A multidisciplinary approach to improving process and outcomes in unscheduled cesarean deliveries.

Background: Effective communication between providers of various disciplines is crucial to the quality of care provided on labor and delivery. The lack of standardized language for communicating the clinical urgency of cesarean delivery and the lack of standardized processes for responding were identified as targets for improvement by the Obstetric Patient Safety Committee at the Hospital of the University of Pennsylvania. The committee developed and implemented a protocol aimed at improving the performance of our multidisciplinary team and patient outcomes.

Spontaneous Adrenal Hemorrhage in Pregnancy: A Case Series.

. Abdominal pain during pregnancy has a broad differential diagnosis which includes spontaneous adrenal hemorrhage (SAH). There is scant literature available on optimal mode of delivery in stable patients.

Second-Trimester 3-Dimensional Placental Sonography as a Predictor of Small-for-Gestational-Age Birth Weight.

Objectives: We previously reported the association between first-trimester 3-dimensional (3D) placental measurements and small-for-gestational-age (SGA) neonates. In this study, we sought to determine whether second-trimester measurements further contribute to the antenatal detection of SGA and preeclampsia.

Methods: We prospectively collected 3D sonographic volume sets and uterine artery pulsatility indices of singleton pregnancies at 18 to 24 weeks.

Transabdominal ultrasonography as a screening test for second-trimester placenta previa.

Objective: To determine the test characteristics of transabdominal ultrasonography as a screening test for second-trimester placenta previa.

Methods: This secondary analysis of a prospective cohort study evaluated the distance from the placental edge to the internal os (placenta-cervix distance) through both transabdominal and transvaginal ultrasonography during the anatomic survey. Patients were recruited in the Maternal-Fetal Medicine Ultrasound Unit at the Hospital of the University of Pennsylvania, an urban tertiary care center.

Reproductive implications of psychological distress for couples undergoing IVF.

Objective: To study implications of psychological distress on in vitro fertilization (IVF) outcome of an infertile couple.

Methods: Prospective study in an academic infertility practice setting. Couples undergoing embryo transfer (ET) following IVF were offered participation.

The Impact of Magnesium Sulfate Therapy on Angiogenic Factors in Preeclampsia.

OBJECTIVE: The objective was to evaluate whether intravenous magnesium sulfate (magnesium) alters levels of angiogenic factors in women with preeclampsia. STUDY DESIGN: This was a prospective cohort study comparing women with preeclampsia treated with magnesium for seizure prophylaxis to those who were not. Serum levels of angiogenic factors, soluble fms-like tyrosine kinase 1, soluble endoglin and placental growth factor, were measured at the time of diagnosis and approximately 24 hours later.