Pub Date : 2024-02-22DOI: 10.1097/01.aoa.0001005328.85153.05
Anna Aabakke, T.G. Petersen, K. Wøjdemann, M.H. Ibsen, F. Jonsdottir, E. Rønneberg, C.S. Andersen, A. Hammer, T.D. Clausen, J. Milbak, L. Burmester, R. Zethner, B. Lindved, A. Thorsen-Meyer, M.R. Khalil, B. Henriksen, L. Jønsson, LS Andersen, K.K. Karlsen, M. Pedersen, G. Hedermann, M. Vestgaard, D. Thisted, A. N. Fallesen, J. N. Johansson, D. C. Møller, G. Dubietyte, C. Andersson, R. Farlie, A. Skaarup Knudsen, L. Hansen, L. Hvidman, A.N. Sørensen, S. L. Rathcke, K.H. Rubin, L.K. Petersen, J. S. Jorgensen, L. Krebs, M. Bliddal
(Acta Obstet Gynecol Scand. 2023;102:282–293) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown to increase a patient’s risk of preterm labor, pre-eclampsia, the need for cesarean delivery, and stillbirth. This study aimed to analyze and better understand the risk factors and complications that relate to SARS-CoV-2 during pregnancy and delivery.
{"title":"Risk Factors and Pregnancy Outcomes After SARS-CoV-2 in Pregnancy According to Disease Severity: A Nationwide Cohort Study With Validation of the SARS-CoV-2 Diagnosis","authors":"Anna Aabakke, T.G. Petersen, K. Wøjdemann, M.H. Ibsen, F. Jonsdottir, E. Rønneberg, C.S. Andersen, A. Hammer, T.D. Clausen, J. Milbak, L. Burmester, R. Zethner, B. Lindved, A. Thorsen-Meyer, M.R. Khalil, B. Henriksen, L. Jønsson, LS Andersen, K.K. Karlsen, M. Pedersen, G. Hedermann, M. Vestgaard, D. Thisted, A. N. Fallesen, J. N. Johansson, D. C. Møller, G. Dubietyte, C. Andersson, R. Farlie, A. Skaarup Knudsen, L. Hansen, L. Hvidman, A.N. Sørensen, S. L. Rathcke, K.H. Rubin, L.K. Petersen, J. S. Jorgensen, L. Krebs, M. Bliddal","doi":"10.1097/01.aoa.0001005328.85153.05","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005328.85153.05","url":null,"abstract":"(Acta Obstet Gynecol Scand. 2023;102:282–293)\u0000 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown to increase a patient’s risk of preterm labor, pre-eclampsia, the need for cesarean delivery, and stillbirth. This study aimed to analyze and better understand the risk factors and complications that relate to SARS-CoV-2 during pregnancy and delivery.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"10 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140441056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-22DOI: 10.1097/01.aoa.0001005268.10522.a1
C.A. Moyer, E.R. Lawrence, T. Beyuo, M. Tuuli, S.A. Oppong
(Lancet. 2023;401(10382):1060–1062. PMID: 36924780) According to a report published by the World Health Organization (WHO) in February 2023, the global maternal mortality rate (MMR) improved considerably from 2000 to 2015 (the Millennium Development Goal era). However, from 2016 to 2020, the first 5 years of the Sustainable Development Goal (SDG) era, MMR stagnated or worsened in most regions of the world. During this period, only 2 regions, Australia and New Zealand and Central and Southern Asia, saw reductions in MMR (34.6% and 15.7%, respectively). The highest MMR was in Sub-Saharan Africa, accounting for ~70% of all maternal deaths in 2020.
{"title":"Stalled Progress in Reducing Maternal Mortality Globally: What Next?","authors":"C.A. Moyer, E.R. Lawrence, T. Beyuo, M. Tuuli, S.A. Oppong","doi":"10.1097/01.aoa.0001005268.10522.a1","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005268.10522.a1","url":null,"abstract":"(Lancet. 2023;401(10382):1060–1062. PMID: 36924780)\u0000 According to a report published by the World Health Organization (WHO) in February 2023, the global maternal mortality rate (MMR) improved considerably from 2000 to 2015 (the Millennium Development Goal era). However, from 2016 to 2020, the first 5 years of the Sustainable Development Goal (SDG) era, MMR stagnated or worsened in most regions of the world. During this period, only 2 regions, Australia and New Zealand and Central and Southern Asia, saw reductions in MMR (34.6% and 15.7%, respectively). The highest MMR was in Sub-Saharan Africa, accounting for ~70% of all maternal deaths in 2020.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"32 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140439604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-22DOI: 10.1097/01.aoa.0001005380.27358.d7
S. West, A. Martin, R. Copping, G. Gard, R. Maher, S. Seeho
(Aust N Z J Obstet Gynaecol. 2023; 63: 372–377) The placenta accreta spectrum (PAS) is defined by aberrant placental invasion into the uterine myometrium. Globally, the prevalence of PAS is rising, which affects maternal health outcomes. The depth of invasion into the uterus determines how it is classified, with placenta accreta (villi connecting to the muscle layer), placenta increta (myometrial invasion), and placenta percreta (transmural invasion beyond the serosa) being the most severe. This study evaluated maternal and neonatal outcomes following a combined surgical and interventional radiology (IR) approach for managing the PAS.
(Aust N Z J Obstet Gynaecol. 2023; 63: 372-377) 胎盘早剥谱（PAS）是指胎盘异常侵入子宫肌层。在全球范围内，PAS 的发病率不断上升，影响了孕产妇的健康。胎盘侵入子宫的深度决定了其分类方式，其中以胎盘增厚（绒毛与肌层相连）、胎盘增大（子宫肌层侵入）和胎盘透明层（超出浆膜的跨壁侵入）最为严重。本研究评估了采用手术和介入放射学（IR）联合方法处理 PAS 后的产妇和新生儿预后。
{"title":"Staged Treatment of the Placenta Accreta Spectrum: A Combined Surgical and Radiologic Approach","authors":"S. West, A. Martin, R. Copping, G. Gard, R. Maher, S. Seeho","doi":"10.1097/01.aoa.0001005380.27358.d7","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005380.27358.d7","url":null,"abstract":"(Aust N Z J Obstet Gynaecol. 2023; 63: 372–377)\u0000 The placenta accreta spectrum (PAS) is defined by aberrant placental invasion into the uterine myometrium. Globally, the prevalence of PAS is rising, which affects maternal health outcomes. The depth of invasion into the uterus determines how it is classified, with placenta accreta (villi connecting to the muscle layer), placenta increta (myometrial invasion), and placenta percreta (transmural invasion beyond the serosa) being the most severe. This study evaluated maternal and neonatal outcomes following a combined surgical and interventional radiology (IR) approach for managing the PAS.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"21 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140440216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-22DOI: 10.1097/01.aoa.0001005300.71572.53
S. Jackson, J. Hunter, G. A. Van Norman
(Anesth Analg. October 6, 2023. doi: 10.1213/ANE.0000000000006669. Online ahead of print) The process of informed consent upholds the principle of patient autonomy, rooted in US constitutional principles of privacy and noninterference. It has been legally required in the United States since 1914, ensuring that individuals have the right to determine what happens to their bodies, as Schloendorff v. New York Society Hospital ruled. The recent US Supreme Court decision on abortion has raised concerns about maternal-fetal conflicts and the rights of pregnant patients to undergo elective anesthesia and surgery. Ethical and legal requirements for informed consent in medical testing vary, with challenges in addressing routine laboratory testing. Not all medical tests carry the same ethical implications, but they should all consider beneficence, nonmaleficence, and patient autonomy. Focusing on the need for preanesthesia pregnancy testing remains a concern in anesthesia and surgery practices. The primary premise is preventing harm to the fetus, but this must be supported by medical evidence and adhere to ethical standards. No study conclusively demonstrates that anesthetic agents significantly increase rates of early human fetal loss or malformations. There is no evidence that anesthetic drugs are generally teratogenic or pose a significant risk of harm to the fetus. While such risks are small, they cannot be guaranteed to be absent.
{"title":"Ethical Principles Do Not Support Mandatory Preanesthesia Pregnancy Screening Tests: A Narrative Review","authors":"S. Jackson, J. Hunter, G. A. Van Norman","doi":"10.1097/01.aoa.0001005300.71572.53","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005300.71572.53","url":null,"abstract":"(Anesth Analg. October 6, 2023. doi: 10.1213/ANE.0000000000006669. Online ahead of print)\u0000 The process of informed consent upholds the principle of patient autonomy, rooted in US constitutional principles of privacy and noninterference. It has been legally required in the United States since 1914, ensuring that individuals have the right to determine what happens to their bodies, as Schloendorff v. New York Society Hospital ruled. The recent US Supreme Court decision on abortion has raised concerns about maternal-fetal conflicts and the rights of pregnant patients to undergo elective anesthesia and surgery. Ethical and legal requirements for informed consent in medical testing vary, with challenges in addressing routine laboratory testing. Not all medical tests carry the same ethical implications, but they should all consider beneficence, nonmaleficence, and patient autonomy. Focusing on the need for preanesthesia pregnancy testing remains a concern in anesthesia and surgery practices. The primary premise is preventing harm to the fetus, but this must be supported by medical evidence and adhere to ethical standards. No study conclusively demonstrates that anesthetic agents significantly increase rates of early human fetal loss or malformations. There is no evidence that anesthetic drugs are generally teratogenic or pose a significant risk of harm to the fetus. While such risks are small, they cannot be guaranteed to be absent.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"38 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140440330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-22DOI: 10.1097/01.aoa.0001005376.36999.45
S. Singh, D. Carusi, P. Wang, E. Reitman-Ivashkov, R. Landau, K. Fields, C. Weiniger, M. Farber
(Anesth Analg. 137(3):537–547) Placenta accreta spectrum (PAS) encompasses various forms of abnormal placental attachment and uterine invasion. PAS is a leading cause of severe postpartum hemorrhage and often leads to an emergency hysterectomy. Managing PAS and its associated complications, such as preterm birth, maternal morbidity, and neonatal intensive care unit admissions, is best achieved in tertiary-level hospitals equipped with specialized multidisciplinary care. To ensure the highest quality of care, proactive planning is essential. This involves identifying risk factors associated with PAS, facilitating rapid transfers to appropriate delivery facilities, efficient resource allocation, and minimizing the occurrence of life-threatening postpartum hemorrhage and its associated complications.
(Anesth Analg.137(3):537-547) 胎盘早剥谱（PAS）包括各种形式的胎盘附着异常和子宫侵犯。PAS 是导致严重产后出血的主要原因，通常会导致紧急子宫切除术。处理 PAS 及其相关并发症（如早产、孕产妇发病率和新生儿重症监护室入院率）的最佳方式是在配备专业多学科护理的三级医院进行。为确保最高质量的护理，积极主动的规划至关重要。这包括识别与产后出血相关的风险因素，促进快速转运至适当的分娩设施，有效分配资源，以及最大限度地减少危及生命的产后出血及其相关并发症的发生。
{"title":"External Validation of a Multivariable Prediction Model for Placenta Accreta Spectrum","authors":"S. Singh, D. Carusi, P. Wang, E. Reitman-Ivashkov, R. Landau, K. Fields, C. Weiniger, M. Farber","doi":"10.1097/01.aoa.0001005376.36999.45","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005376.36999.45","url":null,"abstract":"(Anesth Analg. 137(3):537–547)\u0000 Placenta accreta spectrum (PAS) encompasses various forms of abnormal placental attachment and uterine invasion. PAS is a leading cause of severe postpartum hemorrhage and often leads to an emergency hysterectomy. Managing PAS and its associated complications, such as preterm birth, maternal morbidity, and neonatal intensive care unit admissions, is best achieved in tertiary-level hospitals equipped with specialized multidisciplinary care. To ensure the highest quality of care, proactive planning is essential. This involves identifying risk factors associated with PAS, facilitating rapid transfers to appropriate delivery facilities, efficient resource allocation, and minimizing the occurrence of life-threatening postpartum hemorrhage and its associated complications.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"37 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140440647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-22DOI: 10.1097/01.aoa.0001005368.64564.13
K. Cranfield, D. Horner, M. Vasco, G. Victory, D.N. Lucas
(Anaesthesia. 2023;78(6):758–769) Progress made in reducing maternal mortality rates is plateauing. Projections indicate that maternal mortality rates will reach nearly twice the sustainable development goal of the World Health Organization by 2030. While the reasons for the lack of progress are complex and include factors such as changing maternal demographics and socioeconomic disparities, addressing maternal morbidity is a necessary component of achieving a continuous decrease in maternal mortality. Maternal critical care is an emerging area in obstetrics that will play a crucial role in improving outcomes in maternal morbidity. The recommendations are based on a study in the United Kingdom. However, these principles are likely to be broadly applicable.
{"title":"Current Perspectives on Maternal Critical Care","authors":"K. Cranfield, D. Horner, M. Vasco, G. Victory, D.N. Lucas","doi":"10.1097/01.aoa.0001005368.64564.13","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005368.64564.13","url":null,"abstract":"(Anaesthesia. 2023;78(6):758–769)\u0000 Progress made in reducing maternal mortality rates is plateauing. Projections indicate that maternal mortality rates will reach nearly twice the sustainable development goal of the World Health Organization by 2030. While the reasons for the lack of progress are complex and include factors such as changing maternal demographics and socioeconomic disparities, addressing maternal morbidity is a necessary component of achieving a continuous decrease in maternal mortality. Maternal critical care is an emerging area in obstetrics that will play a crucial role in improving outcomes in maternal morbidity. The recommendations are based on a study in the United Kingdom. However, these principles are likely to be broadly applicable.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"41 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140440926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-22DOI: 10.1097/01.aoa.0001005440.45190.e4
S. Spijkerman, D.M. Manning, L.P. Green-Thompson
(Anesth Analg. 2023. doi: 10.1213/ANE.0000000000006375) To address the lack of clear guidelines for undergraduate anesthesia training, this study assessed the self-perceived competence of medical students in South Africa. Maternal mortality is a concern, with a significant portion of deaths attributed to anesthesia. The country faces a shortage of specialist anesthesiologists, putting the responsibility on nonspecialist medical officers, including newly qualified community service officers. The study investigates the readiness of medical students to provide anesthesia services, with varying exposure to training during internships. The findings aim to support South Africa’s health needs and may guide the goals of global surgery in other developing nations.
{"title":"Undergraduate Anesthesia Skills for a Global Surgery Agenda: Students’ Self-Reported Competence","authors":"S. Spijkerman, D.M. Manning, L.P. Green-Thompson","doi":"10.1097/01.aoa.0001005440.45190.e4","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005440.45190.e4","url":null,"abstract":"(Anesth Analg. 2023. doi: 10.1213/ANE.0000000000006375)\u0000 To address the lack of clear guidelines for undergraduate anesthesia training, this study assessed the self-perceived competence of medical students in South Africa. Maternal mortality is a concern, with a significant portion of deaths attributed to anesthesia. The country faces a shortage of specialist anesthesiologists, putting the responsibility on nonspecialist medical officers, including newly qualified community service officers. The study investigates the readiness of medical students to provide anesthesia services, with varying exposure to training during internships. The findings aim to support South Africa’s health needs and may guide the goals of global surgery in other developing nations.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"10 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140441141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-22DOI: 10.1097/01.aoa.0001005364.90547.dc
R. Nugent, A. Wee, L. Kearney, C. de Costa
(Aust N Z J Obstet Gynaecol 2023. 2023;63(3):290–300) Obstructive sleep apnea (OSA) is characterized by recurrent pauses in breathing during sleep due to upper airway collapse, resulting in decreased oxygen levels. OSA affects around 10.5% of parturients during early pregnancy and up to 30% at term. In pregnancy, OSA is associated with an increased risk for gestational hypertension, pre-eclampsia, and gestational diabetes. Infants born to mothers with OSA may have a lower birth weight and are at increased risk for premature delivery and neonatal intensive care unit admission. Baseline obesity increases the risk of OSA during pregnancy, with lifestyle modifications being the standard treatment, though their influence on maternal outcomes is limited. Continuous positive airway pressure (CPAP) is an effective OSA treatment; however, little research exists on the impact of CPAP on either maternal or fetal outcomes. This systematic review sought to investigate if the use of CPAP improved outcomes for pregnant women with or at risk of OSA.
(Aust N Z J Obstet Gynaecol 2023.2023；63（3）：290-300）阻塞性睡眠呼吸暂停（OSA）的特点是由于上气道塌陷导致睡眠时呼吸反复暂停，从而导致氧含量降低。约有 10.5% 的孕妇在孕早期患有 OSA，而在足月妊娠时则高达 30%。在怀孕期间，OSA 会增加妊娠高血压、先兆子痫和妊娠糖尿病的风险。患有 OSA 的母亲所生的婴儿出生体重可能较轻，早产和入住新生儿重症监护室的风险也会增加。基线肥胖会增加孕期发生 OSA 的风险，而改变生活方式是标准的治疗方法，但其对产妇预后的影响有限。持续气道正压（CPAP）是一种有效的 OSA 治疗方法，但有关 CPAP 对孕产妇或胎儿预后影响的研究却很少。本系统综述旨在研究使用 CPAP 是否能改善患有或可能患有 OSA 的孕妇的预后。
{"title":"The Effectiveness of Continuous Positive Airway Pressure for Treating Obstructive Sleep Apnoea in Pregnancy: A Systematic Review","authors":"R. Nugent, A. Wee, L. Kearney, C. de Costa","doi":"10.1097/01.aoa.0001005364.90547.dc","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005364.90547.dc","url":null,"abstract":"(Aust N Z J Obstet Gynaecol 2023. 2023;63(3):290–300)\u0000 Obstructive sleep apnea (OSA) is characterized by recurrent pauses in breathing during sleep due to upper airway collapse, resulting in decreased oxygen levels. OSA affects around 10.5% of parturients during early pregnancy and up to 30% at term. In pregnancy, OSA is associated with an increased risk for gestational hypertension, pre-eclampsia, and gestational diabetes. Infants born to mothers with OSA may have a lower birth weight and are at increased risk for premature delivery and neonatal intensive care unit admission. Baseline obesity increases the risk of OSA during pregnancy, with lifestyle modifications being the standard treatment, though their influence on maternal outcomes is limited. Continuous positive airway pressure (CPAP) is an effective OSA treatment; however, little research exists on the impact of CPAP on either maternal or fetal outcomes. This systematic review sought to investigate if the use of CPAP improved outcomes for pregnant women with or at risk of OSA.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"12 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140441402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-22DOI: 10.1097/01.aoa.0001005384.33106.8f
T. Barna, K.F. Szucs, A. Schaffer, M. Mirdamadi, J. Hajagos-Toth, R. Gaspar
(Acta Obstet Gynecol Scand. 2023;102:457–464) Preterm birth is a common and impactful complication of pregnancy and is defined as the delivery of a fetus between 20 and 37 weeks of gestation. It can lead to further complications and even developmental problems for the child that can be long term. Standard treatment for symptoms of preterm labor involves tocolytic drugs to stop contractions and delay delivery long enough for interventions to occur, minimizing effects on the infant. Although many different drugs are used, the efficacy and side effects of many are not well characterized or understood. This study was designed to assess the effectiveness and side effects of a combination of drugs: β2-agonist terbutaline and magnesium sulfate (MgSO4). This was done by examining the combined administration of the drugs in an isolated organ bath and performing in vivo smooth muscle electromyographic studies in pregnant rats.
{"title":"Combined Uterorelaxant Effect of Magnesium Sulfate and Terbutaline: Studies on Late Pregnant Rat Uteri In Vitro and In Vivo","authors":"T. Barna, K.F. Szucs, A. Schaffer, M. Mirdamadi, J. Hajagos-Toth, R. Gaspar","doi":"10.1097/01.aoa.0001005384.33106.8f","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005384.33106.8f","url":null,"abstract":"(Acta Obstet Gynecol Scand. 2023;102:457–464)\u0000 Preterm birth is a common and impactful complication of pregnancy and is defined as the delivery of a fetus between 20 and 37 weeks of gestation. It can lead to further complications and even developmental problems for the child that can be long term. Standard treatment for symptoms of preterm labor involves tocolytic drugs to stop contractions and delay delivery long enough for interventions to occur, minimizing effects on the infant. Although many different drugs are used, the efficacy and side effects of many are not well characterized or understood. This study was designed to assess the effectiveness and side effects of a combination of drugs: β2-agonist terbutaline and magnesium sulfate (MgSO4). This was done by examining the combined administration of the drugs in an isolated organ bath and performing in vivo smooth muscle electromyographic studies in pregnant rats.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"8 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140441759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-22DOI: 10.1097/01.aoa.0001005288.21755.71
M. Hadley, A.Y. Oppong, J. Coleman, A. M. Powell
(Obstet Gynecol. 2023;142:911–919) Research has clearly shown that health care outcomes are riddled with disparities surrounding race, but arguments exist about whether these disparities are due to biological differences, environmental, structural, or social elements of overall health, or systemic racism and inherent racial bias. Many observed differences in pregnancy outcomes are consistent even when correcting for poverty, educational status, or income level, suggesting that there are other factors that have not yet been identified. This commentary proposes that structural racism is a major contributing factor to health disparities between those of different races, including aspects such as access to healthy food options, psychosocial stressors, and safe and healthy living environments, and these differences will be manifest in the gut and vaginal microbiomes, thus affecting pregnancy-related outcomes related to the microbiome.
{"title":"Structural Racism and Adverse Pregnancy Outcomes Through the Lens of the Maternal Microbiome","authors":"M. Hadley, A.Y. Oppong, J. Coleman, A. M. Powell","doi":"10.1097/01.aoa.0001005288.21755.71","DOIUrl":"https://doi.org/10.1097/01.aoa.0001005288.21755.71","url":null,"abstract":"(Obstet Gynecol. 2023;142:911–919)\u0000 Research has clearly shown that health care outcomes are riddled with disparities surrounding race, but arguments exist about whether these disparities are due to biological differences, environmental, structural, or social elements of overall health, or systemic racism and inherent racial bias. Many observed differences in pregnancy outcomes are consistent even when correcting for poverty, educational status, or income level, suggesting that there are other factors that have not yet been identified. This commentary proposes that structural racism is a major contributing factor to health disparities between those of different races, including aspects such as access to healthy food options, psychosocial stressors, and safe and healthy living environments, and these differences will be manifest in the gut and vaginal microbiomes, thus affecting pregnancy-related outcomes related to the microbiome.","PeriodicalId":19432,"journal":{"name":"Obstetric Anesthesia Digest","volume":"16 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140441882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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