Objective: This study aimed to evaluate if an estimated fetal weight (EFW) between 10 and 15th percentiles at the time of anatomy ultrasound, referred to as borderline fetal growth, is associated with progression to fetal growth restriction (FGR) on subsequent ultrasound, delivery of a small for gestational age (SGA) neonate, or neonatal intensive care (NICU) admission.
Study Design: We performed a secondary analysis using the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMom2b) data. The exposures were normotensive pregnancies with non-anomalous singleton gestations with normal growth, defined as EFW >15th percentile at the anatomy scan compared to borderline fetal growth fetuses defined as those with an EFW in the 10 to 15th percentiles.
Objective: To evaluate the method of immediate postpartum IUD (ppIUD) insertion (manual versus ring forceps) and expulsion rate within 6-week postpartum.
Study Design: We performed a retrospective cohort study of patients who had a singleton vaginal delivery and an immediate ppIUD inserted at Rush University from January 2014 to September 2023. The primary outcome was rate of expulsion within 6-week postpartum.
Massive perivillous fibrin deposition (MPVFD) is a potentially devastating complication of pregnancy that occurs in 0.03-0.5% of deliveries and is associated with severe fetal growth restriction, stillbirth, and neurologic injury due to uteroplacental insufficiency.
View Article and Find Full Text PDFAim: We aimed to evaluated if fetuses of subjects with one elevated value on the 3-h GTT had a measurable physiologic difference in fetal C-peptide levels as compared to those with no elevated values on the GTT.
Methods: We performed a prospective cohort study to evaluate insulin levels in singleton non-anomalous fetuses of subjects with one elevated value on the GTT as compared to subjects with no elevated values on their GTT. Fetal insulin levels were measured by fetal C-peptide in cord blood.
Am J Obstet Gynecol MFM
July 2023
Background: Preeclampsia is an obstetrical disorder, which complicates 3% to 6% of pregnancies and contributes to 21.6% of readmissions in the postpartum period. The optimal strategy for inpatient monitoring of blood pressures to minimize readmissions for postpartum patients with hypertensive disorders is not known.
View Article and Find Full Text PDFObjective: Our objective was to assess whether variables from an index pregnancy (PG1) can be used to guide testing for gestational diabetes mellitus (GDM) in a subsequent pregnancy (PG2) and to create a risk calculator for GDM in PG2.
Study Design: This was a retrospective cohort study of patients delivering ≥2 singleton gestations at >24 weeks' gestation from June 2009 to December 2018, for whom results of a 1-hour glucose challenge test (GCT) were available from PG1. Univariable and multivariable analyses were performed to evaluate factors associated with GDM in PG2.
Objective: The objective is to evaluate whether the implementation of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) postpartum discharge educational initiative is associated with improved patient knowledge of warning signs of severe maternal morbidity (SMM) and if the initiative is self-sustaining.
Design: A pre-post design was used to evaluate patient knowledge of warning signs of SMM (Plan-Do-Study-Act, PDSA cycle 1) and if the quality improvement initiative was self-sustaining (PDSA cycle 2). Patient understanding of warning signs of SMM prior to initiation of the AWHONN education (Usual Discharge) was compared with understanding of those who were discharged after implementation (POST-BIRTH discharge).
Objective: Gestational diabetes (GDM) affects approximately 6% of pregnancies and has critical maternal and neonatal implications. About 20-33% of these patients have insulin resistance or type 2 diabetes when evaluated at 6 to 12 weeks postpartum, however only approximately half of the affected patients return for postpartum testing. Fasting glucose during delivery hospitalization is correlated with fasting glucose on oral glucose tolerance testing (OGTT) at 4 to 12 weeks postpartum, but there is limited data on the utility of this value to identify the patients at an increased risk for postpartum insulin resistance.
View Article and Find Full Text PDFAm J Obstet Gynecol MFM
November 2021
Background: The association between maternal hypotension and poor fetal growth has not been well studied.
Objective: We hypothesized that the presence of persistent maternal hypotension will reflect a chronic reduction of uteroplacental blood flow, leading to placental hypoperfusion and subsequent poor fetal growth. We aimed to evaluate whether persistent hypotension is associated with the risk of having a small for gestational age neonate.
Objective: The aim of this study was to evaluate whether a 1-hour glucose challenge test (GCT) ≥140 mg/dL in a nondiabetic index pregnancy is associated with the development of gestational diabetes mellitus (GDM) in a subsequent pregnancy.
Study Design: We performed a retrospective cohort study from a single institution from June 2009 to December 2018. Women with a nondiabetic index singleton gestation who underwent a 1-hour GCT at 24 to 28 weeks and had a successive singleton delivery were included.
Objective: The aim of this study was to evaluate whether the risk of perinatal depression is associated with body mass index (BMI) category.
Study Design: We performed a retrospective cohort study of women who completed an Edinburgh Postnatal Depression Scale (EPDS) questionnaire during the antepartum period at an integrated health system from January 2003 to May 2018. Risk of perinatal depression was defined as a score of ≥10 on the EPDS or an affirmative response to thoughts of self-harm.
Objective: To evaluate for difference in outcomes between single- and double-balloon catheters for labor induction.
Study Design: We searched CINAHL, Embase, Cochrane Register, MEDLINE, ISI Web of Sciences, LILACs, and Google Scholar and retrieved studies through May 2017. Selection criteria included randomized controlled trials comparing single- versus double-balloon catheters.
Background: Observational studies have reported varying results about the association of velamentous cord insertion (VCI) with adverse pregnancy outcomes.
Objectives: To evaluate the risk of preterm delivery among singleton pregnancies complicated by VCI.
Search Strategy: Various databases were searched for English-language articles published up to February, 28, 2017, using keywords including VCI; abnormal placentation; abnormal cord insertions; adverse perinatal outcomes; and preterm birth.
Imaging of the human brain has been an invaluable aid in understanding neuropsychopharmacology and, in particular, the role of dopamine in the striatum in mental illness. Here, we report a study in a genetic mouse model for major mental illness guided by results from human brain imaging: a systematic study using small animal positron emission tomography (PET), autoradiography, microdialysis and molecular biology in a putative dominant-negative mutant DISC1 transgenic model. This mouse model showed augmented binding of radioligands to the dopamine D2 receptor (D2R) in the striatum as well as neurochemical and behavioral changes to methamphetamine administration.
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