American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Dec 2014
Uptake of noninvasive prenatal testing at a large academic referral center.
Noninvasive prenatal testing (NIPT) is a recently developed risk-assessment technique with high sensitivity and specificity for fetal aneuploidy. The effect NIPT has had on traditional screening and diagnostic testing has not been clearly demonstrated. In this study, NIPT uptake and subsequent changes in the utilization of first-trimester screen (FTS), chorionic villus sampling (CVS), and amniocentesis in a single referral center is reported. ⋯ NIPT was quickly adopted by our high-risk patient population, and significantly decreased alternate prenatal screening and diagnostic testing in a short period of time.
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Am. J. Obstet. Gynecol. · Dec 2014
Performance of racial and ethnic minority-serving hospitals on delivery-related indicators.
We sought to explore how racial/ethnic minority-serving hospitals perform on 15 delivery-related indicators, and examine whether indicators vary by race/ethnicity within the same type of hospitals. ⋯ We found considerable differences in delivery-related indicators by hospital type and patients' race/ethnicity. Obstetric care quality measures are needed to track racial/ethnic disparities at the facility and population levels.
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Am. J. Obstet. Gynecol. · Dec 2014
The relationship between a reviewer's recommendation and editorial decision of manuscripts submitted for publication in obstetrics.
We sought to determine the extent to which reviewers' recommendations influence the final editorial disposition of manuscripts submitted for publication. ⋯ The degree of influence on the final disposition of the manuscript depends on the type of recommendation. A recommendation for rejection was the most influential and it was associated with a high rate of rejection. Recommendations for acceptance or minor revisions were also influential but to a lesser degree.
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Am. J. Obstet. Gynecol. · Dec 2014
Treating morning sickness in the United States--changes in prescribing are needed.
Presently, 97.7% of prescriptions for the treatment of nausea and vomiting in pregnancy in the United States are with medications not labeled for use in pregnancy, not indicated for nausea and vomiting in pregnancy, and not classified as safe in pregnancy by the Food and Drug Administration. The use of ondansetron for nausea and vomiting in pregnancy has increased from 50,000 monthly prescriptions in 2008 to 110,000 at the end of 2013, despite unresolved issues regarding fetal safety and Food and Drug Administration warnings about serious dysrhythmias. In April 2013, the Food and Drug Administration approved the combination of doxylamine and pyridoxine, specifically for nausea and vomiting in pregnancy symptoms. Now that a safe and effective drug is available in the United States, there is no reason for women to be exposed to a drug of unproven maternal and fetal safety.