American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Feb 2015
Comparative Study Clinical TrialA prospective comparison of postoperative pain and quality of life in robotic assisted vs conventional laparoscopic gynecologic surgery.
We sought to compare robotic vs laparoscopic surgery in regards to patient reported postoperative pain and quality of life. ⋯ Our results demonstrate no difference in postoperative pain between conventional laparoscopy and robotic assisted surgery for gynecologic procedures. Furthermore, pain did not appear to interfere consistently with any daily activity of living. Interference of sleep needs to be further evaluated after controlling for bilateral salpingo-oophorectomy.
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Am. J. Obstet. Gynecol. · Feb 2015
Impact of prolapse meshes on the metabolism of vaginal extracellular matrix in rhesus macaque.
The impact of polypropylene mesh implantation on vaginal collagen and elastin metabolism was analyzed using a nonhuman primate model to further delineate the mechanism of mesh induced complications. ⋯ Following implantation with the heavier, less porous, and stiffer mesh, Gynemesh PS, the degradation of vaginal collagen and elastin exceeded synthesis, most likely as a result of increased activity of MMPs, resulting in a structurally compromised tissue.
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Am. J. Obstet. Gynecol. · Feb 2015
Outcomes of expectantly managed pregnancies with multiple gestations and preterm premature rupture of membranes prior to 26 weeks.
The objective of the study was to determine the obstetric and neonatal outcomes of expectantly managed multifetal pregnancies complicated by early preterm premature rupture of membranes (PPROM) prior to 26 weeks. ⋯ Overall, neonatal survival to hospital discharge was 43%, but only 17% survived without significant neonatal morbidity. These data provide a basis for counseling and management of women with multifetal gestation complicated by very early PPROM.
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Am. J. Obstet. Gynecol. · Feb 2015
The impact of adoption of the international association of diabetes in pregnancy study group criteria for the screening and diagnosis of gestational diabetes.
The objective of the study was to compare the International Association of Diabetes in Pregnancy Study Group (IADPSG) and the Canadian Diabetes Association (CDA) criteria for the diagnosis of gestational diabetes mellitus (GDM). ⋯ The use of the IADPSG criteria instead of the CDA criteria would result in a considerable increase in the rate of GDM, but this also appears to identify additional women at similar risk of adverse pregnancy outcome. Further studies are needed to determine whether this observation persists after controlling for confounders such as body mass index as well as whether treatment in these cases would improve perinatal outcome.
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Am. J. Obstet. Gynecol. · Feb 2015
Is universal cervical length screening indicated in women with prior term birth?
To determine whether universal transvaginal ultrasound (TVU) cervical length (CL) screening is indicated in women with prior term births. ⋯ Women with prior term birth have a trend toward a lower incidence of CL ≤20 mm, compared with nulliparous women. Further studies are needed to determine whether women with prior term births should be included or excluded from TVU CL screening.