American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Jul 2015
Identification of novel mechanisms involved in generating localized vulvodynia pain.
Our goal was to gain a better understanding of the inflammatory pathways affected during localized vulvodynia, a poorly understood, common, and debilitating condition characterized by chronic pain of the vulvar vestibule. ⋯ These findings implicate that a fibroblast-mediated proinflammatory response to C albicans contributes to the induction of pain in LPV cases. Targeting this response may be an ideal strategy for the development of new vulvodynia therapies.
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Am. J. Obstet. Gynecol. · Jul 2015
Randomized Controlled TrialVaginal progesterone for the prevention of preterm birth in twin gestations: a randomized placebo-controlled double-blind study.
The purpose of this study was to investigate the use of vaginal progesterone for the prevention of preterm delivery in twin pregnancies. ⋯ In nonselected twin pregnancies, vaginal progesterone administration does not prevent preterm delivery and does not reduce neonatal morbidity and death.
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Am. J. Obstet. Gynecol. · Jul 2015
Severe anemia from heavy menstrual bleeding requires heightened attention.
The objective of the study was to analyze the behaviors of women that resulted in menstrually related severe anemia (hemoglobin <5 g/dL) from a single public hospital serving indigent women. ⋯ Even when faced with potentially life-threatening anemia because of chronic, excessive menstrual blood loss, some women are not impressed with the serious nature of their problem. Women will benefit from recognizing the health consequences of chronic excessive blood loss. Chronic excessive blood loss should be treated as both an urgent and potentially recurrent problem; physicians should address this clinical concern proactively.
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We sought to determine whether young adolescents aged 11-14 years and teens aged 15-17 and 18-19 years have an increased risk of cesarean or operative delivery, as well as maternal or neonatal delivery-related morbidity, compared to young adults aged 20-24 years. ⋯ Young adolescents have a decreased risk of cesarean and operative vaginal delivery compared to young adults; however, their neonates face higher risks of preterm delivery, low and very low birthweight, and death. This information can be used to inform clinical care for this population.
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Am. J. Obstet. Gynecol. · Jul 2015
The association between fetal Doppler and admission to neonatal unit at term.
Fetal cerebroplacental ratio is emerging as a better proxy than birthweight for placental insufficiency and as a marker of fetal compromise at term. The extent to which these fetal Doppler changes are related to neonatal outcomes has not been systematically assessed. The main aim of this study was to evaluate the association between estimated fetal weight percentile, cerebroplacental ratio recorded at 34(+0)-35(+6) weeks' gestation, and neonatal unit admission at term. ⋯ Lower cerebroplacental ratio and gestational age at delivery, but not fetal size, were independently associated with the need for admission to the neonatal unit at term in a high-risk patient group. The extent to which fetal hemodynamic assessment could be used to predict perinatal morbidity and optimize the timing of delivery merits further investigation.