Publications by authors named "Ariel Many"
Objective: The increasing rate of cesarean sections (CSs) raises concerns over severe intra-abdominal adhesions, which are associated with numerous complications. We aimed to identify risk factors and predictive tools for severe adhesions.
Design: A prospective study was conducted.
Article Synopsis
- This study investigated if pregnant women with "flat" oral glucose tolerance test (OGTT) curves are at higher risk for bad outcomes for themselves or their babies.
- It compared the outcomes of 1,060 women with flat OGTT curves to 10,591 with normal curves, focusing on issues like birth weight and delivery complications.
- Results showed women with flat curves were generally younger and had a lower risk of having larger babies and needing unplanned cesarean sections, but there was no significant difference in overall adverse outcomes for mothers or newborns.
Purpose: To assess the prevalence, microbial profile, and clinical risk factors of maternal bacteremia associated with intrapartum fever (IPF).
Methods: A retrospective cohort study, in a single tertiary university-affiliated medical center between 2012 and 2018. Demographic and labor characteristics of women, who delivered at term (37+0/7-41+6/7) and developed bacteremia following IPF were compared to a control group of women with IPF but without bacteremia.
Article Synopsis
- A retrospective study examined how the timing of delivery in a labor floor staffed by senior physicians impacts maternal and neonatal health outcomes for singleton term deliveries between 2011 and 2020.
- The analysis revealed that adverse maternal outcomes were significantly higher during evening shifts, with the risk of emergency Cesarean sections being a major contributor, while neonatal outcomes showed longer hospital stays for babies delivered during evening and night shifts compared to morning.
- Overall, the findings suggest that deliveries during the evening shift carry increased risks for both mothers and newborns, even in a setting led by experienced physicians.
Article Synopsis
- The study examines the link between grand multiparity (having five or more previous deliveries) and the risk of postpartum complications, specifically blood transfusions following childbirth.
- A total of 87,343 deliveries were analyzed; grand multiparous women accounted for only 1.7% of the sample, with only 1.8% of all women needing red blood cell transfusions.
- The results suggest that, after adjusting for various risk factors, grand multiparity is actually associated with a lower risk of needing blood transfusions postpartum, indicating it may be a protective factor rather than a risk factor.
The decision to postpone parenting has gained momentum in recent years, a shift driven by evolving social dynamics and improved access to fertility treatments. Despite their increasing prevalence, pregnancies at advanced maternal ages are associated with increased risks of adverse maternal and neonatal outcomes. This article addresses the association between advanced maternal age and hypertensive disorders of pregnancies (HDPs), which are more prevalent and a significant cause of maternal morbidity and mortality in this population.
View Article and Find Full Text PDFObjective: This study aimed to determine whether a trial of labor after two cesarean deliveries (TOLAC2) increases the risk of adverse maternal and neonatal outcomes and identify prognostic factors for TOLAC2 success.
Study Design: A retrospective cohort study was conducted at a single medical center. The study group was comprised of women with a history of TOLAC2.
Risk factors for blood component therapy in parturients-Case-control study.
Int J Gynaecol Obstet
September 2023
Objective: Postpartum hemorrhage is a major cause of maternal morbidity and mortality, so early identification of patients at risk is crucial. In this study, we aim to assess the risk factors for major transfusion in parturients.
Methods: A case-control study was conducted between 2011 and 2019.
Estimating predictors of severity of group A infection in pregnancy.
J Matern Fetal Neonatal Med
December 2023
Objective: To identify the clinical characteristics of pregnancy associated group A streptococcus (GAS) infection and predictors for intensive care unit (ICU) admission.
Methods: A retrospective cohort study of culture-proven pregnancy-related GAS infections in tertiary hospital Electronic medical records were reviewed, for cases of cultures positive GAS that were identified between January 2008 and July 2021. A GAS infection was defined by the isolation of the pathogen from a sterile liquid or tissue site.
Objective: To determine and compare the safety and efficacy of different methods of induction of labor in twin gestations and their effect on maternal and neonatal outcomes.
Methods: A retrospective observational cohort study was conducted at a single university-affiliated medical center. Patients with a twin gestation undergoing induction of labor at >32 + 0 weeks comprised the study group.
Article Synopsis
- The study examined the impact of maternal parity on complications during twin deliveries, comparing outcomes among primiparas (first-time mothers), multiparas (mothers with 1-4 previous births), and grand multiparas (mothers with 5 or more previous births) over a 6-year period.
- Findings showed that primiparas had a significantly higher rate of maternal complications, requiring more blood transfusions and experiencing worse composite outcomes compared to multiparas and grand multiparas.
- Additionally, primiparas delivered at an earlier gestational age and had a higher incidence of preterm labor compared to the other groups, although the mode of delivery and time interval between twins were generally similar across all parity
Background: Intraabdominal adhesions may develop following cesarean delivery and are considered a major concern.
Objective: This study aimed to determine the effect of surgeon seniority in evaluating intraabdominal adhesions at cesarean delivery.
Study Design: A prospective study to estimate interrater reliability between surgeons was conducted.
Objective: To determine pregnancy outcomes in women with subjective sensation of increased fetal movements (IFM).
Methods: A prospective cohort study of women after 20 weeks of gestation who were referred with subjective sensation of IFM (April 2018-April 2019) for assessment. Pregnancy outcome was compared to pregnancies with a normal sensation of fetal movements all through pregnancy who underwent obstetrical assessment at term (37-41 weeks of gestation) matched by maternal age and pre-pregnancy BMI in a 1:2 ratio.
Article Synopsis
- - Intrahepatic cholestasis of pregnancy (ICP) leads to elevated total bile acids (TBA) in mothers, posing risks for fetal health, but the exact reasons why some fetuses are more affected than others are unclear.
- - A study of 18 women with high TBA levels (over 40 μmol/L) and their 23 fetuses found that TBA levels in the umbilical vein were significantly lower than in maternal blood, while levels in the umbilical vein and artery were similar.
- - The results indicated that despite high maternal TBA levels, fetuses were not seriously harmed, suggesting that the placenta effectively reduces fetal exposure to bile acids, rather than the fetus metabolizing them significantly.
Article Synopsis
- The study aimed to evaluate the effectiveness of three labor induction methods for women with non-viable fetuses in the third trimester.
- It analyzed data from 107 women who had either a transcervical foley catheter with oxytocin, vaginal Prostin, or Propess for labor induction, focusing on outcomes like delivery time and pain levels.
- Results showed that the foley catheter method led to faster deliveries and higher rates of delivery within 24 hours compared to the other methods, while reporting more moderate to severe pain with the Prostin and Propess treatments.
Introduction: Lower uterine segment scarring after cesarean section can decrease intraoperative bleeding during subsequent surgery. We examined whether first elective cesarean section is associated with greater average blood loss compared to repeated surgery.
Methods: Decrease in maternal hemoglobin and hematocrit after surgery was retrospectively compared between three study groups, women in their first, second and third or more cesarean section.
Laparoscopic management of suspected postpartum uterine rupture: a novel approach.
J Matern Fetal Neonatal Med
December 2022
Background: Exploratory laparotomy is considered the gold standard treatment for women with suspected uterine rupture. We aimed to investigate the feasibility and safety of laparoscopy as an alternative for laparotomy for the management of hemodynamically stable women with suspected postpartum uterine rupture.
Study Design: We conducted a case series study including all women who were diagnosed with postpartum uterine rupture following vaginal delivery in a university-affiliated tertiary hospital, between November 2012 and July 2021.
Objective: To investigate trial of labor after cesarean (TOLAC) success rates in twin gestations with no prior vaginal delivery.
Methods: A retrospective study of women with twin gestations who underwent a TOLAC and had no prior vaginal delivery during 2011-2020. TOLAC success and failure groups were compared.
Background: Advanced magnetic resonance imaging (MRI) methods are increasingly being used to assess the human placenta. Yet, the structure-function interplay in normal placentas and their associations with pregnancy risks are not fully understood.
Purpose: To characterize the normal human placental structure (volume and umbilical cord centricity index (CI)) and function (perfusion) ex-vivo using MRI, to assess their association with birth weight (BW), and identify imaging-markers for placentas at risk for dysfunction.
Background: Visual and acoustic virtual reality (VR) has been increasingly explored as a non-pharmacological tool for pain relief in clinical settings.
Objective: We aimed to evaluate the effectiveness of VR as a distraction technique in the management of acute pain during operative hysteroscopy in the outpatient setting.
Methods: A prospective, open-label, randomized control trial in a tertiary university-affiliated medical centre between April and August 2020.
The importance of breastmilk in postnatal life lies in the strong association between breastfeeding and the reduction in the risk of infection and infection-related infant mortality. However, data regarding the induction and dynamics of breastmilk antibodies following administration of the Pfizer-BioNTech BNT162b2 COVID-19 mRNA vaccine is scarce, as pregnant and lactating women were not included in the initial vaccine clinical trials. Here, we investigate the dynamics of the vaccine-specific antibody response in breastmilk and serum in a prospective cohort of ten lactating women who received two doses of the mRNA vaccine.
View Article and Find Full Text PDFPregnancy and parturition reflect the complex interaction between physiological conditions of the mother and her offspring, and fetal health characteristics may affect maternal health throughout pregnancy and delivery. We aimed to investigate the characteristics of the mother-infant dyad of term infants detected as having congenital hypothyroidism (CH). A retrospective cohort study of 108,717 term infants delivered liveborn at Lis Maternity and Women's Hospital between 2010 and 2017.
View Article and Find Full Text PDFObstetrical outcomes of ART pregnancies in patients with male factor infertility.
J Assist Reprod Genet
August 2021
Article Synopsis
- IVF/ICSI pregnancies often face higher rates of complications, and this study aimed to determine if those conceived due to male factor infertility show different outcomes compared to other infertility causes.
- A retrospective study analyzed 225 pregnancies, categorizing them into male factor infertility and non-male factor infertility, comparing complications between the groups.
- The results indicated that singleton pregnancies from male factor infertility showed lower risks of cesarean delivery, preterm birth, and having male offspring, suggesting potentially fewer maternal health issues, but further research with larger samples is needed to confirm these findings.
Predicting the need for blood transfusion requirement in postpartum hemorrhage.
J Matern Fetal Neonatal Med
December 2022
Objective: We aimed to assess the role of lactate and hemoglobin levels as predictors for the need for blood transfusion in post-partum hemorrhage (PPH).
Methods: A retrospective cohort study of women with PPH in a single university-affiliated tertiary medical center between August 2018 and June 2020. PPH was defined as an estimated excessive blood loss (of more than 500 ml following vaginal delivery and 1000 ml following a cesarean delivery) requiring at least one uterotonic drug and fluid resuscitation.