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American Journal of Obstetrics and Gynecology

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https://www.readbyqxmd.com/read/29157866/vaginal-progesterone-for-preventing-preterm-birth-and-adverse-perinatal-outcomes-in-singleton-gestations-with-a-short-cervix-a-meta-analysis-of-individual-patient-data
#1
Roberto Romero, Agustin Conde-Agudelo, Eduardo Da Fonseca, John M O'Brien, Elcin Cetingoz, George W Creasy, Sonia S Hassan, Kypros H Nicolaides
BACKGROUND: The efficacy of vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix has been questioned after publication of the OPPTIMUM study. OBJECTIVE: To determine whether vaginal progesterone prevents preterm birth and improves perinatal outcomes in asymptomatic women with a singleton gestation and a midtrimester sonographic short cervix. DATA SOURCES: MEDLINE, EMBASE, LILACS, and CINAHL (from their inception to September 2017), Cochrane databases, bibliographies, and conference proceedings...
November 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29155142/microrna-30a-3p-is-overexpressed-in-the-placentas-of-patients-with-preeclampsia-and-affects-trophoblast-invasion-and-apoptosis-by-its-effects-on-igf-1
#2
Zi-Ru Niu, Tao Han, Xiao-Luan Sun, Li-Xia Luan, Wen-Li Gou, Xiao-Ming Zhu
BACKGROUND: Preeclampsia (PE) affects many women globally and remains as a primary cause for neonatal and maternal morbidity and mortality. Aberrant placental microRNAs (miRNAs) expression might associated with PE. Previously, thirty-three PE-related miRNAs, with eleven up-regulated and twenty-three down-regulated were detected in severe-PE placentas when compared with normal patients. One of the most up-regulated miRNAs in PE is miR-30a-3p. The predicted target of it, insulin-like growth factor 1 (IGF-1), which has been reported to have a relatively low expression level in PE patients...
November 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29155141/re-the-environmental-injustice-of-beauty
#3
LETTER
Ami R Zota, Bhavna Shamasunder
No abstract text is available yet for this article.
November 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29155140/pregnancy-and-parturition-negatively-impact-vaginal-angle-and-alters-expression-of-vaginal-mmp-9
#4
Sallie Oliphant, Timothy Canavan, Stacy Palcsey, Leslie Meyn, Pamela Moalli
BACKGROUND: Parity is the greatest risk factor for the development of pelvic organ prolapse. The normally supported vagina is pulled up and back over the levator ani. Loss of vaginal angulation has been associated with prolapse and may represent injury to the vaginal supportive tissues. OBJECTIVE: We propose that 1) pregnancy and delivery impact support to the vagina leading to loss of vaginal angle; 2) vaginal angulation is restored postpartum; and 3) uncomplicated vaginal delivery (VD) is associated with accelerated remodeling of the vaginal fibrillar matrix...
November 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29155037/long-term-anal-incontinence-after-obstetric-anal-sphincter-injury-does-grade-of-tear-matter
#5
Hanna Jangö, Jens Langhoff-Roos, Susanne Rosthøj, Abelone Sakse
BACKGROUND: Anal incontinence is a major concern following delivery with obstetric anal sphincter injury and has been related to the degree of sphincter tear. OBJECTIVES: To 1) evaluate whether women with a fourth degree obstetric anal sphincter injury in the first delivery have an increased risk of long-term anal- and fecal incontinence after a second delivery and 2) assess the impact of mode of second delivery on anal incontinence and related symptoms in these patients...
November 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29155036/effectiveness-of-app-based-self-acupressure-for-women-with-menstrual-pain-compared-to-usual-care-a-randomized-pragmatic-trial
#6
Susanne Blödt, Daniel Pach, Sanna von Eisenhart-Rothe, Fabian Lotz, Stephanie Roll, Katja Icke, Claudia M Witt
BACKGROUND: Primary dysmenorrhea is common among women of reproductive age. Non-steroidal anti-inflammatory drugs and oral contraceptives are effective treatments, although the failure rate is around 20-25%. Therefore additional evidence-based treatments are needed. In recent years, the use of smartphone applications (apps) has increased rapidly and may support individuals in self-management strategies. OBJECTIVE: We aimed to investigate the effectiveness of app-based self-acupressure in women with menstrual pain...
November 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29155035/utility-of-anesthetic-block-for-endometrial-ablation-pain-a-randomized-controlled-trial
#7
Jordan S Klebanoff, Nima R Patel, Nancy L Sloan
BACKGROUND: Second-generation endometrial ablation has been demonstrated safe for abnormal uterine bleeding treatment in premenopausal women, who have completed childbearing, in short-stay surgical centers and in physicians' offices. However, no standard regarding anesthesia exists and practice varies depending on physician or patient preference and hospital policy and setting. OBJECTIVE: To evaluate whether local anesthetic, in combination with general anesthesia, affects postoperative pain and associated narcotic use following endometrial ablation...
November 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29146387/dilemmas-in-genetic-counseling-for-low-penetrance-neuro-susceptibility-loci-detected-on-prenatal-chromosomal-microarray-analysis
#8
Dana Brabbing-Goldstein, Adi Reches, Ran Svirsky, Anat Bar-Shira, Yuval Yaron
BACKGROUND: Chromosomal microarray analysis is standard of care in fetuses with malformations, detecting clinically significant copy number variants in 5-7% of cases over conventional karyotyping. However, it also detects variants of uncertain significance in 1.6% - 4.2% of the cases, some of which are low-penetrance neuro-susceptibility loci. The interpretation of these variants in pregnancy is particularly challenging, because the significance is often unclear and the clinical implications may be difficult to predict...
November 13, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29141197/medical-abortion-reversal-science-and-politics-meet
#9
Khadijah Z Bhatti, Antoinette T Nguyen, Gretchen S Stuart
Medical abortion is a safe, effective, and acceptable option for patients seeking an early non-surgical abortion. In 2014, medical abortion accounted for nearly one-third (31%) of all abortions performed in the United States. State-level attempts to restrict reproductive and sexual health have recently included bills that require physicians to inform women that a medical abortion is reversible. In this commentary, we will review the history, current evidence-based regimen, and regulation of medical abortion...
November 12, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29138038/low-dose-betamethasone-acetate-for-fetal-lung-maturation-in-preterm-sheep
#10
Augusto F Schmidt, Matthew W Kemp, Judith Rittenschober-Böhm, Paranthaman S Kannan, Haruo Usuda, Masatoshi Saito, Lucy Furfaro, Shimpei Watanabe, Sarah Stock, Boris W Kramer, John P Newnham, Suhas G Kallapur, Alan H Jobe
BACKGROUND: Antenatal steroids (ANS) are standard of care for women at risk of preterm delivery; however ANS dosing and formulation have not been adequately evaluated. The standard clinical 2-dose treatment with betamethasone-acetate+betamethasone-phosphate (Beta-P+Beta-Ac) is more effective than 2 doses of Beta-P for inducing lung maturation in preterm fetal sheep. We hypothesized that the slowly-released Beta-Ac component induces similar lung maturation to Beta-P+Beta-Ac with decreased dose and fetal exposure...
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29138037/genetic-predisposition-to-preeclampsia-is-conferred-by-fetal-dna-variants-near-flt1-a-gene-involved-in-the-regulation-of-angiogenesis
#11
Kathryn J Gray, Richa Saxena, S Ananth Karumanchi
Preeclampsia risk is influenced by both the mother's genetic background, as well as the genetics of her fetus; however, the specific genes responsible for conferring preeclampsia risk have largely remained elusive. Evidence that preeclampsia has a genetic predisposition was first detailed in the early 1960's, and overall preeclampsia heritability is estimated at ∼55%. Many traditional gene discovery approaches have been employed to investigate the specific genes that contribute to preeclampsia risk, but these have largely not been successful or reproducible...
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29138036/aspirin-for-the-prevention-of-preterm-and-term-preeclampsia-systematic-review-and-meta-analysis
#12
Stephanie Roberge, Emmanuel Bujold, Kypros H Nicolaides
BACKGROUND: Meta-analyses of randomized controlled trials have reported contradictory results concerning the effect of aspirin in the prevention of preeclampsia both in terms of the gestational age at the onset of treatment and the dose of the drug. The controversy may be resolved by a meta-analysis that includes several recently published trials and particularly the large Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-Based Preeclampsia Prevention (ASPRE) trial and by examining whether there is a difference of the effect of aspirin on preterm vs...
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29138035/defining-failed-induction-of-labor
#13
William A Grobman, Jennifer Bailit, Yinglei Lai, Uma M Reddy, Ronald J Wapner, Michael W Varner, John M Thorp, Kenneth J Leveno, Steve N Caritis, Mona Prasad, Alan T N Tita, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
BACKGROUND: While there are well-accepted standards for the diagnosis of arrested active-phase labor, the definition of a "failed" induction of labor remains less certain. One approach to diagnosing a failed induction is based on the duration of the latent phase. However, a standard for the minimum duration that the latent phase of a labor induction should continue, absent acute maternal or fetal indications for cesarean delivery, remains lacking. OBJECTIVE: The objective of this study was to determine the frequency of adverse maternal and perinatal outcomes as a function of the duration of the latent phase among nulliparous women undergoing labor induction...
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29138034/understanding-cosmetic-product-regulation-could-help-reduce-disparities
#14
LETTER
Mitchell Berger
No abstract text is available yet for this article.
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29138033/randomized-trial-of-high-and-low-fidelity-simulation-to-teach-intrauterine-contraception-placement
#15
Siripanth Nippita, Miriam J Haviland, Sara F Voit, Judith Perez-Peralta, Michele R Hacker, Maureen E Paul
BACKGROUND: High fidelity simulation creates conditions that resemble real circumstances, and can help teach procedures such as intrauterine contraception placement. Its impact on skill retention has not been studied. OBJECTIVE: To evaluate novice learners' skills, attitudes, and knowledge on placement of intrauterine contraception when trained using a high-fidelity commercially available simulator compared with a low-fidelity simulator. STUDY DESIGN: We recruited senior nurse practitioner students and interns in obstetrics and gynecology and family medicine inexperienced with intrauterine contraception placement...
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29138032/letter-to-the-editor-better-reporting-needed-for-cosmetics-and-women-s-health
#16
LETTER
Jessica R Walter, Saya L Jacob, Shuai Xu
No abstract text is available yet for this article.
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29138031/mortality-and-pulmonary-outcomes-of-extremely-preterm-infants-exposed-to-antenatal-corticosteroids
#17
Colm P Travers, Waldemar A Carlo, Scott A Mcdonald, Abhik Das, Edward F Bell, Namasivayam Ambalavanan, Alan H Jobe, Ronald N Goldberg, Carl T D'Angio, Barbara J Stoll, Seetha Shankaran, Abbot R Laptook, Barbara Schmidt, Michele C Walsh, Pablo J Sanchez, M Bethany Ball, Ellen C Hale, Nancy S Newman, Rosemary D Higgins
BACKGROUND: Antenatal corticosteroids are given primarily to induce fetal lung maturation but results from meta-analyses of randomized controlled trials have not shown mortality or pulmonary benefits for extremely preterm infants although these are the infants most at risk of mortality and pulmonary disease. OBJECTIVE: To determine if exposure to antenatal corticosteroids is associated with a lower rate of death and pulmonary morbidities by 36 weeks' postmenstrual age...
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29128521/prenatal-chromosomal-microarray-analysis-in-fetuses-with-congenital-heart-disease-a-prospective-cohort-study
#18
Yan Wang, Li Cao, Dong Liang, Lulu Meng, Yun Wu, Fengchang Qiao, Xiuqing Ji, Chunyu Luo, Jingjing Zhang, Tianhui Xu, Bin Yu, Leilei Wang, Ting Wang, Qiong Pan, Dingyuan Ma, Ping Hu, Zhengfeng Xu
BACKGROUD: Currently, chromosomal microarray analysis is considered as the first-tier test in pediatric care and prenatal diagnosis. However, the diagnostic yield of CMA for prenatal diagnosis of congenital heart disease has not been evaluated based on a large cohort. OBJECTIVE: Our aim was to evaluate the clinical utility of chromosomal microarray as the first-tier test for chromosomal abnormalities in fetuses with congenital heart disease. STUDY DESIGN: In this prospective study, 602 prenatal cases of congenital heart disease were investigated using SNP array over a 5-year period...
November 8, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29079143/anticipated-pain-as-a-predictor-of-discomfort-with-intrauterine-device-placement
#19
Blair Dina, Leah Peipert, Qiuhong Zhao, Jeffery F Peipert
BACKGROUND: Intrauterine devices have been gaining popularity for the past 2 decades. Current data report that >10% of women who use contraception are using an intrauterine device. With <1% failure rates, the intrauterine device is 1 of the most effective forms of long-acting reversible contraception, yet evidence shows that fear of pain during intrauterine device placement deters women from choosing an intrauterine device as their contraceptive method. OBJECTIVES: The objective of this analysis was to estimate the association between anticipated pain with intrauterine device placement and experienced pain...
November 8, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29102503/maternal-hemodynamics-a-method-to-classify-hypertensive-disorders-of-pregnancy
#20
Enrico Ferrazzi, Tamara Stampalija, Lorenzo Monasta, Daniela Di Martino, Sharona Vonck, Wilfried Gyselaers
BACKGROUND: The classification of hypertensive disorders of pregnancy is based on the time at the onset of hypertension, proteinuria, and other associated complications. Maternal hemodynamic interrogation in hypertensive disorders of pregnancy considers not only the peripheral blood pressure but also the entire cardiovascular system, and it might help to classify the different clinical phenotypes of this syndrome. OBJECTIVE: This study aimed to examine cardiovascular parameters in a cohort of patients affected by hypertensive disorders of pregnancy according to the clinical phenotypes that prioritize fetoplacental characteristics and not the time at onset of hypertensive disorders of pregnancy...
November 2, 2017: American Journal of Obstetrics and Gynecology
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