American journal of perinatology
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Due to disproportionately high mortality from 2009 H1N1 influenza, pregnant women were given highest priority for H1N1 vaccination. We surveyed postpartum women to determine vaccine uptake and reasons for lack of vaccination. We performed a cross-sectional survey of postpartum women delivering at our institution from February 1 to April 15, 2010. ⋯ Safety concerns were cited by the majority (66%) of nonvaccinated women. H1N1 vaccine uptake among pregnant women was substantially higher than reported influenza vaccination rates during previous seasons. Safety concerns were the major barrier to vaccination.
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Randomized Controlled Trial Multicenter Study
The timing of antibiotics at cesarean: a randomized controlled trial.
We compared maternal and neonatal outcomes in women who received prophylactic antibiotics prior to skin incision to those who received antibiotics at cord clamp. We performed a randomized clinical trial at two sites. Eligible women included those undergoing nonemergency cesarean at 36 weeks' gestation or greater. ⋯ The rate of suspected sepsis was similar between the two groups. There were no cases of antibiotic resistance in the neonates. Either preoperative antibiotic therapy or antibiotic administration after cord clamp is a reasonable clinical method for reducing the risk of postcesarean infectious morbidity.
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Optimal preclosure fluid resuscitation in gastroschisis (GS) is unknown. The purpose of our study was to evaluate effects of preclosure intravenous fluid resuscitation on GS outcome. Cases were accrued from a national GS database. ⋯ Multivariate outcomes analyses demonstrated a significant, direct relationship between resuscitative volume and days of postclosure ventilation, TPN, length of hospital stay, and bacteremic episodes; specifically, every 17 mL/kg of fluid predicted one additional ventilation day (p = 0.002), TPN day (p = 0.01), and hospital day (p = 0.01) and 0.02 odds increase of an episode of bacteremia (p = 0.03). Judicious, preclosure fluid resuscitation is essential in early GS management. Excessive fluid is associated with several adverse survival outcomes.