Abstract:
:Objectives To identify the probability of survival and severe neurodevelopmental impairment (sNDI) at which perinatal physicians would or would not offer or recommend resuscitation at birth for extremely preterm infants. Methods A Delphi process consisting of five rounds was implemented to seek consensus (>80% agreement) amongst British Columbia perinatal physicians. The first-round consisted of neonatal and maternal-fetal-medicine Focus Groups. Rounds two to five surveyed perinatal physicians, building upon previous rounds. Draft guidelines were developed and agreement sought. Results Based on 401 responses across all rounds, consensus was obtained that resuscitation should not be offered if survival probability <5%, not recommended if survival probability 5 to <10%, resuscitation recommended if survival without sNDI probability >70 to 90% and resuscitation standard care if survival without sNDI >90%. Conclusions This physician consensus-based, objective framework for the management of an anticipated extremely preterm infant is a transparent alternative to existing guidelines, minimizing gestational-ageism and allowing for individualized management utilizing up-to-date data. Further input from other key stakeholders will be required prior to guideline implementation.
journal_name
J Perinat Medjournal_title
Journal of perinatal medicineauthors
Williams N,Synnes A,O'Brien C,Albersheim Sdoi
10.1515/jpm-2019-0444subject
Has Abstractpub_date
2020-09-25 00:00:00pages
751-756issue
7eissn
0300-5577issn
1619-3997pii
/j/jpme.ahead-of-print/jpm-2019-0444/jpm-2019-0444journal_volume
48pub_type
杂志文章abstract::A patient was admitted to the hospital in the 31st week of gestation because of reduced sensation of fetal movements and a pathologic fetal heart rate tracing (Fig. 1). At first no underlying pathology could be found. After a week she developed a polyhydramnios. After repeated ultrasonographic examinations an atresia ...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/jpme.1984.12.6.325
更新日期:1984-01-01 00:00:00
abstract::A new design of vacuum extractor cup--'the New Generation cup'--has recently been introduced into clinical practice. Its major modification is a traction cord which passes around the rim of the cup for 180 degrees and is free to slide within the rim. Claims that this design 'enables the operator to pull obliquely with...
journal_title:Journal of perinatal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1515/jpme.1986.14.2.95
更新日期:1986-01-01 00:00:00
abstract::In preterm infants, feeding with human milk (HM) is a very effective intervention for the prevention of infections and necrotizing enterocolitis (NEC), and for potentially improved neurocognitive and cardiovascular outcomes in the long-term. Hospitals and physicians are advised to recommend HM for preterm and other hi...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章,实务指引
doi:10.1515/jpm.2010.064
更新日期:2010-07-01 00:00:00
abstract::This paper reports two cases of abruptio placentae assessed using pulsed Doppler at 29 and 30 weeks of gestation. Transvaginal pulsed Doppler showed abnormal uterine artery FVWs in both cases. One fetus with normal umbilical and normal middle cerebral artery FVWs was not acidotic and only midly hypoxic, whereas the ot...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/jpme.1994.22.5.441
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVES:Our two objectives were to evaluate the feasibility of fetal brain magnetic resonance imaging (MRI) using a fast spin echo sequence at 3.0T field strength with low radio frequency (rf) energy deposition (as measured by specific absorption rate: SAR) and to compare image quality, tissue contrast and conspicui...
journal_title:Journal of perinatal medicine
pub_type: 临床试验,杂志文章
doi:10.1515/jpm-2014-0268
更新日期:2015-03-01 00:00:00
abstract::In an effort to assess the efficacy of the oral glucose tolerance test to detect patients with gestational diabetes mellitus who require therapeutic measures to maintain normoglycemia, we compared the results of an oral glucose tolerance test with those of a home glucose profile consisting of three postprandial glucos...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/jpme.1989.17.4.253
更新日期:1989-01-01 00:00:00
abstract::In a group of 26 primiparae, 48 hours after cesarean section, we have examined the urinary estriol (E3) and serum cystine aminopeptidase (CAP). 13 patients received ampicillin treatment, and 13 patients did not. In the group of patients without antibiotic treatment the urinary estriol after 48 h reached an average val...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/jpme.1981.9.3.145
更新日期:1981-01-01 00:00:00
abstract::Pre-eclampsia--edema, proteinuria, hypertension (EPH-gestosis) is one of the more common complications observed during pregnancy. The umbilical cord vein walls were taken from newborns delivered by healthy mothers (control material) and by mothers with polysymptomatic pre-eclampsia (investigated material). Normal saph...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/JPM.2000.019
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of atosiban with usual management of threatened preterm labor. METHODS:In this prospective, open-label, randomized controlled trial, women admitted to the hospital in threatened preterm labor (between 24 and 34 weeks' gestation) were randomized to receive atosiban or usual care (beta-...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1515/JPM.2007.078
更新日期:2007-01-01 00:00:00
abstract::Objective To identify socio-cultural and clinician determinants in the decision-making process in the choice for trial of labor after cesarean (TOLAC) or elective repeat cesarean section (ERCS) in delivering women. Methods A tailored questionnaire focused on epidemiological, socio-cultural and obstetric data was admin...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/jpm-2019-0041
更新日期:2019-08-27 00:00:00
abstract::Background Monocytes, after neutrophils, are the most abundant white blood cells found in the amniotic cavity of women with intra-amniotic inflammation/infection. However, the origin of such cells has not been fully investigated. Herein, we determined (1) the origin of amniotic fluid monocytes/macrophages from women w...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/jpm-2019-0262
更新日期:2019-10-25 00:00:00
abstract::The aim of this study was to determine the neonatal outcome in women with well-characterized antiphospholipid syndrome treated during pregnancy with low-dose aspirin. We compared 38 babies born after 36 pregnancies of 33 women diagnosed as having antiphospholipid syndrome with a group of 38 control infants matched for...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/jpme.1997.25.2.192
更新日期:1997-01-01 00:00:00
abstract::A retrospective cohort study on nosocomial infections (NI) in the neonatal intensive care unit (NICU) was performed in the Children's Hospital of Zhejiang University, Hangzhou district, China. The most common infection site was pneumonia and bloodstream infection. Low admission age, long NICU stay, and mechanical vent...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/jpm.2010.063
更新日期:2010-07-01 00:00:00
abstract::Fetal edema was recognized in the past as a complication of alloimmune disease. More recently, fetal edema is frequently seen in conditions that cause non-immune fetal hydrops with increased soft tissue thickness. Classically there is a halo pattern around fetal head, neck, thorax, and abdomen. Fetal edema is associat...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/JPM.2002.013
更新日期:2002-01-01 00:00:00
abstract:AIMS:Psychosocial stress during pregnancy (PSP) is a risk factor of growing interest in the etiology of preterm birth (PTB). This literature review assesses the published evidence concerning the association between PSP and PTB, highlighting established and hypothesized physiological pathways mediating this association....
journal_title:Journal of perinatal medicine
pub_type: 杂志文章,评审
doi:10.1515/jpm-2012-0295
更新日期:2013-11-01 00:00:00
abstract:AIM:To evaluate whether computerized CTG (cCTG) is a reliable method of predicting neonatal outcome in pregnancies complicated by pregestational diabetes at term. PATIENTS AND METHODS:We considered 27 pregnant women affected by pregestational diabetes and 46 normal pregnancies as controls that fulfilled the following ...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/JPM.2004.141
更新日期:2004-01-01 00:00:00
abstract::Objectives Preeclampsia is a hypertensive disorder associated with pregnancy and is the leading cause of both maternal and neonatal morbidity and mortality. Recent reports suggest that free radical-induced endothelial cell injury might be an etiologic factor in the pathogenesis of preeclampsia. The aim of this study w...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/jpm-2019-0469
更新日期:2020-07-28 00:00:00
abstract:OBJECTIVE:To examine trends in twin gestational age over time, with adjustment for potential confounding factors, and to assess twin pair mortality and respiratory support over time. METHODS:Rates of preterm births, respiratory support, and neonatal mortality were calculated for 21,569 twin pairs born from 1980 to 200...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/jpm.2010.020
更新日期:2010-05-01 00:00:00
abstract::Anencephaly in triplets and pergonal induced pregnancies is a very rare incident. Associated cleft lip and palate has never been reported in these case. In this paper we report the first case of an anencephalic infant with cleft lip and palate in a set of pergonal-induced discordant triplet pregnancy. ...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/jpme.1992.20.3.241
更新日期:1992-01-01 00:00:00
abstract::Upper gastrointestinal contrast studies are frequently performed in neonates to rule out conditions such as malrotation. Low osmolality water-soluble (LOWS) contrast media are currently considered safe for use in neonates. The clinical course of a neonate with suspected necrotising enterocolitis, who deteriorated sign...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/JPM.2003.080
更新日期:2003-01-01 00:00:00
abstract::Objective To determine whether the risk of intra-amniotic infection/inflammation and spontaneous preterm delivery (SPTD) varies as a function of the concentration of cervical fetal fibronectin (fFN) in patients with preterm labor and intact membranes. Methods This prospective study included 180 patients with preterm l...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/jpm-2018-0351
更新日期:2019-04-24 00:00:00
abstract::Background Thyroid cancer is one of the most common cancers in women of reproductive age. Our purpose was to evaluate the association between thyroid cancer and maternal and neonatal outcomes of pregnancy. Methods We conducted a retrospective cohort study using the Healthcare Cost and Utilization Project, Nationwide I...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/jpm-2019-0039
更新日期:2019-09-25 00:00:00
abstract::The interest in the limit of viability originated from various sources, including legal requirements, the rejection of mechnical life support, competition for resources, concerns about handicaps, and proximity to the fetus with its limited rights. Gestational age was determined from menstrual history by Hippocratic wr...
journal_title:Journal of perinatal medicine
pub_type: 历史文章,杂志文章
doi:10.1515/jpm.2011.056
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:Group-B Streptococcus has been associated with preterm labor and other pregnancy related complications. This study was performed to evaluate the effect of peptidoglycan polysaccharide (PGPS) derived from a beta hemolytic Streptococcal cell wall on amniochorion cytokine production and to compare PGPS effects w...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/jpme.1998.26.6.442
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:Pregravid maternal weight and appropriate weight gain during pregnancy might be associated with increased cesarean section rate. STUDY DESIGN:We used data from the Slovenian National Perinatal Information System to select singleton pregnancies born at ≥38 weeks, during the period between 2003 and 2012. We ca...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/jpm-2015-0117
更新日期:2016-05-01 00:00:00
abstract::Objectives Recombinant human erythropoietin (rhEPO) has been shown to effectively and safely prevent the anemia of prematurity and to reduce the transfusion need in very low birth weight (VLBW) infants and has been licensed for this indication in Europe in 1997. The objective of the study was to obtain information on ...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/jpm-2020-0070
更新日期:2020-09-25 00:00:00
abstract::The aim of the European Community Multicentre Trial on Fetal ECG Analysis During Labour was to collect a clinical database of electrocardiograms on which the different patterns of ST waveform and time interval changes, so far identified, could be studied. The aim of this paper was to study the PR-RR relationship and t...
journal_title:Journal of perinatal medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1515/jpme.1997.25.1.27
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVE:To compare obstetrical and neonatal outcomes of vaginal deliveries complicated by shoulder dystocia, according to the length of second stage of labor. METHODS:We conducted a retrospective cohort study of 177 shoulder dystocia cases that were divided into three categories according to second stage duration (1...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/jpm-2011-0253
更新日期:2012-03-29 00:00:00
abstract::The diagnostic efficiency in the prediction of intrauterine growth retardation (IUGR) of repeated measurements of the symphysis-fundus (SF) distance and repeated ultrasonic measurements of the biparietal diameter (BPD) was investigated in 377 pregnancies, all at risk for IUGR. Measurements of the SF distance were foun...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/jpme.1985.13.5.227
更新日期:1985-01-01 00:00:00
abstract:UNLABELLED:Congenital cystic adenomatoid lung malformation (CCAM) is a rare disorder characterized by replacement of normal pulmonary tissue with cysts of variable size and distribution. Only sporadic cases of CCAM type III have been described that were stillborn or died in the early neonatal period. To our best knowle...
journal_title:Journal of perinatal medicine
pub_type: 杂志文章
doi:10.1515/JPM.2002.068
更新日期:2002-01-01 00:00:00