Endometrial stromal sarcoma: analysis of recurrence following adjuvant treatment.

Objective: Endometrial stromal sarcoma (ESS) is a rare and indolent form of uterine cancer with ill-defined post-operative treatment guidelines. The goal of this study was to evaluate the rate of recurrence and the effect of various adjuvant treatment modalities.

Methods: Patients with ESS at 4 institutions were identified (1986-2007).

Intrapartum considerations in prenatal care.

The epidemic of obesity continues to grow undaunted, promising to affect the lives of more women of childbearing age. The challenges facing those charged with obstetrical care of the obese may require variation in care from forethought and planning, to consultation or referral for care at specialized centers. The routine management of late pregnancy must take into account the increase in risk for late fetal loss, failed induction and trial of labor after cesarean delivery, and postcesarean complications, such as wound-related morbidity and venous thromboembolism.

Maternal obesity, uterine activity, and the risk of spontaneous preterm birth.

Objective: To assess the associations among maternal obesity, uterine contraction frequency, and spontaneous preterm birth in women at risk for spontaneous preterm birth.

Methods: In a secondary analysis, we analyzed data from 253 women at risk for spontaneous preterm birth (prior spontaneous preterm birth, vaginal bleeding) enrolled in a multicenter observational study of home uterine activity monitoring at 11 centers. All women wore a uterine activity monitor twice daily from 22 weeks through 34 weeks of gestation.

The impact of maternal obesity on satisfactory detailed anatomic ultrasound image acquisition.

Objective: To assess the impact of maternal body mass index (BMI) on ultrasound visualisation of fetal morphology.

Study Design: Singleton pregnancies undergoing targeted ultrasound fetal anatomic evaluation at 18- to 25-weeks gestation from 1/05 to 12/05 were included. Ultrasound reports and maternal medical records were reviewed for maternal characteristics and documentation of adequatecy of ultrasound visualisation for each organ system was obtained by individual chart review.

Abbreviated postpartum magnesium sulfate therapy for women with mild preeclampsia: a randomized controlled trial.

Objective: To determine whether women receiving 12-hour and 24-hour postpartum magnesium sulfate (MgSO4) therapy for mild preeclampsia have differing clinical courses.

Methods: Consenting women with suspected mild preeclampsia were randomly assigned to 12 hours or 24 hours of MgSO4 postpartum therapy. Treatment was continued after the assigned time period if there was evidence of severe preeclampsia.

Perinatal intervention and neonatal outcomes near the limit of viability.

Objective: The purpose of this study was to evaluate trends in the level of obstetric and neonatal intervention near the limit of viability and perinatal morbidity and mortality rates over time.

Study Design: In this retrospective chart review, live-born infants who were delivered at 23 to 26 weeks of gestation and who weighed between 500 and 1500 g between 1990 and 2001 in an urban tertiary care center were identified. Maternal charts were reviewed for clinical characteristics and antenatal and intrapartum course.

The influence of obesity and diabetes on the risk of cesarean delivery.

Objective: To determine the influence of pregravid obesity and diabetes on cesarean delivery (CD) risk.

Study Design: Women with singleton pregnancies of 23 weeks or more estimated gestational age who were undergoing a trial of labor January 1997 through June 2001 were categorized by pregravid body mass index (underweight [<19.8 kg/m 2 ], normal [19.

The influence of obesity and diabetes on the prevalence of macrosomia.

Objective: This study was undertaken to determine the relative contribution of abnormal pregravid maternal body habitus and diabetes on the prevalence of large-for-gestational-age infants.

Study Design: Maternal and neonatal records for singleton term (> or =37 weeks' estimated gestational age) deliveries January 1997 through June 2001 were reviewed. Subjects were characterized by pregravid body mass index (BMI), divided into underweight (BMI <19.

The impact of maternal obesity and weight gain on vaginal birth after cesarean section success.

Objective: This study was undertaken to determine the impact of maternal obesity on success of a trial of labor (vaginal birth after cesarean section [VBAC]) after a single low transverse cesarean delivery.

Study Design: Individual charts of women with low transverse cesarean delivery in their first viable pregnancy who underwent a VBAC in their second viable pregnancy at our urban tertiary care institution were reviewed. Maternal body mass index (BMI) was classified as underweight (<19.

Low maternal weight, failure to thrive in pregnancy, and adverse pregnancy outcomes.

Objective: The purpose of this study was to correlate low maternal pregravid weight, delivery weight, and poor gestational weight gain with perinatal outcomes.

Study Design: Maternal and perinatal data from January 1997 to June 2001 were obtained from a perinatal database at MetroHealth Medical Center. Low maternal weight (LMW) was defined as pregravid or delivery weight <100 pounds or body mass index (BMI) < or =19.

The influence of obesity and gestational diabetes mellitus on accretion and the distribution of adipose tissue in pregnancy.

Objective: The purpose of this study was to evaluate the effect of pregravid obesity and gestational diabetes mellitus (GDM) on the longitudinal accretion and distribution of adipose tissue in pregnancy.

Study Design: Women with normal glucose tolerance and GDM were evaluated before conception, early (12-14 weeks) and late (33-36 weeks) in gestation. Fat mass, lean body mass, and percent body fat were assessed longitudinally with hydrodensitometry.

Pregnancy in a spinal cord-injured bilateral total leg amputee: management and considerations.

A 35-year-old woman, gravida 2, para 0, was seen at 20 weeks' gestation with complete T10 spinal cord transection at age 15 years, subsequent bilateral total leg amputation, urinary diversion, colostomy, and lumbar spine resection. Pregnancy complications included recurrent urinary tract infections, preterm contractions without cervical change, lumbosacral abscesses, and fetal malpresentation. Delivery was through cesarean section near term.

Prevalence of maternal obesity in an urban center.

Objective: The purpose of this study was to evaluate the changing prevalence of maternal obesity in an urban center.

Study Design: The prevalence of obesity in 31,542 pregnancies from January 1986 to December 1996 (group 1) was compared with the prevalence of obesity in 15,600 pregnancies between January 1997 and June 2001 (group 2). Maternal weight was divided into two groups according to measurements performed at delivery (200 pounds).