Neuroactive steroid concentrations are remarkably high in the fetal brain during late gestation. These concentrations are maintained by placental progesterone synthesis and the interaction of enzymes in the placenta and fetal brain. 5α-Pregnane-3α-ol-20-one (allopregnanolone) is a key neuroactive steroid during fetal life, although other 3α-hydroxy- pregnanes may make an additional ...

Neuropathies during pregnancy and the postpartum period are common and are usually due to compression around pregnancy and childbirth. The most common peripheral neuropathies are Bell's palsy, carpal tunnel syndrome (CTS), and lower extremity neuropathies. Although most neuropathies are usually reversible, associated disabilities or morbidities can limit functioning and require ...

PURPOSE: Trauma during pregnancy is among leading causes of non-pregnancy-related maternal death (MD). This study describes risk factors for MD from trauma during pregnancy in a large urban population. METHODS: We queried an urban Level One Trauma Center registry for the medical records of pregnant women suffering trauma from 1990 ...

Traumatic injuries in pregnancy are both common and burdensome. Optimal management includes proper triage, maternal resuscitation, fetal monitoring, and diagnostic imaging.

Hemorrhage during parturition can lower blood pressure beyond the lower limit of cerebral blood flow (CBF) autoregulation that can cause ischemic brain injury. However, the impact of pregnancy on the lower limit of CBF autoregulation is unknown. We measured myogenic vasodilation, a major contributor of CBF autoregulation, in isolated posterior ...

Preeclampsia complicates approximately 3-5% of pregnancies and remains one of the major causes of maternal and neonatal morbidity. It shares pathogenic similarities with adult cardiovascular disease as well as many risk factors. Attempts at prevention of preeclampsia using various supplements and classes of medications have failed or had limited success, ...

Minor traumatic injuries are common in pregnancy, often subsequently requiring painful diagnostic and therapeutic procedures. Pregnant women who are experiencing significant pain, distress, or fear may benefit from procedural sedation in the emergency department. In this review we examine the fetal safety of specific drugs used for procedural sedation.

OBJECTIVE: Several ultrasound methods including intrapartum translabial ultrasound (ITU) head station, angle of progression (AOP), head-perineum distance (HPD) and head-symphysis distance (HSD) have been suggested to assess fetal head station during labor. The aim of this study was to analyze the relationship between the ultrasound parameters and to compare them ...

We reviewed recent data on the prevalence, risk factors, complications and management of trauma during pregnancy. Using the terms "trauma" and "pregnancy" along with specified mechanisms of injury, we queried the Pubmed database for studies reported from January 1 (st), 1990 to May 1 (st), 2012. Studies with the largest ...

: Physical injury, including surgery, can result in chronic pain; yet chronic pain following childbirth, including cesarean delivery in women, is rare. The mechanisms involved in this protection by pregnancy or delivery have not been explored. : We examined the effect of pregnancy and delivery on hypersensitivity to mechanical stimuli ...

Objective: Women with spinal cord lesions present special challenges during pregnancy. We studied their pregnancy outcomes with regard to medical, obstetrical, and social concerns. Methods: We reviewed the records of pregnant women with spinal cord injury who attended our institution between 1999 and 2009. Results: Thirty-two women with a total ...

Study design:Case report.Setting:Prince of Wales Spinal Cord Injuries Unit, Sydney, Australia.Methods:Interrogation of our unit database identified only two women who became spinal cord injured while pregnant; their medical records were reviewed and an unstructured follow-up telephone interview conducted 6 years after discharge. Case 1: CC sustained a fracture dislocation with ...

Background:Fetal hypoxia contributes significantly to the pathogenesis of permanent perinatal brain injury. We hypothesized that hypoxia-induced cerebral angiogenesis and microvascular changes would occur in fetal sheep subjected to a severe hypoxic insult produced by occluding the umbilical cord (UCO) for 10 mins.Methods:At 124-126 days gestation singleton fetal sheep underwent surgery ...

The pregnant trauma patient requires imaging tests to diagnose maternal injuries and diagnostic tests to evaluate the viability of her pregnancy. This article will discuss abdominal trauma in pregnancy and the specific role of diagnostic imaging. Radiation concerns in pregnancy will be addressed. Trauma is the leading cause of nonobstetric ...

Approximately 1% to 4% of pregnant women are evaluated in emergency/delivery room because of traumatic injury, yet there are few educational strategies targeted toward prevention/management of maternal trauma. Use of illicit drugs and alcohol, domestic abuse, and depression contribute to maternal trauma; thus a high index of suspicion should be ...

The treatment of pregnant patients with traumatic injuries requires knowledge of the fundamentals of general trauma management as well as the specific anatomic and physiologic changes brought about by pregnancy. This article provides a review of the spectrum of trauma prevention and treatment in pregnant women, from counseling strategies that ...

Chorioamnionitis and fetal sepsis can induce a fetal inflammatory response syndrome (FIRS) which is closely related to the development of white matter injury in the fetal brain. Large epidemiological studies support the link between FIRS and fetal brain injury with a clear association between the presence of in utero inflammation ...

Over the past 3 decades significant therapeutic inroads have allowed spinal cord injured men to achieve biologic paternity. Prior to the introduction of electroejaculation in the mid-1980's, men with spinal cord injury were considered "hopelessly infertile". With the application of semen retrieval techniques such as electroejaculation (used to achieve the ...

The majority of men with a spinal cord injury (SCI) are infertile due to ejaculatory dysfunction and poor semen quality. The goal of this retrospective study is to present the outcomes of assisted reproductive technology (ART) in a group of couples with SCI male partners. A review was conducted of ...

Abstract Umbilical cord complications (CC) such as true knots (TK), velamentous insertion (VEL), entanglement (CE), excessive cord length (ELUC), or excessive coiling (ETUC) can lead to decreased umbilical blood flow and have been associated with adverse fetal outcome and demise (IUFD). Few large series exist correlating CC with specific pathologic ...

Mechanical endometrial injury (biopsy/scratch or hysteroscopy) in the cycle preceding ovarian stimulation for IVF has been proposed to improve implantation in women with unexplained recurrent implantation failure (RIF). This is a systematic review and meta-analysis of studies comparing the efficacy of endometrial injury versus no intervention in women with RIF ...

BACKGROUND: Serious injury during pregnancy is known to cause adverse maternal outcomes. However, the significance of minor injuries in adverse maternal outcomes requires clarification because most injuries sustained during pregnancy are minor ones. METHODS: Two population-based databases (inpatient and ambulatory care) were used to identify pregnant women who had severe ...

Abstract To assess potential risk factors for differences between predicted and actual calving dates in Holstein-Friesian cows in seasonal calving dairy herds where predicted dates are based on fetal ages estimated using manual rectal palpation. Accuracy of predicted calving dates was assessed in 10,487 Holstein-Friesian dairy cows that were diagnosed ...

PURPOSE: This study compares the efficacy, side effects and patient convenience of vaginal and rectal routes of administration of progesterone suppositories (Cyclogest) when used for luteal phase support during in vitro fertilization cycles, through the use of antagonist protocols. METHODS: 147 patients who underwent intra-cytoplasmic sperm injection cycle were randomized ...

The spectrum of kidney disease occurring during pregnancy includes preeclampsia, hypertensive disorders of pregnancy, urinary tract infection, acute kidney injury, and renal cortical necrosis (RCN). Preeclampsia affects approximately 3-5% of pregnancies. We observed preeclampsia in 5.8% of pregnancies, and 2.38% of our preeclamptic women developed eclampsia. Severe preeclampsia and the ...

To report a case of a pregnant woman with traumatic spinal cord injury complicated with a psychiatric disorder. A 24-year-old woman at 18 weeks of gestation was transferred to our hospital with a history of having jumped from a third-floor apartment patio. A trauma survey showed no life-threatening hemorrhage, and ...

Background: Maternal hypothyroidism in pregnancy is associated with several adverse outcomes. The Endocrine Society guidelines for the management of thyroid diseases in pregnancy were published in 2007; however, impact of the guidelines in the routine clinical practice is unknown. Therefore, we have carried out a survey of members of the ...

PURPOSE OF REVIEW: Thyroid disease is common during pregnancy. There are multiple alterations in maternal thyroid physiology, leading to an increased demand for thyroid hormone during gestation, that have significant implications for both maternal and fetal health. Importantly, pregnant reference ranges must be used for appropriate diagnosis and treatment of ...

The present manuscript provides a definition for, and evaluates the prevalence and maternal/fetal/child impact of, overt hyperthyroidism and overt hypothyroidism. The prevalence of overt hyperthyroidism is 0.5% and the prevalence of overt hyperthyroidism is 0.3%. Overt maternal hyperthyroidism is associated with heart failure, preeclampsia, preterm delivery, still birth, and neonatal ...

PURPOSE OF REVIEW: Examine recent studies on the assessment of thyroid status in pregnancy, approach to thyroid testing, the spectrum of hypothyroidism in pregnancy, and strategies for thyroid replacement in women with known hypothyroidism. RECENT FINDINGS: Trimester-specific references range for thyroid-stimulating hormone (TSH) and free thyroxine in pregnancy must take ...

Background Maternal hypothyroidism (OH and SCH) during early pregnancy is suspected to associate with adverse obstetrical outcomes. Aim The aim of the present study was to investigate whether maternal subclinical hypothyroidism during the early stage of pregnancy increase obstetrical complications and whether treatment results in an improvement in these outcomes. ...

Glaucoma, primarily a disease of the older population, may affect women of childbearing age. Pregnancy affects the intraocular pressure (IOP) of women with pre-existing glaucoma. Both elevations and reductions of IOP have been reported during pregnancy. Additionally, visual field test results may fluctuate during pregnancy. In managing the pregnant glaucoma ...

This case report describes a case of heterotopic cervical ectopic pregnancy in a nulliparous woman that was successfully treated with single-dose local, intra-amniotic methotrexate injection in the gestational sac. Pregnancy was achieved spontaneously. The patient had previously undergone hysteroscopic myomectomy. By using local, single-dose treatment we avoided the continued effects ...

Introduction. Cervical twin ectopic pregnancy after IVF-ET is rare and catastrophic complication. However, here is no consensus on the best treatment strategy. Patient and method. Case report of cervical twin ectopic pregnancy after IVF-ET treated by transvaginal ultrasound-guided aspiration plus systemic single injection of methotrexate, which followed by full-term delivery in next ...

OBJECTIVES: To review the literature on cervical length as a predictor of preterm birth in asymptomatic women with a multiple pregnancy. METHODS: We searched Medline, Embase and reference lists of included articles to identify all studies that reported on the accuracy of cervical length to predict preterm birth in asymptomatic ...

Objectives. To evaluate whether cervical funneling influences pregnancy outcome in women with short cervical length (CL) after cerclage, and to identify funneling parameters associated with pregnancy outcome. Methods. Medical records of women identified to have a short CL with or without funneling after cerclage were reviewed. Women with short CL as well ...

Aim:  To investigate the association between the amount of bleeding during a cesarean section and the effacement of the uterine cervix in patients with placenta previa. Methods:  This study reviewed 115 singleton pregnancies with placenta previa. In cases of placenta previa, the thickness of the uterine muscle and cervical length ...

The cervical mucus plug (CMP) differs from the cervical secretions of non-pregnant women, and is the ultimate sealant of the uterine cavity during pregnancy. Although several studies have analyzed biochemical properties of large glycoproteins in the CMP, comprehensive information about its protein composition is yet unavailable. We hypothesized that protein ...

OBJECTIVE: To determine if high risk asymptomatic women with a short cervical length in their previous pregnancy who delivered at term are at an increased risk of having a short cervical length in the next pregnancy, and whether they are at an increased risk of preterm birth. METHODS: This retrospective ...

Aim:  To study the relationship between cervical lengths measured by ultrasound and risk of preterm delivery. Material & Methods:  We examined 209 women with singleton pregnancies. The inclusion criteria were women who presented with regular and painful contractions (≥2 contractions at intervals of 10 min for at least 1 h). Transvaginal scan ...

Asherman's syndrome is being diagnosed with increasing frequency. Although it usually occurs following curettage of the pregnant or recently pregnant uterus, any uterine surgery can lead to intrauterine adhesions (IUA). Most women with IUA have amenorrhea or hypomenorrhea, but up to a fourth have painless menses of normal flow and ...

A report on a difficult case of first trimester pregnancy bleeding in a 39-year-old woman solved by hysterectomy. The diagnosis was clarified by pathological examination that showed a cervical ectopic pregnancy with perforation.

The purpose of this study was to determine whether optical methods can estimate cervix function during pregnancy and whether progestins modify this process. Photos of the external cervix of timed-pregnant rats were taken every other day from day 13 until postpartum day 5 after daily treatments with vehicle (controls) or ...

To evaluate the value of sonographic measurement of cervical length as a predictor of abortion or delivery within 24 h by misoprostol in second trimester termination of pregnancy (TOP). One hundred and sixty-three women underwent TOP between 14 and 26 weeks of pregnancy due to various indications. The primary outcome ...

The current body of literature concerning cervical conization and its effect on subsequent pregnancy outcome is conflicting. Depending on the type of conization procedure that is examined and the quality of the control group, the results and conclusions vary widely. Because treatment for cervical intraepithelial neoplasia is commonplace among women ...

OBJECTIVE: The purpose of the present study was to examine obstetric outcome of patients following conization and specifically the risk for preterm delivery (PTD). METHODS: A population-based study was performed comparing pregnancies in women following conization with those who had not undergone the procedure. Stratified analysis, using a multiple logistic ...

OBJECTIVE: To present a case of successful management of a heavily bleeding cervical ectopic pregnancy with ultrasound-guided termination procedure of evacuation. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 34-year-old woman, secundigravida with one previous full-term natural childbirth and history of one spontaneous abortion, with a cervical pregnancy. INTERVENTION(S): Prophylactic ...

Anti-Ro/SSA antibodies are associated with neonatal lupus (congenital heart block (CHB), neonatal transient skin rash, hematological and hepatic abnormalities), but do not negatively affects other gestational outcomes, and the general outcome of these pregnancies is now good, when followed by experienced multidisciplinary teams. The prevalence of CHB, defined as an ...

We report a 28-year-old woman presenting with a complete hyaditiform mole localized to the cervix. She had undergone curettage of missed abortion two months previously and the aborted material showed normal placental tissue on histopathologic examination. Two months after curettage she presented with sudden severe vaginal bleeding. Clinical examination revealed ...

A greater understanding of the parturition process is essential in the prevention of preterm birth, which occurs in 12.7% of infants born in the United States annually. Cervical remodeling is a critical component of this process. Beginning early in pregnancy, remodeling requires cumulative, progressive changes in the cervical extracellular matrix ...