American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Apr 2014
Interpregnancy intervals: impact of postpartum contraceptive effectiveness and coverage.
The purpose of this study was to determine the use of contraceptive methods, which was defined by effectiveness, length of coverage, and their association with short interpregnancy intervals, when controlling for provider type and client demographics. ⋯ To achieve optimal birth spacing and ultimately to improve birth outcomes, attention should be given to contraceptive counseling and access to contraceptive methods in the postpartum period.
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Am. J. Obstet. Gynecol. · Apr 2014
Does a maternal-fetal medicine-centered labor and delivery coverage model put the 'M' back in MFM?
Maternal morbidity is increasing in the United States. Our objectives were to examine whether a labor and delivery (L&D) provider model with regular maternal-fetal medicine (MFM) coverage decreases the rates of maternal morbidity during delivery hospitalizations and has an impact on obstetrician-gynecologist residents' perceptions of safety and education. ⋯ Although the MFM-centered provider model appears to have had a positive impact on residents' perceptions of safety and education, it was not associated with significant changes in severe maternal morbidity.
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Am. J. Obstet. Gynecol. · Mar 2014
Observational StudyAntiemetic medications in pregnancy: a prospective investigation of obstetric and neurobehavioral outcomes.
The study goal was to examine the impact of commonly prescribed antiemetic medications in pregnancy on neurobehavioral and obstetric outcomes. ⋯ No clinically significant adverse neurobehavioral effects or obstetric outcomes were identified. This is reassuring as promethazine and ondansetron are commonly prescribed during pregnancy.
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Am. J. Obstet. Gynecol. · Mar 2014
Comparative StudyComparison of placental pathology in preterm, late-preterm, near-term, and term births.
The purpose of this study was to determine whether placental pathologic condition supports the recent suggestion of subcategorizing preterm and term births into smaller gestational age subgroups with different perinatal mortality and morbidity rates. ⋯ Differences in placental pathologic condition among the 4 subgroups of third-trimester pregnancy not only challenge the use of an arbitrary cutoff point of 37 weeks' gestation that separates the preterm birth and term birth but also further support separation of late preterm births from preterm births and term births from near-term births. Based on placental pathologic condition, chronic uteroplacental malperfusion is the dominating etiopathogenetic factor in the mid third trimester (late preterm and near-term births), and acute fetal distress is the factor in full-term births. This obscures relative frequencies of perinatal death and management modalities in the third trimester.