Outcomes of Triplets reduced to Twins versus non-reduced Triplet Pregnancies.

Introduction: This study examined the outcomes of triplet pregnancies selectively reduced to twin pregnancies, compared with non-reduced triplet pregnancies using a standardized approach.

Material And Methods: This study is an observational retrospective study of all women who presented to the Fetal Diagnostic Center between 1999-2009, had triplet pregnancies in the first trimester, received prenatal care and delivered at Abington Memorial Hospital. Data analysis was performed with SPPS version 15 for Windows using analysis of variance and Fisher's Exact test.

The impact of length of second stage of labor on shoulder dystocia outcomes: a retrospective cohort study.

Objective: To compare obstetrical and neonatal outcomes of vaginal deliveries complicated by shoulder dystocia, according to the length of second stage of labor.

Methods: We conducted a retrospective cohort study of 177 shoulder dystocia cases that were divided into three categories according to second stage duration (1-20, 21-59, 60-180 min, respectively). The three categories were compared in terms of obstetric characteristics and neonatal outcomes.

Improved overall delivery documentation following implementation of a standardized shoulder dystocia delivery form.

Objective: Our objective was to evaluate whether using a standardized shoulder dystocia delivery form improved documentation. A standardized delivery form was added to our institution's obstetrical record in August 2003.

Methods: A retrospective cohort study was conducted comparing 100 vaginal deliveries complicated by shoulder dystocia before, and 81 after implementation of the standardized delivery form.

Risk factors associated with retained placenta after cesarean delivery.

Objectives: Retained placenta after cesarean delivery (RPAC) is a rare phenomenon that has not been previously studied in detail. The objective of our study was to identify potential risk factors that predispose to the development of this obstetrical complication.

Methods: We performed a retrospective case-control study comparing 20 cases of RPAC with 40 matched controls, using logistic regression models to test likely risk factors.

The role of ultrasound-indicated cerclage in triplets.

Objectives: Preterm delivery is the leading cause of major perinatal morbidity and mortality associated with triplet pregnancies. The objective of this study was to evaluate the efficacy of ultrasound-indicated cervical cerclage in triplet pregnancies that are diagnosed with cervical shortening on biweekly transvaginal sonography (TVS).

Methods: A retrospective review of all triplets who were followed with biweekly TVS for measurement of cervical length was conducted.

Da Vinci-assisted abdominal cerclage.

Objective: To report the first placement of an abdominal cervicoisthmic cerclage using the da Vinci robot.

Design: Case report.

Setting: Tertiary-care hospital.

Fetal serum beta2-microglobulin before and after bladder shunting: a 2-step approach to evaluate fetuses with lower urinary tract obstruction.

Purpose: The evaluation of renal function in fetuses with lower urinary tract obstruction by analysis of electrolytes and beta2-microglobulin in fetal urine has limitations. We measured fetal serum beta2-microglobulin before and after bladder shunting to evaluate renal function.

Materials And Methods: A total of 12 fetuses with lower urinary tract obstruction underwent vesicoamniotic shunting.

The effects of serial intravascular transfusions in ascitic/hydropic RhD-alloimmunized fetuses.

Objective: To evaluate the effects of serial intravascular transfusions on RhD-alloimmunized fetuses with ascites/hydrops at the time of the first transfusion by measuring multiple hematological/biochemical blood variables.

Methods: Thirty-one singleton pregnancies were referred for management of RhD alloimmunization. Seven fetuses had hydrops on presentation and were transfused immediately.

Lipopolysaccharide-binding protein in microbial invasion of the amniotic cavity and human parturition.

Objective: Lipopolysaccharide-binding protein (LBP) is an acute-phase protein of predominantly hepatic origin, capable of binding the lipid A fraction of bacterial lipopolysaccharide (LPS). The complex LBP-LPS binds to CD14, and has been implicated in the host response to gram-negative infection. The purpose of this study was to determine whether microbial invasion of the amniotic cavity (MIAC) and parturition (term and preterm) are associated with changes in the amniotic fluid concentration of LBP.

Chorionic villus sampling followed by amniocentesis in the same pregnancy.

In our consecutive series of 2,574 chorionic villus sampling (CVS) patients, 146 women (5.7%) underwent a subsequent amniocentesis in the same pregnancy for the indications of absent or insufficient villi (3.3%), elevated maternal serum alpha-fetoprotein (0.

On lumping and splitting: a fetus with clinical findings of the oral-facial-digital syndrome type VI, the hydrolethalus syndrome, and the Pallister-Hall syndrome.

The three midline malformation complexes, the oral-facial-digital syndrome type VI (OFDS VI) or Váradi syndrome, the hydrolethalus syndrome (HS), and the Pallister-Hall syndrome (PHS) have been described as distinct genetic entities. Here, we report a fetus with a combination of clinical findings of all 3 syndromes similar to the twin fetuses described in the accompanying paper (Hingorani et al., 1991).

The normal fetus of an acardiac twin pregnancy: perinatal management based on echocardiographic and sonographic evaluation.

Experience with three prenatally diagnosed pregnancies complicated by an acardiac twin reveals that ultrasonography and echocardiography are helpful in detecting early signs of in-utero congestive heart failure in the normal twin. The use of Doppler blood flow analysis to determine direction of blood flow, post-mortem placental and fetal angiography, and umbilical cord blood gas determination provided proof that retrograde arterial perfusion occurs in the acardiac fetus. In a fourth pregnancy, an experimental approach to occlude the acardiac twin's umbilical cord was attempted, but was unsuccessful.

The use of ritodrine and magnesium sulfate in the arrest of premature labor.

Sixty-seven cases of premature labor (48 with unruptured and 19 with ruptured membranes) were treated with ritodrine or magnesium sulfate infusion supplemented with oral ritodrine in case of initial success. Both treatment regimens were found effective irrespective of maternal age, parity, ethnic background and number of previous abortions. The study supports the clinical experience indicating that early administration of tocolytic agents is highly successful in arresting premature labor and preventing its dire consequences.