and safety in pregnancy and childbirth. An emphasis on risk management places the provider and hospital in control of women's decisions related to pregnancy and birth and may make pregnancy and birth less safe for mothers and babies. Accepting that ...

Systemic lupus erythematosus (SLE) disproportionately affects women in their reproductive age years. Pregnancy in this systemic autoimmune disease has long been associated with poor obstetric outcomes. However, the frequency of pregnancy loss in lupus has dropped to a level commensurate with that of the general US population. The outcomes of ...

Introduction: Females with systemic lupus erythematosus (SLE) have higher prevalence of human papillomavirus (HPV) infection, which can lead to the development of warts. Herein we report the first case of giant disseminated condylomatosis (GDC) in a SLE female on mycophenolate mofetil (MMF). Case report: The patient, a 33-year-old, Black female, ...

Systemic lupus erythematosus (SLE) is the most common autoimmune disease affecting women of reproductive age and is associated with poor maternal and fetal outcomes. CD4(+)CD25(+) Treg cells are a subset of T lymphocytes with potent immunosuppressive activity that play crucial roles in controlling immunological self tolerance. Evidence suggests that they ...

OBJECTIVE: To compare rates and predictors of pregnancy complications in mothers with systemic lupus erythematosus (SLE) with and without previous nephritis (PN). METHODS: Retrospective analysis of 107 pregnancies in 83 women with SLE diagnosed prepregnancy. RESULTS: Mothers with PN had higher rates of preterm delivery (< 37/40, 30% vs 11%, ...

To construct reference ranges of uterine artery Doppler parameters against gestation in twin pregnancies and to present charts of the pulsatility index (PI) and resistance index (RI) for clinical use. This was an observational study of the uterine circulation in 557 women with dichorionic twin pregnancies at 17-38 weeks' gestation. ...

OBJECTIVE: To study the impact on the neonate of maternal antiretroviral therapy with atazanavir (ATV). STUDY DESIGN: An observational study of 22 HIV-infected women receiving, for clinical indications, antiretroviral therapy with ATV 300mg and ritonavir 100mg during pregnancy and their 23 HIV infants (including a twin pair). RESULTS: Mothers had ...

During normal pregnancy there is an increase in the maternal blood volume leading to portal hypertension with some changes in liver functions. However, in an apparently healthy woman without known liver cirrhosis or other advanced liver disease, severe oesophageal varices with along with repeated variceal bleeding during pregnancy is rare. ...

One hundred fifty-two Trypanosoma cruzi seropositive women were submitted to a single hemoculture; 101 were pregnant, and 51 were not pregnant. Seven tubes from each individual were harvested with liver infusion tryptose (LIT) medium and observed monthly until the fifth month. Hemocultures were positive in 50% (76 of 152) of ...

OBJECTIVE: To assess maternal death and severe maternal morbidity from acute fatty liver of pregnancy (AFLP) in the Netherlands. STUDY DESIGN: A retrospective study of all cases of maternal mortality in the Netherlands between 1983 and 2006 and all cases of severe maternal morbidity in the Netherlands between 2004 and ...

Background: Several liver diseases can be observed during pregnancy. Some are proper to pregnancy and others are not. Aim: To study and to analyze the different liver diseases encountered during pregnancy and describe their management. Methods: Retrospective study of 97 patients having a liver disease during their pregnancy, the cases ...

Liver disorders occurring during pregnancy may be specifically pregnancy-related, or may be due to an intercurrent or chronic liver disease, which may present in anyone, pregnant or not. This review focuses on the liver diseases unique to pregnancy. Hyperemesis gravidarum, which occurs during early pregnancy, may be associated with liver ...

Urgent delivery of the fetus is often considered as the treatment of choice for mothers in their second or third trimester with hepatitis unique to pregnancy (HUP). To determine whether standard liver function tests (serum bilirubin and international normalized ratio levels) help to identify mothers and their newborns who might ...

Liver diseases related to pregnancy may be associated with preeclampsia (liver dysfunction related to preeclampsia; hemolysis, elevated liver enzymes, and low platelets with or without preeclampsia [HELLP syndrome]; and acute fatty liver of pregnancy) or may not involve preeclampsia (hyperemesis gravidarum and intrahepatic cholestasis of pregnancy). Liver diseases associated with ...

Doppler evaluation of the placenta and fetal cardiovascular system is one of the primary surveillance tools in prenatal medicine. By assessing uterine and umbilical arteries, placental development can be documented. This is useful for the prediction of hypertensive maternal disorders and placental dysfunction and fetal growth failure. The umbilical artery ...

Citation Torricelli M, Bellisai F, Novembri R, Galeazzi LR, Iuliano A, Voltolini C, Spreafico A, Galeazzi M, Petraglia F. High levels of maternal serum IL-17 and activin A in pregnant women affected by systemic lupus erythematosus. Am J Reprod Immunol 2011; 66: 84-89 Problem  To evaluate changes of serum IL-17, ...

Aim:  Using a longitudinal study design, we investigated changes in maternal core temperature and ambient temperatures before and after a localized cooling procedure to the right hand. Methods:  Fifteen pregnant women participated. The experiments were sequentially performed for 21 month periods on each subject: from the 8th week of gestation to ...

We investigated the accuracy of fetal umbilical artery Doppler to predict the risk of compromise of fetal/neonatal wellbeing in a high-risk population. Searches in MEDLINE, Embase, The Cochrane Library and Medion (from inception to March 2009) were carried out, together with hand searching of relevant journals, reference list checking of ...

To compare liver volume between trisomy 21 and euploid fetuses at 11 to 13 weeks' gestation. Fetal liver volume was measured by 3D ultrasound in fetuses at low risk of aneuploidies (n = 200) and another group at high risk, including 148 euploid and 37 with trisomy 21. The association ...

Doppler evaluation of the fetal ductus venosus has increased our depth of understanding of many fetal conditions. The ductus venosus has an important role in the regulation of nutrient partitioning in the fetus. Alterations in cardiac afterload, contractility compliance, intravascular volume status, and heart rate may significantly impact on the ...

Antepartum fetal surveillance with Doppler ultrasound of umbilical artery has shown significant diagnostic efficacy in identifying fetal compromise in pregnancies complicated with fetal growth restriction and preeclampsia. Moreover, randomized clinical trials and their meta-analyses have shown its effectiveness in decreasing perinatal mortality (level I evidence). This is the only antepartum ...

Ultrasound's record of safety seems to be perfect, with no undisputed reports of adverse effects in humans. However, all epidemiologic studies published so far are based on information obtained with pre-1992 machines, when allowed maximal in-situ intensity for fetal use was increased. Many fetuses are examined very early in pregnancy, ...

Uterine artery Doppler velocimetry has revolutionized the investigation of the developing placental vasculature. Abnormal placental vascular development is the basis of common obstetric disorders such as preeclampsia and intrauterine growth restriction. Uterine artery Doppler velocimetry by itself or in combination with other biochemical markers seems to be an effective first-trimester ...

Pregnancy represents a major challenge in the management of patients with systemic lupus erythematosus, with substantial risks to both mother and baby. Over the past 40 years there have been major improvements in outcomes. This partly relates to the discovery of the antiphospholipid syndrome, which has transformed management of lupus ...

To investigate the maternal serum concentration of insulin-like growth factor-I (IGF-I) in the first trimester of pregnancies that subsequently develop preeclampsia (PE) and to examine the possible association with uterine artery pulsatility index (PI). The maternal serum concentration of IGF-I and uterine artery PI at 11-13 weeks were measured in ...

Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease associated with fibrosis and inflammation of the bile ducts. Its complications include symptoms from pruritis and fatigue to dominant strictures, cholangiocarcinoma and liver failure necessitating liver transplant. Due to its predominance in young males, little is reported regarding PSC and ...

Pregnancy is associated with substantial changes in the maternal circulatory physiology. Our aim was to investigate maternal cerebral blood flow (CBF) during normal pregnancies. We prospectively measured maternal CBF in 210 low-risk pregnant women at different gestational ages, and in 15 nonpregnant women. CBF was assessed by measuring blood flow ...

First-trimester Doppler studies have reported that the lower uterine artery (UtA) resistance index (RI) is better for the prediction of pre-eclampsia (PE) than is either the mean or higher indices. The aim of this study was to determine if this relationship is true in the second trimester. This was a ...

To evaluate whether the persistence of abnormal findings in the third trimester following increased uterine artery (UtA) resistance in the second trimester is related to adverse pregnancy outcome. Low-risk nulliparous women with increased UtA mean pulsatility index (PI) at 20-22 weeks underwent repeat Doppler interrogation at 26-28 weeks and were ...

Preeclampsia is a common and potentially lethal pregnancy complication for women and offspring. Women who develop preeclampsia also run a long-term augmented risk of cardiovascular disease and premature death, and two theories are discussed. Women developing preeclampsia and persons developing cardiovascular disease may have common risk factors, which are unmasked ...