American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Oct 2015
Variation in childbirth services in California: a cross-sectional survey of childbirth hospitals.
The objective of the study was to describe the resources and activities associated with childbirth services. ⋯ Childbirth services varied widely across California hospitals. Cognizance of this variation and linkage of these data to childbirth outcomes should assist in the identification of key resources and activities that optimize the hospital environment for pregnant women and set the groundwork for identifying criteria for the provision of maternal risk-appropriate care.
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Am. J. Obstet. Gynecol. · Oct 2015
Cost-effectiveness of transvaginal ultrasound cervical length screening in singletons without a prior preterm birth: an update.
We sought to reevaluate the cost-effectiveness of universal transvaginal ultrasound (TVU) cervical length (CL) screening in singleton pregnancies without prior spontaneous preterm birth. ⋯ Despite the reduced incidence and efficacy used in this model, universal TVU CL continues to be cost-effective when compared to routine care in singletons without prior preterm birth.
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Am. J. Obstet. Gynecol. · Oct 2015
Randomized Controlled TrialPharmacokinetics of cefazolin prophylaxis in obese gravidae at time of cesarean delivery.
The objective of the study was to compare the pharmacokinetics of 2 g and 3 g doses of cefazolin when used for perioperative prophylaxis in obese gravidae undergoing cesarean delivery. ⋯ Cefazolin concentrations in maternal adipose both at time of hysterotomy closure and fascial closure were above the minimal inhibitory concentration for both Gram-positive and Gram-negative bacteria when either 2 g or 3 g cefazolin was administered as perioperative surgical prophylaxis. Maternal cefazolin concentrations in plasma and maternal adipose tissue are related to both dose and body mass index.
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This study examined maternal and neonatal outcomes that are associated with pancreatitis in pregnancy, in particular preeclampsia. ⋯ We found that pancreatitis in pregnancy was associated with several adverse maternal outcomes; in particular, a strong association existed with preeclampsia, which has its own implications and complications surrounding pregnancy management. Pancreatitis in pregnancy was also associated with increased risk for preterm delivery but not neonatal or infant death, which is consistent with the literature.
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Given the association between risk of cerebral palsy and children born to obese women, the study aim was to estimate whether maternal obesity is associated with reduced effectiveness of conventional antenatal magnesium sulfate dosing for the prevention of cerebral palsy and death. ⋯ Among women receiving antenatal neuroprotective magnesium sulfate, maternal obesity is not associated with an increased risk of having a child with cerebral palsy or death.