American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Aug 2015
Brain metabolite differences in one-year-old infants born small at term and association with neurodevelopmental outcome.
We assessed brain metabolite levels by magnetic resonance spectroscopy (MRS) in 1-year-old infants born small at term, as compared with infants born appropriate for gestational age (AGA), and their association with neurodevelopment at 2 years of age. ⋯ Infants born small show brain metabolite differences at 1 year of age, which are correlated with later neurodevelopment. These results support further research on MRS to develop imaging biomarkers of abnormal neurodevelopment.
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Am. J. Obstet. Gynecol. · Aug 2015
Noninvasive prenatal screening for aneuploidy: positive predictive values based on cytogenetic findings.
We sought to determine the positive predictive value (PPV) of noninvasive prenatal screening (NIPS) for various aneuploidies based on cases referred for follow-up cytogenetic testing. Secondarily, we wanted to determine the false-negative (FN) rate for those cases with a negative NIPS result. ⋯ T21, which has the highest prevalence of all aneuploidies, demonstrated a high true-positive rate, resulting in a high PPV. However, the other aneuploidies, with their lower prevalence, displayed relatively high false-positive rates and, therefore, lower PPV. Patients and physicians must fully understand the limitations of this screening test and the need in many cases to follow up with appropriate diagnostic testing to obtain an accurate diagnosis.
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Am. J. Obstet. Gynecol. · Aug 2015
Observational StudyLabor patterns in women attempting vaginal birth after cesarean with normal neonatal outcomes.
We sought to describe labor patterns in women with a trial of labor after cesarean (TOLAC) with normal neonatal outcomes. ⋯ Labor duration for TOLAC was slower compared to nulliparous labor, particularly for induced labor. By improved understanding of the rates of progress at different points in labor, this new information on labor curves in women undergoing TOLAC, particularly for induction, should help physicians when managing labor.
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Am. J. Obstet. Gynecol. · Jul 2015
Comparative StudyPrevention and management of postpartum hemorrhage: a comparison of 4 national guidelines.
The purpose of this study was to compare 4 national guidelines for the prevention and management of postpartum hemorrhage (PPH). ⋯ Substantial variation exists in PPH prevention and management guidelines among 4 national organizations that highlights the need for better evidence and more consistent synthesis of the available evidence with regard to a leading cause of maternal death.
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Am. J. Obstet. Gynecol. · Jul 2015
Neonatal outcome of very preterm twins: policy of planned vaginal or cesarean delivery.
The objective of the study was to compare neonatal mortality and morbidity in very preterm twins with the first twin in cephalic presentation in hospitals with a policy of planned vaginal delivery (PVD) and those with a policy of planned cesarean delivery (PCD). ⋯ A policy of planned vaginal delivery of very preterm twins with the first twin in cephalic presentation does not increase either severe neonatal morbidity or mortality.