Publications by authors named "Cesar Hernan Meller"

Background: Advances in haemolytic disease of the fetus and newborn have led to numerous treatment options. We report practice variations in the management and outcomes of haemolytic disease of the fetus and newborn in at-risk pregnancies.

Methods: In this international, retrospective, observational cohort study, data from cases with moderate or severe haemolytic disease of the fetus and newborn were retrieved from 31 centres in 22 countries.

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Background: Fetal aortic valvuloplasty (FAV) is proposed to prevent hypoplastic left heart syndrome due to fetal critical aortic stenosis.

Objective: to report our experience on FAV as the first step in a complex therapeutic strategy.

Method: Series of patients with FAV over an 18-year period.

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Purpose: We aim to compare the perinatal outcomes of two consecutive management strategies for fetal growth restriction (FGR), with or without the inclusion of additional Doppler parameters.

Methods: A quasi-experimental before/after study was conducted in which we compared a composite perinatal outcome, prematurity rate, and neonatal complications between two management strategies in small fetuses. In the strategy 1 (S1), the management was based on fetal biometry and umbilical artery Doppler.

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Article Synopsis
  • Hysterectomy is the primary treatment for placenta accreta spectrum (PAS), but a new approach using hybrid operating rooms (OR) aims to minimize surgical risks and improve efficiency.
  • A retrospective study compared 110 patients treated in a conventional OR (80 patients) versus a hybrid OR (30 patients), finding no major complications with the hybrid approach and a significant reduction in operative time.
  • The hybrid OR method shows promise as a safer and faster alternative to the traditional two-step procedure, but further research is necessary to assess its cost-effectiveness and impact on maternal and perinatal health outcomes.
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The administration of magnesium sulphate to mothers at risk for preterm birth for fetal neuroprotection has demonstrated to reduce the risk of cerebral palsy and gross motor dysfunction by 30-40%. Although there is controversy regarding the regimen of administration of magnesium sulphate, the gestational age limit, the extent of its potential benefit or even if it provides any benefit, current evidence is enough to support the use of magnesium sulphate in women at imminent risk for preterm delivery before 32 weeks of gestation. The objective of this study is to describe available evidence and current recommendations regarding neuroprotection with magnesium sulphate.

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Fetal therapy may be needed in certain clinical settings with the primary indication to improve perinatal or long-term outcomes for the fetus or the newborn. It can be classified in pharmacotherapy or non-invasive, and invasive therapy. The first one involves the administration of drugs to the mother that cross the placenta and get to the fetus, a non-invasive approach.

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