The American Diabetes Association has published our recommendations in a format designed specifically for primary care providers. The Standards of Medical Care in Diabetes — 2015
Study suggests “Previously recommended national target rates for cesarean deliveries may be too low.”
“In a study involving 540 patients with osteogenesis imperfecta – the largest study of any on this topic – the team found that cesarean delivery was not associated with decreased fracture rate in the newborns.”
Among the major findings:
- Infants born at 23 and 24 weeks survived in greater numbers over the 20-year period. Of those born at 24 weeks, for example, only 52 percent survived in 1993 while 65 percent survived in 2012.
- A higher number of premature infants survived without major illnesses. For infants born at 27 weeks, for example, survival without major illness increased from 29 percent in 1993 to 47 percent in 2012.
- For more :
“Even though a new treatment or technology may appear promising, it really isn’t possible to know whether it provides any benefits unless it’s tested in a research study,” Dr. Reddy said. “Our study didn’t find any benefit for ECG ST monitoring in term births.”
Retrospective cohort study of discharge data for breech deliveries that occurred from 23-24 6/7 weeks’ gestation finds cesarean delivery increased overall survival AND major morbidity for previable breech neonates. However, there was no difference in 6-month survival among intubated neonates , and cesarean delivery did not increase survival for neonates who weighed <500 g
Tucker Edmonds B, et. al., Morbidity and mortality associated with mode of delivery for breech periviable deliveries. Am J Obstet Gynecol. 2015 Jul;213(1):70.e1-70.e12. PMID: 25747545
Cesarean delivery at periviability compared with term is associated with an increased risk for uterine rupture in a subsequent pregnancy, even after low transverse incision.
Lannon SM, et. al., Uterine rupture risk after periviable cesarean delivery. Obstet Gynecol. 2015 May;125(5):1095-100. PMID: 25932837
Secondary analysis of the a randomized, controlled trial of Magnesium sulfate for the prevention of cerebral palsy supports obstetric indications should dictate mode of delivery at 23 4/7 -25 6/7 weeks.
Mode of delivery at periviability and early childhood neurodevelopment.
Običan SG, Small A, Smith D, Levin H, Drassinower D, Gyamfi-Bannerman C.
Am J Obstet Gynecol. 2015 Jun 24. pii: S0002-9378(15)00660-2. doi: 10.1016/j.ajog.2015.06.047. [Epub ahead of print]
Study finds daily Low-molecular-weight heparin injections do not increase ongoing pregnancy or live-birth rates in women with unexplained RPL
unexplained recurrent pregnancy loss
Schleussner E, et. a., Low-molecular-weight heparin for women with unexplained recurrent pregnancy loss: a multicenter trial with a minimization randomization scheme. ETHIG II group.
Ann Intern Med. 2015 May 5;162(9):601-9. doi: 10.7326/M14-2062.
Oral nifedipine versus intravenous labetalol for severe hypertension during pregnancy: a systematic review and meta-analysis.
Oral nifedipine is as efficacious and safe as intravenous labetalol and may have an edge in low resource settings.