American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Jul 2015
Comparative StudyPrevention and management of postpartum hemorrhage: a comparison of 4 national guidelines.
The purpose of this study was to compare 4 national guidelines for the prevention and management of postpartum hemorrhage (PPH). ⋯ Substantial variation exists in PPH prevention and management guidelines among 4 national organizations that highlights the need for better evidence and more consistent synthesis of the available evidence with regard to a leading cause of maternal death.
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We sought to determine whether young adolescents aged 11-14 years and teens aged 15-17 and 18-19 years have an increased risk of cesarean or operative delivery, as well as maternal or neonatal delivery-related morbidity, compared to young adults aged 20-24 years. ⋯ Young adolescents have a decreased risk of cesarean and operative vaginal delivery compared to young adults; however, their neonates face higher risks of preterm delivery, low and very low birthweight, and death. This information can be used to inform clinical care for this population.
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Am. J. Obstet. Gynecol. · Jul 2015
Identification of novel mechanisms involved in generating localized vulvodynia pain.
Our goal was to gain a better understanding of the inflammatory pathways affected during localized vulvodynia, a poorly understood, common, and debilitating condition characterized by chronic pain of the vulvar vestibule. ⋯ These findings implicate that a fibroblast-mediated proinflammatory response to C albicans contributes to the induction of pain in LPV cases. Targeting this response may be an ideal strategy for the development of new vulvodynia therapies.
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Am. J. Obstet. Gynecol. · Jul 2015
Severe anemia from heavy menstrual bleeding requires heightened attention.
The objective of the study was to analyze the behaviors of women that resulted in menstrually related severe anemia (hemoglobin <5 g/dL) from a single public hospital serving indigent women. ⋯ Even when faced with potentially life-threatening anemia because of chronic, excessive menstrual blood loss, some women are not impressed with the serious nature of their problem. Women will benefit from recognizing the health consequences of chronic excessive blood loss. Chronic excessive blood loss should be treated as both an urgent and potentially recurrent problem; physicians should address this clinical concern proactively.
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Am. J. Obstet. Gynecol. · Jul 2015
Neonatal outcome of very preterm twins: policy of planned vaginal or cesarean delivery.
The objective of the study was to compare neonatal mortality and morbidity in very preterm twins with the first twin in cephalic presentation in hospitals with a policy of planned vaginal delivery (PVD) and those with a policy of planned cesarean delivery (PCD). ⋯ A policy of planned vaginal delivery of very preterm twins with the first twin in cephalic presentation does not increase either severe neonatal morbidity or mortality.