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Seizures
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Sally Mathias, Meriem Bensalem-Owen
Major congenital malformations include neural tube defects (NTDs), congenital heart disease, cleft lip/palate and urogenital defects. Minor congenital malformations include coarse hair, epicanthal folds, small nail beds, and skin tags. Most common congenital malformations, which differ for different AEDs, are cardiac, neural tube, craniofacial, and involving the fingers.
Causes and risk factors
Published in Janetta Bensouilah, Pregnancy Loss, 2021
In congenital malformations the baby has a structural or functional defect or malformation. Some of the most familiar ones are the neural tube defects spina bifida, encephalocoele and anencephaly. Spina bifida has a strong genetic association, but it is exaggerated when an environmental factor such as a deficiency in folic acid intake coexists. Up to 40% of neural tube defects are miscarried, and they account for around 5% of spontaneous miscarriages.8
Obesity
Published in Judy Bothamley, Maureen Boyle, Medical Conditions Affecting Pregnancy and Childbirth, 2020
Many studies have demonstrated an increased number of various congenital abnormalities associated with maternal obesity17,64. It is worth noting that the increased risk, while significant, is still relatively low. In a recent study of over 1 million live births, the risk of major congenital malformation was 3.5% for all women, and whilst the risk of congenital malformation rises with increased increment of BMI, the rate of congenital malformation in the obesity category III was found to be 4.7%. The most common malformation found was neural tube defects64. Others were limb reduction anomalies, cardiac disorders and cleft lip and palate17. The causes of congenital malformation are multifactorial and include genetic and environmental factors such as smoking, alcohol and socio-economic features. Both maternal folate deficiency and glucose intolerance at the critical point of embryological development (as seen in diabetes) have been suggested as possible causes17. It has also been suggested that the increased neural tube defect rate may be due to decreased levels of folic acid reaching the fetus as the obese mother has increased metabolic demands and possibly a diet poor in folate64.
Bucket hydrokinesiotherapy in hospitalized preterm newborns: a randomized controlled trial
Published in Physiotherapy Theory and Practice, 2022
Natália Matos Tedesco, Andressa Lagoa França Nascimento, Geruza de Souza Mallmann, Leila Simone Foerster Merey, Elaine Pereira Raniero, Walusa Assad Gonçalves-Ferri, Daniele Soares-Marangoni
Thirty-four preterm newborns (32.62 ± 1.08 weeks gestation; birth weight 1,722.62 ± 345.95 grams) were included. They were randomly allocated into experimental group (hydrokinesiotherapy, n = 17) or control group (diaper change only, n = 17) (Figure 1 and Table 1). As most preterm infants that undergo hydrokinesiotherapy in clinical practice are required to be clinically stable, this was an inclusion criterion. All infants should show an increase in weight during the last body weight measurement before the experiment. In addition, they should be cleared for bathing by the neonatology team. Newborns who, according to the neonatologists’ medical records, had at least one of the following conditions were not included: 1) congenital malformations; 2) genetic syndromes; 3) progressive diseases; 4) orthopedic or cardiorespiratory abnormalities; 5) grade III and/or IV peri-intraventricular hemorrhage; and 6) hyperbilirubinemia. All included infants were breathing spontaneous on room air although oxygen supplementation was not an exclusion criterion. This study was approved by the Research Ethics Committee of the Federal University of Mato Grosso do Sul (protocol # 1.804.078/2016) and all parents/caregivers signed informed legal consent.
Pregnancy outcomes in patients with psoriasis, psoriatic arthritis, or axial spondyloarthritis receiving ixekizumab
Published in Journal of Dermatological Treatment, 2022
A. Egeberg, L. Iversen, A. B. Kimball, S. Kelly, E. Grace, H. Patel, W. Xu, G. Gallo, E. Riedl, S. R. Feldman
Congenital malformations were reported in three infants and included heart abnormality, syndactyly, and widened pelvis. In the first case (heart abnormality), the mother experienced a miscarriage during the pregnancy. The defect was identified during an examination of the fetus. Reported risk factors included advanced maternal age (37 years), and maternal history of smoking and alcohol use. In the second case (syndactyly), a live, full-term baby boy was delivered. Upon delivery, it was discovered that his left and middle finger were webbed. Risk factors for syndactyly included the maternal history of webbed fingers and toes and a paternal family history of webbed fingers. In the third and final case (widened pelvis), the mother delivered a full-term baby boy. Ultrasound of the baby’s abdomen revealed congenital widening of the right renal pelvis. Risk factors for this malformation included toxoplasmosis during pregnancy.
Diagnosis of central nervous system abnormalities: comparison of prenatal neurosonography and foetal magnetic resonance imaging findings
Published in Journal of Obstetrics and Gynaecology, 2022
Sureyya Saridas Demir, Erkan Cagliyan, Fatma Ceren Sarioglu, Handan Guleryuz, Sabahattin Altunyurt
The central nervous system (CNS) is the most complex structure among the foetal and adult systems. This is where congenital malformations are most frequently observed, both in fetuses with and without chromosomal abnormalities. Structural abnormalities associated with major functional problems are difficult to diagnose. On the contrary, major anatomical defects may not cause significant malfunctioning (Ceausescu et al. 2018). Therefore, accurate diagnosis of CNS abnormalities is essential for pregnancy management and parental counselling (Jarvis et al. 2017). The first preferred imaging method in antenatal screening programs is neurosonography. Foetal magnetic resonance imaging (MRI) is generally preferred as a second-line in cases when the diagnosis could not be confirmed by neurosonography (Paladini et al. 2007).