American journal of perinatology最新文献

{"title":"The Yield of Amnioinfusion in the Prevention of Postpartum Hemorrhage.","authors":"Keren Zloto, Eyal Sivan, Rakefet Yoeli-Ullman, Shali Mazaki-Tovi, Suneet P Chauhan, Michal Fishel Bartal","doi":"10.1055/a-2535-8109","DOIUrl":"10.1055/a-2535-8109","url":null,"abstract":"<p><p>Although amnioinfusion decreases the rate of uterine atony, its effect on postpartum hemorrhage (PPH) is uncertain. This study aimed to assess whether amnioinfusion reduces the risk of PPH in laboring individuals.A retrospective study of all laboring singletons at a tertiary center between January 2013 and December 2022 at ≥34 weeks. Individuals with known major fetal anomalies, stillbirths, or missing delivery records were excluded. The primary outcome was PPH. Neonatal and secondary maternal outcomes were also explored. Adjusted odds ratios (aOR) were estimated using multivariable regression models.Out of 113,816 deliveries during the study period, 83,152 (77.1%) met inclusion criteria, and among them 4,597 (4.03%) had amnioinfusion. Laboring individuals with amnioinfusion were more commonly nulliparous, had more polyhydramnios, oligohydramnios, preeclampsia, gestational diabetes, and fetal growth restriction. Furthermore, individuals with amnioinfusion had a higher rate of labor induction (54.54 vs. 27.8%; <i>p</i> < 0.01) and a higher cesarean rate (36.9 vs. 9.5%; <i>p</i> < 0.01). Following multivariable regression, there was no significant difference in the rate of PPH among individuals who had an amnioinfusion (2.6%) versus those who did not (3.1%; aOR: 0.95, 95% confidence interval [CI]: 0.87, 1.27). The rates of endometritis (aOR: 1.4; 95% CI: 1.04-1.89) and postpartum fever (aOR: 1.70; 95% CI: 1.36-2.12) were higher in those who had amnioinfusion compared with those that did not.Among laboring individuals ≥ 34 weeks, intrapartum amnioinfusion was not associated with a reduction in the rate of PPH and was associated with a higher likelihood of infectious morbidity. · PPH stands as the foremost contributor to maternal mortality.. · There is limited information regarding the yield of amnioinfusion in the reduction of PPH.. · We evaluate whether amnioinfusion reduces the rate of PPH in laboring individuals ≥ 34 weeks..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1771-1777"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Diabetes-in-Pregnancy Outcomes Requires a Care Continuum.","authors":"Audrey M Huang, Menachem Miodovnik, E Albert Reece","doi":"10.1055/a-2505-5330","DOIUrl":"10.1055/a-2505-5330","url":null,"abstract":"<p><p>This study aimed to assess the strengths, limitations, opportunities, and threats presented by diabetes-in-pregnancy. We review the improvements in maternal and fetal mortality since the advent of insulin therapy, evaluate current health challenges, and identify opportunities for preventing increased mortality due to diabetes-in-pregnancy. Prior to 1922, women with type 1 diabetes mellitus (T1DM) of childbearing age were discouraged from becoming pregnant as the maternal and fetal/neonatal mortality rates were extremely high. Starvation-level dietary restriction was the only \"treatment,\" with limited success in managing the disease. The discovery of insulin coupled with careful clinical management presented the possibility of successful pregnancies for women with T1dm. Over the course of the next half-century, maternal survival increased from 54 to 97%. However, the gains made in reducing adverse outcomes of diabetes in pregnancy are eroding due to modern challenges. The global obesity epidemic has led to an increase in type 2 and gestational diabetes mellitus (DM). T1DM also is on the rise. Together, the rise in the prevalence of pregestational diabetes has increased the risks for adverse outcomes. Here we review the ongoing challenges as well as opportunities for research to improve outcomes. We suggest that overweight, obesity, and diabetes management must be coupled with preconception counseling and education and must include, in addition to, Ob/Gyns, primary care, nutrition, weight management, and other experts to ensure that those at risk of pregnancy complications due to diabetes have the best possible outcomes. · Diabetes in pregnancy is affecting more people.. · The obesity epidemic is fueling an increase in pregestational diabetes.. · Research is needed to reduce inequities in diabetes in pregnancy outcomes.. · Blood glucose control should start prior to pregnancy..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1704-1713"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Pregestational Diabetes on Maternal Morbidity and Mortality: Trends, Challenges, and Future Directions.","authors":"Ellen M Murrin, Antonio F Saad, Scott Sullivan, Menachem Miodovnik","doi":"10.1055/a-2489-4539","DOIUrl":"10.1055/a-2489-4539","url":null,"abstract":"<p><p>Maternal mortality in the United States is on the rise, demonstrating a concerning trend that stands in stark contrast to the falling rates in other developed countries. A key challenge facing the improvement of maternal care is the mounting prevalence of chronic health conditions such as hypertension and diabetes, which are often linked to poor diet and sedentary lifestyle. Pregestational diabetes now impacts 1 to 2% of pregnancies, while gestational diabetes affects another 7.8%. Both type 1 and type 2 diabetes elevate the risk of severe maternal morbidity and mortality (SMM), including severe cardiac morbidity, hypertensive disorders of pregnancy, hemorrhage, infection, and mental health conditions. The increase in diabetes is thought to account for 17% of the increase in maternal mortality between 1997 and 2012. Another critical issue facing maternal care is the significant disparity in pregnancy outcomes among populations facing greater burdens of adverse social determinants of health, including socioeconomic characteristics, chronic stress, and systemic racism. For example, non-Hispanic Black women are 2.5 times more likely to die during pregnancy and the postpartum period than non-Hispanic White women. Vulnerable populations, often minorities, are also more likely to develop risk factors for SMM, such as type 2 diabetes. As pregestational diabetes is a particularly morbid condition in pregnancy, examining its complications and evidence-based treatments could significantly impact both maternal mortality rates and disparities in pregnancy outcomes in the United States. This review explores the relationship between pregestational diabetes and SMM, how the risk of SMM can be modified by disparities, and avenues for advancing care through future research. · Diabetes during pregnancy greatly increases the risk of SMM.. · Comprehensive care can improve outcomes in high-risk pregnancies with diabetes.. · Adverse social determinants of health worsen outcomes in pregnancies affected by diabetes.. · Improving diabetes care in pregnancy offers an opportunity to enhance maternal outcomes..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1671-1680"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Coronavirus Disease 2019 on the Incidence of No Prenatal Care.","authors":"Takaki Tanamoto, Misa Hayasaka, Lindsay Robbins, George Saade, Tetsuya Kawakita","doi":"10.1055/a-2535-8309","DOIUrl":"10.1055/a-2535-8309","url":null,"abstract":"<p><p>This study aimed to examine the impact of coronavirus disease 2019 (COVID-19) on the racial disparity in prenatal care utilization in the United States before and during the pandemic.This was a cross-sectional study using the National Vital Statistics Data from 2018 to 2022. Our focus was on low-risk individuals who delivered singleton pregnancies at term. The analysis was restricted to Black and White individuals to explore racial disparities. The study periods based on the last menstrual period (LMP) were prepandemic (March 2018-February 2020) and pandemic (March 2020-February 2022). The primary outcome was the rate of no prenatal care. We employed interrupted time series analysis, negative binomial regression models, adjusting for confounders, seasonality, and autocorrelation. We conducted postestimation analyses to calculate the counterfactual and actual incidences of outcomes for individuals with an LMP in March 2020 and February 2022. Difference-in-difference (DID) with 95% confidence intervals (95% CI) was estimated.The analysis included 3,511,813 individuals in the prepandemic period and 5,163,486 in the pandemic period. For individuals with LMP in March 2020, the actual incidences of no prenatal care per 100 births were 3.2 (95% CI: 3.0, 3.3) for Black individuals and 1.6 (95% CI: 1.2, 2.0) for White individuals. The difference between counterfactual and actual no prenatal care rates per 100 births for Black individuals was 0.4 (95% CI: 0.2, 0.5), indicating a significant increase in no prenatal care. Conversely, there was no significant difference for White individuals. DID analysis further demonstrated that this increase was greater in Black individuals compared with White individuals (DID per 100 births 0.3 [95% CI: 0.1, 0.5]). For individuals with LMP in February 2022, this difference in disparity further worsened (DID per 100 births 0.8 [95% CI: 0.4, 1.2]).The COVID-19 pandemic increased the incidence of no prenatal care, which disproportionately affected Black individuals. · The COVID-19 pandemic increased racial disparities.. · The increase in no prenatal care among Black individuals.. · White individuals are lower affected during this period..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1778-1785"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving First-Attempt Intubation Success Rate in a Level IV Neonatal Intensive Care Unit Through the Use of a Video Laryngoscope: A Quality Improvement Initiative.","authors":"Stephanie Martinez, Monika Bhola, Nori Mercuri Minich, Charlene Nauman, Kathleen Deakins, Allison Oliverio, Gulgun Yalcinkaya","doi":"10.1055/a-2533-2465","DOIUrl":"10.1055/a-2533-2465","url":null,"abstract":"<p><p>There is increasing evidence that the use of a video laryngoscope improves first-attempt intubation rates in neonates. The goal of this quality improvement initiative was to improve the first-attempt intubation success rate from 45 to 65% in 2.5 years through the introduction and increased use of a video laryngoscope in a level IV neonatal intensive care unit (NICU).We utilized the Model for Improvement with plan-do-study-act cycles targeted at increasing buy-in and comfort with the use of a video laryngoscope. Data on 418 intubations were collected from November 2021 to April 2024.Through increasing routine use of the video laryngoscope, achieved via a staggered introduction of the device, creation of reference materials, and coaching workshops, we improved the overall first-attempt intubation success rate from 45 to 57% during the intervention period.We increased the first-attempt success rate of intubations in the NICU by effectively implementing the use of a video laryngoscope into daily practice. · Neonatal intubations have low success rates, but video laryngoscopy improves success especially for those with less experience.. · This study shows that video laryngoscopy adoption in a neonatal ICU improved first-attempt intubation rates.. · This study contributes to neonatal intubation and video laryngoscopy literature from a quality improvement perspective..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1743-1753"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Growth Velocity Using a New Liquid Human Milk Fortifier in Very Low Birth Weight Infants: A Multicenter, Retrospective Study.","authors":"Fernando Moya, Jennifer Fowler, Adrian Florens, Jennifer Dombrowski, Olivia Davis, Tiffony Blanks, Austin Gratton","doi":"10.1055/a-2527-4638","DOIUrl":"10.1055/a-2527-4638","url":null,"abstract":"<p><p>This study aimed to compare growth outcomes and tolerance among very low birth weight (VLBW) infants receiving a new, liquid human milk fortifier (LHMF-NEW) or a human milk fortifier-acidified liquid (HMF-AL).Retrospective, multicenter study of 515 VLBW infants in three regional neonatal intensive care units. The primary objective was to compare growth velocity (g/kg/d) during fortification between groups by repeated measures regression. Secondary outcomes of interest were feeding tolerance and the incidence of late-onset sepsis, necrotizing enterocolitis, and metabolic acidosis. Student's <i>t</i>, analysis of variance, Wilcoxon, and Kruskal-Wallis tests were used for numeric variables, or chi-squared and Fisher's exact test for categorical variables.No demographic differences were identified between the groups (HMF-AL, <i>n</i> = 242; LHMF-NEW, <i>n</i> = 273). Growth velocity during fortification was significantly higher in the group receiving LHMF-NEW, despite relatively similar total fluid, calorie, or protein intake (<i>p</i> = 0.001). Feeding intolerance was comparable between fortifiers. Necrotizing enterocolitis and late-onset sepsis did not differ between groups and metabolic acidosis was diagnosed less frequently with the LHMF-NEW. Anthropometric measures at discharge and length of stay were comparable.Infants receiving human milk fortified with the LHMF-NEW had faster growth velocity during fortification, similar tolerance, and less metabolic acidosis compared with an earlier cohort of infants who received human milk fortified with an HMF-AL. · Among VLBW infants, using an LHMF-NEW resulted in a faster growth velocity in weight during several weeks of fortification than using the previous HMF-AL.. · The incidence of feeding intolerance (stopping feeds >8 hour) in any given week of fortification was low and not different between groups. Also, late-onset sepsis and necrotizing enterocolitis were uncommon with no differences between groups, whereas the incidence of metabolic acidosis was lower in infants receiving the LHMF-NEW.. · No differences in length of stay or anthropometrics at discharge were identified..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1729-1737"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early versus Late Brain Magnetic Resonance Imaging and Spectroscopy in Infants with Neonatal Encephalopathy following Therapeutic Hypothermia.","authors":"Tatiana A Nuzum, Pradeep Mally, Elena V Wachtel","doi":"10.1055/a-2540-2956","DOIUrl":"10.1055/a-2540-2956","url":null,"abstract":"<p><p>This study aimed to evaluate the utility of early and late magnetic resonance imaging (MRI) in infants with neonatal encephalopathy (NE) after therapeutic hypothermia (TH), and to determine the concordance between magnetic resonance spectroscopy (MRS) and early MRI findings.We conducted a retrospective, observational study including encephalopathic neonates born between 2017 and 2023 at two regional perinatal centers. All subjects underwent early diffusion-weighted MRI (DWI) with or without MRS (day: 4-5), and late conventional T1/T2-weighted MRI (day: 12-14). Both MRIs were assigned an injury severity score based on the National Institute of Child Health and Human Development (NICHD) neonatal research network (NRN) pattern of injury, reflecting the injury apparent on the MR modality obtained. MRS injury was defined as the presence of a lactate peak.The majority of the cohort (<i>n</i> = 98) was moderately encephalopathic (78%). Early and late MR imaging was performed at an average of 5.7 and 13.6 days, respectively. Fifteen percent of infants had evidence of hypoxic-ischemic (HI) injury on early imaging only, and 6% on late imaging only. Forty percent of infants exhibited a change in NICHD score severity between early and late MRI. Twenty-three infants (24%) were found to have a milder injury and 16 (16%) were found to have more severe injury on late imaging, when scores were compared with early imaging scores. The concordance of injury between early MRS and MRI was 62.5%. Among the cases of discordant MRI/MRS, MRS detected additional injury in 70% of cases, and MRI detected additional injury in 30% of cases.Both early and late imaging are important to fully define injury and provide accurate neurodevelopmental prognoses in cases of encephalopathic infants following TH. Failure to perform imaging at two intervals would have potentially resulted in missed diagnoses in 6 to 15% of cases and misestimation of injury in up to 40% of cases. · Early and late neuroimaging is important for accurate neurodevelopmental prognostication of encephalopathic neonates.. · The NICHD NRN MRI scoring system is a helpful tool for clinical practice.. · MR spectroscopy shows promise for HI injury but requires more validation..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1786-1792"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk and Causes of Early Mortality among Extremely Preterm Infants Born Small for Gestational Age.","authors":"Olasunkanmi Kehinde, Dmitry Tumin, Uduak S Akpan, Martha Naylor","doi":"10.1055/a-2533-2533","DOIUrl":"10.1055/a-2533-2533","url":null,"abstract":"<p><p>Extreme preterm (EPT) delivery, occurring before 28 weeks of gestation, carries high morbidity and mortality risks. Small for gestational age (SGA) infants, approximately 8 to 20% of EPT neonates, face increased risks. Mortality risk varies with gestational age and birth weight, with mixed reports on specific morbidities. This study aims to determine mortality rates and common causes of death among EPT SGA infants.The study used data from the CDC National Vital Statistics System, covering births and deaths from 2016 to 2021, with follow-up through 2022. It included infants born between 22 and 27 weeks gestation who were admitted to the neonatal intensive care unit. The outcome was all-cause in-hospital mortality within 30 days of birth, with causes of mortality classified based on the International Classification of Diseases, 10th revision codes. SGA was the primary independent variable.Based on a sample of <i>n</i> = 96,134 infants, we estimated 13% were born SGA and 30-day mortality rates were higher among SGA compared with non-SGA infants (31 vs. 13%). On multivariable analysis, SGA infants had higher 30-day mortality than non-SGA (odds ratio: 3.82; confidence interval 95% [CI]: 3.64, 4.01; <i>p</i> < 0.001), and were more likely to have death ascribed to complications of short gestation rather than other causes of death (relative risk ratio: 1.42; 95% CI: 1.27, 1.59; <i>p</i> < 0.001).SGA infants receiving intensive care have a high mortality risk, especially due to complications of short gestation and low birth weight complications. · EPT infants face high mortality risk.. · Mortality risk is increased for infants born SGA.. · Mortality in SGA EPT infants is frequently attributed to complications of prematurity and small size..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1754-1762"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Skincubator: A Novel Incubator for Skin-to-Skin Care (SSC) of Premature Neonates, Enables SSC within Humidified Environment and May Improve Thermoregulation during SSC.","authors":"Itamar Nitzan, Yair Kasirer, Francis B Mimouni, Tehilla Kagan, Alona Bin Nun, Tali B Weiss, Robert D White, Cathy Hammerman","doi":"10.1055/a-2526-5064","DOIUrl":"10.1055/a-2526-5064","url":null,"abstract":"<p><p>This study aimed to assess thermoregulation and humidity within the Skincubator-a novel, wearable skin-to-skin incubator designed to attach to the caregiver.Preterm neonates (PN; born between 24 and 33 weeks gestational age [GA]) received skin-to-skin care (SSC) either via the Skincubator or traditional SSC (t-SSC) with continuous axillary temperature monitoring.Twenty PN were enrolled in the study and treated in the Skincubator. One couple who consented to Skincubator care during delivery subsequently revoked their consent and the baby was excluded from further analysis. Fifty-four paired sessions of Skincubator and t-SCC were performed and compared for 19 babies. The average GA was 29 weeks (range: 26-32), the average weight was -1,296 ± 271 g, and the average day of life was 5 ± 2. The temperature drop after transfer to Skincubator care was smaller than in t-SSC (0.2°C [0.2-0.3] vs. 0.4°C [0.3-0.6]; Wilcoxon's signed rank test [WSRT], <i>p</i> < 0.001). The average hypothermia time per session was a median (25th-75th%) of 8.2 minutes (0-9) for Skincubator, compared to 27.8 minutes (0-56) for t-SSC, respectively (WSRT, <i>p</i> = 0.002). No baby had moderate hypothermia (35.5-35.9°C) during Skincubator care as compared with eight babies who experienced moderate hypothermia during t-SSC (Fisher's exact test <i>p</i> = 0.003). The average Skincubator humidity was 85 ± 7% and was above 70% during 93% of the time.Skincubator SSC was superior to t-SSC in maintaining PN temperature while also maintaining an optimally humidified environment. The Skincubator may promote early SSC in very and extremely PN. (Trial registration number MOH_2021-12-13_010470 registration date 24/10/21.) · Early prolonged SSC improves preterm infants' outcomes but may be challenging to perform.. · To mitigate several SSC barriers we invented the Skincubator, a wearable incubator for SSC.. · We have shown that the Skincubator reduces transient moderate hypothermia at SSC initiation.. · Average Skincubator humidity was 85 ± 7% and above 70% during 93% of SSC time..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1721-1728"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Capacity of First-Trimester Diagnosis of Placenta Previa.","authors":"Minhazur Sarker, Rachel Feiner, Dana Canfield, Madison Kent, Rachel Wiley, Leah Lamale-Smith, Elizabeth N Teal","doi":"10.1055/a-2572-1646","DOIUrl":"10.1055/a-2572-1646","url":null,"abstract":"<p><p>First-trimester transabdominal ultrasound (TAUS) is sometimes used to diagnose placenta previa and counsel patients accordingly. We aimed to determine the predictive capacity of a first-trimester transabdominal ultrasonographic placenta previa diagnosis for persistence to the second trimester.Retrospective cohort study of patients with singleton pregnancies and first-trimester transabdominal ultrasonographic placenta previa diagnoses from January to December 2022. The primary outcome was the predictive capacity of a first-trimester TAUS diagnosis of placenta previa for placenta previa persistence into the second trimester. Secondary outcomes included the predictive capacity of a first-trimester TAUS for placenta previa persistence to delivery and risk factors associated with placenta previa persistence. Chi-square and student's <i>t</i>-test were used to determine statistical significance, and a multivariable logistic regression determined the strength of associations.Of the 185 patients with a first-trimester TAUS diagnosis of placenta previa, 159 (86.0%) resolved by the second-trimester resulting in a predictive capacity for persistence to the second-trimester of 14.0%. Moreover, 182 (98.4%) were resolved by delivery, resulting in a predictive capacity for persistence to delivery of 1.6%. Among the 27 patients with a prior cesarean delivery, the predictive capacity of a first-trimester placenta previa diagnosis for persistence to the second-trimester was 22.2% and to delivery was 7.4%. Advanced maternal age and posterior placenta in the first trimester were risk factors for previa persistence to the second trimester, while prior cesarean delivery and reproductive assistance were not.First-trimester transabdominal ultrasonographic placenta previa diagnosis has a poor predictive capacity for placenta previa persistence to the second trimester and even lower for persistence to delivery. Counseling patients regarding placenta previa diagnosis in the first trimester may result in unnecessary patient anxiety and activity restrictions. · First-trimester transabdominal placenta previa diagnosis has poor predictive capacity.. · Counseling regarding first-trimester placenta previa may result in unnecessary patient anxiety.. · Studies are needed to see whether patients prefer placenta previa disclosure in the first trimester..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1664-1670"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12354017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}