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Aftereffect of Expectant mothers Eating routine on Psychological Aim of Kids.
there was no difference in the rates of infectious morbidity between MBP alone, OA alone, or MBP with OA compared to no preparation. CONCLUSIONS Bowel preparation does not protect against SSI or major morbidity following benign or malignant hysterectomy, regardless of surgical approach, and may be safely omitted. BACKGROUND Obstetric healthcare relies on an adequate antepartum risk selection. Sodium Bicarbonate mw Most guidelines used for risk stratification, however, do not assess absolute risks. In 2017, a prediction tool was implemented in a Dutch region. This tool combines first trimester prediction models with obstetric care paths tailored to the individual risk profile, enabling risk-based care (RBC). OBJECTIVE To assess impact and cost-effectiveness of RBC compared to care-as-usual (CAU) in a general population. METHODS A before-after study was conducted using two multicenter prospective cohorts. The first cohort (2013-2015) received CAU, the second cohort (2017-2018) received RBC. Health outcomes were 1) a composite of adverse perinatal outcomes and 2) maternal quality adjusted life years (QALYs). Costs were estimated using a healthcare perspective from conception to six weeks after the due date. Mean costs per woman, cost differences between the two groups, as well as incremental cost effectiveness ratios were calculated. Sensitivity analyses were performed to evaluate the robustness of the findings. RESULTS In total 3,425 women were included. In nulliparous women there was a significant reduction of perinatal adverse outcomes among the RBC group (aOR 0.56; 95%CI 0.32-0.94)), but not in multiparous women. Mean costs per pregnant woman were significantly lower for RBC (mean difference -€2,766, 95%CI -€3,700 - -€1,825). No differences in maternal quality of life, adjusted for baseline health, were observed. CONCLUSION In the Netherlands, RBC in nulliparous women was associated with improved perinatal outcomes as compared to CAU. Furthermore, RBC was cost-effective compared to CAU and resulted in lower healthcare costs. BACKGROUND Endometriosis is a common gynecological condition affecting women of reproductive age. It has been linked with higher rates of depression and anxiety in small, cross-sectional, and clinical studies. Other studies have reported that women with endometriosis have increased risk of bipolar disorder. These reports suggest that psychiatric disorders might be more common among women with endometriosis, contributing to increased burden of mental ill-health in this population of women. However, this hypothesis has not been adequately studied OBJECTIVES In this population-based study, we investigated the overall psychiatric comorbidity among women with endometriosis, and the role of familial liability. STUDY DESIGN Several Swedish national registers were linked and used to follow all women born in Sweden in 1973-1990 for diagnosed psychiatric disorders and endometriosis from age 14 until year 2016. Sibling comparison analyses were performed in a subsample of 173 650 families. RESULTS After adjustment for bientirely explained by shared familial confounding. Clinical practice may consider psychosocial support to women with endometriosis and treating them from a multidisciplinary perspective. BACKGROUND AND OBJECTIVE In some women placental function may not be adequate to meet fetal growth requirements in late pregnancy or the additional demands during labor thus predisposing these infants to intrapartum fetal compromise (IFC) and subsequent serious morbidity and mortality. The objective of this study was to determine if the introduction of a pre-labor screening test at term combining the cerebroplacental ratio and maternal placental growth factor level would result in a reduction in a composite of adverse outcomes. STUDY DESIGN Single-site, non-blinded, randomized controlled trial conducted at a tertiary hospital in Brisbane, Australia. Eligible women were randomized to either receive the screening test performed between 37-38 weeks or routine obstetric care. Screen positive women were offered induction of labor. The primary outcome was a composite of emergency cesarean for non-reassuring fetal status (fetal distress) or severe neonatal acidosis or low Apgar score or stillbirth or neonatal death. RESULTS Women were recruited and randomized (n=501) between April 2017 to January 2019. 63/249 (25·3%) of the screened group compared to 56/252 (22·2%) of the control group experienced the primary outcome (Relative Risk (RR) = 1·14 [95% CI 0·83 - 1·56]; p = 0·418). Women who screened positive were more likely to require operative delivery for fetal distress, have meconium stained liquor, pathological FHR abnormalities and have infants with lower birth weight compared to women that screened negative. CONCLUSION The introduction of this test did not result in improvements in intrapartum intervention rates or neonatal outcomes. However, it did show discriminatory potential and future research should focus on refining the thresholds used. BACKGROUND Stillbirth is a devastating adverse pregnancy outcome which may occur without any obvious reason, or may occur in the context of fetal growth restriction, preeclampsia or other obstetric complications. There is increasing evidence that women who experience stillbirths are at higher risk of long-term cardiovascular disease (CVD), but little is known about their risk of chronic kidney disease (CKD) and end-stage renal disease (ESRD). We conducted the largest study to date to investigate the subsequent risk of maternal CKD and ESRD following stillbirth. OBJECTIVE To identify whether pregnancy complicated by stillbirth is associated with subsequent risk of maternal CKD and ESRD, independent of underlying medical or obstetric comorbidities. STUDY DESIGN/METHODS We conducted a population-based cohort study using nationwide data from the Swedish Medical Birth Register, National Patient Register and Swedish Renal Register. We included all women who had live births and stillbirths from 1973 to 2012, with foa higher risk of developing CKD (adjusted hazard ratio (aHR) 1.26, 95% CI 1.09-1.45) and ESRD (aHR 2.25, 95% CI 1.55-3.25) compared to women who only had live births. These associations persisted after removing all stillbirths which occurred in the context of preeclampsia, SGA or congenital malformations (for CKD, aHR 1.33, 95% CI 1.13-1.57; for ESRD, aHR 2.95, 95% CI 1.86-4.68). There was no significant association observed between stillbirth and either CKD or ESRD in women who had pre-existing medical comorbidities (CKD, aHR 1.13, 95% CI 0.73-1.75; ESRD, aHR 1.49, 95% CI 0.78-2.85). CONCLUSION Women who have a history of stillbirth may be at increased risk of CKD and ESRD compared to women who have only had live births. This association persists independently of preeclampsia, SGA, maternal smoking, obesity, and medical comorbidities. Further research is required to determine whether affected women would benefit from closer surveillance and follow-up for future renal disease.
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