Vascular dimorphism ensured by regulated proteoglycan dynamics favors rapid umbilical artery closure at birth.

The umbilical artery lumen closes rapidly at birth, preventing neonatal blood loss, whereas the umbilical vein remains patent longer. Here, analysis of umbilical cords from humans and other mammals identified differential arterial-venous proteoglycan dynamics as a determinant of these contrasting vascular responses. The umbilical artery, but not the vein, has an inner layer enriched in the hydrated proteoglycan aggrecan, external to which lie contraction-primed smooth muscle cells (SMC).

Development of an outpatient clinic to provide pertussis vaccinations to maternity patients and family members.

Purpose: The implementation of a hospital-based outpatient pertussis prevention program targeting maternity patients and family members is described.

Summary: Faced with a rising incidence of pertussis statewide, a large Ohio hospital formed a multidisciplinary team to ensure hospital compliance with current guidelines calling for administration of the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine to all maternity patients as well as previously unvaccinated family members and likely neonatal caregivers (i.e.

First-trimester and second-trimester screening at a community hospital: experience from the first year of implementation.

Objective: To review the first-year experience implementing a new early screening during pregnancy program for aneuploidy in a community hospital and compare this program with the screening program immediately preceding its implementation.

Methods: The electronic medical records of all pregnant patients referred from May 17, 2005, through December 31, 2006, for genetic counseling were reviewed for maternal characteristics, indication for referral, a priori and adjusted risk of aneuploidy, and patient choice for screening or testing. The new early screening program (nuchal translucency group) consisted of additional educational materials, nuchal translucency, serum biochemical analytes, quad screening, and invasive testing when indicated.

Management of group B Streptococcus in pregnant women with penicillin allergy.

Objective: To determine whether group B Streptococcus (GBS)-colonized pregnant women who report a history of penicillin allergy can safely undergo diagnostic evaluation to rule out or confirm the potential for an IgE-mediated (allergic) reaction to penicillin.

Study Design: Over 18 months, all pregnant women with GBS-positive vaginal/rectal cultures and a history of penicillin allergy were referred to the Department of Allergy and Immunology for a history and possible skin testing. Patients who had experienced anaphylaxis were advised to continue avoiding penicillin and were not skin tested.