American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Nov 2014
Effect of umbilical cord milking on morbidity and survival in extremely low gestational age neonates.
Delayed umbilical cord clamping benefits extremely low gestational age neonates (ELGANs) but has not gained wide acceptance. We hypothesized that milking the umbilical cord (MUC) would avoid resuscitation delay but improve hemodynamic stability and reduce rates for composite outcome of severe intraventricular hemorrhage, necrotizing enterocolitis, and/or death before discharge. ⋯ MUC improves early hemodynamic stability and is associated with lower rates of serious morbidity and death among ELGANs.
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Am. J. Obstet. Gynecol. · Nov 2014
Clinical significance of amniotic fluid sludge in twin pregnancies with a short cervical length.
The objective of the study was to determine the clinical significance of amniotic fluid (AF) sludge in twin pregnancies with a short cervix. ⋯ The presence of AF sludge in twin pregnancies with a short cervix is a risk factor for extreme prematurity, histological chorioamnionitis, and perinatal death. Twin A had higher rates of funisitis and neonatal morbidity in the presence of AF sludge.
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Am. J. Obstet. Gynecol. · Nov 2014
The fellowship effect: how the establishment of a fellowship in female pelvic medicine and reconstructive surgery affected resident vaginal hysterectomy training.
We report on trends in resident-performed vaginal hysterectomies before and after the establishment of a female pelvic medicine and reconstructive surgery fellowship at Vanderbilt University Medical Center. ⋯ Frequency of resident involvement in TVH cases, either as primary surgeon or team member, remained constant after the addition of the female pelvic medicine and reconstructive surgery fellowship.
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Am. J. Obstet. Gynecol. · Nov 2014
Clinical experience and follow-up with large scale single-nucleotide polymorphism-based noninvasive prenatal aneuploidy testing.
We sought to report on laboratory and clinical experience following 6 months of clinical implementation of a single-nucleotide polymorphism-based noninvasive prenatal aneuploidy test in high- and low-risk women. ⋯ The data from this large-scale report on clinical application of a commercially available noninvasive prenatal test suggest that the clinical performance of this single-nucleotide polymorphism-based noninvasive prenatal test in a mixed high- and low-risk population is consistent with performance in validation studies.
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Am. J. Obstet. Gynecol. · Nov 2014
Resident participation in laparoscopic hysterectomy: impact of trainee involvement on operative times and surgical outcomes.
The purpose of this study was to determine the impact of resident involvement on morbidity after total laparoscopic hysterectomy for benign disease. ⋯ Resident involvement in total laparoscopic hysterectomy for benign disease was associated with clinically appreciable longer surgical time and small differences in the rates of postoperative transfusions, reoperation, and readmission. However, the rates of overall complications, severe complications, and 30-day mortality rate remain comparable.