One-Step Gestational Diabetes Diagnosis of Little Benefit One-Step Gestational Diabetes Diagnosis of Little Benefit

Switching from two-step to one-step gestational diabetes screening at Kaiser Permanente Washington didn't appear to be useful; in fact, it increased labor induction, neonatal hypoglycemia, and insulin use, with little apparent benefit.Medscape Medical News
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Ob/Gyn & Women ' s Health News Source Type: news

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Conclusion Labor induction at 39 weeks was consistently associated with reduced risk of cesarean delivery among women with obesity regardless of parity, age, or comorbidity status. Cesarean delivery findings from induction trials at 39 weeks among low-risk nulliparous women may generalize more broadly across the U.S. obstetric population, with potentially larger benefit among women with a prior vaginal delivery. Key Points [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: American Journal of Perinatology - Category: Perinatology & Neonatology Authors: Tags: Original Article Source Type: research
Abstract Global estimates for 2017 indicated that there were 295,000 maternal deaths, 35 per cent lower than in 2000 with a decline in global maternal mortality ratio from 342 to 211 deaths per 100,000 live births (World Health Organization (WHO) 2019). Maternal hemorrhage is the leading direct cause of maternal death worldwide, representing 27% (20-36) of maternal deaths ( Say L, et al. Lancet 2014). Multiple large retrospective population cohorts have identified risk factors invariably associated with maternal hemorrhage including mode of delivery, prolonged labor, chorioamnionitis, and twins among others (Brile...
Source: BJOG : An International Journal of Obstetrics and Gynaecology - Category: OBGYN Authors: Tags: BJOG Source Type: research
CONCLUSIONS: Low-certainty evidence means we are not certain if there is any difference between probiotic and placebo groups in maternal hypertensive disorders of pregnancy, caesareans; and large-for-gestational-age babies. There were no adverse events reported by the trials. Due to the variability of probiotics used and small sample sizes of trials, evidence from this review has limited ability to inform practice. Well-designed adequately-powered trials are needed to identify whether probiotics may improve maternal blood glucose levels and/or infant/child/adult outcomes; and whether they can be used to treat GDM. PMI...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Authors: Oskovi-Kaplan ZA, Ozgu-Erdinc AS Abstract Once a woman is diagnosed with gestational diabetes mellitus (GDM), two strategies are considered for management; life-style modifications and pharmacological therapy. The management of GDM aims to maintain a normoglycemic state and to prevent excessive weight gain in order to reduce maternal and fetal complications. Lifestyle modifications include nutritional therapy and exercise. Calorie restriction with a low glycemic index diet is recommended to avoid postprandial hyperglycemia and to reduce insulin resistance. Blood glucose levels, HbA1c levels, and ketonuria ...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
Some recent things you may need to know...Current news‘Black mothers were already scared’: coronavirus home births (Guardian video, about experiences in Pennsylvania)Global healthMonitoring intrapartum fetal heart rates by mothers in labour in two public hospitals: an initiative to improve maternal and neonatal healthcare in LiberiaRelated blog postClinical effectivenessLabor dystocia (AHRQ)ResearchDoes low-dose aspirin initiated before 11 weeks'gestation reduce the rate of preeclampsia? (AJOG)Early amniotomy after cervical ripening for induction of labor: a systematic review and meta-analysis of randomized con...
Source: Browsing - Category: Databases & Libraries Tags: midwifery Source Type: blogs
Polycystic ovary syndrome (PCOS) comprises at least two of the following: hyperandrogenism, intermittent or absent menstrual cycles, and polycystic ovaries. It affects 15% −20% of women in their reproductive years, compromising their fertility, fecundity, and cardiometabolic health (1). Assisted reproduction is a common prerequisite for a high conception rate in women with PCOS; but regardless of method of conception, pregnant women are at increased risk for pregnan cy-induced hypertension, preeclampsia, gestational diabetes, spontaneous preterm labor, need for cesarean delivery, and thus severe maternal morbidity.
Source: Fertility and Sterility - Category: Reproduction Medicine Authors: Tags: Reflections Source Type: research
By HANS DUVEFELT, MD After my posts on telemedicine were published recently, (this one on Manly Wellness before the pandemic and this one after it erupted, on A Country Doctor Writes, then reblogged on The Health Care Blog, KevinMD and many others), I have been asked about my views on telemedicine’s role in the future of primary care. Things have changed quickly, and a bit chaotically, and there is a lot of experimentation happening right now in practices I work or speak with. Before thinking about telemedicine in Primary Care, we need to agree on some sort of definition of...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: COVID-19 Medical Practice primary care Telehealth Telemedicine Source Type: blogs
CONCLUSION: HbA1c levels between 5.7% and 6.4% in early pregnancy consistently identified patients who went on to develop GMD. The evidence that particular levels are associated with adverse outcomes is less robust. PMID: 32268994 [PubMed - as supplied by publisher]
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
Abstract Background: Spinal anesthesia-induced maternal hypotension is the most frequent complication associated with maternal morbidity and mortality during Cesarean section. The aim of this study was to compare the incidence and magnitude of hemodynamic changes in preeclamptic and non-preeclamptic parturients undergone Cesarean section under spinal anesthesia. Method: A prospective cohort study was conducted from 01 February to 28 May 2019 in preeclamptic and non-preeclamptic parturients. We hypothesized preeclamptic parturients are at high risk of spinal anesthesia induced hypotension than non preeclamptic...
Source: Patient Safety in Surgery - Category: Surgery Authors: Tags: Patient Saf Surg Source Type: research
AbstractPurposeWhile the increased rates of high degree perineal tears were previously associated with the use of forceps, in the current era of low volume of forceps practice, factors associated with the occurrence of this potential complication remain understudied. We aim to evaluate factors associated with obstetric anal sphincter injury (OASIS) in obstetric units with a low volume forceps practice.MethodsA retrospective cohort study was conducted at two tertiary medical centers. All singleton pregnancies delivered by forceps extraction between 2011 and 2019 were analyzed. Women who experienced anal sphincter injury wer...
Source: Archives of Gynecology and Obstetrics - Category: OBGYN Source Type: research
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