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  1. AU=Kovo Michal
  2. AU="Gaglani, Shiv"
  3. AU="Prathap G"
  4. AU="Luana Bessa"

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  1. Artikel ; Online: Does decreased fetal growth estimation in the appropriate for gestational age range affect delivery outcomes?

    Ovadia, Michal / Gluska, Hadar / Cohen, Gal / Schreiber, Hanoch / Biron-Shental, Tal / Kovo, Michal / Shechter-Maor, Gil

    Archives of gynecology and obstetrics

    2024  

    Abstract: Purpose: To study the effect of decreased estimated fetal weight (EFW) percentiles in appropriate for gestational age fetuses.: Methods: This retrospective cohort study included women who had second and third trimester ultrasound examinations. ... ...

    Abstract Purpose: To study the effect of decreased estimated fetal weight (EFW) percentiles in appropriate for gestational age fetuses.
    Methods: This retrospective cohort study included women who had second and third trimester ultrasound examinations. Delivery and neonatal outcomes of pregnancies with decreased EFW of ≥  30 percentiles in EFW between ultrasound examinations (decreased growth group) and those without such a decrease (control group) were compared. Deliveries with EFW or birthweight below the 10th percentile were excluded.
    Results: Among 1610 deliveries, 57 were in the decreased growth group and 1553 in the control group. Maternal characteristics did not differ between the groups except for higher rate of nulliparity in the decreased growth group. We found similar rates of Category II/III monitoring, cesarean deliveries due to non-reassuring fetal heart rate and adverse neonatal outcomes. Neonatal birthweight was lower in the decreased growth group as compared to controls.
    Conclusions: This study did not find association between the group of appropriate for gestational age fetuses with decreased growth, with adverse outcomes.
    Sprache Englisch
    Erscheinungsdatum 2024-02-27
    Erscheinungsland Germany
    Dokumenttyp Journal Article
    ZDB-ID 896455-5
    ISSN 1432-0711 ; 0932-0067
    ISSN (online) 1432-0711
    ISSN 0932-0067
    DOI 10.1007/s00404-024-07432-2
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: The clinical significance of cervical tears' anatomical location - A retrospective study.

    Gluck, Ohad / David, Maayan / Kovo, Michal / Mor, Liat / Kleiner, Ilia / Weiner, Eran / Ginath, Shimon

    European journal of obstetrics, gynecology, and reproductive biology

    2024  Band 295, Seite(n) 215–218

    Abstract: Objective: Up to 4.8% of all vaginal deliveries are complicated by significant cervical tears related to maternal compromise, yet the location of the cervical tear and its impact on the attributed risk have not been studied to date. This study aimed to ... ...

    Abstract Objective: Up to 4.8% of all vaginal deliveries are complicated by significant cervical tears related to maternal compromise, yet the location of the cervical tear and its impact on the attributed risk have not been studied to date. This study aimed to determine the associations between the location and characteristics of cervical tears with short-term maternal complications and outcomes.
    Methods: This is a retrospective cohort study. Included were all patients that delivered vaginally at our institute between the years 2009-2020 and were diagnosed with a cervical tear. Maternal complications were compared between cases with posterior cervical tears and cases with anterior or lateral cervical tears. Exclusion criteria included patients who delivered by cesarean delivery and preterm labor below 37.0 weeks of gestation.
    Results: Overall, 96 patients were diagnosed with posterior cervical tears, while 117 patients were diagnosed with anterior or lateral tears. Maternal demographics and pregnancy characteristics were similar between the groups. There were also no differences in delivery outcomes between the groups. Patients with posterior cervical tears had a higher rate of disseminated intravascular coagulation (DIC) (6.25 % vs. 0.9 %, p = 0.04) and prolonged hospitalization (35.4 % vs. 23.1 %, p = 0.05), as compared to patients with anterior or lateral tears. There were no differences in other maternal complications.
    Conclusions: Cases of posterior cervical tears are at higher risk for maternal adverse outcomes (DIC and prolonged hospitalization), as compared to cases of anterior or lateral tears.
    Mesh-Begriff(e) Pregnancy ; Infant, Newborn ; Female ; Humans ; Retrospective Studies ; Clinical Relevance ; Delivery, Obstetric/adverse effects ; Cesarean Section
    Sprache Englisch
    Erscheinungsdatum 2024-02-10
    Erscheinungsland Ireland
    Dokumenttyp Journal Article
    ZDB-ID 190605-7
    ISSN 1872-7654 ; 0301-2115 ; 0028-2243
    ISSN (online) 1872-7654
    ISSN 0301-2115 ; 0028-2243
    DOI 10.1016/j.ejogrb.2024.02.022
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel ; Online: Placental disposition of cannabidiol: An ex vivo perfusion study.

    Berman, Erez / Erenburg, Natalia / Beloosesky, Ron / Eyal, Sara / Kovo, Michal

    Epilepsia

    2023  Band 64, Heft 12, Seite(n) 3354–3364

    Abstract: Objective: In the absence of safety data in humans, the use of cannabidiol (CBD) is not recommended during pregnancy. Yet >50% of pregnancies in women with epilepsy are unintended, making fetal exposure to CBD possible. As a small-molecule, highly lipid- ...

    Abstract Objective: In the absence of safety data in humans, the use of cannabidiol (CBD) is not recommended during pregnancy. Yet >50% of pregnancies in women with epilepsy are unintended, making fetal exposure to CBD possible. As a small-molecule, highly lipid-soluble drug, CBD is likely to be distributed into the placenta and cross it. To estimate the placental distribution profile of CBD and its potential short-term placental effects, we conducted an ex vivo perfusion study in human placentas.
    Methods: Placentas were obtained from healthy women undergoing cesarean deliveries. Selected cotyledons were cannulated and perfused for 180 min with a CBD-containing medium (250 ng/mL, .796 μmol·L
    Results: CBD was sequestered in the placental tissue, exhibiting significant variability across samples (median = 5342 ng/g tissue, range = 1066-9351 ng/g tissue). CBD concentrations in the fetal compartment were one fifth of those measured in the maternal compartment (median = 59 ng/mL, range = 48-72 ng/mL vs. 280 = ng/mL, range = 159-388 ng/mL, respectively; p < .01). Placental gene expression was not significantly altered by CBD.
    Significance: The placenta acts as a depot compartment for CBD, slowing down its distribution to the fetus. This phenomenon might yield flatter but prolonged fetal CBD levels in vivo. The attenuated transplacental CBD transfer does not imply that its use by pregnant women is safe for the fetus. Only pregnancy registries and neurocognitive assessments would establish the risk of being antenatally exposed to CBD.
    Mesh-Begriff(e) Pregnancy ; Female ; Humans ; Placenta ; Maternal-Fetal Exchange ; Cannabidiol/pharmacology ; Perfusion ; Fetus/metabolism
    Chemische Substanzen Cannabidiol (19GBJ60SN5)
    Sprache Englisch
    Erscheinungsdatum 2023-10-16
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 216382-2
    ISSN 1528-1167 ; 0013-9580
    ISSN (online) 1528-1167
    ISSN 0013-9580
    DOI 10.1111/epi.17778
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  4. Artikel ; Online: Reply.

    Dafna, Lotem / Kovo, Michal

    American journal of obstetrics & gynecology MFM

    2019  Band 1, Heft 3, Seite(n) 100034

    Mesh-Begriff(e) Analgesia ; Female ; Humans ; Interdisciplinary Studies ; Pain Management ; Pregnancy
    Sprache Englisch
    Erscheinungsdatum 2019-08-05
    Erscheinungsland United States
    Dokumenttyp Letter ; Comment
    ISSN 2589-9333
    ISSN (online) 2589-9333
    DOI 10.1016/j.ajogmf.2019.100034
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  5. Artikel ; Online: Response: Risk factors for retained placenta in a first pregnancy-A clinical trial.

    Cohen, Gal / Kovo, Michal / Biron-Shental, Tal / Markovitch, Ofer / Daykan, Yair / Schreiber, Hanoch

    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

    2023  Band 163, Heft 3, Seite(n) 1054

    Mesh-Begriff(e) Pregnancy ; Female ; Humans ; Placenta, Retained ; Oxytocics ; Postpartum Hemorrhage ; Gravidity ; Risk Factors ; Placenta
    Chemische Substanzen Oxytocics
    Sprache Englisch
    Erscheinungsdatum 2023-10-12
    Erscheinungsland United States
    Dokumenttyp Letter
    ZDB-ID 80149-5
    ISSN 1879-3479 ; 0020-7292
    ISSN (online) 1879-3479
    ISSN 0020-7292
    DOI 10.1002/ijgo.15191
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  6. Artikel: Insulin Detemir Versus Glibenclamide in Gestational Diabetes Mellitus: A Retrospective Cohort Study.

    Ravid, Dorit / Kovo, Michal / Leytes, Sophia / Yagur, Yael / Fakterman, Maty / Weitzner, Omer

    The Israel Medical Association journal : IMAJ

    2023  Band 25, Heft 6, Seite(n) 398–401

    Abstract: Background: Treatment of gestational diabetes mellitus (GDM) has been shown to improve both maternal and neonatal outcomes. For women with GDM who require glucose-lowering medication, insulin is regarded as the drug of choice by most medical societies. ... ...

    Abstract Background: Treatment of gestational diabetes mellitus (GDM) has been shown to improve both maternal and neonatal outcomes. For women with GDM who require glucose-lowering medication, insulin is regarded as the drug of choice by most medical societies. Oral therapy, with metformin or glibenclamide, is a reasonable alternative in certain medical circumstances.
    Objectives: To compare the efficacy and safety of insulin detemir (IDet) vs. glibenclamide for GDM when glycemic control cannot be achieved through lifestyle modification and diet.
    Methods: We conducted a retrospective cohort analysis of 115 women with singleton pregnancy and GDM treated with IDet or glibenclamide. GDM was diagnosed via the two-step oral glucose tolerance test (OGTT) of 50 grams glucose, followed by 100 grams. Maternal characteristics and outcomes (preeclampsia and weight gain) and neonatal outcomes (birth weight and percentile, hypoglycemia, jaundice, and respiratory morbidity) were compared between groups.
    Results: In total, 67 women received IDet and 48 glibenclamide. Maternal characteristics, weight gain, and the incidence of preeclampsia were similar in both groups. Neonatal outcomes were also similar. The proportion of large for gestational age (LGA) infants was 20.8% in the glibenclamide group compared to 14.9% in the IDet group (P = 0.04).
    Conclusions: In pregnant women with GDM, glucose control on IDet yielded comparable results as on glibenclamide, except for a significantly lower rate of LGA neonates.
    Mesh-Begriff(e) Pregnancy ; Infant ; Infant, Newborn ; Female ; Humans ; Insulin Detemir/adverse effects ; Diabetes, Gestational/drug therapy ; Glyburide/adverse effects ; Retrospective Studies ; Pre-Eclampsia/drug therapy ; Pre-Eclampsia/epidemiology ; Birth Weight ; Glucose
    Chemische Substanzen Insulin Detemir (4FT78T86XV) ; Glyburide (SX6K58TVWC) ; Glucose (IY9XDZ35W2)
    Sprache Englisch
    Erscheinungsdatum 2023-06-29
    Erscheinungsland Israel
    Dokumenttyp Journal Article
    ZDB-ID 2008291-5
    ISSN 1565-1088 ; 0021-2180
    ISSN 1565-1088 ; 0021-2180
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  7. Artikel ; Online: The effects of inflammation and acidosis on placental blood vessels reactivity.

    Kovo, Michal / Berman, Erez / Odeh, Hind / Luria, Oded / Beloosesky, Ron / Bar, Jacob

    Placenta

    2023  Band 144, Seite(n) 8–12

    Abstract: Introduction: Inflammation and acidosis are two stress stimuli that correspond to pathophysiological processes occurring in placental-mediated vascular disorders. We aimed to investigate the effects of these stimuli on placental chorionic blood vessels ... ...

    Abstract Introduction: Inflammation and acidosis are two stress stimuli that correspond to pathophysiological processes occurring in placental-mediated vascular disorders. We aimed to investigate the effects of these stimuli on placental chorionic blood vessels reactivity using the ex-vivo placental perfusion model.
    Methods: Term placentas were obtained immediately after cesarean deliveries, and selected cotyledons were cannulated and dually perfused ex-vivo. Placentas were perfused with three different protocols: culture medium (M199-controls, n = 5), culture medium with lipopolysaccharide (inflammatory stimuli) (LPS,1 μg/ml, n = 7), and acidotic culture medium (M - 199, pH: 6.9-7, n = 6). Each perfusion experiment was maintained for 180 min. Fetal perfusion pressure was continuously measured. Measurements in response to angiotensin II (AT II) at the end of the perfusion were compared between the treatment groups, including amplitude of the contraction response, relaxation factor, time to maximal constriction and the area under the pressure curve (AUC).
    Results: In response to ATII there was a significant difference in the amplitude of the contraction and the AUC between the treatment groups, (p = 0.049, p = 0.015, respectively). As compared with control perfused cotyledon, the inflammatory stimuli significantly increased the vasoconstriction response to ATII in fetal placental blood vessels, as expressed by increased AUC - median (IQR): 555 (235-1184) vs. 133 (118-207), respectively, p = 0.017. The time to maximal constriction and the relaxation factor did not differ between the groups.
    Discussion: Inflammatory stimuli but not acidosis impact fetal-placental vasculature in response to ATII, suggesting that inflammation can compromise vascular function.
    Mesh-Begriff(e) Pregnancy ; Female ; Humans ; Placenta/blood supply ; Fetus/blood supply ; Inflammation ; Vasoconstriction ; Perfusion ; Placenta Diseases ; Acidosis
    Sprache Englisch
    Erscheinungsdatum 2023-11-02
    Erscheinungsland Netherlands
    Dokumenttyp Journal Article
    ZDB-ID 603951-0
    ISSN 1532-3102 ; 0143-4004
    ISSN (online) 1532-3102
    ISSN 0143-4004
    DOI 10.1016/j.placenta.2023.10.012
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  8. Artikel ; Online: Risk factors for retained placenta in a first pregnancy-A clinical trial.

    Cohen, Gal / Kovo, Michal / Biron-Shental, Tal / Markovitch, Ofer / Daykan, Yair / Schreiber, Hanoch

    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

    2023  Band 163, Heft 1, Seite(n) 194–201

    Abstract: Objective: To evaluate potential risk factors for retained placenta in a first pregnancy.: Method: This retrospective case-control study included all primigravida with a singleton, live, vaginal birth at 24 weeks or later, at a tertiary hospital, ... ...

    Abstract Objective: To evaluate potential risk factors for retained placenta in a first pregnancy.
    Method: This retrospective case-control study included all primigravida with a singleton, live, vaginal birth at 24 weeks or later, at a tertiary hospital, 2014-2020. The cohort was divided into those with retained placenta versus controls. Retained placenta was defined as the need for manual extraction of the placenta or portions of it, immediately postpartum. Maternal and delivery characteristics, and obstetric and neonatal adverse outcomes, were compared between groups. Multivariable regression was performed to reveal potential risk factors for retained placenta.
    Results: Among 10 796 women, 435 (4.0%) had retained placenta and 10 361 (96.0%) controls did not. Multivariable logistic regression revealed nine potential risk factors for retained placenta: abruption (adjusted odds ratio [aOR] 3.58, 95% confidence interval [CI] 2.36-5.43), hypertensive disorders (aOR 1.74, 95% CI 1.17-2.57), prematurity (<37 weeks, aOR 1.63, 95% CI 1.13-2.35), maternal age older than 30 years (aOR 1.55, 95% CI 1.27-1.90), intrapartum fever (aOR 1.48, 95% CI 1.03-2.11), lateral placentation (aOR 1.39, 95% CI 1.01-1.91), oxytocin administration (aOR 1.39, 95% CI 1.11-1.74), diabetes mellitus (aOR 1.35, 95% CI 1.01-1.79), and female fetus (aOR 1.26, 95% CI 1.03-1.53).
    Conclusion: Retained placentas in first deliveries are associated with obstetric risk factors, some of which could be related to abnormal placentation.
    Mesh-Begriff(e) Pregnancy ; Infant, Newborn ; Female ; Humans ; Adult ; Placenta, Retained/epidemiology ; Retrospective Studies ; Case-Control Studies ; Placenta ; Risk Factors
    Sprache Englisch
    Erscheinungsdatum 2023-04-20
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 80149-5
    ISSN 1879-3479 ; 0020-7292
    ISSN (online) 1879-3479
    ISSN 0020-7292
    DOI 10.1002/ijgo.14800
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  9. Artikel ; Online: Do neonatal birth weight thresholds for labor dystocia outcomes differ between short and normal stature women?

    Cohen, Gal / Schreiber, Hanoch / Shalev-Ram, Hila / Biron-Shental, Tal / Kovo, Michal

    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

    2023  

    Abstract: Objective: To determine if there is a correlation between maternal short stature and neonatal birth weight among women with adverse outcomes related to labor dystocia.: Methods: The medical records of singleton deliveries with adverse obstetric ... ...

    Abstract Objective: To determine if there is a correlation between maternal short stature and neonatal birth weight among women with adverse outcomes related to labor dystocia.
    Methods: The medical records of singleton deliveries with adverse obstetric outcomes related to labor dystocia during 2014-2020, in a single tertiary center, were reviewed. Outcomes included at least one of the following: cesarean delivery (CD) due to cephalopelvic disproportion (CPD), prolonged second stage, shoulder dystocia, third- or fourth-degree perineal tear. Maternal short stature was defined as height below the 10th centile (short stature group) and normal stature was defined as maternal height between the 10th and 90th centiles (normal stature group). Maternal and neonatal characteristics were compared between the groups.
    Results: A total of 3295 women were included, among them, 307 in the short stature group (9.3%, height 1.52 ± 0.02 m) and 2988 in the normal stature group (90.7%, height 1.63 ± 0.04 m). Evaluating the entire cohort revealed similar neonatal birth weights comparing the short and normal stature groups. A subgroup analysis of women after CD due to CPD (n = 296) revealed lower neonatal birth weights in the short stature group (n = 31) compared with the normal stature group (n = 265) (3215 ± 411 vs 3484 ± 427 g, P = 0.001, respectively). Multivariable linear regression was performed for women who underwent CD due to CPD. After adjusting for obesity and diabetes mellitus, short stature and nulliparity were found to be independently associated with decreased neonatal birth weight (266 g less for short stature, P = 0.001, and 294 g less for nulliparity, P = 0.001).
    Conclusions: Among women with short stature, CD due to CPD occurs at lower neonatal birth weights.
    Sprache Englisch
    Erscheinungsdatum 2023-09-23
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 80149-5
    ISSN 1879-3479 ; 0020-7292
    ISSN (online) 1879-3479
    ISSN 0020-7292
    DOI 10.1002/ijgo.15139
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  10. Artikel ; Online: Lacosamide effects on placental carriers of essential compounds in comparison with valproate: Studies in perfused human placentas.

    Berman, Erez / Kohn, Elkana / Berkovitch, Matitiahu / Kovo, Michal / Eyal, Sara

    Epilepsia

    2022  Band 63, Heft 11, Seite(n) 2949–2957

    Abstract: Objective: Lacosamide is increasingly being prescribed to pregnant women, although its effects on the developing fetus have not been fully clarified yet. Previously, we have shown that several antiseizure medications, particularly valproate, can affect ... ...

    Abstract Objective: Lacosamide is increasingly being prescribed to pregnant women, although its effects on the developing fetus have not been fully clarified yet. Previously, we have shown that several antiseizure medications, particularly valproate, can affect the expression of carriers of essential compounds in placental cells. Here, our aim was to assess the effect of short ex vivo exposure of human placentas to lacosamide on the expression of carriers of essential nutrients required by the human fetus.
    Methods: Placentas were obtained from cesarean deliveries of women with no known epilepsy. Cotyledons were cannulated and perfused over 180 min in the presence of lacosamide at 2.5 μg/ml (10 μmol·L
    Results: Following a 3-h perfusion, the mRNA expression of SLC19A1 (encoding the reduced folate carrier 1) was downregulated in placentas treated with 10 μg/ml lacosamide (50%) as compared with the vehicle (p < .05). Across all groups, a significant difference was observed in the expression of SLC19A3 (thiamine transporter 2; 52%, 20%, and 9% decrease by 10 μg/ml lacosamide, 83 μg/ml valproate, and 2.5 μg/ml lacosamide, respectively; p < .05).
    Significance: Lacosamide at high therapeutic concentrations exerted pharmacological effects on the human placenta. Our findings, if manifested in vivo, suggest that lacosamide could potentially affect folate supply to the fetus and support therapeutic monitoring and careful adjustment of lacosamide plasma concentrations during pregnancy.
    Mesh-Begriff(e) Female ; Humans ; Pregnancy ; Valproic Acid/pharmacology ; Valproic Acid/therapeutic use ; Placenta ; Lacosamide/therapeutic use ; Fetus ; Epilepsy/drug therapy ; Epilepsy/metabolism ; Membrane Transport Proteins/metabolism
    Chemische Substanzen Valproic Acid (614OI1Z5WI) ; Lacosamide (563KS2PQY5) ; SLC19A3 protein, human ; Membrane Transport Proteins
    Sprache Englisch
    Erscheinungsdatum 2022-09-03
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 216382-2
    ISSN 1528-1167 ; 0013-9580
    ISSN (online) 1528-1167
    ISSN 0013-9580
    DOI 10.1111/epi.17395
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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