Showing papers in "American Journal of Obstetrics and Gynecology in 2019"

TL;DR: Remedying the diagnostic delay requires increased patient education and timely referral to a women's healthcare provider and a shift in physician approach to the disorder, which is expected to simplify endometriosis diagnosis and make the process accessible to more clinicians and patients, culminating in earlier effective management.

TL;DR: A link between the absence of corpus luteum and adverse obstetric outcomes is suggested in view of the increasing use of frozen cycles and the new policy of freeze-all cycles in in vitro fertilization.

TL;DR: The topics chosen address the most pertinent questions regarding intrapartum management of abnormally invasive placenta with respect to clinically relevant outcomes, including the following: definition of a center of excellence; requirement for antenatal hospitalization; antenatal optimization of hemoglobin; gestational age for delivery; and fertility after conservative management.

TL;DR: Investigating the pathophysiology of the placental bed found that preeclampsia is associated with defective or absent transformation of the myometrial segment of the uteroplacental arteries, and the pathology and pathogenetic mechanisms underlying the impairment of the physiological vascular changes were clarified.

TL;DR: Whether the human placenta delivered at term in patients without labor who undergo cesarean delivery harbors a resident microbiota, which is the assemblage of microorganisms present in a defined niche or environment, is determined.

TL;DR: Large amounts of heterogeneity between studies for all parameters were found and the need for consistency in definitions that are used to describe placenta accreta spectrum at birth and in the reporting of this increasing common obstetric complication was highlighted.

TL;DR: This study supports a causal link between vaginal dysbiosis and cervical cancer along the oncogenic human papillomavirus acquisition, persistence, and cervicovaginal dysplasia development pathway.

TL;DR: Comprehensive and interdisciplinary approaches to disease management and increased education and disease awareness for patients, health care providers, and the public are needed to remove stigma, increase timely and accurate diagnosis and treatment, and allow for new advancements.

TL;DR: The accumulating evidence that prenatal exposure to a wide variety of viral and bacterial infections - or simply inflammation - may subtly alter fetal brain development, leading to neuropsychiatric consequences for the child later in life is presented.

TL;DR: Pregnant women who work rotating shifts, fixed night shifts, or longer hours have an increased risk of adverse pregnancy outcomes.

TL;DR: It is demonstrated that elective induction of labor at 39 weeks, compared with expectant management beyond that gestational age, was associated with a significantly lower risk of cesarean delivery, maternal peripartum infection, and perinatal adverse outcomes, including respiratory morbidity, intensive care unit admission, and mortality.

TL;DR: A competing risks model is developed that allows combination of maternal factors, mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor to estimate the individual patient‐specific risks of preeclampsia requiring delivery before any specified gestation, and is by far superior to that of the risk scoring systems.

TL;DR: Compared to routine prenatal care, OB Nest resulted in higher patient satisfaction and lower prenatal stress, while reducing the number of appointments with clinicians and maintaining care standards for pregnant women.

TL;DR: Excluding risk factors that cause lower birthweights results in prescriptive birthweight charts that are more akin to fetal‐weight charts, enabling proper discrimination between normal and abnormal birthweight.

TL;DR: Fat mass significantly increased between premenopausal and postmenopausal women across most measures, and attention should be paid to the accumulation of central fat after menopause, whereas increases in total fat mass should be monitored consistently across the lifespan.

TL;DR: This review will identify barriers to reporting and ascertainment of maternal suicide and overdose deaths, summarize geographic-specific data available, address potential social and psychological biases that have led to neglect of the topic of maternal self-harm deaths, and suggest recommendations that incorporate the whole woman in prenatal care and thus prevention of this devastating outcome.

TL;DR: A deeper understanding of the vaginal microbiome dynamics has the potential to facilitate development of future practices, for example in the context of postmenopausal vaginal symptoms, stratifying risk for obstetric complications, and controlling sexually transmitted infections.

TL;DR: MH is associated with increased rates of death and recurrence in patients with stage IB cervical cancer even after controlling for surgeon volume; OH should be the recommended approach in this population.

TL;DR: Considering the impact of menstrual symptoms on daily activities in a large group of women, it is time to open the societal dialogue and improve education for both patients and doctors.

TL;DR: Presumptively intact placental microbes are visualized as low-abundance, low-biomass and sparse populations within the placenta regardless of gestational age and mode of delivery and further support several previously published findings.

TL;DR: Eradication of intra-amniotic infection/inflammation after treatment with antibiotics was confirmed in 79% of patients with preterm labor, intact membranes, and intra-amnesty infection/ inflammation who had a follow-up amniocentesis.

TL;DR: An audit of surgical practices demonstrates that improved compliance with Enhanced recovery After Surgery Gynecologic/Oncology guidelines is associated with an improvement in clinical outcomes, including length of stay, highlighting the importance of Enhanced Recovery After Surgery implementation.

TL;DR: The study suggests that the deep‐learning neural network model may be a useful analytic tool for survival prediction in women with cervical cancer because it exhibited superior performance compared with the Cox proportional hazard regression model.

TL;DR: In patients with cervical insufficiency and intra-amniotic infection/inflammation, administration of antibiotics was followed by resolution of the intra-emniotic inflammatory process or intra-ammiotic infection in 75% of patients and was associated with treatment success in about 60% of cases.

TL;DR: Deaths due to drugs and suicide are a major contributor to mortality in the post-partum period and warrant increased clinical attention, including recognition by physicians and Maternal Mortality Review Committees as a medical cause of death.

TL;DR: Goal of the workshop were to discuss critical issues that pertain to perinatal substance use disorders, with a focus on OUD in particular; to draft preliminary recommendations regarding screening, pain management, and medication-assisted therapy (MAT) for OUD during pregnancy; and to delineate research gaps.

TL;DR: The association between endometriosis and depressive symptoms is largely determined by chronic pain but may also be modulated by individual and context vulnerabilities.

TL;DR: Pregnancy-associated deaths included International Classification of Diseases, 10th revision, codes A34 or O00-99, while opioid-related deaths had at least 1 opioid poisoning code.

TL;DR: It is demonstrated that the FMF Bayes theorem-based model is effective in predicting preterm PE in Asian population and this method of screening is superior to the approach recommended by ACOG and NICE.

TL;DR: This systematic review of the literature systematically and quantitate and summarize indirectly the comparative efficacy of antiseptic formulations and their concentrations that are used for the preparation of the vagina before cesarean delivery in the prevention of endometritis and other infectious complications.