Objective: Umbilical cord prolapse is a rare event complicating 0.17%–0.62% of all pregnancies. Funic presentation is a known risk factor for umbilical cord prolapse. Currently, there is no strategy to prevent umbilical cord prolapse in patients with funic presentation. The novel technique used is placement of late cervical cerclage to create a mechanical barrier and prevent an umbilical cord prolapse. Material and Methods: Six patients with a sonographically detected funic presentation were included in the study. Funic presentation was defined as the sonographic presence of the umbilical cord below the presenting part using both transabdominal and transvaginal sonography. Cord prolapse was defined as an umbilical cord seen or palpated below the presenting part. Cervical cerclage was placed in patients with persistent funic presentations, which is the detection of the umbilical cord below the presenting part, on two or more sonograms at least a week apart. Results: Cervical cerclages were placed in six patients with funic presentation between 28 and 34 weeks of gestation without immediate complications. All patients were delivered by a cesarean section between 35 and 38 weeks of pregnancy. None experienced umbilical cord prolapse. Funic presentation was confirmed at birth in all cases. Apgar scores varied between 7 and 10. Conclusion: It appears that cervical cerclage may be an effective measure to prevent umbilical cord prolapse in cases of known persistent funic presentation.
questionnaire assessing SDH. Text messages were sent three times a week reinforcing the core components along with a link to short lessons Progress trackers and award badges were given for goals achieved. Progress was recorded via monthly surveys. Quantitative and qualitative data were analyzed.
RESULTS:Results: 67% had a vaginal delivery and 32% a csection.65% gained more than 25 lb during pregnancy. 48.7% reached their pre-pregnancy weight by 8 weeks postpartum. Among overweight and obese moms 91% reported at least one SDH (60% income and 40% depression and anxiety). Breast feeding was the initiative adopted the least 256%. Water consumption was adopted the most 280.5%.CONCLUSION: CH LA MOMs has the potential to transform the delivery and outcomes of postpartum weight. The program provides support, education, and resources via text messages/web for activities already being done. LA MOMs goes to them via their mobile phone/ tablet/or internet.
The contraction stress test (CST) is currently the only modality used to test for placental insufficiency. It is rarely used due to possible complications. We propose a new test to assess placental reserves by measuring fetal heart rate (FHR) fetal responses to maternal exercise (FRME). A cohort of 640 term patients underwent FRME for accepted clinical indications. There was a total of 1680 tests, performed using a motorized treadmill in a moderate exercise regimen. Monitoring was provided by using standard Philips equipment (Avalon CTS and FM40). FRME was interpreted as negative (absence of decelerations, possible presence of accelerations), positive (presence of late decelerations or sustained bradycardia), or inconclusive. The results demonstrated 1506 tests were negative, 58 were positive, and 312 were inconclusive. If the test was negative, only 2% of the fetuses experienced adverse outcomes, versus 14%, when the test was positive. Positive tests were associated with 29% of category III FHR tracing, 11.6% of 5-minute Apgar score of less than 7, 9.8% admissions to the intensive care nursery, 2.2% of growth restrictions, and 1.2% of fetal or early neonatal demises. FRME if positive is associated with adverse perinatal outcome and could be included into the armamentarium of fetal testing.
Most commercial airlines allow pregnant women to fly up to 36 weeks of gestation. Available information suggests that noise, vibration, and cosmic radiation present a small risk for the pregnant air traveler. The goal of the study was to assess the possible effect of transatlantic flights on the condition of the third-trimester fetus. In total, 112 patients were recruited into the study between January 2005 and June 2016. All underwent a transatlantic flight in the third trimester of pregnancy. All underwent nonstress test before and within 12 hours after the transatlantic flight, and 24 hours later. Patients were asked to report changes in fetal movements (FMs), if any, during takeoff, flight itself, and landing. The time of flight varied from 8 to 15 hours; average flight time was 9 ± 3.8 hours. Ninety-eight patients were the passengers of first or business class, and the rest were of economy class. Increased FM during takeoff was reported by 17 patients (15%), no change in FM by 62 (35%), decreased FM by 4 (3.6%). During flight itself, increased FM was reported by 6 pregnant passengers (5.4%), no change in FM by 70 (63%), decreased FM by 8 (7%).
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