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Tracy M Adams, Timothy J Rafael, Nadia B Kunzier, Supriya Mishra, Rose Calixte, Anthony M Vintzileos
PURPOSE: To determine if use of cerclage in twin gestations with mid-trimester short cervix is associated with decreased preterm birth rate. STUDY DESIGN: This is a retrospective cohort of twin gestations identified with cervical length of ≤2.5 cm before 24 weeks of gestation through the perinatal ultrasound database of two institutions from 2008 to 2014. Patients with and without cerclage were compared for a primary outcome of preterm birth at <35 weeks...
April 10, 2017: Journal of Maternal-fetal & Neonatal Medicine
A M Vintzileos, G H A Visser
No abstract text is available yet for this article.
March 2017: Ultrasound in Obstetrics & Gynecology
Cande V Ananth, Ronald J Wapner, Srinidhi Ananth, Mary E DʼAlton, Anthony M Vintzileos
OBJECTIVE: We hypothesized that the origins of abruption may extend to the stages of placental implantation; however, there are no reliable markers to predict its development. Based on this hypothesis, we sought to evaluate whether first-trimester and second-trimester serum analytes predict placental abruption. METHODS: We performed a secondary analysis of data of 35,307 women (250 abruption cases) enrolled in the First and Second Trimester Evaluation of Risk cohort (1999-2003), a multicenter, prospective cohort study...
March 2017: Obstetrics and Gynecology
Zhen Huang, William Vintzileos, Heather Gordish-Dressman, Anjum Bandarkar, Brian K Reilly
OBJECTIVES: 1) To analyze clinical outcomes of children stratified by ultrasound into three diagnoses: acute tonsillitis, peritonsillar phlegmon, and abscess; and 2) To compare clinical outcomes and financial impact between children who underwent ultrasound protocol to those who did not. STUDY DESIGN: Retrospective analysis between two cohorts: ultrasound protocol group and control group. METHODS: Children with peritonsillar abscess (PTA) diagnosed in the emergency department (ED) were enrolled during a 2-year period for transcervical ultrasound evaluation of bilateral tonsillar fossae...
January 16, 2017: Laryngoscope
Sertac Esin, Mutlu Hayran, Yusuf Aytac Tohma, Mahmut Guden, Ismail Alay, Deniz Esinler, Serdar Yalvac, Omer Kandemir
OBJECTIVE: To compare different ultrasonographic fetal weight estimation formulas in predicting the fetal birth weight of preterm premature rupture of membrane (PPROM) fetuses. METHODS: Based on the ultrasonographic measurements, the estimated fetal weight (EFW) was calculated according to the published formulas. The comparisons used estimated birth weight (EBW) and observed birth weight (OBW) to calculate the mean absolute percentage error [(EBW-OBW)/OBW×100], mean percentage error [(EBW-OBW)/OBW×100)] and their 95% confidence intervals...
February 1, 2017: Journal of Perinatal Medicine
Anthony M Vintzileos, Gerard H A Visser
The aim of this Editorial is to review Level I evidence regarding the effectiveness of interventions in women identified as having short cervix on mid-trimester ultrasound, discuss some of the remaining challenges and outline areas for future research.
November 11, 2016: Ultrasound in Obstetrics & Gynecology
Lindsay M Kissane, Rose Calixte, Bogdan Grigorescu, Peter Finamore, Anthony Vintzileos
STUDY OBJECTIVE: To compare operative time in women stratified by body mass index (BMI) undergoing robotic-assisted sacrocolpopexy (RASC). Secondary objectives included characterizing perioperative characteristics and reoperation rates. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: University-affiliated teaching hospital. PATIENTS: One hundred seventy-nine consecutive patients who underwent RASC by a single surgeon from 2009 through 2013...
January 1, 2017: Journal of Minimally Invasive Gynecology
Sevan A Vahanian, Anthony M Vintzileos
PURPOSE OF REVIEW: Placental implantation abnormalities (PIAs) comprise a large group of disorders associated with significant maternal, fetal, and neonatal morbidity. RECENT FINDINGS: Risk factors include prior uterine surgery/myometrial scarring and the presence of placenta previa with or without prior cesarean delivery. Newly identified risk factors include previous prelabor cesarean delivery and previous postpartum hemorrhage. PIAs contribute substantially to preterm birth with prematurity rates ranging from 38 to 82%...
December 2016: Current Opinion in Obstetrics & Gynecology
Anthony M Vintzileos, John C Smulian
No abstract text is available yet for this article.
September 2016: American Journal of Obstetrics and Gynecology
Maria Andrikopoulou, Jessica A Lavery, Cande V Ananth, Anthony M Vintzileos
OBJECTIVE: The aim of this systematic review and metaanalysis was to determine the efficacy and safety of cervical ripening agents in the second trimester of pregnancy in patients with previous cesarean delivery. STUDY DESIGN: Data sources were PubMed, EMBASE, CINAHL, LILACS, Google Scholar, and (1983 through 2015). Eligibility criteria were cohort or cross-sectional studies that reported on efficacy and safety of cervical ripening agents in patients with previous cesarean delivery...
August 2016: American Journal of Obstetrics and Gynecology
Nadia B Kunzier, Wendy L Kinzler, Martin R Chavez, Tracy M Adams, Donald A Brand, Anthony M Vintzileos
BACKGROUND: Cervical length by transvaginal ultrasound to predict preterm labor is widely used in clinical practice. Virtually no data exist on cervical length measurement to differentiate true from false labor in term patients who present for labor check. False-positive diagnosis of true labor at term may lead to unnecessary hospital admissions, obstetrical interventions, resource utilization, and cost. OBJECTIVE: We sought to determine if cervical length by transvaginal ultrasound can differentiate true from false labor in term patients presenting for labor check...
September 2016: American Journal of Obstetrics and Gynecology
Maria Andrikopoulou, Sevan A Vahanian, Martin R Chavez, Jean Murphy, Nazeeh Hanna, Anthony M Vintzileos
OBJECTIVE: The prenatal detection rate of isolated fetal limb abnormalities ranges from 4 to 29.5%. Our aim was to determine the accuracy of a detailed ultrasound protocol in detecting isolated fetal limb abnormalities Methods: This is a retrospective study of infants born at our institution with isolated limb defects from 2009 to 2014. Antepartum and postpartum records were reviewed for genetic testing results. We routinely image both upper and lower extremities, including all long bones, hands, feet, fingers and toes...
January 2017: Journal of Maternal-fetal & Neonatal Medicine
Kunzier Nadia Bennett, Hyein Park, Joseph Cioffi, Rose Calixte, Anthony Vintzileos
OBJECTIVE: The objective of this study is to compare resource utilization (efficiency) and obstetrical/cost outcomes of single dose misoprostol versus dinoprostone for induction of labor (IOL) at term. METHODS: Retrospective cohort of induced deliveries 37-41 weeks gestation presenting with a Bishop score ≤4 using single-dose-50 mcg vaginal misoprostol or 10 mg-dinoprostone vaginal-inserts. Dinoprostone patients were compared (5:1) with misoprostol patients...
November 2016: Journal of Maternal-fetal & Neonatal Medicine
Maria Andrikopoulou, Anthony M Vintzileos
No abstract text is available yet for this article.
March 2016: American Journal of Obstetrics and Gynecology
Daniel G Kiefer, Jolene C Muscat, Jarrett Santorelli, Martin R Chavez, Cande V Ananth, John C Smulian, Anthony M Vintzileos
BACKGROUND: The rising cesarean birth rate has drawn attention to risks associated with repeat cesarean birth. Prevention of adhesions with adhesion barriers has been promoted as a way to decrease operative difficulty. However, robust data demonstrating effectiveness of such interventions are lacking. OBJECTIVE: We report data from a multicenter trial designed to evaluate the short-term safety and effectiveness of a modified sodium hyaluronic acid (HA)-carboxymethylcellulose (CMC) absorbable adhesion barrier for reduction of adhesions following cesarean delivery...
March 2016: American Journal of Obstetrics and Gynecology
M Baraa Allaf, Sandhya Matha, Martin R Chavez, Anthony M Vintzileos
No abstract text is available yet for this article.
November 2015: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Sevan A Vahanian, Jessica A Lavery, Cande V Ananth, Anthony Vintzileos
We sought to evaluate the extent of the association between placental implantation abnormalities (PIA) and preterm delivery in singleton gestations. We conducted a systematic review of English-language articles published from 1980 onward using PubMed, MEDLINE, EMBASE, CINAHL, LILACS, and Google Scholar, and by identifying studies cited in the references of published articles. Search terms were PIA defined as ≥ 1 of the following: placenta previa, placenta accreta, vasa previa, and velamentous cord insertion...
October 2015: American Journal of Obstetrics and Gynecology
Anthony M Vintzileos, Cande V Ananth, John C Smulian
Placental implantation abnormalities, including placenta previa, placenta accreta, vasa previa, and velamentous cord insertion, can have catastrophic consequences for both mother and fetus, especially as pregnancy progresses to term. In these situations, current recommendations for management usually call for an indicated preterm delivery even in asymptomatic patients. However, the recommended gestational age(s) for delivery in asymptomatic patients are empirically determined without consideration of the recent literature regarding the usefulness of specific ultrasound findings to help individualize management...
October 2015: American Journal of Obstetrics and Gynecology
Cande V Ananth, Jessica A Lavery, Anthony M Vintzileos, Daniel W Skupski, Michael Varner, George Saade, Joseph Biggio, Michelle A Williams, Ronald J Wapner, Jason D Wright
BACKGROUND: Placental abruption traditionally is defined as the premature separation of the implanted placenta before the delivery of the fetus. The existing clinical criteria of severity rely exclusively on fetal (fetal distress or fetal death) and maternal complications without consideration of neonatal or preterm delivery-related complications. However, two-thirds of abruption cases are accompanied by fetal or neonatal complications, including preterm delivery. A clinically meaningful classification for abruption therefore should include not only maternal complications but also adverse fetal and neonatal outcomes that include intrauterine growth restriction and preterm delivery...
February 2016: American Journal of Obstetrics and Gynecology
Daniel G Kiefer, Morgan R Peltier, Sean M Keeler, Orion Rust, Cande V Ananth, Anthony M Vintzileos, Nazeeh Hanna
BACKGROUND: Midtrimester ultrasound is a valuable method for identifying asymptomatic women at risk for spontaneous preterm delivery (PTD). However, response to various treatments (cerclage, progestogen) has been variable in the clinical setting. It remains unclear how other biomarkers may be used to guide intervention strategies. OBJECTIVE: We applied an amniotic fluid inflammatory scoring system to determine if the degree of inflammation is associated with intervention efficacy in patients with midtrimester short cervix...
February 2016: American Journal of Obstetrics and Gynecology
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