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American Journal of Obstetrics and Gynecology

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https://www.readbyqxmd.com/read/29338994/both-patients-and-maternity-care-providers-can-benefit-from-payment-reform-four-steps-to-prepare
#1
Malini A Nijagal, Neel T Shah, Jeff Levin-Scherz
Many Medicaid programs and private health plans are implementing new models of maternity care reimbursement, and clinicians face mounting pressure to demonstrate high quality care at lower cost. Clinicians will be better prepared to meet these challenges with a fuller understanding of new payment models and the opportunities they present. We describe the structure of maternity care "episode payments" and recommend four ways that clinicians can prepare for success as value-based payment models are implemented: identify opportunities to improve outcomes and experience, measure quality, reduce waste and work in teams across settings...
January 12, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29338993/peritoneal-sarcomatosis-5-years-after-laparoscopic-morcellation-of-uterine-leiomyoma
#2
Marco Petrillo, Margherita Dessole, Vito Chiantera
No abstract text is available yet for this article.
January 12, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29338992/subsequent-fertility-pregnancy-and-gynecologic-outcomes-after-fetoscopic-laser-therapy-for-twin-twin-transfusion-syndrome-compared-to-normal-monochorionic-twin-gestations
#3
Simen Vergote, Liesbeth Lewi, Willem Gheysen, Luc de Catte, Roland Devlieger, Jan Deprest
BACKGROUND: An improved survival and quality of life for neonatal survivors after fetoscopic laser therapy (FLC) for twin-twin transfusion syndrome (TTTS) has been reported. However, little is known about the medium-term maternal effects after FLC with respect to reproductive and gynecologic outcomes. OBJECTIVE: To document reproductive, obstetric, gynecologic and psychological outcomes in women who underwent FLC for TTTS. STUDY DESIGN: Monocentric controlled study on consecutive women who underwent FLC for TTTS between 2007 and 2013 at the University Hospitals Leuven (cases; n=198)...
January 12, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29307739/management-of-sexuality-intimacy-and-menopause-symptoms-after-ovarian-cancer
#4
LETTER
Martha F Goetsch
No abstract text is available yet for this article.
January 4, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29305830/the-most-important-quality-of-a-physician
#5
Emmet Hirsch
No abstract text is available yet for this article.
January 3, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29305829/meta-analysis-on-the-effect-of-aspirin-use-for-prevention-of-preeclampsia-on-placental-abruption-and-antepartum-hemorrhage
#6
REVIEW
Stephanie Roberge, Emmanuel Bujold, Kypros H Nicolaides
BACKGROUND: Impaired placentation in the first 16 weeks of pregnancy is associated with increased risk of subsequent development of preeclampsia, birth of small for gestational age neonates and placental abruption. Previous studies reported that prophylactic use of aspirin reduces the risk of preeclampsia and small for gestational age neonates with no significant effect on placental abruption. However, meta-analyses of randomized controlled trials examining the effect of aspirin in relation to gestational age at onset of therapy and dose of the drug reported that significant reduction in the risk of preeclampsia and small for gestational age neonates is achieved only if the onset of treatment is at ≤16 weeks of gestation and the daily dose of the drug is ≥100 mg...
January 3, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29305255/comparative-analysis-of-gene-expression-in-maternal-peripheral-blood-and-monocytes-during-spontaneous-preterm-labor
#7
Alison G Paquette, Oksana Shynlova, Mark Kibschull, Nathan D Price, Stephen J Lye
BACKGROUND: Preterm birth is the leading cause of newborn death worldwide, and is associated with significant cognitive and physiological challenges in later life. There is a pressing need to define the mechanisms that initiate spontaneous preterm labor , and for development of novel clinical biomarkers to identify high-risk pregnancies. Most preterm birth studies utilize fetal tissues, and there is limited understanding of the transcriptional changes that occur in mothers undergoing spontaneous preterm labor...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29305254/pelvic-floor-functional-outcomes-after-total-abdominal-versus-total-laparoscopic-hysterectomy-for-endometrial-cancer
#8
Peta Higgs, Monika Janda, Rebecca Asher, Val Gebski, Peta Forder, Andreas Obermair
BACKGROUND: Pelvic floor functioning is an important concern for women requiring a hysterectomy for endometrial cancer. The incidence of pelvic floor symptoms has not been reported in women who have undergone a hysterectomy for early-stage endometrial cancer. OBJECTIVES: To evaluate pelvic floor function in women who have had surgical treatment for early stage endometrial cancer as part of the multinational Laparoscopic Approach to Cancer of the Endometrium (LACE) trial and to compare patients' outcomes who had total abdominal total versus total laparoscopic hysterectomy...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29305253/chronic-hypertension-first-trimester-blood-pressure-control-and-likelihood-of-severe-hypertension-preeclampsia-and-small-for-gestational-age
#9
Diane Nzelu, Dan Dumitrascu-Biris, Kypros H Nicolaides, Nikos A Kametas
BACKGROUND: There is extensive evidence that pre-pregnancy chronic hypertension is associated with high risk of development of severe hypertension and preeclampsia and birth of small for gestational age neonates. However, previous studies have not reported whether anti-hypertensive use, blood pressure control or normalization of blood pressure during early pregnancy influence the rates of these pregnancy complications. OBJECTIVE: To stratify women with pre-pregnancy chronic hypertension according to the use of antihypertensive medications and level of blood pressure control at the first hospital visit during the first-trimester of pregnancy and examine the rates of severe hypertension, preeclampsia and birth of small for gestational age neonates according to such stratification...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29305252/the-anatomy-of-the-sacral-promontory-how-to-avoid-complications-of-the-sacrocolpopexy-procedure
#10
Géraldine Giraudet, Aurore Protat, Michel Cosson
Because of problems with vaginal meshes and high rate recurrences of native tissue repair, more and more surgeons treat pelvic organ prolapse performing laparoscopic sacrocolpopexy. This surgery requires skilled surgeons. The first step of sacrocolpopexy is the dissection of tissues in front of the sacral promontory to reach the anterior longitudinal ligament. Some complications can occur during this dissection and the attachment of the mesh. This place is dangerous for surgeons because of the proximity of vessels, nerves and ureters...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29305251/cardiac-arrest-during-pregnancy-ongoing-clinical-conundrum-an-expert-review
#11
REVIEW
Carolyn M Zelop, Sharon Einav, Jill M Mhyre, Stephanie Martin
While global maternal mortality has decreased in the last 25 years, the maternal mortality ratio in the United States has actually increased. Maternal mortality is a complex phenomenon involving multifaceted socioeconomic and clinical parameters including inequalities in access to health care, racial and ethnic disparities, maternal comorbidities and epidemiologic ascertainment bias. Escalating maternal mortality underscores the importance of clinician preparedness to respond to maternal cardiac arrest that may occur in any maternal health care setting...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29305250/diagnosis-and-treatment-of-urinary-tract-infections-across-age-groups
#12
REVIEW
Christine M Chu, Jerry L Lowder
Urinary tract infections (UTI) are the most common outpatient infections, but predicting the probability of UTI through symptoms and test results can be complex. The most diagnostic symptoms of UTI include change in frequency, dysuria, urgency, and presence or absence of vaginal discharge, but UTIs may present differently in older women. Dipstick urinalysis is popular for its availability and usefulness, but results must be interpreted in context of the patient's pretest probability based on symptoms and characteristics...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29305249/sonographic-large-fetal-head-circumference-and-risk-of-cesarean-delivery
#13
Michal Lipschuetz, Sarah M Cohen, Ariel Israel, Joel Baron, Shay Porat, Dan V Valsky, Oren Yagel, Doron Kabiri, Yinon Gilboa, Eyal Sivan, Ron Unger, Eyal Schiff, Reli Hershkovitz, Simcha Yagel
BACKGROUND: Persistently high rates of cesarean deliveries are cause for concern for physicians, patients, and health systems. Prelabor assessment might be refined by identifying factors that help predict an individual patient's risk of cesarean delivery. Such factors may contribute to patient safety and satisfaction as well as health system planning and resource allocation. In an earlier study, neonatal head circumference was shown to be more strongly associated with delivery mode and other outcome measures, than neonatal birth weight...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29291413/impact-of-recommended-changes-in-labor-management-for-prevention-of-the-primary-cesarean-delivery
#14
Claire Thuillier, Sophie Roy, Violaine Peyronet, Thibaud Quibel, Aurélie Nlandu, Patrick Rozenberg
BACKGROUND: The dramatic rise in cesarean delivery (CD) rates worldwide in recent decades, without evidence of a concomitant decrease in cerebral palsy rates, has raised concerns about its potential negative consequences for maternal and infant health. In 2014, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine jointly published an Obstetric Care Consensus for safe prevention of the primary cesarean delivery. OBJECTIVE: We sought to assess whether modification of our protocol to implement these recommendations helped to decrease our primary CD rate safely...
December 29, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29291412/pulmonary-vascular-obstruction-by-squamous-cells-is-not-involved-in-amniotic-fluid-embolism
#15
LETTER
Mark Funk, Alexander Damron, Venkata Bandi, Kjersti Aagaard, Reka Szigeti, Steven Clark
No abstract text is available yet for this article.
December 29, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29291411/assisted-reproductive-technology-with-donor-sperm-national-trends-and-perinatal-outcomes
#16
Sabrina A Gerkowicz, Sara B Crawford, Heather S Hipp, Sheree L Boulet, Dmitry M Kissin, Jennifer F Kawwass
BACKGROUND: Information regarding use of donor sperm in assisted reproductive technology, as well as subsequent treatment and perinatal outcomes, remains limited. Outcome data would aid patient counseling and clinical decision-making. OBJECTIVES: To report national trends in donor sperm utilization and live birth rates of donor sperm assisted reproductive technology cycles in the United States, and to compare assisted reproductive technology treatment and perinatal outcomes between cycles using donor and non-donor sperm...
December 29, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29291410/effect-of-frozen-thawed-embryo-transfer-on-birthweight-macrosomia-and-low-birthweight-rates-in-us-singleton-infants
#17
Julia F Litzky, Sheree L Boulet, Navid Esfandiari, Yujia Zhang, Dmitry M Kissin, Regan N Theiler, Carmen J Marsit
BACKGROUND: Singleton infants conceived using assisted reproductive technology have lower average birthweights than naturally-conceived infants and are more likely to be born low birthweight (<2500 grams). Lower birthweights are associated with increased infant and child mortality and poor adult health outcomes, including cardiovascular disease, hypertension, and diabetes. Data from registry and single center studies suggest that frozen/thawed embryo transfer may be associated with larger birthweights...
December 29, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29288068/regular-exercisers-have-stronger-pelvic-floor-muscles-than-non-regular-exercisers-at-midpregnancy
#18
Kari Bø, Marie Ellstrøm Engh, Gunvor Hilde
BACKGROUND: Today, all healthy pregnant women are encouraged to be physically active throughout pregnancy, with recommendations to participate in at least 30 min of aerobic activity on most days of the week, in addition to perform strength training of the major muscle groups 2-3 days per week, and also pelvic floor muscle training. There is, however, an ongoing debate whether general physical activity enhances or declines pelvic floor muscle function. OBJECTIVES: To compare vaginal resting pressure, pelvic floor muscle strength and endurance in regular exercisers (exercise ≥ 30 minutes ≥ 3 times per week) and non-exercisers at mid-pregnancy...
December 26, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29288067/nationwide-trends-in-the-utilization-of-and-payments-for-hysterectomy-in-the-united-states-among-commercially-insured-women
#19
Daniel M Morgan, Neil S Kamdar, Carolyn W Swenson, Emily K Kobernik, Anne G Sammarco, Brahmajee Nallamothu
BACKGROUND: Laparotomy followed by inpatient hospitalization has traditionally been the most common surgical care for hysterectomy. The financial implications of the increased use of laparoscopy and outpatient hysterectomy are unknown. OBJECTIVES: To quantify the increasing use of laparoscopy and outpatient hysterectomy and to describe the financial implications among women with commercially based insurance in the United States. STUDY DESIGN: Hysterectomies between 2010 and 2013 were identified in the Health Care Cost Institute, a national dataset with inpatient and outpatient private insurance claims for more than 25 million women...
December 26, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29288066/cost-effectiveness-of-population-based-brca1-founder-mutation-testing-in-sephardi-jewish-women
#20
Shreeya Patel, Rosa Legood, D Gareth Evans, Clare Turnbull, Antonis C Antoniou, Usha Menon, Ian Jacobs, Ranjit Manchanda
BACKGROUND: Population-based BRCA1/BRCA2 founder-mutation testing has been demonstrated as cost-effective compared to family-history(FH) based testing in Ashkenazi Jewish(AJ) women. However, only one of the three AJ BRCA1/BRCA2 founder-mutations (185delAG(c.68_69delAG), 5382insC(c.5266dupC) and 6174delT(c.5946delT)) is found in the Sephardi Jewish(SJ) population (185delAG(c.68_69delAG)) and the overall prevalence of BRCA mutations in the SJ population is accordingly lower (0.7% compared to 2...
December 26, 2017: American Journal of Obstetrics and Gynecology
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