American journal of obstetrics and gynecology
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We sought to determine the perinatal risks associated with growth discordance in appropriately grown twin gestations. ⋯ In appropriately grown twins, growth discordance is a risk factor for adverse perinatal outcomes in monochorionic, but not dichorionic, twins. Discordant monochorionic twins may benefit from increased antenatal surveillance.
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Am. J. Obstet. Gynecol. · Apr 2013
Mode of delivery and persistence of pelvic girdle syndrome 6 months postpartum.
We sought to study the association between mode of delivery and persistent pelvic girdle syndrome (PGS) (pain in anterior and bilateral posterior pelvis) 6 months postpartum. ⋯ The results suggest an increased risk of severe PGS 6 months postpartum in women who underwent a cesarean section vs women who had an unassisted vaginal delivery.
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Am. J. Obstet. Gynecol. · Apr 2013
Relationship between hysterectomy and admixture in African American women.
Most studies suggest that hysterectomies are more common in African American women than in other ethnic groups. To assess this ethnic surgical disparity in a novel way, our main goal was to determine whether admixture (the proportion of sub-Saharan African or European origin in individuals) is associated with hysterectomy frequency in African American women in the Women's Health Initiative. ⋯ These results suggest that higher African admixture is associated with higher frequencies of hysterectomy and that genetic studies that specifically target African American women and diseases that are associated with hysterectomy may be especially useful in understanding the pathogenesis and underlying cause of this disparity in health outcome.
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Am. J. Obstet. Gynecol. · Mar 2013
ReviewPostpartum hemorrhage in the developed world: whither misoprostol?
We reviewed the literature to determine the optimal medical treatment of postpartum hemorrhage caused by uterine atony. Of the available uterotonics, only misoprostol and oxytocin have undergone rigorous comparative study. ⋯ We conclude that in settings in which oxytocin is available, oxytocin should remain the mainstay of both prophylaxis and first-line treatment of postpartum hemorrhage caused by uterine atony. In the developed world, the use of misoprostol for postpartum hemorrhage should be infrequent.
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Am. J. Obstet. Gynecol. · Mar 2013
Fetoscopic laser therapy for twin-twin transfusion syndrome before 17 and after 26 weeks' gestation.
The purpose of this study was to compare perinatal outcomes of pregnancies that undergo "early" (<17 weeks' gestation) or "late" (>26 weeks' gestation) fetoscopic laser ablation of placental vascular anastomoses for twin-twin transfusion syndrome (TTTS) with "conventional" cases that were treated at 17-26 weeks' gestation. ⋯ Laser therapy for TTTS at <17 or >26 weeks' gestation has similar outcomes to procedures done at 17-26 weeks' gestation. We suggest that conventional gestational age guidelines of 16-26 weeks for laser therapy for TTTS should be reevaluated.