Gestational growth trajectories derived from a dynamic fetal-placental scaling law.

Fetal trajectories characterizing growth rates have relied primarily on goodness of fit rather than mechanistic properties exhibited . Here, we use a validated fetal-placental allometric scaling law and a first principles differential equations model of placental volume growth to generate biologically meaningful fetal-placental growth curves. The growth curves form the foundation for understanding healthy versus at-risk fetal growth and for identifying the timing of key events .

Prior Uterine Evacuation and the Risk of Short Cervical Length: A Retrospective Cohort Study.

Objectives: To determine whether a prior uterine evacuation procedure is associated with an increased risk of short cervical length (≤20 mm) in women without prior spontaneous preterm birth.

Methods: This work was a retrospective cohort study from January 2012 to December 2014 of singletons without prior spontaneous preterm birth with cervical length screening between 18 weeks and 23 weeks 6 days. Women with a prior miscarriage/abortion were excluded if management (medical, surgical, or expectant) was not specified.

Second-trimester cervical length and outcomes of induction of labor at term.

Objective: To evaluate whether second-trimester cervical length (CL) is associated with induction of labor (IOL) outcomes.

Methods: Retrospective cohort study of nulliparous singletons undergoing CL screening at 18 0/7-23 6/7 weeks from 1/1/2012 to 12/31/2013. Women induced at term (≥37 weeks) were included.

Cervical length in adolescents versus adults.

Purpose: Two of the known risk factors for spontaneous preterm birth (sPTB) are short cervical length (CL) ≤ 25 mm and adolescence (≤19 years). Our objective was to evaluate whether adolescent women have a higher incidence of short CL compared to their 20-24 year old counterparts.

Materials And Methods: Retrospective cohort of nulliparous singleton gestations undergoing universal second trimester transvaginal ultrasound (TVU) CL screening between January 2012 and June 2013.

Racial disparities in cervical length for prediction of preterm birth in a low risk population.

Purpose: Racial minorities experience higher rates of spontaneous preterm birth (sPTB). Our objective was to evaluate whether there are racial discrepancies in the incidence of second trimester short cervical length (≤25 mm).

Materials And Methods: Retrospective cohort of women with singleton gestations without prior sPTB undergoing universal second trimester transvaginal ultrasound cervical length (CL) screening between January 2012 and December 2013.

Cervical Length Screening in Asymptomatic Women at High Risk and Low Risk for Spontaneous Preterm Birth.

Cervical length (CL) screening should be offered to singletons because there are interventions for those with a short CL. A transvaginal ultrasound (TVU) is the "gold standard" for CL. In singletons with prior spontaneous preterm birth, serial TVU CL screening is recommended between 16 and 23 6/7 weeks.

Second trimester cervical length and prolonged pregnancy (.).

Objective: To determine whether second trimester transvaginal ultrasound cervical length (CL) is associated with prolonged pregnancy (≥41 0/7 weeks) in nulliparous women who reach term (≥37 weeks) with a planned vaginal delivery.

Methods: Retrospective cohort of nulliparous singletons 18 0/7-23 6/7 weeks gestation undergoing CL screening from 1/1/12 to 12/31/13. Women who delivered at term with spontaneous labor or reached 41 weeks were included.

Severe First Trimester Recurrent Intrahepatic Cholestasis of Pregnancy: A Case Report and Literature Review.

Background Intrahepatic cholestasis of pregnancy (ICP) is a disorder of defective bile acid transport that results in systemic accumulation of bile acids and typically presents in the third trimester of pregnancy with intense pruritus. A positive linear correlation exists between total bile acid level and poor pregnancy outcome, and labor is typically induced at 37 weeks gestation to prevent intrauterine fetal demise (IUFD). Case Study We present the most severe reported case of recurrent ICP presenting early in the first trimester.

Cervical length, risk factors, and delivery outcomes among women with spontaneous preterm birth.

Objectives: To evaluate differences in risk factors and delivery outcomes among women with spontaneous preterm birth (sPTB) with short (≤25 mm) versus normal (>25 mm) cervical length (CL).

Methods: Secondary analysis of a prospective cohort study of singleton gestations between 18 0/7 and 23 6/7 weeks, without prior sPTB, undergoing universal transvaginal CL screening between 1 January 2012 and 31 December 2013. Only women with sPTB (<37 0/7 weeks) were included.

Second Trimester Cervical Length and Its Association with Vaginal Birth after Cesarean Delivery.

Objective: This study aims to evaluate the relationship between cervical length (CL) and trial of labor after cesarean (TOLAC) delivery.

Study Design: This retrospective cohort study evaluated second trimester CL and likelihood of successful TOLAC. Women undergoing TOLAC from January 2009 to December 2011 who underwent transvaginal ultrasound CL between 18(0/7) to 23(6/7) weeks gestation were included.

Cost-effectiveness of transvaginal ultrasound cervical length screening in singletons without a prior preterm birth: an update.

Objective: We sought to reevaluate the cost-effectiveness of universal transvaginal ultrasound (TVU) cervical length (CL) screening in singleton pregnancies without prior spontaneous preterm birth.

Study Design: We developed a decision model to assess costs and effects of universal TVU CL screening at 18-23 weeks' gestation compared to routine care for singleton pregnancies without prior preterm birth. Based on recent data, the model contains the following updates: (1) reduced incidence of CL ≤20 mm at initial screening ultrasound (0.

Is universal cervical length screening indicated in women with prior term birth?

Objective: To determine whether universal transvaginal ultrasound (TVU) cervical length (CL) screening is indicated in women with prior term births.

Study Design: We conducted a prospective cohort study from Jan. 1, 2012, to June 30, 2013, of singleton gestations between 18 0/7-23 6/7 weeks undergoing TVU CL screening for prediction of spontaneous preterm birth (sPTB).

A universal transvaginal cervical length screening program for preterm birth prevention.

Objective: To evaluate a universal transvaginal ultrasonogram cervical length screening program on the incidence of a cervical length 20 mm or less and adherence to the management protocol for a cervical length less than 25 mm.

Methods: We conducted a prospective cohort study of women with singleton gestations 18 0/7 to 23 6/7 weeks of gestation eligible for universal transvaginal ultrasonogram cervical length screening over an 18-month period. Only women receiving antenatal care at our institution were included.

Implementation of a universal cervical length screening program for the prevention of preterm birth.

Objective: The objective of this article is to evaluate the implementation and acceptability of a universal cervical length (CL) screening program for prediction and prevention of preterm birth (PTB).

Study Design: We performed a prospective observational study to evaluate the implementation and acceptability of a universal CL screening program. Between January 1, 2012, and December 31, 2012, women with singleton gestations, without a cerclage or prior spontaneous PTB, were offered transvaginal ultrasound (TVU) for CL between 18(0/7) and 23(6/7) weeks' gestation.

Early pregnancy failure as a training tool for chorionic villus sampling.

Objectives: The goal of this study is to evaluate the success of a training program in chorionic villus sampling (CVS) of early pregnancy failure (EPF) for maternal-fetal medicine (MFM) fellows.

Methods: We conducted a retrospective review of a new training program in CVS for MFM fellows. Women with EPF up to 13 weeks estimated gestational age were offered inclusion in our program and counseled on alternatives.

Common respiratory issues in ambulatory obstetrics.

This article reviews the diagnosis and management of the most common respiratory conditions complicating pregnancy--asthma and influenza. We also review strategies for smoking cessation in pregnancy as, in addition to exacerbating all other pulmonary conditions, smoking is the most modifiable risk factor for poor pregnancy outcome. Moreover, the obstetrician frequently encounters each of these conditions in the ambulatory setting.

Not all child safety seats are created equal: the potential dangers of shield booster seats.

Objective: Children are safest when traveling in a child safety seat appropriate for their age and size. Previous research indicates that children are often transitioned to shield booster seats (SBSs) before reaching the 40-lb weight limit for their forward-facing child safety seat (FFCSS). These children could have otherwise been restrained in a FFCSS as is currently recommended by the American Academy of Pediatrics and the National Highway Traffic Safety Administration.

Patterns of injury to restrained children in side impact motor vehicle crashes: the side impact syndrome.

Background: Injury patterns among children in frontal collisions have been well documented, but little information exists regarding injuries to children in side impact collisions.

Methods: Restrained children 14-years-old or younger admitted to the hospital for crash injuries were analyzed. Data concerning injuries, medical treatment, and outcome were correlated with crash data.