Objective To evaluate adverse pregnancy outcomes in singleton pregnancies diagnosed with oligohydramnios through a systematic review and meta-analysis of controlled trials. (RR, 2.09; 95% CI,), meconium-stained amniotic fluid (RR, 1.32; 95% CI, and Cesarean delivery for fetal distress (RR, 1.65; 95% CI,
Methods
Late preterm and early term deliveries have adverse long-term neurodevelopmental outcomes, and these outcomes should be considered when determining the timing of delivery.
Incarceration of the gravid uterus is a rare but serious complication of pregnancy. The diagnosis is clinical and confirmed with imaging, with magnetic resonance imaging being superior to delineate the distorted maternal anatomy. Reduction of the incarcerated uterus should be attempted to restore polarity and avoid unnecessary cesarean delivery.
Objective: Despite heterogeneity among Pacific Islanders, most studies aggregate them regardless of origin. Thus, limited information is available about perinatal outcomes among various subgroups of Pacific Islanders in the United States, including immigrants from the Republic of the Marshall Islands. We sought to evaluate perinatal outcomes among Marshallese women. Methods: We conducted a cross-sectional study of women with at least one singleton live birth between 1997 and 2013 in two Arkansas counties using birth certificate data from the Arkansas Department of Health. Unadjusted and adjusted prevalence ratios (PR) and 95% confidence intervals (CI) were calculated from modified Poisson regression models. Results: Of the 91,662 singleton births in both counties during the study period, 2,488 were to Marshallese women. In adjusted analyses, Marshallese women had higher prevalence of "other medical risk factors" (PR=1.47; 95% CI: 1.30, 1.65) than NH white women. Marshallese women had higher rates of precipitous labor and fetal distress during labor compared to NH white women (
Objective
To scrutinize a series of pregnant women treated with electroconvulsive therapy (ECT) at a tertiary treatment center and combine this data with a literature review to refine the treatment guidelines for ECT during pregnancy.
Methods
A retrospective chart review of mentally ill pregnant patients treated with ECT since the establishment of a formal women’s mental health program.
Results
A total of eight pregnant women treated with ECT were identified from 01/2012–08/2014. Information was extracted from the medical record from a total of 30 ECT treatments across this group. Subjects received an average of 3.75 ECT treatments (range 1–7). All women were diagnosed with a mood disorder (either unipolar or bipolar), and five of the eight women had suicidal ideation. The treatment team for ECT was consistent across all treatments. Two women experienced significant complications following the initial treatment: 1) an acute episode of complete heart block; and 2) acute onset of mania following ECT. Obstetrical complications included two women with pre-term delivery – one secondary to premature rupture of membranes. No other complications or adverse outcomes were recorded. The five women with suicidal ideation had symptom resolution, and significant symptom improvement was noted in six of the eight women.
Conclusions
Electroconvulsive therapy is a safe and effective treatment during pregnancy and of particular benefit in the acute treatment of suicidal ideation.
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