American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Aug 2015
Noninvasive prenatal screening for aneuploidy: positive predictive values based on cytogenetic findings.
We sought to determine the positive predictive value (PPV) of noninvasive prenatal screening (NIPS) for various aneuploidies based on cases referred for follow-up cytogenetic testing. Secondarily, we wanted to determine the false-negative (FN) rate for those cases with a negative NIPS result. ⋯ T21, which has the highest prevalence of all aneuploidies, demonstrated a high true-positive rate, resulting in a high PPV. However, the other aneuploidies, with their lower prevalence, displayed relatively high false-positive rates and, therefore, lower PPV. Patients and physicians must fully understand the limitations of this screening test and the need in many cases to follow up with appropriate diagnostic testing to obtain an accurate diagnosis.
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Am. J. Obstet. Gynecol. · Aug 2015
Brain metabolite differences in one-year-old infants born small at term and association with neurodevelopmental outcome.
We assessed brain metabolite levels by magnetic resonance spectroscopy (MRS) in 1-year-old infants born small at term, as compared with infants born appropriate for gestational age (AGA), and their association with neurodevelopment at 2 years of age. ⋯ Infants born small show brain metabolite differences at 1 year of age, which are correlated with later neurodevelopment. These results support further research on MRS to develop imaging biomarkers of abnormal neurodevelopment.
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Am. J. Obstet. Gynecol. · Aug 2015
Mode of delivery of twin gestation with very low birthweight: is vaginal delivery safe?
The purpose of this study was to determine whether planned vaginal delivery is associated with increased risk of perinatal death and morbidity in twin pregnancies that are complicated by a very low birthweight of the second twin. ⋯ Vaginal delivery of very low birthweight twins is associated with an increased risk of intraventricular hemorrhage, regardless of presentation. Because of the small sample size and the retrospective cohort design, large prospective randomized studies are needed.
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Am. J. Obstet. Gynecol. · Aug 2015
Observational StudyLabor patterns in women attempting vaginal birth after cesarean with normal neonatal outcomes.
We sought to describe labor patterns in women with a trial of labor after cesarean (TOLAC) with normal neonatal outcomes. ⋯ Labor duration for TOLAC was slower compared to nulliparous labor, particularly for induced labor. By improved understanding of the rates of progress at different points in labor, this new information on labor curves in women undergoing TOLAC, particularly for induction, should help physicians when managing labor.