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https://www.readbyqxmd.com/read/29734453/female-physicians-in-maternal-fetal-medicine-a-32-year-perspective
#1
Jacquelyn Blackstone, Vanessa K Will, William F Rayburn
OBJECTIVE:  To examine trends of female physicians either pursuing fellowships or in active practice in maternal-fetal medicine (MFM). METHODS:  This observational study examined complete sets of MFM fellows and active members of the Society for Maternal-Fetal Medicine (SMFM) between 1985 and 2016. Databases from SMFM, American College of Obstetricians and Gynecologists (ACOG), and Accreditation Council for Graduate Medical Education were used. Analysis of covariance testing was used to assess interactions over time between groups...
May 7, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29733840/clinical-opinion-doing-something-about-the-cesarean-delivery-rate
#2
S L Clark, T J Garite, E J Hamilton, M A Belfort, G D Hankins
There is a general consensus that the cesarean delivery rate in the U.S. is too high, and that practice patterns of obstetricians are largely to blame for this situation. In reality, the U.S. cesarean delivery rate is the result of 3 forces largely beyond the control of the practicing clinician: patient expectations and misconceptions regarding the safety of labor, the medical-legal system, and limitations in technology. Efforts to "do something" about the cesarean delivery rate by promulgating practice directives which are marginally evidence-based or influenced by social pressures are both ineffective and potentially harmful...
May 4, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29705191/society-for-maternal-fetal-medicine-smfm-consult-series-45-mild-fetal-ventriculomegaly-diagnosis-evaluation-and-management
#3
Nathan S Fox, Ana Monteagudo, Jeffrey A Kuller, Sabrina Craigo, Mary E Norton
Ventriculomegaly is defined as dilation of the fetal cerebral ventricles and is a relatively common finding on prenatal ultrasound. The purpose of this document is to review the diagnosis, evaluation, and management of mild fetal ventriculomegaly. When enlargement of the lateral ventricles (≥10 mm) is identified, a thorough evaluation should be performed, including detailed sonographic evaluation of fetal anatomy, amniocentesis for karyotype and chromosomal microarray analysis (CMA), and a workup for fetal infection...
April 26, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29686937/implementing-obstetric-early-warning-systems
#4
EDITORIAL
Alexander M Friedman, Mary L Campbell, Carolyn R Kline, Suzanne Wiesner, Mary E D'Alton, Laurence E Shields
Severe maternal morbidity and mortality are often preventable and obstetric early warning systems that alert care providers of potential impending critical illness may improve maternal safety. While literature on outcomes and test characteristics of maternal early warning systems is evolving, there is limited guidance on implementation. Given current interest in early warning systems and their potential role in care, the 2017 Society for Maternal-Fetal Medicine (SMFM) Annual Meeting dedicated a session to exploring early warning implementation across a wide range of hospital settings...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29548042/maternal-fetal-medicine-workforce-survey-are-we-ready-for-regionalized-levels-of-maternal-care
#5
Katharine D Wenstrom, Mary E D'Alton, Daniel F O'Keefe
OBJECTIVE:  To conduct a survey of the members of the Society for Maternal-Fetal Medicine (SMFM) to determine the practice patterns of maternal-fetal medicine (MFM) subspecialists in the United States and to estimate the likelihood that our work force is sufficient to support the proposed MFM staffing requirements for level III and IV maternity centers. STUDY DESIGN:  All regular SMFM members in the United States were invited to answer a 26 question survey by email...
March 16, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29454303/smfm-2018-meeting-highlights-friday-podcast
#6
(no author information available yet)
No abstract text is available yet for this article.
February 17, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29444534/smfm-2018-meeting-highlights-thursday-podcast
#7
(no author information available yet)
No abstract text is available yet for this article.
February 14, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29409848/smfm-statement-pharmacological-treatment-of-gestational-diabetes
#8
(no author information available yet)
No abstract text is available yet for this article.
May 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29359280/smfm-2018-pregnancy-meeting-looking-ahead-to-the-scientific-program-podcast
#9
(no author information available yet)
No abstract text is available yet for this article.
January 22, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29319591/zika-virus-infection-in-the-pregnant-woman
#10
Meghan Holtzman, William C Golden, Jeanne S Sheffield
Zika virus is a single-stranded RNA virus from the Flaviviridae family. Transmission is typically from the bite of an infected mosquito though mother-to-child, sexual and blood donation transmissions can occur. Although maternal symptoms are uncommon and rarely severe, the consequences of congenital infections are devastating. The emergence of congenital Zika syndrome is a world-wide public health crisis. The Centers for Disease Control and Prevention, ACOG, and SMFM have developed algorithms for screening and managing women exposure to and diagnosed with Zika virus infection...
March 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29315690/joint-position-statement-from-the-international-society-for-prenatal-diagnosis-ispd-the-society-for-maternal-fetal-medicine-smfm-and-the-perinatal-quality-foundation-pqf-on-the-use-of-genome-wide-sequencing-for-fetal-diagnosis
#11
https://www.readbyqxmd.com/read/29315677/acog-and-smfm-guidelines-for-prenatal-diagnosis-is-karyotyping-really-sufficient
#12
Sara B Hay, Trilochan Sahoo, Mary K Travis, Karine Hovanes, Natasa Dzidic, Charles Doherty, Michelle N Strecker
OBJECTIVE: The American College of Obstetricians and Gynecologists (ACOG) and Society for Maternal-Fetal Medicine (SMFM) recommend chromosomal microarray analysis (CMA) for prenatal diagnosis in cases with 1 or more fetal structural abnormalities. For patients who elect prenatal diagnosis and have a structurally normal fetus, either microarray or karyotype is recommended. This study evaluates the frequency of clinically significant chromosomal abnormalities (CSCA) that would have been missed if all patients offered the choice between CMA and karyotyping chose karyotyping...
February 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29240547/implementing-cdc-s-level-of-care-assessment-tool-locate-a-national-collaboration-to-improve-maternal-and-child-health
#13
Andrea Catalano, Amanda Bennett, Ashley Busacker, Alethia Carr, David Goodman, Charlan Kroelinger, Ekwutosi Okoroh, Mary Brantley, Wanda Barfield
Perinatal regionalization, or risk-appropriate care, is an approach that classifies facilities based on capabilities to ensure women and infants receive care at a facility that aligns with their risk. The CDC designed the Levels of Care Assessment Tool (LOCATe) to assist jurisdictions working in risk-appropriate care in assessing a facility's level of maternal and neonatal care aligned with the most current American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine (ACOG/SMFM) and American Academy of Pediatrics (AAP) guidelines...
December 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/29183819/smfm-special-report-putting-the-m-back-in-mfm-reducing-racial-and-ethnic-disparities-in-maternal-morbidity-and-mortality-a-call-to-action
#14
Joses A Jain, Lorene A Temming, Mary E D'Alton, Cynthia Gyamfi-Bannerman, Methodius Tuuli, Judette M Louis, Sindhu K Srinivas, Aaron B Caughey, William A Grobman, Mark Hehir, Elizabeth Howell, George R Saade, Alan T N Tita, Laura E Riley
Racial and ethnic disparities in maternal morbidity and mortality rates are an important public health problem in the United States. Because racial and ethnic minorities are expected to comprise more than one-half of the US population by 2050, this issue needs to be addressed urgently. Research suggests that the drivers of health disparities occur at 3 levels: patient, provider, and system. Although we have recognized this issue and identified elements that contribute to it, knowledge must be converted into action to address it...
February 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29175250/smfm-special-report-putting-the-m-back-in-mfm-addressing-education-about-disparities-in-maternal-outcomes-and-care
#15
Leslie Moroz, Laura E Riley, Mary D'Alton, Haywood L Brown, Anne R Davis, Michael Foley, Cornelia R Graves, Jeanne S Sheffield, Matthew L Zerden, Allison S Bryant
At the 36th Annual meeting of the Society for Maternal-Fetal Medicine (SMFM), leaders in the field of maternal-fetal medicine (MFM) convened to address maternal outcome and care inequities from 3 perspectives: (1) education, (2) clinical care, and (3) research. Meeting attendees identified knowledge gaps regarding disparities within the provider community; reviewed possible frameworks to address these knowledge gaps; and identified models with which to address key clinical issues. Collaboration and communication between all stakeholders will be needed to gain a better understanding of these prevailing disparities and formulate strategies to eliminate them...
February 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29121703/effect-of-gene-act-a-on-the-invasion-efficiency-of-listeria-monocytogenes-as-observed-in-healthy-and-senescent-intestinal-epithelial-cells
#16
Jimyeong Ha, Hyemin Oh, Sejeong Kim, Jeeyeon Lee, Soomin Lee, Heeyoung Lee, Yukyung Choi, Sung Sil Moon, Kyoung-Hee Choi, Yohan Yoon
Listeria monocytogenes can asymptomatically inhabit the human intestine as a commensal bacterium. However, the mechanism by which L. monocytogenes is able to inhabit the intestine without pathogenic symptoms remains unclear. We compared the invasion efficiency of L. monocytogenes strains with the 268- and 385-bp-long act A gene. Clinical strains SMFM-CI-3 and SMFM-CI-6 with 268-bp act A isolated from patients with listeriosis, and strains SMFM-SI-1 and SMFM-SI-2 with the 385-bp gene isolated from carcasses, were used for inoculum preparation...
January 28, 2018: Journal of Microbiology and Biotechnology
https://www.readbyqxmd.com/read/29079144/society-for-maternal-fetal-medicine-smfm-consult-series-44-management-of-bleeding-in-the-late-preterm-period
#17
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 (GRADE 1B); (2) we do not recommend routine cervical length screening for women with placenta previa in the late preterm period due to a lack of data on an appropriate management strategy (GRADE 2C); (3) we recommend delivery between 34 and 37 weeks of gestation for stable women with placenta accreta (GRADE 1B); (4) we recommend delivery between 34 and 37 weeks of gestation for stable women with vasa previa (GRADE 1B); (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 have not previously been administered (GRADE 1A)...
January 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28993175/research-to-knowledge-promoting-the-training-of-physician-scientists-in-the-biology-of-pregnancy
#18
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...
January 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28961562/maternal-death-due-to-amniotic-fluid-embolism-a-national-study-in-france
#19
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)...
January 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28942678/fetal-programming-of-mental-health-by-acetaminophen-response-to-the-smfm-statement-prenatal-acetaminophen-use-and-adhd
#20
REVIEW
Jørn Olsen, Zeyan Liew
A number of studies indicate that acetaminophen taken during pregnancy may have a programming effect on the fetal brain development. The potential adverse consequences may only surface to clinical detection years later. Should we act on these findings now or do we wait for additional evidence? Areas covered: We argue for action inspired by these well analyzed studies that are based on five prospective cohorts data collected from different countries. Several analytical options have been employed especially to address confounding, and all analyses have consistently suggested that confounding alone is an unlikely explanation for this disturbing observation...
December 2017: Expert Opinion on Drug Safety
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