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Sample records for prenatal record revision

  1. Provincial prenatal record revision: a multiple case study of evidence-based decision-making at the population-policy level.

    PubMed

    Edwards, Nancy; Semenic, Sonia; Premji, Shahirose; Montgomery, Phyllis; Williams, Beverly; Olson, Joanne; Mansi, Omaima

    2008-12-19

    There is a significant gap in the knowledge translation literature related to how research evidence actually contributes to health care decision-making. Decisions around what care to provide at the population (rather than individual) level are particularly complex, involving considerations such as feasibility, cost, and population needs in addition to scientific evidence. One example of decision-making at this "population-policy" level involves what screening questions and intervention guides to include on standardized provincial prenatal records. As mandatory medical reporting forms, prenatal records are potentially powerful vehicles for promoting population-wide evidence-based care. However, the extent to which Canadian prenatal records reflect best-practice recommendations for the assessment of well-known risk factors such as maternal smoking and alcohol consumption varies markedly across Canadian provinces and territories. The goal of this study is to better understand the interaction of contextual factors and research evidence on decision-making at the population-policy level, by examining the processes by which provincial prenatal records are reviewed and revised. Guided by Dobrow et al.'s (2004) conceptual model for context-based evidence-based decision-making, this study will use a multiple case study design with embedded units of analysis to examine contextual factors influencing the prenatal record revision process in different Canadian provinces and territories. Data will be collected using multiple methods to construct detailed case descriptions for each province/territory. Using qualitative data analysis techniques, decision-making processes involving prenatal record content specifically related to maternal smoking and alcohol use will be compared both within and across each case, to identify key contextual factors influencing the uptake and application of research evidence by prenatal record review committees. All study participants will be required

  2. NRC comprehensive records disposition schedule. Revision 3

    SciTech Connect

    1998-02-01

    Title 44 US Code, ``Public Printing and Documents,`` regulations issued by the General Service Administration (GSA) in 41 CFR Chapter 101, Subchapter B, ``Management and Use of Information and Records,`` and regulations issued by the National Archives and Records Administration (NARA) in 36 CFR Chapter 12, Subchapter B, ``Records Management,`` require each agency to prepare and issue a comprehensive records disposition schedule that contains the NARA approved records disposition schedules for records unique to the agency and contains the NARA`s General Records Schedules for records common to several or all agencies. The approved records disposition schedules specify the appropriate duration of retention and the final disposition for records created or maintained by the NRC. NUREG-0910, Rev. 3, contains ``NRC`s Comprehensive Records Disposition Schedule,`` and the original authorized approved citation numbers issued by NARA. Rev. 3 incorporates NARA approved changes and additions to the NRC schedules that have been implemented since the last revision dated March, 1992, reflects recent organizational changes implemented at the NRC, and includes the latest version of NARA`s General Records Schedule (dated August 1995).

  3. Adapting the revised prenatal coping inventory (NuPCI) for use in a Spanish population.

    PubMed

    Lorén-Guerrero, L; Gascón-Catalán, A; Romero-Cardiel, M A

    2017-04-19

    To adapt the Revised Prenatal Coping Inventory (NuPCI) for the evaluation of prenatal stress coping strategies utilised by Spanish women. A cross-sectional study was performed to evaluate the psychometric properties of NuPCI adapted for a Spanish population. Two hundred and sixty one puerperium women completed the NuPCI at the time of discharge after childbirth. Instrument construct validity was evaluated using subscale item correlations. Internal consistency was assessed using Cronbach's α test. Items from each subscale (Preparation, Avoidance and Spiritual - Positive Coping) were significantly correlated with the global result (p < .001). The internal reliability of the NuPCI demonstrated suitable values for each of the three coping strategies (α > 0.7). The most frequently used coping strategy was Preparation and the least used was Avoidance. Utilisation of the coping strategies with Preparation decreased with increasing parity (p = .002) and greater prenatal stress was associated with increased use of the Avoidance coping strategy (p < .001). The NuPCI adapted for Spanish women demonstrates good psychometric properties for evaluating the three types of prenatal stress coping strategies: Preparation, Avoidance and Spiritual - Positive Coping. Results were similar to those presented by the instrument in its English language version.

  4. Agricultural Education General Record Book. Revised.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Agricultural Curriculum Materials Service.

    This document is the basic record book in a multi-booklet record keeping system for all students in each of the taxonomy program areas of agricultural education. The record book covers elements common to all agricultural education students: occupational and leadership goal planning, net worth, market value inventory of assets, leadership and…

  5. Effectiveness of the Revised Ontario School Record System.

    ERIC Educational Resources Information Center

    Humphreys, Edward H.; Elwood, Bryan C.

    Results of a study conducted for the Ministry of Education (Ontario) and designed to evaluate the effectiveness of the Ontario School Record System (OSR) as revised in 1973 are reported in this paper. In order to evaluate the OSR's effectiveness, the study team examined educators', parents and students' perceived needs for student information,…

  6. The Best of "The Running Record." Revised Edition.

    ERIC Educational Resources Information Center

    Reading Recovery Council of North America, Columbus, OH.

    This revised edition of the first volume of the "Best of the Running Record Newsletter" contains 23 articles published between March 1989 and Spring 1998--some selections are from the now out-of-print first edition. Articles are arranged by subject matter to assist the reader in finding articles which address a particular point of…

  7. 77 FR 15835 - Privacy Act of 1974: Revision of Privacy Act System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-16

    ... ADMINISTRATION Privacy Act of 1974: Revision of Privacy Act System of Records AGENCY: Small Business Administration (SBA). ACTION: Notice of Revision of Privacy Act Systems of Records. SUMMARY: SBA is revising the Privacy Act Systems of Records for the Loan System, SBA 21 (``SOR 21'') and the Suspension and...

  8. [Pregnant Cards information and medical records of primary care on prenatal care].

    PubMed

    Polgliani, Rúbia Bastos Soares; Dos Santos Neto, Edson Theodoro; Zandonade, Eliana

    2014-06-01

    To determine the agreement between the information on pregnant cards and on primary care medical records about prenatal assistance in the city of Vitória, Espírito Santo, Brazil. A population study of 360 puerperal women living in this city was interviewed at three hospitals where the cards were copied. Prenatal care data were collected by reviewing the medical records at the city health unit. The information was collected, processed, and submitted to Kappa, Adjusted Kappa, and McNemar tests to check agreement and tendency to disagreement between the cards and the medical records. The levels of agreement within prenatal care were predominantly moderate (Kappa=0.4-0.6). There was a higher tendency to keep records of appointments on the cards (McNemar=22.3; p-value<0.01). Records of supplementation with folic acid and ferrous sulphate were kept more often on the medical records (McNemar=70.8 and 69.8, respectively; p-value<0.01). The tetanus vaccination coverage was about 50%. Clinical and obstetric procedures and laboratory tests were primarily recorded on the card. The medical records of primary care were underused as a tool for communication among health professionals, highlighting a precarious record keeping. The results suggest that thought be given to guarantee that the minimum procedures established by the Guidelines of Maternal and Infant Health are followed, and also to the importance of clinical record keeping in health services, since there is variation depending on the source of information.

  9. Relationship between Revised Graduated Index (R-GINDEX) of prenatal care utilization & preterm labor and low birth weight.

    PubMed

    Tayebi, Tahereh; Hamzehgardeshi, Zeinab; Ahmad Shirvani, Marjan; Dayhimi, Marjaneh; Danesh, Mahmonir

    2014-02-28

    Prenatal care refers to accurate and consistent performance of the principles important to maintain healthy pregnancy outcomes and also for mother and child health. One of the new indices to assess the adequacy of care is Revised Graduated Index of Prenatal Care Utilization (R-GINDEX).The study aims to assess the relationship between quantitative prenatal care factors and preterm labor and low birth weight using R-GINDEX. This historical cohort study has been conducted on 420 mothers during the first two years after delivery in 2010. The adequacy of care was calculated by R-GINDEX. Based on this index, participants have been divided into three care groups including inadequate, adequate and intensive care groups. A significant relationship has been found between R-GINDEX and preterm birth and low birth weight (P<0.05). Thus the probability of premature labor in inadequate care group (RR=3.93) and low birth weight (RR= 2.53) was higher than that of the adequate and intensive care group. The results showed that the quantity of prenatal care is effective in reducing preterm birth and low birth weight.

  10. 300 Area Treated Effluent Disposal Facility computer software release cover sheet and revision record

    SciTech Connect

    McCarthy, R.J.

    1994-11-28

    This supporting document contains the computer software release cover sheet and revision records for the 300 Area Treated Effluent Disposal Facility (TEDF). The previous revision was controlled by CH2M Hill which developed the software. A 7-page listing of the contents of directory C:{backslash}TEDF is contained in this report.

  11. Medical records and women's self-report are not reliable sources for determining whether prenatal HIV testing was done.

    PubMed

    Yudin, Mark H; Barbara, Angela M; Guenter, Dale; Shaul, Randi Zlotnik; Remis, Robert S; King, Susan M

    2006-10-01

    To determine whether medical records and the self-report of a postpartum patient provide reliable information about whether or not prenatal HIV testing has been done. Women on the postpartum wards at three Toronto teaching hospitals who gave informed consent were included in the study. The presence or absence of prenatal HIV testing was determined by interviews with postpartum women, review of hospital charts, and search of the Public Health Provincial Laboratory and Prenatal Testing databases. Two hundred ninety-nine women were enrolled. All had had at least one prenatal visit, and 92% had copies of prenatal records in their hospital charts. Health records and patient reports were both unreliable for determining who had and who had not had HIV testing. HIV status was documented on 55% of the charts; on 46% it was noted that testing was performed, and on 46% there was documentation of pre& or post&test counselling. In interviews, 73% of the women reported having an HIV test during this pregnancy. Using the laboratory databases as the gold standard of whether testing had truly been done, medical record sensitivity and specificity were 65% and 62% respectively, and self-report sensitivity and specificity were 87% and 52% respectively. Using medical records resulted in an underestimation and self-reports an overestimation of the number of women who had been tested. Both medical records and patient self-report are unreliable at the time of labour and delivery for determining whether or not a woman has been tested for HIV in pregnancy. Clinical and public health decisions may therefore be compromised by a lack of accurate testing information at the bedside.

  12. 75 FR 8731 - Privacy Act of 1974, as Amended; Revisions to the Existing System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-25

    ... Office of the Secretary Privacy Act of 1974, as Amended; Revisions to the Existing System of Records... Privacy Act System of Records Notice in its inventory of records systems subject to the Privacy Act of...) database and related files, as well as add their system owner and system location to the existing...

  13. Prenatal Care.

    ERIC Educational Resources Information Center

    Office of Child Development (DHEW), Washington, DC.

    Initially published by the Children's Bureau in 1913, this pamphlet has been revised frequently. Its purpose is to point out the importance of medical care during pregnancy. Comfortable pregnancies, easy labor, and better care for their new infants are the usual concerns of prospective mothers. Consequently, this 1962 edition of "Prenatal Care"…

  14. The Factor Structure and Psychometric Properties of the Persian Version of the Revised Prenatal Coping Inventory (Nu-PCI).

    PubMed

    Faramarzi, Mahbobeh; Pasha, Hajar; Khafri, Sorayya; Heidary, Shima

    2017-03-01

    Familiarity with coping strategies is essential for stress management during pregnancy. The Revised Prenatal Coping Inventory (Nu-PCI) was developed to assess coping strategies during pregnancy. This study aimed to assess the factor structure and psychometric properties of the Persian version of the Nu-PCI. After forward-backward translation, the Nu-PCI was administered to 210 pregnant women who were enrolled in two teaching referral clinics in the North of the Islamic Republic of Iran (Babol). The participants completed the Persian Nu-PCI and Ways of Coping Questionnaire (WCQ), which was used to determine the validity of the Persian Nu-PCI. To test construct validity of the Persian Nu-PCI, a principal components factor analysis was performed. Principal components analysis with varimax rotation showed a best fitting 3-factor structure similar to the original with three coping subscales: planning-preparation, avoidance, and spiritual-positive coping. The Persian Nu-PCI was internally consistent and within the acceptable range (α=0.89-0.97). The alpha coefficients for the Nu-PCI and the subscales of planning-preparation, avoidance, and spiritual-positive coping were high. Test-retest coefficients for the Nu-PCI and subscales were 0.98-0.99. The Nu-PCI and its subscales correlated with the WCQ in the entire sample and within each trimester. The Persian version of the Nu-PCI and the subscales of planning-preparation, avoidance, and spiritual-positive coping represent the first reliable standardized tool for measuring coping strategies during pregnancy in the Islamic Republic of Iran. Therefore, it can be applied as a quick and accurate preliminary screening tool for evaluating coping strategies throughout pregnancy in clinics and other medical and research settings.

  15. 75 FR 81205 - Privacy Act: Revision of Privacy Act Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-27

    ... biometric technology may be used; such a system will release information only to authorized individuals... for verification and computer matching purposes. (9) FNS will disclose information from these systems... Office of the Secretary Privacy Act: Revision of Privacy Act Systems of Records AGENCY: Office of the...

  16. 78 FR 65884 - 2014 Edition Electronic Health Record Certification Criteria: Revision to the Definition of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary 45 CFR Part 170 RIN 0991-AB91 2014 Edition Electronic Health Record Certification Criteria: Revision to the Definition of ``Common Meaningful Use (MU) Data...

  17. The Early Cretaceous Sulfur Isotope Record: New Data, Revised Ages, and Updated Modeling

    NASA Astrophysics Data System (ADS)

    Kristall, B.; Hurtgen, M.; Sageman, B. B.; Jacobson, A. D.

    2015-12-01

    The Early Cretaceous is a time of significant transformation with the continued break-up of Pangea, the emplacement of several LIPs, and a climatic shift from a cool greenhouse to a warm greenhouse. The timing of these major events and their relationship to seawater geochemistry (as recorded in isotope records) is critical for understanding changes in global biogeochemical cycles during this time. Within this context, recent revisions to the Cretaceous portion of the geologic timescale necessitate a reevaluation of the Cretaceous S isotope record as recorded in marine barite (Paytan et al., 2004). We present a revised Early Cretaceous S isotope record and present new δ34Sbarite data that extend the record further back in time and provide more detail during two major S isotope shifts of the Early Cretaceous. The new data maintain the major ~5‰ negative shift but raise questions on the timing and structure of this perturbation. Furthermore, recently updated estimates for global rates of marine microbial sulfate reduction (MSR) (Bowles et al., 2014) and sulfate burial during the Phanerozoic (Halevy et al., 2012) require notable revisions in the fluxes and isotopic values used to model the global S cycle. We present a revised global S cycle box model and reconstruct the evolution of the Early Cretaceous S isotope record primarily through perturbations in volcanic and hydrothermal fluxes (e.g., submarine LIPs). Changes to the weathering and pyrite burial fluxes and the global integrated fractionation factor for MSR are also used to modulate, balance, and smooth the LIP-driven perturbation. The massive evaporite burial during the Late Aptian post dates the major -5‰ shift and has little affect on the modeled S isotope composition of seawater sulfate, despite causing a major drop in sulfate concentration. The S cycle box model is coupled to a Sr cycle box model to provide additional constraints on the magnitude and timing of perturbations within the S isotope record.

  18. A revised checklist of the mosquitoes of Guatemala including a new country record, Psorophora cyanescens.

    PubMed

    Darsie, R F

    1994-12-01

    A newly erected genus, Isostomyia, a recently described subgenus, Phenacomyia, of Culex, and 15 species have been added to the mosquito fauna of Guatemala since the last checklist was published by Clark-Gil and Darsie (1983); therefore a revised list is included. One of the additions is Psorophora cyanescens, a new country record for Guatemala. Its presence in Mexico and Central America is reviewed.

  19. The Impact of the Revised Sunspot Record on Solar Irradiance Reconstructions

    NASA Astrophysics Data System (ADS)

    Kopp, G.; Krivova, N.; Wu, C. J.; Lean, J.

    2016-11-01

    Reliable historical records of the total solar irradiance (TSI) are needed to assess the extent to which long-term variations in the Sun's radiant energy that is incident upon Earth may exacerbate (or mitigate) the more dominant warming in recent centuries that is due to increasing concentrations of greenhouse gases. We investigate the effects that the new Sunspot Index and Long-term Solar Observations (SILSO) sunspot-number time series may have on model reconstructions of the TSI. In contemporary TSI records, variations on timescales longer than about a day are dominated by the opposing effects of sunspot darkening and facular brightening. These two surface magnetic features, retrieved either from direct observations or from solar-activity proxies, are combined in TSI models to reproduce the current TSI observational record. Indices that manifest solar-surface magnetic activity, in particular the sunspot-number record, then enable reconstructing historical TSI. Revisions of the sunspot-number record therefore affect the magnitude and temporal structure of TSI variability on centennial timescales according to the model reconstruction methods that are employed. We estimate the effects of the new SILSO record on two widely used TSI reconstructions, namely the NRLTSI2 and the SATIRE models. We find that the SILSO record has little effect on either model after 1885, but leads to solar-cycle fluctuations with greater amplitude in the TSI reconstructions prior. This suggests that many eighteenth- and nineteenth-century cycles could be similar in amplitude to those of the current Modern Maximum. TSI records based on the revised sunspot data do not suggest a significant change in Maunder Minimum TSI values, and from comparing this era to the present, we find only very small potential differences in the estimated solar contributions to the climate with this new sunspot record.

  20. Record of Technical Change - Corrective Action Plan for Corrective Action Unit 204: Storage Bunkers, Nevada Test Site, Nevada, Revision 0

    SciTech Connect

    U.S. Department of Energy, National Nuclear Security Administration, Nevada Site Office; Bechtel Nevada

    2005-04-13

    Record of Technical Change, Technical Change No. CAP-1, dated April 13, 2005 for Corrective Action Plan for Corrective Action Unit 204: Storage Bunkers, Nevada Test Site, Nevada, Revision 0, September 2004, DOE/NV--1003.

  1. Pregnancy Outcome following Prenatal Diagnosis of Chromosomal Anomaly: A Record Linkage Study of 26,261 Pregnancies.

    PubMed

    Jacobs, Myrthe; Cooper, Sally-Ann; McGowan, Ruth; Nelson, Scott M; Pell, Jill P

    2016-01-01

    Previous studies have demonstrated the influence of changes in the age at which women give birth, and of developments in prenatal screening and diagnosis on the number of pregnancies diagnosed and terminated with chromosomal anomalies. However, we are unaware of any population studies examining pregnancy terminations after diagnosis of chromosomal anomalies that has included all aneuploidies and the influence of maternal factors. The aims of this study were to examine the association between results of prenatal tests and pregnancy termination, and the proportion of foetuses with and without chromosomal anomalies referred for invasive diagnostic tests over time. Diagnostic information of 26,261 prenatal invasive tests from all genetic service laboratories in Scotland from 2000 to 2011 was linked to Scottish Morbidity Records to obtain details on pregnancy outcome. Binary logistic regression was carried out to test the associations of year and type of diagnosis with pregnancy termination, while controlling for maternal age, neighbourhood deprivation and parity. There were 24,155 (92.0%) with no chromosomal anomalies, 1,483 (5.6%) aneuploidy diagnoses, and 623 (2.4%) diagnoses of anomaly that was not aneuploidy (including translocations and single chromosome deletions). In comparison with negative test results, pregnancies diagnosed with trisomy were most likely to be terminated (adjusted OR 437.40, 95% CI 348.19-549.46) followed by other aneuploid anomalies (adjusted OR 95.94, 95% CI 69.21-133.01). During the study period, fewer pregnancies that were diagnosed with aneuploidy were terminated, including trisomy diagnoses (adjusted OR 0.44, 95% CI 0.26-0.73). Older women were less likely to terminate (OR 0.35, 95% CI 0.28, 0.42), and parity was also an independent predictor of termination. In keeping with previous findings, while the number of invasive diagnostic tests declined, the proportion of abnormal results increased from 6.09% to 10.88%. Systematic advances in

  2. Pregnancy Outcome following Prenatal Diagnosis of Chromosomal Anomaly: A Record Linkage Study of 26,261 Pregnancies

    PubMed Central

    Cooper, Sally-Ann; McGowan, Ruth; Nelson, Scott M.; Pell, Jill P.

    2016-01-01

    Previous studies have demonstrated the influence of changes in the age at which women give birth, and of developments in prenatal screening and diagnosis on the number of pregnancies diagnosed and terminated with chromosomal anomalies. However, we are unaware of any population studies examining pregnancy terminations after diagnosis of chromosomal anomalies that has included all aneuploidies and the influence of maternal factors. The aims of this study were to examine the association between results of prenatal tests and pregnancy termination, and the proportion of foetuses with and without chromosomal anomalies referred for invasive diagnostic tests over time. Diagnostic information of 26,261 prenatal invasive tests from all genetic service laboratories in Scotland from 2000 to 2011 was linked to Scottish Morbidity Records to obtain details on pregnancy outcome. Binary logistic regression was carried out to test the associations of year and type of diagnosis with pregnancy termination, while controlling for maternal age, neighbourhood deprivation and parity. There were 24,155 (92.0%) with no chromosomal anomalies, 1,483 (5.6%) aneuploidy diagnoses, and 623 (2.4%) diagnoses of anomaly that was not aneuploidy (including translocations and single chromosome deletions). In comparison with negative test results, pregnancies diagnosed with trisomy were most likely to be terminated (adjusted OR 437.40, 95% CI 348.19–549.46) followed by other aneuploid anomalies (adjusted OR 95.94, 95% CI 69.21–133.01). During the study period, fewer pregnancies that were diagnosed with aneuploidy were terminated, including trisomy diagnoses (adjusted OR 0.44, 95% CI 0.26–0.73). Older women were less likely to terminate (OR 0.35, 95% CI 0.28, 0.42), and parity was also an independent predictor of termination. In keeping with previous findings, while the number of invasive diagnostic tests declined, the proportion of abnormal results increased from 6.09% to 10.88%. Systematic

  3. Revising.

    ERIC Educational Resources Information Center

    Wyman, Linda, Ed.

    1983-01-01

    In focusing on recursive writing, the nine articles in this journal issue suggest that student writing should be taken seriously. The first article states that revision should occur throughout the writing process while the second discusses how to invite writers to become active readers of their own texts. The third article presents methods of…

  4. [Precariousness of records of prenatal care in a basic health unit in the city of Ribeirao Preto-SP].

    PubMed

    do Oba M das, D; Tavares, M S

    1998-01-01

    This survey aimed at characterizing the population of pregnant women utilizing prenatal care services of a Basic Health Unit in the city of Ribeirão Preto, São Paulo, Brazil in July 1995 and analyzing the records of the service given to pregnant women who went to this Unit in terms of general and specific anamnesis, general and tocogynecological physical examination and the diagnostic procedures used in this service. The records showed a lack of information about patients' general and specific anamnesis, general and tocogynecological physical examination and clinical condition, characterizing a more ritualistic procedure. Therefore, records did not meet the objectives proposed by the Program for Comprehensive Women Health Care of the Ribeirão Preto City Health Department with the São Paulo State Health Department and the Health Ministry: to ensure good quality in women's care service regarding their clinical, gynecological, obstetric and mental needs; to identify, prevent, and control risk factors which may affect women's health; to diagnose and treat women's pathologies as soon as possible, among others.

  5. Contribution of maternal radionuclide burdens to prenatal radiation doses: Relationships between annual limits on intake and prenatal doses. Revision 1, Addendum 1

    SciTech Connect

    Sikov, M.R.; Hui, T.E.

    1993-10-01

    This addendum describes approaches for calculating and expressing radiation doses to the embryo/fetus from maternal intakes of radionuclides at levels corresponding to fractions or multiples of the Annual Limits on Intake (ALI). Information, concerning metabolic or dosimetric characteristics and the placental transfer of selected, occupationally significant radionuclides was presented in NUREG/CR-5631, Revision 1. That information was used to estimate levels of radioactivity in the embryo/fetus as a function of stage of pregnancy and time after entry. Extension of MIRD methodology to accommodate gestational-stage-dependent characteristics allowed dose calculations for the simplified situation based on introduction of 1 {mu}Ci into the woman`s transfer compartment (blood). The expanded scenarios in this addendum include repeated or chronic ingestion or inhalation intakes by a woman during pregnancy and body burdens at the beginning of pregnancy. Tables present dose equivalent to the embryo/fetus relative to intakes of these radionuclides in various chemical or physical forms and from preexisting maternal burdens corresponding to ALI; complementary intake values (fraction of an ALI and {mu}Ci) that yield a dose equivalent of 0.05 rem are included. Similar tables give these measures of dose equivalency to the uterus from intakes of radionuclides for use as surrogates for embryo/fetus dose when biokinetic information is not available.

  6. 76 FR 66950 - Privacy Act; Notice of Revision of System of Records, the Single Family Housing Enterprise Data...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ... URBAN DEVELOPMENT Privacy Act; Notice of Revision of System of Records, the Single Family Housing... Federal Register about one of its record systems, the Single Family Housing Enterprise Data Warehouse... (202) 402-8087 or Mary Jo Sullivan, System Owner, Director, Office of Single Family Program...

  7. Revised estimates of the risk of fetal loss following a prenatal diagnosis of trisomy 13 or trisomy 18.

    PubMed

    Cavadino, Alana; Morris, Joan K

    2017-04-01

    Edwards syndrome (trisomy 18) and Patau syndrome (trisomy 13) both have high natural fetal loss rates. The aim of this study was to provide estimates of these fetal loss rates by single gestational week of age using data from the National Down Syndrome Cytogenetic Register. Data from all pregnancies with Edwards or Patau syndrome that were prenatally detected in England and Wales from 2004 to 2014 was analyzed using Kaplan-Meier survival estimates. Pregnancies were entered into the analysis at the time of gestation at diagnosis, and were considered "under observation" until the gestation at outcome. There were 4088 prenatal diagnoses of trisomy 18 and 1471 of trisomy 13 in the analysis. For trisomy 18, 30% (95%CI: 25-34%) of viable fetuses at 12 weeks will result in a live birth and at 39 weeks gestation 67% (60-73%) will result in a live birth. For trisomy 13 the survival is 50% (41-58%) at 12 weeks and 84% (73-90%) at 39 weeks. There was no significant difference in survival between males and females when diagnosed at 12 weeks for trisomy 18 (P-value = 0.27) or trisomy 13 (P-value = 0.47). This paper provides the most precise gestational age-specific estimates currently available for the risk of fetal loss in trisomy 13 and trisomy 18 pregnancies in a general population. © 2017 Wiley Periodicals, Inc.

  8. The Impact of the Revised Sunspot Record on Solar Irradiance Reconstructions

    NASA Astrophysics Data System (ADS)

    Kopp, G.; Krivova, N.; Lean, J.; Wu, C. J.

    2015-12-01

    We describe the expected effects of the new sunspot number time series on proxy model based reconstructions of the total solar irradiance (TSI), which is largely explained by the opposing effects of dark sunspots and bright faculae. Regressions of indices for facular brightening and sunspot darkening with time series of direct TSI observations during the recent 37-year spacecraft TSI measurement era determine the relative contributions from each. Historical TSI reconstructions are enabled by extending these proxy models back in time prior to the start of the measurement record using a variety of solar activity indices including the sunspot number time series alone prior to 1882. Such reconstructions are critical for Earth climate research, which requires knowledge of the incident energy from the Sun to assess climate sensitivity to the natural influence of solar variability. Two prominent TSI reconstructions that utilize the sunspot record starting in 1610 are the NRLTSI and the SATIRE models. We review the indices that each currently uses and estimate the effects the revised sunspot record has on these reconstructions.

  9. [Record of the role given to members of the psychological professions in the French Multidisciplinary Prenatal Diagnosis Centers (CPDPN)].

    PubMed

    Abdel-Hamid, N; Frin, G; Flandrin, A; Boulot, P

    2015-01-01

    Create a record of the role given to members of the psychological professions in CPDPN Centers (multidisciplinary prenatal diagnosis). After more than 10 years in operation, describe the work methods of the different centers and their members, evaluate the possible diversity of practices and clarify the scope of interventions used by psychologists with patients and members of the CPDPN. A descriptive survey consisting of 71 questions sent to psychologists, paediatricians and psychiatrists involved with the 48 CPDPN Centers in France. The main parameters studied are the means used by the CPDPN and their organization in the field of psychology, pre-medical counseling for the termination of pregnancy (IMG), conditions of hospitalization and post-IMG counseling. The survey revealed a high-level of homogeneous practices in the French CPDPN Centers between members of the medical and psychological professions, through joint consultations, ethical committees or specific case meetings for complex fetal pathologies. This study has established a working relationship between members of the psychological professions working in the French CPDPN Centers and has led to the creation of a listing/directory, which facilitates the exchange of information. Video-conferencing is currently being considered in order to share respective practices. Copyright © 2014. Published by Elsevier Masson SAS.

  10. Occupational injury and illness recording and reporting requirements--NAICS update and reporting revisions. Final rule.

    PubMed

    2014-09-18

    OSHA is issuing a final rule to update the appendix to its Injury and Illness Recording and Reporting regulation. The appendix contains a list of industries that are partially exempt from requirements to keep records of work-related injuries and illnesses due to relatively low occupational injury and illness rates. The updated appendix is based on more recent injury and illness data and lists industry groups classified by the North American Industry Classification System (NAICS). The current appendix lists industries classified by Standard Industrial Classification (SIC). The final rule also revises the requirements for reporting work-related fatality, injury, and illness information to OSHA. The current regulation requires employers to report work-related fatalities and in-patient hospitalizations of three or more employees within eight hours of the event. The final rule retains the requirement for employers to report work-related fatalities to OSHA within eight hours of the event but amends the regulation to require employers to report all work-related in-patient hospitalizations, as well as amputations and losses of an eye, to OSHA within 24 hours of the event.

  11. Keeping the Business Records. PACE Revised. Level 3. Unit 15. Research & Development Series No. 240CB15.

    ERIC Educational Resources Information Center

    Ashmore, M. Catherine; Pritz, Sandra G.

    This individualized, competency-based unit on keeping business records, the 15th of 18 modules, is on the third level of the revised Program for Acquiring Competence in Entrepreneurship (PACE). Intended for the advanced secondary and postsecondary levels and for adults wanting training or retraining, this unit, together with the other materials at…

  12. Revised Record of Decision for the Electrical Interconnection of the Summit/Westward Project

    SciTech Connect

    N /A

    2004-10-21

    The Bonneville Power Administration (BPA) has decided to amend its July 25, 2003, Record of Decision (ROD) regarding the proposed Summit/Westward Project (Project) to offer contract terms for an optional interconnection of this Project into the Federal Columbia River Transmission System (FCRTS). Under this optional interconnection plan, BPA would integrate electric power from the Project into the FCRTS at a point adjacent to Clatskanie People's Utility District (CPUD) existing Wauna Substation. In order to deliver power to this location, CPUD would develop a new substation (Bradbury Substation) at a site near the Project and a new 230-kV transmission line from there to CPUD's Wauna Substation, which is already connected to the FCRTS. As part of this revised decision, BPA will facilitate CPUD development of the Bradbury-Wauna transmission line by allowing joint use of BPA right-of-way. This will involve reconstructing a section of BPA's 115-kV Allston-Astoria No. 1 transmission line from single-circuit H-frame wood-pole design to double-circuit single metal pole design. Terms of BPA participation in CPUD's development of the Bradbury-Wauna transmission line will be documented in a Construction Agreement. This optional interconnection plan is in addition to BPA's previous offer for interconnection of the Project at BPA's Allston Substation, as documented in the July 25, 2003, ROD. As with the initial interconnection plan, the decision to offer terms to interconnect the Project through the optional interconnection plan is consistent with BPA's Business Plan Final Environmental Impact Statement (BP EIS) (DOE/EIS-0183, June 1995), and the Business Plan Record of Decision (BP ROD, August 1995). This decision thus is similarly tiered to the Business Plan ROD.

  13. Revised estimates of atmospheric CO/sub 2/ variations based on the tree ring /sup 13/C record

    SciTech Connect

    Peng, T.H.; Freyer, H.D.

    1983-01-01

    The composite mean /sup 13/C record for the Northern Hemisphere was revised. The overall decrease of delta /sup 13/C from 1800 to 1980 was estimated to be about -1.5/sup 0///sub 00/, which is 0.5/sup 0///sub 00/ less than the previous estimate. Therefore, the contribution of /sup 13/C-depleted CO/sub 2/ to the atmosphere from the forest and soil source was reevaluated, using the modified box-diffusion ocean model and Freyer's revised /sup 13/C record. On the basis of the assumption that this revised tree ring /sup 13/C record represents changes in the /sup 13/C//sup 12/C ratio induced in atmospheric CO/sub 2/ due to deforestation and soil manipulation and combustion of fossil fuels, the following results are obtained: (1) the magnitude of the integrated CO/sub 2/ release from the terrestrial biosphere since 1800 is about 90% of that from fossil fuel; (2) over the two-decade period covered by the Mauna Loa atmospheric CO/sub 2/ record, the input from the forest plus soil source is about 15% of that from fossil fuels; (3) the /sup 13/C//sup 12/C trend over the last two decades has been dominated by the input of fossil fuel CO/sub 2/; and (4) the pre-1850 atmospheric CO/sub 2/ content is estimated to be about 266 x 10/sup -6/ atm. 15 references, 5 figures, 1 table.

  14. Copyright Information: Record Maintenace and Retention Procedures; Revised Interlibrary Loan Form

    ERIC Educational Resources Information Center

    Catholic Library World, 1978

    1978-01-01

    Procedures are discussed for the creation, use, and retention of a form for interlibrary loans which meets the requirements of the new copyright laws. A facsimile of the revised interlibrary loan form is included. (MBR)

  15. Revision of the Afrotropical Mayrellinae (Cynipoidea, Liopteridae), with the first record of Paramblynotus from Madagascar

    USDA-ARS?s Scientific Manuscript database

    The genus Paramblynotus Cameron from the Afrotropical region is revised including the description of the following eight new species: Paramblynotus alexandriensis Buffington & van Noort sp. nov.; Paramblynotus bayangensis van Noort & Buffington sp. nov.; Paramblynotus behara van Noort & Buffington s...

  16. Revision and Validation of the Individual Child Engagement Record: A Practitioner-Friendly Measure of Learning Opportunities for Children with Disabilities in Early Childhood Settings

    ERIC Educational Resources Information Center

    Kishida, Yuriko; Kemp, Coral; Carter, Mark

    2008-01-01

    Background: The purpose of this study was to revise and validate the "Individual Child Engagement Record" (ICER), an instrument designed to observe and measure the engagement of children with disabilities in early childhood settings. Method: The ICER was revised with reference to pilot study results and the literature. Inter-observer…

  17. Revision and Validation of the Individual Child Engagement Record: A Practitioner-Friendly Measure of Learning Opportunities for Children with Disabilities in Early Childhood Settings

    ERIC Educational Resources Information Center

    Kishida, Yuriko; Kemp, Coral; Carter, Mark

    2008-01-01

    Background: The purpose of this study was to revise and validate the "Individual Child Engagement Record" (ICER), an instrument designed to observe and measure the engagement of children with disabilities in early childhood settings. Method: The ICER was revised with reference to pilot study results and the literature. Inter-observer…

  18. A revised atmospheric δ13C-CO2 record covering the last 1000 years from Law Dome, Antarctica

    NASA Astrophysics Data System (ADS)

    Rubino, M.; Etheridge, D. M.; Trudinger, C. M.; Allison, C.; Battle, M. O.; Bender, M. L.; Langenfelds, R.; Steele, P.; Curran, M.; Blunier, T.; Jenk, T. M.; Francey, R.

    2012-12-01

    We present a revised and expanded record of atmospheric δ13C-CO2 extracted from ice cores sampled at Law Dome (East Antarctica) and firn air sampled at Law Dome and at South Pole covering the last 1000 years. We have performed new measurements of 13C of CO2 extracted from ice, incorporated the results from new firn sampling campaigns in Antarctica and merged them with a revised version of the previous δ13C-CO2 measurements [Francey et al., 1999]. Our new measurements from Law Dome ice increase the temporal sampling density over the last 200 years and show good agreement with the results from South Pole firn, providing evidence that our new record reliably extend the Cape Grim δ13C-CO2 record back in time. We also show the preliminary measurements aimed at covering the preindustrial period with higher sample density, including the 10 ppm CO2 decrease observed in ice from Law Dome at the beginning of 1600 AD [Etheridge et al., 1996, MacFarling Meure et al., 2006]. Having higher sample density for both CO2 and δ13C-CO2 in that period allows us to infer sources and sinks of CO2 with higher confidence. Corresponding author: Mauro Rubino, mauro.rubino@csiro.au, +61(0)392394634 References Etheridge, D. et al. (1996), ISSN: 01480227. MacFarling Meure, C. et al. (2006), DOI: 10.1029/2006GL026152. Francey, R. J. et al. (1999), ISSN: 02806509.

  19. Effectiveness of Revised Pharmacology Record Books as a Teaching-Learning Method for Second Year Medical Students

    PubMed Central

    Gangadhar, Reneega

    2016-01-01

    Introduction The goal of teaching medical undergraduates Pharmacology is to form a sound foundation of therapeutics. The pharmacology record books are maintained as a part of the curriculum. The purpose of this study was to obtain feedback of the medical students about the new record adopted in the institution after major revision Materials and Methods This was a questionnaire based study done in a Government Medical College of Kerala in February 2013. The data was analysed using SPSS. The feedback on clinical pharmacology exercises was given positive and negative scores. Results Majority (64.5%) opined that the content in pharmacology record was good. A total of 78.1% completed the record during discussions in practical classes. Majority wrote the records for understanding pharmacology. For 79.8% General Pharmacology exercises were most relevant, 33.8% considered Clinical Pharmacology exercises to be the most thought provoking. Drug use in special groups received the maximum positive score. Conclusion The new improved pharmacology record is an effective teaching-learning method. Inclusion of more clinically oriented exercises has increased the interest of the students in the subject. PMID:26894083

  20. Prenatal parenting.

    PubMed

    Glover, Vivette; Capron, Lauren

    2017-06-01

    Parenting begins before birth. This includes prenatal maternal and paternal bonding with the baby, and biological effects on fetal development. Recent research has confirmed how prenatal maternal stress can alter the development of the fetus and the child, and that this can persist until early adulthood. Children are affected in different ways depending, in part, on their own genetic makeup. The fetus may also have a direct effect on prenatal maternal mood and later parenting behaviour via the placenta. The father is important prenatally too. An abusive partner can increase the mother's prenatal stress and alter fetal development, but he can also be an important source of emotional support. New research suggests the potential benefits of prenatal interventions, including viewing of prenatal scans and cognitive behavioural therapy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. School Administration Handbook for Approved Schools for Medical Record Technicians. Revised April 66.

    ERIC Educational Resources Information Center

    American Association of Medical Record Librarians, Chicago, IL.

    These guidelines are for the development and operation of approved programs to prepare medical record technicians. "School Approval" discusses the cooperative roles of the American Medical Association (AMA) Council on Medical Education and the American Association of Medical Record Librarians (AAMRL) in connection with program approval,…

  2. 76 FR 62035 - Privacy Act of 1974: Notice of Proposed Privacy Act System of Records Revision

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-06

    ... of a system of records that is maintained for the purpose of the Radiation Safety Management System (RSMS). The RSMS was developed by the Radiation Safety Division, a component of USDA's DM, as a tool for the management of the USDA's radiation safety information and records. The RSMS is an online,...

  3. 78 FR 20108 - Privacy Act of 1974; Notice of Revised System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-03

    ... to ensure that they are relevant, necessary, accurate, up-to-date, and covered by the appropriate legal or regulatory authority. This notice is an updated Privacy Act system of records notice. DATES... reviewed this Privacy Act system of records notice to ensure that it is relevant, necessary, accurate,...

  4. Reliability of Reported Maternal Smoking: Comparing the Birth Certificate to Maternal Worksheets and Prenatal and Hospital Medical Records, New York City and Vermont, 2009.

    PubMed

    Howland, Renata E; Mulready-Ward, Candace; Madsen, Ann M; Sackoff, Judith; Nyland-Funke, Michael; Bombard, Jennifer M; Tong, Van T

    2015-09-01

    Maternal smoking is captured on the 2003 US Standard Birth Certificate based on self-reported tobacco use before and during pregnancy collected on post-delivery maternal worksheets. Study objectives were to compare smoking reported on the birth certificate to maternal worksheets and prenatal and hospital medical records. The authors analyzed a sample of New York City (NYC) and Vermont women (n = 1,037) with a live birth from January to August 2009 whose responses to the Pregnancy Risk Assessment Monitoring System survey were linked with birth certificates and abstracted medical records and maternal worksheets. We calculated smoking prevalence and agreement (kappa) between sources overall and by maternal and hospital characteristics. Smoking before and during pregnancy was 13.7 and 10.4% using birth certificates, 15.2 and 10.7% using maternal worksheets, 18.1 and 14.1% using medical records, and 20.5 and 15.0% using either maternal worksheets or medical records. Birth certificates had "almost perfect" agreement with maternal worksheets for smoking before and during pregnancy (κ = 0.92 and 0.89) and "substantial" agreement with medical records (κ = 0.70 and 0.74), with variation by education, insurance, and parity. Smoking information on NYC and Vermont birth certificates closely agreed with maternal worksheets but was underestimated compared with medical records, with variation by select maternal characteristics. Opportunities exist to improve birth certificate smoking data, such as reducing the stigma of smoking, and improving the collection, transcription, and source of information.

  5. Reliability of Reported Maternal Smoking: Comparing the Birth Certificate to Maternal Worksheets and Prenatal and Hospital Medical Records, New York City and Vermont, 2009

    PubMed Central

    Mulready-Ward, Candace; Madsen, Ann M.; Sackoff, Judith; Nyland-Funke, Michael; Bombard, Jennifer M.; Tong, Van T.

    2015-01-01

    Maternal smoking is captured on the 2003 US Standard Birth Certificate based on self-reported tobacco use before and during pregnancy collected on post-delivery maternal worksheets. Study objectives were to compare smoking reported on the birth certificate to maternal worksheets and prenatal and hospital medical records. The authors analyzed a sample of New York City (NYC) and Vermont women (n = 1,037) with a live birth from January to August 2009 whose responses to the Pregnancy Risk Assessment Monitoring System survey were linked with birth certificates and abstracted medical records and maternal worksheets. We calculated smoking prevalence and agreement (kappa) between sources overall and by maternal and hospital characteristics. Smoking before and during pregnancy was 13.7 and 10.4 % using birth certificates, 15.2 and 10.7 % using maternal worksheets, 18.1 and 14.1 % using medical records, and 20.5 and 15.0 % using either maternal worksheets or medical records. Birth certificates had “almost perfect” agreement with maternal worksheets for smoking before and during pregnancy (κ = 0.92 and 0.89) and “substantial” agreement with medical records (κ = 0.70 and 0.74), with variation by education, insurance, and parity. Smoking information on NYC and Vermont birth certificates closely agreed with maternal worksheets but was underestimated compared with medical records, with variation by select maternal characteristics. Opportunities exist to improve birth certificate smoking data, such as reducing the stigma of smoking, and improving the collection, transcription, and source of information. PMID:25676044

  6. Revision of Myxobolus heterosporus Baker, 1963 (syn. Myxosoma Heterospora) (Myxozoa: Myxosporea) in African records.

    PubMed

    el-Mansy, A

    2005-02-28

    There is uncertainty regarding the validity of Myxobolus heterosporus Baker, 1963. The present study revises the taxonomy, using specimens isolated from plasmodia situated in the infected cornea of Oreochromis aureus, O. niloticus or Tilapia zillii inhabiting the River Nile, Egypt. In addition, histological effects of the parasite on the infected tissue were examined. The spores of M. heterosporus had a variety of shapes expressing remarkable heteromorphism. Five main Myxobolus-like spore types and tailed-spores were found. All forms were photographed, measured, sketched and described. Light and electron microscopy supported that spores of a Myxobolus-like morphology co-existed with so-called tailed-spores in one plasmodium. Some transitional stages from Myxobolus-like spore types to tailed-spores were observed. Therefore, some tailed-spores may be simply heteromorphs of Myxobolus.

  7. 77 FR 62059 - Privacy Act of 1974, as Amended; Revisions to Existing Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-11

    ... located in a second office, e.g., an administrative office closer to where the employee actually works... address, home telephone number, and specialized education. Records reflect Federal service and work... system consist of attorney work product or attorney-client communications, 5 U.S.C. 552a(d)(5) may...

  8. 77 FR 29596 - Privacy Act of 1974; Revision and Republication of Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-18

    ...-4, Hotline Database System location: Systems Integration Incorporated, 8201 Corporate Drive, Suite... social security number (when used as business tax ID), home address, and home telephone number when these... with the employee's government duties and responsibilities. Routine uses of records maintained in the...

  9. The Technique of the Sound Studio: Radio, Record Production, Television, and Film. Revised Edition.

    ERIC Educational Resources Information Center

    Nisbett, Alec

    Detailed explanations of the studio techniques used in radio, record, television, and film sound production are presented in as non-technical language as possible. An introductory chapter discusses the physics and physiology of sound. Subsequent chapters detail standards for sound control in the studio; explain the planning and routine of a sound…

  10. 75 FR 43709 - Privacy Act of 1974; New and Revised Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-26

    ... Regulatory Affairs, Office of Management and Budget (OMB). ADDRESSES: Send comments to Beatrice Ezerski... Employee Personnel Management Files RRB-35 RRB-36 Complaint, Grievance, Disciplinary and Adverse Action... Security Files RRB-47 RRB-48 Physical Access Management System RRB-49 Telephone Call Detail Records...

  11. Supervised Occupational Experience Record Forms for Ornamental Horticulture. (Revised) Master Set. 1974.

    ERIC Educational Resources Information Center

    Harrison, R. W.; And Others

    The worksheets have been developed for use with any production occupational or work experience record book for high school vocational agriculture programs. Separate units have been developed for each of 11 areas in ornamental horticulture, so the student and teacher can select the appropriate one, or several, for the experiences planned by the…

  12. Project Records Information System (PRIS) user`s manual. Revision 2

    SciTech Connect

    Schwarz, R.K.; Cline, B.E.; Smith, P.S.

    1993-10-01

    The Project Records Information System (PRIS) is an interactive system developed for the Information Services Division (ISD) of Martin Marietta Energy Systems, Inc., to perform indexing, maintenance, and retrieval of information about Engineering project record documents for which they are responsible. This PRIS User`s Manual provides instruction on the use of this system. Section 2.0 of this manual presents an overview of PRIS, describing the system`s purpose; the data that it handles; functions it performs; hardware, software, and access; and help and error functions. Section 3.0 describes the interactive menu-driven operation of PRIS. Appendixes A, B, and C contain help screens, report descriptions, and the data dictionary, respectively.

  13. Revision of the Afrotropical Lycorininae (Ichneumonidae; Hymenoptera) II. Three new Lycorina species and additional distribution records.

    PubMed

    Rousse, P; Van Noort, S

    2014-11-14

    Three new Afrotropical Lycorina species are described: L. horstmanni sp. nov., L. jacksonfive sp. nov. and L. riftensis sp. nov. The description of L. globiceps is expanded to include the large variability of the colour pattern. New distribution records are provided for L. fici and L. globiceps. An illustrated dichotomous key, and an online interactive matrix key available on www.waspweb.org, are provided for the identification of the seven known Afrotropical Lycorininae species.

  14. Taxonomic Changes, Revised Occurrence Records and Notes on the Culicidae of Thailand and Neighboring Countries

    DTIC Science & Technology

    1990-12-01

    the distribution of Aedes albopictus. Mosq. Syst. 5:225-226. Darsie , R.F., Jr . and S.P. Pradhan. 1990. The mosquitoes of Nepal: Their identification...History Museum (NHM), London, we are DECEMBER 1990 here elevating nilgiricus Christopher< to species status. Recently, Darsie and Pradhan (1990...although it occurs in southern Thailand and south- ern Myanmar (Reid 1965). Recently, Darsie and Pradhan (1990) recorded fragilis from Nepal based on

  15. New and revised palaeomagnetic secular variation records from post-glacial volcanic materials in New Zealand

    NASA Astrophysics Data System (ADS)

    Greve, Annika; Turner, Gillian M.

    2017-08-01

    Global databases suffer from a paucity of palaeomagnetic secular variation (PSV) data from the SW Pacific region and are often affected by inconsistencies in data quality, or available age control of the sampled units. Here we present new PSV records obtained from post-glacial (≤15 kyrs BP) volcanic materials (mainly lavas) from New Zealand. The new dataset incorporates a compilation and critical assessment of all previous discrete PSV data and their age controls, and the results of new sampling in the Taupo Volcanic Zone. The overall dataset includes 23 directional and 10 absolute palaeointensity records primarily from lavas of rhyolitic or andesitic composition. Age constraints on the rhyolitic lavas are available from correlation with distal, radiocarbon dated tephra deposits, age controls on the andesites from field relationships or from 40Ar/39Ar dating. Directional swings, ranging from 326.5° to 26.0° declination and -81.4 to -46.3° inclination and intensity variations from 37.0 to 71.6 μT, fall well into the range of PSV expected for this time-frame in New Zealand and reproduce features of continuous sediment records.

  16. A revised 1000 year atmospheric δ13C-CO2 record from Law Dome and South Pole, Antarctica

    NASA Astrophysics Data System (ADS)

    Rubino, M.; Etheridge, D. M.; Trudinger, C. M.; Allison, C. E.; Battle, M. O.; Langenfelds, R. L.; Steele, L. P.; Curran, M.; Bender, M.; White, J. W. C.; Jenk, T. M.; Blunier, T.; Francey, R. J.

    2013-08-01

    We present new measurements of δ13C of CO2 extracted from a high-resolution ice core from Law Dome (East Antarctica), together with firn measurements performed at Law Dome and South Pole, covering the last 150 years. Our analysis is motivated by the need to better understand the role and feedback of the carbon (C) cycle in climate change, by advances in measurement methods, and by apparent anomalies when comparing ice core and firn air δ13C records from Law Dome and South Pole. We demonstrate improved consistency between Law Dome ice, South Pole firn, and the Cape Grim (Tasmania) atmospheric δ13C data, providing evidence that our new record reliably extends direct atmospheric measurements back in time. We also show a revised version of early δ13C measurements covering the last 1000 years, with a mean preindustrial level of -6.50‰. Finally, we use a Kalman Filter Double Deconvolution to infer net natural CO2 fluxes between atmosphere, ocean, and land, which cause small δ13C deviations from the predominant anthropogenically induced δ13C decrease. The main features found from the previous δ13C record are confirmed, including the ocean as the dominant cause for the 1940 A.D. CO2 leveling. Our new record provides a solid basis for future investigation of the causes of decadal to centennial variations of the preindustrial atmospheric CO2 concentration. Those causes are of potential significance for predicting future CO2 levels and when attempting atmospheric verification of recent and future global carbon emission mitigation measures through Coupled Climate Carbon Cycle Models.

  17. Prenatal Care

    MedlinePlus

    ... many problems and prevent others. Your doctor or midwife will give you a schedule for your prenatal ... diabetes or high blood pressure, your doctor or midwife will probably want to see you more often. ...

  18. Health information technology: revisions to the 2014 edition electronic health record certification criteria; and Medicare and Medicaid programs; revisions to the Electronic Health Record Incentive Program. Interim final rule with comment period.

    PubMed

    2012-12-07

    The Department of Health and Human Services (HHS) is issuing this interim final rule with comment period to replace the Data Element Catalog (DEC) standard and the Quality Reporting Document Architecture (QRDA) Category III standard adopted in the final rule published on September 4, 2012 in the Federal Register with updated versions of those standards. This interim final rule with comment period also revises the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs by adding an alternative measure for the Stage 2 meaningful use (MU) objective for hospitals to provide structured electronic laboratory results to ambulatory providers, correcting the regulation text for the measures associated with the objective for hospitals to provide patients the ability to view online, download, and transmit information about a hospital admission, and making the case number threshold exemption for clinical quality measure (CQM) reporting applicable for eligible hospitals and critical access hospitals (CAHs) beginning with FY 2013. This rule also provides notice of CMS's intention to issue technical corrections to the electronic specifications for CQMs released on October 25, 2012.

  19. New leafhopper species of Jikradia from Mesoamerica with new records, revised key to species, distribution, origin, and checklist (Hemiptera: Cicadellidae: Coelidiinae: Teruliini).

    PubMed

    Nielson, Mervin W; Zack, Richard S; Poggi, Francesco; Nickel, Herbert

    2014-12-01

    The following four new species of leafhoppers are described and illustrated: Jikradia dentata n. sp. and J. trispinata n. sp. from Guatemala, J. variabilis n. sp. from Belize, and J. exilis n. sp. from Costa Rica. Jikradia basipendula Nielson and J. krameri Nielson are new records for Guatemala. Belize is a new record for the genus. A record of the first introduction of the genus in the Old World is reviewed. A revised key to the known species is provided with a review of its possible origin. A checklist of all known species is also given.

  20. Prenatal maternal stress in relation to the effects of prenatal lead exposure on toddler cognitive development.

    PubMed

    Zhou, Leilei; Xu, Jian; Zhang, Jinsong; Yan, Chonghuai; Lin, Yanfen; Jia, Yinan; Hu, Wenjing

    2017-03-01

    To evaluate the effects of maternal lead exposure during pregnancy on toddler cognitive development and the potential effect modification by maternal stress. We conducted a prospective birth-cohort study in Shanghai from 2010 to 2012 and investigated 225 mother-infant pairs. The mothers were recruited in mid-to-late pregnancy and children were followed up until 24-36 months old. A self-administered Symptom Checklist-90-Revised Scale (SCL-90-R) was used to assess maternal emotional stress during pregnancy. Maternal whole blood lead levels were measured during gestational weeks 28-36. The toddlers' cognitive levels were assessed using the Gesell Development Scale. Multiple linear regression models were established to explore the main effects of prenatal lead exposure on toddlers' cognitive abilities and the modifying effects of maternal stress. Covariate information was collected through interviews, questionnaires and medical records. The mean maternal blood lead concentration was 3.30 (95%CI: 3.05, 3.57) μg/dL. After adjusting for relevant confounders, no significant associations of maternal blood lead concentrations with toddlers' cognitive levels were observed in all five domains of the Gesell scale (P>0.05). However, the interaction between prenatal maternal blood lead and stress was significant in the domains of adaptive behavior, language and social behavior. When stratified by maternal stress levels, compared with non-significant associations (P>0.05) among low (P1-P75) prenatal stress group, adverse associations between maternal blood lead concentrations (log10-transformed) and toddlers' cognitive levels were observed among high (P75-P100) prenatal stress group in the domains of language (β=-33.82, 95%CI: -60.04, -7.59), social behavior (β=-41.00, 95%CI: -63.11, -18.89) and adaptive behavior (β=-17.93, 95%CI: -35.83, -0.03). Prenatal maternal stress may exacerbate the deleterious effects of prenatal exposure to lead on toddler cognitive development

  1. Prenatal Care.

    ERIC Educational Resources Information Center

    Health Resources and Services Administration (DHHS/PHS), Rockville, MD. Office for Maternal and Child Health Services.

    This booklet is the first in a series of publications designed to provide parents with useful information about childrearing. Contents are organized into three parts. Part I focuses on the pregnancy, prenatal care, development of the baby, pregnant lifestyles, nutrition, common discomforts, and problems of pregnancy. Part II provides information…

  2. [Prenatal medicine and prenatal diagnosis].

    PubMed

    Valero de Bernabé Martín de Eugenio, Javier

    2009-01-01

    Prenatal diagnosis universalization allows knowing the prognostic possibilities in a situation of limited therapeutical resources. Therefore, besides permitting the peace of a normal fetal development, in other circumstances it can provoke parent's requirement to interrupt pregnancy in cases of malformation or chromosomal alteration, situations that parents may conceive as difficult for child's life and family environment. Diagnostic tests reliability and risks, information given to the parents, conversion in an eugenic practice of prenatal diagnosis and OMS recommendations in relation to the optional and voluntary character that this diagnosis should have are analysed.

  3. Record of Technical Change {number_sign}1 for ''Corrective Action Investigation Plan for Corrective Action Unit 263: Area 25 Building 4839 Leachfield, Nevada Test Site, Nevada,'' Revision 0

    SciTech Connect

    US DOE Nevada Operations Office

    2000-05-12

    This Record of Technical Change provides updates to the technical information included in ''Corrective Action Investigation Plan for Corrective Action Unit 263: Area 25 Building 4839 Leachfield, Nevada Test Site, Nevada,'' Revision 0

  4. Record of Technical Change {number_sign}1 for ''Corrective Action Investigation Plan for Corrective Action Unit 143: Area 25 Contaminated Waste Dumps, Nevada Test Site, Nevada,'' Revision 1, DOE/NV 506

    SciTech Connect

    US DOE Nevada Operations Office

    1999-07-21

    This Record of Technical Change updates the technical information provided in ''Corrective Action Investigation Plan for Corrective Action Unit 143: Area 25 Contaminated Waste Dumps, Nevada Test Site, Nevada,'' Revision 0, DOE/NV-506

  5. Record of Technical Change {number_sign}1 to ''Corrective Action Investigation Plan for Corrective Action Unit 135: Area 25 Underground Storage Tanks, Nevada Test Site, Nevada,'' Revision 0, DOE/NV--543

    SciTech Connect

    US DOE Nevada Operations Office

    1999-06-01

    This Record of Technical Change provides updates to the technical information in ''Corrective Action Investigation Plan for Corrective Action Unit 135: Area 25 Underground Storage Tanks, Nevada Test Site, Nevada,'' Revision 0, DOE/NV--543

  6. Record of Technical Change {number_sign}2 for ''Corrective Action Investigation Plan for Corrective Action Unit 240: Area 25 Vehicle Washdown, Nevada Test Site, Nevada,'' Revision 0, DOE/NV--532

    SciTech Connect

    USDOE Nevada Operations Office

    2000-03-16

    This Record of Technical Change updates the technical informatioin provided in ''Corrective Action Investigation Plan for Corrective Action Unit 240: Area 25 Vehicle Washdown, Nevada Test Site, Nevada,'' Revision 0, DOE/NV--532.

  7. Record of Technical Change {number_sign}2 for ''Corrective Action Investigation Plan for Corrective Action Unit 261: Test Cell A Leachfield System, Nevada Test Site, Nevada,'' Revision 0

    SciTech Connect

    US DOE Nevada Operations Office

    2000-06-08

    This Record of Technical Change updates the technical information included in ''Corrective Action Investigation Plan for Corrective Action Unit 261: Test Cell A Leachfield System, Nevada Test Site, Nevada,'' Revision 0, DOE/NV--515.

  8. Prenatal screening for clubfoot: What factors predict prenatal detection?

    PubMed Central

    Mahan, Susan T.; Yazdy, Mahsa M.; Kasser, James R.; Werler, Martha M.

    2014-01-01

    Objective Routine prenatal ultrasound has often resulted in the early detection of musculoskeletal disorders. The purpose of this study was to determine which socioeconomic factors are associated with prenatal detection of clubfoot. Methods The Slone Epidemiology Center at Boston University identified infants in three states (MA, NY, NC) who were reported as having a clubfoot. Mothers of these children were contacted, interviewed, and medical records obtained. Data were analyzed by using logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results Overall detection of the clubfoot prenatally was 62.3% (421/676) but this varied considerably by state: 81.1% in Massachusetts (154/190), 58.5% in New York (124/212), and 52.2% in North Carolina (143/274). Multivariate analysis revealed the strongest predictors for prenatal detection were maternal age ≥ 35 years (OR: 3.54), non-Hispanic black race (OR: 0.49), the presence of another birth defect (OR: 2.61), residing in Massachusetts (OR: 2.64) and the presence of a bilateral clubfoot (OR: 1.90). Conclusions We found a statistically significantly increase higher rate of prenatal detection of clubfoot in Massachusetts and decrease lower rate in younger mothers (age<35) and black mothers, even after adjustment for other sociodemographic variables. PMID:24395154

  9. Prenatal screening for chromosomal abnormalities in IVF patients that opted for preimplantation genetic screening/diagnosis (PGS/D): a need for revised algorithms in the era of personalized medicine.

    PubMed

    Takyi, Afua; Santolaya-Forgas, Joaquin

    2017-06-01

    Obstetricians offer prenatal screening for most common chromosomal abnormalities to all pregnant women including those that had in vitro fertilization (IVF) and preimplantation genetic screening/diagnosis (PGS/D). We propose that free fetal DNA in maternal circulation together with the second trimester maternal serum alfa feto protein (MSAFP) and ultrasound imaging is the best prenatal screening test for chromosomal abnormalities and congenital anomalies in IVF-PGD/S patients because risk estimations from all other prenatal screening algorithms for chromosomal abnormalities depend heavily on maternal age which is irrelevant in PGS/D patients.

  10. Prenatal Genetic Diagnostic Tests

    MedlinePlus

    ... disorders and mutations. Only embryos that do not test positive for the disorders are transferred. How are the cells analyzed in prenatal diagnostic testing? A number of technologies are used in prenatal diagnostic testing. Your obstetrician ...

  11. Barriers to adequate prenatal care utilization in American Samoa.

    PubMed

    Hawley, Nicola L; Brown, Carolyn; Nu'usolia, Ofeira; Ah-Ching, John; Muasau-Howard, Bethel; McGarvey, Stephen T

    2014-12-01

    The objective of this study is to describe the utilization of prenatal care in American Samoan women and to identify socio-demographic predictors of inadequate prenatal care utilization. Using data from prenatal clinic records, women (n = 692) were categorized according to the adequacy of prenatal care utilization index as having received adequate plus, adequate, intermediate or inadequate prenatal care during their pregnancy. Categorical socio-demographic predictors of the timing of initiation of prenatal care (week of gestation) and the adequacy of received services were identified using one way analysis of variance and independent samples t tests. Between 2001 and 2008 85.4 % of women received inadequate prenatal care. Parity (P = 0.02), maternal unemployment (P = 0.03), and both parents being unemployed (P = 0.03) were negatively associated with the timing of prenatal care initiation. Giving birth in 2007-2008, after a prenatal care incentive scheme had been introduced in the major hospital, was associated with earlier initiation of prenatal care (20.75 vs. 25.12 weeks; P < 0.01) and improved adequacy of received services (95.04 vs. 83.8 %; P = 0.02). The poor prenatal care utilization in American Samoa is a major concern. Improving healthcare accessibility will be key in encouraging women to attend prenatal care. The significant improvements in the adequacy of prenatal care seen in 2007-2008 suggest that the prenatal care incentive program implemented in 2006 may be a very positive step toward addressing issues of prenatal care utilization in this population.

  12. Barriers to adequate prenatal care utilization in American Samoa

    PubMed Central

    Hawley, Nicola L; Brown, Carolyn; Nu’usolia, Ofeira; Ah-Ching, John; Muasau-Howard, Bethel; McGarvey, Stephen T

    2013-01-01

    Objective To describe the utilization of prenatal care in American Samoan women and to identify socio-demographic predictors of inadequate prenatal care utilization. Methods Using data from prenatal clinic records, women (n=692) were categorized according to the Adequacy of Prenatal Care Utilization Index as having received adequate plus, adequate, intermediate or inadequate prenatal care during their pregnancy. Categorical socio-demographic predictors of the timing of initiation of prenatal care (week of gestation) and the adequacy of received services were identified using one way Analysis of Variance (ANOVA) and independent samples t-tests. Results Between 2001 and 2008 85.4% of women received inadequate prenatal care. Parity (P=0.02), maternal unemployment (P=0.03), and both parents being unemployed (P=0.03) were negatively associated with the timing of prenatal care initation. Giving birth in 2007–2008, after a prenatal care incentive scheme had been introduced in the major hospital, was associated with earlier initiation of prenatal care (20.75 versus 25.12 weeks; P<0.01) and improved adequacy of received services (95.04% versus 83.8%; P=0.02). Conclusion The poor prenatal care utilization in American Samoa is a major concern. Improving healthcare accessibility will be key in encouraging women to attend prenatal care. The significant improvements in the adequacy of prenatal care seen in 2007–2008 suggest that the prenatal care incentive program implemented in 2006 may be a very positive step toward addressing issues of prenatal care utilization in this population. PMID:24045912

  13. [Adequacy of prenatal care according to maternal characteristics in Brazil].

    PubMed

    Domingues, Rosa Maria Soares Madeira; Viellas, Elaine Fernandes; Dias, Marcos Augusto Bastos; Torres, Jacqueline Alves; Theme-Filha, Mariza Miranda; Gama, Silvana Granado Nogueira da; Leal, Maria do Carmo

    2015-03-01

    To verify the degree of adequacy of prenatal care in Brazil and to determine whether it is associated with sociodemographic characteristics of women. This nationwide hospital-based study was performed with 23 894 women in 2011 and 2012. Data were obtained from interviews with puerperal women and from the prenatal card recording prenatal care appointments. Adequate prenatal care was defined as that started no later than the 12th gestational week, with performance of at least six consultations (with number of consultations adjusted for gestational age at delivery), record in the prenatal card of at least one result for each of the recommended routine prenatal tests, and guidance regarding the maternity hospital for delivery. Multivariate logistic regression was performed to verify the association between maternal characteristics and the adequacy of prenatal care. Early onset of prenatal care was observed in 53.9% of participants, adequate number of consultations in 73.2%, record of at least one of each recommended test in 62.9%, guidance regarding maternity hospital in 58.7%, and overall adequate prenatal care in 21.6%. Less adequate prenatal care was observed in women who were younger, black, multiparous, who did not have a partner, without paid employment, having fewer years of formal schooling, belonging to lower socioeconomic classes, and living in the North and Northeast of Brazil. After adjustment of maternal characteristics, no differences were observed between public or private health care services regarding adequacy of prenatal care. Even though the coverage of prenatal care is virtually universal in Brazil, regional and social differences in the access and adequacy of care still persist. The implementation of strategies to facilitate early access to prenatal care is essential.

  14. Outcome of prenatally diagnosed isolated clubfoot.

    PubMed

    Lauson, S; Alvarez, C; Patel, M S; Langlois, S

    2010-06-01

    To analyze the aneuploidy risk and treatment outcome of prenatally diagnosed isolated clubfoot, to determine the false-positive rate (FPR) of ultrasound diagnosis and to calculate the risk of diagnostic revision to complex clubfoot. By chart review, 65 patients were retrospectively ascertained to have unilateral or bilateral clubfeet diagnosed prenatally. We calculated the rates of false positives, aneuploidy and diagnostic revision to complex clubfoot, and used an ad hoc scoring system to determine orthopedic outcome. Published rates of aneuploidy were pooled and evaluated. Prenatally diagnosed isolated clubfoot FPR (defined as 1 - positive predictive value) was 10.5% (95% CI, 5.8-18%) (calculated per foot). After a minimum of 1-year postnatal follow-up, 13% (95% CI, 6-26%) of patients had revised diagnoses of complex clubfoot. No patients had aneuploidy identified by cytogenetic analysis or clinical assessment. Of the 34 patients with 2-year postnatal follow-up, 76.5% were treated with serial casting with or without Botox. All children with isolated clubfoot were walking and had an average outcome score of 'very good' to 'excellent'. When counseling women regarding prenatally diagnosed isolated clubfoot, it is important to tell them that approximately 10% of individuals will have a normal foot or positional foot deformity requiring minimal treatment. Conversely, 10-13% of prenatally diagnosed cases of isolated clubfoot will have complex clubfoot postnatally, based on the finding of additional structural or neurodevelopmental abnormalities. Although this study did not identify an increased risk of fetal aneuploidy associated with isolated clubfoot, a review of the literature indicates a risk of 1.7-3.6% with predominance of sex chromosome aneuploidy. (c) 2010 ISUOG. Published by John Wiley & Sons, Ltd.

  15. Work plan for ground water elevation data recorder/monitor well installation at Gunnison, Colorado. Revision 2

    SciTech Connect

    Not Available

    1994-08-01

    The purpose of this document is to describe the work that will be performed and the procedures that will be followed during installation of ground water monitor wells and ground water elevation data recorders (data loggers) at the Gunnison, Colorado, Uranium Mill Tailings Remedial Action (UMTRA) Project site. The monitor wells and data loggers will be used to gather required time-dependent data to investigate the interaction between ground water and surface water in the area.

  16. Prenatal care and subsequent birth intervals.

    PubMed

    Teitler, Julien O; Das, Dhiman; Kruse, Lakota; Reichman, Nancy E

    2012-03-01

    Prenatal care generally includes contraceptive and health education that may help women to control their subsequent fertility. However, research has not examined whether receipt of prenatal care is associated with subsequent birthspacing. Longitudinally linked birth records from 113,662 New Jersey women who had had a first birth in 1996-2000 were used to examine associations between the timing and adequacy of prenatal care prior to a woman's first birth and the timing of her second birth. Multinomial logistic regression analyses adjusted for social and demographic characteristics, hospital and year of birth. Most women (85%) had initiated prenatal care during the first trimester. Women who had not obtained prenatal care until the second or third trimester, or at all, were more likely than those who had had first-trimester care to have a second child within 18 months, rather than in 18-59 months (odds ratios, 1.2-1.6). Similarly, women whose care had been inadequate were more likely than those who had had adequate care to have a short subsequent birth interval (1.2). The associations were robust to alternative measures of prenatal care and birth intervals, and were strongest for mothers with less than 16 years of education. Providers should capitalize on their limited encounters with mothers who initiate prenatal care late or use it sporadically to ensure that these women receive information about family planning. Copyright © 2012 by the Guttmacher Institute.

  17. Re-evaluation of the Bispingen palaeolake record - a revised chronology for the Eemian in Northern Germany

    NASA Astrophysics Data System (ADS)

    Lauterbach, S.; Brauer, A.; Litt, T.; Schettler, G.

    2012-04-01

    Detailed studies of climate development during past interglacials, i.e. prior to significant human interference, can provide important information about natural climate variability and thus the extent of anthropogenic impact on present and future climate. However, comparison of palaeoclimate records from different regions and archives is often hampered by chronological uncertainties. For example, an asynchronous climate development with a several-thousand-year-long steep climatic gradient in Central Europe at the end of the Last Interglacial has been inferred from differences in the duration of the Eemian in German and French palaeoclimate records (Kukla et al. 1997). One of the key sites in this context is the Bispingen palaeolake sequence in Northern Germany, where a length of about 11 000 years for the Eemian has been estimated from varve counting (Müller 1974), which is a couple of thousand years shorter than in other sediment records in the North Atlantic realm (cf. Kukla et al. 2002). Here we present detailed microfacies analyses on new sediment cores from the Bispingen palaeolake combined with geochemical and pollen analyses, documenting changes in the depositional environment and vegetation during the Last Interglacial. Microscopic varve counting in the distinctly laminated lower part and sedimentation rate estimates for the faintly laminated upper part of the sequence enable a better assessment of the length of the Eemian in Northern Germany than in previous studies. Detailed lithological and palynological comparison of the new Bispingen cores with the record from Müller (1974) indicates the existence of major gaps in the old profile, leading to an underestimation of the duration of the Eemian in Northern Germany. The duration of about 17 000 years obtained from the new Bispingen cores is in good accordance with results from a marine record off Portugal (Shackleton et al. 2002) and the varve-dated Lake Monticchio record in southern Italy (Brauer et al

  18. Work plan for ground water elevation data recorder/monitor well installation at Gunnison, Colorado. Revision 1

    SciTech Connect

    Not Available

    1994-08-01

    The purpose of this document is to describe the work that will be performed and the procedures that will be followed during installation of ground water monitor wells and ground water elevation data recorders (data loggers) at the Gunnison, Colorado, Uranium Mill Tailings Remedial Action (UMTRA) Project site. The monitor wells and data loggers will be used to gather required time-dependent data to investigate the interaction between ground water and surface water in the area. Data collection objectives (DCO) identify reasons for collecting data. The following are DCOs for the Gunnison ground water elevation data recorder/monitor well installation project: long-term continuous ground water level data and periodic ground water samples will be collected to better understand the relationship between surface and ground water at the site; water level and water quality data will eventually be used in future ground water modeling to more firmly establish numerical model boundary conditions in the vicinity of the Gunnison processing site; and modeling results will be used to demonstrate and document the potential remedial alternative of natural flushing.

  19. Prenatal and postnatal prevalence of Turner's syndrome: a registry study.

    PubMed Central

    Gravholt, C. H.; Juul, S.; Naeraa, R. W.; Hansen, J.

    1996-01-01

    OBJECTIVE--To study prevalence of Turner's syndrome in Denmark and to assess validity of prenatal diagnosis. DESIGN--Study of data on prenatal and postnatal Turner's syndrome in Danish Cytogenetic Central Register. SUBJECTS--All registered Turner's syndrome karyotypes (100 prenatal cases and 215 postnatal cases) during 1970-93. MAIN OUTCOME MEASURES--Prevalence of Turner's syndrome karyotypes among prenatally tested fetuses and Turner's syndrome among liveborn infants. RESULTS--Among infant girls, prevalence of Turner's syndrome was 32/100,000. Among female fetuses tested by amniocentesis, prevalence of Turner's syndrome karyotypes was 176/100,000 (relative risk of syndrome, 6.74 compared with prevalence among untested pregnancies). Among female fetuses tested by chorion villus sampling, prevalence of syndrome karyotypes was 392/100,000 (relative risk, 16.8). We excluded prenatal tests referred because of results of ultrasound scanning: among fetuses tested by amniocentesis revised relative risk was 5.68, while revised relative risk among fetuses tested by chorion villus sampling was 13.3. For 29 fetuses with prenatal diagnosis of possible Turner's syndrome, pregnancy was allowed to continue and 24 children were live born. Thirteen of these children were karyotyped postnatally, and diagnosis of Turner's syndrome had to be revised for eight, seven being normal girls and one boy. This gives tentative predictive value of amniocentesis in diagnosing Turner's syndrome of between 21% and 67%. There was no significant relation between mother's age and risk of Turner's syndrome. CONCLUSIONS--Discrepancy between prenatal and postnatal prevalence of Turner's syndrome challenges specificity of prenatal examination in diagnosing Turner's syndrome. PMID:8555850

  20. Revised paleoenvironmental analysis of the Holocene portion of the Barbados sea-level record: Cobbler's Reef revisited

    NASA Astrophysics Data System (ADS)

    Toscano, Marguerite A.

    2016-06-01

    Sample elevations corrected for tectonic uplift and assessed relative to local modeled sea levels provide a new perspective on paleoenvironmental history at Cobbler's Reef, Barbados. Previously, 14C-dated surface samples of fragmented Acropora palmata plotted above paleo sea level based on their present (uplifted) elevations, suggesting supratidal rubble deposited during a period of extreme storms (4500-3000 cal BP), precipitating reef demise. At several sites, however, A. palmata persisted, existing until ~370 cal BP. Uplift-corrected A. palmata sample elevations lie below the western Atlantic sea-level curve, and ~2 m below ICE-6G-modeled paleo sea level, under slow rates of sea-level rise, negating the possibility that Cobbler's Reef is a supratidal storm ridge. Most sites show limited age ranges from corals likely damaged/killed on the reef crest, not the mixed ages of rubble ridges, strongly suggesting the reef framework died off in stages over 6500 yr. Reef crest death assemblages invoke multiple paleohistoric causes, from ubiquitous hurricanes to anthropogenic impacts. Comparison of death assemblage ages to dated regional paleotempestological sequences, proxy-based paleotemperatures, recorded hurricanes, tsunamis, European settlement, deforestation, and resulting turbidity, reveals many possible factors inimical to the survival of A. palmata along Cobbler's Reef.

  1. Historical seismicity of the Texas Panhandle from an examination of Lubbock seismographic station records: Revision 2: Topical report

    SciTech Connect

    Acharya, H.

    1987-09-01

    Seismicity data for the Texas Panhandle area are based on instrumental data and felt reports. Sparse population density and poor instrumental coverage of the area suggest that the data base may not be complete or reliable for small earthquakes. Film chips from the Lubbock Seismographic Station for the period of 1963-1980 were, therefore, examined to identify all earthquakes that had occurred in the Texas Panhandle during that period. Film chips of known events were also used to aid investigators in identifying characteristics of signals from earthquakes that occurred in the Panhandle. This examination identified 40 earthquakes that occurred within approximately 360 km of Lubbock during 1963-1980. These 40 earthquakes were not recorded by many stations and 38 of these were not located earlier. First motion amplitude and direction on all three components were measured for these earthquakes. Earthquakes that occurred north of Lubbock were identified on the basis of azimuth computation and were then approximately located using the time interval between the arrival of P and S phases. Application of a magnitude duration relationship that was developed in Oklahoma suggests a range of 1.6 to 4.5 for these earthquakes. This study suggests an activity rate of two to three earthquakes per year within about 360 km of Lubbock during 1963-1980. The study, therfore, shows that the area north of Lubbock Station, including the Texas Panhandle, is an area of low seismicity. 21 refs., 3 figs., 5 tabs.

  2. Prenatal diagnosis of biliary atresia: A case series.

    PubMed

    Shen, O; Sela, H Y; Nagar, H; Rabinowitz, R; Jacobovich, E; Chen, D; Granot, E

    2017-08-01

    Biliary atresia is a progressive disease presenting with jaundice, and is the most common indication for liver transplantation in the pediatric population. Prenatal series have yielded conflicting results concerning a possible association between BA and prenatal nonvisualization of the gallbladder. This retrospective case series was performed to assess the association between biliary atresia, prenatal nonvisualization of the gallbladder and other sonographic signs. We identified biliary atresia patients who underwent a Kasai procedure by a single pediatric surgeon and/or follow up by a single pediatric gastroenterologist. Axial plane images and/or video recordings were scrutinized for sonographic signs of biliary atresia on the second trimester anomaly scan. Proportion of biliary atresia cases with prenatal sonographic signs. Twenty five charts of children with biliary and high quality prenatal images were retrieved. 6/25 (24%) of cases analyzed had prenatal nonvisualization of the gallbladder or a small gallbladder on the prenatal scan. Two cases had biliary atresia splenic malformation syndrome. None of the cases had additional sonographic markers of biliary atresia. Our study suggests that in addition to the well-established embryonic and cystic forms, an additional type can be suspected prenatally, which is characterized by prenatal nonvisualization of the gallbladder in the second trimester. This provides additional evidence that some cases of BA are of fetal rather than perinatal onset and may have important implications for prenatal diagnosis, for counseling and for research of the disease's etiology and pathophysiology. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Revising the archaeological record of the Upper Pleistocene Arctic Siberia: Human dispersal and adaptations in MIS 3 and 2

    NASA Astrophysics Data System (ADS)

    Pitulko, Vladimir; Pavlova, Elena; Nikolskiy, Pavel

    2017-06-01

    As the main external driver, environmental changes largely predetermine human population distribution, especially in the Arctic, where environmental conditions were often too extreme for human survival. Not that long ago the only evidence of human presence here was the Berelekh site in the lower reaches of the Indighirka River. This landmark dates to 13,000-12,000 years ago but it was widely accepted as documentation of the earliest stage of human dispersal in the Arctic. New research discussed here, shows that humans began colonizing the Siberian Arctic at least by the end of the early stage of MIS 3 at around 45,000 years ago. For now, this earliest known stage of human occupation in the arctic regions is documented by the evidence of human hunting. The archaeological record of continued human occupation is fragmentary; nevertheless, evidence exists for each significant phase including the Last Glacial Maximum (LGM). Siberian Arctic human populations were likely supported by the local mammoth population, which provided humans with food and raw material in the form of mammoth tusks. Processing of mammoth ivory is recognized widely as one of the most important peculiarities of the material culture of ancient humans. In fact, ivory tool manufacturing is one of the most important innovations of the Upper Palaeolithic in northern Eurasia. Technology that allowed manufacturing of long ivory shafts - long points and full-size spears - was critical in the tree-less open landscapes of Eurasian mammoth steppe belt. These technological skills reach their greatest extent and development shortly before the Last Glacial Maximum but are recognizable until the Pleistocene-Holocene boundary across Northern Eurasia in all areas populated by mammoths and humans. Loss of this stable source of raw material due to the late Pleistocene mammoth extinction may have provoked a shift in post-LGM Siberia to the Beringian microblade tradition. This paper reviews the most important

  4. First verified record of the ant genus Calyptomyrmex (Hymenoptera: Formicidae) from India, along with a revised key to known Indomalayan species

    PubMed Central

    Bharti, Himender

    2015-01-01

    Abstract Background The members of genus Calyptomyrmex are mostly encountered under rotten logs, in the soil, under stones and in leaf litter samples. These ants are seldom in collections making estimation of their true distributional patterns problematic (Shattuck 2011). The deep antennal scrobes and the unique configuration of the clypeus are distinct to the genus (Bolton 1981). New information Herein Calyptomyrmex wittmeri Baroni Urbani, 1975 is redescribed and reported for the first time from India. This also confirms the first valid published record of the genus from the country. The image hosted by AntWeb as C. vedda (CASENT0280817; AntWeb 2015b) collected by Besuchet, Löbl, Mussard from Kerala, India and identified by Brown is actually C. wittmeri (Brown was uncertain of his determination of C. vedda and cautiously inserted an interrogation point in front of his determination). Two workers recently collected at Salim Ali Bird Sanctuary, Kerala present similarities to the specimen identified by Brown. However, characters as the lack of well-developed promesonotal suture, absence of clavate setae, and narrow petiolar node, concur with the diagnosis of C. wittmeri. A revised key to known Indomalayan species of the genus is provided herewith. PMID:26696759

  5. [Access to dental care during prenatal assistance].

    PubMed

    dos Santos Neto, Edson Theodoro; Oliveira, Adauto Emmerich; Zandonade, Eliana; Leal, Maria do Carmo

    2012-11-01

    This study sought to evaluate the self-perceived response to dental care during prenatal assistance in the Unified Health System (SUS) in the Metropolitan Region of Vitória, Espírito Santo, Brazil. 1032 postpartum women were interviewed and 1006 prenatal records copied. Postpartum women's self-perceived response was measured by the Oral Health Index Profile-14. When an impact was identified, dental care rendered in educational, preventive and curative terms was considered adequate. When there was no impact, assistance was considered adequate in educational and preventive terms. The Chi-square test revealed an association between prenatal care and dental care. Oral health impact on quality of life was 14.7%. Dental care received by mothers in educational terms was rated at 41.3%, while in preventive terms it was 21% and in curative terms it was 16.6%. Six or more prenatal appointments coupled with educational activities was closely associated with adequate dental care (p < 0.05). Access to dental care is facilitated when pregnant women attend health services and become involved in educational activities during the prenatal period. Consequently, educational measures appear to indicate an improvement in prenatal care in the SUS.

  6. Prenatal Care and Subsequent Birth Intervals

    PubMed Central

    Teitler, Julien O.; Das, Dhiman; Kruse, Lakota; Reichman, Nancy E.

    2013-01-01

    Context Research on the effectiveness of prenatal care has focused primarily on birth outcomes, finding small effects at the population level. However, prenatal care generally includes postpartum contraceptive and health education that may enable women to better control their subsequent fertility. Associations between prenatal care and subsequent fertility have not been previously explored. Methods Using longitudinally-linked birth records from New Jersey between 1996 and 2006, we estimated multinomial logistic regression models to investigate associations between prenatal care (timing or adequacy) in a mother’s first birth and timing of her second birth, controlling for sociodemographic characteristics and hospital and year of birth. Results Most mothers initiated prenatal care in the first (85%) or second (12%) trimester. Initiation of care after the first trimester is strongly associated with short subsequent birth intervals. The odds of having a second child in fewer than 18 months (compared to 18–59 months) were 19% higher if the mother initiated care in the second versus the first trimester, 26% higher if she initiated care in the third trimester, and 61% higher if she did not receive any care, all else equal. The associations are robust to alternative measures of prenatal care and birth intervals and are stronger for mothers with low levels of education. Conclusions The findings suggest that prenatal providers should capitalize on their limited encounters with mothers who initiate prenatal care late or use it sporadically to make information about family planning available. This issue is timely given recent and proposed budget cuts to public family planning. PMID:22405147

  7. Prenatal Genetic Counselling

    PubMed Central

    McGillivray, Barbara C.

    1986-01-01

    Genetic concerns and indications for prenatal diagnosis are first recognized by the family physician. Review of personal, pregnancy and family history may indicate concerns beyond that of advanced maternal age. Amniocentesis is still the most frequently used modality for prenatal diagnosis, but detailed ultrasound is valuable for structural abnormalities, and chorionic villus sampling is now being tested as an alternative to amniocentesis. PMID:21267316

  8. Prenatal distress in Turkish pregnant women and factors associated with maternal prenatal distress.

    PubMed

    Yuksel, Fatma; Akin, Semiha; Durna, Zehra

    2014-01-01

    To assess: (1) the prenatal distress level in Turkish pregnant women and (2) to examine the association between prenatal maternal distress and personal and pregnancy-specific factors. Pregnant women experience stress originating from a variety of pregnancy-specific issues, including physical symptoms and changes, changes in body image, physiological, social and emotional changes, parenting concerns, changes in relationships with significant others, medical problems, anxiety about labour and delivery, concerns about birth and the baby's health. A descriptive cross-sectional study. This study was conducted at a gynaecology clinic of a private hospital in Istanbul, Turkey within a 12-month period. The study sample comprised 522 pregnant women continuing their regular visits for prenatal care. Pregnancy Description Form and Turkish Version of Revised Version of Prenatal Distress Questionnaire [(NUPDQ)-17 Item Version] were used for data collection. Study sample was moderately distressed. Turkish pregnant women were mostly distressed and concerned about premature delivery, having an unhealthy baby, labour and delivery, feeling tired and having low energy during pregnancy. Prenatal distress in Turkish pregnant women was associated with personal and pregnancy-related characteristics. This study found that pregnant women need to be supported emotionally, physically and socially. A better understanding of prenatal maternal distress could assist in informing healthcare professionals about the provision of physically, emotionally, socially and behaviourally appropriate support for achieving a healthy pregnancy. It is crucial for pregnant women to be regularly assessed and educated for dealing successfully with concerns and fears about prenatal period, birth and postnatal period and about difficulties that women may encounter during their pregnancy. © 2013 Blackwell Publishing Ltd.

  9. Implementation of substance use screening in prenatal clinics.

    PubMed

    Li, C; Olsen, Y; Kvigne, V; Welty, T

    1999-02-01

    To reduce women's consumption of alcohol and other drugs during pregnancy, the Department of Epidemiology for the Aberdeen Area Indian Health Service (AAIHS) promoted a maternal substance use screening program for prenatal clinics in 1992. This report describes the adherence to the screening protocol at AAIHS facilities and barriers to such screening. Prenatal clinic staff members at 20 AAIHS health care facilities were surveyed to determine the extent of prenatal substance use screening and the barriers to its implementation. The medical records of a random sample of 235 women who sought prenatal care at five hospitals were reviewed to determine whether prenatal clinic staff adhered to the screening protocol. Of the 20 health care facilities, 13 (65%) had implemented the screening. The major barriers to implementing screening were lack of training in prenatal substance use screening and lack of clinic staff designated to administer the screening protocol. Though not statistically significant, our data suggest that women not administered the screening questionnaire were more likely to be multiparous (prevalence ratio = 2.1; 95% confidence interval = 0.9, 4.5). To improve screening of pregnant women for substance use, prenatal clinic staff members should address administrative barriers and assess adherence of health care providers and patients to the screening protocol. Training of prenatal clinic personnel is essential to implement optimal maternal substance use screening in prenatal clinics.

  10. The prenatal visit.

    PubMed

    Cohen, George J

    2009-10-01

    As advocates for children and their families, pediatricians can support and guide expectant parents in the prenatal period. Prenatal visits allow the pediatrician to gather basic information from expectant parents, offer them information and advice, and identify high-risk conditions that may require special care. In addition, a prenatal visit is the first step in establishing a relationship between the family and the pediatrician (the infant's medical home) and in helping the parents develop parenting skills and confidence. There are several possible formats for this first visit. The one used depends on the experience and preference of the parents, the style of the pediatrician's practice, and pragmatic issues of reimbursement.

  11. Contractual Revision.

    ERIC Educational Resources Information Center

    Engel, Mary F.; Sawyer, Thomas M.

    Contractual revision promotes cooperation between teachers and tutors and, being student initiated, provides a method to increase student control over the revision process and encourage students to communicate their strengths and weaknesses in writing to their teachers or tutors. The contractual revision process requires students to form contracts…

  12. Prenatal and perinatal risk factors of schizophrenia.

    PubMed

    Meli, Giampiero; Ottl, Birgit; Paladini, Angela; Cataldi, Luigi

    2012-12-01

    Schizophrenia could be considered the most severe of all psychiatric disorders. It shows a heterogeneous clinical picture and presents an etiopathogenesis that is not cleared sufficiently. Even if the etiopathogenesis remains a puzzle, there is a scientific consensus that it is an expression of interaction between genotype and environmental factors. In the present article, following a study of literature and the accumulated evidence, the role of prenatal and perinatal factors in the development of schizophrenia will be revised and synthesized. We think that better knowledge of the risk factors could be helpful not only for better comprehension of the pathogenesis but especially to optimize interventions for prevention of the disorder.

  13. Understanding Prenatal Tests

    MedlinePlus

    ... several things, particularly the risk of Down Syndrome. Rh Incompatibility This test determines whether the mother and ... at the first prenatal visit. If there is Rh incompatibility, treatments can help prevent later complications. Ultrasound ...

  14. Invasive Prenatal Testing

    PubMed Central

    Hunter, A.

    1988-01-01

    Invasive prenatal diagnosis is a major diagnostic tool which is used in modern obstetrical care. A synopsis of these techniques is provided to assist the family practitioner in providing this information to his patients. PMID:21253097

  15. Prenatal Genetic Diagnostic Tests

    MedlinePlus

    ... offered to couples who are using in vitro fertilization to become pregnant and who are at increased ... The stage of prenatal development that starts at fertilization (joining of an egg and sperm) and lasts ...

  16. Prenatal diagnosis of achondrogenesis.

    PubMed

    Golbus, M S; Hall, B D; Filly, R A; Poskanzer, L B

    1977-09-01

    Severe rhizomelic and mesomelic dwarfism was demonstrated in a 20-week gestation fetus by amniography. A systematic progressive approach to prenatal diagnosis in the absence of a definitive diagnosis and the use of contrast radiography is discussed.

  17. Prenatal music exposure induces long-term neural effects.

    PubMed

    Partanen, Eino; Kujala, Teija; Tervaniemi, Mari; Huotilainen, Minna

    2013-01-01

    We investigated the neural correlates induced by prenatal exposure to melodies using brains' event-related potentials (ERPs). During the last trimester of pregnancy, the mothers in the learning group played the 'Twinkle twinkle little star'-melody 5 times per week. After birth and again at the age of 4 months, we played the infants a modified melody in which some of the notes were changed while ERPs to unchanged and changed notes were recorded. The ERPs were also recorded from a control group, who received no prenatal stimulation. Both at birth and at the age of 4 months, infants in the learning group had stronger ERPs to the unchanged notes than the control group. Furthermore, the ERP amplitudes to the changed and unchanged notes at birth were correlated with the amount of prenatal exposure. Our results show that extensive prenatal exposure to a melody induces neural representations that last for several months.

  18. Prenatal Music Exposure Induces Long-Term Neural Effects

    PubMed Central

    Partanen, Eino; Kujala, Teija; Tervaniemi, Mari; Huotilainen, Minna

    2013-01-01

    We investigated the neural correlates induced by prenatal exposure to melodies using brains' event-related potentials (ERPs). During the last trimester of pregnancy, the mothers in the learning group played the ‘Twinkle twinkle little star’ -melody 5 times per week. After birth and again at the age of 4 months, we played the infants a modified melody in which some of the notes were changed while ERPs to unchanged and changed notes were recorded. The ERPs were also recorded from a control group, who received no prenatal stimulation. Both at birth and at the age of 4 months, infants in the learning group had stronger ERPs to the unchanged notes than the control group. Furthermore, the ERP amplitudes to the changed and unchanged notes at birth were correlated with the amount of prenatal exposure. Our results show that extensive prenatal exposure to a melody induces neural representations that last for several months. PMID:24205353

  19. Prenatal Influences on the Brain.

    ERIC Educational Resources Information Center

    Eliot, Lise

    2002-01-01

    Gives an overview of embryology and prenatal brain, sensory, and motor development. Includes discussion of maternal nutrition, chemical exposure, prenatal drug and alcohol hazards, cigarette smoking, and some causes of neural tube defects and premature birth. (Author/KB)

  20. Prenatal Influences on the Brain.

    ERIC Educational Resources Information Center

    Eliot, Lise

    2002-01-01

    Gives an overview of embryology and prenatal brain, sensory, and motor development. Includes discussion of maternal nutrition, chemical exposure, prenatal drug and alcohol hazards, cigarette smoking, and some causes of neural tube defects and premature birth. (Author/KB)

  1. Prenatal Tests for Down Syndrome

    MedlinePlus

    PRENATAL TESTS FOR DOWN SYNDROME S HARE W ITH W OMEN PRENATAL TESTS FOR DOWN SYNDROME What Is Down Syndrome? Down syndrome is a common birth defect that includes mental retardation and— often— heart ...

  2. Prenatal Care: Third Trimester Visits

    MedlinePlus

    Healthy Lifestyle Pregnancy week by week During the third trimester, prenatal care might include vaginal exams to check the baby's ... 2015 Original article: http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art- ...

  3. Prenatal Education for Pregnant Adolescents.

    ERIC Educational Resources Information Center

    Timberlake, Bobbi; And Others

    1987-01-01

    This paper describes prenatal education classes offered at Teen Pregnancy Service. Outcome data for 66 pregnant teens shows significant changes in prenatal knowledge following the classes. (Author/MT)

  4. Prenatal Intuitive Coparenting Behaviors

    PubMed Central

    Darwiche, Joëlle; Fivaz-Depeursinge, Elisabeth; Corboz-Warnery, Antoinette

    2016-01-01

    Micro-analytic research on intuitive parenting behaviors has shed light on the temporal dynamics of parent and child interactions. Observations have shown that parents possess remarkable implicit communicative abilities allowing them to adapt to the clues infants give and therefore stimulate the development of many of the infants’ abilities, such as communication skills. This work focused on observing intuitive parenting behaviors that were synchronized and coordinated between the parents. We call them “prenatal intuitive coparenting behaviors” and used an observation task – the Prenatal Lausanne Trilogue Play procedure – to observe them. For this task, the parents role-play their first encounter with their future baby, represented by a doll. Two cases from a study on pregnancy after assisted reproductive technology are provided to illustrate how these behaviors manifest themselves. The observations from the first case suggest that expectant parents can offer the baby a coparental framework, whereas the observations from the second case show that opportunities for episodes of prenatal intuitive coparenting can be missed due to certain relationship dynamics. These kinds of observations deepen our knowledge of the prenatal emergence of the coparenting relationship and allow us to hone our strategies for intervening during pregnancy with couples who experience coparenting difficulties. Furthermore, these observations provide a novel and complementary perspective on prenatal intuitive parenting and coparenting behaviors. PMID:27833576

  5. Noninvasive prenatal diagnosis.

    PubMed

    Cheng, Wei-Lun; Hsiao, Ching-Hua; Tseng, Hua-Wei; Lee, Tai-Ping

    2015-08-01

    Prenatal examination plays an important role in present medical diagnosis. It provides information on fetal health status as well as the diagnosis of fetal treatment feasibility. The diagnosis can provide peace of mind for the perspective mother. Timely pregnancy termination diagnosis can also be determined if required. Amniocentesis and chorionic villus sampling are two widely used invasive prenatal diagnostic procedures. To obtain complete fetal genetic information and avoid endangering the fetus, noninvasive prenatal diagnosis has become the vital goal of prenatal diagnosis. However, the development of a high-efficiency separation technology is required to obtain the scarce fetal cells from maternal circulation. In recent years, the rapid development of microfluidic systems has provided an effective method for fetal cell separation. Advantages such as rapid analysis of small samples, low cost, and various designs, greatly enhance the efficiency and convenience of using microfluidic systems for cell separation. In addition, microfluidic disks can be fully automated for high throughput of rare cell selection from blood samples. Therefore, the development of microfluidic applications in noninvasive prenatal diagnosis is unlimited. Copyright © 2015. Published by Elsevier B.V.

  6. The Fourth International Network of Twin Registries: Overview from Osaka/Research Reviews: Familial Fraternal Twinning; Twin Study of Masculine Faces; Physical Aggression and Epigenetics; Prenatal Education for Parents of Twins/Current Events: 2016 Guinness Book of World Records; Oldest Living Male Twins; Twins Reunited at Sixty-Nine; Panda Twins; Twins.com.

    PubMed

    Segal, Nancy L

    2015-12-01

    The 4th International Network of Twin Registries (INTR) Consortium Meeting took place in Osaka, Japan, September 28-29, 2015. The venue was the Osaka Medical Center for Medical Innovation and Translational Research. An overview of presentations and other activities is provided. Next, 1930s research on familial fraternal twinning, preference for masculine faces, physical aggression and epigenetics, and a prenatal education program for parents of multiples are described. Current twin-related events include the 2016 Guinness Book of World Records (GWR), the oldest living male twins, newly reunited twins, the birth of panda twins and a controversial twin-based website.

  7. Inadequate syphilis screening among women with prenatal care in a community with a high syphilis incidence.

    PubMed

    Trepka, Mary Jo; Bloom, Sharon A; Zhang, Guoyan; Kim, Sunny; Nobles, Robert E

    2006-11-01

    This study was designed to evaluate the extent to which pregnant women in a community with a high syphilis incidence were screened for syphilis according to standard recommendations of twice during prenatal care and at labor and delivery. Labor and delivery records from 4 hospitals in Miami-Dade County, Florida, were abstracted to obtain maternal and prenatal care characteristics and syphilis screening practices. Of the 1991 women, records indicated that 1655 (83%) were screened at least once during prenatal care, 220 (11%) were screened twice during prenatal care before delivery, and 184 (9%) were screened twice during prenatal care and at delivery. Attending a private clinic, having more than adequate prenatal care and having private insurance were associated with not being screened at least twice before delivery. Few women were screened according to standard recommendations, and provider or institutional-related factors affected adequacy of screening.

  8. Human prenatal diagnosis

    SciTech Connect

    Filkins, K.; Russo, J.F.

    1985-01-01

    Advances in the field of prenatal diagnosis have been rapid during the past decade. Moreover, liberal use of birth control methods and restriction of family size have placed greater emphasis on optimum outcome of each pregnancy. There are many prenatal diagnostic techniques of proven value; the risks, including false negatives and false positives, are known. With the rapid proliferation of new and experimental techniques, many disorders are potential diagnosable or even treatable; however, risk factors are unknown and issues relating to quality control have not been resolved. These problems are readily appreciated in the dramatic new techniques involving recombinant DNA, chorion villus sampling, and fetal surgery. Unfortunately, clinicians may not appreciate the difficulties that may also be encountered in the more mundane prenatal diagnostic tests such as ultrasonography or enzymatic testing. The aim of this volume is to clarify and rationalize certain aspects of diagnosis, genetic counseling, and intervention. New and experimental techniques are presented in the light of current knowledge.

  9. "Makin' Somethin' Outta Little-to-Nufin'': Racism, Revision and Rotating Records--The Hip-Hop DJ in Composition Praxis

    ERIC Educational Resources Information Center

    Craig, Todd

    2015-01-01

    Prompted by a moment in the classroom in which the DJ becomes integral for the writing instructor, this article looks at how the hip-hop DJ and hip-hop DJ/Producer become the intrinsic examples for first-year college writing students to think about how they conduct revision in their writing. After a review of two seminal hip-hop books and other…

  10. The color of pain: racial iniquities in prenatal care and childbirth in Brazil.

    PubMed

    Leal, Maria do Carmo; Gama, Silvana Granado Nogueira da; Pereira, Ana Paula Esteves; Pacheco, Vanessa Eufrauzino; Carmo, Cleber Nascimento do; Santos, Ricardo Ventura

    2017-07-24

    Few studies on the influence of race/color on pregnancy and birthcare experiences have been carried out in Brazil. Additionally, none of the existing studies are of national scope. This study sought to evaluate inequities in prenatal and childbirth care according to race/color using propensity score matching. The data comes from the study Birth in Brazil: National Survey into Labor and Birth, a national population study comprised of interviews and revisions of medical records that included 23,894 women in 2011/2012. We used logistic regressions to estimate odds ratios (OR) and respective 95% confidence intervals (95%CI) of race/color associated with the outcomes were analyzed. When compared with white-skinned women, black-skinned women were more likely to have inadequate prenatal care (OR = 1.6; 95%CI: 1.4-1.9), to not be linked to a maternity hospital for childbirth (OR = 1.2 95%CI: 1.1-1.4), to be without a companion (OR = 1.7; 95%CI: 1.4-2.0), to seek more than one hospital for childbirth (OR =1.3; 95%CI: 1.2-1.5), and less likely to receive local anesthesia for an episiotomy (OR = 1.5; 95%CI: 1.1-2.1). Brown-skinned women were also more likely to have inadequate prenatal care (OR = 1.2; 95%CI: 1.1-1.4) and to lack a companion (OR = 1.4; 95%CI: 1.3-1.6) when compared with white-skinned women. We identified racial disparities in care during pregnancy and childbirth, which displayed a gradient going from worst to best care provided to black, brown and white-skinned women.

  11. Scar revision

    MedlinePlus

    ... corrects skin changes (disfigurement) caused by an injury, wound, poor healing, or previous surgery. Description Scar tissue forms as ... stiffening of the joint, you may need physical therapy after surgery. Apply sunscreen to keep sunlight from permanently ... Keloid revision; Hypertrophic scar revision; ...

  12. America Revising.

    ERIC Educational Resources Information Center

    Marty, Myron

    1982-01-01

    Reviews Frances FitzGerald's book, "America Revised," and discusses FitzGerald's critique of recent revisions in secondary-level U.S. history textbooks. The author advocates the implementation of a core curriculum for U.S. history which emphasizes political and local history. (AM)

  13. Childhood maltreatment history, posttraumatic relational sequelae, and prenatal care utilization.

    PubMed

    Bell, Sue Anne; Seng, Julia

    2013-07-01

    To test the hypothesis that childhood maltreatment history would be associated with inadequate prenatal care utilization. A post-hoc analysis of a prospective cohort study of the effects of post traumatic stress disorder (PTSD) on pregnancy outcomes. Recruitment took place via prenatal clinics from three academic health systems in southeast Michigan. This analysis included 467 diverse, nulliparous, English-speaking adult women expecting their first infants. Data were gathered from structured telephone interviews at two time points in pregnancy and from prenatal medical records. Contrary to our hypothesis, history of childhood maltreatment was associated with better likelihood of using adequate prenatal care. Risk for inadequate prenatal care occurred in association with the posttraumatic stress and interpersonal sensitivity that can result from maltreatment, with low alliance with the maternity care provider, and with public insurance coverage. Prior mental health treatment was associated with using adequate prenatal care. When childhood maltreatment survivors were resilient or had used mental health treatment, they were more likely to utilize adequate prenatal care. The maternity care relationship or service delivery model (e.g., no continuity of care) as well as structural factors may adversely affect utilization among PTSD-affected survivors. Since inadequate care was associated with adverse outcomes, further studies of these modifiable factors are warranted. © 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  14. Childhood Maltreatment History, Posttraumatic Relational Sequelae, and Prenatal Care Utilization

    PubMed Central

    Bell, Sue Anne; Seng, Julia

    2015-01-01

    Objective To test the hypothesis that childhood maltreatment history would be associated with inadequate prenatal care utilization. Design A post-hoc analysis of a prospective cohort study of the effects of post traumatic stress disorder (PTSD) on pregnancy outcomes. Setting Recruitment took place via prenatal clinics from three academic health systems in southeast Michigan. Participants This analysis included 467 diverse, nulliparous, English-speaking adult women expecting their first infants. Methods Data were gathered from structured telephone interviews at two time points in pregnancy and from prenatal medical records. Results Contrary to our hypothesis, history of childhood maltreatment was associated with better likelihood of using adequate prenatal care. Risk for inadequate prenatal care occurred in association with the posttraumatic stress and interpersonal sensitivity that can result from maltreatment, with low alliance with the maternity care provider, and with public insurance coverage. Prior mental health treatment was associated with using adequate prenatal care. Conclusion When childhood maltreatment survivors were resilient or have used mental health treatment, they were more likely to utilize adequate prenatal care. The maternity care relationship or service delivery model (e.g., no continuity of care) as well as structural factors may adversely affect utilization among PTSD-affected survivors. Since inadequate care was associated with adverse outcomes, further studies of these modifiable factors are warranted. PMID:23772546

  15. Prenatal and Perinatal Factors Associated with Intellectual Disability

    ERIC Educational Resources Information Center

    Bilder, Deborah A.; Pinborough-Zimmerman, Judith; Bakian, Amanda V.; Miller, Judith S.; Dorius, Josette T.; Nangle, Barry; McMahon, William M.

    2013-01-01

    Prenatal and perinatal risk factors associated with intellectual disability (ID) were studied in 8-year-old Utah children from a 1994 birth cohort (N = 26,108) using broad ascertainment methods and birth records following the most current recording guidelines. Risk factor analyses were performed inclusive and exclusive of children with a known or…

  16. Prenatal and Perinatal Factors Associated with Intellectual Disability

    ERIC Educational Resources Information Center

    Bilder, Deborah A.; Pinborough-Zimmerman, Judith; Bakian, Amanda V.; Miller, Judith S.; Dorius, Josette T.; Nangle, Barry; McMahon, William M.

    2013-01-01

    Prenatal and perinatal risk factors associated with intellectual disability (ID) were studied in 8-year-old Utah children from a 1994 birth cohort (N = 26,108) using broad ascertainment methods and birth records following the most current recording guidelines. Risk factor analyses were performed inclusive and exclusive of children with a known or…

  17. [Prenatal care in Germany].

    PubMed

    Vetter, K; Goeckenjan, M

    2013-12-01

    Prenatal care in Germany is based on a nationwide standardized program of care for pregnant women. Besides support and health counseling, it comprises prevention or early detection of diseases or unfavorable circumstances with risks for mother and child. Prenatal care is regulated by law and structured by directives and standard procedures in maternity guidelines (Mutterschafts-Richtlinien). This includes information and counseling of future mothers on offers of psychosocial and medical assistance in normal pregnancies as well as in unplanned or unwanted pregnancies. Further aspects are clinical examinations and risk determinations for genetic variations or direct genetic analysis. During pregnancy, medical history, clinical examination, and blood testing are part of the sophisticated program, which includes at least three standardized sonographic examinations at 10, 20, and 30 weeks of gestation. The maternity passport allows a pregnant woman to carry the most relevant information on her pregnancy and her personal risks with her. For 45 years now, women in Germany are used to carrying their Mutterpass. Societal changes have influenced the central goals of maternity care: In the beginning, the mortality of mother and child had to be reduced. Today, maternal morbidity and impaired development of the child are the center of interest, with expansion to familial satisfaction. The reduction in the mortality and morbidity of both the mother and the child during pregnancy, delivery, and postpartum can be attributed to prenatal care. Thus, investment in a program of nationwide structured prenatal care seems to be worthwhile-despite the lack of evidence concerning its effectiveness.

  18. Prenatal Genetic Testing Chart

    MedlinePlus

    ... www.acog.org/Patients/FAQs/Prenatal-Genetic-Diagnostic-Tests › › Resources & Publications Committee Opinions Practice Bulletins Patient Education Green Journal Clinical Updates Practice Management Coding Health Info Technology Professional Liability Managing Your Practice Patient Safety & Quality ...

  19. Prenatal Care Training.

    ERIC Educational Resources Information Center

    Hagen, Michael

    Described is the development and evaluation of a prenatal instructional program designed to prevent birth defects. It is explained that the program, composed of five slide tape units on such topics as nutrition and environmental factors, was field tested and found effective with 97 participants (pregnant high school students, nursing students, and…

  20. Prenatal Whole Genome Sequencing

    PubMed Central

    Donley, Greer; Hull, Sara Chandros; Berkman, Benjamin E.

    2014-01-01

    With whole genome sequencing set to become the preferred method of prenatal screening, we need to pay more attention to the massive amount of information it will deliver to parents—and the fact that we don't yet understand what most of it means. PMID:22777977

  1. Prenatal diagnosis: whose right?

    PubMed Central

    Heyd, D

    1995-01-01

    The question who is the subject of the right to prenatal diagnosis may be answered in four ways: the parents, the child, society, or no one. This article investigates the philosophical issues involved in each of these answers, which touch upon the conditions of personal identity, the principle of privacy, the scope of social responsibility, and the debate about impersonalism in ethics. PMID:8558544

  2. Ambiguous genitalia: what prenatal genetic testing is practical?

    PubMed

    Adam, Margaret P; Fechner, Patricia Y; Ramsdell, Linda A; Badaru, Angela; Grady, Richard E; Pagon, Roberta A; McCauley, Elizabeth; Cheng, Edith Y; Parisi, Melissa A; Shnorhavorian, Margarett

    2012-06-01

    Concern for ambiguous genitalia or chromosome-phenotype discordance detected in a prenatal setting has increased over the last two decades. Practitioners faced with this prenatal finding have a variety of genetic tests available to them; however, it is unclear to what extent prenatal testing for disorders of sex development (DSD) is useful or practical. We undertook a retrospective review of the medical records of 140 individuals evaluated through the DSD clinic at Seattle Children's Hospital with birthdates from 01/01/1994 through 08/16/2011 to determine the rate of prenatal detection of ambiguous genitalia in individuals with DSD, what prenatal diagnostic workup was undertaken, and the postnatal outcome, including whether a postnatal genetic diagnosis was confirmed. Of all 140 subjects, 34 (24%) were identified prenatally. The most common postnatal diagnoses were penoscrotal hypospadias with transposition of the scrotum with no known genetic cause (24/140; 17%) and 21-hydroxylase deficiency (20/140; 14%). Apart from these, no single diagnosis comprised more than a few cases. Prenatal diagnostic testing varied widely, from no tests to multiple molecular tests with amniotic fluid hormone concentrations. In the absence of other fetal anomalies or growth retardation on ultrasound, prenatal karyotype with fluorescence in situ hybridization for the SRY gene is the most useful test when ambiguous genitalia is suspected. Further prenatal testing for Smith-Lemli-Opitz syndrome in 46,XY individuals and congenital adrenal hyperplasia in 46,XX individuals may be considered. However, targeted molecular testing for rare DSD conditions in the absence of a family history of DSD has a low yield. Copyright © 2012 Wiley Periodicals, Inc.

  3. Prenatal risk factors for childhood CKD.

    PubMed

    Hsu, Christine W; Yamamoto, Kalani T; Henry, Rohan K; De Roos, Anneclaire J; Flynn, Joseph T

    2014-09-01

    Development of CKD may be programmed prenatally. We sought to determine the association of childhood CKD with prenatal risk factors, including birth weight, maternal diabetes mellitus (DM), and maternal overweight/obesity. We conducted a population-based, case-control study with 1994 patients with childhood CKD (<21 years of age at diagnosis) and 20,032 controls in Washington state. We linked maternal and infant characteristics in birth records from 1987 to 2008 to hospital discharge data and used logistic regression analysis to assess the association of prenatal risk factors with childhood CKD. The prevalence of CKD was 126.7 cases per 100,000 births. High birth weight and maternal pregestational DM associated nominally with CKD, with respective crude odds ratios (ORs) of 1.17 (95% confidence interval [95% CI], 1.03 to 1.34) and 1.97 (95% CI, 1.15 to 3.37); however, adjustment for maternal confounders attenuated these associations to 0.97 (95% CI, 0.79 to 1.21) and 1.19 (95% CI, 0.51 to 2.81), respectively. The adjusted ORs for CKD associated with other prenatal factors were 2.88 (95% CI, 2.28 to 3.63) for low birth weight, 1.54 (95% CI, 1.13 to 2.09) for maternal gestational DM, 1.24 (95% CI, 1.05 to 1.48) for maternal overweight, and 1.26 (95% CI, 1.05 to 1.52) for maternal obesity. In subgroup analysis by CKD subtype, low birth weight and maternal pregestational DM associated significantly with increased risk of renal dysplasia/aplasia. Low birth weight, maternal gestational DM, and maternal overweight/obesity associated significantly with obstructive uropathy. These data suggest that prenatal factors may impact the risk of CKD. Future studies should aim to determine if modification of these factors could reduce the risk of childhood CKD.

  4. Revision of the School Career and Health Record for Children Attending School Abroad. Final Report. The CDCC's Project No. 7: "The Education and Cultural Development of Migrants."

    ERIC Educational Resources Information Center

    Huart, Michelle

    Designed for use during compulsory schooling, the school career and health record described the child's knowledge, aptitudes, and general health at a given time. It was recommended that Council of Europe member states ask their school authorities to use the record for children attending school abroad for a trial period (ending July 31, 1982) and…

  5. The Prenatal Care at School Program

    ERIC Educational Resources Information Center

    Griswold, Carol H.; Nasso, Jacqueline T.; Swider, Susan; Ellison, Brenda R.; Griswold, Daniel L.; Brooks, Marilyn

    2013-01-01

    School absenteeism and poor compliance with prenatal appointments are concerns for pregnant teens. The Prenatal Care at School (PAS) program is a new model of prenatal care involving local health care providers and school personnel to reduce the need for students to leave school for prenatal care. The program combines prenatal care and education…

  6. The Prenatal Care at School Program

    ERIC Educational Resources Information Center

    Griswold, Carol H.; Nasso, Jacqueline T.; Swider, Susan; Ellison, Brenda R.; Griswold, Daniel L.; Brooks, Marilyn

    2013-01-01

    School absenteeism and poor compliance with prenatal appointments are concerns for pregnant teens. The Prenatal Care at School (PAS) program is a new model of prenatal care involving local health care providers and school personnel to reduce the need for students to leave school for prenatal care. The program combines prenatal care and education…

  7. Revising Lecture Notes: How Revision, Pauses, and Partners Affect Note Taking and Achievement

    ERIC Educational Resources Information Center

    Luo, Linlin; Kiewra, Kenneth A.; Samuelson, Lydia

    2016-01-01

    Note taking has been categorized as a two-stage process: the recording of notes and the review of notes. We contend that note taking might best involve a three-stage process where the missing stage is revision. This study investigated the benefits of revising lecture notes and addressed two questions: First, is revision more effective than…

  8. Prenatal surgery for myelomeningocele and the need for cerebrospinal fluid shunt placement

    PubMed Central

    Tulipan, Noel; Wellons, John C.; Thom, Elizabeth A.; Gupta, Nalin; Sutton, Leslie N.; Burrows, Pamela K.; Farmer, Diana; Walsh, William; Johnson, Mark P.; Rand, Larry; Tolivaisa, Susan; D’Alton, Mary E.; Adzick, N. Scott

    2016-01-01

    Object The Management of Myelomeningocele Study (MOMS) was a multicenter randomized trial comparing the safety and efficacy of prenatal and postnatal closure of myelomeningocele. The trial was stopped early because of the demonstrated efficacy of prenatal surgery, and outcomes on 158 of 183 pregnancies were reported. Here, the authors update the 1-year outcomes for the complete trial, analyze the primary and related outcomes, and evaluate whether specific prerandomization risk factors are associated with prenatal surgery benefit. Methods The primary outcome was a composite of fetal loss or any of the following: infant death, CSF shunt placement, or meeting the prespecified criteria for shunt placement. Primary outcome, actual shunt placement, and shunt revision rates for prenatal versus postnatal repair were compared. The shunt criteria were reassessed to determine which were most concordant with practice, and a new composite outcome was created from the primary outcome by replacing the original criteria for CSF shunt placement with the revised criteria. The authors used logistic regression to estimate whether there were interactions between the type of surgery and known prenatal risk factors (lesion level, gestational age, degree of hindbrain herniation, and ventricle size) for shunt placement, and to determine which factors were associated with shunting among those infants who underwent prenatal surgery. Results Ninety-one women were randomized to prenatal surgery and 92 to postnatal repair. The primary outcome occurred in 73% of infants in the prenatal surgery group and in 98% in the postnatal group (p < 0.0001). Actual rates of shunt placement were only 44% and 84% in the 2 groups, respectively (p < 0.0001). The authors revised the most commonly met criterion to require overt clinical signs of increased intracranial pressure, defined as split sutures, bulging fontanelle, or sunsetting eyes, in addition to increasing head circumference or hydrocephalus. Using

  9. Human prenatal diagnosis

    SciTech Connect

    Filkins, K.; Russo, R.J.

    1985-01-01

    The multiauthor text is written as a ''guide to rationalize and clarify certain aspects of diagnosis, general counseling and intervention'' for ''health professionals who provide care to pregnant women.'' The text is not aimed at the ultrasonographer but rather at the physicians who are clinically responsible for patient management. Chapters of relevance to radiologists include an overview of prenatal screening and counseling, diagnosis of neural tube defects, ultrasonographic (US) scanning of fetal disorders in the first and second trimesters of pregnancy, US scanning in the third trimester, multiple gestation and selective termination, fetal echo and Doppler studies, and fetal therapy. Also included are overviews of virtually all currently utilized prenatal diagnostic techniques including amniocentesis, fetal blood sampling, fetoscopy, recombinant DNA detection of hemoglobinopathies, chorionic villus sampling, embryoscopy, legal issues, and diagnosis of Mendelian disorders by DNA analysis.

  10. Prenatal findings of holoprosencephaly.

    PubMed

    Hayashi, Yuko; Suzumori, Nobuhiro; Sugiura, Tokio; Sugiura-Ogasawara, Mayumi

    2015-08-01

    Holoprosencephaly (HPE) is a rare brain abnormality characterized by an incomplete cleavage of the primitive prosencephalon of forebrain during early embryogenesis. To determine the clinical characteristics and outcome of fetuses with HPE, we retrospectively analyzed nine patients who were prenatally diagnosed as fetal HPE by ultrasounds. The mean diagnostic weeks were 20 weeks of gestation. Two cases died within one day after birth. The chromosomal examinations were performed in seven cases (trisomy 18: n = 2; trisomy 13: n = 2; 45,XX,der(18)t(18;21)(p10;p10)mat: n = 1; normal karyotype: n = 2). In our HPE cases, most cases had serious facial anomalies and poor prognosis. Our data suggested that the early prenatal diagnosis of HPE allowed time for parental counseling and delivery planning.

  11. Prenatal stress and epigenetics.

    PubMed

    Cao-Lei, L; de Rooij, S R; King, S; Matthews, S G; Metz, G A S; Roseboom, T J; Szyf, M

    2017-05-18

    In utero exposure to environmental stress in both animals and humans could result in long-term epigenome alterations which further lead to consequences for adaptation and development in the offspring. Epigenetics, especially DNA methylation, is considered one of the most widely studied and well-characterized mechanisms involved in the long-lasting effects of in utero stress exposure. In this review, we outlined evidence from animal and human prenatal research supporting the view that prenatal stress could lead to lasting, broad and functionally organized signatures in DNA methylation which, in turn, could mediate exposure-phenotype associations. We also emphasized the advantage of using stressor from quasi-randomly assigned experiments. Furthermore, we discuss challenges that still need to be addressed in this field in the future. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Prenatal testosterone and stuttering.

    PubMed

    Montag, Christian; Bleek, Benjamin; Breuer, Svenja; Prüss, Holger; Richardt, Kirsten; Cook, Susanne; Yaruss, J Scott; Reuter, Martin

    2015-01-01

    The prevalence of stuttering is much higher in males compared to females. The biological underpinnings of this skewed sex-ratio is poorly understood, but it has often been speculated that sex hormones could play an important role. The present study investigated a potential link between prenatal testosterone and stuttering. Here, an indirect indicator of prenatal testosterone levels, the Digit Ratio (2D:4D) of the hand, was used. As numerous studies have shown, hands with more "male" characteristics (putatively representing greater prenatal testosterone levels) are characterized by a longer ring finger compared to the index finger (represented as a lower 2D:4D ratio) in the general population. We searched for differences in the 2D:4D ratios between 38 persons who stutter and 36 persons who do not stutter. In a second step, we investigated potential links between the 2D:4D ratio and the multifaceted symptomatology of stuttering, as measured by the Overall Assessment of the Speaker's Experience of Stuttering (OASES), in a larger sample of 44 adults who stutter. In the first step, no significant differences in the 2D:4D were observed between individuals who stutter and individuals who do not stutter. In the second step, 2D:4D correlated negatively with higher scores of the OASES (representing higher negative experiences due to stuttering), and this effect was more pronounced for female persons who stutter. The findings indicate for the first time that prenatal testosterone may influence individual differences in psychosocial impact of this speech disorder. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. A national perspective on prenatal testing for mitochondrial disease.

    PubMed

    Nesbitt, Victoria; Alston, Charlotte L; Blakely, Emma L; Fratter, Carl; Feeney, Catherine L; Poulton, Joanna; Brown, Garry K; Turnbull, Doug M; Taylor, Robert W; McFarland, Robert

    2014-11-01

    Mitochondrial diseases affect >1 in 7500 live births and may be due to mutations in either mitochondrial DNA (mtDNA) or nuclear DNA (nDNA). Genetic counselling for families with mitochondrial diseases, especially those due to mtDNA mutations, provides unique and difficult challenges particularly in relation to disease transmission and prevention. We have experienced an increasing demand for prenatal diagnostic testing from families affected by mitochondrial disease since we first offered this service in 2007. We review the diagnostic records of the 62 prenatal samples (17 mtDNA and 45 nDNA) analysed since 2007, the reasons for testing, mutation investigated and the clinical outcome. Our findings indicate that prenatal testing for mitochondrial disease is reliable and informative for the nuclear and selected mtDNA mutations we have tested. Where available, the results of mtDNA heteroplasmy analyses from other family members are helpful in interpreting the prenatal mtDNA test result. This is particularly important when the mutation is rare or the mtDNA heteroplasmy is observed at intermediate levels. At least 11 cases of mitochondrial disease were prevented following prenatal testing, 3 of which were mtDNA disease. On the basis of our results, we believe that prenatal testing for mitochondrial disease is an important option for couples where appropriate genetic analyses and pre/post-test counselling can be provided.

  14. A practical prenatal ultrasound classification system for common oral clefts.

    PubMed

    Maarse, Wiesje; Boonacker, Chantal W B; Breugem, Corstiaan C; Kon, Moshe; Manten, Gwendolyn T R; Mink van der Molen, Aebele B

    2015-09-01

    Our aim is to introduce and validate a new oral cleft classification system based on prenatal ultrasound for use by professionals in daily practice. During a 3-year period (2011-2014), all cases of prenatal oral cleft diagnosed by ultrasound were retrospectively reviewed. A new prenatal ultrasound classification system was introduced. For the purpose of validation, prenatal ultrasound images of oral cleft types were described according to the new classification system and were compared with postnatal findings by reviewing medical records. A total of 103 fetuses with oral cleft were identified by ultrasound. The mean gestation time at detection was 20.4 weeks (95% confidence intervals: 20.0-20.7). The association between oral cleft and other anomalies varied by cleft type; types 2b/3b and 4 were most frequently associated with other anomalies. The measure of agreement between the prenatal and postnatal findings showed a Kappa value of 0.63 (95% confidence intervals: 0.52-0.75), demonstrating the accuracy of this new classification system. A new prenatal oral cleft classification system is presented. This system appears to be accurate, and it shows the variation in the risk of associated anomalies for each cleft type. We expect that ultrasonographers will be able to use the new classification in daily practice. © 2015 John Wiley & Sons, Ltd.

  15. Proliferation of prenatal ultrasonography

    PubMed Central

    You, John J.; Alter, David A.; Stukel, Therese A.; McDonald, Sarah D.; Laupacis, Andreas; Liu, Ying; Ray, Joel G.

    2010-01-01

    Background The extent to which temporal increases in the use of prenatal ultrasonography reflect changes in maternal risk is unknown. In this population-based study, we examined the use of prenatal ultrasonography from 1996 to 2006 in Ontario. Methods With fiscal year 1996/97 as the baseline, we evaluated the relative risk (RR) and 95% confidence interval (CI) for the change in rates of ultrasonography for each subsequent year. The RR was adjusted for maternal age, income, rural residence, maternal comorbidities, receipt of genetics consultation or amniocentesis — all in the index pregnancy — and history of complications in a prior pregnancy. Results The study sample consisted of 1 399 389 singleton deliveries. The rate of prenatal ultrasonography increased from 2055 per 1000 pregnancies in 1996 to 3264 per 1000 in 2006 (adjusted RR 1.55, 95% CI 1.54–1.55). The rate increased among both women with low-risk pregnancies (adjusted RR 1.54, 95% CI 1.53–1.55) and those with high-risk pregnancies (adjusted RR 1.55, 95% CI 1.54–1.57). The proportion of pregnancies with at least four ultrasound examinations in the second or third trimesters rose from 6.4% in 1996 to 18.7% in 2006 (adjusted RR 2.68, 95% CI 2.61–2.74). Paradoxically, this increase was more pronounced among low-risk pregnancies (adjusted RR 2.92, 95% CI 2.83–3.01) than among high-risk pregnancies (adjusted RR 2.25, 95% CI 2.16–2.35). Interpretation Substantial increases in the use of prenatal ultrasonography over the past decade do not appear to reflect changes in maternal risk. Nearly one in five women now undergo four or more ultrasound examinations during the second and third trimesters. Efforts to promote more appropriate use of prenatal ultrasonography for singleton pregnancies appear warranted. PMID:20048009

  16. Playfulness and prenatal alcohol exposure: a comparative study.

    PubMed

    Pearton, Jordan Louise; Ramugondo, Elelwani; Cloete, Lizahn; Cordier, Reinie

    2014-08-01

    South Africa carries a high burden of alcohol abuse. The effects of maternal alcohol consumption during pregnancy are most pronounced in poor, rural communities. Earlier research suggests that children with prenatal alcohol exposure have poor social behaviour; however, to date, no research has investigated their playfulness. This study investigated the differences in playfulness of children with and without prenatal alcohol exposure. Grade one learners with a positive history of prenatal alcohol exposure (n = 15) and a reference group without a positive history of prenatal alcohol exposure (n = 15) were filmed engaging in free play at their schools. The Test of Playfulness was used to measure playfulness from recordings. Data were subjected to Rasch analysis to calculate interval level measure scores for each participant. The overall measure scores and individual Test of Playfulness social items were subjected to paired samples t-tests to calculate if significant differences existed between the groups. Children with prenatal alcohol exposure had a significantly lower mean overall playfulness score than the reference group (t = -2.51; d.f. = 28; P = 0.02). Children with prenatal alcohol exposure also scored significantly lower than the reference group on 5 of the 12 Test of Playfulness items related to social play. This research suggests that children with prenatal alcohol exposure are more likely to experience poorer overall quality of play, with particular deficits in social play. Considering play is a child's primary occupation, this finding becomes pertinent for occupational therapy practice, particularly in post-apartheid South Africa, where high prenatal alcohol exposure prevalence rates are couched within persistent socio-economic inequalities. © 2014 Occupational Therapy Australia.

  17. Deglacial 14C plateau suites recalibrated by Suigetsu atmospheric 14C record - Revised 14C reservoir ages from three ocean basins corroborate extreme surface water variations

    NASA Astrophysics Data System (ADS)

    Sarnthein, M.; Balmer, S.; Grootes, P. M.

    2013-12-01

    Radiocarbon (14C) reservoir/ventilation ages (Δ14C) provide unique insights into the dynamics of ocean water masses over LGM and deglacial times. The 14C plateau-tuning technique enables us to derive both an absolute chronology for marine sediment records and a high-resolution record of changing Δ14C values for deglacial surface and deep waters (Sarnthein et al., 2007; AGU Monogr. 173, 175). We designate as 14C plateau a sediment section in the age-depth profile with several almost constant planktic 14C ages - variation less than ×100 to ×300 yr - which form a plateau-shaped scatter band that extends over ~5 to 50 and up to 200 cm in sediment cores with sedimentation rates of >10 cm/ky. Previously, a suite of >15 plateau boundary ages were calibrated to a joint reference record of U/Th-dated 14C time series measured on coral samples, the Cariaco sediment record, and speleothems (Fairbanks et al., 2005, QSR 24; Hughen et al., 2006, QSR 25; Beck et al., 2001, Science 292). We now used the varve-counted atmospheric 14C record of Lake Suigetsu (Ramsey et al., 2012, Science 338, 370) to recalibrate the boundary ages and average ages of 14C plateaus and apply the amended plateau-tuning technique to a dozen Δ14C records from the Atlantic and Indo-Pacific. Main results are: (1) The Suigetsu atmospheric 14C record reflects all 14C plateaus, their internal structures and relative length previously identified, but implies a rise in the average plateau age by <200 14C yr during the LGM, >700 yr at its end, and <200 yr in the Bølling-Allerød. (2) Based on different 14C ages of coeval atmospheric and planktic 14C plateaus surface water Δ14C may have temporarily dropped to an equivalent of 200 yr in low-latitude stratified waters, such as off northwestern South America, and in turn reached values corresponding to an age difference of >2500 14C yr in stratified subpolar regions and upwelled waters such as in the South China Sea, values that differ significantly from a

  18. Revision of Poa L. (Poaceae, Pooideae, Poeae, Poinae) in Mexico: new records, re-evaluation of P. ruprechtii, and two new species, P. palmeri and P. wendtii

    PubMed Central

    Soreng, Robert J.; Peterson, Paul M.

    2012-01-01

    Abstract A revision and key to the 23 species and eight subspecies of Poa (including Dissanthelium) known to occur in Mexico is provided. All voucher specimens seen are cited for accepted taxa, except Poa annua for which one voucher per state is provided. Taxa not previously known from, or poorly understood in, Mexico are discussed.Poa palmeri sp. nov. is endemic to forested slopes of the Sierra Madre Oriental, and we distinguished it from Poa ruprechtii s.s., a species of central Mexico that is here emended to include Poa sharpii (syn. nov.). Poa wendtii sp. nov. is described from the Sierra Santa Rosa in northern Coahuila. Poa tacanae is placed in synonymy in Poa seleri. Poa gymnantha and Poa occidentalis are newly reported for Mexico, and material historically identified as Poa villaroelii areplaced in Poa chamaeclinos.The genus Dissanthelium is considered to belong within Poa, and the Mexican taxa, Dissanthelium calycina subsp. mathewsii and Dissanthelium californicum, are treated as Poa calycina var. mathewsii and Poa thomasii, respectively. Poa subsect. Papillopoa subsect. nov. is erected for Poa mulleri. Lectotypes are designated for Poa conglomerata and Poa seleri. PMID:23185125

  19. Revision Rhinoplasty.

    PubMed

    Loyo, Myriam; Wang, Tom D

    2016-01-01

    Revision rhinoplasty is one of the most challenging operations the facial plastic surgeon performs given the complex 3-dimensional anatomy of the nose and the psychological impact it has on patients. The intricate interplay of cartilages, bone, and soft tissue in the nose gives it its aesthetic and function. Facial harmony and attractiveness depends greatly on the nose given its central position in the face. In the following article, the authors review common motivations and anatomic findings for patients seeking revision rhinoplasty based on the senior author's 30-year experience with rhinoplasty and a review of the literature.

  20. Associations between Prenatal Exposure to Black Carbon and Memory Domains in Urban Children: Modification by Sex and Prenatal Stress.

    PubMed

    Cowell, Whitney J; Bellinger, David C; Coull, Brent A; Gennings, Chris; Wright, Robert O; Wright, Rosalind J

    2015-01-01

    Whether fetal neurodevelopment is disrupted by traffic-related air pollution is uncertain. Animal studies suggest that chemical and non-chemical stressors interact to impact neurodevelopment, and that this association is further modified by sex. To examine associations between prenatal traffic-related black carbon exposure, prenatal stress, and sex with children's memory and learning. Analyses included N = 258 mother-child dyads enrolled in a Boston, Massachusetts pregnancy cohort. Black carbon exposure was estimated using a validated spatiotemporal land-use regression model. Prenatal stress was measured using the Crisis in Family Systems-Revised survey of negative life events. The Wide Range Assessment of Memory and Learning (WRAML2) was administered at age 6 years; outcomes included the General Memory Index and its component indices [Verbal, Visual, and Attention Concentration]. Relationships between black carbon and WRAML2 index scores were examined using multivariable-adjusted linear regression including effect modification by stress and sex. Mothers were primarily minorities (60% Hispanic, 26% Black); 67% had ≤12 years of education. The main effect for black carbon was not significant for any WRAML2 index; however, in stratified analyses, among boys with high exposure to prenatal stress, Attention Concentration Index scores were on average 9.5 points lower for those with high compared to low prenatal black carbon exposure (P3-way interaction = 0.04). The associations between prenatal exposure to black carbon and stress with children's memory scores were stronger in boys than in girls. Studies assessing complex interactions may more fully characterize health risks and, in particular, identify vulnerable subgroups.

  1. Associations between Prenatal Exposure to Black Carbon and Memory Domains in Urban Children: Modification by Sex and Prenatal Stress

    PubMed Central

    Cowell, Whitney J.; Bellinger, David C.; Coull, Brent A.; Gennings, Chris; Wright, Robert O.; Wright, Rosalind J.

    2015-01-01

    Background Whether fetal neurodevelopment is disrupted by traffic-related air pollution is uncertain. Animal studies suggest that chemical and non-chemical stressors interact to impact neurodevelopment, and that this association is further modified by sex. Objectives To examine associations between prenatal traffic-related black carbon exposure, prenatal stress, and sex with children’s memory and learning. Methods Analyses included N = 258 mother-child dyads enrolled in a Boston, Massachusetts pregnancy cohort. Black carbon exposure was estimated using a validated spatiotemporal land-use regression model. Prenatal stress was measured using the Crisis in Family Systems-Revised survey of negative life events. The Wide Range Assessment of Memory and Learning (WRAML2) was administered at age 6 years; outcomes included the General Memory Index and its component indices [Verbal, Visual, and Attention Concentration]. Relationships between black carbon and WRAML2 index scores were examined using multivariable-adjusted linear regression including effect modification by stress and sex. Results Mothers were primarily minorities (60% Hispanic, 26% Black); 67% had ≤12 years of education. The main effect for black carbon was not significant for any WRAML2 index; however, in stratified analyses, among boys with high exposure to prenatal stress, Attention Concentration Index scores were on average 9.5 points lower for those with high compared to low prenatal black carbon exposure (P3-way interaction = 0.04). Conclusion The associations between prenatal exposure to black carbon and stress with children’s memory scores were stronger in boys than in girls. Studies assessing complex interactions may more fully characterize health risks and, in particular, identify vulnerable subgroups. PMID:26544967

  2. Work plan for ground water elevation data recorder/monitor well installation at the New Rifle Site, Rifle, Colorado. Revision 1

    SciTech Connect

    Not Available

    1994-08-01

    The purpose of this document is to describe the work that will be performed and the procedures that will be followed during installation of ground water monitor wells and ground water elevation data recorders (data loggers) at the New Rifle Uranium Mill Tailings Remedial Action (UMTRA) Project site, Rifle, Colorado. The monitor wells and data loggers will be used to gather required time-dependent data to investigate the interaction between the shallow aquifer and the Colorado River.

  3. The Place of Prenatal Clases

    PubMed Central

    Enkin, M. W.

    1978-01-01

    The past 20 years has shown an exponential rise in both obstetrical intervention and family centred maternity care. Prenatal classes, although not as yet fully integrated into prenatal care, fill a vital role in teaching couples the information, skills, and attitudes required to participate actively in their reproductive care, and to recognize both their rights and their responsibilities. PMID:21301557

  4. Selective abortion after prenatal diagnosis.

    PubMed

    Schubert-Lehnhardt, V

    1996-01-01

    This paper deals with the main arguments in Europe against selective abortion after prenatal diagnoses and against using prenatal diagnoses as a whole from an ethical point of view. The different experiences from the Eastern and the Western parts of Germany are used as examples. The paper suggests that using ethics could promote multicultural experiences and different strategies of decision-making.

  5. Group Prenatal Care: Model Fidelity and Outcomes

    PubMed Central

    NOVICK, Gina; REID, Allecia E.; LEWIS, Jessica; KERSHAW, Trace S.; RISING, Sharon S.; ICKOVICS, Jeannette R.

    2013-01-01

    Objective CenteringPregnancy group prenatal care has been demonstrated to improve pregnancy outcomes. However, there is likely variation in how the model is implemented in clinical practice, which may be associated with efficacy, and therefore variation, in outcomes. We examined the association of fidelity to process and content of the CenteringPregnancy group prenatal care model with outcomes previously shown to be affected in a clinical trial: preterm birth, adequacy of prenatal care and breastfeeding initiation. Study Design Participants were 519 women who received CenteringPregnancy group prenatal care. Process fidelity reflected how facilitative leaders were and how involved participants were in each session. Content fidelity reflected whether recommended content was discussed in each session. Fidelity was rated at each session by a trained researcher. Preterm birth and adequacy of care were abstracted from medical records. Participants self-reported breastfeeding initiation at 6-months postpartum. Results Controlling for important clinical predictors, greater process fidelity was associated with significantly lower odds of both preterm birth (B=−0.43, Wald χ2=8.65, P=.001) and intensive utilization of care (B=−0.29, Wald χ2=3.91, P=.05). Greater content fidelity was associated with lower odds of intensive utilization of care (B=−0.03, Wald χ2=9.31, P=.001). Conclusion Maintaining fidelity to facilitative group processes in CenteringPregnancy was associated with significant reductions in preterm birth and intensive care utilization of care. Content fidelity also was associated with reductions in intensive utilization of care. Clinicians learning to facilitate group care should receive training in facilitative leadership, emphasizing the critical role that creating a participatory atmosphere can play in improving outcomes. PMID:23524175

  6. Revision of Ernst Antevs' New England Varve Chronology: A Record of Meltwater Production and Southeastern LIS Recession: 18.2-12.5 kyr BP (Invited)

    NASA Astrophysics Data System (ADS)

    Ridge, J. C.

    2013-12-01

    runoff, vegetation, and erosion on a recently deglaciated paraglacial landscape. However, in this case cooling events are recognized by higher sediment input and thicker varves. Comparison of varve thickness records to GISP2 ice core records (δ18O original measurements with GICC05 time scale applied) show that from 15.0-12.5 kyr BP climate changes of decadal and longer scale recorded in both records appear identical in spacing and magnitude. Independent time scales for both records (varve 14C calibration and ice core layer counts) are different by 55 yr (well within time scale uncertainties) when similar features in the two records are matched. Varves and the Greenland ice cores appear to simultaneously record the same regional climate changes or, less likely, there is a consistent offset at all scales. After 15.0 yr BP there appears to have been a link between North Atlantic climate and glacial processes (ablation, meltwater production, and ice recession/advance). Prior to 15.0 kyr BP, glacial events are marked by more subtle changes in varve thickness but there is only a weak relationship between varve thickness and Greenland climate.

  7. Health information technology: standards, implementation specifications, and certification criteria for electronic health record technology, 2014 edition; revisions to the permanent certification program for health information technology. Final rule.

    PubMed

    2012-09-04

    With this final rule, the Secretary of Health and Human Services adopts certification criteria that establish the technical capabilities and specify the related standards and implementation specifications that Certified Electronic Health Record (EHR) Technology will need to include to, at a minimum, support the achievement of meaningful use by eligible professionals, eligible hospitals, and critical access hospitals under the Medicare and Medicaid EHR Incentive Programs beginning with the EHR reporting periods in fiscal year and calendar year 2014. This final rule also makes changes to the permanent certification program for health information technology, including changing the program's name to the ONC HIT Certification Program.

  8. Prenatal diagnosis of hemimegalencephaly.

    PubMed

    Lang, Shih-Shan; Goldberg, Ethan; Zarnow, Deborah; Johnson, Mark P; Storm, Phillip B; Heuer, Gregory G

    2014-01-01

    In recent literature, there have been case reports of prenatal diagnosis of hemimegalencephaly, an extremely rare entity characterized by enlargement of all or portions of 1 cerebral hemisphere and intractable seizures. A unique case is presented of hemimegalencephaly of a fetus diagnosed in utero. A 27-year-old woman presented at 32 weeks' gestation for fetal magnetic resonance imaging after an abnormal fetal ultrasound. Fetal magnetic resonance imaging showed hemimegalencephaly of the left cerebral hemisphere with abnormal gyration. The patient was born via cesarean section at 39 weeks' gestation. He had continuous infantile spasms and partial-onset seizures starting on day 1 of life, and electroencephalography showed burst suppression. The patient's seizures were initially managed with antiepileptics, prednisolone, and a ketogenic diet; however, he was hospitalized multiple times because of status epilepticus. At 6 months of age, he underwent a successful anatomic left hemispherectomy. In utero diagnosis of complex developmental brain anomalies allows a multidisciplinary approach to provide optimal prenatal patient treatment and parental counseling. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Prenatal Cell-Free DNA Screening

    MedlinePlus

    Prenatal cell-free DNA screening Overview By Mayo Clinic Staff Prenatal cell-free DNA (cfDNA) screening, also known as noninvasive prenatal screening, is ... in a developing baby. During prenatal cell-free DNA screening, DNA from the mother and fetus is ...

  10. Prenatal vitamins: what is in the bottle?

    PubMed

    Duerbeck, Norman B; Dowling, David D; Duerbeck, Jillinda M

    2014-12-01

    Nearly all obstetricians routinely prescribe prenatal vitamins to their pregnant patients at the time of the first prenatal visit. Many times, patients' understanding of the health benefits of prenatal vitamins differs substantially from that of the prescribing physician. The following is a review of the most common ingredients found in prenatal vitamins and their purported health benefits.

  11. Record of Technical Change {number_sign}1 for ''Corrective Action Investigation Plan for Corrective Action Unit 406: Area 3 Building 03-74 and Building 03-58 Underground Discharge Points and Corrective Action Unit 429: Area 3 Building 03-55 and Area 9 Building 09-52 Underground Discharge Points, Tonopah Test Range, Nevada'' Revision 0

    SciTech Connect

    US DOE Nevada Operations Office

    1999-06-30

    This Record of Technical Change provides updates to the technical information included in ''Corrective Action Investigation Plan for Corrective Action Unit 406: Area 3 Building 03-74 and Building 03-58 Underground Discharge Points and Corrective Action Unit 429: Area 3 Building 03-55 and Area 9 Building 09-52 Underground Discharge Points, Tonopah Test Range, Nevada'' Revision 0

  12. Measuring adequacy of prenatal care: does missing visit information matter?

    PubMed

    Kurtzman, Jordan H; Wasserman, Erin B; Suter, Barbara J; Glantz, J Christopher; Dozier, Ann M

    2014-09-01

    Kotelchuck's Adequacy of Prenatal Care Utilization (APNCU) Index is frequently used to classify levels of prenatal care. In the Finger Lakes Region (FLR) of upstate New York, prenatal care visit information late in pregnancy is often not documented on the birth certificate. We studied the extent of this missing information and its impact on the validity of regional APNCU scores. We calculated the "weeks between" a mother's last prenatal care visit and her infant's date of birth. We adjusted the APNCU algorithm creating the Last Visit Adequacy of Prenatal Care (LV-APNC) Index using the last recorded prenatal care visit date as the end point of care and the expected number of visits at that time. We compared maternal characteristics by care level with each index, examining rates of reclassification and number of "weeks between" by birth hospital. Stuart-Maxwell, McNemar, chi-square, and t-tests were used to determine statistical significance. Based on 58,462 births, the mean "weeks between" was 2.8 weeks. Compared with their APNCU Index score, 42.4 percent of mothers were reclassified using the LV-APNC Index. Major movement occurred from Intermediate (APNCU) to Adequate or Adequate Plus (LV-APNC) leaving the Intermediate Care group a more at-risk group of mothers. Those with Adequate or Adequate Plus Care (LV-APNC) increased by 31.6 percent, surpassing the Healthy People 2020 objective. In the FLR, missing visit information at the end of pregnancy results in an underestimation of mothers' prenatal care. Future research is needed to determine the extent of this missing visit information on the national level. © 2014 Wiley Periodicals, Inc.

  13. Women’s Experiences of Group Prenatal Care

    PubMed Central

    Novick, Gina; Sadler, Lois S.; Kennedy, Holly Powell; Cohen, Sally S.; Groce, Nora E.; Knafl, Kathleen A.

    2011-01-01

    Group prenatal care (GPNC) is an innovative alternative to individual prenatal care. In this longitudinal study we used ethnographic methods to explore African American and Hispanic women’s experiences of receiving GPNC in two urban clinics. Methods included individual, in-depth, semistructured interviews of women and group leaders in GPNC, participant observation of GPNC sessions, and medical record review. GPNC offered positive experiences and met many of the women’s expressed preferences regarding prenatal care. Six themes were identified, which represented separate aspects of women’s experiences: investment, collaborative venture, a social gathering, relationships with boundaries, learning in the group, and changing self. Taken together, the themes conveyed the overall experience of GPNC. Women were especially enthusiastic about learning in groups, about their relationships with group leaders, and about having their pregnancy-related changes and fears normalized. There were also important boundaries on relationships between participants, and some women wished for greater privacy during physical examinations. PMID:20693516

  14. Cytogenetic analysis in prenatal diagnosis.

    PubMed Central

    Schonberg, S A

    1993-01-01

    Chromosome analysis is the single most frequent test used in laboratory prenatal diagnostic studies. I summarize the current status of the field, including diagnostic problems in the laboratory and the clinical problems associated with communicating unexpected laboratory findings. I explore the effect of molecular genetics on these issues and its possible future effects on the entire practice of prenatal diagnosis as it relates to the risk for chromosome nondisjunction (trisomy). I also discuss the use of cytogenetic analysis in the prenatal diagnosis of certain inherited genetic diseases. Images PMID:8236978

  15. Prenatal features of Noonan syndrome: prevalence and prognostic value.

    PubMed

    Baldassarre, G; Mussa, A; Dotta, A; Banaudi, E; Forzano, S; Marinosci, A; Rossi, C; Tartaglia, M; Silengo, M; Ferrero, G B

    2011-10-01

    Noonan syndrome (NS) is a common autosomal dominant developmental disorder, mainly characterized by congenital heart defects, short stature, and a variable degree of developmental delay. We have reviewed the prenatal findings in NS and we have correlated them with genotype and postnatal phenotype. The cohort consisted of 47 patients with molecular diagnosis of NS. Prenatal and postnatal phenotypes were assessed by analysis of medical records, and clinical follow-up. Postnatal clinical phenotype, congenital heart disease, neuropsychomotor development, and growth pattern were arbitrarily scored in terms of severity. Mean age at diagnosis of NS was 7 years (ranging from birth to 38 years). Abnormal maternal serum triple screen was present in 36% of cases, nuchal translucency > 2.5 mm in 41%, polyhydramnios in 38% and fetal anomalies at prenatal ultrasonography in 21%. No statistical association was observed between prenatal findings and NS genotype or scores of postnatal clinical phenotype, congenital heart disease, neuropsychomotor development, or short stature. Presence of morphologic fetal anomalies at ultrasonography was associated with developmental delay/intellectual disabilities (p < 0.001) and juvenile myelomonocytic leukaemia (p = 0.006). Abnormal prenatal findings are frequent in NS pregnancies, though they are not specific and most are not useful for the prediction of the postnatal phenotype. Copyright © 2011 John Wiley & Sons, Ltd.

  16. Prenatal management of anencephaly.

    PubMed

    Cook, Rebecca J; Erdman, Joanna N; Hevia, Martin; Dickens, Bernard M

    2008-09-01

    About a third of anencephalic fetuses are born alive, but they are not conscious or viable, and soon die. This neural tube defect can be limited by dietary consumption of foliates, and detected prenatally by ultrasound and other means. Many laws permit abortion, on this indication or on the effects of pregnancy and prospects of delivery on a woman's physical or mental health. However, abortion is limited under some legal systems, particularly in South America. To avoid criminal liability, physicians will not terminate pregnancies, by induced birth or abortion, without prior judicial approval. Argentinian courts have developed means to resolve these cases, but responses of Brazilian courts are less clear. Ethical concerns relate to late-term abortion, meaning after the point of fetal viability, but since anencephalic fetuses are nonviable, many ethical concerns are overcome. Professional guidance is provided by several professional and institutional codes on management of anencephalic pregnancies.

  17. Choosing Your Prenatal Care Provider

    MedlinePlus

    ... care is choosing your provider. Who can you go to for prenatal care? You can choose who ... baby if your provider’s not available when you go into labor? What hospital or birthing center does ...

  18. Prenatal Care: First Trimester Visits

    MedlinePlus

    ... your partner in the appointment as well. Medical history Your health care provider will ask many questions, ... pregnancy-week-by-week/in-depth/prenatal-care/art-20044882 . Mayo Clinic Footer Legal Conditions and Terms ...

  19. ACL Revision

    PubMed Central

    Costa-Paz, Matias; Dubois, Julieta Puig; Zicaro, Juan Pablo; Rasumoff, Alejandro; Yacuzzi, Carlos

    2017-01-01

    Objectives: The purpose of this study was to evaluate a series of patients one year after an ACL revision with clinical evaluation and MRI, to consider their condition before returning to sports activities. Methods: A descriptive, prospective and longitudinal study was performed. A series of patients who underwent an ACL revision between March 2014 and March 2015 were evaluated after one year post surgery. They were evaluated using the Lysholm score, IKDC, Tegner, artrometry and MRI (3.0 t). A signal pattern and osteointegration was determined in the MRI. Graft signal intensity of the ACL graft using the signal/noise quotient value (SNQ) was also determined to evaluate the ligamentatization process state. Results: A total of 18 male patients were evaluated with a mean age of 31 years old.Average scores were: Lysholm 88 points, IKDC 80 points, Pre-surgical Tegner 9 points and postoperative 4 points. Artrhometry (KT1000) at 20 newtons showed a side to side difference of less than 3 mm in 88%. Only 44% of patients returned to their previous sport activity one year after revision.The MRI showed a heterogeneous signal in neoligaments in 34% of patients. SNQ showed graft integration in only 28%. Synovial fluid was found in bone-graft interphase in 44% of tunnels, inferring partial osteointegration. The heterogeneous signal was present in 50% of patients who did not return to the previous sport level activity. (Fisher statistics: p = 0.043) There were no meaningful differences in patients with auto or allografts. Conclusion: Although the clinical evaluation was satisfactory, only 44% of patients returned to the previous level of sport activity one year after the ACL surgery. The ligamentatization process was found in 28% of knees evaluated with MRI one year later. Partial osteointegration is inferred in 44%. Results showed a meaningful relation between the signal of neoligaments in the MRI and the return to sport activity in said series of patients. MRI is a useful tool

  20. Prenatal education for congenital toxoplasmosis.

    PubMed

    Di Mario, Simona; Basevi, Vittorio; Gagliotti, Carlo; Spettoli, Daniela; Gori, Gianfranco; D'Amico, Roberto; Magrini, Nicola

    2009-01-21

    Congenital toxoplasmosis is considered a rare but potentially severe infection. Prenatal education about congenital toxoplasmosis could be the most efficient and least harmful intervention, yet its effectiveness is uncertain. To assess the effects of prenatal education for preventing congenital toxoplasmosis. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (November 2007), CENTRAL (The Cochrane Library 2007, Issue 3), MEDLINE (1966 to November 2007), EMBASE (1980 to November 2007), CINAHL (1982 to November 2007), LILACS (1982 to November 2007) IMEMR (1984 to November 2007), and reference lists of relevant papers, reviews and websites. Randomized and quasi-randomized controlled trials (RCT) of all types of prenatal education on toxoplasmosis infection during pregnancy. Three authors independently assessed study quality and extracted data. One cluster-randomized controlled trial (432 women) met the inclusion criteria. However, the overall methodological quality was poor. The authors did not report measure of association but only provided P values (P less than 0.05) for all outcomes. The authors concluded that prenatal education can effectively change pregnant women's behavior as it increased pet, personal and food hygiene. There are no randomized trials on the effect of prenatal education on congenital toxoplasmosis rate, or toxoplasmosis seroconversion rate during pregnancy, but three observational studies consistently suggest that prenatal education might have a positive impact on these outcomes. Even though primary prevention of congenital toxoplasmosis is considered a desirable intervention, given the lack of related risks compared to secondary and tertiary prevention, its effectiveness has not been adequately evaluated. There is very little evidence from RCTs that prenatal education is effective in reducing congenital toxoplasmosis even though evidence from observational studies suggests it is. Given the lack of good evidence supporting

  1. Prenatal anxiety effects: A review.

    PubMed

    Field, Tiffany

    2017-09-05

    This review is based on literature on prenatal anxiety effects that was found on Pubmed and PsycINFO for the years 2010-2016. Prenatal anxiety is thought to have distinct features, although it has been measured both by specific prenatal anxiety symptoms as well as by standardized anxiety scales. Its prevalence has ranged from 21 to 25% and it has been predicted by a number of pregnancy - related variables such as unintended pregnancy, demographic variables such as low acculturation and income and psychosocial factors including pessimism and partner tension. Prenatal anxiety effects on pregnancy include increased cortisol levels, pro-inflammatory cytokines, obstetric problems and cesarean section. Effects on the neonate include lower gestational age, prematurity, less insulin-like growth factor in cord blood, less exclusive breast-feeding and less self-regulation during the heelstick procedure. Prenatal anxiety effects continue into infancy and childhood both on physiological development and emotional/mental development. Among the physiological effects are lower vagal activity across the first two years, and lower immunity, more illnesses and reduced gray matter in childhood. Prenatal anxiety effects on emotional/mental development include greater negative emotionality and in infants, lower mental development scores and internalizing problems. Anxiety disorders occur during childhood and elevated cortisol and internalizing behaviors occur during adolescence. Interventions for prenatal anxiety are virtually nonexistent, although stroking (massaging) the infant has moderated the pregnancy - specific anxiety effects on internalizing behaviors in the offspring. The limitations of this literature include the homogeneity of samples, the frequent use of anxiety measures that are not specific to pregnancy, and the reliance on self-report. Nonetheless, the literature highlights the negative, long-term effects of prenatal anxiety and the need for screening and early

  2. Prenatal counseling regarding cesarean delivery.

    PubMed

    Leeman, Lawrence M

    2008-09-01

    In 1970, the cesarean delivery rate in the United States was 5.5% and women receiving prenatal care only required the knowledge that cesarean delivery was an uncommon solution to dire obstetric emergencies. In 2008, when almost one in three women deliver by cesarean, counseling on cesarean delivery must be part of each woman's prenatal care. The content of that discussion varies based on the woman's obstetric history and the anticipated mode of delivery.

  3. [Does prenatal diagnosis modify neonatal management and early outcome of children with esophageal atresia type III?].

    PubMed

    Garabedian, C; Sfeir, R; Langlois, C; Bonnard, A; Khen-Dunlop, N; Gelas, T; Michaud, L; Auber, F; Piolat, C; Lemelle, J-L; Fouquet, V; Habonima, É; Becmeur, F; Polimerol, M-L; Breton, A; Petit, T; Podevin, G; Lavrand, F; Allal, H; Lopez, M; Elbaz, F; Merrot, T; Michel, J-L; Buisson, P; Sapin, E; Delagausie, P; Pelatan, C; Gaudin, J; Weil, D; de Vries, P; Jaby, O; Lardy, H; Aubert, D; Borderon, C; Fourcade, L; Geiss, S; Breaud, J; Pouzac, M; Echaieb, A; Laplace, C; Gottrand, F; Houfflin-Debarge, V

    2015-11-01

    Evaluate neonatal management and outcome of neonates with either a prenatal or a post-natal diagnosis of EA type III. Population-based study using data from the French National Register for EA from 2008 to 2010. We compared children with prenatal versus post-natal diagnosis in regards to prenatal, maternal and neonatal characteristics. We define a composite variable of morbidity (anastomotic esophageal leaks, recurrent fistula, stenosis) and mortality at 1 year. Four hundred and eight live births with EA type III were recorded with a prenatal diagnosis rate of 18.1%. Transfer after birth was lower in prenatal subset (32.4% versus 81.5%, P<0.001). Delay between birth and first intervention was not significantly different. Defect size (2cm vs 1.4cm, P<0.001), gastrostomy (21.6% versus 8.7%, P<0.001) and length in neonatal unit care were higher in prenatal subset (47.9 days versus 33.6 days, P<0.001). The composite variables were higher in prenatal diagnosis subset (38.7% vs 26.1%, P=0.044). Despite the excellent survival rate of EA, cases with antenatal detection have a higher morbidity related to the EA type (longer gap). Even if it does not modify neonatal management and 1-year outcome, prenatal diagnosis allows antenatal parental counseling and avoids post-natal transfer. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  4. Prenatal meditation influences infant behaviors.

    PubMed

    Chan, Ka Po

    2014-11-01

    Meditation is important in facilitating health. Pregnancy health has been shown to have significant consequences for infant behaviors. In view of limited studies on meditation and infant temperament, this study aims to explore the effects of prenatal meditation on these aspects. The conceptual framework was based on the postulation of positive relationships between prenatal meditation and infant health. A randomized control quantitative study was carried out at Obstetric Unit, Queen Elizabeth Hospital in Hong Kong. 64 pregnant Chinese women were recruited for intervention and 59 were for control. Outcome measures were cord blood cortisol, infant salivary cortisol, and Carey Infant Temperament Questionnaire. Cord blood cortisol level of babies was higher in the intervention group (p<0.01) indicates positive health status of the newborns verifies that prenatal meditation can influence fetal health. Carey Infant Temperament Questionnaire showed that the infants of intervention group have better temperament (p<0.05) at fifth month reflects the importance of prenatal meditation in relation to child health. Present study concludes the positive effects of prenatal meditation on infant behaviors and recommends that pregnancy care providers should provide prenatal meditation to pregnant women.

  5. Prenatal Depression Restricts Fetal Growth

    PubMed Central

    Diego, Miguel A.; Field, Tiffany; Hernandez-Reif, Maria; Schanberg, Saul; Kuhn, Cynthia; Gonzalez-Quintero, Victor Hugo

    2009-01-01

    Objective To identify whether prenatal depression is a risk factor for fetal growth restriction. Methods Midgestation (18-20 weeks GA) estimated fetal weight and urine cortisol and birth weight and gestational age at birth data were collected on a sample of 40 depressed and 40 non-depressed women. Estimated fetal weight and birthweight data were then used to compute fetal growth rates. Results Depressed women had a 13% greater incidence of premature delivery (Odds Ratio (OR) = 2.61) and 15% greater incidence of low birthweight (OR = 4.75) than non-depressed women. Depressed women also had elevated prenatal cortisol levels (p = .006) and fetuses who were smaller (p = .001) and who showed slower fetal growth rates (p = .011) and lower birthweights (p = .008). Mediation analyses further revealed that prenatal maternal cortisol levels were a potential mediator for the relationship between maternal symptoms of depression and both gestational age at birth and the rate of fetal growth. After controlling for maternal demographic variables, prenatal maternal cortisol levels were associated with 30% of the variance in gestational age at birth and 14% of the variance in the rate of fetal growth. Conclusion Prenatal depression was associated with adverse perinatal outcomes, including premature delivery and slower fetal growth rates. Prenatal maternal cortisol levels appear to play a role in mediating these outcomes. PMID:18723301

  6. Revised Late Oligocene to Early Miocene magnetic stratigraphy recorded by drift sediments at Sites U1405 and U1406, IODP Expedition 342 (Newfoundland, NW Atlantic)

    NASA Astrophysics Data System (ADS)

    van Peer, Tim; Xuan, Chuang; Wilson, Paul; Liebrand, Diederik; Lippert, Peter

    2015-04-01

    to impact the completeness of the spliced magnetostratigraphic record. Rock and mineral magnetic studies of selected samples are currently ongoing to characterise the magnetic mineralogy of the sediments and how it changes across the stratigraphic gaps and intervals with contrasting lithological and/or palaeomagnetic properties. These data will help us understand the origin of the palaeomagnetic signal and test its reliability, while providing insights on the nature of the observed stratigraphic gaps and how they relate to global climate dynamics of the OMT and the Deep Western Boundary Current.

  7. Physical intimate partner violence during gestation as a risk factor for low quality of prenatal care.

    PubMed

    Moraes, Claudia Leite; Arana, Flávia Dias Nogueira; Reichenheim, Michael Eduardo

    2010-08-01

    To evaluate physical intimate partner violence during gestation as an independent risk factor for low quality of prenatal care. A cross-sectional study was carried out at three public maternity wards of the municipality of Rio de Janeiro (Southeastern Brazil). The 528 puerperal women included in the study were selected by simple random sampling from all babies born at term in 2000. Prenatal care information was collected through the pregnant woman's card and face-to-face interviews. The Kotelchuck index was employed to assess the quality of prenatal care. In order to identify violence situations, the Brazilian version of the instrument Revised Conflict Tactics Scales was used. Non-conditional logistic regression was used to assess the effect of exposure, after controlling for confounding variables. Even after adjustment for socioeconomic, demographic, reproductive, and couple's lifestyle variables, physical intimate partner violence during gestation remained associated with low quality of prenatal care. Women exposed to physical violence during gestation had 2.2 times more chance of presenting inadequate prenatal care compared to those without history of physical violence. These findings point to the need of identifying family conflict situations since the beginning of prenatal care in order to address the issue and enable higher adherence to follow-up among victimized pregnant women.

  8. Scar revision

    PubMed Central

    Sharma, Mohit; Wakure, Abhijeet

    2013-01-01

    Most surgical patients end up with a scar and most of these would want at least some improvement in the appearance of the scar. Using sound techniques for wound closure surgeons can, to a certain extent, prevent suboptimal scars. This article reviews the principles of prevention and treatment of suboptimal scars. Surgical techniques of scar revision, i.e., Z plasty, W plasty, and geometrical broken line closure are described. Post-operative care and other adjuvant therapies of scars are described. A short description of dermabrasion and lasers for management of scars is given. It is hoped that this review helps the surgeon to formulate a comprehensive plan for management of scars of these patients. PMID:24516292

  9. Determinants of prenatal health care utilisation by low-risk women: a prospective cohort study.

    PubMed

    Feijen-de Jong, Esther I; Jansen, Danielle E M C; Baarveld, Frank; Boerleider, Agatha W; Spelten, Evelien; Schellevis, François; Reijneveld, Sijmen A

    2015-06-01

    Prenatal health care is pivotal in providing adequate prevention and care to pregnant women. We examined the determinants of inadequate prenatal health care utilisation by low-risk women in primary midwifery-led care in the Netherlands. We used longitudinal data from the population-based DELIVER study with 20 midwifery practices across the Netherlands in 2009 and 2010 as the experimental setting. The participants were 3070 pregnant women starting pregnancy care in primary midwifery care. We collected patient-reported data on potential determinants of prenatal care utilisation derived from the Andersen model. Prenatal health care utilisation was measured by a revised version of the Kotelchuck Index, which measures a combination of care entry and number of visits. Low-risk pregnant women (not referred during pregnancy) were more likely to use prenatal care inadequately if they intended to deliver at a hospital, if they did not use folic acid adequately periconceptionally, or if they were exposed to cigarette smoke during pregnancy. Among those who were referred to secondary care, women reporting a chronic illnesses or disabilities, and women who did not use folic acid periconceptionally were more likely to make inadequate use of prenatal care. Inadequate prenatal health care use in primary midwifery care is more likely in specific groups, and the risk groups differ when women are referred to secondary care. The findings suggest routes that can target interventions to women who are at risk of not adequately using prenatal prevention and care services. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  10. Prenatal exercise research.

    PubMed

    Field, Tiffany

    2012-06-01

    In this review of recent research on prenatal exercise, studies from several different countries suggest that only approximately 40% of pregnant women exercise, even though about 92% are encouraged by their physicians to exercise, albeit with some 69% of the women being advised to limit their exercise. A moderate exercise regime reputedly increases infant birthweight to within the normal range, but only if exercise is decreased in late pregnancy. Lower intensity exercise such as water aerobics has decreased low back pain more than land-based physical exercise. Heart rate and blood pressure have been lower following yoga than walking, and complications like pregnancy-induced hypertension with associated intrauterine growth retardation and prematurity have been less frequent following yoga. No studies could be found on tai chi with pregnant women even though balance and the risk of falling are great concerns during pregnancy, and tai chi is one of the most effective forms of exercise for balance. Potential underlying mechanisms for exercise effects are that stimulating pressure receptors during exercise increases vagal activity which, in turn, decreases cortisol, increases serotonin and decreases substance P, leading to decreased pain. Decreased cortisol is particularly important inasmuch as cortisol negatively affects immune function and is a significant predictor of prematurity. Larger, more controlled trials are needed before recommendations can be made about the type and amount of pregnancy exercise.

  11. Prenatal arsenic exposure and drowning among children in Bangladesh.

    PubMed

    Rahman, Mahfuzar; Sohel, Nazmul; Hore, Samar Kumar; Yunus, Mohammad; Bhuiya, Abbas; Streatfield, Peter Kim

    2015-01-01

    There is increasing concern regarding adverse effects of prenatal arsenic exposure on the neurodevelopment of children. We analyzed mortality data for children, who were born to 11,414 pregnant women between 2002 and 2004, with an average age of 5 years of follow-up. Individual drinking-water arsenic exposure during pregnancy was calculated using tubewell water arsenic concentration between last menstrual period and date of birth. There were 84 drowning deaths registered, with cause of death ascertained using verbal autopsy (International Classification of Diseases, 10th revision, codes X65-X70). The prenatal water arsenic exposure distribution was tertiled, and the risk of drowning mortality was estimated by Cox proportional hazard models, adjusted for potential confounders. We observed a significant association between prenatal arsenic exposure and drowning in children aged 1-5 years in the highest exposure tertile (HR=1.74, 95% CI: 1.03-2.94). This study showed that in utero arsenic exposure might be associated with excess mortality among children aged 1-5 years due to drowning.

  12. Prenatal arsenic exposure and drowning among children in Bangladesh

    PubMed Central

    Rahman, Mahfuzar; Sohel, Nazmul; Kumar Hore, Samar; Yunus, Mohammad; Bhuiya, Abbas; Kim Streatfield, Peter

    2015-01-01

    There is increasing concern regarding adverse effects of prenatal arsenic exposure on the neurodevelopment of children. We analyzed mortality data for children, who were born to 11,414 pregnant women between 2002 and 2004, with an average age of 5 years of follow-up. Individual drinking-water arsenic exposure during pregnancy was calculated using tubewell water arsenic concentration between last menstrual period and date of birth. There were 84 drowning deaths registered, with cause of death ascertained using verbal autopsy (International Classification of Diseases, 10th revision, codes X65–X70). The prenatal water arsenic exposure distribution was tertiled, and the risk of drowning mortality was estimated by Cox proportional hazard models, adjusted for potential confounders. We observed a significant association between prenatal arsenic exposure and drowning in children aged 1–5 years in the highest exposure tertile (HR=1.74, 95% CI: 1.03–2.94). This study showed that in utero arsenic exposure might be associated with excess mortality among children aged 1–5 years due to drowning. PMID:26511679

  13. Does prenatal diagnosis modify neonatal treatment and early outcome of children with esophageal atresia?

    PubMed

    Garabedian, Charles; Sfeir, Rony; Langlois, Carole; Bonnard, Arnaud; Khen-Dunlop, Naziha; Gelas, Thomas; Michaud, Laurent; Auber, Fréderic; Gottrand, Fréderic; Houfflin-Debarge, Véronique

    2015-03-01

    Our study aimed at (1) evaluating neonatal treatment and outcome of neonates with either a prenatal or a postnatal diagnosis of esophageal atresia (EA) and (2) analyzing the impact of prenatal diagnosis on outcome based on the type of EA. We conducted a population-based study using data from the French National Register for infants with EA born from 2008-2010. We compared prenatal, maternal, and neonatal characteristics among children with prenatal vs postnatal diagnosis and EA types I and III. We defined a composite variable of morbidity (anastomotic esophageal leaks, recurrent fistula, stenosis) and death at 1 year. Four hundred sixty-nine live births with EA were recorded with a prenatal diagnosis rate of 24.3%; 82.2% of EA type I were diagnosed prenatally compared with 17.9% of EA type III (P < .001). Transfer after birth was lower in case of prenatal diagnosis (25.6% vs 82.5%; P < .001). The delay between birth and first intervention did not differ significantly among groups. The defect size was longer among the prenatal diagnosis group (2.61 vs 1.48 cm; P < .001). The composite variables were higher in prenatal diagnosis subset (44% vs 27.6%; P = .003) and in EA type I than in type III (58.1% vs 28.3%; P < .001). Despite the excellent survival rate of EA, cases with antenatal detection have a higher morbidity rate related to the EA type (type I and/or long gap). Even though it does not modify neonatal treatment and the 1-year outcome, prenatal diagnosis allows antenatal parental counselling and avoids postnatal transfers. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Child Health USA 2013: Prenatal Care Utilization

    MedlinePlus

    ... Accessed: on 7/31/13 ↑ Back to top Graphs This image is described in the Data section. ... this! Email Print-Friendly Downloads Prenatal Care Utilization Graphs (56k zipped folder of 2 GIFs) Prenatal Care ...

  15. Cystic Fibrosis: Prenatal Screening and Diagnosis

    MedlinePlus

    ... Management Education & Events Advocacy For Patients About ACOG Cystic Fibrosis: Prenatal Screening and Diagnosis Home For Patients Search ... Screening and Diagnosis FAQ171, June 2017 PDF Format Cystic Fibrosis: Prenatal Screening and Diagnosis Pregnancy What is cystic ...

  16. Cortical miscommunication after prenatal exposure to alcohol.

    PubMed

    Lewis, Scott M; Vydrová, Rosa R; Leuthold, Arthur C; Georgopoulos, Apostolos P

    2016-11-01

    We report on the effects of prenatal alcohol exposure on resting-state brain activity as measured by magnetoencephalography (MEG). We studied 37 subjects diagnosed with fetal alcohol spectrum disorder in one of three categories: fetal alcohol syndrome, partial fetal alcohol syndrome, and alcohol-related neurodevelopmental disorder. For each subject, the MEG signal was recorded for 60 s during rest while subjects lay supine. Using time series analysis, we calculated the synchronous neural interactions for all pair-wise combinations of 248 MEG sensors resulting in 30,628 partial correlations for each subject. We found significant differences from control subjects in 6.19 % of the partial zero-lag crosscorrelations (synchronous neural interactions; Georgopoulos et al. in J Neural Eng 4:349-355, 2007), with these differences localized in the right posterior frontal, right parietal, and left parietal/posterior frontal regions. These results show that MEG can detect functional brain differences in the individuals affected by prenatal exposure to alcohol. Furthermore, these differences may serve as a biomarker for future studies linking symptoms and signs to specific brain areas. This may lead to new insights into the neuropathology of fetal alcohol spectrum disorders.

  17. Recording and cataloging hazards information, revision A

    NASA Technical Reports Server (NTRS)

    Stein, R. J.

    1974-01-01

    A data collection process is described for the purpose of discerning causation factors of accidents, and the establishment of boundaries or controls aimed at mitigating and eliminating accidents. A procedure is proposed that suggests a discipline approach to hazard identification based on energy interrelationships together with an integrated control technique which takes the form of checklists.

  18. Update on prenatal care.

    PubMed

    Zolotor, Adam J; Carlough, Martha C

    2014-02-01

    Many elements of routine prenatal care are based on tradition and lack a firm evidence base; however, some elements are supported by more rigorous studies. Correct dating of the pregnancy is critical to prevent unnecessary inductions and to allow for accurate treatment of preterm labor. Physicians should recommend folic acid supplementation to all women as early as possible, preferably before conception, to reduce the risk of neural tube defects. Administration of Rho(D) immune globulin markedly decreases the risk of alloimmunization in an RhD-negative woman carrying an RhD-positive fetus. Screening and treatment for iron deficiency anemia can reduce the risks of preterm labor, intrauterine growth retardation, and perinatal depression. Testing for aneuploidy and neural tube defects should be offered to all pregnant women with a discussion of the risks and benefits. Specific genetic testing should be based on the family histories of the patient and her partner. Physicians should recommend that pregnant women receive a vaccination for influenza, be screened for asymptomatic bacteriuria, and be tested for sexually transmitted infections. Testing for group B streptococcus should be performed between 35 and 37 weeks' gestation. If test results are positive or the patient has a history of group B streptococcus bacteriuria during pregnancy, intrapartum antibiotic prophylaxis should be administered to reduce the risk of infection in the infant. Intramuscular or vaginal progesterone should be considered in women with a history of spontaneous preterm labor, preterm premature rupture of membranes, or shortened cervical length (less than 2.5 cm). Screening for diabetes should be offered using a universal or a risk-based approach. Women at risk of preeclampsia should be offered low-dose aspirin prophylaxis, as well as calcium supplementation if dietary calcium intake is low. Induction of labor may be considered between 41 and 42 weeks' gestation.

  19. Prenatal diagnosis of persistent cloaca.

    PubMed

    Suzumori, Nobuhiro; Obayashi, Shintaro; Hattori, Yukio; Kaneko, Saori; Suzuki, Yoshikatsu; Sugiura-Ogasawara, Mayumi

    2009-09-01

    We report four cases of persistent cloaca diagnosed at 32-33 weeks of gestation. In cases of persistent cloaca, serial prenatal ultrasonography shows transient fetal ascites, enlarged cystic structures arising from the fetal pelvis. Our four cases of persistent cloaca were diagnosed prenatally. Persistent cloaca should be considered in any female fetus presenting with hydronephrosis and a large cystic lesion arising from the pelvis as assessed by ultrasound and magnetic resonance imaging. Neither pulmonary hypoplasia nor severe oligohydramnios were found in any of our four cases, and they each had a good prognosis. Prenatal diagnosis allows time for parental counseling and delivery planning at a tertiary care center for neonatal intensive care and pediatric surgery.

  20. [Communication skills for prenatal counselling].

    PubMed

    Bitzer, J; Tschudin, S; Holzgreve, W; Tercanli, S

    2007-04-18

    Prenatal counselling is characterized by specific characteristics: A):The communication is about the values of the pregnant woman and her relationship with the child to be. B) The communication deals with patient's images and emotions. C) It is a communication about risks, numbers and statistics. D) Physician and patient deal with important ethical issues. In this specific setting of prenatal diagnosis and care physicians should therefore learn to apply basic principles of patient-centred communication with elements of non directive counselling, patient education and shared decision making. These elements are integrated into a process which comprises the following "steps": 1. Clarification of the patient's objectives and the obstetrician's mandate. 2. The providing of individualized information and education about prenatal tests and investigations. 3. Shared decision making regarding tests and investigations 4. Eventually Breaking (bad, ambivalent) news. 5. Caring for patients with an affected child.

  1. Prenatal Lead Exposure Modifies the Impact of Maternal Self-Esteem on Children's Inattention Behavior.

    PubMed

    Xu, Jian; Hu, Howard; Wright, Rosalind; Sánchez, Brisa N; Schnaas, Lourdes; Bellinger, David C; Park, Sung Kyun; Martínez, Sandra; Hernández-Avila, Mauricio; Téllez-Rojo, Martha Maria; Wright, Robert O

    2015-08-01

    To prospectively evaluate the association of maternal self-esteem measured when their offspring were toddlers with the subsequent development of attention deficit hyperactivity disorder (ADHD)-like behavior in their school-age offspring and the potential modifying effects of prenatal lead exposure. We evaluated a subsample of 192 mother-child pairs from a long-running birth-cohort project that enrolled mothers in Mexico from 1994-2011. Prenatal lead exposure was assessed using cord blood lead and maternal bone lead around delivery (tibia and patella lead, measured by K-x-ray-fluorescence). When children were 2 years old, maternal self-esteem was measured using the Coopersmith Self-Esteem Inventory. When children were 7-15 years old, children's blood lead levels and ADHD symptoms were assessed, and Conners' Parent Rating Scale-Revised and Behavior Rating Inventory of Executive Function-Parent Form were used as measures of ADHD-like behavior. Adjusting for family economic status, marital status, maternal education and age, child's age and sex, and children's current blood lead levels, increased maternal self-esteem was associated with reduced child inattention behavior. Compared with those among high prenatal lead exposure (P25-P100), this association was stronger among low prenatal lead exposure groups (P1-P25, P values for the interaction effects between prenatal lead exposure and maternal self-esteem levels of <.10). Each 1-point increase in maternal self-esteem scores was associated with 0.6- to 1.3-point decrease in Conners' Parent Rating Scale-Revised and Behavior Rating Inventory of Executive Function-Parent Form T-scores among groups with low cord blood lead and patella lead (P1-P25). Children experiencing high maternal self-esteem during toddlerhood were less likely to develop inattention behavior at school age. Prenatal lead exposure may play a role in attenuating this protective effect. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. [Prenatal diagnosis using chorionic villi].

    PubMed

    Vega Hernández, M E; Hicks, J J; González-Angulo, J

    1991-07-01

    Chorionic villus sampling (CVS) has a promising future about early detection of fetal abnormalities. It has the potential to become a major tool in the prenatal diagnosis and therapy of genetic disorders. Villus samples can be analyzed by means of cytogenetic, biochemical or molecular technics. Information available at present indicates fetal loss rate should be in the same proportion than amniocentesis. CVS appears to be a reasonably safe and reliable method of prenatal diagnosis in the first trimester of pregnancy. This procedure is setting as fast as it is possible like an excellent alternative to amniocentesis.

  3. Prenatal prediction of pulmonary hypoplasia.

    PubMed

    Triebwasser, Jourdan E; Treadwell, Marjorie C

    2017-03-15

    Pulmonary hypoplasia, although rare, is associated with significant neonatal morbidity and mortality. Conditions associated with pulmonary hypoplasia include those which limit normal thoracic capacity or movement, including skeletal dysplasias and abdominal wall defects; those with mass effect, including congenital diaphragmatic hernia and pleural effusions; and those with decreased amniotic fluid, including preterm, premature rupture of membranes, and genitourinary anomalies. The ability to predict severe pulmonary hypoplasia prenatally aids in family counseling, as well as obstetric and neonatal management. The objective of this review is to outline the imaging techniques that are widely used prenatally to assess pulmonary hypoplasia and to discuss the limitations of these methods.

  4. [Scientific and practical aspects of prenatal diagnosis].

    PubMed

    Baranov, V S

    2003-01-01

    Prenatal diagnostics (PD) is a relatively new branch of medical genetics enjoining presently a rapid practical and scientific progress. The key practical issues related with detecting the pregnant women at high risk of fetal congenital and inherited pathologies have already been solved, and a variety of fetal examinations by non-invasive (ultrasound) and invasive (cytogenetics, biochemistry and molecular tests) methods have been elaborated. Their practical application are totally dependant on the managerial and financial input in the discussed field of medicine. Further advancement in PD are tensely associated with early pregnancy stages (trimester 1), with the molecular diagnostic tools in the diagnosis of chromosomal diseases and with a comprehensive use of Pregnancy Genetic Form worked out and used already at our institute. DP opens up the promising opportunities for analyzing the human genome activity at the initial development stages, which comprises the revision of previously-obtained data on the cytogenetics of human embryo evolution, human chromosomes' functioning and of temporary embryonic organs as observed during the mentioned stages; it also comprises an analysis and application of umbilical and embryonic cells (embryonic cell therapy) and elaboration of scientific fundamentals for embryonic gene therapy. PD should not be referred to only as a set of diagnostic methods for it is also a good starting-ground for research of human embryo-genesis.

  5. Prenatal radiation exposure policy: A labor arbitration

    SciTech Connect

    Kelly, J.J. )

    1990-07-01

    A policy on prenatal radiation exposure at two nuclear power plants was revised to give better assurance of compliance with NCRP recommendations on fetal radiation exposure. This action was taken after publication of NCRP 91 in June 1987 to provide better assurance that a total dose equivalent limit to an embryo-fetus be no greater than 0.5 mSv (0.05 rem) in any month and no more than 5 mSv (500 mrem) for a gestation period. For any female worker to receive radiation exposure greater than 1.5 mSv (0.15 rem) in a month at these nuclear power plants, she was asked to initiate an administrative request for radiation exposure in excess of this limit. In this request, she was asked to acknowledge that she was aware of the guidance in U.S. NRC Regulatory Guide 8.13. A worker who had the potential for radiation exposure in excess of 1.5 mSv (0.15 rem) refused to process this request and was consequently denied overtime work. She filed a grievance for denial of overtime, and this grievance was submitted for labor arbitration in June 1988. The arbitration decision and its basis and related NRC actions are discussed.

  6. Comparative effectiveness of a prenatal medical food to prenatal vitamins on hemoglobin levels and adverse outcomes: a retrospective analysis.

    PubMed

    Bentley, Susan; Hermes, Amy; Phillips, Diane; Daoud, Yahya A; Hanna, Sylvia

    2011-02-01

    The role of folate in pregnancy is well established, with most prenatal vitamins (PNVs) on the market containing at least 800 μg of folic acid. Folic acid must be converted in the body to L-methylfolate, the natural and biologically active form of folate. The role of vitamin B(12) in pregnancy is less characterized, and most PNV formulations contain only 0 to 12 μg. The present study was undertaken to evaluate whether taking a prenatal medical food containing L-methylfolate and much higher doses of vitamin B(12) results in higher hemoglobin levels and thus, a lower incidence of anemia during pregnancy. The objective of this exploratory study was to evaluate the effects of the prenatal medical food versus standard PNVs on hemoglobin levels and adverse outcomes throughout pregnancy. For this retrospective analysis, we reviewed the charts of female patients taking either a prenatal medical food or standard PNV during pregnancy. Hemoglobin levels measured at initiation of prenatal care, end of second trimester, and delivery were recorded. Patients who had received additional iron supplementation, beyond that contained in the prenatal medical food or PNV they were taking and before anemia screening at the end of the second trimester, were excluded from the study. Fisher exact test, χ(2) test, student t test, and ANOVA were used to evaluate differences between the treatment groups. Data were analyzed from 112 charts: 58 patients (51.8%) were taking the prenatal medical food; 54 patients (48.2%) were taking standard PNVs. Mean (SD) age at first prenatal visit was 27 (4.6) years in the medical food group and 28.8 (3.5) years in the PNV group (P = 0.024). Mean (SD) body mass indices were 29.1 (6.5) and 31.7 (8.9) in the medical food and PNV groups, respectively (P = NS). In the medical food group, 35 women (60.3%) were white/Caucasian, 17 (29.3%) were African American, and 6 (10.4%) were of other races. In the PNV group, 24 women (44.4%) were white/Caucasian, 25 (46

  7. Prenatal Discussion of Contraceptive Options in Teenage Pregnancies.

    PubMed

    Patel, Pooja R; Lamarre, Roxanne; Baxley, Sarah; Jennings, Kristofer

    2016-05-01

    To determine if contraceptive options are discussed during prenatal care among pregnant teenagers. Hospital and outpatient clinical records were reviewed for teenagers between the ages 12 and 19, inclusive, who delivered at the University of Texas Medical Branch in Galveston (UTMB) John Sealy Hospital and received prenatal care at one of the UTMB-affiliated ambulatory clinics. A total of 244 postpartum teenagers were included in this study. The mean age was 17.6 ± 1.2 years. The majority of teenagers were Hispanic (57%), followed by white (34%) and black (9%). Of the patients, 41% had less than 10 prenatal visits. Only 14% of the patients had a discussion about contraception during these prenatal visits, most of which occurred after 29 weeks of gestation. Pregnant teenagers are not frequently counseled about postpartum contraceptives. When counseling does occur, it happens in the third trimester, which may not provide enough time for a teenager to thoroughly consider contraceptive options. Guidelines on when providers should discuss postpartum contraception are necessary.

  8. Prenatal diagnosis and telemedicine consultation of fetal urologic disorders.

    PubMed

    Rabie, Nader Z; Canon, Stephen; Patel, Ashay; Zamilpa, Ismael; Magann, Everett F; Higley, Jared

    2016-06-01

    In Arkansas, telemedicine is used commonly in obstetrics through Antenatal and Neonatal Guidelines, Education and Learning System (ANGELS), the existing statewide telemedicine network. This network is used primarily for tele-ultrasound and maternal-fetal medicine consultation. This study is a retrospective case series, describing all the patients who had a prenatally diagnosed urologic anomaly that required prenatal urologic consultation. From 2009-2013, approximately 1300 anomalies were recorded in the Arkansas Fetal Diagnosis and Management (AFDM) database, 14% of which were urologic anomalies. Twenty-six cases required prenatal urologic consultation, 25 of which were conducted via telemedicine. Teleconsultation allowed patients to combine maternal-fetal medicine and urologic consultations in one visit, saving time and effort and ultimately, for most patients, providing reassurance that delivery could be accomplished locally with postnatal follow-up already arranged. While there are several studies reporting the use of telemedicine for various subspecialty consultations, to our knowledge, this is the first to describe the use of telemedicine for prenatal urology consultation. Future research could randomize patients prospectively to allow comparison of both the outcomes as well as the patient experience.

  9. [Factors associated with the quality of prenatal care: an approach to premature birth].

    PubMed

    Melo, Emiliana Cristina; Oliveira, Rosana Rosseto de; Mathias, Thais Aidar de Freitas

    2015-08-01

    To assess the quality of prenatal care in mothers with premature and term births and identify maternal and gestational factors associated with inadequate prenatal care. Cross-sectional study collecting data with the pregnant card, hospital records and interviews with mothers living in Maringa-PR. Data were collected from 576 mothers and their born alive infants who were attended in the public service from October 2013 to February 2014, using three different evaluation criteria. The association of prenatal care quality with prematurity was performed by univariate analysis and occurred only at Kessner criteria (CI=1.79;8.02). The indicators that contributed most to the inadequacy of prenatal care were tests of hemoglobin, urine, and fetal presentation. After logistic regression analysis, maternal and gestational variables associated to inadequate prenatal care were combined prenatal (CI=2.93;11.09), non-white skin color (CI=1.11;2.51); unplanned pregnancy (CI=1.34;3.17) and multiparity (CI=1.17;4.03). Prenatal care must follow the minimum recommended protocols, more attention is required to black and brown women, multiparous and with unplanned pregnancies to prevent preterm birth and maternal and child morbimortality.

  10. Prenatal Maternal Reactivity to Infant Cries Predicts Postnatal Perceptions of Infant Temperament and Marriage Appraisal.

    ERIC Educational Resources Information Center

    Pedersen, Frank A.; And Others

    1996-01-01

    Examined cardiac response and ratings of subjective aversiveness to recordings of unfamiliar infant cries in 60 primiparous women at 32 weeks' gestation. Mothers who prenatally rated the crying recordings as more aversive postnatally described their infants as more fussy and unpredictable. Women who showed greater cardiac acceleration to the cries…

  11. Assessing the quality of last menstrual period date on California birth records.

    PubMed

    Pearl, Michelle; Wier, Megan L; Kharrazi, Martin

    2007-09-01

    Birth certificate last menstrual period (LMP) date is widely used to estimate gestational age in the US. While data quality concerns have been raised, no large population-based study has isolated data quality issues by comparing birth record LMP (Birth LMP) with reliable LMP dates from another source. We assessed LMP data quality in 2002 California singleton livebirth records (n = 515 381) and in a subset of records with linked prenatally collected LMP from California's statewide Prenatal Expanded Alpha-fetoprotein Screening Program (XAFP) (n = 105 936). Missing or incomplete LMP data affected 13% of birth records; 17% of those had complete LMP within XAFP records. Data quality indicators supported XAFP LMP as more accurate than Birth LMP, with a lower prevalence of digit preference, post-term delivery, out-of-range gestational age estimates and implausible birthweight-for-gestational age. The bimodal birthweight distribution evident at 20-31 weeks' gestation based on Birth LMP was nearly absent with XAFP LMP-based gestational age. Approximately 32% of the second birthweight mode was explained by apparent clerical errors in Birth LMP month. Digit preference errors, particularly day 1, were associated with gestational age overestimation. Preterm delivery rates were higher according to Birth (7.6%) vs. XAFP LMP (7.2%). One-fifth of observed preterm and over half of observed post-term births using Birth LMP were not true cases; 15% of true preterm cases were missed. African American or Hispanic, less educated, and publicly or uninsured women were most likely to be misclassified and have large LMP date discrepancies attributable to clerical or digit preference error. The implementation of a revised birth certificate is an opportunity for targeted training and data entry checks that could substantially improve LMP accuracy on birth records.

  12. [Prenatal genetic diagnosis and related nursing care].

    PubMed

    Tzeng, Ya-Ling; Chiu, Tsan-Hung

    2009-12-01

    Prenatal genetic diagnosis plays an important role in eugenics. Early detection of embryo and fetus abnormalities allows preventive precautions to be taken and treatment to begin early in order to reduce the severity and extent of congenital deformities. Advancements in genetic diagnostic techniques infer that nurses are increasingly likely to deal with prenatal genetic diagnosis cases. This essay introduces a few prevalent prenatal genetic diagnosis methods used at different stages of pregnancy; describes in a comprehensive manner the potential physical and psychological responses of the client; and introduces principles of administering prenatal genetic diagnosis to healthcare clients. Ethical issues related to prenatal genetic diagnosis are also discussed.

  13. Prenatal care effectiveness and utilization in Brazil.

    PubMed

    Wehby, George L; Murray, Jeffrey C; Castilla, Eduardo E; Lopez-Camelo, Jorge S; Ohsfeldt, Robert L

    2009-05-01

    The impact of prenatal care use on birth outcomes has been understudied in South American countries. This study assessed the effects of various measures of prenatal care use on birth weight (BW) and gestational age outcomes using samples of infants born without and with common birth defects from Brazil, and evaluated the demand for prenatal care. Prenatal visits improved BW in the group without birth defects through increasing both fetal growth rate and gestational age, but prenatal care visits had an insignificant effect on BW in the group with birth defects when adjusting for gestational age. Prenatal care delay had no effects on BW in both infant groups but increased preterm birth risk in the group without birth defects. Inadequate care versus intermediate care also increased LBW risk in the group without birth effects. Quantile regression analyses revealed that prenatal care visits had larger effects at low compared with high BW quantiles. Several other prenatal factors and covariates such as multivitamin use and number of previous live births had significant effects on the studied outcomes. The number of prenatal care visits was significantly affected by several maternal health and fertility indicators. Significant geographic differences in utilization were observed as well. The study suggests that more frequent use of prenatal care can increase BW significantly in Brazil, especially among pregnancies that are uncomplicated with birth defects but that are at high risk for low birth weight. Further research is needed to understand the effects of prenatal care use for pregnancies that are complicated with birth defects.

  14. Pediatric prenatal diagnosis of congenital heart disease.

    PubMed

    Killen, Stacy A S; Mouledoux, Jessica H; Kavanaugh-McHugh, Ann

    2014-10-01

    Fetal cardiology is a rapidly evolving field. Imaging technology continues to advance as do approaches to in-utero interventions and care of the critically ill neonate, with even greater demand for improvement in prenatal diagnosis of congenital heart disease (CHD) and arrhythmias. Reviewing the advances in prenatal diagnosis of CHD in such a rapidly developing field is a broad topic. Therefore, we have chosen to focus this review of recent literature on challenges in prenatal detection of CHD, challenges in prenatal counseling, advances in fetal arrhythmia diagnosis, and potential benefits to patients with CHD who are identified prenatally. As methods and tools to diagnose and manage CHD and arrhythmias in utero continue to improve, future generations will hopefully see a reduction in both prenatal and neonatal morbidity and mortality. Prenatal diagnosis can and should be used to optimize location and timing of delivery and postnatal interventions.

  15. Does Group Prenatal Care Affect Satisfaction And Prenatal Care Utilization in Iranian Pregnant Women?

    PubMed Central

    Jafari, F; Eftekhar, H; Mohammad, K; Fotouhi, A

    2010-01-01

    Background: The need to provide high quality prenatal care services, which take account of women’s views and specifically address their need for information, support and communication, has been advocated and group prenatal care, had been suggested as one of the ways to achieve this objective. The purpose of this study was to examine the impact of group versus individual prenatal care on satisfaction and prenatal care use. Methods: This was a cluster-randomized controlled trial with the health center as the randomization unit that conducted in 2007. Satisfaction was measured through a standardized questionnaire, and the Kotelchuck Adequacy of Prenatal Care Utilization Index was used to measure prenatal care utilization. Results: We recruited 678 women (group prenatal care, (N= 344) and individual prenatal care, (N=334) in the study. Women in group prenatal care model were more satisfied than women in individual prenatal care model in all areas evaluated, including information, communication, co-ordination and quality of care. Group care women were significantly more likely to have adequate prenatal care than individual care women were (OR=1.35 95% CI=1.26–1.44). Conclusions: Group prenatal care was associated with a significant improvement in client satisfaction and prenatal care utilization. This model of care has implications for the planning and provision of prenatal services within public health system, which is moving toward a better quality health care, and increasing use of services. PMID:23113007

  16. Factors affecting adequate prenatal care and the prenatal care visits of immigrant women to Taiwan.

    PubMed

    Liang, Yia-Wun; Chang, Hua-Pin; Lin, Yu-Hsiu; Lin, Long-Yau; Chen, Wen-Yi

    2014-02-01

    This paper investigates prenatal care utilization, identifies factors affecting the adequacy of prenatal care, and explores the effect of adequate initial timing of prenatal care on total prenatal care visits among Taiwan new immigrant females. Data was obtained from the 2008 Prenatal Care Utilization among Taiwan New Immigrant Females Survey on women who either had at least one preschool-aged child or had delivered their infants but were still hospitalized (N = 476). The Adequacy of Prenatal Care Utilization Index was applied to rate the prenatal care adequacy. The logistic regression model was used to investigate factors associated with the adequacy of prenatal care utilization, and the linear regression model was estimated to identify the impact of influential factors on the prenatal care usage. Females' nationality, employment, and transportation convenience increased the likelihood of receiving adequate prenatal care. Having adequate initial timing of prenatal care was found to be positively related to the frequency of prenatal care visits. Prenatal care utilization can be affected by factors within the health care system and by characteristics of the population; therefore, a measure of prenatal care utilization cannot distinguish these factors but reflects the result of all of them in varying combinations.

  17. Prenatal Nutrition and Later Education

    ERIC Educational Resources Information Center

    Evans, T. N.

    1972-01-01

    Text of an affidavit in the case, Kennedy v. Detroit Board of Education. Reports on a study which established that prenatal nutrition is directly related to brain size and volume determined at 48 hours of infancy and at eight months of age. Pinpoints the relationship between inadequate nutrition in pregnancy, infant brain size, and intellectual…

  18. Prenatal Nutrition and Later Education

    ERIC Educational Resources Information Center

    Evans, T. N.

    1972-01-01

    Text of an affidavit in the case, Kennedy v. Detroit Board of Education. Reports on a study which established that prenatal nutrition is directly related to brain size and volume determined at 48 hours of infancy and at eight months of age. Pinpoints the relationship between inadequate nutrition in pregnancy, infant brain size, and intellectual…

  19. Prenatal diagnosis of 47,XXX.

    PubMed

    Khoury-Collado, Fady; Wehbeh, Ammar N; Fisher, Allan J; Bombard, Allan T; Weiner, Zeev

    2005-05-01

    We report 2 cases of 47,XXX that were diagnosed prenatally and were screened positive for trisomy 21 by biochemical and ultrasound markers. These cases underline the importance of discussing the sex chromosome abnormalities during the genetic counseling after an abnormal triple screen test or ultrasound examination.

  20. The impact of group prenatal care on pregnancy and postpartum weight trajectories

    PubMed Central

    Magriples, Urania; Boynton, Marcella H.; Kershaw, Trace S.; Lewis, Jessica; Rising, Sharon Schindler; Tobin, Jonathan N.; Epel, Elissa; Ickovics, Jeannette R.

    2016-01-01

    OBJECTIVE The objective of the study was to investigate whether group prenatal care (Centering Pregnancy Plus [CP+]) has an impact on pregnancy weight gain and postpartum weight loss trajectories and to determine whether prenatal depression and distress might moderate these trajectories. STUDY DESIGN This was a secondary analysis of a cluster-randomized trial of CP+ in 14 Community Health Centers and hospitals in New York City. Participants were pregnant women aged 14–21 years (n = 984). Medical record review and 4 structured interviews were conducted: in the second and third trimesters and 6 and 12 months postpartum. Longitudinal mixed modeling was utilized to evaluate the weight change trajectories in the control and intervention groups. Prenatal distress and depression were also assessed to examine their impact on weight change. RESULTS There were no significant differences between the intervention and control groups in baseline demographics. Thirty-five percent of the participants were overweight or obese, and more than 50% had excessive weight gain by Institute of Medicine standards. CP+ was associated with improved weight trajectories compared with controls (P < .0001): women at clinical sites randomized to group prenatal care gained less weight during pregnancy and lost more weight postpartum. This effect was sustained among women who were categorized as obese based on prepregnancy body mass index (P < .01). Prenatal depression and distress were significantly associated with higher antepartum weight gain and postpartum weight retention. Women with the highest levels of depression and prenatal distress exhibited the greatest positive impact of group prenatal care on weight trajectories during pregnancy and through 12 months postpartum. CONCLUSION Group prenatal care has a significant impact on weight gain trajectories in pregnancy and postpartum. The intervention also appeared to mitigate the effects of depression and prenatal distress on antepartum weight

  1. Prenatal diethylstilbestrol exposure and risk of obesity in adult women.

    PubMed

    Hatch, E E; Troisi, R; Palmer, J R; Wise, L A; Titus, L; Strohsnitter, W C; Ricker, W; Hyer, M; Hoover, R N

    2015-06-01

    Diethylstilbestrol (DES) is a non-steroidal estrogen that was commonly prescribed during pregnancy from the late 1940s to 1971. A potent endocrine disruptor, prenatal DES exposure has been linked with reproductive tract malformations, adverse pregnancy outcomes, cancer, infertility and earlier menopause. DES was used for years as a growth promoter in animal production. Some animal studies suggest that prenatal DES exposure is associated with obesity and metabolic disturbances. Using data from the National Cancer Institute DES Follow-Up Study, we evaluated the association between DES and adult obesity, weight gain from age 20 to mid-life, central adiposity and height among 2871 prenatally exposed and 1352 unexposed women between 23 and 52 years of age (median 41.5) at baseline in 1994. DES exposure status was confirmed by prenatal medical record review. We used multivariable log-binomial models to calculate risk ratios (RRs) for obesity in 2006, and linear regression to calculate mean differences in body mass index, weight gain, waist circumference and height. The adjusted RR for DES and obesity was 1.09 [95% confidence interval (CI): 0.97, 1.22], and RRs were 1.23 (CI: 1.07, 1.42) and 1.05 (CI: 0.91, 1.20) for low and high estimated total DES dose, respectively, compared with no exposure. DES-exposed women gained slightly more weight than unexposed women [mean difference, 0.70 kg (CI: -0.27, 1.66)]. This study suggests that prenatal DES exposure may be associated with a small increase in adult obesity.

  2. Prenatal prevention for severe thalassemia disease at Srinagarind Hospital.

    PubMed

    Ratanasiri, Thawalwong; Charoenthong, Chutharat; Komwilaisak, Ratana; Changtrakul, Yotsombat; Fucharoen, Supan; Wongkham, Jamras; Kleebkaow, Pilaiwan; Seejorn, Kanok

    2006-10-01

    To evaluate the results and cost-effectiveness of prenatal prevention measurement in severe thalassemia diseases at Srinagarind Hospital. Descriptive study. Antenatal care (ANC) Clinic, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University. 1,498 thalassemic screened pregnant women first presenting at ANC Clinic at gestational age less than 17 weeks. Medical records of thalassemic screened pregnant women between February 2002 and February 2005 were analyzed. Those with a value of mean corpuscular volume (MCV) less than 80 fl, or positive dichlorophenol indophenol precipitation test (KKU-DCIP Clear Reagent Kit) underwent hemoglobin (Hb) typing by high performance liquid chromatography (HPLC) together with thalassemia investigation (complete blood count, MCV and Hb typing) of their husbands and to identify couples at risk of 3 severe thalassemia diseases; Hb Bart's hydrops fetalis, homozygous, -thalassemia and, -thalassemia/ Hb E disease. Then they were advised to undergo DNA analysis and, if they had fetal risk, appropriate prenatal diagnosis was offered. Number of affected fetuses detected by prenatal diagnosis. Nine hundred and ninety six pregnant women (66.49%) were positive on screening. Of these, 642 (64.46%) had thalassemia investigation done with their spouses. There were 19 couples at risk (1.27% of total screened pregnant women) for having fetal severe thalassemia disease from initial laboratory results. Most of them were, -thalassemia/ Hb E diseases. We found only 10 pregnant women (52.63%) that had undergone prenatal diagnosis. The consequent results were two affected fetuses (20%), one was Hb Bart's hydrops fetalis, and the other was, o-thalassemia/ Hb E disease. In these cases, their parents decided to discontinue the pregnancy. Our prevention program could save 1.14 million bahts for the cost of treatment in two prevented severe thalassemia cases. The prenatal prevention program of severe thalassemia disease at Srinagarind Hospital can

  3. Intraventricular hemorrhage after ventriculoperitoneal shunt revision: a retrospective review.

    PubMed

    Calayag, Mark; Paul, Alexandra R; Adamo, Matthew A

    2015-07-01

    OBJECT The authors review their ventriculoperitoneal (VP) shunt revisions over a 3-year period to determine the rate of intraventricular hemorrhage (IVH) and subsequent need for re-revision. METHODS Review of medical records identified 35 pediatric patients who underwent 52 VP shunt revisions between 2009 and 2012. The presence and amount of IVH as determined by CT and the time to re-revision were documented. The reason for shunting, catheter position, and time between initial VP shunt placement and subsequent revisions were also recorded. RESULTS After 13 (25%) of the 52 revisions, IVH was evident on postoperative CT scans. The majority of patients had a trace amount of IVH, with only 2% having IVH greater than 5 ml. After 2 (15%) of the 13 revisions associated with IVH, re-revision was required within 1 month. In contrast, the re-revision rate in patients without IVH was 18%. All of the patients who developed IVH had occipital catheters. CONCLUSIONS Some degree of IVH can be expected after approximately one-quarter of all VP shunt revision procedures in pediatric patients, but the rate of significant IVH is low. Furthermore, the presence of IVH does not necessitate an early shunt revision.

  4. The Padua Inventory: Do Revisions Need Revision?

    ERIC Educational Resources Information Center

    Gonner, Sascha; Ecker, Willi; Leonhart, Rainer

    2010-01-01

    The purpose of the present study was to examine the psychometric properties, factorial structure, and validity of the Padua Inventory-Washington State University Revision and of the Padua Inventory-Revised in a large sample of patients with obsessive-compulsive disorder (n = 228) and with anxiety disorders and/or depression (n = 213). The…

  5. The Padua Inventory: Do Revisions Need Revision?

    ERIC Educational Resources Information Center

    Gonner, Sascha; Ecker, Willi; Leonhart, Rainer

    2010-01-01

    The purpose of the present study was to examine the psychometric properties, factorial structure, and validity of the Padua Inventory-Washington State University Revision and of the Padua Inventory-Revised in a large sample of patients with obsessive-compulsive disorder (n = 228) and with anxiety disorders and/or depression (n = 213). The…

  6. Neandertals revised

    PubMed Central

    Roebroeks, Wil; Soressi, Marie

    2016-01-01

    The last decade has seen a significant growth of our knowledge of the Neandertals, a population of Pleistocene hunter-gatherers who lived in (western) Eurasia between ∼400,000 and 40,000 y ago. Starting from a source population deep in the Middle Pleistocene, the hundreds of thousands of years of relative separation between African and Eurasian groups led to the emergence of different phenotypes in Late Pleistocene Europe and Africa. Both recently obtained genetic evidence and archeological data show that the biological and cultural gaps between these populations were probably smaller than previously thought. These data, reviewed here, falsify inferences to the effect that, compared with their near-modern contemporaries in Africa, Neandertals were outliers in terms of behavioral complexity. It is only around 40,000 y ago, tens of thousands of years after anatomically modern humans first left Africa and thousands of years after documented interbreeding between modern humans, Neandertals and Denisovans, that we see major changes in the archeological record, from western Eurasia to Southeast Asia, e.g., the emergence of representational imagery and the colonization of arctic areas and of greater Australia (Sahul). PMID:27274044

  7. Prenatal diagnosis of Sanfilippo syndrome.

    PubMed

    Hopwood, John J

    2005-02-01

    The focus of this communication is to comment on the relative importance of enzymatic and molecular genetics, potential false results and future options for prenatal diagnosis of Sanfilippo syndrome (mucopolysaccharidosis (MPS) types IIIA, IIIB, IIIC and IIID). During the provision of an international service over the past 25 years, our department has identified 7 affected out of 49 MPS III prenatal assessments. During this period, the technology used by us and others (Thompson et al., 1993; Kleijer et al., 1996) in these diagnoses has undergone considerable development in evolution. Our policy to maintain a close relationship between the provision of a diagnostic service and research to achieve an overall goal of early diagnosis and effective therapy have progressed both activities.

  8. Prenatal Screening Methods for Aneuploidies

    PubMed Central

    Dey, Madhusudan; Sharma, Sumedha; Aggarwal, Sumita

    2013-01-01

    Aneuploidies are a major cause of perinatal morbidity and mortality. Therefore, it is the most common indication for invasive prenatal diagnosis. Initially, screening for aneuploidies started with maternal age risk estimation. Later on, serum testing for biochemical markers and ultrasound markers were added. Women detected to be at high-risk for aneuploidies were offered invasive testing. New research is now focusing on non-invasive prenatal testing using cell-free fetal DNA in maternal circulation. The advantage of this technique is the ability to reduce the risk of miscarriage associated with invasive diagnostic procedures. However, this new technique has its own set of technical limitations and ethical issues at present and careful consideration is required before broad implementation PMID:23626953

  9. Prenatal diagnosis of cloacal malformation.

    PubMed

    Peiro, Jose L; Scorletti, Federico; Sbragia, Lourenco

    2016-04-01

    Persistent cloaca malformation is the most severe type of anorectal and urogenital malformation. Decisions concerning the surgical treatment for this condition are taken during the first hours of life and may determine the quality of life of these patients. Thus, prenatal diagnosis becomes important for a prompt and efficient management of the fetus and newborn, and accurate counseling of the parents regarding its consequences and the future of the baby. Careful evaluation by ultrasonography, and further in-depth analysis with MRI, allow prenatal detection of characteristic findings, which can lead to diagnose or at least suspect this condition. We reviewed our experience and the literature in order to highlight the most important clues that can guide the physician in the differential diagnosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Prenatal Screening Using Maternal Markers

    PubMed Central

    Cuckle, Howard

    2014-01-01

    Maternal markers are widely used to screen for fetal neural tube defects (NTDs), chromosomal abnormalities and cardiac defects. Some are beginning to broaden prenatal screening to include pregnancy complications such as pre-eclampsia. The methods initially developed for NTDs using a single marker have since been built upon to develop high performance multi-maker tests for chromosomal abnormalities. Although cell-free DNA testing is still too expensive to be considered for routine application in public health settings, it can be cost-effective when used in combination with existing multi-maker marker tests. The established screening methods can be readily applied in the first trimester to identify pregnancies at high risk of pre-eclampsia and offer prevention though aspirin treatment. Prenatal screening for fragile X syndrome might be adopted more widely if the test was to be framed as a form of maternal marker screening. PMID:26237388

  11. Prenatal nutrition and birth outcomes.

    PubMed

    Fowles, Eileen R

    2004-01-01

    The complex relationship between maternal nutritional and birth outcomes emphasizes the need for consistent and thorough assessments of women's diet throughout pregnancy and individualized nutritional education to promote positive birth outcomes. The purpose of this article is to examine the influence of prenatal nutrition on birth outcomes, describe research on the effects of macro- and micronutrients on birth outcomes, and discuss strategies for monitoring diet and implementing nutrition education during pregnancy.

  12. Prenatal Development: How Your Baby Grows During Pregnancy

    MedlinePlus

    ... ACOG Prenatal Development: How Your Baby Grows During Pregnancy Home For Patients Search FAQs Prenatal Development: How ... Format Prenatal Development: How Your Baby Grows During Pregnancy Pregnancy How does pregnancy begin? What is the ...

  13. Laparoscopic revision surgery for gastroesophageal reflux disease

    PubMed Central

    Celasin, Haydar; Genc, Volkan; Celik, Suleyman Utku; Turkcapar, Ahmet Gökhan

    2017-01-01

    Abstract Laparoscopic antireflux surgery is a frequently performed procedure for the treatment of gastroesophageal reflux in surgical clinics. Reflux can recur in between 3% and 30% of patients on whom antireflux surgery has been performed, and so revision surgery can be required due to recurrent symptoms or dysphagia in approximately 3% to 6% of the patients. The objective of this study is to evaluate the mechanism of recurrences after antireflux surgery and to share our results after revision surgery in recurrent cases. From 2001 to 2014, revision surgery was performed on 43 patients (31 men, 12 women) between the ages of 24 and 70 years. The technical details of the first operation, recurrence symptoms, endoscopy, and manometry findings were evaluated. The findings of revision surgery, surgical techniques, morbidity rates, length of hospitalization, and follow-up period were also recorded and evaluated. The first operation was Nissen fundoplication in 34 patients and Toupet fundoplication in 9 patients. Mesh hiatoplasty was performed for enforcement in 18 (41.9%) of these patients. The period between the first operation and the revision surgery ranged from 4 days to 60 months. The most common finding was slipped fundoplication and presence of hiatal hernia during revision surgery. Revision fundoplication and hernia repair with mesh reinforcement were used in 33 patients. The other techniques were Collis gastroplasty, revision fundoplication, and hernia repair without mesh. The range of follow-up period was from 2 to 134 months. Recurrence occurred in 3 patients after revision surgery (6.9%). Although revision surgery is difficult and it has higher morbidity, it can be performed effectively and safely in experienced centers. PMID:28072725

  14. Prenatal programming of postnatal plasticity?

    PubMed

    Pluess, Michael; Belsky, Jay

    2011-02-01

    Evidence indicates that maternal prenatal distress predicts problematic health and behavioral outcomes in children as well as infant/child cortisol levels and negative emotionality as reviewed here. Evidence that these physiological and behavioral characteristics themselves moderate environmental effects on development in a "for better and for worse" manner consistent with Belsky's differential susceptibility hypothesis and Boyce and Ellis' notions of biological sensitivity to context raises the prospect that susceptibility to rearing is a function of nurture (i.e., fetal environment), consistent with Boyce and Ellis' proposal that plasticity can be shaped by developmental experience. This hypothesis is supported by new findings from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development showing that low birth weight, a marker for an adverse prenatal environment, predicts infant difficult temperament, which is a susceptibility factor that we previously showed as moderating, in a for better and for worse manner, the effects of parenting and child care quality on socioemotional functioning. Moreover, recent Gene × Environment interaction research raises the prospect that some fetuses may be more susceptible to such "prenatal programming of postnatal plasticity" as a result of their genetic makeup. If this proves true, it will be consistent with the conclusion that early developmental plasticity is a function of both nature and nurture and may be evolutionarily adaptive, a further possibility considered in the discussion.

  15. Consequences of prenatal substance use.

    PubMed

    Sithisarn, Thitinart; Granger, Don T; Bada, Henrietta S

    2012-01-01

    Prenatal substance use is a major public health problem and a social morbidity, with consequences on the drug user and the offspring. This review focuses on the child and adolescent outcomes following in utero drug exposure. Studies on the effects of specific substances, legal and illegal; i.e., tobacco or nicotine, alcohol, marijuana, cocaine, opiates, and methamphetamine were evaluated and analyzed. In general, manifestations of prenatal exposure to legal and illegal substances include varying deficits in birth anthropometric measurements, mild-to-moderate transient neurobehavioral alterations in infancy and long-term behavioral problems noted from early childhood to adolescence. Severity of expression of behavioral problems is influenced by environmental factors. Further, behavioral alterations following in utero drug exposure often exist with mental health co-morbidities. Because of the long-term consequences of prenatal drug exposure on child and adolescent mental health, health providers need to promote substance use prevention, screen for exposure effects and provide or refer affected youths for intervention services. Preventive measures and treatment should consider other factors that may further increase the risk of psychopathology in the exposed children.

  16. Exploring birth outcome disparities and the impact of prenatal care utilization among North Carolina teen mothers.

    PubMed

    Coley, Sheryl L; Aronson, Robert E

    2013-01-01

    This study investigated the role of prenatal care utilization in explaining disparities in birth outcomes between African-American and White teen mothers in North Carolina. This cross-sectional study analyzed birth record data for African-American and White teen mothers provided by the North Carolina State Center of Health Statistics for 2009 (n = 10,515). Hierarchical moderated multiple regression models were completed to explore associations between racial status, prenatal care utilization, and birth outcome disparities amid multiple demographic and medical risk factors. Racial status as African American was identified as a significant predictor for lower birth weight and gestational age in each regression model when accounting for other demographic variables, medical risk factors, and prenatal care utilization. Results illuminate significant associations between higher prenatal care utilization levels and higher infant birth weight and gestational age for the overall teen population. However, these results did not identify protective effects in reducing racial disparities in birth weight or gestational age. Given these results, a more in-depth exploration of prenatal care client assessment, education, and alternative prenatal care models is warranted to identify strategies for reducing birth outcome disparities between these populations. These findings also suggest the need for further examination of other potential social and economic factors that explain racial disparities in birth outcomes between African-American and White teen populations. Copyright © 2013 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  17. Prenatal diagnosis of nonsyndromic congenital heart defects.

    PubMed

    Ailes, Elizabeth C; Gilboa, Suzanne M; Riehle-Colarusso, Tiffany; Johnson, Candice Y; Hobbs, Charlotte A; Correa, Adolfo; Honein, Margaret A

    2014-03-01

    Congenital heart defects (CHDs) occur in nearly 1% of live births. We sought to assess factors associated with prenatal CHD diagnosis in the National Birth Defects Prevention Study (NBDPS). We analyzed data from mothers with CHD-affected pregnancies from 1998 to 2005. Prenatal CHD diagnosis was defined as affirmative responses to questions about abnormal prenatal ultrasounds and fetal echocardiography obtained during a structured telephone interview. Fifteen percent (1097/7299) of women with CHD-affected pregnancies (excluding recognized syndromes and single-gene disorders) reported receiving a prenatal CHD diagnosis. Prenatal CHD diagnosis was positively associated with advanced maternal age, family history of CHD, type 1 or type 2 diabetes, twin or higher-order gestation, CHD complexity, and presence of extracardiac defects. Prenatal CHD diagnosis was inversely associated with maternal Hispanic race/ethnicity, prepregnancy overweight or obesity, and preexisting hypertension. Prenatal CHD diagnosis varied by time to NBDPS interview and NBDPS study site. Further work is warranted to identify reasons for the observed variability in maternal reports of prenatal CHD diagnosis and the extent to which differences in health literacy or health system factors such as access to specialized prenatal care and fetal echocardiography may account for such variability. © 2013 John Wiley & Sons, Ltd.

  18. Variation in Excessive Fetal Growth across Levels of Prenatal Care among Women with Gestational Diabetes.

    PubMed

    Hale, Nathan L; Probst, Janice C; Liu, Jihong; Bennett, Kevin J; Martin, Amy Brock; Glover, Saundra

    2011-10-01

    Examine the association between prenatal care and excessive fetal growth outcomes among mothers with gestational diabetes mellitus (GDM). We conducted a retrospective analysis of 2004-2007 singleton live births to South Carolina women, limited to those for whom both birth certificate and hospital discharge data were available (N = 179 957). Gestational diabetes mellitus was identified from birth certificate and/or hospital discharge claims. Measures of excessive fetal growth were large for gestational age (90th and 95th percentiles) and macrosomia (birth weight > 4500 g). The Adequacy of Prenatal Care Utilization index was used to measure prenatal care. Gestational diabetes mellitus was recorded for 6.9% of women in the study population. Women with GDM were more likely than other women to have an infant with excessive fetal growth, regardless of the level of prenatal care; however, there was a significant interaction between GDM status and levels of prenatal care. All women with GDM had increased odds for large infant outcomes. However, those receiving inadequate prenatal care were markedly more likely to experience excessive fetal growth outcomes (odds ratio = 1.38, confidence interval = 1.15-1.66) than women also with GDM and intermediate/adequate prenatal care. Similar patterns were noted for large for gestational age (95th) and macrosomia (total birth weight ≥ 4500 g). Observed associations suggest a link between inadequate prenatal care and a higher risk for excessive fetal growth among women with GDM. Further research is needed to clarify the nature of the association and suggest ways to get high-risk women into care sooner.

  19. Brachytelephalangic chondrodysplasia punctata: prenatal diagnosis and postnatal outcome.

    PubMed

    Boulet, S; Dieterich, K; Althuser, M; Nugues, F; Durand, C; Charra, C; Schaal, J P; Jouk, P S

    2010-01-01

    We report the prenatal management of a brachytelephalangic chondrodysplasia punctata (CDPX1) case and how postnatal findings confirmed the diagnosis. The mother was initially referred after ultrasound revealed an abnormal fetal mid-face and punctuation of upper femoral epiphyses. Chondrodysplasia punctata (CP) with Binder anomaly was suspected. 3D-HCT revealed brachytelephalangy suggesting CDPX1. At birth, mid-face hypoplasia was marked. Postnatal imaging and genetic analysis confirmed the initial diagnosis. Binder anomaly is probably always associated with CP. The newly revised CP classification facilitates the diagnosis. The main etiologies are metabolic and chromosomal abnormalities, and arylsulfatase E enzyme dysfunction. Thus, screening for arylsulfatase E mutation is mandatory for an accurate diagnosis and can lead to better delineation among CP etiologies associated with a Binder phenotype. Copyright © 2010 S. Karger AG, Basel.

  20. Prenatal lead exposure modifies the impact of maternal self-esteem on children's inattention behavior

    PubMed Central

    Xu, Jian; Hu, Howard; Wright, Rosalind; Sánchez, Brisa N.; Schnaas, Lourdes; Bellinger, David C.; Park, Sung Kyun; Martínez, Sandra; Hernández-Avila, Mauricio; Téllez-Rojo, Martha Maria; Wright, Robert O.

    2015-01-01

    Objective To prospectively evaluate the association of maternal self-esteem measured when their offspring were toddlers with the subsequent development of attention-deficit-hyperactivity-disorder (ADHD)-like behavior in their school-age offspring and the potential modifying effects of prenatal lead exposure. Study design We evaluated a subsample of 192 mother-child pairs from a long-running birth-cohort project that enrolled mothers in Mexico from 1994 to 2011. Prenatal lead exposure was assessed using cord blood lead and maternal bone lead around delivery (tibia and patella lead, measured by K-x-ray-fluorescence). When children were 2 years old, maternal self-esteem was measured using the Coopersmith-Self-esteem-Inventory. When children were 7-to-15 years old, children's blood lead levels and ADHD symptoms were assessed, and Conners’ Parental-Rating-Scales-Revised (CPRS-R) and Behavior-Rating-Inventory-of-Executive-Function-Parent Form (BRIEF-P) were used as measures of ADHD-like behavior. Results Adjusting for family economic status, marital status, maternal education and age, child's age and sex, and children's current blood lead levels, increased maternal self-esteem was associated with reduced child inattention behavior. Compared with those among high prenatal lead exposure (P25-P100), this association was stronger among low prenatal lead exposure groups (P1-P25, p-values for the interaction effects between prenatal lead exposure and maternal self-esteem levels < 0.10). Each 1-point increase in maternal self-esteem scores was associated with 0.6-to-1.3-point decrease in CPRS-R and BRIEF-P T-scores among groups with low cord blood lead and patella lead (P1-P25). Conclusions Children experiencing high maternal self-esteem during toddlerhood were less likely to develop inattention behavior at school-age. Prenatal lead exposure may play a role in attenuating this protective effect. PMID:26047683

  1. MOTHERS' AND FATHERS' PRENATAL REPRESENTATIONS IN RELATION TO MARITAL DISTRESS AND DEPRESSIVE SYMPTOMS.

    PubMed

    Ahlqvist-Björkroth, Sari; Korja, Riikka; Junttila, Niina; Savonlahti, Elina; Pajulo, Marjukka; Räihä, Hannele; Aromaa, Minna

    2016-07-01

    Marital distress, parental depression, and weak quality of parental representations are all known risk factors for parent-child relationships. However, the relation between marital distress, depressive symptoms, and parents' prenatal representation is uncertain, especially regarding fathers. The present study aimed to explore how mothers' and fathers' prenatal experience of marital distress and depressive symptoms affects the organization of their prenatal representations in late pregnancy. Participants were 153 pregnant couples from a Finnish follow-up study called "Steps to the Healthy Development and Well-being of Children" (H. Lagström et al., ). Marital distress (Revised Dyadic Adjustment Scale; D.M. Busby, C. Christensen, D. Crane, & J. Larson, 1995) and depressive symptoms (Edinburgh Postnatal Depression Scale) were assessed at 20 gestational weeks, and prenatal representations (Working Model of the Child Interview; D. Benoit, K.C.H. Parker, & C.H. Zeanah, 1997; C.H. Zeanah, D. Benoit, M. Barton, & L. Hirshberg, 1996) were assessed between 29 and 32 gestational weeks. The mothers' risks of distorted representations increased significantly when they had at least minor depressive symptoms. Marital distress was associated with the fathers' prenatal representations, although the association was weak; fathers within the marital distress group had less balanced representations. Coexisting marital distress and depressive symptoms were only associated with the mothers' representations; lack of marital distress and depressive symptoms increased the likelihood for mothers to have balanced representations. The results imply that marital distress and depressive symptoms are differently related to the organizations of mothers' and fathers' prenatal representations.

  2. Prevalence of syphilis in pregnancy and prenatal syphilis testing in Brazil: Birth in Brazil study

    PubMed Central

    Domingues, Rosa Maria Soares Madeira; Szwarcwald, Celia Landmann; Souza, Paulo Roberto Borges; Leal, Maria do Carmo

    2014-01-01

    OBJECTIVE Determine the coverage rate of syphilis testing during prenatal care and the prevalence of syphilis in pregnant women in Brazil. METHODS This is a national hospital-based cohort study conducted in Brazil with 23,894 postpartum women between 2011 and 2012. Data were obtained using interviews with postpartum women, hospital records, and prenatal care cards. All postpartum women with a reactive serological test result recorded in the prenatal care card or syphilis diagnosis during hospitalization for childbirth were considered cases of syphilis in pregnancy. The Chi-square test was used for determining the disease prevalence and testing coverage rate by region of residence, self-reported skin color, maternal age, and type of prenatal and child delivery care units. RESULTS Prenatal care covered 98.7% postpartum women. Syphilis testing coverage rate was 89.1% (one test) and 41.2% (two tests), and syphilis prevalence in pregnancy was 1.02% (95%CI 0.84;1.25). A lower prenatal coverage rate was observed among women in the North region, indigenous women, those with less education, and those who received prenatal care in public health care units. A lower testing coverage rate was observed among residents in the North, Northeast, and Midwest regions, among younger and non-white skin-color women, among those with lower education, and those who received prenatal care in public health care units. An increased prevalence of syphilis was observed among women with < 8 years of education (1.74%), who self-reported as black (1.8%) or mixed (1.2%), those who did not receive prenatal care (2.5%), and those attending public (1.37%) or mixed (0.93%) health care units. CONCLUSIONS The estimated prevalence of syphilis in pregnancy was similar to that reported in the last sentinel surveillance study conducted in 2006. There was an improvement in prenatal care and testing coverage rate, and the goals suggested by the World Health Organization were achieved in two regions. Regional

  3. Congenital cystic adenomatoid malformation: impact of prenatal diagnosis and changing strategies in the treatment of the asymptomatic patient.

    PubMed

    Marshall, K W; Blane, C E; Teitelbaum, D H; van Leeuwen, K

    2000-12-01

    This study was designed to assess the effect of prenatal sonographic diagnosis on the treatment of congenital cystic adenomatoid malformation of the lung. The medical records of 27 patients with pathologically proven congenital cystic adenomatoid malformations were retrospectively reviewed. Patients were divided into four groups based on mode of presentation: with or without abnormal findings on prenatal sonography and with or without symptoms at birth. Age at diagnosis, age at surgical intervention, complications, and length of hospital stay were recorded for each group. Twenty-seven patients with 31 proven congenital cystic adenomatoid malformations were included. Eleven patients underwent prenatal sonography establishing the diagnosis (6 asymptomatic at birth, 5 symptomatic), and 16 did not have a prenatal diagnosis (10 asymptomatic at birth, 6 symptomatic). In the symptomatic populations, prenatal diagnosis had no impact on age at surgery, length of stay, or surgical complication rate (p = 0.78-0.83). In the asymptomatic population, prenatal diagnosis allowed early diagnosis (p < 0.001) and resection in the asymptomatic period. It was also associated with a shorter length of stay at the time of surgical resection (mean time, 4.2 days for patients with prenatal diagnosis versus 12.9 days for those without it;p < 0.001) and with a trend toward lower serious complication rate (3 patients without prenatal diagnosis versus 1 patient with it). Prenatal sonography provides the radiologist a means to identify congenital cystic adenomatoid malformations in a population of infants who are asymptomatic at birth. Surgical intervention in the asymptomatic infant is associated with a shorter length of stay, a trend toward fewer complications, and decreased medical cost compared with intervening after symptoms develop.

  4. Effects of Prenatal Nicotine Exposure on Infant Language Development: A Cohort Follow Up Study.

    PubMed

    Hernández-Martínez, Carmen; Voltas Moreso, Núria; Ribot Serra, Blanca; Arija Val, Victoria; Escribano Macías, Joaquín; Canals Sans, Josefa

    2017-04-01

    Objectives To study the longitudinal effects of prenatal nicotine exposure on cognitive development, taking into consideration prenatal and postnatal second-hand smoke exposure. Methods A cohort follow up study was carried out. One hundred and fifty-eight pregnant women and their infants were followed during pregnancy and infant development (at 6, 12, 30 months). In each trimester of pregnancy and during postnatal follow-up, a survey was administered to obtain sociodemographic data and the details of maternal and close familial toxic habits. Obstetric and neonatal data were obtained from hospital medical records. To assess cognitive development, the Bayley Scales of Infant Development were applied at 6, 12 and 30 months; to assess language development, the MacArthur-Bates Communicative Development Inventories were applied at 12 months and the Peabody Picture Vocabulary Test at 30 months. Results After adjustment for confounding variables, the results showed that infants prenatally exposed to cigarette smoke recorded poor cognitive development scores. Language development was most consistently affected, specifically those aspects related to auditory function (vocalizations, sound discrimination, word imitation, prelinguistic vocalizations, and word and sentence comprehension). Conclusions for Practice Irrespective of prenatal, perinatal and sociodemographic data (including infant postnatal nicotine exposure), prenatal exposure to cigarette smoke and second-hand smoke affect infant cognitive development, especially language abilities.

  5. Conceptions of Prenatal Development: Behavioral Embryology

    ERIC Educational Resources Information Center

    Gottlieb, Gilbert

    1976-01-01

    Describes recent progress in research on prenatal behavioral development and in a systematic fashion the various ways in which prenatal experience can affect the development of behavior in the neonate as well as in the embryo and fetus. (Author/RK)

  6. Conceptions of Prenatal Development: Behavioral Embryology

    ERIC Educational Resources Information Center

    Gottlieb, Gilbert

    1976-01-01

    Describes recent progress in research on prenatal behavioral development and in a systematic fashion the various ways in which prenatal experience can affect the development of behavior in the neonate as well as in the embryo and fetus. (Author/RK)

  7. Primary Pupils' Preconceptions about Child Prenatal Development

    ERIC Educational Resources Information Center

    Zoldosova, Kristina; Prokop, Pavol

    2007-01-01

    The research deals a problem of primary pupils' preconceptions about a child prenatal development. Even the pupils cannot experience the phenomenon and can get only mediate information; their idea about the prenatal development is quite well constructed. The quality of the preconceptions depends mainly upon variety of informational sources kept at…

  8. Prenatal Maternal Stress Programs Infant Stress Regulation

    ERIC Educational Resources Information Center

    Davis, Elysia Poggi; Glynn, Laura M.; Waffarn, Feizal; Sandman, Curt A.

    2011-01-01

    Objective: Prenatal exposure to inappropriate levels of glucocorticoids (GCs) and maternal stress are putative mechanisms for the fetal programming of later health outcomes. The current investigation examined the influence of prenatal maternal cortisol and maternal psychosocial stress on infant physiological and behavioral responses to stress.…

  9. Primary Pupils' Preconceptions about Child Prenatal Development

    ERIC Educational Resources Information Center

    Zoldosova, Kristina; Prokop, Pavol

    2007-01-01

    The research deals a problem of primary pupils' preconceptions about a child prenatal development. Even the pupils cannot experience the phenomenon and can get only mediate information; their idea about the prenatal development is quite well constructed. The quality of the preconceptions depends mainly upon variety of informational sources kept at…

  10. Prenatal Drug Exposure: Implications for Personnel Preparation.

    ERIC Educational Resources Information Center

    Watson, Silvana M. R.; Westby, Carol E.

    2003-01-01

    A study involving 34 children (ages 5-16) prenatally and environmentally exposed to drugs or alcohol, found teachers perceived the students as distractible, lazy, stubborn, and impulsive. Teachers who knew the children had been prenatally exposed seemed to be willing to adjust expectations and to modify the learning environment. (Contains…

  11. Prenatal Maternal Stress Programs Infant Stress Regulation

    ERIC Educational Resources Information Center

    Davis, Elysia Poggi; Glynn, Laura M.; Waffarn, Feizal; Sandman, Curt A.

    2011-01-01

    Objective: Prenatal exposure to inappropriate levels of glucocorticoids (GCs) and maternal stress are putative mechanisms for the fetal programming of later health outcomes. The current investigation examined the influence of prenatal maternal cortisol and maternal psychosocial stress on infant physiological and behavioral responses to stress.…

  12. Prenatal exclusion of the HHH syndrome.

    PubMed

    Gray, R G; Green, A; Hall, S; McKeown, C

    1995-05-01

    Prenatal diagnosis of the hyperornithinaemia, hyperammonaemia, and homocitrullinuria syndrome is described by the analysis of ornithine incorporation in second-trimester cultured amniotic fluid cells. An unaffected fetus was predicted and confirmed in the newborn child. This is the third reported prenatal diagnosis for this disorder and the second predicting an unaffected fetus.

  13. Medicaid reimbursement, prenatal care and infant health.

    PubMed

    Sonchak, Lyudmyla

    2015-12-01

    This paper evaluates the impact of state-level Medicaid reimbursement rates for obstetric care on prenatal care utilization across demographic groups. It also uses these rates as an instrumental variable to assess the importance of prenatal care on birth weight. The analysis is conducted using a unique dataset of Medicaid reimbursement rates and 2001-2010 Vital Statistics Natality data. Conditional on county fixed effects, the study finds a modest, but statistically significant positive relationship between Medicaid reimbursement rates and the number of prenatal visits obtained by pregnant women. Additionally, higher rates are associated with an increase in the probability of obtaining adequate care, as well as a reduction in the incidence of going without any prenatal care. However, the effect of an additional prenatal visit on birth weight is virtually zero for black disadvantaged mothers, while an additional visit yields a substantial increase in birth weight of over 20 g for white disadvantaged mothers.

  14. Prenatal management of disorders of sex development.

    PubMed

    Chitty, Lyn S; Chatelain, Pierre; Wolffenbuttel, Katja P; Aigrain, Yves

    2012-12-01

    Disorders of sex development (DSD) rarely present prenatally but, as they are very complex conditions, management should be directed by highly specialised medical teams to allow consideration of all aspects of diagnosis, treatment and ethical issues. In this brief review, we present an overview of the prenatal presentation and management of DSD, including the sonographic appearance of normal genitalia and methods of determining genetic sex, the prenatal management of pregnancies with the unexpected finding of genital ambiguity on prenatal ultrasound and a review of the prenatal management of pregnancies at high risk of DSD. As this is a rapidly developing field, management options will change over time, making the involvement of clinical geneticists, paediatric endocrinologists and urologists, as well as fetal medicine specialists, essential in the care of these complex pregnancies. The reader should also bear in mind that local social, ethical and legal aspects may also influence management.

  15. Prenatal Diagnosis and Postnatal Outcome of Schizencephaly.

    PubMed

    Kutuk, Mehmet Serdar; Gorkem, Sureyya Burcu; Bayram, Ayse; Doganay, Selim; Canpolat, Mehmet; Basbug, Mustafa

    2015-09-01

    The aim of this study was to present our experience with 5 cases of fetal schizencephaly in terms of prenatal diagnostic features, and postnatal outcome. The database of prenatal diagnosis unit was searched for antenatally diagnosed cases with schizencephaly. Maternal characteristics, ultrasonography, prenatal-postnatal magnetic resonance imaging (MRI) findings, and postnatal outcome were noted. Of 5 cases, 2 had definitive prenatal diagnoses on ultrasound and 3 cases were diagnosed by fetal MRI. All cases had cerebral cortical migration anomalies including polymicrogyria, subependymal heterotopia, and lissencephaly, and 2 cases had additional extracranial malformations. Three cases showed regression of the cerebral clefts on follow-up postnatal MRIs. Three cases had moderate to severe psychomotor retardation, and 1 case needed repeated ventriculoperitoneal shunt operation due to hydrocephaly. Prenatal diagnosis of schizencephaly with ultrasonography is not straightforward and required further evaluation with fetal MRI. Additional cerebral anomalies worsen the prognosis of schizencephaly. © The Author(s) 2014.

  16. Prenatal microwave exposure and behavior

    SciTech Connect

    O'Connor, M.E.

    1988-01-01

    The hypotheses for the initial investigation was based on the idea that failure to observe structural teratogenesis following microwave exposure did not preclude the possibility that such exposure would result in behavioral changes. We also proposed that such exposure might specifically alter some aspect of thermoregulatory behavior. The results of these studies support both of these hypotheses. Whether the studies show enhanced thermal sensitivity or enhanced development, they do support the hypothesis that prenatal exposure to microwave radiation is more likely to alter postnatal sensitivity to thermally related stimuli or conditions as compared to stimuli that are thermally neutral.

  17. 77 FR 11534 - Privacy Act of 1974; Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-27

    ... INVESTMENT BOARD Privacy Act of 1974; Systems of Records AGENCY: Federal Retirement Thrift Investment Board. ACTION: Notice of revision to existing systems of records. SUMMARY: The Federal Retirement Thrift Investment Board (Agency) is proposing to revise its Privacy Act Systems of Records to reflect the...

  18. Candidate diseases for prenatal gene therapy.

    PubMed

    David, Anna L; Waddington, Simon N

    2012-01-01

    Prenatal gene therapy aims to deliver genes to cells and tissues early in prenatal life, allowing correction of a genetic defect, before irreparable tissue damage has occurred. In contrast to postnatal gene therapy, prenatal application may target genes to a large population of stem cells, and the smaller fetal size allows a higher vector to target cell ratio to be achieved. Early gestation delivery may allow the development of immune tolerance to the transgenic protein, which would facilitate postnatal repeat vector administration if needed. Moreover, early delivery would avoid anti-vector immune responses which are often acquired in postnatal life. The NIH Recombinant DNA Advisory Committee considered that a candidate disease for prenatal gene therapy should pose serious morbidity and mortality risks to the fetus or neonate, and not have any effective postnatal treatment. Prenatal gene therapy would therefore be appropriate for life-threatening disorders, in which prenatal gene delivery maintains a clear advantage over cell transplantation or postnatal gene therapy. If deemed safer and more efficacious, prenatal gene therapy may be applicable for nonlethal conditions if adult gene transfer is unlikely to be of benefit. Many candidate diseases will be inherited congenital disorders such as thalassaemia or lysosomal storage disorders. However, obstetric conditions such as fetal growth restriction may also be treated using a targeted gene therapy approach. In each disease, the condition must be diagnosed prenatally, either via antenatal screening and prenatal diagnosis, for example, in the case of hemophilias, or by ultrasound assessment of the fetus, for example, congenital diaphragmatic hernia. In this chapter, we describe some examples of the candidate diseases and discuss how a prenatal gene therapy approach might work.

  19. Barriers to prenatal care in Europe.

    PubMed

    Delvaux, T; Buekens, P; Godin, I; Boutsen, M

    2001-07-01

    In Europe, it is sometimes assumed that few barriers to prenatal care exist because extensive programs of health insurance and initiatives to promote participation in prenatal care have been established for many decades. A case-control study was performed in ten European countries (Austria, Denmark, Germany, Greece, Hungary, Ireland, Italy, Portugal, Spain, and Sweden). Postpartum interviews were conducted between 1995 and 1996. A total of 1283 women with inadequate prenatal care (i.e., with 0, 1, or 2 prenatal care visits or a first prenatal care visit after 15 completed weeks of pregnancy) and 1280 controls with adequate prenatal care were included in the analysis combining data from the ten countries. Based on combined data of the ten countries, lack of health insurance was found to be an important risk factor for inadequate prenatal care (crude odds ratio [OR] at 95% confidence interval [CI]: 30.1 [20.1-47.1]). Women with inadequate prenatal care were more likely to be aged < 20 years (16.4% vs 4.8%) and with higher parity (number of children previously borne) than controls. They were more likely to be foreign nationals, unmarried, and with an unplanned pregnancy. Women with inadequate care were also more likely to have less education and no regular income. They had more difficulties dealing with health services organization and child care. Cultural and financial barriers were present, but after adjusting for confounders by logistic regression, perceived financial difficulty was not a significant factor for inadequate prenatal care (adjusted OR [95% CI]: 0.7 [0.4-1.3]). Personal, socioeconomic, organizational, and cultural barriers to prenatal care exist in Europe.

  20. [Adequacy process of prenatal care according to the criteria of humanizing of prenatal care and childbirth program and stork network].

    PubMed

    Martinelli, Katrini Guidolini; Santos Neto, Edson Theodoro Dos; Gama, Silvana Granado Nogueira da; Oliveira, Adauto Emmerich

    2014-02-01

    To evaluate the adequacy of the process of prenatal care according to the parameters of the Program for the Humanization of Prenatal Care (PHPN) and of the procedures provided by the Stork Network of Unified Health System (SUS) in the microregion of Espirito Santo state, Brazil. A cross-sectional study was conducted in 2012-2013 by interviewing and analyzing the records of 742 women during the postpartum period and of their newborns in 7 hospitals in the region chosen for the research. The information was collected, processed and analyzed by the χ² and Fisher's exact test to determine the difference in proportion between the criteria adopted by the PHPN and the Stork Network and the place of residence, family income and type of coverage of prenatal service. The level of significance was set at 5%. The parameters showing the lowest adequacy rate were quick tests and repeated exams, with frequencies around 10 and 30%, respectively, in addition to educational activities (57.9%) and tetanus immunization (58.7%). In contrast, risk management (92.6%) and the fasting plasma glucose test (91.3%) showed the best results. Adequacy was 7.4% for the PHPN, 0.4% for the Stork Network, with respect to the parameters of normal risk pregnancies, and 0 for high risk pregnancies. There was a significant difference between puerperae according to housing location regarding the execution of serology for syphilis (VDRL), anti-HIV and repeated fasting glucose tests, and monthly income influenced the execution of blood type/Rh factor tests, VDRL, hematocrit and anti-HIV test. Prenatal care in the SUS proved to be inadequate regarding the procedures required by the PHPN and Stork Network in the micro-region of a state in southeastern Brazil, especially for women of lower income, PACS users and residents of rural areas.

  1. Prenatal exposure to ionizing radiation and subsequent development of seizures

    SciTech Connect

    Dunn, K.; Yoshimaru, H.; Otake, M.; Annegers, J.F.; Schull, W.J. )

    1990-01-01

    Seizures are a frequent sequela of impaired brain development and can be expected to affect more children with radiation-related brain damage than children without such damage. This report deals with the incidence and type of seizures among survivors prenatally exposed to the atomic bombing of Hiroshima and Nagasaki, and their association with specific stages of prenatal development at the time of irradiation. Fetal radiation dose was assumed to be equal to the dose to the maternal uterus. Seizures here include all references in the clinical record to seizure, epilepsy, or convulsion. Histories of seizures were obtained at biennial routine clinical examinations starting at about the age of 2 years. These clinical records were used to classify seizures as febrile or unprovoked (without precipitating cause). No seizures were ascertained among subjects exposed 0-7 weeks after fertilization at doses higher than 0.10 Gy. The incidence of seizures was highest with irradiation at the eighth through the 15th week after fertilization among subjects with doses exceeding 0.10 Gy and was linearly related to the level of fetal exposure. This obtains for all seizures without regard to the presence of fever or precipitating causes, and for unprovoked seizures. When the 22 cases of severe mental retardation were excluded, the increase in seizures was only suggestively significant and only for unprovoked seizures. After exposure at later stages of development, there was no increase in recorded seizures.

  2. Hemimegalencephaly: prenatal diagnosis and outcome.

    PubMed

    Alvarez, Rosa María; García-Díaz, Lutgardo; Márquez, Javier; Fajardo, Manuel; Rivas, Eloy; García-Lozano, Juan Carlos; Antiñolo, Guillermo

    2011-01-01

    Hemimegalencephaly (HME) is a developmental abnormality of the central nervous system (CNS) which may present as either a syndromic or isolated case. Here, we present two cases of early prenatal diagnosis of HME. Prenatal CNS ultrasound and MRI in the first case revealed ventricular asymmetry, midline shift with displacement of the occipital lobe across the midline, large dilatation mainly at the posterior horn of the left lateral ventricle, and a head circumference in the 90th percentile without involvement of the brain stem and cerebellum, as well as abdominal lymphangioma. Right hemispherectomy was performed at 3 months of age due to intractable seizures. The pathological specimen showed findings characteristic of HME, including a disorganized cytoarchitecture with lack of neuronal lamination, focal areas of polymicrogyria, and neuronal heterotopias with dysplastic cells. In the second case, 2D and 3D neurosonography demonstrated similar findings (asymmetry of cerebral hemispheres, midline shift, and dilation of the posterior horn of the left lateral cerebral ventricle). Posterior fossa structures were unremarkable. HME was diagnosed and the pregnancy was terminated. Autopsy findings confirmed the diagnosis of HME. Copyright © 2011 S. Karger AG, Basel.

  3. Prenatal diagnosis in multiple pregnancy.

    PubMed

    Taylor, M J; Fisk, N M

    2000-08-01

    Fetal abnormality is more common in multiple than in singleton pregnancies. This, together with the requirement to consider the risks with at least two babies to sample correctly each fetus and to undertake accurately-targeted selective termination, amounts to a major challenge for obstetricians involved in prenatal diagnosis. Early determination of chorionicity should be routine, since this influences not only the genetic risks but also the invasive procedure chosen for karyotyping or genotyping. Assessment of nuchal translucency identifies individual fetuses at risk of trisomy. Contrary to expectation, invasive procedures in twins appear to have procedure-related miscarriage rates that are similar to those in singletons. Instead, contamination remains a concern at chorionic villus sampling. Elective late karyotyping of fetuses may have a role in some countries. Whereas management options for discordant fetal abnormality are relatively straightforward in dichorionic pregnancies, monochorionic pregnancies are at risk of co-twin sequelae after any single intrauterine death. Techniques have now been developed to occlude completely the cord vasculature by laser and/or ultrasound guided bipolar diathermy. Given the complexities associated with prenatal diagnosis, all invasive procedures in multiple pregnancies should be performed in tertiary referral centres. Copyright 2000 Harcourt Publishers Ltd.

  4. The Yugoslavia Prospective Lead Study: contributions of prenatal and postnatal lead exposure to early intelligence.

    PubMed

    Wasserman, G A; Liu, X; Popovac, D; Factor-Litvak, P; Kline, J; Waternaux, C; LoIacono, N; Graziano, J H

    2000-01-01

    To investigate associations between the timing of lead (Pb) exposure on early intelligence, we examined the results of psychometric evaluations at ages 3, 4, 5, and 7 years, from 442 children whose mothers were recruited during pregnancy from a smelter town and a non-lead-exposed town in Yugoslavia. We compared the relative contribution of prenatal blood lead (BPb) with that of relative increases in BPb in either the early (0-2 years) or the later (from 2 years on) postnatal period to child intelligence measured longitudinally at ages 3 and 4 (McCarthy GCI), 5 (Wechsler Preschool and Primary Scale of Intelligence-Revised, WPPSI-R IQ), and 7 (Wechsler Intelligence Scale for Children-version III, WISC-III IQ), controlling for: Home Observation for Measurement of the Environment (HOME) quality; maternal age, intelligence, education, and ethnicity; and birthweight and gender. Elevations in both prenatal and postnatal BPb were associated with small decrements in young children's intelligence.

  5. Correlation in the Discharges of Neighboring Rat Retinal Ganglion Cells During Prenatal Life

    NASA Astrophysics Data System (ADS)

    Maffei, Lamberto; Galli-Resta, Lucia

    1990-04-01

    The spontaneous discharges of neighboring retinal ganglion cells were recorded simultaneously in anesthetized prenatal rats between embryonic days 18 and 21. We report here that in the majority of cases the firings of neighboring retinal ganglion cells are strongly correlated during prenatal life. Correlation in the discharges of neighboring cells during development has long been suggested as a way to consolidate synaptic connections with a target cell onto which they converge, a model first proposed by Hebb. Correlation in the activities of neighboring neurons in the retina could be the basis of developmental processes such as refinement of retinotopic maps in the brain and segregation of the inputs from the two eyes.

  6. Disposition and health outcomes among infants born to mothers with no prenatal care.

    PubMed

    Friedman, Susan Hatters; Heneghan, Amy; Rosenthal, Miriam

    2009-02-01

    This study assessed infant disposition and health outcomes among offspring born to mothers without prenatal care, based on maternal characteristics and the reason for lack of prenatal care (i.e., denial of pregnancy, concealment of pregnancy, primary substance use, financial barriers and multiparity). A retrospective record review was completed at an urban academic medical center. Subjects were women who presented at delivery or immediately postpartum with no history of prenatal care (N=211), and their infants. Infants of mothers with substance use problems had the highest rates of referral to child protective services and out-of-home placement at discharge, though mothers with other reasons for no prenatal care also experienced both referral and placement. Infants born to mothers using substances experienced the highest rates of neonatal intensive care unit admission, and the lowest mean birth weight. Though those without prenatal care experienced a variety of adverse outcomes, substance use problems were most frequently correlated with adverse infant outcomes. Mothers who either had lost custody of other children or with substance use problems were at highest risk of losing custody of their infants. Those who denied or concealed their pregnancy still frequently retained custody. Among mothers without prenatal care, those with substance use problems were least likely to retain custody of their infant at hospital discharge. Custody status of the mother's other children was also independently associated with infant custody. Mothers who denied or concealed their pregnancy still often retained custody. Referrals of mothers with no prenatal care for psychiatric evaluation were rare, though referrals to social work were frequent. Child protective services occasionally did not investigate referrals in the denial and concealment groups. Healthcare providers should be aware of the medical and psychological needs of this vulnerable population of infants and mothers.

  7. Prenatal Diagnosis of Congenital Adrenal Hyperplasia Caused by P450 Oxidoreductase Deficiency

    PubMed Central

    Reisch, Nicole; Idkowiak, Jan; Hughes, Beverly A.; Ivison, Hannah E.; Abdul-Rahman, Omar A.; Hendon, Laura G.; Olney, Ann Haskins; Nielsen, Shelly; Harrison, Rachel; Blair, Edward M.; Dhir, Vivek; Krone, Nils; Shackleton, Cedric H. L.

    2013-01-01

    Context: Mutations in the electron donor enzyme P450 oxidoreductase (POR) result in congenital adrenal hyperplasia with apparent combined 17α-hydroxylase/17,20 lyase and 21-hydroxylase deficiencies, also termed P450 oxidoreductase deficiency (PORD). Major clinical features present in PORD are disordered sex development in affected individuals of both sexes, glucocorticoid deficiency, and multiple skeletal malformations. Objective: The objective of the study was to establish a noninvasive approach to prenatal diagnosis of PORD including assessment of malformation severity to facilitate optimized prenatal diagnosis and timely treatment. Design: We analyzed 20 pregnancies with children homozygous or compound heterozygous for disease-causing POR mutations and 1 pregnancy with a child carrying a heterozygous POR mutation by recording clinical and biochemical presentations and fetal ultrasound findings. In 4 of the pregnancies (3 homozygous and 1 heterozygous for disease-causing POR mutations), prenatal analysis of steroid metabolite excretion in maternal urine was carried out by gas chromatography/mass spectrometry during gestational weeks 11–23. Results: Pregnancy complications in our cohort included maternal virilization (6 of 20) with onset in the second trimester. Seven pregnant women presented with low unconjugated estriol at prenatal screening (triple or quadruple antenatal screening test). Overt dysmorphic features were noted in 19 of the 20 babies at birth but observed in only 5 by prenatal ultrasound. These 5 had the most severe malformation phenotypes and poor outcome, whereas the other babies showed normal development. Steroid profiling of maternal urine revealed significantly increased steroids of fetal origin, namely the pregnenolone metabolite epiallopregnanediol and the androgen metabolite androsterone, with concomitant low values for estriol. Diagnostic steroid ratios conclusively indicated PORD as early as gestational week 12. In the heterozygous

  8. Oregon's Coordinated Care Organizations and Their Effect on Prenatal Care Utilization Among Medicaid Enrollees.

    PubMed

    Oakley, Lisa P; Harvey, S Marie; Yoon, Jangho; Luck, Jeff

    2017-07-12

    Introduction Previous studies indicate that inadequate prenatal care is more common among women covered by Medicaid compared with private insurance. Increasing the proportion of pregnant women who receive early and adequate prenatal care is a Healthy People 2020 goal. We examined the impact of the implementation of Oregon's accountable care organizations, Coordinated Care Organizations (CCOs), for Medicaid enrollees, on prenatal care utilization among Oregon women of reproductive age enrolled in Medicaid. Methods Using Medicaid eligibility data linked to unique birth records for 2011-2013, we used a pre-posttest treatment-control design that compared prenatal care utilization for women on Medicaid before and after CCO implementation to women never enrolled in Medicaid. Additional stratified analyses were conducted to explore differences in the effect of CCO implementation based on rurality, race, and ethnicity. Results After CCO implementation, mothers on Medicaid had a 13% increase in the odds of receiving first trimester care (OR 1.13, CI 1.04, 1.23). Non-Hispanic (OR 1.20, CI 1.09, 1.32), White (OR 1.20, CI 1.08, 1.33) and Asian (OR 2.03, CI 1.26, 3.27) women on Medicaid were more likely to receive initial prenatal care in the first trimester after CCO implementation and only Medicaid women in urban areas were more likely (OR 1.14, CI 1.05, 1.25) to initiate prenatal care in the first trimester. Conclusion Following Oregon's implementation of an innovative Medicaid coordinated care model, we found that women on Medicaid experienced a significant increase in receiving timely prenatal care.

  9. Antidepressants May Mitigate the Effects of Prenatal Maternal Anxiety on Infant Auditory Sensory Gating

    PubMed Central

    Hunter, Sharon K.; Mendoza, Jordan H.; D’Anna, Kimberly; Zerbe, Gary O; McCarthy, LizBeth; Hoffman, Camille; Freedman, Robert; Ross, Randal G.

    2013-01-01

    Objective Prenatal maternal anxiety has detrimental effects on the resulting offspring’s neurocognitive development, including impaired attentional function. Antidepressants are commonly utilized during pregnancy, yet their impact on offspring attention and their interaction with maternal anxiety has not been assessed. Using P50 auditory sensory gating, a putative marker of early attentional processes measurable in young infants, the impact of maternal anxiety and antidepressant use are explored. Method Two hundred forty-two mother-infant dyads were classified relative to maternal history of anxiety and maternal prenatal antidepressant use. Infant P50 auditory sensory gating was recorded during active sleep at a mean± standard deviation of 76 ± 38 days of age. Results In the absence of prenatal antidepressant exposure, infants with mothers with a history of anxiety diagnoses had diminished P50 sensory gating (p<.001). Prenatal antidepressants mitigated the effect of anxiety (uncorrected p=.041). The effect of maternal anxiety was limited to amplitude of response to the second stimulus while antidepressants impacted the amplitude or response to both the first and second stimulus. Conclusion Maternal anxiety disorders are associated less inhibition during infant sensory gating, a performance deficit mitigated by prenatal antidepressant use. This effect may be important in considering the risks and benefits of prenatal antidepressant treatment. Cholinergic mechanisms are hypothesized for both anxiety and antidepressant effects; however the cholinergic receptors involved are likely different for anxiety and antidepressant effects. Additional work focused on understanding how treatment impacts the relationship between maternal prenatal illness and offspring neurocognitive development is indicated. PMID:22581104

  10. Within prisons, is there an association between the quantity of prenatal care and infant birthweight?

    PubMed

    Howard, David L; Strobino, Donna; Sherman, Susan; Crum, Rosa

    2008-07-01

    There is still controversy surrounding the effectiveness of prenatal care in reducing low birthweight. In addition, very few studies have assessed the relationship between prenatal care and infant birthweight among pregnant women within the prison system. We sought to ascertain whether there is an association between the quantity of prenatal care and infant birthweight among pregnant women within such a setting. We examined the prison medical records of 147 infants born to women delivering at term (37-41 weeks of gestation) between 1 January 2002 and 31 December 2004 who were incarcerated during pregnancy in Texas state prisons. Linear regression was used to evaluate the association between the number of prison prenatal care visits and infant birthweight while adjusting for potential confounders (age, gravidity, maternal education, maternal race, history of substance use, history of alcohol use, history of tobacco use and the presence of any chronic disease). We also adjusted for the interaction between the gestational age at admission to prison and the number of prison prenatal care visits. There was a statistically significant 120.5 g increase in adjusted mean birthweight with each additional prison prenatal care visit (P = 0.001) among study infants whose mothers entered prison during the first trimester. This trend was not observed among women who came in after the first trimester. There appears to be a positive association between the amount of prison prenatal care and infant birthweight among incarcerated pregnant women delivering at term, but this association appears to be limited to women entering prison during the first trimester of pregnancy.

  11. Prenatal myelomeningocele repair: Do bladders better?

    PubMed

    Horst, Maya; Mazzone, Luca; Schraner, Thomas; Bodmer, Christine; Möhrlen, Ueli; Meuli, Martin; Gobet, Rita

    2017-08-01

    Prenatal myelomeningocele (MMC) repair has been proven to significantly reduce the need for hydrocephalus shunting and improve lower-extremity motor outcomes. The aim of this study was to evaluate the effect of prenatal MMC repair on the urological outcome. All patients who underwent fetal MMC repair at our institution are followed prospectively. Assessments include medical history, renal and bladder ultrasound, voiding cystourethrogram and urodynamic study, need for clean intermittent catheterization (CIC) and anticholinergics, and the occurrence of urinary tract infections (UTI). Of the 30 patients who underwent prenatal MMC closure from December 2010 to December 2015, eight patients with a postnatal follow-up of at least 2 years were included in this study and compared with eight patients after postnatal MMC repair. The level of the bony spinal defect was similar in both groups. Urological evaluation at 2 years revealed normal bladder function in 50% after prenatal repair. Neurogenic bladder dysfunction requiring CIC and anticholinergic therapy was seen in 50% in the prenatal and in 100% in the postnatal group. Significant bladder wall thickening was found in 37.5% and 87.5%, respectively. Febrile UTIs occurred in 37.5% in the prenatal and 62.5% in the postnatal group during the observation period. Our data suggest a positive effect of prenatal MMC closure on lower urinary tract function. The long-term significance of these results remains unclear. Therefore, continued close monitoring of renal and bladder function are mandatory. © 2016 Wiley Periodicals, Inc.

  12. Postnatal Evaluation and Outcome of Prenatal Hydronephrosis

    PubMed Central

    Sadeghi-Bojd, Simin; Kajbafzadeh, Abdol-Mohammad; Ansari-Moghadam, Alireza; Rashidi, Somaye

    2016-01-01

    Background: Prenatal hydronephrosis (PNH) is dilation in urinary collecting system and is the most frequent neonatal urinary tract abnormality with an incidence of 1% to 5% of all pregnancies. PNH is defined as anteroposterior diameter (APD) of renal pelvis ≥ 4 mm at gestational age (GA) of < 33 weeks and APD ≥ 7 mm at GA of ≥ 33 weeks to 2 months after birth. All patients need to be evaluated after birth by postnatal renal ultrasonography (US). In the vast majority of cases, watchful waiting is the only thing to do; others need medical or surgical therapy. Objectives: There is a direct relationship between APD of renal pelvis and outcome of PNH. Therefore we were to find the best cutoff point APD of renal pelvis which leads to surgical outcome. Patients and Methods: In this retrospective cohort study we followed 200 patients 1 to 60 days old with diagnosis of PNH based on before or after birth ultrasonography; as a prenatal or postnatal detected, respectively. These patients were referred to the nephrology clinic in Zahedan Iran during 2011 to 2013. The first step of investigation was a postnatal renal US, by the same expert radiologist and classifying the patients into 3 groups; normal, mild/moderate and severe. The second step was to perform voiding cystourethrogram (VCUG) for mild/moderate to severe cases at 4 - 6 weeks of life. Tc-diethylene triamine-pentaacetic acid (DTPA) was the last step and for those with normal VCUG who did not show improvement in follow-up examination, US to evaluate obstruction and renal function. Finally all patients with mild/moderate to severe PNH received conservative therapy and surgery was preserved only for progressive cases, obstruction or renal function ≤35%. All patients’ data and radiologic information was recorded in separate data forms, and then analyzed by SPSS (version 22). Results: 200 screened PNH patients with male to female ratio 3.5:1 underwent first postnatal control US, of whom 65% had normal, 18% mild

  13. Stripping for Revision.

    ERIC Educational Resources Information Center

    Smith, Donna

    1996-01-01

    Describes a three-step process by which students are taught to revise their writing by listing each sentence on another paper, combining sentences by eliminating redundancy, reducing information to appositives, and reducing information to participles, as well as revising the reduced number of sentences by including verbals, action verbs,…

  14. Writing as Revision.

    ERIC Educational Resources Information Center

    Della-Piana, Gabriel M.; Endo, George T.

    This proposal for a longitudinal experimental study with a treatment intervention focuses on the process of writing as revision. Revision refers to the process which occurs prior to and throughout the writing of a work, rather than the final editing. According to this process, the writer goes through five stages: preconceptions concerning style…

  15. [Prenatal Information System: critical analysis of register in a municipality of São Paulo State].

    PubMed

    Moimaz, Suzely Adas Saliba; Garbin, Cléa Adas Saliba; Garbin, Artênio José Isper; Zina, Lívia Guimarães; Yarid, Sérgio Donha; Francisco, Kléryson Martins Soares

    2010-01-01

    The prenatal assistance is one of the health care pillars. This study aimed to conduct a critical evaluation of the SIS Prenatal in a city of São Paulo State, to compare its data with the local assistance and to verify the registry of pregnant women attended at Health Care Centers. It was analyzed the pregnant women records through consultation at Health Regional Unit and municipal health service. There were inconsistencies between the system and local registry. The failures were related to the inadequate filling of attendance files, besides scarce control of pregnant women files and scheduling on health centers. The results suggest the need for better planning of actions for the improvement of prenatal service quality.

  16. Prenatal diagnosis of imperforate hymen with hydrometrocolpos.

    PubMed

    Yildirim, Gokhan; Gungorduk, Kemal; Aslan, Halil; Sudolmus, Sinem; Ark, Cemal; Saygin, Sezin

    2008-11-01

    Imperforate hymen is one of the most simple and most common anomalies in the female genital organs, occurring in 0.1% of girls born at term. Some are recognized because of mucocolpos at birth, but the diagnosis is usually not detected before puberty. Rarely, obstetric sonography may prenatally detect imperforate hymen due to presentation of hydrocolpos or hydrometrocolpos in the fetus if fetal cervical and vaginal secretions accumulate in response to circulating maternal estrogens. Nonetheless, reports of prenatal ultrasound diagnosis of hydrometrocolpos are still very rare. In this article we report a prenatally diagnosed of imperforate hymen with hydrometrocolpos.

  17. Prenatal and pre-implantation genetic diagnosis.

    PubMed

    Vermeesch, Joris Robert; Voet, Thierry; Devriendt, Koenraad

    2016-09-15

    The past decade has seen the development of technologies that have revolutionized prenatal genetic testing; that is, genetic testing from conception until birth. Genome-wide single-cell arrays and high-throughput sequencing analyses are dramatically increasing our ability to detect embryonic and fetal genetic lesions, and have substantially improved embryo selection for in vitro fertilization (IVF). Moreover, both invasive and non-invasive mutation scanning of the genome are helping to identify the genetic causes of prenatal developmental disorders. These advances are changing clinical practice and pose novel challenges for genetic counselling and prenatal care.

  18. Prenatal diagnosis: essentials for the pediatric surgeon.

    PubMed

    Rice, H E; Adzick, N S

    1993-05-01

    Prenatal diagnosis is a rapidly growing field that has supported new treatments for the developing fetus. Improved methods of diagnosing anatomic, biochemical, and molecular defects of the fetus have fostered a parallel growth of better techniques of fetal therapy. A fundamental knowledge of the basic uses and limitation of prenatal diagnosis is essential for the practicing pediatric surgeon. This review summarizes clinical uses and recent advances in various methods of prenatal diagnosis, including ultrasound, fetal echocardiography, amniocentesis, chorionic villus sampling, fetal blood sampling, alpha-fetoprotein, and DNA analysis. For each technique, the common indications, risks, and clinical utility are discussed.

  19. Ethical issues in prenatal diagnosis.

    PubMed

    Johnson, S R; Elkins, T E

    1988-06-01

    Prenatal diagnosis raises complex ethical issues not only in terms of individual decision making, but also in the development of clinical services and the formulation of public policy regarding access and funding. The motivation behind prenatal diagnosis is generally to provide the family with information regarding the pregnancy so that the outcome can be improved or, in the case of severely affected pregnancies, a decision can be made about pregnancy termination. Although many of the ethical issues involved in prenatal diagnosis and treatment overlap those common to all types of diagnostic procedures, the former situation is complicated by controversy about the moral status of the fetus and the use of selective abortion as a form of treatment. While there is general agreement that pregnancy termination after the 2nd trimester can be justified if the fetus is afflicted with a condition that is incompatible with postnatal survival or characterized by the virtual absence of cognitive functioning, the disposition of a fetus afflicted with a non-life-threatening physical or mental disability (e.g., Down's syndrome) is more controversial. An additional concern is that women with positive screening test results may choose elective abortion rather than undergo a definitive work-up. The issue of maternal versus fetal rights is perhaps the single most controversial dilemma. Here, the basic ethical dilemma is the conflict between respecting maternal autonomy versus acting beneficently toward the fetus. As a general rule, the more invasive the medical technique and the less certain the benefit to the fetus (e.g., laparotomy), the more difficult it is to make a convincing argument for forced interventions involving the mother's body. Situations in which compelling arguments can be made for forced interventions against the will of the mother are those where an otherwise healthy infant will die without immediate intervention or failure to perform a procedure will result in the

  20. Reciprocal Relationships: the Genetic Counselor-Patient Relationship Following a Life-Limiting Prenatal Diagnosis.

    PubMed

    Williams, S R; Berrier, K L; Redlinger-Grosse, K; Edwards, J G

    2016-10-22

    Utilizing the tenet, "Relationship is integral to the genetic counseling process" from the Reciprocal Engagement Model (REM) of genetic counseling practice, this study sought to explore the relationship between the genetic counselor and patient following a "life-limiting" prenatal diagnosis that resulted in a major loss (termination, stillbirth/miscarriage, or neonatal death). The specific aims of this study were to: 1) Understand and describe aspects of the genetic counselor-patient relationship in the context of the life-limiting prenatal diagnosis, and identify characteristics and actions of the 2) genetic counselor and 3) patient that influence the relationship. Genetic counselor (GC) participants were recruited via a web-based survey distributed by NSGC and the NSGC Prenatal SIG. Eligible GCs maintained a relationship with a patient beyond the prenatal diagnosis and had a willing patient participant. Individual 60-min audio-recorded telephone interviews were conducted with eight GC and 8 respective patients (n = 16) using parallel interview guides (n = 16). Transcriptions underwent thematic content analysis for systematic coding and identification of emergent themes. The GC-patient relationship was characterized by the evolution of communication and promoted by the supportive needs of the patient, the nature of the diagnosis, and characteristics and supportive actions of the participants. This exploratory study highlights the unique service of support offered by genetic counselors in the context of a life-limiting prenatal diagnosis.

  1. Prenatal nicotine exposure enhances the trigeminocardiac reflex via serotonin receptor facilitation in brainstem pathways.

    PubMed

    Gorini, C; Jameson, H; Woerman, A L; Perry, D C; Mendelowitz, D

    2013-08-15

    In this study we used a rat model for prenatal nicotine exposure to test whether clinically relevant concentrations of brain nicotine and cotinine are passed from dams exposed to nicotine to her pups, whether this changes the trigeminocardiac reflex (TCR), and whether serotonergic function in the TCR brainstem circuitry is altered. Pregnant Sprague-Dawley dams were exposed to 6 mg·kg(-1)·day(-1) of nicotine via osmotic minipumps for the duration of pregnancy. Following birth dams and pups were killed, blood was collected, and brain nicotine and cotinine levels were measured. A separate group of prenatal nicotine-exposed pups was used for electrophysiological recordings. A horizontal brainstem slice was obtained by carefully preserving the trigeminal nerve with fluorescent identification of cardiac vagal neurons (CVNs) in the nucleus ambiguus. Stimulation of the trigeminal nerve evoked excitatory postsynaptic current in CVNs. Our data demonstrate that prenatal nicotine exposure significantly exaggerates both the TCR-evoked changes in heart rate in conscious unrestrained pups, and the excitatory neurotransmission to CVNs upon trigeminal afferent nerve stimulation within this brainstem reflex circuit. Application of the 5-HT1A receptor antagonist WAY 100635 (100 μM) and 5-HT2A/C receptor antagonist ketanserin (10 μM)significantly decreased neurotransmission, indicating an increased facilitation of 5-HT function in prenatal nicotine-exposed animals. Prenatal nicotine exposure enhances activation of 5-HT receptors and exaggerates the trigeminocardiac reflex.

  2. Prenatal Ethanol Exposure and Whisker Clipping Disrupt Ultrasonic Vocalizations and Play Behavior in Adolescent Rats

    PubMed Central

    Waddell, Jaylyn; Yang, Tianqi; Ho, Eric; Wellmann, Kristen A.; Mooney, Sandra M.

    2016-01-01

    Prenatal ethanol exposure can result in social deficits in humans and animals, including altered social interaction and poor communication. Rats exposed to ethanol prenatally show reduced play fighting, and a combination of prenatal ethanol exposure and neonatal whisker clipping further reduces play fighting compared with ethanol exposure alone. In this study, we explored whether expression of hedonic ultrasonic vocalizations (USVs) correlated with the number of playful attacks by ethanol-exposed rats, rats subjected to postnatal sensory deprivation by whisker clipping or both compared to control animals. In normally developing rats, hedonic USVs precede such interactions and correlate with the number of play interactions exhibited in dyads. Pregnant Long-Evans rats were fed an ethanol-containing liquid diet or a control diet. After birth, male and female pups from each litter were randomly assigned to the whisker-clipped or non-whisker-clipped condition. Animals underwent a social interaction test with a normally developing play partner during early or late-adolescence. USVs were recorded during play. Prenatal ethanol exposure reduced both play and hedonic USVs in early adolescence compared to control rats and persistently reduced social play. Interestingly, ethanol exposure, whisker clipping and the combination abolished the significant correlation between hedonic USVs and social play detected in control rats in early adolescence. This relationship remained disrupted in late adolescence only in rats subjected to both prenatal ethanol and whisker clipping. Thus, both insults more persistently disrupted the relationship between social communication and social play. PMID:27690116

  3. Prenatal nicotine exposure enhances the trigeminocardiac reflex via serotonin receptor facilitation in brainstem pathways

    PubMed Central

    Gorini, C.; Jameson, H.; Woerman, A. L.; Perry, D. C.

    2013-01-01

    In this study we used a rat model for prenatal nicotine exposure to test whether clinically relevant concentrations of brain nicotine and cotinine are passed from dams exposed to nicotine to her pups, whether this changes the trigeminocardiac reflex (TCR), and whether serotonergic function in the TCR brainstem circuitry is altered. Pregnant Sprague-Dawley dams were exposed to 6 mg·kg−1·day−1 of nicotine via osmotic minipumps for the duration of pregnancy. Following birth dams and pups were killed, blood was collected, and brain nicotine and cotinine levels were measured. A separate group of prenatal nicotine-exposed pups was used for electrophysiological recordings. A horizontal brainstem slice was obtained by carefully preserving the trigeminal nerve with fluorescent identification of cardiac vagal neurons (CVNs) in the nucleus ambiguus. Stimulation of the trigeminal nerve evoked excitatory postsynaptic current in CVNs. Our data demonstrate that prenatal nicotine exposure significantly exaggerates both the TCR-evoked changes in heart rate in conscious unrestrained pups, and the excitatory neurotransmission to CVNs upon trigeminal afferent nerve stimulation within this brainstem reflex circuit. Application of the 5-HT1A receptor antagonist WAY 100635 (100 μM) and 5-HT2A/C receptor antagonist ketanserin (10 μM)significantly decreased neurotransmission, indicating an increased facilitation of 5-HT function in prenatal nicotine-exposed animals. Prenatal nicotine exposure enhances activation of 5-HT receptors and exaggerates the trigeminocardiac reflex. PMID:23766497

  4. Antidepressants may mitigate the effects of prenatal maternal anxiety on infant auditory sensory gating.

    PubMed

    Hunter, Sharon K; Mendoza, Jordan H; D'Anna, Kimberly; Zerbe, Gary O; McCarthy, Lizbeth; Hoffman, Camille; Freedman, Robert; Ross, Randal G

    2012-06-01

    Prenatal maternal anxiety has detrimental effects on the offspring's neurocognitive development, including impaired attentional function. Antidepressants are commonly used during pregnancy, yet their impact on offspring attention and their interaction with maternal anxiety has not been assessed. The authors used P50 auditory sensory gating, a putative marker of early attentional processes measurable in young infants, to assess the impact of maternal anxiety and antidepressant use. A total of 242 mother-infant dyads were classified relative to maternal history of anxiety and maternal prenatal antidepressant use. Infant P50 auditory sensory gating was recorded during active sleep at a mean age of 76 days (SD=38). In the absence of prenatal antidepressant exposure, infants whose mothers had a history of anxiety diagnoses had diminished P50 sensory gating. Prenatal antidepressant exposure mitigated the effect of anxiety. The effect of maternal anxiety was limited to amplitude of response to the second stimulus, while antidepressant exposure had an impact on the amplitude of response to both the first and second stimulus. Maternal anxiety disorders are associated with less inhibition during infant sensory gating, a performance deficit mitigated by prenatal antidepressant exposure. This effect may be important in considering the risks and benefits of antidepressant use during pregnancy. Cholinergic mechanisms are hypothesized for both anxiety and antidepressant effects, although the cholinergic receptors involved are likely different for anxiety and antidepressant effects.

  5. Prenatal Therapy Improves the Survival of Premature Infants with Congenital Chylothorax.

    PubMed

    Lee, Chia-Jung; Tsao, Po-Nien; Chen, Chien-Yi; Hsieh, Wu-Shiun; Liou, Jyun-You; Chou, Hung-Chieh

    2016-04-01

    Chylothorax is a rare condition among neonates, although it is considered clinically significant, as it is difficult to manage in these patients. In addition, the course of chylothorax varies widely. Therefore, we aimed to elucidate the clinical features and effect of prenatal therapy on the prognosis of congenital chylothorax in neonates. We retrospectively reviewed the medical records of all infants with congenital chylothorax who were admitted to National Taiwan University Hospital, Taipei, Taiwan between January 2000 and December 2012. Their demographic characteristics, as well as their antenatal, perinatal, and postnatal information, were collected for our analysis of the mortality risk. We found 29 infants who were diagnosed with congenital chylothorax during the study period. The median gestational age at birth was 34 weeks (range, 28-41 weeks), and 71% of the infants presented with hydrops fetalis. Most cases of congenital chylothorax were bilateral (bilateral: 86.2%, unilateral: 13.79%), and the overall survival rate was 59.6%. Among the cases with a prenatal diagnosis at ≤ 34 weeks of gestation, infants who received prenatal therapy had a significantly higher survival rate, compared to infants who did not receive prenatal therapy (76.9% vs. 11%, respectively; p = 0.008). We found that infants whose chylothorax was diagnosed ≤ 34 weeks of gestation, and who subsequently received prenatal therapy, experienced a better perinatal condition and exhibited improved postnatal outcomes. Copyright © 2016. Published by Elsevier B.V.

  6. Pfeiffer syndrome: literature review of prenatal sonographic findings and genetic diagnosis.

    PubMed

    Giancotti, Antonella; D'Ambrosio, Valentina; Marchionni, Enrica; Squarcella, Antonia; Aliberti, Camilla; La Torre, Renato; Manganaro, Lucia; Pizzuti, Antonio

    2017-09-01

    Pfeiffer syndrome (PS) is an autosomal dominant disorder caused by mutations in FGFR1 and FGFR2 genes. Given its wide range of clinical expression and severity, early prenatal diagnosis is difficult and genetic counseling is desirable. We report a literature review of all prenatal diagnosis of PS and a case report, with a focused description of ultrasound findings. After literature search, we selected 14 studies of antenatal diagnosis of PS. Prenatal ultrasound findings, outcome, maternal and obstetrical data and genetic tests were recorded and analyzed. A total of 18 cases including the one we present were selected. Among the most frequent sonographic features, skull shape anomalies were evident in 72.2% of cases, nasal abnormalities in 50%, proptosis and hypertelorism in 44.4% and frontal bossing in 22.2%. Thumbs' anomalies were present in 33.3% of cases and toes' abnormalities in 38.9%. In all cases, postnatal or postmortem examination confirmed the prenatal diagnosis of PS. We provide a literature review of prenatal diagnosis of PS to identify ultrasound features that may be supportive in the diagnosis of this rare disease, helping in making a differential diagnosis with the other possible craniosynostosis syndromes and in suggesting gene molecular testing.

  7. Prenatal diagnosis of Pierre Robin Sequence: accuracy and ability to predict phenotype and functional severity.

    PubMed

    Lind, Katia; Aubry, Marie-Cécile; Belarbi, Nadia; Chalouhi, Christel; Couly, Gérard; Benachi, Alexandra; Lyonnet, Stanislas; Abadie, Véronique

    2015-09-01

    To assess the outcome of fetuses who had sonographic features suggestive of Pierre Robin Sequence (PRS). All prenatal ultrasounds that mentioned 'posterior cleft palate', or 'micro or retrognathia' or 'PRS' over 13 and 20 years, respectively, at two obstetrical centers were reviewed. Medical records for children with isolated PRS monitored over 20 years at a PRS referral center for prenatal anomalies and the severity of neonatal feeding and respiratory functional disorders were utilized for comparison. From a prenatal ultrasound database of 166 000 cases, 157 had one or more of the sonographic signs suggestive of PRS and had follow-up available. Of them, 33 (21%) had confirmed PRS, 9 (6%) were normal and 115 (73%) had chromosomal aberrations, associated malformations or neurological anomalies. Visualization of a posterior cleft palate in addition to retro-micrognathia had a positive predictive value of 100% for PRS. The distribution of functional severity grades was similar in cases suspected prenatally as in 238 cases of PRS followed in the referral center in Necker Hospital. Only a minority of cases of fetal retrognathia have complete PRS; the majority have other severe conditions. Prenatal prediction of functional severity of isolated PRS is not possible. © 2015 John Wiley & Sons, Ltd.

  8. Prenatal Testosterone Increases Sensitivity to Prenatal Stressors in Males with Disruptive Behavior Disorders

    PubMed Central

    Martel, Michelle M.; Roberts, Bethan A.

    2014-01-01

    Disruptive Behavior Disorders (DBD) exhibit a sex-biased prevalence rate favoring boys, and prenatal testosterone exposure appears to be part of the complex etiology of these disorders. The current study examines whether high prenatal testosterone exposure may heighten risk for DBD symptoms in males by increasing susceptibility to negative environmental conditions such as maternal nicotine and alcohol use during pregnancy. Participants were 109 three- to six-year-olds (64% male; 72% with DBD) and their 109 primary caregivers and 55 daycare providers/teachers who completed a multi-informant diagnostic procedure. A proxy of prenatal testosterone exposure, finger-length ratios, interacted with maternal report of prenatal nicotine use to predict teacher-rated hyperactivity-impulsivity during preschool, for boys, but not girls, although the three-way interaction was not significant. Prenatal testosterone interacted with prenatal alcohol exposure to predict teacher-rated hyperactivity-impulsivity and ODD symptoms differentially based on child sex (significant three-way interaction). Boys with higher levels of prenatal testosterone who were also exposed to higher levels of nicotine and alcohol during pregnancy exhibited increased hyperactivity-impulsivity during early childhood, but girls did not exhibit this same pattern. Thus, high prenatal testosterone exposure seems to increase risk for DBD symptoms particularly in males by increasing susceptibility to prenatal environmental stressors. PMID:24819590

  9. Prenatal cannibalism in an insect

    NASA Astrophysics Data System (ADS)

    de Vries, Thomas; Lakes-Harlan, Reinhard

    2007-06-01

    Host selection and infection strategies of parasitoids often correlate with high parental investment and low numbers of progeny. In this study, we investigate how additional internal mechanisms might shape brood size and fitness of the offspring. Emblemasoma auditrix is a parasitoid fly in which about 38 larvae hatch simultaneously in utero. After host location, a single larva is deposited into the host, where it rapidly develops and pupates after about 5 days. The search for hosts can take several weeks, and during that time, the larvae arrest their development and remain in the first larval instar. Nevertheless, the larvae increase in weight within the uterus, and this growth correlates to a decrease in the number of larvae, although no larvae are deposited. Thus, our data indicate a first case of prenatal cannibalism in an invertebrate with larvae feeding on each other within the uterus of the adult.

  10. Prenatal stress, prematurity and asthma

    PubMed Central

    Medsker, Brock; Forno, Erick; Simhan, Hyagriv; Celedón, Juan C.

    2016-01-01

    Asthma is the most common chronic disease of childhood, affecting millions of children in the U.S. and worldwide. Prematurity is a risk factor for asthma, and certain ethnic or racial minorities such as Puerto Ricans and non-Hispanic Blacks are disproportionately affected by both prematurity and asthma. In this review, we examine current evidence to support maternal psychosocial stress as a putative link between prematurity and asthma, while also focusing on disruption of the hypothalamic-pituitary-adrenal (HPA) axis and immune responses as potential underlying mechanisms for stress-induced “premature asthma”. Prenatal stress may not only cause abnormalities in the HPA axis but also epigenetic changes in the fetal glucocorticoid receptor gene (NR3C1), leading to impaired glucocorticoid metabolism. Moreover, maternal stress can alter fetal cytokine balance, favoring Th2 (allergic) immune responses characteristic of atopic asthma: IL-6, which has been associated with premature labor, can promote Th2 responses by stimulating production of IL-4 and IL-13. Given a link among stress, prematurity, and asthma, future research should include birth cohorts aimed at confirming and better characterizing “premature asthma”. If confirmed, clinical trials of prenatal maternal stress reduction would be warranted to reduce the burden of these common co-morbidities. While awaiting the results of such studies, sound policies to prevent domestic and community violence (e.g. from firearms) are justified, not only by public safety but also by growing evidence of detrimental effects of violence-induced stress on psychiatric and somatic health. PMID:26676148

  11. Prenatal diagnosis of genetic disorders.

    PubMed Central

    Niermeijer, M F; Sachs, E S; Jahodova, M; Tichelaar-Klepper, C; Kleijer, W J; Galjaard, H

    1976-01-01

    Three hundred and fifty pregnancies were monitored by transabdominal amniocentesis in the fourteenth to sixteenth week of gestation followed by karyotyping or biochemica assays of cultured amniotic fluid cells and analysis of alpha-fetoprotein in the amniotic fluid supernatant. The pregnancy was interrupted in 36 cases (10%) either becasue of a fetal abnormality or the presence of a male fetus in pregnancies at risk for an X-linked disease. Four chromosomal aberrations were found in 87 pregnancies tested because of advanced maternal age. In 101 pregnancies with a recurrence risk of Down's syndrome, 2 fetuses with an abnormal karyotype were detected. In 11 cases, in which 1 parent was a carrier of a balanced translocation, 2 unbalanced fetal karyotypes were found. Fetal chromosome studies in 43 pregancies at risk for an X-linked disease indicated the presence of a male fetus in 21 cases. Prenatal diagnosis of 11 different metabolic diseases was performed in a total of 34 cases. Microchemical techniques were used to allow completion of the diagnosis of seven different enzyme deficiencies within 9 to 22 days after amniocentesis. Alpha-fetoprotein assay in the amniotic fluid supernatant of 47 pregnancies at risk for an open neural tube defect resulted in the detection of 3 anencephalic fetuses during the second half of pregnancy. The safety and reliability of amniocentesis and the possible effects on the outcome of pregnancy are evaluated. Prenatal diagnosis offers a promising alternative for parents who are at risk of having a child with a genetic disease which can be detected in amniotic fluid or in cultured amniotic fluid cells. Images PMID:58990

  12. Situs anomalies on prenatal MRI.

    PubMed

    Nemec, Stefan F; Brugger, Peter C; Nemec, Ursula; Bettelheim, Dieter; Kasprian, Gregor; Amann, Gabriele; Rimoin, David L; Graham, John M; Prayer, Daniela

    2012-04-01

    Situs anomalies refer to an abnormal organ arrangement, which may be associated with severe errors of development. Due regard being given to prenatal magnetic resonance imaging (MRI) as an adjunct to ultrasonography (US), this study sought to demonstrate the in utero visualization of situs anomalies on MRI, compared to US. This retrospective study included 12 fetuses with situs anomalies depicted on fetal MRI using prenatal US as a comparison modality. With an MRI standard protocol, the whole fetus was assessed for anomalies, with regard to the position and morphology of the following structures: heart; venous drainage and aorta; stomach and intestines; liver and gallbladder; and the presence and number of spleens. Situs inversus totalis was found in 3/12 fetuses; situs inversus with levocardia in 1/12 fetuses; situs inversus abdominis in 2/12 fetuses; situs ambiguous with polysplenia in 3/12 fetuses, and with asplenia in 2/12 fetuses; and isolated dextrocardia in 1/12 fetuses. Congenital heart defects (CHDs), vascular anomalies, and intestinal malrotations were the most frequent associated malformations. In 5/12 cases, the US and MRI diagnoses were concordant. Compared to US, in 7/12 cases, additional MRI findings specified the situs anomaly, but CHDs were only partially visualized in six cases. Our initial MRI results demonstrate the visualization of situs anomalies and associated malformations in utero, which may provide important information for perinatal management. Using a standard protocol, MRI may identify additional findings, compared to US, which confirm and specify the situs anomaly, but, with limited MRI visualization of fetal CHDs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  13. Infants at Risk: Is the Federal Government Assuring Prenatal Care for Poor Women? Hearing before a Subcommittee of the Committee on Government Operations. House of Reppresentatives, One Hundredth Congress, First Session.

    ERIC Educational Resources Information Center

    Congress of the U. S., Washington, DC. House Committee on Government Operations.

    The oral testimony of health professionals recorded in this document questions the Federal government's success at assuring prenatal care for poor women. The concern is that many of the infant deaths that occur in the United States might be prevented if the mother had received adequate prenatal care. Programs have improved the health care delivery…

  14. Record of Technical Change {number_sign}1 for Corrective Action Investigation Plan for Corrective Action Unit 500: Test Cell A Septic System, Nevada Test Site, Nevada, Revision 0

    SciTech Connect

    US DOE Nevada Operations Office

    1999-04-12

    This Record of Technical Change provides updates to the technical information in ''Corrective Action Investigation Plan for Corrective Action Unit 500: Test Cell A Septic System, Nevada Test Site, Nevada,'' DOE/NV--528.

  15. Record of Technical Change {number_sign}1 to ''Corrective Action Investigation Plan for Corrective Action Unit 261: Test Cell A Leachfield System, Nevada Test Site, Nevada,'' Revision 0, DOE/NV-519

    SciTech Connect

    US DOE Nevada Operations Office

    2000-02-25

    This Record of Technical Change provides updates to the technical information included in ''Corrective Action Investigation Plan for Corrective Action Unit 261: Test Cell A Leachfield System, Nevada Test Site, Nevada,'' DOE/NV--519.

  16. Improving Prenatal Care for Minority Women

    PubMed Central

    Gennaro, Susan; Melnyk, Bernadette Mazurek; CPNP/PMHNP; FAANP; O'Connor, Caitlin; Gibeau, Anne M.; Nadel, Ellen

    2015-01-01

    Since the inception of prenatal care in the early 1900s, the focus of care has been on risk reduction rather than on health promotion. Prenatal care began as individualized care, but more recently group prenatal care has been documented to be very successful in improving birth outcomes. For all women, an emphasis on improving health behaviors is important at this critical time while women are engaging regularly with the health care system. An emphasis on mental health promotion may decrease some of the disparities in birth outcomes that are well documented between minority and majority women, as minority women are known to experience increased levels of stress, anxiety, and depression. Providing support for pregnant women and incorporating knowledge and skills through prenatal care may promote both physical and mental health in minority women. PMID:26854915

  17. Prenatal Testing: MedlinePlus Health Topic

    MedlinePlus

    ... Reliable Is Laboratory Testing? (American Association for Clinical Chemistry) Prenatal Testing: Is It Right for You? (Mayo ... Spanish Amniotic Fluid Analysis (American Association for Clinical Chemistry) Biophysical Profile (Mayo Foundation for Medical Education and ...

  18. PRENATAL STRESS AND RISK FOR AUTISM

    PubMed Central

    Kinney, Dennis K.; Munir, Kerim M.; Crowley, David J.; Miller, Andrea M.

    2008-01-01

    This paper reviews several converging lines of research that suggest that prenatal exposure to environmental stress may increase risk for Autistic Disorder (AD). We first discuss studies finding that prenatal exposure to stressful life events is associated with significantly increased risk of AD, as well as other disorders, such as schizophrenia and depression. We then review evidence from animal and human studies that prenatal stress can produce both (a) abnormal postnatal behaviors that resemble the defining symptoms of AD, and (b) other abnormalities that have elevated rates in AD, such as learning deficits, seizure disorders, perinatal complications, immunologic and neuroinflammatory anomalies, and low postnatal tolerance for stress. We explain why an etiologic role for prenatal stress is compatible with genetic factors in AD, and describe how stress can disrupt fetal brain development. Finally, we discuss implications for understanding underlying processes in AD, including potential gene-environment interactions, and developing new therapies and early prevention programs. PMID:18598714

  19. Revision arthroscopic Bankart repair.

    PubMed

    Abouali, Jihad Alexander Karim; Hatzantoni, Katerina; Holtby, Richard; Veillette, Christian; Theodoropoulos, John

    2013-09-01

    Failed anterior shoulder stabilization procedures have traditionally been treated with open procedures. Recent advances in arthroscopic techniques have allowed for certain failed stabilization procedures to be treated by arthroscopic surgery. The aim of this systematic review was to determine the outcomes of revision arthroscopic Bankart repair. We searched Medline, Embase, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) for articles on revision arthroscopic Bankart repairs. Key words included shoulder dislocation, anterior shoulder instability, revision surgery, and arthroscopic Bankart repair. Two reviewers selected studies for inclusion, assessed methodologic quality, and extracted data. We included 16 studies comprising 349 patients. All studies were retrospective (1 Level II study and 15 Level IV studies). The mean incidence of recurrent instability after revision arthroscopic Bankart repair was 12.7%, and the mean follow-up period was 35.4 months. The most common cause for failure of the primary surgeries was a traumatic injury (62.1%), and 85.1% of patients returned to playing sports. The reasons for failure of revision cases included glenohumeral bone loss, hyperlaxity, and return to contact sports. With proper patient selection, the outcomes of revision arthroscopic Bankart repair appear similar to those of revision open Bankart repair. Prospective, randomized clinical trials are required to confirm these findings. Level IV, systematic review of Level II and Level IV studies. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  20. Prenatal Antidepressants and Autism Spectrum Disorder

    DTIC Science & Technology

    2014-09-01

    1 AWARD NUMBER: W81XWH-13-1-0306 TITLE: Prenatal Antidepressants and Autism Spectrum Disorder PRINCIPAL INVESTIGATOR...TYPE Annual 3. DATES COVERED 1Sept 2013-31Aug2014 4. TITLE AND SUBTITLE Prenatal Antidepressants and Autism Spectrum Disorder 5a... antidepressants (ADs) during pregnancy. We are testing this hypothesis in rodents. The study is a 2-year long experiment to be decoded and

  1. Cementless acetabular revision arthroplasty

    PubMed Central

    Jain, Rina; Schemitsch, Emil H.; Waddell, James P.

    2000-01-01

    Objective To evaluate the effects of clinical factors on outcome after acetabular revision with a cementless beaded cup. Design Retrospective case series. Setting Tertiary care referral centre. Patients Forty-one patients who underwent acetabular revision with a cementless cup were followed up for a mean of 3.4 years. Interventions Acetabular revision with a beaded cementless cup in all patients. A morcellized allograft was used in 10 patients. Outcome measures A modified Harris hip score (range of motion measurement omitted), the SF-36 health survey, and the Western Ontario McMaster (WOMAC) osteoarthritis index. Multivariate analysis was used to evaluate the effects of age, gender, morcellized allografting, time to revision from the previous operation, acetabular screw fixation and concurrent femoral revision on outcome. Results Gender accounted for a significant portion of the variation seen in the SF-36 physical component scores (r = 0.36, p = 0.02), with women tending to have worse results. Increasing age was associated with lower WOMAC index function scores (r = 0.36, p = 0.03), whereas concurrent femoral revision tended to have a positive effect on WOMAC index function (r = 0.39, p = 0.01). None of the potential clinical predictors had any significant effect on the SF-36 mental component scores, or WOMAC index pain and stiffness scores. Conclusions In cementless acetabular revision arthroplasty, physical function, as measured by generic and limb-specific scales, may be affected by gender, age and the presence of a concurrent femoral revision. Time to revision from the previous operation, morcellized allografting and screw fixation of the acetabulum did not affect outcomes. This information may provide some prognostic value for patients’ expectations. PMID:10948687

  2. Prenatal diagnosis of 45,X/46,XX

    SciTech Connect

    Hsu, L.Y.F.

    1996-03-01

    I read with great interest the paper on {open_quotes}Prenatal Diagnosis of 45,X/46,XX mosaicism and 45,X: Implications for Postnatal Outcome{close_quotes} by Koeberl et al. They reported their experience with 12 prenatally diagnosed cases of 45,X/46,XX mosaicism and made a clinical comparison between those 12 cases and their own 41 postnatally diagnosed cases of 45,X/46,XX mosaicism. As expected, they found an overall milder phenotypic manifestation in the prenatal cases than in the postnatal ones. These authors report a lack of previous prognostic information on this type of prenatally diagnosis of mosaicism and offer their findings to fill this need. However, considerable information on this topic has been published. There have been >200 prenatally diagnosed cases of 45,X/46,XX. According to my data on 189 cases with a prenatal diagnosis of 45,X/46,XX mosaicism (Hsu 1992), there are 114 cases with available information on phenotypic outcome. Of these, 12 (10.5%) were reported to have some features of Turner syndrome, 4 had other anomalies probably not related to Turner syndrome, and 2 resulted in stillbirth. The overall rate for an abnormal phenotype in this category was thus 16/114 (14.03%). However, we must realize that, even in patients with a nonmosaic 45,X complement, the major features of Turner syndrome, such as short stature and sexual infantilism, are manifested only later in childhood or in adolescence. 3 refs.

  3. Invasive prenatal diagnosis of fetal thalassemia.

    PubMed

    Li, Dong-Zhi; Yang, Yan-Dong

    2017-02-01

    Thalassemia is the most common monogenic inherited disease worldwide, affecting individuals originating from many countries to various extents. As the disease requires long-term care, prevention of the homozygous state presents a substantial global disease burden. The comprehensively preventive programs involve carrier detections, molecular diagnostics, genetic counseling, and prenatal diagnosis. Invasive prenatal diagnosis refers to obtaining fetal material by chorionic villus sampling (CVS) at the first trimester, and by amniocentesis or cordocentesis at the second trimester. Molecular diagnosis, which includes multiple techniques that are aimed at the detection of mutations in the α- or β-globin genes, facilitates prenatal diagnosis and definitive diagnosis of the fetus. These are valuable procedures for couples at risk, so that they can be offered options to have healthy offspring. According to local practices and legislation, genetic counseling should accompany the invasive diagnostic procedures, DNA testing, and disclosure of the results. The most critical issue in any type of prenatal molecular testing is maternal cell contamination (MCC), especially when a fetus is found to inherit a particular mutation from the mother. The best practice is to perform MCC studies on all prenatal samples. The recent successful studies of fetal DNA in maternal plasma may allow future prenatal testing that is non-invasive for the fetus and result in significant reduction of invasive diagnostic procedures.

  4. Family structure and use of prenatal care.

    PubMed

    Alves, Elisabete; Silva, Susana; Martins, Simone; Barros, Henrique

    2015-06-01

    This cross-sectional study intended to assess the use of prenatal care according to the family structure in a population with free universal access to prenatal care. In 2005-2006, the Portuguese birth cohort was assembled by the recruitment of puerperae at public maternity wards in Porto, Portugal. In the current analysis, 7,211 were included. Data on socio-demographic characteristics, obstetric history, and prenatal care were self-reported. Single mothers were considered as those whose household composition did not include a partner at delivery. Approximately 6% of the puerperae were single mothers. These women were more likely to have an unplanned pregnancy (OR = 6.30; 95%CI: 4.94-8.04), an inadequate prenatal care (OR = 2.30; 95%CI: 1.32-4.02), and to miss the ultrasound and the intake of folic acid supplements during the first trimester of pregnancy (OR = 1.71; 95%CI: 1.30-2.27; and OR = 1.67; 95%CI: 1.32-2.13, respectively). The adequacy and use of prenatal care was less frequent in single mothers. Educational interventions should reinforce the use and early initiation of prenatal care.

  5. Prenatal nicotine exposure and child behavioural problems.

    PubMed

    Tiesler, Carla M T; Heinrich, Joachim

    2014-10-01

    In utero exposure to tobacco smoke has been related to numerous adverse health effects in new-borns, infants, children, adolescents and adults. The aim of this review was to summarise findings on prenatal nicotine exposure and its relationship with behavioural problems in the offspring. The majority of studies, and especially several recent epidemiological studies, observed a higher likelihood for attention-deficit/hyperactivity disorder (ADHD) or ADHD symptoms in exposed subjects. However, both human and animal studies have failed to provide clear evidence on causality. Existing literature on studies investigating the association between prenatal nicotine exposure and conduct or externalising problems in the offspring suggests a causal effect. The establishment of a final conclusion concerning the relationship between prenatal nicotine exposure and internalising problems in the offspring is complicated by insufficient data and mixed results in epidemiological studies. Prenatal nicotine exposure has been associated with altered brain structure and function in human offspring, and a proposed biological mechanism is related to nicotine's adverse influence on neurotransmitter systems during brain development. In conclusion, establishing a statement on the causality of the relationship between prenatal nicotine exposure and behavioural problems in children remains a challenging task. Nevertheless, considering the results of an increasing number of studies which link prenatal exposure to nicotine to externalising problems applying different methodologies to account for confounding and in view of other adverse health effects known to be caused by this exposure, parents should consider smoking cessation.

  6. Nasa Records Disposition Handbook: Procedures Governing the Retention, Retirement, and Destruction of Agency Records

    NASA Technical Reports Server (NTRS)

    1970-01-01

    This handbook sets forth the disposition of official records of the National Aeronautics and Space Administration. Its provisions are applicable to NASA Headquarters and all field installations. This revised edition has been enlarged in scope and re-titled to provide guidance in all aspects of records retirements, transfers, destruction, and retrievals from Federal Records Centers. New records control schedules have been added and others revised. Also included are procedures for making recommendations for improved coverage of records categories by additions or revisions. The NASA Records Control Schedules are issued under authority of the NASA Records Management Officer in accordance with Section 101-11.406, Federal Property Management Regulations. They were approved for NASA use by the National Archives and Records Service, the General Accounting Office, and by the Joint Committee on the Disposition of Executive Papers, U.S. Congress.

  7. NASA records disposition handbook: Procedures governing the retention, retirement, and destruction of agency records

    NASA Technical Reports Server (NTRS)

    1970-01-01

    This handbook sets forth the disposition of official records of the National Aeronautics and Space Administration. Its provisions are applicable to NASA Headquarters and all field installations. This revised edition has been enlarged in scope and re-titled to provide guidance in all aspects of records retirements, transfers, destruction, and retrievals from Federal Records Centers. New records control schedules have been added and others revised. Also included are procedures for making recommendations for improved coverage of records categories by additions or revisions. The NASA Records Control Schedules are issued under authority of the NASA Records Management Officer in accordance with Section 101-11.406, Federal Property Management Regulations. They were approved for NASA use by the National Archives and Records Service, the General Accounting Office, and by the Joint Committee on the Disposition of Executive Papers, U.S. Congress.

  8. Prenatal transportation stress alters temperament and serum cortisol concentrations in suckling Brahman calves.

    PubMed

    Littlejohn, B P; Price, D M; Banta, J P; Lewis, A W; Neuendorff, D A; Carroll, J A; Vann, R C; Welsh, T H; Randel, R D

    2016-02-01

    This experiment examined the relationship between prenatal stress and subsequent calf temperament through weaning. The prenatal stressor used was repeated transportation of pregnant Brahman cows for 2 h at 60 ± 5, 80 ± 5, 100 ± 5, 120 ± 5, and 140 ± 5 d of gestation. Prenatally stressed calves ( = 41) were compared with controls ( = 44; dams did not undergo transportation during pregnancy) from 2 wk of age until weaning (average age at weaning = 174.8 ± 1.3 d). Temperament was defined by pen score (PS; 1 = calm and 5 = excitable), exit velocity (EV; m/sec), and temperament score (TS; (PS + EV)/2) and was recorded for each calf on d -168, -140, -112, -84, -56, -28, and 0 relative to weaning (d 0 = weaning). Cortisol concentrations were determined in serum samples obtained on d -168, -140, -28, and 0 relative to weaning. Birth weight and weaning weight were not different between treatment groups ( > 0.1). Pen score was greater ( = 0.03) in prenatally stressed calves (2.84 ± 0.21) relative to controls (2.31 ± 0.21). Exit velocity was greater ( < 0.01) in prenatally stressed calves (2.1 ± 0.14 m/sec) than in controls (1.61 ± 0.14 m/sec). Exit velocity was affected by a treatment × calf sex interaction ( = 0.04) and was greater in prenatally stressed females. Exit velocity was also affected by day ( < 0.0001). Temperament score was greater ( = 0.01) in prenatally stressed calves (2.45 ± 0.16) than in controls (1.95 ± 0.16). Temperament score was affected by day ( < 0.01). Basal cortisol concentrations were greater ( = 0.04) in prenatally stressed calves (15.87 ± 1.04 ng/mL) than in controls (13.42 ± 1.03 ng/mL). Basal cortisol concentrations were greater ( < 0.01) in females (16.61 ± 1.06 ng/mL) than in males (12.68 ± 1.02 ng/mL). Cortisol concentrations were positively correlated ( < 0.01) with PS ( = 0.55, < 0.01), EV ( = 0.4, < 0.01), and TS ( = 0.55, < 0.01). Overall, suckling Brahman calves that were prenatally stressed were more temperamental and

  9. Predictive accuracy of the Miller assessment for preschoolers in children with prenatal drug exposure.

    PubMed

    Fulks, Mary-Ann L; Harris, Susan R

    2005-01-01

    The Miller Assessment for Preschoolers (MAP) is a standardized test purported to identify preschool-aged children at risk for later learning difficulties. We evaluated the predictive validity of the MAP Total Score, relative to later cognitive performance and across a range of possible cut-points, in 37 preschool-aged children with prenatal drug exposure. Criterion measures were the Wechsler Preschool & Primary Scale of Intelligence-Revised (WPPSI-R), Test of Early Reading Ability-2, Peabody Picture Vocabulary Test-Revised, and Developmental Test of Visual Motor Integration. The highest predictive accuracy was demonstrated when the WPPSI-R was the criterion measure. The 14th percentile cutoff point demonstrated the highest predictive accuracy across all measures.

  10. [Prenatal diagnosis of neural tube defects: Correlation between prenatal and postnatal data].

    PubMed

    Matuszewski, L; Perdriolle-Galet, E; Clerc-Urmès, I; Bach-Segura, P; Klein, O; Masutti, J P; Morel, O

    2017-03-01

    Neural tube defects (NTD) are congenital anomalies that can cause significant neurological long-term disabilities. Theses malformations are accessible to prenatal diagnosis and quite recently, to in utero repair for some myelomeningoceles. The aim of this study was to analyse the correlation between prenatal and postnatal examinations. A descriptive retrospective monocentric study has been conducted between January 2004 and December 2014 in a tertiary care maternity. All patients who benefited a prenatal diagnosis of NTD for their foetus, and for whom postnatal data were available were included. Prenatal and postnatal data, especially type of dysraphism, levels of defect and extent, and associated anomalies were compared. Sixty spinal dysraphisms were diagnosed antenataly. Concerning the type of dysraphism, ultrasound diagnosis was well correlated with postnatal findings (ρ=0.7048). Prenatal level and extent were correlated with postnatal data (respectively ρ=0.539 and ρ=0.562). Vertebral upper level defined by ultrasound agreed with postnatal constatations in 80.8% of cases within one vertebra, and in 84.6% of cases within two vertebras. Concerning indirect signs of spina bifida, prenatal data agreed with postnatal ones for most of them, especially for Arnold Chiari II malformation. There is a high correlation between prenatal and postnatal data. Prenatal ultrasound seems to be efficient for description of neural tube defects and to identify foetuses for which the benefit of in utero surgery exists. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  11. Revised Total Coliform Rule

    EPA Pesticide Factsheets

    The Revised Total Coliform Rule (RTCR) aims to increase public health protection through the reduction of potential pathways for fecal contamination in the distribution system of a public water system (PWS).

  12. Access Barriers to Prenatal Care in Emerging Adult Latinas.

    PubMed

    Torres, Rosamar

    2016-03-01

    Despite efforts to improve access to prenatal care, emerging adult Latinas in the United States continue to enter care late in their pregnancies and/or underutilize these services. Since little is known about emerging adult Latinas and their prenatal care experiences, the purpose of this study was to identify actual and perceived prenatal care barriers in a sample of 54 emerging adult Latinas between 18 and 21 years of age. More than 95% of the sample experienced personal and institutional barriers when attempting to access prenatal care. Results from this study lend support for policy changes for time away from school or work to attend prenatal care and for group prenatal care.

  13. Exploring group composition among young, urban women of color in prenatal care: Implications for satisfaction, engagement, and group attendance

    PubMed Central

    Earnshaw, Valerie A.; Rosenthal, Lisa; Cunningham, Shayna D.; Kershaw, Trace; Lewis, Jessica; Rising, Sharon; Stasko, Emily; Tobin, Jonathan; Ickovics, Jeannette R.

    2015-01-01

    Purpose Group models of prenatal care continue to grow in popularity. Yet, little is known about how group composition (similarity or diversity between members of groups) relates to care-related outcomes. The current investigation aimed to explore associations between prenatal care group composition with patient satisfaction, engagement, and group attendance among young, urban women of color. Methods Data were drawn from two studies conducted in New Haven and Atlanta (2001–2004; n=557) and New York City (2008–2011; n=375), designed to evaluate group prenatal care among young, urban women of color. Women aged 14–25 were assigned to group prenatal care and completed surveys during their second and third trimesters of pregnancy. Group attendance was recorded. Data were merged and analyzed guided by the Group Actor-Partner Interdependence Model using multilevel regression. Analyses explored composition in terms of age, race, ethnicity, and language. Main findings Women in groups with others more diverse in age reported greater patient engagement and, in turn, attended more group sessions [b(se)= −0.01(0.01), p=0.04]. Conclusion The composition of prenatal care groups appears to be associated with young women’s engagement in care, ultimately relating to the number of group prenatal care sessions they attend. Creating groups diverse in age may be particularly beneficial for young, urban women of color, who have unique pregnancy needs and experiences. Future research is needed to test the generalizability of these exploratory findings. PMID:26542382

  14. Exploring Group Composition among Young, Urban Women of Color in Prenatal Care: Implications for Satisfaction, Engagement, and Group Attendance.

    PubMed

    Earnshaw, Valerie A; Rosenthal, Lisa; Cunningham, Shayna D; Kershaw, Trace; Lewis, Jessica; Rising, Sharon Schindler; Stasko, Emily; Tobin, Jonathan; Ickovics, Jeannette R

    2016-01-01

    Group models of prenatal care continue to grow in popularity. However, little is known about how group composition (similarity or diversity between members of groups) relates to care-related outcomes. The current investigation aimed to explore associations between prenatal care group composition with patient satisfaction, engagement, and group attendance among young, urban women of color. Data were drawn from two studies conducted in New Haven and Atlanta (2001-2004; n = 557) and New York City (2008-2011; n = 375) designed to evaluate group prenatal care among young, urban women of color. Women aged 14 to 25 were assigned to group prenatal care and completed surveys during their second and third trimesters of pregnancy. Group attendance was recorded. Data were merged and analyzed guided by the Group Actor-Partner Interdependence Model using multilevel regression. Analyses explored composition in terms of age, race, ethnicity, and language. Women in groups with others more diverse in age reported greater patient engagement and, in turn, attended more group sessions, b(se) = -0.01(0.01); p = .04. The composition of prenatal care groups seems to be associated with young women's engagement in care, ultimately relating to the number of group prenatal care sessions they attend. Creating groups diverse in age may be particularly beneficial for young, urban women of color, who have unique pregnancy needs and experiences. Future research is needed to test the generalizability of these exploratory findings. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  15. Pregnancy outcomes in prenatally diagnosed 47, XXX and 47, XYY syndromes: a 30-year French, retrospective, multicentre study.

    PubMed

    Gruchy, Nicolas; Blondeel, Eleonore; Le Meur, Nathalie; Joly-Hélas, Géraldine; Chambon, Pascal; Till, Marianne; Herbaux, Martine; Vigouroux-Castera, Adeline; Coussement, Aurélie; Lespinasse, James; Amblard, Florence; Jimenez Pocquet, Mélanie; Lebel-Roy, Camille; Carré-Pigeon, Frédérique; Flori, Elisabeth; Mugneret, Francine; Jaillard, Sylvie; Yardin, Catherine; Harbuz, Radu; Collonge-Rame, Marie-Agnès; Vago, Philippe; Valduga, Mylène; Leporrier, Nathalie; Vialard, François

    2016-06-01

    Sex chromosome aneuploidies are frequently detected fortuitously in a prenatal diagnosis. Most cases of 47, XXX and 47, XYY syndromes are diagnosed in this context, and parents are thus faced with an unexpected situation. The objective of the present study was to characterize a French cohort of prenatally diagnosed cases of 47, XXX and 47, XYY and to evaluate the termination of pregnancy (TOP) rate before and after France's implementation of multidisciplinary centres for prenatal diagnosis in 1997. This retrospective study identified respectively 291 and 175 cases of prenatally diagnosed 47, XXX and 47, XYY between 1976 and 2012. For each case, the indication, maternal age, karyotype and outcome were recorded. Most diagnoses of the two conditions were fortuitous. The occurrence of 47, XXX was associated with advanced maternal age. The overall TOP rate was higher for 47, XXX (22.9%) than for 47, XYY (14.6%), although this difference was not statistically significant. However, the TOP rates fell significantly after 1997 (from 41.1% to 11.8% for 47, XXX and from 25.8% to 6.7% for 47, XYY). The TOP rates after prenatal diagnoses of 47, XXX and 47, XYY fell significantly after 1997, following France's implementation of multidisciplinary centres for prenatal diagnosis. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

  16. Quality of life outcomes after revision lumbar discectomy.

    PubMed

    Lubelski, Daniel; Senol, Nilgun; Silverstein, Michael P; Alvin, Matthew D; Benzel, Edward C; Mroz, Thomas E; Schlenk, Richard

    2015-02-01

    The authors investigated quality of life (QOL) outcomes after primary versus revision discectomy. A retrospective review was performed for all patients who had undergone a primary or revision discectomy at the Cleveland Clinic Center for Spine Health from January 2008 through December 2011. Among patients in the revision cohort, they identified those who needed a second revision discectomy. Patient QOL measures were recorded before and after surgery. These measures included responses to the EQ-5D health questionnaire, Patient Health Questionnaire-9, Pain and Disability Questionnaire, and quality-adjusted life years (QALYs). Cohorts were compared by using independent-sample t-tests and Fisher exact tests for continuous and categorical variables, respectively. Multivariable logistic regression was performed to adjust for confounding. A total of 196 patients were identified (116 who underwent primary discectomy and 80 who underwent revision discectomy); average follow-up time was 150 days. There were no preoperative QOL differences between groups. Postoperatively, both groups improved significantly in all QOL measures. For QALYs, the primary cohort improved by 0.25 points (p<0.001) and the revision cohort improved by 0.18 points (p<0.001). QALYs improved for significantly more patients in the primary than in the revision cohort (76% vs 59%, respectively; p=0.02), and improvement exceeded the minimum clinically important difference for more patients in the primary cohort (62% vs 45%, respectively; p=0.03). Of the 80 patients who underwent revision discectomy, yet another recurrent herniation (third herniation) occurred in 14 (17.5%). Of these, 4 patients (28.6%) chose to undergo a second revision discectomy and the other 10 (71.4%) underwent conservative management. For those who underwent a second revision discectomy, QOL worsened according to all questionnaire scores. QOL, pain and disability, and psychosocial outcomes improved after primary and revision discectomy

  17. Prenatal x-ray exposure and childhood cancer in twins

    SciTech Connect

    Harvey, E.B.; Boice, J.D. Jr.; Honeyman, M.; Flannery, J.T.

    1985-02-28

    A case-control study was conducted to investigate the relation between prenatal exposure to x-rays and childhood cancer, including leukemia, in over 32,000 twins born in Connecticut from 1930 to 1969. Twins as opposed to single births were chosen for study to reduce the likelihood of medical selection bias, since twins were often exposed to x-rays to diagnose the twin pregnancy or to determine fetal positioning before delivery and not because of medical conditions that may conceivably pre-dispose to cancer. Each of 31 incident cases of cancer, identified by linking the Connecticut twin and tumor registries, was matched with four twin controls according to sex, year of birth, and race. Records of hospitals, radiologists, and private physicians were searched for histories of x-ray exposure and other potentially important risk factors. Documented prenatal x-ray exposures were found for 39 per cent of the cases (12 of 31) and for 26 per cent of the controls (28 of 109). No other pregnancy, delivery, or maternal conditions were associated with cancer risk except low birth weight: 38 per cent of the cases as compared with 25 per cent of the controls weighed under 2.27 kg at birth. When birth weight was adjusted for, twins in whom leukemia or other childhood cancer developed were twice as likely to have been exposed to x-rays in utero as twins who were free of disease (relative risk, 2.4; 95 per cent confidence interval, 1.0 to 5.9). The results, though based on small numbers, provide further evidence that low-dose prenatal irradiation may increase the risk of childhood cancer.

  18. Prenatal programming of childhood overweight and obesity.

    PubMed

    Huang, Jennifer S; Lee, Tiffany A; Lu, Michael C

    2007-09-01

    To review the scientific evidence for prenatal programming of childhood overweight and obesity, and discuss its implications for MCH research, practice, and policy. A systematic review of observational studies examining the relationship between prenatal exposures and childhood overweight and obesity was conducted using MOOSE guidelines. The review included literature posted on PubMed and MDConsult and published between January 1975 and December 2005. Prenatal exposures to maternal diabetes, malnutrition, and cigarette smoking were examined, and primary study outcome was childhood overweight or obesity as measured by body mass index (BMI) for children ages 5 to 21. Four of six included studies of prenatal exposure to maternal diabetes found higher prevalence of childhood overweight or obesity among offspring of diabetic mothers, with the highest quality study reporting an odds ratio of adolescent overweight of 1.4 (95% CI 1.0-1.9). The Dutch famine study found that exposure to maternal malnutrition in early, but not late, gestation was associated with increased odds of childhood obesity (OR 1.9, 95% CI 1.5-2.4). All eight included studies of prenatal exposure to maternal smoking showed significantly increased odds of childhood overweight and obesity, with most odds ratios clustering around 1.5 to 2.0. The biological mechanisms mediating these relationships are unknown but may be partially related to programming of insulin, leptin, and glucocorticoid resistance in utero. Our review supports prenatal programming of childhood overweight and obesity. MCH research, practice, and policy need to consider the prenatal period a window of opportunity for obesity prevention.

  19. Performance of prenatal diagnosis in esophageal atresia.

    PubMed

    Spaggiari, Emmanuel; Faure, Giuliana; Rousseau, Veronique; Sonigo, Pascale; Millischer-Bellaiche, Anne-Elodie; Kermorvant-Duchemin, Elsa; Muller, Francoise; Czerkiewicz, Isabelle; Ville, Yves; Salomon, Laurent J

    2015-09-01

    The aim of this study was to evaluate the performance of prenatal diagnosis of esophageal atresia (EA) and its associated abnormalities. We conducted a retrospective study from a pediatric database of EA managed postnatally in a single center. Prenatal data included ultrasound and magnetic resonance imaging parameters including amniotic fluid (AF) volume, stomach visualization, AF biochemistry, and associated malformations. Postnatal data included type of EA, mortality, and postnatal diagnosis of associated malformations. One hundred twenty-two cases were included. The diagnosis was suspected prenatally in 39/122 (32%) cases. Polyhydramnios was noted in 64/122 (52.4%), and the stomach was not visualized or small in 39 (32%). There was 14 (11.5%), 2 (1.6%), 101 (82.8%), 5 (4.1%), and 0 (0%) types I, II, III, IV, and V, respectively. EA was suspected prenatally in 12/14 (85.7%) in type I and in 27/108 (25%) in cases with tracheoesophageal fistula (II + III + IV + V). Magnetic resonance imaging was performed in 28 cases, which confirmed EA in 19/28 (sensitivity 67.8%). AF biochemistry was performed in 17 cases, which confirmed EA in 15/17 (sensitivity 88.2%) cases. Of the 69 syndromic associations, 41/69 (59.4%) cases were detected prenatally. Associated malformation was a strong predictor of postnatal death [19/69 vs 3/53, odds ratio 6.33 (1.76; 22.75), p < 0.01]. Prenatal diagnosis of EA remains challenging. MRI and AF biochemistry may prove useful in the diagnosis of EA. Prenatal ultrasound and MRI examination should also focus on associated anomalies. © 2015 John Wiley & Sons, Ltd. © 2015 John Wiley & Sons, Ltd.

  20. [Prenatal diagnosis of abdominal wall defects].

    PubMed

    El Mhabrech, H; Ben Hmida, H; Charfi, H; Zrig, A; Hafsa, C

    2017-09-07

    Anterior abdominal wall defects (AAWD) correspond to a wide spectrum of congenital defects affecting 6.3/10,000 pregnancies. They have in common a closure defect of the anterior abdominal wall and can be fatal or expose the fetus and the neonate (NN) to many complications. This study was based on a retrospective study of 22 cases of AAWD collected between May 2009 and December 2014. Its purpose was to specify the importance of prenatal ultrasonography in the diagnosis and prognosis assessment of these defects. These 22 AAWDs consisted in 13 cases of omphalocele (including four cases of Beckwith-Wiedemann syndrome), four of gastroschisis, one of pentalogy of Cantrell, three of vesical exstrophy and one of cloacal exstrophy. Prenatal ultrasonography provided the diagnosis of 14 of these defects with a changing sensitivity with the gestational age varying from 17% in the first trimester to 71.4% and 77.8% in the second and third trimesters, respectively. The relevance of this examination was improved when performed by an imaging specialist. The prenatal diagnosis of these defects indicated an amniocentesis in eight cases, allowing the diagnosis of two cases of trisomy 18. It also motivated a therapeutic termination of the pregnancy (TTP) in ten cases. Prenatal ultrasonography allowed better prenatal follow-up and planning of the delivery of the continued pregnancies. It indicated an emergency C-section in only one case by showing intestinal complications of gastroschisis. Four NNs died (two cases of omphalocele and two of gastroschisis), three of which postoperatively and the prenatal diagnosis did not improve survival. Prenatal ultrasonographic diagnosis provided a precise morphological study determining the type of the AAWD, a complete malformation assessment, and the prognosis factors. This resulted in adequate multidisciplinary pre and postnatal care, including a rigorous ultrasound follow-up, a TTP in case of associated defects, and emergency delivery once the

  1. Prenatal Diagnosis and Genetic Counseling

    PubMed Central

    Dumars, Kenneth W.; Dalrymple, Gisela T.; Murray, Allen K.

    1976-01-01

    Since the early 1960's knowledge regarding human genetics has increased at an exponential rate. Because genetics was not commonly taught in medical schools before the late 1960's, this review article is intended to acquaint physicians or refresh their knowledge regarding chromosomal, mendelian and multifactorial inheritance and the indications for prenatal diagnosis. Establishing an accurate diagnosis and mode of inheritance is essential in identifying and selecting those families at risk for genetic disease in their offspring. Medical genetics is evolving as a specialty in order to provide consultation and, if needed, management of those families who would benefit by genetic services. Families who would benefit from genetic counseling include, for example, those in whom any of the following conditions is present: known chromosomal disorders, known disorders due to mendelian inheritance, mental retardation of unknown origin, failure of sexual maturation or failure of sexual development, congenital malformations, floppy infant syndrome or leukemia. A list of more than 70 disorders now detectable in a fetus by means of amniocentesis provides a beginning in the prevention of genetic disease. Knowledge regarding these diseases allows a physician to provide families with accurate risk figures so that they may make informed decisions about having children. Also, a compassionate and nonjudgmental approach to counseling is essential. Decisions, in the final analysis, must be made by the family but aided and supported by the physician. ImagesFigure 4.Figure 5. PMID:1274337

  2. Prenatal nipple conditioning for breastfeeding.

    PubMed

    Atkinson, L D

    1979-01-01

    Twenty-two primigravida women who planned to breastfeed began conditioning their nipples six weeks before their expected delivery date by nipple rolling twice a day for two minutes each time; providing gentle friction against the nipple with a terry cloth towel for 15 seconds once a day; and nipple airing for two hours a day, allowing outer clothing to rub against the nipple. Each woman served as her own control, conditioning one nipple but not the other. No nipple ointments or soap were used on either nipple during the course of the study. Each woman was given instructions on breastfeeding techniques to be used after delivery. The women completed two checklists: One revealed how consistently they followed the nipple-conditioning regime; with the other, they rated nipple pain on each breast, for every nursing, during the first five days postdelivery. Ratings were: 1--negligible pain or no pain, 2--definite pain, 3--extreme pain. Seventeen women successfully completed the study. Effect of skin color on the amount of nipple pain was also investigated. The prenatal nipple-conditioning regime significantly reduced the amount of total nipple pain experienced during the first few days of breastfeeding. The amount of extreme pain experienced on the conditioned nipple was significantly (p less than .01) reduced compared to the control nipple. Fair-skinned women reported more nipple soreness on unconditioned nipples, and olive-complected women reported significantly (p less than .01) less nipple soreness on unconditioned nipples.

  3. Prenatal death in Fraser syndrome.

    PubMed

    Comstock, Jessica M; Putnam, Angelica R; Opitz, John M; Pysher, Theodor J; Szakacs, Juliana

    2005-01-01

    Cryptophthalmos may be partial or complete, unilateral or bilateral, apparently nonsyndromal or syndromal. A recent study of 2 stillborn infants at the University of Utah prompted an analysis of the developmental aspects of the syndromal form (Fraser syndrome). We conclude that, per se, cryptophthalmos is a developmental field defect on the basis of heterogeneity (autosomal dominant and recessive forms) and phylogeneity (occurrence also in the pheasant, rabbit, pigeon, dog, and mouse). In humans this autosomal recessive disorder maps to 4q21, is homologous to the bleb (bl/bl) mouse, and is due to mutations in the FRAS1 gene that codes for a 4007 amino acid protein 85% identical to the Fras1 gene of the bleb mouse. Commonest anomalies in humans are cryptophthalmos, cutaneous syndactyly of digits, abnormal ears and genitalia, renal agenesis, and congenital heart defects. Almost half of affected infants are stillborn or die in infancy, and mental retardation is common. The pathogenesis evidently involves abnormal epithelial integrity during prenatal life. Older (mostly German) publications, some dating to the 19th century, provide a fascinating historical insight into the process of syndrome delineation.

  4. Prenatal marijuana and alcohol exposure and academic achievement at age 10.

    PubMed

    Goldschmidt, Lidush; Richardson, Gale A; Cornelius, Marie D; Day, Nancy L

    2004-01-01

    The effects of prenatal marijuana and alcohol exposure on school achievement at 10 years of age were examined. Women were interviewed about their substance use at the end of each trimester of pregnancy, at 8 and 18 months, and at 3, 6, 10, 14, and 16 years. The women were of lower socioeconomic status, high-school-educated, and light-to-moderate users of marijuana and alcohol. The sample was equally divided between Caucasian and African-American women. At the 10-year follow-up, the effects of prenatal exposure to marijuana or alcohol on the academic performance of 606 children were assessed. Exposure to one or more marijuana joints per day during the first trimester predicted deficits in Wide Range Achievement Test-Revised (WRAT-R) reading and spelling scores and a lower rating on the teachers' evaluations of the children's performance. This relation was mediated by the effects of first-trimester marijuana exposure on the children's depression and anxiety symptoms. Second-trimester marijuana use was significantly associated with reading comprehension and underachievement. Exposure to alcohol during the first and second trimesters of pregnancy predicted poorer teachers' ratings of overall school performance. Second-trimester binge drinking predicted lower reading scores. There was no interaction between prenatal marijuana and alcohol exposure. Each was an independent predictor of academic performance.

  5. Population-based trends in prenatal screening and diagnosis for aneuploidy: a retrospective analysis of 38 years of state-wide data.

    PubMed

    Hui, L; Muggli, E E; Halliday, J L

    2016-01-01

    To analyse population-based trends over the entire history of prenatal testing for aneuploidy. Retrospective analysis of state-wide data sets. Australian state of Victoria with ~70 000 annual births. All pregnant women undergoing invasive prenatal testing at <25 weeks' gestation from 1976 to 2013. Analysis of three state-wide data sets: (1) Prenatal diagnosis data set of 119 404 amniocenteses and chorionic villus samplings from 1976 to 2013; (2) central serum screening laboratory data set from 1996 to 2013; (3) government birth statistics from 1976 to 2013. Annual numbers and uptake rates of invasive prenatal tests and serum screening, indications for invasive prenatal testing, prenatal diagnoses of aneuploidy, diagnostic yield of invasive tests. Annual numbers of invasive prenatal tests climbed steadily from 1976, then declined from 2000. In 2013, the number of invasive prenatal tests was the lowest in 25 years, while the number of trisomy 21 diagnoses was the highest ever recorded. Annual uptake of serum screening climbed from 1.6 to 83% over 1996-2013. Results from 2013 showed a high diagnostic yield (15.8%) for a low rate of invasive testing (3.4% of births). Over four decades, the number of invasive procedures performed for each diagnosis of major chromosome abnormality declined from 100 to six. This study demonstrates historic reductions in the proportion of women undergoing invasive testing and dramatic improvements in diagnostic yield. Monitoring the impact of new prenatal technologies on this progress remains an important research priority. Invasive prenatal testing has reached historic lows due to dramatic improvements in Down syndrome screening. © 2015 Royal College of Obstetricians and Gynaecologists.

  6. Records Management

    EPA Pesticide Factsheets

    All Federal Agencies are required to prescribe an appropriate records maintenance program so that complete records are filed or otherwise preserved, records can be found when needed, the identification and retention of permanent records are facilitated, and permanent and temporary records are physically segregated, or for electronic records, segregable.

  7. Access, quality and costs of prenatal diagnosis.

    PubMed

    Izquierdo, Luis A; Berkshire, Steven

    2010-01-01

    The background risk of birth defects ranges from 2 to 5%. These birth defects are responsible for 30% of all admissions to pediatric hospitals and are responsible for a large proportion of neonatal and infant deaths. Medicine and Genetics have taken giant steps in their ability to detect and treat genetic disorders in utero. Screening tests for prenatal diagnosis should be offered to all pregnant women to assess their risk of having a baby with a birth defect or genetic disorder. Psychosocial and financial factors, inadequate insurance coverage, and the inability to pay for health care services are some of the known barriers to healthcare. These barriers are particularly magnified when there is a language barrier. From an economical standpoint it has been demonstrated that prenatal diagnosis has the potential of saving millions of dollars to our healthcare system. But when patients do not have the resources to access prenatal care and prenatal diagnosis cost shifting occurs, escalating healthcare costs. Our current healthcare system promotes inequalities in its delivery. With the existing barriers to access, quality, and costs of prenatal diagnosis we are confronted with an inefficient and flawed system.

  8. Prenatal Testosterone and Preschool Disruptive Behavior Disorders.

    PubMed

    Roberts, Bethan A; Martel, Michelle M

    2013-11-01

    Disruptive Behaviors Disorders (DBD), including Oppositional-Defiant Disorder (ODD) and Attention-Deficit/Hyperactivity Disorder (ADHD), are fairly common and highly impairing childhood behavior disorders that can be diagnosed as early as preschool. Prenatal exposure to testosterone may be particularly relevant to these early-emerging DBDs that exhibit a sex-biased prevalence rate favoring males. The current study examined associations between preschool DBD symptom domains and prenatal exposure to testosterone measured indirectly via right 2D:4D finger-length ratios. The study sample consisted of 109 preschool-age children between ages 3 and 6 (64% males;72% with DBD) and their primary caregivers. Primary caregivers completed a semi-structured interview (i.e., Kiddie Disruptive Behavior Disorder Schedule), as well as symptom questionnaires (i.e., Disruptive Behavior Rating Scale, Peer Conflict Scale); teachers and/or daycare providers completed symptom questionnaires and children provided measures of prenatal testosterone exposure, measured indirectly via finger-length ratios (i.e., right 2D:4D). Study results indicated a significant association of high prenatal testosterone (i.e., smaller right 2D:4D) with high hyperactive-impulsive ADHD symptoms in girls but not boys, suggesting that the effect may be driven by, or might only exist in, girls. The present study suggests that prenatal exposure to testosterone may increase risk for early ADHD, particularly hyperactivity-impulsivity, in preschool girls.

  9. Prenatal Testosterone and Preschool Disruptive Behavior Disorders

    PubMed Central

    Roberts, Bethan A.; Martel, Michelle M.

    2013-01-01

    Disruptive Behaviors Disorders (DBD), including Oppositional-Defiant Disorder (ODD) and Attention-Deficit/Hyperactivity Disorder (ADHD), are fairly common and highly impairing childhood behavior disorders that can be diagnosed as early as preschool. Prenatal exposure to testosterone may be particularly relevant to these early-emerging DBDs that exhibit a sex-biased prevalence rate favoring males. The current study examined associations between preschool DBD symptom domains and prenatal exposure to testosterone measured indirectly via right 2D:4D finger-length ratios. The study sample consisted of 109 preschool-age children between ages 3 and 6 (64% males;72% with DBD) and their primary caregivers. Primary caregivers completed a semi-structured interview (i.e., Kiddie Disruptive Behavior Disorder Schedule), as well as symptom questionnaires (i.e., Disruptive Behavior Rating Scale, Peer Conflict Scale); teachers and/or daycare providers completed symptom questionnaires and children provided measures of prenatal testosterone exposure, measured indirectly via finger-length ratios (i.e., right 2D:4D). Study results indicated a significant association of high prenatal testosterone (i.e., smaller right 2D:4D) with high hyperactive-impulsive ADHD symptoms in girls but not boys, suggesting that the effect may be driven by, or might only exist in, girls. The present study suggests that prenatal exposure to testosterone may increase risk for early ADHD, particularly hyperactivity-impulsivity, in preschool girls. PMID:25598567

  10. Callosal agenesis followed postnatally after prenatal diagnosis.

    PubMed

    Imataka, George; Nakagawa, Eiji; Kuwashima, Shigeko; Watanabe, Hiroshi; Yamanouchi, Hideo; Arisaka, Osamu

    2006-09-01

    Callosal agenesis is a congenital brain anomaly caused by embryonal hypogenesis of the corpus callosum. Concerning the neurological prognosis, epilepsy and motor disturbance are noted in some cases, while many cases are asymptomatic and the prognosis is good. We report a fetus tentatively diagnosed with hydrocephaly on prenatal echo-encephalography, which was performed without adequate explanation to and understanding of the parents. The parents had not expected an abnormality before the screening, and were subsequently not psychologically prepared for the discovery of the congenital brain anomaly on imaging. Moreover, they received no guidance on how to deal with any possible abnormalities. The pregnant mother was referred to our hospital. Prenatal MRI was performed after informed consent was obtained, and the fetus was diagnosed with callosal agenesis. The patient was followed for 5 years, and neurological development was normal. However, the parents have remained anxious while raising the child. Thus, the prenatal diagnosis of callosal agenesis in this case caused unnecessary mental burden to the parents. Here, we report the course of the case, and discuss the way prenatal ultrasonography should be used as a prenatal screening method, and the importance of counseling before the test.

  11. Prenatal and newborn screening for hemoglobinopathies.

    PubMed

    Hoppe, C C

    2013-06-01

    The hemoglobinopathies encompass a heterogeneous group of disorders associated with mutations in both the alpha-globin and beta-globin genes. Increased immigration of high-risk populations has prompted the implementation of prenatal and newborn screening programs for hemoglobinopathies across Europe and North America. In Canada, the UK, and other European countries, prenatal screening to identify hemoglobinopathy carriers and offer prenatal diagnostic testing to couples at risk is linked to newborn screening, while in the United States, it is still not universally performed. The structure of screening programs, whether prenatal or postnatal, universal or selective, varies greatly among these countries and within the United States. The laboratory methods used to identify hemoglobinopathies are based on the prevalence of hemoglobinopathies within the population and the type of screening performed. Advances in molecular testing have facilitated the diagnosis of complex thalassemias and sickling disorders observed in ethnically diverse populations. This review summarizes the current approaches and methods used for carrier detection, prenatal diagnosis, and newborn screening.

  12. Prenatal weight gain: who is counseled?

    PubMed

    Stotland, Naomi; Tsoh, Janice Y; Gerbert, Barbara

    2012-06-01

    Because prenatal counseling is associated with adherence to weight gain guidelines, we sought to identify patient-level characteristics associated with the receipt of counseling on weight gain, nutrition, and exercise during prenatal care. We performed a secondary data analysis on a cohort of women enrolled in a prenatal counseling intervention study. We controlled for study group assignment (intervention versus usual care) as well as patient characteristics in a multivariable analysis. We performed three separate multivariable analyses for predictors of provider-patient discussions about (1) weight gain, (2) nutrition, and (3) exercise. The cohort consisted of 311 predominantly low-income prenatal patients receiving care at several sites in the San Francisco Bay Area. Prepregnancy body mass index, nutrition knowledge, maternal age, parity, and type of insurance were not significantly associated with receipt of counseling about weight gain, nutrition, and exercise. In the multivariable analysis, white women were significantly less likely to be counseled about nutrition than non-white women (p=0.02). Former smokers were more likely to receive counseling about nutrition and exercise than never smokers (p<0.05). More advanced gestational age was associated with a higher rate of counseling on weight gain (p=0.01). Despite having the highest rates of excessive weight gain nationally, white women were the least likely to receive counseling about nutrition during pregnancy. Interventions that prompt clinicians and simplify counseling may improve counseling rates for all patients during prenatal care.

  13. Parental decisions of prenatally detected sex chromosome abnormality.

    PubMed Central

    Kim, Yon-Ju; Park, So-Yeon; Han, Jung-Heol; Kim, Moon-Young; Yang, Jae-Hyug; Choi, Kyu-Hong; Kim, Young-Mi; Kim, Jin-Mee; Ryu, Hyun-Mee

    2002-01-01

    Because of the widespread use of amniocentesis, the prenatal recognition of sex chromosome abnormality (SCA) has become increasingly common. Recent literature provided an insight into the understanding of the natural history and prognosis for individuals with SCA. Our study was designed to review the parental decision on pregnancy with SCA. Over the last 10 yr, we diagnosed 38 cases (0.50%) with SCA out of 7,498 prenatal cases. We reviewed the records and the results of the pregnancies. We included the cases (n=25) of apparently normal anatomic fetus to analyze the factors influencing parental decision. We excluded 13 cases with obvious anomaly or presumably bad outcome. Fifteen (60%) couples continued their pregnancies and ten (40%) terminated theirs. Nine couples (64%) out of fourteen mosaicism cases continued their pregnancies. All five pregnancies assisted by reproductive technique continued their pregnancies. More pregnancies were continued when counseling was done by an MD geneticist rather than by an obstetrician. A significant trend was observed with a higher rate of pregnancy continuation in recent years. The genetic counseling is important to give appropriate information to the parents. Establishing guidelines and protocols will help both obstetricians and parents to make a decision. PMID:11850589

  14. Pregnancy-specific stress, prenatal health behaviors, and birth outcomes.

    PubMed

    Lobel, Marci; Cannella, Dolores Lacey; Graham, Jennifer E; DeVincent, Carla; Schneider, Jayne; Meyer, Bruce A

    2008-09-01

    Stress in pregnancy predicts earlier birth and lower birth weight. The authors investigated whether pregnancy-specific stress contributes uniquely to birth outcomes compared with general stress, and whether prenatal health behaviors explain this association. Three structured prenatal interviews (N = 279) assessing state anxiety, perceived stress, life events, pregnancy-specific stress, and health behaviors. Gestational age at delivery, birth weight, preterm delivery (<37 weeks), and low birth weight (<2,500 g). A latent pregnancy-specific stress factor predicted birth outcomes better than latent factors representing state anxiety, perceived stress, or life event stress, and than a latent factor constructed from all stress measures. Controlling for obstetric risk, pregnancy-specific stress was associated with smoking, caffeine consumption, and unhealthy eating, and inversely associated with healthy eating, vitamin use, exercise, and gestational age at delivery. Cigarette smoking predicted lower birth weight. Clinically-defined birth outcomes were predicted by cigarette smoking and pregnancy-specific stress. Pregnancy-specific stress contributed directly to preterm delivery and indirectly to low birth weight through its association with smoking. Pregnancy-specific stress may be a more powerful contributor to birth outcomes than general stress. PsycINFO Database Record (c) 2008 APA, all rights reserved.

  15. Prenatal Secondhand Smoke Exposure and Infant Birth Weight in China

    PubMed Central

    Lee, Nora L.; Samet, Jonathan M.; Yang, Gonghuan; Zhou, Maigeng; Yang, Jie; Correa, Adolfo; Lees, Peter S. J.

    2012-01-01

    Epidemiologic evidence provides some support for a causal association between maternal secondhand smoke (SHS) exposure during pregnancy and reduction in infant birth weight. The purpose of this cross-sectional study is to examine the magnitude of this association in China, where both prevalence and dose of SHS exposure are thought to be higher than in U.S. populations. Women who gave birth in Beijing and Changchun September 2000–November 2001 were interviewed to quantify self-reported prenatal SHS exposure. Their medical records were reviewed for data on pregnancy complications and birth outcomes. Non-smoking women who delivered term babies (≥37 weeks gestation) were included in the study (N = 2,770). Nearly a quarter of the women (24%) reported daily SHS exposure, 47% reported no prenatal exposure, and 75% denied any SHS exposure from the husband smoking at home. Overall, no deficit in mean birth weight was observed with exposure from all sources of SHS combined (+11 grams, 95% CI: +2, +21). Infants had higher mean birth weights among the exposed than the unexposed for all measures of SHS exposure. Future studies on SHS exposure and infant birth weight in China should emphasize more objective measures of exposure to quantify and account for any exposure misclassification. PMID:23202753

  16. [Diagnosis, evolution and prognosis of prenatally diagnosed suprasellar cysts].

    PubMed

    Di Rocco, F; André, A; Roujeau, T; Selek, L; Ville, Y; Garel, C; Zérah, M

    2016-12-01

    Suprasellar arachnoid cysts (SAC) in children are considered rare, but the incidence is increasing due to the improvement of prenatal diagnosis. We present 15 cases of SAC diagnosed during the antenatal period between 2005 and 2015. The records were reviewed retrospectively by specifying the radiological characteristics, treatment modalities, outcomes, and long-term monitoring. Mean follow-up was 71 months. The forms (SAC-1) accounted for 2 cases (13%) with hydrocephalus. We observed 8 (53%) lower forms (SAC-2) with interpeduncular cistern expansion without hydrocephalus. The 5 (33.5%) remaining patients showed asymmetrical forms (SAC-3). Six patients (40%) were treated by ventriculo-cysto-cisternostomy, 1 by fetoscopy, 1 (6.5%) by ventriculo-peritoneal shunt, 2 (13.5%) by pterional craniotomy, and 6 (40%) were simply followed. The surgical outcomes were initially favorable in 9 cases (100%), 1 patient (13%) had to be re-treated later. Non-operated patients were all type 2 and showed no radiological changes. In the long-term, 1 patient (6.5%) had endocrine disruption, 1 had delayed development, 2 (13.5%) had minor neuropsychological impairments, and 1 had epilepsy. Combined monitoring with prenatal MRI and ultrasound can be used to distinguish three subtypes of SAC. SAC-1 and SAC-3 have an excellent prognosis after treatment in the perinatal period. SAC-2 can benefit from simple monitoring and remain asymptomatic in their majority. This classification allows a better prognosis estimation and better treatment decision.

  17. Regional and international prenatal telemedicine network for computerized antepartum cardiotocography.

    PubMed

    Di Lieto, Andrea; De Falco, Marianna; Campanile, Marta; Török, Miklós; Gábor, Spánik; Scaramellino, Mariangela; Schiraldi, Paola; Ciociola, Francesca

    2008-01-01

    The objective of this work was to review the activity of TOCOMAT, a system for antepartum cardiotocographic telemonitoring. Nine peripheral units recorded the traces, transmitted them via modem to the University operation center, where the computerized analysis was performed, and received the medical report within a few minutes, via fax or e-mail. Traces were classified as reassuring, nonreassuring, or pathological. The parameters of computerized analysis were grouped together for each week of gestation. The perinatal outcome was also evaluated. In 5 years, 5830 traces were analyzed: 4372 (75%) from 1344 high-risk patients and 1458 (25%) from 529 patients at apparent low risk. The system allowed the identification of high-risk patients (32.8% with nonreassuring traces and 7.1% with pathologic traces) and lowrisk patients (16.3% with nonreassuring traces and 4.3% with pathologic traces) that required further evaluation. The neonatal outcome was good overall. At each week of pregnancy, the mean values of computerized parameters resulted in normal ranges. The TOCOMAT system allowed a decentralization of prenatal surveillance and improved the patients quality of life and the level of prenatal care.

  18. Effect of non-invasive prenatal testing as a contingent approach on the indications for invasive prenatal diagnosis and prenatal detection rate of Down's syndrome.

    PubMed

    Kou, K O; Poon, C F; Kwok, S L; Chan, K Yk; Tang, M Hy; Kan, A Sy; Leung, K Y

    2016-06-01

    In Hong Kong, universal combined first-trimester screening for Down's syndrome was started as a 'free service' in July 2010. Non-invasive prenatal testing was available as a self-financed item in August 2011. This study aimed to determine whether the introduction of non-invasive prenatal testing as a contingent approach influenced the indications for invasive prenatal diagnosis and the consequent prenatal detection of Down's syndrome. This historical cohort study was conducted at the Prenatal Diagnosis Clinic of Queen Elizabeth Hospital in Hong Kong. We compared the indications for invasive prenatal diagnosis and prenatal detection of Down's syndrome in singleton pregnancies 1 year before and 2 years following the availability of non-invasive prenatal testing as a contingent test after a positive aneuploidy test. All pregnant women who attended our hospital for counselling about universal Down's syndrome screening between August 2010 and July 2013 were recruited. A total of 16 098 women were counselled. After the introduction of non-invasive prenatal testing, the invasive prenatal diagnosis rate for a positive aneuploidy screening reduced from 77.7% in 2010-11 to 68.8% in 2012-13. The new combined conventional plus non-invasive prenatal testing strategy was associated with a lower false-positive rate (6.9% in 2010-11 vs 5.2% in 2011-12 and 4.9% in 2012-13). There was no significant increase in invasive prenatal diagnosis for structural anomalies over the years. There was no significant trend in the overall prenatal detection rate of Down's syndrome (100% 1 year before vs 89.1% 2 years after introduction of non-invasive prenatal testing). Four (2.6%) of 156 women who underwent non-invasive prenatal testing for a screen-positive result had a high-risk result for trisomy 21, which was subsequently confirmed by invasive prenatal diagnosis. There were no false-negative cases. The introduction of non-invasive prenatal testing as a contingent approach reduced the invasive

  19. Effects of prenatal methamphetamine exposure on behavioral and cognitive findings at 7.5 years of age.

    PubMed

    Diaz, Sabrina D; Smith, Lynne M; LaGasse, Linda L; Derauf, Chris; Newman, Elana; Shah, Rizwan; Arria, Amelia; Huestis, Marilyn A; Della Grotta, Sheri; Dansereau, Lynne M; Neal, Charles; Lester, Barry M

    2014-06-01

    To examine child behavioral and cognitive outcomes after prenatal exposure to methamphetamine. We enrolled 412 mother-infant pairs (204 methamphetamine-exposed and 208 unexposed matched comparisons) in the Infant Development, Environment, and Lifestyle study. The 151 children exposed to methamphetamine and 147 comparisons who attended the 7.5-year visit were included. Exposure was determined by maternal self-report and/or positive meconium toxicology. Maternal interviews assessed behavioral and cognitive outcomes using the Conners' Parent Rating Scale-Revised: Short Form. After adjusting for covariates, children exposed to methamphetamine had significantly higher cognitive problems subscale scores than comparisons and were 2.8 times more likely to have cognitive problems scores that were above average on the Conners' Parent Rating Scale-Revised: Short Form. No association between prenatal methamphetamine exposure and behavioral problems, measured by the oppositional, hyperactivity, and attention-deficit/hyperactivity disorder index subscales, were found. Prenatal methamphetamine exposure was associated with increased cognitive problems, which may affect academic achievement and lead to increased negative behavioral outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. UpStart Parent Survey-Prenatal: A New Tool for Evaluating Prenatal Education Programs.

    PubMed

    Benzies, Karen M; Barker, Leslie; Churchill, Jocelyn; Smith, Jennifer; Horn, Sarah

    2016-09-01

    To evaluate a new prenatal education program evaluation tool, the UpStart Parent Survey - Prenatal, in terms of: (a) reliability and validity; (b) sensitivity to change over time; (c) whether results differed for mothers versus fathers; and (d) whether results differed when using an electronic tablet-computer versus a paper survey. Psychometric study. Participants were 277 expectant mothers (n = 161) and fathers (n = 106) enrolled in Childbirth Essentials, a 6-week prenatal education program. The UpStart Parent Survey - Prenatal is a retrospective pretest/posttest survey with three scales: Parenting Knowledge, Parenting Experience, and Program Satisfaction, and three open-ended questions. The UpStart Parent Survey - Prenatal is sensitive to change and demonstrated significant positive differences in parenting knowledge and parenting experience. There was no difference in results whether the survey was completed by mothers or fathers. Results were similar whether paper or electronic formats were used. The survey was easy to complete. The UpStart Parent Survey - Prenatal holds promise as a reliable and valid evaluation tool to capture outcomes of brief prenatal education programs that target the general population of expectant parents. © 2016 Wiley Periodicals, Inc.

  1. Acetabular Cup Revision.

    PubMed

    Kim, Young-Ho

    2017-09-01

    The use of acetabular cup revision arthroplasty is on the rise as demands for total hip arthroplasty, improved life expectancies, and the need for individual activity increase. For an acetabular cup revision to be successful, the cup should gain stable fixation within the remaining supportive bone of the acetabulum. Since the patient's remaining supportive acetabular bone stock plays an important role in the success of revision, accurate classification of the degree of acetabular bone defect is necessary. The Paprosky classification system is most commonly used when determining the location and degree of acetabular bone loss. Common treatment options include: acetabular liner exchange, high hip center, oblong cup, trabecular metal cup with augment, bipolar cup, bulk structural graft, cemented cup, uncemented cup including jumbo cup, acetabular reinforcement device (cage), trabecular metal cup cage. The optimal treatment option is dependent upon the degree of the discontinuity, the amount of available bone stock and the likelihood of achieving stable fixation upon supportive host bone. To achieve successful acetabular cup revision, accurate evaluation of bone defect preoperatively and intraoperatively, proper choice of method of acetabular revision according to the evaluation of acetabular bone deficiency, proper technique to get primary stability of implant such as precise grafting technique, and stable fixation of implant are mandatory.

  2. Prenatal Programming and Toxicity (PPTOX) Introduction.

    PubMed

    Birnbaum, Linda S; Miller, Mark F

    2015-10-01

    The developmental origin of health and disease hypothesis posits that early-life exposures, including prenatal, can influence disease outcomes throughout the entire lifespan of an organism. Over the past 30 years, scientific researchers have compiled robust epidemiological and mechanistic data showing the effects of early-life nutrition, chemical exposures, and stress on prenatal programing and toxicity. Using novel techniques in genomics and epigenetics, science is now establishing strong links between low-level early-life environmental exposures and the later development of noncommunicable diseases, such as cardiovascular disease, obesity, diabetes, neurodevelopmental and neurodegenerative disease, reproductive effects, immune system function and cancer. Now scientists must engage with communities, industry, policy makers, and clinicians to leverage our newfound understanding of prenatal programing and toxicity into better health outcomes across the lifespan.

  3. Prenatal education in the work place.

    PubMed

    Shapiro, H R

    1993-01-01

    Advances in neonatal care have improved survival rates among premature and low-birth-weight (LBW) infants, but highly technical care for these infants costs more than $2 billion a year in the United States. The incidence of premature and LBW infants can be reduced by prenatal education programs that focus on nutrition, obtaining prenatal care, avoiding dangerous substances, and recognizing preterm labor. In an effort to contain health care costs, many companies self-insure employee health benefits and offer health promotion programs designed to improve life style behaviors. This article examines providing a prenatal education program in the work place as a way of reducing the incidence and costs of prematurity and low birth weight.

  4. Prenatal pharmacogenomics: a promising area for research.

    PubMed

    Dorfman, E H; Cheng, E Y; Hebert, M F; Thummel, K E; Burke, W

    2016-08-01

    Clinical applications of prenatal genetic screening currently focus on detection of aneuploidy and other genetic diseases in the developing fetus. Growing evidence suggests that the fetal genome may also be informative about fetal exposures through contributions to placental transport as well as placental and fetal metabolism. Possible clinical applications of prenatal pharmacogenomic screening include prospective optimization of medication selection and dosage, as well as retrospective assessment of whether a fetus was previously exposed to significant risk. Newly available noninvasive methods of prenatal genetic screening mean that relevant fetal genotypes could be made available to obstetricians for use in management of a current pregnancy. This promising area for research merits more attention than it has thus far received.The Pharmacogenomics Journal advance online publication, 10 May 2016; doi:10.1038/tpj.2016.33.

  5. How prenatal care can improve maternal health.

    PubMed

    1993-01-01

    Prenatal care aims to preserve the health of the fetus and mother. It screens for indications of illness or pregnancy-related complications and tries to prevent them from becoming emergencies. Sufficient referral services are needed for prenatal screening to be effective. Women and their families must be motivated to go to them promptly. Often prenatal care is the first time women receive any medical care. Thus, quality care is imperative so women will again request medical care when necessary. Prenatal care providers must ask women about signs and symptoms of placenta previa and placental abruptio. They should also tell them about the gravity of hemorrhaging in late pregnancy. Referral facilities must have operative capabilities and be able to provide adequate transfusion to treat severe hemorrhage. Health workers must prevent and treat anemia in pregnant women to improve their chances of recovery from blood loss; they must also measure blood pressure and periodically test for proteinuria and edema to diagnose preeclampsia, eclampsia, and hypertension. Health workers must screen women at high risk for cephalopelvic disproportion (e.g. by assessing, height, foot size, and age) and for a malpositioned fetus and multiple pregnancies (e.g. via abdominal examination). They must also educate mothers about the importance of hygienic delivery and provide sanitary delivery kits. Unhygienic delivery conditions and untreated sexually transmitted diseases (STDs) can cause puerperal sepsis. STDs can also have other adverse effects such as ectopic pregnancy and blindness, death, or retardation of the fetus/ infant. STD screening could prevent needless suffering in many women; 5-15% of pregnant women in some developing countries have syphilis. Prenatal care should include screening for urinary tract infections which can cause preterm delivery and low birth weight. Antibiotics can treat these infections. Some pregnant women have infectious diseases which may undetected without

  6. Neurodevelopment of children prenatally exposed to selective reuptake inhibitor antidepressants: Toronto sibling study.

    PubMed

    Nulman, Irena; Koren, Gideon; Rovet, Joanne; Barrera, Maru; Streiner, David L; Feldman, Brian M

    2015-07-01

    The reproductive safety of selective reuptake inhibitor (SRI) antidepressants needs to be established to provide optimal control of maternal depression while protecting the fetus. To define a child's neurodevelopment following prenatal exposure to SRIs and to account for genetic and environmental confounders in a sibling design using the Toronto Motherisk prospective database. Intelligence and behavior of siblings prenatally exposed and unexposed to SRIs were assessed by using the Wechsler Preschool and Primary Scale of Intelligence-Third Edition, Child Behavior Checklist, and Conners Parent Rating Scale-Revised and subsequently compared. Mothers, diagnosed with depression using DSM-IV, were assessed for intelligence quotient (IQ) and for severity of depressive symptoms with the Center for Epidemiologic Studies Depression scale. Prenatal drug doses and durations of exposure, child's age, child's sex, birth order, severity of maternal depression symptoms, and Full Scale IQ, the primary outcome measure, of both the mother and the child were considered in the analyses. Forty-five sibling pairs (ages 3 years to 6 years 11 months, prenatally exposed and unexposed to SRIs) did not differ in their mean ± SD Full Scale IQs (103 ± 13 vs 106 ± 12; P = .30; 95% CI, -7.06 to 2.21) or rates of problematic behaviors. Significant predictor of children's intelligence was maternal IQ (P = .043, β = 0.306). Severity of maternal depression was a significant predictor of Child Behavior Checklist Internalizing (P = .019, β = 0.366), Externalizing (P = .003, β = 0.457), and Total scores (P = .001, β = 0.494). Drug doses and durations of exposure during pregnancy did not predict any outcomes of interest in the exposed siblings. SRI antidepressants were not found to be neurotoxic. Maternal depression may risk the child's future psychopathology. The sibling design in behavioral teratology aids in separating the effects of maternal depression from those of SRIs, providing stronger

  7. [References for prenatal diagnosis of morphological defects including the central nervous system].

    PubMed

    Blohmer, J U; Caemmerer, C D; Bollmann, R; Bartho, S

    1993-02-01

    Clinical and autopsy records of 209 stillborn and 81 miscarried infants with 484 congenital defects of the central nervous system were analysed. Sets of more than one defect were retrospectively classified by pathogenetic criteria as syndrome, sequence, association and midline defects. Pathogenetic thinking makes the prenatal diagnosis of further defects easier if one has already been diagnosed. Statements regarding the most probable localisation of neural tube defects have been made.

  8. Associations of prenatal growth with metabolic syndrome, insulin resistance, and nutritional status in Chilean children.

    PubMed

    Mardones, Francisco; Arnaiz, Pilar; Pacheco, Paz; Dominguez, Angelica; Villarroel, Luis; Eriksson, Johan G; Barja, Salesa; Farías, Marcelo; Castillo, Oscar

    2014-01-01

    The association of prenatal growth with nutritional status, metabolic syndrome (MS), and insulin resistance (IR) was studied in school-age children. A retrospective cohort study was designed linking present data of children with perinatal records. 3325 subjects were enrolled. Anthropometry, blood pressure (BP), and pubertal status were assessed. Blood lipids, glucose, and insulin were measured. Linear associations were assessed using the Cochran-Armitage test. Odds ratios and nonlinear associations were computed. 3290 children (52% females, mean age of 11.4 ± 1 years) were analyzed. Prevalence of obesity, stunting, MS, and IR was 16.0%, 3.6%, 7.3%, and 25.5%, respectively. The strongest positive association was between birth weight (BW) and obesity (OR 2.97 (95% CI 2.01-4.40) at BW ≥ 4,000 g compared to BW 2,500-2,999). The strongest inverse association was between birth length (BL) and stunting (OR 8.70 (95% CI 3.66-20.67) at BL < 48 cm compared to BL 52-53 cm). A U-shaped association between BL and BP ≥ 90th percentile was observed. Significant ORs were also found for MS and IR. Adjustments for present fat mass increased or maintained the most prenatal growth influences. Prenatal growth influences MS, IR, and nutritional status. Prenatal growth was more important than present body composition in determining these outcomes.

  9. Coordinated movement is influenced by prenatal light experience in bobwhite quail chicks (Colinus virginianus).

    PubMed

    Belnap, Starlie C; Lickliter, Robert

    2017-03-27

    Sensory-motor development begins early during embryogenesis and is influenced by sensory experience. Little is known about the prenatal factors that influence the development of motor coordination. Here we investigated whether and to what extent prenatal light experience can influence the development of motor coordination in bobwhite quail hatchlings. Quail embryos were incubated under four light conditions: no light (dark), 2h of total light (2HR), 6h of total light (6HR), and diffused sunlight (controls). Hatchlings were video recording walking down a runway at three developmental ages (12, 24, and 48h). Videos were assessed for forward locomotion, a measurement of motor coordination, falls, a measurement of motor instability, and motivation to complete the task. We anticipated a linear decline of coordination with a reduction in prenatal light experience and improved coordination with age. Furthermore, as motor coordination becomes more laborious we anticipated motivation to complete the task would decline. However, our findings revealed hatchlings did not uniformly improve with age as expected, nor did the reduction of light result in a linear reduction in motor coordination. Instead, we found a more complex relationship with 6HR and 2HR hatchlings showing distinct patterns of stability and instability. Similarly, we found a reduction in motivation within the 6HR light condition. It appears that prenatal light exposure influences the development of postnatal motor coordination and we discuss these finding in light of neurodevelopmental processes influenced by light experience.

  10. Maternal Prenatal Psychological Distress and Preschool Cognitive Functioning: the Protective Role of Positive Parental Engagement.

    PubMed

    Schechter, Julia C; Brennan, Patricia A; Smith, Alicia K; Stowe, Zachary N; Newport, D Jeffrey; Johnson, Katrina C

    2017-02-01

    Considerable animal research and available human studies suggest that psychological distress experienced by mothers during gestation is associated with later neurodevelopmental deficits in offspring; however, little research has examined potential protective factors that might mitigate this risk. The current study examined the impact of maternal prenatal psychological distress during pregnancy on cognitive outcomes in preschoolers (ages 2.5-5 years) and positive parenting as a potential protective factor. Mother-child dyads (N = 162, mean child age = 44 months, 49 % female) were recruited from a longitudinal cohort of women who had previously participated in a study of maternal mood disorders during pregnancy. Maternal prenatal distress was assessed with multiple measures collected throughout pregnancy. During a follow-up visit, mothers were interviewed about their psychological symptoms since the birth of the child, parenting behaviors were recorded during a parent-child interaction, and children's cognitive abilities were measured using the Differential Ability Scales, 2nd Edition. Maternal prenatal distress significantly predicted lower general cognitive abilities; however, this relationship was strongest for children whose mothers exhibited low levels of positive engagement and not significant when mothers exhibited high levels of positive engagement. Results suggest that positive parental engagement can protect against the detrimental effects of maternal prenatal distress on preschoolers' cognitive abilities.

  11. Associations of Prenatal Growth with Metabolic Syndrome, Insulin Resistance, and Nutritional Status in Chilean Children

    PubMed Central

    Mardones, Francisco; Arnaiz, Pilar; Pacheco, Paz; Dominguez, Angelica; Villarroel, Luis; Eriksson, Johan G.; Barja, Salesa; Farías, Marcelo; Castillo, Oscar

    2014-01-01

    Introduction. The association of prenatal growth with nutritional status, metabolic syndrome (MS), and insulin resistance (IR) was studied in school-age children. Methods. A retrospective cohort study was designed linking present data of children with perinatal records. 3325 subjects were enrolled. Anthropometry, blood pressure (BP), and pubertal status were assessed. Blood lipids, glucose, and insulin were measured. Linear associations were assessed using the Cochran-Armitage test. Odds ratios and nonlinear associations were computed. Results. 3290 children (52% females, mean age of 11.4 ± 1 years) were analyzed. Prevalence of obesity, stunting, MS, and IR was 16.0%, 3.6%, 7.3%, and 25.5%, respectively. The strongest positive association was between birth weight (BW) and obesity (OR 2.97 (95% CI 2.01–4.40) at BW ≥ 4,000 g compared to BW 2,500–2,999). The strongest inverse association was between birth length (BL) and stunting (OR 8.70 (95% CI 3.66–20.67) at BL < 48 cm compared to BL 52-53 cm). A U-shaped association between BL and BP ≥ 90th percentile was observed. Significant ORs were also found for MS and IR. Adjustments for present fat mass increased or maintained the most prenatal growth influences. Conclusions. Prenatal growth influences MS, IR, and nutritional status. Prenatal growth was more important than present body composition in determining these outcomes. PMID:25025054

  12. Prenatal, perinatal, and neonatal risk factors for specific language impairment: a prospective pregnancy cohort study.

    PubMed

    Whitehouse, Andrew J O; Shelton, W M R; Ing, Caleb; Newnham, John P

    2014-08-01

    Although genetic factors are known to play a causal role in specific language impairment (SLI), environmental factors may also be important. This study examined whether there are prenatal, perinatal, and neonatal factors that are associated with childhood SLI. Participants were members of the Raine Study, a prospective cohort investigation of pregnant women and their offspring. Parent report indicated that 26 children had received a clinical diagnosis of SLI. Data from antenatal and birth medical records were compared between the children with SLI and typically developing comparison children (N = 1,799). There were no statistically significant differences between the SLI and comparison groups in the individual prenatal, perinatal, and neonatal factors examined. Aggregate risk scores were calculated for each period on the basis of factors known to be associated with neurodevelopmental disorder. There were no group differences in aggregate risk scores in the prenatal and perinatal periods. However, significantly more children in the SLI group (50%) compared with the comparison group (27.6%) experienced 2 or more risk factors during the neonatal period. The vast majority of prenatal, perinatal, and neonatal complications do not play a clear causal role in childhood SLI. However, poor neonatal health may signify increased risk for SLI.

  13. Factors associated with inadequate prenatal care in Ecuadorian women.

    PubMed

    Paredes, I; Hidalgo, L; Chedraui, P; Palma, J; Eugenio, J

    2005-02-01

    Although inadequate prenatal care has been associated with adverse perinatal outcomes, reports on the factors associated with poor prenatal care in developing Latin American countries are scarce. To determine factors associated with inadequate prenatal care among women from low socioeconomic circumstances. Women delivered after a pregnancy duration of more than 20 weeks at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, Ecuador, were surveyed. The questionnaire collected sociodemographic data and reasons for having inadequate prenatal care. Adequacy of prenatal care was measured with the Kessner index and correlated to the sociodemographic data. During the study period, 1016 pregnant women were surveyed. Among them, there were adolescents (23.7%), primigravidas (30.8%), and women with a high-risk pregnancy (29.3%). According to the Kessner index, prenatal care was considered adequate or inadequate in 24.5% and 75.5% of cases, respectively. Knowledge regarding the importance of adequate prenatal care and the effects of poor prenatal care was lower among women who had received inadequate prenatal care. The women that were considered to have had adequate prenatal care had at least one visit, and they were more often cared for by a specialist than women who considered having inadequate prenatal care. The three most important reasons associated to inadequate prenatal care in this series (n=767), were economic difficulties having to care for a small child, and transportation difficulties. Logistic regression analysis determined that women with undesired pregnancies who resided in rural areas and were para 5 or higher had an increased risk of inadequate prenatal care. On the other hand, an adverse outcome to a prior pregnancy (abortion, intrauterine fetal demise, or ectopic pregnancy) decreased this risk. Marital status and educational level were confounding factors. Although prenatal care at our institution is free, adequacy was thought to be low

  14. Validation of Minimum Data of Archetyped Telehealth Clinical Report for Monitoring Prenatal Care.

    PubMed

    Santos Alves, Danielle; Times, Valéria Cesário; de Araújo Novaes, Magdala

    2015-01-01

    Studies on the validation of minimum data sets from international information standards have drawn the attention of the academic community to the identification of necessary requirements for the development of Electronic Health Records (EHRs). The primary motivation of such studies is the development of systems using archetypes. The aim of this study was to validate the minimum data set that should be used when constructing an archetyped EHR for prenatal care applications in telehealth. In order to achieve this, a data validation tool was built and used by nine expert obstetricians. The statistical analysis employed was the percentage of agreement and the content validity index. The study was conducted in three steps: 1) Literature review, 2)Instrument development, and 3) Validation of the minimum data set. Of the 179 evaluated pieces of data, 157 of them were validated to be included in the archetyped record of the first prenatal consultation, while 56 of them were allocated for the subsequent consultation record. The benefit of this research is the standardization (data validation for an archetyped system) of prenatal care, with the perspective of employing, both nationally and internationally, an archtyped telehealth system.

  15. Proposed Revisions to Method 202

    EPA Pesticide Factsheets

    EPA is proposing the following revisions to Method 202: Revisions to the procedures for determining the systematic error of the method, which is used to correct the results of the measurements made using this method; Removes some procedural options to

  16. Prenatal radiation exposure: dose calculation.

    PubMed

    Scharwächter, C; Röser, A; Schwartz, C A; Haage, P

    2015-05-01

    .• In case of radiation a suitable hygiene consultation may be necessary.• For risk assessment a three-stage concept is applied, which, depending on the radiation exposure, estimates or calculates the dose for the unborn child.• The radiologist plays a crucial role as a competent advisor and provider of reliable expert information. Citation Format: • Scharwächter C, Röser A, Schwartz CA et al. Prenatal Radiation Exposure: Dose Calculation. Fortschr Röntgenstr 2015; 187: 338 - 346.

  17. The learning curve in revision cholesteatoma surgery.

    PubMed

    Stankovic, Milan

    2013-01-01

    To review the results of revision surgery for cholesteatoma. Retrospective review of patient's records. Tertiary referral center. A retrospective study of patients operated for acquired middle ear cholesteatoma during the period 1990-2002 was performed. A total of 758 patients were divided into two groups according to surgical experience, and followed during short-term and long-term period. The cholesteatoma was divided according to location, age of patients, status of auditory ossicles, and bilaterality of disease. The patients were treated with single canal wall up or wall down, according to the propagation of disease and condition of middle ear. The indications for the reoperations were: recurrent or residual cholesteatoma, resuppuration, and AB gap more than 20 dB. Type of surgical therapy, localization of cholesteatoma, age of patients, revisions, bilaterality of disease, damage of auditory ossicles and learning curve were analyzed. The number of revision operations was reduced in the second period (from totally 24.3% to 16.4%). Closed technique gave a significantly lower rate of failure. For attic cholesteatoma, adults, bilateral disease, and ossicular damage the rate of revisions was significantly lower with surgical experience. Surgical experience was important for reduction of reoperation rate for attic and sinus cholesteatoma, adults, bilateral cholesteatoma, and when closed technique is used. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Prenatal care: associations with prenatal depressive symptoms and social support in low-income urban women.

    PubMed

    Sidebottom, Abbey C; Hellerstedt, Wendy L; Harrison, Patricia A; Jones-Webb, Rhonda J

    2017-06-03

    We examined associations of depressive symptoms and social support with late and inadequate prenatal care in a low-income urban population. The sample was prenatal care patients at five community health centers. Measures of depressive symptoms, social support, and covariates were collected at prenatal care entry. Prenatal care entry and adequacy came from birth certificates. We examined outcomes of late prenatal care and less than adequate care in multivariable models. Among 2341 study participants, 16% had elevated depressive symptoms, 70% had moderate/poor social support, 21% had no/low partner support, 37% had late prenatal care, and 29% had less than adequate prenatal care. Women with both no/low partner support and elevated depressive symptoms were at highest risk of late care (AOR 1.85, CI 1.31, 2.60, p < 0.001) compared to women with both good partner support and low depressive symptoms. Those with good partner support and elevated depressive symptoms were less likely to have late care (AOR 0.74, CI 0.54, 1.10, p = 0.051). Women with moderate/high depressive symptoms were less likely to experience less than adequate care compared to women with low symptoms (AOR 0.73, CI 0.56, 0.96, p = 0.022). Social support and partner support were negatively associated with indices of prenatal care use. Partner support was identified as protective for women with depressive symptoms with regard to late care. Study findings support public health initiatives focused on promoting models of care that address preconception and reproductive life planning. Practice-based implications include possible screening for social support and depression in preconception contexts.

  19. Prenatal diagnosis and assessment of congenital spinal anomalies: Review for prenatal counseling

    PubMed Central

    Upasani, Vidyadhar V; Ketwaroo, Pamela Deaver; Estroff, Judy A; Warf, Benjamin C; Emans, John B; Glotzbecker, Michael P

    2016-01-01

    The last two decades have seen continuous advances in prenatal ultrasonography and in utero magnetic resonance imaging. These technologies have increasingly enabled the identification of various spinal pathologies during early stages of gestation. The purpose of this paper is to review the range of fetal spine anomalies and their management, with the goal of improving the clinician’s ability to counsel expectant parents prenatally. PMID:27458551

  20. Revising Russian History.

    ERIC Educational Resources Information Center

    Wertsch, James V.

    1999-01-01

    Examines the production of new history textbooks that appeared after the breakup of the Soviet Union. Argues that the radical revisions in official history in this context are shaped by the Bakhtinian process of "hidden dialogicality." Suggests that the importance of hidden dialogicality between narrative forms must be considered. (SC)

  1. School Safety Handbook. Revised.

    ERIC Educational Resources Information Center

    Association of School Business Officials International, Reston, VA.

    The revised edition of this handbook represents a concerted effort to bring school safety to the forefront of business managers' daily and long-range planning activities. Although statistics show few fatalities on school grounds, schools appear to have a high frequency and incident rate of nonfatal injuries. According to the introduction, school…

  2. Scar revision - slideshow

    MedlinePlus

    ... anatomy URL of this page: //medlineplus.gov/ency/presentations/100098.htm Scar revision - series—Normal anatomy To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 4 Go to slide 2 ...

  3. Hospital Nurse Aide. Revised.

    ERIC Educational Resources Information Center

    Iowa Univ., Iowa City. Coll. of Education.

    This report presents results of a project to revise the current 120-hour advanced nurse aide course to include all recommended minimum competencies. A three-page description of project objectives, activities, and outcomes is followed by a list of the competencies for the 75-hour nurse aide course for long-term care and for the 120-hour advanced…

  4. Residential Wiring. Revised.

    ERIC Educational Resources Information Center

    Taylor, Mark

    This competency-based curriculum guide contains materials for conducting a course in residential wiring. A technically revised edition of the 1978 publication, the guide includes 28 units. Each instructional unit includes some or all of the following basic components: performance objectives, suggested activities for teachers and students,…

  5. School Safety Handbook. Revised.

    ERIC Educational Resources Information Center

    Association of School Business Officials International, Reston, VA.

    The revised edition of this handbook represents a concerted effort to bring school safety to the forefront of business managers' daily and long-range planning activities. Although statistics show few fatalities on school grounds, schools appear to have a high frequency and incident rate of nonfatal injuries. According to the introduction, school…

  6. The Modular Universal Tumour And Revision System (MUTARS®) in endoprosthetic revision surgery

    PubMed Central

    Gebert, Carsten; Götze, Christian; Gosheger, Georg; Hardes, Jendrik

    2010-01-01

    The aim of this study was to present the clinical and functional results of revision surgery after failed hip endoprostheses using the Modular Universal Tumour And Revision System (MUTARS®). Functional results of the hip endoprostheses were recorded by applying the Harris hip score. The extent of the presurgical radiological bone defect was measured according to the classification system of the German orthopaedic association (DGOOC). Indications for revision surgery on 45 patients (21 female, 24 male) were aseptic loosening (19 patients), infection (16 patients), or periprosthetic fracture (Vancouver classification B2, B3 and C, in nine patients). Revision surgery was performed after 8.6 years on average (min. 0.6; max. 14.25 years). Large defects of the proximal femur (80% medial or lateral diaphysis; 20% meta-diaphysis according to DGOOC classification) were adequately reconstructed. The average follow-up was 38.6 months. Complications occurred in eight patients: one luxation, two aseptic loosenings, and five reinfections were diagnosed. The Harris hip score (presurgical 30; postsurgical 78) showed significant improvement after revision surgery. Regarding the extent of the patients’ bone defects, good functional results were achieved. The comparatively low number of luxations and loosenings is due to the high modularity of the prosthesis with arbitrary antetorsion in the hip joint. However, high reinfection rates in mega-implants still constitute a problem and should be the subject of further studies. PMID:20379815

  7. The Modular Universal Tumour And Revision System (MUTARS®) in endoprosthetic revision surgery.

    PubMed

    Gebert, Carsten; Wessling, Martin; Götze, Christian; Gosheger, Georg; Hardes, Jendrik

    2010-12-01

    The aim of this study was to present the clinical and functional results of revision surgery after failed hip endoprostheses using the Modular Universal Tumour And Revision System (MUTARS®). Functional results of the hip endoprostheses were recorded by applying the Harris hip score. The extent of the presurgical radiological bone defect was measured according to the classification system of the German orthopaedic association (DGOOC). Indications for revision surgery on 45 patients (21 female, 24 male) were aseptic loosening (19 patients), infection (16 patients), or periprosthetic fracture (Vancouver classification B2, B3 and C, in nine patients). Revision surgery was performed after 8.6 years on average (min. 0.6; max. 14.25 years). Large defects of the proximal femur (80% medial or lateral diaphysis; 20% meta-diaphysis according to DGOOC classification) were adequately reconstructed. The average follow-up was 38.6 months. Complications occurred in eight patients: one luxation, two aseptic loosenings, and five reinfections were diagnosed. The Harris hip score (presurgical 30; postsurgical 78) showed significant improvement after revision surgery. Regarding the extent of the patients' bone defects, good functional results were achieved. The comparatively low number of luxations and loosenings is due to the high modularity of the prosthesis with arbitrary antetorsion in the hip joint. However, high reinfection rates in mega-implants still constitute a problem and should be the subject of further studies.

  8. Prenatal diagnosis and prenatal imaging features of fetal monosomy 1p36.

    PubMed

    Lissauer, D; Larkins, S A; Sharif, S; MacPherson, L; Rhodes, C; Kilby, M D

    2007-09-01

    Deletion of the distal end of the short arm of chromosome 1 (1p36) is thought to be a common terminal chromosomal deletion. However, few cases prospectively diagnosed prenatally have been reported. In this case, prenatal ultrasound at 21 weeks of gestation noted the fetus to have mild ventriculomegaly (Vhanterior = 11 mm and Vhposterior = 12 mm) and increased nuchal edema (6 mm). Maternal serum alpha-fetoprotein was normal unlike in a majority of previously described cases. The prenatal ultrasound features were further clarified with fetal MRI. Chromosome analysis following amniocentesis demonstrated a 1p36 deletion, which was confirmed by fluorescence in situ hybridization (FISH). The syndrome associated with 1p36 deletion is well described in infants and is characterized by typical facial features (prominent forehead, straight eyebrows. deep-set eyes, flat nasal bridge and a pointed chin). Other associated features are neurodevelopmental delay, seizures, cardiomyopathy and neurosensory hearing impairment. This case supplements our knowledge of the prenatal features of 1p36. Identification of this deletion by direct chromosomal analysis can be technically difficult and vigilance is required to improve diagnosis. FISH analysis is an important diagnostic adjunct where the diagnosis is suspected following classical G-banding techniques. However, in this chromosomal anomaly there remain few characteristic prenatal signs that are readily diagnosed with prenatal imaging.

  9. Progression of care among women who use a midwife for prenatal care: Who remains in midwife care?

    PubMed

    Weisband, Yiska Loewenberg; Gallo, Maria F; Klebanoff, Mark A; Shoben, Abigail B; Norris, Alison H

    2017-09-09

    Prenatal care provided by midwives provides a safe and cost-effective alternative to care provided by physicians. However, no studies have evaluated the frequency of women who leave midwifery care, in a hospital setting. Our study objectives were to measure the frequency of transfers of care to physicians, to describe the sociodemographic and pregnancy-related characteristics of women who transferred to the care of a physician during prenatal care and at delivery, and to assess correlates of these transfers. We used electronic medical records to perform a retrospective cohort study of women who delivered at The Ohio State University Wexner Medical Center (OSUWMC) and had at least one prenatal care visit within OSUWMC's network. We report descriptive findings, using proportions and means with standard deviations. We used logistic regression, with Firth's bias correction as necessary, to assess correlates of transferring to a physician during prenatal care and at delivery. Most women who initiated prenatal care with a midwife remained in midwifery care throughout delivery, with 4.7% transferring to a physician during prenatal care, and an additional 21.4% transferring to a physician during delivery. After adjusting for pregnancy-related factors, the black race was statistically significantly associated with leaving midwifery care during prenatal care (adjusted odds ratio AOR 3.0 [95% CI 1.4-6.6]) and delivery (AOR 2.5 [95% CI 1.5-4.3]). Findings indicate that most women remain in midwifery care throughout pregnancy, but raise important questions with respect to the possible role that race has in pregnancy care. © 2017 Wiley Periodicals, Inc.

  10. Noninvasive Prenatal Molecular Karyotyping from Maternal Plasma

    PubMed Central

    Yu, Stephanie C. Y.; Jiang, Peiyong; Choy, Kwong W.; Chan, Kwan Chee Allen; Won, Hye-Sung; Leung, Wing C.; Lau, Elizabeth T.; Tang, Mary H. Y.; Leung, Tak Y.; Lo, Yuk Ming Dennis; Chiu, Rossa W. K.

    2013-01-01

    Fetal DNA is present in the plasma of pregnant women. Massively parallel sequencing of maternal plasma DNA has been used to detect fetal trisomies 21, 18, 13 and selected sex chromosomal aneuploidies noninvasively. Case reports describing the detection of fetal microdeletions from maternal plasma using massively parallel sequencing have been reported. However, these previous reports were either polymorphism-dependent or used statistical analyses which were confined to one or a small number of selected parts of the genome. In this report, we reported a procedure for performing noninvasive prenatal karyotyping at 3 Mb resolution across the whole genome through the massively parallel sequencing of maternal plasma DNA. This method has been used to analyze the plasma obtained from 6 cases. In three cases, fetal microdeletions have been detected successfully from maternal plasma. In two cases, fetal microduplications have been detected successfully from maternal plasma. In the remaining case, the plasma DNA sequencing result was consistent with the pregnant mother being a carrier of a microduplication. Simulation analyses were performed for determining the number of plasma DNA molecules that would need to be sequenced and aligned for enhancing the diagnostic resolution of noninvasive prenatal karyotyping to 2 Mb and 1 Mb. In conclusion, noninvasive prenatal molecular karyotyping from maternal plasma by massively parallel sequencing is feasible and would enhance the diagnostic spectrum of noninvasive prenatal testing. PMID:23613765

  11. Noninvasive prenatal molecular karyotyping from maternal plasma.

    PubMed

    Yu, Stephanie C Y; Jiang, Peiyong; Choy, Kwong W; Chan, Kwan Chee Allen; Won, Hye-Sung; Leung, Wing C; Lau, Elizabeth T; Tang, Mary H Y; Leung, Tak Y; Lo, Yuk Ming Dennis; Chiu, Rossa W K

    2013-01-01

    Fetal DNA is present in the plasma of pregnant women. Massively parallel sequencing of maternal plasma DNA has been used to detect fetal trisomies 21, 18, 13 and selected sex chromosomal aneuploidies noninvasively. Case reports describing the detection of fetal microdeletions from maternal plasma using massively parallel sequencing have been reported. However, these previous reports were either polymorphism-dependent or used statistical analyses which were confined to one or a small number of selected parts of the genome. In this report, we reported a procedure for performing noninvasive prenatal karyotyping at 3 Mb resolution across the whole genome through the massively parallel sequencing of maternal plasma DNA. This method has been used to analyze the plasma obtained from 6 cases. In three cases, fetal microdeletions have been detected successfully from maternal plasma. In two cases, fetal microduplications have been detected successfully from maternal plasma. In the remaining case, the plasma DNA sequencing result was consistent with the pregnant mother being a carrier of a microduplication. Simulation analyses were performed for determining the number of plasma DNA molecules that would need to be sequenced and aligned for enhancing the diagnostic resolution of noninvasive prenatal karyotyping to 2 Mb and 1 Mb. In conclusion, noninvasive prenatal molecular karyotyping from maternal plasma by massively parallel sequencing is feasible and would enhance the diagnostic spectrum of noninvasive prenatal testing.

  12. Prenatal care in your second trimester

    MedlinePlus

    ... MedlinePlus GO GO About MedlinePlus Site Map FAQs Customer Support Health Topics Drugs & Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Prenatal care in your second trimester URL of this page: // ...

  13. Prenatal Diagnosis and Evaluation of Abnormal Placentation.

    PubMed

    Fox, Karin A; Lee, Wesley

    2017-09-01

    Abnormalities in placental location or adherence can have important consequences on pregnancy outcome for both mother and fetus. Accurate antenatal detection is crucial for delivery timing and planning to help reduce perinatal risks for adverse events. We review the relevant literature and present a practical approach for the prenatal detection of abnormal placentation.

  14. An interesting prenatal diagnosis: double aneuploidy.

    PubMed

    Aydin, Cetin; Eris, Serenat; Yalcin, Yakup; Sen Selim, Halime

    2013-01-01

    Double aneuploidy, the existence of two chromosomal abnormalities in the same individual, is a rare condition. Early diagnosis of this condition is important to offer termination of pregnancy in genetic counselling. Cytogenetic analysis with amniocentesis and ultrasound examination is valuable for diagnosis of double aneuploidy. In this report we present a case with the karyotype of 48XXY+21 diagnosed prenatally.

  15. Psychiatric Conditions Associated with Prenatal Alcohol Exposure

    ERIC Educational Resources Information Center

    O'Connor, Mary J.; Paley, Blair

    2009-01-01

    Since the identification of fetal alcohol syndrome (FAS) over 35 years ago, mounting evidence about the impact of maternal alcohol consumption during pregnancy has prompted increased attention to the link between prenatal alcohol exposure (PAE) and a constellation of developmental disabilities that are characterized by physical, cognitive, and…

  16. Ethical Considerations in Prenatal Sex Selection

    ERIC Educational Resources Information Center

    Hollingsworth, Leslie Doty

    2005-01-01

    Developments in assisted reproductive technologies have made it possible for couples to select the sex of a child prenatally. This article used the NASW Code of Ethics and information from the Ethics Committee of the American Society of Reproductive Medicine to consider ethical dilemmas related to social justice (for example, reinforcement of…

  17. Prenatal Cocaine Exposure and Infant Cortisol Reactivity

    ERIC Educational Resources Information Center

    Eiden, Rina D.; Veira, Yvette; Granger, Douglas A.

    2009-01-01

    This study examined the effects of prenatal cocaine exposure on infant hypothalamic-pituitary-adrenal axis activity and reactivity at 7 months of infant age. Participants were 168 caregiver-infant dyads (87 cocaine exposed, 81 not cocaine exposed; 47% boys). Maternal behavior, caregiving instability, and infant growth and behavior were assessed,…

  18. Prenatal diagnosis of Chinese families with phenylketonuria.

    PubMed

    Liu, N; Kong, X D; Zhao, D H; Wu, Q H; Li, X L; Guo, H F; Cui, L X; Jiang, M; Shi, H R

    2015-11-19

    The aim of this study is to investigate the ability to prenatally diagnose phenylketonuria (PKU) by using phenylalanine hydroxylase (PAH) gene mutation analysis combined with short tandem repeat (STR) linkage analysis in 118 fetuses from 112 Chinese families. Genomic DNA was extracted from the peripheral blood from members of 112 families and the exons and exon-intron boundaries of the PAH gene were amplified by PCR. PCR products were analyzed by bi-directional Sanger sequencing and multiplex ligation-dependent probe amplification (MLPA). The three variable number of tandem repeat (VNTR) markers PAH-1, PAH-26, PAH-32 were used in the prenatal diagnosis for the PKU families. We identified a spectrum of 63 different mutations, including 61 point mutations and indels, two large exon deletion mutations, and five novel mutations. A substantial proportion of mutant alleles were accounted for by p.R243Q (15.62%), EX6-96AG (9.82%), p.V399V (7.59%), p.Y356X (6.70%), and p.R413P (5.36%). The same mutations were identified in 31 prenatally genotyped fetuses. We identified 58 fetuses that carried only one mutant allele and 29 fetuses that carried no mutations of PAH and were presumed normal. PAH gene mutation analysis combined with STR linkage analysis can provide rapid and accurate prenatal diagnosis for PKU families.

  19. Ethical Considerations in Prenatal Sex Selection

    ERIC Educational Resources Information Center

    Hollingsworth, Leslie Doty

    2005-01-01

    Developments in assisted reproductive technologies have made it possible for couples to select the sex of a child prenatally. This article used the NASW Code of Ethics and information from the Ethics Committee of the American Society of Reproductive Medicine to consider ethical dilemmas related to social justice (for example, reinforcement of…

  20. Prenatal Cocaine Exposure and Infant Cortisol Reactivity

    ERIC Educational Resources Information Center

    Eiden, Rina D.; Veira, Yvette; Granger, Douglas A.

    2009-01-01

    This study examined the effects of prenatal cocaine exposure on infant hypothalamic-pituitary-adrenal axis activity and reactivity at 7 months of infant age. Participants were 168 caregiver-infant dyads (87 cocaine exposed, 81 not cocaine exposed; 47% boys). Maternal behavior, caregiving instability, and infant growth and behavior were assessed,…

  1. Psychiatric Conditions Associated with Prenatal Alcohol Exposure

    ERIC Educational Resources Information Center

    O'Connor, Mary J.; Paley, Blair

    2009-01-01

    Since the identification of fetal alcohol syndrome (FAS) over 35 years ago, mounting evidence about the impact of maternal alcohol consumption during pregnancy has prompted increased attention to the link between prenatal alcohol exposure (PAE) and a constellation of developmental disabilities that are characterized by physical, cognitive, and…

  2. OEIS complex: prenatal ultrasound and autopsy findings.

    PubMed

    Ben-Neriah, Z; Withers, S; Thomas, M; Toi, A; Chong, K; Pai, A; Velscher, L; Vero, S; Keating, S; Taylor, G; Chitayat, D

    2007-02-01

    To describe prenatal ultrasound and autopsy findings in fetuses with OEIS (omphalocele, bladder exstrophy, imperforate anus, spina bifida) complex. This was a retrospective study of the nine cases with OEIS complex diagnosed at our center using detailed fetal ultrasound during the last 10 years. We summarized the fetal ultrasound findings that led to the diagnosis and compared them with the autopsy results. All affected fetuses were diagnosed using detailed fetal ultrasound after 16 weeks' gestation. The main prenatal findings were omphalocele, skin-covered lumbosacral neural tube defect, non-visualized bladder and limb defects. Prenatal sonography failed to detect the abnormal genitalia, bladder exstrophy and anal atresia. All cases had abnormalities in a 'diaper distribution', which helped in making the prenatal diagnosis. Eight of the nine couples chose to terminate the pregnancies following multidisciplinary counseling. The pregnancy that was continued was a case with dizygotic twins discordant for OEIS, and the affected fetus died in utero. The combination of the following ultrasound findings: ventral wall defect, spinal defect and a non-visualized bladder with or without limb defects, are characteristic of OEIS complex. Diagnosis can be made with confidence as early as 16 weeks' gestation, although earlier diagnosis may be possible. Copyright 2007 ISUOG. Published by John Wiley & Sons, Ltd.

  3. Hispanic subgroup differences in prenatal care.

    PubMed

    Albrecht, S L; Miller, M K

    1996-01-01

    Within SES categories in the United States, racial and ethnic minorities generally fare less well on a variety of health-related indicators than do majority groups. Important differences exist within subgroups, however, and at present, these differences are poorly understood. In this paper we address Hispanic subgroup (Cuban American, Mexican American. Puerto Rican, and Central/South American) differences in utilization of prenatal care. Data from the 1986 and 1987 national Linked Birth/Infant Death files are used to assess patterns of prenatal care utilization across subgroups. Using Kotelchuck's Adequacy of Prenatal Care Utilization Index, we find that when controlling for other factors, Cuban American and Puerto Rican women are more likely to obtain adequate care than are Hispanic women of Mexican or Central/South American origin. Other factors important in understanding utilization patterns include marital status, education level, birthplace, and region of the country. We conclude with a discussion of the relatively weak link between prenatal care and birth outcomes and identify important cultural factors that may be important in understanding why this relationship is not stronger.

  4. 78 FR 17778 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-22

    ... ``Patient Medical Record--VA'' (24VA19) as set forth in the Federal Register at 74 FR 60040. That notice... of records entitled ``Patient Medical Records-- VA'' (24VA19), which revised the System Number (the... AFFAIRS Privacy Act of 1974; System of Records AGENCY: Department of Veterans Affairs. ACTION: Notice...

  5. Improved standards for prenatal diagnosis of citrullinemia.

    PubMed

    Miller, Marcus J; Soler-Alfonso, Claudia R; Grund, Jaime E; Fang, Ping; Sun, Qin; Elsea, Sarah H; Sutton, V Reid

    2014-07-01

    Citrullinemia type I is a urea cycle disorder caused by autosomal recessive mutations in argininosuccinate synthetase 1 (ASS1). In the classical form of this disease, symptoms manifest during the neonatal period as progressive lethargy, poor feeding, and central nervous system depression secondary to hyperammonemia. In pregnancies involving two carrier parents, prenatal diagnosis is important for both reproductive decisions and advanced preparation for neonatal care. The current gold standard for prenatal diagnosis has been the citrulline incorporation assay in addition to DNA mutation analysis. Herein, we review our experience with prenatal diagnosis of citrullinemia type I over the span of 11 years in 41 at-risk pregnancies. During this time, we identified 15 affected fetuses using a combination of molecular and biochemical testing. Given the established limitations of both the citrulline incorporation assay as well DNA mutation analysis, we probed our data to assess the value of amniotic fluid amino acid levels in prenatal diagnosis. Previous publications have proposed using the amniotic fluid ratio of citrulline/(arginine+ornithine) in prenatal diagnosis; however, we noted that amniotic fluid arginine levels were normal in our cohort and hypothesized that the amniotic fluid citrulline/ornithine ratio may be superior. Indeed, our analyses revealed that the ratio of amniotic fluid citrulline/ornithine alone correctly distinguished affected from unaffected fetuses in all cases. During the establishment of a normal reference range we discovered significant elevations in amniotic fluid citrulline levels in at-risk pregnancies compared to the normal population even when the fetus was unaffected. This highlights the importance of using amniotic fluid from carrier mothers when setting up a normal reference range. Finally, we report our experience as one of the first centers to adopt Sanger sequencing for prospective prenatal diagnosis of citrullinemia. While this is

  6. Streamlined Approach for Environmental Restoration (SAFER) Plan for Corrective Action Unit 357: Mud Pits and Waste Dump, Nevada Test Site, Nevada: Revision 0, Including Record of Technical Change No. 1

    SciTech Connect

    2003-06-25

    This Streamlined Approach for Environmental Restoration (SAFER) plan was prepared as a characterization and closure report for Corrective Action Unit (CAU) 357, Mud Pits and Waste Dump, in accordance with the Federal Facility Agreement and Consent Order. The CAU consists of 14 Corrective Action Sites (CASs) located in Areas 1, 4, 7, 8, 10, and 25 of the Nevada Test Site (NTS). All of the CASs are found within Yucca Flat except CAS 25-15-01 (Waste Dump). Corrective Action Site 25-15-01 is found in Area 25 in Jackass Flat. Of the 14 CASs in CAU 357, 11 are mud pits, suspected mud pits, or mud processing-related sites, which are by-products of drilling activities in support of the underground nuclear weapons testing done on the NTS. Of the remaining CASs, one CAS is a waste dump, one CAS contains scattered lead bricks, and one CAS has a building associated with Project 31.2. All 14 of the CASs are inactive and abandoned. Clean closure with no further action of CAU 357 will be completed if no contaminants are detected above preliminary action levels. A closure report will be prepared and submitted to the Nevada Division of Environmental Protection for review and approval upon completion of the field activities. Record of Technical Change No. 1 is dated 3/2004.

  7. Using Prenatal Advocates to Implement a Psychosocial Education Intervention for Posttraumatic Stress Disorder during Pregnancy: Feasibility, Care Engagement, and Predelivery Behavioral Outcomes.

    PubMed

    Upshur, Carole C; Wenz-Gross, Melodie; Weinreb, Linda; Moffitt, Jennifer Jo Averill

    2016-01-01

    Pregnant women with posttraumatic stress disorder (PTSD) engage in more high-risk behavior and use less prenatal care. Although treating depression in pregnancy is becoming widespread, options for addressing PTSD are few. This study was designed to test the feasibility of implementing a manualized psychosocial PTSD intervention, Seeking Safety, delivered by prenatal advocates. All women entering prenatal care at two federally qualified health centers were screened for current symptoms of PTSD. One site was selected randomly to have prenatal care advocates deliver eight Seeking Safety topics for women that indicated clinical or subclinical PTSD symptoms. Baseline and pre-delivery interviews were conducted, which collected background characteristics and assessed PTSD severity and coping skills. Medical records were collected to document care visits. Documentation of participation rates, fidelity to the treatment, and qualitative feedback from advocates and participants was collected. More than one-half (57.3%) of the intervention women received all Seeking Safety sessions and fidelity ratings of the session showed acceptable quality. Using an intent-to-treat analysis, intervention women participated in significantly more prenatal care visits (M = 11.7 versus 8.9; p < .001), and had a significantly higher rate of achieving adequate prenatal care (72.4% vs. 42.9%; p < .001). Although not significant when accounting for baseline differences, intervention women also reduced negative coping skills but not PTSD symptoms. Using prenatal care advocates to deliver Seeking Safety sessions to women screening positive for PTSD symptoms at entry to prenatal care is a promising intervention that seems to increase prenatal care participation and may reduce negative coping strategies. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  8. Comprehensive Operative Note Templates for Primary and Revision Total Hip and Knee Arthroplasty

    PubMed Central

    Electricwala, Ali J.; Amanatullah, Derek F.; Narkbunnam, Rapeepat I.; Huddleston, James I.; Maloney, William J.; Goodman, Stuart B.

    2016-01-01

    Background: Adequate preoperative planning is the first and most crucial step in the successful completion of a revision total joint arthroplasty. The purpose of this study was to evaluate the availability, adequacy and accuracy of operative notes of primary surgeries in patients requiring subsequent revision and to construct comprehensive templates of minimum necessary information required in the operative notes to further simplify re-operations, if they should become necessary. Methods: The operative notes of 144 patients (80 revision THA’s and 64 revision TKA’s) who underwent revision total joint arthroplasty at Stanford Hospital and Clinics in the year 2013 were reviewed. We assessed the availability of operative notes and implant stickers prior to revision total joint arthroplasty. The availability of implant details within the operative notes was assessed against the available surgical stickers for adequacy and accuracy. Statistical comparisons were made using the Fischer-exact test and a P-value of less than 0.05 was considered statistically significant. Results: The primary operative note was available in 68 of 144 revisions (47%), 39 of 80 revision THAs (49%) and 29 of 66 revision TKAs (44%, p = 0.619). Primary implant stickers were available in 46 of 144 revisions (32%), 26 of 80 revision THAs (32%) and 20 of 66 revision TKAs (30%, p = 0.859). Utilizing the operative notes and implant stickers combined identified accurate primary implant details in only 40 of the 80 revision THAs (50%) and 34 of all 66 revision TKAs (52%, p = 0.870). Conclusion: Operative notes are often unavailable or fail to provide the necessary information required which makes planning and execution of revision hip and knee athroplasty difficult. This emphasizes the need for enhancing the quality of operative notes and records of patient information. Based on this information, we provide comprehensive operative note templates for primary and revision total hip and knee

  9. [New molecular methods in prenatal invasive diagnostics].

    PubMed

    Łaczmańska, Izabela; Stembalska, Agnieszka

    2013-10-01

    New diagnostic techniques employed in laboratories all over the world enable to create new tests for prenatal genetic diagnosis. They include cytogenetics, molecular-cytogenetics and molecular methods. Chromosomal numerical aberrations (aneuploidies) remain to be the most frequent genetic changes diagnosed prenatally Therefore, our paper presents the latest methods used mainly in prenatal diagnosis of the most common chromosome numerical changes, as well as other methods applicable in detecting chromosome structural changes or gene mutations. One of the main advantages of these new approaches is the short period of time needed to obtain a result. Some of these techniques are used world-wide: QF-PCR (Fluorescence Quantitive Polymerase Chain Reaction)--based on the analysis of the short polymorphic sequences characteristic for each individual; MLPA (Multiplex Ligation-dependent Probe Amplification)--based on the probes ligation to complementary genomic fragments in patient DNA; microarray CGH (Comparative Genomic Hybridization)--based on genomic hybridization to microarray, which enables analysis of the entire genome. Other new methods are also gradually introduced to invasive prenatal diagnosis: NGS (Next-generation DNA sequencing)--for the analysis of the whole genome at the DNA level; BoBs (BACS-on-Beads)--molecular-cytogenetic technique based on hybridization of probes immobilized on polystyrene microspheres with fetal DNA. Nowadays, rapid diagnosis of the most common chromosomal aneuploidies is not a standard procedure in Poland, as opposed to cytogenetics (karyotyping). However, for specific clinical indications, fast and reliable methods of genetic analysis present are likely to become standard procedures in prenatal diagnosis.

  10. Magnetic Recording.

    ERIC Educational Resources Information Center

    Lowman, Charles E.

    A guide to the technology of magnetic recorders used in such fields as audio recording, broadcast and closed-circuit television, instrumentation recording, and computer data systems is presented. Included are discussions of applications, advantages, and limitations of magnetic recording, its basic principles and theory of operation, and its…

  11. Clinical utility of fetal autopsy and comparison with prenatal ultrasound findings.

    PubMed

    Sankar, V H; Phadke, S R

    2006-04-01

    To present a comprehensive analysis of autopsy findings in 206 fetuses referred to our genetic center and to assess the clinical utility of fetal autopsy in reaching a final diagnosis, which is essential for counseling regarding the risk of recurrence. We also compared the autopsy findings with prenatal ultrasound findings to evaluate the potential benefit of fetal autopsy in fetuses terminated after prenatal diagnosis of malformations. Retrospective review of patient records in a tertiary referral genetic center in North India during 5-year period (April 2000-March 2005). This includes 206 fetuses, 138 terminated after detecting an anomaly in ultrasonogram and 68 spontaneous fetal losses. In all cases, fetal autopsy was carried out and complimented by radiography, karyotype wherever possible and histopathological examination wherever necessary. In fetuses with prenatally diagnosed malformations, ultrasound findings were compared with autopsy findings. Fetal autopsy was able to provide a definite final diagnosis in 59% (122/206) cases. Fetal autopsy confirmed the ultrasound findings in all cases but two. Moreover, autopsy provided additional findings in 77 cases and of these, 24 cases had a significant change of recurrence risk. This study confirms the utility of fetal autopsy in identifying the cause of fetal loss, which will help in the genetic counseling of the couple. In cases with prenatally diagnosed anomalies, the new information from fetal autopsy changes the predicted probability of recurrence in 18% cases. Even though the prenatal ultrasonogram reasonably predicts the malformations, fetal autopsy gives significant additional malformations in one-third of the cases and is essential for genetic counseling.

  12. Associations of prenatal and childhood antibiotic use with child body mass index at age 3 years.

    PubMed

    Poulsen, Melissa N; Pollak, Jonathan; Bailey-Davis, Lisa; Hirsch, Annemarie G; Glass, Thomas A; Schwartz, Brian S

    2017-02-01

    Early-life antibiotic exposure, whether through prenatal or childhood antibiotic use, may contribute to increased child body mass. Associations of prenatal and childhood antibiotic use with body mass index z-score (BMIz) were evaluated at age 3 years. Electronic health records were utilized from 8,793 mothers and singleton children delivered at Geisinger Clinic in Pennsylvania between 2006 and 2012. Antibiotic orders were ascertained for mothers during pregnancy and for children through their age-3 BMI measurement. Linear mixed-effects regression models evaluated associations of prenatal and childhood antibiotic use with child BMIz. Prenatal antibiotic orders were not associated with child BMIz. Children in the three largest categories of lifetime antibiotic orders had higher BMIz compared with children with no orders; associations persisted when controlling for prenatal antibiotics (β [95% confidence interval]) (4-5 child orders: 0.090 [0.011 to 0.170]; 6 to 8: 0.113 [0.029 to 0.197]; ≥9: 0.175 [0.088 to 0.263]; trend P value <0.001). Two or more first-year orders were also associated with BMIz (1: 0.021 [-0.038 to 0.081]; 2: 0.088 [0.017 to 0.160]; ≥3: 0.104 [0.038 to 0.170]; trend P value < 0.001). Associations of early-life and lifetime childhood antibiotic use with increased child BMI highlight antibiotic exposure as a modifiable factor for reducing population-level excess weight. © 2017 The Obesity Society.

  13. Prenatal reporting to child protection: Characteristics and service responses in one Australian jurisdiction.

    PubMed

    Taplin, Stephanie

    2017-03-01

    Prenatal reporting to child protection services has been enacted into most jurisdictions across Australia and in other countries, its aims being to intervene early and provide supports which will either identify or prevent the need for a baby to be taken into care and protection once born. Despite indications that there are increasing numbers of prenatal reports, little is known about the characteristics of those reported, the timing and reasons for reports, service responses, and the impacts of being reported. This study is one of the first to use administrative data to examine the characteristics of two samples from one Australian jurisdiction: (i) data from casefiles of 38 cases reported in 2012-13, and (ii) administrative data from 117 cases reported prenatally in 2013. These data showed that women who were reported to child protection services in relation to their pregnancy were predominantly disadvantaged, and were likely to be reported relatively late in their pregnancy due to 'future risk concerns'. Approximately two-thirds of those reported were provided with some prenatal support, as recorded by the child protection system, generally of limited duration. Twelve percent of the babies born to the larger cohort of women were removed within 100days of their birth. It is likely that longer term supportive interventions are needed, to reduce the risk factors evident in women reported during pregnancy, and to improve their ability to safely care for their children. Information on the short and long-term impacts from rigorous evaluations and longer-term intervention trials are also vital to ensure that prenatal reporting and interventions are, in fact, improving outcomes for infants and families.

  14. Non-invasive prenatal testing for aneuploidy and beyond: challenges of responsible innovation in prenatal screening.

    PubMed

    Dondorp, Wybo; de Wert, Guido; Bombard, Yvonne; Bianchi, Diana W; Bergmann, Carsten; Borry, Pascal; Chitty, Lyn S; Fellmann, Florence; Forzano, Francesca; Hall, Alison; Henneman, Lidewij; Howard, Heidi C; Lucassen, Anneke; Ormond, Kelly; Peterlin, Borut; Radojkovic, Dragica; Rogowski, Wolf; Soller, Maria; Tibben, Aad; Tranebjærg, Lisbeth; van El, Carla G; Cornel, Martina C

    2015-11-01

    This paper contains a joint ESHG/ASHG position document with recommendations regarding responsible innovation in prenatal screening with non-invasive prenatal testing (NIPT). By virtue of its greater accuracy and safety with respect to prenatal screening for common autosomal aneuploidies, NIPT has the potential of helping the practice better achieve its aim of facilitating autonomous reproductive choices, provided that balanced pretest information and non-directive counseling are available as part of the screening offer. Depending on the health-care setting, different scenarios for NIPT-based screening for common autosomal aneuploidies are possible. The trade-offs involved in these scenarios should be assessed in light of the aim of screening, the balance of benefits and burdens for pregnant women and their partners and considerations of cost-effectiveness and justice. With improving screening technologies and decreasing costs of sequencing and analysis, it will become possible in the near future to significantly expand the scope of prenatal screening beyond common autosomal aneuploidies. Commercial providers have already begun expanding their tests to include sex-chromosomal abnormalities and microdeletions. However, multiple false positives may undermine the main achievement of NIPT in the context of prenatal screening: the significant reduction of the invasive testing rate. This document argues for a cautious expansion of the scope of prenatal screening to serious congenital and childhood disorders, only following sound validation studies and a comprehensive evaluation of all relevant aspects. A further core message of this document is that in countries where prenatal screening is offered as a public health programme, governments and public health authorities should adopt an active role to ensure the responsible innovation of prenatal screening on the basis of ethical principles. Crucial elements are the quality of the screening process as a whole (including non

  15. Non-invasive prenatal testing for aneuploidy and beyond: challenges of responsible innovation in prenatal screening

    PubMed Central

    Dondorp, Wybo; de Wert, Guido; Bombard, Yvonne; Bianchi, Diana W; Bergmann, Carsten; Borry, Pascal; Chitty, Lyn S; Fellmann, Florence; Forzano, Francesca; Hall, Alison; Henneman, Lidewij; Howard, Heidi C; Lucassen, Anneke; Ormond, Kelly; Peterlin, Borut; Radojkovic, Dragica; Rogowski, Wolf; Soller, Maria; Tibben, Aad; Tranebjærg, Lisbeth; van El, Carla G; Cornel, Martina C

    2015-01-01

    This paper contains a joint ESHG/ASHG position document with recommendations regarding responsible innovation in prenatal screening with non-invasive prenatal testing (NIPT). By virtue of its greater accuracy and safety with respect to prenatal screening for common autosomal aneuploidies, NIPT has the potential of helping the practice better achieve its aim of facilitating autonomous reproductive choices, provided that balanced pretest information and non-directive counseling are available as part of the screening offer. Depending on the health-care setting, different scenarios for NIPT-based screening for common autosomal aneuploidies are possible. The trade-offs involved in these scenarios should be assessed in light of the aim of screening, the balance of benefits and burdens for pregnant women and their partners and considerations of cost-effectiveness and justice. With improving screening technologies and decreasing costs of sequencing and analysis, it will become possible in the near future to significantly expand the scope of prenatal screening beyond common autosomal aneuploidies. Commercial providers have already begun expanding their tests to include sex-chromosomal abnormalities and microdeletions. However, multiple false positives may undermine the main achievement of NIPT in the context of prenatal screening: the significant reduction of the invasive testing rate. This document argues for a cautious expansion of the scope of prenatal screening to serious congenital and childhood disorders, only following sound validation studies and a comprehensive evaluation of all relevant aspects. A further core message of this document is that in countries where prenatal screening is offered as a public health programme, governments and public health authorities should adopt an active role to ensure the responsible innovation of prenatal screening on the basis of ethical principles. Crucial elements are the quality of the screening process as a whole (including non

  16. Project Ice Storm: prenatal maternal stress affects cognitive and linguistic functioning in 5 1/2-year-old children.

    PubMed

    Laplante, David P; Brunet, Alain; Schmitz, Norbert; Ciampi, Antonio; King, Suzanne

    2008-09-01

    This was a prospective study designed to determine the extent to which the degree of exposure to prenatal maternal stress due to a natural disaster explains variance in the intellectual and language performance of offspring at age 5(1/2) while controlling for several potential confounding variables. Subjects were eighty-nine 5(1/2)-year-old children whose mothers were pregnant during a natural disaster: the January 1998 ice storm crisis in the Canadian province of Québec that resulted in power losses for 3 million people for as long as 40 days. In June 1998, women completed several questionnaires including those about the extent of objective stress (Storm 32) and subjective distress (Impact of Events Scale-Revised) experienced due to the storm. Their children were assessed with the Wechsler Preschool and Primary Scale of Intelligence-Revised (IQ) and Peabody Picture Vocabulary Test-Revised (language) at 5(1/2) years of age, and mothers completed assessments of recent life events and psychological functioning. Children exposed in utero to high levels of objective stress had lower Full Scale IQs, Verbal IQs, and language abilities compared to children exposed to low or moderate levels of objective prenatal maternal stress; there were no effects of subjective stress or objective stress on Performance IQs. Trend analyses show that for all outcome variables except Block Design, there was a significant curvilinear association between objective stress and functioning. Prenatal exposure to a moderately severe natural disaster is associated with lower cognitive and language abilities at 5(1/2) years of age.

  17. Postnatal development of rat pups is altered by prenatal methamphetamine exposure.

    PubMed

    Slamberová, Romana; Pometlová, Marie; Charousová, Petra

    2006-01-01

    There are studies showing that drug abuse during pregnancy may have impairing effect on progeny of drug-abusing mothers. Methamphetamine (MA) is one of the most common illicit drugs throughout the world. The purpose of the present study was to assess the effect of prenatal MA exposure on postnatal development of rat pups before the time of separation from their mothers. Female rats were injected with MA (5 mg/kg daily) for the duration of their pregnancy. Pups were then tested throughout the lactation period. They were weighed daily and the ano-genital distance was measured on postnatal day (PD) 1. Development of postural motor reaction was tested by righting reflex on surface between PD 1 and 12, and righting reflex in mid-air after PD 12 until successfully accomplished. On PD 15 homing test was examined as a test of pup acute learning. On PD 23 sensory-motor coordination was examined using the rotarod and bar-holding tests. Additionally, the markers of physical maturation, such as eye opening, testes descent in males and vaginal opening in females were also recorded. The birth weight in prenatally MA-exposed pups was lower than in controls or saline-exposed pups regardless of sex. There were no changes induced by prenatal MA exposure in weight gain or in sexual maturation. In righting reflexes, we demonstrated that pups exposed prenatally to MA were slower in righting reflex on surface and that they accomplished the test of righting reflex in mid-air later than controls or saline-exposed pups. The performance of homing test was not affected by prenatal drug exposure. The sensory-motor coordination was impaired in prenatally MA-exposed pups when testing in the rotarod test. Also, the number of falls in the bar-holding test was higher in MA-exposed pups than in controls. There were no sex differences in any measures. Thus, the present study demonstrated that prenatal MA exposure impairs development of postural motor movements of rat pups during the first 3 weeks

  18. NASA records retention schedules: Procedures governing the retention, retirement, and destruction of agency records

    NASA Technical Reports Server (NTRS)

    1994-01-01

    This handbook sets forth the minimum retention periods of official records of NASA. Its provisions are applicable to NASA Headquarters and all field installations. This revised edition has been correlated to the 'NASA Uniform Files Index (UFI) (NHB 1442.1B), the General Records Schedules' produced by the National Archives and Records Administration (NARA), and has been enlarged in scope to cover Privacy Act Systems of Records and record series previously omitted. Guidance is provided in the areas of record retirement, transfer, and retrieval from Federal Record Centers (FRC) and disposal actions. Included are provisions for making changes to these schedules by addition of new items or revision of current items. The NASA Records Retention Schedules (NRRS) were approved for NASA use by NARA, the General Services Administration, and the General Accounting Office.

  19. NASA records retention schedules: Procedures governing the retention, retirement, and destruction of agency records

    NASA Technical Reports Server (NTRS)

    1994-01-01

    This handbook sets forth the minimum retention periods of official records of NASA. Its provisions are applicable to NASA Headquarters and all field installations. This revised edition has been correlated to the 'NASA Uniform Files Index (UFI) (NHB 1442.1B), the General Records Schedules' produced by the National Archives and Records Administration (NARA), and has been enlarged in scope to cover Privacy Act Systems of Records and record series previously omitted. Guidance is provided in the areas of record retirement, transfer, and retrieval from Federal Record Centers (FRC) and disposal actions. Included are provisions for making changes to these schedules by addition of new items or revision of current items. The NASA Records Retention Schedules (NRRS) were approved for NASA use by NARA, the General Services Administration, and the General Accounting Office.

  20. 36 CFR 1224.10 - What must agencies do to implement an effective records disposition program?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... necessary, update them. (d) Incorporate records retention and disposition functionality during the design, development, and implementation of new or revised recordkeeping systems (whether paper or electronic)....

  1. Medicare and Medicaid programs; modifications to the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program for 2014 and other changes to EHR Incentive Program; and health information technology: revision to the certified EHR technology definition and EHR certification changes related to standards. Final rule.

    PubMed

    2014-09-04

    This final rule changes the meaningful use stage timeline and the definition of certified electronic health record technology (CEHRT) to allow options in the use of CEHRT for the EHR reporting period in 2014. It also sets the requirements for reporting on meaningful use objectives and measures as well as clinical quality measure (CQM) reporting in 2014 for providers who use one of the CEHRT options finalized in this rule for their EHR reporting period in 2014. In addition, it finalizes revisions to the Medicare and Medicaid EHR Incentive Programs to adopt an alternate measure for the Stage 2 meaningful use objective for hospitals to provide structured electronic laboratory results to ambulatory providers; to correct the regulation text for the measures associated with the objective for hospitals to provide patients the ability to view online, download, and transmit information about a hospital admission; and to set a case number threshold exemption for CQM reporting applicable for eligible hospitals and critical access hospitals (CAHs) beginning with FY 2013. Finally, this rule finalizes the provisionally adopted replacement of the Data Element Catalog (DEC) and the Quality Reporting Document Architecture (QRDA) Category III standards with updated versions of these standards.

  2. Avoiding revision rhinoplasty.

    PubMed

    Waite, Peter D

    2011-02-01

    Reoperation of the nose is challenging and sometimes emotionally difficult for the surgeon and patient. There are multiple pitfalls to be avoided and it is always best to carefully diagnose and establish a surgical treatment plan. Even among the best of plans and surgical techniques, revision may be necessary. The patient and surgeon should understand the limitations of the surgical techniques and the individual anatomy. Published by Elsevier Inc.

  3. Grafting in revision rhinoplasty.

    PubMed

    Bussi, M; Palonta, F; Toma, S

    2013-06-01

    Rhinoplasty is one of the most difficult aesthetic surgery procedures with a high rate of revision. In revision rhinoplasty the surgeon should explore the patient's concerns and then verify the possibility to satisfy expectations after complete internal and external examination of the nose. For the vast majority of complex secondaries, an open approach is the only reasonable method. In fact, in secondary nasal surgery, because of the scarring process following the primary operation, dissection is tedious, and landmarks are lost. One of the main objectives for the surgeon who approaches secondary rhinoplasty is to restore the structural support of the nose and to replace the lost volume of soft tissues. To achieve this purpose, the surgeon must often rely on grafts. An ideal grafting material must be easy to sculpt, resistant to trauma, infection and extrusion, mechanically stable, inert and readily available. For all these reasons, autogenous cartilage grafts harvested from septum, auricular concha and rib represent the first choice in rhinoplasty. In order to obtain a camouflage graft that provides natural contouring to the nose, temporalis fascia can be used. All these carefully trimmed grafts are useful in tip revision surgery, in secondary surgery of the dorsum and to resolve or reduce functional problems.

  4. Reduced school dropout rates among adolescent mothers receiving school-based prenatal care.

    PubMed

    Barnet, Beth; Arroyo, Carmen; Devoe, Margo; Duggan, Anne K

    2004-03-01

    Adolescent pregnancy is associated with increased school dropout rates. Dropping out amplifies the probability of persistent social and economic disadvantage. Whether school-based health centers might help reduce school absenteeism and dropout rates in this group has not been well studied. To examine the association of school-based prenatal services on school attendance and dropout rates. In this retrospective cohort study, using school rosters from an alternative school, we identified adolescents aged 18 years or younger who delivered a baby between July 1, 1995, and August 30, 1997, in Baltimore, Md. We linked school records spanning 3 years with medical records and birth certificates. School variables such as attendance and dropout rates were examined in relation to the teen's year of pregnancy and prenatal care setting (school-based vs non-school-based). Hierarchical logistic regression was used to examine effects of school-based prenatal care on dropout and promotion or graduation rates, with adjustment for baseline group differences. We identified 431 predominantly African American, low-income adolescents who attended the alternative school in their pregnancy school year. In the year prior to pregnancy, most performed poorly in school and had significant absenteeism. During their pregnancy school year, teens receiving school-based prenatal care were absent 12 fewer days, as compared with those receiving non-school-based care (P =.001), and their dropout rate was half that of those receiving non-school-based care (6% vs 15%; P =.02). Hierarchical logistic regression analyses, with adjustment for baseline prepregnancy differences, demonstrated that teens receiving school-based prenatal care were less likely to drop out of school during the pregnancy year (adjusted odds ratio, 0.39; 95% confidence interval, 0.15-0.99; P =.048). Absenteeism and dropout rates were reduced for pregnant adolescents receiving prenatal care at a school-based health center in an urban

  5. Radiological aspects of prenatal-onset cortical hyperostosis [Caffey Dysplasia].

    PubMed

    Nemec, Stefan F; Rimoin, David L; Lachman, Ralph S

    2012-04-01

    Cortical hyperostosis is a bone disease that may, at times, occur with a prenatal onset. This study seeks to present the characteristic patterns of prenatal-onset cortical hyperostosis (PCH) with regard to the radiographic features, and tries to ascertain whether PCH is a separate entity from infantile cortical hyperostosis (ICH), known as classic Caffey Disease. This retrospective study identified cases with PCH based upon abnormal radiographic and chondro-osseous morphological and clinical findings, as available, from the International Skeletal Dysplasia Registry between 1987 and 2009. Outcomes and clinical information were also identified from medical records. Based upon radiographic results, we found 20 individuals with PCH, of whom 10 neonatally survived, and 10 died. Hyperostosis of the mandible was found in 18/20, and of the skull base in 16/20 cases. Hyperostosis of the ribs was found in 17/20 cases, of the scapulae in 14/20, and of the clavicles in 4/20. Hyperostosis of the ileum was found in 11/20 cases, and of the long bones in all 20/20 cases, of which three cases had fibula sparing. No hyperostosis of the hands, feet, and spine was found. Our results suggest that, based upon clinical features and radiographic expression, ICH and PCH represent two separate entities, and that ICH should continue to be referred to as Caffey Disease and that PCH should be called Caffey Dysplasia. The findings of symmetrical hyperostosis of the mandible, ribs, scapulae, ilea, and long bones in any combination should suggest the diagnosis of PCH. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  6. Prenatal Phenol and Phthalate Exposures and Birth Outcomes

    PubMed Central

    Wolff, Mary S.; Engel, Stephanie M.; Berkowitz, Gertrud S.; Ye, Xiaoyun; Silva, Manori J.; Zhu, Chenbo; Wetmur, James; Calafat, Antonia M.

    2008-01-01

    Background Many phthalates and phenols are hormonally active and are suspected to alter the course of development. Objective We investigated prenatal exposures to phthalate and phenol metabolites and their associations with body size measures of the infants at birth. Methods We measured 5 phenol and 10 phthalate urinary metabolites in a multiethnic cohort of 404 women in New York City during their third trimester of pregnancy and recorded size of infants at birth. Results Median urinary concentrations were > 10 μg/L for 2 of 5 phenols and 6 of 10 phthalate monoester metabolites. Concentrations of low-molecular-weight phthalate monoesters (low-MWP) were approximately 5-fold greater than those of high-molecular-weight metabolites. Low-MWP metabolites had a positive association with gestational age [0.97 day gestational age per ln-biomarker; 95% confidence interval (CI), 0.07–1.9 days, multivariate adjusted] and with head circumference. Higher prenatal exposures to 2,5-dichlorophenol (2,5-DCP) predicted lower birth weight in boys (−210 g average birth weight difference between the third tertile and first tertile of 2,5-DCP; 95% CI, 71–348 g). Higher maternal benzophenone-3 (BP3) concentrations were associated with a similar decrease in birth weight among girls but with greater birth weight in boys. Conclusions We observed a range of phthalate and phenol exposures during pregnancy in our population, but few were associated with birth size. The association of 2,5-DCP and BP3 with reduced or increased birth weight could be important in very early or small-size births. In addition, positive associations of urinary metabolites with some outcomes may be attributable partly to unresolved confounding with maternal anthropometric factors. PMID:18709157

  7. Descriptive epidemiology of the Multicenter ACL Revision Study (MARS) cohort.

    PubMed

    Wright, Rick W; Huston, Laura J; Spindler, Kurt P; Dunn, Warren R; Haas, Amanda K; Allen, Christina R; Cooper, Daniel E; DeBerardino, Thomas M; Lantz, Brett Brick A; Mann, Barton J; Stuart, Michael J

    2010-10-01

    Revision anterior cruciate ligament (ACL) reconstruction has worse outcomes than primary reconstructions. Predictors for these worse outcomes are not known. The Multicenter ACL Revision Study (MARS) Group was developed to perform a multisurgeon, multicenter prospective longitudinal study to obtain sufficient subjects to allow multivariable analysis to determine predictors of clinical outcome. To describe the formation of MARS and provide descriptive analysis of patient demographics and clinical features for the initial 460 enrolled patients to date in this prospective cohort. Cross-sectional study; Level of evidence, 2. After training and institutional review board approval, surgeons began enrolling patients undergoing revision ACL reconstruction, recording patient demographics, previous ACL reconstruction methods, intra-articular injuries, and current revision techniques. Enrolled subjects completed a questionnaire consisting of validated patient-based outcome measures. As of April 1, 2009, 87 surgeons have enrolled a total of 460 patients (57% men; median age, 26 years). For 89%, the reconstruction was the first revision. Mode of failure as deemed by the revising surgeon was traumatic (32%), technical (24%), biologic (7%), combination (37%), infection (<1%), and no response (<1%). Previous graft present at the time of injury was 70% autograft, 27% allograft, 2% combination, and 1% unknown. Sixty-two percent were more than 2 years removed from their last reconstruction. Graft choice for revision ACL reconstruction was 45% autograft, 54% allograft, and more than 1% both allograft and autograft. Meniscus and/or chondral damage was found in 90% of patients. The MARS Group has been able to quickly accumulate the largest revision ACL reconstruction cohort reported to date. Traumatic reinjury is deemed by surgeons to be the most common single mode of failure, but a combination of factors represents the most common mode of failure. Allograft graft choice is more common

  8. Religious Traditions and Prenatal Genetic Counseling

    PubMed Central

    Anderson, Rebecca Rae

    2009-01-01

    Members of organized religious groups may look to their faith traditions for guidance regarding the moral implications of prenatal diagnosis and intervention. Many denominations have doctrinal statements relevant to these deliberations. In this paper, common spiritual issues arising in the genetic counseling encounter are described. Representative doctrinal positions, derived from the responses of 31 U.S. religious denominations to a survey relating to prenatal genetic counseling, are given. Because the long-term adjustment of patients may be dependent in part on their ability to reconcile their actions with their faith traditions, genetic counselors best serve their patients when they invite discussion of matters of faith. Unless invited, patients may assume these topics are ‘off limits’ or that care providers are indifferent to their beliefs. Although genetics professionals ought not assume the role of spiritual advisor, a working knowledge of doctrinal approaches should help counselors frame the issues, and avoid missteps. PMID:19170093

  9. Prenatal diagnosis of Pfeiffer syndrome type II.

    PubMed

    Blaumeiser, Bettina; Loquet, Philip; Wuyts, Wim; Nöthen, Markus M

    2004-08-01

    Pfeiffer syndrome is an autosomal dominant disorder characterized by coronal craniosynostosis, midface hypoplasia, broad thumbs and great toes. On the basis of clinical findings, three subtypes have been delineated. The clinical variability of Pfeiffer syndrome as well as other causes of craniosynostosis can make a prenatal diagnosis based on sonography alone difficult. We describe a fetus in whom sonographic findings (including 3D ultrasound) suggested a Pfeiffer syndrome type II and in which subsequent molecular analysis verified the diagnosis by identifying a de novo mutation in the FGFR2 gene. To the best of our knowledge, this is the first report of a prenatal molecular diagnosis of Pfeiffer syndrome in a patient without family history.

  10. Prenatal diagnosis of type 2 Pfeiffer syndrome.

    PubMed

    Bernstein, P S; Gross, S J; Cohen, D J; Tiller, G R; Shanske, A L; Bombard, A T; Marion, R W

    1996-12-01

    Pfeiffer syndrome is an autosomal dominantly inherited disorder consisting of craniosynostosis, a flattened midface with a beaked nose and ocular proptosis, and broad and medially deviated thumbs and great toes. Recently, based on clinical findings, the disorder has been divided into three subtypes: type 1, characterized by mild expression; type 2, in which clover leaf skull deformity and multiple congenital anomalies are present at birth; and type 3, which is similar to type 2, but lacks the presence of the clover leaf skull at birth. We describe a fetus in whom sonographic findings of clover leaf skull deformity, ocular hypertelorism, and varus deformity of the great toe led to the prenatal diagnosis of Pfeiffer syndrome type 2. We believe this is the second prenatal diagnosis of Pfeiffer syndrome, and the first time type 2 has been definitely identified in the second trimester of pregnancy.

  11. Outcome of prenatally diagnosed trisomy 6 mosaicism.

    PubMed

    Wallerstein, Robert; Oh, Tracey; Durcan, Judy; Abdelhak, Yaakov; Clachko, Mark; Aviv, Hana

    2002-08-01

    We report the prenatal diagnosis of trisomy 6 mosaicism via amniocentesis, in which trisomy 6 cells were identified in three of five culture vessels with 33% (5/15) of colonies showing trisomic cells. The pregnancy was electively terminated and examination revealed minor abnormalities (shortening of the femurs, micrognathia, posterior malrotation of the ears, and bilateral camptomelia of the second digit of the hands and fifth digits of the feet). Cytogenetic analysis of the placenta showed trisomy 6 in 100% of 20 cells studied. Karyotype was 46,XX in 100 cells examined from fetal skin. There are relatively few prenatally diagnosed cases of mosaic trisomy 6 at amniocentesis. Confined placental mosaicism (CPM) has been postulated in other cases where follow-up cytogenetic studies were not available. The present case differs from those previously reported, as it appears to represent CPM of chromosome 6 with phenotypic effects to the fetus. Copyright 2002 John Wiley & Sons, Ltd.

  12. Consequences of prenatal opioid use for newborns.

    PubMed

    Anand, Kanwaljeet J S; Campbell-Yeo, Marsha

    2015-11-01

    One-third of childbearing women take prescription opioids, previously occurring only in 6-7% of pregnant women. Prenatal opioid exposures may cause birth defects, altered brain development and neonatal abstinence syndrome (NAS). NAS incidence increased fourfold and length of stay increased from 13 to 19 days over 10 years (2004-2013), leading to sevenfold increases in NICU days due to NAS. Initial data suggest that recent NAS increases have resulted from increased use of prescription opioids rather than illicit drugs. Paediatricians will have to manage the consequences of prenatal opioid exposures, as the offspring often have complex medical and social issues associated with these families. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  13. Prenatal diagnosis of ectopia cordis: case report.

    PubMed

    Chelli, Dalenda; Dimassi, Kaouther; Jallouli-Bouzguenda, Souhir; Ebdellah, Essia; Hermi, Feten; Zouaoui, Bechir; Sfar, Ezzeddine; Kitova, Tania; Chelli, Hela; Channoufi, Mohamed Badis; Gaigi, Soumaya

    2008-02-01

    Ectopia cordis is a rare and impressive malformation presenting as an isolated lesion or as part of the Cantrell's pentology syndrom. It is defined as an anomaly in which the fetal heart lies outside the thoracic cavity. THE AIM of the study is to report the prenatal diagnostic features and management of ectopia cordis. We report a prenatal diagnosis case of ectopia cordis using two-dimensional ultrasound at 19 weeks of gestation. Multiple congenital anomalies were found. The most important one was the presence of a ventral thoracoabdominal wall defect with exstrophy of the heart, liver, stomach and intestines. Histopathological examination confirmed the ultrasound findings. Due to severity of the malformations, termination of pregnancy was made.

  14. Prenatal nutritional influence on skeletal development.

    PubMed

    Curtis, Elizabeth; Cheah, Jonathan; Harvey, Nicholas C

    2013-01-01

    There is increasing evidence to suggest that prenatal nutritional factors may have long-term effects on the offspring. Osteoporosis is a worldwide public health problem leading to both morbidity and mortality, through associated bone fractures. Although in clinical practice most effort in fracture prevention is aimed at slowing the rate of age-related bone loss, there is accumulating evidence that peak bone mass, achieved in early adulthood, is an important factor in determining bone strength in later life. A variety of studies have shown that peak bone mass is influenced by early life events, including nutrition in the prenatal period. This chapter will use the example of bone development to consider the effects of maternal diet and nutritional status on the offspring.

  15. Confirmation of prenatal diagnosis of sex chromosome mosaicism.

    PubMed

    McFadden, D E; Kalousek, D K

    1989-04-01

    Prenatal diagnosis of mosaicism causes problems in interpretation and in genetic counselling. Part of the difficulty with any prenatal diagnosis of mosaicism is interpretation of results without knowing the exact origin, embryonic or extraembryonic, of the abnormal cell line. To confuse the issue in cases of prenatal diagnosis of 45,X/46,XY mosaicism is the recent demonstration that a diagnosis of 45,X/46,XY made prenatally is not necessarily associated with the same phenotype as when diagnosed postnatally. We present two cases of prenatal diagnosis of sex chromosome mosaicism (45,X/46,XY and 45,X/47,XYY). Posttermination examination of the phenotypically normal male fetuses and their placentas established that the placenta was the most likely source of the 45,X cell line. An approach to confirming the prenatal diagnosis of sex chromosome mosaicism and establishing its origin utilizing detailed cytogenetic examination of both fetus and placenta is suggested.

  16. A cost-savings analysis of prenatal interventions.

    PubMed

    Bonifield, S L

    1998-01-01

    Proper prenatal care has long been established as the single most important factor in improving both maternal and infant health (Henderson 1994) yet the United States remains one of only two industrialized nations that have yet to ensure universal healthcare for pregnant women (National Center for Farmworker Health, Inc. 1997). Through clinical innovations, many progressive interventions now available are not only medically effective but also financially prudent. This study addresses the efficacy and feasibility and discusses the policy implications of the following four prenatal programs: universal prenatal screening for the human immunodeficiency virus, prenatal carrier screening for cystic fibrosis, condition-specific care for pregnant diabetics, and prenatal nutrition counseling. The healthcare community is challenged to expand the breadth of routine prenatal care to include those services that are both financially sensible and clinically imperative.

  17. The Value of Prenatal Ultrasonographic Diagnosis of Diastematomyelia.

    PubMed

    Wei, Qiuju; Cai, Ailu; Wang, Xintian; Wang, Xiaoguang; Xie, Limei

    2017-06-01

    To evaluate the value of prenatal ultrasonographic diagnosis of diastematomyelia, and to provide a basis for the diagnosis and differential diagnosis of fetal diastematomyelia. Four fetuses with suspected diastematomyelia based on prenatal ultrasonography are presented. Detailed prenatal ultrasonography was performed to examine spinal cord abnormalities. The region of interest-based spine sagittal plane was defined and 3D volumetric scans were performed, as needed. Images were stored and compared with MRI or ultrasonographic images after abortion. In the four cases of diastematomyelia diagnosed by prenatal ultrasonography, two were confirmed by MRI after birth, and the other two were confirmed by autopsy and pathologic examination after abortion. Varying degrees of spine or spinal cord deformities were noted. Two pregnancies were terminated, and two newborns underwent surgery. Prenatal ultrasonography contributes to the diagnosis of diastematomyelia and provides a basis for prenatal counseling and prognosis. © 2017 by the American Institute of Ultrasound in Medicine.

  18. 76 FR 11465 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-02

    ... From the Federal Register Online via the Government Publishing Office FEDERAL HOUSING FINANCE... Finance Agency. ACTION: Notice of the Revision and Establishment of Privacy Act Systems of Records... Federal Housing Finance Agency (FHFA-OIG) gives notice of the revision of an existing system of...

  19. Chromosomal Microarray versus Karyotyping for Prenatal Diagnosis

    PubMed Central

    Wapner, Ronald J.; Martin, Christa Lese; Levy, Brynn; Ballif, Blake C.; Eng, Christine M.; Zachary, Julia M.; Savage, Melissa; Platt, Lawrence D.; Saltzman, Daniel; Grobman, William A.; Klugman, Susan; Scholl, Thomas; Simpson, Joe Leigh; McCall, Kimberly; Aggarwal, Vimla S.; Bunke, Brian; Nahum, Odelia; Patel, Ankita; Lamb, Allen N.; Thom, Elizabeth A.; Beaudet, Arthur L.; Ledbetter, David H.; Shaffer, Lisa G.; Jackson, Laird

    2013-01-01

    Background Chromosomal microarray analysis has emerged as a primary diagnostic tool for the evaluation of developmental delay and structural malformations in children. We aimed to evaluate the accuracy, efficacy, and incremental yield of chromosomal microarray analysis as compared with karyotyping for routine prenatal diagnosis. Methods Samples from women undergoing prenatal diagnosis at 29 centers were sent to a central karyotyping laboratory. Each sample was split in two; standard karyotyping was performed on one portion and the other was sent to one of four laboratories for chromosomal microarray. Results We enrolled a total of 4406 women. Indications for prenatal diagnosis were advanced maternal age (46.6%), abnormal result on Down’s syndrome screening (18.8%), structural anomalies on ultrasonography (25.2%), and other indications (9.4%). In 4340 (98.8%) of the fetal samples, microarray analysis was successful; 87.9% of samples could be used without tissue culture. Microarray analysis of the 4282 nonmosaic samples identified all the aneuploidies and unbalanced rearrangements identified on karyotyping but did not identify balanced translocations and fetal triploidy. In samples with a normal karyotype, microarray analysis revealed clinically relevant deletions or duplications in 6.0% with a structural anomaly and in 1.7% of those whose indications were advanced maternal age or positive screening results. Conclusions In the context of prenatal diagnostic testing, chromosomal microarray analysis identified additional, clinically significant cytogenetic information as compared with karyotyping and was equally efficacious in identifying aneuploidies and unbalanced rearrangements but did not identify balanced translocations and triploidies. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and others; ClinicalTrials.gov number, NCT01279733.) PMID:23215555

  20. Chromosomal microarray versus karyotyping for prenatal diagnosis.

    PubMed

    Wapner, Ronald J; Martin, Christa Lese; Levy, Brynn; Ballif, Blake C; Eng, Christine M; Zachary, Julia M; Savage, Melissa; Platt, Lawrence D; Saltzman, Daniel; Grobman, William A; Klugman, Susan; Scholl, Thomas; Simpson, Joe Leigh; McCall, Kimberly; Aggarwal, Vimla S; Bunke, Brian; Nahum, Odelia; Patel, Ankita; Lamb, Allen N; Thom, Elizabeth A; Beaudet, Arthur L; Ledbetter, David H; Shaffer, Lisa G; Jackson, Laird

    2012-12-06

    Chromosomal microarray analysis has emerged as a primary diagnostic tool for the evaluation of developmental delay and structural malformations in children. We aimed to evaluate the accuracy, efficacy, and incremental yield of chromosomal microarray analysis as compared with karyotyping for routine prenatal diagnosis. Samples from women undergoing prenatal diagnosis at 29 centers were sent to a central karyotyping laboratory. Each sample was split in two; standard karyotyping was performed on one portion and the other was sent to one of four laboratories for chromosomal microarray. We enrolled a total of 4406 women. Indications for prenatal diagnosis were advanced maternal age (46.6%), abnormal result on Down's syndrome screening (18.8%), structural anomalies on ultrasonography (25.2%), and other indications (9.4%). In 4340 (98.8%) of the fetal samples, microarray analysis was successful; 87.9% of samples could be used without tissue culture. Microarray analysis of the 4282 nonmosaic samples identified all the aneuploidies and unbalanced rearrangements identified on karyotyping but did not identify balanced translocations and fetal triploidy. In samples with a normal karyotype, microarray analysis revealed clinically relevant deletions or duplications in 6.0% with a structural anomaly and in 1.7% of those whose indications were advanced maternal age or positive screening results. In the context of prenatal diagnostic testing, chromosomal microarray analysis identified additional, clinically significant cytogenetic information as compared with karyotyping and was equally efficacious in identifying aneuploidies and unbalanced rearrangements but did not identify balanced translocations and triploidies. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and others; ClinicalTrials.gov number, NCT01279733.).

  1. [Prenatal diagnosis of X-linked adrenoleukodystrophy].

    PubMed

    Bao, Xin-hua; Ping, Li-li; Wang, Ai-hua; Pan, Hong; Wu, Ye; Xiong, Hui; Zhang, Yue-hua; Shi, Chun-yan; Qin, Jiong; Wu, Xiru

    2007-02-01

    To make prenatal dignosis of X-linked adrenoleukodystrophy (ALD) for the prevention of the disease. Eighteen amniocenteses were performed on 17 suspected carriers of X-ALD during 18-30 gestation weeks. The very long chain fatty acids (VLCFAs) levels of cultured amniocytes were tested by gas chromatography-mass spectrometry (GC/MS). The plasma VLCFAs levels were measured in 8 of the 18 prenatal diagnosed children when they were born or after abortion. ABCD1 gene mutation analysis was carried out in 8 cases by PCR and sequencing. ALDP of amniocytes was tested by Western blotting in 2 cases from a family, one female, another male, and the VLCFAs of cultured amniocytes were increased in both of them. Among the 18 fetuses, 10 were males and 8 were females. The VLCFAs levels of the cultured amniocytes were increased in 3 males and 4 females. The postnatal plasma VLCFAs were normal in 5 cases with normal VLCFAs levels of amniocytes, and increased in 3 cases with high VLCFAs levels of amniocytes. ABCD1 gene mutations were found in 4 cases with high VLCFAs levels of amniocytes, no mutation was found in other 4 cases with normal VLCFAs levels of amniocytes. ALDP of amniocytes could be detected in the female with high VLCFAs levels of amniocytes, and it could not be detected in the male with high VLCFAs levels of amniocytes. Three male fetuses with high VLCFAs levels of amniocytes were aborted. The others who were born were normal clinically so far. The prenatal diagnosis is very important for the prevention of ALD. Amniocyte VLCFAs level analysis combined with ABCD1 gene mutation analysis and ALDP test could make a proper prenatal diagnosis.

  2. Prenatal programming of neuroendocrine reproductive function.

    PubMed

    Evans, Neil P; Bellingham, Michelle; Robinson, Jane E

    2016-07-01

    It is now well recognized that the gestational environment can have long-lasting effects not only on the life span and health span of an individual but also, through potential epigenetic changes, on future generations. This article reviews the "prenatal programming" of the neuroendocrine systems that regulate reproduction, with a specific focus on the lessons learned using ovine models. The review examines the critical roles played by steroids in normal reproductive development before considering the effects of prenatal exposure to exogenous steroid hormones including androgens and estrogens, the effects of maternal nutrition and stress during gestation, and the effects of exogenous chemicals such as alcohol and environment chemicals. In so doing, it becomes evident that, to maximize fitness, the regulation of reproduction has evolved to be responsive to many different internal and external cues and that the GnRH neurosecretory system expresses a degree of plasticity throughout life. During fetal life, however, the system is particularly sensitive to change and at this time, the GnRH neurosecretory system can be "shaped" both to achieve normal sexually differentiated function but also in ways that may adversely affect or even prevent "normal function". The exact mechanisms through which these programmed changes are brought about remain largely uncharacterized but are likely to differ depending on the factor, the timing of exposure to that factor, and the species. It would appear, however, that some afferent systems to the GnRH neurons such as kisspeptin, may be critical in this regard as it would appear to be sensitive to a wide variety of factors that can program reproductive function. Finally, it has been noted that the prenatal programming of neuroendocrine reproductive function can be associated with epigenetic changes, which would suggest that in addition to direct effects on the exposed offspring, prenatal programming could have transgenerational effects on

  3. Prenatal investments, breastfeeding, and birth order.

    PubMed

    Buckles, Kasey; Kolka, Shawna

    2014-10-01

    Mothers have many opportunities to invest in their own or their child's health and well-being during pregnancy and immediately after birth. These investments include seeking prenatal care, taking prenatal vitamins, and breastfeeding. In this paper, we investigate a potential determinant of mothers' investments that has been largely overlooked by previous research-birth order. Data are from the National Longitudinal Study of Youth 1979 (NLSY79) Child and Young Adult Survey, which provides detailed information on pre- and post-natal behaviors of women from the NLSY79. These women were between the ages of 14 and 22 in 1979, and form a nationally representative sample of youth in the United States. Our sample includes births to these women between 1973 and 2010 (10,328 births to 3755 mothers). We use fixed effects regression models to estimate within-mother differences in pre- and post-natal behaviors across births. We find that mothers are 6.6 percent less likely to take prenatal vitamins in a fourth or higher-order birth than in a first and are 10.6 percent less likely to receive early prenatal care. Remarkably, mothers are 15.4 percent less likely to breastfeed a second-born child than a first, and are 20.9 percent less likely to breastfeed a fourth or higher-order child. These results are not explained by changing attitudes toward investments over time. These findings suggest that providers may want to increase efforts to encourage these behaviors at women with higher parity. The results also identify a potential mechanism for the emergence of differences in health and other outcomes across birth orders. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. The challenge of the reference and counter-reference system in the prenatal assistance to pregnant women with infectious diseases.

    PubMed

    Figueiredo, Elisabeth N; Vianna, Lucila A C; Peixe, Marina B; Ramos, Valdete M; Succi, Regina C M

    2009-09-01

    The objective of this study was to determine the prevalence of infectious diseases, such as syphilis, acquired immune deficiency syndrome (AIDS) and hepatitis B and C, in pregnant women who undertook their prenatal care in thirteen basic health units (BHU) in São Paulo city. The efficiency of the reference and counter-reference system in such prenatal infectious diseases was evaluated considering the medical recordings of the final result of the pregnancy and the vertical transmission rates of these diseases. It consists of an epidemiologic study whose observations were based on the notes of the prenatal medical and nurse records of pregnant women who had infectious diseases susceptible to vertical transmission and final infectious status registers of their concepts. Women's syphilis prevalence was 0. 86%, HIV and Hepatitis B was 0. 22% and Hepatitis C was 0. 36%. It's possible to conclude that there is no register of the reference and counter-reference system of these infectious diseases analyzed at the thirteen basic health units of the south-east region of São Paulo city evaluated in 2005. This lack of register makes it impossible to know the preventive measures taken and the vertical transmission rates. Making the professionals and the Health Coordination authorities aware of the importance of the dynamic of the prenatal attendance is necessary.

  5. Prenatal care through the eyes of Canadian Aboriginal women.

    PubMed

    Di Lallo, Sherri

    2014-01-01

    The Aboriginal Prenatal Wellness Program (APWP) in Canada represents a culturally safe approach to prenatal care. By understanding the history of colonization and residential schools and how this history has contributed to health disparities, a multidisciplinary team provides culturally competent and integrated prenatal care to Aboriginal women and their families. This article describes the APWP and discusses how increased participation in health care by historically marginalized populations can lead to better maternal and neonatal health outcomes.

  6. Prenatal Diagnosis of Congenital Heart Disease and Birth Outcomes

    PubMed Central

    Levey, Allison; Levasseur, Stephanie M.; Glickstein, Julie S.; Kleinman, Charles S.; Simpson, Lynn L.; Williams, Ismee A.

    2013-01-01

    This study was undertaken to examine the impact that prenatal diagnosis of congenital heart disease (CHD) has on birth and early neonatal outcomes. The prevalence of prenatally diagnosed CHD has risen over the past decade, but the effect that prenatal diagnosis of CHD has on peripartum decisions remains unclear. No consensus exists on the effect of prenatal diagnosis on neonatal outcomes. Between January 2004 and July 2009, a retrospective chart review of all neonates with CHD admitted to our institution’s neonatal intensive care unit was conducted. Obstetric and postnatal variables were collected. Among the 993 subjects, 678 (68.3 %) had a prenatal diagnosis. A prenatal diagnosis increased the odds of a scheduled delivery [odds ratio (OR) 4.1, 95 % confidence interval (CI) 3.0–5.6] and induction of labor (OR 11.5, 95 % CI 6.6–20.1). Prenatal diagnosis was not significantly associated with cesarean delivery when control was used for maternal age, multiple gestation, and presence of extracardiac anomaly. Mean gestational age had no impact on prenatal diagnosis, but prenatal diagnosis was associated with increased odds of delivery before a gestational age of 39 weeks (OR 1.5, 95 % CI 1.1–1.9) and decreased odds of preoperative intubation (OR 0.5, 95 % CI 0.3–0.6). Prenatal diagnosis did not have an impact on preoperative or predischarge mortality. Prenatal diagnosis was associated with increased odds of a scheduled delivery, birth before a gestational age of 39 weeks, and a decreased need for invasive respiratory support. Prenatal diagnosis of CHD was not associated with preoperative or predischarge mortality. PMID:23052660

  7. Group Prenatal Care: A Financial Perspective.

    PubMed

    Rowley, Rebecca A; Phillips, Lindsay E; O'Dell, Lisa; Husseini, Racha El; Carpino, Sarah; Hartman, Scott

    2016-01-01

    Multiple studies have demonstrated improved perinatal outcomes for group prenatal care (GPC) when compared to traditional prenatal care. Benefits of GPC include lower rates of prematurity and low birth weight, fewer cesarean deliveries, improved breastfeeding outcomes and improved maternal satisfaction with care. However, the outpatient financial costs of running a GPC program are not well established. This study involved the creation of a financial model that forecasted costs and revenues for prenatal care groups with various numbers of participants based on numerous variables, including patient population, payor mix, patient show rates, staffing mix, supply usage and overhead costs. The model was developed for use in an urban underserved practice. Adjusted revenue per pregnancy in this model was found to be $989.93 for traditional care and $1080.69 for GPC. Cost neutrality for GPC was achieved when each group enrolled an average of 10.652 women with an enriched staffing model or 4.801 women when groups were staffed by a single nurse and single clinician. Mathematical cost-benefit modeling in an urban underserved practice demonstrated that GPC can be not only financially sustainable but possibly a net income generator for the outpatient clinic. Use of this model could offer maternity care practices an important tool for demonstrating the financial practicality of GPC.

  8. Prenatal methamphetamine use and neonatal neurobehavioral outcome.

    PubMed

    Smith, Lynne M; Lagasse, Linda L; Derauf, Chris; Grant, Penny; Shah, Rizwan; Arria, Amelia; Huestis, Marilyn; Haning, William; Strauss, Arthur; Della Grotta, Sheri; Fallone, Melissa; Liu, Jing; Lester, Barry M

    2008-01-01

    Methamphetamine (MA) use among pregnant women is an increasing problem in the United States. How prenatal MA exposure affects neonatal neurobehavior is unknown. To examine the neurobehavioral effects of prenatal MA exposure. The Infant Development, Environment and Lifestyle (IDEAL) study screened 13,808 subjects and 1632 were eligible and consented. 166 (n=74 exposed) were enrolled in a longitudinal follow-up. Exposure was determined by meconium assay and self-report with alcohol, marijuana, and tobacco present in both groups. The NICU Network Neurobehavioral Scale (NNNS) was administered within the first 5 days of life. Analyses conducted on NNNS summary scores included exposure group effects, heavy MA use effects, association with frequency of use by trimester, and dose-response relationships with amphetamine metabolites. After adjusting for covariates, exposure to MA was associated with increased physiological stress. Heavy MA use was related to lower arousal, more lethargy, and increased physiological stress. First trimester MA use was related to elevated stress abstinence. Third trimester use was related to poorer quality of movement. Higher level of amphetamine metabolites in meconium was associated with increased CNS stress. Prenatal MA exposure was associated with neurobehavioral patterns of decreased arousal, increased stress, and poor quality of movement. The dose-response relationships may represent neurotoxic effects from MA.

  9. [Prenatal gene diagnosis of alpha-thalassemias].

    PubMed

    Zhang, X; Li, Q; Wu, Y

    1998-03-01

    To study the value of polymerase chain reaction (PCR) in prenatal diagnosis of alpha thalassemias. Amniotic fluid prenatal gene diagnosis with polymerase chain reaction was carried out on eleven fetuses whose parents are both heterozygotes with alpha-globin gene deficiency. A DNA fragment of 224bp in the production means normal alpha-globin gene sequence, while a 630bp fragment indicated the alpha-globin gene deficiency. Both 224bp and 630bp fragments in the same sample means heterozygote. Three of the 11 fetuses (one pregnancy was twin) were with normal alpha-globin gene sequence, while 4 were homozygotes and the other 4 were heterozygotes. For the 3 fetuses with ascitic fluid under ultrasound examination, 2 were homozygotes and the other one was heterozygote by gene diagnosis. Two of the 4 homozygotes from induced abortion were typical Bart's syndrome, one was edema in the whole body and the other one with short limbs and abdominal hernia. The method of PCR in prenatal diagnoses for detection of alpha-thalassemias is simple, accurate and rapid.

  10. Prenatal sonographic diagnosis of ectopia cordis.

    PubMed

    Tongsong, T; Wanapirak, C; Sirivatanapa, P; Wongtrangan, S

    1999-10-01

    We present a small series of prenatally diagnosed cases of ectopia cordis. Four fetuses with prenatally diagnosed ectopia cordis were sonographically evaluated and followed up. The fetuses were diagnosed with ectopia cordis at 9, 13, 21, and 29 weeks' menstrual age. The case diagnosed at 9 weeks is the earliest prenatal diagnosis reported, to our knowledge. The diagnoses were based on the demonstration of a fetal heart outside the thoracic cavity with Doppler waveforms typical of intracardiac flow. One fetus had isolated ectopia cordis, and 3 had other associated anolmalies. The diagnosis was postnatally confirmed in all cases. Therapeutic abortion was done in 2 cases. One infant survived, and the fourth died shortly after birth. Chromosome study was successfully performed in 2 cases and was normal in both of them. This small series suggests that ectopia cordis can be readily diagnosed in utero as early as the first trimester. Later in pregnancy, sonography provides important information for planning surgical correction. Copyright 1999 John Wiley & Sons, Inc.

  11. Prenatal Methamphetamine Use and Neonatal Neurobehavioral Outcome

    PubMed Central

    Smith, Lynne M.; LaGasse, Linda L.; Derauf, Chris; Grant, Penny; Shah, Rizwan; Arria, Amelia; Huestis, Marilyn; Haning, William; Strauss, Arthur; Grotta, Sheri Della; Fallone, Melissa; LiuPhD, Jing; Lester, Barry M.

    2008-01-01

    Background Methamphetamine (MA) use among pregnant women is an increasing problem in the United States. How prenatal MA exposure affects neonatal neurobehavior is unknown. Objective To examine the neurobehavioral effects of prenatal MA exposure. Design The Infant Development, Environment and Lifestyle (IDEAL) study screened 13,808 subjects and 1632 were eligible and consented. 166 (n=74 exposed) were enrolled in a longitudinal follow up. Exposure was determined by meconium assay and self-report with alcohol, marijuana, and tobacco present in both groups. The NICU Network Neurobehavioral Scale (NNNS) was administered within the first 5 days of life. Analyses conducted on NNNS summary scores included exposure group effects, heavy MA use effects, association with frequency of use by trimester, and dose-response relationships with amphetamine metabolites. Results After adjusting for covariates, exposure to MA was associated with increased physiological stress. Heavy MA use was related to lower arousal, more lethargy, and increased physiological stress. First trimester MA use was related to elevated physiological stress. Third trimester use was related to poorer quality of movement. Higher level of amphetamine metabolites in meconium was associated with increased CNS stress. Conclusions Prenatal MA exposure was associated with neurobehavioral patterns of decreased arousal, increased stress, and poor quality of movement. The dose response relationships may represent neurotoxic effects from MA. PMID:18031987

  12. In defense of prenatal genetic interventions.

    PubMed

    Murphy, Timothy F

    2014-09-01

    Jürgen Habermas has argued against prenatal genetic interventions used to influence traits on the grounds that only biogenetic contingency in the conception of children preserves the conditions that make the presumption of moral equality possible. This argument fails for a number of reasons. The contingency that Habermas points to as the condition of moral equality is an artifact of evolutionary contingency and not inviolable in itself. Moreover, as a precedent for genetic interventions, parents and society already affect children's traits, which is to say there is moral precedent for influencing the traits of descendants. A veil-of-ignorance methodology can also be used to justify prenatal interventions through its method of advance consent and its preservation of the contingency of human identities in a moral sense. In any case, the selection of children's traits does not undermine the prospects of authoring a life since their future remains just as contingent morally as if no trait had been selected. Ironically, the prospect of preserving human beings as they are--to counteract genetic drift--might even require interventions to preserve the ability to author a life in a moral sense. In light of these analyses, Habermas' concerns about prenatal genetic interventions cannot succeed as objections to their practice as a matter of principle; the merits of these interventions must be evaluated individually.

  13. Tomorrow's prenatal genetic testing. Should we test for 'minor' diseases?

    PubMed

    Strong, C

    1993-11-01

    New genetic knowledge will make it possible to test prenatally for a wide range of fetal genetic characteristics. One consequence will be an expansion of potential reasons for selective abortion following prenatal testing. It will likely become possible for patients to request prenatal testing and abortion not only for serious diseases but also relatively mild diseases, late-onset diseases, treatable diseases, elevated risks for common diseases, and eventually nondisease characteristics, such as height and body build. Two main ethical views concerning prenatal testing have been advocated: (1) Prenatal testing should be restricted to the "most severe" disorders, involving profound retardation, severe physical handicaps, or prolonged physical suffering and (2) Patients' requests for prenatal tests should be honored except for diseases considered to be "too minor." At least two additional views can be identified: (3) Physicians should honor requests for prenatal testing for diseases, including relatively minor ones, but not requests pertaining to nondisease characteristics and (4) All requests for prenatal tests should be honored. A difficulty with the first and second views is that they deviate from the norm of nondirectiveness in prenatal testing and counseling. The problems with the fourth view are that it leads to abortions for morally trivial reasons and that attempts to design our children could adversely affect parent-child relationships and exacerbate current social inequities. These considerations support the third view, which holds that the future role of reproductive genetic testing and counseling should be based on the imperfect, but helpful, distinction between disease and nondisease.

  14. Prenatal Diagnosis of Non-Syndromic Congenital Heart Defects

    PubMed Central

    Ailes, Elizabeth C.; Gilboa, Suzanne M.; Riehle-Colarusso, Tiffany; Johnson, Candice Y.; Hobbs, Charlotte A.; Correa, Adolfo; Honein, Margaret A.

    2015-01-01

    Objectives Congenital heart defects (CHDs) occur in nearly 1% of live births. We sought to assess factors associated with prenatal CHD diagnosis in the National Birth Defects Prevention Study (NBDPS). Methods We analyzed data from mothers with CHD-affected pregnancies from 1998–2005. Prenatal CHD diagnosis was defined as affirmative responses to questions about abnormal prenatal ultrasounds and/or fetal echocardiography obtained during a structured telephone interview. Results Fifteen percent (1,097/7,299) of women with CHD-affected pregnancies (excluding recognized syndromes and single-gene disorders) reported receiving a prenatal CHD diagnosis. Prenatal CHD diagnosis was positively associated with advanced maternal age, family history of CHD, type 1 or type 2 diabetes, twin or higher order gestation, CHD complexity and presence of extracardiac defects. Prenatal CHD diagnosis was inversely associated with maternal Hispanic race/ethnicity, prepregnancy overweight or obesity, and pre-existing hypertension. Prenatal CHD diagnosis varied by time to NBDPS interview and NBDPS study site. Conclusions Further work is warranted to identify reasons for the observed variability in maternal reports of prenatal CHD diagnosis and the extent to which differences in health literacy or health system factors such as access to specialized prenatal care and/or fetal echocardiography may account for such variability. PMID:24222433

  15. Efficiency of prenatal diagnosis in Pierre Robin sequence.

    PubMed

    Di Pasquo, Elvira; Amiel, Jeanne; Roth, Philippe; Malan, Valérie; Lind, Katia; Chalouhi, Christel; Soupre, Véronique; Gordon, Christopher T; Lyonnet, Stanislas; Salomon, Laurent J; Abadie, Véronique

    2017-09-26

    to analyze the efficiency of prenatal diagnosis of Pierre Robin sequence (PRS) regarding the final specific diagnosis and to determine whether infants have more severe respiratory disorders with than without prenatally suspected PRS. review of the outcome of all prenatal cases of suspected PRS managed in our prenatal diagnosis center during the last 15 years; analysis of the consistency between pre- and postnatal diagnoses in 2 groups of women with and without a family history of PRS; comparison of the grades of disease severity for infants with and without prenatally suspected PRS. 59 files were studied. Pre- and post-natal consistency of a specific diagnosis of PRS was 100% for women with a family history of PRS and with prenatally suspected non-isolated PRS. It was 78.6% for those with prenatally suspected isolated PRS. We describe 13 terminations of pregnancy. The 41 children living beyond 18 months seem to have more functionally severe phenotypes than the 227 children without prenatally suspected PRS. Antenatal diagnosis of isolated PRS is a challenge as other features can be missed. Use of prenatal chromosomal microarray can improve the accuracy of diagnosis. In all cases, adequate neonatal care should be offered. This article is protected by copyright. All rights reserved.

  16. [Prenatal diagnosis. II. Importance of ultrasonographic markers in prenatal diagnosis of chromosome abnormalities].

    PubMed

    Prieto-Carrasquero, M; Molero, A; Carrasquero, N; Del Villar, A; González-Ferrer, S; Rojas, A; Brito, J; Mena, R; González, L; Pérez, F; Alvarez, F; Quintero, M; Fulcado, W

    1998-12-01

    The Medical Genetic Unit of the University of Zulia (MGUUZ) has developed a Prenatal Diagnosis Program (PDP) since January-1993, in which Genetic Risk Factors are determined in couples who request prenatal genetic counseling. In this program, different prenatal diagnostic procedures are performed to detect congenital defects during intrauterine life. One of these procedures is the Fetal Sonogram (FS). FS is a non invasive technique which permits the prenatal diagnosis of many genetic dysmorphic syndromes. Through the search of abnormal specific characteristics in the fetus, chromosomopathies may be suspected. These findings are named "Echosonographic Markers of Chromosomal Abnormalities" (EMCA). During three years (January-1993 to December-1996), patients attended in the PDP included 321 pregnant women in which 312 FS were performed. Abnormal outcomes were 22 (17 with isolated congenital malformations and 5 with EMCA). Only one fetus with chromosome abnormality (46,XX21q-) could not be detected by FS. The goals of this paper are: 1) to report 5 patients with sonographic markers suggestive of chromosomal abnormalities and 2) to show the FS usefulness in prenatal diagnosis of chromosompathies. We conclude that, in the search of the EMCA the FS should be offered systematically to all pregnant women without recognizable genetic risk. They are the main group with optimal reproductive age and in consequence, with the possibility of having a relatively major number of conception outcomes with congenital defects, with or without chromosomic etiology. The majority of those defects can be detected by FS and could allow us to select the patients in which the use of an invasive prenatal diagnostic procedure could be justified.

  17. Common Bibliographic Standards for Baylor University Libraries. Revised.

    ERIC Educational Resources Information Center

    Scott, Sharon; And Others

    Developed by a Baylor University (Texas) Task Force, the revised policies of bibliographic standards for the university libraries provide formats for: (1) archives and manuscript control; (2) audiovisual media; (3) books; (4) machine-readable data files; (5) maps; (6) music scores; (7) serials; and (8) sound recordings. The task force assumptions…

  18. The LS Graph: A Methodology for Visualizing Writing Revision.

    ERIC Educational Resources Information Center

    Lindgren, Eva; Sullivan, Kirk P. H.

    2002-01-01

    Computer keystroke-logging programs, which record all keystrokes and mouse actions, facilitate the collection of quantitative data about text creation during writing revision. Presents the LS graph, a novel way of graphically representing and summarizing the quantitative data collected when keystroke logging. (Author/VWL)

  19. Neck Pain: Revision 2017.

    PubMed

    Blanpied, Peter R; Gross, Anita R; Elliott, James M; Devaney, Laurie Lee; Clewley, Derek; Walton, David M; Sparks, Cheryl; Robertson, Eric K

    2017-07-01

    The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these revised clinical practice guidelines is to review recent peer-reviewed literature and make recommendations related to neck pain. J Orthop Sports Phys Ther. 2017;47(7):A1-A83. doi:10.2519/jospt.2017.0302.

  20. Revision Total Elbow Arthroplasty.

    PubMed

    Ramirez, Miguel A; Cheung, Emilie V; Murthi, Anand M

    2017-08-01

    Despite recent technologic advances, total elbow arthroplasty has complication rates higher than that of total joint arthroplasty in other joints. With new antirheumatic treatments, the population receiving total elbow arthroplasty has shifted from patients with rheumatoid arthritis to those with posttraumatic arthritis, further compounding the high complication rate. The most common reasons for revision include infection, aseptic loosening, fracture, and component failure. Common mechanisms of total elbow arthroplasty failure include infection, aseptic loosening, fracture, component failure, and instability. Tension band fixation, allograft struts with cerclage wire, and/or plate and screw constructs can be used for fracture stabilization.

  1. Prenatal diagnosis and the pediatric surgeon: the impact of prenatal consultation on perinatal management.

    PubMed

    Crombleholme, T M; D'Alton, M; Cendron, M; Alman, B; Goldberg, M D; Klauber, G T; Cohen, A; Heilman, C; Lewis, M; Harris, B H

    1996-01-01

    Pediatric surgeons are increasingly called on by obstetrical colleagues to counsel parents about the implications of a prenatal ultrasound finding. Our understanding of the natural history of many prenatally diagnosed surgical conditions has grown significantly in recent years. Whether prenatal surgical consultation can influence perinatal course had not been investigated. During an 21-month period, 12,865 prenatal ultrasound studies were performed on a total of 4,551 patients, and 221 prenatal surgical consultations were obtained through a newly established fetal treatment program at a tertiary care prenatal diagnostic center. To evaluate the impact of prenatal pediatric surgical consultation on perinatal course, the authors reviewed changes in management including termination of pregnancy, in utero intervention, and altered site, mode, or timing of delivery. Two hundred twenty-one fetuses were referred for consultation; their 234 congenital anomalies included genitourinary (36%), thoracic (16%), intraabdominal (14.5%), abdominal wall (10.6%), neurological (9%), skeletal (6%), and head and neck (2.5%) defects; 2.5% had tumors and 2.5% were twin pregnancies. Pregnancy was terminated in 9.5% of cases, because of patient request, chromosomal abnormality, or dismal prognosis. In 3.6%, the decision to terminate was changed as a result of consultation. Site of delivery was changed as a result of consultation in 37% to facilitate postnatal evaluation and initiate immediate treatment. Mode of delivery was changed in 6.8% to prevent dystocia, hemorrhage into a tumor, as in sacrococcygeal teratoma, or to provide an emergency airway, as in cervical teratoma. The timing of delivery was changed in 4.5% to avoid further damage to fetal organs in cases of obstructive uropathy, gastroschisis, sacrococcygeal teratoma with high-output failure, and hydrocephalus. Five percent (11) underwent treatment in utero for fetal hydrothorax, obstructive uropathy, twin-twin transfusion

  2. Prenatal screening and prenatal diagnosis: contemporary practices in light of the past.

    PubMed

    Iltis, Ana S

    2016-06-01

    The 20th century eugenics movement in the USA and contemporary practices involving prenatal screening (PNS), prenatal diagnosis (PND), abortion and preimplantation genetic diagnosis (PGD) share important morally relevant similarities. I summarise some features of the 20th century eugenics movement; describe the contemporary standard of care in the USA regarding PNS, PND, abortion and PGD; and demonstrate that the 'old eugenics' the contemporary standard of care share the underlying view that social resources should be invested to prevent the birth of people with certain characteristics. This comparison makes evident the difficulty of crafting moral arguments that treat some uses of PNS, PND, abortion and PGD as licit and others as illicit.

  3. Outcomes of management decisions by parents for their infants with hypoplastic left heart syndrome born with and without a prenatal diagnosis.

    PubMed

    Tibballs, James; Cantwell-Bartl, Annie

    2008-06-01

    To study the influence of a prenatal diagnosis on parental choice of treatment for infants born with hypoplastic left heart syndrome (HLHS). Retrospective review of medical records of infants admitted to a paediatric tertiary hospital 1983-2004 with a diagnosis of HLHS. A total of 201 infants had HLHS diagnosed by echocardiography after birth with 129 subsequently undergoing surgery and 72 non-surgical management (compassionate/comfort care). When the diagnosis of HLHS was made prenatally, 68 of 71 (96%) infants underwent surgery whereas when the diagnosis was made post-natally 61 of 130 (47%) infants underwent surgery. Prenatal diagnosis was significantly associated with a parental choice of surgery (P < 0.001). Among 72 infants managed non-surgically, compassionate care was chosen by parents for 49 (68%) despite being fit for surgery, 20 (28%) were deemed unfit for surgery and in three (4%) the reasons for non-surgical management were unknown. Of the total 178 infants considered fit for surgery, 68 (38%) had had a prenatal diagnosis and 110 (62%) did not. Of 20 considered unfit for surgery, none had had a prenatal diagnosis. A prenatal diagnosis was significantly associated with fitness for surgery (P < 0.001). Approximately half of parents chose non-surgical management (compassionate care) of their infant if the diagnosis was post-natal. Although most parents of infants born with a prenatal diagnosis of HLHS chose surgical management of their infant, this is the likely influence of termination of pregnancy for this condition. Lack of prenatal diagnosis compromised fitness for surgery.

  4. Prenatal exposure to wartime famine and development of antisocial personality disorder in early adulthood.

    PubMed

    Neugebauer, R; Hoek, H W; Susser, E

    1999-08-04

    Several observational epidemiological studies report an association of pregnancy and obstetric complications with development of antisocial personality disorder (ASPD) in offspring. However, the precise nature and timing of the hypothesized biological insults are not known. To test whether severe maternal nutritional deficiency early in gestation is associated with risk for ASPD in offspring. Retrospective cohort study. From October 1944 to May 1945, the German army blockaded food supplies to the Netherlands, subjecting the western Netherlands first to moderate (official food rations, 4200-6300 kJ/d) then to severe (<4200 kJ/d) nutritional deficiency. The north and south were subjected to moderate nutritional deficiency only. Dutch men born in large urban areas in 1944-1946 who were given psychiatric examinations for military induction at age 18 years (N = 100543) were classified by the degree and timing of their prenatal exposure to nutritional deficiency based on their birthdate and birthplace. Diagnosis of ASPD by psychiatric interview at time of medical examination for military induction, using the International Classification of Diseases, Sixth Revision (ICD-6). Men exposed prenatally to severe maternal nutritional deficiency during the first and/or second trimesters of pregnancy exhibited increased risk for ASPD (adjusted odds ratio [OR], 2.5; 95% confidence interval [CI], 1.5-4.2). Third-trimester exposure to severe nutritional deficiency and prenatal exposure to moderate nutritional deficiency were not associated with risk for ASPD. Our data suggest that severe nutritional insults to the developing brain in utero may be capable of increasing the risk for antisocial behaviors in offspring. The possible implications of these findings for both developed countries and developing countries, where severe nutritional deficiency is widespread and often exacerbated by war, natural disaster, and forced migration, warrant study.

  5. Differential effects of prenatal stress on metabolic programming in diet-induced obese and dietary-resistant rats

    PubMed Central

    Balasubramanian, Priya; Varde, Pratibha A.; Abdallah, Simon Labib; Najjar, Sonia M.; MohanKumar, P. S.

    2015-01-01

    Stress during pregnancy is a known contributing factor for the development of obesity in the offspring. Since maternal obesity is on the rise, we wanted to identify the effects of prenatal stress in the offspring of diet-induced obese (DIO) rats and compare them with the offspring of dietary-resistant (DR) rats. We hypothesized that prenatal stress would make both DIO and DR offspring susceptible to obesity, but the effect would be more pronounced in DIO rats. Pregnant DIO and DR rats were divided into two groups: nonstressed controls (control) and prenatal stress (subjected to restraint stress, three times/day from days 14 to 21 of gestation). After recording birth weight and weaning weight, male offspring were weaned onto a chow diet for 9 wk and shifted to a high-fat (HF) diet for 1 wk. At the end of the 10th wk the animals were euthanized, and visceral adipose mass, blood glucose, serum insulin, and C-peptide levels were measured. Prenatal stress resulted in hyperinsulinemia and higher C-peptide levels without altering caloric intake, body weight gain, or fat mass in the DIO offspring after 1 wk of HF intake, but not in DR offspring. To determine the mechanism underlying the hyperinsulinemia, we measured the levels of CEACAM1 that are responsible for insulin clearance. CEACAM1 levels in the liver were reduced in prenatally stressed DIO offspring after the HF challenge, suggesting that preexisting genetic predisposition in combination with prenatal stress increases the risk for obesity in adulthood, especially when offspring are fed a HF diet. PMID:26219866

  6. Descriptive epidemiology of prenatal and perinatal risk factors in a Chinese population with reading disorder

    PubMed Central

    Liu, Lingfei; Wang, Jia; Shao, Shanshan; Luo, Xiu; Kong, Rui; Zhang, Xiaohui; Song, Ranran

    2016-01-01

    Several prenatal and perinatal factors have been found to be associated with developmental dyslexia (reading disorder) in alphabetic language. Given the absence of relevant studies of Chinese children, the present study tries to investigate these risk factors. A total of 45,850 students were recruited from grades three to six, from seven cities of Hubei province. Dyslexia in Chinese was diagnosed based on children’s clinical symptoms. The clinical symptoms of children’s reading performance were assessed by Dyslexia Checklist for Chinese Children (DCCC) and Pupil Rating Scale Revised Screening for Learning Disabilities (PRS) which were completed by parent/guardian and header teacher respectively. Chinese language exam was used to screen children with poor reading capacity. Questionnaires about prenatal and perinatal factors were completed by parent or guardian. Among the 34,748 eligible participants, 1,200 (3.45%) were diagnosed with dyslexia in Chinese. More boys suffered from dyslexia than the girls and the gender ratio was 3:1. Family history of neuropsychiatric diseases, maternal infectious diseases, difficult vaginal delivery, preterm birth, and neonatal asphyxia were found to increase the risk of developmental dyslexia in China. Closer longitudinal developmental monitoring and preventive measures should be taken for high risk children. PMID:27819320

  7. No association between prenatal exposure to psychotropics and intelligence at age five.

    PubMed

    Eriksen, Hanne-Lise Falgreen; Kesmodel, Ulrik Schiøler; Pedersen, Lars Henning; Mortensen, Erik Lykke

    2015-05-01

    To examine associations between prenatal exposure to selective serotonin reuptake inhibitors (SSRIs)/anxiolytics and intelligence assessed with a standard clinical intelligence test at age 5 years. Longitudinal follow-up study. Denmark, 2003-2008. A total of 1780 women and their children sampled from the Danish National Birth Cohort. Self-reported information on use of SSRI and anxiolytics was obtained from the Danish National Birth Cohort at the time of consent and from two prenatal interviews. Intelligence was assessed at age 5 years, and parental education, maternal intelligence quotient (IQ), maternal smoking and alcohol consumption in pregnancy, the child's age at testing, sex, and tester were included in the full model. The IQ of 13 medication-exposed children was compared with the IQ of 19 children whose mothers had untreated depression and 1748 control children. Wechsler Preschool and Primary Scale of Intelligence - Revised. In unadjusted analyses, children of mothers who used antidepressants or anxiolytics during pregnancy had higher verbal IQ; this association, however, was insignificant after adjustment for potentially confounding maternal and child factors. No consistent associations between IQ and fetal exposure to antidepressants and anxiolytics were observed, but the study had low statistical power, and there is an obvious need to conduct long-term follow-up studies with comprehensive cognitive assessment and sufficiently large samples of adolescent or adult offspring. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  8. Prenatal hydrocephalus: outcome and prognosis.

    PubMed

    Renier, D; Sainte-Rose, C; Pierre-Kahn, A; Hirsch, J F

    1988-08-01

    The clinical records of 108 infants presenting with hydrocephalus at birth and operated on from 1971 to 1981 were reviewed in order to evaluate the functional results. Premature newborns and spina bifida patients were excluded. Communicated hydrocephalus (39 cases) and aqueductal stenosis (32 cases, excluding 6 X-linked hydrocephalus and 4 toxoplasmoses) were the two main types of hydrocephalus in this series. Eighty-four percent of the infants were operated on before the age of 3 months. The mean follow-up time was 7 years (range 1 to 14 years). The survival rate, calculated by the life table method, was 62% at 10 years. The functional results were evaluated according to intellectual performance, academic level, and psychological status. Of the 75 surviving children, 28% have an I.Q. over 80 and 50% an I.Q. under 60. The mean I.Q. is 54 (range 0 to 130). Of the 52 children who have now reached school age, only 29% have reached a normal academic level. The psychological status is normal or borderline in 46% of the patients. The importance of head enlargement at birth, ventricular size, and the age at the time of surgery are not related to late functional results. The results were best when there were no associated malformations, no shunt infection, when hydrocephalus was due to aqueductal stenosis (excluding X-linked hydrocephalus and toxoplasmosis), or when the first developmental quotient measured at 6 months was over 80.

  9. Revision and Validation of the Revised Teacher Beliefs Survey.

    ERIC Educational Resources Information Center

    Benjamin, Jane

    This study revised the Teacher Beliefs Survey (S. Wooley and A. Wooley, 1999; TBS), an instrument to assess teachers beliefs related to constructivist and behaviorist theories of learning, and then studied the validity of the revised TBS. Drawing on a literature review, researchers added items for the existing constructs of the TBS and added a new…

  10. Mobility Monitoring System and Vehicle Performance Recorder. Revision.

    DTIC Science & Technology

    1985-09-01

    counter/timer. g. Four channel pulse conditioners. h. Four channel analog signal conditioner. i. Floating point math processor. j. Real-time clock . The...bytes of PROM, 2 K bytes of RAM, an 8 level priority interrupt controller, and a system clock . The ADC has 32 single ended channels, with full scale...output of the comparator (a logic level signal) is then either passed on through to the counter, or used to gate a 1 or 2 M z clock (for one period

  11. Revision of some ophiuroid records (Echinodermata: Ophiuroidea) from Argentina.

    PubMed

    Brogger, Martin I; O'Hara, Timothy D

    2015-06-12

    The taxonomy of some ophiuroids reported from off Argentina, western Antarctica and the SW Atlantic Ocean is reviewed. The species Amphilepis sanmatiensis, known only from the small holotype, is a synonym of Amphioplus lucyae. This synonymy removes the only reported endemic ophiuroid from Argentina. The species name "Ophiacantha ingrata Koehler, 1923" used for specimens from South Georgia is invalid; the specimens are likely to belong to one of two cryptic species within the O. vivipara complex. Specimens of Amphiura joubini reported from Argentina are re-identified as Amphiura princeps, and specimens of Ophiactis amator from the Antarctic Peninsula are re-identified as Ophiactis asperula.

  12. Cognitive development of Yu-Cheng ("oil disease") children prenatally exposed to heat-degraded PCBs.

    PubMed

    Chen, Y C; Guo, Y L; Hsu, C C; Rogan, W J

    1992-12-09

    To compare the cognitive development in Taiwanese children who had been exposed prenatally to high levels of heat-degraded polychlorinated biphenyls (PCBs) with control children who were exposed to background levels. The disorder was called Yu-Cheng, "oil disease," in Taiwan. Matched-pair cohort study. Communities in central Taiwan in which there had been a cooking-oil contamination and mass poisoning by heat-degraded PCBs in 1978 through 1979. One hundred eighteen children born between June 1978 and March 1985 during or after their mothers' consumption of contaminated rice oil; 118 children matched for age, sex, neighborhood, maternal age, and parental education and occupational class; and 15 older siblings of exposed children, born before the poisoning. Cognitive development measured from 1985 through 1990 using the Chinese versions of the Stanford-Binet test and the Wechsler Intelligence Scale for Children, Revised, The exposed children scored approximately 5 points lower on the Stanford-Binet test at the ages of 4 and 5 years and approximately 5 points lower on the Wechsler Intelligence Scale for Children, Revised, at the ages of 6 and 7 years. Children born up to 6 years after their mothers' exposure were as affected as children born within a year or two after exposure when examined at 6 and 7 years of age. Older siblings resembled the control children. Children prenatally exposed to heat-degraded PCBs had poorer cognitive development than their matched controls. The effect persisted in the children up to the age of 7 years, and children born long after the exposure were still affected.

  13. 21 CFR 20.26 - Indexes of certain records.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Indexes of certain records. 20.26 Section 20.26... INFORMATION General Policy § 20.26 Indexes of certain records. (a) Indexes shall be maintained, and revised at least quarterly, for the following Food and Drug Administration records: (1) Final orders published in...

  14. 21 CFR 20.26 - Indexes of certain records.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Indexes of certain records. 20.26 Section 20.26... INFORMATION General Policy § 20.26 Indexes of certain records. (a) Indexes shall be maintained, and revised at least quarterly, for the following Food and Drug Administration records: (1) Final orders published in...

  15. 22 CFR 1507.7 - Contents of records systems.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) Publish a notice in the Federal Register of any new or revised use of the information in the system or... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Contents of records systems. 1507.7 Section 1507... Contents of records systems. (a) The Foundation will maintain in its records only such information about an...

  16. 22 CFR 1507.7 - Contents of records systems.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...) Publish a notice in the Federal Register of any new or revised use of the information in the system or... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Contents of records systems. 1507.7 Section....7 Contents of records systems. (a) The Foundation will maintain in its records only such information...

  17. 77 FR 74282 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-13

    ... existing system of records ``Loan Guaranty Home, Condominium and Manufactured Home Loan Applicants Records... to amend its system of records entitled ``Loan Guaranty Home, Condominium and Manufactured Home Loan... revised to add a new Routine Use Number 35 as follows: 55VA26 System name: Loan Guaranty Home,...

  18. Prenatal stress alters amygdala functional connectivity in preterm neonates.

    PubMed

    Scheinost, Dustin; Kwon, Soo Hyun; Lacadie, Cheryl; Sze, Gordon; Sinha, Rajita; Constable, R Todd; Ment, Laura R

    2016-01-01

    Exposure to prenatal and early-life stress results in alterations in neural connectivity and an increased risk for neuropsychiatric disorders. In particular, alterations in amygdala connectivity have emerged as a common effect across several recent studies. However, the impact of prenatal stress exposure on the functional organization of the amygdala has yet to be explored in the prematurely-born, a population at high risk for neuropsychiatric disorders. We test the hypothesis that preterm birth and prenatal exposure to maternal stress alter functional connectivity of the amygdala using two independent cohorts. The first cohort is used to establish the effects of preterm birth and consists of 12 very preterm neonates and 25 term controls, all without prenatal stress exposure. The second is analyzed to establish the effects of prenatal stress exposure and consists of 16 extremely preterm neonates with prenatal stress exposure and 10 extremely preterm neonates with no known prenatal stress exposure. Standard resting-state functional magnetic resonance imaging and seed connectivity methods are used. When compared to term controls, very preterm neonates show significantly reduced connectivity between the amygdala and the thalamus, the hypothalamus, the brainstem, and the insula (p < 0.05). Similarly, when compared to extremely preterm neonates without exposure to prenatal stress, extremely preterm neonates with exposure to prenatal stress show significantly less connectivity between the left amygdala and the thalamus, the hypothalamus, and the peristriate cortex (p < 0.05). Exploratory analysis of the combined cohorts suggests additive effects of prenatal stress on alterations in amygdala connectivity associated with preterm birth. Functional connectivity from the amygdala to other subcortical regions is decreased in preterm neonates compared to term controls. In addition, these data, for the first time, suggest that prenatal stress exposure amplifies these

  19. [Complex Congenital Heart Disease: The Influence of Prenatal Diagnosis].

    PubMed

    Correia, Marta; Fortunato, Fabiana; Martins, Duarte; Teixeira, Ana; Nogueira, Graça; Menezes, Isabel; Anjos, Rui

    2015-01-01

    Complex congenital heart disease is a group of severe conditions. Prenatal diagnosis has implications on morbidity and mortality for most severe conditions. The purpose of this work was to evaluate the influence of prenatal diagnosis and distance of residence and birth place to a reference center, on immediate morbidity and early mortality of complex congenital heart disease. Retrospective study of complex congenital heart disease patients of our Hospital, born between 2007 and 2012. There were 126 patients born with complex congenital heart disease. In 95%, pregnancy was followed since the first trimester, with prenatal diagnosis in 42%. There was a statistically significant relation between birth place and prenatal diagnosis. Transposition of great arteries was the most frequent complex congenital heart disease (45.2%), followed by pulmonary atresia with ventricular septal defect (17.5%) and hypoplastic left ventricle (9.5%). Eighty-two patients (65.1%) had prostaglandin infusion and 38 (30.2%)were ventilated before an intervention. Surgery took place in the neonatal period in 73%. Actuarial survival rate at 30 days, 12 and 24 months was 85%, 80% and 75%, respectively. There was no statistically significant relation between prenatal diagnosis and mortality. Most patients with complex congenital heart disease did not have prenatal diagnosis. All cases with prenatal diagnosis were born in a tertiary center. Prenatal diagnosis did not influence significantly neonatal mortality, as already described in other studies with heterogeneous complex heart disease. prenatal diagnosis of complex congenital heart disease allowed an adequate referral. Most patients with complex congenital heart disease werenâÄôt diagnosed prenatally. This data should be considered when planning prenatal diagnosis of congenital heart disease.

  20. Prenatal congenital vertical talus (rocker bottom foot): a marker for multisystem anomalies.

    PubMed

    Rubio, Eva I; Mehta, Nimisha; Blask, Anna R; Bulas, Dorothy I

    2017-09-06

    Congenital vertical talus is a rare foot anomaly characterized by a prominent calcaneus and rigid forefoot dorsiflexion. While congenital vertical talus has been associated with anomalies such as trisomy 18, myelomeningocele and arthrogryposis, postnatal series have reported cases of isolated congenital vertical talus. The purpose of our study was to determine the incidence of isolated congenital vertical talus prenatally and identify the most common anomalies associated with this finding. A retrospective review was performed of congenital vertical talus cases identified in our fetal center from 2006 to 2015. The prenatal US and MR imaging appearance of congenital vertical talus was evaluated and differentiation from congenital talipes equinovarus was assessed. Studies were evaluated for additional abnormalities affecting the central nervous system, face, limbs, viscera, growth and amniotic fluid. Imaging findings were recorded and correlated with outcomes when available. Twenty-four cases of congenital vertical talus were identified prenatally (gestational age: 19-36 weeks). All 24 had prenatal US and 21 also underwent fetal MRI on the same day. There were no isolated cases of congenital vertical talus in this series; all 24 had additional anomalies identified prenatally. Sixteen cases had bilateral congenital vertical talus (67%). Additional anomalies were identified in the brain (15), spine (11), face (6), abdominal wall (3), heart (8) and other limbs (12). Chromosomal abnormalities were identified in 6 of 20 patients who underwent genetic testing. Overall, US held some advantage in detecting the abnormality: in 10 cases, US depicted congenital vertical talus more clearly than MRI; in 8 cases, US and MRI were equal in detection and in 3 cases, MRI was superior. In 9/15 cases with intracranial abnormalities, MRI was superior to US in demonstrating structural anomalies. Outcomes included termination (11), intrauterine fetal demise (1), stillbirth or immediate

  1. ABM Clinical Protocol #19: Breastfeeding Promotion in the Prenatal Setting, Revision 2015.

    PubMed

    Rosen-Carole, Casey; Hartman, Scott

    2015-12-01

    A central goal of the Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.

  2. ABM Clinical Protocol #19: Breastfeeding Promotion in the Prenatal Setting, Revision 2015

    PubMed Central

    Rosen-Carole, Casey; Hartman, Scott

    2015-01-01

    A central goal of the Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. PMID:26651541

  3. Contribution of maternal radionuclide burdens to prenatal radiation doses. Interim Recommendations: Revision 1

    SciTech Connect

    Sikov, M.R.; Hui, T.E.; Meznarich, H.K.; Thrall, K.D.; Traub, R.J.

    1992-03-01

    This report discusses approaches to calculating and expressing radiation doses to the embryo/fetus from internal radionuclides. Information was obtained for selected, occupationally significant radionuclides in chemical forms that provided a spectrum of metabolic and dosimetric characteristics. Fractional placental transfer and/or ratios of concentration in the embryo/fetus to that in the woman were estimated for these materials, and were combined with data from biokinetic transfer models to predict radioactivity levels in the embryo/fetus as a function of stage of pregnancy and time after entry into the transfer compartment or blood of the pregnant woman. Medical Internal Radiation Dosimetry (MIRD) methodologies were extended to formalize and describe details for calculating radiation absorbed doses to the embryo/fetus. Calculations were performed for representative situations; introduction of 1 {mu}Ci into a woman`s blood at successive months of pregnancy was assumed to accommodate the stage dependence of geometric relationships and biological behaviors. Summary tables of results, correlations, and dosimetric relations, and of tentative generalized categorizations, are provided in the report.

  4. Blood management in revision total knee arthroplasty.

    PubMed

    Cushner, Fred D; Foley, Iris; Kessler, Debra; Scuderi, Giles; Scott, W Norman

    2002-11-01

    Much attention has been focused on blood management issues in orthopaedic surgery in recent years, but blood management in patients having revision total knee arthroplasty is not well-established. Hematologic values and transfusion records of 100 patients (52 women, 48 men; mean age, 65 years) who had aseptic revision total knee arthroplasty at the authors' institution were evaluated retrospectively. Two- or three-component revisions comprised 66% of the procedures, and 58 patients participated in a preoperative autologous donation program. The mean preoperative hemoglobin level was 12.1 g/dL in the women and 14.1 g/dL in the men, but the men experienced a greater decrease in hemoglobin level (mean largest decrease, 4.2 g/dL versus 3.1 g/dL), possibly caused by the higher allogeneic transfusion rate in women (19.2%) versus men (4.2%). Patient age did not influence hemoglobin level or transfusion rates. Patients who participated in a preoperative autologous donation program had significantly higher hemoglobin levels before donation (14.4 g/dL versus 13.3 g/dL for patients who did not participate in a program) but comparable hemoglobin levels after predonation (12.9 g/dL). Patients with preoperative hemoglobin levels less than 13 g/dL were significantly more likely to have a transfusion. Symptom-based transfusion strategies and blood management approaches such as epoetin alfa that elevate preoperative hemoglobin level therefore may be beneficial in patients having revision total knee arthroplasty.

  5. Usefulness of additional fetal magnetic resonance imaging in the prenatal diagnosis of congenital abnormalities.

    PubMed

    We, Ji Sun; Young, Lee; Park, In Yang; Shin, Jong Chul; Im, Soo Ah

    2012-12-01

    Our aim was to compare the value of fetal magnetic resonance imaging (MRI) with detailed ultrasound in the prenatal diagnosis of congenital abnormalities. This retrospective study reviewed the medical records of pregnant women and their neonates who, after ultrasound, were suspected to have congenital abnormalities. They then underwent a detailed ultrasound examination and a fetal MRI in our institutions. Fetal MRI was performed in 81 cases. Each prenatal presumptive diagnosis, based on detailed ultrasound examination and fetal MRI, was compared with the postnatal confirmed diagnosis. In 58 cases, the data collected were confirmed by the postnatal diagnosis. Supplemental information from fetal MRI was useful in 17 of the 22 cases involving the central nervous system (CNS), two of two cases involving the thorax, nine of nine cases involving the genitourinary system, two of eight cases involving the gastrointestinal system, and ten of ten cases involving complex malformations. Fetal MRI did not provide significantly useful information or facilitate a more accurate diagnosis except for CNS abnormalities. Fetal MRI was not superior to an ultrasound examination in the prenatal detection of congenital abnormalities. A detailed ultrasound examination performed by experienced obstetricians had satisfactory accuracy in the diagnosis of fetal abnormalities compared with fetal MRI. Fetal MRI might be useful in appropriate cases in Korea. Greater effort is required to increase the ultrasound knowledge and skill of competent obstetricians.

  6. The role of attitudes towards the targets of behaviour in predicting and informing prenatal testing choices.

    PubMed

    Bryant, Louise D; Green, Josephine M; Hewison, Jenny

    2010-12-01

    Research considering the role of attitudes in prenatal testing choices has commonly focused on the relationship between the attitude towards undergoing testing and actual testing behaviour. In contrast, this study focused on the relationship between testing behaviour and attitudes towards the targets of the behaviour (in this case people with Down syndrome (DS) and having a baby with DS). A cross-sectional, prospective survey of 197 pregnant women measured attitudes towards the targets of prenatal testing along with intentions to use screening and diagnostic testing, and the termination of an affected pregnancy. Screening uptake was established via patient records. Although attitudes towards DS and having a baby with DS were significantly associated with screening uptake and testing and termination intentions, unfavourable attitudes were better than favourable ones at predicting these outcomes. For example, in the quartile of women with the 'most favourable' attitude towards people with DS 67% used screening although only 8% said they would terminate an affected pregnancy. Qualitative data suggested that not all women considered personal attitudes towards DS to be relevant to their screening decisions. This finding has implications for the way in which informed choice is currently understood and measured in the prenatal testing context.

  7. Holoprosencephaly at prenatal diagnosis: analysis of 28 cases regarding etiopathogenic diagnoses.

    PubMed

    Petracchi, F; Crespo, L; Michia, C; Igarzabal, L; Gadow, E

    2011-09-01

    To assess the likelihood of finding an etiopathogenic cause in an ultrasonographic prenatal diagnosis of holoprosencephaly. From January 1996 to June 2010, 13 883 prenatal diagnoses through chorionic villus sampling or amniocentesis were made. Every fetus with holoprosencephaly at ultrasound was evaluated. Gestational age, additional ultrasound findings, and fetal karyotype were recorded. Molecular diagnosis and parental karyotype were studied, if relevant. Twenty-eight fetuses were diagnosed with holoprosencephaly (0.20%). All cases had additional ultrasound findings (100%). A definitive etiology was found in 23 cases (82.14%): karyotype was abnormal in 19 (67.9%) and normal in 8 (28.5%) cases. In the normal karyotype group, although molecular testing was performed in a few cases, one mutation of gene SIX 3 was diagnosed, one diagnosis of dysgnathia complex was made, and two fetuses presented Smith-Lemli-Opitz syndrome. No etiopathogenic diagnosis was made in five fetuses. Our results showed that a definitive etiology can be established in most cases of prenatal holoprosencephaly. Chromosomal anomalies were the most frequent finding. However, in euploid fetuses, molecular diagnosis is worthwhile, as different genes with different inheritance patterns may be responsible for this malformation. Thorough evaluation proved beneficial for assessing more accurate prognosis and recurrence risks. Copyright © 2011 John Wiley & Sons, Ltd.

  8. Prenatal exposure to H2 blockers and to proton pump inhibitors and asthma development in offspring.

    PubMed

    Yitshak-Sade, Maayan; Gorodischer, Rafael; Aviram, Micha; Novack, Lena

    2016-01-01

    Fetal exposure to H2 blockers (H2 Bs) or proton pump inhibitors (PPIs) has been reported to be associated with asthma in children. We evaluated the risk of asthma in offspring following prenatal H2 Bs. We enrolled 91 428 children and their mothers who resided in southern Israel during 1998-2011. The computerized medications database was linked with records from the district hospital. Of the eligible children, 11 227 developed asthma, and overall 5.5% had been exposed to H2 Bs or PPIs prenatally. The risk of developing asthma was slightly higher in the group exposed to H2 Bs or PPIs (RR, 1.09; P = .023). At greater risk were children whose mothers purchased these medications more than 3 times (RR, 1.22; P = .038) or exposed to >20 defined daily doses or prenatally exposed to lansoprazole. The statistical association was significant and depended on magnitude of exposure and specific medication, but the absolute risk was low. The association between maternal consumption of H2 Bs or PPIs and asthma and childhood remained statistically significant 2 years after delivery, raising the possibility of confounding by the indication phenomenon. In view of the findings, a causal relationship could not be ascertained, and an unidentified etiological factor could be operative.

  9. A qualitative study of the experience of CenteringPregnancy group prenatal care for physicians

    PubMed Central

    2013-01-01

    Background This study sought to understand the central meaning of the experience of group prenatal care for physicians who were involved in providing CenteringPregnancy through a maternity clinic in Calgary, Canada. Method The study followed the phenomenological qualitative tradition. Three physicians involved in group prenatal care participated in a one-on-one interview between November and December 2009. Two physicians participated in verification sessions. Interviews followed an open ended general guide and were audio recorded and transcribed. The purpose of the analysis was to identify meaning themes and the core meaning experienced by the physicians. Results Six themes emerged: (1) having a greater exchange of information, (2) getting to knowing, (3) seeing women get to know and support each other, (4) sharing ownership of care, (5) having more time, and (6) experiencing enjoyment and satisfaction in providing care. These themes contributed to the core meaning for physicians of “providing richer care.” Conclusions Physicians perceived providing better care and a better professional experience through CenteringPregnancy compared to their experience of individual prenatal care. Thus, CenteringPregnancy could improve work place satisfaction, increase retention of providers in maternity care, and improve health care for women. PMID:23445867

  10. The effectiveness of an abuse assessment protocol in public health prenatal clinics.

    PubMed Central

    Wiist, W H; McFarlane, J

    1999-01-01

    OBJECTIVES: This study evaluated whether incorporation of an abuse assessment protocol into the routine procedures of the prenatal clinics of a large urban public health department led to increased referral for and assessment, identification, and documentation of abuse. METHODS: Evaluation was conducted at 3 matched prenatal clinics serving a total of 12,000 maternity patients per year. Two clinics used the abuse protocol and 1 did not. An audit was performed at the clinics on a randomly selected sample of 540 maternity patient charts for the 15 months before the protocol was initiated and of 540 records for the 15 months after the protocol was introduced. Ninety-six percent of the patients represented in the sample were Latina. RESULTS: At the clinics using the protocol, abuse assessment increased from 0 to 88%. Detection of abuse increased from 0.8% to 7%. There were no changes at the comparison clinic. CONCLUSIONS: Incorporation of an abuse assessment protocol into the routine procedures of public health department prenatal clinics increases the assessment, identification, and documentation of and referral for abuse among pregnant women. An abuse protocol should be a routine part of maternity care. PMID:10432909

  11. Adult Neuropsychological Performance Following Prenatal and Early Postnatal Exposure to Tetrachloroethylene (PCE)-contaminated Drinking Water

    PubMed Central

    Janulewicz, Patricia A; White, Roberta F; Martin, Brett M; Winter, Michael R; Weinberg, Janice M; Vieira, Veronica; Aschengrau, Ann

    2012-01-01

    This population-based retrospective cohort study examined adult performance on a battery of neuropsychological tests in relation to prenatal and early postnatal exposure to tetrachloroethylene (PCE)-contaminated drinking water on Cape Cod, Massachusetts. Subjects were identified through birth records from 1969 through 1983. Exposure was modeled using pipe network information from town water departments, a PCE leaching and transport algorithm, EPANet water flow modeling software, and a Geographic Information System (GIS). Results of crude and multivariate analyses among 35 exposed and 28 unexposed subjects showed no association between prenatal and early postnatal exposure and decrements on tests that assess abilities in the domains of omnibus intelligence, academic achievement or language. The results were suggestive of an association between prenatal and early postnatal PCE exposure and diminished performance on tests that assessed abilities in the domains of visuospatial functioning, learning and memory, motor, attention and mood. Because the sample size was small, most findings were not statistically significant. Future studies with larger sample sizes should be conducted to further define the neuropsychological consequences of early developmental PCE exposure. PMID:22522125

  12. Gendered Performances during Peer Revision

    ERIC Educational Resources Information Center

    Styslinger, Mary E.

    2008-01-01

    This study explored the ways gender is accomplished in varied social contexts during the peer revision process in a secondary English classroom. Using a post-structural feminist theoretical framework, an analysis of classroom discourse provided a basis for understanding the performance of gender during peer revision, the effects of gender…

  13. Interior Design: Revision as Focus.

    ERIC Educational Resources Information Center

    Smede, Shelly D.

    2000-01-01

    Describes how the author teaches her eighth-grade students to revise their writing, providing "working revision days" in class, offering direction and structure, and thereby helping students learn how much impact going back to a piece of writing and making sweeping changes can have on the end result. (SR)

  14. Emotion Processes in Knowledge Revision

    ERIC Educational Resources Information Center

    Trevors, Gregory J.; Kendeou, Panayiota; Butterfuss, Reese

    2017-01-01

    In recent years, a number of insights have been gained into the cognitive processes that explain how individuals overcome misconceptions and revise their previously acquired incorrect knowledge. The current study complements this line of research by investigating the moment-by-moment emotion processes that occur during knowledge revision using a…

  15. Multimodal Revision Techniques in Webtexts

    ERIC Educational Resources Information Center

    Ball, Cheryl E.

    2014-01-01

    This article examines how an online scholarly journal, "Kairos: Rhetoric, Technology, Pedagogy," mentors authors to revise their webtexts (interactive, digital media scholarship) for publication. Using an editorial pedagogy in which multimodal and rhetorical genre theories are merged with revision techniques found in process-based…

  16. Multimodal Revision Techniques in Webtexts

    ERIC Educational Resources Information Center

    Ball, Cheryl E.

    2014-01-01

    This article examines how an online scholarly journal, "Kairos: Rhetoric, Technology, Pedagogy," mentors authors to revise their webtexts (interactive, digital media scholarship) for publication. Using an editorial pedagogy in which multimodal and rhetorical genre theories are merged with revision techniques found in process-based…

  17. TRICARE reimbursement revisions. Final rule.

    PubMed

    2012-06-27

    This final rule provides several necessary revisions to the regulation in order for TRICARE to be consistent with Medicare. These revisions affect: Hospice periods of care; reimbursement of physician assistants and assistant-at-surgery claims; and diagnosis-related group values, removing references to specific numeric diagnosis-related group values and replacing them with their narrative description.

  18. Prenatal alcohol exposure assessment: multiple embedded measures in a prenatal questionnaire.

    PubMed

    Burd, Larry; Martsolf, John; Klug, Marilyn G; O'Connor, Ellen; Peterson, Marlene

    2003-01-01

    Alcohol exposure during pregnancy is a well-recognized public health problem. Accurate assessment of prenatal alcohol exposure is especially important to identify women in need of intervention. In this study, a 36-item prenatal questionnaire was utilized to survey a representative sample of prenatal care providers to examine prevalence rates of exposure. The questionnaire included three common screening tools for alcohol use during pregnancy and the items necessary to establish a maternal risk profile. In North Dakota, 1081 pregnant women were included in the sample. Eighty (7.4%) were Native American and 952 (88%) were White. The TWEAK screening tool was positive for 253 (23.4%) of the women. Native American women had a 71% increase in positive TWEAK screenings compared to White women. Logistic regression was used to develop a high-risk model. The data from prenatal care can also be used for maternal risk stratification. Early identification can provide opportunity for early interventions to decrease total exposure during pregnancy and to improve the outcome for the child.

  19. Surgical Scar Revision: An Overview

    PubMed Central

    Garg, Shilpa; Dahiya, Naveen; Gupta, Somesh

    2014-01-01

    Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods. PMID:24761092

  20. Revision Trabeculectomy: Pearls and Pitfalls

    PubMed Central

    Crowston, Jonathan

    2012-01-01

    ABSTRACT Revision trabeculectomy is used to describe any surgical intervention subsequent to an existing trabeculectomy. Mostly, it is used to describe resurgery for failure of trabeculectomy, as defined by inadequate pressure control. Revision may also be performed for unsafe, uncomfortable or leaking blebs. Mostly bleb failure occurs within the subconjunctival space, although the flap and ostium may be involved or causative. Clear surgical principles, meticulous surgical technique and scrupulous postoperative care are key to successful revision surgery. This review is an attempt to elucidate the technique of bleb revision for bleb failure. How to cite this article: Coote M, Crowston J. Revision Trabeculectomy: Pearls and Pitfalls. J Current Glau Prac 2012;6(3):131-138. PMID:26997769

  1. 77 FR 55221 - Agency Information Collection Activities: Report of Medical Examination and Vaccination Record...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-07

    ... Medical Examination and Vaccination Record, Form I-693; Revision of a Currently Approved Collection ACTION...: Report of Medical Examination and Vaccination Record. (3) Agency form number, if any, and the...

  2. [Social factors associated with use of prenatal care in Ecuador].

    PubMed

    Sánchez-Gómez, Amaya; Cevallos, William; Grijalva, Mario J; Silva-Ayçaguer, Luis C; Tamayo, Susana; Jacobson, Jerry O; Costales, Jaime A; Jiménez-Garcia, Rodrigo; Hernández-Barrera, Valentín; Serruya, Suzanne; Riera, Celia

    2016-11-01

    Prenatal care is a pillar of public health, enabling access to interventions including prevention of mother-to-child transmission of HIV and congenital syphilis. This paper describes social factors related to use of prenatal care in Ecuador. In 2011 and 2012, participant clinical history and interview information was analyzed from a national probability sample of 5 998 women presenting for delivery or miscarriage services in 15 healthcare facilities in Ecuador, to estimate prevalence of HIV, syphilis, and Chagas disease, and prenatal care coverage. The study found that 94.1% of women had attended at least one prenatal visit, but that attendance at no less than four visits was 73.1%. Furthermore, lower educational level, greater number of pregnancies, occupation in the agriculture or livestock sector, and membership in ethnic indigenous, Afro-Ecuadorian, or other minority groups were factors associated with lack of use (no prenatal visits) or insufficient use of prenatal care (fewer than four visits or first visit at >20 weeks gestation) in Ecuador. These results point to persistence of marked inequalities in access to and use of prenatal health services attributable to socioeconomic factors and to the need to strengthen strategies to address them, to reach the goal of universal prenatal care coverage.

  3. Effects of prenatal care on child health at age 5.

    PubMed

    Noonan, Kelly; Corman, Hope; Schwartz-Soicher, Ofira; Reichman, Nancy E

    2013-02-01

    The broad goal of contemporary prenatal care is to promote the health of the mother, child, and family through the pregnancy, delivery, and the child's development. Although the vast majority of mothers giving birth in developed countries receive prenatal care, past research has not found compelling evidence that early or adequate prenatal care has favorable effects on birth outcomes. It is possible that prenatal care confers health benefits to the child that do not become apparent until after the perinatal period. Using data from a national urban birth cohort study in the US, we estimate the effects of prenatal care on four markers of child health at age 5-maternal-reported health status, asthma diagnosis, overweight, and height. Prenatal care, defined a number of different ways, does not appear to have any effect on the outcomes examined. The findings are robust and suggest that routine health care encounters during the prenatal period could potentially be used more effectively to enhance children's health trajectories. However, future research is needed to explore the effects of prenatal care on additional child health and developmental outcomes as well as the effects of preconceptional and maternal lifetime healthcare on child health.

  4. Does Rural Residence Affect Access to Prenatal Care in Oregon?

    ERIC Educational Resources Information Center

    Epstein, Beth; Grant, Therese; Schiff, Melissa; Kasehagen, Laurin

    2009-01-01

    Context: Identifying how maternal residential location affects late initiation of prenatal care is important for policy planning and allocation of resources for intervention. Purpose: To determine how rural residence and other social and demographic characteristics affect late initiation of prenatal care, and how residence status is associated…

  5. Memory and Brain Volume in Adults Prenatally Exposed to Alcohol

    ERIC Educational Resources Information Center

    Coles, Claire D.; Goldstein, Felicia C.; Lynch, Mary Ellen; Chen, Xiangchuan; Kable, Julie A.; Johnson, Katrina C.; Hu, Xiaoping

    2011-01-01

    The impact of prenatal alcohol exposure on memory and brain development was investigated in 92 African-American, young adults who were first identified in the prenatal period. Three groups (Control, n = 26; Alcohol-related Neurodevelopmental Disorder, n = 36; and Dysmorphic, n = 30) were imaged using structural MRI with brain volume calculated for…

  6. Long-term behavioral consequences of prenatal MDMA exposure

    PubMed Central

    Thompson, Valerie B.; Heiman, Justin; Chambers, James B; Benoit, Stephen C.; Buesing, William R.; Norman, Mantana K.; Norman, Andrew B.; Lipton, Jack W.

    2009-01-01

    The current study sought to determine whether prenatal 3,4-methylenedioxy-N-methamphetamine (MDMA) exposure from E14-20 in the rat resulted in behavioral sequelae in adult offspring. Prenatal MDMA exposure results in increased dopaminergic fiber density in the prefrontal cortex, striatum and nucleus accumbens of young rats. Since these areas are critical in response to novelty, reward, attention and locomotor activity, we hypothesized that prenatal MDMA exposure would produce significant changes in the performance of tasks that examine such behaviors in adult rats. Adult rats prenatally exposed to MDMA exhibited greater activity and spent more time in the center during a novel open field test as compared to controls. This increased activity was not reflected in normal home cage activity. Prenatal exposure to MDMA did not affect feeding or food reward. It did not alter cocaine self-administration behaviors, nor did it have an effect on the locomotor response to amphetamine challenge. Finally, while prenatal MDMA did not affect performance in the radial arm maze or the Morris water maze (MWM), these animals demonstrated altered performance in a cued MWM paradigm. Prenatal MDMA exposure resulted in perseverative attendance to a hanging cue when the platform in the MWM was removed as compared to controls. Together, these data demonstrate that prenatal exposure to MDMA results in a behavioral phenotype in adult rats characterized by reduced anxiety, a heightened response to novelty, and “hyperattentiveness” to environmental cues during spatial learning. PMID:19162054

  7. Does Rural Residence Affect Access to Prenatal Care in Oregon?

    ERIC Educational Resources Information Center

    Epstein, Beth; Grant, Therese; Schiff, Melissa; Kasehagen, Laurin

    2009-01-01

    Context: Identifying how maternal residential location affects late initiation of prenatal care is important for policy planning and allocation of resources for intervention. Purpose: To determine how rural residence and other social and demographic characteristics affect late initiation of prenatal care, and how residence status is associated…

  8. Prenatal Care: A Content-Based ESL Curriculum.

    ERIC Educational Resources Information Center

    Hassel, Elissa Anne

    A content-based curriculum in English as a Second Language (ESL) focusing on prenatal self-care is presented. The course was designed as a solution to the problem of inadequate prenatal care for limited-English-proficient Mexican immigrant women. The first three sections offer background information on and discussion of (1) content-based ESL…

  9. Prenatal Smoking Exposure, Low Birth Weight, and Disruptive Behavior Disorders

    ERIC Educational Resources Information Center

    Nigg, Joel T.; Breslau, Naomi

    2007-01-01

    Background: Prenatal problems are among theorized etiologies for child disruptive behavior problems. A key question concerns whether etiological contributors are shared across the broad range of disruptive psychopathology or are partially or largely distinct. Method: We examined prenatal smoking exposure and low birth weight as risk factors for…

  10. Effects of Prenatal Care on Child Health at Age 5

    PubMed Central

    Noonan, Kelly; Corman, Hope; Schwartz-Soicher, Ofira; Reichman, Nancy E.

    2012-01-01

    Objectives The broad goal of contemporary prenatal care is to promote the health of the mother, child, and family through the pregnancy, delivery, and the child’s development. Although the vast majority of mothers giving birth in developed countries receive prenatal care, past research has not found compelling evidence that early or adequate prenatal care has favorable effects on birth outcomes. It is possible that prenatal care confers health benefits to the child that do not become apparent until after the perinatal period. Methods Using data from a national urban birth cohort study in the U.S., we estimate the effects of prenatal care on four markers of child health at age 5—maternal-reported health status, asthma diagnosis, overweight, and height. We implement a number of different strategies to address the issue of potential omitted variables bias as well as a large number of specification checks to validate the findings. Results and Conclusions Prenatal care, defined a number of different ways, does not appear to have any effect on the outcomes examined. The findings are robust and suggest that routine health care encounters during the prenatal period could potentially be used more effectively to enhance children’s health trajectories. However, future research is needed to explore the effects of prenatal care on additional child health and developmental outcomes as well as the effects of preconceptional and maternal lifetime helathcare on child health. PMID:22374319

  11. An Evaluation of an Adolescent Prenatal Education Program.

    ERIC Educational Resources Information Center

    Covington, Deborah L.; Peoples-Sheps, Mary D.; Buescher, Paul A.; Bennett, Trude A.; Paul, Melanie V.

    1998-01-01

    Evaluated the effectiveness of a prenatal-education program in increasing prenatal care utilization, improving maternal weight gain, and reducing low-birthweight births among adolescents. Data from weekly program reports and state vital statistics and health services information indicated that program participants were less likely to have…

  12. Prenatal Estrogens and the Development of Homosexual Orientation.

    ERIC Educational Resources Information Center

    Meyer-Bahlburg, Heino F. L.; And Others

    1995-01-01

    Examines the hypothesis that prenatal estrogens contribute to the development of human sexual orientation. Several groups of women with a history of prenatal exposure to diethylstilbestrol (DES) were compared with several samples of control women. Findings showed that more DES-exposed women than controls were rated as bisexual or homosexual,…

  13. Nonuse of Prenatal Care: Implications for Social Work Involvement.

    ERIC Educational Resources Information Center

    Bedics, Bonnie C.

    1994-01-01

    Interviewed 44 women who did not obtain prenatal care. Identified four categories of reasons for nonuse: women's lifestyles differed from mainstream; stressful events took priority over prenatal care; women attempted to receive care but were discouraged, turned away, or given poor information by service delivery system personnel; and women did not…

  14. Prenatal Alcohol Exposure and Infant Information Processing Ability.

    ERIC Educational Resources Information Center

    Jacobson, Sandra W.; And Others

    1993-01-01

    A total of 403 black, inner-city infants born to women recruited prenatally on basis of their alcohol consumption during pregnancy were assessed on a battery of tests focusing on information processing and complexity of play. Increased prenatal alcohol exposure was associated with longer fixation duration, a result indicative of less efficient…

  15. Prenatal Exposure to Maternal Depression and Cortisol Influences Infant Temperament

    ERIC Educational Resources Information Center

    Davis, Elysia Poggi; Glynn, Laura M.; Schetter, Christine Dunkel; Hobel, Calvin; Chicz-Demet, Aleksandra; Sandman, Curt A.

    2007-01-01

    Background: Accumulating evidence indicates that prenatal maternal and fetal processes can have a lasting influence on infant and child development. Results from animal models indicate that prenatal exposure to maternal stress and stress hormones has lasting consequences for development of the offspring. Few prospective studies of human pregnancy…

  16. Memory and Brain Volume in Adults Prenatally Exposed to Alcohol

    ERIC Educational Resources Information Center

    Coles, Claire D.; Goldstein, Felicia C.; Lynch, Mary Ellen; Chen, Xiangchuan; Kable, Julie A.; Johnson, Katrina C.; Hu, Xiaoping

    2011-01-01

    The impact of prenatal alcohol exposure on memory and brain development was investigated in 92 African-American, young adults who were first identified in the prenatal period. Three groups (Control, n = 26; Alcohol-related Neurodevelopmental Disorder, n = 36; and Dysmorphic, n = 30) were imaged using structural MRI with brain volume calculated for…

  17. An Evaluation of an Adolescent Prenatal Education Program.

    ERIC Educational Resources Information Center

    Covington, Deborah L.; Peoples-Sheps, Mary D.; Buescher, Paul A.; Bennett, Trude A.; Paul, Melanie V.

    1998-01-01

    Evaluated the effectiveness of a prenatal-education program in increasing prenatal care utilization, improving maternal weight gain, and reducing low-birthweight births among adolescents. Data from weekly program reports and state vital statistics and health services information indicated that program participants were less likely to have…

  18. Prenatal Exposure to Maternal Depression and Cortisol Influences Infant Temperament

    ERIC Educational Resources Information Center

    Davis, Elysia Poggi; Glynn, Laura M.; Schetter, Christine Dunkel; Hobel, Calvin; Chicz-Demet, Aleksandra; Sandman, Curt A.

    2007-01-01

    Background: Accumulating evidence indicates that prenatal maternal and fetal processes can have a lasting influence on infant and child development. Results from animal models indicate that prenatal exposure to maternal stress and stress hormones has lasting consequences for development of the offspring. Few prospective studies of human pregnancy…

  19. Prenatal counselling for congenital anomalies: a systematic review.

    PubMed

    Marokakis, Sarah; Kasparian, Nadine A; Kennedy, Sean E

    2016-07-01

    Prenatal diagnosis of fetal anomalies may arouse fear, anxiety and distress in parents, and counselling may assist parents to cope with the diagnosis. This systematic review aimed to (1) synthesise the evidence on the impact of non-genetic, prenatal counselling after fetal diagnosis of a congenital anomaly on parental knowledge and psychological adjustment and (2) identify parents' preferences for the timing and format of counselling. Five electronic databases were systematically searched to identify studies assessing prenatal counselling provided to parents after prenatal diagnosis of one or more structural congenital anomalies. Data were extracted using predefined data forms, according to the preferred reporting items for systematic reviews and meta-analyses guidelines, and synthesised. Twenty four articles were included for review; most articles reported results of retrospective surveys and the quality of included studies was variable. Only three studies assessed parental anxiety, and each reported a significant decrease in anxiety following prenatal counselling. Parents expressed a preference for counselling on all aspects of their baby's anomaly as soon as possible after prenatal diagnosis, and desired written, visual and web-based information resources, and support group contacts. Although prenatal counselling reduced parental anxiety, further research is needed to adequately assess the impact of prenatal counselling on other psychological outcomes. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

  20. Nonuse of Prenatal Care: Implications for Social Work Involvement.

    ERIC Educational Resources Information Center

    Bedics, Bonnie C.

    1994-01-01

    Interviewed 44 women who did not obtain prenatal care. Identified four categories of reasons for nonuse: women's lifestyles differed from mainstream; stressful events took priority over prenatal care; women attempted to receive care but were discouraged, turned away, or given poor information by service delivery system personnel; and women did not…

  1. Children's Prenatal Exposure to Drugs: Implications for Early Childhood Educators.

    ERIC Educational Resources Information Center

    Mayfield, Phyllis K.; Chapman, J. Keith

    1998-01-01

    Examines the effects of drug use during pregnancy on early and later child development, the extent of women's drug use, and behavioral and learning characteristics of children prenatally exposed to drugs. Provides intervention guidelines for early childhood settings including children with prenatal drug exposure, focusing on recommendations for…

  2. Human Prenatal Effects: Methodological Problems and Some Suggested Solutions

    ERIC Educational Resources Information Center

    Copans, Stuart A.

    1974-01-01

    Briefly reviews the relevant literature on human prenatal effects, describes some of the possible designs for such studies; and discusses some of the methodological problem areas: sample choice, measurement of prenatal variables, monitoring of labor and delivery, and neonatal assessment. (CS)

  3. Maternal Prenatal Positive Affect, Depressive and Anxiety Symptoms and Birth Outcomes: The PREDO Study

    PubMed Central

    Kuusinen, Tiina; Tuovinen, Soile; Villa, Pia; Hämäläinen, Esa; Laivuori, Hannele; Kajantie, Eero; Räikkönen, Katri

    2016-01-01

    Background We investigated whether maternal prenatal emotions are associated with gestational length and birth weight in the large PREDO Study with multiple measurement points of emotions during gestation. Methods Altogether 3376 pregnant women self-assessed their positive affect (PA, Positive and Negative Affect Schedule) and depressive (Center for Epidemiologic Studies Depression Scale, CES-D) and anxiety (Spielberger State Anxiety Scale, STAI) symptoms up to 14 times during gestation. Birth characteristics were derived from the National Birth Register and from medical records. Results One standard deviation (SD) unit higher PA during the third pregnancy trimester was associated with a 0.05 SD unit longer gestational length, whereas one SD unit higher CES-D and STAI scores during the third trimester were associated with 0.04–0.05 SD unit shorter gestational lengths (P-values ≤ 0.02), corresponding to only 0.1–0.2% of the variation in gestational length. Higher PA during the third trimester was associated with a significantly decreased risk for preterm (< 37 weeks) delivery (for each SD unit higher positive affect, odds ratio was 0.8-fold (P = 0.02). Mothers with preterm delivery showed a decline in PA and an increase in CES-D and STAI during eight weeks prior to delivery. Post-term birth (≥ 42 weeks), birth weight and fetal growth were not associated with maternal prenatal emotions. Conclusions This study with 14 measurements of maternal emotions during pregnancy show modest effects of prenatal emotions during the third pregnancy trimester, particularly in the weeks close to delivery, on gestational length. From the clinical perspective, the effects were negligible. No associations were detected between prenatal emotions and birth weight. PMID:26919119

  4. Prenatal exposure to fenugreek impairs sensorimotor development and the operation of spinal cord networks in mice.

    PubMed

    Khalki, Loubna; Ba M'hamed, Saadia; Sokar, Zahra; Bennis, Mohamed; Vinay, Laurent; Bras, Hélène; Viemari, Jean-Charles

    2013-01-01

    Fenugreek is a medicinal plant whose seeds are widely used in traditional medicine, mainly for its laxative, galactagogue and antidiabetic effects. However, consumption of fenugreek seeds during pregnancy has been associated with a range of congenital malformations, including hydrocephalus, anencephaly and spina bifida in humans. The present study was conducted to evaluate the effects of prenatal treatment of fenugreek seeds on the development of sensorimotor functions from birth to young adults. Pregnant mice were treated by gavage with 1 g/kg/day of lyophilized fenugreek seeds aqueous extract (FSAE) or distilled water during the gestational period. Behavioral tests revealed in prenatally treated mice a significant delay in righting, cliff avoidance, negative geotaxis responses and the swimming development. In addition, extracellular recording of motor output in spinal cord isolated from neonatal mice showed that the frequency of spontaneous activity and fictive locomotion was reduced in FSAE-exposed mice. On the other hand, the cross-correlation coefficient in control mice was significantly more negative than in treated animals indicating that alternating patterns are deteriorated in FSAE-treated animals. At advanced age, prenatally treated mice displayed altered locomotor coordination in the rotarod test and also changes in static and dynamic parameters assessed by the CatWalk automated gait analysis system. We conclude that FSAE impairs sensorimotor and coordination functions not only in neonates but also in adult mice. Moreover, spinal neuronal networks are less excitable in prenatally FSAE-exposed mice suggesting that modifications within the central nervous system are responsible, at least in part, for the motor impairments.

  5. Prenatal Exposure to Fenugreek Impairs Sensorimotor Development and the Operation of Spinal Cord Networks in Mice

    PubMed Central

    Khalki, Loubna; Ba M’hamed, Saadia; Sokar, Zahra; Bennis, Mohamed; Vinay, Laurent

    2013-01-01

    Fenugreek is a medicinal plant whose seeds are widely used in traditional medicine, mainly for its laxative, galactagogue and antidiabetic effects. However, consumption of fenugreek seeds during pregnancy has been associated with a range of congenital malformations, including hydrocephalus, anencephaly and spina bifida in humans. The present study was conducted to evaluate the effects of prenatal treatment of fenugreek seeds on the development of sensorimotor functions from birth to young adults. Pregnant mice were treated by gavage with 1g/kg/day of lyophilized fenugreek seeds aqueous extract (FSAE) or distilled water during the gestational period. Behavioral tests revealed in prenatally treated mice a significant delay in righting, cliff avoidance, negative geotaxis responses and the swimming development. In addition, extracellular recording of motor output in spinal cord isolated from neonatal mice showed that the frequency of spontaneous activity and fictive locomotion was reduced in FSAE-exposed mice. On the other hand, the cross-correlation coefficient in control mice was significantly more negative than in treated animals indicating that alternating patterns are deteriorated in FSAE-treated animals. At advanced age, prenatally treated mice displayed altered locomotor coordination in the rotarod test and also changes in static and dynamic parameters assessed by the CatWalk automated gait analysis system. We conclude that FSAE impairs sensorimotor and coordination functions not only in neonates but also in adult mice. Moreover, spinal neuronal networks are less excitable in prenatally FSAE-exposed mice suggesting that modifications within the central nervous system are responsible, at least in part, for the motor impairments. PMID:24224030

  6. Maternal prenatal urinary phthalate metabolite concentrations and visual recognition memory among infants at 27 weeks.

    PubMed

    Ipapo, Khristina N; Factor-Litvak, Pam; Whyatt, Robin M; Calafat, Antonia M; Diaz, Diurka; Perera, Frederica; Rauh, Virginia; Herbstman, Julie B

    2017-05-01

    Prior research has demonstrated inverse associations between maternal prenatal urinary phthalate metabolite concentrations and cognitive development assessed in preschool and school-aged children. While there are a limited number of studies that evaluated these associations during infancy, no study has evaluated whether these associations exist when using the Fagan Test of Infant Intelligence (FTII), which captures novelty preference as a function of visual recognition memory. We evaluated associations between phthalate metabolite concentrations in maternal prenatal urine and cognition in infancy using the FTII at 27 weeks and determine if these associations are sex-specific. Mono-n-butyl phthalate (MnBP), monobenzyl phthalate (MBzP), monoisobutyl phthalate (MiBP), mono-ethyl phthalate (MEP), mono-3-carboxypropyl phthalate (MCPP) and four di-2-ethylhexyl phthalate metabolites (DEHP) were quantified in urine samples collected from 168 minority women living in urban neighborhoods during their third trimester of pregnancy. The FTII was administered to infants at 27 weeks to measure visual recognition memory and was recorded as the novelty preference score. There were no associations between prenatal phthalate metabolite concentrations and novelty preference score in the full sample. However, there was evidence of effect modification by infant sex. Sex-stratified models demonstrated that compared to girls in the lowest tertile of MBzP concentrations, girls in tertiles 2 and 3 had, on average, 3.98 and 4.65 points lower novelty preference scores (p-value=0.04 and 0.03, respectively). The relationship was similar for ΣDEHP, MiBP, and MEP. Effects among boys were inconsistent and generally not significant. Maternal prenatal exposure to some phthalates was negatively associated with visual recognition memory as measured by the FTII among girls at age 27 weeks. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Docosahexaenoic acid partially ameliorates deficits in social behavior and ultrasonic vocalizations caused by prenatal ethanol exposure.

    PubMed

    Wellmann, Kristen A; George, Finney; Brnouti, Fares; Mooney, Sandra M

    2015-06-01

    Prenatal ethanol exposure disrupts social behavior in humans and rodents. One system particularly important for social behavior is the somatosensory system. Prenatal ethanol exposure alters the structure and function of this area. Docosahexaenoic acid (DHA), an omega 3 polyunsaturated fatty acid, is necessary for normal brain development and brains from ethanol-exposed animals are DHA deficient. Thus, we determined whether postnatal DHA supplementation ameliorated behavioral deficits induced by prenatal ethanol exposure. Timed pregnant Long-Evans rats were assigned to one of three groups: ad libitum access to an ethanol-containing liquid diet, pair fed an isocaloric isonutritive non-alcohol liquid diet, or ad libitum access to chow and water. Pups were assigned to one of two postnatal treatment groups; gavaged intragastrically once per day between postnatal day (P)11 and P20 with DHA (10g/kg in artificial rat milk) or artificial rat milk. A third group was left untreated. Isolation-induced ultrasonic vocalizations (iUSVs) were recorded on P14. Social behavior and play-induced USVs were tested on P28 or P42. Somatosensory performance was tested with a gap crossing test around P33 or on P42. Anxiety was tested on elevated plus maze around P35. Animals exposed to ethanol prenatally vocalized less, play fought less, and crossed a significantly shorter gap than control-treated animals. Administration of DHA ameliorated these ethanol-induced deficits such that the ethanol-exposed animals given DHA were no longer significantly different to control-treated animals. Thus, DHA administration may have therapeutic value to reverse some of ethanol's damaging effects.

  8. DOCOSAHEXAENOIC ACID PARTIALLY AMELIORATES DEFICITS IN SOCIAL BEHAVIOR AND ULTRASONIC VOCALIZATIONS CAUSED BY PRENATAL ETHANOL EXPOSURE

    PubMed Central

    Wellmann, Kristen A.; George, Finney; Brnouti, Fares; Mooney, Sandra M.

    2015-01-01

    Prenatal ethanol exposure disrupts social behavior in humans and rodents. One system particularly important for social behavior is the somatosensory system. Prenatal ethanol exposure alters the structure and function of this area. Docosahexaenoic acid (DHA), an omega 3 polyunsaturated fatty acid, is necessary for normal brain development and brains from ethanol-exposed animals are DHA deficient. Thus, we determined whether postnatal DHA supplementation ameliorated behavioral deficits induced by prenatal ethanol exposure. Timed pregnant Long-Evans rats were assigned to one of three groups: ad libitum access to an ethanol-containing liquid diet, pair fed an isocaloric isonutritive non-alcohol liquid diet, or ad libitum access to chow and water. Pups were assigned to one of two postnatal treatment groups; gavaged intragastrically once per day between postnatal day (P)11 and P20 with DHA (10 g/kg in artificial rat milk) or artificial rat milk. A third group was left untreated. Isolation-induced ultrasonic vocalizations (iUSVs) were recorded on P14. Social behavior and play-induced USVs were tested on P28 or P42. Somatosensory performance was tested with a gap crossing test around P33 or on P42. Anxiety was tested on elevated plus maze around P35. Animals exposed to ethanol prenatally vocalized less, play fought less, and crossed a significantly shorter gap than control-treated animals. Administration of DHA ameliorated these ethanol-induced deficits such that the ethanol-exposed animals given DHA were no longer significantly different to control-treated animals. Thus, DHA administration may have therapeutic value to reverse some of ethanol’s damaging effects. PMID:25746516

  9. Brain fibronectin expression in prenatally irradiated mice

    SciTech Connect

    Meznarich, H.K.; McCoy, L.S.; Bale, T.L.; Stiegler, G.L.; Sikov, M.R. )

    1993-01-01

    Activation of gene transcription by radiation has been recently demonstrated in vivo. However, little is known on the specificity of these alterations on gene transcription. Prenatal irradiation is a known teratogen that affects the developing mammalian central nervous system (CNS). Altered neuronal migration has been suggested as a mechanism for abnormal development of prenatally irradiated brains. Fibronectin (FN), an extracellular glycoprotein, is essential for neural crest cell migration and neural cell growth. In addition, elevated levels of FN have been found in the extracellular matrix of irradiated lung. To test whether brain FN is affected by radiation, either FN level in insoluble matrix fraction or expression of FN mRNA was examined pre- and postnatally after irradiation. Mice (CD1), at 13 d of gestation (DG), served either as controls or were irradiated with 14 DG, 17 DG, or 5,6, or 14 d postnatal. Brain and liver were collected from offspring and analyzed for either total FN protein levels or relative mRNAs for FN and tubulin. Results of prenatal irradiation on reduction of postnatal brain weight relative to whole are comparable to that reported by others. Insoluble matrix fraction (IMF) per gram of brain, liver, lung, and heart weight was not significantly different either between control and irradiated groups or between postnatal stages, suggesting that radiation did not affect the IMF. However, total amounts of FN in brain IMF at 17 DG were significantly different (p < .02) between normal (1.66 [+-] 0.80 [mu]g) and irradiated brains (0.58 [+-] 0.22 [mu]g). FN mRNA was detectable at 13, 14, and 17 DG, but was not detectable at 6 and 14 d postnatal, indicating that FN mRNA is developmentally regulated. 41 refs., 4 figs., 3 tabs.

  10. Empowering Women's Prenatal Communication: Does Literacy Matter?

    PubMed

    Roter, Debra L; Erby, Lori H; Rimal, Rajiv N; Smith, Katherine C; Larson, Susan; Bennett, Ian M; Cole, Katie Washington; Guan, Yue; Molloy, Matthew; Bienstock, Jessica

    2015-01-01

    This study was designed to evaluate the impact of an interactive computer program developed to empower prenatal communication among women with restricted literacy skills. A total of 83 women seeing 17 clinicians were randomized to a computer-based communication activation intervention (Healthy Babies Healthy Moms [HBHM]) or prenatal education (Baby Basics [BB]) prior to their prenatal visit. Visit communication was coded with the Roter Interaction Analysis System, and postvisit satisfaction was reported. Participants were on average 24 years of age and 25 weeks pregnant; 80% were African American. Two thirds scored ≤8th grade on a literacy screener. Women with literacy deficits were more verbally active, disclosed more medical and psychosocial/lifestyle information, and were rated as more dominant by coders in the HBHM group relative to their counterparts in the BB group (all ps < .05). Clinicians were less verbally dominant and more patient centered with literate HBHM relative to BB group women (p < .05); there was a similar, nonsignificant trend (p < .1) for lower literate women. Clinicians communicated less medical information and made fewer reassurance statements to lower literate women in the HBHM relative to the BB group (p < .05). There was a trend toward lower visit satisfaction for women with restricted literacy in the HBHM relative to the BB group (p < .1); no difference in satisfaction was evident for more literate women. The HBHM intervention empowered communication of all women and facilitated verbal engagement and relevant disclosure of medical and psychosocial information of women with literacy deficits. Satisfaction, however, tended to be lower for these women.

  11. Culturally sensitive prenatal care for Southeast Asians.

    PubMed

    Mattson, S; Lew, L

    1992-01-01

    The outreach program for Southeast Asian immigrants, chiefly Cambodians who arrived after 1980, begun by St. Mary Medical CEnter of Long Beach California, called the Southeast Asian Health Project (SEAHP) was evaluated by structured interviews of 199 women. The obstacles to full participation by these Asian immigrants in health care are described at length. They range from illiteracy and abuse in refugee camps to the immense cultural barrier involving philosophy of health to language barriers. The SEAHP Outreach services began with door-to-door canvassing, ads in refugee papers, and meetings in temples. Special educational resource materials were printed covering prenatal care, nutrition, child development, and feeding. Oral classes were held in CAmbodian and Lao with Vietnamese translators, as well as babysitters, transportation, and snacks. Class topics were nutrition, parenting skills, labor and delivery, child development, hygiene, and breast feeding. Training was also given to professional staff. 600 clients in prenatal clinics since 1987, 119 were interviewed by 4 workers fluent in Cambodian and Lao. The women were typical of refugees, only 1/2 were literate in native languages. 49% had delivered babies at home in Asia; 39% had delivered in refugee camp clinics. Women cited several different behaviors as a result of SEAHP classes: intake of milk products, use of food substitutes, food preparation, attendance at regular medical care, child care, and bathing. They said that they felt more comfortable at the clinic, and would recommend that friends go to the clinic for prenatal care. The concept of culture broker, and the role of nurses as culture brokers are discussed.

  12. Prenatal immunotoxicant exposure and postnatal autoimmune disease.

    PubMed Central

    Holladay, S D

    1999-01-01

    Reports in humans and rodents indicate that immune development may be altered following perinatal exposure to immunotoxic compounds, including chemotherapeutics, corticosteroids, polycyclic hydrocarbons, and polyhalogenated hydrocarbons. Effects from such exposure may be more dramatic or persistent than following exposure during adult life. For example, prenatal exposure to the insecticide chlordane or to the polycyclic aromatic hydrocarbon benzo[(italic)a(/italic)]pyrene produces what appears to be lifelong immunosuppression in mice. Whether prenatal immunotoxicant exposure may predispose the organism to postnatal autoimmune disease remains largely unknown. In this regard, the therapeutic immunosuppressant cyclosporin A (CsA) crosses the placenta poorly. However, lethally irradiated rodents exposed to CsA postsyngeneic bone marrow transplant (i.e., during re-establishment of the immune system) develop T-cell-mediated autoimmune disease, suggesting this drug may produce a fundamental disruption in development of self-tolerance by T cells. The environmental contaminant 2,3,7, 8-tetrachlorodibenzo-(italic)p(/italic)-dioxin (TCDD) crosses the placenta and produces fetal thymic effects (italic)in vivo(/italic) similar to effects of CsA in fetal thymic organ culture, including inhibited thymocyte maturation and reduced expression of thymic major histocompatability complex class II molecules. These observations led to the suggestion that gestational exposure to TCDD may interfere with normal development of self-tolerance. Possibly supporting this hypothesis, when mice predisposed to development of autoimmune disease were treated with TCDD during gestation, postnatal autoimmunity was exacerbated. Similar results have been reported for mice exposed to diethylstilbestrol during development. These reports suggest that prenatal exposure to certain immunotoxicants may play a role in postnatal expression of autoimmunity. PMID:10502532

  13. Prenatal dichlorodiphenyldichloroethylene (DDE) and asthma in children.

    PubMed

    Sunyer, Jordi; Torrent, Maties; Muñoz-Ortiz, Laura; Ribas-Fitó, Núria; Carrizo, Daniel; Grimalt, Joan; Antó, Josep M; Cullinan, Paul

    2005-12-01

    Prevalence of asthma increases with increasing dichlorodiphenyldichloroethylene (DDE) levels. However, the effect of early-life exposure, the fundamental window of exposure, is unknown. We assessed the association between prenatal DDE and other organochlorine compounds, and atopy and asthma during infancy. All women presenting for antenatal care in Menorca (Spain) over 12 months starting in mid-1997 were invited to take part in a longitudinal study; 482 children were subsequently enrolled, and 468 (97.1%) provided complete outcome data up to the fourth year of study. Prenatal exposure of organochlorine compounds was measured in cord serum in 405 (83%) children. Asthma was defined on the basis of wheezing at 4 years of age, persistent wheezing, or doctor-diagnosed asthma. We measured specific immunoglobulin-E (IgE) against house dust mite, cat, and grass in sera extracted at 4 years of age. DDE (median = 1.03 ng/mL) was detected in all children, as well as hexachlorobenzene (0.68 ng/mL) and polychlorobiphenyls (0.69 ng/mL). Wheezing at 4 years of age increased with DDE concentration, particularly at the highest quartile [9% in the lowest quartile (< 0.57 ng/mL) vs. 19% in the highest quartile (1.90 ng/mL); relative risk = 2.63 (95% confidence interval 1.19-4.69), adjusting for maternal asthma, breast-feeding, education, social class, or other organochlorines]. The association was not modified by IgE sensitization and occurred with the same strength among nonatopic subjects and among those with persistent wheezing or diagnosed asthma. DDE was not associated with atopy alone. Prenatal exposure to DDE residues may contribute to development of asthma.

  14. Prenatal Dichlorodiphenyldichloroethylene (DDE) and Asthma in Children

    PubMed Central

    Sunyer, Jordi; Torrent, Maties; Muñoz-Ortiz, Laura; Ribas-Fitó, Núria; Carrizo, Daniel; Grimalt, Joan; Antó, Josep M.; Cullinan, Paul

    2005-01-01

    Prevalence of asthma increases with increasing dichlorodiphenyldichloroethylene (DDE) levels. However, the effect of early-life exposure, the fundamental window of exposure, is unknown. We assessed the association between prenatal DDE and other organochlorine compounds, and atopy and asthma during infancy. All women presenting for antenatal care in Menorca (Spain) over 12 months starting in mid-1997 were invited to take part in a longitudinal study; 482 children were subsequently enrolled, and 468 (97.1%) provided complete outcome data up to the fourth year of study. Prenatal exposure of organochlorine compounds was measured in cord serum in 405 (83%) children. Asthma was defined on the basis of wheezing at 4 years of age, persistent wheezing, or doctor-diagnosed asthma. We measured specific immunoglobulin-E (IgE) against house dust mite, cat, and grass in sera extracted at 4 years of age. DDE (median = 1.03 ng/mL) was detected in all children, as well as hexachlorobenzene (0.68 ng/mL) and polychlorobiphenyls (0.69 ng/mL). Wheezing at 4 years of age increased with DDE concentration, particularly at the highest quartile [9% in the lowest quartile (< 0.57 ng/mL) vs. 19% in the highest quartile (1.90 ng/mL); relative risk = 2.63 (95% confidence interval 1.19–4.69), adjusting for maternal asthma, breast-feeding, education, social class, or other organochlorines]. The association was not modified by IgE sensitization and occurred with the same strength among nonatopic subjects and among those with persistent wheezing or diagnosed asthma. DDE was not associated with atopy alone. Prenatal exposure to DDE residues may contribute to development of asthma. PMID:16330365

  15. Prenatal Brain-Body Allometry in Mammals.

    PubMed

    Halley, Andrew C

    2016-01-01

    Variation in relative brain size among adult mammals is produced by different patterns of brain and body growth across ontogeny. Fetal development plays a central role in generating this diversity, and aspects of prenatal physiology such as maternal relative metabolic rate, altriciality, and placental morphology have been proposed to explain allometric differences in neonates and adults. Primates are also uniquely encephalized across fetal development, but it remains unclear when this pattern emerges during development and whether it is common to all primate radiations. To reexamine these questions across a wider range of mammalian radiations, data on the primarily fetal rapid growth phase (RGP) of ontogenetic brain-body allometry was compiled for diverse primate (np = 12) and nonprimate (nnp = 16) mammalian species, and was complemented by later ontogenetic data in 16 additional species (np = 9; nnp = 7) as well as neonatal proportions in a much larger sample (np = 38; nnp = 83). Relative BMR, litter size, altriciality, and placental morphology fail to predict RGP slopes as would be expected if physiological and life history variables constrained fetal brain growth, but are associated with differences in birth timing along allometric trajectories. Prenatal encephalization is shared by all primate radiations, is unique to the primate Order, and is characterized by: (1) a robust change in early embryonic brain/body proportions, and (2) higher average RGP allometric slopes due to slower fetal body growth. While high slopes are observed in several nonprimate species, primates alone exhibit an intercept shift at 1 g body size. This suggests that primate prenatal encephalization is a consequence of early changes to embryonic neural and somatic tissue growth in primates that remain poorly understood. © 2016 S. Karger AG, Basel.

  16. Social Behavior of Offspring Following Prenatal Cocaine Exposure in Rodents: A Comparison with Prenatal Alcohol

    PubMed Central

    Sobrian, Sonya K.; Holson, R. R.

    2011-01-01

    Clinical and experimental reports suggest that prenatal cocaine exposure (PCE) alters the offsprings’ social interactions with caregivers and conspecifics. Children exposed to prenatal cocaine show deficits in caregiver attachment and play behavior. In animal models, a developmental pattern of effects that range from deficits in play and social interaction during adolescence, to aggressive reactions during competition in adulthood is seen. This review will focus primarily on the effects of PCE on social behaviors involving conspecifics in animal models. Social relationships are critical to the developing organism; maternally directed interactions are necessary for initial survival. Juvenile rats deprived of play behavior, one of the earliest forms of non-mother directed social behaviors in rodents, show deficits in learning tasks and sexual competence. Social behavior is inherently complex. Because the emergence of appropriate social skills involves the interplay between various conceptual and biological facets of behavior and social information, it may be a particularly sensitive measure of prenatal insult. The social behavior surveyed include social interactions, play behavior/fighting, scent marking, and aggressive behavior in the offspring, as well as aspects of maternal behavior. The goal is to determine if there is a consensus of results in the literature with respect to PCE and social behaviors, and to discuss discrepant findings in terms of exposure models, the paradigms, and dependent variables, as well as housing conditions, and the sex and age of the offspring at testing. As there is increasing evidence that deficits in social behavior may be sequelae of developmental exposure alcohol, we compare changes in social behaviors reported for prenatal alcohol with those reported for prenatal cocaine. Shortcomings in the both literatures are identified and addressed in an effort to improve the translational value of future experimentation. PMID:22144967

  17. Student Records: Complying with Federal Privacy Laws May be Simpler than You Think

    ERIC Educational Resources Information Center

    Shoop, Robert J.

    2008-01-01

    The Family Educational Rights and Privacy Act (FERPA) was passed in 1974 and revised in 1996. This act, also known as the Buckley Amendment, guarantees parents access to their children's education records and limits the disclosure of those records. The revised law regards most information that teachers, school administrators, and education…

  18. Student Records: Complying with Federal Privacy Laws May be Simpler than You Think

    ERIC Educational Resources Information Center

    Shoop, Robert J.

    2008-01-01

    The Family Educational Rights and Privacy Act (FERPA) was passed in 1974 and revised in 1996. This act, also known as the Buckley Amendment, guarantees parents access to their children's education records and limits the disclosure of those records. The revised law regards most information that teachers, school administrators, and education…

  19. 76 FR 77575 - Privacy Act of 1974; Report of an Altered System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-13

    ....C. 552a), PC-21-- Peace Corps Response Database. The first revision modifies the individuals covered... revision modifies the purpose of the system of records which is to maintain records of individuals who... know. System name: PC-21--Peace Corps Response Database. Changes: * * * * * Category of...

  20. The Motivation-Facilitation Theory of Prenatal Care Access.

    PubMed

    Phillippi, Julia C; Roman, Marian W

    2013-01-01

    Despite the availability of services, accessing health care remains a problem in the United States and other developed countries. Prenatal care has the potential to improve perinatal outcomes and decrease health disparities, yet many women struggle with access to care. Current theories addressing access to prenatal care focus on barriers, although such knowledge is minimally useful for clinicians. We propose a middle-range theory, the motivation-facilitation theory of prenatal care access, which condenses the prenatal care access process into 2 interacting components: motivation and facilitation. Maternal motivation is the mother's desire to begin and maintain care. Facilitation represents the goal of the clinic to create easy, open access to person-centered beneficial care. This simple model directs the focus of research and change to the interface of the woman and the clinic and encourages practice-level interventions that facilitate women entering and maintaining prenatal care. © 2013 by the American College of Nurse‐Midwives.