Maternal hemoglobin A1c and left ventricular hypertrophy in infants of mothers with pre-gestational diabetes.

Objective: Maternal hemoglobin A1c (HbA1c) has been suggested to be a predictor of left ventricular hypertrophy (LVH) in the offspring of mothers with pre-gestational diabetes mellitus, although there is little data supporting this contention. We aimed to assess the relationship between maternal HbA1c and postnatal LVH.

Methods: We performed a retrospective cohort study of infants born to mothers with pre-gestational diabetes mellitus from 2015 to 2021 at our institution.

Hyperparathyroidism in Pregnancy: A Review of the Literature.

Importance: Maternal hyperparathyroidism can be associated with significant maternal and fetal morbidity and fetal mortality. Because the maternal symptoms are typically nonspecific, the disorder may not be recognized leading to adverse pregnancy outcomes.

Objective: The aim of this study was to review the literature on the etiology/prevalence, pathophysiology, diagnosis, management (medical and surgical), and the maternal/neonatal complications associated with pregnancies complicated by hyperparathyroidism.

Fetal intracranial hemorrhage associated with maternal coagulopathy and vitamin K deficiency after biliary drain placement: A case report and literature review.

Introduction: Fetal intracranial hemorrhage (ICH) is a rare but serious prenatal diagnosis. Predisposing factors include maternal trauma and fetal coagulation dysfunction. Maternal vitamin K deficiency has been described as an etiology.

Knowledge, Attitudes, Beliefs, and Treatment Burden Related to the Use of Levothyroxine in Hypothyroid Pregnant Women in the United States.

The use of prescribed medications during pregnancy is a challenge and an underestimated source of treatment burden. Levothyroxine (LT4) for the treatment of overt and subclinical hypothyroidism is extensively prescribed during pregnancy. To this end, we aimed to explore the patients' perceived benefits and risks, knowledge, beliefs, attitudes, and related burden of LT4 therapy during pregnancy.

Placental changes in diabetic pregnancies and the contribution of hypertension.

Objective: To evaluate placental abnormalities in pregnancies affected by diabetes compared to unaffected pregnancies from a single academic center.

Methods: This is a retrospective cohort study of women with singleton gestations delivered at the University of Arkansas for Medical Sciences from 2007 to 2016. Pathologic examination of placentas from pregestational and gestational diabetic pregnancies were compared to placentas from patients without diabetes using 12 histologic elements.

Parental adiposity differentially associates with newborn body composition.

Background: Maternal obesity increases offspring's obesity risk. However, studies have not often considered maternal metabolic and exercise patterns as well as paternal adiposity as potential covariates.

Objective: To assess the relationship between parental and newborn adiposity.

The Third Stage of Labour in the Extremely Obese Parturient.

Background: Maternal obesity has been associated with an increased risk for an abnormal progression of labour; however, less is known about the length of the third stage of labour and its relation to maternal obesity.

Objective: To determine if the length of the third stage of labour is increased in extremely obese women and its possible correlation with an increased risk for postpartum hemorrhage.

Study Design: This was a retrospective cohort study of deliveries from January 2008 to December 2015 at our university hospital.

Discrepancy in Insulin Regulation between Gestational Diabetes Mellitus (GDM) Platelets and Placenta.

Earlier findings have identified the requirement of insulin signaling on maturation and the translocation of serotonin (5-HT) transporter, SERT to the plasma membrane of the trophoblast in placenta. Because of the defect on insulin receptor (IR) in the trophoblast of the gestational diabetes mellitus (GDM)-associated placenta, SERT is found entrapped in the cytoplasm of the GDM-trophoblast. SERT is encoded by the same gene expressed in trophoblast and platelets.

Legionella Infection in Pregnancy: The Forgotten Pathogen in Septic Shock.

Background: Of eight cases of Legionella infection in pregnancy reported over 35 years, there was one case of maternal septic shock with poor outcome, one recovery with good outcome, and six with poor outcome.

Case: A 30-year-old woman, gravida 2 para 1, at 28 weeks of gestation presented with a high fever, cough, nausea, and vomiting. She deteriorated despite treatment for presumed urosepsis, was transferred to the intensive care unit, and remained intubated for 10 days receiving cardiovascular support, antivirals, antifungals, and multiple wide-spectrum antibiotics.

GDM-associated insulin deficiency hinders the dissociation of SERT from ERp44 and down-regulates placental 5-HT uptake.

Serotonin (5-HT) transporter (SERT) regulates the level of 5-HT in placenta. Initially, we found that in gestational diabetes mellitus (GDM), whereas free plasma 5-HT levels were elevated, the 5-HT uptake rates of trophoblast were significantly down-regulated, due to impairment in the translocation of SERT molecules to the cell surface. We sought to determine the factors mediating the down-regulation of SERT in GDM trophoblast.

Antenatal management of at-risk pregnancies from a distance.

This study was undertaken to determine whether antenatal care can be achieved in women with at-risk pregnancies residing in rural areas with limited access to antenatal care and maternal fetal medicine (MFM) specialists. Over a period of 15 months, 156 women with high-risk pregnancies (diabetes, hypertensive disorders, suspected fetal anomalies, prior caesarean complications) from six different healthcare units had 350 visits managed by telemedicine.

Correlation of ultrasound estimated with dye-determined or directly measured amniotic fluid volume revisited.

Background/aims: To examine the relationship of the amniotic fluid index (AFI) and single deepest pocket (SDP) with an AFV as modelled by Brace or Magann.

Methods: AFI and SDP were evaluated for their correlation with an actual AFV using the Spearman correlation coefficient.

Results: 482 AFI and 468 SDP pregnancies were evaluated.

Complications of shoulder dystocia.

Complications of shoulder dystocia are divided into fetal and maternal. Fetal brachial plexus injury (BPI) is the most common fetal complication occurring in 4-40% of cases. BPI has also been reported in abdominal deliveries and in deliveries not complicated by shoulder dystocia.

Antiemetic medications in pregnancy: a prospective investigation of obstetric and neurobehavioral outcomes.

Objective: The study goal was to examine the impact of commonly prescribed antiemetic medications in pregnancy on neurobehavioral and obstetric outcomes.

Study Design: Five hundred thirty-three women accounting for 550 live births (17 multiple gestations) enrolled before 16 weeks' gestation participating in an observational longitudinal study of stress and pharmacologic exposure in pregnancy at Emory Women's Mental Health Program were included in this study. Maternal report of exposure to medications was documented by weeks of use.

Role of serial MRI assessment in the management of an abdominal pregnancy.

A 33-year-old woman was admitted to the hospital with an abdominal pregnancy at a gestational age of 20 weeks. An initial MRI mapping of fetal location and placental vascular invasion was obtained. The patient refused surgical intervention until fetal survival would be possible.

Depression and diabetes: Establishing the pharmacist's role in detecting comorbidity in pregnant women.

Objectives: To determine the prevalence of depression in women with diabetes receiving prenatal care and to determine whether pregnant women with comorbid depression and diabetes are receiving adequate care for depression.

Setting: Little Rock, AR, between June and August 2007.

Practice Description: At a women's health clinic providing obstetrical services to local and statewide patients, the clinical pharmacist functions as a diabetes educator, provides treatment recommendations for the OB/GYN medical residents, and precepts fourth-year student pharmacists.

Prolonged morphine exposure in utero causes fetal and placental vasoconstriction: a case report.

Vasoconstriction was observed in the fetal middle cerebral and umbilical arteries by Doppler assessment at 27 weeks gestation in a patient requiring continuous morphine infusion for pain control. Fetal heart tracings were also concerning. Fetal status improved after a change to fentanyl infusion, a shorter acting opioid.

Prenatal diagnosis of congenital cardiac anomalies: a practical approach using two basic views.

Structural cardiac anomalies are estimated to occur in 8 of every 1,000 live births. Cardiovascular anomalies are frequently associated with other congenital anomalies because the heart is among the last organs to develop completely in the embryo. The guidelines for routine prenatal evaluation of both the American College of Radiology and the American Institute of Ultrasound in Medicine require evaluation of the fetal heart.