Neonatal outcome in polycystic ovarian syndrome patients treated with metformin during pregnancy.

Objective: The present study aimed to evaluate the effect of metformin exposure during pregnancy on neonates of polycystic ovarian syndrome (PCOS) patients.

Method: Neonatal outcomes of 33 women with PCOS treated with metformin during pregnancy were compared to neonatal outcomes of 66 normal healthy women in a retrospective case-control study.

Results: The mean birth weight percentile of neonates exposed to metformin in utero during the first trimester was significantly lower than that of neonates delivered to normal healthy matched controls.

Effect of betamethasone administration on fetal heart rate tracing: a blinded longitudinal study.

Objective: Computerized fetal heart rate (FHR) analysis revealed that antenatal corticosteroids transiently suppress multiple parameters of fetal well-being, potentially leading to the erroneous diagnosis of fetal distress and to unnecessary iatrogenic delivery of premature infants. Our aim was to determine whether clinicians who visually analyze FHR tracings detect these suppressive effects, thereby potentially affecting their clinical management decisions.

Methods: Singleton pregnancies admitted for preterm labor between 26 and 34 weeks' gestation received two doses of betamethasone, 24 h apart, and were monitored daily between 16:00 and 19:00 h for 5 days.

Comparison of transvaginal sonography with digital examination and transabdominal sonography for the determination of fetal head position in the second stage of labor.

Objective: Precise determination of fetal head position in labor is a prerequisite for safe instrumental deliveries, and essential for the assessment of labor progress. Recent studies have cast serious doubts on the accuracy of the time-honored digital vaginal examination (DVE) in comparison to transabdominal ultrasound scans (TUS). However, transabdominal imaging is technically difficult with a deeply engaged fetal head in the second stage of labor.

High-risk pregnancy and hospitalization: the women's voices.

The study is a phenomenological analysis of 10 focus groups with Israeli women who were hospitalized because of high-risk pregnancy. The goal of this study was to understand the lived experience of hospitalization due to high-risk pregnancy. Five themes were recognized: (1) the desire to nurture and the social pressure to do so; (2) the personal and social meaning of a family; (3) loss of normal experiences of life and childbearing; (4) the woman's needs versus the fetus's well-being; and (5) sources of strength and stress.

Oral misoprostol vs. vaginal gemeprost prior to surgical termination of pregnancy in nulliparae.

Background: To compare the efficacy and side-effects of intravaginal gemeprost with those of oral misoprostol for cervical ripening prior to first-trimester pregnancy termination in nulliparous women.

Methods: Retrospective analysis of surgical terminations of pregnancy performed before 90 days of gestation. Intravaginal gemeprost 1 mg or oral misoprostol 800 micro g was administered 2 h before the procedure.

Familial occurrence of isolated nonseptated nuchal cystic hygromata in midtrimester of pregnancy.

Objective: Nonseptated cystic hygromata of the fetal neck in midtrimester of pregnancy have been associated with chromosomal and structural malformations. Consequently, fetal karyotyping is frequently offered. We describe 18 families in which 18 pairs of siblings were affected by transient nonseptated cystic hygromata in utero.

Early resolution of increased nuchal translucency in a fetus with trisomy 18.

The normal timing for first-trimester nuchal translucency screening of aneuploidies is 10 to 14 weeks' gestation. We describe a fetus with trisomy 18 that presented at 11 weeks with increased nuchal thickness. Reevaluation at 12 and 13 weeks showed early return to normal of the increased nuchal measurement.

The duration of the third stage of labor is subject to the location of placental implantation.

We evaluated the association between placental location and length of the third stage of labor in normal term singleton pregnancies. Two hundred consecutive singleton term live vaginal deliveries following uncomplicated pregnancies were included in a retrospective study. The mean maternal age was 27.

Vacuum application through a nonfully dilated cervix: a viable option.

The aim of this cross-sectional study was to assess the feasibility of vacuum delivery through a nonfully dilated cervix. The study group consisted of 39 women with vacuum deliveries through a nonfully dilated cervix larger than 9 cm and station of the head at S or more +2 cm. These were compared to a control group of 215 vacuum deliveries at a fully dilated cervix and 46 women who underwent cesarean section at a nonfully dilated cervix larger than 9 cm.

What to do after a failed attempt of vacuum delivery?

Objectives: To determine whether there is a difference in maternal and neonatal outcomes if a sequential operative vaginal or cesarean delivery follows failed vacuum delivery.

Study Design: A cross sectional study. We have analyzed maternal and neonatal outcomes of 215 vacuum extractions (group 1), 106 forceps assisted deliveries (group 2), 28 deliveries in which failed vacuum extraction were followed by forceps delivery (group 3) and 22 deliveries in which failed vacuum extraction were followed by cesarean delivery (group 4).

Clinical significance of the floating fetal head in nulliparous women in labor.

Objective: To examine the course of labor in nulliparous women in active labor with a floating fetal head.

Study Design: A prospective, cohort study of nulliparous women presenting in active labor at term with a floating fetal head (station > or = -3, n = 108) or engaged fetal head (n = 241). All patients were examined by a senior physician.

Role of steroid receptors in the pathogenesis of tubal pregnancy.

Objective: To determine the role of steroid receptors in the pathogenesis of tubal pregnancy.

Study Design: Twenty-two women in the reproductive-age group who had undergone salpingectomy because of ectopic pregnancy or sterilization were enrolled. The study group consisted of 12 women who underwent salpingectomy for ectopic pregnancy.

Breast engorgement and galactorrhea during magnesium sulfate treatment of preterm labor.

Breast engorgement and galactorrhea occasionally occur during tocolysis with ritodrine. We are not aware of breast engorgement and galactorrhea associated with other tocolytics. We report the first case of breast engorgement and galactorrhea during tocolysis with intravenous magnesium sulfate in a generally healthy 24-year-old woman admitted for tocolysis at 30 weeks' gestation.