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Amnioinfusion

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41. Long-term neurologic outcomes after common fetal interventions (Abstract)

with a cohort of more than 5 patients and with follow-up of 1 year or longer. We divided procedures into those performed for singletons and for multiples. Singleton procedures included amnioinfusion for preterm premature rupture of membranes, intrauterine transfusion for red cell alloimmunization-associated anemia, intrauterine transfusion for parvovirus-associated anemia, vesicoamniotic shunts, thoracoamniotic shunts, ventriculoamniotic shunts, fetal endoscopic tracheal occlusion for congenital

2015 EvidenceUpdates

42. The Comparative Effectiveness of Liberal Versus Restricted Maternal Administration of Oxygen During Labor

Use [ Time Frame: during labor ] Number of Participants Who Received Intrauterine Resuscitation Other Than Administration of Maternal Oxygen [ Time Frame: during labor ] "Intrauterine resuscitation" includes administration of terbutaline, amnioinfusion, cessation of oxytocin, and intravenous (IV) fluid boluses. In this measure, the number of participants who received any of these 5 procedures will be reported in aggregate as the "number of participants who received intrauterine resuscitation other

2016 Clinical Trials

43. Fetal Cystoscopy for Lower Urinary Tract Obstruction

and we will not attempt to perforate this structure. A vesicoamniotic shunting placement will be performed in this situation depending on the patient's consent prior to the surgery. Active Comparator: Vesicoamniotic shunt The fetal vesicoamniotic shunt is considered the standard prenatal therapy for severe LUTO. Amnioinfusion and vesicoamniotic shunt placement will be performed under ultrasound guidance. Procedure: Fetal vesicoamniotic shunt Fetal vesicoamniotic shunt will be performed under

2015 Clinical Trials

44. Severe midtrimester oligohydramnios: treatment strategies. (Abstract)

Severe midtrimester oligohydramnios: treatment strategies. Nearly 1% of pregnancies are affected by some type of midtrimester oligohydramnios. Evidence is currently accumulating that suggests the better efficacy of the new therapeutic procedures relative to conventional management. This review summarizes the available evidence.The prolongation of the period between the diagnosis of oligohydramnios and delivery following amnioinfusion and amniopatch techniques appears to be strongly associated (...) with the gestational age and whether the situation was based on rupture of the membranes or not. Case series reveal that amnioinfusion significantly improves the perinatal outcome and prolongs the pregnancy in severe second-trimester oligohydramnios in both idiopathic cases and those involving rupture of the amniotic membranes [preterm prelabor rupture of the membranes (PPROM)]. There is clear evidence of a lower frequency of perinatal complications and successfully prolonged gestation in iatrogenic PPROM after

2014 Current Opinion in Obstetrics and Gynecology

45. Successful in utero intervention for bilateral renal agenesis. (Abstract)

Successful in utero intervention for bilateral renal agenesis. We report a case of bilateral renal agenesis treated with serial amnioinfusion in which the newborn survived the newborn period and was able to undergo peritoneal dialysis as a bridge to planned renal transplantation.A 34-year-old woman, gravida 1 para 0, presented at 23 1/7 weeks of gestation with a diagnosis of anhydramnios and bilateral renal agenesis. The patient underwent weekly serial amnioinfusion with the goal of improving (...) fetal pulmonary development. At 28 weeks of gestation, the patient delivered a live newborn who required minimal respiratory support. The neonate is currently 9 months old and is undergoing daily peritoneal dialysis.Serial amnioinfusion appears to have mitigated the severe pulmonary compromise that has, in the past, led to the death of newborns with bilateral renal agenesis.

2014 Obstetrics and Gynecology

46. Premature Rupture of Membranes (Diagnosis)

informed and educated about the risks and the dismal prognosis for the neonate. Delivery is also appropriate when the mother is concerned about her own risks, especially when PPROM has occurred prior to 20 weeks' gestation. Incomplete abortion may be the appropriate term for the condition, as products of conception (the amniotic fluid) have passed the cervical opening and into the vagina in these cases. Other heroic measures such as amnioinfusion, tocolysis, and cervical plug to seal the membranes

2014 eMedicine.com

47. Fetal Growth Restriction (Overview)

, continuous cardiotocography, steroids, maternal oxygen, and/or amnioinfusion and then repeat all testing up to 3 times a day depending on status. Situation 5 See the list below: Test results – IUGR with accelerating compromise, BPS less than or equal to 6, abnormal IVC and DV indices, pulsatile UV flow Interpretation – IUGR with decompensation, cardiovascular instability, hypoxemia certain, acidemia/asphyxia common, high perinatal mortality, death imminent Recommended management – If fetus is considered

2014 eMedicine.com

48. Breech Presentation (Overview)

or back down). [ ] Of those who received acoustic stimulation, 12 of 12 fetuses shifted to a spine-lateral position after acoustic stimulation, and 11 (91%) underwent successful ECV. In the control group, 0 of 11 shifts and 1 (9%) successful ECV ( P < .0001) occurred. Additional studies are needed. Amnioinfusion Although an earlier study reported on the utility of amnioinfusion to successfully turn 6 fetuses who initially failed ECV, [ ] a subsequent study was published of 7 women with failed ECV who (...) underwent amniocentesis and amnioinfusion of up to 1 liter of crystalloid. [ ] Repeat attempts of ECV were unsuccessful in all 7 cases. Amnioinfusion to facilitate ECV cannot be recommended at this time. Vaginal delivery rates after successful version The rate of cesarean delivery ranges from 0-31% after successful external cephalic version (ECV). Controversy has existed on whether there is a higher rate of cesarean delivery for labor dystocia following ECV. In 1994, a retrospective study by Egge et al

2014 eMedicine.com

49. Breech Presentation (Treatment)

or back down). [ ] Of those who received acoustic stimulation, 12 of 12 fetuses shifted to a spine-lateral position after acoustic stimulation, and 11 (91%) underwent successful ECV. In the control group, 0 of 11 shifts and 1 (9%) successful ECV ( P < .0001) occurred. Additional studies are needed. Amnioinfusion Although an earlier study reported on the utility of amnioinfusion to successfully turn 6 fetuses who initially failed ECV, [ ] a subsequent study was published of 7 women with failed ECV who (...) underwent amniocentesis and amnioinfusion of up to 1 liter of crystalloid. [ ] Repeat attempts of ECV were unsuccessful in all 7 cases. Amnioinfusion to facilitate ECV cannot be recommended at this time. Vaginal delivery rates after successful version The rate of cesarean delivery ranges from 0-31% after successful external cephalic version (ECV). Controversy has existed on whether there is a higher rate of cesarean delivery for labor dystocia following ECV. In 1994, a retrospective study by Egge et al

2014 eMedicine.com

50. Fetal Growth Restriction (Treatment)

, continuous cardiotocography, steroids, maternal oxygen, and/or amnioinfusion and then repeat all testing up to 3 times a day depending on status. Situation 5 See the list below: Test results – IUGR with accelerating compromise, BPS less than or equal to 6, abnormal IVC and DV indices, pulsatile UV flow Interpretation – IUGR with decompensation, cardiovascular instability, hypoxemia certain, acidemia/asphyxia common, high perinatal mortality, death imminent Recommended management – If fetus is considered

2014 eMedicine.com

51. Premature Rupture of Membranes (Treatment)

informed and educated about the risks and the dismal prognosis for the neonate. Delivery is also appropriate when the mother is concerned about her own risks, especially when PPROM has occurred prior to 20 weeks' gestation. Incomplete abortion may be the appropriate term for the condition, as products of conception (the amniotic fluid) have passed the cervical opening and into the vagina in these cases. Other heroic measures such as amnioinfusion, tocolysis, and cervical plug to seal the membranes

2014 eMedicine.com

52. Postterm Pregnancy (Treatment)

interventions designed to protect the lungs from the chemical pneumonitis caused by chronic meconium exposure, such as amnioinfusion [ , ] or routine nasopharyngeal suctioning of meconium-stained neonates. [ ] Postterm pregnancy is also an independent risk factor for neonatal encephalopathy [ ] and for death in the first year of life. [ , ] While much of the work above has been conducted in postterm pregnancies. Some of the fetal risks such as presence of meconium, increased risk of neonatal acidemia (...) in utero. Traditionally, saline amnioinfusion and aggressive nasopharyngeal and oropharyngeal suctioning at the perineum were used to decrease the risk of meconium aspiration syndrome. Recent studies contradict this standard practice. Fraser et al performed a prospective, randomized, multicenter study evaluating the risks and benefits of amnioinfusion for the prevention of meconium aspiration syndrome. [ ] They concluded that in clinical settings, which have peripartum surveillance, amnioinfusion

2014 eMedicine.com

53. Premature Rupture of Membranes (Overview)

informed and educated about the risks and the dismal prognosis for the neonate. Delivery is also appropriate when the mother is concerned about her own risks, especially when PPROM has occurred prior to 20 weeks' gestation. Incomplete abortion may be the appropriate term for the condition, as products of conception (the amniotic fluid) have passed the cervical opening and into the vagina in these cases. Other heroic measures such as amnioinfusion, tocolysis, and cervical plug to seal the membranes

2014 eMedicine.com

54. Postterm Pregnancy (Overview)

interventions designed to protect the lungs from the chemical pneumonitis caused by chronic meconium exposure, such as amnioinfusion [ , ] or routine nasopharyngeal suctioning of meconium-stained neonates. [ ] Postterm pregnancy is also an independent risk factor for neonatal encephalopathy [ ] and for death in the first year of life. [ , ] While much of the work above has been conducted in postterm pregnancies. Some of the fetal risks such as presence of meconium, increased risk of neonatal acidemia (...) in utero. Traditionally, saline amnioinfusion and aggressive nasopharyngeal and oropharyngeal suctioning at the perineum were used to decrease the risk of meconium aspiration syndrome. Recent studies contradict this standard practice. Fraser et al performed a prospective, randomized, multicenter study evaluating the risks and benefits of amnioinfusion for the prevention of meconium aspiration syndrome. [ ] They concluded that in clinical settings, which have peripartum surveillance, amnioinfusion

2014 eMedicine.com

55. Postterm Pregnancy (Follow-up)

interventions designed to protect the lungs from the chemical pneumonitis caused by chronic meconium exposure, such as amnioinfusion [ , ] or routine nasopharyngeal suctioning of meconium-stained neonates. [ ] Postterm pregnancy is also an independent risk factor for neonatal encephalopathy [ ] and for death in the first year of life. [ , ] While much of the work above has been conducted in postterm pregnancies. Some of the fetal risks such as presence of meconium, increased risk of neonatal acidemia (...) in utero. Traditionally, saline amnioinfusion and aggressive nasopharyngeal and oropharyngeal suctioning at the perineum were used to decrease the risk of meconium aspiration syndrome. Recent studies contradict this standard practice. Fraser et al performed a prospective, randomized, multicenter study evaluating the risks and benefits of amnioinfusion for the prevention of meconium aspiration syndrome. [ ] They concluded that in clinical settings, which have peripartum surveillance, amnioinfusion

2014 eMedicine.com

56. Premature Rupture of Membranes (Follow-up)

informed and educated about the risks and the dismal prognosis for the neonate. Delivery is also appropriate when the mother is concerned about her own risks, especially when PPROM has occurred prior to 20 weeks' gestation. Incomplete abortion may be the appropriate term for the condition, as products of conception (the amniotic fluid) have passed the cervical opening and into the vagina in these cases. Other heroic measures such as amnioinfusion, tocolysis, and cervical plug to seal the membranes

2014 eMedicine.com

57. Amniotic Fluid Embolism (Overview)

, of 182 patients with AFE, found a strong association between AFE and renal disease, placenta previa, polyhydramnios, placental abruption, and eclampsia and with procedures such as amnioinfusion, classical cesarean delivery, and dilation and curettage. The risk of AFE was also found to rise with maternal age, with the greatest increase occurring after age 39. [ ] Previous Next: Epidemiology United States and international statistics Incidence of amniotic fluid embolism (AFE) is estimated at 1 case per

2014 eMedicine.com

58. Oligohydramnios

may be AFI less than the fifth percentile. Single deepest pocket (SDP) of less than 2 cm Amniotic fluid index (AFI) of less than 5 cm or less than the fifth percentile See the images below. Sonogram obtained before second-trimester amnioinfusion. This fetus has bilaterally absent kidneys consistent with a diagnosis of Potter syndrome. The cystic structures in the renal fossae are most likely the adrenal glands. Sonogram obtained after second-trimester amnioinfusion. This fetus has bilaterally (...) fetal kidneys and fluid-filled bladder may be observed to rule out renal agenesis (see the following 2 images), cystic dysplasia, and ureteral obstruction. Check fetal growth to rule out intrauterine growth restriction (IUGR) leading to oliguria. Sonogram obtained before second-trimester amnioinfusion. This fetus has bilaterally absent kidneys consistent with a diagnosis of Potter syndrome. The cystic structures in the renal fossae are most likely the adrenal glands. Sonogram obtained after second

2014 eMedicine Radiology

59. Breech Presentation (Follow-up)

or back down). [ ] Of those who received acoustic stimulation, 12 of 12 fetuses shifted to a spine-lateral position after acoustic stimulation, and 11 (91%) underwent successful ECV. In the control group, 0 of 11 shifts and 1 (9%) successful ECV ( P < .0001) occurred. Additional studies are needed. Amnioinfusion Although an earlier study reported on the utility of amnioinfusion to successfully turn 6 fetuses who initially failed ECV, [ ] a subsequent study was published of 7 women with failed ECV who (...) underwent amniocentesis and amnioinfusion of up to 1 liter of crystalloid. [ ] Repeat attempts of ECV were unsuccessful in all 7 cases. Amnioinfusion to facilitate ECV cannot be recommended at this time. Vaginal delivery rates after successful version The rate of cesarean delivery ranges from 0-31% after successful external cephalic version (ECV). Controversy has existed on whether there is a higher rate of cesarean delivery for labor dystocia following ECV. In 1994, a retrospective study by Egge et al

2014 eMedicine.com

60. Fetal Growth Restriction (Follow-up)

, continuous cardiotocography, steroids, maternal oxygen, and/or amnioinfusion and then repeat all testing up to 3 times a day depending on status. Situation 5 See the list below: Test results – IUGR with accelerating compromise, BPS less than or equal to 6, abnormal IVC and DV indices, pulsatile UV flow Interpretation – IUGR with decompensation, cardiovascular instability, hypoxemia certain, acidemia/asphyxia common, high perinatal mortality, death imminent Recommended management – If fetus is considered

2014 eMedicine.com

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