Clinical Research Coordinators (CRCs) are a vital component of the clinical research enterprise providing a pivotal role in human subject protection through the numerous activities and responsibilities assigned to them. In 2006, the National Institutes of Health's National Center for Research resources (NCRR) implemented the Clinical and Translational Science Awards program (CTSA) to advance biomedical research. As a part of this endeavor, many workgroups were formed among the Consortium to support translational research.
View Article and Find Full Text PDFObjective: To determine if race is associated with election to attempt vaginal birth after cesarean delivery (VBAC), VBAC success, and maternal morbidities associated with VBAC.
Methods: A retrospective, multi-center cohort study was conducted of women with a history of at least one prior cesarean delivery. Data were obtained on maternal demographics, medical history, antepartum and intrapartum course, delivery mode, and maternal outcomes.
Objective: The purpose of this study was to examine the rate of and risks for abruption and adverse pregnancy outcome after minor trauma in pregnancy.
Study Design: This is a 3-year prospective cohort study of patients after noncatastrophic trauma. Data collected included maternal demographics and history, trauma mechanism, and pregnancy outcome.
Objective: To investigate whether short or long interpregnancy interval is associated with uterine rupture and other major maternal morbidities in women who attempt vaginal birth after cesarean delivery (VBAC).
Methods: We performed a secondary analysis of a U.S.
Objective: The objective of the study was to test the null hypothesis that outcomes of vaginal birth after cesarean (VBAC) do not differ on the basis of the hospital setting.
Study Design: The study was a retrospective cohort study of women who were offered VBAC in 17 hospitals from 1996 to 2000. VBAC attempts occurring in hospitals with and without obstetrics-gynecology residency programs were compared, as were outcomes from university and community hospitals.
Objective: The purpose of this study was to determine whether the maximum dose of oxytocin impacts the risk of uterine rupture in women who attempt vaginal birth after cesarean delivery (VBAC).
Study Design: We conducted a retrospective, multicenter cohort study of women with a history of cesarean delivery. We compared uterine rupture rates between VBAC candidates that did and did not receive oxytocin, analyzing the association between maximum dose of oxytocin and uterine rupture.
The purpose of this study was to determine if placental abruption or previa in women with a history of a prior cesarean delivery (CD) can be predicted. A retrospective cohort study of pregnant women with previous CD was conducted in 17 centers between 1996 and 2000. Women developing placenta previa or abruption in the subsequent pregnancy were compared with those without these complications.
View Article and Find Full Text PDFObjective: To identify a group of clinical factors that could be used to accurately predict failure in women attempting vaginal birth after cesarean (VBAC).
Methods: We conducted a planned secondary analysis of a retrospective cohort study of women who were offered VBAC from 1996 to 2000 in 17 community and university hospitals. We collected information about maternal history and outcomes of the index pregnancy.
Paediatr Perinat Epidemiol
March 2007
To estimate maternal age effects on the rates of vaginal birth after caesarean delivery (VBAC), the related maternal complications and patient election to attempt VBAC, we conducted a secondary analysis of a retrospective cohort study of women who were offered VBAC from 1996 to 2000 in 17 community and university hospitals. We used bivariable and multivariable analyses to assess the association between maternal age and the study outcomes. A total of 25 005 patients were included, of whom 13 706 (54.
View Article and Find Full Text PDFObjective: This study was undertaken to use multivariable methods to develop clinical predictive models for the occurrence of uterine rupture by using both antepartum and early intrapartum factors.
Study Design: This was a planned secondary analysis from a multicenter case-control study of uterine rupture among women attempting vaginal birth after cesarean (VBAC) delivery. Multivariable methods were used to develop 2 separate clinical predictive indices--one that used only prelabor factors and the other that used both prelabor and early labor factors.
Objective: This study was undertaken to determine whether vaginal birth after cesarean (VBAC) or elective repeat cesarean delivery is safer overall for a woman with a prior vaginal delivery.
Study Design: This retrospective cohort study of pregnant women from 1996 to 2000 who had a prior cesarean delivery, was conducted in 17 centers. Trained nurses extracted historical and maternal outcome data on subjects by using standardized tools.
The objective of this study was to determine if preeclampsia (PRE) or gestational hypertension (GH) affects the rate of success of vaginal birth after cesarean delivery (VBAC), VBAC-related complications, or patient election to attempt VBAC. We performed a retrospective cohort study of all women who were offered VBAC from 1996 to 2000 in 17 community and university hospitals. Demographic, medical, and obstetric history, complications, treatment, and index pregnancy outcome information was collected on all patients in the database.
View Article and Find Full Text PDFObjective: This study was undertaken to determine incidence and risk factors for uterine rupture in women attempting vaginal birth after cesarean delivery (VBAC) in a wide range of hospital settings.
Study Design: We performed a case-control study nested within a cohort of women who have had a prior cesarean to determine the incidence and risk factors for uterine rupture in women attempting VBAC.
Results: The incidence rate of uterine rupture in those who attempt VBAC was 9.
Objective: To compare rates of vaginal birth after cesarean (VBAC) failure and major complications in women attempting VBAC before and after the estimated date of delivery (EDD) METHODS: This was a 5-year retrospective cohort study in 17 university and community hospitals of women with at least 1 prior cesarean delivery. Women who attempted VBAC before the EDD were compared with those at or beyond 40 weeks of gestation. Logistic regression analyses were performed to assess the relationship between delivery beyond the EDD and VBAC failure or complication rate.
View Article and Find Full Text PDFAm J Obstet Gynecol
September 2005
Objective: The purpose of this study was to compare the rate of vaginal birth after cesarean (VBAC) attempt, VBAC failure, and major maternal adverse outcomes in women with a previous cesarean with twin or singleton pregnancies.
Study Design: This was a multicenter retrospective cohort study between the years 1996 and 2000. Subjects were identified by ICD-9 code.
Objective: This study was undertaken to compare clinical outcomes in women with 1 versus 2 prior cesarean deliveries who attempt vaginal birth after cesarean delivery (VBAC) and also to compare clinical outcomes of women with 2 prior cesarean deliveries who attempt VBAC or opt for a repeat cesarean delivery.
Study Design: We performed a secondary analysis of a retrospective cohort study, in which the medical records of more than 25,000 women with a prior cesarean delivery from 16 community and tertiary care hospitals were reviewed by trained nurse abstractors. Information on demographics, obstetric history, medical and social history, and the outcomes of the index pregnancy was obtained.
Objective: We sought to compare vaginal birth after cesarean (VBAC) success and uterine rupture rates between preterm and term gestations in women with a history of one prior cesarean delivery. Our hypothesis was that preterm women undergoing VBAC were more likely to be successful and have a lower rate of complications than term women undergoing VBAC.
Methods: We reviewed medical records of women with a history of a cesarean delivery who either attempted a VBAC or underwent a repeat cesarean delivery from 1995 through 2000 in 17 community and university hospitals.
Objective: We sought to determine whether women with diet-controlled gestational diabetes mellitus who attempt vaginal birth after cesarean delivery are at increased risk of failure, when compared with their non-diabetic counterparts.
Study Design: We identified 13,396 women who attempted vaginal birth after cesarean delivery among 25,079 pregnant women with a previous cesarean delivery who were delivered between 1995 and 1999 at 16 community and university hospitals. Analysis was limited to 9437 women without diabetes mellitus and 423 women with diet-controlled diabetes mellitus who attempted vaginal birth after cesarean delivery with a singleton gestation and 1 previous low-flap cesarean delivery.
Objective: To estimate the clinical and nonclinical factors associated with whether a patient attempts a trial of labor after previous cesarean delivery or elects to have a repeat cesarean delivery.
Methods: We conducted a retrospective, cohort study comparing all women with previous low transverse cesarean delivery who attempted a trial of labor with those who elected to have a repeat cesarean delivery. Data from 17 hospital sites for the period 1995-1998 were included, for a total of 15,172 patients.
Objective: The purpose of this study was to evaluate the effect of increasing birth weight on the success rates for a trial of labor in women with one previous cesarean delivery.
Study Design: To evaluate the effect of increasing birth weight for women who undergo a trial of labor, the medical records of women who had attempted a vaginal birth after cesarean delivery (VBAC) from 1995 through 1999 in 16 community and university hospitals were reviewed retrospectively by trained abstractors. Information was collected about demographics, medical history, obstetric history, neonatal birth weight, complications, treatment, and outcome of the index pregnancy.