Remodeling and relaxation of the mouse pubic symphysis (PS) are central events in parturition. The mouse PS remodels in a hormone-controlled process that involves the modification of the fibrocartilage into an interpubic ligament (IpL), followed by its relaxation prior to parturition. It is recognized that nitric oxide synthase (NOS) and ...

  Background:  Maternal perception of decreased fetal movements has been associated with adverse pregnancy outcomes, including stillbirth. Little is known about other aspects of perceived fetal activity. The objective of this study was to explore the relationship between maternal perception of fetal activity and late stillbirth (≥ 28 wk gestation) risk. Methods:  ...

OBJECTIVES. To compare early and late presentations of fetal haemoglobin Bart's disease in the Kowloon West Cluster in Hong Kong, and to find reasons for the re-emergence of late presentations. DESIGN. Case series with internal comparisons. SETTING. Two tertiary obstetric units in Hong Kong. PATIENTS. All cases with confirmed diagnosis ...

OBJECTIVE: The objective of this article was to ascertain the opinion of lay persons and medical practitioners in India regarding late termination of pregnancies (LTOP) for fetal abnormalities. METHODS: One hundred and fifty lay persons and 120 medical practitioners were given separate questionnaires and asked their opinions regarding LTOP for ...

OBJECTIVES: We evaluated late pregnancy abortions from 1981 to 2006 in Québec, Canada. METHODS: We extracted late abortions from the stillbirth mortality file, and calculated yearly rates per 100,000 pregnancies, including mean gestational age, birth weight, maternal age and education. RESULTS: There were 14.4 late abortions per 100,000 overall pregnancies ...

OBJECTIVE: Prospective assignment at 11 + 0 to 13 + 6 weeks of risk for late pre-eclampsia (PE) using eight logistic regression-based statistical models. METHODS: Five hundred and fifty-four pregnancies. Uterine artery pulsatility index, parity, body mass index, mean arterial pressure, pregnancy-associated plasma protein-A, free β-human chorionic gonadotrophin and maternal age, were combined to obtain ...

Abstract Objective: Termination of pregnancy (TOP) for medical reasons is regularly performed using misoprostol. Presence of placental remnants, followed by curettage, frequently complicate the procedure. Aim of this analysis is to audit our current policy for medical termination in late first and second trimester, looking at the management of third ...

Many aspects of postnatal development are influenced by events before birth, including cognitive and language development. An adverse intrauterine environment, for example secondary to poor maternal nutritional status, multiple pregnancy, or late preterm birth, is associated with increased risks of delayed or impaired childhood development and altered physiology in adulthood ...

Intrauterine growth restriction (IUGR) is commonly defined as an estimated fetal weight of less than the 10th percentile. While 70% of these are small for normal reasons and not at risk, 30% are pathologically small at risk for numerous complications including fetal death. In the late preterm IUGR fetus (>34 ...

Insulin resistance is a characteristic of late pregnancy, and adipose tissue is one of the tissues that most actively contributes to the reduced maternal insulin sensitivity. There is evidence that pregnancy is a condition of moderate inflammation, although the physiological role of this low-grade inflammation remains unclear. The present study ...

BACKGROUNDAs in many advanced societies, the age at first birth and the rate of post-menopausal pregnancies in Israel are constantly increasing. Since Israeli university students are the most likely population to postpone parenthood, this study aims at evaluating their awareness of: (i) women's age-related fertility decline; (ii) age-dependent success rates ...

Please cite this paper as: Joseph K. The natural history of pregnancy: diseases of early and late gestation. BJOG 2011; DOI: 10.1111/j.1471-0528.2011.03128.x. Objective  To identify the disease processes underlying the increasing rate of gestational age-specific perinatal mortality observed under the fetuses-at-risk model. Design  Retrospective cohort study. Setting  USA and Nova ...

PURPOSE: To investigate the relationship between meiotic spindle characteristics in human oocytes and the timing of the first zygotic cleavage after intracytoplasmic sperm injection (ICSI). METHODS: Zygotes that had cleaved to two-cell stage by 27 h post-ICSI were classified as early cleaving and the remainder as late cleaving. Meiotic spindle parameters ...

The balance of maternal, fetal, and neonatal risks of continued pregnancy versus iatrogenic delivery must be based on best evidence. Although avoiding elective deliveries prior to 39 weeks is well established to improve neonatal outcomes, several "soft" conditions are commonly considered to require delivery prior to 39 weeks. Review of ...

Our aim was to identify which ultrasound parameters can be most accurately measured and best predict ovine fetal weight in late gestation. Singleton pregnancies were established using embryo transfer in 32 adolescent ewes, which were subsequently overnourished to produce fetuses of variable size (1720-6260 g). Ultrasound measurements at 126-133 days ...

Preeclampsia is a leading cause of pregnancy-related morbidity and mortality in the United States. In the past 30 years, a large amount of research has been performed to investigate the pathogenesis and pathophysiology of preeclampsia, ways to treat preeclampsia, markers that can be used to predict preeclampsia, and associations with ...

The growing public health awareness of prematurity and its complications has prompted careful evaluation of the timing of deliveries by clinicians and hospitals. Preterm birth is associated with significant morbidity and mortality, and affects more than half a million births in the United States each year. In some situations, however, ...

OBJECTIVE We sought to define 24-h glycemia in normal-weight and obese pregnant women using continuous glucose monitoring (CGM) while they consumed a habitual and controlled diet both early and late in pregnancy. RESEARCH DESIGN AND METHODS Glycemia was prospectively measured in early (15.7 ± 2.0 weeks' gestation) and late (27.7 ...

PURPOSE: There is a paucity of data characterizing infertile men with maturation arrest. We hypothesized that men with early stage maturation arrest could be clinically distinguished from men with late maturation arrest and would have worse reproductive outcomes. MATERIALS AND METHODS: We retrospectively reviewed the records of all patients with ...

Most fetal lung masses present by mid gestation, grow during the canalicular phase of lung development (18-26 weeks of gestation), and plateau in growth or shrink after 26 weeks of gestation. We describe the unique case of a fetal lung mass presenting at 37 weeks of gestation with hydrops and ...

BACKGROUND Folic acid supplementation has an established role in early pregnancy for preventing neural tube defects. However, there is controversy over a possible link between late pregnancy folic acid supplementation and childhood asthma. OBJECTIVE To review the evidence exploring the association between maternal folate exposure in pregnancy and childhood asthma ...

To evaluate the importance in the modern era of either too thin or too thick of an endometrium in the late proliferative phase on success following embryo transfer. Pregnancy rates following fresh embryo transfer in cycles using controlled ovarian hyperstimulation and following donor egg or frozen embryo transfers using artificial ...

Objectives: The aim of this study was to describe our experience of imaging following hysteroscopic sterilisation with the Essure (Conceptus Inc., Mountain View, San Carlos, CA) microinsert, and to underline the importance of a carefully performed follow-up hysterosalpingogram (HSG) in the management of these patients. Methods: 18 women underwent the ...

Instrumental deliveries are believed to be associated with increased maternal and, especially, fetal morbidity and mortality. Hence, it is less practiced in many developing countries. The aim of this retrospective study, conducted between 1 January 2007 and 31 December 2008, was to assess the prevalence, indications, neonatal wellbeing and maternal ...

Objective. To determine if cesarean delivery is associated with improved survival and morbidity in the breech fetus at the threshold of viability. Study design. The Missouri maternally linked cohort data files covering the period 1989 through 2005 were utilized for analysis. All pregnancies with singleton fetuses in the breech presentation delivered between ...

Remodeling of vaginal extracellular matrix and smooth muscle likely plays a critical role in reducing the risk of maternal injury during vaginal delivery by altering the mechanical properties to increase distension and reduce stress. Long-Evans rats were divided into five groups to examine the passive mechanical and active contractile properties ...

BACKGROUND: At term, about 3-5% of the presentations are breech. Vaginal breech deliveries are associated with increased maternal and fetal morbidity and mortality, but delivery by cesarean section in an emergency does not eliminate all maternal and perinatal morbidity. The use of external cephalic version can produce considerable cost savings ...

To compare the measurements of women's pelvic floor musculature strength (PFMS) during pregnancy and postpartum period. Pregnancy and childbirth can have an influence on the muscles and pelvic floor and can cause morbidities of women's genito-urinary tract. A prospective cohort study. There were included 226 primigravidae women, attended by community ...

OBJECTIVE: To review clinical experience at our institution on postural tachycardia syndrome (POTS) complicating pregnancy. METHODS: In a retrospective review, we identified nine pregnancies in seven patients with POTS syndrome at our institution. RESULTS: Patients who did not require treatment for POTS before conception were less likely to have an ...

The popularity of the TVT procedure for treating stress urinary incontinence has led to more women of childbearing age undergoing this surgery. Therefore the incidence of pregnancy after TVT procedure is likely to increase. We present a review of the current literature and we report the case of a 26-year-old ...

Although first-trimester vaginal bleeding is an alarming symptom, few studies have investigated the prevalence and predictors of early bleeding. This study characterizes first trimester bleeding, setting aside bleeding that occurs at time of miscarriage. Participants (n = 4539) were women ages 18 to 45 enrolled in Right From the Start, ...

OBJECTIVE: To examine regional variations in rates of primary cesarean delivery and assisted vaginal delivery in the population of British Columbia, while adjusting for the maternal characteristics and conditions that increase the likelihood of operative delivery. METHODS: Using data from the British Columbia Perinatal Database Registry, we studied all deliveries ...

BACKGROUND: Most previous trials of vacuum-assisted delivery have been in settings with high rates of instrumental vaginal delivery (8-12%) and high rates of failure to deliver with the intended instrument (20-30%). Over the past 20 years, vacuum-assisted delivery rates at the Port Moresby General Hospital have been 3-4% with failure ...

OBJECTIVE: The purpose of this study was to investigate the influence of fetal head flexion during vaginal delivery with a 3-dimensional computational finite element model. STUDY DESIGN: A finite element model of the pelvic skeletal structure, pelvic floor, and fetus was developed. The movements of the fetus during birth were ...

OBJECTIVE: To compare 24-hour controlled-release vaginal dinoprostone pessary vs. gel for induction of labor at term in women with an unfavorable cervix. DESIGN: Randomized controlled trial. SETTING: University hospital. POPULATION: A total of 133 women with singleton pregnancies, fetal cephalic presentation, Bishop score < or = 4, gestational age of ...

OBJECTIVES: Morphological changes of the pelvic floor during pregnancy and delivery can be visualized by three-dimensional (3D) perineal ultrasound. The aim of this study was to compare biometric measurements of the levator ani muscle according to maternal constitutional factors, delivery mode and size of the baby immediately after the first ...

OBJECTIVE: To assess the incidence, risk factors ,maternal and foetal outcome in women with peripartum cardiomyopathy. METHODS: A descriptive study was conducted in the department of gynae obstetrics Civil Hospital, and Dow University of Health Sciences, Karachi from Oct, 2003 till Sept, 2007. Thirtytwo patients of any parity and age ...

We sought to define changes in vaginal distensibility (VD) induced by pregnancy and vaginal delivery using a novel in vivo biomechanical testing protocol. Under sedation, a balloon was inserted into the vagina of 27 virgin, pregnant and 4-week postpartum Long-Evans rats and incrementally distended. Pressure-volume curves were generated with slopes ...

The surgical treatment of intractable detrusor overactivity is complex and includes clam ileocystoplasty and appendix Mitrofanoff. Due to improved health and quality of life of these patients after surgery, the option of pregnancy is made possible for them. Pregnancy for these women can be complicated and requires multidisciplinary team input. ...

To compare the efficacy of Crinone vaginal gel and intramuscular progesterone (IMP) for luteal phase support in in vitro fertilization-embryo transfer (IVF-ET) with respect to pregnancy rates and outcomes, and to assess patient satisfaction with both products. Prospective randomized trial. University-affiliated IVF unit. Women under age 40 years with day-3 ...

We compared maternal morbidity between planned vaginal and planned cesarean delivery. A university hospital's database was queried for delivery outcomes. Between 1995 and 2005, 26,356 deliveries occurred. Subjects were divided into two groups: planned vaginal and planned cesarean delivery. This was based on intent to deliver vaginally or by cesarean, ...

OBJECTIVE: To describe the first vaginal approach to an ectopic pregnancy after hysterectomy. DESIGN: Case report. SETTING: Private hospital. PATIENT(S): A 38-year-old woman presenting with an ectopic pregnancy 5 months after having a vaginal hysterectomy due to uterine myomatosis. INTERVENTION(S): Vaginal adnexectomy. MAIN OUTCOME MEASURE(S): Vaginal surgery as a plausible ...

AIM: To investigate factors related to analgesic use after delivery, and especially whether rates of analgesic use were different in a midwife-managed maternity hotel as compared to conventional postnatal wards. SETTING: One maternity hotel and two conventional postnatal wards at Ullev?l University Hospital in Oslo, Norway. METHOD: Data were obtained ...

The focus of this article is first-trimester bleeding. Vaginal bleeding during the first 3 months of pregnancy is a common event. It is important that the emergency physicians recognize patients with vaginal bleeding who may have an adverse outcome if misdiagnosed or not treated appropriately in the emergency department. Causes ...

OBJECTIVE: To estimate neonatal morbidity and delivery outcomes according to planned mode of delivery in twin pregnancies with active second-stage management. METHODS: This was an historic cohort of twin pregnancies delivered in one practice between June 2005 and September 2009 using a strict protocol of second-stage management, including breech extraction ...

BACKGROUND: Physiological changes during pregnancy may affect laboratory parameters. Reference values based on samples from non-pregnant women are not necessarily useful for clinical decisions during pregnancy. There is a need to establish reference values during pregnancy in order to recognize pathological conditions. METHODS: Eight hundred and one women with expected ...

The original cups used for vacuum extraction delivery of the fetus were rigid metal cups. Subsequently, soft cups of flexible materials such as silicone rubber or plastic were introduced. Soft cups are thought to have a poorer success rate than metal cups. However they are also thought to be less ...

Proponents of vacuum delivery argue that it should be chosen first for assisted vaginal delivery, because it is less likely to injure the mother. The objective of this review was to assess the effects of vacuum extraction compared to forceps, on failure to achieve delivery and maternal and neonatal morbidity. ...

OBJECTIVE: To compare the impact of a dinoprostone vaginal insert and intravenous oxytocin in reducing blood loss of women undergoing vaginal or cesarean delivery. METHODS: This study was conducted among term singleton pregnancies delivered vaginally or by elective cesarean section. In the vaginally delivered cases, active management of the third ...

Previous reports have suggested that delivery is associated with the induction of inflammatory cytokines. The present study was designed to investigate whether increased cytokine production was present on postpartum day 3 after a normal pregnancy and whether any changes were associated with the mode of delivery. In total, 33 pregnant ...