40,202 results match your criteria American journal of obstetrics and gynecology[Journal]


SMFM Special Statement: State of the Science on Multifetal Gestations: Unique Considerations and Importance.

Am J Obstet Gynecol 2019 Apr 16. Epub 2019 Apr 16.

Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, United States.

We sought to review the state of the science for research on multiple gestations. A literature search was performed using PubMed to quantify the representation of multiple gestations for a sample period (2012-2016) limited to Phase III and IV randomized controlled trials and written in English addressing at least one of four major pregnancy complications for illustration: fetal growth restriction or small-for-gestational-age fetus, gestational diabetes, preeclampsia, and preterm delivery. Of the 226 studies included in the analysis, multiple pregnancies were most represented in studies of preterm delivery: 17% of trials recruited both singleton and multiple pregnancies, and another 18% of trials recruited only multiple pregnancies. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.04.013DOI Listing

Risk of Severe Maternal Morbidity by Maternal Fertility Status: A US study in 8 States.

Am J Obstet Gynecol 2019 Apr 14. Epub 2019 Apr 14.

Center for Assisted Reproduction, Bedford, Texas.

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https://linkinghub.elsevier.com/retrieve/pii/S00029378193057
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http://dx.doi.org/10.1016/j.ajog.2019.04.011DOI Listing
April 2019
2 Reads

Guidelines for Postoperative care in Cesarean Delivery: Enhanced Recovery After Surgery (ERAS) Society Recommendations (Part 3 ).

Am J Obstet Gynecol 2019 Apr 14. Epub 2019 Apr 14.

Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, OR, United States.

This Enhanced Recovery After Surgery (ERAS) Guideline for postoperative care in Cesarean Delivery (CD) will provide best practice, evidenced-based, recommendations for post-operative care with, primarily a maternal focus. The pathway process for scheduled and unscheduled CD, for this ERAS CD guideline, will consider time from completion of cesarean until maternal hospital discharge. The literature search (1966-2017) used Embase and PubMed to search medical subject headings including "Cesarean Section", "Cesarean Delivery", "Cesarean Section Delivery" and all post-operative ERAS® items. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00029378193057
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http://dx.doi.org/10.1016/j.ajog.2019.04.012DOI Listing
April 2019
2 Reads

Comparing pregnancy outcomes and loss rates in elective twin pregnancy reduction to ongoing twin gestations in a large contemporary cohort.

Am J Obstet Gynecol 2019 Apr 14. Epub 2019 Apr 14.

Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.

Background: As compared to singleton gestations, twin pregnancies are associated with a significantly higher risk of preterm birth, maternal complications, as well as fetal and neonatal morbidity and mortality. Multifetal pregnancy reduction (MPR) is a technique developed in the 1980s to reduce the fetal number in higher-order multiple pregnancies to reduce the risk of adverse pregnancy outcomes, most importantly preterm birth.

Objective: To compare pregnancy outcomes and loss rates in elective twin pregnancy reduction to ongoing twin gestations in a large contemporary cohort. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.04.001DOI Listing
April 2019
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Fresh IVF cycles increase risk of SGA, Frozen Cycles increase risk of LGA: Which is Worse?

Am J Obstet Gynecol 2019 Apr 14. Epub 2019 Apr 14.

Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Tripler Army Medical Center, Hawaii.

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http://dx.doi.org/10.1016/j.ajog.2019.04.010DOI Listing
April 2019
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Comparing the diagnostic accuracy of three ultrasound modalities for diagnosing obstetric anal sphincter injuries.

Am J Obstet Gynecol 2019 Apr 11. Epub 2019 Apr 11.

Obstetrics and Gynecology, Croydon University Hospital, London, United Kingdom. Electronic address:

Background: The optimal imaging modality of obstetric anal sphincter injuries (OASIs) needs to take into consideration convenience, availability and ability to assess the sphincter morphology. Endoanal ultrasound is currently regarded as the reference standard but is not widely available in obstetric units. Exoanal alternatives exist, such as three-dimensional (3D) introital or transperineal ultrasound, which are already readily available in most obstetrics and gynecology units. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.04.009DOI Listing

Fetal electrocardiography ST analysis for intrapartum monitoring: a critical appraisal of conflicting evidence and a way forward.

Am J Obstet Gynecol 2019 Apr 10. Epub 2019 Apr 10.

In the past century, some areas of obstetric including intrapartum care have been slow to benefit from the dramatic advances in technology and medical care. Although fetal heart rate monitoring (cardiotocography, CTG) became available a half century ago, its interpretation often differs between institutions and countries, its diagnostic accuracy needs improvement, and a technology to help reduce the unnecessary obstetric interventions that have accompanied the CTG is urgently needed. During the second half of the 20 century, key findings in animal experiments captured the close relationship between myocardial glycogenolysis, myocardial workload, and ST changes, thus demonstrating that ST waveform analysis of the fetal ECG can provide information on oxygenation of the fetal myocardium and establishing the physiological basis for the use of ECG in intrapartum fetal surveillance. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.04.003DOI Listing
April 2019
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Elective Induction of Labor at 39 weeks.

Am J Obstet Gynecol 2019 Apr 10. Epub 2019 Apr 10.

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http://dx.doi.org/10.1016/j.ajog.2019.04.007DOI Listing

Induction of Labor at Term.

Am J Obstet Gynecol 2019 Apr 10. Epub 2019 Apr 10.

Department of Obstetrics and Gynecology, George Washington University Medical Faculty Associates. Electronic address:

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http://dx.doi.org/10.1016/j.ajog.2019.04.006DOI Listing

Total and out-of-pocket costs of different primary management strategies in ovarian cancer.

Am J Obstet Gynecol 2019 Apr 6. Epub 2019 Apr 6.

Department of Gynecologic Oncology and Reproductive Medicine, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address:

Background: Communicating healthcare costs to patients is an important component of delivering high-quality value-based care, yet cost data is lacking. This is especially relevant for ovarian cancer, where no clinical consensus on optimal first-line treatment exists.

Objective: The objective of this study was to generate cost estimates of different primary management strategies in ovarian cancer. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.04.005DOI Listing
April 2019
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Delivery type, opioid prescribing, and the risk of persistent opioid use after delivery.

Am J Obstet Gynecol 2019 Apr 25;220(4):405-407. Epub 2018 Oct 25.

Department of Health Policy, Department of Medicine, Geriatric Research Education and Clinical Center, Nashville, TN 37232.

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https://linkinghub.elsevier.com/retrieve/pii/S00029378183091
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http://dx.doi.org/10.1016/j.ajog.2018.10.026DOI Listing
April 2019
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Povidone-iodine 1% is the most effective vaginal antiseptic for preventing post-cesarean endometritis: A systematic review and network meta-analysis.

Am J Obstet Gynecol 2019 Apr 4. Epub 2019 Apr 4.

University of Florida College of Medicine-Jacksonville Department of Obstetrics and Gynecology.

Background: Direct comparison meta-analyses have reported benefits with pre-surgical vaginal preparation prior to cesarean delivery for the reduction of endometritis. These reports did not perform a multi-treatment comparison of the various antiseptic solutions assessed in prior studies.

Objective: To systematically review the literature and indirectly quantitate and summarize the comparative efficacy of antiseptic formulations and their concentrations employed for preparation of the vagina prior to cesarean delivery in preventing endometritis and other infectious complications. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.04.002DOI Listing
April 2019
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The effect of parity on longitudinal maternal hemodynamics.

Am J Obstet Gynecol 2019 Apr 2. Epub 2019 Apr 2.

Fetal Medicine Research Institute, King's College London. Electronic address:

Background: Parous women have a lower risk for pregnancy complications, such as preeclampsia (PE) or delivery of small for gestational age (SGA) neonates. However, parous women are a heterogeneous group of patients as they contain a low-risk cohort with previously uncomplicated pregnancies and a high-risk cohort with previous pregnancies complicated by PE and / or SGA. Previous studies examining the effect of parity on maternal hemodynamics, including cardiac output (CO) and peripheral vascular resistance (PVR), did not distinguish between parous women with and without a history of PE or SGA and reported contradictory results. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.03.027DOI Listing
April 2019
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Standard vs population reference curves in obstetrics: which one should we use?

Am J Obstet Gynecol 2019 Apr;220(4):293-296

Department of Obstetrics and Gynecology, NYU Winthrop Hospital, NYU Long Island School of Medicine, Mineola, NY.

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http://dx.doi.org/10.1016/j.ajog.2019.02.060DOI Listing
April 2019
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Risk of Pressure Ulcers in Maternity units.

Am J Obstet Gynecol 2019 Mar 30. Epub 2019 Mar 30.

Obstetrics department, Paule de Viguier Hospital, CHU Toulouse, Toulouse, 31059, France; Faculté de Médecine, Université Toulouse III, Toulouse, France.

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http://dx.doi.org/10.1016/j.ajog.2019.03.023DOI Listing

Is maternal lipid profile in early pregnancy associated with pregnancy complications and blood pressure in pregnancy and long-term postpartum?

Am J Obstet Gynecol 2019 Mar 30. Epub 2019 Mar 30.

Erasmus MC, University Medical Center Rotterdam, the Netherlands, Department of Obstetrics and Gynecology.

Background: An atherogenic lipid profile is a risk factor for the initiation and progression of atherosclerosis. This ultimately leads to cardiovascular disease. Women with a history of hypertensive disorders of pregnancy are at increased risk of sustained hypertension and cardiovascular disease later in life. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.03.025DOI Listing
March 2019
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Neonatal developmental and behavioral outcomes of immediate delivery versus expectant monitoring in mild hypertensive disorders of pregnancy: 2-year outcomes of the HYPITAT II trial.

Am J Obstet Gynecol 2019 Mar 30. Epub 2019 Mar 30.

Epidemiology, University Medical Centre Groningen, Groningen, The Netherlands.

Background: Management of preterm hypertensive disorders remains a clinical dilemma. The maternal benefits of delivery need to be weighed against the adverse neonatal consequences of preterm birth. Long-term consequences of obstetric management in offspring of women with hypertensive disorders in preterm pregnancy are largely unknown. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.03.024DOI Listing
March 2019
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Prediction of mode of delivery using the first ultrasound based "intrapartum app".

Am J Obstet Gynecol 2019 Mar 27. Epub 2019 Mar 27.

Department of Cancer and Surgery, Imperial College London. Du Cane Road, London, W12 0NN, UK; Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, Du Cane Road, London, W12 0HS, UK; Department of Development & Regeneration, KU Leuven, Oude Markt 13, 3000 Leuven, Belgium. Electronic address:

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http://dx.doi.org/10.1016/j.ajog.2019.03.019DOI Listing
March 2019
2 Reads
4.704 Impact Factor

Antibiotic administration can eradicate intra-amniotic infection or inflammation in a subset of patients with preterm labor and intact membranes.

Am J Obstet Gynecol 2019 Mar 27. Epub 2019 Mar 27.

Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea; Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-si, Korea.

Background: Intra-amniotic infection is present in 10% of patients with an episode of preterm labor, and is a risk factor for impending preterm delivery and neonatal morbidity/mortality. Intra-amniotic inflammation is often associated with intra-amniotic infection, but sometimes is present in the absence of detectable microorganisms. Antibiotic treatment of intra-amniotic infection has traditionally been considered to be ineffective. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.03.018DOI Listing
March 2019
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Evidence that antibiotic administration is effective in the treatment of a subset of patients with intra-amniotic infection/inflammation presenting with cervical insufficiency.

Am J Obstet Gynecol 2019 Mar 27. Epub 2019 Mar 27.

Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea. Electronic address:

Background: Cervical insufficiency is a risk factor for spontaneous midtrimester abortion or early preterm birth. Intra-amniotic infection has been reported in 8-52% of such patients, and intra-amniotic inflammation in 81%. Some professional organizations have recommended perioperative antibiotic treatment when emergency cervical cerclage is performed. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.03.017DOI Listing
March 2019
3 Reads

Reply.

Am J Obstet Gynecol 2019 Mar 26. Epub 2019 Mar 26.

Department of Obstetrics and Gynecology, Poissy-Saint Germain Hospital, Versailles-St Quentin University, Poissy, France.

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http://dx.doi.org/10.1016/j.ajog.2019.03.014DOI Listing

Delayed recognition of lower urinary tract injuries following hysterectomy for benign indications: a NSQIP-based study.

Am J Obstet Gynecol 2019 Mar 26. Epub 2019 Mar 26.

Center for Urogynecology & Pelvic Reconstructive Surgery, Obstetrics, Gynecology & Women's Health Institute, Cleveland Clinic, Cleveland, OH.

Objective: To describe the incidence of and factors associated with lower urinary tract (LUT) complications recognized in the immediate postoperative period following hysterectomy for benign gynecologic indications using the National Surgical Quality Improvement Program (NSQIP) database.

Methods: Patients who underwent hysterectomy for benign indications from 2014 through 2016 were identified in the NSQIP database using Current Procedural Terminology codes and International Classification of Diseases codes. Patient demographics, preoperative comorbidities, American Society of Anesthesiologists (ASA) classification system scores and total operating time were collected. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.03.015DOI Listing
March 2019
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High prevalence of precocious menarche in Puerto Barrios, Guatemala.

Am J Obstet Gynecol 2019 Mar 26. Epub 2019 Mar 26.

Department of Pathology, Hospital San Juan de Dios, Guatemala City, Guatemala.

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http://dx.doi.org/10.1016/j.ajog.2019.03.013DOI Listing
March 2019
4.704 Impact Factor

Intravesical pregnancy due to vesicouterine fistula.

Am J Obstet Gynecol 2019 Mar 26. Epub 2019 Mar 26.

Department of Radiology and Oncology, Instituto de Radiologia (INRAD), University of Sao Paulo, School of Medicine.

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http://dx.doi.org/10.1016/j.ajog.2019.03.016DOI Listing
March 2019
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Neonatal and maternal outcome after frozen embryo transfer: increased risks in programmed cycles.

Am J Obstet Gynecol 2019 Mar 22. Epub 2019 Mar 22.

Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.

Background: Frozen embryo transfer is associated with better perinatal outcome regarding preterm birth and low birth weight yet higher risk of large for gestational age and macrosomia compared to fresh transfer. Further, higher rates of hypertensive disorders in pregnancy are noted after frozen embryo transfer. Whether these differences are due to the protocol used in frozen cycles remains unknown. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.03.010DOI Listing
March 2019
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Influence of metabolic syndrome on female fertility and in vitro fertilization outcomes in PCOS women.

Am J Obstet Gynecol 2019 Mar 22. Epub 2019 Mar 22.

Center for Reproductive Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 845 Lingshan Road, Shanghai 200135, P.R. China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, 845 Lingshan Road, Shanghai 200135, P.R. China. Electronic address:

Objective: With a high incidence of insulin resistance, central obesity and dyslipidemia, polycystic ovary syndrome (PCOS) women are susceptible to metabolic syndrome (MetS). Our objective was to explore whether MetS had an effect on overall female fertility and in vitro fertilization (IVF) outcomes in PCOS infertile women.

Methods: This was a secondary analysis of a multicenter randomized trial in 1508 PCOS women, which was originally designed to compare live birth rate after fresh embryo transfer vs. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.03.011DOI Listing
March 2019
4 Reads

Azithromycin versus erythromycin for the management of preterm premature rupture of membranes.

Am J Obstet Gynecol 2019 Mar 20. Epub 2019 Mar 20.

Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine; Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA.

Background: Preterm premature rupture of membranes (PPROM) complicates 2-3% of pregnancies. Many institutions have advocated for the use of azithromycin instead of erythromycin. This is secondary to national shortages of erythromycin, ease of administration, better side effect profile and decreased cost of azithromycin as compared to erythromycin. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.03.009DOI Listing
March 2019
2 Reads

Pelvic organ prolapse as a function of levator ani avulsion, hiatus size, and strength.

Am J Obstet Gynecol 2019 Mar 15. Epub 2019 Mar 15.

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

Background: Obstetrical levator ani muscle avulsion is detected after 10%-30% of vaginal deliveries and is associated with pelvic organ prolapse later in life. However, the mechanism by which levator avulsion may contribute to prolapse is unknown.

Objectives: This study investigated the extent by which size of the levator hiatus and pelvic muscle weakness may explain the association between levator avulsion and pelvic organ prolapse. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.03.004DOI Listing
March 2019
1 Read

Factors Associated with Postpartum Use of Long-Acting Reversible Contraception.

Am J Obstet Gynecol 2019 Mar 15. Epub 2019 Mar 15.

Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, GA.

Background: Contraception use among postpartum women is important to prevent unintended pregnancies and optimize birth spacing. Long-acting reversible contraception (LARC), including intrauterine devices and implants, is highly effective, yet compared to less effective methods utilization rates are low.

Objectives: We sought to estimate prevalence of LARC use among postpartum women and examine factors associated with LARC use among those using any reversible contraception. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.03.005DOI Listing
March 2019
3 Reads

Can in utero fetal pacing cause cardiac complications?

Am J Obstet Gynecol 2019 Mar 15. Epub 2019 Mar 15.

Sunny Isles Medical Center, Miami, FL. Electronic address:

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http://dx.doi.org/10.1016/j.ajog.2019.03.006DOI Listing

Subsequent Pregnancy Outcomes After Open Maternal-Fetal Surgery for Myelomeningocele.

Am J Obstet Gynecol 2019 Mar 15. Epub 2019 Mar 15.

Colorado Fetal Care Center, Denver, CO.

Background: Open maternal-fetal surgery (OMFS) for fetal myelomeningocele (fMMC) results in reduction in neonatal morbidity related to spina bifida but may be associated with fetal, neonatal, and maternal complications in subsequent pregnancies.

Objective: The objective of this study was to ascertain obstetric risk in subsequent pregnancies after OMFS for fMMC closure.

Study Design: An international multicenter prospective observational registry created to track and report maternal, obstetric, fetal/neonatal and subsequent pregnancy outcomes following OMFS for fMMC, was evaluated for subsequent pregnancy outcome variables. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00029378193048
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http://dx.doi.org/10.1016/j.ajog.2019.03.008DOI Listing
March 2019
9 Reads

The impact of menstrual symptoms on everyday life: a survey among 42,879 women.

Am J Obstet Gynecol 2019 Mar 15. Epub 2019 Mar 15.

Department of Obstetrics and Gynaecology, Rijnstate Hospital, Arnhem, The Netherlands.

Background: Menstrual symptoms such as dysmenorrhea, heavy menstrual bleeding, and perimenstrual mood disorders are known to be widespread among the general population. From studies in patients with endometriosis and premenstrual disorder, it has been shown that these symptoms can have a large impact on women's quality of life and account for substantial health care use. Furthermore, it is estimated that many women initially do not consult a doctor while facing menstrual symptoms. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00029378193042
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http://dx.doi.org/10.1016/j.ajog.2019.02.048DOI Listing
March 2019
4 Reads

Effect of antenatal dietary interventions in maternal obesity on pregnancy weight-gain and birthweight: Healthy Mums and Babies (HUMBA) randomized trial.

Am J Obstet Gynecol 2019 Mar 13. Epub 2019 Mar 13.

Department of Obstetrics and Gynaecology, University of Auckland, Auckland; Faculty of Medical and Health Sciences, University of Auckland, Auckland.

Background: Pregnancy interventions that improve maternal and infant outcomes are urgently needed in populations with high rates of obesity. We undertook the Healthy Mums and Babies (HUMBA) randomized controlled trial to assess the effect of dietary interventions and or probiotics in a multiethnic population of pregnant women with obesity, living in an area of high deprivation.

Objectives: To determine whether a culturally tailored dietary intervention and or daily probiotic capsules in pregnant women with obesity reduces the co-primary outcomes of (1) excessive gestational weight gain (mean >0. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.03.003DOI Listing
March 2019
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Routine assessment of cerebroplacental ratio at 35-37 weeks' gestation in the prediction of adverse perinatal outcome.

Am J Obstet Gynecol 2019 Mar 13. Epub 2019 Mar 13.

Fetal Medicine Research Institute, King's College Hospital, London, United Kingdom. Electronic address:

Background: Third-trimester studies in selected high-risk pregnancies have reported that low cerebroplacental ratio, due to high pulsatility index in the umbilical artery, and or decreased pulsatility index in the fetal middle cerebral artery, is associated with increased risk of adverse perinatal outcomes.

Objective: To investigate the predictive performance of screening for adverse perinatal outcome by the cerebroplacental ratio measured routinely at 35-37 weeks' gestation.

Study Design: This was a prospective observational study in 47,211 women with singleton pregnancies undergoing routine ultrasound examination at 35 to 37 weeks' gestation, including measurement of umbilical artery-pulsatility index and middle cerebral artery-pulsatility index. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.03.002DOI Listing
March 2019
6 Reads

Successful use of an artificial placenta to support extremely preterm ovine fetuses at the border of viability.

Am J Obstet Gynecol 2019 Mar 7. Epub 2019 Mar 7.

Division of Obstetrics and Gynecology, The University of Western Australia, Crawley, WA 6009, Australia; Center for Perinatal and Neonatal Medicine, Tohoku University Hospital, Sendai, Miyagi 980-8574, Japan; School of Veterinary and Life Sciences, Murdoch University, WA 6150, Australia.

Background: Ex-vivo uterine environment (EVE) therapy is an experimental life support platform designed to reduce the risk of morbidity and mortality for extremely preterm infants born at the border of viability (21-24 weeks gestation). To spare the functionally immature lung, this platform performs gas exchange via a membranous oxygenator connected to the umbilical vessels, and the fetus is submerged in a protective bath of artificial amniotic fluid. We and others have demonstrated the feasibility of extended survival with EVE therapy in late preterm fetuses; however, there is presently no evidence to show that the use of such a platform can support extremely preterm fetuses, the eventual translational target for therapy of this nature. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00029378193047
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http://dx.doi.org/10.1016/j.ajog.2019.03.001DOI Listing
March 2019
5 Reads

Prevalence, characteristics, and risk factors of occult uterine cancer in presumed benign hysterectomy.

Am J Obstet Gynecol 2019 Mar 7. Epub 2019 Mar 7.

Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT; Yale Cancer Outcomes, Public Policy and Effectiveness Research Center, New Haven, CT. Electronic address:

Background: Occult uterine cancer at the time of benign hysterectomy poses unique challenges in patient care. There is large variability and uncertainty in estimated risk of occult uterine cancer in the literature and prior research often did not differentiate/include all subtypes.

Objectives: To thoroughly examine the prevalence of occult uterine cancer in a large population-based sample of women undergoing hysterectomy for presumed benign indications and to identify associated risk factors. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00029378193043
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http://dx.doi.org/10.1016/j.ajog.2019.02.051DOI Listing
March 2019
5 Reads

Diagnosis airhead: a case of pneumocephalus in labor.

Am J Obstet Gynecol 2019 Mar 5. Epub 2019 Mar 5.

Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.

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http://dx.doi.org/10.1016/j.ajog.2019.02.057DOI Listing

Evidence-based guidelines for the management of abnormally-invasive placenta (AIP): recommendations from the International Society for AIP.

Am J Obstet Gynecol 2019 Mar 5. Epub 2019 Mar 5.

Department of Obstetrics and Gynecology, CHR Citadelle, University of Liege, Liege, Belgium.

The worldwide incidence of abnormally invasive placenta is rapidly rising following the trend of increasing caesarean delivery. It is a heterogeneous condition and has a high maternal morbidity and mortality rate, presenting specific intra-partum challenges. Its rarity makes developing individual expertise difficult for the majority of clinicians. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.02.054DOI Listing
March 2019
3 Reads

M281, an anti-FcRn antibody, inhibits IgG transfer in a human ex vivo placental perfusion model.

Am J Obstet Gynecol 2019 Mar 5. Epub 2019 Mar 5.

Momenta Pharmaceuticals, Cambridge, MA, USA. Electronic address:

Background: The transfer of pathogenic immunoglobulin G antibodies from mother to fetus is a critical step in the pathophysiology of alloimmune and autoimmune diseases of the fetus and neonate. Immunoglobulin G transfer across the human placenta to the fetus is mediated by the neonatal Fc receptor, and blockade of the neonatal Fc receptor may provide a therapeutic strategy to prevent or minimize pathological events associated with immune-mediated diseases of pregnancy. M281 is a fully human, aglycosylated monoclonal immunoglobulin G1 anti-neonatal Fc receptor antibody that has been shown to block the neonatal Fc receptor with high affinity in nonclinical studies and in a phase 1 study in healthy volunteers. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.02.058DOI Listing
March 2019
2 Reads

Hyperoxygenation in pregnancy exerts a more profound effect on cardiovascular hemodynamics than is observed in the nonpregnant state.

Am J Obstet Gynecol 2019 Apr 5;220(4):397.e1-397.e8. Epub 2019 Mar 5.

Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, Rotunda, Hospital, Dublin, Ireland.

Background: Supplemental oxygen is administered to pregnant women in many different clinical scenarios in obstetric practice. Despite the accepted uses for maternal hyperoxygenation, the impact of hyperoxia on maternal hemodynamic indices has not been evaluated. As a result, there is a paucity of data in the literature in relation to the physiological changes to the maternal circulation in response to supplemental oxygen. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.02.059DOI Listing

Putting the "M" back in maternal-fetal medicine: A 5-year report card on a collaborative effort to address maternal morbidity and mortality in the United States.

Am J Obstet Gynecol 2019 Mar 5. Epub 2019 Mar 5.

University of Arizona College of Medicine Phoenix at Banner University Medical Center Phoenix, Phoenix, AZ.

The Centers for Disease Control and Prevention have demonstrated continuous increased risk for maternal mortality and severe morbidity with racial disparities among non-Hispanic black women an important contributing factor. More than 50,000 women experienced severe maternal morbidity in 2014, with a mortality rate of 18.0 per 100,000, higher than in many other developed countries. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.02.055DOI Listing
March 2019
7 Reads

Clinicopathologic features, incidence, and survival trends of gynecologic neuroendocrine tumors: a SEER database analysis.

Am J Obstet Gynecol 2019 Mar 5. Epub 2019 Mar 5.

Division of Gynecologic Oncology, SUNY Downstate Medical Center, Brooklyn, NY.

Background: Primary gynecologic neuroendocrine tumors are uncommon malignant neoplasms associated with poor prognosis. Clinically, these tumors present a significant challenge because of the lack of standardized management guidelines.

Objective: The objective of this study is to evaluate the clinicopathologic features, incidence, and survival trends in gynecologic neuroendocrine tumors. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.02.052DOI Listing
March 2019
5 Reads

Effect of using silver nylon dressings to prevent superficial surgical site infection after cesarean delivery: a randomized clinical trial.

Am J Obstet Gynecol 2019 Mar 5. Epub 2019 Mar 5.

Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL. Electronic address:

Background: Surgical site infections are associated with significant healthcare cost and burden. Silver-impregnated dressings have been associated with a decrease in surgical site infections in select populations, but it is unknown whether the benefit can be observed after cesarean deliveries.

Objective: We sought to evaluate the impact of silver nylon dressings in reducing superficial surgical site infections after cesarean delivery. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.02.053DOI Listing
March 2019
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Surgical variance between post-conceptional and pre-conceptional minimally invasive trans-abdominal cerclage placement.

Am J Obstet Gynecol 2019 Mar 25;220(3):289-290. Epub 2018 Oct 25.

Department of Obstetrics and Gynecology, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris (APHP), Le Kremlin-Bicêtre, France; Faculté de Médecine Paris-Sud, Université Paris-Sud, 94276, Le Kremlin-Bicêtre, France; INSERM, CESP Centre for research in Epidemiology and Population Health, U1018, Villejuif, France.

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https://linkinghub.elsevier.com/retrieve/pii/S00029378183091
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http://dx.doi.org/10.1016/j.ajog.2018.10.030DOI Listing
March 2019
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Postponing early intrauterine transfusion with intravenous immunoglobulin treatment: the PETIT study on severe hemolytic disease of the fetus and newborn.

Am J Obstet Gynecol 2019 Mar 25;220(3):288. Epub 2018 Oct 25.

Centre National de Référence en Hémobiologie Périnatale Clinique, Service de Médecine Foetale, Hôpital Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France; Médecine Sorbonne Université, 26 Avenue Arnold Netter, 75012 Paris, France. Electronic address:

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http://dx.doi.org/10.1016/j.ajog.2018.10.025DOI Listing

Opioid use after laparoscopic hysterectomy: prescriptions, patient use, and a predictive calculator.

Am J Obstet Gynecol 2019 Mar 25;220(3):259.e1-259.e11. Epub 2018 Oct 25.

Center for Minimally Invasive Gynecologic Surgery, Newton-Wellesley Hospital, Newton, MA.

Background: In the setting of America's opioid epidemic, judicious postoperative opioid prescribing is important. Gynecologists lack standard guidelines about postoperative opioid prescriptions.

Objectives: The objectives of the study were to describe opioid prescribing practices by a group of minimally invasive gynecologic surgeons, to measure postoperative opioid use after minimally invasive hysterectomy, and to identify preoperative factors that could predict whether a patient will be a low or high postoperative opioid user. Read More

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http://dx.doi.org/10.1016/j.ajog.2018.10.022DOI Listing
March 2019
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