American Journal of Obstetrics & Gynecology Mfm最新文献

{"title":"Comparing users to nonusers of remote patient monitoring for postpartum hypertension","authors":"Jennifer M.J. Kidd MD, MPH, Dajana Alku MD, Rosanne Vertichio MS, BSN, Meredith Akerman MS, Lakha Prasannan MD, Devin M. Mann MD, Paul A. Testa MD, Martin Chavez MD, Hye J. Heo MD","doi":"10.1016/j.ajogmf.2024.101520","DOIUrl":"10.1016/j.ajogmf.2024.101520","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"6 12","pages":"Article 101520"},"PeriodicalIF":3.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476674","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 the diagnosis and initial management of acute right ventricular failure during pregnancy using point-of-care ultrasound","authors":"Juliana Gevaerd Martins MD ,&nbsp;Antonio Saad MD ,&nbsp;George Saade MD ,&nbsp;Luis D. Pacheco MD","doi":"10.1016/j.ajogmf.2024.101517","DOIUrl":"10.1016/j.ajogmf.2024.101517","url":null,"abstract":"<div><div>Acute right ventricular failure is a critical condition in pregnancy that can lead to severe maternal and fetal complications. This expert review discusses the instrumental role of point-of-care ultrasound in diagnosing and managing ARVF in pregnant patients, highlighting its benefits for immediate clinical decision-making in obstetric emergencies. The unique physiological changes during pregnancy, such as increased blood volume and cardiac output, can exacerbate underlying or latent cardiac issues, making pregnant patients particularly susceptible to acute right ventricular failure. Common causes during pregnancy include pulmonary embolism, peripartum cardiomyopathy, and congenital heart diseases, each presenting distinct challenges in diagnosis and management. The real-time capability of point-of-care ultrasound allows for the immediate assessment of right ventricular size and function, evaluation of fluid status via the inferior vena cava, and identification of potential pulmonary embolism, offering a non-invasive, rapid, and dynamic diagnostic tool right at the bedside. The expert review details specific point-of-care ultrasound techniques adapted for pregnant patients, including the parasternal long and short axis and apical 4-chamber view, essential for evaluating right heart function and guiding acute management strategies. These include fluid management, adjustment of pharmacological treatment, and immediate interventions to support cardiac function and reduce ventricular overload. Point-of-care ultrasound enhances clinical outcomes by allowing clinicians to make informed decisions quickly, reducing the time to intervention, and tailoring management strategies to individual patient needs. However, despite its apparent advantages, the adoption of point-of-care ultrasound requires specialized training and familiarity with obstetric-specific protocols. This review advocates for the integration of point-of-care ultrasound into standard obstetric care protocols, emphasizing the need for clear guidelines and structured protocols that equip healthcare providers with the skills necessary to utilize this technology effectively. Future research should aim to refine these protocols and expand the evidence base to solidify the role of point-of-care ultrasound in improving maternal and fetal outcomes in acute right ventricular failure.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"6 12","pages":"Article 101517"},"PeriodicalIF":3.8,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406995","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":"Early hospital discharge after cesarean delivery: a systematic review and meta-analysis of randomized controlled trials","authors":"Nadim Chaarani MD ,&nbsp;Sara Sorrenti MD ,&nbsp;Antonio Sasanelli MD ,&nbsp;Daniele Di Mascio MD ,&nbsp;Vincenzo Berghella MD","doi":"10.1016/j.ajogmf.2024.101524","DOIUrl":"10.1016/j.ajogmf.2024.101524","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The aim of this systematic review and meta-analysis was to assess whether early discharge from hospital after cesarean delivery (CD) affects the rate of maternal readmission.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Data source&lt;/h3&gt;&lt;div&gt;The research was conducted using PubMed, Embase, Web of Sciences, Scopus, ClinicalTrials.gov, and the Cochrane Central Register of Controlled Trials as electronic databases, from the inception of each database to August 2023 with RCT as publication type. No restrictions for language or geographic location were applied.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study eligibility criteria&lt;/h3&gt;&lt;div&gt;Selection criteria included only RCTs comparing the effect of earlier versus later hospital discharge after CD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study appraisal and synthesis methods&lt;/h3&gt;&lt;div&gt;The primary outcome was the rate of maternal readmission. The summary measures were reported as relative risk (RR) or as mean difference (MD) with 95% confidence intervals (CI) using the random effects model of Mentel–Haenszel. I-squared (Higgins I&lt;sup&gt;2&lt;/sup&gt;) greater than 0% was used to identify heterogeneity. “Early” and “late” hospital discharge was first considered according to each study's definition and then a subgroup analysis was performed including only studies defining as “early” a discharge within 24–28 hours and “late” a discharge at ≥48 hours after CD. The study was registered on PROSPERO (CRD 42024529885).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Seven RCTs including 4,267 individuals, of which 2,125 (49.8%) randomized in the early discharge and 2,142 (50.2%) in the late discharge group were included. There was no difference between the two groups in the rate of maternal readmission (3.6% vs. 3.4%, RR 1.10; 95% CI 0.80–1.52). There was no significant difference in both maternal complications diagnosed within 6 weeks after CD and neonatal complications. Early discharge after CD was associated with improved psychological wellbeing and was cost-effective. The subgroup analysis of the primary outcomes only in high-quality studies showed similar results: no difference in the rate of maternal readmission was observed (3.8% vs. 3.2%, RR 1.20; 95% CI 0.63–2.30) between the two groups. When focusing only on studies comparing 24–28-hour versus ≥ 48-hour hospital discharge, the rate of maternal readmission did not differ between the two groups, while the rates of neonatal readmission and neonatal jaundice were significantly higher in the early discharge group.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;There is no increase in the rate of maternal readmission following early hospital discharge at 24–28 hours as opposed to later hospital discharge after a CD. The rates of neonatal readmission and neonatal jaundice were significantly higher in the early discharge group. Patients undergoing uncomplicated CDs might be discharged from the hospital at 24–28 hours postpartum, as long as close neonatal outpatient follow-up is done in 1–2 days; if this is unfeasible, discha","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"6 12","pages":"Article 101524"},"PeriodicalIF":3.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401543","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":"Myomectomy at the time of cesarean delivery is not a predictor of transfusion among pregnant individuals with fibroids: a retrospective cohort study","authors":"Stephanie Jarvi BSc,&nbsp;Amir Aviram MD,&nbsp;Courtney Jolliffe MD,&nbsp;Sophie Wortsman BSc,&nbsp;Grace Liu MD,&nbsp;Anne Berndl MD,&nbsp;Jon Barrett MD,&nbsp;Jamie Kroft MD","doi":"10.1016/j.ajogmf.2024.101522","DOIUrl":"10.1016/j.ajogmf.2024.101522","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"6 11","pages":"Article 101522"},"PeriodicalIF":3.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401544","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":"Factors influencing article citations in top obstetrics and gynecology journals","authors":"Marzieh Soheili MD, MS,&nbsp;Natalia Shcherbakova PhD,&nbsp;Gladys Ekong PhD,&nbsp;Heather Sankey MD, MS","doi":"10.1016/j.ajogmf.2024.101511","DOIUrl":"10.1016/j.ajogmf.2024.101511","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"6 11","pages":"Article 101511"},"PeriodicalIF":3.8,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393960","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":"Screening for developmental dysplasia of the hip following external cephalic version","authors":"Alison M. Hoffer MD, LT, MC, USN,&nbsp;Brianne W. Morrow MD, LT, MC, USN,&nbsp;Andrea F. McGlynn MS,&nbsp;Jonathan T. Hunt MD, MBA, Maj, USAF, MC,&nbsp;Study conducted in Portsmouth, Virginia","doi":"10.1016/j.ajogmf.2024.101521","DOIUrl":"10.1016/j.ajogmf.2024.101521","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"6 12","pages":"Article 101521"},"PeriodicalIF":3.8,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381841","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":"Rate of preterm delivery and latency period in asymptomatic patients undergoing cerclage for very short cervix ≤10.0 mm","authors":"Erin S. Huntley MD,&nbsp;Edgar Hernandez-Andrade MD,&nbsp;Eleazar Soto-Torres MD,&nbsp;Baha M. Sibai MD,&nbsp;Donatella Gerulewicz-Vannini MD,&nbsp;Sean C. Blackwell MD","doi":"10.1016/j.ajogmf.2024.101496","DOIUrl":"10.1016/j.ajogmf.2024.101496","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND&lt;/h3&gt;&lt;div&gt;In asymptomatic women with cervical length ≤10 mm, vaginal progesterone has a limited effect in reducing the rate of preterm delivery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OBJECTIVE&lt;/h3&gt;&lt;div&gt;This study aimed to estimate the rate of preterm delivery and mean latency period to delivery in asymptomatic women with no history of preterm delivery and a cervical length of ≤10.0 mm undergoing or not undergoing cerclage and who were not treated with vaginal progesterone.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN&lt;/h3&gt;&lt;div&gt;This was a retrospective analysis of asymptomatic patients with singleton pregnancies and no history of preterm delivery with an incidental finding of a cervical length of ≤10.0 mm measured by transvaginal ultrasound during midtrimester scan. Of note, 56 patients (63.6%) underwent cerclage placement and 32 patients (36.4%) did not, none of them received vaginal progesterone. Patients with evidence of advanced dilation, prolapsing membranes, ruptured membranes, or positive signs of infection were not candidates for cerclage placement and were excluded from the analysis. Differences in the prevalence of preterm delivery, mean gestational age at delivery, and mean latency from very short cervix identification to delivery between the 2 groups were calculated. Associations between cerclage and preterm delivery adjusted for maternal characteristics and fetal weight were estimated.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;The median gestational ages at the time of cervical length measurement were 20 6/7 weeks (interquartile range, 17 5/7 to 23 3/7) in the cerclage group and 21 5/7 weeks (interquartile range, 17 6/7 to 23 6/7) in the no-cerclage group (&lt;em&gt;P&lt;/em&gt;=.02). No difference in cervical length was observed between patients who had a cerclage (5.9±3.1 mm) and those who did not have a cerclage (6.5±3.2 mm) (&lt;em&gt;P&lt;/em&gt;=.4). The prevalence of preterm delivery in women with cerclage vs women without cerclage was as follows: PTD at &lt;37 weeks of gestation (31/56 [55.3%] in the cerclage group vs 28/32 [87.5%] in the no-cerclage group; adjusted odds ratio, 0.17; 95% confidence interval, 0.05–0.62; &lt;em&gt;P&lt;/em&gt;=.008), PTD at ≤34 weeks of gestation (27/56 [48.2%] in the cerclage group vs 24/32 [75.0%] in the no-cerclage group; adjusted odds ratio, 0.16; 95% confidence interval, 0.05–0.55; &lt;em&gt;P&lt;/em&gt;=.02), and PTD at ≤28 weeks of gestation (19/56 [33.9%] in the cerclage group vs 22/32 [68.7%] in the no-cerclage group; adjusted odds ratio, 0.15; 95% confidence interval, 0.05–0.51; &lt;em&gt;P&lt;/em&gt;=.002). The median gestational ages at delivery were 32 6/7 weeks (interquartile range, 19 1/7 to 40 1/7) in the cerclage group and 28 1/7 weeks (interquartile range, 20 1/7 to 40 2/7) in the no-cerclage group (&lt;em&gt;P&lt;/em&gt;=.001). The median latencies from the time of cervical length measurement to delivery were 84 days (interquartile range, 8–144) in the cerclage group and 43 days (interquartile range, 1–146) in the no-cerclage group (&lt;em&gt;P&lt;/em&gt;=.003).&lt;/div&gt;&lt;/div&gt;&lt;d","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"6 11","pages":"Article 101496"},"PeriodicalIF":3.8,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381840","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":"Implementation of an algorithm for testing, diagnosis, and antibiotic stewardship of asymptomatic bacteriuria in pregnancy","authors":"Sarah B. Bergbower DCLS ,&nbsp;Antonio F. Saad MD ,&nbsp;Natalie M. Williams-Bouyer PhD ,&nbsp;Rajkumar Rajendran DCLS","doi":"10.1016/j.ajogmf.2024.101516","DOIUrl":"10.1016/j.ajogmf.2024.101516","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND&lt;/h3&gt;&lt;div&gt;Asymptomatic bacteriuria affects 2% to 15% of pregnant women, with 20% to 40% developing symptoms later. Symptomatic urinary tract infections are more common in pregnancy, with a prevalence of 33%, posing risks, such as preterm delivery, low birthweight, and maternal pyelonephritis. The gold standard for urinary tract infection detection is a urine culture, but point-of-care urinalysis dipsticks are frequently performed as screens during regular obstetrical visits. Leukocyte esterase has been used to justify the treatment of asymptomatic bacteriuria, even with low sensitivity and specificity. Confirmatory tests are crucial for avoiding false positives and ensuring optimal outcomes. Current guidelines for urinalysis dipstick interpretation and the decision to treat asymptomatic bacteriuria in pregnancy are limited. It remains unclear whether an evidence-based algorithm can improve test utilization, diagnosis, and treatment decisions for asymptomatic bacteriuria in pregnancy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OBJECTIVE&lt;/h3&gt;&lt;div&gt;The primary objective of our study was to develop, implement, and evaluate an evidence-based algorithm to guide urinalysis interpretation, culture, diagnosis, and antibiotic stewardship of asymptomatic bacteriuria in pregnant patients during routine obstetric visits.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN&lt;/h3&gt;&lt;div&gt;The project involves both retrospective and quasi-experimental prospective medical record reviews of pregnant patients aged ≥18 years, beyond 20 weeks of gestation, from routine obstetrical visits with urinalysis dipstick tests. A doctorate in clinical laboratory sciences student developed an educational algorithm to guide urinalysis dipstick interpretation, culturing necessity, and treatment decisions based on evidence-based practice. Our study considered patient records from February 1, 2022, to February 28, 2022, as retrospective (prealgorithm implementation) data and January 24, 2023, to February 22, 2023, as prospective (postalgorithm implementation) data. Data collected from the electronic medical record included deidentified patient information, urinalysis results, culture dates and outcomes, antibiotic prescriptions, urinary tract infection or asymptomatic bacteriuria diagnoses, provider details, adverse pregnancy outcomes, and demographics. Data analysis using SPSS (version 29; SPSS IBM, Armonk, NY) involved chi-square tests, likelihood ratios, and effect size calculations, with &lt;em&gt;P&lt;/em&gt; values of &lt;.05 considered statistically significant.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;This study examined a total of 1176 patient records. Preimplementation data included 440 records, of which 224 were abnormal urinalyses and 216 were normal urinalyses. Postimplementation data included 736 records, of which 255 were abnormal urinalyses and 481 were normal urinalysis. The patient demographics predominantly featured White individuals (87%), with a median maternal age of 27 years and a gestational age of 32 ","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"6 11","pages":"Article 101516"},"PeriodicalIF":3.8,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393963","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":"Survival rates in pregnancies complicated by twin-to-twin transfusion syndrome undergoing laser therapy: a systematic review and meta-analysis: Survival rates in twin-to-twin transfusion syndrome.","authors":"Francesco D'Antonio, Delia Marinceu, Nashwa Eltaweel, Smriti Prasad, Asma Khalil","doi":"10.1016/j.ajogmf.2024.101503","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2024.101503","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Twin-to-twin transfusion syndrome (TTTS) is associated with excess perinatal mortality and morbidity. Even though Quintero staging is commonly used to assess its severity, the limitations of its prognostic value have been highlighted by researchers over the years. Recent literature indicates that fetal survival, whether for both twins or at least one, following fetoscopic laser photocoagulation of the placental anastomoses is similar in TTTS Quintero stages I and II (combined) and III and IV (combined). In this context we perform a systematic review and meta-analysis of the published literature to elucidate the survival rate of twins according to the stage of TTTS and to compare the survival rates in pregnancies complicated by stage I and II (combined) vs those with stages III and IV (combined).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;Medline, Embase and Cochrane databases were searched.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study eligibility criteria: &lt;/strong&gt;The inclusion criteria were studies reporting the outcome of MCDA twin pregnancies with TTTS undergoing laser therapy according to the Quintero stage of the disease. The primary outcome was double survival at birth. The secondary outcomes were no survival, and survival of at least one twin. All the explored outcomes were reported according to the Quintero staging system. Furthermore, we aimed to compare all the observed outcomes in pregnancies complicated by TTTS affected by stage I and II vs those with stages III and IV.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study appraisal and synthesis methods: &lt;/strong&gt;Random-effect meta-analyses were used to combine data, and the results reported as pooled proportions or odd ratios (OR) with their 95% confidence intervals (CI).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;26 studies were included. Survival of both fetuses was observed in 72.9% (95% CI 68.2-77.3) of pregnancies complicated by stage I, 67.9% (95% CI 62.3-73.3) with stage II, 48.1% (95% CI 42.5-53.8) with stage III, and 53.4% (95% CI 42.5-64.3) with stage IV TTTS (Table 3). At least one survivor was reported in 89.4% (95% CI 86.9-91.9) of cases with stage I, 87.1% (95% CI 82.9-90.7) with stage II, 77.3% (95% CI 71.7-82.5) with stage III, and 80.1% (95% CI 69.4-89.0) with stage 4. The corresponding figures for no survivors were 10.7% (95% CI 7.7-14.0), 11.4% (95% CI 7.8-15.6), 20.4% (95% CI 15.6-25.8), and 16.7% (95% CI 8.3-27.2), respectively. When comparing the different outcomes according to the different TTTS stages, there was no significant difference in the incidence of double survival (p=0.933), at least one survivor (p=0.688), and no survivors (p=0.866) between stages I and II TTTS. There was also no significant difference in the incidence of double survival (p=0.201), at least one survivor (p=0.380), and no survivors (p=0.947) between stages III and IV. Conversely, when comparing the outcome of pregnancies with stage I/II (combined) vs stages III/IV (combined), the incidence of double survival was significantly","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101503"},"PeriodicalIF":3.8,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393965","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":"Implementing a specialized fourth trimester clinic pilot for high-risk individuals","authors":"Kavita Vani MD,&nbsp;Cien Huang BA,&nbsp;Jessica Hecht BA,&nbsp;Matthew R. Lootens PhD,&nbsp;Chavi Eve Karkowksy MD,&nbsp;Kevin Fiori MD, MPH, MS,&nbsp;Edith Gurewitsch Allen MD, MBA, MEd,&nbsp;David W. Lounsbury PhD","doi":"10.1016/j.ajogmf.2024.101523","DOIUrl":"10.1016/j.ajogmf.2024.101523","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"6 12","pages":"Article 101523"},"PeriodicalIF":3.8,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393964","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}