American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Apr 2014
Does a maternal-fetal medicine-centered labor and delivery coverage model put the 'M' back in MFM?
Maternal morbidity is increasing in the United States. Our objectives were to examine whether a labor and delivery (L&D) provider model with regular maternal-fetal medicine (MFM) coverage decreases the rates of maternal morbidity during delivery hospitalizations and has an impact on obstetrician-gynecologist residents' perceptions of safety and education. ⋯ Although the MFM-centered provider model appears to have had a positive impact on residents' perceptions of safety and education, it was not associated with significant changes in severe maternal morbidity.
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Am. J. Obstet. Gynecol. · Apr 2014
Interpregnancy intervals: impact of postpartum contraceptive effectiveness and coverage.
The purpose of this study was to determine the use of contraceptive methods, which was defined by effectiveness, length of coverage, and their association with short interpregnancy intervals, when controlling for provider type and client demographics. ⋯ To achieve optimal birth spacing and ultimately to improve birth outcomes, attention should be given to contraceptive counseling and access to contraceptive methods in the postpartum period.
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Am. J. Obstet. Gynecol. · Mar 2014
Observational StudyAntiemetic medications in pregnancy: a prospective investigation of obstetric and neurobehavioral outcomes.
The study goal was to examine the impact of commonly prescribed antiemetic medications in pregnancy on neurobehavioral and obstetric outcomes. ⋯ No clinically significant adverse neurobehavioral effects or obstetric outcomes were identified. This is reassuring as promethazine and ondansetron are commonly prescribed during pregnancy.
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Am. J. Obstet. Gynecol. · Mar 2014
Mycoplasma, bacterial vaginosis-associated bacteria BVAB3, race, and risk of preterm birth in a high-risk cohort.
Genital tract infection accounts for approximately 25-40% of all preterm births. We sought to assess the relationship between preterm birth and selected vaginal bacterial taxa associated with preterm birth either directly or through their association with bacterial vaginosis (BV). ⋯ BV is characterized by a reduction of Lactobacillus, and lactic acid-producing bacteria and the presence of Mobiluncus; we found these factors and the presence of Mycoplasma to be associated with an increased risk of preterm birth. By contrast, the presence of a recently identified organism sufficient to cause BV, BVAB3, decreased the risk of preterm birth. These findings give insight into why treating BV has mixed impact on risk of preterm birth.