1,721,318 research outputs found
Antibiotic prophylaxis for term or near-term premature rupture of membranes: Metaanalysis of randomized trials
Full text linkOBJECTIVE:
The objective of the study was to evaluate the efficacy of antibiotic prophylaxis in women with term or near-term premature rupture of membranes.
STUDY DESIGN:
Searches were performed in MEDLINE, OVID, Scopus, ClinicalTrials.gov, the PROSPERO International Prospective Register of Systematic Reviews, EMBASE, ScienceDirect.com, MEDSCAPE, and the Cochrane Central Register of Controlled Trials with the use of a combination of key words and text words related to antibiotics, premature rupture of membranes, term, and trials from inception of each database to September 2014. We included all randomized trials of singleton gestations with premature rupture of membranes at 36 weeks or more, who were randomized to antibiotic prophylaxis or control (either placebo or no treatment). The primary outcomes included maternal chorioamnionitis and neonatal sepsis. A subgroup analysis on studies with latency more than 12 hours was planned. Before data extraction, the review was registered with the PROSPERO International Prospective Register of Systematic Reviews (registration number CRD42014013928). The metaanalysis was performed following the Preferred Reporting Item for Systematic Reviews and Meta-analyses statement.
RESULTS:
Women who received antibiotics had the same rate of chorioamnionitis (2.7% vs 3.7%; relative risk [RR], 0.73, 95% confidence interval [CI], 0.48-1.12), endometritis (0.4% vs 0.9%; RR, 0.44, 95% CI, 0.18-1.10), maternal infection (3.1% vs 4.6%; RR, 0.48, 95% CI, 0.19-1.21), and neonatal sepsis (1.0% vs 1.4%; RR, 0.69, 95% CI, 0.34-1.39). In the planned subgroup analysis, women with latency longer than 12 hours, who received antibiotics, had a lower rate of chorioamnionitis (2.9% vs 6.1%; RR, 0.49, 95% CI, 0.27-0.91) and endometritis (0% vs 2.2%; RR, 0.12, 95% CI, 0.02-0.62) compared with the control group.
CONCLUSION:
Antibiotic prophylaxis for term or near-term premature rupture of membranes is not associated with any benefits in either maternal or neonatal outcomes. In women with latency longer than 12 hours, prophylactic antibiotics are associated with significantly lower rates of chorioamnionitis by 51% and endometritis by 88%
Gli omologhi dei geni Sex-lethal and doublesex di Drosophila melanogaster in Ceratitis capitata: parziale conservazione evolutiva di una gerarchia di regolazione genica della determinazione del sesso
No full textSono stati isolati e caratterizzati gli omologhi dei geni di Drosophila melanogaster doublesex e Sex-lethal in Ceratitis capitata, detta mosca mediterranea che causa importanti danni all'agricoltura in svariati paesi nel mondo. I due geni svolgono funzioni chiave nella determinazione del sesso e differenziamento sessuale di Drosophila, ed inoltre sono organizzati in una cascata regolativa che vede Sex-lethal a monte di doublesex. In Ceratitis capitata è stata evidenziata un conservazione strutturale di entrambi ma regolativa/funzionale del solo doublesex
Utero-cervical angle to predict the risk of spontaneous preterm birth: a review of literature
No full textBACKGROUND: The aim of this paper was to evaluate the predictive role of the uterocervical angle (UCA) in spontaneous preterm birth (sPTB). . METHODS: A systematic review of the literature was performed including all studies reporting the association between UCA and sPTB. Searches were performed with the use of a combination of keywords: "cervical length," "uterocervical angle," and "preterm birth" from inception of each database to March 2022. The statistical evaluations were carried out using the Comprehensive Meta -Analysis version 3 (Biostat Inc. USA). RESULTS: Sixteen studies all conducted on the second trimester UCA as well as its association with sPTB were included in this study. In all studies the measurements of cervical length (CL) and UCA were performer in the second trimester, except in one that in the third trimester. In most studies the CL is greater than 30 mm and the UCA is greater than 110 degrees. In seven studies women with symptoms were considered while in 8 studies the women were asymptomatic. CONCLUSIONS: It is too early for it to reach a firm conclusion on UCA utilization in clinical settings. A higher UCA measurement (greater than 150 degrees) is an important risk factor for deliveries before 37 weeks' gestation. It provides a higher diagnostic performance in high risk patients than the CL measurement. However, the most relevant ultrasound parameter for the prediction of delivery within the next few data in women with preterm delivery remains the cervical length. There is a need to consider both markers and create protocols so that the values obtained with UCA and those with CL can make a real contribution to decisions to be made rather than using only CL. ( Cite this article as: Giorno A, Mari S, Rispoli EM, Cipullo LM, Manzo L, Saccone G, et al. Utero-cervical angle to predict the risk of spontaneous preterm birth: a review of literature. Minerva Obstet Gynecol 2024 May 21. DOI: 10.23736/ S2724 -606X.24.05433-2
Reply to correspondence: Vaginal delivery in a woman infected with SARS-CoV-2 – The first case reported in Portugal
Full text linkSelective serotonin reuptake inhibitor (SSRI) use during pregnancy and risk of preterm birth: a systematic review and meta-analysis
Full text linkBACKGROUND:
Depression is a prevalent condition in pregnancy affecting about 10% of women. Maternal depression has been associated with an increase in preterm births (PTB), low birthweight and fetal growth restriction, and postnatal complications. Available treatments for depressive disorders are psychotherapeutic interventions and antidepressant medications including selective serotonin inhibitors (SSRIs). SSRI use during pregnancy has been associated with several fetal and neonatal complications; so far, however, the risk of PTB in women using SSRIs during pregnancy is still a subject of debate.
OBJECTIVE:
To evaluate the risk of preterm birth (PTB) in cases of exposure to SSRIs during pregnancy.
SEARCH STRATEGY:
Electronic databases (MEDLINE, Scopus, ClinicalTrials.gov, the PROSPERO International Prospective Register of Systematic Reviews, EMBASE and the Cochrane Central Register of Controlled Trials) were searched from their inception until May 2015 with the use of a combination of the following text words 'depression', 'pregnancy', 'exposure', 'antidepressant', 'SSRI', 'selective serotonin reuptake inhibitor', 'preterm birth', 'small for gestational age' and 'prematurity'.
SELECTION CRITERIA:
We included studies evaluating the effect of SSRIs exposure in utero and pregnancy outcomes. All cohort and case-control studies were eligible to be included if they reported the incidence of PTB after any exposure to SSRIs and had a comparison group of unexposed pregnant women. Studies without a control group were excluded.
DATA COLLECTION AND ANALYSIS:
The primary outcome was the incidence of PTB <37 weeks. Subgroup analysis of studies in which controls were defined as women with depression but without SSRI exposure during pregnancy were planned.
MAIN RESULTS:
Eight studies (1 237 669 women) were included: 93 982 in the exposure group and 1 143 687 in the control group. After adjusting for confounders, the incidence of PTB was significantly higher in the group of women treated with SSRIs compared with controls (i.e. both women with depression but without SSRI exposure and women without depression) (adjusted OR (aOR) 1.24, 95% CI 1.09-1.41). In the subgroup analysis of studies in which controls were defined as women with depression but without SSRI exposure during pregnancy, an increased risk of PTB (6.8 versus 5.8%; OR 1.17, 95% CI 1.10-1.25) in the SSRI group was found compared with controls (i.e. depressed women treated with psychotherapy alone).
CONCLUSIONS:
Women who received SSRIs during pregnancy had a significantly higher risk of developing PTB compared with controls. This higher risk remained significant even when comparing depressed women on SSRI with women not on SSRI.
TWEETABLE ABSTRACT:
Selective serotonin reuptake inhibitors may be associated with preterm birth
Detachment of gas bubbles from an inclined surface
No full textDetachment of gas bubbles from an inclined surfac
Third trimester ultrasound soft-tissue measurements accurately predicts macrosomia
Full text linkOBJECTIVE:
To evaluate the accuracy of sonographic measurements of fetal soft tissue in the prediction of macrosomia.
METHODS:
Electronic databases were searched from their inception until September 2015 with no limit for language. We included only studies assessing the accuracy of sonographic measurements of fetal soft tissue in the abdomen or thigh in the prediction of macrosomia ≥34 weeks of gestation. The primary outcome was the accuracy of sonographic measurements of fetal soft tissue in the prediction of macrosomia. We generated the forest plot for the pooled sensitivity and specificity with 95% confidence interval (CI). Additionally, summary receiver-operating characteristics (ROC) curves were plotted and the area under the curve (AUC) was also computed to evaluate the overall performance of the diagnostic test accuracy.
RESULTS:
Three studies, including 287 singleton gestations, were analyzed. The pooled sensitivity of sonographic measurements of abdominal or thigh fetal soft tissue in the prediction of macrosomia was 80% (95% CI: 66-89%) and the pooled specificity was 95% (95% CI: 91-97%). The AUC for diagnostic accuracy of sonographic measurements of fetal soft tissue in the prediction of macrosomia was 0.92 and suggested high diagnostic accuracy.
CONCLUSIONS:
Third-trimester sonographic measurements of fetal soft tissue after 34 weeks may help to detect macrosomia with a high degree of accuracy. The pooled detection rate was 80%. A standardization of measurements criteria, reproducibility, building reference charts of fetal subcutaneous tissue and large studies to assess the optimal cutoff of fetal adipose thickness are necessary before the introduction of fetal soft-tissue markers in the clinical practice
Reply to Delayed versus immediate pushing in the second stage of labor in women with neuraxial analgesia: a systematic review and meta-analysis of randomized controlled trials
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