Defining uterine tachysystole: how much is too much?

Objective: We sought to determine if uterine tachysystole, ≥ 6 contractions per 10 minutes, within the first 4 hours of labor induction, is associated with adverse infant outcomes.

Study Design: This was a prospective cohort study of 584 women ≥ 37 weeks' gestation undergoing induction of labor with 100 μg of oral misoprostol. Fetal heart rate tracings were analyzed for contractions per 10 minutes during the initial 4 hours after misoprostol administration.

Oral misoprostol for labor augmentation: a randomized controlled trial.

Objective: To estimate the efficacy of oral misoprostol for labor augmentation.

Methods: We performed a randomized, controlled trial comparing intravenous oxytocin to a 75-microgram dose of oral misoprostol. Women in spontaneous labor were eligible if they had cervical dilation of 4-8 cm and required labor augmentation.

A dose-finding study of oral misoprostol for labor augmentation.

Objective: We designed a dose-finding trial of oral misoprostol administered for labor augmentation.

Study Design: Healthy, nulliparous women in active labor and diagnosed with arrest of dilation were enrolled in cohorts of 10 at a time. Five regimens were studied: (1) 25 μg every 4 hours, (2) 50 μg every 4 hours, (3) 100 μg every 4 hours, (4) 50 μg every 2 hours, and (5) 75 μg every 4 hours.

Loop electrosurgical excision procedure and risk of preterm birth.

Objective: To examine whether preterm birth is related to the loop electrosurgical excision procedure (LEEP) itself or intrinsic to the women undergoing the procedure.

Methods: Rates of preterm birth, defined as births before 37 weeks of gestation, as well as causes were analyzed in women undergoing LEEP before or after an index pregnancy. These rates were compared with the general obstetric population.

Prediction of diabetes recurrence in women with class A1 (diet-treated) gestational diabetes.

We sought to evaluate the likelihood of recurrent diabetes in women with a prior history of diet-treated (class A(1)) gestational diabetes mellitus (GDM). In a retrospective cohort analysis, nulliparous women diagnosed based upon National Diabetes Data Group criteria with diet-treated GDM who had recurrent diabetes in a subsequent pregnancy were compared with those who did not have recurrent diabetes. The probability of recurrent diabetes was calculated using maternal age at first pregnancy, interpregnancy interval, and body mass index (BMI) during the subsequent pregnancy.

Weekly compared with daily blood glucose monitoring in women with diet-treated gestational diabetes.

Objective: To estimate whether daily blood glucose self-monitoring reduces macrosomia when compared with weekly office testing in women with gestational diabetes.

Methods: Between January 1991 and December 1997, standard treatment at our hospital for women with diet-treated gestational diabetes included routine office monitoring of fasting blood glucose. Beginning in January 1998, blood glucose self-monitoring (four times daily) became the standard management.

Diet-treated gestational diabetes mellitus: comparison of early vs routine diagnosis.

Objective: The purpose of this study was to compare pregnancy outcomes in women with diet-treated gestational diabetes mellitus (GDM) that was diagnosed at < 24 weeks of gestation to those women who received the diagnosis at > or = 24 weeks of gestation.

Study Design: This was a retrospective cohort study of 2596 women with diet-treated GDM who delivered between December 1999 and June 2005 at Parkland Hospital. Women with risk factors for GDM underwent immediate glucose screening; women without risk factors underwent universal glucose screening between 24 and 28 weeks of gestation.

A hospital-sponsored quality improvement study of pain management after cesarean delivery.

Objective: We undertook this study to systematically assess prevailing pain management regimes used at our hospital in women after cesarean delivery.

Study Design: Between August 1999 and July 2000, all women delivered by cesarean section at Parkland Hospital were assigned to 1 of 4 different pain management strategies: (1). intramuscular (IM) meperidine, (2).

Ruptured membranes at term: randomized, double-blind trial of oral misoprostol for labor induction.

Objective: To determine if oral misoprostol can replace oxytocin for labor stimulation in women with ruptured membranes at term and without evidence of labor.

Methods: Nulliparous women at 36 to 41 weeks with a singleton, cephalic-presenting fetus and ruptured membranes without evidence of labor were randomized to receive oral misoprostol (100 microg) or a placebo every 4 hours for a maximum of two doses. Intravenous oxytocin was initiated if active labor had not ensued within 8 hours of the initial study drug dose.

Effect of a resident-created study guide on examination scores.

Objective: To evaluate the effect of a resident-created study guide on Council on Resident Education in Obstetrics and Gynecology (CREOG) In-Training and American Board of Obstetrics and Gynecology (ABOG) written examination scores.

Methods: In 1995, a group of residents at the University of Texas Southwestern Medical Center began creating an annual study guide based on the CREOG Test Item Summary Booklet. Individual, program, and national scores for 3 years before the intervention were compared with scores for 3 years after the intervention.