Objective: To determine whether women with spontaneous preterm birth (PTB) have increased risks for long-term mortality.
Design: Retrospective cohort.
Setting: Births in Utah between 1939 and 1977.
Background: To standardize research terminology and to reduce unanticipated placenta accreta spectrum, the European Working Group for Abnormally Invasive Placenta developed a consensus checklist for reporting suspected placenta accreta spectrum observed during an antenatal ultrasound. The diagnostic accuracy of the European Working Group for Abnormally Invasive Placenta checklist has not been assessed.
Objective: This study aimed to test the performance of the European Working Group for Abnormally Invasive Placenta sonographic checklist in predicting histologic placenta accreta spectrum.
Objective: To evaluate the association between prophylactic ureteral stent placement at the time of hysterectomy for placenta accreta spectrum and genitourinary injury.
Methods: We conducted a retrospective cohort study of patients with placenta accreta spectrum who underwent hysterectomy at two referral centers from 2001 to 2021. The exposure was prophylactic ureteral stent placement.
The incidence of unplanned peripartum hysterectomy is increasing nationwide, which may reflect an increase in placenta accreta spectrum disorders.
View Article and Find Full Text PDFThere are no program evaluation approaches designed for a crisis, such as the COVID-19 pandemic. It is critical to evaluate the educational impact of COVID-19 to keep administrators informed and guide decision-making. The authors used systems thinking to design an evaluation model.
View Article and Find Full Text PDFObjective: The study aimed to assess the feasibility of creating and transplanting human umbilical cord mesenchymal stem cell sheets applied to a rat model of hysterotomy, and additionally to determine benefits of human umbilical cord mesenchymal stem cell sheet transplantation in reducing uterine fibrosis and scarring.
Study Design: Human umbilical cord mesenchymal stem cell sheets are generated by culturing human umbilical cord mesenchymal stem cells on thermo-responsive cell culture plates. The temperature-sensitive property of these culture dishes facilitates normal cell culture in a thin contiguous layer and allows for reliable recovery of intact stem cell sheets without use of destructive proteolytic enzymes.
Objective: This study aimed to determine whether routine third-trimester ultrasounds in low-risk pregnancies decrease the rate of perinatal death compared with regular antenatal care with serial fundal height measurements.
Data Sources: This was a systematic review and meta-analysis of randomized control trials to identify relevant studies published from inception to October 2019. The databases used were Ovid, PubMed, Scopus, ClinicalTrials.
Most biological agents are safe to use in pregnancy. Biologic agents may be divided into 4 risk categories: minimal, uncertain, moderate, and high. Treatment options should be individualized to each patient's disease activity, response to medication, and adverse effects.
View Article and Find Full Text PDFEur J Obstet Gynecol Reprod Biol
September 2020
Introduction: Among SGA newborns, those < 5th % for GA are more likely to have adverse outcomes than those at 5-9th %. The differential morbidity and mortality may be due to abnormal placental pathology between groups. Our purpose was to compare placental pathology characteristics and composite placental pathology among SGA infants with birth weights <5th % vs.
View Article and Find Full Text PDFObjective: Umbilical cord abnormalities are commonly cited as a cause of stillbirth, but details regarding these stillbirths are rare. Our objective was to characterize stillbirths associated with umbilical cord abnormalities using rigorous criteria and to examine associated risk factors.
Methods: The Stillbirth Collaborative Research Network conducted a case-control study of stillbirth and live births from 2006 to 2008.
Background: Fetal environment has a substantial influence on an individual's health throughout their life course. Animal models of hypertensive disease of pregnancy have demonstrated adverse health outcomes among offspring exposed to hypertensive disease of pregnancy in utero. Although there are numerous descriptions of the neonatal, infant, and pediatric outcomes of human offspring affected by hypertensive disease of pregnancy, there are few data in US populations on later life outcomes, including mortality.
View Article and Find Full Text PDFJ Matern Fetal Neonatal Med
September 2020
To determine the accuracy of Actim PROM, Amnisure, and ROM Plus tests for detecting amniotic fluid proteins in the setting of blood contamination. IGFBP-1 and AFP are proteins present in high concentrations in amniotic fluid, and are detected by three commercially-available immunoassays used for diagnosing ruptured membranes: Actim PROM, Amnisure, and ROM Plus. We used whole blood samples and diluted these with amniotic fluid (containing known concentrations of amniotic fluid proteins) to whole blood levels of 50, 20, 10, 5, and 1%.
View Article and Find Full Text PDFObjective The purpose of this multicenter pilot study was to determine the feasibility of randomizing uncomplicated pregnancies (UPs) to have third trimester ultrasonographic exams (USE) versus routine prenatal care (RPNC) to improve the detection of small for gestational age (SGA; birth weight < 10% for GA). Material and Methods At three referral centers, 50 UPs were randomized after gestational diabetes was ruled out. Women needed to screen, consenting, and loss to follow-up was ascertained, as was the detection rate of SGA in the two groups.
View Article and Find Full Text PDFObjectives: The objectives of this review are to (1) ascertain the frequency with which odd ratio (OR) and relative risk (RR) are in the zone of potential bias or interest in the American College of Obstetricians and Gynecologists (ACOG) practice bulletins (PB); (2) the likelihood that false alarms have been linked to recommendations; and (3) if there are differences in obstetric versus gynecological PB, vis-à-vis OR and RR in the zone of bias or interest.
Data Sources: We reviewed all ACOG PBs published between May 1999 and March 2014.
Methods: Documents were searched for statements with mention of OR and RR.
Objective: The objective of this study was to determine the morbidity of preterm small for gestational age (SGA) infants compared with appropriate for GA (AGA).
Study Design: This is a secondary analysis of the randomized trial evaluating magnesium sulfate for the prevention of cerebral palsy (CP). We compared outcomes of preterm (< 37 weeks) nonanomalous infants who were SGA (birth weight < 10% for GA) versus AGA (birth weight 10-89% for GA).
Objective: Since 1997, the Maternal-Fetal Medicine Units (MFMU) have published 39 articles involving over 70,000 cesarean deliveries (CD), including primary, elective repeat (ERCD) or trial of labor after cesarean (TOLAC). The purpose of this review article is to summarize the peripartum morbidity or mortality (M/M) with CD (primary or ERCD) or TOLAC.
Methods: For 12 clinical scenarios and 17 M/M, we summarized 135 rates and, whenever feasible, calculated odds ratio (OR) with 95% confidence intervals (CI).
Inefficient drug delivery to the brain is a major obstacle for pharmacological management of brain diseases. We investigated the ability of bolavesicles - monolayer membrane vesicles self-assembled from synthetic bolaamphiphiles that contain two hydrophilic head groups at each end of a hydrophobic alkyl chain - to permeate the blood-brain barrier and to deliver the encapsulated materials into the brain. Cationic vesicles with encapsulated kyotorphin and leu-enkephalin (analgesic peptides) were prepared from the bolalipids GLH-19 and GLH-20 and studied for their analgesic effects in vivo in experimental mice.
View Article and Find Full Text PDFObjective: The objective was to determine the rate of neonatal brachial plexus palsy (NBPP) among women with vaginal birth after cesarean delivery (VBAC) and to compare the peripartum characteristics with control subjects.
Study Design: The Maternal-Fetal Medicine Unit cesarean registry data were used to identify nonanomalous singleton pregnancies with VBAC and NBPP at gestational age of ≥37 weeks (term) and 4 control subjects (matched for gestational age and diabetes mellitus status but without brachial injury). Odds ratio (OR) and 95% confidence intervals (CIs) were calculated.
Bolaamphiphilic cationic vesicles with acetylcholine (ACh) surface groups were investigated for their ability to deliver a model protein-bovine serum albumin conjugated to fluorescein isothiocyanate (BSA-FITC) across biological barriers in vitro and in vivo. BSA-FITC-loaded vesicles were internalized into cells in culture, including brain endothelial b.End3 cells, at 37 °C, but not at 4 °C, indicating an active uptake process.
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