The utility of fetal echocardiography after an unremarkable anatomy scan.

Objective: To estimate whether fetal echocardiography detects major cardiac anomalies after normal anatomy ultrasound scan in patients at increased risk for having a fetus with congenital heart disease.

Methods: A computerized database was used to identify patients who underwent fetal echocardiography at the New York University Division of Pediatric Cardiology after anatomy ultrasound scan at the New York University Obstetrics and Gynecology Ultrasound Unit. Only patients with normal anatomy ultrasound scan results were included in the primary analysis.

Angiogenic imbalances: the obstetric perspective.

Clinical and experimental evidence indicates that angiogenic imbalances may participate in the mechanisms of disease of several pregnancy complications, some of which may be life threatening. This article reviews current evidence in support of this view and the possibility that the fetus may play a central role in these imbalances; it also reviews recent experimental observations that modulation of angiogenic imbalances during pregnancy may have prophylactic and/or therapeutic value.

Indications for fetal echocardiography high referral, low yield?

Unlabelled: An excellent imaging tool in the prenatal diagnosis and ongoing evaluation of congenital heart defects, fetal echocardiography is indicated in a selected population at increased risk compared with the general population. For certain "soft markers" of fetal congenital heart defects, ambiguity in the indications for fetal echo may result in a high referral rate, but low yield of congenital heart disease. Here, we critically examine 4 conditions, 2 maternal and 2 fetal: maternal gestational diabetes, advanced maternal age, isolated echogenic focus, and single umbilical artery.

Universal tuberculosis screening in pregnancy.

We reviewed our practice of universal tuberculosis (TB) screening in an at-risk pregnant population with regards to utility and patient compliance. The Gouverneur Healthcare Services prenatal database was analyzed for compliance with TB screening. Age, ethnicity, country of origin, and education level were also analyzed.

Predictors of severe perineal lacerations in Chinese women.

Objective: Chinese women have been shown to have a higher incidence of severe perineal laceration compared to other ethnic groups. We sought to test the hypothesis that this risk is related to body mass index (BMI) or to a relative fetal-maternal size disproportion as measured by the ratio of the newborn birthweight to maternal BMI (BW:BMI).

Methods: A retrospective cohort study was performed using a pre-existing obstetric database.

Debate preparation/participation: an active, effective learning tool.

Background: Passive educational techniques (such as lectures) are thought to be less productive than active learning.

Purpose: We examined whether preparing for and participating in a debate would be an effective, active way to learn about a controversial topic.

Methods: We compared quiz performance in residents who attended a lecture to residents who prepared for/participated in a debate.

Intrahepatic cholestasis of pregnancy: detection with urinary bile acid assays.

Aims: To determine sensitivity and specificity of urine bile acid sulfate (UBAS) and non-sulfated urine bile acid (UBA) assays for detection of intrahepatic cholestasis of pregnancy (ICP).

Methods: Urine was collected prospectively from healthy and pruritic patients evaluated for ICP. Results were expressed as a ratio to urinary creatinine.

Medical legal issues in the prevention of prematurity.

Preterm birth remains the leading cause of neonatal morbidity and mortality in the world today. This article discusses ways the treatment team can inform parents of probable outcomes and help them reach decisions about treatment for the newborn under emotionally fraught conditions. In addition to supporting the patient, these approaches may help the clinician avoid malpractice litigation.

Comparison of three outpatient regimens in the management of nausea and vomiting in pregnancy.

Objective: This study compares pyridoxine-metoclopramide combination therapy to prochlorperazine and promethazine monotherapies in the outpatient treatment of nausea and vomiting in pregnancy.

Study Design: In total, 174 first trimester, singleton pregnancies were evaluated for nausea and vomiting. Patients were prospectively randomized into three treatment groups: pyridoxine-metoclopramide, prochlorperazine, or promethazine.