American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Aug 1997
Case ReportsParental rights at the birth of a near-viable infant: conflicting perspectives.
Our purpose was to clarify the roles of parents and caregivers in making decisions for resuscitation of near-viable infants. ⋯ Effective communication is essential to prevent misunderstanding and conflicts. In most instances parents are the best decision makers for a near-viable infant. Parental rights are limited by best interests of the infant.
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Am. J. Obstet. Gynecol. · Jul 1997
Multicenter Study Clinical TrialThe preterm prediction study: patterns of cervicovaginal fetal fibronectin as predictors of spontaneous preterm delivery. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network.
Our purpose was to determine how various temporal patterns of fetal fibronectin positivity from 24 to 30 weeks predict subsequent fetal fibronectin test results and spontaneous preterm delivery. ⋯ The presence of a positive cervical or vaginal fetal fibronectin test result predicts subsequent positive fetal fibronectin positivity and subsequent spontaneous preterm birth. The greater the percent of positive results, the higher is the risk of spontaneous preterm birth. After a positive test result, two negative results are required before the risk of spontaneous preterm birth returns to baseline.
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Am. J. Obstet. Gynecol. · Jul 1997
Comparative StudyAmniotic fluid inflammatory cytokines (interleukin-6, interleukin-1beta, and tumor necrosis factor-alpha), neonatal brain white matter lesions, and cerebral palsy.
Ultrasonographically detectable neonatal brain white matter lesions are the most important identifiable risk factor for cerebral palsy. Inflammatory cytokines released during the course of intrauterine infections have been implicated in the genesis of brain white matter lesions and subsequent cerebral palsy. This study was undertaken to determine whether fetuses who subsequently were diagnosed to have periventricular brain white matter lesions could be identified by determining the concentrations of inflammatory cytokines in the amniotic fluid. ⋯ Infants at risk for development of brain white matter lesions can be identified by the concentrations of interleukin-6 and interleukin-1beta in amniotic fluid. Our findings support the hypothesis that inflammatory cytokines released during the course of intrauterine infection play a role in the genesis of brain white matter lesions.
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Am. J. Obstet. Gynecol. · Jul 1997
Multicenter Study Clinical TrialFetal fibronectin as a predictor of preterm birth in patients with symptoms: a multicenter trial.
Our aim was to determine whether the presence of fetal fibronectin in vaginal secretions of patients with symptoms suggestive of preterm labor predicts preterm delivery. ⋯ In a population of patients with symptoms, the presence of fetal fibronectin in vaginal secretions best defines a subgroup at increased risk for delivery within 7 days; the high negative predictive value of fetal fibronectin sampling supports less intervention for patients with this result.