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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Despite a lower percentage of primary cesareans than non-Hispanic White and Black women, Hispanic women in the United States had the highest rate of repeat cesarean deliveries (RCD) in 2016; it is unclear if reasons for differences are due to known risk factors. Our study examined the association between ethnicity/race and RCD among women with one previous cesarean and whether demographic (age, marital status, education, language, and delivery year), anthropomorphic (height, prepregnancy body mass index), obstetrical/medical (parity, gestational age, infant birth weight, gestational diabetes, labor induction or augmentatio...
Source: Womens Health Issues - Category: Primary Care Authors: Tags: Original article Source Type: research
(BJOG. 2018;125:1558–1566.) Overweight and obesity represent a significant impact on the world’s public health, and are associated with increased risks of adverse maternal and infant outcomes during pregnancy and delivery. As maternal body mass index (BMI) increases, gestational diabetes mellitus (GDM) also increases in prevalence. GDM is associated with adverse perinatal outcomes similar to those seen in obese pregnant women, including the need for induction of labor and cesarean section, and having an infant born large for gestational age or birthweight over 4 kg. The aim of this secondary analysis fr...
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Mother, Fetus, Neonate Source Type: research
Amer J Perinatol DOI: 10.1055/s-0039-1695011 Objective Prior studies suggest knowledge of estimated fetal weight (EFW), particularly by ultrasound (US), increases the risk for cesarean delivery. These same studies suggest that concern for macrosomia potentially alters labor management leading to increased rates of cesarean delivery. We aimed to assess if shortened labor management, as a result of suspected macrosomia (≥4,000 g), leads to an increased rate of cesarean delivery. Study Design This is a secondary analysis of a retrospective cohort study at a single tertiary center in 2015 of women wit...
Source: American Journal of Perinatology - Category: Perinatology & Neonatology Authors: Tags: SMFM Fellowship Series Article Source Type: research
CONCLUSION: This model provides valuable estimation as to the cumulative effect of multiple factors on the risk of failed induction of labor among obese parturients. The predictive model identifies women at increased or decreased risk (ie, greater than 75% vs less than 20%) for cesarean delivery. This risk calculator may be a useful tool for practitioners in the counseling, triaging, risk stratifying, and delivery planning for obese women before attempted induction of labor. PMID: 31403588 [PubMed - as supplied by publisher]
Source: Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Obstet Gynecol Source Type: research
Conclusion: Preliminary results show that amniotomy-to-delivery interval was prolonged with 9 hours in the DO-group, with equal patient reported childbirth perception in the overall group. Parous women have a less positive perception of their delivery and used pain relief more often when oxytocin was delayed. Delaying oxytocin infusion after amniotomy should be further investigated in an adequately powered randomised trial.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
In Reply The Letter to the Editor by Pitocco et al states that the study by Kong et al on associations between maternal diabetes disorders and offspring being large for gestation age (LGA) and/or preterm birth would have been improved by the consideration of maternal self-reported prepregnancy weight. Indeed, in our study, we stratified the association analyses by self-reported prepregnancy body mass index (BMI) and found that the BMI influenced the association for maternal type 2 diabetes and gestational diabetes to the offspring LGA. Pitocco et al also commented that it would have been appropriate to also consider gestat...
Source: JAMA Pediatrics - Category: Pediatrics Source Type: research
CONCLUSION: Substantial variation in clinical practice guidelines for indications for induction exists. As guidelines rated of similar quality presented conflicting recommendations, guideline variability was not explained by guideline quality. Guideline variability may partly account for unexplained variation in induction of labour rates. PMID: 31285166 [PubMed - as supplied by publisher]
Source: Women Birth - Category: Midwifery Authors: Tags: Women Birth Source Type: research
The objectives were to examine pregnancy outcomes in adolescent primigravida and to determine the effects of adolescent pregnancy on pregnancy-induced hypertension (PIH). A retrospective analysis of pregnancy outcomes was carried out in 2440 adolescent primigravida, compared with 14,259 primigravida aged 20-29 years. The adolescents had significantly higher rates of maternal death, maternal heart disease, PIH, puerperal infection, chorioamnionitis, urinary tract infection, foetal anomaly, preterm delivery, low birth weight, low Apgar scores and stillbirth. Multivariate logistic regression analysis showed that both old...
Source: Journal of Obstetrics and Gynaecology - Category: OBGYN Tags: J Obstet Gynaecol Source Type: research
CERVICAL RIPENING BALLOON AS A METHOD OF PREINDUCTION - ONE CENTER STUDY. Acta Clin Croat. 2018 Dec;57(4):762-767 Authors: Košec V, Djaković I, Sabolović Rudman S Abstract - Cervical ripening can be promoted in many ways, but mechanical methods are among the oldest. Like all other methods, this one also has its pros and cons. Disadvantages compared to pharmacological methods include some maternal discomfort upon manipulation of the cervix, a theoretical increase in the risk of maternal and neonatal infection from the introduction of a foreign body, potential disruption of a low-lying placenta,...
Source: Acta Clinica Croatica - Category: General Medicine Tags: Acta Clin Croat Source Type: research
Conclusion: Obesity is associated with increased complications during pregnancy, an increased incidence of a cesarean section and induced birth but it has no significant effect on the delivery time.
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
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