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American Journal of Obstetrics and Gynecology

Lisa S Callegari, Abigail R A Aiken, Christine Dehlendorf, Patty Cason, Sonya Borrero
Engaging women in discussions about reproductive goals in health care settings is increasingly recognized as an important public health strategy to reduce unintended pregnancy and improve pregnancy outcomes. "Reproductive Life Planning" has gained visibility as a framework for these discussions, endorsed by public health and professional organizations and integrated into practice guidelines. However, women's health advocates and researchers have voiced the concern that aspects of the reproductive life planning framework may have the unintended consequence of alienating rather than empowering some women...
October 21, 2016: American Journal of Obstetrics and Gynecology
Alfonso J Tafur, Juan I Arcelus, Joseph A Caprini
No abstract text is available yet for this article.
October 20, 2016: American Journal of Obstetrics and Gynecology
Emma L Barber, Daniel L Clarke-Pearson
No abstract text is available yet for this article.
October 20, 2016: American Journal of Obstetrics and Gynecology
Kimberly A Kilfoyle, Roxanne Vrees, Christina A Raker, Kristen A Matteson
BACKGROUND: Emergency department use is common among pregnant women. Non-urgent emergency department use may represent care that would be better provided by an established obstetric provider in an ambulatory setting. OBJECTIVE: To identify socio-demographic factors associated with non-urgent emergency department use in pregnancy. STUDY DESIGN: This is a cross-sectional study of women recruited during their postpartum hospitalization. Data regarding prenatal care and emergency department visits was collected from medical records; participants completed a survey with questions regarding demographics and emergency department use...
October 20, 2016: American Journal of Obstetrics and Gynecology
Quentin C Karpilow, Adam T Thomas
BACKGROUND: Several recent studies have highlighted the need for greater use of long-acting contraception. The most influential of these studies is the Contraceptive CHOICE Project, which was credited with substantially reducing participants' pregnancy risk by increasing their use of long-acting methods such as intrauterine devices and subdermal implants. However, because participants' rates of nonuse and condom use fell to zero at the outset of the intervention, it is possible that sizeable pregnancy reductions could still have been achieved if enrollees had chosen shorter-acting female-controlled methods such as oral contraception...
October 20, 2016: American Journal of Obstetrics and Gynecology
Mary D Brantley, Nicole L Davis, David A Goodman, William M Callaghan, Wanda D Barfield
BACKGROUND: Perinatal services exist today as a dyad of maternal and neonatal care. When perinatal care is fragmented or unavailable, excess morbidity and mortality may occur in pregnant women and newborns. OBJECTIVE: Describe spatial relationships between women of reproductive age, individual perinatal subspecialists (Maternal Fetal Medicine and Neonatology), and obstetric and neonatal critical care facilities in the United States to identify gaps in health care access...
October 20, 2016: American Journal of Obstetrics and Gynecology
(no author information available yet)
No abstract text is available yet for this article.
October 18, 2016: American Journal of Obstetrics and Gynecology
Angel Paternina-Caicedo, Jezid Miranda, Ghada Bourjeily, Andrew Levinson, Carmelo Dueñas, Camilo Bello Muñoz, José A Rojas-Suarez
BACKGROUND: Every day, about 830 women die worldwide from preventable causes related to pregnancy and childbirth. Obstetric early-warning scores have been proposed as a potential tool to reduce maternal morbidity and mortality, based upon the identification of predetermined abnormal values in the vital signs or laboratory parameters, to generate a rapid and effective medical response. Several early-warning scores have been developed for obstetrical patients, but the majority are the result of a clinical consensus rather than statistical analyses of clinical outcome measures (i...
October 14, 2016: American Journal of Obstetrics and Gynecology
Tiffany Y Peng, Samantha F Ehrlich, Yvonne Crites, John L Kitzmiller, Michael W Kuzniewicz, Monique H Hedderson, Assiamira Ferrara
BACKGROUND: Despite concern for adverse perinatal outcomes in women with diabetes prior to pregnancy, recent data on the prevalence of pregestational type 1 and type 2 diabetes in the U.S. are lacking. OBJECTIVE: To estimate changes in the prevalence of overall pregestational diabetes (all types) and pregestational type 1 and type 2 diabetes, and whether changes varied by race-ethnicity between 1996 and 2014. STUDY DESIGN: Cohort study conducted among 655,428 pregnancies at a Northern California integrated health delivery system in 1996-2014...
October 14, 2016: American Journal of Obstetrics and Gynecology
Quinn K Lippmann, Jeff M Slezak, Shawn A Menefee, Casey K Ng, Emily L Whitcomb, Ronald K Loo
BACKGROUND: Urologic cancer has a lower prevalence in women compared to men, however there are no differences in the recommended evaluation for women and men with microscopic hematuria. OBJECTIVES: To identify risk factors associated with urologic cancer in female patients with microscopic hematuria and to determine the applicability of a hematuria risk score for women. STUDY DESIGN: We conducted a retrospective cohort study within an integrated health care system in Southern California...
October 14, 2016: American Journal of Obstetrics and Gynecology
Marian Wiegersma, Chantal M C R Panman, Marjolein Y Berger, Henrica C W De Vet, Boudewijn J Kollen, Janny H Dekker
BACKGROUND: The Pelvic Floor Distress Inventory-20 is used to evaluate symptoms and treatment effects in women with pelvic floor disorders. To interpret changes in the scores of this inventory, information is needed on what patients and clinicians perceive as the minimal important (meaningful) change. Although this change in the inventory score has previously been investigated in women undergoing pelvic floor surgery, the results could not be generalized to women with milder symptoms (i...
October 14, 2016: American Journal of Obstetrics and Gynecology
Steven L Clark, Emily Hamilton, Thomas J Garite, Audra Timmins, Philip A Warrick, Samuel Smith
BACKGROUND: Despite intensive efforts directed at initial training in fetal heart rate interpretation, continuing medical education, board certification/recertification, team training and the development of specific protocols for the management of abnormal fetal heart rate patterns, the goals of consistently preventing hypoxia-induced fetal metabolic acidemia and neurologic injury remain elusive. OBJECTIVE: To validate a recently published algorithm for the management of category II fetal heart rate tracings , examine reasons for the birth of infants with significant metabolic acidemia despite the use of electronic fetal heart rate monitoring and critically examine the limits of EFHRM in the prevention of neonatal metabolic acidemia...
October 14, 2016: American Journal of Obstetrics and Gynecology
Chun Chao, Michael J Silverberg, Tracy A Becerra, Douglas A Corley, Christopher D Jensen, Qiaoling Chen, Virginia P Quinn
BACKGROUND: Human papillomavirus vaccination may result in lowered intention to be screened for cervical cancer, potentially leading to gaps in screening coverage and avoidable cervical cancer diagnoses. OBJECTIVE: To examine the association between human papillomavirus vaccination and subsequent cervical cancer screening initiation and adherence to recommended screening intervals to detect gaps in screening coverage and inform future prevention efforts. STUDY DESIGN: A retrospective cohort study was conducted in two distinct cohorts of female members of Kaiser Permanente Southern California, a large integrated healthcare delivery system...
October 13, 2016: American Journal of Obstetrics and Gynecology
Saba W Masho, Susan Cha, Derek A Chapman, David Chelmow
BACKGROUND: Preterm birth is one of the leading causes of infant morbidity and mortality. Although major strides have been made in identifying risk factors for preterm birth, the complexities between social and individual risk factors are not well understood. OBJECTIVE: This study examines the association between neighborhood youth violence and preterm birth. STUDY DESIGN: A ten-year live birth registry dataset (2004-2013) from Richmond, Virginia, a mid-sized, racially diverse city was analyzed (N=27,519)...
October 8, 2016: American Journal of Obstetrics and Gynecology
John J Mccarthy, Martin H Leamon, Loretta P Finnegan, Catherine Fassbender
Increase in the number of opioid dependent pregnant women delivering babies at risk for neonatal abstinence syndrome (NAS) prompted a General Accountability Office (GAO) report documenting deficits in research and provider knowledge about care of the maternal/fetal unit and the neonate. There are three general sources of dependence: untreated opioid use disorder (OUD), pain management, and medication assisted treatment with methadone or buprenorphine. A survey of methadone patients' experiences when telling a physician of their pregnancy and opioid dependence demonstrated physician confusion about proper care, frequent negative interactions with the mother, and failures to provide appropriate referral...
October 8, 2016: American Journal of Obstetrics and Gynecology
Leslie A Moroz, Clifton O Brock, Shravya Govindappagari, Denise L Johnson, Elizabeth H Leopold, Cynthia Gyamfi-Bannerman
BACKGROUND: There is a lack of consensus on the optimal transvaginal cervical length (TVCL) for determining risk for spontaneous preterm (SPTB) in twin pregnancies. Change in TVCL over time may reflect early activation of the parturition process, as has been demonstrated in singleton pregnancies. The association between change in TVCL and the risk for SPTB has not yet been described in the population of women with diamniotic twin pregnancies. OBJECTIVES: Our primary objective is to determine whether rate of change in TVCL in the midtrimester is associated with SPTB in twin gestations...
October 8, 2016: American Journal of Obstetrics and Gynecology
Blanka Vasak, Jessica J Verhagen, Steven V Koenen, Maria P H Koster, P A O M de Reu, Arie Franx, Jan G Nijhuis, Gouke J Bonsel, Gerard H A Visser
BACKGROUND: Twin pregnancies are at increased risk for perinatal morbidity and mortality, due to many factors including a high incidence of preterm delivery. Compared to singleton pregnancies overall perinatal mortality risk is higher in twin pregnancies, however for the preterm period perinatal mortality has been reported to be lower in twins. OBJECTIVE: To compare perinatal mortality in relation to gestational age at birth between singleton and twin pregnancies, taken into account socioeconomic status, fetal sex and parity...
October 8, 2016: American Journal of Obstetrics and Gynecology
Linda C Giudice
No abstract text is available yet for this article.
October 7, 2016: American Journal of Obstetrics and Gynecology
Sofia Klingberg, Hilde K Brekke, Anna Winkvist, Gunnar Engström, Bo Hedblad, Isabel Drake
BACKGROUND: High parity has been suggested to increase risk of maternal cardiovascular disease (CVD) independent of BMI measured after childbearing. Pregnancy is however associated with persistent weight gain and metabolic changes which all independent of parity increase the risk of CVD. It could therefore be questioned if high parity independently increases the risk of CVD or if this association may be confounded, mediated or modified by other parity-related factors. OBJECTIVE: To investigate the association between parity and risk of cardiovascular disease (CVD), and secondary outcomes in terms of myocardial infarction (MI) and cerebral infarction, with particular focus on potential mediation by anthropometric measures and effect-modification by lactation...
October 6, 2016: American Journal of Obstetrics and Gynecology
Jwan Al-Mukhtar Othman, Sigvard Åkervall, Ian Milsom, Maria Gyhagen
BACKGROUND: A systematic survey of pelvic floor disorders in nulliparous women has not been presented previously. OBJECTIVE: The purpose of this study was to determine the prevalence of urinary incontinence parameters in a large cohort of non-pregnant, nulliparous women, and thereby construct a reference group for comparisons with parous women. STUDY DESIGN: This postal and web-based questionnaire survey was conducted in 2014. The study population was identified from the Total Population Register in Sweden and comprised women who had not given birth and were aged 25-64 years...
October 6, 2016: American Journal of Obstetrics and Gynecology
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