American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Mar 2015
Comparative StudyPerinatal outcomes among women with bipolar disorder: a population-based cohort study.
To evaluate the risk of adverse perinatal outcomes among pregnant women previously hospitalized for bipolar disorder. ⋯ Women previously hospitalized for bipolar disorder are at increased risk of adverse perinatal outcomes compared with the general population. Their level of risk is comparable to women previously hospitalized for major depressive disorder. These risks must be considered in the management of pregnant women with a history of major mood disorders. Attention to potentially modifiable risk factors such as obesity, diabetes, and hypertension before and during pregnancy could reduce the risk for adverse perinatal outcomes.
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Am. J. Obstet. Gynecol. · Mar 2015
Utility of magnetic resonance imaging for suspected appendicitis in pregnant women.
The purpose of this study was to estimate the rate and risk of appendix nonvisualization and alternative diagnoses made with magnetic resonance imaging (MRI) for suspected appendicitis in pregnant women. ⋯ MRI yields a high diagnostic rate and accuracy in pregnant women with suspected appendicitis and provides alternative diagnoses to guide further management. Given the high rate of appendix nonvisualization on ultrasound scanning that has been reported in the literature, we recommend MRI as the imaging modality of choice for this population in settings in which MRI is readily available.
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Am. J. Obstet. Gynecol. · Mar 2015
Comparative StudyPerinatal risks of planned home births in the United States.
We analyzed the perinatal risks of midwife-attended planned home births in the United States from 2010 through 2012 and compared them with recommendations from the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) for planned home births. ⋯ At least 30% of midwife-attended planned home births are not low risk and not within clinical criteria set by ACOG and AAP, and 65.7% of planned home births in the United States are attended by non-AMCB certified midwives, even though both AAP and ACOG state that only AMCB-certified midwives should attend home births.
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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.