American Journal of Obstetrics & Gynecology Mfm最新文献

{"title":"Postpartum Readmissions Among Patients with Adult Congenital Heart Disease.","authors":"Lisa D Levine, Alexander M Friedman, Yuli Y Kim, Stephanie E Purisch, Timothy Wen","doi":"10.1016/j.ajogmf.2024.101580","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2024.101580","url":null,"abstract":"<p><strong>Background: </strong>Given risks associated with CHD in the postpartum period, epidemiologic data identifying risk factors and timing of complications may be useful in improving postpartum care.</p><p><strong>Objective: </strong>The objectives of this study were to determine timing of, risk factors for, and complications associated with 60-day postpartum readmissions following deliveries with maternal congenital heart disease (CHD).</p><p><strong>Study design: </strong>The 2010-2020 Nationwide Readmissions Database was used for this retrospective cohort study. Postpartum readmissions occurring within 60-days of delivery hospitalization discharge were ascertained. Clinical, demographic, and hospital risk factors associated with postpartum readmission were analyzed with logistic regression models with unadjusted and adjusted odds ratios (aORs) as measures of association. Among patients with CHD the role of additional cardiac risk factors in likelihood of readmission was analyzed. Risks for adverse maternal outcomes during readmission including severe maternal morbidity (SMM), cardiac SMM, and a critical care composite were analyzed.</p><p><strong>Results: </strong>Of an estimated 40,780,439 delivery hospitalizations, 35,242 had an associated CHD diagnosis (8.6 per 10,000) including 2,279 (6.5%) for complex CHD and 32,963 (93.5%) for non-complex CHD. The proportion of deliveries with a maternal CHD diagnosis increased significantly from 6.7 per 10,000 in 2010 to 11.8 in 2020. Overall risk for 60-day postpartum readmission was 1.6% among women without CHD and 3.1% among women with CHD (p<0.01). Among women with CHD, 36.0% of 60-day postpartum readmissions occurred 1-5 days after discharge, 18.0% 5-10 days after discharge, and 14.5% 10-20 days after discharge. In adjusted models for the entire population, CHD retained a significant association with 60-day postpartum readmission (aOR 1.73, 95% CI 1.55, 1.94). When the cohort was restricted to deliveries with CHD, adjusted analyses demonstrate an increased odds associated with additional cardiac risk factors (congestive heart failure, aOR 1.72, 95% CI 1.13-2.62; arrhythmia, aOR 1.68, 95% CI 1.27-2.21; pulmonary circulation disorders, aOR 1.57, 95% CI 1.10-2.24; and chronic hypertension, aOR 1.88, 95% CI 1.26-2.80), hypertensive disorders of pregnancy (aOR 1.97, 95% CI 1.49-2.61) and cesarean delivery (primary aOR 1.82, 95% CI 1.39-2.38; repeat cesarean: aOR 1.91, 95% CI 1.42-2.55). The risk of adverse outcomes during readmissions was higher for women with CHD compared to those without: SMM (23.8% versus 16.1%, p<0.01), cardiac SMM (9.6% versus 4.9%, p<0.01), and a critical care composite (3.1% versus 1.8%, p<0.01).</p><p><strong>Conclusion: </strong>Deliveries with CHD were associated with increased odds of postpartum readmission and complications during readmissions. The majority of readmissions occurred soon after delivery discharge. Among patients with CHD, risk for readmission was higher ","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101580"},"PeriodicalIF":3.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Step forward: Implementation and evaluation of STEPS program to optimize postpartum hemorrhage management in vaginal deliveries.","authors":"Pei Zhang, Yifan Fan, Hui Song, Yan Lv, Hao Geng, Pingchuan Ma, Hongyan Cui, Yanju Jia, Xu Chen","doi":"10.1016/j.ajogmf.2024.101581","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2024.101581","url":null,"abstract":"<p><strong>Background: </strong>Postpartum hemorrhage (PPH) is a leading cause of maternal mortality worldwide, particularly in resource-limited settings. Enhancing maternal safety in relation to PPH requires optimizing care protocols, continuous monitoring, and timely interventions. However, integrating these methodologies into vaginal delivery practices remains underexplored.</p><p><strong>Objective: </strong>To assess the impact and sustainability of a recently implemented Strategies and Tools to Enhance Parturient Safety (STEPS) program on PPH management.</p><p><strong>Methods: </strong>This before-and-after study included women who delivered vaginally between January 2020 and November 2023. Clinical practices and PPH-related outcomes were compared for two-year periods before and after STEPS implementation, initiated in January 2022. The program involved enhanced perinatal care bundles, interdisciplinary team training, and continuous monitoring using statistical process control (SPC) tools. The primary outcome was PPH incidence (≥500 mL blood loss within 24 hours).</p><p><strong>Results: </strong>During the 4-year observation period, 24,235 women underwent vaginal deliveries. The incidence of PPH was 11.1% (1,473/13272) before STEPS and 11.8% (1,293/10963) after STEPS (aRR, 1.09; 95% CI, 1.00-1.18; p=0.042). Severe PPH rates remained unchanged (aRR, 1.09; 95% CI, 0.90-1.33; p=0.391). However, the proportion requiring blood transfusion significantly decreased (aRR, 0.77; 95% CI, 0.61-0.98; p=0.035). Compared to pre-intervention period, a higher proportion of women experiencing PPH were identified as being at elevated risk prior to delivery in the post-intervention period (p<0.001). Notably, blood transfusion rates (p=0.047) and hospital stay durations for women with PPH (p<0.001) significantly declined.</p><p><strong>Conclusions: </strong>The STEPS program effectively improved PPH management by enhancing risk identification, increasing targeted interventions, and reducing blood transfusion rates and hospital stays. These findings highlight the importance of a comprehensive approach that integrates risk assessment, monitoring, and tailored interventions for managing PPH in vaginal deliveries, particularly in resource-limited settings.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101581"},"PeriodicalIF":3.8,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-based cesarean delivery: intraoperative management from skin incision until placental delivery (Part 8).","authors":"A D Mackeen, M V Sullivan, V Berghella","doi":"10.1016/j.ajogmf.2024.101576","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2024.101576","url":null,"abstract":"<p><p>The goal of standardizing the technique of the routine, uncomplicated cesarean delivery (CD) is to decrease maternal morbidity while optimizing neonatal outcomes. During the procedure, a family-oriented CD is recommended. The low transverse cesarean skin incision (created with either scalpel or diathermy) is preferred with either the Joel-Cohen or Pfannenstiel methods being acceptable. For patients with obesity (BMI ≥ 35kg/m²), surgeons may also elect either the Cohen (including supraumbilical) or Pfannenstiel (infraumbilical or infrapannus) technique as there are similar outcomes, however the Cohen approach has been associated with lower Apgar scores and decreased surgeon satisfaction related to the feasibility of the incision. Diathermy may be preferred for subcutaneous tissue opening as compared to sharp dissection. Though postoperative recovery outcomes may be improved with an extraperitoneal approach to CD, a transperitoneal technique is the current standard of care. The initial fascial incision is made sharply, further extension can be carried out either sharply or bluntly. Inferior dissection of the rectus muscle can be omitted and routine cutting of the muscles is not needed. If necessary, a Maylard modification is acceptable. Though based on limited data, blunt peritoneal entry and extension should be considered. With regards to uterine entry and delivery: bladder flap creation should be omitted, a low transverse hysterotomy is recommended with blunt cephalo-caudad expansion, and manual delivery of the fetal head should be performed. If the fetal head is impacted, then reverse breech extraction may be preferred for maternal benefit. Delayed cord clamping is recommended for at least 30 seconds and up to 120 seconds (recommended for preterm deliveries) with either routine or selected umbilical cord gas collection being considered. In areas where available, carbetocin is more effective in prevention of postpartum hemorrhage (PPH). Otherwise, the combination of oxytocin plus either misoprostol or methergine should be utilized. There is insufficient evidence regarding the effectiveness of uterine massage for PPH prevention. Spontaneous removal of the placenta with gentle cord traction is recommended.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101576"},"PeriodicalIF":3.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Single vs. Double Blind Peer Review: A Difference-in-Difference Analysis.","authors":"Rula Atwani, Carole Barake, Misooja Lee, George Saade, Hugh Taylor, Jim C Huang, Tetsuya Kawakita","doi":"10.1016/j.ajogmf.2024.101582","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2024.101582","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101582"},"PeriodicalIF":3.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Practical Approach to Diagnosing and Managing Long QT Syndrome from Pregnancy through Postpartum.","authors":"Antonio F Saad, Eunice Yang, Andrew H Nguyen, Garima Sharma, Scott A Sullivan, George L Maxwell, Luis D Pacheco, George R Saade","doi":"10.1016/j.ajogmf.2024.101577","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2024.101577","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101577"},"PeriodicalIF":3.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tugging the Foley Catheter Balloon Every Three Hours in Induction of Labor After One Previous Cesarean: A Randomized Controlled Trial.","authors":"Krishnan Yunesh, Aizura Syafinaz Ahmad Adlan, Thai Ying Wong, Farah Gan, Mukhri Hamdan, Peng Chiong Tan","doi":"10.1016/j.ajogmf.2024.101579","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2024.101579","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Induction of labor after one previous cesarean (IOLAC) with unripe cervixes is at especially high risk for unplanned cesarean birth and uterine rupture. Balloon mechanical ripening is often preferred over prostaglandin during IOLAC, as uterine rupture is associated with prostaglandin use. The transcervical Foley balloon can dislodged past the ripened cervix and be comfortably retained in the vagina during passive placement. Tugging of the Foley catheter can be a non-invasive and tolerated method for timelier retrieval of the retained balloon; expediting discovery of a ripened cervix, permitting follow-on amniotomy and oxytocin infusion, thus hastening birth.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate tugging the Foley balloon for 30 seconds every three hours compared to standard care (no tugging) during the 12 hours of scheduled placement on the induction to birth interval and patient satisfaction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;A randomized controlled trial in a university hospital in Malaysia recruited participants from April 2023 to March 2024. Eligible participants admitted for Foley balloon induction of labor who had one previous cesarean were recruited. After balloon insertion, participants were randomized to tugging or standard care. Following balloon displacement, a vaginal examination was performed to check the cervix. The examination findings then dictated follow-on IOLAC management according to usual practice. The primary outcomes were the induction (Foley insertion) to delivery interval and participants' satisfaction with the birth process. Secondary outcomes were largely derived from the core outcome set for trials (CROWN) on IOL. A sample size of 126 was calculated to cover for a 4 hours reduction in the induction to delivery interval and a 1.5 point increase in satisfaction score based on 0-10 numerical rating scale predicated on a superiority hypothesis with the level of significance set at 0.05, power at 80% and a 10% drop out rate. Analysis was by t-test, Mann-Whitney U test, Chi square test and Fisher exact test as appropriate to the data on an intention-to-treat basis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;126 participants were randomized; 63 to each trial arm. The induction to birth interval was (mean±standard deviation) 29.7±9.6 hours vs. 29.8±9.1 hours p=0.950 and maternal satisfaction with the IOLAC birth process assessed by 0-10 numerical rating scale was median [interquartile range] 8[7-9] vs. 8[7-9] p=0.936 for 3-hourly tugging and standard care respectively. Caesarean delivery rate was 37/63 (59%) vs. 41/63 (65%) p=0.238 and the main indication for unplanned caesarean was failure to progress was 24/37 (65%) vs. 24/41 (59%) p=0.914 in tugging vs. standard care arms respectively. Three-hourly tugging also did not shorten the intervals from induction to balloon displacement, amniotomy, start of oxytocin infusion or the second stage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;At Foley balloon IOLAC wit","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101579"},"PeriodicalIF":3.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging Personal and Professional: The Impact of Birth Trauma on a Maternal-Fetal Medicine Specialist's Empathy and Practice.","authors":"Anna R Whelan","doi":"10.1016/j.ajogmf.2024.101584","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2024.101584","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101584"},"PeriodicalIF":3.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dilapan-S versus Standard Methods for Cervical Ripening in Term Pregnancies: An Individual Patient Data Meta-Analysis.","authors":"Antonio F Saad, Claudia Pedroza, Rachana Gavara, Janesh Gupta, Ronald J Wapner, George R Saade","doi":"10.1016/j.ajogmf.2024.101583","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2024.101583","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Dilapan-S is a cervical ripening agent approved by the FDA that has been found to be just as effective as other agents and can be utilized for outpatient ripening. No large-scale studies have been conducted to compare cesarean delivery rates between Dilapan-S and other ripening methods. Our objective was to combine these trials to compare cesarean delivery rates for Dilapan-S with other cervical ripening methods, overall and in sub-groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;The time period for this study was from January 1994 to April 2023. Ovid MEDLINE, Embase via Ovid, Ovid Emcare, CINAHL Plus, ClinicalTrials.gov, euclinicaltrialsregister.eu, and Scopus were searched. The study was conducted according to the Preferred Reporting Item for Systematic Reviews guidelines and was registered with PROSPERO (CRD42023423573).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study eligibility criteria: &lt;/strong&gt;This was a systematic review and meta-analysis of individual patient data (IPD) from randomized controlled trials comparing Dilapan-S to other mechanical or pharmacologic cervical ripening methods for labor induction in singleton gestations. The main outcome measure assessed was the cesarean delivery (CD) rate in comparing Dilapan-S to alternative methods. Secondary maternal outcomes included changes in Bishop score post-intervention, vaginal delivery without complications, postpartum hemorrhage, cervical ripening issues, uterine infection, and patient satisfaction. Secondary neonatal outcomes were Apgar score &lt;7 at 5 minutes, arterial cord pH &lt;7.1, meconium presence, NICU admission and length of stay, hypoxic-ischemic encephalopathy, intraventricular hemorrhage, infant infection, and infant death. This study exclusively included randomized controlled trials (RCTs) involving participants who underwent labor induction during the third trimester of a singleton pregnancy. At least one group within these trials received Dilapan-S for the purpose of cervical ripening. Trials were excluded if induction occurred prior to 37 weeks of gestation or if cervical ripening was deemed unnecessary.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study appraisal and synthesis: &lt;/strong&gt;Two reviewers independently selected studies, assessed the risk of bias using the Cochrane Risk of Bias Tool for randomized controlled trials, and extracted the data. Pre-specified subgroup analysis was performed for parity, BMI, Bishop score, and gestational age. Pooled odds ratios (ORs) adjusted for maternal age and parity with 95% confidence intervals (CI) were calculated using frequentist and Bayesian approaches.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Four randomized controlled trials were identified, with 1731 women included (1036 allocated to Dilapan-S; 695 to alternative cervical ripening methods). CD rates were 28% and 30% with Dilapan-S and other methods, respectively. There was no difference in maternal age and parity-adjusted CD rates between Dilapan-S and other methods (OR 1.03, 95% CI 0.8-1.3). Bayesian inferenc","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101583"},"PeriodicalIF":3.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amlodipine versus Nifedipine ER for the Management of Postpartum Hypertension: A Noninferiority Randomized Controlled Trial.","authors":"Katelyn Pratt, Ross Lordo, Stella Self, Laura Carlson","doi":"10.1016/j.ajogmf.2024.101575","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2024.101575","url":null,"abstract":"<p><strong>Background: </strong>Postpartum hypertension is an increasingly prevalent problem and optimizing its treatment is imperative in reducing maternal morbidity and improving long-term health outcomes. Despite this, data on treatment of postpartum hypertension is limited. While most available studies focus on labetalol and nifedipine ER, these medications are not frequently used for hypertension treatment in the non-obstetric setting. As we aim to establish best practices for managing postpartum hypertension, use of more commonly encountered antihypertensives should be evaluated.</p><p><strong>Objective: </strong>To evaluate the use of amlodipine for the treatment of postpartum hypertension, as assessed by postpartum length of stay.</p><p><strong>Study design: </strong>In a pragmatic, randomized controlled noninferiority trial, patients were assigned to amlodipine or nifedipine ER for treatment of postpartum hypertension. The primary outcome was time from delivery until discharge with a noninferiority limit of 24 hours. A sample size of 132 was needed to achieve 80% power with a 2-tailed alpha of 0.05. Intent-to-Treat and Per Protocol analyses were performed. Prespecified secondary outcomes included the need for additional antihypertensives, side effects, medication discontinuation, breastfeeding satisfaction, and readmission rate. A post-hoc analysis of time from medication initiation until hospital discharge was also performed.</p><p><strong>Results: </strong>From April 2021 to December 2022, 7,618 patients were screened and 175 patients were randomized, with 132 meeting criteria for antihypertensive initiation. Baseline demographics were similar between groups. Amlodipine had a non-inferior length of stay compared to nifedipine ER (Intent-to-Treat Wilcoxon pseudo-median amlodipine=73.5 hours, nifedipine ER=72.0 hours, 95% CI -8.00-6.00). The remainder of analyses were performed only on the Per Protocol cohort. Time from medication initiation until hospital discharge was similar between groups (amlodipine=45.0 hours, nifedipine ER=45.5 hours, 95% CI -8.00-13.00). There were no differences in use of additional antihypertensives or patient-reported side effects or breastfeeding outcomes, but hypotension and tachycardia were less common with amlodipine use. Amlodipine was significantly less likely to be discontinued due to side effects (amlodipine n=0, nifedipine ER n=7 (10.1%), p=0.02). Readmission rates were similar between groups.</p><p><strong>Conclusion: </strong>Amlodipine is non-inferior to nifedipine ER for postpartum hypertension treatment, as defined by median length of postpartum stay. Rates of side effects were similar between groups, but there was a statistically significant difference in medication discontinuation rates.</p><p><strong>Clinical trial registration: </strong>Clinicaltrials.gov, www.</p><p><strong>Clinicaltrials: </strong>gov, NCT04790279.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101575"},"PeriodicalIF":3.8,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disentangling causal pathways in uterine fibroids and preterm birth research.","authors":"Moti Gulersen, Vincenzo Berghella, Matthew J Blitz","doi":"10.1016/j.ajogmf.2024.101574","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2024.101574","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101574"},"PeriodicalIF":3.8,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}