American journal of obstetrics and gynecology
-
Am. J. Obstet. Gynecol. · Jun 2007
ANGELS and University of Arkansas for Medical Sciences paradigm for distant obstetrical care delivery.
This article describes the process by which the Arkansas Medicaid Program, the University of Arkansas for Medical Sciences (the state's only academic health center), and Arkansas' practicing physicians are collaborating to improve the process of perinatal regionalization by providing access to expertise, education, and support of maternal-fetal medicine specialists. The described ANGELS model encourages replication among other programs that wish to improve perinatal regionalization attempts in their service areas. ⋯ ANGELS' continued efforts have the potential to significantly improve perinatal care in rural areas throughout the state, while the cost of maternal and fetal health care could decline. The program's design, although unique, can be replicated elsewhere to encourage perinatal regionalization.
-
Am. J. Obstet. Gynecol. · May 2007
Use of epidural anesthesia and the risk of acute postpartum urinary retention.
We aimed to examine the relationship between the use of epidural analgesia during labor and acute postpartum urinary retention. ⋯ Epidural analgesia during labor may increase the risk of developing urinary retention by up to 3 times. However, this effect is mediated by other obstetric variables.
-
Am. J. Obstet. Gynecol. · May 2007
ReviewThe long-term outcome in surviving infants with Apgar zero at 10 minutes: a systematic review of the literature and hospital-based cohort.
The purpose of this study was to investigate the outcomes of infants who had Apgar scores of zero at 10 minutes and were resuscitated successfully. ⋯ The outcome of infants with an Apgar score of zero at 10 minutes is almost universally poor.
-
Am. J. Obstet. Gynecol. · Apr 2007
Risk factors for primary and subsequent anal sphincter lacerations: a comparison of cohorts by parity and prior mode of delivery.
This study was performed to assess the effect of pregnancy, route of delivery, and parity on the risk of primary and subsequent anal sphincter laceration in women at first vaginal delivery (1st VD), vaginal birth after cesarean delivery (VBAC), or second vaginal delivery (2nd VD). ⋯ At this institution, women undergoing VBAC are at similarly high risk of anal sphincter laceration, compared with nulliparous women. Women with prior anal sphincter laceration are at 3 times increased risk for subsequent sphincter laceration, compared with women with prior vaginal delivery without sphincter laceration. Pregnancy by itself does not appear to be an important factor in decreasing the risk of anal sphincter laceration in subsequent deliveries.
-
Am. J. Obstet. Gynecol. · Apr 2007
Comparative StudyNatriuretic peptides and hemodynamics in preeclampsia.
The purpose of this study was to evaluate the relationship between natriuretic peptides (NT-proANP and NT-proBNP) and hemodynamic parameters in preeclampsia. ⋯ High NT-proANP and NT-proBNP concentrations in preeclampsia reflect the strain on the heart caused by high afterload, rather than the function of the heart expressed as SI or CI.