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American Journal of Perinatology

Jourdan E Triebwasser, Jamie VanArtsdalen, Emily K Kobernik, Kristian Seiler, Elizabeth S Langen
OBJECTIVE:  To assess whether prolonged induction of labor was associated with increased maternal or neonatal morbidity. STUDY DESIGN:  We performed a retrospective cohort study of women undergoing induction of labor at a single institution. We included women with singletons ≥ 36 weeks with initial cervical dilation ≤4 cm. Prolonged induction of labor was defined as lasting > 36 hours from the time of initial method to delivery. A 2-to-1 propensity score-matched analysis was performed between women with and those without prolonged induction of labor...
November 10, 2018: American Journal of Perinatology
Jeffrey D Sperling, Rachel Shulman, Cinthia Blat, Edward E Miller, Jolene Kokroko, Marya G Zlatnik, Juan Gonzalez-Velez, Mary E Norton, Dana R Gossett
OBJECTIVE:  This article evaluates gender differences in academic rank and National Institutes of Health (NIH) funding among academic maternal-fetal medicine (MFM) physicians. STUDY DESIGN:  This was a cross-sectional study of board-certified academic MFM physicians. Physicians were identified in July 2017 from the MFM fellowship Web sites. Academic rank and receipt of any NIH funding were compared by gender. Data on potential confounders were collected, including years since board certification, region of practice, additional degrees, number of publications, and h-index...
November 10, 2018: American Journal of Perinatology
Sourabh Verma, Sean M Bailey, Pradeep V Mally, Heather B Howell
OBJECTIVE:  To determine longitudinal measurements of resting energy expenditure (REE) by indirect calorimetry (IC) in healthy term infants during the first 2 months of life. STUDY DESIGN:  An outpatient prospective pilot study was performed in healthy term infants to estimate REE by measuring expired gas fractions of oxygen (O2 ) and carbon dioxide (CO2 ) with IC in a respiratory and metabolic steady state. RESULTS:  A total of 30 measurements were performed...
November 10, 2018: American Journal of Perinatology
Rodney K Edwards, Neil R Euliano, Savyasachi Singh, Rachel C LeDuke, William W Andrews, Victoria Jauk, Akila Subramaniam, Jeff M Szychowski
OBJECTIVE:  To evaluate if fundal (F) dominance of the electrohysterogram is associated with vaginal delivery and lack of F dominance is associated with cesarean for labor dystocia. STUDY DESIGN:  We conducted a prospective cohort study of nulliparous women in spontaneous labor at ≥36 weeks. Clinicians were blinded to electrohysterography data which were in addition to standard cardiotocography. All contractions in the hour preceding diagnosis of complete cervical dilation (for women delivering vaginally) or the hour preceding the decision for cesarean were analyzed...
November 10, 2018: American Journal of Perinatology
Suzanne Demers, Amélie Boutin, Cédric Gasse, Olivier Drouin, Mario Girard, Emmanuel Bujold
OBJECTIVE:  This study aimed to estimate the performance of first-trimester uterine artery (UtA) pulsatility index (PI) for the prediction of preeclampsia (PE). METHODS:  We conducted a prospective cohort study of nulliparous women with singleton gestation at 11 0/7 -13 6/7 weeks. UtA-Doppler's was performed on both UtAs and the mean UtA-PI was reported in multiple of median (MoM) adjusted for gestational age. Using receiver operating characteristic curves and their area under the curves (AUC); we calculated the performance of UtA-PI for the prediction of PE...
November 10, 2018: American Journal of Perinatology
Melissa J Chen, Jennifer K Hsia, Melody Y Hou, Machelle D Wilson, Mitchell D Creinin
OBJECTIVE:  To evaluate whether scheduling a 2- to 3-week versus 6-week postpartum visit results in higher visit attendance. STUDY DESIGN:  We conducted a secondary analysis of a quasi-experimental before-after study to compare postpartum visit attendance after changing routine scheduling of visits from 6 weeks to 2 to 3 weeks after delivery. Secondary outcomes include patient satisfaction and breastfeeding continuation at 3 and 6 months postpartum. We collected postpartum visit information through a chart review and conducted telephonic interviews at 3 and 6 months postpartum to assess satisfaction with visit timing and breastfeeding status...
November 10, 2018: American Journal of Perinatology
Hector Boix, Segundo Rite, Luis Arruza, Cristina Fernandez, Itziar Serrano, Irene Baquedano, Ana Sanchez, Erika Ferreira, Patricia Fernandez, Rosa Gonzalez, M Dolores Elorza
OBJECTIVE:  To evaluate the initial doses of surfactant administered to preterm infants with respiratory distress syndrome. STUDY DESIGN:  This is a retrospective cohort study of 206 preterm infants admitted in four level III neonatal intensive care units of acute tertiary care hospitals in Spain between 2013 and 2015. RESULTS:  The mean initial dose of surfactant was 173.9 (37.3) mg/kg, and 47.5% of infants received a dose of 200 mg/kg ± 10% (180-220 mg/kg), 47% less than 180 mg/kg (-10%), and 5...
November 10, 2018: American Journal of Perinatology
Daniel N Pasko, Kathryn M Miller, Victoria C Jauk, Akila Subramaniam
OBJECTIVE:  We sought to evaluate differences in pregnancy outcomes following early amniotomy in women with class III obesity (body mass index ≥40 kg/m2 ) undergoing induction of labor. STUDY DESIGN:  This is a retrospective cohort study of women with class III obesity undergoing term induction of labor from January 2007 to February 2013. Early amniotomy was defined as artificial membrane rupture at less than 4 cm cervical dilation. The primary outcome was cesarean delivery...
November 5, 2018: American Journal of Perinatology
Virginia Tangel, Robert S White, Anna S Nachamie, Jeremy S Pick
OBJECTIVE:  Racial and ethnic disparities in obstetric care and delivery outcomes have shown that black women experience high rates of pregnancy-related mortality and morbidity, along with high rates of cesarean delivery, compared with other racial and ethnic groups. We aimed to quantify these disparities and test the effects of race/ethnicity in stratified statistical models by insurance payer and socioeconomic status, adjusting for comorbidities specific to an obstetric population...
November 5, 2018: American Journal of Perinatology
Neetu Singh, Matthew J McNally, Robert A Darnall
OBJECTIVE:  To compare the level of continuous positive airway pressure (CPAP) delivered by the RAM cannula system (Neotech, Valencia, CA) with that delivered by a traditional CPAP nasal delivery interface (Hudson prongs; Hudson-RCI, Temecula, CA) in preterm infants with respiratory distress. METHODS:  This was a crossover intervention study in a convenience sample of preterm infants with respiratory distress requiring treatment with CPAP. We measured the mean intraoral (pharyngeal) pressure, which approximates the applied CPAP level, using both the RAM cannula and Hudson prongs...
November 5, 2018: American Journal of Perinatology
Cecilia Mulcahy, Fionnuala Mone, Peter McParland, Fionnuala Breathnach, Fiona Cody, John J Morrison, John Higgins, Sean Daly, Samina Dornan, Amanda Cotter, Patrick Dicker, Elizabeth Tully, Fergal D Malone, Fionnuala M McAuliffe
OBJECTIVE:  This article evaluates the effect of low-dose aspirin on uterine artery (UtA) Doppler, placental volume, and vascularization flow indices in low-risk pregnancy. STUDY DESIGN:  In this secondary analysis of the TEST randomized controlled trial, low-risk nulliparous women were originally randomized at 11 weeks to: (1) routine aspirin 75 mg; (2) no aspirin; and (3) aspirin based upon the preeclampsia Fetal Medicine Foundation screening test. UtA Doppler, three-dimensional (3D) placental volume, and vascularization flow indices were assessed prior to and 6 weeks postaspirin commencement...
November 5, 2018: American Journal of Perinatology
Ivana Marić, Jonathan A Mayo, Maurice L Druzin, Ronald J Wong, Virginia D Winn, David K Stevenson, Gary M Shaw
OBJECTIVE:  Shorter maternal height has been associated with preeclampsia risk in several populations. It has been less evident whether an independent contribution to the risk exists from maternal height consistently across different races/ethnicities. We investigated associations between maternal height and risk of preeclampsia for different races/ethnicities. STUDY DESIGN:  California singleton live births from 2007 to 2011 were analyzed. Logistic regression was used to estimate adjusted odds ratios for the association between height and preeclampsia after stratification by race/ethnicity...
November 5, 2018: American Journal of Perinatology
David A Becker, Hannah C Machemehl, Joseph R Biggio, Anne M Siegel, Alan T Tita, Lorie M Harper
OBJECTIVE:  Compare outcomes in women with chronic hypertension who remain normotensive, experience exacerbation, or meet laboratory criteria for superimposed preeclampsia. STUDY DESIGN:  This is a retrospective cohort study of singleton pregnancies with chronic hypertension from 2000 to 2014. Delivery admission records were used to categorize women into three groups: stable chronic hypertension, exacerbated hypertension, and superimposed preeclampsia. The primary outcomes were a neonatal composite of death, respiratory support, umbilical arterial pH < 7, 5-minute Apgar ≤3, and seizures, in addition to maternal severe hypertension requiring intravenous (IV) antihypertensives...
November 5, 2018: American Journal of Perinatology
Melissa E Bauer, Michael Balistreri, Mark MacEachern, Ruth Cassidy, Robert Schoenfeld, Keerthana Sankar, Daniel J Clauw, Elizabeth Langen
OBJECTIVE:  This article systematically reviews the literature to establish the normal range of lactic acid in healthy pregnant women. STUDY DESIGN:  Ovid MEDLINE,, and were searched to identify studies that reported maternal lactic acid in healthy pregnant women. Pooled aggregate means and two standard deviations for each time period were computed using the inverse variance weighting technique. Analyses were performed separately for 1st, 2nd, and 3rd trimesters, scheduled cesarean delivery, early labor, active labor, 2nd stage of labor, and delivery...
November 5, 2018: American Journal of Perinatology
Jonah Bardos, Holly Loudon, Patricia Rekawek, Frederick Friedman, Michael Brodman, Nathan S Fox
OBJECTIVE:  To determine if women under the care of obstetricians in solo practice have different delivery outcomes from women in a group practice. STUDY DESIGN:  This is a retrospective cohort of live, term, singleton, vertex (LTSV) deliveries at one hospital from 2011 to 2015. We compared outcomes between women whose obstetrician was in solo practice with women in a group practice model. RESULTS:  There were 18,214 LTSV deliveries by private obstetricians...
November 5, 2018: American Journal of Perinatology
Mesk A Alrais, Nana-Ama E Ankumah, Farah H Amro, Tyisha Barrett, Kendra Folh, Han-Yang Chen, Baha M Sibai, Sean C Blackwell
OBJECTIVE:  To evaluate the degree of adherence to the new the American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine guidelines in labor arrest management. STUDY DESIGN:  A retrospective study of term, live, singleton deliveries with intrapartum primary cesarean delivery solely for failed induction of labor or labor arrest. Adherence was defined according to the Safe Prevention of the Primary Cesarean Delivery 2014 criteria...
November 5, 2018: American Journal of Perinatology
Alexis Panzer, Sarah Dotters-Katz, Marcela Smid, Kim Boggess, Tracy Manuck
OBJECTIVE:  To identify factors associated with previable delivery in second trimester preterm rupture of membranes (PROM). MATERIALS AND METHODS:  We conducted a single-center retrospective cohort study of women with pregnancies complicated by second trimester PROM (14.0-21.9 weeks' gestation) from 2000 to 2015 who elected expectant pregnancy management and achieved at least 24 hours latency. Maternal characteristics and clinical factors were compared among pregnancies that reached viability (≥ 23...
November 2, 2018: American Journal of Perinatology
Hector Mendez-Figueroa, Suneet P Chauhan, Tyisha Barrett, Van Thi Thanh Truong, Claudia Pedroza, Sean C Blackwell
OBJECTIVE:  To assess the ability of customized and population growth nomograms in identifying newborns with composite neonatal morbidity (CNM). MATERIALS AND METHODS:  This study included women who participated in the 10 Maternal-Fetal Medicine Units (MFMU) trials and delivered a nonanomalous singleton with a known gestational age (GA) of 24 weeks or more and documented birthweight. Population nomograms were based on Alexander's nomogram, whereas customized nomograms used publicly available softwares...
November 2, 2018: American Journal of Perinatology
Christopher Goodier, Roger Newman, Latha Hebbar, Julie Ross, Cynthia Schandl, Laura Goetzl
BACKGROUND:  Epidural analgesia is associated with a fourfold increased rate of intrapartum fever. The likely pathophysiology is a noninfectious maternal inflammatory activation. Safe interventions to reduce maternal and neonatal exposures to intrapartum fever and inflammation are needed. OBJECTIVE:  The purpose of this study was to determine if prophylactic epidural steroids decrease fetal exposure to hyperthermia and inflammatory cytokines following epidural analgesia...
November 2, 2018: American Journal of Perinatology
Cassandra Leighton, Molly Conroy, Andrew Bilderback, Wendy Kalocay, James K Henderson, Hyagriv N Simhan
OBJECTIVE:  The increase in maternal morbidity has resulted in higher need for maternal-fetal medicine (MFM) subspecialty care. To meet the rising demand, particularly in rural areas, the use of MFM telemedicine services has increased. This study describes the structure, implementation, and patient and child health outcomes associated with a large health system's MFM telemedicine program. STUDY DESIGN:  Observational electronic health record data are used to compare maternal and childbirth outcomes between patients receiving care via telemedicine or in-person visits through regression analysis...
October 31, 2018: American Journal of Perinatology
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