What inhibits obstetricians implementing reliable guidelines?

What inhibits obstetricians implementing reliable guidelines? BJOG. 2020 Feb 18;: Authors: Bewley S Abstract Junior doctors used to pass on dog-eared pocket notebooks with helpful phone numbers, Mr X and Y's patient care preferences for anti-convulsants, induction timing or catheter size. We had to check the boss's wishes; certainly not the evidence or patients' view! Surely, despite plausible explanations, one intervention or other might achieve better outcomes? Why did the Great Man refuse 'his patients' to be prescribed steroids in premature labour, for example? That issue was settled from laboratory science to bedside RCTs long before practice changed (Crowley BJOG. 2003 Apr;110 Suppl 20:77-8) resulting in many avoidably damaged babies and negligence cases. PMID: 32072736 [PubMed - as supplied by publisher]
Source: BJOG : An International Journal of Obstetrics and Gynaecology - Category: OBGYN Authors: Tags: BJOG Source Type: research

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(Frontiers) Pregnant women who deliver early are more likely to have a varied vaginal microbiome, especially in their first trimester. Combining data from several studies, the researchers analyzed information across a wide range of women in terms of ethnicity and stage of pregnancy and also highlight the specific bacteria associated with premature births. The authors hope these findings could help identify women at higher risk of giving birth prematurely.
Source: EurekAlert! - Biology - Category: Biology Source Type: news
"Had [the mother] not been COVID-19 positive... likely she would not have gone into preterm labor and there would have been a different outcome," an official said
Source: Health News: CBSNews.com - Category: Consumer Health News Source Type: news
The odd hush that has fallen over New York City has lately been broken once every day, at precisely 7:00 PM. That’s when New Yorkers are stepping onto balconies or flinging open windows to applaud the people—pharmacy clerks, supermarket cashiers, food delivery workers and more—who continue to keep to keep the silent city running. But even the most heroic of health-care workers are faced with a difficult reality in the city that has become the center of COVID-19 in the U.S., as officials have predicted that New York City will need at least 400 more ventilators by Sunday and thousands more in the days to fo...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized COVID-19 Source Type: news
This study consists of a case series describing 13 single pregnancies of 11 women with a history of anorexia nervosa, and a cross-sectional study comparing 13 cases with 240 healthy controls. In the case group, nine cases conceived while underweight, including three who had fertility treatment. Anorexia symptoms during pregnancy were quite common, and pregnant smokers presented with extremely disturbed eating behaviors. In a cross-sectional study, premature birth and the standard deviations from the mean birth weight and mean head circumference at birth were evaluated as outcome measures. The adjusted odds ratios or the ad...
Source: The Tohoku Journal of Experimental Medicine - Category: Research Authors: Tags: Tohoku J Exp Med Source Type: research
Abstract Premature birth is not only the commonest cause of new-born babies dying, but also an important cause of long-term handicap. This is why the paper by van Winden et al. in this issue, reporting two-year outcomes for participants in their APOSTEL-3 trial, comparing atosiban with nifedipine tocolysis, is so important. PMID: 32223008 [PubMed - as supplied by publisher]
Source: BJOG : An International Journal of Obstetrics and Gynaecology - Category: OBGYN Authors: Tags: BJOG Source Type: research
Abstract This research aims to improve anaesthesia services given to preterm infants by the use of dexamethasone and aminophylline administrated under sevoflurane, and to analyze its effect on the cell-mediated immunity (CD4+CD25+Foxp3+(Treg) and CD4+CD25highFoxp3+CD127low). We have examined 74 premature babies with retinopathy of prematurity (ROP) at the 3-5 stages during the 25-32 gestation period (1-6 months after birth). Both immunomodulators had not significant effect on clinical parameters after one dose (p>0.05). Aminophylline (2.4% solution, 0.1 ml/kg or 0.132 ml per infant on average) and dexamethasone...
Source: Clinical and Experimental Pharmacology and Physiology - Category: Drugs & Pharmacology Authors: Tags: Clin Exp Pharmacol Physiol Source Type: research
Preterm birth (PTB) is defined as birth before 37 completed weeks of gestation. The causes of PTB are multiple and complex, the underlying pathophysiology being largely unknown. Interferences in the fine-tuned balance of the maternal immune system have been pointed to as one possible cause of PTB. Regulatory B cells (Breg) are part of the adaptive immune response, and recent data suggest that they may contribute to a healthy pregnancy by their regulatory/suppressive function.We investigated the frequency of Breg cells in peripheral blood of women undergoing PTB and control women immediately before giving birth via cesarean...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
In this study, we used the constitutive lung-specific Pdgfa deletion mouse model to analyze the consequences of developmental lung defects in adult mice. We assessed lung morphology, physiology, cellular content, ECM composition and proteomics data in mature mice, that perinatally exhibited lungs with a BPD-like morphology. Histological and physiological analyses both revealed that enlarged alveolar airspaces remained until adulthood, resulting in higher lung compliance and higher respiratory volume in knockout mice. Still, no or only small differences were seen in cellular, ECM and protein content when comparing knockout ...
Source: American Journal of Physiology. Lung Cellular and Molecular Physiology - Category: Cytology Authors: Tags: Am J Physiol Lung Cell Mol Physiol Source Type: research
Patent ductus arteriosus (PDA) is common in preterm infants and can contribute to morbidity and mortality. We aimed to compare results and outcome of transcatheter closure using the Amplatzer Piccolo Occluder versus surgical closure in 2 matched groups of preterm infants weighing
Source: International Journal of Cardiology - Category: Cardiology Authors: Source Type: research
(Washington University School of Medicine) Researchers at Washington University School of Medicine in St. Louis and Mayo Clinic in Rochester, Minn., have found -- in newborn mice -- that a component of breast milk may help protect premature babies from developing life-threatening sepsis.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
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