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Malpresentation And Malposition
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Alexis C. Gimovsky, Andrea Dall’Asta, Giovanni Morganelli, Tullio Ghi
Given the possible complications, it is prudent to perform ECV in a facility with ready availability of emergency CD. Consent should be obtained after counseling regarding possible complications, alternatives (CD), prognosis, and explanation of the actual procedure. A nonstress test should be performed before and after ECV. Anesthesia is usually not necessary and has not been absolutely proven to benefit outcomes. Betamimetic prophylactic tocolysis should be given (e.g. terbutaline 25 µg subcutaneously 5–10 minutes prior to procedure). There are no trials comparing other technical aspects of ECV. One or two operators can be used. When the fetal back is accessible to palpation with no intervening placenta, the stimulation of the Galant or the stepping or walking fetal reflexes have been suggested to improve the outcome of ECV [53]. Frequent, if not continuous, ultrasound guidance to assess for fetal well-being and presentation is suggested. Rh-negative women should receive anti-D immunoglobulin. There is no evidence to support immediate induction after successful ECV.
Medical evaluation and management of pregnant patients undergoing non-obstetrical surgery
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
The preoperative evaluation of the pregnant patient should include all the elements one would perform if the patient were not pregnant plus an antenatal assessment of the fetus and pregnancy to assess for the effect of the condition needing the surgery on the outcome of the pregnancy. Determination of gestational age, fetal well-being by nonstress test or biophysical profile assessment, assessment of the maternal cervical status, and an assessment for contractions should be carried out. Laboratory assessment, imaging studies, and preoperative assessments must take into account the maternal adaptations of pregnancy and gestational age. Ionizing radiation studies should be limited and fetal status should be considered before any imaging studies are performed.
Investigation and management of recurrent cholestasis of pregnancy
Published in Minakshi Rohilla, Recurrent Pregnancy Loss and Adverse Natal Outcomes, 2020
RCOG recommends booking these patients for “consultant-led care” and hospital deliveries [16]. The role of careful obstetrical fetal surveillance needs special emphasis. However, no fetal monitoring has been shown to predict fetal demise. The suggested fetal monitoring includes biweekly biophysical profile and nonstress test. The role of maternal daily fetal movement count cannot be overemphasized. There is no evidence of fetal growth restriction or placental insufficiency with Doppler, similar to other pregnancies. Various scientific bodies recommend that the decision for termination of pregnancy after 37 completed weeks should be made with the patient after prior counseling [21–23, 26, 27].
Laparoscopic surgery for fallopian tube torsion due to benign tumour in the third trimester of pregnancy: a case report and literature review
Published in Journal of Obstetrics and Gynaecology, 2022
Jae Yoon Jo, In Ae Cho, Jeong Kyu Shin, Soon Ae Lee, Won Jun Choi
A 32-year-old primigravida woman at 29 weeks and four days of gestation, visited our tertiary hospital emergency. She complained of sudden right flank abdominal pain starting that morning without any other obstetric symptoms. On physical examination, the height of the fundus was compatible with her gestational age; however, there was localised pain in the right periumbilical region, which was tender on palpation. The patient’s blood pressure was 123/70 mmHg; pulse was 70 beats per minute, and body temperature was 36.6 °C. She had no underlying diseases or family history of diseases, and her routine antenatal examination findings were unremarkable. The laboratory findings were as follows: white blood cell count, 9.34 × 109/L; haemoglobin, 10.5 g/dL; lipase, 19 U/L, and CRP level, 0.7 mg/dL. Other serologic tests including electrolyte levels, liver function tests and urinalysis were within the normal range. Ultrasound examination showed a live singleton foetus at 29 weeks of gestation with normal amniotic fluid and placental site. The foetal heart rate was reactive in the non-stress test, and there were no provoked uterine contractions. During sonography, a right hypoechoic cystic mass measuring 6.5 ×4 cm was observed and was suspected to have developed from the adnexa. MRI without contrast was performed to rule out appendicitis, adnexal torsion, adnexal cyst rupture or other conditions that may induce pain. MRI revealed normal findings except a right adnexal mass with surrounding fluid collection (Figure 1). Over time, the patient’s right flank pain and RLQ (right lower quadrant) pain became worse.
The effects of music therapy applied to pregnant women on maternal, fetal, and neonatal results: A randomized controlled study
Published in Health Care for Women International, 2022
Şeyma Çatalgöl, Esin Ceber Turfan
Good psychological health during pregnancy is very important for maternal and fetal health. Researchers report that stress and anxiety during pregnancy create negative results such as prematurity, low birth weight, intrauterine growth retardation (Rondó et al., 2003). It is known that anxiety and stress increase during pregnancy, especially in the third trimester, and affect the Nonstress Test (NST) parameters (Avcioğlu et al., 2016; Salafas et al., 2020). Many researchers examine effective interventions to reduce anxiety during pregnancy and prevent negative maternal, fetal, and neonatal outcomes. Music used for this purpose can be used as an effective non-pharmacological method in the management of stress and anxiety during pregnancy, labor, and postpartum period (McCaffrey et al., 2020; Van Willenswaard et al., 2017).
The effect of music on fetal well-being and anxiety levels and vital signs of pregnant women during non-stress test: Turkey sample
Published in Health Care for Women International, 2022
Nurseli Soylu, Tülay Bülbül, İptisam İpek Müderris
The maternal mortality rate has decreased significantly in developing countries. Thus, more focus has been placed on fetal health. The fetus is a second patient with a high risk of morbidity and mortality. By using diagnostic tests, 56% of stillbirths can be preventable. One of the diagnostic tests is the non-stress test (NST) (Raouf et al., 2014). NST is a procedure used to record fetal heart sounds and monitor the correlation between fetal movements and fetal heart rate. NST method is commonly used all over the world for noninvasive assessment of fetal well-being during pregnancy and labor. NST is a noninvasive, painless, and easy procedure; however, during this procedure, pregnant woman lies in supine position and waits in this position for 20-30 min, thus leading to increase her anxiety level. Her high anxiety level may affect the test result, thereby leading to misevaluation and an increase in c-section rates by increasing the non-reactive NST rate (Alp & Ertem, 2016; Kızılkaya-Beji & Dişsiz, 2015; Şimşek Küçükkelepçe & Timur Taşhan, 2018; Taşkın, 2015).