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    39642 results match your criteria American journal of obstetrics and gynecology[Journal]

    1 OF 793

    Impact of Targeted Scanning Protocols on Perinatal Outcomes in Pregnancies at Risk of Placenta Accreta Spectrum or Vasa Previa.
    Am J Obstet Gynecol 2018 Jan 15. Epub 2018 Jan 15.
    Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel, affiliated with the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address:
    Background: Placenta accreta spectrum (PAS) and vasa previa (VP) are congenital disorders of placentation associated with high morbidity and mortality for both mothers and newborns when undiagnosed before delivery. Prenatal diagnosis of these conditions is essential to allow multidisciplinary management and thus improve perinatal outcomes.

    Objectives: To compare perinatal outcome in women with PAS or VP before and after implementation of targeted scanning protocols. Read More

    Clinical Assessment and Brain Findings in a Cohort of Mothers, Fetuses and Infants Infected with Zika Virus.
    Am J Obstet Gynecol 2018 Jan 15. Epub 2018 Jan 15.
    Department of Obstetrics and Gynecology. Division of Maternal Fetal Medicine. Cediul-Cedifetal, Barranquilla, Colombia.
    Background: Congenital Zika virus (ZIKV) infection can be detected in both the presence and absence of microcephaly, and manifests as a number of signs and symptoms detected clinically and by neuroimaging. However, to date, qualitative and quantitative measures for the purpose of diagnosis and prognosis are limited.

    Objectives: Main objectives of this study conducted on fetuses and infants with confirmed congenital ZIKV infection and detected brain abnormalities are: 1) To assess the prevalence of microcephaly and the frequency of the anomalies including a detailed description based on ultrasound and magnetic resonance imaging (MRI) in fetuses and ultrasound, MRI and computed tomography imaging postnatally; 2) To provide quantitative measures of fetal and infant brain findings by MRI using volumetric analyses and diffusion weighted imaging (DWI); 3) To obtain additional information from placental and fetal histopathological assessments and postnatal clinical evaluations. Read More


    Adherence to practice guidelines is associated with reduced referral times for patients with ovarian cancer.
    Am J Obstet Gynecol 2018 Jan 15. Epub 2018 Jan 15.
    Department of Gynecologic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA. Electronic address:
    Background: Patients with ovarian cancer tend to receive the highest quality of care at high-volume cancer centers with gynecologic oncologists. However, the care that they receive prior to gynecologic oncology consult has not been examined. We investigated the quantity and quality of care given to patients with ovarian cancer before being seen by a gynecologic oncologist. Read More

    Applying Surgical Antimicrobial Standards in Cesarean Deliveries.
    Am J Obstet Gynecol 2018 Jan 15. Epub 2018 Jan 15.
    Northwestern University Feinberg School of Medicine, Chicago, IL.
    Antimicrobial prophylaxis practices are critical to surgical site infection risk reduction strategies. Included in these practices is antibiotic redosing following prolonged procedures or after large blood losses. Guidelines have been published by several professional associations with most endorsing repeat antibiotic administration after an estimated blood loss of 1500ml or following two half-lives of the select agent. Read More

    Both Patients and Maternity Care Providers Can Benefit from Payment Reform: Four Steps to Prepare.
    Am J Obstet Gynecol 2018 Jan 12. Epub 2018 Jan 12.
    Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA.
    Many Medicaid programs and private health plans are implementing new models of maternity care reimbursement, and clinicians face mounting pressure to demonstrate high quality care at lower cost. Clinicians will be better prepared to meet these challenges with a fuller understanding of new payment models and the opportunities they present. We describe the structure of maternity care "episode payments" and recommend four ways that clinicians can prepare for success as value-based payment models are implemented: identify opportunities to improve outcomes and experience, measure quality, reduce waste and work in teams across settings. Read More

    Subsequent fertility, pregnancy and gynecologic outcomes after fetoscopic laser therapy for twin-twin transfusion syndrome compared to normal monochorionic twin gestations.
    Am J Obstet Gynecol 2018 Jan 12. Epub 2018 Jan 12.
    Department of Obstetrics and Gynecology, University Hospitals Leuven, Belgium, and Department of Development and Regeneration, Cluster Woman and Child, Group Biomedical Sciences, KU Leuven, Leuven, Belgium; Institute for Women's Health, University College London, London, UK. Electronic address:
    Background: An improved survival and quality of life for neonatal survivors after fetoscopic laser therapy (FLC) for twin-twin transfusion syndrome (TTTS) has been reported. However, little is known about the medium-term maternal effects after FLC with respect to reproductive and gynecologic outcomes.

    Objective: To document reproductive, obstetric, gynecologic and psychological outcomes in women who underwent FLC for TTTS. Read More

    Obstetric and gynecologic ultrasound curriculum and competency assessment in residency training programs: consensus report.
    Am J Obstet Gynecol 2018 01;218(1):29-67
    Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA.
    Ultrasound imaging has become integral to the practice of obstetrics and gynecology. With increasing educational demands and limited hours in residency programs, dedicated time for training and achieving competency in ultrasound has diminished substantially. The American Institute of Ultrasound in Medicine assembled a multisociety task force to develop a consensus-based, standardized curriculum and competency assessment tools for obstetric and gynecologic ultrasound training in residency programs. Read More

    Reply.
    Am J Obstet Gynecol 2018 01;218(1):146
    Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, 39 Jabotinski St., Petah Tikva, Israel 49100; Sackler Faculty of Medicine, Tel Aviv University, Tell Aviv, Israel. Electronic address:

    Meta-analysis on the effect of aspirin use for prevention of preeclampsia on placental abruption and antepartum hemorrhage.
    Am J Obstet Gynecol 2018 Jan 3. Epub 2018 Jan 3.
    Harris Birthright Research Centre of Fetal Medicine, Fetal Medicine Research Institute, King's College Hospital, London, United Kingdom.
    Background: Impaired placentation in the first 16 weeks of pregnancy is associated with increased risk of subsequent development of preeclampsia, birth of small for gestational age neonates and placental abruption. Previous studies reported that prophylactic use of aspirin reduces the risk of preeclampsia and small for gestational age neonates with no significant effect on placental abruption. However, meta-analyses of randomized controlled trials examining the effect of aspirin in relation to gestational age at onset of therapy and dose of the drug reported that significant reduction in the risk of preeclampsia and small for gestational age neonates is achieved only if the onset of treatment is at ≤16 weeks of gestation and the daily dose of the drug is ≥100 mg. Read More

    Comparative analysis of gene expression in maternal peripheral blood and monocytes during spontaneous preterm labor.
    Am J Obstet Gynecol 2018 Jan 2. Epub 2018 Jan 2.
    Program in Development and Fetal Health, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario M5G 1X5, Canada; Department of Obstetrics & Gynecology, University of Toronto, Canada. Electronic address:
    Background: Preterm birth is the leading cause of newborn death worldwide, and is associated with significant cognitive and physiological challenges in later life. There is a pressing need to define the mechanisms that initiate spontaneous preterm labor , and for development of novel clinical biomarkers to identify high-risk pregnancies. Most preterm birth studies utilize fetal tissues, and there is limited understanding of the transcriptional changes that occur in mothers undergoing spontaneous preterm labor. Read More

    Pelvic floor functional outcomes after total abdominal versus total laparoscopic hysterectomy for endometrial cancer.
    Am J Obstet Gynecol 2018 Jan 2. Epub 2018 Jan 2.
    Queensland Centre for Gynaecological Cancer, University of Queensland, Brisbane Australia; School of Medicine, University of Queensland, Brisbane, Australia. Electronic address:
    Background: Pelvic floor functioning is an important concern for women requiring a hysterectomy for endometrial cancer. The incidence of pelvic floor symptoms has not been reported in women who have undergone a hysterectomy for early-stage endometrial cancer.

    Objectives: To evaluate pelvic floor function in women who have had surgical treatment for early stage endometrial cancer as part of the multinational Laparoscopic Approach to Cancer of the Endometrium (LACE) trial and to compare patients' outcomes who had total abdominal total versus total laparoscopic hysterectomy. Read More

    Chronic hypertension: first-trimester blood pressure control and likelihood of severe hypertension, preeclampsia and small for gestational age.
    Am J Obstet Gynecol 2018 Jan 2. Epub 2018 Jan 2.
    King's College Hospital, London, UK. Electronic address:
    Background: There is extensive evidence that pre-pregnancy chronic hypertension is associated with high risk of development of severe hypertension and preeclampsia and birth of small for gestational age neonates. However, previous studies have not reported whether anti-hypertensive use, blood pressure control or normalization of blood pressure during early pregnancy influence the rates of these pregnancy complications.

    Objective: To stratify women with pre-pregnancy chronic hypertension according to the use of antihypertensive medications and level of blood pressure control at the first hospital visit during the first-trimester of pregnancy and examine the rates of severe hypertension, preeclampsia and birth of small for gestational age neonates according to such stratification. Read More

    The anatomy of the sacral promontory: how to avoid complications of the sacrocolpopexy procedure.
    Am J Obstet Gynecol 2018 Jan 2. Epub 2018 Jan 2.
    Gynecological department, Jeanne de Flandre hospital, University hospital of Lille, Avenue Eugène avinée, 59037 Lille Cedex, France.
    Because of problems with vaginal meshes and high rate recurrences of native tissue repair, more and more surgeons treat pelvic organ prolapse performing laparoscopic sacrocolpopexy. This surgery requires skilled surgeons. The first step of sacrocolpopexy is the dissection of tissues in front of the sacral promontory to reach the anterior longitudinal ligament. Read More

    Cardiac Arrest during pregnancy: Ongoing Clinical Conundrum An Expert Review.
    Am J Obstet Gynecol 2018 Jan 2. Epub 2018 Jan 2.
    Southern Colorado Maternal Fetal Medicine, Colorado Springs, Colorado. Electronic address:
    While global maternal mortality has decreased in the last 25 years, the maternal mortality ratio in the United States has actually increased. Maternal mortality is a complex phenomenon involving multifaceted socioeconomic and clinical parameters including inequalities in access to health care, racial and ethnic disparities, maternal comorbidities and epidemiologic ascertainment bias. Escalating maternal mortality underscores the importance of clinician preparedness to respond to maternal cardiac arrest that may occur in any maternal health care setting. Read More

    Diagnosis and Treatment of Urinary Tract Infections Across Age Groups.
    Am J Obstet Gynecol 2018 Jan 2. Epub 2018 Jan 2.
    Louisville, KY; St Louis, MO; Department of Obstetrics & Gynecology, Washington University in St Louis.
    Urinary tract infections (UTI) are the most common outpatient infections, but predicting the probability of UTI through symptoms and test results can be complex. The most diagnostic symptoms of UTI include change in frequency, dysuria, urgency, and presence or absence of vaginal discharge, but UTIs may present differently in older women. Dipstick urinalysis is popular for its availability and usefulness, but results must be interpreted in context of the patient's pretest probability based on symptoms and characteristics. Read More

    Sonographic Large Fetal Head Circumference and Risk of Cesarean Delivery.
    Am J Obstet Gynecol 2018 Jan 2. Epub 2018 Jan 2.
    Division of Obstetrics & Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. Electronic address:
    Background: Persistently high rates of cesarean deliveries are cause for concern for physicians, patients, and health systems. Prelabor assessment might be refined by identifying factors that help predict an individual patient's risk of cesarean delivery. Such factors may contribute to patient safety and satisfaction as well as health system planning and resource allocation. Read More

    Impact of recommended changes in labor management for prevention of the primary cesarean delivery.
    Am J Obstet Gynecol 2017 Dec 29. Epub 2017 Dec 29.
    Department of Obstetrics and Gynecology, Poissy-Saint Germain Hospital, Versailles-St Quentin University, France.
    Background: The dramatic rise in cesarean delivery (CD) rates worldwide in recent decades, without evidence of a concomitant decrease in cerebral palsy rates, has raised concerns about its potential negative consequences for maternal and infant health. In 2014, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine jointly published an Obstetric Care Consensus for safe prevention of the primary cesarean delivery.

    Objective: We sought to assess whether modification of our protocol to implement these recommendations helped to decrease our primary CD rate safely. Read More

    Assisted Reproductive Technology with Donor Sperm: National Trends and Perinatal Outcomes.
    Am J Obstet Gynecol 2017 Dec 29. Epub 2017 Dec 29.
    Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University, Atlanta, GA; Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
    Background: Information regarding use of donor sperm in assisted reproductive technology, as well as subsequent treatment and perinatal outcomes, remains limited. Outcome data would aid patient counseling and clinical decision-making.

    Objectives: To report national trends in donor sperm utilization and live birth rates of donor sperm assisted reproductive technology cycles in the United States, and to compare assisted reproductive technology treatment and perinatal outcomes between cycles using donor and non-donor sperm. Read More

    Effect of Frozen/Thawed Embryo Transfer on Birthweight, Macrosomia, and Low Birthweight Rates in us Singleton Infants.
    Am J Obstet Gynecol 2017 Dec 29. Epub 2017 Dec 29.
    Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA. Electronic address:
    Background: Singleton infants conceived using assisted reproductive technology have lower average birthweights than naturally-conceived infants and are more likely to be born low birthweight (<2500 grams). Lower birthweights are associated with increased infant and child mortality and poor adult health outcomes, including cardiovascular disease, hypertension, and diabetes. Data from registry and single center studies suggest that frozen/thawed embryo transfer may be associated with larger birthweights. Read More

    Regular Exercisers Have Stronger Pelvic Floor Muscles than Non-Regular Exercisers at Midpregnancy.
    Am J Obstet Gynecol 2017 Dec 26. Epub 2017 Dec 26.
    Norwegian School of Sport Sciences, Department of Sports Medicine, Oslo, Norway; Akershus University Hospital, Department of Obstetrics and Gynaecology, Lørenskog, Norway.
    Background: Today, all healthy pregnant women are encouraged to be physically active throughout pregnancy, with recommendations to participate in at least 30 min of aerobic activity on most days of the week, in addition to perform strength training of the major muscle groups 2-3 days per week, and also pelvic floor muscle training. There is, however, an ongoing debate whether general physical activity enhances or declines pelvic floor muscle function.

    Objectives: To compare vaginal resting pressure, pelvic floor muscle strength and endurance in regular exercisers (exercise ≥ 30 minutes ≥ 3 times per week) and non-exercisers at mid-pregnancy. Read More

    Nationwide Trends in the Utilization of and Payments for Hysterectomy in the United States Among Commercially Insured Women.
    Am J Obstet Gynecol 2017 Dec 26. Epub 2017 Dec 26.
    University of Michigan Institute for Healthcare Policy & Innovation, Ann Arbor, MI.
    Background: Laparotomy followed by inpatient hospitalization has traditionally been the most common surgical care for hysterectomy. The financial implications of the increased use of laparoscopy and outpatient hysterectomy are unknown.

    Objectives: To quantify the increasing use of laparoscopy and outpatient hysterectomy and to describe the financial implications among women with commercially based insurance in the United States. Read More

    Cost effectiveness of population based BRCA1 founder mutation testing in Sephardi Jewish women.
    Am J Obstet Gynecol 2017 Dec 26. Epub 2017 Dec 26.
    Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK; Gynaecological Cancer Research Centre, Department of Women's Cancer, Institute for Women's Health, University College London, London, UK, W1T 7DN; Department of Gynaecological Oncology, Barts Health NHS Trust, Royal London Hospital, London E1 1BB, UK. Electronic address:
    Background: Population-based BRCA1/BRCA2 founder-mutation testing has been demonstrated as cost-effective compared to family-history(FH) based testing in Ashkenazi Jewish(AJ) women. However, only one of the three AJ BRCA1/BRCA2 founder-mutations (185delAG(c.68_69delAG), 5382insC(c. Read More

    A Proteomic Clock of Human Pregnancy.
    Am J Obstet Gynecol 2017 Dec 22. Epub 2017 Dec 22.
    Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine; Stanford, CA. Electronic address:
    Background: Early detection of maladaptive processes underlying pregnancy-related pathologies is desirable, as it will enable targeted interventions ahead of clinical manifestations. The quantitative analysis of plasma proteins features prominently among molecular approaches used to detect deviations from normal pregnancy. However, derivation of proteomic signatures sufficiently predictive of pregnancy-related outcomes has been challenging. Read More

    Patterns and correlates of cervical cancer screening initiation in a large integrated healthcare system.
    Am J Obstet Gynecol 2017 Dec 22. Epub 2017 Dec 22.
    Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA. Electronic address:
    Background: The latest 2012 United States Preventive Services Task Force cervical cancer screening guidelines recommended screening initiation at age 21 years. Little is known about the cervical cancer screening initiation practices in the community, and whether there are critical gaps with respect to adherence to current clinical guidelines. Despite an overall decline in cervical cancer incidence across women of all ages, the incidence rate has not declined among 24-25 year-olds between 2000 (2. Read More

    Longitudinal study of quantitative changes in pelvic organ support among parous women.
    Am J Obstet Gynecol 2017 Dec 22. Epub 2017 Dec 22.
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
    Background: Pelvic organ prolapse is more common among parous (versus nulliparous) women and also more common after vaginal (versus cesarean) birth. However, very little is known about how childbirth affects the course and progression of pelvic organ prolapse across a woman's lifespan.

    Objective: To investigate longitudinal, quantitative changes in pelvic organ support after childbirth, focusing on the impact of vaginal versus cesarean delivery. Read More

    Is there a role for placental senescence in the genesis of obstetric complications and fetal growth restriction?
    Am J Obstet Gynecol 2017 Dec 22. Epub 2017 Dec 22.
    Mothers and Babies Research Centre, Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, Callaghan, New South Wales, Australia; School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre in Reproductive Science, Faculty of Health and Medicine, Callaghan, New South Wales, Australia. Electronic address:
    The placenta ages as pregnancy advances, yet its continued function is required for a successful pregnancy outcome. Placental aging is a physiological phenomenon; however, there are some placentas that show signs of aging earlier than others. Premature placental senescence and aging are implicated in a number of adverse pregnancy outcomes, including fetal growth restriction, preeclampsia, spontaneous preterm birth, and intrauterine fetal death. Read More

    Screening for fetal growth restriction using fetal biometry combined with maternal biomarkers.
    Am J Obstet Gynecol 2017 Dec 22. Epub 2017 Dec 22.
    Department of Obstetrics and Gynecology, National Institute for Health Research Cambridge Comprehensive Biomedical Research Center, and Center for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom. Electronic address:
    Fetal growth restriction is a major determinant of perinatal morbidity and mortality. Screening for fetal growth restriction is a key element of prenatal care but it is recognized to be problematic. Screening using clinical risk assessment and targeting ultrasound to high-risk women is the standard of care in the United States and United Kingdom, but the approach is known to have low sensitivity. Read More

    Fetal growth standards: the NICHD fetal growth study approach in context with INTERGROWTH-21st and the World Health Organization Multicentre Growth Reference Study.
    Am J Obstet Gynecol 2017 Dec 22. Epub 2017 Dec 22.
    Division of Intramural Population Health Research, Office of the Director, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.
    Three recently completed longitudinal cohort studies have developed intrauterine fetal growth charts, one in the United States and two international. This expert review compares and contrasts the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies, INTERGROWTH-21st and World Health Organization Multicentre Growth Reference Study conclusions in light of differences in aims, sampling frames, and analytical approaches. An area of controversy is whether a single growth reference is representative of growth, regardless of ethnic or country origin. Read More

    Extremely preterm fetal sheep lung responses to antenatal steroids and inflammation.
    Am J Obstet Gynecol 2017 Dec 21. Epub 2017 Dec 21.
    Background: The efficacy of antenatal steroids for fetal lung maturation in the peri-viable period is not fully understood.

    Objective(s): To determine the lung maturational effects of ANS and inflammation in early gestation sheep fetuses, similar to the peri-viable period in humans.

    Study Design: Date-mated ewes with singleton fetuses were randomly assigned to one of 4 treatment groups (n=8/group): 1) maternal intramuscular injection (IM) of betamethasone (Beta), 2) intra-amniotic lipopolysaccharide (IA) (LPS), 3) Beta+LPS, 4) IA+IM Saline (controls). Read More

    Preoperative Cesarean Section Intravenous Acetaminophen Treatment for Postoperative Pain Control: A Randomized Double-Blinded Placebo Control Trial.
    Am J Obstet Gynecol 2017 Dec 21. Epub 2017 Dec 21.
    Department of Obstetrics & Gynecology, University of Tennessee Medical Center, Knoxville, Tennessee.
    Background: The United States currently has an opioid use disorder epidemic and research evaluating ways to minimize the use of opioids post-surgery are needed. One of these options is intravenous (IV) acetaminophen. If the use of preoperative IV acetaminophen was found to be effective for cesarean delivery, this would be beneficial for both the mother and breastfeeding neonate. Read More

    The past, present, and future of selective progesterone receptor modulators in the management of uterine fibroids.
    Am J Obstet Gynecol 2017 Dec 21. Epub 2017 Dec 21.
    Department of Obstetrics & Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
    Uterine fibroids (UF) are common in women of reproductive age and can have a significant impact on quality of life and fertility. Although a number of international OB/GYN societies have issued evidence-based clinical practice guidelines for the management of symptomatic UF, many of these guidelines do not yet reflect the most recent clinical evidence and approved indication for one of the key medical management options: the selective progesterone receptor modulator (SPRM) class. This paper aims to share the clinical experience gained with SPRMs in Europe and Canada by reviewing the historical development of SPRMs, current best practices for SPRM use based on available data, and potential future uses for SPRMs in UF and other gynecologic conditions. Read More

    A 2009 fetal monitor recall that arguably should have been class I.
    Am J Obstet Gynecol 2017 Dec 21. Epub 2017 Dec 21.
    Hôpital de Thetford Mines, Department of Obstetrics and Gynecology, 1717 rue Notre Dame E, Thetford Mines, QC, Canada, G6G 2V4. Electronic address:
    The Philips Avalon 2009 fetal monitor class II recall should arguably been class I and vigilance is required to be sure that all providers still using these monitors are adequately informed. Read More

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