American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Jan 2018
Review Meta AnalysisDelayed vs early umbilical cord clamping for preterm infants: a systematic review and meta-analysis.
The effects of delayed cord clamping of the umbilical cord in preterm infants are unclear. ⋯ This systematic review provides high-quality evidence that delayed clamping reduced hospital mortality, which supports current guidelines recommending delayed clamping in preterm infants. This review does not evaluate cord milking, which may also be of benefit. Analyses of individual patient data in these and other randomized controlled trials will be critically important in reliably evaluating important secondary outcomes.
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Am. J. Obstet. Gynecol. · Jan 2018
Review Meta AnalysisDelayed vs early umbilical cord clamping for preterm infants: a systematic review and meta-analysis.
The effects of delayed cord clamping of the umbilical cord in preterm infants are unclear. ⋯ This systematic review provides high-quality evidence that delayed clamping reduced hospital mortality, which supports current guidelines recommending delayed clamping in preterm infants. This review does not evaluate cord milking, which may also be of benefit. Analyses of individual patient data in these and other randomized controlled trials will be critically important in reliably evaluating important secondary outcomes.
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Am. J. Obstet. Gynecol. · Jan 2018
ReviewPlacenta accreta spectrum: pathophysiology and evidence-based anatomy for prenatal ultrasound imaging.
Placenta accreta spectrum is a complex obstetric complication associated with high maternal morbidity. It is a relatively new disorder of placentation, and is the consequence of damage to the endometrium-myometrial interface of the uterine wall. When first described 80 years ago, it mainly occurred after manual removal of the placenta, uterine curettage, or endometritis. ⋯ Adherent and invasive placentation may coexist in the same placental bed and evolve with advancing gestation. This may explain why no single, or set combination of, ultrasound sign(s) was found to be specific for the depth of abnormal placentation, and accurate for the differential diagnosis between adherent and invasive placentation. Correlation of pathological and clinical findings with prenatal imaging is essential to improve screening, diagnosis, and management of placenta accreta spectrum, and standardized protocols need to be developed.