American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Mar 2019
Meta AnalysisDepressive symptoms among women with endometriosis: a systematic review and meta-analysis.
To evaluate whether endometriosis is associated with depressive symptoms, and whether the association is modulated by pelvic pain. ⋯ The association between endometriosis and depressive symptoms is largely determined by chronic pain but may also be modulated by individual and context vulnerabilities. Awareness of the complex relationship between endometriosis and depressive symptoms informs tailored care and patient-centered research outcomes.
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Am. J. Obstet. Gynecol. · Jan 2019
Meta AnalysisPrenatal exposure to selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors and risk for persistent pulmonary hypertension of the newborn: a systematic review, meta-analysis, and network meta-analysis.
There is a marked increase in the use of selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors in the last decade. Many newborns are likely to be exposed during pregnancy and labor. ⋯ Exposure to selective serotonin reuptake inhibitors or serotonin norepinephrine reuptake inhibitors during pregnancy is associated with an increased risk for persistent pulmonary hypertension of the newborn. According to our findings, sertraline ranked as most likely to have the lowest risk for persistent pulmonary hypertension of the newborn compared to other selective serotonin reuptake inhibitors, suggesting it may have the best safety profile for use in pregnancy in this regard. Further studies are needed to fully establish these results.
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Am. J. Obstet. Gynecol. · Oct 2018
Meta AnalysisProgestogens in singleton gestations with preterm prelabor rupture of membranes: a systematic review and metaanalysis of randomized controlled trials.
Preterm prelabor rupture of membranes occurs in 3% of all pregnancies. Neonatal benefit is seen in uninfected women who do not deliver immediately after preterm prelabor rupture of membranes. The purpose of this study was to evaluate whether the administration of progestogens in singleton pregnancies prolongs pregnancy after preterm prelabor rupture of membranes. ⋯ Progestogen administration does not prolong pregnancy in singleton gestations with preterm prelabor rupture of membranes.
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Am. J. Obstet. Gynecol. · Aug 2018
Meta AnalysisThe intrapartum and perinatal risks of sleep-disordered breathing in pregnancy: a systematic review and metaanalysis.
Sleep-disordered breathing is an increasingly common condition in nonobstetric populations and is associated with significant morbidity. The incidence of sleep-disordered breathing in pregnancy is unknown, and it is likely that many cases go undiagnosed. ⋯ Maternal sleep-disordered breathing is associated with increased risks of adverse intrapartum and perinatal outcomes.
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Am. J. Obstet. Gynecol. · Jul 2018
Meta AnalysisVaginal progesterone is as effective as cervical cerclage to prevent preterm birth in women with a singleton gestation, previous spontaneous preterm birth, and a short cervix: updated indirect comparison meta-analysis.
An indirect comparison meta-analysis published in 2013 reported that both vaginal progesterone and cerclage are equally efficacious for preventing preterm birth and adverse perinatal outcomes in women with a singleton gestation, previous spontaneous preterm birth, and a sonographic short cervix. The efficacy of vaginal progesterone has been challenged after publication of the OPPTIMUM study. However, this has been resolved by an individual patient-data meta-analysis (Am J Obstet Gynecol. 2018;218:161-180). ⋯ Vaginal progesterone and cerclage are equally effective for preventing preterm birth and improving perinatal outcomes in women with a singleton gestation, previous spontaneous preterm birth, and a midtrimester sonographic short cervix. The choice of treatment will depend on adverse events and cost-effectiveness of interventions and patient/physician's preferences.