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Obstetrics and Gynecology

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https://www.readbyqxmd.com/read/28816736/distance-traveled-for-an-abortion-and-source-of-care-after-abortion
#1
Ushma D Upadhyay, Nicole E Johns, Karen R Meckstroth, Jennifer L Kerns
OBJECTIVE: To examine the association between distance traveled for an abortion and site of postabortion care among low-income women. METHODS: We conducted a retrospective cohort study using claims data from 39,747 abortions covered by California's Medicaid program in 2011-2012. Primary outcomes were the odds of abortion-related visits to an emergency department (ED) and the original abortion site, and the secondary outcome was total abortion care costs. We used mixed-effects logistic regression adjusting for patient and abortion characteristics to examine the associations between distance traveled and subsequent abortion-related care at each location...
August 14, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796691/neonatal-outcomes-of-low-risk-late-preterm-twins-compared-with-late-preterm-singletons
#2
Shimrit Yaniv Salem, Mia Kibel, Elizabeth Asztalos, Arthur Zaltz, Jon Barrett, Nir Melamed
OBJECTIVE: To test the hypothesis that the risk of neonatal morbidity among late-preterm twins is similar to that of late-preterm singletons. METHODS: We conducted a retrospective cohort study of all women with twin or singleton pregnancy who gave birth during the late-preterm period in a single tertiary center between 2008 and 2015. Neonatal outcomes of low-risk, late-preterm twins were compared with those of low-risk, late-preterm singletons. The primary outcome was the same primary composite respiratory morbidity variable that was used in the randomized controlled trial of Gyamfi-Bannerman et al on the administration of antenatal corticosteroids during the late-preterm period...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796690/human-metapneumovirus-infection-and-acute-respiratory-distress-syndrome-during-pregnancy
#3
Alina Fuchs, Rodney McLaren, Paul Saunders, Scarlett Karakash, Howard Minkoff
BACKGROUND: Human metapneumovirus has recently been recognized as an important cause of severe respiratory viral infections and of viral infections in patients admitted to intensive care units. Little is known about the course of this infection in pregnancy. CASE: A late-preterm primigravid woman was admitted to the intensive care unit for acute respiratory distress syndrome and subsequently diagnosed with human metapneumovirus. Because of worsening maternal respiratory status, she was intubated and a primary cesarean delivery was performed...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796689/partnering-of-public-academic-and-private-entities-to-reestablish-maternal-mortality-review-in-georgia
#4
Michael K Lindsay, David Goodman, Seema Csukas, Pat Cota, Tammy L Loucks, Jane E Ellis
The pregnancy-related mortality ratio in the United States has increased over the past 25 years. Georgia's pregnancy-related mortality ratio is among the highest in the United States. Confronted with this harsh reality, Georgia reestablished maternal mortality review as one strategy to address its high maternal mortality. To achieve a comprehensive process for review of maternal deaths involved securing the knowledge, resources, and support of physician experts, public health agencies and professional organizations as well as representatives in the state legislature...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796688/optimal-order-of-successive-office-hysteroscopy-and-endometrial-biopsy-for-the-evaluation-of-abnormal-uterine-bleeding-a-randomized-controlled-trial
#5
Papri Sarkar, Emad Mikhail, Robyn Schickler, Shayne Plosker, Anthony N Imudia
OBJECTIVE: To estimate the optimal order of office hysteroscopy and endometrial biopsy when performed successively for evaluation of abnormal uterine bleeding. METHODS: Patients undergoing successive office hysteroscopy and endometrial biopsy were included in a single-blind, prospective, randomized trial. The primary outcome was to evaluate the effect of order of procedures on patients' pain score. Prespecified secondary outcomes include procedure duration, hysteroscopic visualization of the uterine cavity, endometrial sample adequacy, and number of attempts at biopsy...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796687/comparison-of-subcuticular-suture-type-for-skin-closure-after-cesarean-delivery-a-randomized-controlled-trial
#6
Arin M Buresch, Anne Van Arsdale, Myriam Ferzli, Nicole Sahasrabudhe, Mengyang Sun, Jeffrey Bernstein, Peter S Bernstein, Ivan M Ngai, David J Garry
OBJECTIVE: To compare the rate of wound complications among women who underwent cesarean delivery through a Pfannenstiel skin incision followed by subcuticular closure with either poliglecaprone 25 suture or polyglactin 910 suture. METHODS: Patients undergoing nonemergent cesarean delivery at or beyond 37 weeks of gestation were randomized to undergo subcuticular skin closure with either poliglecaprone 25 or polyglactin 910. The primary outcome was a wound composite outcome of one or more of the following: surgical site infection, wound separation, hematoma, or seroma within the first 30 days postpartum...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796686/a-transperineal-approach-to-hysterectomy-of-a-retained-didelphic-uterine-horn
#7
Mary M Mullen, Lindsay M Kuroki, Steven R Hunt, Kristy L Ratkowski, David G Mutch
BACKGROUND: Gynecologic surgeries are performed through abdominal, vaginal, laparoscopic, or robot-assisted laparoscopic routes. However, if the pelvis is not accessible by one of these routes, there are no published reports to guide pelvic surgeons. CASE: A 34-year-old conjoined twin status postseparation with uterine didelphys and absence of her left colon and sacrum underwent hemihysterectomy, at which time her müllerian anomaly was unknown. She re-presented with vaginal bleeding and pain eventually attributed to a retained uterine horn...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796685/using-an-elastic-band-device-after-a-severe-obstetric-pubic-symphyseal-separation-clinical-and-imaging-evaluation
#8
Jeremy Lasbleiz, François-Xavier Sevestre, Pierre-Yves Moquet
BACKGROUND: Severe separation of the pubic symphysis is a rare delivery complication. Facing this pathology, we decided to study a new elastic band device. METHOD: To evaluate the elastic band device, clinical (pain-rated) and imaging (magnetic resonance imaging and radiography) evaluations with and without the device were performed. The elastic band device is a European Conformity-certified medical device, which is made of neoprene straps, that reduces the mobility of the pelvis and the use of the internal rotator muscles...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796684/maternal-and-infant-outcomes-after-human-papillomavirus-vaccination-in-the-periconceptional-period-or-during-pregnancy
#9
Heather S Lipkind, Gabriela Vazquez-Benitez, James D Nordin, Paul A Romitti, Allison L Naleway, Nicola P Klein, Rulin C Hechter, Michael L Jackson, Simon J Hambidge, Grace M Lee, Lakshmi Sukumaran, Elyse O Kharbanda
OBJECTIVE: To evaluate whether quadrivalent human papillomavirus (HPV) vaccine administered during the periconceptional period or during pregnancy was associated with increased risks for adverse obstetric events, adverse birth outcomes, or selected major structural birth defects. METHODS: We conducted a retrospective, observational cohort study using administrative and health care data from the Vaccine Safety Datalink. Insured women 13-27 years old with singleton pregnancies and a live birth from January 1, 2007, through September 1, 2013, who received quadrivalent HPV vaccine during the periconceptional period (2 weeks before to 2 weeks after their last menstrual period), during pregnancy, or during both periods combined were compared with women who had a live birth during the same time period and received quadrivalent HPV vaccine 4-18 months before their last menstrual period...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796683/vaginal-cleansing-before-cesarean-delivery-a-systematic-review-and-meta-analysis
#10
Claudia Caissutti, Gabriele Saccone, Fabrizio Zullo, Johanna Quist-Nelson, Laura Felder, Andrea Ciardulli, Vincenzo Berghella
OBJECTIVE: To assess the efficacy of vaginal cleansing before cesarean delivery in reducing postoperative endometritis. DATA SOURCES: MEDLINE, Ovid, EMBASE, Scopus, Clinicaltrials.gov, and Cochrane Library were searched from their inception to January 2017. METHODS OF STUDY SELECTION: Selection criteria included all randomized controlled trials comparing vaginal cleansing (ie, intervention group) with a control group (ie, either placebo or no intervention) in women undergoing cesarean delivery...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796682/a-guide-to-terminology-for-rh-immunoprophylaxis
#11
S Gerald Sandler, John T Queenan
Rh immunoprophylaxis for Rh-negative women requires an understanding of terminology used for Rh blood typing laboratory reports. The pathophysiology of Rh hemolytic disease of the fetus and newborn was elucidated by studies in rhesus monkeys. Subsequent studies revealed that the human blood group antigen responsible for Rh hemolytic disease of the newborn (D antigen) is related to, but different from, the rhesus monkey antigen. Weak expression of the D antigen on red cells, originally termed D, is currently reported by laboratories as a "serologic weak D phenotype," which can be further defined by RHD genotyping to be either an RHD weak D type or a partial D phenotype...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796681/vasa-previa-diagnosis-clinical-practice-and-outcomes-in-australia
#12
Elizabeth A Sullivan, Nasrin Javid, Gregory Duncombe, Zhuoyang Li, Nadom Safi, Robert Cincotta, Caroline S E Homer, Lesley Halliday, Yinka Oyelese
OBJECTIVE: To estimate the incidence of women with vasa previa in Australia and to describe risk factors, timing of diagnosis, clinical practice, and perinatal outcomes. METHODS: A prospective population-based cohort study was undertaken using the Australasian Maternity Outcomes Surveillance System between May 1, 2013, and April 30, 2014, in hospitals in Australia with greater than 50 births per year. Women were included if they were diagnosed with vasa previa during pregnancy or childbirth, confirmed by clinical examination or placental pathology...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796680/association-between-type-of-screening-for-gestational-diabetes-mellitus-and-cesarean-delivery
#13
Anna Palatnik, Kate Swanson, Tessa Churchill, Ania Bilski, William A Grobman, Emily S Miller
OBJECTIVE: To compare maternal and neonatal outcomes using two different testing strategies for gestational diabetes mellitus (GDM) diagnosis: the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) and Carpenter-Coustan approaches. Specifically, we wanted to compare the rates of cesarean delivery between the two epochs. METHODS: This was a retrospective cohort study of women with a singleton pregnancy delivering at 37 0/7 weeks of gestation or greater, between 2010 and 2015, in a single tertiary care center...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796679/delivery-after-40-weeks-of-gestation-in-pregnant-women-with-well-controlled-human-immunodeficiency-virus
#14
Rachel K Scott, Nahida Chakhtoura, Margaret M Burke, Rachel A Cohen, Regis Kreitchmann
OBJECTIVE: To evaluate whether there is increased mother-to-child transmission of human immunodeficiency virus (HIV)-1 associated with deliveries at 40 weeks of estimated gestational age (EGA) or greater in pregnant women with HIV-1 viral loads of 1,000 copies/mL or less. METHODS: We performed a secondary analysis of the Eunice Kennedy Shriver National Institute of Child Health and Human Development International Site Development Initiative Perinatal and Longitudinal Study in Latin American Countries and International Maternal Pediatric Adolescent AIDS Clinical Trials P1025 cohorts...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796678/socioeconomic-status-as-a-risk-factor-for-unintended-pregnancy-in-the-contraceptive-choice-project
#15
Abigail Iseyemi, Qiuhong Zhao, Colleen McNicholas, Jeffrey F Peipert
OBJECTIVE: To evaluate the association of low socioeconomic status as an independent risk factor for unintended pregnancy. METHODS: We performed a secondary analysis of data from the Contraceptive CHOICE project. Between 2007 and 2011, 9,256 participants were recruited and followed for up to 3 years. The primary outcome of interest was unintended pregnancy; the primary exposure variable was low socioeconomic status, defined as self-report of either receiving public assistance or having difficulty paying for basic necessities...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796677/association-of-hospital-volume-and-quality-of-care-with-survival-for-ovarian-cancer
#16
Jason D Wright, Ling Chen, June Y Hou, William M Burke, Ana I Tergas, Cande V Ananth, Alfred I Neugut, Dawn L Hershman
OBJECTIVE: To assess whether strict adherence to quality metrics by hospitals could explain the association between hospital volume and survival for ovarian cancer. METHODS: We used the National Cancer Database to perform a retrospective cohort study of women with ovarian cancer from 2004 to 2013. Hospitals were stratified by annual case volume into quintiles (2 or less, 2.01-5, 5.01-9, 9.01-19.9, 20 cases or greater) and by adherence to ovarian cancer quality metrics into quartiles...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796676/sleep-disorder-diagnosis-during-pregnancy-and-risk-of-preterm-birth
#17
Jennifer N Felder, Rebecca J Baer, Larry Rand, Laura L Jelliffe-Pawlowski, Aric A Prather
OBJECTIVE: To test the hypothesis that sleep disorder diagnosis would be associated with increased risk of preterm birth and to examine risk by gestational age, preterm birth type, and specific sleep disorder (insomnia, sleep apnea, movement disorder, and other). METHODS: In this observational study, participants were from a cohort of nearly 3 million women in California between 2007 and 2012. Inclusion criteria were women with singleton neonates liveborn between 20 and 44 weeks of gestation without chromosomal abnormalities or major structural birth defects linked to a hospital discharge database maintained by the California Office of Statewide Health Planning and Development and without mental illness during pregnancy...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796675/long-term-follow-up-after-endometrial-ablation-in-finland-cancer-risks-and-later-hysterectomies
#18
Tuuli Soini, Matti Rantanen, Jorma Paavonen, Seija Grénman, Johanna Mäenpää, Eero Pukkala, Mika Gissler, Ritva Hurskainen
OBJECTIVE: To study the risk of endometrial cancer and breast cancer and the hysterectomy rate after endometrial ablation. METHODS: In this retrospective cohort study, records of all women with endometrial ablation at ages 30-49 years in Finland (1997-2014) were extracted from the Hospital Discharge Register and linked to the Cancer Registry and Finnish Central Population Register. The primary outcome was cancer incidences in the endometrial ablation cohort compared with those in the background population of the same age...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796674/neonatal-morbidity-of-small-and-large-for-gestational-age-neonates-born-at-term-in-uncomplicated-pregnancies
#19
Suneet P Chauhan, Madeline Murguia Rice, William A Grobman, Jennifer Bailit, 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, Jorge E Tolosa
OBJECTIVE: To compare morbidity among small-for-gestational-age (SGA; birth weight less than the 10th percentile for gestational age), appropriate-for-gestational-age (AGA; birth weight 10th to 90th percentile; reference group), and large-for-gestational-age (LGA; birth weight greater than the 90th percentile) neonates in apparently uncomplicated pregnancies at term (37 weeks of gestation or greater). METHODS: This secondary analysis, derived from an observational obstetric cohort of 115,502 deliveries, included women with apparently uncomplicated pregnancies of nonanomalous singletons who had confirmatory ultrasound dating no later than the second trimester and who delivered between 37 0/7 and 42 6/7 weeks of gestation...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796673/human-immunodeficiency-virus-viral-load-rebound-near-delivery-in-previously-suppressed-combination-antiretroviral-therapy-treated-pregnant-women
#20
Isabelle Boucoiran, Arianne Y K Albert, Karen Tulloch, Emily C Wagner, Neora Pick, Julie van Schalkwyk, P Richard Harrigan, Deborah Money
OBJECTIVE: To assess the stability of human immunodeficiency virus (HIV) viral load suppression within 1 month before birth in pregnant women receiving antenatal combination antiretroviral therapy (CART). METHODS: This is a retrospective cohort study of a Canadian provincial perinatal HIV database from 1997 to 2015. Inclusion criteria were live birth and CART received for at least 4 weeks. Viral load rebound, defined as viral load greater than 50 copies/mL (or greater than 400 copies/mL for 1997-1998) and measured within 1 month before delivery, was identified in women who had at least one previous undetectable viral load during pregnancy...
August 4, 2017: Obstetrics and Gynecology
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