Publications by authors named "Dana Vitner"

Purpose: Retroverted uterus affects 15-20% of patients. While typically not a cause for concern, some studies suggest a relationship between a retroverted uterus and subfertility. Study objective was to investigate the association between uterine position and spontaneous conception rates, as well as potential risks for adverse pregnancy outcomes in nulliparous patients.

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Article Synopsis
  • - The study aimed to assess the effectiveness of using a double balloon device for cervical ripening for 6 hours compared to 12 hours in patients with a cervical length of 30 mm or more before labor induction.
  • - It was a secondary analysis involving 67 women, where the main focus was the change in Bishop score after removing the device, with secondary measures like delivery timing and oxytocin use.
  • - Results showed no significant difference in Bishop score changes between the two time groups, but the 6-hour group had a notably shorter delivery time by 10 hours compared to the 12-hour group.
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Objective: Short inter-pregnancy interval (IPI) of <18 months following a live birth, has been associated with adverse pregnancy outcome. This study aimed to evaluate whether a short IPI following a medically treated missed abortion (MA) poses similar perinatal risks in a subsequent pregnancy.

Study Design: The retrospective analysis included patients with history of an MA at up to 10 weeks of gestation, treated with misoprostol (pgE1) only, and with a documented subsequent live pregnancy (2010-2022).

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Objective: To evaluate whether a short interpregnancy interval (IPI) after vacuum extraction (VE), poses similar perinatal risks in a subsequent pregnancy.

Methods: This was a retrospective, single-center cohort study between 2011 and 2021. Nulliparous women with term, singleton VE deliveries and with known pregnancy outcomes in their subsequent pregnancy were eligible for inclusion in the study.

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Purpose: To compare mode of delivery and maternal and neonatal outcomes using cervical ripening balloon (CRB) for induction of labor (IOL) in nulliparous patients vs. those undergoing first trial of labor after cesarean (TOLAC).

Methods: Retrospective cohort study including data from two tertiary medical centers.

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Background: Scheduled administration of analgesics was proven superior to on-demand dosing following cesarean deliveries. However, this protocol was not compared after vaginal delivery.

Objective: To compare the efficacy of a fixed- vs on-demand analgesic protocol for the management of pain in the first 24 hours after a vaginal delivery.

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The effect of prolonged intertwin delivery interval (IDI) is not well studied. This work aimed to assess the inflection point for Cesarean delivery (CD) and associated adverse maternal and neonatal outcomes. This was a retrospective cohort study at a single tertiary care center.

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Objective: To determine the cutoff of intertwin delivery intervals (IDIs) as a predictor for neonatal acidemia.

Method: This retrospective cohort study was conducted at a single tertiary care center. Women attempting vaginal delivery of twins between 2010 and 2019 and who reached the second stage of labor were included.

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Objective: To compare maternal and fetal outcomes between early (<2 h) and delayed (>2 h) vacuum extraction (VE) deliveries.

Methods: We performed a retrospective cohort study in a single, university-affiliated medical center (2014-2021). We included term singleton pregnancies delivered by VE, allocated into one of two groups according to second stage duration: <2 h or >2 h.

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Background: Gestational diabetes mellitus should be treated adequately to avoid maternal hyperglycemia-related complications. Previously, probiotic supplements were suggested to improve fasting blood glucose in women with gestational diabetes mellitus. However, a major limitation of previous studies was that preprandial and especially postprandial glucose values, which are important predictors of pregnancy outcomes, were not studied.

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Objectives: The management for improving maternal and neonatal outcomes of women with gestational diabetes mellitus (GDM) arriving at the delivery ward with pre-labour rupture of membranes (PROM) has not been elucidated. We tested the hypothesis that prolonged PROM in women with GDM would result in higher rates of neonatal hypoglycemia.

Methods: We retrospectively enrolled women with diet or insulin-controlled GDM who presented with spontaneous clear PROM.

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Background: Oxytocin is considered the drug of choice for the induction of labor, although the optimal protocol and infusion duration remain to be determined.

Objective: This study aimed to assess whether the duration of oxytocin infusion increases 24-hour delivery rates and affects the length of time-to-delivery and patient's experience.

Study Design: A randomized controlled trial was performed at a single tertiary medical center, between January 1, 2020 and June 30, 2022.

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Objective: This work aimed to identify possible risk factors and the morbidity associated with prolonged intertwin delivery interval (IDI).

Study Design: A retrospective cohort study at a single tertiary care center. Women with twin gestations who reached the second stage of labor between January 2010 and December 2019 were included in the study.

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Background: Postpartum urinary retention is a common complication in the immediate postpartum period. However, there is no consensus regarding optimal management.

Objective: This study aimed to compare 2 catheterization strategies for the treatment of postpartum urinary retention.

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Objective: Term prelabour rupture of membrane (PROM) occurs in 8% of term deliveries, but it is unclear when to initiate induction. Our objective was to assess the optimal timing of oxytocin induction in the management of term PROM in terms of maternal and neonatal outcomes.

Methods: A retrospective cohort study was performed at a single tertiary care center from 2010 to 2020.

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Objective: To evaluate the effects of extending the second stage of labor in women attempting a trial of labor after a cesarean section (TOLAC).

Method: A retrospective cohort study comparing maternal and neonatal outcomes following TOLAC over two periods: period I whose prolonged second stage was considered 2 h, and period II whose prolonged second stage was considered 3 h. The primary outcome was repeat cesarean delivery (CD) rate.

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Background: Late preterm neonates born between 34.0 and 36.6 weeks' gestation are at increased risk for short- and long-term morbidity and mortality when compared with their term counterparts.

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Objective: To evaluate the predictive value of transvaginal ultrasonography measures: total cervical length (TCL), length to internal OS (LIO) and external OS (LEO) from the cerclage following cerclage placement, for spontaneous preterm birth (PTB).

Methods: A retrospective cohort at a single tertiary care center (2010-2020). Women with McDonald cerclage were evaluated during the 2nd and 3rd trimesters for cervical measurements: TCL, LIO, LEO.

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Objectives: To evaluate the impact of asymptomatic cervical shortening (ACS) at mid-trimester on maternal and neonatal outcomes.

Methods: This was a retrospective cohort study. Women with singleton gestations and an accidental finding of cervical length of 25 mm or less at mid-trimester were compared with women with symptomatic cervical shortening (SCS) and women with normal cervical length (NCL).

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Introduction: Maternal inflammation may induce placental cytokine production resulting in fetal exposure, and development of neonatal neurologic injury. Maternal magnesium sulphate (MG) is used as neuroprotective in preventing white matter brain injury. We sought to determine whether maternal MG can prevent placental activation of inflammatory pathways associated with fetal injury.

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Background: Total salpingectomy during benign gynecologic surgery is recommended after completion of childbearing to reduce the risk of developing ovarian cancer.

Objective: This study aimed to assess operating time and complication rates of "traditional" salpingectomy using the "Knot and Cut" technique, compared with bipolar salpingectomy for sterilization at the time of cesarean delivery.

Study Design: This was a randomized controlled trial.

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Objectives: To compare rates of surgical-site infections following continuous, as compared with interrupted, subcutaneous tissue closure technique during cesarean delivery (CD).

Methods: A retrospective cohort study during 2008-2018. The study group included women who underwent either elective or emergent CD with continuous subcutaneous tissue closure, while the control group comprised those with interrupted subcutaneous tissue closure.

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Data regarding the preferred induction method in women with obesity is scarce. The current study was aimed at comparing pharmacological and mechanical induction in this population. This prospective randomized controlled trial was conducted between 2016−2020, in nulliparas with a pre-pregnancy body mass index >30.

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Objective: To determine the impact of combined medical and medical/mechanical methods for cervical ripening on the risk of preterm birth in subsequent pregnancy, in nulliparous women.

Methods: A retrospective cohort study of nulliparous women with term singleton gestations induced by single or combined methods at one center who had their subsequent second birth in the same center. Study groups were compared with a control group of nulliparous women not induced.

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Article Synopsis
  • The study aimed to determine if there is a specific maternal age, particularly a cut-off, at which maternal and neonatal adverse outcomes significantly increase.
  • It analyzed data from 11,343 nulliparous women, finding that those older than 28 years faced notably higher risks for cesarean delivery, premature births, hypertensive disorders, and gestational diabetes compared to younger women.
  • The conclusion emphasizes that women over 28 years are independently at a greater risk for adverse outcomes during pregnancy, highlighting the importance of age in maternal health considerations.
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