Case Report of a Triplet Pregnancy with Complete Hydatidiform Mole and Coexisting Twins.

Background: Triplet pregnancy with complete hydatidiform mole and coexisting twin fetuses is extremely rare with an unknown incidence.

Case: Here, we present a case report of a pregnancy with twin fetuses and concurrent hydatidiform mole that resulted in the preterm delivery of one viable baby, the unfortunate intrauterine demise of the other twin, and successful treatment of gestational trophoblastic neoplasia in the postpartum period.

Conclusion: This case highlights several important questions that arise for women who choose to carry a multiple gestation pregnancy with complete hydatidiform mole and describes complications that can occur.

Transvaginal cervical length scans to prevent prematurity in twins: a randomized controlled trial.

Background: Twin pregnancies are associated with an increased risk of perinatal morbidity and mortality primarily due to spontaneous preterm deliveries. The mean gestational age for delivery is 35.3 weeks and twins account for 23% of preterm births <32 weeks.

Late-preterm birth: does the changing obstetric paradigm alter the epidemiology of respiratory complications?

Objective: To analyze the effect of gestational age, delivery mode, and maternal-fetal risk factors on rates of respiratory problems among infants born 34 or more weeks of gestation over a 9-year period.

Methods: Retrospective analysis of prospectively collected maternal and neonatal data on all inborn births at 34 or more weeks of gestation at a single tertiary care center for the years 1990-1998. Specific diagnostic criteria were concurrently applied by a single investigator.

Postcesarean delivery adhesions associated with delayed delivery of infant.

Objective: The purpose of this study was to estimate the incidence of adhesions after cesarean deliveries and to determine their impact on delivery and infant well-being.

Study Design: This was a retrospective cohort analysis with chart review. The charts of 542 women who had undergone primary (265 women) or repeat cesarean (277 women) deliveries were reviewed.

Does local anesthesia decrease pain perception in women undergoing amniocentesis?

Objective: The null hypothesis is that local anesthesia does not decrease pain perception during amniocentesis.

Study Design: We performed a prospective randomized study comparing local anesthesia (1% lidocaine) with no anesthesia before amniocentesis in a racially diverse population. Immediately after the procedure, subjects were asked to assess their pain using both a Visual Analogue Scale and a 101-point Numerical Rating Scale.

Severe hemolytic disease of the newborn due to anti-Cw.

Background: Pregnancies complicated by Rh isoimmunization have decreased significantly since the widespread use of Rh immune globulin. Uncommon red blood cell antigens have therefore become more clinically evident. We report a case of anti-Cw immunization that resulted in severe fetal anemia that required multiple transfusions.

Changing obstetric practices associated with decreasing incidence of meconium aspiration syndrome.

Objective: To describe changes in neonatal and obstetric practices that may have contributed to the decreasing incidence of meconium aspiration syndrome in our population during this time.

Methods: We compared neonatal and obstetric characteristics of 61 infants diagnosed with meconium aspiration syndrome with 1365 infants born through moderate or thick meconium-stained amniotic fluid at more than 37 weeks' completed gestation. Data were prospectively collected, and all respiratory diagnoses were concurrently made.

Complications of third-trimester amniocentesis using continuous ultrasound guidance.

Objective: The objective of the study was to estimate the risks of third-trimester amniocentesis with continuous ultrasound guidance.

Methods: Cohort study. We reviewed the medical records of women who had an amniocentesis with continuous ultrasound guidance after 30 weeks' gestation at a single institution from January 1991 through December 1994.