641 research outputs found
Enabling precision medicine in neonatology, an integrated repository for preterm birth research
Three-dimensional power Doppler evaluation of cerebral vascular blood flow: A novel tool in the assessment of fetal growth restriction
Clinical Diagnosis of Placenta Accreta and Clinicopathological Outcomes
Objective To investigate the association between the intraoperative diagnosis of placenta accreta at the time of cesarean hysterectomy and pathological diagnosis.
Study Design This is a retrospective cohort study of all patients undergoing cesarean hysterectomy for suspected placenta accreta from 2000 to 2016 at Barnes-Jewish Hospital. The primary outcome was the presence of invasive placentation on the pathology report. We estimated predictive characteristics of clinical diagnosis of placenta accreta using pathological diagnosis as the correct diagnosis.
Results There were 50 cesarean hysterectomies performed for suspected abnormal placentation from 2000 to 2016. Of these, 34 (68%) had a diagnosis of accreta preoperatively and 16 (32%) were diagnosed intraoperatively at the time of cesarean delivery. Two patients had no pathological evidence of invasion, corresponding to a false-positive rate of 4% (95% confidence interval [CI]: 0.5%, 13.8%) and a positive predictive value of 96% (95% CI: 86.3%, 99.5%). There were no differences in complications among patients diagnosed intraoperatively compared with those diagnosed preoperatively.
Conclusion Most patients undergoing cesarean hysterectomy for placenta accreta do have this diagnosis confirmed on pathology. However, since the diagnosis of placenta accreta was made intraoperatively in nearly a third of cesarean hysterectomies, intraoperative vigilance is required as the need for cesarean hysterectomy may not be anticipated preoperatively
Performance of a multianalyte \u27rule-out\u27 assay in pregnant individuals with suspected preeclampsia
BACKGROUND: The ability to diagnose preeclampsia clinically is suboptimal. Our objective was to validate a novel multianalyte assay and characterize its performance, when intended for use as an aid to rule-out preeclampsia.
METHODS: Prospective, multicenter cohort study of pregnant individuals presenting between 28
RESULTS: One thousand thirty-six pregnant individuals were enrolled in the study cohort with an incidence of preeclampsia of 30.3% (27.6%-33.2%). The time to develop preeclampsia was shorter for those with an at-risk compared with negative assay result (log-rank
CONCLUSIONS: We confirmed that a novel multianalyte assay was associated with the time to develop preeclampsia and has a moderate sensitivity and negative likelihood ratio but high negative predictive value when assessed as an aid to rule out preeclampsia within 7 days of enrollment.
REGISTRATION: The study was registered on Clinicaltrials.gov (Identifier NCT02780414)
First-trimester 3-dimensional power Doppler placental vascularization indices from the whole placenta versus the placental bed to predict preeclampsia: Does pregnancy-associated plasma protein A or uterine artery Doppler sonography help?
Ultrasound is safe. . . right?: Resident and maternal-fetal medicine fellow knowledge regarding obstetric ultrasound safety
Evaluating the optimal definition of abnormal first-trimester uterine artery Doppler parameters to predict adverse pregnancy outcomes
Strategies for Prevention of Varicella Pneumonia: A Cost-Effectiveness Analysis
Objective: The objective of this study was to compare the cost-effectiveness of 3 strategies of serologic
enzyme-linked immunosorbent assay (ELISA) testing and post-exposure varicella zoster immune globulin
(VZIG) prophylaxis for the prevention of maternal varicella pneumonia during pregnancy in patients with
negative or uncertain histories of varicella infection
Randomized Trial of Erythromycin and Azithromycin for Treatment of Chlamydial Infection in Pregnancy
Objective: The purpose of this study was to compare erythromycin and azithromycin in the treatment
of chlamydial cervicitis during pregnancy with regard to efficacy, side effects, and compliance
Isolated short femur length on second-trimester sonography: A marker for fetal growth restriction and other adverse perinatal outcomes
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