Articles Tagged With: preterm
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Emergencies in the Second and Third Trimesters of Pregnancy
Common emergencies specific to the second and third trimesters will be reviewed in this paper, including preterm labor, causes of antepartum bleeding in late pregnancy, and the hypertensive disorders of pregnancy. It is important to emphasize that obstetrics consultation is recommended in most emergencies that occur in the second and third trimesters prior to initiating therapies.
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Outcomes in Pregnant Women Treated with Anti-Tumor Necrosis Factor-Alpha Biologic Therapy
In this population-based cohort study of 1,027 infants born to women treated with anti-TNF-α biologic therapy, there was an increased prevalence of preterm birth (adjusted odds ratio [aOR], 1.61; 95% confidence interval [CI], 1.29-2.02), cesarean delivery (aOR, 1.57; 95% CI, 1.35-1.82), and small for gestational age neonates (aOR, 1.36; 95% CI, 0.96-1.92) when treatment with anti-TNF was compared to non-biologic systemic treatment. Since disease processes varied greatly in these pregnant women, it was difficult to rule out confounding by disease severity (confounding by indication).
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Is Vaginal Progestogen Equivalent to Intramuscular Progestogen for Preventing Preterm Birth in High-Risk Women?
In this open-label, equivalence randomized trial of vaginal progestogen compared to intramuscular progestogens for preventing preterm birth in high-risk women, the difference in the risk of preterm birth at < 37 weeks of gestation between both groups was 3.1% (95% confidence interval, -7.6% to 13.8%), which was within the equivalence margin of 15% used in the study.
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Study Reveals Low Rate of Contraceptive Use in Women with Recent Preterm Births
Medicaid claims data among a North Carolina cohort show that women were less likely to fill a contraceptive claim within 90 days after preterm birth. Investigators theorized it would be harder for women to access contraception after a preterm birth because they would be caring for a medically fragile infant. Also, women who deliver preterm experience shorter pregnancies, which means there is less time for a conversation with their healthcare providers about contraception.
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17P to Prevent Recurrent PTB in Singleton Gestations: The PROLONG Study
In this large, double-blind, placebo-controlled, international trial, pregnant women at risk for preterm birth (PTB) between 16-36 weeks gestational age were randomized to an intramuscular weekly injection of either 17-hydroxyprogesterone caproate (17P) or placebo. There was no difference in rates of PTB or neonatal morbidity between these two groups. In comparison to the Meis trial published in 2003, the findings of the PROLONG trial question the use of intramuscular 17P injection as the cornerstone of PTB prevention.
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Maternal and Infant Health Need Science-Based Case Management Plan
Evidence-based recommendations to prevent preterm births include assessing patients’ risk levels and considering a variety of potential complications and health problems.
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Maternity Case Managers Can Help Patients and Reduce Costs
American women who are pregnant or have just given birth are dying at a rate higher than most high-resource nations, and the morbidity rate is three to four times greater for black women. Their death rate is equivalent to pregnant women in less affluent nations, including Mexico or Uzbekistan. Maternity case managers can help prevent pregnant women from experiencing health crises and help keep their infants out of the neonatal ICU. Case management helps promote better education about the risks of preterm births.
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Adverse Perinatal Outcomes Related to Intrahepatic Cholestasis of Pregnancy
While a diagnosis of intrahepatic cholestasis of pregnancy is associated with an increased risk for stillbirth, preterm birth, and neonatal respiratory issues, consensus on management within the obstetrics community has not been reached.
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Test in Development to Detect Preterm Birth
Scientists at Brigham and Women’s Hospital have published early results of an investigative blood test designed to predict which women may be at increased risk and which ones may be at lower-than-average risk for spontaneous preterm delivery. The researchers have identified circulating microparticle proteins found in blood samples taken in the first trimester of pregnancy that may provide clues about the risk of spontaneous preterm birth.
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Research Focuses on Risk of Preterm Birth in Subsequent Pregnancy
In new research, investigators analyzed the risk of preterm birth among women with a previous poor pregnancy outcome. The results indicated that women had a higher chance of delivering before 32 weeks if their previous infant was born small for its gestational age. Those with a previous neonatal death were three times as likely to have a preterm birth subsequently, data indicated.