Obstetrics and gynecology
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Obstetrics and gynecology · Apr 2016
ReviewZika Virus and Pregnancy: What Obstetric Health Care Providers Need to Know.
Zika virus is a flavivirus transmitted by Aedes (Stegomyia) species of mosquitoes. In May 2015, the World Health Organization confirmed the first local transmission of Zika virus in the Americas in Brazil. The virus has spread rapidly to other countries in the Americas; as of January 29, 2016, local transmission has been detected in at least 22 countries or territories, including the Commonwealth of Puerto Rico and the U. ⋯ Several pieces of evidence suggest that maternal Zika virus infection is associated with adverse neonatal outcomes, most notably microcephaly. Because of the number of countries and territories with local Zika virus transmission, it is likely that obstetric health care providers will care for pregnant women who live in or have traveled to an area of local Zika virus transmission. We review information on Zika virus, its clinical presentation, modes of transmission, laboratory testing, effects during pregnancy, and methods of prevention to assist obstetric health care providers in caring for pregnant women considering travel or with a history of travel to areas with ongoing Zika virus transmission and pregnant women residing in areas with ongoing Zika virus transmission.
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Obstetrics and gynecology · Apr 2016
Cervical Pessary and Vaginal Progesterone in Twin Pregnancies With a Short Cervix.
To evaluate cervical pessary as an intervention to prevent preterm birth in twin pregnancies with a short cervix. ⋯ For twin pregnancies with a short cervix, the addition of a cervical pessary to vaginal progesterone is associated with prolonged pregnancy and reduced risk of adverse neonatal outcomes. A large randomized trial should be performed to verify these retrospective findings.
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Obstetrics and gynecology · Apr 2016
Randomized Controlled Trial Multicenter StudyComplications and Safety of Preconception Low-Dose Aspirin Among Women With Prior Pregnancy Losses.
To evaluate complications and safety of preconception low-dose aspirin in 1,228 U.S. women (2007-2011). ⋯ Although rare but serious complications resulting from low-dose aspirin cannot be ruled out, preconception low-dose aspirin appears to be well tolerated by women trying to conceive, women who become pregnant, and by their fetuses and neonates.
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Obstetrics and gynecology · Apr 2016
Multicenter Study Observational StudyAssociation of the Duration of Active Pushing With Obstetric Outcomes.
To estimate the associations between the duration of active pushing during the second stage of labor and maternal and neonatal outcomes. ⋯ A longer duration of pushing is associated with an increased relative risk, but small absolute difference in risk, of neonatal complications. Approximately 78% of nulliparous women delivered vaginally even after 4 hours of pushing.