Doctors should 'wait longer' before diagnosing miscarriage

ConclusionThis observational study reviewed the reliability of different measurements taken at a transvaginal ultrasound scan to diagnose miscarriage during early pregnancy. The recommended cut-off values for gestational sac diameter and embryo crown-to-rump length were changed in 2011 based on a number of reports, with mixed findings suggesting previous ones may have been unreliable. This study looked at the performance of currently used cut-off values, and found that the current cut-offs used to diagnose miscarriage are reliable. No healthy, continuing pregnancies would be wrongly diagnosed as miscarriage using these values.However, a finding of note was that if a repeat scan is needed to confirm miscarriage, there are some issues around timing. If there is a gestational sac only, with no embryo present, reliable diagnosis can be harder, and researchers say there should be a wait of two weeks rather than one before carrying out a repeat scan. This reduces the chance of incorrect diagnosis from 2% to 0%. If an embryo is identified at the first scan, then interpretation of miscarriage is more straightforward and timing between scans is less of an issue. This study has a number of strengths, namely a prospective design and large sample size, with measurements taken by experienced professionals, thereby increasing the certainty of the findings. However, there was no available data for 337 women and this may have influenced results. Miscarriages are common, can happen for m...
Source: NHS News Feed - Category: Consumer Health News Tags: Medical practice Pregnancy/child Source Type: news

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Publication date: Available online 17 April 2019Source: The Journal of Molecular DiagnosticsAuthor(s): Emily B. Hollister, Numan Oezguen, Bruno P. Chumpitazi, Ruth Ann Luna, Erica M. Weidler, Michelle Rubio-Gonzales, Mahmoud Dahdouli, Julia L. Cope, Toni-Ann Mistretta, Sabeen Raza, Ginger A. Metcalf, Donna M. Muzny, Richard A. Gibbs, Joseph F. Petrosino, Margaret Heitkemper, Tor C. Savidge, Robert J. Shulman, James VersalovicAccurate diagnosis and stratification of children with irritable bowel syndrome (IBS) remain challenging. Given the central role of recurrent abdominal pain in IBS, we evaluated the relationships of pe...
Source: The Journal of Molecular Diagnostics - Category: Pathology Source Type: research
ConclusionHangman's fracture is associated with low rates of mortality and neurological complications. Non-operative treatment is appropriate in Type I hangman's fracture, with a 100% healing rate in our study. Types II and III are characterised by damage to the ligaments and discs requiring either anterior C2-C3 fusion or posterior C1-C3 screw fixation.Level of evidenceIII.
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
ConclusionMetallosis-associated osteolysis should be suspected in cases with radiologically evident polyethylene wear after knee replacement. Recognizing that revision arthroplasty is very technically demanding in such cases, surgeons should have a back-up with modular revision components and a ready access to reconstructive options at this revision setting.
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
Conclusions: FMF rarely involves the posterior pole. Visual loss in FMF results from either posterior scleritis or posterior uveitis. A high degree of suspicion of posterior scleritis is warranted in female patients with known FMF presenting with cloudy serous macular detachment.Case Rep Ophthalmol 2019;10:134 –139
Source: Case Reports in Ophthalmology - Category: Opthalmology Source Type: research
ConclusionsMicrovascular retinal structural anomalies detectable on OCT-A could shed further light on the causes of amblyopia.
Source: Journal of American Association for Pediatric Ophthalmology and Strabismus - Category: Opthalmology Source Type: research
Conclusion The implementation of a controlled and supervised exercise program in pregnancy was associated with significantly lower odds of induced deliveries.Resumo Objetivo Avaliar o efeito de um programa de exerc ícios na gravidez (baseado nas recomendações do American College of Obstetricians and Gynecologists) na via, duração e início do trabalho de parto. Métodos Estudo realizado no Hospital Senhora da Oliveira entre outubro de 2015 e fevereiro de 2017. Trata-se de um estudo quasi-experimental co m 255 grávidas, divididas em dois grupos: grupo de intervenç...
Source: Revista Brasileira de Ginecologia e Obstetricia - Category: OBGYN Source Type: research
Abstract Objective To promote informed choice for women and to compare home andhospital births in relation to the Apgar score. Methods Mother ’ s profile and Apgar score of naturally born infants (without forceps assistance) in Brazil between 2011 and 2015, in both settings-hospital or home-were collected from live birth records provided by the Informatics Department of the Unified Health System (DATASUS, in the Portuguese acronym). For the analysis, were included only data fromlow-riskdeliveries, including gestational time between 37 and 41weeks, singleton pregnancy, at least four visits of prenatal care, infants we...
Source: Revista Brasileira de Ginecologia e Obstetricia - Category: OBGYN Source Type: research
Conclusion Pethidine in low doses and dipyrone presented equivalent analgesia during labor. Public Registry of Clinical TrialsRBR-4hsyy4.Resumo Objetivo Comparar doses baixas de petidina com dipirona na analgesia de parto. M étodos Em um estudo prospectivo randomizado realizado pela Universidade de Fortaleza, Ceará, Brasil, entre maio e dezembro de 2016, 200 parturientes a termo, com contrações uterinas muito dolorosas e apresentando dilatação do colo uterino ≥ 5 cm, foram selecionadas para receber dose única intravenosa de 0,25 mg/kg de petidina (n = 100) ou 25 mg/kg de ...
Source: Revista Brasileira de Ginecologia e Obstetricia - Category: OBGYN Source Type: research
Abstract Objective: The present study assessed epidemiological and obstetrical data from pregnant women with syphilis at the Hospital de Cl ínicas of the Universidade Federal do Triângulo Mineiro (UFTM, in the Portuguese acronym), describing this disease during pregnancy and its vertical transmission for future healthcare actions. Methods: Records from pregnant women who had been admitted to the Obstetrics Department of the Hospital de Clínicas of the UFTM and were diagnosed with syphilis between 2007 and 2016 were reviewed. A standardized form was used to collect epidemiological, obstetric data and out...
Source: Revista Brasileira de Ginecologia e Obstetricia - Category: OBGYN Source Type: research
Conclusion The use of specific mobile applications should be en couraged to attain a better quality and accuracy in prescriptions and to include strategies that not only reduce the risk of negative outcomes, but also improve the quality of care and treatment for maintaining the health both of the mother and of the baby.Resumo Objetivo Analisar a prescri ção de antimicrobianos para gestantes admitidas no serviço de obstetrícia que apresentaram pielonefrite aguda. Métodos Foram realizados três estudos transversais comparando a prescrição de antimicrobianos para pielonefr...
Source: Revista Brasileira de Ginecologia e Obstetricia - Category: OBGYN Source Type: research
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