First-trimester metabolomic prediction of stillbirth.

Stillbirth remains a major problem in both developing and developed countries. Omics evaluation of stillbirth has been highlighted as a top research priority. To identify new putative first-trimester biomarkers in maternal serum for stillbirth prediction using metabolomics-based approach.

Using a multifaceted quality improvement initiative to reverse the rising trend of cesarean births.

Purpose: National efforts exist to safely reduce the rate of cesarean delivery, a major source of increased morbidity and healthcare costs. This is a report of a quality improvement study targeting reduction of primary cesarean deliveries.

Materials And Methods: From March 2014 to March 2016, interventions included a nested case-control review of local risk factors, provider and patient education, multidisciplinary reviews based on published guidelines with feedback, provider report cards, commitment to labor duration guidelines, and a focus on natural labor.

Vasa previa: clinical presentations, outcomes, and implications for management.

Objective: To review experience with diagnosis, clinical associations, and outcomes of vasa previa in a single institution.

Methods: This was a retrospective review of all identified vasa previa cases from January 1 1990, to June 30, 2010.

Results: Sixty cases of vasa previa were identified (53 singletons, seven twins); 56 cases were diagnosed before delivery.

Asymptomatic uterine rupture of a cornual pregnancy in the third trimester: a case report.

Background: Reports of cornual pregnancy persisting until fetal viability and of ultrasound diagnosis of asymptomatic uterine rupture are rare.

Case: A 24-year-old woman, gravida 6, para 5, presented for initial ultrasound evaluation at 28 5/7 weeks' gestation after registering late for prenatal care. Her history included 2 prior cesarean deliveries.

Venous thromboembolism during pregnancy. Clinical suspicion warrants evaluation.

Objective: To determine the incidence, signs, symptoms and clinical outcomes of venous thromboembolism (VTE) during pregnancy.

Study Design: A retrospective review was conducted from 1997 to 2001 including women with a diagnosis or suspicion of VTE during pregnancy. Demographics and clinical characteristics of patients with a suspicion for VTE were reviewed.

Cesarean delivery rates at the threshold of viability.

Objective: The purpose of this study was to assess whether the treatment of deliveries at the traditional threshold of viability has become more interventional since the publication of higher survival rates.

Study Design: State vital statistic data from 1995 to 2000 were reviewed to identify deliveries at 22 to 25 weeks of gestation with a birth weight of <1 kg. Demographic data and frequency of cesarean delivery, antepartum bleeding, breech presentation, fetal distress, and cord prolapse were recorded.

The ninety-fifth percentile for growth discordance predicts complications of twin pregnancy.

Objective: Our purpose was to define twin growth discordance on the basis of perinatal outcome.

Study Design: Twins delivered at >23 weeks' gestation between 1995 and 2000 were identified by use of our computerized perinatal database. Birth weight (BW), chorionicity, and the following outcomes were recorded: cesarean delivery for nonreassuring fetal status (NRFS), umbilical artery (UA) pH, 5-minute Apgar score, neonatal intensive care unit (NICU) admission, and stillbirth.

Relationship between meconium staining and amniotic fluid volume in term pregnancies.

Objective: Our purpose was to evaluate the relationship between meconium-stained amniotic fluid (MEC-AF) and amniotic fluid volume (AFV) and their impact on the risk of cesarean delivery for fetal indications in term pregnancies.

Methods: 1,655 live-born singleton gestations delivering at > or = 37 weeks within 7 days of sonographic assessment of the amniotic fluid index (AFI) were studied. AFI was categorized as: oligohydramnios (< or = 5.