Publications by authors named "Yinka Oyelese"

Placenta Previa.

Clin Obstet Gynecol

December 2024

Article Synopsis
  • Placenta previa is a significant cause of bleeding during pregnancy and used to be a major cause of maternal deaths, but advancements in care have improved outcomes.
  • It is usually detected during routine ultrasounds in the second trimester, and most cases resolve before the due date.
  • Key risk factors include previous cesarean deliveries, older age, and smoking, and if the condition persists late in pregnancy, a cesarean delivery is advised.
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Article Synopsis
  • The symposium presents a series of reviews focused on important clinical aspects of the placenta and umbilical cord, covering conditions like placenta previa and abruption, as well as various pathologies and infections.
  • It highlights the critical functions of the umbilical cord as a lifeline for the fetus, discussing how its dysfunction can lead to complications such as vasa previa.
  • This collection emphasizes the significance of understanding these structures for ensuring maternal-fetal health throughout pregnancy.
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Article Synopsis
  • Postpartum depression (PPD) is a serious condition impacting both mothers and children, making it essential to study trends and risk factors related to its prevalence.
  • A recent study analyzed over 442,000 pregnancies from Kaiser Permanente Southern California between 2010 and 2021, examining the relationship between PPD and factors like race, ethnicity, and prepregnancy body mass index (BMI).
  • Results showed that PPD rates doubled from 9.4% in 2010 to 19.0% in 2021, with the highest increases among Asian/Pacific Islander and non-Hispanic Black populations, and worsening rates were particularly noted in individuals with obesity.
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"" This maxim underscores the importance of historical awareness in medicine, particularly for obstetricians and gynecologists (ObGyns). ObGyns significantly impact societal health through their care for pregnant women, fetuses, and newborns, uniquely positioning them to advocate for health initiatives with lasting societal benefits. Despite its importance, the history of medicine is underrepresented in medical curricula, missing opportunities to foster critical thinking and ethical decision-making.

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Objectives: To estimate the number of pregnancies complicated by vasa previa annually in nine developed countries, and the potential preventable stillbirths associated with undiagnosed cases. We also assessed the potential impact of universal screening for vasa previa on reducing stillbirth rates.

Methods: We utilized nationally-reported birth and stillbirth data from public databases in the United States, United Kingdom, Canada, Germany, Ireland, Greece, Sweden, Portugal, and Australia.

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Vasa previa is a condition where unprotected fetal vessels cross the cervix within the membranes, posing a considerable risk of fetal death or severe morbidity if the membranes rupture before or during delivery. There has not been a definitive treatment for this condition. Patients are typically closely monitored and hospitalized in the early third trimester and scheduled for cesarean delivery before term.

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Nicolaides-Baraitser syndrome (NCBRS) is a rare autosomal dominant genetic condition that is characterized by severe intellectual disability, dysmorphic facial features, short stature, sparse hair, and early onset seizures. This diagnosis is established by suggestive clinical findings and the identification of a heterozygous SMARCA2 pathogenic variant by molecular genetic testing. There are not, however, consensus clinical diagnostic criteria for this condition as there are so few documented cases.

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Congenital anomalies of the umbilical cord are associated with an increased risk of pregnancy and perinatal complications. Some anomalies of the cord have a higher prevalence than other fetal structural anomalies. The most common anomalies are the absence of an umbilical artery and velamentous insertion of the cord (with or without vasa previa).

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Recent advances in genetics and imaging have ushered substantial breakthroughs in screening and diagnosis for chromosomal and structural abnormalities. Thus, it is imperative that health care providers caring for pregnant individuals should reexamine established practices in prenatal screening and diagnosis. In the past, screening for chromosomal abnormalities was based almost entirely on Down syndrome.

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Objective: The incidence of preterm delivery is much higher in twin pregnancies than in singletons and even higher if a short cervical length is detected in the second trimester. Studies are contradictory regarding the efficacy of a cervical pessary to decrease preterm birth in twin pregnancies and short cervical length. To conduct a systematic review and meta-analysis investigating the efficacy of cervical pessary in prolonging gestation, preventing preterm birth, and reducing adverse neonatal outcomes in twin pregnancies with an asymptomatic short cervix.

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Introduction: Vasa previa (VP), defined as unprotected fetal vessels traversing the membranes over the cervix, is associated with a high perinatal mortality when undiagnosed prenatally. Conversely, prenatal diagnosis with ultrasound and cesarean delivery before the membranes rupture is associated with excellent outcomes. However, controversy exists regarding screening for VP.

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Objective:  Recent studies have reported associations between severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection during pregnancy and adverse perinatal outcomes but the extent to which these associations vary by race/ethnicity remains uncertain. Therefore, we examined how the association between prenatal SARS-CoV-2 infection and adverse perinatal outcomes may be modified by race/ethnicity.

Study Design:  A retrospective cohort study was performed using data on 67,986 pregnant women extracted from the Kaiser Permanente Southern California electronic health records between April 6, 2020, and December 31, 2021.

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Background: There are limited data to guide the diagnosis and management of vasa previa. Currently, what is known is largely based on case reports or series and cohort studies.

Objective: This study aimed to systematically collect and classify expert opinions and achieve consensus on the diagnosis and clinical management of vasa previa using focus group discussions and a Delphi technique.

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Objective: To evaluate trends of attention-deficit/hyperactivity disorder (ADHD) diagnosis rates among children aged 5-17 years over the past decade (2010-2021) and to investigate whether there have been differences in temporal changes based on race and ethnicity, sex, or income.

Study Design: Childhood ADHD diagnosis was ascertained from electronic health records using International Classification of Diseases ninth revision (314.xx) and International Classification of Diseases tenth revision (F90.

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Aim: To estimate the incidence of abruption in first births and recurrence in the subsequent birth in patients of a large US-based integrated health care system.

Methods: Retrospective population-based cohort study of patients with first two consecutive singleton births using data from the Kaiser-Permanente South California health care system who delivered over a period of 30 years (1991-2021), using longitudinally linked electronic health records. ICD-9/ICD-10 codes "641.

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Randomized controlled trials are considered the "gold standard" for therapeutic interventions, and it is not uncommon for sweeping changes in medical practice to follow positive results from such trials. However, randomized controlled trials are not without their limitations. Physicians frequently view randomized controlled trials as infallible, whereas they tend to dismiss evidence derived from sources other than randomized controlled trials as less credible or reliable.

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Article Synopsis
  • The study presents a management protocol for women diagnosed with vasa previa (VP) during pregnancy, detailing its effects on maternal and neonatal outcomes.
  • It analyzed 14 cases of VP from a total of 5,150 deliveries between 2014 and 2021, finding that a significant portion of these cases were referred due to complications.
  • Results indicate that tailored management, including scheduled cesarean sections, can lead to positive outcomes; however, more intensive care is recommended for symptomatic patients or those at risk for premature delivery.
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Vasa previa refers to unprotected fetal vessels running through the membranes over the cervix. Until recently, this condition was associated with an exceedingly high perinatal mortality rate attributable to fetal exsanguination when the membranes ruptured. However, ultrasonography has made it possible to diagnose the condition prenatally, allowing cesarean delivery before labor or rupture of the membranes.

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