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#1
Kasey Buckles, Melanie Guldi
Early term birth is defined as birth at 37 or 38 weeks gestation. While infants born early term are not considered premature, the medical literature suggests that they have an increased risk of serious adverse health outcomes compared to infants born at term (39 or 40 weeks). Despite these known harms, we document a rise in early term births in the United States from 1989 to the mid-2000s, followed by a decline in recent years. We posit that the recent decline in early term births has been driven by changes in medical practice advocated by the American College of Obstetricians and Gynecologists, programs such as the March of Dimes’ "Worth the Wait" campaign, and by Medicaid policy...
2017: Journal of Policy Analysis and Management
https://www.readbyqxmd.com/read/28965442/the-impact-of-curve-severity-on-obstetric-complications-and-regional-anesthesia-utilization-in-pregnant-patients-with-adolescent-idiopathic-scoliosis-a-preliminary-analysis
#2
Emily W Chan, Stephen R Gannon, Chevis N Shannon, Jeffrey E Martus, Gregory A Mencio, Christopher M Bonfield
OBJECTIVE Adolescent idiopathic scoliosis (AIS), the most common type of scoliosis, often presents immediately prior to a woman's childbearing years; however, research investigating the impact of AIS on women's health, particularly pregnancy delivery outcomes, is sparse, with existing literature reporting mixed findings. Similarly limited are studies examining the change in scoliotic curve during or after pregnancy. Therefore, this study aims to determine 1) the impact of scoliotic curvature on obstetric complications (preterm births, induction of labor, and urgent/emergency caesarean section delivery), 2) regional anesthetic decision making and success during delivery for these patients, and 3) the effect of pregnancy on curve progression...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28892225/expectant-management-of-pregnancies-complicated-by-fetal-growth-restriction-without-any-evidence-of-placental-dysfunction-at-term-comparison-with-routine-labor-induction
#3
Nobuhiro Hidaka, Yuka Sato, Saki Kido, Yasuyuki Fujita, Kiyoko Kato
AIM: To assess the feasibility and practicality of expectant management for pregnancies with fetal growth restriction (FGR) at term without evidence of placental dysfunction. METHODS: We reviewed the records of pregnancies with an estimated fetal weight ≤ 1.5 SD below the mean at 37 weeks of gestation. We excluded elective cesarean deliveries and pregnancies that, at 37 weeks, were complicated by oligohydramnios, decreased fetal cerebroplacental ratio, or pregnancy-related hypertensive disorders...
September 11, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28703927/reducing-the-primary-cesarean-birth-rate-a-quality-improvement-project
#4
Julie A Javernick, Amy Dempsey
INTRODUCTION: Research continues to support vaginal birth as the safest mode of childbirth, but despite this, cesarean birth has become the most common surgical procedure performed on women. The rate has increased 500% since the 1970s without a corresponding improvement in maternal or neonatal outcomes. A Colorado community hospital recognized that its primary cesarean birth rate was higher than national and state benchmark levels. To reduce this rate, the hospital collaborated with its largest maternity care provider group to implement a select number of physiologic birth practices and measure improvement in outcomes...
July 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28672292/association-between-pregnancy-and-perinatal-outcomes-among-women-with-epilepsy
#5
Neda Razaz, Torbjörn Tomson, Anna-Karin Wikström, Sven Cnattingius
Importance: To date, few attempts have been made to examine associations between exposure to maternal epilepsy with or without antiepileptic drug (AED) therapy and pregnancy and perinatal outcomes. Objectives: To investigate associations between epilepsy in pregnancy and risks of pregnancy and perinatal outcomes as well as whether use of AEDs influenced risks. Design, Setting, and Participants: A population-based cohort study was conducted on all singleton births at 22 or more completed gestational weeks in Sweden from 1997 through 2011; of these, 1 424 279 were included in the sample...
August 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28532262/trial-of-vaginal-delivery-for-twins-is-it-safe-a-single-center-experience
#6
Dana Sadeh-Mestechkin, Yair Daykan, Mor Bustan, Ofer Markovitch, Gil Shechter-Maor, Tal Biron-Shental
PURPOSE: This study assessed our hospital protocol of vaginal delivery for twins and evaluated whether trial of vaginal delivery (unless contraindicated) was as safe as elective cesarean. Risk factors leading to failed trial of labor (TOL) were characterized to improve our ability to advise patients and select cases for TOL. METHODS: This retrospective, cohort study included women >32 weeks gestation, with twin A in cephalic presentation and no contraindications for vaginal delivery...
June 14, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28494996/prediction-of-labor-onset-type-spontaneous-vs-induced-role-of-electrohysterography
#7
Jose Alberola-Rubio, Javier Garcia-Casado, Gema Prats-Boluda, Yiyao Ye-Lin, Domingo Desantes, Javier Valero, Alfredo Perales
BACKGROUND AND OBJECTIVE: Induction of labor (IOL) is a medical procedure used to initiate uterine contractions to achieve delivery. IOL entails medical risks and has a significant impact on both the mother's and newborn's well-being. The assistance provided by an automatic system to help distinguish patients that will achieve labor spontaneously from those that will need late-term IOL would help clinicians and mothers to take an informed decision about prolonging pregnancy. With this aim, we developed and evaluated predictive models using not only traditional obstetrical data but also electrophysiological parameters derived from the electrohysterogram (EHG)...
June 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28467617/mode-of-first-delivery-and-severe-maternal-complications-in-the-subsequent-pregnancy
#8
Lotte B Colmorn, Lone Krebs, Kari Klungsøyr, Maija Jakobsson, Anna-Maija Tapper, Mika Gissler, Pelle G Lindqvist, Karin Källen, Karin Gottvall, Per E Bordahl, Ragnheiður I Bjarnadóttir, Jens Langhoff-Roos
INTRODUCTION: Severe obstetric complications increase with the number of previous cesarean deliveries. In the Nordic countries most women have two children. We present the risk of severe obstetric complications at the delivery following a first elective or emergency cesarean and the risk by intended mode of second delivery. MATERIAL AND METHODS: A two-year population-based data collection of severe maternal complications in women with two deliveries in the Nordic countries (n = 213 518)...
September 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28320031/can-the-induction-of-labor-with-misoprostol-increase-maternal-blood-loss
#9
Paulo César Praciano Souza, Karla Santana Azevedo Damasceno, Edward Araujo Júnior, Carlos Augusto Alencar Júnior, Francisco Edson de Lucena Feitosa
Purpose To evaluate blood loss during misoprostol-induced vaginal births and during cesarean sections after attempted misoprostol induction. Methods We conducted a prospective observational study in 101 pregnant women indicated for labor induction; pre- and postpartum hemoglobin levels were measured to estimate blood loss during delivery. Labor was induced by administering 25 µg vaginal misoprostol every 6 hours (with a maximum of 6 doses). The control group included 30 patients who spontaneously entered labor, and 30 patients who underwent elective cesarean section...
February 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28264947/texas-medicaid-payment-reform-fewer-early-elective-deliveries-and-increased-gestational-age-and-birthweight
#10
Heather M Dahlen, J Mac McCullough, Angela R Fertig, Bryan E Dowd, William J Riley
Infants born at full term have better health outcomes. However, one in ten babies in the United States are born via a medically unnecessary early elective delivery: induction of labor, a cesarean section, or both before thirty-nine weeks gestation. In 2011 the Texas Medicaid program sought to reduce the rate of early elective deliveries by denying payment to providers for the procedure. We examined the impact of this policy on clinical care practice and perinatal outcomes by comparing the changes in Texas relative to comparison states...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28215984/the-cost-of-nurse-midwifery-care-use-of-interventions-resources-and-associated-costs-in-the-hospital-setting
#11
Molly R Altman, Sean M Murphy, Cynthia E Fitzgerald, H Frank Andersen, Kenn B Daratha
INTRODUCTION: Obstetrical care often involves multiple expensive, and often elective, interventions that may increase costs to patients, payers and the health care system with little effect on patient outcomes. The objectives of this study were to examine the following hospital related outcomes: 1) use of labor and birth interventions, 2) inpatient duration of stay, and 3) total direct health care costs for patients attended by a certified nurse-midwife (CNM) compared with those attended by an obstetrician-gynecologist (OB-GYN), within an environment of safe and high-quality care...
February 15, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/27980880/discrepancy-between-identification-of-early-term-elective-deliveries-by-manual-chart-review-and-data-vendor
#12
Kelly Yamasato, Pai-Jong Stacy Tsai, Marguerite Bartholomew, Marsha Durbin, Chieko Kimata, Bliss Kaneshiro
Elective delivery from 37 to 39 weeks gestation (early-term deliveries) is a Joint Commission National Quality Measure, and hospitals report on early-term elective delivery rates through Outcome Research Yields Excellence (ORYX) vendors. The objective of this study was to compare early-term elective deliveries, identified through ORYX vendors with those identified through manual chart review, the traditional method of medical record review. We reviewed early-term labor inductions and cesarean deliveries at a single hospital from June 1, 2010 to May 31, 2012...
December 2016: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/27914274/the-adaptive-psychological-changes-of-elective-induction-of-labor-in-breastfeeding-women
#13
Vincenzo Zanardo, Martina Bertin, Laura Sansone, Laura Felice
BACKGROUND: Labor induction has been associated with breastfeeding suppression, but reasons for why this association exists have not been well determined. METHODS: We examined the influence of elective labor induction by vaginal prostaglandin at gestational week 41(+3)days on affective, cognitive, and behavioural adaptations early in puerperium and on breastfeeding pattern at 1 and 3months. RESULTS: One hundred and eighty consecutive puerperae were assigned to two groups: mothers having received vaginal prostaglandin E2 gel (Prepidil®, dinoprostone) before labor (PGE group, n=90) and mothers having received no treatment (unmedicated group, n=90)...
November 30, 2016: Early Human Development
https://www.readbyqxmd.com/read/27824748/oregon-s-hard-stop-policy-limiting-elective-early-term-deliveries-association-with-obstetric-procedure-use-and-health-outcomes
#14
Jonathan M Snowden, Ifeoma Muoto, Blair G Darney, Brian Quigley, Mark W Tomlinson, Duncan Neilson, Steven A Friedman, Joanne Rogovoy, Aaron B Caughey
OBJECTIVE: To evaluate the association of Oregon's hard-stop policy limiting early elective deliveries (before 39 weeks of gestation) and the rate of elective early-term inductions and cesarean deliveries and associated maternal-neonatal outcomes. METHODS: This was a population-based retrospective cohort study of Oregon births between 2008 and 2013 using vital statistics data and multivariable logistic regression models. Our exposure was the Oregon hard-stop policy, defined as the time periods prepolicy (2008-2010) and postpolicy (2012-2013)...
December 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27803267/what-s-the-rush-tort-laws-and-elective-early-term-induction-of-labor
#15
Louise Marie Roth
Tort laws aim to deter risky medical practices and increase accountability for harm. This research examines their effects on deterrence of a high-risk obstetric practice in the United States: elective early-term (37-38 weeks gestation) induction of labor. Using birth certificate data from the Natality Detail Files and state-level data from publicly available sources, this study analyzes the effects of tort laws on labor induction with multilevel models (MLM) of 665,491 early-term births nested in states. Results reveal that caps on damages are associated with significantly higher odds of early-term induction and Proportionate Liability (PL) is associated with significantly lower odds compared to Joint and Several Liability (JSL)...
December 2016: Journal of Health and Social Behavior
https://www.readbyqxmd.com/read/27788533/24-7-presence-of-medical-staff-in-the-labor-ward-no-day-night-differences-in-perinatal-and-maternal-outcomes
#16
Sara Tavares, João Cavaco-Gomes, Marina Moucho, Milton Severo, Mário Mateus, Carla Ramalho, Gerard H A Visser, Nuno Montenegro
Objective The objective of this study was to assess possible day-night differences in perinatal and maternal labor outcomes in a hospital setting with no day-night differences in the presence of experienced medical staff. Design This was a retrospective study conducted over 5 years between 2008 and 2012. Setting This study was set at the obstetric delivery unit in a tertiary hospital. Population A total of 9,143 singleton deliveries were assessed after 34 weeks of gestation and after exclusion of major congenital malformations, inductions of labor, and elective cesarean sections...
May 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/27771202/-in-case-of-fetal-macrosomia-the-best-strategy-is-the-induction-of-labor-at-38%C3%A2-weeks-of-gestation
#17
REVIEW
P Rozenberg
Macrosomic fetuses are at increased risk of obstetric complications, and notably shoulder dystocia, responsible for a severe neonatal morbidity. In case of fetal macrosomia, three options are: (i) the elective cesarean delivery, but this is recommended only when the estimated fetal weight is≥4500g for diabetic women and 5000g for non-diabetic women; (ii) the expectative management, but children with birth weight≥4500 had significantly increased risk of perinatal mortality, neonatal asphyxia, trauma, and cesarean delivery; (iii) the induction of labor which, reducing the possibility of fetal growth, reduce the risk of cesarean delivery for cephalopelvic disproportion and shoulder dystocia...
November 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27741178/body-mass-index-and-the-spontaneous-onset-of-parturition
#18
Amy C Hermesch, Amanda A Allshouse, Kent D Heyborne
OBJECTIVE: To investigate the relationship between body mass index (BMI) and the onset of parturition throughout gestation. METHODS: This was a secondary analysis of the Maternal-Fetal Medicine Units Network Preterm Prediction Study. Time-to-spontaneous-birth-event (ie, "survival") methods were used to study the association of BMI with the timing of spontaneous onset of labor throughout gestation with indicated births censored at delivery. A Kaplan-Meier estimate of the probability of spontaneous labor was compared with a log rank test across five categories of BMI (kg/m): underweight (less than 18...
November 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27650628/pregnancy-outcome-after-false-diagnosis-of-fetal-growth-restriction
#19
Rinat Gabbay-Benziv, Amir Aviram, Eran Hadar, Rony Chen, Ron Bardin, Arnon Wiznitzer, Yariv Yogev
OBJECTIVES: To evaluate pregnancy outcome following false diagnosis of fetal growth restriction (FGR). METHODS: Retrospective analysis of all singleton term deliveries of appropriately grown fetuses (10-90th weight percentiles) in a single medical center (2007-2014). Elective cesarean-section, diabetes, and hypertension were excluded. Cohort was stratified based on third trimester sonographic estimated-fetal-weight (≥32 weeks). Women with false diagnosis FGR (<10th percentile) were compared with the rest (control)...
August 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27561937/-clinical-study-on-vaginal-birth-after-cesarean
#20
L He, M Chen, G L He, X X Liu
OBJECTIVE: To investigate the incidence and pregnant outcome on vaginal birth after cesarean (VBAC). METHODS: From January 2005 to December 2015, clinical data of 507 cases with VBAC in West China Second Hospital were studied retrospectively. There were 370 cases of VBAC from January 2013 to December 2015 as study group (VBAC group), in contrast, 740 cases of elective repeat cesarean section (ERCS group) and 740 primiparas of vaginal delivery without history of cesarean section as control groups, the pregnancy outcome were analyzed between the study group and control groups respectively...
August 25, 2016: Zhonghua Fu Chan Ke za Zhi
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