Cervical assessment by ultrasound for preventing preterm delivery.

Background: Measurement of cervical length (CL) by transvaginal ultrasound (TVU) is predictive of preterm birth (PTB). It is unclear if this screening test is effective for prevention of PTB.

Objectives: To assess the effectiveness of antenatal management based on transvaginal ultrasound of cervical length (TVU CL) screening for preventing PTB.

Prenatally diagnosed 17q12 microdeletion syndrome with a novel association with congenital diaphragmatic hernia.

We describe the first reported case of a prenatally diagnosed and recently described 17q12 microdeletion syndrome. The fetus was noted to have a congenital diaphragmatic hernia (CDH), echogenic kidneys and cystic left lung on prenatal ultrasound. The patient underwent amniocentesis which resulted in a normal fluorescence in-situ hybridization and karyotype.

Clostridium perfringens Sepsis and Fetal Demise after Genetic Amniocentesis.

Clostridium perfringens is a rare cause of intrauterine infection. There have been five case reports concerning infection associated with invasive procedures. We report a woman who underwent a genetic amniocentesis due to her history of chronic granulomatous disease.

Comparison of two national guidelines in obstetrics: American versus royal college of obstetricians and gynecologists.

We compared the obstetric guidelines published by the American College of Obstetrics And Gynecology (ACOG) and Royal Colleges of Obstetricians and Gynaecologists (RCOG). The references and the recommendations in the current practice bulletins (PBs) and green guidelines (GGs) were compared. As of December 2007, there were 42 PBs and 27 GGs.

Cervical assessment by ultrasound for preventing preterm delivery.

Background: Measurement of cervical length (CL) by transvaginal ultrasound (TVU) is predictive of preterm birth (PTB). It is unclear if this screening test is effective for prevention of PTB.

Objectives: To assess the effectiveness of antenatal management based on TVU CL screening for preventing PTB.

Shoulder dystocia: comparison of the ACOG practice bulletin with another national guideline.

Our objective was to compare national guidelines regarding shoulder dystocia. Along with the American College of Obstetricians and Gynecologists (ACOG) practice bulletin on shoulder dystocia, guidelines from England, Canada, Australia, and New Zealand were reviewed. The Royal College of Obstetricians and Gynaecologists (RCOG) guideline agrees with the ACOG definition of shoulder dystocia, but there are variances in the management of suspected macrosomia and resolution of impacted shoulders.

Intrauterine growth restriction: comparison of American College of Obstetricians and Gynecologists practice bulletin with other national guidelines.

Objective: The objective of the study was to compare national guidelines regarding small for gestational age (SGA).

Study Design: Along with American College of Obstetricians and Gynecologists (ACOG) practice bulletin on abnormal growth, guidelines from England, Canada, Australia, and New Zealand were reviewed.

Results: There are no guidelines on SGA from Canada, Australia, and New Zealand.

Randomized clinical trials behind level A recommendations in obstetric practice bulletins: compliance with CONSORT statement.

We appraised the compliance of randomized clinical trials (RCTs) cited for level A recommendations in obstetric practice bulletins (OPBs) and published after the CONSORT (Consolidated Standards of Reporting Trials, published 1996) statement. From the CONSORT checklist, we identified 50 separate items the RCTs should describe in the article and assigned 1 point if present; 0, if absent. The CONSORT score was the total points, expressed as a percentage.

Non-placental causes of intrauterine growth restriction.

Placental insufficiency, in some form or fashion, is associated with the majority of cases of intrauterine growth restriction (IUGR). There are numerous causes of IUGR which are not caused primarily by placental insufficiency, but indirectly lead to it. The causes of IUGR can be subdivided into fetal and maternal etiologies.

A review of sonographic estimate of fetal weight: vagaries of accuracy.

Purpose: To determine the factors that might influence the accuracy of sonographic estimated fetal weight.

Study Design: A PubMed search (Jan 1975 to Jan 2003) of articles published in the English language was carried out and the inclusion criterion was that estimates were within 10% of birth weight. A Chi-square test for trend was used and odds ratio (OR) with 95% confidence intervals (CI) was calculated.

Neonatal organ dysfunction among newborns at gestational age 34 weeks and umbilical arterial pH<7.00.

Purpose: Among newborns at 34 weeks or more with umbilical arterial pH<7.00, we endeavoured to determine the pH threshold and risk factors for neonatal organ injury within 72 hours of birth.

Study Design: Retrospectively, all non-anomalous newborns delivered over 6 years near term with a low pH were identified.

Suspicion and treatment of the macrosomic fetus: a review.

Objective: To review the prevalence of and our ability to identify macrosomic (birthweight >4000 g) fetuses. Additionally, based on the current evidence, propose an algorithm for treatment of suspected macrosomia.

Study Design: A review.

Professional liability claims and Central Association of Obstetricians and Gynecologists members: myth versus reality.

Objective: The purpose of this study was to survey members of the Central Association of Obstetricians and Gynecologists about professional liability claims.

Study Design: A survey was mailed to Central Association of Obstetricians and Gynecologists members regarding medical liability experience.

Results: Of the 897 surveys mailed, 73% were completed.

Cesarean delivery for nonreassuring fetal heart rate tracing.

An understanding of cesarean delivery for nonreassuring fetal heart rate tracing is important for several reasons. This article describes the prevalence of cesarean for nonreassuring fetal heart rate tracing and risk factors, indicates what type of fetal heart rate tracing abnormalities prompts cesarean delivery, reiterates the intrauterine resuscitation that the American College of Obstetricians and Gynecologists guidelines, and suggests steps clinicians should undertake to minimize legal liability.

Emergency cesarean delivery for nonreassuring fetal heart rate tracings. Compliance with ACOG guidelines.

Objective: To review the English-language literature from 1990 to 2000 on cesarean delivery for "fetal distress" and assess compliance with American College of Obstetricians and Gynecologists (ACOG) guidelines.

Study Design: A PubMed search with the search items cesarean, fetal distress, cesarean, nonreassuring fetal heart rate, cesarean, neonatal acidosis and cesarean, umbilical arterial pH was undertaken. Excluded from the search were case reports, letters to the editor, focus on fetal anomaly, combinations with other reasons for operative delivery (either abdominally or vaginally) or absence of pertinent information.

Clinical and sonographic estimations of uterine weight.

Over a 36 month period, all hysterectomies with clinical assessment, sonographic measurement of uterine length and estimated uterine weight were reviewed. Accuracy of these methods was ascertained by: 1) mean error, 2) mean standardized error, and 3) percentage of estimates within 10% of the actual weight. Among 210 hysterectomies, the mean (+/- standard deviation) of uterine weight was 514.

Cesarean delivery for fetal distress: rate and risk factors.

Unlabelled: The objective of this article was to review the recent English language literature on cesarean delivery for fetal distress to determine its incidence, diagnostic tests, and the contributing factors to this obstetric complications. A PubMed search (1990-2000) with items of "cesarean, fetal distress," "cesarean, non-reassuring fetal heart rate," "cesarean, neonatal acidosis," and "cesarean, umbilical arterial pH," was undertaken. Reports, letters to the editor, focus on anomalous fetuses, and papers not specifically focused on this topic were excluded.