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Comparison of two misoprostol regimens for cervical priming before surgical pregnancy termination at 13 to 16 week. gestations

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Open Journal of Obstetrics and Gynecology 2011年第4期1卷 187-190页

作者： Dennis G. Chambers Robin J. Willcourt Anthony R. Laver jane k. baird Wye Y. Herbert 不详

Back.round: The optimal regimen has still to be determined for the use of misoprostol in the surgical termination of pregnancy in the early second trimester. Objective: To compare the outcomes of two different regimens for cervical priming with misoprostol before dilatation and evacuation (D & E) in 13 week. - 16 week. gestation pregnancy terminations. Methods: A retrospective analysis was performed of the medical records of two cohorts of 334 women each who were treated with either 3 sublingual doses of 2 misoprostol 200 μg tablets 30 minutes apart on admission or the same dosage preceded by 1 oral tablet of misoprostol 200 μg at home 3 hours before admission. Results: The addition of the home tablet of misoprostol increased the rate of one day completion of D & E from 97.3% to 100% (P = 0.004), and the overall mean theatre time for D&E was reduced by 12.3% in parous women (P = 0.001) and 6.4% in nulliparous women (P = 0.003) with the reduction being consistent across all gestations. Conclusions: This retrospective study showed that the addition of 1 oral tablet of misoprostol 200 μg at home 3 hours before admission to a regimen of 3 sublingual doses of 2 misoprostol 200 μg tablets 30 minutes apart on admission significantly increases the probability of all women at 13 week. - 16 week. gestation completing a termination of pregnancy in one day with a single D & E procedure and with a reduced theatre time.

关键词： Early Second-Trimester Surgical Abortion D & E Misoprostol Cervical Priming

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Systemic postnatal corticosteroid use for the prevention of bronchopulmonary dysplasia and its relationship to early neurodevelopment in extremely preterm

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World Journal of Pediatrics 2023年第6期19卷 586-594页

作者： Emilia Esterman Traci-Anne Goyen Pranav Jani Gemma Lowe jane baird Rajesh Maheshwari Daphne D’Cruz Melissa Luig Dharmesh Shah Department of Neonatology Westmead HospitalWestmeadAustralia Faculty of Medicine and Health The University of SydneySydneyAustralia

Back.round Systemic postnatal corticosteroid use in extremely preterm infants poses a risk.of adverse neurodevelopmental *** study explores their use beyond seven days of age with early neurodevelopmental assessments during the fidgety period(9-20 week. postterm age).Methods This retrospective single-center cohort study included inborn extremely preterm infants from 1 January 2014 to 31 December *** infants,those with congenital or genetic abnormalities,and those who received postnatal cor-ticosteroids for nonrespiratory reasons were *** cohort was dichotomized based on the status of corticosteroid *** neurodevelopmental outcomes were reported using Prechtl's General Movements *** Of the 282 infants,67(23.75%)received *** these,34(50.75%)received them for dependency on invasive ventilation(intermittent positive-pressure ventilation),and the remainder received them for dependency on non-invasive ventilation continuous positive airway pressure(CPAP)or bi-level positive airway pressure(BiPAP).Abnormal or absent fidgety movements were observed in 13% of infants(7/54)who received corticosteroids compared to 2% of infants(3/146)who did *** increased odds for an abnormal general movements assessment from corticosteroid use after adjusting for gestational age[adjusted odds ratio(aOR)=5.5,95% confidence interval(CI)=1.14-26.56]was *** motor optimality scores differed between the two groups[corticosteroid group:25.5(23-26)versus no-corticosteroid group:26(24-28);z=-2.02].A motor optimality score<20 was observed in 14.8% of infants(8/54)in the corticosteroid group compared to 2% of infants(3/146)in the noncorticosteroid *** difference was significant after adjustment for gestational age(aOR 5.96,95%CI 1.28-27.74).Conclusions Abnormal early neurodevelopment was observed in infants who received systemic postnatal *** relationship between these findings and other factors influen

关键词： Corticosteroids Early neurodevelopment General movement assessment Preterm infants

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