American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Oct 2016
Quantitative fetal fibronectin and cervical length to predict preterm birth in asymptomatic women with previous cervical surgery.
Quantitative fetal fibronectin testing has demonstrated accuracy for prediction of spontaneous preterm birth in asymptomatic women with a history of preterm birth. Predictive accuracy in women with previous cervical surgery (a potentially different risk mechanism) is not known. ⋯ Prediction of spontaneous preterm birth using cervicovaginal fluid quantitative fetal fibronectin in asymptomatic women with cervical surgery is valid, and has comparative accuracy to that in women with a history of spontaneous preterm birth.
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Am. J. Obstet. Gynecol. · Oct 2016
Childhood abuse and suicidal ideation in a cohort of pregnant Peruvian women.
Childhood abuse is a major global and public health problem associated with a myriad of adverse outcomes across the life course. Suicide is one of the leading causes of mortality during the perinatal period. However, few studies have assessed the relationship between experiences of childhood abuse and suicidal ideation in pregnancy. ⋯ Maternal history of childhood abuse was associated with increased odds of antepartum suicidal ideation. It is important for clinicians to be aware of the potential increased risk of suicidal behaviors among pregnant women with a history of childhood physical and sexual abuse.
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Am. J. Obstet. Gynecol. · Oct 2016
A prediction model of vaginal birth after cesarean in the preterm period.
A validated model exists that predicts the probability of vaginal birth after cesarean delivery in patients at term who are undergoing a trial of labor after cesarean delivery. However, a model that predicts the success of a vaginal birth after cesarean delivery in the preterm period has not been developed. ⋯ A cross-validated predictive model was created for patients undergoing a trial of labor after cesarean delivery in the preterm period using 8 variables known on admission. These factors were notably different from factors used in the model for term patients. This new model can be used to counsel patients in the preterm period who want to undergo a trial of labor after cesarean delivery on their predicted vaginal birth after cesarean delivery success.
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Am. J. Obstet. Gynecol. · Oct 2016
Pregnancy as a window to future health: maternal placental syndromes and short-term cardiovascular outcomes.
Cardiovascular disease is the leading cause of death among women. Identifying risk factors for future cardiovascular disease may lead to earlier lifestyle modifications and disease prevention. Additionally, interpregnancy development of cardiovascular disease can lead to increased perinatal morbidity in subsequent pregnancies. Identification and implementation of interventions in the short term (within 5 years of first pregnancy) may decrease morbidity in subsequent pregnancies. ⋯ Women and girls experiencing placental syndromes and preterm birth or small-for-gestational-age infant are at increased risk of subsequent cardiovascular disease in short-term follow-up. Strategies to identify and improve cardiovascular disease risk in the postpartum period may improve future heart disease outcomes.
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Am. J. Obstet. Gynecol. · Oct 2016
Observational StudyUrgency urinary incontinence and the interoceptive network: a functional magnetic resonance imaging study.
Treatment of urgency urinary incontinence has focused on pharmacologically treating detrusor overactivity. Recent recognition that altered perception of internal stimuli (interoception) plays a role in urgency urinary incontinence suggests that exploration of abnormalities of brain function in this disorder could lead to better understanding of urgency incontinence and its treatment. ⋯ Increasing urge was associated with greater urgency incontinent participant than control activation of the interoceptive network and activation in networks that are determinants of self-awareness (default mode network) and of response to unexpected external stimuli (ventral attention network). Differences in connectivity between interoceptive networks and opposing attentional networks (ventral attention network vs dorsal attention network) were present even before bladder filling (in the resting state). These findings are strong evidence for a central nervous system component of urgency urinary incontinence that could be mediated by brain-directed therapies.