Combination of Foley bulb and vaginal misoprostol compared with vaginal misoprostol alone for cervical ripening and labor induction: a randomized controlled trial.

Objective: To test the hypothesis that use of the Foley bulb plus vaginal misoprostol will result in shorter induction-to-delivery time compared with vaginal misoprostol alone.

Methods: We randomized 123 women undergoing induction of labor with singleton pregnancies at 24 weeks of gestation or greater with an unfavorable cervix (Bishop score 6 or lower) to Foley bulb plus vaginal misoprostol (n=56) or vaginal misoprostol alone (n=61). Women with fetal malpresentation, multifetal gestation, spontaneous labor, contraindication to prostaglandins, nonreassuring fetal heart rate tracing, intrauterine growth restriction, anomalous fetus, fetal demise, or previous cesarean delivery or other significant uterine surgery were excluded.

Efficiency of first-trimester growth restriction and low pregnancy-associated plasma protein-A in predicting small for gestational age at delivery.

Objective: To evaluate the efficiency of first-trimester fetal growth restriction (FGR), low pregnancy-associated plasma protein A (PAPP-A), and their combination for predicting small for gestational age (SGA) at delivery.

Methods: Retrospective cohort study of women undergoing first-trimester aneuploidy screening. Fetal crown-rump lengths (CRLs) were at 10 to 14 weeks' gestation and converted to gestational age adjusted Z-scores.

Cervical cerclage: one stitch or two?

Objective: We sought to determine whether routine placement of a second stitch at the time of cervical cerclage improves its efficacy.

Study Design: This is a retrospective cohort study of patients who had cervical cerclage placement at a single institution. Operative reports, ultrasound images, and delivery records were reviewed.

Revisiting the risk for aneuploidy in fetuses with isolated pyelectasis.

Objective: Previous studies are contradictory with regard to the association of isolated pyelectasis and aneuploidy. Our objective was to test the hypothesis that isolated pyelectasis is associated with aneuploidy and calculate likelihood ratios using a large ultrasound database.

Methods: A retrospective cohort study of pregnancies presenting to our prenatal ultrasound unit at 16 to 22 weeks was conducted.

Staples compared with subcuticular suture for skin closure after cesarean delivery: a systematic review and meta-analysis.

Objective: To estimate whether staples or subcuticular suture closure is associated with a higher risk of wound complications when used for transverse skin incisions after cesarean delivery.

Data Sources: A systematic review and meta-analysis were performed through electronic database searches (MEDLINE, Cochrane, and Trial Registries).

Methods Of Study Selection: We searched electronic databases from 1966 to September 2010 for randomized controlled trials (RCTs) and prospective cohort studies comparing staples to subcuticular sutures after cesarean delivery.

Prenatal screening for thrombophilias: indications and controversies.

A thrombophilia is defined as a disorder of hemostasis that predisposes a person to a thrombotic event. Data suggest that at least 50% of cases of venous thromboembolism in pregnant women are associated with an inherited or acquired thrombophilia, which can lead to an increased risk of maternal thromboembolism and adverse pregnancy outcomes such as recurrent pregnancy loss, intrauterine fetal demise, preterm preeclampsia, and intrauterine growth restriction. Inherited and acquired thrombophilias have different indications for testing.