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Ultrasound
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
L. M. Porche, S. P. Chauhan, A. Abuhamad
Precise estimation of gestational age is extremely important for optimal obstetric care, including evaluation of fetal growth, interpretation of maternal screening markers, choosing the appropriate gestational age to perform interventions, and management of preterm and late-term pregnancies.
Fetal Growth Restriction
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Juliana Gevaerd Martins, Alfred Abuhamad
Since gestational age is the primary component dictating whether a fetus is measuring small, accurate determination of an estimated date of confinement (EDC) is paramount. First-trimester ultrasound < 13 weeks and 6 days is the most precise method to determine the EDC. For precise estimation of gestational age by ultrasound, see Table 2 in Chapter 4, Obstetric Evidence Based Guidelines [10].
Care of the Premature and Ill Neonate
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Ting Ting Fu, Kera McNelis, Carrie Smith, Jae H. Kim
There are a number of conditions that can present challenges for optimal growth in newborns either through limits in amount of intake or increased demands in energy and nutrient requirements. An infant born before 37-completed weeks gestational age is considered preterm. Preterm infants are at risk of a variety of medical complications and are at increased nutrition risk. Preterm infants born before 34 weeks gestation will require nutrition support therapy as they have not yet developed safe coordination of sucking, swallowing, and breathing. Premature infants born between 28 and 38 weeks usually do not have adequate subcutaneous fat, muscle tissue, or tissue stores of iron and calcium as these stores are acquired during the third trimester of pregnancy. Infants born at this gestation will require nutrition interventions to meet these needs.
Inappropriate gestational weight gain impact on maternofetal outcomes in gestational diabetes
Published in Annals of Medicine, 2023
Sílvia Santos Monteiro, Tiago S. Santos, Liliana Fonseca, Miguel Saraiva, Fernando Pichel, Clara Pinto, Maria T. Pereira, Joana Vilaverde, Maria C. Almeida, Jorge Dores
Gestational age was estimated from the last menstrual period and was either confirmed or corrected by ultrasonography. Prepregnancy BMI was calculated from self-reported prepregnancy weight and height. BMI categories were classified as follows: BMI <18.5 kg/m2 was classified as underweight, 18.5–24.9 kg/m2 as normal weight, 25.0–29.9 kg/m2 as overweight and ≥30.0 kg/m2 as obesity. Pregnant women were required to meet with their diabetes team regularly and weight was measured at every appointment. Total GWG (kg) was measured by calculating the difference between the last visit before delivery weight and prepregnancy weight. GWG before the 1st GDM appointment and between the 1st GDM appointment to delivery were also calculated. Women were classified as within, less or greater than IOM GWG recommendations for prepregnancy BMI category. IOM guidelines recommend an adequate GWG of 12.5–18.0 kg for underweight women, 11.5–16.0 kg for normal weight women, 7.0–11.5 kg for overweight women and 5.0–9.0 kg for obese women [9]. All pregnant women were evaluated fortnightly until 35 weeks of gestation and then weekly until delivery. Pregnant women with missing data on their prepregnancy weight and height or pre-delivery weight were excluded from analysis.
The Association between Placental Abruption and Platelet Indices
Published in Fetal and Pediatric Pathology, 2023
Duygu Tugrul Ersak, Özgür Kara, Kadriye Yakut, Aytekin Tokmak, Cem Yaşar Sanhal, Aykan Yücel, Dilek Şahin
Placental abruption (PA) is an obstetric disaster with a frequency varying between 0.4% and 1%. In abruption, the placenta is separated from the uterus while the second stage of labor has not yet been completed. Bleeding may lead to fetal ischemia and hypoxia and is of maternal origin [1,2]. The diagnosis of placental abruption is clinical [3]. PA manifests classically by vaginal bleeding, abdominopelvic pain, maternal tachycardia or hypotension, prolonged fetal bradycardia, and late decelerations on non-stress testing indicating impaired fetal well-being [4]. The life of both the mother and fetus is threatened. Maternal complications of PA depend on the successive process leading to coagulation disorders with hemorrhage followed by hypovolemic shock and death. Fetal complications of PA such as preterm labor, fetal death, intrauterine growth restriction, and neonatal asphyxia was shown to be associated with the gestational age and the severity of separation of the placenta [5,6].
Transient abnormal myelopoiesis in Down syndrome: Experience of long term follow up from a single tertiary center in Thailand
Published in Pediatric Hematology and Oncology, 2023
Thirachit Chotsampancharoen, Shevachut Chavananon, Pornpun Sripornsawan, Natsaruth Songthawee, Edward B. McNeil
Over the 26-year study period, we identified 32 patients diagnosed as DS with TAM from 997 DS patients, giving an incidence of TAM of 3.2%. Among these, the median age was 5 days (range: 1-50 days), with a male:female ratio of 0.78:1. The median gestational age was 38 weeks (range: 33 to 40 weeks). Thirty of the 32 patients (93.8%) had Down syndrome features with chromosome studies showing trisomy 21. Two of the 32 patients (6.2%) had normal phenotypes but chromosome studies showed mosaicism patterns of 47,XX,+21/46,XX and 47,XY,+21/46,XY. Hepatomegaly (93.8%), splenomegaly (78.1%), respiratory distress needing oxygen therapy (62.5%), and jaundice (40.6%) were the most common physical findings in the symptomatic patients. The clinical manifestations of the patients at presentation are shown in Table 1.