Publications by authors named "J A Kuller"
Nondiabetic Fetal Macrosomia: Causes, Outcomes, and Clinical Management.
Obstet Gynecol Surv
November 2024
Article Synopsis
- - Fetal macrosomia (FM) poses significant health risks for both mothers and newborns, particularly in cases without maternal diabetes, yet existing research largely focuses on diabetic populations.
- - Key risk factors for nondiabetic FM include previous macrosomic births, excessive weight gain during pregnancy, and obesity; complications from FM can lead to higher cesarean rates and neonatal challenges such as shoulder dystocia.
- - Exercise during pregnancy may help reduce FM risk, and current guidelines recommend against inducing labor before 39 weeks or opting for elective cesarean delivery unless fetal weight is notably high, underscoring the need for further research in this area.
Importance: Though the incidence of familial Mediterranean fever (FMF) in pregnancy is rare, understanding the etiology and symptomatology of FMF is essential for obstetric treatment of patients with FMF.
Objective: Familial Mediterranean fever is a hereditary periodic fever syndrome that has unique obstetric considerations. Familial Mediterranean fever is typically characterized by recurrent episodes of high-grade fevers, pleuritis/pericarditis, and arthritis lasting 1-3 days with complete recovery seen in between episodes.
Article Synopsis
- Pregnant individuals often use cannabis to alleviate symptoms, but national medical groups strongly advise against it due to safety concerns for fetal neurodevelopment.
- The study reviewed existing literature and identified potential negative impacts of prenatal cannabis exposure, such as increased neonatal startle responses, memory and reasoning challenges in early childhood, and issues like inattention and hyperactivity.
- Current data on the effects of prenatal cannabis use are limited by various confounding factors, but the potential risks highlighted suggest that complete avoidance of cannabis during pregnancy is advisable until more comprehensive research is conducted.
Importance: With advances in prenatal cell-free DNA (cfDNA) technology, the information available with cfDNA continues to expand beyond the common fetal aneuploidies such as trisomies 21, 18, and 13. Due to the admixture of maternal and fetal/placental DNA, prenatal cfDNA remains a screening test with the possibility of false-positive and false-negative results.
Objective: This review aims to summarize unusual incidental maternal and fetal genomic abnormalities detectable by cfDNA and to provide anticipatory guidance regarding management.
Therapeutic Rest as an Intervention in Early Labor: A Literature Review.
Obstet Gynecol Surv
September 2024
Importance: The latent phase of labor poses a challenge for pregnant patients due to the limited options available for pain relief and management. Therapeutic rest, an intervention involving medication administration during this phase, has shown promise in addressing prelabor discomfort and anxiety.
Objective: To emphasize the significance of therapeutic rest during early labor, describe methods of administering this intervention, review data on efficacy and maternal/fetal outcomes, and determine appropriate criteria and timing of utilization.