American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Jul 2015
Is fetal cerebroplacental ratio an independent predictor of intrapartum fetal compromise and neonatal unit admission?
We sought to evaluate the association between fetal cerebroplacental ratio (CPR) and intrapartum fetal compromise and admission to the neonatal unit (NNU) in term pregnancies. ⋯ Lower fetal CPR, regardless of the fetal size, was independently associated with the need for operative delivery for presumed fetal compromise and with NNU admission at term. The extent to which fetal hemodynamic status could be used to predict perinatal morbidity and optimize the mode of delivery merits further investigation.
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Am. J. Obstet. Gynecol. · Jun 2015
Does midtrimester cervical length aid in predicting vaginal birth after cesarean?
A longer midtrimester cervical length (CL) is associated with an increased chance of cesarean delivery, but CL has not been used to predict the chance of successful trial of labor after cesarean delivery (TOLAC). The objective of this study was to identify whether midtrimester CL improves the prediction of vaginal birth after cesarean delivery (VBAC) among women undergoing a TOLAC. ⋯ Shorter midtrimester CL is associated with a greater chance of vaginal birth after a TOLAC. However, midtrimester CL does not significantly improve the clinical value of a previously developed VBAC prediction model.
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In this review, South Atlantic Association of Obstetricians and Gynecologists President N. Donald Diebel examines a brief history of health care in the United States and shares his thoughts about questions raised in his 2015 presidential address: How can the enormous advances in medical science be extended to everyone and not just some? What are the obstacles or impediments to this task? How can they be overcome?
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Am. J. Obstet. Gynecol. · May 2015
Meta Analysis Comparative StudySuture versus staples for skin closure after cesarean: a metaanalysis.
We sought to perform a metaanalysis to synthesize randomized clinical trials of cesarean skin closure by subcuticular absorbable suture vs metal staples for the outcomes of wound complications, pain perception, patient satisfaction, cosmesis, and operating time. ⋯ For patients undergoing cesarean, closure of the transverse skin incision with suture significantly decreases wound morbidity, specifically wound separation, without significant differences in pain, patient satisfaction, or cosmesis. Suture placement does take 7 minutes longer than staples.
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Am. J. Obstet. Gynecol. · May 2015
Meta AnalysisAntibiotic prophylaxis for term or near-term premature rupture of membranes: metaanalysis of randomized trials.
The objective of the study was to evaluate the efficacy of antibiotic prophylaxis in women with term or near-term premature rupture of membranes. ⋯ Antibiotic prophylaxis for term or near-term premature rupture of membranes is not associated with any benefits in either maternal or neonatal outcomes. In women with latency longer than 12 hours, prophylactic antibiotics are associated with significantly lower rates of chorioamnionitis by 51% and endometritis by 88%.