Effect of HIV infection on pregnancy-related mortality in sub-Saharan Africa: secondary analyses of pooled community-based data from the network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA)
The Lancet, May 17, 2013
Zaba B et al. - Model-based estimates of the global proportions of maternal deaths that are in HIV-infected women range from 7% to 21%, and the effects of HIV on the risk of maternal death is highly uncertain. Authors used longitudinal data from the Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA) network to estimate the excess mortality associated with HIV during pregnancy and the post-partum period in sub-Saharan Africa. ...
Immediate post-partum initiation of intrauterine contraception and implants: A review of the safety and guidelines for use
Australian and New Zealand Journal of Obstetrics and Gynaecology, May 3, 2013
Mwalwanda CS et al. - This review aims to describe the benefits and risks of use of IUC and implants in the immediate post-partum period. Expulsion rates are significantly higher immediately after vaginal delivery compared to interval insertions, but are no higher after insertion at caesarean section. post-partum implants appear to have the same side effects as interval insertions, and to date, no adverse impact on breast milk or infant growth has been demonstrated. Most ...
Extensive Multifocal Mammary Infarction - a Case Report
Breast Care, May 20, 2013
Aggon AA et al. - Breast infarction can occur in benign breast lesions, such as fibroadenomas, as well as healthy breast tissue, typically in the gravid or lactating patient. Few theories, however, exist to explain this unusual lesion. Extensive multifocal post-partum breast infarction is a rare occurrence that has potential long-term effects. This should be considered when taking patient history in post-partum patients, as well as those with extensive calcifications on ...
Effect of a facility-based multifaceted intervention on the quality of obstetrical care: a cluster randomized controlled trial in Mali and Senegal
BMC Pregnancy and Childbirth, February 7, 2013
Pirkle CM et al. - Authors assessed whether an intervention, based on maternal death review, could improve obstetrical quality of care. Patients treated at hospitals with maternal death review had greater CBCA scores suggesting that the intervention improves quality of care. Results indicate that the intervention mostly improves clinical examination at admission and post-partum monitoring. They also indicate that quality of care scores can be maximized by increasing the ...
Is prophylaxis required for delivery in women with factor VII deficiency
Haemophilia, April 29, 2013
Kreuziger LMB et al. - The aim of this study was to define management, haemorrhagic and thrombotic complications of pregnant women with fVII deficiency through a systematic review. No difference in post-partum haemorrhage was seen in deliveries with and without prophylaxis. Therefore,the authors recommend that rfVIIa be available in the case of haemorrhage or surgical intervention, but not as mandatory prophylaxis.
Gestational diabetes mellitus among Norwegian women with polycystic ovary syndrome: Prevalence and risk factors according to WHO and modified IADPSG criteria
European Journal of Endocrinology, May 3, 2013
Helseth R et al. - The consequences of the recently proposed International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria for gestational diabetes mellitus (GDM) in women with polycystic ovary syndrome (PCOS) are not known. The authors compared prevalence rates and risk factors for GDM in PCOS women according to both the WHO and modified IADPSG criteria. No difference was found in GDM prevalence between the two criteria used. Less weight gain in pregnancy associated ...
Is there a role for ambulatory blood pressure monitoring in pregnancy
Clinical and Experimental Pharmacology and Physiology, May 9, 2013
Brown M - Ambulatory blood pressure monitoring (ABPM) has been used in pregnancy for just over 20 years now and is generally well tolerated. Normal values have been established for different gestations; these are slightly higher than conventional BP in normal pregnancy, presumably reflecting greater activity during the 24 hr of ABPM recordings. Women who have had pre-eclampsia are at greater life time risk for cardiovascular diseases; several years post-partum these women ...
Placental Mesenchymal Stem Cells: A Unique Source for Cellular Cardiomyoplasty
Annals of Thoracic Surgery, May 13, 2013
Makhoul G et al. - The authors discuss and compare the characteristics of placenta-derived mesenchymal stem cells as a novel alternative cell source for cellular cardiomyoplasty. These cells are isolated from the human term placenta, which is normally discarded post partum. With their lack of ethical conflicts and young age, the readily available placenta-derived mesenchymal stem cells could be more suitable for myocardial regenerative therapy.
Moving beyond essential interventions for reduction of maternal mortality (the WHO Multicountry Survey on Maternal and Newborn Health): a cross-sectional study
The Lancet, May 17, 2013
Souza JP et al. - Authors report the main findings of the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS), which aimed to assess the burden of complications related to pregnancy, the coverage of key maternal health interventions, and use of the maternal severity index (MSI) in a global network of health facilities. High coverage of essential interventions did not imply reduced maternal mortality in the health-care facilities we studied. If substantial reductions ...
Clinical and genetic determinants of plasma nevirapine exposure following an intrapartum dose to prevent mother-to-child transmission
The Journal of Infectious Diseases, May 24, 2013
Vardhanabhuti S et al. - Nevirapine is metabolized by cytochrome P450 (CYP) 2B6 and CYP3A4. The authors characterized relationships between clinical parameters, human genetics, pharmacokinetics, and HIV-1 drug resistance mutations in pregnant women following single-dose intrapartum nevirapine. Effects on plasma drug exposure following single-dose nevirapine may be greater for CYP2B6 983T?C than 516G?T, and are less pronounced than at steady state. Methods In ...