Is there a useful cesarean birth measure? Assessment of the nulliparous term singleton vertex cesarean birth rate as a tool for obstetric quality improvement.

Objective: This study was undertaken to assess the utility of the nulliparous term singleton vertex cesarean birth (NTSV CB) measure as a quality improvement tool for use at the hospital level.

Study Design: We prospectively collected data on all NTSV births in Sutter Health's 20 birthing units over a 3-year period, 2001 through 2003, totaling 41,416 births. Hospital rates of NTSV CB, obstetric practices, and infant outcomes were calculated and compared by using weighted logistic analyses.

Transvaginal placement of cervicoisthmic cerclage: report on pregnancy outcome.

Objective: This study was undertaken to review pregnancy course and outcome in 56 pregnancies after the placement of a cervicoisthmic cerclage transvaginally.

Study Design: Fifty-three pregnant patients with unique indications such as previous failure of conventional cerclages or compromised cervical anatomy, underwent transvaginal placement of a cervicoisthmic cerclage during pregnancy.

Results: There was 100% fetal survival.

A perspective on the diagnosis of preterm labor.

Over the past few decades there has not been any significant reduction in the rate of preterm birth. As we enter into a new millennium, prematurity is still the leading cause of perinatal morbidity and mortality in the non-anomalous infant. The only major contributions in reducing perinatal mortality in the preterm infant are those in the field of neonatology, while the area of preterm birth prevention has lagged far behind.