Obstetrics and gynecology
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Obstetrics and gynecology · May 1996
The epidemiology of placental features: associations with gestational age and neonatal outcome.
To investigate the epidemiologic and pathogenetic significance of placental features and neonatal outcome in a high-risk population. ⋯ The frequency of many major pathologic placental features, especially ischemic changes and meconium, in the absence of immediately detectable abnormality is relatively high. Thus, continued follow-up is needed to determine their long-term clinical significance. In addition, associations of ischemic changes and infarction with FGR in term infants suggest that need for comprehensive investigations of the effects of histopathologically apparent low placental blood flow.
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Obstetrics and gynecology · May 1996
Multicenter Study Comparative StudyThe preterm prediction study: fetal fibronectin, bacterial vaginosis, and peripartum infection. NICHD Maternal Fetal Medicine Units Network.
To determine the relation between vaginal and upper genital tract infection and cervical-vaginal fetal fibronectin levels. ⋯ Women with bacterial vaginosis were more likely to have a positive fetal fibronectin test than uninfected women. Women with a positive fetal fibronectin test who delivered before 32 weeks' gestation all had evidence of histologic chorioamnionitis. Women positive for fetal fibronectin also had a 16-fold increase in clinical chorioamnionitis and a sixfold increase in neonatal sepsis. There is strong evidence that upper genital tract infection and cervical and/or vaginal fetal fibronectin are closely linked.
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Obstetrics and gynecology · May 1996
Multicenter StudyThe preterm prediction study: fetal fibronectin testing and spontaneous preterm birth. NICHD Maternal Fetal Medicine Units Network.
To evaluate the presence of fetal fibronectin in the cervix and vagina as a screening test for spontaneous preterm birth. ⋯ A positive cervical or vaginal fetal fibronectin test at 22-24 weeks predicted more than half of the spontaneous preterm births at less than 28 weeks (sensitivity 0.63). As the definition of spontaneous preterm birth was extended to include later gestational ages or when the fetal fibronectin test was performed later in pregnancy, the level of association between a positive fetal fibronectin test and spontaneous preterm birth, while remaining highly significant, tended to decrease. Although fetal fibronectin is an excellent test for predicting spontaneous preterm birth, we present no evidence that the use of this test will result in a reduction in spontaneous preterm birth.
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Obstetrics and gynecology · May 1996
Case ReportsPersistence of partial molar placenta and severe preeclampsia after selective termination in a twin pregnancy.
Triploid molar pregnancies are usually managed by evacuation of the uterine contents. ⋯ Selective termination of a triploid twin does not guarantee resolution of molar growth and sequelae of the mole; severe preeclampsia can still develop.
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Obstetrics and gynecology · May 1996
Case ReportsHysterotomy to effect vaginal delivery with mentum anterior head entrapment.
Entrapment of the aftercoming head after mentum anterior rotation is a life-threatening complication of vaginal breech delivery. Few options exist when rotation and flexion from this position cannot be performed successfully either transabdominally or with vaginal maneuvers. ⋯ Hysterotomy is a safe and effective maneuver for delivery of the entrapped fetal head with mentum anterior rotation after standard procedures have failed.