American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Sep 2014
Monitoring childbirth morbidity using hospital discharge data: further development and application of a composite measure.
The purpose of this study was to evaluate the use of a childbirth composite morbidity indicator for monitoring childbirth morbidity at hospital and regional levels in California. ⋯ The childbirth composite morbidity rate is designed to report childbirth complication rates that combine maternal and neonatal morbidity. This measure and its submeasures met the criteria for quality indicator evaluation as specified by the Agency for Healthcare Research and Quality and can be used for benchmarking or for monitoring childbirth outcomes at regional levels.
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Am. J. Obstet. Gynecol. · Sep 2014
Balancing the risks of stillbirth and neonatal death in the early preterm small-for-gestational-age fetus.
Timing of delivery for the early preterm small-for-gestational-age (SGA) fetus remains unknown. Our aim was to estimate the risk of stillbirth in the early preterm SGA fetus compared with the risk of neonatal death. ⋯ Our findings suggest that the balance between the competing risks of stillbirth and neonatal death for the early preterm SGA fetus occurs at 32-33 weeks 6 days of gestation. These data can be useful when delivery timing remains uncertain.
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Am. J. Obstet. Gynecol. · Sep 2014
Maternal and neonatal outcomes in electively induced low-risk term pregnancies.
Elective induction of labor has been discouraged over concerns regarding increased complications. We evaluated the mode of delivery and maternal and neonatal morbidities in low-risk patients whose labor was electively induced or expectantly managed at term. ⋯ Elective induction of labor at term is associated with decreased risks of cesarean delivery and other maternal and neonatal morbidities compared with expectant management regardless of parity or cervical status on admission.
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Am. J. Obstet. Gynecol. · Aug 2014
Multicenter StudyRacial disparities in outcomes of twin pregnancies: elective cesarean or trial of labor?
The objective of the study was to determine the relationships between maternal race and obstetric outcomes in twin gestations by planned mode of delivery. ⋯ Unplanned cesarean delivery rates are similar in twin pregnancies, regardless of race. Maternal and neonatal outcomes in twin gestations are similar across ethnicities, regardless of mode of delivery.
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Am. J. Obstet. Gynecol. · Jul 2014
Comparative StudyRisk of cesarean in obese nulliparous women with unfavorable cervix: elective induction vs expectant management at term.
The objective of the study was to examine maternal and neonatal outcomes in obese nulliparous women with an unfavorable cervix undergoing elective induction of labor compared with expectant management after 39.0 weeks. ⋯ Elective labor induction at term in obese nulliparous parturients carries an increased risk of cesarean delivery and higher neonatal intensive care unit admission rate as compared with expectant management.