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Aimee G Kim, Jesse D Vrecenak, Matthew M Boelig, Linda Eissenberg, Michael P Rettig, John S Riley, Matthew S Holt, Michael A Conner, Stavros P Loukogeorgakis, Haiying Li, John F DiPersio, Alan W Flake, William H Peranteau
In utero hematopoietic cell transplantation (IUHCT) is a novel nonmyeloablative approach that results in donor specific tolerance and mixed allogeneic chimerism. Clinical application is limited by low levels of donor cell engraftment. Competition from endogenous hematopoietic stem cells (HSCs) for limited "space" in fetal hematopoietic organs remains a significant barrier to successful IUHCT. AMD3100, a CXCR4 inhibitor, and firategrast, an α4β1 and α4β7 integrin inhibitor (α4β1/7) have been shown to disrupt HSC retention in the postnatal hematopoietic niche (HN)...
September 20, 2016: Blood
Rupsa C Boelig, Samantha J Barton, Gabriele Saccone, Anthony J Kelly, Steve J Edwards, Vincenzo Berghella
BACKGROUND: Hyperemesis gravidarum is a severe form of nausea and vomiting in pregnancy affecting 0.3% to 1.0% of pregnancies, and is one of the most common indications for hospitalization during pregnancy. While a previous Cochrane review examined interventions for nausea and vomiting in pregnancy, there has not yet been a review examining the interventions for the more severe condition of hyperemesis gravidarum. OBJECTIVES: To assess the effectiveness and safety, of all interventions for hyperemesis gravidarum in pregnancy up to 20 weeks' gestation...
2016: Cochrane Database of Systematic Reviews
Kelly M Orzechowski, Rupsa C Boelig, Vincenzo Berghella
Cervical length (CL) screening should be offered to singletons because there are interventions for those with a short CL. A transvaginal ultrasound (TVU) is the "gold standard" for CL. In singletons with prior spontaneous preterm birth, serial TVU CL screening is recommended between 16 and 23 6/7 weeks. Universal TVU CL screening between 18 and 24 weeks may be considered for low-risk singletons with the administration of vaginal progesterone for TVU CL≤20 mm; alternatively, transabdominal ultrasound CL screening may be considered with reflux to TVU CL screening for a transabdominal ultrasound CL<35 mm or inadequate visualization...
June 2016: Clinical Obstetrics and Gynecology
Rupsa C Boelig, Kelly M Orzechowski, Anju Suhag, Vincenzo Berghella
OBJECTIVE: To determine whether second trimester transvaginal ultrasound cervical length (CL) is associated with prolonged pregnancy (≥41 0/7 weeks) in nulliparous women who reach term (≥37 weeks) with a planned vaginal delivery. METHODS: Retrospective cohort of nulliparous singletons 18 0/7-23 6/7 weeks gestation undergoing CL screening from 1/1/12 to 12/31/13. Women who delivered at term with spontaneous labor or reached 41 weeks were included. Primary outcome was incidence of prolonged pregnancy...
December 2016: Journal of Maternal-fetal & Neonatal Medicine
Vincenzo Berghella, Rupsa C Boelig
No abstract text is available yet for this article.
March 2016: American Journal of Obstetrics and Gynecology
Matthew M Boelig, Aimee G Kim, John D Stratigis, Lauren E McClain, Haiying Li, Alan W Flake, William H Peranteau
In utero hematopoietic cell transplantation (IUHCT) has the potential to treat a number of congenital hematologic disorders. Clinical application is limited by low levels of donor engraftment. Techniques that optimize donor cell delivery to the fetal liver (FL), the hematopoietic organ at the time of IUHCT, have the potential to enhance engraftment and the clinical success of IUHCT. We compared the 3 clinically applicable routes of injection (intravenous [i.v.], intraperitoneal [i.p.], and intrahepatic [i.h...
June 2016: Biology of Blood and Marrow Transplantation
William H Peranteau, Matthew M Boelig, Nahla Khalek, Julie S Moldenhauer, Juan Martinez-Poyer, Holly L Hedrick, Alan W Flake, Mark P Johnson, N Scott Adzick
PURPOSE: Administration of maternal betamethasone (BMZ) is a therapeutic option for fetuses with large microcystic congenital lung lesions at risk for, or causing, hydrops. Not all fetuses respond to a single course of BMZ. We review our experience with the use of single and multiple courses of maternal BMZ for the management of these patients. METHODS: A retrospective review of fetuses with congenital lung lesions managed with maternal BMZ from 2003 to 2014 was performed...
January 2016: Journal of Pediatric Surgery
Rupsa C Boelig, Kelly M Orzechowski, Vincenzo Berghella
OBJECTIVES: To evaluate differences in risk factors and delivery outcomes among women with spontaneous preterm birth (sPTB) with short (≤25 mm) versus normal (>25 mm) cervical length (CL). METHODS: Secondary analysis of a prospective cohort study of singleton gestations between 18 0/7 and 23 6/7 weeks, without prior sPTB, undergoing universal transvaginal CL screening between 1 January 2012 and 31 December 2013. Only women with sPTB (<37 0/7 weeks) were included...
November 9, 2015: Journal of Maternal-fetal & Neonatal Medicine
Matthew M Boelig, Pablo Laje, William H Peranteau
No abstract text is available yet for this article.
July 2015: JAMA Surgery
Rupsa C Boelig, Jenell S Coleman, Jean Keller, Catherine Sewell, Jean Anderson
OBJECTIVE: To describe the demographic and clinical characteristics of HIV-infected individuals and HIV-affected couples who were referred for preconception counseling (PCC) at a large urban US-based HIV clinic. METHODS: Electronic medical records were reviewed for HIV-infected individuals and HIV-affected couples. Medical, reproductive, surgical, psychosocial, and family history data were abstracted. Univariate analyses were done. RESULTS: There were 8 single HIV-infected women and 100 HIV-affected couples who underwent PCC...
2015: Infectious Diseases in Obstetrics and Gynecology
William H Peranteau, N Scott Adzick, Matthew M Boelig, Alan W Flake, Holly L Hedrick, Lori J Howell, Julie S Moldenhauer, Nahla Khalek, Juan Martinez-Poyer, Mark P Johnson
PURPOSE: Hydrops and pulmonary hypoplasia are associated with significant morbidity and mortality in the setting of a congenital lung lesion or pleural effusion (PE). We reviewed our experience using in utero thoracoamniotic shunts (TA) to manage fetuses with these diagnoses. METHODS: A retrospective review of fetuses diagnosed with a congenital lung lesion or pleural effusion who underwent TA shunt placement from 1998-2013 was performed. RESULTS: Ninety-seven shunts were placed in 75 fetuses...
February 2015: Journal of Pediatric Surgery
Kelly Marie Orzechowski, Rupsa Boelig, Sara Shaw Nicholas, Jason Baxter, Vincenzo Berghella
OBJECTIVE: To determine whether universal transvaginal ultrasound (TVU) cervical length (CL) screening is indicated in women with prior term births. STUDY DESIGN: We conducted a prospective cohort study from Jan. 1, 2012, to June 30, 2013, of singleton gestations between 18 0/7-23 6/7 weeks undergoing TVU CL screening for prediction of spontaneous preterm birth (sPTB). Women with a prior sPTB, with cerclage, and without delivery data available were excluded. Primary outcomes were the incidence of a CL ≤20 mm, and rates of sPTB <37, <34, and <32 weeks gestation among women with prior term births vs nulliparous women...
February 2015: American Journal of Obstetrics and Gynecology
Kelly M Orzechowski, Rupsa C Boelig, Jason K Baxter, Vincenzo Berghella
OBJECTIVE: To evaluate a universal transvaginal ultrasonogram cervical length screening program on the incidence of a cervical length 20 mm or less and adherence to the management protocol for a cervical length less than 25 mm. METHODS: We conducted a prospective cohort study of women with singleton gestations 18 0/7 to 23 6/7 weeks of gestation eligible for universal transvaginal ultrasonogram cervical length screening over an 18-month period. Only women receiving antenatal care at our institution were included...
September 2014: Obstetrics and Gynecology
Alison Vogell, Rupsa C Boelig, Joanna Skora, Jason K Baxter
BACKGROUND: Bell palsy is a facial nerve neuropathy that is a rare disorder but occurs at higher frequency in pregnancy. Almost 30% of cases are associated with preeclampsia or gestational hypertension. Bilateral Bell palsy occurs in only 0.3%-2.0% of cases of facial paralysis, has a poorer prognosis for recovery, and may be associated with a systemic disorder. CASE: We describe a case of a 24-year-old primigravid woman with a twin gestation at 35 weeks diagnosed initially with bilateral facial palsy and subsequently with preeclampsia...
August 2014: Obstetrics and Gynecology
Matthew M Boelig, Michael B Streiff, Deborah B Hobson, Peggy S Kraus, Peter J Pronovost, Elliott R Haut
OBJECTIVES: Sequential compression devices (SCDs) help prevent deep venous thrombosis and pulmonary embolism in hospitalized patients; however, clinicians often decline to use this therapy because of a perceived increased risk for patient falls. There is limited information regarding the association between the use of SCDs and patient falls. In this study, we analyze if SCD use is a common risk factor for in-hospital falls. METHODS: We used the Patient Safety Net event reporting system at our university-affiliated hospital to retrospectively quantify reports of SCD-related falls over a nearly 5-year period (July 1, 2004, through May 25, 2009)...
June 2011: Journal of Patient Safety
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