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Re-evaluating large for gestational age: differential effects on perinatal outcomes in term and premature births.
Front Med (Lausanne)
January 2025
Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Objective: Pregnancies with large-for-gestational-age (LGA) fetuses are associated with increased risks of various adverse perinatal outcomes. While existing research primarily focuses on term neonates, less is known about preterm neonates. This study aims to explore the risks of adverse maternal and neonatal perinatal outcomes associated with LGA in term neonates and neonates with different degrees of prematurity, compared to appropriate-for-gestational-age (AGA) neonates.
View Article and Find Full Text PDFEnhancing Perinatal Safety with the Advancement of Obstetric Anesthesia in Japan.
Womens Health Rep (New Rochelle)
January 2025
Department of Anesthesia, National Center for Child Health and Development, Tokyo, Japan.
Japan is one of the most developed countries in the world, and perinatal care is safe, with low maternal and neonatal mortality rates. However, as birthrate declines, advanced maternal age and the number of cesarean deliveries increases, efforts must be made to maintain safety in the future. The characteristic of the delivery facilities is "many small clinics," and half of all facilities have fewer than 500 deliveries per year.
View Article and Find Full Text PDFNon-Surgical Management of Gallstones During Pregnancy: A Clinical Case Report.
Cureus
December 2024
Neurosurgery, County Clinical Emergency Hospital of Sibiu, Sibiu, ROU.
Gallstone disease during pregnancy, or cholelithiasis, presents significant clinical challenges due to hormonal, anatomical, and metabolic changes. Progesterone therapy, commonly used in pregnancy for uterine bleeding, can exacerbate gallstone risk by reducing gallbladder motility and promoting cholesterol gallstone formation. This case report describes a 29-year-old pregnant woman with no prior gallbladder disease who developed multiple cholesterol gallstones during the third trimester while undergoing progesterone therapy for bleeding associated with a bicornuate uterus.
View Article and Find Full Text PDFSuccessful treatment of subinvolution of the placenta site with uterine artery embolisation, sparing the patient's fertility: A case report.
Case Rep Womens Health
March 2025
Department of Interventional Radiology, Fiona Stanley Hospital, Western Australia, Australia.
Subinvolution of the placental site can lead to severe post-partum haemorrhage, though it is a rare cause of the condition. Subinvolution of the placental site is an abnormal persistence of widely dilated uteroplacental spiral arteries in the absence of retained products of conception, and is associated with an increased risk of maternal morbidity and mortality. This report presents a case of an uneventful caesarean section that was followed by multiple presentations of major secondary post-partum haemorrhage, with a subsequent diagnosis of subinvolution of the placental site on histopathology.
View Article and Find Full Text PDFThe implementation of intrathecal morphine for caesarean delivery into clinical practice, and assessment of its impact on patient-reported quality of recovery using the ObsQoR-10-Dutch scale.
Eur J Anaesthesiol
January 2025
From the Department of Anaesthesiology, Wilhelmina Children's Hospital (OFCvdB, SR, LvB, WB), Pain Clinic, Department of Anaesthesiology (MR), Department of Obstetrics, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands (TPS) and Department of Anaesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA (PS).
Background: Optimising a mother's quality of recovery following caesarean delivery is of paramount importance as it facilitates maternal care of the newborn and affects physical, psychological and emotional well being. Intrathecal morphine (ITM) reduces postoperative pain and may improve quality of recovery: however its widespread use is limited.
Objective: To assess the effects of implementing ITM for caesarean delivery on postoperative quality of recovery.
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