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Society of Maternal Fetal Medicine

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https://www.readbyqxmd.com/read/29141482/obstetric-practice-guidelines-labor-s-love-lost
#1
Wayne R Cohen, Emanuel A Friedman
Implementation of clinical practice guidelines may moderate health care costs, improve care, reduce medicolegal liability, and provide a uniformity in care allowing meaningful investigation of treatments and outcomes. However, new guidelines are often uncritically embraced by clinicians, risk management organizations, insurance companies, and the courts as the standard of care. Adoption of incompletely vetted recommendations can lead to patient harm. Recent recommendations made by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine for assessment and management of labor provide an example of well-intended guidelines adopted uncritically...
November 15, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29120454/hospital-volume-and-cesarean-delivery-among-low-risk-women-in-a-nationwide-sample
#2
M A Clapp, K E James, A Melamed, J L Ecker, A J Kaimal
OBJECTIVE: We sought to determine if hospital delivery volume was associated with a patient's risk for cesarean delivery in low-risk women. STUDY DESIGN: This study retrospectively examines a cohort of 1 657 495 deliveries identified in the 2013 Nationwide Readmissions Database. Hospitals were stratified by delivery volume quartiles. Low-risk patients were identified using the Society for Maternal-Fetal Medicine definition (n=845 056). A multivariable logistic regression accounting for hospital-level clustering was constructed to assess the factors affecting a patient's odds for cesarean delivery...
November 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29115686/inner-volume-echo-volumar-imaging-ivevi-for-robust-fetal-brain-imaging
#3
Rita G Nunes, Giulio Ferrazzi, Anthony N Price, Jana Hutter, Andreia S Gaspar, Mary A Rutherford, Joseph V Hajnal
PURPOSE: Fetal functional MRI studies using conventional 2-dimensional single-shot echo-planar imaging sequences may require discarding a large data fraction as a result of fetal and maternal motion. Increasing the temporal resolution using echo volumar imaging (EVI) could provide an effective alternative strategy. Echo volumar imaging was combined with inner volume (IV) imaging (IVEVI) to locally excite the fetal brain and acquire full 3-dimensional images, fast enough to freeze most fetal head motion...
November 8, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/29100260/a-comparison-of-the-nulliparous-term-singleton-vertex-and-society-of-maternal-fetal-medicine-cesarean-birth-metrics-based-on-hospital-size
#4
Laurence E Shields, Suzan Walker, Herman L Hedriana, Suzanne Wiesner, Barbara Pelletreau, Jane Hitti, Thomas J Benedetti
No abstract text is available yet for this article.
November 3, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/29079144/society-for-maternal-fetal-medicine-smfm-consult-series-44-management-of-bleeding-in%C3%A2-the-late-preterm-period
#5
Cynthia Gyamfi-Bannerman
Third-trimester bleeding is a common complication arising from a variety of etiologies, some of which may initially present in the late preterm period. Previous management recommendations have not been specific to this gestational age window, which carries a potentially lower threshold for delivery. The purpose of this document is to provide guidance on management of late preterm (34 0/7-36 6/7 weeks of gestation) vaginal bleeding. The following are Society for Maternal-Fetal Medicine recommendations: (1) we recommend delivery at 36-37 6/7 weeks of gestation for stable women with placenta previa without bleeding or other obstetric complications, such as preeclampsia or fetal growth restriction (Grade 1B); (2) we do not recommend routine cervical length screening for women with placenta previa in the late preterm period because of a lack of data on an appropriate management strategy (Grade 2C); (3) we recommend a planned delivery between 34 and 37 weeks of gestation for stable women with placenta accreta (Grade 1C); (4) we recommend delivery between 34 and 37 weeks of gestation for stable women with vasa previa (Grade 1C); (5) we recommend that in women with active hemorrhage in the late preterm period, delivery should not be delayed for the purpose of administering antenatal corticosteroids (Grade 1B); (6) we recommend that fetal lung maturity testing should not be used to guide management in the late preterm period when an indication for delivery is present (Grade 1B); and (7) we recommend that antenatal corticosteroids should be administered to women who are eligible and are managed expectantly if delivery is likely within 7 days, the gestational age is between 34 0/7 and 36 6/7 weeks of gestation, and antenatal corticosteroids has not previously been administered (Grade 1A)...
October 25, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29059453/what-s-new-in-prenatal-genetics-a-review-of-current-recommendations-and-guidelines
#6
Annalisa L Post, Amy T Mottola, Jeffrey A Kuller
Importance: The rapid development of prenatal genetic testing and screening tools and choices constantly challenges clinicians to stay up to date on current best practice. Objective: We sought to review, compare, and summarize recent national society guidelines on prepregnancy genetic screening and prenatal diagnosis for aneuploidy with a focus on changes and additions to previous guidelines. Evidence Acquisition: We performed a descriptive review of 8 recently published (2016-2017) national guidelines and updates on prenatal genetic screening and testing including American Congress of Obstetricians and Gynecologists committee opinions and practice bulletins, Society for Maternal-Fetal Medicine consult series publications, and an American College of Medical Genetics and Genomics position statement...
October 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/29016505/implementing-a-systematic-approach-to-reduce-cesarean-birth-rates-in-nulliparous-women
#7
Amy D Bell, Saju Joy, Susan Gullo, Robert Higgins, Eleanor Stevenson
OBJECTIVE: To implement a systematic approach to safely reduce nulliparous cesarean birth rates. METHODS: This is a quality improvement project at two rural community hospitals and one urban community hospital in North Carolina. These facilities implemented a systematic approach to reduce nulliparous cesarean birth rates, aligning with recommendations developed by the Council on Patient Safety in Women's Health Care: Patient Safety Bundle on the Safe Reduction of Primary Cesarean Births...
November 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28993175/research-to-knowledge-promoting-the-training%C3%A2-of-physician-scientists-in-the-biology%C3%A2-of%C3%A2-pregnancy
#8
Yoel Sadovsky, Aaron B Caughey, Michelle DiVito, Mary E D'Alton, Amy P Murtha
Common disorders of pregnancy, such as preeclampsia, preterm birth, and fetal growth abnormalities, continue to challenge perinatal biologists seeking insights into disease pathogenesis that will result in better diagnosis, therapy, and disease prevention. These challenges have recently been intensified with discoveries that associate gestational diseases with long-term maternal and neonatal outcomes. Whereas modern high-throughput investigative tools enable scientists and clinicians to noninvasively probe the maternal-fetal genome, epigenome, and other analytes, their implications for clinical medicine remain uncertain...
October 7, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28961562/maternal-death-due-to-amniotic-fluid-embolism-a-national-study-in-france
#9
Marie-Pierre Bonnet, Diane Zlotnik, Monica Saucedo, Dominique Chassard, Marie-Hélène Bouvier-Colle, Catherine Deneux-Tharaux
BACKGROUND: A structured definition of amniotic fluid embolism (AFE) based on 4 criteria was recently proposed for use in research by the Society for Maternal-Fetal Medicine (SMFM) and the Amniotic Fluid Embolism Foundation. The main objective of this study was to review all AFE-related maternal deaths in France during 2007-2011 according to the presence or not of all these 4 diagnostic criteria. METHODS: Maternal deaths due to AFE were identified by the national experts committee of the French Confidential Enquiry into Maternal Deaths during 2007-2011 (n = 39)...
September 28, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28935064/no-231-guidelines-for-the-management-of-vasa-previa
#10
Robert Gagnon
OBJECTIVES: To describe the etiology of vasa previa and the risk factors and associated condition, to identify the various clinical presentations of vasa previa, to describe the ultrasound tools used in its diagnosis, and to describe the management of vasa previa. OUTCOMES: Reduction of perinatal mortality, short-term neonatal morbidity, long-term infant morbidity, and short-term and long-term maternal morbidity and mortality. EVIDENCE: Published literature on randomized trials, prospective cohort studies, and selected retrospective cohort studies was retrieved through searches of PubMed or Medline, CINAHL, and the Cochrane Library, using appropriate controlled vocabulary (e...
October 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28935062/no-260-ultrasound-in-twin-pregnancies
#11
Lucie Morin, Kenneth Lim
OBJECTIVE: To review the literature with respect to the use of diagnostic ultrasound in the management of twin pregnancies. To make recommendations for the best use of ultrasound in twin pregnancies. OUTCOMES: Reduction in perinatal mortality and morbidity and short- and long-term neonatal morbidity in twin pregnancies. Optimization of ultrasound use in twin pregnancies. EVIDENCE: Published literature was retrieved through searches of PubMed and the Cochrane Library in 2008 and 2009 using appropriate controlled vocabulary (e...
October 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28892210/myoma-and-myomectomy-poor-evidence-concern-in-pregnancy
#12
REVIEW
Giusi Natalia Milazzo, Angelica Catalano, Valentina Badia, Maddalena Mallozzi, Donatella Caserta
AIM: Summarize the results of the many, but often underpowered, studies on pregnancy complicated by myoma or myomectomy. METHODS: Survey of the electronic PubMed database for the last two decades was conducted. We selected reviews, meta-analyses, case series, case reports, clinical studies only with statistical analysis, and guidelines from scientific societies. RESULTS: Delaying childbearing leads to an increased incidence of pregnancy complicated by fibroids or previous myomectomy...
September 11, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28859768/no-233-antibiotic-therapy-in-preterm-premature-rupture-of-the-membranes
#13
Mark H Yudin, Julie van Schalkwyk, Nancy Van Eyk
OBJECTIVE: To review the evidence and provide recommendations on the use of antibiotics in preterm premature rupture of the membranes (PPROM). OUTCOMES: Outcomes evaluated include the effect of antibiotic treatment on maternal infection, chorioamnionitis, and neonatal morbidity and mortality. EVIDENCE: Published literature was retrieved through searches of Medline, EMBASE, CINAHL, and The Cochrane Library, using appropriate controlled vocabulary and key words (PPROM, infection, and antibiotics)...
September 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28859766/no-348-joint-sogc-ccmg-guideline-update-on-prenatal-screening-for-fetal-aneuploidy-fetal-anomalies-and-adverse-pregnancy-outcomes
#14
Francois Audibert, Isabelle De Bie, Jo-Ann Johnson, Nanette Okun, R Douglas Wilson, Christine Armour, David Chitayat, Raymond Kim
OBJECTIVE: To review the available prenatal screening options in light of the recent technical advances and to provide an update of previous guidelines in the field of prenatal screening. INTENDED USERS: Health care providers involved in prenatal screening, including general practitioners, obstetricians, midwives, maternal fetal medicine specialists, geneticists, and radiologists. TARGET POPULATION: All pregnant women receiving counselling and providing informed consent for prenatal screening...
September 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28859764/no-347-obstetric-management-at-borderline-viability
#15
Noor Niyar N Ladhani, Radha S Chari, Michael S Dunn, Griffith Jones, Prakesh Shah, Jon F R Barrett
OBJECTIVE: The primary objective of this guideline was to develop consensus statements to guide clinical practice and recommendations for obstetric management of a pregnancy at borderline viability, currently defined as prior to 25+6 weeks. INTENDED USERS: Clinicians involved in the obstetric management of women whose fetus is at the borderline of viability. TARGET POPULATION: Women presenting for possible birth at borderline viability. EVIDENCE: This document presents a summary of the literature and a general consensus on the management of pregnancies at borderline viability, including maternal transfer and consultation, administration of antenatal corticosteroids and magnesium sulfate, fetal heart rate monitoring, and considerations in mode of delivery...
September 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28782502/hepatitis-c-in-pregnancy-screening-treatment-and-management
#16
Brenna L Hughes, Charlotte M Page, Jeffrey A Kuller
In the United States, 1-2.5% of pregnant women are infected with hepatitis C virus, which carries an approximately 5% risk of transmission from mother to infant. Hepatitis C virus can be transmitted to the infant in utero or during the peripartum period, and infection during pregnancy is associated with increased risk of adverse fetal outcomes, including fetal growth restriction and low birthweight. The purpose of this document is to discuss the current evidence regarding hepatitis C virus in pregnancy and to provide recommendations on screening, treatment, and management of this disease during pregnancy...
August 4, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28735702/quality-measures-in-high-risk-pregnancies-executive-summary-of-a-cooperative-workshop-of-the-society-for-maternal-fetal-medicine-national-institute-of-child-health-and-human-development-and-the-american-college-of-obstetricians-and-gynecologists
#17
Brian K Iriye, Kimberly D Gregory, George R Saade, William A Grobman, Haywood L Brown
Providers perceive current obstetric quality measures as imperfect and insufficient. Our organizations convened a "Quality Measures in High-Risk Pregnancies Workshop." The goals were to (1) review the current landscape regarding quality measures in obstetric conditions with increased risk for adverse maternal or fetal outcomes, (2) evaluate the available evidence for management of common obstetric conditions to identify those that may drive the highest impact on outcomes, quality, and value, (3) propose measures for high-risk obstetric conditions that reflect enhanced quality and efficiency, and (4) identify current research gaps, improve methods of data collection, and recommend means of change...
October 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28729106/no-223-content-of-a-complete-routine-second-trimester-obstetrical-ultrasound-examination-and-report
#18
Yvonne Cargill, Lucie Morin
OBJECTIVE: To review the benefits of and requirements for a complete second trimester ultrasound and the documentation needed. OUTCOMES: A complete second trimester ultrasound provides information about the number of fetuses, the gestational age, the location of the placenta, and fetal and maternal anatomy. EVIDENCE: In the production of this document, the American Institute of Ultrasound in Medicine's "Practice Guideline for the Performance of Obstetric Ultrasound Examinations," the American College of Obstetricians and Gynecologists' practice bulletin, "Ultrasound in Pregnancy," and the Royal College of Obstetricians and Gynaecologists' Working Party Report, "Ultrasound Screening" were reviewed...
August 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28594753/opioid-use-in-pregnancy-neonatal-abstinence-syndrome-and-childhood-outcomes-executive-summary-of-a-joint-workshop-by-the-eunice-kennedy-shriver-national-institute-of-child-health-and-human-development-american-college-of-obstetricians-and-gynecologists-american
#19
Uma M Reddy, Jonathan M Davis, Zhaoxia Ren, Michael F Greene
In April 2016, the Eunice Kennedy Shriver National Institute of Child Health and Human Development invited experts to a workshop to address numerous knowledge gaps and to review the evidence for the screening and management of opioid use in pregnancy and neonatal abstinence syndrome. The rising prevalence of opioid use in pregnancy has led to a concomitant dramatic fivefold increase in neonatal abstinence syndrome over the past decade. Experts from diverse disciplines addressed research gaps in the following areas: 1) optimal screening for opioid use in pregnancy; 2) complications of pregnancy associated with opioid use; 3) appropriate treatments for pregnant women with opioid use disorders; 4) the best approaches for detecting, treating, and managing newborns with neonatal abstinence syndrome; and 5) the long-term effects of prenatal opioid exposure on children...
July 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28549984/the-development-and-implementation-of-checklists-in-obstetrics
#20
Peter S Bernstein, C Andrew Combs, Laurence E Shields, Steven L Clark, Catherine S Eppes
Checklists have been long used as a cognitive aid in various high-stakes environments to improve the reliability and performance of individuals and teams. When designed well, implemented thoughtfully, and monitored closely, they offer the opportunity to improve the performance of health care teams and advance patient safety. There are different types of checklists; examples include task lists, troubleshooting lists, coordination lists, discipline lists, and to-do lists. Each is useful in different situations and requires different implementation strategies...
August 2017: American Journal of Obstetrics and Gynecology
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