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Society for Maternal-Fetal Medicine (SMFM)

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https://www.readbyqxmd.com/read/27819164/current-trends-in-the-diagnosis-and-management-of-gestational-diabetes-mellitus-in-the-united-states
#1
Brianne E Bimson, Barak M Rosenn, Sara A Morris, Elizabeth B Sasso, Rachelle A Schwartz, Lois E Brustman
OBJECTIVE: To assess current practice patterns among members of the Society for Maternal-Fetal Medicine (SMFM) with respect to the diagnosis and management of gestational diabetes mellitus (GDM). METHODS: A 38 question survey on GDM diagnosis and management was distributed to SMFM members. RESULTS: 2330 SMFM members were surveyed with a 40% response rate. Overall, 90.6% of respondents recommend a 2-step (versus a 1-step) diagnostic test. Cutoff values for the 1-h-50 g glucose challenge test vary from 130-140 mg/dL, but the majority (83%) adopts Carpenter Coustan criteria for the 3-h-100 g oral glucose tolerance test...
November 24, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27662643/prenatal-screening-for-microcephaly-an-update-after-three-decades
#2
Shari E Gelber, Amos Grünebaum, Frank A Chervenak
BACKGROUND: Due to the recent outbreak of Zika virus, there has been a newfound interest in fetal and neonatal microcephaly. In 1984, Chervenak et al. proposed criteria for the prenatal ultrasound diagnosis of microcephaly as ≤3 standard deviations (SD) from the mean. Despite improvements in medicine these criteria have not been reevaluated in 30 years. OBJECTIVE: To examine how the original 1984 Chervenak et al. criteria for the diagnosis of fetal microcephaly apply to a current population utilizing modern ultrasound equipment and techniques...
September 23, 2016: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/27638987/joint-sogc-ccmg-opinion-for-reproductive-genetic-carrier-screening-an-update-for-all-canadian-providers-of-maternity-and-reproductive-healthcare-in-the-era-of-direct-to-consumer-testing
#3
R Douglas Wilson, Isabelle De Bie, Christine M Armour, Richard N Brown, Carla Campagnolo, June C Carroll, Nan Okun, Tanya Nelson, Rhonda Zwingerman, Francois Audibert, Jo-Ann Brock, Richard N Brown, Carla Campagnolo, June C Carroll, Isabelle De Bie, Jo-Ann Johnson, Nan Okun, Melanie Pastruck, Karine Vallée-Pouliot, R Douglas Wilson, Rhonda Zwingerman, Christine Armour, David Chitayat, Isabelle De Bie, Sara Fernandez, Raymond Kim, Josee Lavoie, Norma Leonard, Tanya Nelson, Sherry Taylor, Margot Van Allen, Clara Van Karnebeek
OBJECTIVE: This guideline was written to update Canadian maternity care and reproductive healthcare providers on pre- and postconceptional reproductive carrier screening for women or couples who may be at risk of being carriers for autosomal recessive (AR), autosomal dominant (AD), or X-linked (XL) conditions, with risk of transmission to the fetus. Four previous SOGC- Canadian College of Medical Geneticists (CCMG) guidelines are updated and merged into the current document. INTENDED USERS: All maternity care (most responsible health provider [MRHP]) and paediatric providers; maternity nursing; nurse practitioner; provincial maternity care administrator; medical student; and postgraduate resident year 1-7...
August 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27530804/first-stage-of-labour-management-practices-a-survey-of-australian-obstetric-providers
#4
Louise White, Nigel Lee, Michael Beckmann
AIMS: To report on the opinions and reported practices of Australian obstetricians and general practice (GP) obstetricians, in the definition and management of spontaneous first stage of labour, in low-risk nulliparous women. MATERIALS AND METHODS: Cross-sectional survey sent electronically to all Australian Specialist obstetricians (FRANZCOG) and Diplomates. Respondents answered questions regarding care of nulliparous women in spontaneous labour at term across three domains: (i) practitioners' characteristics; (ii) current practice; (iii) opinion regarding joint statement by ACOG/SMFM (Society of Maternal Fetal Medicine) 'Safe prevention of primary caesarean section'...
August 17, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27427470/the-use-of-chromosomal-microarray-for%C3%A2-prenatal%C3%A2-diagnosis
#5
Lorraine Dugoff, Mary E Norton, Jeffrey A Kuller
Chromosomal microarray analysis is a high-resolution, whole-genome technique used to identify chromosomal abnormalities, including those detected by conventional cytogenetic techniques, as well as small submicroscopic deletions and duplications referred to as copy number variants. Because chromosomal microarray analysis has a greater resolution than conventional karyotyping, it can detect deletions and duplications down to a 50- to 100-kb level. The purpose of this document is to discuss the technique, advantages, and disadvantages of chromosomal microarray analysis and its indications and limitations...
October 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27418448/society-for-maternal-fetal-medicine-smfm-special-report-current-approaches-to-measuring-quality-of-care-in-obstetrics
#6
Jennifer L Bailit, Kimberly D Gregory, Sindhu Srinivas, Thomas Westover, William A Grobman, George R Saade
Heath care measurement and evaluation is an integral piece of the health care system. The creation and assessment of care performance metrics are important and relevant for the obstetric community including both clinicians and patients. Careful deliberation is required to create a measurement system that results in optimal care for women and families. This article reviews the current approaches to measuring quality in obstetrics.
September 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27133011/the-role-of-routine-cervical-length-screening-in-selected-high-and-low-risk-women-for-preterm-birth-prevention
#7
Jennifer McIntosh, Helen Feltovich, Vincenzo Berghella, Tracy Manuck
Preterm birth remains a major cause of neonatal death and short and long-term disability in the US and across the world. The majority of preterm births are spontaneous and cervical length screening is one tool that can be utilized to identify women at increased risk who may be candidates for preventive interventions. The purpose of this document is to review the indications and rationale for CL screening to prevent preterm birth in various clinical scenarios. The Society for Maternal-Fetal Medicine recommends (1) routine transvaginal cervical length screening for women with singleton pregnancy and history of prior spontaneous preterm birth (grade 1A); (2) routine transvaginal cervical length screening not be performed for women with cervical cerclage, multiple gestation, preterm premature rupture of membranes, or placenta previa (grade 2B); (3) practitioners who decide to implement universal cervical length screening follow strict guidelines (grade 2B); (4) sonographers and/or practitioners receive specific training in the acquisition and interpretation of cervical imaging during pregnancy (grade 2B)...
September 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26987420/amniotic-fluid-embolism-diagnosis-and-management
#8
Luis D Pacheco, George Saade, Gary D V Hankins, Steven L Clark
OBJECTIVE: We sought to provide evidence-based guidelines regarding the diagnosis and management of amniotic fluid embolism. STUDY DESIGN: A systematic literature review was performed using MEDLINE, PubMed, EMBASE, and the Cochrane Library. The search was restricted to English-language articles published from 1966 through March 2015. Priority was given to articles reporting original research, in particular randomized controlled trials, although review articles and commentaries were consulted...
August 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26902990/diagnosis-and-antenatal-management-of-congenital-cytomegalovirus-infection
#9
Brenna L Hughes, Cynthia Gyamfi-Bannerman
Congenital cytomegalovirus (CMV) is the most common viral infection, affecting nearly 40,000 infants each year in the United States. Of seronegative women, 1-4% will acquire a primary infection during pregnancy, and the majority of these women will be asymptomatic. Prior maternal exposure to CMV does not preclude neonatal infection. The purpose of this document is to review diagnosis of primary maternal CMV infection, diagnosis of fetal CMV infection, and whether antenatal therapy is warranted. We recommend the following: (1) that women with a diagnosis of primary CMV infection in pregnancy be advised that the risk of congenital infection is 30-50%, on average, and that the severity of infection varies widely (Best Practice); (2) for women suspected of having primary CMV infection in pregnancy, we recommend that diagnosis should be either by IgG seroconversion or with positive CMV IgM, positive IgG, and low IgG avidity (grade 1B); (3) amniocentesis is the best option as a prenatal diagnostic tool to detect fetal congenital CMV infection, performed >21 weeks of gestation and >6 weeks from maternal infection (grade 1C); (4) we do not recommend routine screening of all pregnant women for evidence of primary CMV infection at this time (grade 1B); and (5) we do not recommend antenatal treatment with ganciclovir or valacyclovir; and we recommend that any antenatal therapy, either with antivirals or CMV hyperimmune globulin, should only be offered as part of a research protocol (Best Practice)...
June 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26593970/comparing-variation-in-hospital-rates-of-cesarean-delivery-among-low-risk-women-using-3-different-measures
#10
COMPARATIVE STUDY
Joanne C Armstrong, Katy B Kozhimannil, Patricia McDermott, George R Saade, Sindhu K Srinivas
This report describes the development of a measure of low-risk cesarean delivery by the Society for Maternal-Fetal Medicine (SMFM). Safely lowering the cesarean delivery rate is a priority for maternity care clinicians and health care delivery systems. Therefore, hospital quality assurance programs are increasingly tracking cesarean delivery rates among low-risk pregnancies. Two commonly used definitions of "low risk" are available, the Joint Commission (JC) and the Agency for Healthcare Research and Quality (AHRQ) measures, but these measures are not clinically comprehensive...
February 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26458766/smfm-statement-clarification-of-recommendations-regarding-cell-free-dna-aneuploidy-screening
#11
(no author information available yet)
The purpose of this statement is to clarify that the Society for Maternal-Fetal Medicine (SMFM) does not recommend that cell-free DNA aneuploidy screening be offered to all pregnant women, nor does it suggest a requirement for insurance coverage for cell-free DNA screening in women at low risk of aneuploidy. However, SMFM believes, due to the ethics of patient autonomy, that the option should be available to women who request additional testing beyond what is currently recommended by professional societies.
December 2015: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26454123/-38-hepatitis-b-in-pregnancy-screening-treatment-and-prevention-of-vertical-transmission
#12
REVIEW
Jodie Dionne-Odom, Alan T N Tita, Neil S Silverman
Between 800,000-1.4 million people in the United States and more than 240 million people worldwide are infected with hepatitis B virus (HBV). Specific to pregnancy, an estimated prevalence of 0.7-0.9% for chronic hepatitis B infection among pregnant women in the United States has been reported, with >25,000 infants at risk for chronic infection born annually to these women. Vertical transmission of HBV from infected mothers to their fetuses or newborns, either in utero or peripartum, remains a major source of perpetuating the reservoir of chronically infected individuals globally...
January 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26340518/role-of-the-hospitalist-and-maternal-fetal-medicine-physician-in-obstetrical-inpatient-care
#13
Lisa D Levine, Jay Schulkin, Brian M Mercer, Daniel O'Keeffe, Vincenzo Berghella, Thomas J Garite
OBJECTIVE: The objective of this study was to evaluate the role of hospitalists and Maternal Fetal Medicine (MFM) subspecialists in obstetrical inpatient care. STUDY DESIGN: This electronic survey study was offered to members of the American College of Obstetrics & Gynecology (ACOG; n = 1,039) and the Society for Maternal-Fetal Medicine (SMFM; n = 1,813). RESULTS: Overall, 607 (21%) respondents completed the survey. Overall, 35% reported that hospitalists provided care in at least one of their hospitals...
January 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/26004324/smfm-statement-benefit-of-antihypertensive-therapy-for-mild-to-moderate-chronic-hypertension-during-pregnancy-remains-uncertain
#14
REVIEW
(no author information available yet)
Chronic hypertension is present in up to 5% of pregnant women and constitutes a major cause of maternal and neonatal morbidity and mortality. The purpose of this document is to summarize the current recommendations regarding use of antihypertensive medications during pregnancy for women with mild-to-moderate chronic hypertension in the setting of the recently published Control of Hypertension in Pregnancy Study (CHIPS). The recently published CHIPS trial was a multicenter international randomized controlled trial comparing "less tight control" to "tight control" of blood pressure for pregnant women with hypertension...
July 2015: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/25981850/conversion-of-society-for-maternal-fetal-medicine-abstract-presentations-to-manuscript-publications
#15
Tracy A Manuck, Kelli Barbour, Lindsay Janicki, Sean C Blackwell, Vincenzo Berghella
OBJECTIVE: We sought to evaluate the rate of conversion of Society for Maternal-Fetal Medicine (SMFM) annual meeting abstract presentations to full manuscript publications over time. STUDY DESIGN: Full manuscript publications corresponding to all SMFM oral abstracts 2003 through 2010 inclusive, and SMFM poster abstracts in 2003, 2005, 2007, and 2009 were manually searched in PubMed. An abstract was considered to "match" a full publication if the abstract and publication titles as well as main methods and results were similar and the abstract first author was a publication author...
September 2015: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/25891996/misguided-guidelines-for-managing-labor
#16
Wayne R Cohen, Emanuel A Friedman
In a recent review we expressed concerns about new guidelines for the assessment and management of labor recommended jointly by the American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM). These guidelines are based heavily on a new concept of how cervical dilatation and fetal descent progress, derived from the work of Zhang et al. In their Viewpoint article they have addressed, but not allayed, the concerns we described in our review. We assert that the dilatation curve promulgated by Zhang et al cannot be reconciled with direct clinical observation...
June 2015: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/25824811/society-for-maternal-fetal-medicine-smfm-clinical-guideline-8-the-fetus-at-risk-for-anemia-diagnosis-and-management
#17
Giancarlo Mari, Mary E Norton, Joanne Stone, Vincenzo Berghella, Anthony C Sciscione, Danielle Tate, Mauro H Schenone
OBJECTIVE: We sought to provide evidence-based guidelines for the diagnosis and management of fetal anemia. METHODS: A systematic literature review was performed using MEDLINE, PubMed, EMBASE, and the Cochrane Library. The search was restricted to English-language articles published from 1966 through May 2014. Priority was given to articles reporting original research, in particular randomized controlled trials, although review articles and commentaries were consulted...
June 2015: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/25813012/-36-prenatal-aneuploidy-screening-using-cell-free-dna
#18
(no author information available yet)
Recent advances in technology have created exciting opportunities to expand and improve genetic testing options that are available to women during pregnancy. However, the novelty and complexity of these technologies, combined with the commercial interest to implement these tests rapidly into routine clinical care, have created challenges for physicians and patients and potentially will lead to misunderstanding, misuse, and unintended consequences. The purpose of this document was to aid clinicians in their day-to-day practice of counseling patients regarding prenatal aneuploidy testing options with cell-free DNA screening, which includes how it compares to current testing methods, potential benefits and harms, and its limitations and caveats...
June 2015: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/25557883/society-for-maternal-fetal-medicine-smfm-clinical-guideline-7-nonimmune-hydrops-fetalis
#19
REVIEW
Mary E Norton, Suneet P Chauhan, Jodi S Dashe
OBJECTIVE: Nonimmune hydrops is the presence of ≥2 abnormal fetal fluid collections in the absence of red cell alloimmunization. The most common etiologies include cardiovascular, chromosomal, and hematologic abnormalities, followed by structural fetal anomalies, complications of monochorionic twinning, infection, and placental abnormalities. We sought to provide evidence-based guidelines for the evaluation and management of nonimmune hydrops fetalis. METHODS: A systematic literature review was performed using MEDLINE, PubMed, EMBASE, and Cochrane Library...
February 2015: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/25439812/society-for-maternal-fetal-medicine-smfm-special-report-the-maternal-fetal-medicine-subspecialists-role-within-a-health-care-system
#20
Anthony Sciscione, Vincenzo Berghella, Sean Blackwell, Kim Boggess, Andrew Helfgott, Brian Iriye, James Keller, M Kathryn Menard, Daniel O'Keeffe, Laura Riley, Joanne Stone
A maternal-fetal medicine (MFM) subspecialist has advanced knowledge of the medical, surgical, obstetrical, fetal, and genetic complications of pregnancy and their effects on both the mother and fetus. MFM subspecialists are complementary to obstetric care providers in providing consultations, co-management, or transfer of care for complicated patients before, during, and after pregnancy. The MFM subspecialist provides peer and patient education and performs research concerning the most recent approaches and treatments for obstetrical problems, thus promoting risk-appropriate care for these complicated pregnancies...
December 2014: American Journal of Obstetrics and Gynecology
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