Olivia O Cardenas-Trowers, Alyce G Abraham, Thomas K Dotson, Brooke A Houlette, Jeremy T Gaskins, Sean L Francis
OBJECTIVE: To evaluate the utility of adding triamcinolone acetonide to a standard bladder instillation solution for treatment of interstitial cystitis-bladder pain syndrome. METHODS: This was a single-center, randomized, double-blind trial that compared symptom response in women with interstitial cystitis-bladder pain syndrome who underwent six bladder instillations with triamcinolone acetonide or six instillations without. All instillation solutions contained heparin, viscous lidocaine, sodium bicarbonate, and bupivacaine...
April 8, 2021: Obstetrics and Gynecology
Shayan Dioun, Ling Chen, Alexander Melamed, Allison Gockley, Caryn M St Clair, June Y Hou, Ana I Tergas, Fady Khoury-Collado, Chin Hur, Dawn L Hershman, Jason D Wright
OBJECTIVE: To examine the utilization, morbidity, and cost of sentinel lymph node mapping in women undergoing hysterectomy for complex atypical endometrial hyperplasia. METHODS: Women with complex atypical endometrial hyperplasia who underwent hysterectomy from 2012 to 2018 in the Perspective database were examined. Perioperative morbidity, mortality, and cost were examined based on performance of sentinel lymph node mapping, lymph node dissection or no nodal evaluation...
April 8, 2021: Obstetrics and Gynecology
Jean Guglielminotti, Cynthia A Wong, Alexander M Friedman, Guohua Li
OBJECTIVE: To analyze racial and ethnic disparities in failure to rescue (ie, death) associated with severe maternal morbidity and describe temporal trends. METHODS: This was a retrospective cohort study using administrative data. Data for delivery hospitalizations with severe maternal morbidity, as defined by the Centers for Disease Control and Prevention, were abstracted from the 1999-2017 National Inpatient Sample. Race and ethnicity were categorized into non-Hispanic White (reference), non-Hispanic Black, Hispanic, other, and missing...
April 8, 2021: Obstetrics and Gynecology
Jason D Wright, Ling Chen, Hye-Chun Hur, Alexander Melamed, Dawn L Hershman
No abstract text is available yet for this article.
April 8, 2021: Obstetrics and Gynecology
Tiffany L Green, Jasmine Y Zapata, Heidi W Brown, Nao Hagiwara
In this article, we address the limitations of existing implicit bias interventions as a strategy for achieving maternal health equity. We then focus on how institutionally sanctioned racial stereotyping harms Black maternal health and marginalizes a key group in the fight for health equity-Black physicians. Finally, we provide strategies to address racial bias in perinatal health care and structural barriers impeding Black physicians' success.
April 8, 2021: Obstetrics and Gynecology
Emma R Allanson, Sean Copson, Katrina Spilsbury, Sonya Criddle, Belinda Jennings, Dorota A Doherty, Antonia M Wong, Jan E Dickinson
OBJECTIVE: To assess the efficacy of pretreatment with mifepristone before misoprostol, compared with misoprostol alone, for termination of pregnancy after a fetal death in the second trimester. METHODS: This prospective, double blind, placebo-controlled trial randomized women requiring a termination of pregnancy after fetal death between 14 and 28 weeks of gestation to placebo or 200 mg mifepristone orally 24-48 hours before the termination of pregnancy with misoprostol (400 micrograms every 6 hours vaginally for women at 24 weeks of gestation or less, and 200 micrograms every 4 hours vaginally for women at 24 weeks of gestation or more)...
April 8, 2021: Obstetrics and Gynecology
Elisabeth C Sappenfield, Elena Tunitsky-Bitton
BACKGROUND: This surgical simulation model for vaginal posterior repair is designed to enhance vaginal surgical training. METHODS: A beef tongue simulation model was previously described and validated to practice the repair of obstetric laceration. The model was modified for surgical simulation of vaginal posterior repair. Chicken skin was used to simulate the anal canal. The model was secured in a PVC (polyvinyl chloride) pipe attached to a wooden base to simulate operating within the vaginal canal...
April 8, 2021: Obstetrics and Gynecology
Stefanie J Hollenbach, Kathryn Drennan, Eva K Pressman, Lisa Gray
OBJECTIVE: To use a data-fusion approach to improve ascertainment of maternal deaths not detected with standard surveillance strategies. METHODS: We conducted a retrospective cohort study from the electronic health records of a tertiary medical center from 2011 to 2018. Cases of maternal death were identified in two ways: 1) using a standard medical informatics service query of hospital data and 2) using the TriNetX discovery tool as patients with a vital status of "deceased" and evidence of antecedent pregnancy exposure based on such factors as obstetric diagnostic codes or obstetric-related procedures...
April 8, 2021: Obstetrics and Gynecology
Aaron M Dom, Rebecca Royzer, Courtney Olson-Chen
BACKGROUND: Although acetaminophen is commonly used in pregnancy, it can deplete glutathione concentrations and cause accumulation of 5-oxoproline, with subsequent metabolic acidosis. CASE: A malnourished 25-year-old woman, G2P1001, with chronic acetaminophen use presented with abdominal pain and high anion gap metabolic acidosis. After ruling out other potential causes, her urine 5-oxoproline level was found to be elevated. She received N-acetylcysteine, with resolution of the acidosis...
April 8, 2021: Obstetrics and Gynecology
Kate Coleman-Minahan, Elizabeth J Ela, Kari White, Daniel Grossman
OBJECTIVE: To examine the prevalence of contraindications to hormonal contraception among postpartum women. METHODS: Low-income postpartum women who planned to delay childbearing for 2 years or longer after delivery were recruited for a prospective cohort study from eight Texas hospitals. Women self-reported health conditions that corresponded to category 3 and 4 contraindications to combined hormonal contraception and progestin-only methods, based on the Centers for Disease Control and Prevention's 2016 Medical Eligibility Criteria for Contraceptive Use...
April 8, 2021: Obstetrics and Gynecology
Mariam M AlHilli, Holly J Pederson
Personalized management of patients at risk ideally should involve a multidisciplinary team of not only genetic counselors and surgeons, but also women's health or menopause specialists, knowledgeable psychologists, and primary care providers or obstetrician-gynecologists aware of the risks and fears "previvors" (survivors of a predisposition to cancer who have not had the disease) face as well as the issues that are common postoperatively. Identification of patients at risk for hereditary cancer, understanding of current genetic testing modalities and potential results, knowledge about screening and prevention including timing of surveillance, preventive medication and risk-reducing surgeries, understanding limitations and comorbidities associated with these risk management strategies and long-term psychological support are all important in hereditary cancer management...
April 8, 2021: Obstetrics and Gynecology
Aasta Mehta, Sindhu K Srinivas
No abstract text is available yet for this article.
April 8, 2021: Obstetrics and Gynecology
Marika Toscano, Rebecca Royzer, Daniel Castillo, Dongmei Li, Ellen Poleshuck
OBJECTIVE: To systematically review the prevalence of antenatal depression and anxiety in women hospitalized in an antepartum unit for obstetric complications. DATA SOURCES: We searched PubMed, EMBASE, CINAHL, PsycINFO, and for English-language articles published from database inception through March 2020. METHODS OF STUDY SELECTION: We included cross-sectional, cohort, case-control, quasi-experimental, and randomized controlled studies from any country that reported the proportion of pregnant women with an elevated depression or anxiety screening scale or diagnostic interview during antepartum hospitalization of any duration and at any gestational age...
April 8, 2021: Obstetrics and Gynecology
Avery M Whitis, Edison Chen, Morgan Sekhon, Sraavya Akella, Catherine S Bradley, Joseph T Kowalski
OBJECTIVE: To assess whether candy cane stirrup use is associated with an increased risk of lower extremity peripheral neuropathy compared with boot stirrups in women undergoing surgery requiring dorsal lithotomy positioning. METHODS: This retrospective cohort study (June 2008-August 2015) included patients who underwent gynecologic surgery for benign indication lasting 60 minutes or longer in the lithotomy position. Patients with preexisting neurologic disease were excluded...
April 8, 2021: Obstetrics and Gynecology
Marian F MacDorman, Eugene Declercq
No abstract text is available yet for this article.
April 8, 2021: Obstetrics and Gynecology
Maura Jones, Manisha Sigdel, Karen Fernandes, Dwight J Rouse
No abstract text is available yet for this article.
April 8, 2021: Obstetrics and Gynecology
Maria W Steenland, Katy B Kozhimannil, Erika F Werner, Jamie R Daw
OBJECTIVE: To compare the type, frequency, and timing of health care use among commercially insured postpartum and nonpostpartum women. METHODS: This retrospective cohort study used data from a large national commercial claims database. Women between 18 and 44 years of age who gave birth in 2016 (n=149,563) and women who were neither pregnant nor postpartum between 2015 and 2017 (n=2,048,831) (nonpostpartum) were included. We examined hospitalization, and preventive visits, problem visits, and emergency department (ED) visits among postpartum women during the early postpartum period (less than 21 days after childbirth), the postpartum period (21-60 days postpartum), and extended postpartum period (61-365 days after childbirth)...
April 8, 2021: Obstetrics and Gynecology
Jessica R Meeker, Silvia P Canelón, Ray Bai, Lisa D Levine, Mary Regina Boland
OBJECTIVE: To investigate the association between individual-level and neighborhood-level risk factors and severe maternal morbidity. METHODS: This was a retrospective cohort study of all pregnancies delivered between 2010 and 2017 in the University of Pennsylvania Health System. International Classification of Diseases codes classified severe maternal morbidity according to the Centers for Disease Control and Prevention guidelines. Logistic regression modeling evaluated individual-level risk factors for severe maternal morbidity, such as maternal age and preeclampsia diagnosis...
April 8, 2021: Obstetrics and Gynecology
Melissa P McHale, Anna Jo B Smith, Amanda N Fader, Stephanie L Wethington
OBJECTIVE: To characterize the indications for and complication rates of excision of the retained cervix after supracervical hysterectomy. METHODS: We performed a retrospective cohort study of women undergoing excision of the retained cervix after supracervical hysterectomy in the 2010-2014 National Inpatient Sample. International Classification of Diseases, Ninth Revision codes were used to identify indication for the procedure and surgical complications. We weighted the hospital-level data to obtain nationwide estimates of patient characteristics, surgical complications, and length of stay...
April 8, 2021: Obstetrics and Gynecology
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No abstract text is available yet for this article.
April 8, 2021: Obstetrics and Gynecology
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