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Pregnancy Risk Assessment

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1. MRI during pregnancy: the pros and cons should be carefully assessed

MRI during pregnancy: the pros and cons should be carefully assessed Prescrire IN ENGLISH - Spotlight ''MRI during pregnancy: the pros and cons should be carefully assessed'', 1 February 2019 {1} {1} {1} | | > > > MRI during pregnancy: the pros and cons should be carefully assessed Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight MRI during (...) pregnancy: the pros and cons should be carefully assessed Before deciding to give a pregnant woman an MRI scan, with or without contrast agents, it is important to consider how the MRI results would change the clinical course. MRI, or magnetic resonance imaging, uses powerful electromagnetic fields that make tissues hot. In a study of 1500 children who had been exposed to MRI (without injection of a contrast agent) in the first trimester of pregnancy, vascular, digestive, musculoskeletal and auditory

2019 Prescrire

2. Support during pregnancy for women at increased risk of low birthweight babies. (PubMed)

Support during pregnancy for women at increased risk of low birthweight babies. Studies consistently show a relationship between social disadvantage and low birthweight. Many countries have programmes offering special assistance to women thought to be at risk for giving birth to a low birthweight infant. These programmes, collectively referred to in this review as additional social support, may include emotional support, which gives a person a feeling of being loved and cared for, tangible (...) , instrumental/tangible and informational) compared with routine care, for pregnant women believed to be at high risk for giving birth to babies that are either preterm (less than 37 weeks' gestation) or weigh less than 2500 g, or both, at birth. Secondary objectives were to determine whether the effectiveness of support was mediated by timing of onset (early versus later in pregnancy) or type of provider (healthcare professional or lay person).For this update, we searched Cochrane Pregnancy and Childbirth's

2019 Cochrane

3. Prenatal Management of Pregnancies at Risk of Fetal Neonatal Alloimmune Thrombocytopenia (FNAIT)

Prenatal Management of Pregnancies at Risk of Fetal Neonatal Alloimmune Thrombocytopenia (FNAIT) Prenatal Management of Pregnancies at Risk of Fetal Neonatal Alloimmune Thrombocytopenia (FNAIT) - Regan - - BJOG: An International Journal of Obstetrics & Gynaecology - Wiley Online Library By continuing to browse this site, you agree to its use of cookies as described in our . Search within Search term Search term RCOG Scientific Impact Paper Free Access Prenatal Management of Pregnancies (...) , and as a consequence, reduced use of invasive fetal testing and fetal blood sampling (FBS). There is very little high quality evidence on which to base management of this condition, but advances in treatment report very good outcomes. Severe FNAIT is very rare, adverse consequences for the fetus are potentially disastrous and the treatments are costly. This document considers the latest evidence in relation to treatment options in the prenatal management of pregnancies at risk of FNAIT; specifically, the role

2019 Royal College of Obstetricians and Gynaecologists

4. Ultrasonographic Cervical Length Assessment in Predicting Preterm Birth in Singleton Pregnancies

of cervical length. If repeat measurements are performed, they should be done at suitable intervals to minimize the likelihood of observation error (II-2). 3. Transvaginal sonography can be used to assess the risk of preterm birth in women with a history of spontaneous preterm birth and to differentiate those at higher and lower risk of preterm delivery. The gestational age of a prior preterm birth affects the cervical length in a future pregnancy (II–2). 4. Cervical length measurement can be used (...) Ultrasonographic Cervical Length Assessment in Predicting Preterm Birth in Singleton Pregnancies No. 257-Ultrasonographic Cervical Length Assessment in Predicting Preterm Birth in Singleton Pregnancies - Journal of Obstetrics and Gynaecology Canada Email/Username: Password: Remember me Search Terms Search within Search Volume 40, Issue 2, Pages e151–e164 No. 257-Ultrasonographic Cervical Length Assessment in Predicting Preterm Birth in Singleton Pregnancies x Kenneth Lim , MD Vancouver, BC x

2018 Society of Obstetricians and Gynaecologists of Canada

5. Assessing the risk factors before pregnancy of preterm births in Iran: a population-based case-control study. (PubMed)

Assessing the risk factors before pregnancy of preterm births in Iran: a population-based case-control study. Preterm birth is a major cause of prenatal and postnatal mortality particularly in developing countries. This study investigated the maternal risk factors associated with the risk of preterm birth.A population-based case-control study was conducted in several provinces of Iran on 2463 mothers referred to health care centers. Appropriate descriptive and analytical statistical methods (...) were used to evaluate the association between maternal risk factors and the risk of preterm birth. All tests were two-sided, and P values < 0.05 were considered to be statistically significant.The mean gestational age was 31.5 ± 4.03 vs. 38.8 ± 1.06 weeks in the case and control groups, respectively. Multivariate regression analysis showed a statistically significant association between preterm birth and mother's age and ethnicity. Women of Balooch ethnicity and age ≥ 35 years were significantly

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2019 BMC Pregnancy and Childbirth

6. Disparities in Preconception Health Indicators — 
Behavioral Risk Factor Surveillance System, 2013–2015, and Pregnancy Risk Assessment Monitoring System, 2013–2014 (PubMed)

Disparities in Preconception Health Indicators — 
Behavioral Risk Factor Surveillance System, 2013–2015, and Pregnancy Risk Assessment Monitoring System, 2013–2014 Preconception health is a broad term that encompasses the overall health of nonpregnant women during their reproductive years (defined here as aged 18-44 years). Improvement of both birth outcomes and the woman's health occurs when preconception health is optimized. Improving preconception health before and between (...) . The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing U.S. state- and population-based surveillance system administered collaboratively by CDC and state health departments. PRAMS is designed to monitor selected maternal behaviors, conditions, and experiences that occur before, during, and shortly after pregnancy that are self-reported by women who recently delivered a live-born infant. This report summarizes BRFSS and PRAMS data on nine of 10 prioritized preconception health indicators (i.e

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2018 MMWR Surveillance Summaries

7. Fetal and umbilical Doppler ultrasound in high-risk pregnancies. (PubMed)

Fetal and umbilical Doppler ultrasound in high-risk pregnancies. Abnormal blood flow patterns in fetal circulation detected by Doppler ultrasound may indicate poor fetal prognosis. It is also possible that false positive Doppler ultrasound findings could lead to adverse outcomes from unnecessary interventions, including preterm delivery.The objective of this review was to assess the effects of Doppler ultrasound used to assess fetal well-being in high-risk pregnancies on obstetric care (...) and fetal outcomes.We updated the search of Cochrane Pregnancy and Childbirth's Trials Register on 31 March 2017 and checked reference lists of retrieved studies.Randomised and quasi-randomised controlled trials of Doppler ultrasound for the investigation of umbilical and fetal vessels waveforms in high-risk pregnancies compared with no Doppler ultrasound. Cluster-randomised trials were eligible for inclusion but none were identified.Two review authors independently assessed the studies for inclusion

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2017 Cochrane

8. Can risk factors, clinical history and symptoms be used to predict risk of ectopic pregnancy in women attending an early pregnancy assessment unit? (PubMed)

Can risk factors, clinical history and symptoms be used to predict risk of ectopic pregnancy in women attending an early pregnancy assessment unit? To examine whether risk factors and symptoms may be used to predict the likelihood of ectopic pregnancy (EP) in women attending early pregnancy assessment units in the UK.This was an observational cohort study of pregnant women under 12 weeks' gestation who were recruited from three London university hospitals between August 2012 and April 2013. One (...) in the previous 24 h, two had EP.Only the presence of pelvic pain, diarrhea > three times in the previous 24 h and duration of bleeding were symptoms that significantly increased the risk for EP in women attending early pregnancy assessment units. Risk factors and symptoms alone could not be used to predict reliably an EP. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

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2016 Ultrasound in Obstetrics and Gynecology

10. Use of secondary contraception following vasectomy: insights from the Pregnancy Risk Assessment Monitoring System, 2007–2011 (PubMed)

Use of secondary contraception following vasectomy: insights from the Pregnancy Risk Assessment Monitoring System, 2007–2011 To assess postpartum use of secondary contraception with vasectomy within Pregnancy Risk Assessment Monitoring System (PRAMS).Secondary contraception and type of method used were assessed among married women reporting partner vasectomy 4 months after a recent live birth in female residents of 15 US states and New York City who participated in the 2007-2011 PRAMS.Between (...) , and, of those who did, most relied on less effective methods. Clinicians need to better understand reasons for limited use of secondary contraception with vasectomy to improve counseling strategies for reducing unintended pregnancy.

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2018 Translational andrology and urology

11. Trophoblast retrieval and isolation from the cervix: origins of cervical trophoblasts and their potential value for risk assessment of ongoing pregnancies. (PubMed)

Trophoblast retrieval and isolation from the cervix: origins of cervical trophoblasts and their potential value for risk assessment of ongoing pregnancies. Early during human development, the trophoblast lineage differentiates to commence placentation. Where the placenta contacts the uterine decidua, extravillous trophoblast (EVT) cells differentiate and invade maternal tissues. EVT cells, identified by expression of HLA-G, invade into uterine blood vessels (endovascular EVT), as well as glands (...) trophoblast cells after TRIC correlates with subsequent pregnancy loss, pre-eclampsia and fetal growth restriction. A key remaining question is the degree to which EVT cells in the cervix might differ from those in the basal plate and placental bed.TRIC could one day provide a method of risk assessment for maternal and fetal disease, and reveal molecular pathways disrupted during the first trimester in EVT cells associated with placental maldevelopment. As perinatal interventions emerge for pregnancy

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2018 Human Reproduction Update

12. Antenatal non-medical risk assessment and care pathways to improve pregnancy outcomes: a cluster randomised controlled trial (PubMed)

Antenatal non-medical risk assessment and care pathways to improve pregnancy outcomes: a cluster randomised controlled trial Social deprivation negatively affects health outcomes but receives little attention in obstetric risk selection. We investigated whether a combination of (1) risk assessment focused on non-medical risk factors, lifestyle factors, and medical risk factors, with (2) subsequent institution of risk-specific care pathways, and (3) multidisciplinary consultation between care (...) of threatening preterm delivery and fetal growth restriction during pregnancy [aOR 1.27 (95% CI 1.01-1.61)]. Implementation of additional non-medical risk assessment and preventive strategies into general practices is feasible but did not decrease the incidence of preterm and/or SGA birth in the index pregnancy in deprived urban areas.Trial registration Netherlands National Trial Register (NTR-3367).

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2018 European journal of epidemiology

13. The Pregnancy Risk Assessment Monitoring System (PRAMS): Overview of Design and Methodology. (PubMed)

The Pregnancy Risk Assessment Monitoring System (PRAMS): Overview of Design and Methodology. Data System. The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing state-based surveillance system of maternal behaviors, attitudes, and experiences before, during, and shortly after pregnancy. PRAMS is conducted by the Centers for Disease Control and Prevention's Division of Reproductive Health in collaboration with state health departments. Data Collection/Processing. Birth certificate

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2018 American Journal of Public Health

14. Women from racial or ethnic minority and low socioeconomic backgrounds receive more prenatal education: Results from the 2012 to 2014 Pregnancy Risk Assessment Monitoring System. (PubMed)

Women from racial or ethnic minority and low socioeconomic backgrounds receive more prenatal education: Results from the 2012 to 2014 Pregnancy Risk Assessment Monitoring System. Racial or ethnic and socioeconomic disparities in adverse birth outcomes are well known, but few studies have examined disparities in the receipt of prenatal health education. The objectives of this study were to examine racial or ethnic and socioeconomic variations in receiving (1) comprehensive prenatal health (...) education and (2) education about human immunodeficiency virus (HIV) testing, breastfeeding, alcohol, and smoking cessation from health care practitioners.Data were drawn from the 2012 to 2014 Pregnancy Risk Assessment Monitoring System (PRAMS). Twenty-seven states were included with an analysis sample size of 68 025 participants. Receiving counseling on all listed health topics during prenatal care visits was denoted as comprehensive prenatal health education. Logistic regression was used to examine

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2018 Birth

15. Preconception risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease. (PubMed)

Preconception risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease. Globally, about five per cent of children are born with congenital or genetic disorders. The most common autosomal recessive conditions are thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease, with higher carrier rates in specific patient populations. Identifying and counselling couples at genetic risk of the conditions before pregnancy enables them to make fully (...) informed reproductive decisions, with some of these choices not being available if genetic counselling is only offered in an antenatal setting. This is an update of a previously published review.To assess the effectiveness of systematic preconception genetic risk assessment to improve reproductive outcomes in women and their partners who are identified as carriers of thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease in healthcare settings when compared to usual care.We searched

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2018 Cochrane

16. Topiramate use early in pregnancy and the risk of oral clefts: A pregnancy cohort study

Topiramate use early in pregnancy and the risk of oral clefts: A pregnancy cohort study To assess the relative risk of oral clefts associated with maternal use of high and low doses of topiramate during the first trimester for epilepsy and nonepilepsy indications.This population-based study nested in the US 2000-2010 Medicaid Analytic eXtract included a cohort of 1,360,101 pregnant women with a live-born infant enrolled in Medicaid from 3 months before conception through 1 month after delivery (...) was 200 mg for women with epilepsy and 100 mg for women without epilepsy. For topiramate monotherapy, the RR for oral clefts associated with doses ≤100 mg was 1.64 (95% CI 0.53-5.07) and for doses >100 mg it was 5.16 (95% CI 1.94-13.73). Results were similar when lamotrigine was used as a reference group.The increased risk of oral clefts associated with use of topiramate early in pregnancy was more pronounced in women with epilepsy, who used higher doses.Copyright © 2017 American Academy of Neurology.

2018 EvidenceUpdates

17. Associations of mid-pregnancy HbA1c with gestational diabetes and risk of adverse pregnancy outcomes in high-risk Taiwanese women. (PubMed)

Associations of mid-pregnancy HbA1c with gestational diabetes and risk of adverse pregnancy outcomes in high-risk Taiwanese women. The objective of this study was to investigate the associations among the mid-pregnancy glycated hemoglobin A1c (HbA1c) level, gestational diabetes (GDM), and risk of adverse pregnancy outcomes in women without overt diabetes and with positive 50-g, 1-h glucose challenge test (GCT) results (140 mg/dL or greater).This prospective study enrolled 1,989 pregnant (...) Taiwanese women. A two-step approach, including a 50-g, 1-h GCT and 100-g, 3-h oral glucose tolerance test (OGTT), was employed for the diagnosis of GDM at weeks 23-32. The mid-pregnancy HbA1c level was measured at the time the OGTT was performed. A receiver operating characteristic (ROC) curve was used to determine the relationship between the mid-pregnancy HbA1c level and GDM. Multiple logistic regression models were implemented to assess the relationships between the mid-pregnancy HbA1c level

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2017 PLoS ONE

18. Patterns of Health Insurance Coverage Around the Time of Pregnancy Among Women With Live-Born Infants—Pregnancy Risk Assessment Monitoring System, 29 States, 2009 (PubMed)

Patterns of Health Insurance Coverage Around the Time of Pregnancy Among Women With Live-Born Infants—Pregnancy Risk Assessment Monitoring System, 29 States, 2009 26959274 2016 07 26 2016 04 06 1541-0048 106 4 2016 Apr American journal of public health Am J Public Health Patterns of Health Insurance Coverage Around the Time of Pregnancy Among Women With Live-Born Infants--Pregnancy Risk Assessment Monitoring System, 29 States, 2009. e1-2 10.2105/AJPH.2016.303133 eng News United States Am J (...) Public Health 1254074 0090-0036 AIM IM Adolescent Adult Female Humans Infant, Newborn Insurance Coverage statistics & numerical data Insurance, Health statistics & numerical data Maternal-Child Health Services Medicaid statistics & numerical data Medically Uninsured statistics & numerical data Population Surveillance Pregnancy Risk Assessment United States Young Adult 2016 3 10 6 0 2016 3 10 6 0 2016 7 28 6 0 ppublish 26959274 10.2105/AJPH.2016.303133 PMC4816026

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2016 American Journal of Public Health

19. Pre-pregnancy obesity and non-adherence to multivitamin use: findings from the National Pregnancy Risk Assessment Monitoring System (2009-2011). (PubMed)

Pre-pregnancy obesity and non-adherence to multivitamin use: findings from the National Pregnancy Risk Assessment Monitoring System (2009-2011). Although adequate folic acid or multivitamins can prevent up to 70 % of neural tube defects, the majority of U.S. non-pregnant women of childbearing age do not use multivitamins every day. Factors influencing consistent multivitamin use are not fully explored. This study aims to investigate the association between pre-pregnancy body mass index (BMI (...) ) and multivitamin use before pregnancy using a large, nationally representative sample of women with recent live births.The national 2009-2011 Pregnancy Risk Assessment Monitoring System data were analyzed. The sample included women with recent singleton live births (N = 104,211). The outcome of interest was multivitamin use which was categorized as no multivitamin use, 1-3 times/week, 4-6 times/week, and daily use. Maternal BMI was examined as underweight (<18.50 kg/m(2)), normal weight (18.50-24.99 kg/m(2

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2016 BMC Pregnancy and Childbirth

20. Donor eggs may be linked to higher risk of pregnancy complications following IVF

Donor eggs may be linked to higher risk of pregnancy complications following IVF Donor eggs may be linked to higher risk of pregnancy complications following IVF Discover Portal Discover Portal Donor eggs may be linked to higher risk of pregnancy complications following IVF Published on 26 May 2016 doi: Women who use donor eggs in their IVF may have significantly higher rates of pregnancy complications than those who use their own eggs, a systematic review and meta-analysis has found. Use (...) of donor eggs was linked to up to four times the risk of developing high blood pressure in pregnancy. Other risks associated with donor eggs were low birth weight in the baby, caesarean section and premature delivery. It is always possible that other factors, such as the age of women who use donor eggs, may have influenced the study results. Advanced maternal age is itself associated with pregnancy complications, including high blood pressure. Nevertheless it seems likely from this research that donor

2019 NIHR Dissemination Centre

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