journal
https://read.qxmd.com/read/38387029/treating-mild-chronic-hypertension-during-pregnancy-a-cost-effectiveness-analysis
#21
JOURNAL ARTICLE
Uma Doshi, Sarina Chaiken, Alyssa Hersh, Karen J Gibbins, Aaron B Caughey
OBJECTIVE: To assess the cost effectiveness of targeting a blood pressure of less than 140/90 mm Hg compared with 160/105 mm Hg. METHODS: A decision-analytic model was constructed to compare the treatment of chronic hypertension in pregnancy at mild-range blood pressures (140/90 mm Hg) with the treatment of chronic hypertension before 20 weeks of gestation at severe-range blood pressures (160/105 mm Hg) in a theoretical cohort of 180,000 patients with mild chronic hypertension...
February 22, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38350107/a-comparison-of-newer-and-traditional-approaches-to-diagnosing-vaginal-infections
#22
JOURNAL ARTICLE
Anna Powell, Oluwatosin Goje, Paul Nyirjesy
Molecular diagnostic testing (eg, polymerase chain reaction [PCR]-based vaginitis testing) is widely used in clinical practice, although vaginitis experts have reservations about its use for vaginitis diagnosis. As with any new technology, cost to the health system is a large concern. Although clinical evaluation of signs and symptoms along with wet mount microscopy is traditionally used for vaginitis diagnosis, it is less accurate compared with molecular diagnostic testing. Here we review the benefits of adopting newer molecular diagnostics into routine gynecologic practice with some guidance from vaginitis experts that favor both traditional and more modern approaches...
February 13, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38350106/angiogenic-biomarkers-in-preeclampsia
#23
JOURNAL ARTICLE
Richard M Burwick, M Hellen Rodriguez
Preeclampsia contributes disproportionately to maternal and neonatal morbidity and mortality throughout the world. A critical driver of preeclampsia is angiogenic imbalance, which is often present weeks to months before overt disease. Two placenta-derived angiogenic biomarkers, soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF), have proved useful as diagnostic and prognostic tests for preeclampsia. Recently, the U.S. Food and Drug Administration approved the sFlt-1/PlGF assay to aid in the prediction of preeclampsia with severe features among women with hypertensive disorders of pregnancy at 24-34 weeks of gestation...
February 13, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38350105/uterine-sacculation-with-entrapped-placenta-after-delivery
#24
JOURNAL ARTICLE
Michael T Solotke, Glenn Boyles, Kara Rood, Emily Hinchcliff, Jeanne M Horowitz, Lynn M Yee
BACKGROUND: Uterine sacculation refers to a temporary pouch or sac within the uterus that may contain the placenta or fetal parts and that may be diagnosed antepartum or after delivery. There is very limited published information about this rare condition and its management. CASES: We report two cases of uterine sacculation with entrapped placenta diagnosed immediately postpartum, managed with two different approaches. In one case, the patient underwent immediate laparotomy and placental extraction...
February 13, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38330411/late-preterm-antenatal-steroids-for-reduction-of-neonatal-respiratory-complications-a-randomized-controlled-trial
#25
JOURNAL ARTICLE
Hilda Yenuberi, Benjamin Ross, Richa Sasmita Tirkey, Santosh Joseph Benjamin, Swati Rathore, Reka Karuppusami, Aadarsh Lal, Niranjan Thomas, Jiji Elizabeth Mathew
OBJECTIVE: To evaluate the efficacy of antenatal corticosteroids in reducing neonatal respiratory complications when administered to those at risk of preterm delivery between 34 and 36 6/7 weeks of gestation. METHODS: This was a single-center, triple-blind, randomized, placebo-controlled trial in southern India enrolling pregnant participants at risk of preterm delivery between 34 and 36 6/7 weeks of gestation. Computer-generated block randomization was used with participants randomized to either one course of intramuscular betamethasone or placebo...
February 8, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38330409/neonatal-birth-weight-with-daily-compared-with-every-other-day-glucose-monitoring-in-gestational-diabetes-mellitus-a-randomized-controlled-trial
#26
JOURNAL ARTICLE
Kristina Martimucci Feldman, Arielle Coughlin, Jasmin Feliciano, Guillaume Stoffels, Kelly Z Wang, Tirtza Spiegel Strauss, Olivia Grubman, Zainab Al-Ibraheemi, David Cole, Graham Ashmead, Farrah Hussain, Sophia Scarpelli Shchur, Deborah Lee, Lois Brustman
OBJECTIVE: To assess whether universal use of every-other-day glucose monitoring in patients with gestational diabetes mellitus (GDM) resulted in similar birth weights and medication use and was preferred by the patient compared with traditional daily glucose monitoring. METHODS: This was a noninferiority randomized controlled trial conducted at a single New York City hospital between April 2021 and May 2022. Patients with singleton pregnancies who were diagnosed with GDM after 20 weeks of gestation and had a minimum of 7 days of previous daily blood glucose testing were randomly assigned to test blood glucose values daily or every other day...
February 8, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38330408/late-preterm-corticosteroids-in-low-resource-settings
#27
JOURNAL ARTICLE
Blair J Wylie, Syed Asad Ali
No abstract text is available yet for this article.
February 8, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38330405/understanding-new-recommendations-for-respiratory-syncytial-virus-prevention-in-pregnancy
#28
JOURNAL ARTICLE
Rebecca Horgan, Brenna L Hughes, Jerri Waller, Yara Hage Diab, George Saade
Respiratory syncytial virus (RSV) is a significant cause of infant morbidity and mortality worldwide with peak hospitalization rates for RSV-mediated illnesses between 2 and 3 months of life. Until very recently, prevention strategies for RSV involved primarily passive immunization of neonates at high risk with monoclonal antibodies and promotion of breastfeeding. The Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices now recommends passive immunization of all neonates with monoclonal antibodies during RSV season, and the American Association of Pediatrics has endorsed this practice...
February 8, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38330401/endometrial-cancer-in-a-transgender-man-with-prolonged-exogenous-testosterone-use
#29
JOURNAL ARTICLE
Stephanie Gill, Michelle Anderson, Joannie Neveu
BACKGROUND: Hormone therapy (HT) in transgender males requires monitoring. For amenorrheic transmasculine individuals on HT, episodes of abnormal vaginal bleeding should be assessed promptly. CASE: A 33-year-old transgender man on exogenous testosterone therapy for medical gender transition was found to have stage IV endometrioid endometrial adenocarcinoma. Surgical resection was performed for symptom control, and the patient was treated with palliative chemotherapy...
February 8, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38330397/effects-of-obesity-on-urogynecologic-prolapse-surgery-outcomes-a-systematic-review-and-meta-analysis
#30
JOURNAL ARTICLE
Nancy E Ringel, Stacy M Lenger, Rachel High, Alexandriah Alas, Sara Houlihan, Olivia H Chang, Jon Pennycuff, Ruchira Singh, Amanda White, Lioudmila Lipitskaia, Sadikah Behbehani, David Sheyn, Bela Kudish, Mikio Nihira, Ambereen Sleemi, Cara Grimes, Ankita Gupta, Ethan M Balk, Danielle D Antosh
OBJECTIVE: To systematically review the literature on outcomes of pelvic organ prolapse (POP) surgery in patients from various body mass index (BMI) categories to determine the association between obesity and surgical outcomes. DATA SOURCES: PubMed, EMBASE, and Cochrane databases were searched from inception to April 12, 2022; ClinicalTrials.gov was searched in September 2022 (PROSPERO 2022 CRD42022326255). Randomized and nonrandomized studies of urogynecologic POP surgery outcomes were accepted in which categories of BMI or obesity were compared...
February 8, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38301258/inpatient-management-of-hyperemesis-gravidarum
#31
JOURNAL ARTICLE
Shannon M Clark, Xue Zhang, Daphne Arena Goncharov
Hyperemesis gravidarum has a reported incidence of approximately 0.3-3% of pregnancies. Without treatment, refractory hyperemesis gravidarum can result in dehydration, electrolyte deficiencies, and severe nutritional deficiencies, resulting in significant maternal morbidity. The overall goals of inpatient management of refractory hyperemesis gravidarum are the resumption of oral intake to an adequate level to maintain hydration and nutrition, including the ability to tolerate oral pharmacotherapy. Patients initially are stabilized with rehydration and electrolyte repletion...
February 1, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38301256/association-between-neighborhood-deprivation-in-early-pregnancy-and-gestational-diabetes-mellitus
#32
JOURNAL ARTICLE
Emily F Liu, Assiamira Ferrara, Sneha B Sridhar, Mara B Greenberg, Monique M Hedderson
OBJECTIVE: To evaluate whether having a pregnancy in a deprived neighborhood was associated with an increased risk of gestational diabetes mellitus (GDM) compared with having a pregnancy in the least-deprived neighborhoods. METHODS: This was a retrospective observational cohort study of pregnant individuals within Kaiser Permanente Northern California from 2011 to 2018 with residential history from prepregnancy through 24 weeks of gestation and clinical data from prepregnancy through delivery...
February 1, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38301255/enabling-technologies-for-gynecologic-vaginal-surgery-a-systematic-review
#33
JOURNAL ARTICLE
Sunil Balgobin, Ethan M Balk, Anne E Porter, Meenal Misal, Tamara Grisales, Kate V Meriwether, Peter C Jeppson, Paula J Doyle, Sarit O Aschkenazi, Jeannine M Miranne, Deslyn T Hobson, David L Howard, Saifuddin Mama, Ankita Gupta, Danielle D Antosh
OBJECTIVE: To systematically review the literature to evaluate clinical and surgical outcomes for technologies that facilitate vaginal surgical procedures. DATA SOURCES: We systematically searched MEDLINE, EMBASE, and ClinicalTrials.gov from January 1990 to May 2022. METHODS OF STUDY SELECTION: Comparative and single-arm studies with data on contemporary tools or technologies facilitating intraoperative performance of vaginal gynecologic surgical procedures for benign indications were included...
February 1, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38301254/structural-racism-and-use-of-labor-neuraxial-analgesia-among-non-hispanic-black-birthing-people
#34
JOURNAL ARTICLE
Jean Guglielminotti, Allison Lee, Ruth Landau, Goleen Samari, Guohua Li
OBJECTIVE: To assess the association between structural racism and labor neuraxial analgesia use. METHODS: This cross-sectional study analyzed 2017 U.S. natality data for non-Hispanic Black and White birthing people. The exposure was a multidimensional structural racism index measured in the county of the delivery hospital. It was calculated as the mean of three Black-White inequity ratios (ratios for lower education, unemployment, and incarceration in jails) and categorized into terciles, with the third tercile corresponding to high structural racism...
February 1, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38262066/neurodevelopment-of-children-whose-mothers-were-randomized-to-low-dose-aspirin-during-pregnancy
#35
JOURNAL ARTICLE
Matthew K Hoffman, Shivaprasad Goudar, Sangappa Dhaded, Lester Figueroa, Manolo Mazariegos, Nancy F Krebs, Jamie Westcott, Shiyam Sunder Tikmani, Fatima Karim, Sarah Saleem, Robert L Goldenberg, Adrien Lokangaka, Antoinette Tshefu, Melissa Bauserman, Archana Patel, Prabir Das, Patricia Hibberd, Elwyn Chomba, Musaku Mwenchanya, Waldemar A Carlo, Marissa Trotta, Alexis Williams, Janet Moore, Tracy Nolen, Norman Goco, Elizabeth M McClure, Michele A Lobo, Andrea B Cunha, Richard J Derman
OBJECTIVE: Because low-dose aspirin is now commonly prescribed in pregnancy, we sought to assess the association between early antenatal exposure and child neurodevelopment. METHODS: We performed a noninferiority, masked, neurodevelopmental follow-up study of children between age 33 and 39 months whose mothers had been randomized to daily low-dose aspirin (81 mg) or placebo between 6 0/7 and 13 6/7 weeks of gestation through 37 weeks. Neurodevelopment was assessed with the Bayley-III (Bayley Scales of Infant and Toddler Development, 3rd Edition) and the ASQ-3 (Ages and Stages Questionnaire, 3rd Edition)...
January 23, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38262065/outcomes-after-induction-of-labor-compared-with-dilation-and-evacuation-for-the-management-of-rupture-of-membranes-in-the-second-trimester
#36
JOURNAL ARTICLE
Elizabeth A Hoffman, Jason Kaufman, Nathanael C Koelper, Sarita Sonalkar, Andrea H Roe
Previable and periviable rupture of membranes is associated with significant morbidity for the pregnant patient. For those who have a choice of options and undergo active management, it is not known how the risks of induction of labor compare with those for dilation and evacuation (D&E). We performed a retrospective cohort study of patients with rupture of membranes between 14 0/7 and 23 6/7 weeks of gestation who opted for active management. Adverse events (52.2% vs 16.9%, P<.01) and time to uterine evacuation greater than 24 hours (26...
January 23, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38227947/longitudinal-reoperation-risk-after-apical-prolapse-procedures-in-women-aged-65-years-and-older
#37
JOURNAL ARTICLE
Alexander A Berger, Carol E Bretschneider, W Thomas Gregory, Vivian Sung
OBJECTIVE: To describe longitudinal reoperation risk among older women undergoing surgery for apical pelvic organ prolapse (POP) and to compare risk of reoperation for prolapse and complications among different surgical approaches. METHODS: This nationwide, retrospective cohort study evaluated older adult women (aged 65 years and older) within the Centers for Medicare & Medicaid Services' (CMS) 5% LDS (Limited Data Set) who underwent sacrocolpopexy, uterosacral ligament suspension (USLS), sacrospinous ligament fixation (SSLF), or colpocleisis, or their uterine-preserving equivalents, from January 1, 2011, to December 31, 2018, with follow-up through 2019...
January 16, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38227938/immunosuppressant-medications-in-pregnancy
#38
JOURNAL ARTICLE
Antonio F Saad, Luis D Pacheco, George R Saade
Pregnant patients are often on immunosuppressant medications, most commonly to manage transplantation or autoimmune disorders. Most immunosuppressant agents, including tacrolimus, corticosteroids, azathioprine, and calcineurin inhibitors, are safe during pregnancy and lactation. However, mycophenolic acid is associated with higher risks of birth defects and should be avoided in pregnancy. Tacrolimus, the commonly used drug in transplantation medicine and autoimmune disorders, requires monitoring of serum levels for dose adjustment, particularly during pregnancy...
January 16, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38207338/effect-of-uterine-leiomyomas-on-noninvasive-prenatal-testing-parameters-in-the-first-trimester
#39
JOURNAL ARTICLE
Teodora R Kolarova, Ali Alderson, Hayley MacKinnon, Leah Chen, Jillian G Buchan, Christina Lockwood, Raj Shree
Uterine leiomyomas may affect the performance of cell-free DNA (cfDNA)-based noninvasive prenatal testing (NIPT). We conducted a retrospective cohort study of pregnant individuals with and without leiomyomas undergoing first-trimester cfDNA-based NIPT. Characteristics of NIPT in patients with leiomyomas (n=122) were compared with those in patients without leiomyomas (n=937). Mean fetal fraction was lower in patients with leiomyomas compared with patients without (10.0% vs 11.5%; P=.001); however, the rate of indeterminate results was different only in patients without obesity (body mass index [BMI] lower than 30) (5...
January 11, 2024: Obstetrics and Gynecology
https://read.qxmd.com/read/38207334/association-between-length-of-maternity-leave-and-breastfeeding-duration-in-the-united-states-a-systematic-review
#40
JOURNAL ARTICLE
Lorena Wicklund, Allison Epstein, Heidi Szugye, Mary Schleicher, Suet Kam Lam
OBJECTIVE: To perform a systematic review to assess the association between the length of maternity leave and breastfeeding duration in the United States. DATA SOURCES AND METHODS OF STUDY SELECTION: This review was conducted with a five-stage model for reviews. We included publications from 2000 to 2023, U.S.-based studies written in English, and primary research and peer-reviewed articles. In February 2023, a medical librarian conducted a search across seven databases, yielding 1,540 results...
January 11, 2024: Obstetrics and Gynecology
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